Life

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

Abstract

(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

Abstract

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

Abstract

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

Abstract

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

Abstract

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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18 pages, 1141 KB

Open AccessArticle

Recovery from Post-Traumatic Amnesia During Inpatient Rehabilitation: A Retrospective Cohort Study

by Tay Kai Wen Elvina, Lim Gek Hsiang and Chua Karen

Life 2026, 16(2), 221; https://doi.org/10.3390/life16020221 - 28 Jan 2026

Abstract

Background: Traumatic brain injury (TBI) is a global healthcare problem, and post-traumatic amnesia (PTA) is a known predictor of long-term and societal outcomes. However, factors influencing PTA recovery during the inpatient rehabilitation phase remain underexplored, particularly in Asian populations. Objective: To identify factors [...] Read more.

Background: Traumatic brain injury (TBI) is a global healthcare problem, and post-traumatic amnesia (PTA) is a known predictor of long-term and societal outcomes. However, factors influencing PTA recovery during the inpatient rehabilitation phase remain underexplored, particularly in Asian populations. Objective: To identify factors associated with PTA duration and emergence during inpatient rehabilitation and examine their impact on functional outcomes. Materials and Methods: We conducted a retrospective, single-center cohort study over a 7-year period among patients with acute TBI who were admitted to an inpatient rehabilitation hospital. Outcomes included PTA emergence and duration, discharge Functional Independence Measure (FIM), rehabilitation length of stay, and Glasgow Outcome Scale (GOS) at ≥1 year. Results: A total of 100 patients were analyzed. In an adjusted Cox regression, age ≥ 55 years (Hazard Ratio [HR] 0.47) and non-infective medical complications during rehabilitation (HR 0.31) were associated with reduced likelihood of PTA emergence, while mild admission GCS (13–15; HR 4.80) and epidural hemorrhage (EDH) (HR 2.00) were associated with PTA emergence. PTA non-emergence was associated with approximately a 20-point lower discharge FIM total score (adjusted model, p < 0.001). A PTA duration of ≥90 days was associated with a lower total discharge FIM score by approximately 45 points compared with those with a PTA duration of <28 days (p < 0.001). PTA emergence was associated with better GOS at ≥1 year (odds ratio [OR] 3.92, p = 0.02). Conclusion: Both acute injury characteristics and intra-rehabilitation factors were associated with PTA recovery functional outcomes. PTA emergence, beyond PTA duration, was strongly associated with discharge functional status and long-term global outcome, supporting the clinical value of PTA in prognostication, rehabilitation planning, and goal setting. Full article

(This article belongs to the Special Issue Traumatic Brain Injury (TBI))

17 pages, 527 KB

Open AccessReview

United Airway Disease: An Evolving Concept? A Scoping Review of the Modern Literature on Integrated Treatment Approaches

by Victor Alexandru, Alexia Manole, Ligia Salomea Groza and Felicia Manole

Life 2026, 16(2), 220; https://doi.org/10.3390/life16020220 - 28 Jan 2026

Abstract

Background: This scoping review screens modern literature in search of effective treatment approaches that target both upper and lower airway diseases. Methods: After the establishment of a research protocol, 227 potential articles were obtained through a logged search method. These were screened and [...] Read more.

Background: This scoping review screens modern literature in search of effective treatment approaches that target both upper and lower airway diseases. Methods: After the establishment of a research protocol, 227 potential articles were obtained through a logged search method. These were screened and narrowed down to 26 included articles. Data were extracted using a standardized data extraction form and were analyzed thematically and analytically. Results: The main integrated treatment approaches are biological (dupilumab was the most mentioned molecule) and non-biological (allergen immunotherapy, nasal saline irrigation, and endoscopic polypectomy). Data suggest that these approaches are effective in improving upper and lower airway outcomes and showcase a good safety profile. Conclusions: Patients with upper and lower airway diseases should benefit from integrated treatment approaches when possible. Full article

(This article belongs to the Special Issue Advances in Pulmonology: Transforming Diagnosis and Treatment of Lung Diseases)

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24 pages, 1950 KB

Open AccessReview

Evolution from Composome to RNA Replicase

by Shaojie Deng, Doron Lancet and Roy Yaniv

Life 2026, 16(2), 219; https://doi.org/10.3390/life16020219 - 28 Jan 2026

Abstract

This paper proposes a novel scheme for the origin of RNA replicase based on the replication-first stable complex evolution (SCE) model, also known as the stable complex encoding (SCE) model, and attempts to derive this scheme from the metabolism-first graded autocatalysis replication domain [...] Read more.

This paper proposes a novel scheme for the origin of RNA replicase based on the replication-first stable complex evolution (SCE) model, also known as the stable complex encoding (SCE) model, and attempts to derive this scheme from the metabolism-first graded autocatalysis replication domain (GARD) model, thereby theoretically integrating the two hypotheses of the origin of life: replication-first and metabolism-first. Currently, although the replication-first model has made some progress in the artificial selection of RNA replicase, it has yet to achieve a true breakthrough. Meanwhile, metabolism-first models such as the CAS (Collectively Autocatalytic Set) and its graph version RAF (Reflexively Autocatalytic and Food-generated) models, have conducted in-depth research into the origin of metabolic networks but have failed to address the critical transformation issue from metabolism to RNA replication. This paper argues that these two hypotheses should mutually support each other. By introducing oligonucleotide assemblies and expanding the concept of composomes in the GARD model, this paper attempts to understand the general evolutionary mechanism of enzymes, thereby addressing the long-standing neglect of enzymatic catalysis in metabolism-first theories. This integrated scheme not only provides new theoretical support for the evolution of RNA replicase but also offers important insights into solving the key transition problem from chemical evolution to biological evolution. Full article

(This article belongs to the Special Issue The 15th Anniversary of Life—Alternatives to RNA World)

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17 pages, 571 KB

Open AccessArticle

Comparative Effects of Home-Based and Aquatic Resistance Training on Hand Tremor Severity and Manual Dexterity in Older Adults with Essential Tremor: A Preliminary Randomized Controlled Trial

by Cemal Polat, Tuba Sevil, Zarife Pancar and Luca Russo

Life 2026, 16(2), 218; https://doi.org/10.3390/life16020218 - 28 Jan 2026

Abstract

Essential tremor (ET) negatively affects neuromuscular control and hand function in older adults. Resistance exercise may enhance musculoskeletal and functional capacity, yet its modality-specific effects in ET remain unclear. This study compared the effects of home-based and aquatic resistance training on tremor severity, [...] Read more.

Essential tremor (ET) negatively affects neuromuscular control and hand function in older adults. Resistance exercise may enhance musculoskeletal and functional capacity, yet its modality-specific effects in ET remain unclear. This study compared the effects of home-based and aquatic resistance training on tremor severity, manual dexterity, and handgrip strength in older adults with ET. Twenty-seven participants were randomly assigned using block randomization to a home-based resistance exercise group (HBREG; n = 9), an aquatic resistance exercise group (AREG; n = 9), or a control group (CG; n = 9). Both intervention groups completed an 18-session resistance exercise program, with initial sessions supervised and subsequent sessions performed independently under regular monitoring. Tremor severity (FTMTRS), manual dexterity (Nine-Hole Peg Test), and handgrip strength were assessed pre- and post-intervention. Within-group changes were analyzed using the Wilcoxon signed-rank test and between-group differences using the Kruskal–Wallis test with Bonferroni-adjusted Mann–Whitney U tests (p < 0.05). Both HBREG and AREG demonstrated significant improvements in drawing and pouring tremor tasks, manual dexterity, and handgrip strength compared with the control group, with large effect sizes across outcomes. No significant differences were observed between the two exercise modalities, and no improvement occurred in the highest-difficulty spiral-B task. These findings indicate that both home-based and aquatic resistance training are safe and effective non-pharmacological strategies for reducing tremor severity and enhancing upper-extremity function in older adults with ET. Full article

(This article belongs to the Special Issue Effects of Exercise and Functional Interventions on Musculoskeletal Health)

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11 pages, 571 KB

Open AccessArticle

Randomized Clinical Study of Laser-Assisted Delivery of Exosome Boosters for Postoperative Facial Scars and Facial Rejuvenation

by Jei Youn Park and Jun Ho Park

Life 2026, 16(2), 217; https://doi.org/10.3390/life16020217 - 28 Jan 2026

Abstract

Postoperative facial scars frequently remain aesthetically problematic despite advances in laser-based treatments, as residual inflammation and disorganized dermal remodeling often limit clinical outcomes. Exosome-based formulations have gained attention as biologically active adjuncts capable of influencing key wound-healing pathways, including inflammatory regulation, neovascularization, and [...] Read more.

Postoperative facial scars frequently remain aesthetically problematic despite advances in laser-based treatments, as residual inflammation and disorganized dermal remodeling often limit clinical outcomes. Exosome-based formulations have gained attention as biologically active adjuncts capable of influencing key wound-healing pathways, including inflammatory regulation, neovascularization, and extracellular matrix modulation. This randomized, controlled clinical study aimed to evaluate the short-term clinical effect of laser-assisted delivery of exosome skin boosters for postoperative facial scars and facial rejuvenation. Seventy-five patients with postoperative facial scars were randomly allocated to receive fractional non-ablative Nd:YAG laser treatment alone or in combination with either human-derived or plant-derived exosome skin boosters. All participants completed five treatment sessions at two-week intervals. Clinical outcomes were evaluated using validated scar assessment tools, including the modified Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale, along with objective imaging analyses using Mark-Vu and ImageJ software. Compared with laser monotherapy, adjunctive exosome treatment was associated with numerically greater short-term improvements in scar appearance and reductions in grayscale intensity. Improvements in additional skin quality parameters, such as pigmentation uniformity, erythema, pore size, and fine wrinkles, were also observed in the exosome-treated groups. Clinical responses were comparable between human- and plant-derived exosome formulations, and no serious adverse events were reported. These findings indicate that exosome-based skin boosters may serve as a safe and well-tolerated biological complement to laser therapy for short-term improvement of postoperative facial scars and skin quality. Larger studies with longer follow-up are warranted to determine long-term efficacy and clinical durability. Full article

(This article belongs to the Section Medical Research)

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12 pages, 2754 KB

Open AccessArticle

Exploring Telomere Association in Donor–Recipient Pairs: Implications for Kidney Graft Longevity

by Zeinab Abdelrahman, Alexander P. Maxwell and Amy Jayne McKnight

Life 2026, 16(2), 216; https://doi.org/10.3390/life16020216 - 28 Jan 2026

Abstract

Introduction: Telomeres, which protect chromosome ends, are important in cell replication and are altered by ageing. In the realm of organ transplantation, telomere length has emerged as a potential biomarker for predicting both graft survival and recipient longevity. This study explores the correlation [...] Read more.

Introduction: Telomeres, which protect chromosome ends, are important in cell replication and are altered by ageing. In the realm of organ transplantation, telomere length has emerged as a potential biomarker for predicting both graft survival and recipient longevity. This study explores the correlation of telomere length with transplant outcomes to assess whether longer telomere length is associated with better long-term graft function and patient survival. Methods: Telomere length (TL) was analysed in 274 European renal transplant pairs (donors/recipients). Recipient DNA was collected before and after kidney transplantation, and donor DNA just prior to transplant surgery. Results: Donor TL was not significantly associated with graft survival. Donor age was a significant predictor of graft failure (1.02, 95% CI: 1.01–1.03, p < 0.01). Post-transplant recipient TL had a significant association with graft survival. Longer TL was associated with an up to 90% reduction in risk of graft failure (HR = 0.10, 95% CI: 0.015–0.71, p = 0.02). Conclusions: In this study, kidney transplant recipients with longer telomere length demonstrated significantly better long-term graft survival. If validated in additional kidney transplant cohorts, recipient telomere length could serve as a valuable biomarker for improving graft failure risk stratification and enhancing the long-term care of transplant recipients. Full article

(This article belongs to the Special Issue Telomere Length as a Marker of Biological Age and Age-Related Diseases)

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3 pages, 152 KB

Open AccessReply

Reply to Wostyn, P.; Nedergaard, M. Ocular Glymphatic Dysfunction as a Potential Link Between Obstructive Sleep Apnea and Retinal Structural Changes. Comment on “Pusic Sesar et al. Multimodal Assessment of Ocular Parameters in Patients with Severe Obstructive Sleep Apnea with Emphasis on Retinal Structural Changes. Life 2025, 15, 1307”

by Anita Pusic Sesar, Anja Cehajic, Antonela Geber, Mia Zoric Geber, Ivan Cavar and Antonio Sesar

Life 2026, 16(2), 215; https://doi.org/10.3390/life16020215 - 28 Jan 2026

Abstract

We sincerely thank you for your thoughtful and scientifically enriching comments [...] Full article

(This article belongs to the Section Physiology and Pathology)

3 pages, 155 KB

Open AccessComment

Ocular Glymphatic Dysfunction as a Potential Link Between Obstructive Sleep Apnea and Retinal Structural Changes. Comment on Pusic Sesar et al. Multimodal Assessment of Ocular Parameters in Patients with Severe Obstructive Sleep Apnea with Emphasis on Retinal Structural Changes. Life 2025, 15, 1307

by Peter Wostyn and Maiken Nedergaard

Life 2026, 16(2), 214; https://doi.org/10.3390/life16020214 - 28 Jan 2026

Abstract

We read the article by Pusic Sesar and colleagues [...] Full article

(This article belongs to the Special Issue Sleep and Sleep Apnea: Impacts, Mechanisms, and Interventions)

11 pages, 239 KB

Open AccessArticle

Determinants of Peri-Procedural Mechanical Complications During Peripheral Endovascular Revascularization: Insights from Single-Center Experience

by Thierry Unterseeh, Livio D’Angelo, Youcef Lounes, Francesca Sanguineti, Antoinette Neylon, Hakim Benamer, Benjamin Honton, Antoine Sauguet, Antonella Millin, Julius Jelisejevas, Giacomo Maria Cioffi, Stephane Cook, Mario Togni, Neila Sayah, Pietro Laforgia, Nicolas Amabile, Thomas Hovasse, Philippe Garot, Mariama Akodad, Stephane Champagne and Ioannis Skalidis Show full author list Hide full author list

Life 2026, 16(2), 213; https://doi.org/10.3390/life16020213 - 28 Jan 2026

Abstract

Background: Peripheral endovascular intervention is the preferred revascularization strategy for patients with chronic lower-limb ischemia. Although generally safe, peri-procedural mechanical complications may occur and are influenced by both lesion complexity and procedural strategy. Data identifying determinants of such complications in routine clinical practice [...] Read more.

Background: Peripheral endovascular intervention is the preferred revascularization strategy for patients with chronic lower-limb ischemia. Although generally safe, peri-procedural mechanical complications may occur and are influenced by both lesion complexity and procedural strategy. Data identifying determinants of such complications in routine clinical practice remain limited. Methods: We performed a retrospective single-center analysis of consecutive patients undergoing peripheral endovascular intervention for chronic lower-limb ischemia between 2010 and 2023. The primary endpoint was the occurrence of peri-procedural mechanical complications, defined as mechanical adverse events occurring during or immediately following the index intervention and directly related to catheter manipulation, device deployment, or vascular access. Lesion- and procedure-related predictors were evaluated using multivariable logistic regression analysis. Results: A total of 283 index procedures were included. Peri-procedural mechanical complications occurred in 9 procedures (3.2%), with arterial dissection being the most frequent event (2.1%). No cases of peri-procedural bleeding, distal embolization, or emergent surgical conversion were observed. In multivariable analysis, chronic total occlusion (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI] 1.14–3.11; p = 0.014), moderate-to-severe arterial calcification (aOR 1.74, 95% CI 1.03–2.93; p = 0.039), introducer sheath size ≥7 French (aOR 2.08, 95% CI 1.21–3.57; p = 0.007), and ≥3 vascular access attempts (aOR 1.67, 95% CI 1.00–2.81; p = 0.048) were associated with increased risk of peri-procedural mechanical complications in adjusted analyses. Conclusions: In this real-world institutional registry, peri-procedural mechanical complications during peripheral endovascular intervention were uncommon. Lesion complexity and procedural factors, rather than access route or device type, were the primary determinants of mechanical risk. These findings highlight the importance of careful lesion assessment and procedural planning to optimize peri-procedural safety in routine practice. Full article

(This article belongs to the Special Issue Innovation and Translation in Cardiovascular Interventions)

20 pages, 1124 KB

Open AccessArticle

Progressive Smartphone Restriction Combined with Psychoeducational Guidance and Pre-Sleep Autonomic Regulation Improves Sleep Efficiency and Time-of-Day Cognitive Performance in Physically Active Students with Nomophobia: A Randomized Controlled Trial

by Wiem Ben Alaya, Wissem Dhahbi, Mohamed Abdelkader Souissi, Nidhal Jebabli, Halil İbrahim Ceylan, Nagihan Burçak Ceylan, Raul Ioan Muntean and Nizar Souissi

Life 2026, 16(2), 212; https://doi.org/10.3390/life16020212 - 28 Jan 2026

Abstract

Aim: This study compared the effects of standard evening smartphone restriction with an adapted intervention combining progressive restriction, psychoeducational guidance, and pre-sleep relaxation on sleep, psychological state, cognitive performance, and physical performance in physically active physical education students with moderate-to-high nomophobia. Methods [...] Read more.

Aim: This study compared the effects of standard evening smartphone restriction with an adapted intervention combining progressive restriction, psychoeducational guidance, and pre-sleep relaxation on sleep, psychological state, cognitive performance, and physical performance in physically active physical education students with moderate-to-high nomophobia. Methods: Thirty participants (age 21.9 ± 1.2 years; intermediate chronotype) completed a randomized controlled trial consisting of a 7-day baseline period, a 14-day intervention phase, and post-intervention assessments. The standard group (n = 15) implemented a 2-h pre-bedtime smartphone restriction combined with general sleep hygiene guidance. The adapted group (n = 15) followed a progressive restriction protocol (30→60→120 min) supplemented with psychoeducational guidance targeting smartphone-related anxiety and a nightly slow-paced breathing routine. Objective sleep parameters were quantified using wrist-worn actigraphy. Subjective sleep quality, pre-sleep anxiety, and stress were assessed using visual analog scales. Cognitive performance (psychomotor vigilance task and choice reaction time) and physical performance (vertical jumps and agility) were evaluated at both morning and afternoon time points. Results: The adapted intervention produced significantly greater improvements in sleep efficiency (time × group: F(1,28) = 6.84, p = 0.014, ηp² = 0.20; d = 0.78) and sleep onset latency (F(1,28) = 5.97, p = 0.021, ηp² = 0.18; d = 0.72) compared with standard restriction. Significant reductions were also observed in pre-sleep anxiety (F(1,28) = 7.12, p = 0.012, ηp² = 0.20; d = 0.81) and stress (F(1,28) = 6.45, p = 0.017, ηp² = 0.19; d = 0.74). Cognitive performance showed significant time × group × time-of-day interactions, with improvements during afternoon assessments in psychomotor vigilance (F(1,28) = 7.48, p = 0.011; d = 0.83) and choice reaction time (F(1,28) = 6.89, p = 0.014; d = 0.79) exclusively in the adapted group. Physical performance outcomes remained stable across interventions. Conclusions: Progressive smartphone restriction combined with psychoeducational strategies and pre-sleep relaxation yields clinically meaningful improvements in sleep continuity, psychological arousal, and afternoon cognitive performance, exceeding the benefits achieved through behavioral restriction alone. Full article

(This article belongs to the Section Physiology and Pathology)

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21 pages, 2988 KB

Open AccessArticle

The Ratio of S²⁻/SO₄²⁻ Induces the Transference of Cadmium in Rhizosphere Soil, Soil Pore Water and Root Iron Plaque

by Yuansheng Liu, Kun Wang, Xia Jiang and Guoxi Wang

Life 2026, 16(2), 211; https://doi.org/10.3390/life16020211 - 27 Jan 2026

Abstract

Rice (Oryza sativa L.) readily accumulates cadmium (Cd), posing dietary exposure risks in populations dependent on rice-based diets. This study investigated how sulfur (S) redox processes regulate Cd mobility in S-deficient, Cd-contaminated paddy soil under waterlogged conditions. A pot experiment was conducted [...] Read more.

Rice (Oryza sativa L.) readily accumulates cadmium (Cd), posing dietary exposure risks in populations dependent on rice-based diets. This study investigated how sulfur (S) redox processes regulate Cd mobility in S-deficient, Cd-contaminated paddy soil under waterlogged conditions. A pot experiment was conducted with two S treatments (−S and +S, 30 mg kg⁻¹) throughout the rice growing season. S addition markedly increased pore water S²⁻ concentrations during early growth (tillering) and mid-season (booting) and suppressed the diffusion of SO₄²⁻ from non-rhizosphere to rhizosphere at later stages (filling–maturity). Consequently, Cd in soil pore water was significantly lower in +S than −S treatments at all stages. Sulfur-amended soil showed a redistribution of Cd from labile fractions (exchangeable and carbonate-bound) to more stable fractions (Fe/Mn oxide-bound). Sulfur application also altered the rhizosphere microbiome: the relative abundance of sulfate-reducing bacteria (SRB) increased at the booting and filling stages, while sulfur-oxidizing bacteria (SOB) became more dominant at maturity. Additionally, +S enhanced Cd sequestration on rice root iron plaque by 32–67% during the grain-filling and maturity stages compared to −S. Throughout the rice growing period, redox-driven shifts in the S²⁻/SO₄²⁻ ratio emerged as a key control on Cd behavior, with low pe + pH (strongly reducing conditions) promoting Cd sulfide precipitation and high pe + pH (more oxidizing conditions) causing Cd remobilization. Full article

(This article belongs to the Section Plant Science)

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14 pages, 14608 KB

Open AccessArticle

Alterations in the Crystallization Pattern of Tear Fluid Induced by Increases in the Body Mass Index

by Cosmin Victor Ganea, Corina Georgiana Bogdanici, Nicoleta Anton, Calina Anda Sandu, Ioana Madalina Bilha, Anisia Iuliana Alexa, Vlad Constantin Donica, Irina Andreea Pavel, Roxana Elena Ciuntu and Camelia Margareta Bogdanici

Life 2026, 16(2), 210; https://doi.org/10.3390/life16020210 - 27 Jan 2026

Abstract

(1) Purpose: The study investigated the correlation between variations in body mass index (BMI) and tear crystallization class according to the Masmali classification. Moreover, it examined the potential diagnostic value of a patterning test within the population affected by obesity. (2) Methods: A [...] Read more.

(1) Purpose: The study investigated the correlation between variations in body mass index (BMI) and tear crystallization class according to the Masmali classification. Moreover, it examined the potential diagnostic value of a patterning test within the population affected by obesity. (2) Methods: A total of 61 patients were investigated, with ages ranging from 25 to 72 years (median age [interquartile range] = 39.0 [26] years). BMI values ranged from 19.1 to 47.5 kg/m², with a median BMI (interquartile range) of 29.3 (12.1) kg/m². (3) Results: The Kruskal–Wallis test was used to assess differences in BMI across the Masmali classes and revealed statistically significant disparities between at least two groups (p = 0.024). The rank η² value of 0.094 shows a small-to-moderate effect size, suggesting that approximately 9% of the variance in rank distributions is explained by the Masmali classification. The post hoc Dunn test with Bonferroni and Holm corrections showed that patients classified as Masmali grade 2 exhibited a significantly higher BMI compared to those in grade 0 (p = 0.009), whereas no statistically significant differences were identified between grades 0 and 1 or between grades 1 and 2. The analysis of variance (ANOVA) revealed a statistically significant difference among Masmali Classes 0, 1, and 2 with respect to the number of branching structures in dried tear samples analyzed at a brightness threshold of 220. The effect size (η² = 0.263) shows that approximately 26% of the variability in branching number can be attributed to the severity of tear film dysfunction as defined by the Masmali classification. Accordingly, as the Masmali score increases, the number of branches decreases significantly, particularly among patients with elevated BMI. (4) Conclusion: The findings suggest that when classified according to the Masmali scale the dry eye syndrome exhibits a distinct crystallization pattern in patients with excess body weight. Specifically, higher BMI values are associated with a marked decrease in the number of fern-like branches identified in the tear ferning test. Full article

(This article belongs to the Section Medical Research)

14 pages, 543 KB

Open AccessArticle

Genomic Landscape of Poorly Differentiated Gastric Carcinoma: An AACR GENIE^® Project

by Joshua Lodenquai, Tyson J. Morris, Ava Garcia, Emely Sokolovski, Grace S. Saglimbeni, Beau Hsia and Abubakar Tauseef

Life 2026, 16(2), 209; https://doi.org/10.3390/life16020209 - 27 Jan 2026

Abstract

Poorly differentiated gastric carcinoma (PGC) is aggressive, yet subtype-specific genomics are under-characterized. We queried AACR Project GENIE^® (cBioPortal v18.0-public; 12 August 2025) for PGC and analyzed somatic alterations from targeted panels (depth ≥ 100×; variant allele frequency ≥ 5%). Mutation and copy [...] Read more.

Poorly differentiated gastric carcinoma (PGC) is aggressive, yet subtype-specific genomics are under-characterized. We queried AACR Project GENIE^® (cBioPortal v18.0-public; 12 August 2025) for PGC and analyzed somatic alterations from targeted panels (depth ≥ 100×; variant allele frequency ≥ 5%). Mutation and copy number frequencies were summarized, co-occurrence and exclusivity were tested, and primary versus metastatic tumors were compared using chi-square with Benjamini–Hochberg correction. The cohort included 189 tumors from 188 patients (71% primary; 25% metastatic), with primary and metastatic tumor samples being collected from different patients. Recurrently mutated genes were TP53 (48.7%), CDH1 (31.2%), ARID1A (21.2%), KMT2C (8.5%), and POLD1 (7.4%); additional alterations involved ERBB3, KMT2D, KEL, CDKN2A, and FAT1 (≈1–7%). Amplifications in CCNE1 (8.2%) and FGFR2 (7.6%) were common, alongside gains in MET, MYC, KRAS, and ERBB2 and losses in CDKN2A/CDKN2B, CDH1, and PTEN. Significant co-occurrence was observed for POLD1–KMT2D (p < 0.001), POLD1–ARID1A (p < 0.001), and ARID1A–KMT2D (p < 0.001), while TP53 was mutually exclusive with ARID1A (p = 0.029) and CDH1 (p = 0.041). CDH1 (48.9% vs. 29.6%; p = 0.021) and MLH1 (8.5% vs. 1.5%; p = 0.040) were enriched in metastases, and CCNE1 alterations showed female predominance (p = 2.83 × 10⁻⁴). Several “primary-only” findings likely reflect small denominators and require replication. PGC demonstrates a mutational framework dominated by TP53, CDH1, ARID1A, and recurrent CCNE1/FGFR2 amplifications, underscoring dysregulation of cell cycle and chromatin-remodeling pathways as key drivers. Co-occurrence of POLD1, ARID1A, and KMT2D suggests coordinated disruption of DNA repair and epigenetic regulation, whereas mutual exclusivity of TP53, ARID1A, and CDH1 indicates distinct tumorigenic routes. Metastatic enrichment of CDH1 and MLH1 supports their roles in invasion and therapeutic resistance. Together, these findings highlight candidate biomarkers and actionable pathways warranting validation in larger, multi-omic cohorts to refine precision treatment strategies for this aggressive gastric cancer subtype. Full article

(This article belongs to the Section Genetics and Genomics)

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17 pages, 1767 KB

Open AccessArticle

Isotopic Niche of Three Sympatric Mustelids

by Linas Balčiauskas, Andrius Garbaras, Rasa Vaitkevičiūtė Koklevičienė, Inga Garbarienė and Laima Balčiauskienė

Life 2026, 16(2), 208; https://doi.org/10.3390/life16020208 - 27 Jan 2026

Abstract

Although sympatric carnivores typically exhibit dietary differentiation to reduce interspecific competition, contemporary isotopic comparisons of European mustelids remain scarce. In this study, we present the first modern stable isotope analysis of hair to evaluate the dietary niches and trophic relationships of pine martens [...] Read more.

Although sympatric carnivores typically exhibit dietary differentiation to reduce interspecific competition, contemporary isotopic comparisons of European mustelids remain scarce. In this study, we present the first modern stable isotope analysis of hair to evaluate the dietary niches and trophic relationships of pine martens (Martes martes), stone martens (Martes foina), and European polecats (Mustela putorius) in Lithuania and Latvia. The stable carbon and nitrogen isotope values differed among the species. M. martes showed lower δ¹⁵N values and more depleted δ¹³C signatures than the two more synanthropic species. Isotopic niche analyses revealed that M. martes occupied the broadest niche, while M. foina and M. putorius exhibited narrower niches with substantial overlap. Habitat influenced trophic position: individuals from settlements showed higher δ¹⁵N values than those from forests or wetlands. In contrast, sex- and age-related differences were weak or absent. These results demonstrate that despite partial spatial coexistence, sympatric mustelids differ primarily in isotopic niche structure rather than mean isotope values and that human-modified environments promote trophic convergence among generalist mesocarnivores. However, the small sample sizes for M. foina and M. putorius mean that estimates of isotopic niche width and overlap should be regarded as preliminary, and observed sex- and age-related patterns likely reflect limited statistical power rather than the absence of intraspecific dietary variation. Full article

(This article belongs to the Section Diversity and Ecology)

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