Life

7 pages, 9973 KB

Open AccessCase Report

Convulsive Syncope Due to Complete Atrioventricular Block in a Remote Area: The Critical Role of Helicopter Emergency Medical Services

by Ioana Năvălici, Mihai-Cristian Marinescu, Gabriel Ioan Prada, Cezarina Mihaela Mehedinți, Mihaela Alina Călin, Mihai Grecu, Sorina Nicoleta Munteanu, Diana Oprea and Aurelia Romila

Life 2026, 16(6), 895; https://doi.org/10.3390/life16060895 - 26 May 2026

Abstract

Background: Syncope in older adults is a frequent and diagnostically challenging presentation in prehospital emergency care, particularly in geographically remote areas with limited access to advanced cardiac services. While many syncopal episodes are benign, some are caused by life-threatening conduction disorders such [...] Read more.

Background: Syncope in older adults is a frequent and diagnostically challenging presentation in prehospital emergency care, particularly in geographically remote areas with limited access to advanced cardiac services. While many syncopal episodes are benign, some are caused by life-threatening conduction disorders such as complete atrioventricular block (CAVB), which may manifest with seizure-like activity due to severe cerebral hypoperfusion. Case Presentation: We report the case of a 70-year-old man with a history of hypertension, residing in a remote rural area, who experienced a nocturnal tonic–clonic episode followed by recurrent loss of consciousness. Due to difficult ground access, a helicopter emergency medical service (HEMS) team was deployed. On arrival, the patient was hypotensive and severely bradycardic, with recurrent syncopal episodes. Electrocardiography (ECG) confirmed CAVB with a slow escape rhythm. Temporary transvenous pacing was initiated but required progressively higher output, up to approximately 80 mV, with intermittent loss of capture, indicating a high risk of pacing failure and asystole. The patient was transported by helicopter to a tertiary interventional cardiology center, where he experienced additional syncopal episodes before undergoing emergent implantation of a permanent single-chamber ventricular pacemaker (VVI). Permanent pacing resulted in immediate hemodynamic stabilization, and no further syncopal or seizure-like episodes were observed. Conclusions: In geriatric patients presenting with convulsive syncope, cardiac causes such as CAVB must be rapidly identified. Unstable temporary pacing with high capture thresholds represents a life-threatening condition requiring urgent permanent pacemaker implantation. HEMS plays a critical role in ensuring timely access to definitive cardiac care in geographically isolated regions. Full article

(This article belongs to the Section Medical Research)

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18 pages, 5868 KB

Open AccessArticle

Impact of a Mediterranean Diet Supplemented with Extra Virgin Olive Oil on Gut Microbiota in Fibromyalgia: A Randomized Controlled Trial

by Elena Durán González, Jorge Antolín Ramírez Tejero, Ismael San Mauro Martín, Ana Terrén Lora, Marta Pérez Sánchez, Rosa Gómez Morano, Claudia Díaz López, Antonio Martínez Lara, Marta Aguilar Díaz and David Cotán Marín

Life 2026, 16(6), 894; https://doi.org/10.3390/life16060894 - 26 May 2026

Abstract

Fibromyalgia is a chronic syndrome associated with pain, fatigue, and cognitive symptoms, often linked to gut microbiota alterations. The Mediterranean Diet (MD), particularly extra-virgin olive oil (EVOO), has antioxidant and anti-inflammatory properties that may beneficially modulate the microbiota. We conducted a prospective, randomized, [...] Read more.

Fibromyalgia is a chronic syndrome associated with pain, fatigue, and cognitive symptoms, often linked to gut microbiota alterations. The Mediterranean Diet (MD), particularly extra-virgin olive oil (EVOO), has antioxidant and anti-inflammatory properties that may beneficially modulate the microbiota. We conducted a prospective, randomized, double-blind, placebo-controlled clinical trial that included 250 women (206 with fibromyalgia, 44 controls). Participants followed a MD supplemented with EVOO or refined olive oil (placebo) for six months. Microbiota composition was analyzed at four time points (T0–T3) by 16S rRNA sequencing (V3–V4). At baseline, fibromyalgia patients exhibited reduced microbial diversity compared to controls. While global diversity did not change after intervention, specific taxa increased significantly with EVOO, including Bacteroides fragilis, Anaerotruncus colihominis, Adlercreutzia equolifaciens, and butyrate producers such as Faecalibacterium prausnitzii, Roseburia intestinalis, and Agathobacter. These shifts suggest EVOO supplementation might promote anti-inflammatory and metabolic bacteria, suggesting diet as a complementary strategy to modulate gut microbiota in fibromyalgia. Full article

(This article belongs to the Section Microbiology)

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18 pages, 2044 KB

Open AccessArticle

Integrating Osteology and Ancient DNA: Cranial Variation, Hemoglobin S, and Paternal Lineage in a Roman-Period Individual from Anatolia

by Aylin Köseler, Ali Yalçın, İlker Kiraz, Gergana Lengerova, Martina Bozhkova, Steliyan Petrov and Ayla Sevim Erol

Life 2026, 16(6), 893; https://doi.org/10.3390/life16060893 - 26 May 2026

Abstract

(1) Background: Integrated bioarchaeological approaches combining osteological and ancient DNA analyses provide powerful insights into health, disease, and population history in past societies. However, the relationship between rare skeletal variations, genetic disorders, and ancestry remains insufficiently explored within single individuals. This study aimed [...] Read more.

(1) Background: Integrated bioarchaeological approaches combining osteological and ancient DNA analyses provide powerful insights into health, disease, and population history in past societies. However, the relationship between rare skeletal variations, genetic disorders, and ancestry remains insufficiently explored within single individuals. This study aimed to investigate the combined osteological, paleopathological, and genetic characteristics of a Roman-period individual from southwestern Anatolia. (2) Methods: A multidisciplinary approach was applied to the skeletal remains of an adult male recovered from the Sekköy excavation site. Osteological analysis was conducted to assess cranial morphology, pathological lesions, and dental status. Ancient DNA was extracted from petrous bone under strict contamination control. The hemoglobin beta (HBB) gene was analyzed using Next Generation Sequencing and validated by Sanger sequencing. Y-chromosomal STR analysis was performed to determine paternal lineage. (3) Results: Osteological examination revealed a rare craniovertebral anomaly consistent with a third occipital condyle, along with porotic hyperostosis and extensive antemortem dental pathology, indicating prolonged physiological stress. Genetic analysis identified a heterozygous hemoglobin S mutation (HbAS; rs334), confirmed by both next-generation sequencing and Sanger sequencing, providing direct molecular evidence of hereditary hemoglobinopathy. Y-STR profiling assigned the individual to haplogroup R1b (predicted based on Y-STR data), indicating affiliation with Western Eurasian paternal lineages. (4) Conclusions: Despite the presence of comparable skeletal stress indicators, the integration of osteological and genetic data revealed a complex interaction between anatomical variation, chronic physiological stress, and inherited disease. The co-occurrence of a rare cranial anomaly, HbS mutation, and a defined paternal lineage represents a unique bioarchaeological case. These findings highlight the value of integrating skeletal and molecular approaches to reconstruct individual health profiles in archaeological contexts and demonstrate the methodological potential of interdisciplinary bioarcheological analysis. Full article

(This article belongs to the Section Genetics and Genomics)

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33 pages, 9605 KB

Open AccessReview

Silk-Derived 3D-Bioprinted Scaffolds for Neural Repair and Nerve Regeneration: A Comprehensive Review

by Alynah J. Adams, Sanjana Challa, Cynthia Yan, Isabella Beltz, Alexa Kambol, Kaavian Shariati, Jocelyn Hunt, Charlotte Thomas, Dorien I. Schonebaum, Jose A. Foppiani, Umar Choudry and Samuel J. Lin

Life 2026, 16(6), 892; https://doi.org/10.3390/life16060892 - 26 May 2026

Abstract

Traumatic injuries often result in nerve tissue damage and functional deficits due to limited regeneration. Silk fibroin, a biopolymer with inherent biocompatibility and tunable properties, is a promising material for 3D-bioprinted neural tissue scaffolds. This review highlights recent advancements in silk-derived composite scaffolds, [...] Read more.

Traumatic injuries often result in nerve tissue damage and functional deficits due to limited regeneration. Silk fibroin, a biopolymer with inherent biocompatibility and tunable properties, is a promising material for 3D-bioprinted neural tissue scaffolds. This review highlights recent advancements in silk-derived composite scaffolds, often incorporating additional materials like collagen or conductive polymers to enhance their performance. This review examines how material composition, scaffold architecture, and fabrication strategy influence biological response and functional recovery. This comprehensive review follows PRISMA guidelines and uses comprehensive searches of PubMed, MEDLINE, Embase, Web of Science, Cochrane Central, and ClinicalTrials.gov for studies published through 2025. Studies were screened for eligibility based on substance type, mechanical properties, production methods, and outcomes. Findings were synthesized qualitatively. Twelve studies were included, comprising rat (50%), canine (8.3%), and in vitro (41.7%) models. Analysis reveals that silk fibroin acts as a highly adaptable mechanical backbone. It can consistently integrate with bioactive additives (collagen, dECM) or conductive polymers (Polypyrrole, MXene) to meet specific therapeutic demands. For spinal cord injuries, composites reached a compressive modulus capable of resisting physiological pressures and preventing scaffold collapse. In soft tissue applications, silk–hydrogel blends provided localized release of exosomes and small molecules during the acute injury phase, reducing neuroinflammatory markers. Additionally, adding conductive materials allowed the scaffolds to bridge electrical gaps and promote Schwann cell proliferation and neuronal differentiation. Furthermore, 3D bioprinting enabled the creation of defined microchannels that replicate native fascicular architecture. In vivo outcomes consistently showed superior axonal regeneration, myelination, and synaptic reconnection compared to controls, correlating with significant improvements in electrophysiological and motor function. This review highlights the clinical potential of silk fibroin-based 3D-printed biomaterials for nerve regeneration, including neural repair and neural tissue engineering. More recent studies place greater emphasis on integrating mechanical, architectural, and biological considerations into scaffold design, resulting in increasingly multifunctional scaffold systems. Despite promising efficacy, the heterogeneity of fabrication methods and the predominance of rodent models highlight the need for standardized protocols and evaluations in relevant models to facilitate clinical translation. Full article

(This article belongs to the Section Medical Research)

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13 pages, 660 KB

Open AccessArticle

Early (≤10 Days) vs. Late (>10 Days) Tracheostomy in the Intensive Care Unit: Impact on Discontinuation of Sedation and Mechanical Ventilation

by Angelo Buglione, Carmine Colella, Elena Pepe, Luca Gregorio Giaccari, Maria Caterina Pace, Vincenzo Pota, Dario Gaetano, Modestino Matarazzo and Pasquale Sansone

Life 2026, 16(6), 891; https://doi.org/10.3390/life16060891 - 26 May 2026

Abstract

Background: The timing of tracheostomy in the intensive care unit (ICU) is debated because of its potential effects on comfort, sedation management, and ventilator weaning. Objective: To compare early (≤10 days) versus late (>10 days) tracheostomy with respect to discontinuation of sedation and [...] Read more.

Background: The timing of tracheostomy in the intensive care unit (ICU) is debated because of its potential effects on comfort, sedation management, and ventilator weaning. Objective: To compare early (≤10 days) versus late (>10 days) tracheostomy with respect to discontinuation of sedation and invasive ventilation. Methods: Single-centre retrospective observational study. We included 52 consecutive ICU patients who underwent tracheostomy (January 2023–June 2025): 16 early and 36 late. Switching to dexmedetomidine was considered discontinuation of hypnotic sedation; transition to home mechanical ventilation (VAM) was considered discontinuation of invasive ventilation. Results: Sedation discontinuation occurred in 15/16 (93.8%) early vs. 35/36 (97.2%) late patients (p = 0.525). Discontinuation of invasive ventilation occurred in 12/16 (75.0%) early vs. 31/36 (86.1%) late patients (p = 0.431). Tracheostomy-to-sedation stop time: median 3 days [IQR 1–10] (overlapping between groups). Tracheostomy-to-ventilation stop time: median 17 days [IQR 10–27] (17 [11–33] early vs. 17 [10–25] late). ICU mortality: 3/16 (18.8%) vs. 6/36 (16.7%) (p = 1.00). Conclusions: In this retrospective cohort, no statistically significant differences emerged between early and late tracheostomy regarding discontinuation of sedation or invasive ventilation. However, given the retrospective design and small sample size, the study may have been underpowered to detect smaller but clinically relevant differences between groups. Prospective studies with larger sample sizes and severity-related variables may clarify any effects of timing. Full article

(This article belongs to the Special Issue Intensive Care Medicine: Current Concepts and Future Perspectives)

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19 pages, 6588 KB

Open AccessArticle

Integrative Multi-Omics Analysis Reveals Nutritional Metabolite Diversity and Regulatory Mechanisms in Ocimum basilicum

by Yuanyuan Zhang, Manman Xu, Zizuo Miseme, Shiqi Yang, Xiangrong Chen, Cong Zhao, Yujian Wang and Jingtian Yang

Life 2026, 16(6), 890; https://doi.org/10.3390/life16060890 - 26 May 2026

Abstract

Ocimum basilicum is widely used as both a culinary and medicinal plant; however, its nutritional metabolite composition, functional relevance, and underlying regulatory mechanisms remain incompletely characterized. To systematically profile nutritional metabolites and explore their potential biological relevance in O. basilicum, an integrative [...] Read more.

Ocimum basilicum is widely used as both a culinary and medicinal plant; however, its nutritional metabolite composition, functional relevance, and underlying regulatory mechanisms remain incompletely characterized. To systematically profile nutritional metabolites and explore their potential biological relevance in O. basilicum, an integrative multi-omics strategy that combined UPLC-MS/MS-based metabolomics, transcriptomics, network pharmacology, and molecular docking was deployed herein. A total of 443 nutritional metabolites across four accessions were identified, including vitamins, saccharides, amino acids and lipids. Of these, Vitamin A1 (retinol) and N-acetyl-L-tryptophan were found to be important metabolites that could have functional significance. Predictive network pharmacology and molecular docking analyses suggested potential in silico interactions between these metabolites and disease-associated targets, including ESR2 and MAPK1; these findings await experimental validation. Transcriptomic analysis also showed that genes involved in Vitamin A1 biosynthesis (PSY, LCYB) were expressed, and the expression patterns of the genes were validated by the qPCR analysis, in which expression level was largely consistent with the transcriptome results. Specifically, the accessions G083 and G082 showed high values of Vitamin A1 and N-acetyl-L-tryptophan, respectively, suggesting that they may also be interesting germplasm for functional food innovation and the development of nutraceuticals. Overall, this study offers a comprehensive multi-omics dataset and mechanistic insights that can help in the targeted use of O. basilicum for nutritional and functional applications. Full article

(This article belongs to the Section Genetics and Genomics)

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37 pages, 10372 KB

Open AccessArticle

Mechanistic Understanding of Pandemic Dynamics: A Multiscale Algorithmic Framework

by Dimitris M. Manias, Dimitrios G. Patsatzis, Haralampos Hatzikirou and Dimitris A. Goussis

Life 2026, 16(6), 889; https://doi.org/10.3390/life16060889 - 25 May 2026

Abstract

We present a robust, data-efficient framework for early outbreak assessment using multiscale analysis and Computational Singular Perturbation (CSP). This framework overcomes the shortcomings of the standard compartmental epidemiological models, which often struggle with parameter identifiability during the early stages of a pandemic, limiting [...] Read more.

We present a robust, data-efficient framework for early outbreak assessment using multiscale analysis and Computational Singular Perturbation (CSP). This framework overcomes the shortcomings of the standard compartmental epidemiological models, which often struggle with parameter identifiability during the early stages of a pandemic, limiting their predictive utility considerably when data is sparse. Rather than relying on curve-fitting population profiles, which are sensitive to uncertainty, our approach isolates the dominant “explosive time scale that characterizes the outbreak’s intensity and duration. Using a calibrated SEIRD model, CSP allows for the identification of the paths that drive the process during the outbreak phase and the critical transition from accelerating to decelerating growth, which serves as a reliable precursor to the epidemic peak. This framework is assessed against the 4th, 5th, and 6th waves of the COVID-19 pandemic in Greece during 2021, covering periods dominated by the Delta and Omicron variants. Using only early-stage data from short calibration windows, CSP diagnostic tools revealed distinct dynamical drivers for each wave; e.g., a transition from the 4th wave that was driven by transmission intensity (Delta variant dominance) to the 6th wave that was driven by rapid exposure-to-infection turnover and reduced opposition from recovery mechanisms (Omicron variant dominance). Furthermore, it is demonstrated that the timing of the outbreak’s weakening can be accurately predicted, demonstrating robustness with results obtained from longer observation windows. These findings position multiscale analysis as a powerful, pathogen-agnostic early-warning system, capable of disentangling complex epidemic mechanisms and assessing intervention efficacy in real-time. Full article

(This article belongs to the Section Epidemiology)

28 pages, 1044 KB

Open AccessReview

Environmental Biofilms in Livestock Production Systems: Reservoirs of Pathogens and Antimicrobial Resistance

by Alexandra Ban-Cucerzan, Adriana Morar and Kálmán Imre

Life 2026, 16(6), 888; https://doi.org/10.3390/life16060888 - 25 May 2026

Abstract

Environmental biofilms are persistent structural components of livestock production systems and represent under-recognized drivers of pathogen persistence and antimicrobial resistance (AMR). This review examines the engineering, ecological, and operational factors that promote biofilm formation in dairy, poultry, and swine environments, with emphasis on [...] Read more.

Environmental biofilms are persistent structural components of livestock production systems and represent under-recognized drivers of pathogen persistence and antimicrobial resistance (AMR). This review examines the engineering, ecological, and operational factors that promote biofilm formation in dairy, poultry, and swine environments, with emphasis on drinking water distribution systems, feeding infrastructure, housing surfaces, and waste channels. Biofilms develop preferentially in low-shear zones, dead ends, and aging materials, where they enhance microbial tolerance to sanitation and facilitate horizontal gene transfer. Conventional monitoring approaches, largely based on planktonic sampling and single-time-point testing, underestimate attached biomass and fail to capture spatial heterogeneity. Although molecular and sensor-based technologies provide improved resolution, their farm-level implementation remains limited by cost, standardization challenges, and the absence of validated operational thresholds. Current EU surveillance frameworks focus primarily on antimicrobial use and resistance prevalence in animal isolates, while environmental compartments are rarely incorporated as monitored system elements. This review proposes a proportionate, risk-based approach that integrates existing farm data streams such as antimicrobial use metrics and biosecurity scoring systems with targeted environmental assessment of high-risk infrastructure. Mitigation strategies emphasize mechanical disruption, combined chemical sanitation, hydraulic optimization, material selection, and infrastructure lifecycle management. Embedding environmental biofilm control within existing engineering and stewardship frameworks supports more resilient, systems-based management of infectious and AMR risks in livestock production. Full article

(This article belongs to the Special Issue Antibiotic Resistance in Biofilm: Mechanisms and Novel Interventions)

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26 pages, 5159 KB

Open AccessArticle

Hyposalivation Treatment with Non-Crosslinked Hyaluronic Acid and Amino Acids Solution—A Clinical Pilot Study

by Marzena Liliana Wyganowska, Sylwia Klewin-Steinböck and Peng Ao

Life 2026, 16(6), 887; https://doi.org/10.3390/life16060887 - 25 May 2026

Abstract

Background. This randomized controlled clinical study aimed to evaluate changes in salivary secretion following injections of a hyaluronic acid and amino acid solution in patients with hyposalivation. Materials and Methods. A total of 100 patients with symptoms of hyposalivation were randomly assigned to [...] Read more.

Background. This randomized controlled clinical study aimed to evaluate changes in salivary secretion following injections of a hyaluronic acid and amino acid solution in patients with hyposalivation. Materials and Methods. A total of 100 patients with symptoms of hyposalivation were randomly assigned to either a study group or a control group (1:1). The consistency and pH of unstimulated saliva, as well as the volume and buffering capacity of stimulated saliva, were assessed using the Saliva-Check Buffer GC test at baseline and after the study period. Patients in the study group received injections of a hyaluronic acid and amino acid solution into the buccal mucosa in four sessions at two-week intervals, while the control group received no intervention. Results: Significant improvements were observed in the intervention group, including favorable changes in the consistency and pH of unstimulated saliva as well as increases in the volume and buffering capacity of stimulated saliva over the study period. A paired t-test demonstrated a significant increase in salivary pH following treatment (t = −10.07, p < 0.001). The mean pH increased from 6.54 (95% CI: 6.42–6.65) at baseline to 7.31 (95% CI: 7.22–7.40) after the intervention, representing a mean increase of 0.78 units (95% CI: 0.62–0.93). Additionally, the Wilcoxon signed-rank test revealed a significant improvement in stimulated salivary flow (V = 1275, p < 0.001). The median salivary volume increased from 1.5 mL at baseline to 5.0 mL post-treatment, representing a median increase of 3.75 mL (95% CI: 3.5–4.0). No statistically significant changes were observed in the control group for saliva pH, consistency, or buffering capacity. Stimulated salivary flow showed a statistically significant difference (p = 0.002) but with a median increase of 0 mL, indicating no clinically meaningful change. Conclusions: Injections of a hyaluronic acid and amino acid solution may represent a promising therapeutic option for patients with symptoms of dry mouth. Study registered on Clinicaltrials NCT07309588. Full article

(This article belongs to the Section Medical Research)

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8 pages, 928 KB

Open AccessCase Report

Mechanical Tricuspid Valve Thrombosis and Pregnancy

by Míriam Mayal Etreros, Susana Beltrán Martínez, Diana Domingo Valero, Carmen Padilla Prieto, Javier Valero Domínguez, Javier Monleón Sancho, Dolores Borrás Suñer, Beatriz Marcos Puig and Vicente José Diago Almela

Life 2026, 16(6), 886; https://doi.org/10.3390/life16060886 - 25 May 2026

Abstract

Mechanical tricuspid valve thrombosis during pregnancy is a rare but extremely high-risk condition due to the thrombogenic nature of tricuspid prostheses and the hypercoagulable state of pregnancy, which complicates anticoagulation management. This article reports the case of a 39-year-old pregnant woman who developed [...] Read more.

Mechanical tricuspid valve thrombosis during pregnancy is a rare but extremely high-risk condition due to the thrombogenic nature of tricuspid prostheses and the hypercoagulable state of pregnancy, which complicates anticoagulation management. This article reports the case of a 39-year-old pregnant woman who developed thrombosis of a mechanical tricuspid valve after switching from warfarin to low-molecular-weight heparin. Owing to her hemodynamic stability, a conservative approach with intensified anticoagulation and close multidisciplinary monitoring was adopted, allowing continuation of the pregnancy without maternal clinical deterioration. Partial echocardiographic improvement was observed. Delivery was achieved by planned ischemic cesarean section to minimize hemodynamic stress, resulting in a stable preterm neonate. The patient recovered well and subsequently underwent elective replacement of the mechanical valve with a bioprosthesis postpartum. This case highlights the complexity of diagnosing and managing mechanical tricuspid valve thrombosis during pregnancy and emphasizes the importance of individualized, multidisciplinary care, as well as the selective use of ischemic cesarean section in extreme-risk scenarios. Full article

(This article belongs to the Section Medical Research)

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15 pages, 6600 KB

Open AccessArticle

RpaA Overexpression Enhances Bioluminescence Intensity and Elevates Rhythmic Extracellular Vesicle Yield in Synechococcus elongatus PCC 7942

by Xiaoshuang Liu, Wenlei Zhang, Lu Wang, Ronggui Li, Chi Zhao and Xuefeng Lu

Life 2026, 16(6), 885; https://doi.org/10.3390/life16060885 - 25 May 2026

Abstract

The cyanobacterial circadian clock orchestrates a wide range of physiological processes. However, its involvement in extracellular vesicle (EV) biogenesis remains largely unexplored. In this study, we investigated the role of the master circadian output regulator RpaA in modulating EV production in Synechococcus elongatus [...] Read more.

The cyanobacterial circadian clock orchestrates a wide range of physiological processes. However, its involvement in extracellular vesicle (EV) biogenesis remains largely unexplored. In this study, we investigated the role of the master circadian output regulator RpaA in modulating EV production in Synechococcus elongatus PCC 7942. Deletion of rpaA simultaneously abolished the bioluminescence rhythmicity and rhythmic EV production, whereas overexpression of rpaA enhances the output of circadian clock signals in a dose-dependent manner and markedly increases the bioluminescence intensity and EV production while maintaining the normal circadian oscillation patterns. Transcriptional analyses indicated that rpaA positively regulates lpxD to promote membrane synthesis and differentially inhibits glgC transcription to optimize carbon allocation. These findings reveal a previously unrecognized link between circadian output signaling and EV biogenesis and suggest that rpaA overexpression is an effective strategy for improving the yield of EVs. It also provides novel insights and regulatory targets for facilitating the synthesis of other high-value metabolites in cyanobacterial cell factories, and holds certain practical significance for advancing cyanobacterial synthetic biology research and the application of nanocarrier technology. Full article

(This article belongs to the Section Microbiology)

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24 pages, 6812 KB

Open AccessArticle

Human Milk MiRNA Acts on Infections in Both the Maternal Body and the Child During Breastfeeding

by Mohammed Alsaweed, Mezyndra Badsha, Ching Tat Lai, Donna T. Geddes and Foteini Kakulas

Life 2026, 16(6), 884; https://doi.org/10.3390/life16060884 - 25 May 2026

Abstract

Human milk is highly rich in miRNAs, with differential expression amongst its fractions, including cells, fat, and skim milk. Various factors, such as the stage of lactation or milk removal during breastfeeding, have been shown to influence the miRNA content of. Here, we [...] Read more.

Human milk is highly rich in miRNAs, with differential expression amongst its fractions, including cells, fat, and skim milk. Various factors, such as the stage of lactation or milk removal during breastfeeding, have been shown to influence the miRNA content of. Here, we sought to determine the effect of maternal and/or infant infection on the miRNA profile of cell and fat fractions analyzed using next-generation sequencing. Breastfeeding mother/infant dyads (n = 18) were followed during one or more infection episodes as well as upon recovery. Cells and fat together contain 1780 known miRNA species, which is the highest number of known miRNAs assayed in human body fluids to date. In addition, 592 novel miRNAs were predicted, of which 95 were of high confidence. Comparisons between samples collected when the participants were healthy and when infected yielded 453 differentially expressed (p < 0.05) known miRNAs. Of these, 70 were highly expressed and differentially regulated during infection, with 62 upregulated and 8 downregulated known miRNAs during infection. Most of the highly and differentially expressed miRNAs are known to play critical roles in immunity and immune system development. These findings support the use of miRNAs as biomarkers of the health status of the lactating breast and the breastfeeding mother/infant dyad. Full article

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

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19 pages, 4174 KB

Open AccessReview

Capillary Microvascular Dysfunction in Rheumatoid Arthritis: The Promising Role of Nailfold Videocapillaroscopy—A Narrative Review

by Elena Angeloudi, Panagiota Anyfanti, Konstantinos Tragiannidis, Eleni Korki, Eleni Aintinidou, Vasiliki Dimitriadou, Paraskevi Avgerou, George D. Kitas and Theodoros Dimitroulas

Life 2026, 16(6), 883; https://doi.org/10.3390/life16060883 - 25 May 2026

Abstract

Arthritis (RA) is characterized by immune-mediated chronic inflammation and endothelial dysfunction, ultimately resulting in clinically overt cardiovascular complications. As a prototypical disease of microvascular dysfunction, RA represents an ideal model to study microvascular alterations. The dermal capillary network offers an easily accessible window [...] Read more.

Arthritis (RA) is characterized by immune-mediated chronic inflammation and endothelial dysfunction, ultimately resulting in clinically overt cardiovascular complications. As a prototypical disease of microvascular dysfunction, RA represents an ideal model to study microvascular alterations. The dermal capillary network offers an easily accessible window to the peripheral microcirculation, whose function can be easily assessed using Nailfold videocapillaroscopy (NVC) or laser techniques. Whereas the clinical significance of structural alterations is not always clear, functional abnormalities may provide more direct insight into the dynamic status of the microvasculature and endothelial integrity. The present narrative review aims to provide an integrative overview of available studies evaluating functional abnormalities of the dermal microcirculation in RA, with particular emphasis on the emerging role of NVC as a dynamic vascular assessment tool. Several studies in RA have assessed the structure and morphology of the peripheral microvasculature using NVC, but far fewer data exist on functional alterations assessed with this method. The study of functional alterations of the dermal microvascular network in RA has largely been based on laser techniques, which consistently point towards altered microvascular reactivity. By contrast, functional NVC-related approaches remain limited, despite their potential ability to simultaneously assess structural and dynamic capillary abnormalities in vivo. Available evidence supports that NVC may be reframed as a promising functional vascular biomarker in RA. However, the available literature is characterized by small sample sizes, predominantly cross-sectional designs, and methodological heterogeneity, highlighting the need for standardized prospective studies. Full article

(This article belongs to the Special Issue Recent Advances in Vascular Biology and Chronic Kidney Disease (CKD))

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18 pages, 971 KB

Open AccessReview

Characteristics, Epigenetics, and Management of Non-Infectious Preterm Birth—Sterile Intrauterine Inflammation and Idiopathic Preterm Birth

by Vilmos Fulop, László Kalmár, György Végh, Sándor Nagy, Borbála Szeiler and Kornél Lakatos

Life 2026, 16(6), 882; https://doi.org/10.3390/life16060882 - 25 May 2026

Abstract

Preterm birth is a major cause of neonatal morbidity and mortality, and many spontaneous cases remain idiopathic. Increasing evidence suggests that intrauterine inflammation may occur in the absence of detectable infection, leading to the recognition of sterile intrauterine inflammation as an important mechanism [...] Read more.

Preterm birth is a major cause of neonatal morbidity and mortality, and many spontaneous cases remain idiopathic. Increasing evidence suggests that intrauterine inflammation may occur in the absence of detectable infection, leading to the recognition of sterile intrauterine inflammation as an important mechanism contributing to threatened preterm labor and spontaneous preterm birth. This review summarizes current knowledge regarding the role of damage-associated molecular patterns (DAMPs), alarmins, pattern recognition receptors, inflammasome activation, cellular senescence, and pyroptosis in the initiation of sterile inflammatory pathways associated with labor. Key mediators including HMGB1, IL-1α, fetal cell-free DNA, platelet-activating factor, and S100 proteins appear to promote inflammatory activation within fetal membranes and the amniotic cavity. The review also discusses the emerging contribution of fetal immune activation, maternal–fetal immune dysregulation, maternal microchimerism, and epigenetic mechanisms to idiopathic preterm birth. Current diagnostic and therapeutic options remain limited, and no targeted treatment for sterile intrauterine inflammation has yet been established. Future approaches may include precision biomarkers, multiomics-based risk stratification, targeted immunomodulatory therapies, and modulation of maternal–fetal immune interactions. Improved understanding of sterile inflammatory mechanisms may ultimately support development of personalized strategies to prevent preterm birth and improve perinatal outcomes. Full article

(This article belongs to the Special Issue Gynecology Update: Modern Diagnostic Approaches and Innovative Therapies)

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11 pages, 581 KB

Open AccessArticle

Enhancing Hemophilia Care: Real-World Outcomes Following Switching to Extended Half-Life Factor VIII in Greece—The TOOL Study

by Helen Pergantou, Sofia Vakalopoulou, Efrosyni Nomikou, Marina Economou, Anna Kouramba, Aikaterini Michalopoulou, Athina Dettoraki, Eleni Moka, Alkistis Adramerina and Olga Katsarou

Life 2026, 16(6), 881; https://doi.org/10.3390/life16060881 - 25 May 2026

Abstract

Introduction: Extended half-life (EHL) factor VIII (FVIII) products aim to reduce treatment burden and improve bleeding control in hemophilia A. Real-world evidence remains essential to complement clinical trials. Aim: To evaluate clinical outcomes following switching from standard half-life (SHL) rFVIII to [...] Read more.

Introduction: Extended half-life (EHL) factor VIII (FVIII) products aim to reduce treatment burden and improve bleeding control in hemophilia A. Real-world evidence remains essential to complement clinical trials. Aim: To evaluate clinical outcomes following switching from standard half-life (SHL) rFVIII to efmoroctocog alfa in routine clinical practice in Greece. Methods: Multicenter observational pre–poststudy including patients with moderate to severe hemophilia A. Outcomes were assessed during the 12 months before and after switching. The primary endpoint was change in annualized bleeding rate (ABR). Secondary endpoints included annualized joint bleeding rate (AjBR), infusion frequency, joint health, pain, and FVIII consumption. Results: Sixty patients were included. Following switching, ABR decreased from 6.8 to 3.2 (53%), and AjBR from 6.4 to 2.9 (55%), p < 0.001. Reductions were more pronounced in patients switching from on-demand treatment, while more modest improvements were observed among patients already on prophylaxis. HJHS significantly decreased from 17.9 to 11.5 (p < 0.007), accompanied by a decrease in pain scores (p < 0.001), in available paired subsets. Weekly infusion frequency decreased (3.2 to 2.2; p < 0.001), while mean dose per infusion increased, resulting in no consistent reduction in total annual FVIII consumption. No inhibitor or treatment-related adverse events have been observed. Conclusions: Switching to efmoroctocog alfa in routine practice was associated with improved bleeding outcomes, reduced infusion frequency, and better joint-related parameters. These findings support the real world feasibility and clinical utility οf EHL FVIII therapy, while further controlled studies are needed to better define the independent effect of product switching from changes in treatment regimen and other potential confounders. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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18 pages, 4590 KB

Open AccessArticle

Expression of NF-κB Isoforms and IKK Complex Subunits Differs in Peripheral Blood Mononuclear Cells (PBMCs) of Patients with Meningiomas: A Pilot Study

by Ewa Kowalewska, Joanna Kamińska, Marta Żebrowska-Nawrocka, Ewa Balcerczak, Magdalena Rybaczek, Tomasz Łysoń, Marzena Tylicka, Natalia Wawrusiewicz-Kurylonek, Joanna Matowicka-Karna and Olga Martyna Koper-Lenkiewicz

Life 2026, 16(6), 880; https://doi.org/10.3390/life16060880 - 24 May 2026

Abstract

Introduction: The NF-κB signaling pathway is a key regulator of oncogenic processes; however, its systemic role in meningiomas remains poorly understood. The aim of this pilot study was to evaluate the expression of genes encoding NF-κB isoforms and IKK complex subunits in peripheral [...] Read more.

Introduction: The NF-κB signaling pathway is a key regulator of oncogenic processes; however, its systemic role in meningiomas remains poorly understood. The aim of this pilot study was to evaluate the expression of genes encoding NF-κB isoforms and IKK complex subunits in peripheral blood mononuclear cells (PBMCs) of patients with meningiomas prior to tumor resection. Methods: The study included 31 patients with meningiomas (WHO grades G1-G3) and 18 healthy volunteers. PBMCs were isolated using density gradient centrifugation, and total RNA was extracted. mRNA expression levels of NFKB1, NFKB2, RELA, RELB, c-REL, CHUK, IKBKB, and IKBKG were quantified by real-time PCR, with GAPDH used as the reference gene. Results: In patients with meningiomas, significantly lower expression of NFKB1 and higher expression of RELA, CHUK, and IKBKB were observed compared with the control group. NFKB1 expression was significantly higher in patients with higher tumor grades (WHO G2/G3) than in those with grade G1 tumors. Moreover, male patients exhibited higher expression levels of c-REL, CHUK, and IKBKB than female patients. Strong positive correlations were observed between components of the canonical NF-κB pathway. Discussion: The results may indicate systemic dysregulation of the NF-κB pathway in immune cells of patients with meningiomas, potentially characterized by activation of the canonical pathway and a shift toward p65/p65 homodimer formation. These alterations could reflect mechanisms associated with immunosuppression. NFKB1 expression may warrant further investigation as a candidate peripheral biomarker of tumor aggressiveness, while the observed sexual dimorphism in gene expression might suggest that sex could represent a relevant factor, requiring confirmation in prospective studies. Full article

(This article belongs to the Special Issue Common and Novel Markers of Inflammation and Tissue Damage in Various Pathological Conditions—2nd Edition)

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13 pages, 4849 KB

Open AccessCase Report

Acute Myocardial Infarction Complicated by Papillary Muscle Rupture and Cardiogenic Shock Requiring ECMO Support in a Patient with Bipolar Disorder and Chronic Cannabis Use

by Oana Elena Branea, Mihaly Veres, Oana Frandeș, Matild Keresztes, Mihai Claudiu Pui, Ciprian Fișcă, Radu Bălău and Leonard Azamfirei

Life 2026, 16(6), 879; https://doi.org/10.3390/life16060879 - 24 May 2026

Abstract

Cardiogenic shock secondary to acute myocardial infarction complicated by mechanical failure remains associated with high mortality despite advances in cardiac surgery and mechanical circulatory support. We report the case of a 42-year-old patient with posterior papillary muscle rupture leading to severe mitral regurgitation, [...] Read more.

Cardiogenic shock secondary to acute myocardial infarction complicated by mechanical failure remains associated with high mortality despite advances in cardiac surgery and mechanical circulatory support. We report the case of a 42-year-old patient with posterior papillary muscle rupture leading to severe mitral regurgitation, managed with emergency surgical intervention and extracorporeal membrane oxygenation. The patient, with a history of Type I Bipolar Disorder under long-term lithium therapy and chronic Cannabis use, presented in critical condition with cardiogenic shock (Killip IV), acute pulmonary edema, and ST-segment elevation myocardial infarction in the infero-posterior territory. Coronary angiography revealed right coronary artery occlusion and involvement of an obtuse marginal branch. Emergency mitral valve replacement with a mechanical prosthesis and aortocoronary bypass were performed. Due to failure to wean from cardiopulmonary bypass, central veno-arterial ECMO was initiated. The postoperative course was complicated by hemodynamic instability and recurrent pericardial collections requiring repeated surgical interventions and conversion to peripheral ECMO. Multiorgan dysfunction developed, including hepato-renal failure requiring hemofiltration, neurological injury, respiratory impairment, and neuropsychiatric complications. Despite these challenges, progressive recovery was achieved under intensive multidisciplinary management. This case emphasizes the importance of early surgical correction and tailored ECMO support in managing post-infarction mechanical complications. Full article

(This article belongs to the Special Issue Critical Issues in Intensive Care Medicine—2nd Edition)

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20 pages, 2473 KB

Open AccessArticle

Pilot Study on the Effects of First-Line Antituberculosis Drugs and Their Combinations on Selected Reproductive Endpoints in Female Rats

by Elif Esra Uyar, Bulent Yavuzer, Mansura Babayeva, Nurinisa Yucel, Murat Gunay and Halis Suleyman

Life 2026, 16(6), 878; https://doi.org/10.3390/life16060878 - 24 May 2026

Abstract

Background: The reproductive toxicity of first-line antituberculosis drugs remains poorly understood, particularly when used in combination. Rifampicin, isoniazid, pyrazinamide, and ethambutol are essential in tuberculosis therapy, but their potential influence on female fertility is uncertain. This pilot study evaluated their effects, given alone [...] Read more.

Background: The reproductive toxicity of first-line antituberculosis drugs remains poorly understood, particularly when used in combination. Rifampicin, isoniazid, pyrazinamide, and ethambutol are essential in tuberculosis therapy, but their potential influence on female fertility is uncertain. This pilot study evaluated their effects, given alone or in dual, triple, and quadruple combinations, on oxidative stress, endocrine markers, and reproductive outcomes in healthy female rats. Materials and Methods: Ninety-six albino Wistar-type female rats were divided into sixteen groups of six animals each and treated with single, dual, triple, or quadruple regimens of first-line antituberculosis drugs for 28 days. After treatment, two sexually mature males were introduced per group, and therapy continued for seven additional days. Serum malondialdehyde (MDA), total glutathione (tGSH), prolactin, and anti-Mullerian hormone (AMH) levels were measured, and fertility outcomes were evaluated. Results: In single-drug groups, MDA increased and tGSH decreased, but detectable infertility was not recorded. Prolactin remained stable except in the pyrazinamide group, where it declined. Dual-drug regimens increased oxidative imbalance; fertility failure occurred only in pyrazinamide-lacking groups and was accompanied by higher prolactin and lower AMH. Triple and quadruple combinations produced prominent oxidative imbalance. In triple-drug regimens, infertility was lower in pyrazinamide-containing groups than in the pyrazinamide-free group, but this pattern was not maintained in the quadruple regimen. Fertility impairment was not consistently aligned with the degree of oxidative stress and may involve prolactin and AMH alterations. Conclusions: These findings suggest that reproductive impairment under these experimental conditions may involve endocrine alterations and cannot be explained solely by serum oxidative imbalance. Pyrazinamide-associated fertility preservation appeared context-dependent and requires further confirmation in larger mechanistic studies with broader reproductive and endocrine assessment. Full article

(This article belongs to the Special Issue Obstetrics and Gynecology Medicine: From Bench to Bedside—3rd Edition)

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19 pages, 907 KB

Open AccessArticle

Epidemiological Analysis of Rabies Outbreaks in the European Union and Türkiye (2013–2023)

by Ralitsa Rankova, Dilek Muz, Koycho Koev and Gergana Balieva

Life 2026, 16(6), 877; https://doi.org/10.3390/life16060877 - 24 May 2026

Abstract

Rabies is a fatal zoonotic viral disease that continues to pose a significant threat to both animal and public health worldwide. Despite considerable progress in its control across Europe, sporadic outbreaks still occur, particularly in regions where wildlife reservoirs and stray animal populations [...] Read more.

Rabies is a fatal zoonotic viral disease that continues to pose a significant threat to both animal and public health worldwide. Despite considerable progress in its control across Europe, sporadic outbreaks still occur, particularly in regions where wildlife reservoirs and stray animal populations sustain virus circulation. This study provides one of the first comparative longitudinal analyses integrating European countries and Turkiye rabies surveillance data over a decade (2013–2023). Information on reported outbreaks was obtained from the Animal Disease Information System (ADIS) and the World Animal Health Information System (WAHIS) database. The analysis focused on temporal trends, regional differences, and the distribution of affected animal species. During the study period, a total of 4865 outbreaks were reported in 16 countries. The number of detected outbreaks declined considerably over time, decreasing from 1022 cases in 2013 to 325 cases in 2023, representing an overall reduction of approximately 68%. The temporal trend was not uniform, with periods of decline followed by temporary increases. The highest number of outbreaks was registered in Türkiye, followed by Romania and Poland, indicating pronounced regional disparities. Domestic dogs represented the most frequently affected species, while cases were also recorded in wildlife and domestic cats, confirming the epidemiological importance of both domestic and wild reservoirs. The observed reduction in the number of outbreaks reflects the impact of vaccination programs and coordinated control measures, but may also be influenced by differences in surveillance systems and reporting practices. Nevertheless, the persistence of rabies in several regions indicates that the disease remains an epidemiological concern. Sustained vaccination of domestic animals, continued wildlife immunization, and strengthened surveillance and cross-border cooperation are essential for long-term control and prevention. Full article

(This article belongs to the Special Issue Molecular Epidemiology of Animal Viral Diseases)

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