Search Results (352)

Background: Burnout syndrome (BS) is an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed. Although there are underlying causes associated with personal attributes, it is generally linked to external factors within the work environment. The aim of the present study was to investigate the impact of lifestyle factors on BS and its dimensions, as well as on suicidal ideation among Spanish professionals dedicated to implant dentistry. Methods: A cross-sectional observational study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was distributed to members of the Spanish Society of Implants. The data were analysed using descriptive statistical methods. Results: A total of 305 participants (20.9%) responded to the questionnaire. Notably, 10.8% of the professionals reported experiencing suicidal thoughts, a factor significantly associated with the presence of BS. The lifestyle factors associated with BS included the following: not engaging in aerobic exercise for at least 30 min per day (p < 0.05), not having hobbies that facilitate mental disconnection from work (p < 0.001), not following a balanced diet (p < 0.0001), having an insufficient social life (p < 0.0001), and experiencing suicidal ideation (p < 0.01). Conclusions: The surveyed dentists generally reported having healthy lifestyle habits. Nevertheless, one in ten professionals acknowledged having experienced suicidal ideation at some point, highlighting a concerning association with BS. Full article

Background: Breast and prostate cancer represent a significant global public health burden. Among the adverse effects of oncological treatments, fatigue is one of the most prevalent, persistent, and disabling symptoms. Therapeutic exercise has been shown to be effective for its management, with supervision identified as a key factor that may enhance adherence, safety, and intensity control. This systematic review and meta-analysis aimed to compare the effects of supervised exercise programs versus usual care on cancer-related fatigue in patients with breast or prostate cancer. Methods: A systematic search (September–December 2024) was conducted in six databases (PubMed, Web of Science, Scopus, Cochrane, PEDro, Scielo), selecting RCTs from the past 10 years in English or Spanish. Studies compared supervised exercise with unsupervised exercise or usual care in stage I–III breast or prostate cancer patients within five years post-treatment. Methodological quality was assessed with the PEDro scale and risk of bias with Cochrane’s RoB 2.0. A random-effects model was used to calculate pooled effect sizes (ES, 95% CI), with heterogeneity (I²), sensitivity, subgroup, and publication bias analyses. Results: A total of 25 interventions from 19 randomized controlled trials involving over 2200 participants were included. Supervised exercise significantly reduced cancer-related fatigue compared to usual care (effect size = 0.34; 95% CI: 0.22–0.47; p < 0.001; I² = 56%). Sensitivity analyses supported the robustness of the findings. Subgroup analyses revealed greater effects in combined exercise programs, in men, and in patients with prostate cancer. No evidence of publication bias was observed. While 73.7% of studies were rated as having good methodological quality, the risk of bias was often unclear or high. Conclusions: Supervised therapeutic exercise programs are effective and safe for reducing fatigue in breast and prostate cancer survivors. These interventions should be incorporated into comprehensive care plans, with individualization based on patients’ clinical and demographic characteristics. Further research is needed to identify the most effective and sustainable strategies for different patient subgroups. Full article

Background/objectives: The increasing prevalence of multidrug-resistant (MDR) bacteria, particularly Klebsiella pneumoniae, calls for the development of new antimicrobial agents. This study investigates a series of fluorinated azolium salts and their rhodium(I) complexes for antibacterial activity against clinical and reference strains of K. pneumoniae. Methods: Eleven fluorinated azolium salts and their corresponding Rh(I) complexes (22 compounds total) were synthesized and tested against several K. pneumoniae strains, including three MDR clinical isolates (U–13685, H–9871, U–13815) and ATCC reference strains. Minimum inhibitory concentrations (MICs) were determined. In silico ADMET analyses were conducted to evaluate intestinal absorption, oral bioavailability, Caco-2 permeability, carcinogenicity, solubility, and synthetic accessibility. Results: Among the Rh(I) complexes, Rh–1, Rh–3, and Rh–11 showed activity against the three MDR isolates (MIC = 62.5–250 µg/mL), while Rh–1, Rh–4, Rh–6, and Rh–11 were active against all ATCC strains (MIC = 3.9–250 µg/mL). The corresponding azolium salts displayed weak or no activity, highlighting the critical role of the metal center. ADMET predictions indicated that most Rh complexes had good intestinal absorption, and all except Rh–3, Rh–4, and Rh–9 were predicted to be orally bioavailable. Compounds Rh–1 to Rh–7 showed Caco-2 permeability, and all were classified as non-carcinogenic. Rh–8 to Rh–11 exhibited lower solubility and synthetic accessibility. Conclusions: The results underscore the potential of fluorinated Rh(I) complexes as antibacterial agents against MDR K. pneumoniae, with Rh–1 and Rh–11 emerging as promising leads based on activity and favorable predicted pharmacokinetics. Full article

Background: Sex differences in type 2 diabetes (T2D) are a growing area of diabetes research. No data have been reported on sex differences with oral semaglutide (oSEMA) in a real-world setting. Methods: We included people with T2D who started treatment with oSEMA in routine clinical practice between November 2021 and November 2022, with at least one report of clinical follow-up (FU) data at 3 months. We evaluated in women with T2D (WWT2D) the clinical effectiveness of oSEMA and factors associated with clinical response and persistence. We also analyzed differences in baseline characteristics, clinical effectiveness, persistence rates and safety according to biological sex. Results: Of the 1018 subjects [median age: 63 years, body mass index (BMI): 33.8 kg/m², HbA1c: 7.8%], 469 were WWT2D. In WWT2D, oSEMA reduced HbA1c by 0.7% [−0.1 to −1.3] and 0.9% [−0.2 to −1.5] at the 6- and 12-month FU visits, while weight decreased by 4.6% [2.0 to 7.9] and 7.2% [2.5 to 10.9], respectively. Weight loss was >10% in 29.8% of WWT2D (95% CI 25.8 to 34.1); meanwhile, the combined endpoint (HbA1c decrease ≥ 1% + weight reduction ≥ 5%) was achieved in 23.5% (95% CI 19.8 to 27.5%) of WWT2D at the 12-month FU visit. Achievement of glycaemic targets was similar in women and men (59.3% vs. 61.1%). We found no sex differences in weight loss (6.9% vs. 6.8%), oSEMA maintenance dose, persistence rate (76.3% vs. 77.3%), or adverse events. Conclusions: oSEMA was effective and safe in WWT2D in a real-world setting, with nearly one-third of patients reporting weight loss >10% and more than two-thirds achieving HbA1c < 7%. oSEMA showed no sex bias in terms of effectiveness and safety. Full article

Background: Burnout syndrome (BS) is an occupational condition resulting from chronic stress, characterized by three dimensions, emotional exhaustion (EE), depersonalization (DE), and diminished personal accomplishment (PA), particularly prevalent in caregiving professions such as healthcare. The aim of this study is to analyse the prevalence of BS among Spanish dental implantology specialists, along with the impact of demographic, educational, and professional aspects. Methods: This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines and was open to respondents from May to December 2024. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was sent to members of the Spanish Society of Implants. The data were analysed using descriptive analysis. Results: A total of 305 participants (20.9%) (31.5% females and 68.5% males) completed the questionnaire. The prevalence of BS was 4.3%; however, 61.0% of the dentists showed signs of suffering from the syndrome. The mean values of EE were “average” (20.3 ± 13.8) and of DE and EE “low” (5.1 ± 5.9, and 32.5 ± 14.5, respectively). The factors significantly associated with suffering from BS were being female and having more than 20 years of experience in dental implant treatments. Conclusions: It is advisable to conduct instructive and awareness-raising initiatives among dental professionals to promote an awareness of their mental health, ultimately aiming at preserving their physical and emotional well-being while delivering optimal care to their patients. Full article

Bidirectionality between insomnia and depression is well documented in general and clinical populations but remains under-researched in family caregivers of people with dementia. This study aimed to explore this relationship using a longitudinal design with 155 family caregivers assessed annually over three years. Data collected included sociodemographic information, health behaviors, medical data, caregiving stressors, and depressive and insomnia symptoms. Two linear mixed models were tested: Model 1 considered insomnia symptoms as the independent variable and depressive symptoms as the outcome; Model 2 considered depressive symptoms as the independent variable and insomnia symptoms as the outcome. The results showed that caregivers with more insomnia symptoms over time had significantly higher depressive symptoms, even after adjusting for covariates. Insomnia accounted for an additional 7.47% of the variance, with a total explained variance of 57.93%. Conversely, higher depressive symptoms over time were associated with increased insomnia. Depressive symptoms explained an additional 7.28% of the variance, with a total explained variance of 25.74%. These results were consistent with previous studies on non-caregiving populations, adding empirical evidence to the notion that both insomnia and depression may operate as a risk factor for the other disorder. Caregiver support interventions could improve their psychological well-being if they incorporate sleep-focused strategies. Full article

The use of postbiotics for dietary fortification in aquaculture is gaining increasing attention due to their potential immunomodulatory and gut health benefits. In this study, we evaluated the effects of postbiotics derived from Vibrio proteolyticus DCF12.2 on intestinal histology, microbiota composition, and the expression of genes related to epithelial integrity and inflammation in juvenile gilthead seabream (Sparus aurata). Fish were fed either a control (CRTL) diet or the postbiotic-supplemented diet (VP) for 62 days. At the end of the feeding trial, a lipopolysaccharide (LPS) challenge was conducted to evaluate the immune response in fish. Histological analysis revealed a healthy mucosa in both groups, though fish fed the VP diet reduced fold height and mucosal layer thickness, alongside a significant increase in goblet cells. Microbiota profiling indicated higher alpha diversity and significant shifts in community composition in the VP group, including enrichment of potentially beneficial genera (Pseudomonas, Sphingomonas) and depletion of opportunistic taxa (Enterococcus, Stenotrophomonas). After the feeding trial, fish fed the VP diet exhibited downregulation of pro-inflammatory markers (tnfα, cox2). Following LPS challenge, cdh1—a key epithelial adhesion protein required for maintaining intestinal barrier integrity—expression was upregulated significantly in the VP group, suggesting enhanced epithelial resilience. These findings demonstrate that dietary fortification with V. proteolyticus-derived postbiotics supports mucosal health as well as modulates the intestinal microbiota and immune responses in gilthead seabream juveniles, offering a promising strategy for functional aquafeed development in sustainable aquaculture. Full article

Heavy metal pollution in aquatic ecosystems is a critical environmental issue worldwide. In these ecosystems, the seston adsorbs heavy metals from the water and introduces them into the food web, causing potential environmental and health risks. This study analyses how heavy metals (Cd, Hg, Cr, Cu, Pb, Fe, and Mn) are distributed in the water and seston of the Tampamachoco Lagoon, an ecosystem affected by pollution from a thermoelectric plant and by hydrometeorological variability, both of which influence their concentrations. The relationships among metal distribution, physicochemical variables, and the influence of plant emissions in three seasons (rainy, northerly windstorms, and dry) were analyzed. The metal concentrations in seston (Fe > Mn > Pb > Cu > Cr > Hg) were up to four times higher than in the water column (Fe > Mn > Cr > Cd > Pb > Cu > Hg), emphasizing the key role of particulate matter in metal transport and bioavailability. Particularly, the Cd concentrations exceeded WHO thresholds by 527.6% in the water column during the rainy season, while Hg and Pb exceeded the thresholds of the Mexican criteria for the protection of marine aquatic life by 4.05% and 41.6%, respectively. Principal Component Analyses revealed distinct spatiotemporal distribution patterns for metals in water and seston, reflecting the combined effects of natural variability and anthropogenic inputs. The strong association between metals and seston indicates continued contamination and potential risks to aquatic ecosystems. These findings highlight the environmental impact of metals on seston and the need for monitoring to assess aquatic ecosystems’ health. Our results highlight the importance of understanding how metals are distributed between seston and water, and how climate variability affects pollutant redistribution patterns. We propose that water quality regulations need to be rethought and redirected towards the achievement of new strategic objectives that truly integrate the different pollutant sources whose final destination is water bodies, so as to protect and conserve biodiversity and aquatic ecosystems. Full article

Human papillomavirus-mediated recurrent respiratory papillomatosis (RRP) is a premalignant neoplasia of the upper airway characterized by significant dysphonia and respiratory obstruction. Immune checkpoint blockade has emerged as a potential alternative to repeated surgical interventions in RRP. Here, we investigated the intralesional T-cell composition and expression of the immune checkpoints programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4) in RRP. We analyzed tissue samples from 30 patients treated at a tertiary care center between 2009 and 2021, including paired samples from individual patients collected at different time points. Immunohistochemical staining was performed for CD4, CD8, CTLA-4, FoxP3, and PD-L1 and correlated with disease severity and previous adjuvant therapies. Overall disease burden and intervention-free survival were not associated with the abundance of CD4⁺, CD8⁺, or FoxP3⁺ T cells, nor with immune checkpoint expression. However, patients with aggressive disease exhibited a higher intralesional FoxP3/CD4 T-cell ratio. Prior intralesional cidofovir treatment was associated with reduced CD4⁺ T-cell infiltration. These findings suggest that a locally immunosuppressive microenvironment, reflected by an elevated FoxP3/CD4 ratio, contributes to disease severity in RRP. Consistent CTLA-4 expression across all evaluated samples supports further investigation of anti-CTLA-4 therapy, either alone or in combination with other checkpoint inhibitors. Full article

Aim of the study: Idiopathic inflammatory myopathies (IIM) are autoimmune diseases with a low prevalence and incidence worldwide. The levels of IFN-γ production by T-lymphocytes are related to disease activity. IFN-γ +874 T/A (rs2430561) has been shown to alter the serum levels of IFN-γ in different pathologies. The aim of this work is to explore the role of IFN-γ +874 T/A polymorphism in IIM. Methods: Using a specific sequence primer-polymerase chain reaction (SSP-PCR), the genotype was defined for normal healthy controls (HC) and patients with IIM. Markers of muscle damage, clinical features and treatment were collected from chart at the time of diagnosis and at recruitment point. All the data were analyzed by demographic characteristics, genotype, type of IIM, treatment, clinical features, and enzymatic levels. Results: No association was found comparing the genotypes or alleles of the IIM patients vs. HC. On the other hand, the TT genotype, previously described as a high producer of INF γ, showed higher levels of CPK at diagnosis in IIM patients, whereas females at diagnosis and males in remission presented higher levels. Conclusions: Even with a limited number of patients due to the rarity of this disease, no association was found between the disease development. Further, the TT genotype promoted muscle damage due to CPK elevation in the sera compared to the TA/AA genotype in patients with IIM. This could be genetic evidence of the impact of IFN-γ in the disease activity of IIM patients. A larger cohort is needed to confirm these results. Full article

Polymeric nanoparticles based on poly(ethyl cyanoacrylate) (PECA) and poly(ε-caprolactone) (PCL) were synthesized via semicontinuous microemulsion polymerization for potential biomedical applications. A systematic evaluation of four surfactants (Tween 80, Alkonat L70, Genapol LRO, and Brij-20) was carried out to determine their effects on micelle formation and particle size. Brij-20 enabled the formation of nanoparticles under 100 nm, with optimal conditions identified at 4% surfactant concentration and pH 1.75. The polymerization process included acid-catalyzed ring-opening of ε-caprolactone, followed by the semicontinuous addition of ethyl-2-cyanoacrylate under an inert atmosphere. Copolymerization was confirmed through FT-IR spectroscopy, nuclear magnetic resonance (NMR) spectroscopy, and differential scanning calorimetry, revealing a glass transition temperature (T_g) of 110.9 °C, indicating PECA as the dominant phase. Thermogravimetric analysis showed two decomposition events corresponding to each polymer. Transmission electron microscope analysis revealed nanoparticles averaging 51.74 nm in diameter. These findings demonstrate the feasibility of producing PECA-PCL nanoparticles with controlled size and composition, suitable for drug delivery and other biomedical uses. Full article

Background/Objectives: Cervical cancer (CC) is the fourth most common cancer among women worldwide. This study explored the use of machine learning (ML) and deep learning (DL) in the prediction, diagnosis, and prognosis of CC. Methods: An electronic search was conducted in the PubMed, IEEE, Web of Science, and Scopus databases from January 2015 to April 2025 using the search terms ML, DL, and uterine cervical neoplasms. A total of 153 studies were selected in this review. A comprehensive summary of the available evidence was compiled. Results: We found that 54.9% of the studies addressed the application of ML and DL in CC for diagnostic purposes, followed by prognosis (22.9%) and an incipient focus on CC treatment (22.2%). The five countries where most ML and DL applications have been generated are China, the United States, India, Republic of Korea, and Japan. Of these studies, 48.4% proposed a DL-based approach, and the most frequent input data used to train the models on CC were images. Conclusions: Although there are results indicating a promising application of these artificial intelligence approaches in oncology clinical practice, further evidence of their validity and reproducibility is required for their use in early detection, prognosis, and therapeutic management of CC. Full article

Biogas produced from agricultural and forestry waste is emerging as a strategic and multifunctional solution to address climate change, inefficient waste management, and the need for renewable energy by transforming large volumes of biomass. Global estimates indicate that approximately 1.3 billion tons of waste is produced each year for these sectors; this waste is processed through anaerobic digestion, allowing it to be transformed into energy and biofertilizers. This reduces greenhouse gas emissions by up to 90%, promotes rural development, improves biodiversity, and prevents environmental risks, such as forest fires. However, despite its high global technical potential, which is estimated at 8000 TWh per year, its use remains limited as a result of its high initial costs, low efficiency in relation to lignocellulosic waste, and weak regulatory frameworks, especially in countries like Mexico, which use less than 5% of their available biomass. In response, emerging technologies, such as co-digestion with microalgae, integrated biorefineries, and artificial intelligence tools, are opening up new avenues for overcoming these barriers under a comprehensive approach that combines science, technology, and community participation. Therefore, biogas is positioned as a key pillar for a circular, fair, and resilient bioeconomy, promoting energy security and advancing toward a just and environmentally responsible future. Full article

South American coffee producers face growing challenges due to external trade dependencies and climate-induced disruptions. This study investigates the role of export market diversification as a sustainability strategy for four major regional exporters of roasted non-decaffeinated coffee: Brazil, Colombia, Peru, and Ecuador. A quantitative and comparative methodology was applied over a ten-year period using the Herfindahl–Hirschman Index (HHI) to evaluate export market concentration and the Revealed Comparative Advantage (RCA) Index—including its normalized variant—to assess international competitiveness by destination. The results reveal substantial disparities: Brazil and Colombia exhibit moderate to high diversification and relative competitiveness in select markets, while Peru and Ecuador remain dependent on a few strategic buyers, with limited or declining comparative advantages. The findings emphasize that sustained export performance in the coffee sector requires not only a broader destination portfolio but also improved positioning through trade agreements, infrastructure development, and climate-resilient innovation. This study concludes with a strategic proposal based on three pillars—commercial, logistical, and technological—to support structural transformation and enhance the long-term sustainability of the coffee trade in South America. Full article

Fishery products are highly perishable; therefore, effective preservation strategies are essential to maintain their freshness, quality, and shelf life. One promising approach involves the use of edible coatings formulated with natural extracts, such as muicle (Justicia spicigera). This study evaluated the effect of a muicle–chitosan edible coating on the physical, chemical, and microbiological quality of cazon fish (Mustelus lunulatus) fillets stored in ice for 18 days. The muicle extract was obtained by macerating dried leaves for 48 h, and its antibacterial activity was subsequently assessed. A control group (C) and three treatments—muicle extract (ME), chitosan (CH), and a combined muicle–chitosan coating (MECH)—were applied and monitored throughout the storage period. Quality parameters, including pH, colour, water-holding capacity (WHC), texture, total volatile basic nitrogen (TVB-N), and mesophilic microbial counts, were evaluated. The muicle extract exhibited antibacterial activity, with MIC and IC₅₀ values of 3.01 ± 0.73 and 204.56 ± 20.23 µg/mL against Shewanella putrefaciens, and 0.10 ± 0.07 and 118.09 ± 14.51 µg/mL against Listeria monocytogenes, respectively. Treatments of ME, CH, and MECH significantly improved (p < 0.05) the quality of fillets by reducing TVB-N, pH, and microbial load compared to the control. In conclusion, the muicle extract demonstrated antibacterial potential and, either alone or in combination with chitosan, effectively preserved the physical, chemical, and microbiological quality of cazon fillets during ice storage. Full article