Search Results (55,462)

Background: While mobile health (mHealth) interventions show promise for type 2 diabetes management, mechanisms linking user experience to clinical outcomes remain poorly understood. We hypothesized that perceived usability may mediate associations between patient characteristics and short-term clinical changes, with implications for health equity in digital interventions. Methods: Secondary analysis of the intervention arm from a randomized controlled trial in urban Mexican primary care (ClinicalTrials.gov NCT05924516). Participants used a diabetes self-management mobile application for 90 days. We assessed usability with the validated Computer System Usability Questionnaire (CSUQ; 16 items, 7-point scale) and measured clinical changes in body mass index (BMI), systolic blood pressure (SBP), and HbA1c. Bayesian mediation analysis (literature-informed priors) examined interface quality as a mediator of age-related clinical effects. Item-level analysis identified educational disparities in specific usability dimensions using independent t-tests adjusted for multiple comparisons. Results: Mean overall usability was 5.20/7 (SD = 0.89, 74th percentile). Interface quality mediated 39% of the age–SBP association. Participants experiencing high usability (≥6) versus low usability showed BMI reduction −0.78 vs. −0.21 kg/m² (Cohen’s d = 0.56) and SBP reduction −7.3 vs. −1.2 mmHg (Cohen’s d = 0.51). No mediation effect was observed for HbA1c change. Users with ≤primary education (41% of sample) scored 1.9 points lower on error messages (3.2 vs. 5.1, p < 0.01) and 1.4 points lower on help documentation (3.6 vs. 5.0, p < 0.03). These disparities persisted after controlling for age and baseline severity. Conclusions: Perceived usability was associated with a potential mechanistic pathway linking user experience to clinical outcomes. Higher usability scores were associated with clinically meaningful improvements in cardiometabolic parameters. Educational disparities in understanding error messages and helping documentation represent modifiable design barriers. Implementing contextual error explanations with visual examples and plain-language help content may enhance both clinical effectiveness and equity in digital diabetes interventions. Full article

A novel sensitive and selective electrochemiluminescence (ECL) sensor using nitrogen-doped graphyne as the platform was proposed for kanamycin (KAN) detection. First, nitrogen-doped graphyne nanomaterial (1N-GY) with high conductivity was synthesized using a high-energy ball milling method. Compared with ordinary graphyne, the addition of nitrogen atoms can improve the conductivity of the material and reduce the electronic migration energy barrier. Then it was used as a substrate material of the ECL sensor, not only increasing the conductivity of the biosensor but also improving the sensitivity of the ECL sensor by providing more immobilization space for the luminescent probe of Nafion-coated mesoporous silica adsorbed Ru(bpy)₃²⁺ (mSiO₂@Nafion@Ru(bpy)₃²⁺). On this basis, mSiO₂@Nafion@Ru(bpy)₃²⁺ functionalized DNA probes were used as luminescent and capture probes to specifically recognize different concentrations of KAN to produce ECL signals. Under optimal conditions, the proposed ECL sensor exhibited good linearity (10⁻¹²–10⁻⁶ M KAN) and a low detection limit of 1.08 pM. The prepared biosensor with good stability and selectivity successfully detected KAN in honey and milk samples, with spiked recovery rates ranging from 98% to 111.79%. This method not only expands the application of 1N-GY as a novel graphitic material in ECL biosensors but also provides an effective way to check antibiotics in dairy products. Full article

The opportunistic pathogen Pseudomonas aeruginosa poses a serious threat to immunocompromised patients. Monosodium glutamate (MSG), a widely used flavor enhancer, has been reported to possess anti-inflammatory and antioxidant properties. However, its therapeutic potential and mechanism against Pseudomonas aeruginosa (P. aeruginosa) infection have remained unexplored. This study systematically elucidated the protective effects and molecular mechanisms of MSG against P. aeruginosa-induced acute lung injury (ALI). In a murine pneumonia model, MSG administration effectively alleviated lung pathological damage, edema, and inflammatory responses. Mechanistically, MSG exerted protection through a multifaceted strategy, including direct suppression of bacterial virulence via binding to PopB of T3SS inhibition of the TLR4/MyD88/MAPK-driven inflammatory cascade and pro-inflammatory cytokine production, enhancement of endogenous antioxidant defense (SOD, CAT), and reshaping of pulmonary macrophages from the M1 to M2 phenotype. Notably, the anti-virulence effect of MSG, achieved by binding to PopB (K_D = 3.52 × 10⁻⁶ M), presented a distinct advantage over traditional antimicrobials by potentially mitigating resistance development. Collectively, these findings indicated that MSG can alleviate ALI caused by P. aeruginosa infection. Full article

Background/Objectives: There is a clear need for more options to control the progression of breast cancer and prevent the occurrence of breast cancer in minority populations that have a higher rate of mortality due to triple-negative breast cancer (TNBC) subtypes. Prevalent nutraceuticals such as Ashwagandha (also known as the Indian Winter Cherry) have anti-inflammatory and apoptotic capabilities, as well as the ability to inhibit cancer growth. The purpose of this study is to analyze the novel combination of withaferin A (derived from the Indian Winter Cherry and known to have histone deacetylase inhibition capabilities) and sodium butyrate (a short-chain fatty acid produced from the gut microbiome and known to have DNA methyltransferase inhibition capabilities) treatment on breast cancer-derived cell lines. There is a scientific gap of possible causality of decreasing breast cancer progression when treated with sodium butyrate and withaferin A. Methods: Two in vitro cell viability assays were utilized consisting of [MTT (4,5 Dimethylthiazol-2-yl)] and the neutral red assay to analyze the impact of treatment of compounds alone and in combination on breast cancer cells for 72 h. The Highest Single Agent (HSA) combination analysis was utilized to derive combination indexes for our breast cancer cell types. Protein and gene expression was investigated for Class 1 histone deacetylases, de novo DNA methyltransferase, the p65 subunit of NF-κB, and NFκB1. Lastly, DNA methyltransferase enzymatic activity was analyzed via the Epigentek DNMT Activity/Inhibition ELISA Easy Kit. Results: Through the cell viability assay [MTT (4,5 Dimethylthiazol-2-yl)], MCF−7, MDA−MB−231, and MDA−MB−157 cells were found to have a decrease in cell viability due to combinatorial treatment with withaferin A and sodium butyrate. Western blot results depicted a decrease in protein expression levels for DNA methyltransferases due to the administration of 2.5 mM sodium butyrate and 0.2 µM withaferin A alone and in combination for breast cancer cell lines MCF−7, MDA-MB-231, and MDA−MB−157. Additionally, the combination of these two components have successfully inhibited the progression of the NFκB1 gene within analysis through the quantitative polymerase chain reaction (qPCR). Conclusions: The novel combination of withaferin A and sodium butyrate have markedly reduced the progression of breast cancer-derived cell lines for cell viability, epigenetic DNMT gene expression, as well as inhibiting NFκB1 signaling on the gene expression level. Full article

Background: Immediate prepectoral implant-based breast reconstruction (IBR) following skin-reducing mastectomy (SRM) preserves the pectoralis major muscle, improving recovery and aesthetics. A dual-layer technique combining porcine-derived acellular dermal matrix (ADM) with an inferior autologous dermal sling may enhance implant support, vascularization, and lower-pole stability, particularly in patients with macromastia or ptosis. Methods: This retrospective single-center study included 20 patients (24 breasts) who underwent SRM with immediate prepectoral IBR using the dual-layer technique between January 2023 and May 2025. Demographic, oncologic, and perioperative data were collected prospectively. Complications were classified by severity, and patient-reported outcomes were evaluated using the BREAST-Q scale preoperatively and at 1, 3, 6, and 12 months postoperatively. Statistical analysis included paired t-tests, Shapiro–Wilk tests, and effect size estimation (Cohen’s dz). Results: Mean age was 42 ± 6.3 years and BMI 26.1 ± 3.2 kg/m². Mean mastectomy specimen weight was 432.5 ± 120.8 g, and implant volume 375 ± 60 cc. No reconstruction failures or infections occurred. Early complications were reported in 20.8% of breasts, including superficial nipple–areola complex epidermolysis (8.3%), seroma (4.2%), and hematoma (4.2%), all managed conservatively. At 12 months, BREAST-Q scores improved significantly: satisfaction with breasts increased from 63 ± 8 to 89 ± 11 (p < 0.001); psychosocial well-being from 60 ± 10 to 81 ± 11 (p < 0.001); and physical well-being from 62 ± 7 to 82 ± 10 (p < 0.001). Conclusions: Dual-layer prepectoral reconstruction using porcine ADM and autologous dermal sling is safe, provides durable implant stability, and significantly improves patient satisfaction and quality of life following SRM. Full article

Acidithiobacillus caldus is perpetually exposed to multiple extreme environmental stresses. CsrA, functioning as a post-transcriptional regulator of physiological metabolism, acts as a differential modulator, facilitating more economical and efficient adaptation to extreme environments. The csrA expression recombinant strain was constructed in A. caldus MTH-04 by conjugative transfer technology pJD215. Physiological characterization revealed enhanced acid tolerance, significantly elongated flagella, elevated extracellular secretion, and altered biofilm composition. Notably, intracellular concentrations of free glutamate and aspartate increased to 24.18 mg/L and 16.07 mg/L, respectively. The secondary structure of CsrA protein was determined in vitro through circular dichroism spectroscopy and size-exclusion chromatography. Electrophoretic Mobility Shift Assay (EMSA) successfully demonstrated in vitro binding activity of CsrA to the rpoS leader mRNA. CsrA suppresses rpoS mRNA translation by competing with ribosomes for binding sites, thereby negatively regulating rpoS expression. Critical binding sites were further validated through site-directed mutagenesis. Through EMSA, RT-qPCR and the translation reporter system, it was also found that CsrA has a dual regulatory function for nearby flagella- and motility-related gene clusters (flgC, 07035, motD, 15040), which also implies the global regulatory role of CsrA. In summary, a potential overall post-transcriptional regulatory mechanism based on CsrA and rpoS by extremophile A. caldus was proposed. Finally, the efficiency of bioleaching application by csrA overexpression strain was improved by 20.81%. Full article

Eutrophication is a pervasive issue in Mediterranean reservoirs, where external nutrient inputs and internal sediment releases interact to impair water quality and ecological stability. This study assessed the trophic condition of the artificial lake Cuga in Sardinia (Italy), mainly used for irrigation and providing potable water, by integrating watershed nutrient load estimates, inter-lake transfers, and internal phosphorus release. Field campaigns between July 2022 and May 2023 provided bi-monthly measurements of physical, chemical, and biological parameters, complemented by GIS-based land cover analysis and export coefficient modeling to quantify spatial nutrient sources. Additional phosphorus inputs from water transfers with a nearby reservoir were calculated, while internal sediment release was estimated using a calibrated mass balance model. Results revealed high nutrient concentrations, with mean total phosphorus of 128 mg P m⁻³, chlorophyll a averaging 9.9 mg m⁻³, and Secchi depth below 1 m, classifying the reservoir as eutrophic to hypertrophic under OECD and Carlson indices. Spatial loads were dominated by agricultural areas, while inter-lake transfers and internal sediment release contributed substantially to the overall phosphorus budget. The predictive Vollenweider model closely matched the observed conditions, confirming the robustness of the combined approach. Maintaining good ecological status in Mediterranean reservoirs is essential for safeguarding human well-being, as eutrophication degrades drinking-water quality, increases treatment costs, and can promote toxin-producing algal blooms with direct implications for public health. These findings highlight the need for integrated management strategies addressing both external and internal nutrient sources to mitigate eutrophication in Mediterranean reservoirs, which affects the ecosystem functioning and the related human needs and well-being. Full article

Background/Objectives: Over the last two decades, there has been a substantial change in the understanding of post-traumatic hypopituitarism (PTHP), which is no longer regarded as a marginal phenomenon. Clinical manifestations of pituitary hormone deficiency are frequently nonspecific, with fatigue and cognitive dysfunction predominating. Given that head injuries currently constitute a global burden for healthcare systems, the aim of the present study was to determine whether self-reported post-mild traumatic brain injury (mTBI) symptoms that may indicate hypopituitarism reflect true pituitary insufficiency or are attributable to other hormonal aberrations. The study aimed to assess the relationship between self-reported symptoms of PTHP and hormonal test results following mTBI. Setting: Patients were recruited from a tertiary trauma center Emergency Department (ED) in northern Poland from January 2023 to October 2025. Participants: The participants were adult (18 > y.o.) individuals with mTBI who met the inclusion criteria. Design: This was a prospective cohort study. During their post-head injury admission to the ED, patients had a blood sample taken. The procedure was repeated consecutively after 3, 6 and 12 months. After 6 and 12 months, patients were asked to complete a questionnaire. Methods: Pituitary and thyroid hormones were measured using the chemiluminescence immunoassay method and the heterogenous immunochemiluminescence method. The questionnaire used, Questionnaire for the Assessment of Symptoms of Anterior Pituitary Insufficiency in Patients After Mild Traumatic Brain Injury (mTBI) Hospitalized in the Emergency Department, was designed for the purposes of this study. Results: Self-reported symptoms suggestive of anterior pituitary dysfunction following mTBI were not confirmed by laboratory assessment of pituitary hormones. However, after 6 months, a statistically significant correlation was found between the number of reported symptoms and prolactin levels (ρ = 0.730; p = 0.0013), whereas after 12 months a downward trend in free triiodothyronine (fT3) levels was observed compared with the baseline. Conclusions: Persistent symptoms reported by patients following mTBI at 6 and 12 months, particularly fatigue and impaired concentration, showed statistical associations with prolactin levels at 6 months and lower fT3 levels at 12 months. These findings reflect correlations identified in the statistical analysis and do not support inferences regarding causality or the presence of true PTHP. Full article

We report on the isolation and comprehensive genomic and biochemical characterization of Aspergillus fumigatus VP2T, a thermophilic filamentous fungus recovered from Himalayan Forest soil with exceptional lignocellulolytic capacity. Whole-genome sequencing revealed a 32.1 Mb genome encoding 12,675 predicted genes, including an extensive repertoire of >300 carbohydrate-active enzymes (CAZymes). Notably, the genome harbors multiple auxiliary activity enzymes, including AA9-family lytic polysaccharide monooxygenases and several cellobiose dehydrogenases (CDHs), supporting oxidative–hydrolytic synergism during biomass degradation. Submerged fermentation using a cellulose–wheat bran–rice straw substrate induced high enzyme titers, including 33 U/mL endoglucanase and 131 U/mL CDH, exceeding activities commonly reported for both native and engineered fungal strains. Although exoglucanase (0.02 U/mL) and xylanase (14.22 U/mL) activities were comparatively modest, the strain VP2T demonstrated superior hydrolysis of untreated rice straw, achieving a 1.89-fold increase in saccharification efficiency relative to the commercial enzyme cocktail Cellic^® CTec2. Scanning electron microscopy confirmed extensive disruption of lignocellulosic architecture, consistent with enhanced enzyme accessibility and oxidative fiber loosening. Collectively, genomic evidence and functional assays identify A. fumigatus VP2T as a redox-optimized, moderately thermophilic biocatalyst suited for low-pH lignocellulose conversion. This study highlights the value of exploring thermophilic fungal biodiversity to discover native strains with inherent oxidative capacity, offering promising alternatives to pretreatment-intensive biorefinery processes and informing the rational development of tailored enzyme systems. Full article

Cyantraniliprole, a second-generation diamide insecticide, exhibits broad-spectrum efficacy against numerous insect pests due to its selective activation of insect ryanodine receptors (RyRs). This activation triggers uncontrolled calcium release from the sarcoplasmic reticulum, resulting in sustained muscle contraction, paralysis, and ultimately death. Its unique mode of action, which is different from that of organophosphates, carbamates, pyrethroids, and neonicotinoids, helps minimize cross-resistance, making it a valuable component of integrated pest management (IPM). However, continuous field use has led to the development of resistance, primarily mediated by target-site mutations within the RyR transmembrane domain (e.g., G4946E, I4743M, and I4790K) and by enhanced metabolic detoxification via cytochrome P450 monooxygenases, carboxylesterases, and glutathione S-transferases. These mechanisms often confer cross-resistance to other diamide insecticides, thereby complicating resistance management. Moreover, sublethal exposures can disrupt insect growth, development, and reproduction, potentially accelerating resistance evolution. In addition, cyantraniliprole poses ecological risks due to its toxicity to non-target organisms such as aquatic species, including zebrafish and water fleas, pollinators such as honeybees, and soil fauna, as well as the environmental persistence of its major metabolite, J9Z38. This review comprehensively integrated current knowledge on the molecular mechanisms of action, genetic and metabolic bases of resistance, sublethal effects, and ecotoxicological impacts of cyantraniliprole, along with its environmental fate, plant uptake and translocation, and residue dynamics in agricultural systems. Finally, we discuss potential risk-mitigation strategies, including formulation optimization, application-method improvements, and resistance monitoring. Overall, this review aims to provide a comprehensive scientific foundation for the sustainable use, resistance management, and regulatory assessment of this widely used insecticide. Full article

Background: Outcomes with enzalutamide in metastatic castration-resistant prostate cancer (mCRPC) are influenced by tumor burden, disease kinetics, and host factors. We evaluated the relative prognostic impact of metastatic pattern, laboratory markers, and prostate-specific antigen (PSA) dynamics in a real-world cohort. Methods: We retrospectively analyzed 72 patients with mCRPC treated with enzalutamide. Progression-Free Survival (PFS) and Overall Survival (OS) were estimated using the Kaplan–Meier method. Multivariate Cox proportional hazards models were utilized to identify independent predictors of survival, incorporating clinical variables (visceral metastases, bone tumor burden), kinetic parameters (Time to Castration Resistance [TTCR], Time to PSA Nadir [TTN]), and host factors (Charlson Comorbidity Index [CCI], Eastern Cooperative Oncology Group Performance Status (ECOG PS), Systemic Immune-Inflammation Index [SII], HALP score). Results: Visceral metastasis was a dominant predictor of poor outcomes, increasing the risk of death by 4.0-fold (HR: 4.05; 95% CI: 1.84–8.89; p < 0.001). A high skeletal tumor burden (≥5 bone lesions) was identified as a critical threshold, associated with a 5.5-fold increase in mortality risk (HR: 5.53; p < 0.001). Delays in initiating enzalutamide significantly compromised survival, with each 1-month delay increasing the risk of death by 7.3% (HR: 1.07; p = 0.003). While early PSA decline (≥50% at 3 months) did not independently predict OS, a prolonged TTN (>12 months) was associated with superior survival. Notably, host-related factors, including age, CCI, and ECOG PS, were not found to be significantly associated with survival outcomes in this specific dataset. Conclusions: Our preliminary findings suggest that survival in real-world mCRPC patients treated with enzalutamide may be influenced predominantly by intrinsic tumor biology—specifically anatomical extent and resistance kinetics—rather than host frailty or comorbidity burden. However, given the retrospective and single-center nature of this study, these findings should be considered hypothesis-generating and require validation in larger, multi-center cohorts. Host-related variables (including age and CCI) were evaluated but were not retained as independent predictors in the final multivariable model. Early initiation of therapy and monitoring of kinetic markers like TTN and TTCR offer superior prognostic stratification compared to static baseline characteristics. Full article

The sustainability of livestock farming is becoming a key consideration in the European pork industry, particularly regarding the balance between intensive and extensive farming practices. This study focuses on the Iberian pig breed, assessing the pure breed and the Iberian × Duroc crossbreed and three production systems: intensive indoor fattening, outdoor intensive fattening, and free-range fattening, with an emphasis on their impact on both sustainability and pork quality. The quick-scan sustainability assessment tool developed within the H2020 project mEATquality was used to evaluate the environmental, social, and economic performance of each system. The results revealed that the free-range system performed best in environmental and economic sustainability, while the intensive indoor system showed higher economic stability. Significant differences in meat quality were observed based on the production system, including pH, fat and protein content, colour, texture, and fatty acid profiles. Notably, the free-range system produced pork with higher levels of MUFA and omega-3 fatty acids while intensive indoor showed a more favourable texture, while the intensive systems were associated with paler meat and higher SFA content. Indeed, the results highlighted a significant interaction between the production system × breed, indicating that the 100% Iberian is better adapted to the extensive systems. This study highlights the importance of integrating sustainability assessments with meat quality parameters to identify production methods that are both environmentally responsible and capable of meeting the consumer demand for high-quality pork. Full article

Maritime UAV perception must reliably detect and track tiny vessels under harsh specular glare. In practice, detection failures are dominated by two coupled factors: (i) vessels often occupy only a few pixels, causing small-object recall collapse and (ii) sun glint and sea-surface reflections generate over-exposed regions that trigger false positives and unstable associations. This paper presents Resi-YOLO, a system-level pipeline that improves tiny-vessel sensitivity while preserving embedded throughput on a Jetson Orin Nano. At the model level, Resi-YOLO combines a P2-enhanced feature path with CBAM-based glare suppression to strengthen high-resolution semantics and suppress glare-induced artifacts; optional SAHI-style slicing is supported for ultra-high-resolution scenes. At the system level, we adopt a heterogeneous dual-brain deployment, where the Orin Nano performs primary inference and an MCU-based safety-island tracker mitigates delay/jitter via time-stamped measurement replay and IMM-UKF updates. We further define a Glare Severity Score (GSS) to stratify robustness by illumination intensity. Experiments show that Resi-YOLO improves AP_small by 13.1 percentage points over YOLOv8n (18.4% to 31.5%), raises high-glare mAP@0.5 from 41.2% to 53.7%, and runs at 12.8 FPS end-to-end (~100 ms latency) on Jetson Orin Nano, while TensorRT inference-only throughput exceeds 30 FPS. Full article

Legumes (Fabaceae) are key functional components of tropical forests due to their role in nitrogen fixation and nutrient cycling. This study provides an integrated assessment of forest legume diversity and its relationship with soil physicochemical properties across three protected areas in the Peruvian upper Amazon: the Alto Mayo Protected Forest (BPAM), the Cordillera Escalera Regional Conservation Area (ACR-CE), and the Shunté and Mishollo Forests Regional Conservation Area (ACR-BOSHUMI). Floristic studies were conducted in nine sectors ranging from 618 to 1729 m a.s.l. Soil samples were analyzed, and vegetation cover was quantified using high-resolution drone imagery with four vegetation indices derived from RGB data. We recorded eleven legume species from eight genera within the sampling plots, identifying Inga as the most frequent genus. Species diversity was highest in the ACR-CE, whereas BPAM showed lower richness and abundance. Multivariate analyses revealed that legume diversity was positively associated with higher soil pH, cation concentrations, and cation exchange capacity, but negatively associated with elevated Al³⁺ and Fe³⁺ levels. Vegetation indices effectively distinguished between vegetated and degraded areas, indicating higher legume occurrence in sites with greater canopy cover. These findings emphasize that soil fertility and vegetation structure are key drivers of legume diversity, with significant implications for conservation in the upper Amazon. Full article

Background/Objectives: This retrospective exploratory study aimed to characterize sex-specific patterns of coronary artery disease (CAD) and valvular heart disease (VHD) in a cardiac surgical cohort. In clinical routine, men appear to be more commonly affected by obstructive CAD, whereas women more frequently present valvular heart disease requiring surgical intervention. It remains unclear whether these sex-specific patterns are related to ABO blood groups and selected clinical parameters. Methods: Here, we retrospectively analyzed 983 patients admitted between 2020 and 2024 to a single cardiac centre with CAD and/or VHD requiring valve replacement. Patients were stratified by sex and disease entity (CAD only, CAD + VHD, isolated VHD). ABO and Rhesus factor distributions, cardiovascular risk factors, body mass index (BMI), and renal function (estimated glomerular filtration rate, eGFR) were assessed. Group comparisons were performed using Chi-square and Welch’s t-tests. Associations were evaluated using multivariable logistic and linear regression models adjusted for age, BMI, diabetes mellitus, hypertension, smoking, and eGFR. Results: Men were predominantly represented in the CAD-only group, whereas women more frequently underwent valve replacement, either isolated or combined with CAD (p < 0.001). When comparing the overall study cohort, blood group O was less prevalent in women than in men (p = 0.031), whereas blood group A was more frequent among female patients, although this difference did not reach statistical significance. Moreover, patients with valve disease demonstrated lower eGFR compared with those without valve involvement (men: −6.3 mL/min/1.73 m², p = 0.0036; women: −10.4 mL/min/1.73 m², p = 0.0019). This effect remained independently associated with reduced eGFR, with women slightly more affected. Conclusions: Gender- specific diseases should be included as secondary diagnoses when considering cardiac surgery. Nephrological complications in the postoperative period can be an important factor in assessing the benefits of surgery. Blood group O was more common in male Patients, suggesting that cardiovascular diseases also exhibit blood group dependence. Full article