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Life

Life is an international, peer-reviewed, open access journal related to fundamental themes in life sciences from basic to applied research, published monthly online by MDPI. The Spanish Association for Cancer Research (ASEICA) is affiliated with Life and its members receive a discount on the article processing charges.

Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, CAPlus / SciFinder, and other databases.
Journal Rank: JCR - Q1 (Biology) / CiteScore - Q1 (Paleontology)
Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 16.6 days after submission; acceptance to publication is undertaken in 2.4 days (median values for papers published in this journal in the second half of 2025).
Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Testimonials: See what our editors and authors say about Life.
Companion journals for Life include: Physiologia and Hydrobiology.

Impact Factor: 3.4 (2024); 5-Year Impact Factor: 3.4 (2024)

Imprint Information Journal Flyer Open Access ISSN: 2075-1729

Latest Articles

13 pages, 390 KB

Open AccessArticle

Eosinophilia and Risk of Thrombosis and Mortality in Hospitalized Patients: A Retrospective Cohort Study

by Ronen Shavit, Adi Kidron, Ramit Maoz Segal, Stanley Niznik, Soad Haj Yahia, Mona Iancovici-Kidon, Irena Offengenden, Diti Machnes Maayan, Yulia Lifshitz-Tunitsky, Liraz Olmer and Nancy Agmon-Levin

Life 2026, 16(2), 241; https://doi.org/10.3390/life16020241 (registering DOI) - 2 Feb 2026

Background: Eosinophilia, defined as peripheral blood eosinophil counts > 0.5 K/μL, is associated with various clinical conditions, including allergic, infectious, and malignant diseases. Emerging evidence suggests that eosinophils may contribute to thrombo-inflammatory processes, but their association with thromboembolic events and mortality remains insufficiently [...] Read more.

Background: Eosinophilia, defined as peripheral blood eosinophil counts > 0.5 K/μL, is associated with various clinical conditions, including allergic, infectious, and malignant diseases. Emerging evidence suggests that eosinophils may contribute to thrombo-inflammatory processes, but their association with thromboembolic events and mortality remains insufficiently characterized. This study aimed to evaluate whether eosinophilia is independently associated with increased risk of thromboembolic events and mortality in hospitalized patients. Methods: We conducted a retrospective cohort study using electronic medical records from Sheba Medical Center (2011–2020). Eosinophilia was classified as mild (0.5–1.5 K/μL) or hypereosinophilia (HE, >1.5 K/μL). Patients with eosinophilia were matched 1:1 to controls with normal eosinophil counts based on age, sex, and follow-up duration. Results: Among 93,320 patients (46,660 with eosinophilia and 46,660 controls), thromboembolic events occurred in 20.9% of eosinophilic patients vs. 9.8% of controls. Eosinophilia was independently associated with thrombosis (OR = 1.33; 95% CI, 1.28–1.38; p < 0.0001), with increased risk from counts ≥ 0.7 K/μL. Mortality was also higher among eosinophilic patients (HR = 1.17; 95% CI, 1.13–1.20; p < 0.0001). Conclusions: Eosinophilia is associated with increased thromboembolic and mortality risk, highlighting the importance of eosinophil monitoring in clinical practice. Full article

(This article belongs to the Special Issue Research Updates in Hematology)

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34 pages, 2544 KB

Open AccessReview

Complex and Messy Prebiotic Chemistry: Obstacles and Opportunities for an RNA World

by Alberto Vázquez-Salazar

Life 2026, 16(2), 240; https://doi.org/10.3390/life16020240 (registering DOI) - 2 Feb 2026

Traditional prebiotic chemistry experiments often isolated single reactions under clean, controlled conditions, yet early Earth was chemically diverse and physically dynamic. Such primordial complexity likely imposed obstacles, including side reactions, low yields, and unstable intermediates, but it also generated opportunities, including redundant routes, [...] Read more.

Traditional prebiotic chemistry experiments often isolated single reactions under clean, controlled conditions, yet early Earth was chemically diverse and physically dynamic. Such primordial complexity likely imposed obstacles, including side reactions, low yields, and unstable intermediates, but it also generated opportunities, including redundant routes, parallel pathways, and environmental filters that could bias mixtures toward subsets of persistent and chemically productive compounds. This review examines how heterogeneous prebiotic settings could generate RNA precursors, including nucleobases, ribose, and phosphate-containing species, through multiple concurrent pathways. Although side reactions can sequester carbon in inert tars and reduce yields of specific targets, networked chemistry can also enhance robustness when different routes converge on shared intermediates, or when apparent byproducts reenter productive cycles. Environmental factors such as ultraviolet irradiation, mineral surfaces, wet-dry cycling, and thermal gradients can act as constraints that enrich certain products by differential stability, reactivity, and compartmentalization. In this context, the RNA world hypothesis remains compelling, as RNA can store heritable sequence information and catalyze reactions through sequence dependent folding, thereby linking heredity and chemistry within a single polymer. At the same time, the emergence of functional sequence information and of control architectures that couple sequence to reproducible function remains a central open problem, and it sets clear limits on what chemistry alone can explain. Rather than dismissing messy mixtures as irrelevant noise, it is more accurate to treat them as the native context in which concentration mechanisms, environmental cycling, and selective persistence could enable the accumulation and survival of RNA related molecules. Full article

(This article belongs to the Special Issue Origin of Life in Chemically Complex Messy Environments: 3rd Edition)

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17 pages, 672 KB

Open AccessArticle

Trends and Challenges of Surgical Site Infections Burden in Croatia: A Nationwide Comparative Analysis of Two Point Prevalence Surveys (2017–2023)

by Ana Gverić Grginić, Zrinka Bošnjak, Alen Babacanli, Zoran Herljević, Mislav Peras, Ivana Ferenčak, Igor Pelaić, Lana Videc Penavić and Ana Budimir

Life 2026, 16(2), 239; https://doi.org/10.3390/life16020239 (registering DOI) - 2 Feb 2026

Background: Surgical site infections (SSIs) are among the most frequent healthcare-associated infections (HCAIs) worldwide. Changes in the functioning of healthcare systems may affect the implementation of SSIs prevention practices, with consequent alterations in the occurrence of HCAIs. The main aims of our study [...] Read more.

Background: Surgical site infections (SSIs) are among the most frequent healthcare-associated infections (HCAIs) worldwide. Changes in the functioning of healthcare systems may affect the implementation of SSIs prevention practices, with consequent alterations in the occurrence of HCAIs. The main aims of our study were to analyze specific SSIs prevalence and proportions together with overall HCAIs prevalence in acute care hospitals (ACHs) before and after the COVID-19 pandemic. Additional aims were to identify bacterial causative agents, the use of perioperative antibiotic prophylaxis (PAP), related structural and process quality indicators, and to determine trends between two periods. Methods: The National Reference Centre for HCAIs (University Hospital Centre Zagreb) conducted point prevalence surveys in May 2017 and May 2023 in ACHs throughout Croatia, using the technical protocol developed by the European Centre for Disease Prevention and Control (ECDC). Results: The prevalence of HCAIs in ACHs in Croatia rose from 5.3% (95% CI 4.8–5.7) in 2017 to 7.2% (95% CI 6.6–7.8) in 2023 (p = 9.93 × 10⁻¹⁴). This trend was paralleled with the rising of the HCAIs prevalence in surgical departments from 5.1% to 6.7% (p = 0.0099). The prevalence of overall SSIs across ACHs increased from 0.9% (95% CI 0.7–1.1) in 2017 to 1.2% (95% CI 1.0–1.5) in 2023 (OR 1.36 (1.03–1.80), p = 0.032. While the prevalence of superficial incisional SSIs significantly decreased (OR 0.53 (0.30–0.95), p = 0.028), the share of deep-seated SSIs (deep incisional and organ/space SSIs) among classified SSIs shifted from 48/92 to 77/96; odds ratio (OR) 2.09 (95% CI 1.45–3.01). In 2017, Gram-positive cocci were the most frequently isolated bacterial causative agents (44.6%). By 2023, this shifted, with Enterobacterales species comprising most isolates (42.2%). In 2023, significantly a higher proportion of patients received PAP (χ² = 25.419, df = 1, p < 0.5). An increase in the positive trend of alcohol-based hand rub antiseptics use in surgical departments (+15.7 L/patient-days, p < 0.001) contrasted with a decrease in infection prevention and control (IPC) nurses and medical doctors per hospital (−0.5, p = 0.041/−0.5, p = 0.003). Conclusions: Findings of the two point prevalence surveys over time indicate the changes in trends in surgical site infections burden, and highlight the need for the implementation and strengthening of preventive measures with the focus on targeted prevention of deep-seated infections. Full article

(This article belongs to the Section Medical Research)

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17 pages, 695 KB

Open AccessArticle

Altered Ocular Surface Temperature in Congenital Aniridia with PAX6 Pathogenic Variants: Impact of Age, Salzmann Nodules and Ocular Surgery

by Orsolya Németh, Annamária Náray, Mária Csidey, Klaudia Kéki-Kovács, Krisztina Knézy, Mária Bausz, Andrea Szigeti, Anita Csorba, Kitti Kormányos, Ditta Zobor, Zoltán Zsolt Nagy, Marta Cortón, Eszter Jávorszky, Kálmán Tory, Erika Maka, Timo Eppig, Achim Langenbucher and Nóra Szentmáry

Life 2026, 16(2), 238; https://doi.org/10.3390/life16020238 (registering DOI) - 2 Feb 2026

PAX6 haploinsufficiency-related congenital aniridia is frequently associated with ocular surface disease, including meibomian gland dysfunction (MGD), dry eye, limbal stem cell deficiency (LSCD), aniridia-associated keratopathy (AAK), and inflammation. This study measured ocular surface temperature (OST) at the corneal center and four paracentral points [...] Read more.

PAX6 haploinsufficiency-related congenital aniridia is frequently associated with ocular surface disease, including meibomian gland dysfunction (MGD), dry eye, limbal stem cell deficiency (LSCD), aniridia-associated keratopathy (AAK), and inflammation. This study measured ocular surface temperature (OST) at the corneal center and four paracentral points (2 mm from center) in patients with congenital aniridia and examined factors influencing OST. Forty-five eyes from 26 aniridia patients (55.6% female; 26.29 ± 17.78 years) with PAX6 pathogenic variants and 47 eyes from 25 controls (68.1% female; 24.81 ± 4.73 years; p = 0.1639) were included. Body temperature, OSDI, and OST (TG-1000) were recorded; clinical assessment evaluated MGD, LSCD, AAK, iris malformation, epithelial defects, Salzmann nodules, glaucoma and previous ocular surgery. Body temperature and OSDI did not differ in aniridia and controls (p ≥ 0.606). LSCD was mainly Grade 2 (46.7%) or Grade 4 (40.0%), and AAK Grade 1 (33.3%) or Grade 2 (31.1%). MGD affected 51.1%, Salzmann nodules 22.2%, epithelial defects 2.2%, glaucoma 60.0%, and previous ocular surgery 35.5%. Superior OST was higher in aniridia (34.98 ± 0.55 °C vs. 34.75 ± 0.47 °C; p = 0.012). Exploratory univariate analyses identified that higher AAK grade correlated with lower inferior OST (p = 0.030), iris malformation with reduced central/paracentral OST (p ≤ 0.029), and Salzmann nodules with lower OST overall (p ≤ 0.011). However, in a multivariate model, age, Salzmann nodular degeneration, and prior ocular surgery emerged as key determinants of OST. OST may serve as a noninvasive biomarker in congenital aniridia. Full article

(This article belongs to the Special Issue Mechanisms and Treatment of Eye and Vision Conditions)

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10 pages, 822 KB

Open AccessArticle

Echocardiographic Red Flags in Wild-Type Transthyretin Amyloidosis: Sex-Specific Gaps for Wall Thickness and Left Ventricular Mass

by Emilio Nardi, Carola Maria Gagliardo, Davide Noto, Carlo Maria Barbagallo, Antonina Giammanco, Gianluca Di Rosa, Federica Bellini, Maurizio Averna and Angelo Baldassare Cefalù

Life 2026, 16(2), 237; https://doi.org/10.3390/life16020237 (registering DOI) - 1 Feb 2026

Background: Wild-type transthyretin amyloidosis (ATTRwt) diagnosis remains challenging. Echocardiographic “red flags” play a significant role in raising diagnostic suspicion. Methods: Retrospective study including 33 patients diagnosed with ATTRwt. All patients underwent comprehensive echocardiographic evaluation focusing on the red flags for ATTRwt. Left ventricular [...] Read more.

Background: Wild-type transthyretin amyloidosis (ATTRwt) diagnosis remains challenging. Echocardiographic “red flags” play a significant role in raising diagnostic suspicion. Methods: Retrospective study including 33 patients diagnosed with ATTRwt. All patients underwent comprehensive echocardiographic evaluation focusing on the red flags for ATTRwt. Left ventricular hypertrophy (LVH) was defined as interventricular septal wall thickness (IVST) ≥ 12 mm and/or LV mass indexed for body surface area (LVMI) ≥ 115 g/m² in men and ≥ 95 g/m² in women. Results: Relative wall thickness > 0.42 and early diastolic myocardial velocity < 7 cm/s were detected in 100% of patients. Severe diastolic dysfunction (grade ≥ 3) (72.7%), apical sparing (36.4%), granular sparkling pattern (30.3%), and pericardial effusion (39.4%) were also observed. Females were younger than males (median age 68 vs. 74.5 years), and IVST ≥ 12 mm was lower in females than in males (64.4% vs. 100%, respectively, p < 0.05). The combined criterion of IVST ≥ 12 mm in men and LVMI ≥ 95 g/m² in women was encountered in 100% of the global cohort. Conclusions: IVST is a good predictor of LVH in males but shows limited sensitivity for ATTRwt in females; a gender-differenced approach (IVST for men and LVMI for women) might better stratify for ATTRwt suspicion. Full article

(This article belongs to the Section Medical Research)

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26 pages, 1080 KB

Open AccessReview

Peripartum Depression as a Heart–Brain–Endocrine–Immune Syndrome: Neuroendocrine, Cardiovascular, and Inflammatory Pathways Underlying Maternal Vulnerability

by Giuseppe Marano and Marianna Mazza

Life 2026, 16(2), 236; https://doi.org/10.3390/life16020236 (registering DOI) - 1 Feb 2026

Peripartum depression (PPD) represents one of the most prevalent and disabling psychiatric conditions among women, yet its underlying biology remains poorly integrated across medical disciplines. Emerging evidence highlights PPD as a prototypical disorder of the heart–brain axis, where neuroendocrine changes, immune activation, and [...] Read more.

Peripartum depression (PPD) represents one of the most prevalent and disabling psychiatric conditions among women, yet its underlying biology remains poorly integrated across medical disciplines. Emerging evidence highlights PPD as a prototypical disorder of the heart–brain axis, where neuroendocrine changes, immune activation, and cardiovascular dysregulation converge to shape maternal vulnerability. During pregnancy and the postpartum period, abrupt fluctuations in estrogen, progesterone (P4), and placental corticotropin-releasing hormone (CRH) interact with a sensitized hypothalamic–pituitary–adrenal (HPA) axis, altering neural circuits involved in mood regulation, stress reactivity, and maternal behavior. Parallel cardiovascular adaptations, including endothelial dysfunction, altered blood pressure variability, and reduced heart rate variability (HRV), suggest a profound perturbation of autonomic balance with potential long-term implications for maternal cardiovascular health. Neuroinflammation, microglial activation, and systemic cytokine release further mediate the bidirectional communication between the heart and the brain, linking emotional dysregulation with vascular and autonomic instability. Evidence also indicates that conditions such as preeclampsia and peripartum cardiomyopathy share biological pathways with PPD, reinforcing the concept of a unified pathophysiological axis. This review synthesizes current knowledge on the neurobiological, cardiovascular, endocrine, and inflammatory mechanisms connecting PPD to maternal heart–brain health, while discussing emerging biomarkers and therapeutic strategies aimed at restoring integrative physiology. Understanding PPD as a multisystem heart–brain disorder offers a transformative perspective for early detection, risk stratification, and personalized intervention during one of the most biologically vulnerable periods of a woman’s life. Full article

(This article belongs to the Section Reproductive and Developmental Biology)

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10 pages, 422 KB

Open AccessCommunication

α-Glucosidase and Pancreatic Lipase Inhibitory Activity of Chemical Constituents from Adzuki Bean (Vigna angularis)

by Qingfeng Guo, Xia Zhang, Hao Zhang, Mengxue Wang, Haoran Zhou, Meiru Chen, Zhenhua Yin, Juanjuan Zhang, Baocheng Yang, Li Wang and Lin Chen

Life 2026, 16(2), 235; https://doi.org/10.3390/life16020235 (registering DOI) - 1 Feb 2026

Originating in East Asia, the adzuki bean (Vigna angularis) is a diploid crop mainly grown in this region that belongs to the Fabaceae family. As a potential functional food resource with both medicinal and nutritional value, it offers various health benefits. [...] Read more.

Originating in East Asia, the adzuki bean (Vigna angularis) is a diploid crop mainly grown in this region that belongs to the Fabaceae family. As a potential functional food resource with both medicinal and nutritional value, it offers various health benefits. However, research on its chemical constituents, particularly key bioactive components such as triterpenoid saponins and flavonoids, remains relatively limited. In this study, a new triterpenoid saponin, adzukisaponin A (1), along with eleven known compounds (2–12), were isolated from adzuki bean (V. angularis). Among them, compounds 3 (yunganoside B1), 6 (3β-acetyl oleanolic acid), and 7 (β-amyrin) are reported from this source for the first time. Saponins 1–3 and flavonoid 8 exhibited significant dual inhibitory activity. Notably, saponins 1–3 inhibited pancreatic lipase (IC₅₀ = 0.11 ± 0.18 to 0.40 ± 0.21 mM) more strongly than the positive control orlistat, while also acting against α-glucosidase (IC₅₀ = 0.14 ± 0.11 to 0.23 ± 0.17 mM). Molecular docking supported their binding to the enzymes’ active sites. This study identifies 1–3 and 8 as dual α-glucosidase/pancreatic lipase inhibitors, underscoring the potential of adzuki bean as a source of bioactive functional food ingredients. Full article

(This article belongs to the Section Pharmaceutical Science)

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18 pages, 3788 KB

Open AccessReview

Neurovascular Issues in Neurofibromatosis Type I: Focus on Intracranial Stenosis

by Marialuisa Zedde and Rosario Pascarella

Life 2026, 16(2), 234; https://doi.org/10.3390/life16020234 (registering DOI) - 1 Feb 2026

Background/Objectives: Neurofibromatosis type 1 (NF1) is a genetic disorder characterized by various clinical manifestations, including significant neurovascular complications. This review aims to synthesize current knowledge regarding intracranial stenoses and associated vascular abnormalities in patients with NF1, emphasizing the differences between pediatric and adult [...] Read more.

Background/Objectives: Neurofibromatosis type 1 (NF1) is a genetic disorder characterized by various clinical manifestations, including significant neurovascular complications. This review aims to synthesize current knowledge regarding intracranial stenoses and associated vascular abnormalities in patients with NF1, emphasizing the differences between pediatric and adult populations. Methods: A narrative review was conducted, analyzing the existing literature on the epidemiology, clinical manifestations, and management of neurovascular issues related to NF1. Data were collected from a range of studies, including retrospective analyses and case series, focusing on the incidence and outcomes of intracranial vascular abnormalities. Results: The study found that intracranial vasculopathy affects between 0.4% and 6.4% of NF1 patients, with children experiencing higher rates of stenotic lesions. However, vascular issues in adults are less understood, with 3.5% of adult patients presenting vascular abnormalities. The review highlights a significant underdiagnosis of these conditions due to the lack of routine use of magnetic resonance angiography (MRA) in standard evaluations. The management of NF1-related vascular conditions, particularly in adults, remains poorly defined, particularly regarding the efficacy of antithrombotic therapies. Conclusions: The management of neurovascular complications in NF1 requires urgent attention, with a need for standardized screening protocols and further research to elucidate the natural history and optimal treatment strategies for these patients. Enhanced diagnostic practices, including routine neuroimaging, are essential to improve outcomes and reduce the risk of significant vascular events. Full article

(This article belongs to the Special Issue Advances in Vascular Medicine: From Endovascular Innovations to Pathophysiological Insights)

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33 pages, 963 KB

Open AccessReview

Transcranial Magnetic Stimulation in Parkinson’s Disease and Parkinsonian Syndromes: A Narrative Expert Review

by Mariagiovanna Cantone, Manuela Pennisi, Rita Bella, Raffaele Ferri, Francesco Fisicaro, Giuseppe Lanza, Maria P. Mogavero, Aurora Palmigiano, Angelica Quercia and Mario Zappia

Life 2026, 16(2), 233; https://doi.org/10.3390/life16020233 (registering DOI) - 1 Feb 2026

Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation tool for investigating the neurophysiology of different neurological and neuropsychiatric disorders, including Parkinson’s disease (PD) and other parkinsonian syndromes and movement disorders. Briefly, TMS enables targeted stimulation of specific cortical regions through externally applied [...] Read more.

Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation tool for investigating the neurophysiology of different neurological and neuropsychiatric disorders, including Parkinson’s disease (PD) and other parkinsonian syndromes and movement disorders. Briefly, TMS enables targeted stimulation of specific cortical regions through externally applied magnetic pulses, avoiding surgical intervention (as it occurs in deep brain stimulation) and making it a safe, repeatable, and well-tolerated approach. Over the past two decades, extensive research has explored the clinical utility of TMS in PD, with particular emphasis on motor cortex excitability, synaptic plasticity, and functional connectivity, which are central contributors to both motor and non-motor symptoms in PD patients. In addition, repetitive TMS and related stimulation paradigms have been shown to positively modulate cortical plasticity, i.e., the brain’s capacity to reorganize neural circuits, suggesting potential benefits for longer-term non-pharmacological management and rehabilitation protocols. More recently, studies have also investigated the role of TMS in atypical and secondary parkinsonisms, indicating that it may help characterize distinct neurophysiological abnormalities and provide symptomatic improvement in selected patients. This narrative expert review provides a comprehensive summary of TMS applications across the wide spectrum of parkinsonian syndromes, highlighting not only clinical potential, but also methodological limitations and future research directions. Full article

(This article belongs to the Special Issue Advances in Non-Invasive Brain Stimulation)

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12 pages, 1521 KB

Open AccessArticle

Serum and Clinical Factors Associated with Total Knee Arthroplasty in Patients with Knee Osteoarthritis

by Sergiu Andrei Iordache, Adrian Cursaru, Bogdan Serban, Mihnea Ioan-Gabriel Popa, Mihai Aurel Costache, Sergiu Stanciu, Bogdan Stefan Cretu and Florin Catalin Cirstoiu

Life 2026, 16(2), 232; https://doi.org/10.3390/life16020232 (registering DOI) - 1 Feb 2026

Knee osteoarthritis (KOA) is one of the most prevalent chronic joint disorders, with its incidence rising over the past decade due to an increase in risk factors, including age, obesity, metabolic conditions, sedentary behavior, and mechanical stress on the knee joints. We conducted [...] Read more.

Knee osteoarthritis (KOA) is one of the most prevalent chronic joint disorders, with its incidence rising over the past decade due to an increase in risk factors, including age, obesity, metabolic conditions, sedentary behavior, and mechanical stress on the knee joints. We conducted a cross-sectional, two-group comparison including 70 knee-pain patients aged ≥ 44 years: 50 patients meeting clinical and radiological criteria for TKA and 20 patients undergoing knee arthroscopy as controls. All patients underwent clinical assessments, WOMAC scoring, radiography, and 3T knee MRI. Serum interleukin-6 (IL-6), cartilage oligomeric matrix protein (COMP), vitamin D3, calcium, and phosphorus were measured at admission. TKA patients were older and had higher WOMAC scores. WOMAC discriminated groups perfectly (AUC = 1.000), but age discriminated well (AUC = 0.911). IL-6 (AUC = 0.819) and COMP (AUC = 0.838) were significant discriminators, with IL-6 threshold ≥ 4.585 pg/mL achieving 66% sensitivity and 85% specificity and COMP cutoff ≥ 11.52 ng/mL achieving 84% sensitivity and 75% specificity. TKA group vitamin D3 levels were considerably lower but had limited discriminatory performance (AUC = 0.683). Although all patients had adequate mineral metabolism, TKA patients had lower serum calcium and higher serum phosphorus levels than controls. Full article

(This article belongs to the Special Issue Osteoarthritis: New Insights into Mechanisms, Diagnosis, Therapy and Management)

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21 pages, 3419 KB

Open AccessReview

Effect of Hypoxic Exercise with Different Oxygen Concentrations on Metabolic Outcomes in Obesity: A Systematic Review and Network Meta-Analysis

by Kai Gao, Shuting Liu, Chengyu Zhou, Diandong Lang and Huaichuan Zhang

Life 2026, 16(2), 231; https://doi.org/10.3390/life16020231 (registering DOI) - 1 Feb 2026

Objective: This study aimed to systematically evaluate the effects of hypoxic exercise at different oxygen concentrations on body composition, glucose metabolism, and lipid metabolism in individuals with obesity, and to explore potential optimal oxygen concentration ranges to inform personalized hypoxic exercise prescriptions. Methods: [...] Read more.

Objective: This study aimed to systematically evaluate the effects of hypoxic exercise at different oxygen concentrations on body composition, glucose metabolism, and lipid metabolism in individuals with obesity, and to explore potential optimal oxygen concentration ranges to inform personalized hypoxic exercise prescriptions. Methods: We searched databases including the Cochrane Library, PubMed, Web of Science, Embase, and CNKI for randomized controlled trials and pre-post studies on hypoxic exercise interventions in obese populations published before 30 June 2025. A network meta-analysis was performed using Stata 18.0 software to assess the effects of various oxygen concentrations on BMI, FBG, FINS, HOMA-IR, TG, LDL-C, and HDL-C. Subgroup analyses were conducted to explore sources of heterogeneity. Results: Fourteen studies with a total sample size of 189 participants were included. The meta-analysis revealed that exercise in a moderate hypoxic environment (12–14% FiO₂) significantly reduced BMI, FBG, TG, and LDL-C. Notably, hypoxic exercise did not show a statistically significant effect on HDL-C. In contrast, a higher oxygen concentration (≥15% FiO₂) was more effective for improving FINS and HOMA-IR. Conclusion: Hypoxic exercise can significantly improve the body composition, glucose metabolism and lipid metabolism indicators of obese people. Tailored exercise in specific hypoxic environments provides preliminary evidence for a non-pharmacological intervention strategy in obesity management. Full article

(This article belongs to the Special Issue Explore Innovative Exercise-Based Interventions for Chronic Diseases)

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11 pages, 915 KB

Open AccessArticle

Primary Adrenal Gland Lymphoma: Report of 13 Cases—A Retrospective Multicenter Polish Lymphoma Research Group Analysis

by Magdalena Witkowska, Kacper Kościelny, Agnieszka Giza, Ryszard Swoboda, Joanna Drozd-Sokołowska and Dariusz Wołowiec

Life 2026, 16(2), 230; https://doi.org/10.3390/life16020230 (registering DOI) - 1 Feb 2026

Introduction: The existence of primary adrenal gland lymphoma (PAGL) has been debated due to lack of lymphoid tissue in the adrenal glands. PAGL is extremely rare, accounting for less than 1% of all types of lymphomas. The aim of this study was to [...] Read more.

Introduction: The existence of primary adrenal gland lymphoma (PAGL) has been debated due to lack of lymphoid tissue in the adrenal glands. PAGL is extremely rare, accounting for less than 1% of all types of lymphomas. The aim of this study was to analyze patients with PAGL in Polish population. Material and Methods: We retrospectively reviewed 13 adult patients with PAGL diagnosed in Polish Hematological Centers. Results: A total of 13 patients (5 women and 8 men) with PAGL were included into the study. The median age at the diagnosis was 69.1 years (range: 31–85). The most common histological type was diffuse large B-cell lymphoma (DLBCL)-12 patients, the remaining one was diagnosed with Hodgkin lymphoma (HL). In 7 patients (54%), the left adrenal gland was involved; in 3 patients (23.5%), the right adrenal gland was involved; and 3 patients (23.5%) had bilateral lymphoma. Systemic symptoms (B symptoms) were observed in 11 out of 13 patients (85%). Two patients (15%) were treated with chemotherapy alone and the remaining eleven patients (85%) with immune and chemotherapy together (85%). During the follow-up period, 11 patients died, 8 had relapsed or refractory disease (62%), and 3 patients (23%) had relapse in central nervous system (CNS). The median progression-free survival (PFS) was 14.63 months, while the median overall survival (OS) was 20.30 months. Adrenalectomy of the involved adrenal gland was associated with shorter PFS (p = 0.0165), with trend of shorter OS. Achieving complete remission (CR) after front line treatment was associated with significantly longer OS (p = 0.0239) and PFS (p = 0.0152). Conclusions: Adrenal glands are extremely rare as primary locations of extranodal lymphoma. The prognosis of PAGL is generally poor. In this study, we described demographic, clinical, and pathological characteristics as well as factors that may affect survival among these groups. So far, it is the largest polish multicenter experience describing patients with PAGL. Full article

(This article belongs to the Special Issue Recent Advances in Lymphomas)

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14 pages, 602 KB

Open AccessArticle

Comparative Effects of Weighted Vest and Whole-Body Vibration Training on Bone and Muscle Health in Osteopenia

by Jidapa Tantanasest, Apiwan Manimmanakorn, Orathai Tunkamnerdthai, Chiraphorn Khaengkhan, Peeraporn Nithisup, Suphawijak Youdprang, Nuttaset Manimmanakorn and Michael John Hamlin

Life 2026, 16(2), 229; https://doi.org/10.3390/life16020229 (registering DOI) - 1 Feb 2026

Background: The growing elderly population faces health problems like osteoporosis, but novel exercises like weighted vests (WV) and whole-body vibration (WBV) may help prevent bone loss. Methods: Thirty-one women aged 60–79 years with osteopenia or osteoporosis (T-score −2.15 ± 0.9) were randomly assigned [...] Read more.

Background: The growing elderly population faces health problems like osteoporosis, but novel exercises like weighted vests (WV) and whole-body vibration (WBV) may help prevent bone loss. Methods: Thirty-one women aged 60–79 years with osteopenia or osteoporosis (T-score −2.15 ± 0.9) were randomly assigned to three groups: a control group performed exercise only; a whole-body vibration group performed the exercise on a 40 Hz, 2 mm vibration platform; and a weighted vest group performed the exercise while wearing a weighted vest. T-score, bone mineral density (BMD), muscle mass, and physical performance were assessed before and after 8 weeks. Results: The WV showed a greater T-score increase than the CT and WBV groups (WV: 0.08 ± 0.03; CT: −0.18 ± 0.04; WBV: −0.11 ± 0.16; p = 0.01, 95%CI). Leg BMD increased in the WV group (1.75 ± 0.13 to 1.79 ± 0.16 g/cm²; p = 0.02). Leg lean mass also increased in the WV (1.28 ± 0.91 kg) compared to WBV (0.17 ± 0.14 kg) and CT (0.06 ± 0.79 kg, p = 0.01, 95%CI). The WV group showed greater physical performance improvements (5TSTS and 6-MWT). The WBV group showed improved total lean mass compared to the CT group (WBV: 0.32 ± 0.17; CT = −1.20 ± 1.86, p = 0.006, 95%CI). Conclusions: WV exercise improved bone density, leg lean mass, and physical performance in older women. WBV exercise increased total lean mass and skeletal muscle index while reducing fat mass. WV exercise provides an additive effect beyond exercise alone or WBV. Full article

(This article belongs to the Special Issue Musculoskeletal Pain and Disorders: Diagnosis, Treatment and Management)

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4 pages, 157 KB

Open AccessEditorial

Cystic Fibrosis: A Disease with a New Face

by Janice Wang and Patricia A. Walker

Life 2026, 16(2), 228; https://doi.org/10.3390/life16020228 - 30 Jan 2026

Medical advancements in the field of Cystic Fibrosis (CF), a rare, genetic disorder, have been profound over the last decade, allowing care to evolve in ways previously thought unimaginable by those living with CF and those caring for people with CF [...] Full article

(This article belongs to the Special Issue Cystic Fibrosis: A Disease with a New Face)

10 pages, 9152 KB

Open AccessCommunication

Dissection of Cell Death Induction by Arabidopsis thaliana CC-NBS-LRR Receptor SUT1 and Its Interacting Protein TOPP4 Mutant in Nicotiana benthamiana

by Jianzhong Huang, Xiaoqiu Wu, Kai Chen and Zhiyong Gao

Life 2026, 16(2), 227; https://doi.org/10.3390/life16020227 - 29 Jan 2026

Nucleotide-binding and leucine-rich repeat receptors (NLRs) play an important role in plant innate immunity. Previous reports indicate that SUT1 (SUPPRESSOR OF TOPP4 1) is required for the autoimmune response mediated by TYPE ONE PROTEIN PHOSPHATASE 4 (TOPP4) mutation topp4-1 (namely TOPP4^T246M) [...] Read more.

Nucleotide-binding and leucine-rich repeat receptors (NLRs) play an important role in plant innate immunity. Previous reports indicate that SUT1 (SUPPRESSOR OF TOPP4 1) is required for the autoimmune response mediated by TYPE ONE PROTEIN PHOSPHATASE 4 (TOPP4) mutation topp4-1 (namely TOPP4^T246M) in Arabidopsis. We observed that co-expression of SUT1 with TOPP4 mutant versions, instead of wild-type TOPP4, produced robust cell death in N. benthamiana. The YFP-labeled SUT1 was localized on the plasma membrane (PM), and Gly2, Cys4, and Ser6 are crucial amino acid sites for its PM localization and function. Further dissection proclaimed that the function and localization of SUT1 are influenced by mutations in conserved specific residues. These findings may provide a new perspective for elucidating the activation mechanism of SUT1. Full article

(This article belongs to the Section Plant Science)

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19 pages, 3977 KB

Open AccessArticle

Modulation of Forward Propulsion and Foot Dorsiflexion by Spinal and Muscular Stimulation During Human Stepping

by Sergey Ananyev, Ivan Sakun, Vsevolod Lyakhovetskii, Alexander Grishin, Tatiana Moshonkina and Yury Gerasimenko

Life 2026, 16(2), 226; https://doi.org/10.3390/life16020226 - 29 Jan 2026

(1) Background: We developed a novel technology that regulates human locomotion using transcutaneous electrical spinal cord stimulation to activate spinal locomotor networks and posterior root stimulation to activate leg flexor and extensor motor pools during swing and stance phases, respectively. This technology effectively [...] Read more.

(1) Background: We developed a novel technology that regulates human locomotion using transcutaneous electrical spinal cord stimulation to activate spinal locomotor networks and posterior root stimulation to activate leg flexor and extensor motor pools during swing and stance phases, respectively. This technology effectively restores walking in post-stroke individuals while forward propulsion in the stance phase and foot dorsiflexion in the swing phase are insufficient. In this study the effectiveness of regulating the stance and swing phases while healthy volunteers walked on a treadmill with transcutaneous electrical stimulation of the posterior roots, leg muscles, and their combined effects has been examined. (2) Methods: We analyzed the kinematic characteristics of stepping movements in healthy participants with spinal stimulation of the posterior roots and flexor/extensor leg muscles. (3) Results: Our findings clearly show that posterior root stimulation at T12 combined with tibialis anterior muscle stimulation during the swing phase effectively regulates foot dorsiflexion, whereas posterior root stimulation at L2 combined with hamstrings and medial gastrocnemius stimulation during the stance phase effectively regulates forward propulsion. (4) Conclusions: Combined stimulation in the stance and swing phases within the same gait cycle resulted in the most coordinated stepping, and effective control of forward propulsion and foot dorsiflexion. Full article

(This article belongs to the Section Physiology and Pathology)

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14 pages, 545 KB

Open AccessSystematic Review

Efficacy and Safety of Biologic and Targeted Synthetic DMARDs in Young-Onset Rheumatoid Arthritis: A Systematic Review

by Mara Russu, Vladia Lăpuște, Diana Elena Cosău, Alexandra Lori Donica, Alexandra-Diana Diaconu, Georgiana Strugariu, Cristina Pomîrleanu and Codrina Ancuța

Life 2026, 16(2), 225; https://doi.org/10.3390/life16020225 - 29 Jan 2026

Background: Young-onset rheumatoid arthritis (YORA), defined by disease onset between 16–40 years, raises distinct clinical challenges related to long-term disease burden, fertility, and prolonged exposure to immunomodulatory therapy. Despite its relevance, evidence regarding treatment outcomes in this population remains limited and heterogeneous, [...] Read more.

Background: Young-onset rheumatoid arthritis (YORA), defined by disease onset between 16–40 years, raises distinct clinical challenges related to long-term disease burden, fertility, and prolonged exposure to immunomodulatory therapy. Despite its relevance, evidence regarding treatment outcomes in this population remains limited and heterogeneous, largely due to inconsistent definitions of YORA across studies. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines to synthesize contemporary evidence on the efficacy and safety of biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in younger rheumatoid arthritis populations. A structured search of PubMed and Embase was performed to identify studies published between 2020 and 2025 that evaluated advanced therapies in patients with young-onset rheumatoid arthritis or in rheumatoid arthritis cohorts reporting age-stratified outcomes for younger adults. Results: From the screened literature, 16 studies met the predefined inclusion criteria, including 6 studies explicitly defining YORA based on age at disease onset and 10 studies reporting outcomes in younger adult subgroups (<40–45 years). Across studies, younger patients demonstrated higher remission rates, greater reductions in disease activity, and superior treatment persistence compared with older-onset rheumatoid arthritis cohorts. Tumor necrosis factor inhibitors, interleukin-6 receptor antagonists, and Janus kinase inhibitors showed consistent clinical efficacy. Structural outcomes, reported in a limited number of studies, suggested low rates of radiographic progression in younger patients. Safety profiles were generally favorable, with infections and laboratory abnormalities representing the most reported adverse events and no age-specific safety signals being identified. Conclusions: Biologic and targeted therapies provide substantial clinical benefit in YORA and younger adult RA populations, with outcomes being generally superior to those observed in older-onset RA. However, heterogeneity in YORA definitions and limited long-term data highlight the need for prospective, age-at-onset-defined studies and extended pharmacovigilance to better inform lifelong treatment strategies. Full article

(This article belongs to the Special Issue Musculoskeletal Medicine in Rheumatic Diseases)

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9 pages, 4033 KB

Open AccessCase Report

Surviving Adulthood with Rare Combined Congenital Heart Defects: Complete AV Canal Defect, Ebstein’s Anomaly, and Right Ventricular Hypoplasia

by Ana Peruničić, Stefan Veljković, Jovana Lakčević, Mirko Lipovac, Armin Šljivo, Slobodan Tomić, Milovan Bojić, Miloš Babić, Sanja Vučinić and Aleksandra Nikolić

Life 2026, 16(2), 224; https://doi.org/10.3390/life16020224 - 29 Jan 2026

Background/Objectives. Ebstein’s anomaly (EA), which accounts for fewer than 1% of congenital heart diseases, and atrioventricular canal defect (AVCD), present in approximately 4–5% of cases, exceptionally coexist, with this combination observed in fewer than 0.5% of patients with AVCD. We aim to report [...] Read more.

Background/Objectives. Ebstein’s anomaly (EA), which accounts for fewer than 1% of congenital heart diseases, and atrioventricular canal defect (AVCD), present in approximately 4–5% of cases, exceptionally coexist, with this combination observed in fewer than 0.5% of patients with AVCD. We aim to report the oldest documented case of a 45-year-old female with the exceptionally rare combination of complete AVCD, EA, and right ventricular hypoplasia and to provide a concise review of these anomalies. Case presentation. Diagnosed in early childhood with a complete AVCD, pulmonary stenosis, and right ventricular (RV) hypoplasia, the patient underwent palliative surgical intervention with a modified Blalock–Taussig shunt at the age of 10 but did not receive subsequent regular follow-up. Over the ensuing 35 years, she remained largely untreated until presentation at 45 years of age with progressive exertional dyspnea, central cyanosis, and palpitations, corresponding to NYHA class III. Comprehensive multimodal imaging, including transthoracic echocardiography and cardiac magnetic resonance, revealed a complete AVCD with moderate-to-severe mitral regurgitation secondary to an anterior mitral leaflet cleft, severe tricuspid regurgitation, RV hypoplasia, and hallmark features of EA. Given the complex cardiac anatomy and the elevated surgical risk, the patient was considered inoperable, and a strategy of conservative management with multidisciplinary follow-up was implemented. Conclusions. This case highlights the exceptional longevity of a patient with the rare coexistence of complete AVCD, EA, and RV hypoplasia, surviving 45 years from diagnosis despite limited early intervention. It underscores the importance of lifelong follow-up in complex congenital heart disease and illustrates the role of multimodal imaging in assessing anatomy and guiding management when surgical options are high-risk or not feasible. Full article

(This article belongs to the Section Medical Research)

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23 pages, 3230 KB

Open AccessSystematic Review

Pre-Eclampsia-Induced Maternal Liver Dysfunction: Systematic Review, Meta-Analysis and Meta-Regression of Observation Studies

by Kay-Lee E. Strauss, Wendy N. Phoswa and Kabelo Mokgalaboni

Life 2026, 16(2), 223; https://doi.org/10.3390/life16020223 - 29 Jan 2026

Introduction: Pre-eclampsia (PE) is a pregnancy-related hypertensive condition defined by the onset of hypertension after 20 weeks of gestation that is associated with proteinuria and maternal organ damage or uteroplacental dysfunction. It continues to be a leading cause of maternal and perinatal [...] Read more.

Introduction: Pre-eclampsia (PE) is a pregnancy-related hypertensive condition defined by the onset of hypertension after 20 weeks of gestation that is associated with proteinuria and maternal organ damage or uteroplacental dysfunction. It continues to be a leading cause of maternal and perinatal morbidity and mortality globally. PE is linked to systemic inflammation, endothelial dysfunction, and oxidative stress, which may compromise hepatic function. Aim: This meta-analysis assesses the impact of PE on maternal liver function by evaluating hepatic biomarkers, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total serum bilirubin. Methods: This meta-analysis of observational studies in Epidemiology (MOOSE) involved a search of PubMed and Scopus and manual screening of studies published between 2000 and 2025. Eligible studies included cross-sectional, case–control, and cohort designs. The quality of the studies was evaluated using the Newcastle–Ottawa Scale. Statistical analysis was conducted using the online meta-analysis, Jamovi version 2.6.44, and IBM SPSS Statistics version 30, and effect estimates were reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Results: Forty-five studies, comprising 257,929 women 9420 with PE; 248,509 normotensive, were included. Women with PE had elevated AST, MD = 1.81 (95% CI: 1.51 to 2.10; p < 0.0001) and ALT, SMD = 1.73 (95% CI: 1.38 to 2.07; p < 0.0001); ALP, SMD = 1.43 (95% CI: 0.97 to 1.88; p < 0.0001); and total serum bilirubin (TSB), SMD = 0.62 (95% CI: 0.36 to 0.88; p < 0.0001) in comparison to normotensive controls. In the meta-regression, maternal age and quality were significant moderators, with older age and high-quality studies associated with smaller and larger effect sizes, respectively, for ALP (β = −0.720 and β = 1.444) and TSB (β = −0.304 and β = 0.761). For every 1-unit increase in body mass index, there was a significant 0.406-unit decrease in ALT effect size. Conclusions: PE is significantly associated with elevated maternal hepatic enzyme levels, indicating hepatocellular damage and impaired liver function. These findings emphasise the necessity for routine liver function monitoring in pregnant women with hypertensive disorders. Full article

(This article belongs to the Special Issue Molecular Mechanisms of Preeclampsia)

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32 pages, 5469 KB

Open AccessSystematic Review

Systematic Review and Meta-Analysis of RCTs on Efficacy of Conventional vs. Emerging Treatments for Amblyopia

by Clara Martinez-Perez and Ana Paula Oliveira

Life 2026, 16(2), 222; https://doi.org/10.3390/life16020222 - 28 Jan 2026

Amblyopia affects 1–4% of the population and remains a leading cause of unilateral visual impairment, with adherence and residual deficits limiting outcomes of standard therapies. This systematic review and meta-analysis compared the effectiveness of conventional and emerging amblyopia treatments in children, adolescents, and [...] Read more.

Amblyopia affects 1–4% of the population and remains a leading cause of unilateral visual impairment, with adherence and residual deficits limiting outcomes of standard therapies. This systematic review and meta-analysis compared the effectiveness of conventional and emerging amblyopia treatments in children, adolescents, and adults with anisometropic, strabismic, or mixed amblyopia. Following PRISMA guidelines and PROSPERO registration (CRD420251123552), PubMed, Web of Science, and Scopus were searched up to 5 August 2025 for randomized controlled trials. Sixty-six trials (sample sizes 7–404) were included, with thirty-six contributing to the meta-analysis. Primary outcomes were best-corrected visual acuity (logMAR) and stereopsis. Risk of bias was assessed using the Cochrane tool, and certainty of evidence was assessed using GRADE. Atropine penalization and occlusion demonstrated equivalent effects on visual acuity (mean difference 0.04 logMAR; 95% CI −0.04 to 0.12; moderate-certainty evidence). Digital, dichoptic, binocular, and virtual reality therapies showed a statistically significant but small improvement over patching (mean difference 0.02 logMAR; 95% CI 0.00–0.04; low-certainty evidence). Pharmacological adjuvants combined with patching yielded slightly larger gains (mean difference 0.08 logMAR; 95% CI 0.03–0.13; low-to-moderate certainty). No consistent benefit was observed for stereopsis outcomes. Overall, the certainty of evidence ranged from low to moderate, and most pooled effects were below commonly accepted thresholds for clinically meaningful visual acuity improvement (≈0.1 logMAR, one line). Atropine and occlusion remain equivalent first-line treatments, while adjunctive and multimodal approaches may offer limited additional benefit in selected patients when adherence, tolerability, and engagement are prioritized. Full article

(This article belongs to the Special Issue Advances in Binocular Vision Assessment and Management: From Anomalies to Oculomotor Norms)

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