Search Results (9,505)

The Gross Motor Function Measure-66 (GMFM-66, range of values: 0 to 100 points) is one of the most widely used clinical tests to quantify motor function in children with cerebral palsy (CP). A disadvantage of the GMFM-66 is that it can take up to one hour to complete. The aim of the study was to evaluate whether the GMFM-66 can be predicted with sufficient accuracy by the results of an instrumental gait analysis (IGA) in ambulant children with CP. A retrospective analysis was conducted on n = 256 ambulant children with CP enrolled in a rehabilitation program between 2018 and 2023. The sample consisted of 97 females and 159 males, with a mean age of 9.0 years (SD 3.6 years). The IGA was performed with a Zebris FDM pressure plate. For the prediction of the GMFM-66, different statistical models were used (multiple linear regression and machine learning algorithms). Among the models considered, the XGBoost model had the best predictive performance (mean absolute error 6.32 (95%CI 5.35–7.28)). Agreement between results from gait analyses by the Zebris FDM pressure plate and GMFM-66 is not yet sufficient to predict the GMFM-66 score with acceptable accuracy for clinical purposes. Full article

Background and Objectives: Dual-task training (DTT) is an innovative therapeutic approach that involves the simultaneous application of two tasks, which can be motor, cognitive, or a combination of both. Children with cerebral palsy (CP) often exhibit impairments in balance, motor skills, and gait, conditions that may be amenable to improvement through DTT. The aim of this study was to determine the effectiveness of DTT in enhancing balance, walking speed, and gross motor function-related balance in children with CP. Materials and Methods: In accordance with PRISMA guidelines, a comprehensive systematic review with meta-analysis (SRMA) was conducted. Electronic databases like PubMed Medline, Scopus, Web of Science, CINAHL, and PEDro were searched up to March 2025, with no language or publication date restrictions. Only randomized controlled trials (RCTs) examining the effectiveness of DTT on balance, gross motor function, and walking speed in children with CP were included. The methodological quality and risk of bias of the included RCTs were assessed using the PEDro scale. Pooled effects were calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) within random-effects models. Results: Eight RCTs, providing data from 216 children, were included. Meta-analyses suggested that DTT was more effective than conventional therapies for increasing functional (SMD = 0.65; 95% CI 0.18 to 1.13), dynamic (SMD = 0.61; 95% CI 0.15 to 1.1), and static balance (SMD = 0.46; 95% CI 0.02 to 0.9), as well as standing (SMD = 0.75; 95% CI 0.31 to 1.18; p = 0.001) and locomotion dimensions (SMD = 0.65; 95% CI 0.22 to 1.08) of the Gross Motor Function Measure (GMFM) and walking speed (SMD = 0.46; 95% CI 0.06 to 0.87). Subgroup analyses revealed that a motor–cognitive dual task is better than a motor single task for functional, dynamic, and static balance and standing and locomotion dimensions for the GMFM. Conclusions: This SRMA, including the major number of RCTs to date, suggests that DTT is effective in increasing balance, walking and gross motor function-related balance in children with CP. Full article

Background/Objectives: Neuromedin U (NMU) is a highly conserved gene encoding a neuropeptide involved in the regulation of feeding behavior and energy homeostasis. We aimed to analyze the association between NMU genetic and epigenetic variations and cardio-metabolic parameters in an Italian population to identify the role of these variants in cardio-metabolic risk. Methods: A total of 4028 subjects were randomly selected from the Moli-sani study cohort. NMU haplotypes were estimated using seven SNPs located in the gene body and in the promoter region; DNA methylation levels in the promoter region, previously associated with lipid-related variables in the same population, were also used. Results: Among the haplotypes inferred, the haplotype carrying the highest number of minor variants (frequency 16.6%), when compared with the most frequent haplotype, was positively associated with insulin levels, HOMA-IR, and diastolic blood pressure, and negatively with HDL-cholesterol. The multivariable analysis that considered methylation levels along with their interactions with SNPs showed that increased methylation levels in two close CpG sites were associated with higher levels of lipid-related variables. Conclusions: This study supports a role for NMU as a regulator of human metabolism. This finding suggests that NMU could be a potential target for preventive interventions against coronary and cerebrovascular diseases, and that NMU genetic and epigenetic variability may serve as a biomarker for cardio-metabolic risk. Full article

Background: A dilated main pancreatic duct (MPD) ≥ 5 mm can be observed in main-duct IPMNs (MD-IPMN) and chronic pancreatitis (CP); however, distinguishing between the two differently treated diseases can be difficult. Cell-free (cf) DNA in MPD fluid obtained by EUS-guided FNA might help to distinguish MD-IPMN from CP. Methods: All patients with a dilated MPD ≥ 5 mm on EUS during the period of 1 June 2017 to 30 April 2024 were prospectively analysed in this single-centre study, with EUS-guided MPD fluid aspiration performed for suspected MD-IPMN or CP in patients who were suitable for surgery. Twenty-two known gastrointestinal cancer genes, including GNAS and KRAS, were analysed by deep targeted (dt) NGS. The results were correlated with resected tissue, biopsy, and long-term follow-up. Results: A total of 164 patients with a dilated MPD were identified, of which 30 (18.3%) underwent EUS-guided FNA, with 1 patient having a minor complication (3.3%). Twenty-two patients (mean MPD diameter of 12.4 (7–31) mm) with a definitive, mostly surgically confirmed diagnosis were included in the analysis. Only a fish-mouth papilla, which was present in 3 of 12 (25%) MD-IPMNs, could reliably differentiate between the two diseases, with history, symptoms, diffuse or segmental MPD dilation, presence of calcifications on imaging, cytology, and CEA in the ductal fluid failing to achieve differentiation. However, GNAS mutations were found exclusively in 11 of the 12 (91.6%) patients with MD-IPMN (p < 0.01), whereas KRAS mutations were identified in both diseases. Conclusions: GNAS testing by dtNGS in aspirated fluid from dilated MPD obtained by EUS-guided FNA may help differentiate MD-IPMN from CP for surgical resection. Full article

Purpose: The present study aims to evaluate alterations in the peripapillary retinal nerve fiber layer (RNFL) thickness in pediatric patients following surgical resection of childhood-onset craniopharyngioma (CP) and to identify tumor characteristics and other factors influencing these alterations, including changes in the lesion’s location. Design: retrospective clinical cohort study. Methods: A retrospective analysis was conducted on 73 eyes from 38 patients with CP and 64 eyes from 32 age- and sex-matched healthy controls. The mean age of the CP patients was 10.3 ± 4.2 years (range 4–17), while the control group had a mean age of 10.5 ± 3.1 years (range 4–17). Optical coherence tomography (OCT) was used to assess the peripapillary RNFL thickness in the study and control groups. RNFL thickness was analyzed in the superior, inferior, and average sectors, as well as across eight optic nerve sectors. Tumor characteristics were evaluated to determine their correlation with changes in RNFL thickness in individual sectors. Results: Postoperative thickness of peripapillary RNFL in all individual sectors was significantly reduced in the CP group compared to healthy controls. Location, tumor volume, maximum tumor diameter, calcification, ventriculoperitoneal shunt, surgery technique, total resection, presence of Rosenthal fibers, and reoperation due to progression or recurrence correlated with damage to RNFL. Conclusions: CP is associated with significant reductions in RNFL thickness, indicating the tumor’s impact on optic nerve fibers. OCT is a valuable tool for monitoring visual pathway impairment and postoperative outcomes. Correlations between RNFL thickness in individual sectors and clinical parameters may offer valuable insights for diagnosis and monitoring, underlining their potential role in predicting visual outcomes. Regular RNFL evaluation should be integrated into the long-term care of CP patients to optimize visual prognosis and detect progressive or residual damage. Full article

This study aims to evaluate eco-innovative solutions in the fertilizer industry that allow for waste valorization in the context of a resource-efficient circular economy. A comprehensive reuse strategy was developed for low-rank peat and post-cultivation horticultural mineral wool, involving the extraction of valuable humic substances from peat and residual nutrients from used mineral wool, followed by the use of both post-extraction residues to produce organic–mineral substrates. The resulting products/semifinished products were characterized in terms of their composition and properties, which met the requirements necessary to obtain the admission of this type of product to the market in accordance with the Regulation of the Minister for Agriculture and Rural Development of 18 June 2008 on the implementation of certain provisions of the Act on fertilizers and fertilization (Journal of Laws No 119, item 765). Elemental analysis, FTIR spectroscopy, and solid-state CP-MAS ¹³C NMR spectroscopy suggest that post-extraction peat has a relatively condensed structure with a high C content (47.4%) and a reduced O/C atomic ratio and is rich in alkyl-like matter (63.2%) but devoid of some functional groups in favor of extracted fulvic acids. Therefore, it remains a valuable organic biowaste, which, in combination with post-extraction waste mineral wool in a ratio of 60:40 and possibly the addition of mineral nutrients, allows us to obtain a completely new substrate with a bulk density of 264 g/m³, a salinity of 7.8 g/dm³ and a pH of 5.3, with an appropriate content of heavy metals and with no impurities, meeting the requirements of this type of product. A liquid fertilizer based on an extract containing previously recovered nutrients also meets the criteria in terms of quality and content of impurities and can potentially be used as a fertilizing product suitable for agricultural crops. This study demonstrates a feasible pathway for transforming specific waste streams into valuable agricultural inputs, contributing to environmental protection and sustainable production. The production of a new liquid fertilizer using nutrients recovered from post-cultivation mineral wool and the preparation of an organic–mineral substrate using post-extraction solid residue is a rational strategy for recycling hard-to-biodegrade end-of-life products. Full article

Understanding changes in land use structures under multiple scenarios and their impacts on carbon storage is essential for revealing the evolution of regional development patterns and the underlying mechanisms of carbon cycle dynamics. This study adopted an integrated PLUS-InVEST modeling framework to analyze and predict changes in carbon storage in the Central Plains Urban Agglomeration (CPUA) under different scenarios for the years 2030 and 2060. The results showed the following: (1) From 2000 to 2020, the areas of forest land, water bodies, and construction land expanded, while the areas of cropland, grassland, and barren land decreased. Over this 20-year period, carbon storage showed a declining trend, decreasing from 2390.07 × 10⁶ t in 2000 to 2372.19 × 10⁶ t in 2020. (2) In both 2030 and 2060, cropland remained the primary land use type in the CPUA. Overall, carbon storage in the CPUA was higher in the southwestern area and decreased in the central and eastern parts, which was mainly related to the land use distribution pattern in the CPUA. (3) Carbon storage under the EP (ecological protection) and CP (cropland protection) scenarios was significantly higher than under the other two scenarios, and in 2030, carbon storage under the CP and EP scenarios exceeded that in 2020, while the UD (urban development) scenario had the lowest total carbon storage. This indicated that the expansion of construction land was detrimental to carbon storage enhancement, underscoring the importance of implementing ecological protection strategies. In summary, the results of this study quantitatively reflected the changes in carbon storage in the CPUA under different future development scenarios, providing a reference for formulating regional development strategies. Full article

Maternal undernutrition (MUN) causes severe metabolic disruption in the offspring of mammals. Here we determined the role of histone modification in hepatic gene expression in late-gestation fetuses of nutritionally restricted cows, an established model using low-nutrition (LN) and high-nutrition (HN) conditions. The chromatin immunoprecipitation sequencing results show that genes with an altered trimethylation of histone 3 lysine 4 (H3K4me3) are associated with cortisol synthesis and secretion, the PPAR signaling pathway, and aldosterone synthesis and secretion. Genes with the H3K27me3 alteration were associated with glutamatergic synapse and gastric acid secretion. Compared to HN fetuses, promoter H3K4me3 levels in LN fetuses were higher in GDF15, IRF2BP2, PPP1R3B, and QRFPR but lower in ANGPTL4 and APOA5. Intriguingly, genes with the greatest expression changes (>1.5-fold) exhibited the anticipated up-/downregulation from elevated or reduced H3K4me3 levels; however, a significant relationship was not observed between promoter CpG methylation or H3K27me3 and the gene set with the greatest expression changes. Furthermore, the stress response genes EIF2A, ATF4, DDIT3, and TRIB3 were upregulated in the MUN fetal liver, suggesting activation by upregulated GDF15. Thus, H3K4me3 likely plays a crucial role in MUN-induced physiological adaptation, altering the hepatic gene expression responsible for the integrated stress response and systemic energy metabolism, especially circulating lipoprotein lipase regulation. Full article

Background/Objectives: The advent of tyrosine kinase inhibitors (TKIs) revolutionized the management of chronic myeloid leukemia (CML), achieving survival rates near those of the general population. Despite this success, prolonged therapy presents challenges, including physical, emotional, and financial burdens. Treatment-free remission (TFR), defined as sustained deep molecular response (DMR) after discontinuing TKIs, has emerged as a viable clinical goal. This study evaluates real-world data from the Canary Islands Registry of CML (RCLMC) to explore outcomes, predictors, and the feasibility of TFR. Methods: This retrospective observational study included 393 patients diagnosed with CML-CP between 2007 and 2023. Molecular response was monitored according to international guidelines. Survival probabilities were estimated using the Kaplan–Meier method. Logistic regression analysis was performed to identify predictors of molecular relapses after TKI discontinuation. Results: Of the 383 patients who received TKI treatment, 58.3% achieved molecular response grade 2 (MR2) (BCR-ABL1 ≤ 1%), 95.05% achieved MR2, and 50.5% reached MR4 within the first year. Of the 107 patients attempting TFR, 73.2% maintained remission at 36 months. Relapses occurred in 24 patients, all regaining molecular response upon reintroduction of TKIs. No cases of disease progression were observed. Conclusions: Our findings support the feasibility and safety of TFR in a real-world clinical setting for well-selected patients, with outcomes consistent with international studies. The study underscores the importance of molecular monitoring and patient-specific strategies to optimize outcomes. Full article

Objective: Cervical pregnancy (CP) accounts for less than 1% of all ectopic pregnancies. The standard of management for CP is still under detailed investigation; however, among the known treatment methods, super-selective uterine artery embolization (UAE) and the use of methotrexate (MTX) have emerged as effective and minimally invasive options in recent years. Our aim is to present our center’s experience and provide available evidence evaluating the efficacy of UAE in the treatment of CP. Materials and Methods: This single-center and retrospective study evaluated the procedural and clinical outcomes of patients with CP who underwent endovascular uterine embolization with MTX between 2017 and 2024. Both procedural and clinical efficacy and safety, as well as the rate of complications and long-term outcomes, were noted. Results: A total of nine patients were diagnosed with CP (imaging examination included transvaginal ultrasound and/or magnetic resonance imaging) and referred for endovascular treatment. The mean age of the patients was 36.7 years, and the mean gestational age on admission was 9 weeks. In all cases, selective catheterization of supplying vessels and subsequent embolization with a mixture of methotrexate and gel sponge was carried out. The technical success rate was 100% with no complications. Follow-up ultrasound confirmed the disappearance of the flow signal around the intracervical gestational sac in all cases. Conclusions: In conclusion, this retrospective study demonstrated the procedural and clinical safety and efficacy of uterine artery embolization in patients with cervical pregnancy. This is why endovascular therapy should be proposed to these individuals and be included in treatment options discussed during multidisciplinary boards. Full article

To study the mechanical properties and modification mechanism of thermosetting polyurethane (PU)-modified asphalt, the effects of polyurethane dosage on the workability of polyurethane-modified asphalt were analyzed by means of rotational viscosity tests. The mechanical properties of polyurethane-modified asphalt with different polyurethane dosages were explored using tensile tests and dynamic mechanical analysis (DMA). In addition, the thermodynamic behavior and micromorphology of polyurethane-modified asphalt were also thoroughly investigated using the test results of differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). The results showed that PU obtained the optimum workability when the polyurethane dose was 50%: at 120 min, its rotational viscosity was 1005 cp, which was lower than 2800 cp (40% PU) and 760 cp (60% PU). Additionally, the results of fracture elongation and fracture strength indicated that the PU-modified asphalt had good flexibility and strength. Compared with base asphalt, the tensile strength of 50% PU-modified asphalt increased by 509%, which was significantly higher than 157% (40% PU) and more balanced than 897% (60% PU) in terms of strength and flexibility. Added PU can significantly improve the elasticity of asphalt at high temperatures, while increasing the proportion of asphalt adhesive components, enhancing the deformation ability and temperature stability of asphalt. As the dose of PU increases, the interface between asphalt and PU blended more fully, and the surface became smoother. When the dose of PU was 50% or more, the interface between asphalt and PU was well integrated with a smooth and flat surface, forming a more uniform and stable cross-linked network structure. Full article

Human colorectal cancer (CRC) encompasses tumors affecting a segment of the large intestine (colon) and rectum. It is the third most commonly diagnosed malignancy and the second leading cause of cancer deaths worldwide. It is a multifactorial disease, whose carcinogenesis process involves genetic and epigenetic alterations in oncogenes and tumor suppressor genes, including genes related to DNA repair. The pathogenic mechanisms are described based on the pathways of chromosomal instability, microsatellite instability, and CpG island methylator phenotype. When detected early, CRC is potentially curable, and its treatment is based on the pathological characteristics of the tumor and factors related to the patient, as well as on drug efficacy and toxicity studies. Therefore, the aim of this study was to review the pathogenesis and molecular subtypes of CRC and to describe the main targets of disease-directed therapy used in patients refractory to current treatments. Full article

Cutibacterium acnes is linked to the prevalent inflammatory skin disorder known as Acne Vulgaris (AV). Some topical agents exhibit unfavorable side effects like dryness and skin inflammation, and antimicrobial resistance (AMR) poses an increasing risk to effective AV management. This study develops and characterizes stable topical essential oil (EO)-loaded microemulgels with in vitro validated antimicrobial activities against C. acnes ATCC 6919, providing a solid scientific basis for their effectiveness. These microemulgels, with their potential to serve as an alternative to AMR-prone synthetic agents, could revolutionize the field of acne treatment. The MICs of the EOs (citronella, tea tree, and lemongrass) against C. acnes were determined. EO-loaded microemulgels were developed using a blend of microemulsion and carbopol/hyaluronic acid gel in a ratio of 1:1 and characterized, and their stability was observed over three months. The MICs of citronella, tea tree, and lemongrass EOs were 0.08, 0.16, and 0.62% v/v, respectively. The microemulgels were whitish and smooth, with characteristic EO odors. They demonstrated pH values ranging between 4.81 ± 0.20 and 5.00 ± 0.03, good homogeneity, a spreadability of 9.79 ± 0.6 and 12.76 ± 0.8 cm², a viscosity of 29,500 and 31,130 cP, and retained stability at 4, 25, and 40 °C. EO-loaded microemulgels were developed with the potential of C. acnes management. The formulation shows adequate potential for further pharmaceutical development towards translational adoption in acne management. Full article

Background: Genetic polymorphisms in the cyclooxygenase-2 (COX-2) gene may contribute to individual susceptibility to periodontal disease. A meta-analysis assessed the association between three COX-2 single-nucleotide polymorphisms (SNPs) namely, −765 G/C (rs20417), −1195 G/A (rs689466), and 8473 T/C (rs5275), and the risk of CP. Methods: Following the PRISMA 2020 guidelines, we conducted a comprehensive search of five electronic databases and additional sources. The eligible studies were observational (case–control or cohort) with genotypic data comparing individuals with periodontal disease and periodontally healthy controls. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS), and the certainty of evidence was evaluated via the GRADE framework. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated under dominant genetic models. Results: Seven studies (n = 1467 participants) met the inclusion criteria. No eligible studies evaluated the 8473 T/C SNP. The meta-analysis of the −765 G/C variant revealed a significant association with periodontal disease (OR = 1.61; 95% CI: 1.12–2.32, p = 0.03; I² = 0%). For the −1195 G/A variant, the pooled OR was 1.86 (95% CI: 1.00–3.43, p = 0.05; I² = 35%), suggesting a borderline significant association. The certainty of evidence was graded as moderate for −765 G/C and low for −1195 G/A. Conclusions: The COX-2 −765 G/C polymorphism is significantly associated with increased CP risk, while the −1195 G/A variant shows a potential, though less certain, link. Larger, high-quality studies using standardized classifications are needed to confirm these associations. Full article

Carbon (C) sequestration and nitrogen (N) and phosphorus (P) accumulation in urban forest green spaces are significant for global climate regulation and alleviating nutrient pollution. However, the effects of management and conservation practices across different urban forest vegetation types on soil C, N, and P contents and stoichiometric ratios remain largely unexplored. We selected forest soils from Guangzhou, a major Metropolis in China, as our study area. Soil samples were collected from two urban secondary forests that naturally regenerated after disturbance (108 samples) and six urban forest parks primarily composed of artificially planted woody plant communities (72 samples). We employed mixed linear models and variance partitioning to analyze and compare soil C, N, and P contents and their stoichiometry and its main driving factors beneath suburban forests and urban park vegetation. These results exhibited that soil pH and bulk density in urban parks were higher than those in suburban forests, whereas soil water content, maximum storage capacity, and capillary porosity were higher in urban forests than in urban parks. Soil C, N, and P contents and their stoichiometry (except for N:P ratio) were significantly higher in suburban forests than in urban parks. Multiple analyzes showed that soil pH had the most pronounced negative influence on soil C, N, C:N, C:P, and N:P, but the strongest positive influence on soil P in urban parks. Soil water content had the strongest positive effect on soil C, N, P, C:N, and C:P, while soil N:P was primarily influenced by the positive effect of soil non-capillary porosity in suburban forests. Overall, our study emphasizes that suburban forests outperform urban parks in terms of carbon and nutrient accumulation, and urban green space management should focus particularly on the impact of soil pH and moisture content on soil C, N, and P contents and their stoichiometry. Full article