Search Results (610)

Background/Objectives: Cardiovascular–kidney–metabolic (CKM) syndrome, characterized by disturbances in glucose and lipid metabolism as its core pathophysiological feature, is a major driver of target organ damage. While early risk stratification in CKM stages 0–3 is critical to intercept renal decline, the practical utility of accessible metabolic surrogates remains poorly characterized. This study evaluated and compared the prospective capacity of the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, and C-reactive protein–triglyceride glucose index (CTI) for predicting renal deterioration in early-stage CKM. Methods: Data were extracted from the China Health and Retirement Longitudinal Study (2011–2015). In total, 4064 participants aged ≥ 45 with CKM stages 0–3 (with exclusion of participants with baseline CKM stage 4) were prospectively followed. Renal function decline was defined as an estimated glomerular filtration rate (eGFR) decrease of ≥30% over 4 years, calculated using the CKD-EPI 2012 cystatin C equation. Multivariable logistic regression, restricted cubic splines (RCSs), and receiver operating characteristic (ROC) curves were applied. Results: Overall, 122 participants developed the renal outcome. In fully adjusted models, AIP, TyG, and CTI were valid independent risk factors for renal decline, with the lipid-driven AIP exhibiting the strongest association (OR = 5.54, 95% CI: 3.30–9.29; TyG: OR = 1.97, 95% CI: 1.49–2.59; CTI: OR = 1.63, 95% CI: 1.30–2.05; all p < 0.001). RCS analysis demonstrated significant non-linear dose–response trajectories, with renal risk escalating sharply past specific exploratory inflection points (AIP = 0.97, TyG = 7.80, CTI = 8.07). ROC curves confirmed robust predictive performance (AUCs > 0.75), with AIP performing optimally (AUC = 0.773). Conclusions: AIP, TyG, and CTI are independent longitudinal predictors of renal decline in early-stage CKM, with AIP demonstrating superior discriminatory power. Monitoring these composite indices and maintaining them within observed metabolic ranges may aid in early renal risk stratification and monitoring, though the exploratory statistical inflection points identified require validation in independent cohorts before clinical application. Full article

Bacteria in the human intestinal tract express more than 46 million genes, suggesting that interbacterial communication and communication with human cells are well-controlled and synchronized. Many papers have been published on quorum sensing (QS) and other forms of bacterial communication, e.g., nanotubes, nanovibrations, and electromagnetism. Autoinducers (AIs) such as AI-1 N-acyl homoserine lactones (AHLs), AI-2 boron-containing furanosyl borate diesters, AI-3 pyrazinone derivatives, a combination of AI-3/Epi (epinephrine)/NE (norepinephrine), auto-inducer peptides (AIPs), and SdiA (suppressor of division inhibition), along with their receptors, have been well-studied. However, little is known about the roles of quantum mechanics, quantum tunneling, and quantum entanglement in bacterial communication. Most proposals are hypothetical and remain conceptual frameworks supported by indirect evidence rather than validated experiments. The wave-like behavior of ions (quantum tunneling) may facilitate crossing potential energy barriers, such as cell membranes, in concert with protein channels. If this is indeed the case, ions in a quantum-tunneling state would, hypothetically, be able to pass through any part of the cell membrane and cell wall. This would, in theory, enhance biochemical reactions, interbacterial communication, and interactions with human cells. The long-range signaling ability of quanta could allow bacterial cells to maintain contact over long distances, modify their metabolic activities, and activate DNA repair systems. The wave-like behavior of subatomic particles and molecules may cause nanovibrations and generate electromagnetic fields. We argue that electrical signals generated within a biofilm by quanta may attract distant cells and enable cross-species communication. We propose a hypothetical “two-pillar” bacterial communication system, i.e., QS and quantum mechanics/tunneling/entanglement (QMTE), and discuss the advantages of combining both. Full article

Background and Objectives: Chronotype and sleep quality are related but non-identical dimensions of sleep health. We examined whether later chronotype is associated with subclinical visceral adiposity and atherogenic dyslipidaemia independently of perceived sleep quality, and whether this association differs by sex, in adults without previously diagnosed chronic disease. Materials and Methods: This single-centre cross-sectional study included 282 adults without previously diagnosed chronic disease or regular medication use. Chronotype was assessed with the Morningness–Eveningness Questionnaire (MEQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Composite cardiometabolic indices were calculated from routine anthropometric and biochemical data. Primary dependent variables were log-transformed Visceral Adiposity Index (log[VAI]) and Atherogenic Index of Plasma (AIP). Multivariable linear models used heteroscedasticity-consistent type 3 (HC3) robust standard errors and adjusted for age, sex, education, physical activity, and PSQI; body mass index (BMI) was additionally included in the AIP model. Sex × MEQ interactions, false-discovery-rate (FDR) correction, and glycaemic sensitivity analyses were performed. Results: Median age was 28.0 years; 50.4% were women, 25.9% were evening type, and 51.8% had poor sleep quality. Higher MEQ score (greater morningness) was independently associated with lower log(VAI) (B = −0.0096; 95% confidence interval (CI), −0.0159 to −0.0033; β = −0.190; p = 0.003) and AIP (B = −0.0035; 95% CI, −0.0063 to −0.0008; β = −0.160; p = 0.011), whereas PSQI was not independently associated with either outcome. Sex × MEQ interactions were nominally significant and estimates were stronger in women, but interaction terms did not survive FDR correction. Associations persisted after excluding diabetes-range glycaemia but attenuated in strictly normoglycaemic participants. Conclusions: Later chronotype was associated with a less favourable subclinical adiposity–atherogenic profile independently of perceived sleep quality. Findings are cross-sectional, and the sex-specific pattern is hypothesis-generating. Prospective studies with objective circadian, sleep, dietary-timing, behavioural, and hormonal measures are required. Full article

Environmental enrichment is widely recognized as an important strategy for improving the welfare of laboratory rodents by promoting species-specific behaviors, reducing stress, and enhancing physiological adaptation. In the present study, animals were maintained either under standard housing conditions without enrichment or exposed to different combinations of commercially available maple cardboard, cardboard rolls, and Kraft paper. Welfare was assessed using a multidimensional approach that included anxiety-related behavioral tests, hematological and biochemical analyses, and growth performance measurements. The results demonstrate that the welfare benefits of environmental enrichment are influenced by the type and combination of materials provided, highlighting the importance of selecting enrichment strategies that are appropriate for the specific housing conditions. Full article

The dynamics and transient response of fuel cell systems are critical aspects, especially in commercial applications where an immediate response to fluctuating power demands is required. This study presents experimental results obtained from evaluating the dynamic behavior of a 1.2 kW Ballard Nexa fuel cell, subjected to various operational disturbances, including startups, shutdowns, step load increases, irregular and constant loading, and system purging operations. The variables analyzed include voltage, current, and temperature, both in individual cells and in the entire system. The results indicate that the temperature exhibits an attenuated response with an arc-like evolution, but with an upward trend correlated with the increase in the demanded current. Meanwhile, when multiple load steps are applied, the system exhibits rapid responses in both cell and stack voltages, with transient overshoot and undershoot peaks whose magnitudes increase proportionally with the applied current. Regarding the purge system, tests show that its activation improves operational efficiency, resulting in approximately 0.3 V of voltage increase per operation. Furthermore, it is observed that the purge frequency increases with higher external load levels, suggesting a direct interaction between energy demand and active waste gas management in the system. Full article

Most truck stops in rural areas are located along high-demand highway corridors, consistent with current methods based on capacity and demand models. However, these models underestimate the safety aspect, failing to detect highway corridors with low traffic demand and low truck stop accessibility. This study proposes a Geographic Information System (GIS)-based planning methodology to identify highway corridors affected by atypical crash rates involving commercial trucks and truck stop shortages. The proposed methodology defines two indexes to measure commercial truck safety and truck stop supply, serving as a basis for identifying four levels of need for new truck stops using reclassification and map algebra techniques. Results reveal that the identified highway corridors exhibit atypical crash rates and largely coincide with areas of low truck stop accessibility and low to moderate truck demand. Thus, the methodology introduces an important component, truck safety, in identifying new parking locations, usually dismissed by existing models. Full article

The Raramuri Criollo (RC) cattle is recognized for its adaptability, resilience, and low feeding requirements under low-input production systems. This study compared the productive and reproductive performance of purebred RC and Angus × Raramuri Criollo (AC) heifers with Hereford × Angus (HA) heifers. Experiment I evaluated post-weaning growth, feed intake, and feed efficiency in a 56 d individual feeding trial using 10 RC, 10 AC, and 8 HA heifers after a 14 d adaptation period; heifers received the experimental diet ad libitum throughout the trial. Experiment II evaluated puberty attainment and growth development of 14 RC, 17 AC, and 11 HA heifers under rangeland with limited supplementation (RLS) and 11 RC, 16 AC, and 10 HA heifers under annual irrigated pasture (AIP). Puberty attainment was determined from two consecutive serum progesterone concentrations >1 ng/mL, and body weight, average daily gain (ADG), age at puberty (AP), and body weight at puberty (BWP) were analyzed using mixed models and Kaplan–Meier survival analysis. Under individual feeding, RC and AC heifers gained 0.56 ± 0.06 and 0.32 ± 0.06 kg/d less and consumed 40.4% and 22.0% less feed than HA heifers (p < 0.05), whereas feed conversion and residual feed intake did not differ among breed groups. Heifers developed under AIP attained puberty earlier than those under RLS (median AP: 369 vs. 546 d; logrank p < 0.001). Overall, AC heifers combined the adaptive capacity of RC cattle with the productive potential of British breeds, achieving a favorable balance among growth, feed intake, feed efficiency, and reproductive development under contrasting development conditions, supporting their use in low-input beef production systems. Full article

Metabolic risk increases with age and may be accompanied by changes in adipocytokine secretion and insulin sensitivity. The primary exploratory aim of this prospective, uncon-trolled study was to determine whether repeated whole-body cryotherapy (WBC) changes circulating meteorin-like hormone (METRNL) concentrations in women of different ages. Secondary exploratory outcomes included irisin, asprosin, leptin, adiponectin, insulin, fasting blood glucose (FBG), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride–glucose index (TyG), atherogenic index of plasma (AIP), and the leptin/adiponectin ratio. A total of 48 women were divided into three groups: GR-60 (60–70 years, n = 14), GR-40 (40–50 years, n = 18), and GR-20 (20–30 years, n = 16). Participants underwent 30 WBC sessions, each lasting 3 min at minus 120 °C. Blood samples were collected before the first WBC session, after the 10th, 20th, and 30th sessions, and two weeks after the final session. Repeated WBC did not significantly change circulating METRNL or other adipocytokines in any age group. A preliminary decrease in insulin concentration and HOMA-IR was observed after 20 WBC sessions only in GR-60. These findings suggest that repeated WBC may be associated with favorable changes in selected insulin-resistance markers in older postmenopausal women; however, the absence of a non-WBC control group, small subgroup sizes, and the multiplicity burden preclude causal or therapeutic conclusions. Randomized controlled studies are needed to verify these exploratory observations. Full article

In the present study, cardiovascular risk indices (Atherogenic Index of Plasma [AIP], Atherogenic Coefficient [AC], Castelli Risk Index-1 [CRI-1], and Castelli Risk Index-2 [CRI-2]) and bone mineral density (BMD SDS) were evaluated in patients with Familial Mediterranean Fever (FMF), and the association of these parameters with disease severity and MEFV gene mutations was investigated. A total of 126 participants (96 FMF patients and 30 healthy controls) were included in the study. FMF patients were classified as mild, moderate, or severe according to the PRAS severity score. Cardiovascular risk indices, biochemical parameters of bone metabolism, and BMD SDS values were compared among the groups. The relationship between BMD SDS and atherogenic indices was assessed by Spearman correlation analysis. The results were also analyzed according to MEFV gene mutations. No significant difference was detected among the groups in terms of sex or age (p > 0.05). FMF patients were found to have substantially higher cardiovascular risk indices than the control group, and these indices increased in parallel with disease severity (p < 0.05). The BMD SDS value of the severe FMF group was significantly lower than that of the other groups (p = 0.025). No difference was detected among the groups with respect to bone metabolism parameters (p > 0.05). No significant correlation was observed between BMD SDS and cardiovascular risk indices (p > 0.05). M694V was the most frequently detected mutation, and the BMD SDS value was lower in patients carrying mutations other than M694V (p = 0.011). The increased cardiovascular risk in FMF patients is associated with disease severity. Severe disease is accompanied by a reduction in bone mineral density. The lack of an association between cardiovascular risk and bone mineral density suggests that these systems may be affected through different mechanisms. It is important that FMF patients are monitored with respect to cardiovascular and bone health. Full article

Population aging has made aging in place (AIP) a central goal of sustainable welfare and urban governance, yet older adults’ perceived feasibility of remaining in their current home under conditions of vulnerability remains unevenly distributed. This study conceptualizes AIP intention under anticipated mobility limitation as a stratified condition of social sustainability, asking who expects to remain in the community as a supported and recognized member when mobility declines. Using the 2023 National Survey of Older Koreans (N = 9951), it examines older adults’ stated intention to remain in their current residence under mobility limitation through weighted logistic regression. The results show that this intention is structured most strongly by housing inequality: non-owner tenure reduces the likelihood of intending to remain in place, whereas housing satisfaction increases it. Co-residence with adult children is positively associated with this intention, while activities of daily living limitations are negatively associated with it. Beyond material and health conditions, social participation intention and digital adaptability increase the likelihood of intending to remain in place, whereas age discrimination in public institutions reduces it. Government trust is negatively associated with the intention to remain in place. Because the survey does not directly measure older adults’ awareness, availability, evaluation, or use of alternative residential or care facilities, this association is treated only as a discussion point rather than as an empirically tested mechanism: higher institutional trust may be linked to greater openness to publicly supported alternatives. The findings demonstrate that the perceived feasibility of AIP is not merely an individual preference, but an unevenly distributed possibility shaped by housing security, institutional inclusion, and civic capacity. Sustainable aging policy should integrate housing support, anti-discrimination measures, digital inclusion, and community participation. Full article

In this study, the valorization of poly(lactic acid) (PLA) waste as well as rice husk into sustainable materials was explored. To simulate the industrial valorization of defective PLA parts, scraps and burrs, PLA was reprocessed (rPLA) by melt extrusion and further plasticized with 15 wt.% of acetyl tributyl citrate (ATBC) and reinforced with rice husk (RH) or rice husk biochar (RHB) in 1 or 3 wt.%. The melt flow index was determined to assess the effect of reprocessing and the addition of RH or RHB on the material degradation. The obtained films were characterized in terms of their structural, mechanical, and thermal behavior. The water-related behavior of the materials was evaluated by measuring the static water contact angle and the water vapor transmission rate (WVTR). Compostability was proposed as an end-of-life option, therefore disintegration under composting conditions was assessed. Reprocessing increased the MFI and slightly reduced the strength and the modulus, consistent with chain scission. ATBC facilitated the processability, improved the particles’ dispersion and provided ductility to the final materials. RH and RHB acted mainly as nucleating agents and strongly modified the surface wettability. A low RHB loading improved the WVTR, whereas a higher filler content and ATBC generally increased the WVTR. All the films were completely disintegrated within 18 to 21 days. These results show practical valorization routes to obtain rPLA films with tunable properties and to preserve the inherent composting disintegration of PLA. Full article

Background and Aims: Pancreatic hyperenzymemia in inflammatory bowel disease (IBD) is an under-recognized and challenging condition, as elevated pancreatic enzymes may arise from heterogeneous mechanisms and do not necessarily reflect true pancreatic disorder. This multicenter study aimed to characterize the clinical spectrum, diagnostic work-up, and outcomes of hyperenzymemia in IBD. Methods: This retrospective multicenter study was conducted within the PANDORA network, including 34 international IBD centers. For the present analysis, only centers providing patient-level data on pancreatic hyperenzymemia were considered. Collected variables included demographic, clinical, biochemical, imaging, and therapeutic data. Cases were categorized into three predefined phenotypes: chronic asymptomatic pancreatic hyperenzymemia (CAPH), reclassified acute pancreatitis not meeting Atlanta criteria (recAP), and autoimmune pancreatitis (AIP). Results: A total of 148 IBD patients with elevated pancreatic enzymes were included (CAPH 54.7%, RecAP 35.1%, AIP 10.1%). Ulcerative colitis (UC) accounted for 56.8% of cases and Crohn’s disease (CD) for 43.2%. Overall, 73.6% of patients were asymptomatic at the time of enzyme elevation. Marked hyperenzymemia (≥3× ULN) occurred in 22.3% of patients and was more frequent in RecAP than in CAPH or AIP (50.0%, 6.2%, and 13.3%, respectively). IBD was clinically active in 48.6% of patients, with higher rates in CD. Notably, the clinical meaning of hyperenzymemia differed across IBD phenotypes: in CD it was more often associated with active inflammation, whereas in UC it more frequently prompted advanced imaging and led to the identification of AIP. Imaging strategies differed significantly across phenotypes, and drug withdrawal was common in CAPH and RecAP but unnecessary in AIP. Only two rechallenges confirmed a drug-related mechanism. Conclusions: Pancreatic hyperenzymemia in IBD encompasses a spectrum of conditions with different implications. A phenotype-oriented diagnostic approach is essential to avoid misclassification and unnecessary treatment changes. Full article

Background: This study aimed to investigate the relationships of AHA/ACC blood pressure stages and circadian blood pressure patterns with clinical, metabolic, inflammatory, and structural echocardiographic parameters in newly diagnosed hypertensive (HT) patients, and to identify independent predictors of high-risk circadian disruptions. Methods: A total of 539 patients undergoing 24 h Ambulatory Blood Pressure Monitoring (ABPM) between 2022 and 2024 were retrospectively analyzed. Patients were grouped by nocturnal blood pressure dipping percentages and HT stages; laboratory markers (TyG index (Triglyceride–Glucose İndex), AIP (Atherogenic İndex of Plasma), SII (Systemic Immune-Inflammation Index), AISI (Aggregate Index of Systemic Inflammation), NLR (Neutrophil-to-Lymphocyte Ratio)) and echocardiographic data were evaluated via multivariable logistic regression. Results: The mean cohort age was 46.49 ± 13.98 years. Progressing HT stages were associated with significant increases in metabolic risk indicators: TyG index (p = 0.002) and AIP (p = 0.004). The prevalence of left ventricular hypertrophy (LVH) increased significantly from 7.3% in the normal group to 34.5% in Stage 2 HT (p < 0.001). The highest-risk “reverse-dipper” group had a significantly higher mean age (50.32 ± 14.55 years) than other groups (p < 0.001). In multivariable logistic regression, left atrial diameter (LAd) was the only common independent structural predictor of circadian disruption across all models (Extreme-Dipper OR: 1.19, p = 0.003; Non-Dipper OR: 1.11, p = 0.001). In the Reverse-Dipper model score analysis, both LAd (p < 0.001) and LVH (p = 0.001) demonstrated strong independent predictive potential. Inflammatory indices (SII, AISI, NLR) showed no independent predictive value (p > 0.05). Conclusions: Advanced HT stages and disrupted circadian rhythms are strongly associated with metabolic impairment, left atrial dilatation, and LVH. In older hypertensive patients presenting with left atrial enlargement and LVH, echocardiographic screening and close ABPM are crucial for early “reverse-dipper” pattern detection. Full article

Background/Objectives: Obesity-related insulin resistance is accompanied by chronic low-grade inflammation, but the extent to which weight loss modifies circulating cytokines in a sex-specific manner remains insufficiently understood. The aim of this study was to assess sex-specific cytokine responses and metabolic adaptation in adults with obesity and insulin resistance following a six-month weight-reduction program (WRP). Methods: Thirty-six participants (24 women and 12 men) with a value of Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) ≥ 2 underwent an individualized low-calorie diet combined with moderate physical activity and health education. Anthropometric, body composition, biochemical, oxidative stress, and cytokine parameters were evaluated before and after the intervention. Results: Both women and men showed significant reductions in body mass, Body Mass Index (BMI), waist circumference, visceral fat area (VFA), body fat mass (BFM), fasting glucose, HOMA-IR, modified Atherogenic Index of Plasma (new-AIP), malondialdehyde (MDA), and Oxidative Stress Index (OSI). Women additionally showed significant decreases in fat-free mass (FFM), skeletal-muscle mass (SMM), total body water (TBW), glycated hemoglobin A_1c (HbA1c), and triacylglycerols, whereas cholesterol in high-density lipoproteins (HDL-C) increased significantly in men. Cytokine changes were selective rather than uniform. Interleukin-1 receptor antagonist (IL-1ra), Interleukin 6 (IL-6), and Tumor Necrosis Factor alpha (TNF-α) decreased in both women and men. In sex-stratified analyses, IL-1β decreased significantly only in women, whereas IL-7 decreased significantly only in men. ClinicalTrials.gov Registration: [NCT07645105] (retrospectively registered on [11 June 2026]). Conclusions: A 6-month lifestyle-based weight-reduction program in adults with overweight or obesity and insulin resistance was associated with metabolic improvement, reduced oxidative stress, and partial attenuation of obesity-related low-grade inflammation. The observed cytokine and metabolic changes suggest sex-related patterns of immunometabolic adaptation to weight reduction. However, these findings should be interpreted cautiously because of the relatively small sex-stratified subgroups and the number of cytokine endpoints analyzed, and they require confirmation in larger, sex-balanced studies. Full article

Background: Acute intermittent porphyria (AIP) is the most common and severe form of acute hepatic porphyria, caused by heterozygous mutations in the HMBS gene. Due to its non-specific clinical manifestations and low clinical awareness among clinicians, AIP is frequently misdiagnosed, leading to significant diagnostic delays and potentially fatal complications. Case presentation: We report a 20-year-old female patient who presented with a 9-month history of recurrent abdominal pain, paralytic ileus, unexplained liver injury, and hyponatremia, followed by progressive limb weakness. She was initially misdiagnosed with Guillain–Barré syndrome (GBS) and received intravenous immunoglobulin and systemic glucocorticoids. However, her condition deteriorated, and she developed life-threatening respiratory muscle paralysis requiring invasive mechanical ventilation. The diagnosis of AIP was confirmed by positive urinary porphobilinogen (PBG) testing and identification of the heterozygous HMBS c.517C>T pathogenic variant. The patient was treated with high-dose carbohydrate loading therapy and comprehensive supportive care, resulting in gradual clinical improvement. Discussion and Conclusions: This case exemplifies the substantial diagnostic challenges associated with AIP, especially when it manifests with peripheral neuropathy that closely mimics GBS. The triad of absent albuminocytologic dissociation in cerebrospinal fluid, preceding visceral symptoms, and inadequate response to standard first-line GBS therapy should immediately raise clinical suspicion for AIP. Enhanced clinical awareness of this rare disorder and timely implementation of urinary PBG screening are of paramount importance to prevent irreversible neurological complications and optimize long-term patient outcomes. Full article