Search Results (98)

Spinal cord injuries (SCIs) present a major clinical challenge, often resulting in permanent loss of function and limited treatment options. Traditional approaches, including surgery, drugs, and rehabilitation, have had modest success in restoring neural connectivity due to the complex pathophysiology of SCI. In recent years, bioactive hydrogels have gained attention as a versatile platform for neural repair. Their ability to mimic the extracellular matrix, deliver therapeutic agents, and support cell survival makes them promising tools in regenerative medicine. This narrative review highlights the latest advances in hydrogel-based therapies for SCI, with a focus on innovations such as self-healing, conductive, and anti-inflammatory hydrogels. We also explore hybrid approaches that integrate nanomaterials, stem cells, and bioelectronics to address both primary and secondary injury mechanisms. While various hydrogel systems have been investigated, we place particular emphasis on gelatin-based hydrogels, especially gelatin methacryloyl (GelMA), due to their emerging clinical relevance. GelMA stands out for its bioactivity, tunable mechanics, and compatibility with 3D printing, making it a strong candidate for personalized therapies and scalable production. Unlike previous reviews that broadly summarize hydrogel use, this work specifically contextualizes gelatin-based platforms within the wider landscape of SCI repair, underscoring their translational potential. We also address current challenges, such as immune response, long-term integration, and clinical validation, and suggest future directions for bridging the gap from bench to bedside. Full article

Background and Objectives: Due to the progress made in all areas of research, pediatric patients diagnosed with acute lymphoblastic leukemia (ALL) now have an average overall survival rate of 90%. There are still discrepancies between high-income countries and limited-resource centers. The aim of this study was to analyze prognostic factors and outcome parameters in a 223-patient cohort from a single center in Romania, treated with two adapted BFM protocols. Materials and Methods: The patients diagnosed with ALL in our center were enrolled in this study from January 2016 to December 2022 and subsequently followed up until December 2024. The patients were treated first according to the ALL IC BFM 2009 protocol until June 2019 and afterwards with the ALL AIEOP BFM 2017 protocol starting with July 2019. The prognostic factors were analyzed in both subgroups and the outcomes were measured: event-free survival (EFS), overall survival (OS), cumulative incidence of relapse (CIR), relapse-free survival (RFS) and non-relapse mortality (NRM). Results: The comparison between the two subgroups revealed that every parameter improved over time: complete remission after induction (87.75% vs. 80.7%), early deaths (3.92% vs. 5.78%), deaths in remission (4.08% vs. 5.26%), 5-year EFS (73.79% vs. 70.22%), 5-year CIR (18.36% vs. 19.04%), 5-year RFS (81.76% vs. 80.97%), 5-year NRM (7.85% vs. 10.77%), and 5-year OS (88.18% vs. 82.54%). Whereas for the standard-risk group, events such as relapse or death were isolated, for intermediate-risk patients, the events were limited to a small number and did not significantly influence the overall results, and for high-risk children, the results improved significantly between the two subgroups. The worst outcomes were observed in patients with the BCR::ABL1 fusion gene, T-cell phenotype, and in teenagers, compared to the ETV6::RUNX1 fusion gene, B precursor ALL, and in smaller children, respectively. Conclusions: The 5-year OS increased in our center from 82.54% to almost 90%, with the most substantial finding being the survival rate for high-risk patients, now reaching up to 80%. The prognostic factors were age at diagnosis, genetic characteristics, and response to treatment, especially prednisone sensibility. Full article

This study presents the fabrication and characterization of magnetically active textiles using cotton fibers impregnated with suspensions of pumpkin seed oil, carbonyl iron microparticles, and propolis microparticles. The textiles were utilized to manufacture planar capacitors, enabling an investigation of the effects of static magnetic fields and the introduced microparticles on the components of complex dielectric permittivity. The results reveal that the dielectric properties of the fabricated textiles are highly sensitive to the applied magnetic field intensity, the frequency of the alternating electric field, and the composition of the impregnating suspension. The experimental findings suggest that the dielectric loss and permittivity can be finely tuned by adjusting the magnetic flux density and the proportion of propolis microparticles. The multifunctional nature of these magnetically responsive textiles, combined with the bioactive properties of the incorporated natural components, opens promising pathways for applications in smart textiles, biomedical devices, and sensor technologies. Full article

Background and Objectives: Secondary bacterial pneumonia can substantially worsen the clinical trajectory of patients hospitalized for Coronavirus Disease 2019 (COVID-19). This study aimed to characterize bacterial superinfections in COVID-19, including pathogen profiles, resistance patterns, inflammatory responses, severity scores, and ICU admission risk. Methods: In a retrospective cohort design, we reviewed 141 patients admitted to a single tertiary-care hospital between February 2021 and December 2024. A total of 58 patients had laboratory-confirmed bacterial superinfection by sputum, bronchoalveolar lavage, or blood cultures (superinfection group), whereas 83 had COVID-19 without any documented bacterial pathogens (COVID-only group). We collected detailed microbiological data from sputum, bronchoalveolar lavage (BAL), and blood cultures. Antibiotic sensitivity testing was performed using standard breakpoints for multidrug resistance (MDR). Inflammatory markers (C-reactive protein, procalcitonin, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index) and the severity indices Acute Physiology and Chronic Health Evaluation (APACHE) II, Confusion, Urea, Respiratory rate, Blood pressure (CURB), and National Early Warning Score (NEWS) were measured at admission. Primary outcomes included intensive care unit (ICU) admission, mechanical ventilation, and mortality. Results: Patients in the superinfection group showed significantly elevated inflammatory markers and severity scores compared to the COVID-only group (mean APACHE II of 17.2 vs. 13.8; p < 0.001). Pathogens most frequently isolated from sputum and BAL included Klebsiella pneumoniae (27.6%) and Pseudomonas aeruginosa (20.7%). Multidrug-resistant strains were documented in 32.8% of isolates. The superinfection group had higher ICU admissions (37.9% vs. 19.3%; p = 0.01) and more frequent mechanical ventilation (25.9% vs. 9.6%; p = 0.01). Mortality trended higher among superinfected patients (15.5% vs. 7.2%; p = 0.09). A total of 34% of the cohort had prior antibiotic use, which independently predicted MDR (aOR 2.6, p = 0.01). The presence of MDR pathogens such as Klebsiella pneumoniae (OR 2.8), Pseudomonas aeruginosa (OR 2.5), and Staphylococcus aureus (OR 2.1) significantly increases the risk of ICU admission. Conclusions: Bacterial superinfection exacerbates inflammation and worsens outcomes in COVID-19 patients, such as a higher risk of ICU admission. Full article

Background/Objectives: Infertility is a reproductive disorder affecting approximately 10–15% of reproductive-age couples worldwide. Recent studies have suggested that miRNAs in follicular fluid may provide insights into reproductive potential and follicle health. This study evaluated the altered profile of miRNAs in the follicular fluid in patients undergoing IVF, considering the underlying etiology of infertility. Among our study participants, we identified four major underlying causes of infertility: polycystic ovary syndrome (PCOS), pelvic inflammatory disease (PID), male factor infertility, and unexplained infertility (UI). Methods: This study aimed to assess whether these infertility diagnoses are associated with distinct follicular behaviors and to identify altered miRNA patterns linked to these conditions. Ingenuity Pathway Analysis (IPA) was used to evaluate the impact of the altered miRNA signature on key biological processes. Results: The bioinformatics analysis of microarray data revealed altered miRNA patterns in FF for selected subgroups. Compared to healthy controls, 25 differentially expressed miRNAs were identified in PCOS (9 downregulated and 16 overexpressed), 21 in PID (15 downregulated and 6 overexpressed), and 34 in UI (24 downregulated and 10 overexpressed). These altered miRNA signatures indicate a complex interplay with essential signaling pathways, including hormonal regulation and tissue remodeling. Conclusions: Our analysis revealed key miRNAs that were differentially expressed across selected groups, indicating their potential as biomarkers for more accurate diagnosis and targeted treatment strategies. These findings provide valuable insights into the molecular mechanisms underlying reproductive disorders and underscore the importance of further research to develop targeted interventions that can enhance patient outcomes. Full article

This study presents the fabrication and characterization of hybrid magneto-responsive composites (hMRCs), composed of recyclable components: magnetite microparticles (MMPs) as fillers, lard as a natural binding matrix, and cotton fabric for structural reinforcement. MMPs are obtained by in-house plasma-synthesis, a sustainable, efficient, and highly tunable method for producing high-performance MMPs. hMRCs are integrated into flat capacitors, and their electrical capacitance (C), resistance (R), dielectric permittivity (${ϵ}^{\prime }$), and electrical conductivity ($\sigma$) are investigated under a static magnetic field, uniform force field, and an alternating electric field. The experimental results reveal that the electrical properties of hMRCs are dependent on the volume fractions of MMPs and microfibers in the fabric, as well as the applied magnetic flux density (B) and compression forces (F). C shows an increase with both B and F, while R decreases due to improved conductive pathways formed by alignment of MMPs. $\sigma$ is found to be highly tunable, with increases of up to 300% under combined field effects. In the same conditions, C increases up to 75%, and R decreases up to 80%. Thus, by employing plasma-synthesized MMPs, and commercially available recyclable lard and cotton fabrics, this study demonstrates an eco-friendly, low-cost approach to designing multifunctional smart materials. The tunable electrical properties of hMRCs open new possibilities for adaptive sensors, energy storage devices, and magnetoelectric transducers. Full article

The Monit4Healthy system is an IoT-enabled health monitoring solution designed to address critical challenges in real-time biomedical signal processing, energy efficiency, and data transmission. The system’s modular design merges wireless communication components alongside a number of physiological sensors, including galvanic skin response, electromyography, photoplethysmography, and EKG, to allow for the remote gathering and evaluation of health information. In order to decrease network load and enable the quick identification of abnormalities, edge computing is used for real-time signal filtering and feature extraction. Flexible data transmission based on context and available bandwidth is provided through a hybrid communication approach that includes Bluetooth Low Energy and Wi-Fi. Under typical monitoring scenarios, laboratory testing shows reliable wireless connectivity and ongoing battery-powered operation. The Monit4Healthy system is appropriate for scalable deployment in connected health ecosystems and portable health monitoring due to its responsive power management approaches and structured data transmission, which improve the resiliency of the system. The system ensures the reliability of signals whilst lowering latency and data volume in comparison to conventional cloud-only systems. Limitations include the requirement for energy profiling, distinctive hardware miniaturizing, and sustained real-world validation. By integrating context-aware processing, flexible design, and effective communication, the Monit4Healthy system complements existing IoT health solutions and promotes better integration in clinical and smart city healthcare environments. Full article

The heterogeneity among patients with obesity is particularly evident in the weight loss response to interventions such as diets, drugs, devices and surgery. Obesity can be “catalogued” into four phenotypes: hungry brain (abnormal satiety for alteration of gut–brain axis), emotional hunger (hedonic eating), hungry gut (abnormal duration of satiety for faster gastric emptying) and slow burning (slowing of the metabolic rate). Phenotypes are grafted onto this complexity, the recognition of which allows for personalized medicine and increasingly targeted therapies. Although there are no standardized treatment protocols, we present management options consisting of lifestyle modifications and pharmacologic therapies. Nutritional advice and encouragement of adequate physical activity lead to increased self-efficacy and promote a sense of well-being when coupled with psychological approaches involving mindful eating. In summary, obesity has a complex pathophysiology best addressed through a therapeutic process suited to the phenotype encountered and in synergy with multifactorial interventions. Full article

Background: GATA2-related myelodysplastic syndrome (GATA2-MDS) is a unique predisposition syndrome with a high risk of leukemic transformation. This systematic review synthesizes current literature and presents two illustrative pediatric GATA2-MDS cases. Methods: Data retrieval from eight cohort and case–control studies provides comprehensive analysis on disease features, diagnostic complexities, management, and outcomes related to hematopoietic stem cell transplantation (HSCT) in GATA2-related myeloid malignancies. Additionally, two pediatric cases are included to exemplify clinical and therapeutic challenges in real-world setting. Results: The literature data demonstrates high incidence of monosomy 7, and recurrent infections as the most common clinical feature, followed by immunodeficiency and lymphedema. Prognosis clearly worsens with age and HSCT remains the only curative treatment. GATA2 patients undergoing HSCT experience high rates of graft versus host disease (GvHD) as well as unique neurological, thrombotic, and infectious complications. Transplant-related mortality (TRM) is linked to GvHD and infections. Post-transplant cyclophosphamide (PT/Cy) strategies seem to improve survival by reducing GvHD incidence. Overall survival (OS) remains variable across groups. The first case presents rapid disease progression to pulmonary alveolar proteinosis (PAP) and leukemic transformation, further developing severe HSCT complications. The second case addresses novel GATA2 mutation and raises concerns regarding alternative prophylactic and therapeutic strategies in transplant setting. Conclusions: Collaborative efforts aim to enhance understandings of GATA2-related myeloid malignancies and guide towards more effective management approaches. Full article

The global rise in type 2 diabetes mellitus (T2DM) calls for an urgent focus on lifestyle interventions, particularly physical activity, as a critical factor in its management and prevention. This systematic review evaluates the impact of physical activity and sedentary behavior on glycemic control in individuals with T2DM. Studies included in this review were selected based on specific criteria: randomized controlled trials involving adults aged 18 and older, published in English between January 2018 and May 2024, with full-text availability and quantifiable outcome results. Exclusion criteria included non-peer-reviewed research, small sample sizes, and studies limited to abstracts, posters, or editorials. The analysis of the selected studies revealed that regular physical activity, including aerobic exercises and resistance training, significantly improves glycemic control as measured by fasting blood glucose (FBG) and glycated hemoglobin (HbA1C) levels. Reductions in sedentary behavior were also associated with better metabolic outcomes, highlighting the importance of integrating physical activity into daily routines for individuals with T2DM. These findings feature the need for continued research to refine and optimize lifestyle interventions to mitigate the global burden of T2DM. Full article

Background and Objectives: Severe early childhood caries (S-ECC) is a chronic infectious disease with a multifactorial etiology which has not been completely elucidated. Research on the role of oxidative stress in the etiopathogenesis of oral diseases suggests that the level of local antioxidants plays an important role in determining susceptibility to caries. This study aimed to demonstrate that the host’s redox imbalance, modified by genetic polymorphisms, may influence the onset and severity of S-ECC. Materials and Methods: A total of 110 patients were included in the study (59 diagnosed with S-ECC and 51 healthy controls). Upon initial appraisal, the DMFT (decayed-missing-filled teeth) index was determined, and epithelial cells were collected using oral swabs for genomic DNA extraction. Genotyping of SOD2 (rs4880) and GPX1 (rs1050450) was performed using TaqMan SNP genotyping assays and real-time polymerase chain reaction (PCR). Results: According to the results of the present study, there was a significant difference between the frequency of the reference genotype and variants for rs4880 (p = 0.0303). Subjects carrying the AG and GG variant genotype of rs4880 were significantly associated with a high DMFT value (p = 0.0005). However, no significant difference was found between the genotypes for rs1050450, nor was there an association with the severity of S-ECC. Conclusions: The AG and GG variant genotypes of the SOD2 polymorphism (rs4880) increase the severity of caries in preschoolers and predispose patients to develop carious lesions, especially when associated with certain feeding practices and infrequent toothbrushing. This observation emphasizes that host sensitivity to caries is a crucial factor in the onset and development of carious lesions in primary dentition, despite the main contributing factors to this pathology. The rs1050450 polymorphism was not associated with the severity of S-ECC. Full article

Background/Objectives: Molar–incisor hypomineralization (MIH) is a prevalent dental condition characterized by hypomineralized enamel affecting the first permanent molars and incisors. It leads to visible enamel opacities, with varying severity. Children with MIH often experience dental hypersensitivity, which can result in increased dental fear and anxiety, complicating dental treatment. Salivary cortisol, a well-established biomarker of stress, has been used to assess stress levels in various pediatric conditions but has not been extensively studied in MIH. This study aimed to assess salivary cortisol levels as a stress biomarker in children with MIH and compare them to those in children without MIH. Methods: Sixty children aged 5–9 years were divided into two groups: 31 with MIH and 29 healthy controls. Salivary cortisol levels were measured using ELISA, and statistical analysis was performed using IBM SPSS software, version 23 The Mann–Whitney test was used for group comparison, and the Kruskal–Wallis test evaluated the correlation between MIH severity and cortisol levels. Results: Children with MIH showed significantly higher mean cortisol levels (2.63 ng/mL) compared to controls (0.96 ng/mL), with a p-value of 0.0001. A progressive increase in cortisol levels was observed with the severity of MIH, with the highest levels recorded in grade 3 (4.38 ng/mL), in contrast to grade 0 (0.95 ng/mL), with a p-value of 0.001. Conclusions: Salivary cortisol levels are significantly higher in children with MIH, suggesting that MIH-related stress may contribute to dental anxiety and hypersensitivity. These findings highlight the importance of stress management in pediatric dental care. Full article

The separation of lead from the impurity bismuth remains a significant challenge, with achieving effective separation being a critical bottleneck in the production of high-purity lead via the vacuum gasification method. This study focuses on lead as the primary subject of investigation, conducting both theoretical and experimental research on the auxiliary conversion of lead through vacuum gasification. The calculations of the Gibbs free energy indicate that, within the temperature range of 600 to 610 K, the impurity bismuth reacts completely with calcium and magnesium, resulting in the formation of the compound CaMg₂Bi₂. Under optimal experimental conditions, the bismuth compound CaMg₂Bi₂ is converted into BiCa₂. Notably, BiCa₂ is nonvolatile and remains in the crucible as a residue. The auxiliary calcium is entirely transformed into CaSe and CaTe, leading to a reduction in the calcium content of the volatile substances from 0.5% to 16 ppm. Similarly, the magnesium content in the volatiles decreases from 0.66% to 187 ppm. Ultimately, the bismuth content in the final product is reduced from 6 ppm to 1.4 ppm, achieving a removal rate of 76.6%, while the direct yield of metallic lead reaches 71%. This process effectively facilitates the separation of metallic lead from the bismuth impurities. Full article

Background: Carpal tunnel syndrome (CTS) is a common peripheral neuropathy, often assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). The BCTQ evaluates symptom severity (SSS) and functional status (FSS) but has limitations in stratifying CTS severity, particularly in severe cases. Objective: This study aimed to evaluate the utility of the BCTQ in a homogeneous cohort of female workers engaged in repetitive manual tasks, exploring its correlation with objective clinical measures and its performance in detecting CTS severity. Methods: A cross-sectional study was conducted on 24 right-hand-dominant female workers with repetitive occupational tasks. CTS diagnosis was confirmed via clinical and electrodiagnostic criteria. Subjects completed the BCTQ, and correlations between BCTQ scores and objective measures such as median nerve cross-sectional area and nerve conduction studies were analyzed. Statistical analyses included comparisons across CTS severity groups and subgroup evaluations based on age and tenure. Results: The BCTQ demonstrated moderate correlations with objective measures, with a strong correlation between SSS and FSS scores (r = 0.86, p < 0.001). However, the sensitivity of the SSS and FSS was limited, particularly for severe CTS cases. Paradoxically lower scores in severe cases may reflect questionnaire limitations or adaptive responses. Targeted questions addressing pain and sensory symptoms showed better sensitivity (>80%) and may guide clinicians in identifying slight CTS cases. Conclusions: While the BCTQ remains a valuable tool for assessing CTS, its limitations necessitate complementary use of objective diagnostic tools, particularly for severe cases. Future refinements, such as tailored scoring systems and integration with clinical measures, could enhance its diagnostic utility and ensure comprehensive assessment of CTS severity. Full article

Carpal Tunnel Syndrome (CTS) is a prevalent neuropathic disorder caused by chronic compression of the median nerve, leading to sensory and motor impairments. Conventional treatments, such as corticosteroid injections, wrist splinting, and surgical decompression, often fail to provide adequate outcomes for chronic or recurrent cases, emphasizing the need for innovative therapies. Hydrogels, highly biocompatible three-dimensional biomaterials with customizable properties, hold significant potential for CTS management. Their ability to mimic the extracellular matrix facilitates localized drug delivery, anti-adhesion barrier formation, and tissue regeneration. Advances in hydrogel engineering have introduced stimuli-responsive systems tailored to the biomechanical environment of the carpal tunnel, enabling sustained therapeutic release and improved tissue integration. Despite these promising developments, hydrogel applications for CTS remain underexplored. Key challenges include the absence of CTS-specific preclinical models and the need for rigorous clinical validation. Addressing these gaps could unlock the full potential of hydrogel-based interventions, which offer minimally invasive, customizable solutions that could improve long-term outcomes and reduce recurrence rates. This review highlights hydrogels as a transformative approach to CTS therapy, advocating for continued research to address translational barriers. These innovations have the potential to redefine the treatment landscape, significantly enhancing patient care and quality of life. Full article