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Search Results (1,120)

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21 pages, 439 KiB  
Article
Effects of Rumen-Protected Methionine, Choline, and Betaine Supplementation on Ewes’ Pregnancy and Reproductive Outcomes
by Basiliki Kotsampasi, Eleni Tsiplakou, Maria-Anastasia Karatzia, Stavroula Oikonomou, Christina Mitsiopoulou, Dimitris Kalogiannis, Eleni Dovolou, Aristotelis Lymperopoulos, Kyriaki Sotirakoglou, Maria Anastasiadou, George Zervas and Stella Chadio
Vet. Sci. 2025, 12(8), 723; https://doi.org/10.3390/vetsci12080723 (registering DOI) - 31 Jul 2025
Abstract
This study evaluated the effects of maternal supplementation with rumen-protected methionine (RPM), alone or combined with rumen-protected choline (RPC) and betaine (RPB), during the periconceptional and prepartum periods on reproductive outcomes and offspring performance in Chios ewes. One hundred synchronized ewes were assigned [...] Read more.
This study evaluated the effects of maternal supplementation with rumen-protected methionine (RPM), alone or combined with rumen-protected choline (RPC) and betaine (RPB), during the periconceptional and prepartum periods on reproductive outcomes and offspring performance in Chios ewes. One hundred synchronized ewes were assigned to three groups—control (no supplementation), M (5.50 g RPM/day), and MCB (3.50 g RPM, 1.60 g RPC, 0.49 g RPB/day)—from day −14 to +14 relative to mating. Blood was collected on days −14, 0, and +14 for ABTS (2,2′-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid), ferric-reducing ability (FRAP), and malondialdehyde (MDA), on days 18 and 21 for progesterone, and on day 26 for pregnancy-associated glycoprotein (PAG) detection. Thirty days before and up to lambing, the ewes were further divided into C-C, C-M, C-MCB, M-M, M-C, MCB-MCB, and MCB-C subgroups. Embryonic loss did not differ between groups. FRAP was higher (p < 0.001) in MCB ewes, and ABTS was lower (p < 0.05) in M ewes, in the periconceptional period. Offspring in the C-M, C-MCB, M-M, M-C, and MCB-MCB groups had higher birth weights (p < 0.01), along with increased MDA levels (p < 0.05). The results suggest that maternal methyl donor supplementation during early and/or late gestation enhances antioxidant status, supports embryonic development, and increases birth weight. Full article
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12 pages, 294 KiB  
Review
Targeting Advanced Pancreatic Ductal Adenocarcinoma: A Practical Overview
by Chiara Citterio, Stefano Vecchia, Patrizia Mordenti, Elisa Anselmi, Margherita Ratti, Massimo Guasconi and Elena Orlandi
Gastroenterol. Insights 2025, 16(3), 26; https://doi.org/10.3390/gastroent16030026 - 30 Jul 2025
Viewed by 56
Abstract
Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumors, with a five-year overall survival rate below 10%. While the introduction of multi-agent chemotherapy regimens has improved outcomes marginally, most patients with advanced disease continue to have limited therapeutic options. Molecular [...] Read more.
Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumors, with a five-year overall survival rate below 10%. While the introduction of multi-agent chemotherapy regimens has improved outcomes marginally, most patients with advanced disease continue to have limited therapeutic options. Molecular profiling has uncovered actionable genomic alterations in select subgroups of PDAC, yet the clinical impact of targeted therapies remains modest. This review aims to provide a clinically oriented synthesis of emerging molecular targets in PDAC, their therapeutic relevance, and practical considerations for biomarker testing, including current FDA and EMA indications. Methods: A narrative review was conducted using data from PubMed, Embase, Scopus, and international guidelines (NCCN, ESMO, ASCO). The selection focused on evidence published between 2020 and 2025, highlighting molecularly defined PDAC subsets and the current status of targeted therapies. Results: Actionable genomic alterations in PDAC include KRAS G12C mutations, BRCA1/2 and PALB2-associated homologous recombination deficiency, MSI-H/dMMR status, and rare gene fusions involving NTRK, RET, and NRG1. While only a minority of patients are eligible for targeted treatments, early-phase trials and real-world data have shown promising results in these subgroups. Testing molecular profiling is increasingly standard in advanced PDAC. Conclusions: Despite the rarity of targetable mutations, systematic molecular profiling is critical in advanced PDAC to guide off-label therapy or clinical trial enrollment. A practical framework for identifying and acting on molecular targets is essential to bridge the gap between precision oncology and clinical management. Full article
(This article belongs to the Special Issue Advances in the Management of Gastrointestinal and Liver Diseases)
14 pages, 689 KiB  
Systematic Review
The Effect of Mental Health First Aid Training on Pharmacist and Pharmacy Student Confidence and Knowledge: A Systematic Review and Meta-Analysis
by David Frond, Shannon Habba, Brittany Stewart and Kyle J. Burghardt
Brain Sci. 2025, 15(8), 816; https://doi.org/10.3390/brainsci15080816 - 29 Jul 2025
Viewed by 186
Abstract
Background/Objectives: Pharmacists are highly accessible healthcare providers who have frequent, repeated contact with diverse patient populations. They are poised to offer expanded and comprehensive healthcare, including mental health services. One potential barrier to this is a lack of knowledge, confidence, or training in [...] Read more.
Background/Objectives: Pharmacists are highly accessible healthcare providers who have frequent, repeated contact with diverse patient populations. They are poised to offer expanded and comprehensive healthcare, including mental health services. One potential barrier to this is a lack of knowledge, confidence, or training in mental health, which may be overcome with a program like Mental Health First Aid (MHFA) training. The aim of this systematic review and meta-analysis is to fill this gap in knowledge by critically evaluating all studies of MHFA training for pharmacists or pharmacy students that report on knowledge, attitudes, or self-efficacy outcomes. Methods: A systematic review was performed to identify all relevant studies. Data was extracted and a random-effects meta-analysis was performed for knowledge and attitudes/self-efficacy outcomes, respectively. Subgroup analyses were performed based on survey question type, geographic location, and population studied. Results: Overall, MHFA training significantly increased pharmacists’ and pharmacy students’ knowledge (Hedges’ g = 0.228) and combined attitudinal/self-efficacy measures (Hedges’ g = 0.376). Subgroup analyses based on question type, study quality, design, population studied, and location showed similar, significant effects. Conclusions: MHFA training appears to have significant effects on pharmacist and pharmacy student knowledge, attitudes, and self-efficacy. Future work should establish the durability of these effects. Full article
(This article belongs to the Special Issue Pharmacy and Mental Health)
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17 pages, 536 KiB  
Article
Optimal Vegetable Intake for Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD) Prevention: Insights from a South Italian Cohort
by Maria Noemy Pastore, Caterina Bonfiglio, Rossella Tatoli, Rossella Donghia, Pasqua Letizia Pesole and Gianluigi Giannelli
Nutrients 2025, 17(15), 2477; https://doi.org/10.3390/nu17152477 - 29 Jul 2025
Viewed by 210
Abstract
(1) Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is now the most prevalent chronic liver disease worldwide, posing a growing public health concern. While dietary improvements are key to prevention, the impact of different vegetable types remains unclear. This study focuses on the association [...] Read more.
(1) Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is now the most prevalent chronic liver disease worldwide, posing a growing public health concern. While dietary improvements are key to prevention, the impact of different vegetable types remains unclear. This study focuses on the association between vegetable consumption and the risk of MASLD in a cohort of Southern Italy. (2) Methods: This research involved 1297 participants from the NUTRIHEP study, examining overall vegetable intake and classifying them into color subgroups to determine optimal quantity and variety for risk reduction. (3) Results: Daily consumption of approximately 325 g (two servings) of total vegetables significantly reduces the risk of MASLD (OR: 0.521; 95% CI: 0.317; 0.858). Among the subgroups, green vegetables were most protective at 35 g/day, while red and orange vegetables offered protection at 130 g/day. A higher intake of the other vegetable category, specifically onions, was associated with a reduced probability of MASLD (OR = 0.995; 95%CI: 0.989; 0.999). (4) Conclusions: These findings suggest a threshold effect, where moderate but regular consumption of specific vegetables offers maximal protection. Consuming excessive amounts may not enhance this benefit within this cohort. Cultural and regional dietary patterns should be considered when designing targeted nutritional interventions. Full article
(This article belongs to the Special Issue Mediterranean Diet and Nutrition Literacy)
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27 pages, 5430 KiB  
Article
Gene Monitoring in Obesity-Induced Metabolic Dysfunction in Rats: Preclinical Data on Breast Neoplasia Initiation
by Francisco Claro, Joseane Morari, Camila de Angelis, Emerielle Cristine Vanzela, Wandir Antonio Schiozer, Lício Velloso and Luis Otavio Zanatta Sarian
Int. J. Mol. Sci. 2025, 26(15), 7296; https://doi.org/10.3390/ijms26157296 - 28 Jul 2025
Viewed by 220
Abstract
Obesity and metabolic dysfunction are established risk factors for luminal breast cancer, yet current preclinical models inadequately recapitulate the complex metabolic and immune interactions driving tumorigenesis. To develop and characterize an immunocompetent rat model of luminal breast cancer induced by chronic exposure to [...] Read more.
Obesity and metabolic dysfunction are established risk factors for luminal breast cancer, yet current preclinical models inadequately recapitulate the complex metabolic and immune interactions driving tumorigenesis. To develop and characterize an immunocompetent rat model of luminal breast cancer induced by chronic exposure to a cafeteria diet mimicking Western obesogenic nutrition, female rats were fed a cafeteria diet or standard chow from weaning. Metabolic parameters, plasma biomarkers (including leptin, insulin, IGF-1, adiponectin, and estrone), mammary gland histology, tumor incidence, and gene expression profiles were longitudinally evaluated. Gene expression was assessed by PCR arrays and qPCR. A subgroup underwent dietary reversal to assess the reversibility of molecular alterations. Cafeteria diet induced significant obesity (mean weight 426.76 g vs. 263.09 g controls, p < 0.001) and increased leptin levels without altering insulin, IGF-1, or inflammatory markers. Histological analysis showed increased ductal ectasia and benign lesions, with earlier fibroadenoma and luminal carcinoma development in diet-fed rats. Tumors exhibited luminal phenotype, low Ki67, and elevated PAI-1 expression. Gene expression alterations were time point specific and revealed early downregulation of ID1 and COX2, followed by upregulation of MMP2, THBS1, TWIST1, and PAI-1. Short-term dietary reversal normalized several gene expression changes. Overall tumor incidence was modest (~12%), reflecting early tumor-promoting microenvironmental changes rather than aggressive carcinogenesis. This immunocompetent cafeteria diet rat model recapitulates key metabolic, histological, and molecular features of obesity-associated luminal breast cancer and offers a valuable platform for studying early tumorigenic mechanisms and prevention strategies without carcinogen-induced confounders. Full article
(This article belongs to the Special Issue Genomic Research in Carcinogenesis, Cancer Progression and Recurrence)
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15 pages, 1200 KiB  
Article
Effects of Levetiracetam Treatment on Hematological and Immune Systems in Children: A Single-Center Experience
by Yasemin Özkale, Pınar Kiper Mısırlıoğlu, İlknur Kozanoğlu and İlknur Erol
Children 2025, 12(8), 988; https://doi.org/10.3390/children12080988 - 28 Jul 2025
Viewed by 238
Abstract
Objective: The interactions between the central nervous system (CNS) and the immune system suggest that immune mechanisms may be effective in the pathogenesis of epilepsy and epileptic seizures. Although studies on the natural immune response and epilepsy are continuing, it is not yet [...] Read more.
Objective: The interactions between the central nervous system (CNS) and the immune system suggest that immune mechanisms may be effective in the pathogenesis of epilepsy and epileptic seizures. Although studies on the natural immune response and epilepsy are continuing, it is not yet clear whether the interaction of the current immune system is due to epilepsy itself or antiepileptic drugs (AEDs), since epileptic patients also use AEDs There are a limited number of studies that have reported an increased incidence of upper respiratory tract infections (URTIs) in patients during levetiracetam (LEV) treatment. Therefore, we aimed to report our experience regarding the effect of LEV monotherapy on the complete blood count (CBC), immunoglobulin (Ig) levels, and lymphocyte subgroups in the interictal period in children and adolescents with epilepsy. Methods: This study enrolled 31 children who presented with epilepsy and underwent LEV monotherapy for at least one year (patient group) and 43 healthy children (control group). The CBC parameters (hemoglobin (hb), lymphocytes, leukocytes, neutrophils, and platelets), Ig levels (IgA, IgM, IgG, and IgE), and lymphocyte subsets (CD3, CD4, CD8, CD4/CD8 ratio, CD19, CD56, NKT cells, and Treg cells) were measured and compared between the two groups. The patients were also investigated regarding the frequency and types of infections that they experienced in the first month and first year of the study, and these data were compared between the patient group and the control group. In addition, the same parameters and the frequency of infection were compared among the patient subgroups (focal and generalized seizures). Results: The results of the present study indicate that there were no significant differences in the CBC parameters, lymphocyte subsets, or Ig levels between the patient group and the control group. The comparison among the patient subgroups was similar; however, the CD4/CD8 ratio was lower in the patient subgroup with focal seizures. In addition, there were no significant differences in the frequency or type of infections experienced one month and one year of the study between the patient group and the control group, and likewise for the patient subgroups (focal and generalized seizures). Conclusions: The present study demonstrated that LEV monotherapy did not increase the incidence of infection, and there were no significant effects on the CBC or on the humoral or cellular immune system in epileptic children. These findings also suggest that the CD4/CD8 ratio among lymphocyte subgroups is lower in patients with focal seizures. However, the epilepsy subgroups had a relatively small sample size; therefore, further prospective studies involving a larger patient population are needed to establish the association between LEV monotherapy and lymphocyte subgroups in patients with epilepsy. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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18 pages, 5168 KiB  
Article
Arabidopsis Antiporter Genes as Targets of NO Signalling: Phylogenetic, Structural, and Expression Analysis
by Rabia Amir, Zuhra Qayyum, Sajeel Hussain, Byung-Wook Yun, Adil Hussain and Bong-Gyu Mun
Int. J. Mol. Sci. 2025, 26(15), 7195; https://doi.org/10.3390/ijms26157195 - 25 Jul 2025
Viewed by 118
Abstract
Nitric oxide is a gaseous signalling molecule produced by plants. Slight changes in endogenous NO levels have significant biochemical and physiological consequences. We investigated the structural and functional properties of NO-responsive antiporter genes in Arabidopsis thaliana. Phylogenetic analysis of 50 antiporter genes [...] Read more.
Nitric oxide is a gaseous signalling molecule produced by plants. Slight changes in endogenous NO levels have significant biochemical and physiological consequences. We investigated the structural and functional properties of NO-responsive antiporter genes in Arabidopsis thaliana. Phylogenetic analysis of 50 antiporter genes classified them into four subgroups based on the presence of NHX and CPA domains and the evolutionary similarity of the protein sequences. Antiporters were found scattered across the five chromosomes with unique physico-chemical properties and subcellular localisation in the plasma membrane, nucleus, chloroplasts, and vacuole. Furthermore, we performed QPCR analysis of eight different antiporter genes after infiltrating the plants with 1 mM CySNO (S-nitroso-L-cysteine), a nitric oxide donor, in WT and the loss-of-function atgsnor1-3 (disruptive S-nitrosoglutathione reductase 1 activity) plants. The AT1G79400 (CHX2), AT2G38170 (RCI4), and AT5G17400 (ER-ANT1) showed a significant increase in their expression in response to CySNO infiltration. However, their expression in atgsnor1-3 plants was found to be lower than in the WT plants, indicating a significant redundancy in the response of these genes to 1 mM levels of CySNO and physiological levels of SNOs in atgsnor1-3. On the other hand, a significant reduction in the expression of AT1G16380 (CHX1), AT2G47600 (MHX1), AT3G13320 (CAX2), and AT5G11800 (KEA6) was observed in WT plants after CySNO infiltration as well as in the leaves of atgsnor1-3 plants. Our study identified three NO-responsive antiporter genes in Arabidopsis, indicating their roles in stress responsiveness and ion homeostasis that could be used for further validation of their roles in NO signalling in plants. Full article
(This article belongs to the Special Issue Nitric Oxide Signalling in Plants)
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17 pages, 3346 KiB  
Article
Genome-Wide Identification of the SiNHX Gene Family in Foxtail Millet (Setaria Italica) and Functional Characterization of SiNHX7 in Arabidopsis
by Xiaoqian Chu, Dan-Ying Chen, Mengmeng Sun, Jiajing Zhang, Minghua Zhang, Hejing Wu, Hongzhi Wang, Shuqi Dong, Xiangyang Yuan, Xiaorui Li, Lulu Gao, Guanghui Yang and Jia-Gang Wang
Int. J. Mol. Sci. 2025, 26(15), 7139; https://doi.org/10.3390/ijms26157139 - 24 Jul 2025
Viewed by 173
Abstract
Plant growth is susceptible to abiotic stresses like salt and drought, and Na+/H+ antiporters (NHXs) play a pivotal role in stress responses. NHX proteins belong to the CPAs (cation/proton antiporters) family with a conserved Na+ (K+)/H+ [...] Read more.
Plant growth is susceptible to abiotic stresses like salt and drought, and Na+/H+ antiporters (NHXs) play a pivotal role in stress responses. NHX proteins belong to the CPAs (cation/proton antiporters) family with a conserved Na+ (K+)/H+ exchange domain, which is widely involved in plant growth, development, and defense. While NHX genes have been extensively studied in model plants (e.g., Arabidopsis thaliana and Oryza sativa), research in other species remains limited. In this study, we identified nine NHX genes in foxtail millet (Setaria italica) and analyzed their systematic phylogeny, gene structure, protein characteristics, distribution of the chromosome, collinearity relationship, and cis-elements prediction at the promoter region. Phylogenetic analysis revealed that the members of the SiNHX gene family were divided into four subgroups. RT-qPCR analysis of the SiNHX family members showed that most genes were highly expressed in roots of foxtail millet, and their transcriptional levels responded to salt stress treatment. To determine SiNHX7’s function, we constructed overexpression Arabidopsis lines for each of the two transcripts of SiNHX7, and found that the overexpressed plants exhibited salt tolerance. These findings provide valuable insights for further study of the function of SiNHX genes and are of great significance for breeding new varieties of salt-resistant foxtail millet. Full article
(This article belongs to the Section Molecular Plant Sciences)
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29 pages, 742 KiB  
Systematic Review
The Bacterial Composition of the Gut Microbiota of Mexicans with Overweight and Obesity: A Systematic Review
by María Alejandra Samudio-Cruz, Alexandra Luna-Angulo, Elizabeth Cabrera-Ruiz, Carlos Landa-Solis, Edgar Rangel-López, Paul Carrillo-Mora, Juan Ríos-Martínez, Rafael Toledo-Pérez, Rogelio Paniagua-Pérez, Carlos Jorge Martínez-Canseco, Ana Luisa Lino-González, Abigail Jhoana Saldaña Solano and Laura Sánchez-Chapul
Microorganisms 2025, 13(8), 1727; https://doi.org/10.3390/microorganisms13081727 - 24 Jul 2025
Viewed by 371
Abstract
The role of the gut microbiota in obesity has been extensively studied worldwide, but research in Mexican populations is still limited. This is particularly important given the high obesity rates in Mexico, despite a traditional diet rich in diverse, plant-based foods. We conducted [...] Read more.
The role of the gut microbiota in obesity has been extensively studied worldwide, but research in Mexican populations is still limited. This is particularly important given the high obesity rates in Mexico, despite a traditional diet rich in diverse, plant-based foods. We conducted a systematic review of studies examining the gut microbiota in obese Mexican children and adults. The literature search was conducted in the Medline, CINAHL, SciELO, Redalyc and Web of Science databases. The included studies addressed topics such as obesity in different Mexican subgroups (e.g., adults, children, rural communities), dietary behaviors and interventions, traditional dietary patterns, and gut microbiota composition. Of the 2332 datasets, 19 studies met the inclusion criteria. These studies indicated that obesity in Mexican individuals is associated with specific changes in the gut microbiota, including decreased bacterial diversity and shifts in the abundance of key microbial genera. Differences were found between age groups and regions. This review highlights a clear association between gut microbiota composition and obesity in the Mexican population. Further research is essential to investigate how the traditional Mexican diet may influence gut health and serve as a potential tool to treat obesity. Full article
(This article belongs to the Special Issue Advances in Human Microbiomes)
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14 pages, 954 KiB  
Article
Left Ventricular Ejection Fraction Predicts Outcomes in Different Subgroups of Patients Undergoing Coronary Angiography
by Henning Johann Steffen, Tobias Schupp, Mohammad Abumayyaleh, Lasse Kuhn, Philipp Steinke, Jonas Dudda, Kathrin Weidner, Jonas Rusnak, Mahboubeh Jannesari, Fabian Siegel, Daniel Duerschmied, Michael Behnes and Ibrahim Akin
J. Clin. Med. 2025, 14(15), 5219; https://doi.org/10.3390/jcm14155219 - 23 Jul 2025
Viewed by 266
Abstract
Objectives: To evaluate the long-term prognostic value of left ventricular ejection fraction (LVEF) in consecutive patients undergoing invasive coronary angiography (CA). Background: LVEF is a key prognostic marker in cardiovascular disease, but its value across different clinical indications for CA remains insufficiently characterized. [...] Read more.
Objectives: To evaluate the long-term prognostic value of left ventricular ejection fraction (LVEF) in consecutive patients undergoing invasive coronary angiography (CA). Background: LVEF is a key prognostic marker in cardiovascular disease, but its value across different clinical indications for CA remains insufficiently characterized. Methods: Consecutive patients undergoing CA between January 2016 and August 2022 were retrospectively included at one institution. Patients were stratified into four LVEF groups: ≥ 55%, 45–54%, 35–44%, and <35%. The primary endpoint was rehospitalization for heart failure (HF) at 36 months. Secondary endpoints were acute myocardial infarction (AMI) and coronary revascularization. Kaplan–Meier and multivariable Cox regression analyses were conducted within the entire study cohort and pre-defined subgroups. Results: A total of 6888 patients were included (median age: 71 years; 65.2% males). LVEF < 35% was associated with a higher comorbidity burden and more extensive coronary artery disease (e.g., three-vessel CAD: 38.6% vs. 20.7%, p < 0.001). Event rates for HF rehospitalization and AMI increased progressively with declining LVEF, while revascularization rates varied across categories. Statistically significant differences across LVEF groups were observed for all three endpoints in unadjusted analyses (log-rank p < 0.001). In multivariable models, LVEF < 35% independently predicted HF rehospitalization (HR = 3.731, p < 0.001) and AMI (HR = 4.184, p < 0.001), but not revascularization (HR = 0.867, p = 0.378). The prognostic association was demonstrated across all subgroups stratified by age, sex, subtype of acute coronary syndrome, and CAD severity. Conclusions: Reduced LVEF is an independent predictor of HF rehospitalization and AMI in patients undergoing coronary angiography, irrespective of its indication, whereas no independent association was observed with coronary revascularization. Full article
(This article belongs to the Section Cardiology)
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13 pages, 656 KiB  
Article
Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers
by Juan José Guarro Miquel, Pedro Juan Tárraga López, María Dolores Marzoa Jansana, Ángel Arturo López-González, Pere Riutord Sbert, Carla Busquets-Cortés and José Ignacio Ramirez-Manent
Metabolites 2025, 15(8), 495; https://doi.org/10.3390/metabo15080495 - 23 Jul 2025
Viewed by 236
Abstract
Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body [...] Read more.
Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p < 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection. Full article
(This article belongs to the Section Endocrinology and Clinical Metabolic Research)
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20 pages, 3742 KiB  
Review
Predictive Biomarkers for Immunotherapy in Endometrial Carcinoma
by Cristina Pizzimenti, Vincenzo Fiorentino, Ludovica Pepe, Mariausilia Franchina, Chiara Ruggeri, Alfredo Ercoli, Giuliana Ciappina, Massimiliano Berretta, Giovanni Tuccari and Antonio Ieni
Cancers 2025, 17(15), 2420; https://doi.org/10.3390/cancers17152420 - 22 Jul 2025
Viewed by 284
Abstract
Endometrial carcinoma (EC) is the most common gynaecological malignancy in developed nations, exhibiting significant molecular heterogeneity that impacts prognosis and treatment response, particularly in advanced or recurrent settings. Traditional classification is increasingly supplemented by molecular subtyping (POLE-ultramutated, MSI-high/dMMR, NSMP, p53-mutated/CNH), which [...] Read more.
Endometrial carcinoma (EC) is the most common gynaecological malignancy in developed nations, exhibiting significant molecular heterogeneity that impacts prognosis and treatment response, particularly in advanced or recurrent settings. Traditional classification is increasingly supplemented by molecular subtyping (POLE-ultramutated, MSI-high/dMMR, NSMP, p53-mutated/CNH), which provides crucial prognostic information and predicts benefit from immunotherapy. This review summarizes the landscape of predictive biomarkers for immune checkpoint inhibitor (ICI) therapy in EC, emphasizing a new therapeutic scenario for advanced and recurrent EC. Mismatch repair deficiency (dMMR) or high microsatellite instability (MSI-H), leading to high tumor mutational burden (TMB) and increased neoantigen production, is the most established predictor, resulting in FDA approvals for pembrolizumab and dostarlimab in this subgroup. POLE mutations also confer hypermutation and high immunogenicity, predicting a favorable ICI response. Other biomarkers, including PD-L1 expression and TMB, show variable correlation with response and require further standardization. The tumor immune microenvironment, including tumor-infiltrating lymphocytes (TILs), also influences treatment outcomes. Clinical trials have demonstrated significant survival benefits for ICIs combined with chemotherapy (e.g., dostarlimab/pembrolizumab + carboplatin/paclitaxel) in first-line settings, especially for dMMR/MSI-H EC, and for ICI combinations with targeted agents (e.g., lenvatinib + pembrolizumab) in previously treated patients. Integrating molecular classification and validated biomarkers is essential for optimizing patient selection and developing personalized immunotherapy strategies for EC. Full article
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10 pages, 243 KiB  
Article
Relative Vertex-Source-Pairs of Modules of and Idempotent Morita Equivalences of Rings
by Morton E. Harris
Mathematics 2025, 13(15), 2327; https://doi.org/10.3390/math13152327 - 22 Jul 2025
Viewed by 112
Abstract
Here all rings have identities. Let R be a ring and let R-mod denote the additive category of left finitely generated R-modules. Note that if R is a noetherian ring, then R-mod is an abelian category and every R-module [...] Read more.
Here all rings have identities. Let R be a ring and let R-mod denote the additive category of left finitely generated R-modules. Note that if R is a noetherian ring, then R-mod is an abelian category and every R-module is a finite direct sum of indecomposable R-modules. Finite Group Modular Representation Theory concerns the study of left finitely generated OG-modules where G is a finite group and O is a complete discrete valuation ring with O/J(O) a field of prime characteristic p. Thus OG is a noetherian O-algebra. The Green Theory in this area yields for each isomorphism type of finitely generated indecomposable (and hence for each isomorphism type of finitely generated simple OG-module) a theory of vertices and sources invariants. The vertices are derived from the set of p-subgroups of G. As suggested by the above, in Basic Definition and Main Results for Rings Section, let Σ be a fixed subset of subrings of the ring R and we develop a theory of Σ-vertices and sources for finitely generated R-modules. We conclude Basic Definition and Main Results for Rings Section with examples and show that our results are compatible with a ring isomorphic to R. For Idempotent Morita Equivalence and Virtual Vertex-Source Pairs of Modules of a Ring Section, let e be an idempotent of R such that R=ReR. Set B=eRe so that B is a subring of R with identity e. Then, the functions eRR:RmodBmod and ReB:BmodRmod form a Morita Categorical Equivalence. We show, in this Section, that such a categorical equivalence is compatible with our vertex-source theory. In Two Applications with Idemptent Morita Equivalence Section, we show such compatibility for source algebras in Finite Group Block Theory and for naturally Morita Equivalent Algebras. Full article
12 pages, 1498 KiB  
Article
Long-Term Effect of Semaglutide on the Glomerular Filtration Rate Slope in High-Risk Patients with Diabetic Nephropathy: Analysis in Real-World Clinical Practice
by Enrique Luna, Álvaro Álvarez, Jorge Rodriguez-Sabiñón, Juan Villa, Teresa Giraldo, Maria Victoria Martín, Eva Vázquez, Noemi Fernández, Belén Ruiz, Guadalupe Garcia-Pino, Coral Martínez, Lilia Azevedo, Rosa María Diaz, Nicolas Roberto Robles and Guillermo Gervasini
Pharmaceutics 2025, 17(7), 943; https://doi.org/10.3390/pharmaceutics17070943 - 21 Jul 2025
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Abstract
Background: Semaglutide, a GLP-1 receptor agonist, has shown promising nephroprotective effects in clinical trials, though real-world data on its long-term impact on renal function in high-risk diabetic nephropathy patients remain scarce. Methods: We conducted a multicenter, retrospective observational study involving 156 patients with [...] Read more.
Background: Semaglutide, a GLP-1 receptor agonist, has shown promising nephroprotective effects in clinical trials, though real-world data on its long-term impact on renal function in high-risk diabetic nephropathy patients remain scarce. Methods: We conducted a multicenter, retrospective observational study involving 156 patients with type 2 diabetes and chronic kidney disease (CKD) treated with subcutaneous semaglutide between 2019 and 2023. Inclusion required an eGFR > 15 mL/min/1.73 m2 or albuminuria > 30 mg/g and at least two years of follow-up. The primary outcome was the change in eGFR slope after semaglutide initiation. Subgroup analyses were performed based on baseline eGFR, albuminuria, and SGLT2i co-treatment. Results: In the whole study population, the median eGFR slope significantly improved from −3.29 (IQR 7.54) to −0.79 (IQR 6.01) mL/min/1.73 m2/year post-treatment (p < 0.001). Multiple linear regression showed a hazard ratio for the effect of semaglutide on the eGFR slope of 4.06 (2.43–5.68), p < 0.001. In patients with baseline eGFR < 60 mL/min/1.73 m2, the slope improved from −3.77 to −1.01 (p < 0.0001), while patients on concurrent SGLT2i therapy saw slope changes from −2.96 to −0.37 (p < 0.0001). Patients with albuminuria 30–1000 mg/g also improved from −2.96 to −0.04 (p < 0.0001); however, those > 1000 mg/g did not show a significant change (p = 0.184). Semaglutide also reduced BMI (p = 0.04), HbA1c (p = 0.002), triglycerides (p = 0.001), CRP (p = 0.003), and GGT values (p = 0.004). Conclusions: In real-world practice, semaglutide significantly attenuated renal function decline in high-risk diabetic patients, particularly those with advanced CKD or concurrent SGLT2i therapy. These findings support its nephroprotective role beyond glycemic control. Full article
(This article belongs to the Special Issue Optimizing Drug Therapy in Kidney Diseases: Effectiveness and Safety)
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Article
Genes Encoding Multiple Modulators of the Immune Response Are Methylated in the Prostate Tumor Microenvironment of African Americans
by Vinay Kumar, Tara Sinta Kartika Jennings, Lucas Ueta, James Nguyen, Liankun Song, Michael McClelland, Weiping Chu, Michael Lilly, Michael Ittmann, Patricia Castro, Arash Rezazadeh Kalebasty, Dan Mercola, Omid Yazdanpanah, Xiaolin Zi and Farah Rahmatpanah
Cancers 2025, 17(14), 2399; https://doi.org/10.3390/cancers17142399 - 19 Jul 2025
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Abstract
Background/Objectives: Prostate cancer (PCa) is diagnosed at an earlier median age, more advanced stage, and has worse clinical outcomes in African American (AA) men compared to European Americans (EA). Methods: To investigate the role of aberrant DNA methylation in tumor-adjacent stroma [...] Read more.
Background/Objectives: Prostate cancer (PCa) is diagnosed at an earlier median age, more advanced stage, and has worse clinical outcomes in African American (AA) men compared to European Americans (EA). Methods: To investigate the role of aberrant DNA methylation in tumor-adjacent stroma (TAS), methyl binding domain sequencing (MBD-seq) was performed on AA (n = 17) and EA (n = 15) PCa patients. This was independently confirmed using the long interspersed nuclear element-1 (LINE-1) assay. Pathway analysis was performed on statistically significantly differentially methylated genes for AA and EA TAS. DNA methylation profiles of primary cultured AA and EA carcinoma-associated fibroblasts (CAFs) were compared with AA and EA TAS. AA and EA CAFs were treated with demethylating agent 5-Azacytidine (5-AzaC). Results: AA TAS exhibited higher global DNA methylation than EA TAS (p-value < 0.001). Of the 3268 differentially methylated regions identified (DMRs, p-value < 0.05), 85% (2787 DMRs) showed increased DNA methylation in AA TAS, comprising 1648 genes, of which 1379 were protein-coding genes. Based on DNA methylation levels, two AA subgroups were identified. Notably, AA patients with higher DNA methylation were predominantly those with higher Gleason scores. Pathway analysis linked methylated genes in AA TAS to several key signaling pathways (p-value < 0.05), including immune response (e.g., IL-1, IL-15, IL-7, IL-8, IL-3, and chemokine), Wnt/β-catenin, androgen, PTEN, p53, TGF-β, and circadian clock regulation. A total of 168 concordantly methylated genes were identified, with 109 genes (65%) showing increased methylation in AA CAFs and TAS (p-value < 0.05). Treatment with 5-AzaC significantly reduced DNA methylation of concordant genes in AA CAFs (p-value < 0.001). Conclusions: These findings suggest a distinct stromal methylome in AA, providing a foundation for integrating demethylating agents into standard therapies. This approach targets the tumor microenvironment, potentially addressing PCa disparities in AA men. Full article
(This article belongs to the Section Tumor Microenvironment)
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