Search Results (79)

Background: Microbiological culture and histology are gold standards for diagnosing chronic osteomyelitis (cOM) and fracture-related infection (FRI). This study investigated whether combining these modalities within a single tissue sample provides additional insight into disease severity. We hypothesized that high neutrophil and osteoclast numbers correlate with culture-positive microbiology and that double-positive samples may indicate more severe disease. Methods: In this prospective single-centre study, adults undergoing surgery for confirmed FRI or cOM were included. Clinical and disease classification data (FRI and BACH) were recorded. Five deep-tissue samples were collected intraoperatively and divided for paired microbiological culture and histological assessment of neutrophil infiltration, according to international diagnostic guidelines. Results: Forty-one patients were included (11 cOM, 30 FRI) of whom 68% received preoperative antibiotics. Nineteen patients (46%) were identified as culture-positive, while 32 patients (78%) were histologically positive according to international diagnostic guidelines, respectively. Among the 205 samples, 31% were culture-positive, 56% histology-positive, and 26% double-positive. Histological scores were significantly higher in culture-positive samples (p < 0.001). Treatment failure occurred in seven patients (18%), all with FRI. Paired positive samples were associated with increased odds of clinical failure and earlier revision, with odds increasing 1.68-fold for each additional paired positive sample (95% CI, 1.10–2.77). Conclusions: The paired analysis demonstrated a strong concordance between culture-positivity and suppurative inflammation within the same sample. Combining microbiology and histology may help identify patients at increased risk of revision and enhance diagnostic certainty, particularly in patients identified as culture-negative. Full article

Background/Objectives: Low physical activity (PA) is becoming an increasingly serious health problem among overweight school-age children. This study aimed to evaluate the influence of elevated PA during school hours on the nutritional behavior and fat mass of overweight and obese children. Methods: The study involved 11-year-old children (n = 148) who were overweight and obese. In the control group, children received physical education lessons in the standard dimension (4 h a week) while the intervention group received 10 h. Body mass index (BMI), fat mass (FM), and nutritional behavior were analyzed. Results: Compared to baseline, at the end of the intervention, the proportion of obese children increased in the control group and decreased in the intervention group. Regarding nutritional behavior, low consumption of vegetables, fruits, whole grains, poultry, and fish was observed. After a 12-month period, the intervention group showed a slight decrease in the consumption of fruits, vegetables, cold cuts, fried dishes, sweets, and fast food, and an increase in the consumption of white bread, whole-grain bread, poultry, red meat, and dairy products (milk, yogurt). In the control group, children exhibited an average increase in the consumption of fruits, vegetables, poultry, red meat, sweets, and fast food Conclusions: Although extended physical activity during school hours was correlated with a decrease in the number of obese children, the observational nature of the study precludes the drawing of definitive conclusions. The intervention may have contributed to an increase in energy expenditure, which could account for the improvements in BMI and FM. Nevertheless, the impact on nutritional behavior was limited. Full article

Background: Obesity is a well-established risk factor for numerous chronic diseases, including heart disease and type 2 diabetes, and its impact is particularly acute among Black/African American men. According to the Centers for Disease Control and Prevention (CDC), 70.9% of Black men aged 20 and older are overweight or obese. Despite this alarming prevalence, there remains a limited number of studies that specifically investigate the root causes of obesity in this population. Addressing this gap is critical to developing culturally relevant interventions that promote health equity. The purpose of this study was to assess dietary patterns, that are associated with overweight/obesity, in Black men aged 18–65 across the United States of America, to gain an in-depth understanding of variables influencing BMI in Black men. Methods: This study utilized a quantitative approach to collect information from participants. A survey questionnaire was developed and administered via Qualtrics to participants using a web link. The survey collected information across 18 dietary variables. Data was exported to Microsoft Excel for statistical analysis. A simple linear regression was used to determine dietary variables correlation strength and significance with BMI. A significance level of p < 0.05 was used to determine if a variable was statistically significant. Variables were then organized based on significance vs. non significance and correlation strength. Result: The study sample consisted of 466 Black men aged 18 to 65 years. The mean BMI was 30.21. Approximately 19% (n = 87) had a BMI within the healthy range (18.5–24.9), 41% (n = 190) were categorized as overweight (BMI 25.0–29.9), and another 41% (n = 189) were classified as obese (BMI ≥ 30.0). The findings revealed that fruit and vegetable consumption and whole grain cereal consumption were significantly and positively correlated with BMI. Other variables, such as fried foods, processed foods, and sugary drinks, though historically associated with obesity, did not show statistical significance in this population. Conclusions: Results suggest that while multiple dietary factors influence BMI, fruit, vegetable, and whole grain consumption are significantly correlated with BMI in Black men living in America. The findings from this study serve as a foundational step for designing targeted, culturally sensitive interventions aimed at reducing obesity-related health disparities. Future research should further explore how tailored public health messaging and community-based programming can address the specific needs of this population. Full article

Background/Objectives: Electronic fetal monitoring (EFM) has been used for intrapartum fetal surveillance for over 50 years. Despite numerous trials comparing EFM with standard fetal heart rate (FHR) auscultation, it remains contentious whether continuous monitoring with standard interpretation has reliably improved perinatal outcomes, specifically lower rates of perinatal morbidity and mortality. This review examines previous attempts to improve fetal monitoring and presents future directions for novel intrapartum fetal surveillance systems. Methods: We conducted a chronological review of EFM developments, including ancillary methods such as fetal ECG analysis, automated systems for FHR analysis, and artificial intelligence applications. We analyzed the evolution from visual interpretation to intelligent systems and evaluated the performance of various automated monitoring platforms. Results: Various ancillary methods developed to improve EFM accuracy for predicting fetal compromise have shown limited success. Only a limited number of studies demonstrated that adding fetal ECG analysis to visual FHR pattern interpretation resulted in better fetal outcomes. Automated systems for FHR analysis have not consistently enhanced intrapartum fetal surveillance. However, novel approaches such as the Fetal Reserve Index (FRI) show promise by incorporating clinical risk factors with traditional FHR patterns to provide higher-level risk assessment and prognosis. Conclusions: The shortcomings of visual interpretation of FHR patterns persist despite technological advances. Future intelligent intrapartum surveillance systems must combine conventional fetal monitoring with comprehensive risk assessment that incorporates maternal, fetal, and obstetric factors. The integration of artificial intelligence with contextualized metrics like the FRI represents the most promising direction for improving intrapartum fetal surveillance and clinical outcomes. Full article

Background/Objectives: Frailty is a multidimensional syndrome characterized by diminished physiological reserves, reduced mobility, and increased fall risk. While clinical assessments are commonly used to screen for frailty, they may not capture minor deficits in postural control. Center-of-pressure (CoP) metrics from force plates provide objective markers of postural control, yet their role in frailty screening remains underexplored. This study aimed to investigate the associations between functional performance measures and CoP-based metrics to identify predictors of frailty among older adults. Methods: Eighty-three adults aged ≥ 55 years with a history of falls were classified as frail or pre-frail based on modified Fried criteria. Functional assessments (Timed Up and Go (TUG), grip strength, Berg Balance Scale [BBS], Falls Efficacy Scale [FES]) and CoP metrics (mean velocity, sway path; eyes open/closed) were evaluated. Both unadjusted and age-adjusted logistic regression models were used to identify independent predictors of frailty. Results: Increased TUG time and number of falls were the strongest risk factors for frailty, while increased sway path and CoP velocity were protective. In particular, sway path under eyes-closed conditions showed the strongest protective association (OR = 0.323, p < 0.001). Additionally, fear of falling (OR = 1.078, p = 0.013) emerged as a significant psychological factor, consistently associated with increased frailty risk regardless of physical performance. Correlation analysis supported these findings, showing that better functional performance was linked to lower frailty risk. Conclusions: CoP sway path and mean velocity independently predict frailty status and offer added value beyond traditional clinical tools. These findings highlight the importance of incorporating instrumented balance assessments into frailty screening to capture nuanced postural control deficits and guide early intervention strategies. Full article

Annona amazonica R.E. Fries (synonyms Annona amazonica var. lancifolia R.E. Fries), popularly known in Brazil as “envireira”, is a tropical tree belonging to the Annonaceae family and is traditionally used as a food source. In this work, the in vitro and in vivo anti-liver cancer effects of essential oil (EO) from A. amazonica leaves were investigated for the first time. The chemical composition of the EO was evaluated via GC–MS and GC–FID. The alamar blue assay was used to evaluate the cytotoxicity of EOs against different cancerous and noncancerous cell lines. Cell cycle analyses, YO-PRO-1/PI staining, and rhodamine 123 staining were performed via flow cytometry in HepG2 cells treated with EO. The in vivo antitumor activity of EO was evaluated in NSG mice that were xenografted with HepG2 cells and treated with EO at a dose of 60 mg/kg. The major constituents (>5%) of the EO were (E)-caryophyllene (32.01%), 1,8-cineole (13.93%), α-copaene (7.77%), α-humulene (7.15%), and α-pinene (5.13%). EO increased apoptosis and proportionally decreased the number of viable HepG2 cells. The induction of DNA fragmentation and cell shrinkage together with a significant reduction in the ΔΨm in EO-treated HepG2 cells confirmed that EO can induce apoptosis. A significant 39.2% inhibition of tumor growth in vivo was detected in EO-treated animals. These data indicate the anti-liver cancer potential of EO from A. amazonica leaves. Full article

Microbiological safety and quality consistency are critical challenges in the production of traditional Indian fried snacks, particularly in small-scale food enterprises. With growing export demand, maintaining strict quality control measures is essential. This study assessed the microbiological and physicochemical quality of five traditional Indian fried snacks—Kerala Murukku, Kerala Mixture, Banana Chips, Tapioca Chips, and Achappam—produced in a Food Safety Management System (FSMS)-certified facility over a four-year period (2020–2023). Products were evaluated for moisture, pH, salt content, acid value, and Total Plate Count (TPC). The number of ingredients for each product was recorded from standardized product formulation documents. TPC levels remained within acceptable limits (below 50,000 CFU/g) across all products. Among them, Kerala Mixture consistently showed the highest microbial counts (up to 4.61 log CFU/g) and Achappam the lowest, with no detectable variance (1.00 log CFU/g). Statistically significant year-wise differences (p < 0.05) were observed in all quality parameters. Kerala Mixture showed variation in salt and microbial load; Kerala Murukku varied in moisture, pH, and salt; while Tapioca Chips varied in moisture and salt. PCA identified that TPC, salt content, number of ingredients, and pH were key contributors to product variability. Cluster analysis confirmed Kerala Mixture as the most susceptible product to contamination risk. These findings provide valuable insights into the quality trends within an FSMS-certified environment and highlight the importance of strict post-processing controls. Full article

Orphan genes (OGs), which are unique to a specific taxon and have no detectable sequence homology to any known genes across other species, play a pivotal role in governing species-specific phenotypic traits and adaptive evolution. In this study, 20 OGs of Chinese cabbage (Brassica rapa OGs, BrOGs) were transferred into Arabidopsis thaliana by genetic transformation to construct an overexpression library in which 50% of the transgenic lines had a delayed flowering phenotype, 15% had an early flowering phenotype, and 35% showed no difference in flowering time compared to control plants. There were many other phenotypes attached to these transgenic lines, such as leaf color, number of rosette leaves, and silique length. To understand the impact of BrOGs on delayed flowering, BrOG142OE, which showed the most significantly delayed flowering phenotype, was chosen for further analysis, and BrOG142 was renamed BOLTING RESISTANCE 4 (BR4). In BR4OE, the expression of key flowering genes, including AtFT and AtSOC1, significantly decreased, and AtFLC and AtFRI expression increased. GUS staining revealed BR4 promoter activity mainly in the roots, flower buds and leaves. qRT-PCR showed that BR4 primarily functions in the flowers, flower buds, and leaves of Chinese cabbage. BR4 is a protein localized in the nucleus, cytoplasm, and cell membrane. The accelerated flowering time phenotype of BR4OE was observed under gibberellin and vernalization treatments, indicating that BR4 regulates flowering time in response to these treatments. These results provide a foundation for elucidating the mechanism by which OGs regulate delayed flowering and have significance for the further screening of bolting-resistant Chinese cabbage varieties. Full article

The present study was designed to evaluate the effect of supplementation with papaya seeds (PSM), fish testes powder (FTP), and 17α-methyltestosterone (MT) on the reproductive parameters, growth performance, digestive enzymes, and histology of Cyprinus carpio. In the present study, fries (2–3 days old) were acclimatized for 2 days and then equally distributed into one control and six treatment groups and fed with one control and six experimental diets for 30 days, followed by a control diet for 60 days in each group with triplicates. These diets included control (T0), different levels of 17α-methyltestosterone (T1: 60 mg/kg; T2: 70 mg/kg), papaya seed powder (T3: 6 g/kg; T4: 7 g/kg), and fish (tilapia) testes powder (T5: 70%; T6: 80%). The treatment groups receiving papaya seed meal (PSM) showed significant improvements in growth performance, with a significant increase in final body weight. The best zootechnical performances (PER, SGR, and CF) were observed in fish fed with papaya seed compared to the control group. Reproductive analysis showed significant variations between treatment groups, with a large number of female C. carpio observed in the control group. Fish treated with T4 increased the sex percentage in favor of male fish by achieving 90% male phenotype followed by T6 with 88% male. Diets based on papaya seeds and fish testes powder significantly reduced the reproductive performance by reducing GSI, which affected the gonadal histology. The results revealed a visible effect of 17 α-MT and PSM feeding on the gonad structure. There were significant elevations in protease enzyme activity in T6 compared to the control (p < 0.05), and the highest amylase activity was observed in T3. Natural resources are not only more cost-effective but also environmentally friendly and readily available; they are a superior choice over synthetic alternatives for controlling the prolific breeding of C. carpio. Full article

Near-infrared (NIR) spectroscopy, combined with multivariate calibration techniques such as stepwise decorrelation of variables (SELECT) and ordinary least squares (OLS) regression, was used to develop robust, reduced-spectrum regression models for quantifying key phenolic compound markers in various olive oils. These oils included nine extra virgin olive oil (EVOO) varieties, refined olive oil (ROO) blended with virgin olive oil (VOO) or EVOO, and pomace olive oil, both with and without hydroxytyrosol (HTyr) supplementation. Olive oils were analyzed before and after deep frying. The results show that HTyr ranged from 7.28 mg/kg in Manzanilla (lowest) to 21.43 mg/kg in Royuela (highest). Tyrosol (Tyr) varied from 5.87 mg/kg in Royuela (lowest) to 14.86 mg/kg in Hojiblanca (highest). Similar trends were observed in all phenolic fractions across olive oil cultivars before and after deep-frying. HTyr supplementation significantly increased both HTyr and Tyr levels in non-fried and fried supplemented oils, with HTyr rising from single digits in some controls (around 0 mg/kg) to over 300 mg/kg in most of the supplemented samples. SELECT efficiently reduced redundancy by selecting the most vital wavelengths and thus significantly improved the regression models for key phenolic compounds, including HTyr, Tyr, caffeic acid, decarboxymethyl ligstroside aglycone in dialdehyde form (oleocanthal), decarboxymethyl oleuropein aglycone in dialdehyde form (oleacein), homovanillic acid, pinoresinol, oleuropein aglycone in oxidized aldehyde and hydroxylic form (OAOAH), ligstroside aglycone in oxidized aldehyde and hydroxylic form (LAOAH), and total phenolic content (TPC), achieving correlation coefficients (R) of 0.91–0.98. The SELECT-OLS method generated highly predictive models with minimal complexity, using at most 30 wavelengths out of 700. The number of decorrelated predictors varied, at 12, 14, 15, 30, 30, 21, 30, 30, 30, and 18 for HTyr, Tyr, caffeic acid, oleocanthal, oleacein, homovanillic acid, pinoresinol, OAOAH, LAOAH, and TPC, respectively, demonstrating the adaptability of the SELECT-OLS approach to different spectral patterns. These reliable calibration models enabled online and routine quantification of phenolic compounds in EVOO, VOO, ROO, including both non-fried and fried as well as supplemented and non-supplemented samples. They performed well across eight deep-frying conditions (3–6 h at 170–210 °C). Implementing an NIR instrument with optimized variable selection would simplify spectral analysis and reduce costs. The developed models all demonstrated strong predictive performance, with low leave-one-out mean prediction errors (LOOMPEs) with values of 15.69, 8.47, 3.64, 9.18, 16.71, 3.26, 8.57, 13.56, 56.36, and 82.38 mg/kg for HTyr, Tyr, caffeic acid, oleocanthal, oleacein, homovanillic acid, pinoresinol, OAOAH, LAOAH, and TPC, respectively. These results confirm that NIR spectroscopy combined with SELECT-OLS is a feasible, rapid, non-destructive, and eco-friendly tool for the reliable evaluation and quantification of phenolic content in edible oils. Full article

Background: Vestibular hypofunction occurs in 29.5% of older adults with benign paroxysmal positional vertigo (BPPV), but its impact on postural control, well-being and frailty was not studied before. This study compared the well-being, frailty and postural control between older adults with BPPV and vestibular hypofunction (oaBPPV+), and older adults with only BPPV (oaBPPV). Methods: Thirty-one older adults (≥65 years old) diagnosed with BPPV were recruited. Unilateral vestibular hypofunction was defined as a >25% caloric asymmetry, and bilateral vestibular hypofunction as a total response <6°/s per ear, using bithermal caloric irrigations. The oaBPPV+ group was compared to the oaBPPV group using the measures of well-being (Dizziness Handicap Inventory, Falls Efficacy Scale and 15-item Geriatric Depression Scale), frailty (Modified Fried Criteria), and postural control (timed chair stand test, mini-Balance Evaluation Systems test and Clinical Test of Sensory Interaction on Balance (CTSIB)). Falls and the number of repositioning maneuvers were documented. Significance level was set at α = 0.05. Results: Unilateral vestibular hypofunction was present in 32% of participants, mainly in females (p = 0.04). Bilateral vestibular hypofunction was not found. The oaBPPV+ group (n = 10, mean age 72.5 (4.5)) experienced more comorbidities (p = 0.02) than the oaBPPV group (n = 21, mean age 72.6 (4.9)). Groups did not differ regarding dizziness symptoms (p = 0.46), fear of falling (p = 0.44), depression (p = 0.48), falls (p = 0.08) or frailty (p = 0.36). However, the oaBPPV+ group showed significantly worse postural control under vestibular-dependent conditions (p < 0.001). Conclusions: Despite equally impaired well-being and frailty, the oaBPPV+ group showed greater sensory orientation deficits. Clinicians and researchers should be alert for co-existing vestibular hypofunction in older adults with BPPV, since this may exacerbate their already impaired postural control more than only BPPV. Full article

Aim/Objectives: To investigate whether frailty predicts adherence to psychotropic drug treatment or adverse drug reactions, within 6 months after treatment initiation. Methods: A prospective cohort study including 77 patients over the age of 65, treated in one large psychiatric institute in the Netherlands. Patients were assessed at baseline for their frailty status, using different operationalizations of the Fried frailty criteria. Data on duration of psychotropic drug treatment and number of reported adverse drug reactions were retrieved from electronic patient files. Regression analyses were adjusted for age, sex, patient setting, and polypharmacy as potential confounders. Results: Frail patients were not significantly more likely to discontinue psychotropic treatment than non-frail patients (OR = 1.4; 95% CI 0.6–3.7, p = 0.468). Time to treatment discontinuation was also not statistically different between both study groups (HR = 0.8; 95% CI 0.4–1.6, p = 0.498), and neither was the number of adverse drug reactions (OR = 1.6, 95% CI 0.6–4.1, p = 0.345). Conclusions: We could not demonstrate a statistically significant effect of frailty as predictor of discontinuing psychotropic treatment or adverse drug reactions, but a lack of power may also explain our results. A more comprehensive frailty assessment may be needed to predict treatment adherence or adverse drug reactions in psychiatric patients. Full article

Background: Diagnosing fracture-related infection (FRI) without clinical confirmatory signs is challenging. [18F]FDG-PET/CT has been shown to have good diagnostic accuracy. However, direct interpretation criteria are lacking. The aim of this study was to assess the diagnostic value of increased FDG-uptake in locoregional lymph nodes on [18F]FDG-PET/CT in patients with suspected upper and lower extremity FRI. Methods: This was a retrospective cohort study of patients who underwent [18F]FDG-PET/CT for suspected extremity FRI in two tertiary referral centers between January 2011 and December 2023. The sensitivity, specificity and diagnostic value of the presence, number and intensity of [18F]FDG uptake in locoregional lymph nodes was assessed. Uptake intensity was measured by calculating the maximum standard uptake value (SUVmax) of the ‘hottest’ lymph node. All scans were acquired according to the European Association of Nuclear Medicine (EANM) standards, and quantification was performed based on standardized EARL reconstructed images. FRI was diagnosed based on positive intra-operative microbiology results or development of clinical confirmatory signs within six months of follow-up. Results: In total, 124 patients were included in the analysis, with 53 cases of confirmed FRI. The presence of locoregional lymph nodes alone showed poor diagnostic accuracy (sensitivity, 55%; specificity, 68%; diagnostic accuracy, 62%). The number of active lymph nodes showed poor discriminative performance between FRI and non-infectious cases (AUC 0.63). Utilizing the SUVmax of the ‘hottest’ lymph nodes, moderate discriminative performance was revealed, with an AUC of 0.71. The optimal cutoff point (SUVmax 3.48) resulted in a sensitivity of 72%, a specificity of 78% and a diagnostic accuracy of 75%. A logistic regression model was fitted to calculate the added value of lymph node assessment to the regular [18F]FDG-PET/CT assessment. This resulted in a sensitivity of 71%, a specificity of 82% and a diagnostic accuracy of 76%. Conclusions: Presence and number of locoregional lymph nodes with increased [18F]FDG-uptake alone has poor diagnostic accuracy for FRI. The SUVmax of the ‘hottest’ lymph node showed moderate diagnostic performance. Lymph node assessment slightly increased the diagnostic value of regular [18F]FDG-PET/CT assessment. Based on these results, increased [18F]FDG-uptake in locoregional lymph nodes should only be considered as a suggestive sign for a positive scan result in suspected FRI. Full article

Background: Vegan/vegetarian (VEG) restaurants and VEG options in omnivore (OMNI) restaurants may serve unhealthful plant-based food that may be more harmful than a typical American diet. Methods: A sample of 561 restaurants with online menus were analyzed over a 3-year period. Each plant-based menu entrée was counted, up to a maximum of ten entrées per restaurant, meaning that a restaurant customer could select from ten or more healthful plant-based choices. Entrées containing refined grains (e.g., white rice and refined flour), saturated fat (e.g., palm oil and coconut oil), or deep-fried foods were counted as zero. Results: We evaluated 278 VEG and 283 OMNI restaurants. A full menu (10 or more plant-based entrées) was available in 59% of the VEG, but only 16% of the OMNI (p < 0.0001). Zero healthful options occurred in 27% of OMNI, but only 14% of VEG (p = 0.0002). The mean healthy entrée count for all restaurants was 3.2, meaning that, on average, there were only about three healthful plant-based choices of entrées on the menu, significantly more in VEG (4.0 vs. 2.4 p < 0.0001). The most common entrée reduction was for refined grains (e.g., white flour in veggie-burger buns or white rice in Asian entrées, n = 1408), followed by fried items (n = 768) and saturated fat (n = 318). VEG restaurants had a significantly higher frequency of adequate VEG options (≥7 options, 24% vs. 13%, p = 0.0005). Conclusions: Restaurants listed as VEG have a slightly higher number of healthful entrées than OMNI restaurants, which offer more limited vegan/vegetarian options. Given the published relationship between unhealthful dietary patterns, chronic illness, and mortality, we propose that detailed nutrition facts be publicly available for every restaurant. Full article

Background/Objectives: To identify joint trajectories of physical frailty and cognitive impairment among community-dwelling older adults and to determine modifiable factors for each trajectory. Methods: Data were utilized from the Korean Longitudinal Study of Aging, which was conducted between 2006 and 2018. Physical frailty was assessed using the Fried phenotype, and cognitive impairment was evaluated using the Korean version of the Mini-Mental State Examination. Group-based trajectory modeling and logistic regression were employed for the analyses. Results: Based on longitudinal data, 415 participants averaging 72.2 years of age were analyzed. Three trajectories of physical frailty were identified: mild physical frailty, moderate physical frailty, and improving frailty. Two trajectories of cognitive impairment were identified: stable cognitive impairment and improving cognitive impairment. Factors influencing physical frailty trajectories included the number of medications taken, being overweight or obese, and depression. Education level was found to be associated with cognitive impairment trajectories. Conclusions: This study provides evidence for the distinct identification of joint trajectories of physical frailty and cognitive impairment, which can inform the target groups for intervention. It offers a basis for including modifiable physical and mental factors in intervention components for physical frailty trajectories. Full article