Search Results (177,598)

Background: Colorectal cancer (CRC) is the third most diagnosed malignancy and the second leading cause of cancer-related mortality worldwide. Recent therapeutic advancements have significantly improved clinical management, underscoring the importance of routine molecular profiling to guide personalised treatment strategies. This study aims to evaluate the prognostic impact of main molecular alterations—including allele frequency (AF) of RAS mutations—on survival outcomes in a real-world hospital-based cohort of patients with metastatic CRC. Methods: A total of 208 consecutive patients with a histologically confirmed diagnosis of CRC and complete clinical, molecular, and survival data were retrospectively analysed. Somatic mutations in KRAS, NRAS, BRAF, and the occurrence of microsatellite instability (MSI) were assessed using pyrosequencing and real-time PCR assays, respectively, on formalin-fixed, paraffin-embedded tumour samples. Associations between mutational status, clinicopathological parameters, and overall survival (OS) were evaluated. Results: Overall, 138 patients (66.3%) harboured at least one somatic mutation: 115 (55.3%) in KRAS, 8 (3.8%) in NRAS, and 15 (7.2%) in BRAF. MSI was detected in 17/208 (8.2%) patients. A statistically significant improvement in OS was observed in patients lacking mutations in any of the three genes—referred to as wild-type (WT) patients—with BRAF mutated cases showing the worst survival (p = 0.041). Increasing age at the time of first-line therapy for advanced disease stage was associated with a statistically significant increase in the hazard of death (p = 0.031). Conclusions: In the advanced disease stage, RAS/BRAF wild-type colorectal cancers were significantly associated with a survival advantage. Full article

This study evaluated the impact of treated dry-aged crust inclusions on final ground beef quality. Ground beef (80 lean: 20 fat) was divided into: CON (beef only), NTC (non-treated crust), WW (warm-water-washed crust), DH (dehydrated crust), and SV (sous-vide crust). Treated crusts were chopped, mixed with ground beef (10% inclusion), reground, formed into patties, and subjected to quality and microbial analyses. The pH for day 1 (d1) samples was lower than for day 7 (d7) samples regardless of treatment (p < 0.05). No differences were found for proximate analysis, cook loss, or display loss (p > 0.05). An interaction effect was observed for all color traits (p < 0.05), demonstrating rapid color decline during display in both NTC and WW treatments compared to other treatments. Greater lipid oxidation was observed in CON compared to other treatments before and after display (p < 0.05). The CON, DH, and SV treatments had lower microbial concentrations than NTC and WW (p < 0.05). Texture profile analysis showed elevated hardness values in SV compared to CON, NTC, and WW, while DH did not differ from any treatment (p < 0.05). Our results indicate that DH and SV interventions minimally impact product quality while reducing initial microbial concentrations, suggesting potential use as intervention methods for dry-aged crust. Full article

Background: Mobile health has been increasingly integrated into tuberculosis care to support patient education, communication, and treatment engagement. However, evidence remains limited regarding whether positive engagement with mHealth is associated with knowledge, attitudes, and practices among patients with multidrug-resistant tuberculosis. This study aimed to examine the association between positive mHealth engagement and knowledge, attitude, practice, and total KAP among patients with multidrug-resistant tuberculosis, and to evaluate the psychometric properties of the engagement score used as the primary exposure variable. Methods: A cross-sectional study was conducted among patients with multidrug-resistant tuberculosis. A positive mHealth engagement score was constructed from 12 mHealth-related items after harmonizing item directionality so that higher scores indicated more favorable engagement. The 12 items reflected five behavioural domains: intensity of use, ease and acceptability of use, functional engagement (communication with providers, access to health information, and perceived benefit for disease self-management), continuity of use, and barriers to sustained engagement. The composite score was computed as the mean of the 12 standardised items, with higher values indicating more positive engagement. Internal consistency was assessed using Cronbach’s alpha and corrected item–total correlations, and structural validity was explored using principal component analysis. Adjusted linear regression models were used to examine associations between the engagement score and Knowledge, Attitude, Practice, and total KAP scores, controlling for age, sex, and occupation. Sensitivity analyses were performed after excluding a poorly performing item, and tertile analyses were used to assess dose–response patterns. Results: The positive mHealth engagement score showed good internal consistency, with a Cronbach’s alpha of 0.852. One item demonstrated poor psychometric performance, and Cronbach’s alpha increased to 0.864 after its exclusion. The data were suitable for dimensionality assessment, with a Kaiser–Meyer–Olkin value of 0.870 and a significant Bartlett’s test. Principal component analysis identified a dominant first component explaining 43.29% of the total variance. Using the refined score, higher positive mHealth engagement was significantly associated with higher Knowledge scores (β = 2.06; 95% CI: 1.28–2.85; p < 0.001), higher Attitude scores (β = 4.68; 95% CI: 3.30–6.06; p < 0.001), and higher total KAP scores (β = 6.68; 95% CI: 4.62–8.74; p < 0.001), whereas no significant association was observed for the Practice score (β = −0.07; 95% CI: −0.63 to 0.49; p = 0.804). In tertile analyses, Knowledge, Attitude, and total KAP scores increased significantly across engagement levels, while Practice scores did not. Conclusions: Positive mHealth engagement was associated with better knowledge, attitudes, and overall KAP among patients with multidrug-resistant tuberculosis, but not with practice. These findings are associative; the cross-sectional design does not permit causal conclusions. The engagement score demonstrated good reliability and acceptable structural validity and may be a useful summary measure for evaluating patient interaction with mHealth interventions in tuberculosis care. Integrated strategies combining mHealth with clinical follow-up, adherence counseling, and structural support may be needed to translate informational and attitudinal gains into practice change. Full article

Background: Ureteropelvic junction obstruction (UPJO) represents a common congenital anomaly in infants and young children. While minimally invasive approaches, including laparoscopic pyeloplasty (LP) and robot-assisted laparoscopic pyeloplasty (RALP), have gained acceptance, comparative outcomes in children younger than 3 years have still not been well-established. This study aimed to evaluate the safety and efficacy of RALP versus LP in infants and children younger than 3 years or weighing < 15 kg. Methods: A systematic literature search of PubMed, Web of Science, and Embase was conducted through May 2025. Five retrospective cohort studies comprising 272 patients met inclusion criteria (age younger than 3 years or weighing < 15 kg). Meta-analysis was performed using random-effects models. Results: Hospital stay was significantly shorter in the RALP group compared with LP (mean difference = −1.69 days; 95% CI: −2.71 to −0.67). No statistically significant differences were observed in operative time, complication rates, or success rates between approaches. Conclusions: RALP is associated with significantly reduced hospitalization time compared with LP in infants and young children, while maintaining comparable safety and efficacy profiles. These findings support RALP as a valuable minimally invasive option in this challenging patient population, though larger prospective studies are warranted. Full article

Sarcopenia, characterized by progressive loss of muscle mass and function, is highly prevalent among patients with heart failure (HF) and contributes to frailty, disability, and poor prognosis. Shared mechanisms—chronic inflammation, neurohormonal dysregulation, mitochondrial dysfunction, inactivity, and inadequate nutrition—promote anabolic resistance and accelerate muscle wasting. This narrative review summarizes current evidence on the interplay between HF and sarcopenia, focusing on practical strategies for integrated management. Exercise training, particularly combined aerobic and resistance programs, improves physical performance and quality of life, while targeted nutritional interventions ensure adequate energy and protein intake and mitigate malnutrition. Emerging evidence supports the synergistic benefit of coupling tailored dietary support with structured rehabilitation. Despite robust data, implementation of person-centered, multidisciplinary care remains limited. Routine screening for sarcopenia and nutritional risk should be embedded in HF pathways to enable early intervention, functional recovery, and improved long-term outcomes. Full article

In Uganda, in 2019, 6.8 million people experienced health conditions that are amenable to rehabilitation. This is largely due to musculoskeletal disorders such as low back pain (LBP). Measuring effective coverage of rehabilitation means assessing whether a population that needs rehabilitation services receives the interventions with sufficient quality to produce the desired health gain. This study reports on the first measurement of effective coverage of rehabilitation in Uganda and globally using chronic primary LBP as the tracer health condition. A population survey was conducted to administer the WHO global tracer indicator questions. The survey questions were used to identify respondents with chronic primary LBP experiencing limitations in functioning and to determine utilization of rehabilitation services. The WHO Disability Assessment Schedule (WHODAS) 2.0 12-item was used for the measurement of an improvement in functioning that is meaningful to service users. The questions were nested in the Iganga–Mayuge Health and Demographic Surveillance Site (IMHDSS) update round 22 in seven sub-counties in rural Eastern Uganda between June and September 2023. Data collection followed a training session on survey administration and data capture for enumerators, field supervisors, research managers and lead scientists from the Makerere University Centre for Health and Population Research and a pilot testing of the data collection tool. Survey administration resulted in data collection for 8645 respondents aged 18 years and above. Specifically, 15.2% of the respondents had experienced chronic LBP in the last 12 months, of which 88.5% had experienced pain that was severe enough to affect their usual household, recreational or work activities. A total of 46% of this population in need of rehabilitation had been utilizing rehabilitation services (crude coverage), with no difference between women and men. Only 7.05% of the respondents with chronic primary low back pain experiencing limitations in functioning had been managed with sufficient quality to produce the desired health gain, defined by a minimal but meaningful improvement in functioning (effective coverage). Full article

Modern wound care is challenged by the emergence of antibiotic-resistant bacterial strains, causing the need for advanced dressing materials that provide infection control while promoting healing. Although polyacrylamide (PAAm) hydrogels are widely investigated due to their biocompatibility, their lack of intrinsic antibacterial activity and poor mechanical properties restrict their clinical use. To overcome these limitations, this study proposes a natural–synthetic hydrogel that combines PAAm with TEMPO-oxidized cellulose nanofiber (TOCNF) functionalized silver nanoparticles (AgNPs). The synthesis is performed through the polymerization of the synthetic monomer in the presence of the TOCNF–AgNPs, the nanofibrillar cellulose simultaneously serving as a reducing and stabilizing agent for AgNPs, and as a plasticizer for the PAAm network. Morpho-structural analysis of the hybrid precursor (TOCNF–AgNPs) revealed two populations of AgNPs, offering a cumulative effect between rapid bacterial penetration and a prolonged ionic reservoir, while maintaining the stability of the system. The subsequent incorporation of the hybrid into PAAm matrix resulted in tunable swelling kinetics and mechanical properties. Wettability and surface stiffness improve with the increase in hybrid content. The antibacterial effect was confirmed by a colony-counting assay for formulations with higher AgNPs content, exhibiting inhibitory metabolic activity against several pathogenic strains. These results suggest that PAAm/TOCNF–AgNPs (PTA) nanocomposites represent a promising mechanically adaptive candidate for wound-care applications. Full article

Radiation detection technology is critical in medical diagnosis, high-energy physics experiments, nuclear environmental monitoring, and radiation safety protection. Its technological iteration stems from innovations in high-performance radiation detection materials. Traditional materials often have narrow dose–response intervals, insufficient high-precision measurement capability, low spatial resolution, and poor stability, failing to meet high-precision detection requirements. Ag-doped phosphate glass (Ag-PG), based on radio-photoluminescence (RPL), effectively addresses these limitations with its comprehensive advantages: high radiation sensitivity, a wide linear dose–response range, submicron spatial resolution for radiation imaging, write-erase-rewrite capability, and visualized dose monitoring potential, and it also boasts significant fundamental research value and engineering application prospects. Specifically, while existing RPL reviews mainly provide a comprehensive analysis from the perspective of RPL and present typical RPL material systems, this paper systematically analyzes the structural characteristics of the Ag-PG matrix and the coordination configuration and site occupation of Ag ions. It clarifies RPL luminescence properties, dose–response mechanisms, and the evolution of luminescence centers, while reviewing advancements in applications such as radiation dose detection and high-resolution X-ray imaging. By summarizing the current research status, technical advantages and existing challenges of Ag-PG, this study provides theoretical references and conceptual insights to promote breakthroughs in its fundamental research and practical applications in high-precision radiation dose detection, advanced medical imaging, micro-nano-scale radiation detection, and nuclear industry non-destructive testing. Full article

Firefighters face high-stress occupational demands and irregular shift work that negatively impact sleep quality, which is intrinsically linked to long-term physical and psychological health. This cross-sectional study examines how the physical sleep environment (home vs. work) and station sleeping arrangements (bunk-style vs. individual dorm-style quarters) influence subjective sleep quality in this population. Sixty-six career firefighters (Age = 40.89 ± 11.05 years), completed the Pittsburgh Sleep Quality Index (PSQI) to assess their sleep in both home and fire station environments, with data analyzed using Wilcoxon Signed Ranks and Mann–Whitney U tests. The results reveal significant differences (p < 0.001), with sleep duration, efficiency, subjective quality, and global PSQI scores all performing significantly better at home than at work. Notably, no significant differences were found between bunk-style and dorm-style sleeping quarters at the station. These findings suggest that firefighters experience poorer sleep while on duty regardless of room design, indicating that operational stressors like call volume and nocturnal arousal may be more influential on sleep quality than the physical arrangement of sleeping quarters, and could inform organizational policies and wellness programs aimed at reducing occupational fatigue. Full article

Chemotherapy-induced cognitive impairment (CICI), often referred to as “chemobrain,” is a common and sometimes persistent consequence of cancer treatment, characterized by deficits in memory, attention, executive function, and processing speed; it disproportionately affects older adults and women, suggesting a role for aging- and sex-related biological factors, including estrogen depletion. This work examines the potential of dietary phenolic compounds as multi-target modulators of mechanisms underlying CICI. A narrative synthesis of preclinical and clinical evidence was conducted, focusing on major phenolic subclasses (flavonoids, phenolic acids, stilbenes, lignans, and secoiridoids) and their effects on pathways implicated in chemotherapy-related neurotoxicity. The reviewed data indicate that phenolic compounds can influence redox balance, neuroinflammatory responses, mitochondrial function, synaptic plasticity, and estrogen-related signaling, with effects that appear to be structure-dependent; however, evidence remains heterogeneous and largely derived from experimental models rather than studies in humans. Overall, the current findings suggest that selected phenolic compounds could mitigate vulnerability to CICI, particularly in higher risk groups such as older individuals and women with low estrogen levels. These compounds represent promising and safe adjunctive strategies, although further well-designed clinical studies are needed to confirm their efficacy and clarify the underlying mechanisms. Full article

Internalized Weight Bias (IWB) is consistently associated with poor body image, elevated depression, and diminished self-esteem. However, very little research has examined how additional psychological constructs may indirectly influence the association between IWB and these outcomes. This investigation examined whether IWB was associated with body image, depression, and self-esteem among individuals with overweight and obesity indirectly through body shame, experiential avoidance, and self-compassion. The current sample included 403 participants, with slightly over half the participants (51%) identifying as a female with an average age of 48.3 (SD = 16.9, range 18 to 84), and an average BMI of 33.1 (SD = 7.5, range 25 to 68). Participants were recruited through a Qualtrics research panel that was reflective of the United States population on variables of education, geographic location, income, and biological sex. All participants were aged 18+ and had a BMI ≥ 25. To maximize racial/ethnic diversity, the current sample contained three equally represented self-identified racial/ethnic groups: Black non-Hispanic or Latino/a (N = 140), Hispanic or Latino/a (N = 133), and White non-Hispanic or Latino/a (N = 130). Results showed a significant indirect effect of IWB on psychological and body image outcomes through body shame, experiential avoidance, and self-compassion. Future longitudinal research examining the contexts in which body shame, experiential avoidance, and self-compassion may act as mediators will be important to further develop an understanding of IWB. Full article

Background: Myocarditis is an inflammatory disease of the myocardium with multiple causes and evolutions. The aim of our study was to design a prognostic multiparametric score in patients with myocarditis, to identify those at higher risk of cardiovascular outcomes. Methods: A prospective study was performed enrolling 98 patients with myocarditis: 72 M, 26 F; median age 27 [IQR 20–40]. Patients were divided into two groups: complicated (CM) and uncomplicated myocarditis (UM). Six months after hospital admission, cardiac magnetic resonance (CMR) and cardiological consultation were repeated. Cardiovascular outcomes (death, hospitalization for heart failure, heart transplant, ICD implantation, and heart failure development) were evaluated at 6 months and after 3 years. Results: We found 67 UM and 31 CM. Cardiovascular outcomes were significantly higher in patients with CM. We found a significant correlation between cardiovascular outcomes and reduced LVEF at hospital admission, reduced global longitudinal strain in absolute values, septal late gadolinium enhancement (LGE) at CMR, longer persistence time of increased troponin, LGE extension progression or persistence at 6 months of CMR. A myocarditis prognostic score was developed. A score ≥ 5 showed higher sensitivity (100%) and specificity (87%)—AUC 1, to identify cardiovascular outcomes in patients with myocarditis. A score between 3 and 4 showed high sensitivity but low specificity. A score ≤ 2 was associated with low probability of cardiovascular outcomes. Conclusion: Our study confirms the high probability of cardiovascular outcomes in patients with CM and it suggests a myocarditis prognostic score to identify patients at higher risk of cardiovascular outcomes. Full article

Liupao tea develops characteristic sensory properties during aging. However, the evolution of non-volatile metabolites and their relationship with sensory quality remain unclear. Here, three samples aged for 8, 13, and 20 years were analyzed using electronic tongue, colorimetry, and metabolomics. Tea liquor brightness (L*) increased with aging, whereas redness (a*) and yellowness (b*) decreased. Strong correlations between taste and color were observed. Catechins and free amino acids peaked at the intermediate stage, while alkaloids varied, with caffeine remaining stable. A total of 1897 metabolites were identified, with flavonoids increasing and terpenoids and lipids decreasing during aging. The intermediate stage represented a critical transition point with metabolic reprogramming. Key sensory-related metabolites included theobromine, glutamic acid, and theanine (associated with umami, sweetness, and color), as well as gallocatechin gallate, catechin gallate, theacrine, aspartic acid, and arginine (linked to bitterness and yellowness). Flavonoid- and terpenoid-rich modules were also identified. All samples were from a single producer and may not represent all Liupao teas. Overall, this study reveals coordinated changes in sensory quality and metabolites during Liupao tea aging. Full article

Aesthetic medicine is shifting from symptomatic correction to biological structural restoration. Regenerative aesthetics represents a frontier in dermatology, focusing on the restoration of the skin microenvironment to enhance cellular vitality and tissue resilience. Central to this approach is the concept of “skin bed preparation”, a strategic priming phase designed to optimize the physiological terrain before the delivery of advanced aesthetic interventions. This review explores the molecular and cellular mechanisms by which skin bed preparation modulates the extracellular matrix (ECM) and the dermal niche to maximize the efficacy of subsequent treatments and promote long-term skin longevity. Evidence suggests that biostimulatory priming utilizing senolytics, senomorphics, mitochondrial, and/or epigenetic rejuvenators rehabilitates the fibroblast–collagen interactome. By reducing oxidative stress and chronic low-grade inflammation, these preparatory steps transition the skin from a catabolic to an anabolic state. This metabolic reset ensures that subsequent procedures, such as laser therapy, injectable fillers, encounter a responsive cellular environment, resulting in superior collagen induction and prolonged clinical outcomes. Optimizing the skin microenvironment via regenerative aesthetics is not merely an adjunctive step but a fundamental requirement for therapeutic success. Integrating skin bed preparation into clinical protocols provides a synergistic framework that enhances immediate procedural results while addressing the underlying hallmarks of skin aging, ultimately redefining the trajectory of skin health and longevity. Full article

Background: Late-onset neonatal sepsis (LONS) remains a major cause of morbidity in preterm neonates admitted to the neonatal intensive care unit (NICU), yet the contribution of vitamin D status to neonatal infectious susceptibility remains uncertain. Objective: To evaluate clinical and demographic variables and serum vitamin D levels assessed at birth in preterm neonates with and without LONS. Methods: A retrospective observational cohort study was conducted in a tertiary NICU in northeastern Mexico between May 2023 and October 2024. Preterm neonates (<37 weeks of gestation) with serum 25(OH)D measured within the first hour of life were included. Vitamin D status was classified as sufficient (≥30 ng/mL), insufficient (20–29 ng/mL), or deficient (<20 ng/mL). LONS was defined as sepsis occurring after 72 h of life. Comparisons between neonates with and without LONS were performed using Fisher’s exact test for categorical variables and Student’s t-test or Mann–Whitney U test for continuous variables, as appropriate. Results: Twenty-nine preterm neonates were included (mean gestational age: 32.0 ± 2.6 weeks; mean birth weight: 1748 ± 545 g). The mean serum 25(OH)D level at birth was 35.5 ± 13.0 ng/mL. LONS occurred in 31% (9/29) of neonates, of which 55% were microbiologically confirmed. No significant differences were observed in vitamin D levels between neonates with and without LONS (35.0 ± 12.0 vs. 35.7 ± 13.7 ng/mL; p = 0.899). Vitamin D deficiency was not associated with LONS (OR 1.13, 95% CI 0.09–14.28). The prevalence of vitamin D deficiency was low (10%) in this cohort. Conclusions: A clear association between serum 25(OH)D levels at birth and the development of LONS could not be demonstrated in this small exploratory cohort. Given the limited sample size and low prevalence of vitamin D deficiency, further multicenter prospective studies are required to better understand the potential relationship between vitamin D status and neonatal infectious outcomes. Full article