Search Results (290)

Background and Objectives: Ischemic stroke (IS) is a critical health issue, affecting individuals of all ages, sexes, and backgrounds. Mounting evidence suggests that sex indeed could play some distinct role in shaping the incidence, outcomes, and treatment of IS. In the context of the COVID-19 pandemic, contradictory findings from previous studies that also addressed sex differences in cerebrovascular diseases demonstrate the need for further focused research. This study aimed to evaluate the sex discrepancies in the clinical presentation of IS and its outcomes in patients admitted to Kaunas Hospital of the Lithuanian University of Health Sciences (LUHS), Lithuania. Materials and Methods: This is a retrospective record-based single-center study. All the study patients—727 men and 1082 women—enrolled between 1 January 2020, and 27 February 2022; suffered from acute IS; and had absolute contraindications against interventional IS treatment. These patients received a conservative non-interventional IS treatment at the neurological department of the LUHS’s Kaunas Hospital. The sociodemographic data; laboratory findings; comorbidities, including COVID-19; in-hospital complications; and outcome factors were obtained from the patients’ medical records and evaluated by deploying appropriate statistical tests. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by the Cox proportional hazards regression for in-hospital lethality. Results: The mean age of IS patients was significantly higher in women compared to men (p < 0.001), as was the proportion of in-hospital deaths (19.10% and 15.36%, respectively; p < 0.05). The mean total number of in-hospital complications was again significantly higher in the group of women compared to men (p < 0.05). The prevalence of COVID-19 was higher in men compared to women (p < 0.05). COVID-19 diagnosis (HR = 1.53; p = 0.02) and acute in-hospital pulmonary complications (HR = 1.91; p = 0.008) significantly increased the risk of in-hospital lethality in men. The risk of in-hospital lethality was significantly higher in women with comorbid diabetes mellitus type 2 (DM) compared to those with comorbid isolated arterial hypertension (AH) (HR = 2.25, p = 0.007). Increased C-reactive protein elevated the risk of in-hospital lethality by more than twice in both men and women (HR = 2.46; p < 0.001 and HR = 2.28; p < 0.001, respectively). Conclusions: The following differences between men and women with IS were determined: Acute in-hospital pulmonary complications, including COVID-19, significantly increased the risk of in-hospital lethality in the male group, but not in women. However, women suffering from DM had a significantly increased risk of in-hospital lethality compared with those women IS patients with AH or chronic ischemic heart disease (IHD). Increased C-reactive protein was associated with an elevated risk of in-hospital lethality both in male and female groups. Full article

Fifth-generation Vehicle-to-Everything (V2X) networks have ushered in a new set of challenges that negatively affect seamless connectivity, specifically owing to high user equipment (UE) mobility and high density. As UE accelerates, there are frequent transitions from one cell to another, and handovers (HOs) are triggered by network performance metrics, including latency, higher energy consumption, and greater packet loss. Traditional HO mechanisms fail to handle such network conditions, requiring the development of Intelligent HO Decisions for V2X (IHD-V2X). By leveraging Q-Learning, the intelligent mechanism seamlessly adapts to real-time network congestion and varying UE speeds, thereby resulting in efficient handover decisions. Based on the results, IHD-V2X significantly outperforms the other mechanisms in high-density and high-mobility networks. This results in a reduction of 73% in unnecessary handover operations, and an 18% reduction in effective energy consumption. On the other hand, it improved handover success rates by 80% from the necessary handover and lowered packet loss for high mobility UE by 73%. The latency was kept at a minimum of 22% for application-specific requirements. The proposed intelligent approach is particularly effective for high-mobility situations and ultra-dense networks, where excessive handovers can degrade user experience. Full article

Resilience, the ability to adapt and thrive in the face of adversity, is an essential yet under-recognized determinant of outcomes in patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD), particularly those undergoing home-based peritoneal dialysis (PD). While studies have shown that PD can enhance autonomy and quality of life compared to in-center hemodialysis (IHD), it also places substantial emotional, physical and self-management demands on patients. Despite this, resilience is rarely assessed or systematically supported in PD care. This narrative review highlights the importance of resilience in CKD and dialysis populations and extends its application to the unique psychosocial challenges faced by PD patients. This review also introduces psychological frameworks of resilience, in particular the GROW model (Good emotions, Reason and purpose, Others and connections, Wellness flexibility), as tools for clinicians to support PD patients in developing optimism, purpose, strong social networks, and emotional adaptability. We also explore how routine, longitudinal assessment of resilience using validated tools can help improve patient well-being, treatment adherence, and long-term outcomes. Full article

Cardiovascular diseases remain the leading cause of death worldwide, highlighting the urgent need for novel therapeutic strategies. The Mediterranean diet is renowned for its cardiovascular benefits, largely attributed to extra virgin olive oil (EVOO) and its phenolic compounds, particularly hydroxytyrosol (HT). HT, a potent antioxidant and anti-inflammatory agent, has demonstrated significant therapeutic potential in mitigating myocardial damage following acute myocardial infarction (AMI). However, there is a notable lack of published evidence regarding the effects of HT administration in the context of acute ischemia/reperfusion (I/R) injury, making this study a novel contribution to the field. This study aimed to evaluate the cardioprotective effects of HT using the Langendorff technique in an isolated mouse heart ischemia/reperfusion (I/R) model. Mice were administered a single intraperitoneal dose of HT (10 mg/kg) 24 h prior to the I/R protocols, and parameters such as the infarct size, mitochondrial function, and redox balance were assessed. The results revealed a remarkable 57% reduction in infarct size in HT-treated mice compared to untreated controls. HT treatment also improved mitochondrial bioenergetics, as evidenced by the increased membrane potential (ΔΨm), enhanced oxygen consumption, and reduced hydrogen peroxide (H₂O₂) production. Furthermore, HT restored the activity of the mitochondrial respiratory complexes, notably Complex I, even under I/R conditions. These findings highlight the efficacy of HT in reducing oxidative stress and preserving mitochondrial function, critical factors in cardiac disease. In conclusion, HT emerges as a promising therapeutic agent for ischemic heart disease, demonstrating both preventive and restorative potential. Future research should explore its clinical applicability to advance cardiovascular disease management. Full article

Protein C (PC) is the main anticoagulant protein of the hemostasis system. It can inhibit the blood clotting cascade before the formation of a thrombus, while its concentration can decrease significantly during strong activation of blood clotting. The PC concentration was found to decrease during systemic lupus erythematosus (SLE) (with a median of 75%) and depended heavily on the inflammation index. It was also associated with the accumulation of soluble fibrin monomeric (SFMCs) (with a median of 7 µg/mL). A low PC level was detected during severe ischemic heart disease (IHD) (with medians of 60 and 63%, respectively). These pathologies also were associated with clotting activation. During abdominal aortic aneurysm (AAA), the PC level in blood plasma before surgery was found to range from 40% to 119%. A decrease in the PC level in the blood plasma of patients with AAA before surgery, lower than 78%, was associated with high blood loss (more than 1.5 L). A decrease in the PC level can lead to an imbalance between coagulation and anticoagulation. Thus, during the treatment of complex pathologies associated with the activation of coagulation, specific attention should be paid not only to classic markers of thrombus formation but also to the state of the anticoagulant link. Full article

The Yangtze River Delta (YRD) is one of the most important japonica rice planting areas in China. Balancing the resistance, yield, and quality has always been a core issue in rice breeding due to the negative correlation among these three factors, while the broad-spectrum blast resistance gene Piz is closely linked with Hd1, the major gene regulating days to heading (DTH), and a precise combination of their beneficial alleles plays a key role in synchronously improving blast resistance and the regional adaptability of japonica rice in YRD. In this study, using the backcross progeny population derived from backbone parent ZD9471 and W1063, two alleles of Hd1 were identified. Then, through molecular marker-assisted selection combined with Green Super Rice 40K (GSR40K) chip-based screening, six introgression lines (ILs) with two different alleles combinations of Hd1 and Pigm were obtained. An evaluation of the blast resistance, yield, and quality traits showed that compared with the recipient parent, the panicle blast resistance of ILs was significantly enhanced; the grain number per panicle increased consistently with the delaying of the growth period, leading to higher yield in the ILs; the grain quality were synchronously improved. Two representative lines with similar genetic backgrounds but a significantly different regional adaptability, exhibiting a good blast resistance, high yield, and prominent quality were approved and demonstrated promising application prospects. Full article

Background: Low selenium intake and age-related decline of coenzyme Q₁₀ (CoQ₁₀) have been associated with an increased risk of cardiovascular disease (CVD) and oxidative stress. In a randomised placebo-controlled trial (RTC) in elderly people with low selenium levels, the supplementation with selenium and CoQ₁₀ reduced CVD and mortality. However, whether the supplementation elicited sex-specific benefits remained to be explored. Methods: Elderly Swedish persons (n = 443; balanced sex ratio) receiving selenium yeast (200 µg/day) and CoQ₁₀ (200 mg/day) combined or a placebo for four years were followed for additional six years. The response to supplementation, cardiovascular (CV) mortality, and risk factors were determined at four and ten years. Kaplan–Meier analyses, ANCOVA, repeated measurements of variance, and Cox proportional hazard regression analyses were performed. Results: The measured 10-year CV mortality rate was lower in females, and supplementation reduced this risk to a greater extent compared to in males. The improved survival rate apparently kicked in later in females than in males. At baseline, males had a higher smoking rate, increased inflammation and oxidative stress, and a higher prevalence of more advanced ischaemic heart disease (IHD) and signs of heart failure. When stratified by sex, in individuals with IHD, the intervention improved CV survival in both sexes, whereas supplementation had a more pronounced effect in females without IHD at inclusion. Supplementation diminished inflammation and oxidative stress, impaired the increase of NT-proBNP, and improved renal function in both sexes. Conclusions: The supplementation improved CV survival, especially in women. The higher prevalence of structural CVD and smoking in males may have contributed to the observed greater supplementation benefits in females. The preventive impact of selenium and CoQ₁₀ supplementation in elderly males and females may be particularly strong and meaningful in the early stages of CVD development. Full article

Background/Objectives: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using a fully covered self-expandable metal stent (FCSEMS) is an alternative to endoscopic retrograde cholangiopancreatography for biliary drainage; however, FCSEMSs may cause intrahepatic bile duct (IHD) obstruction and cholangitis. In this study, we developed an FCSEMS with multiple self-made side holes at its tip and evaluated its safety and efficacy. Methods: This retrospective study included 100 patients who underwent EUS-HGS with FCSEMS placement between April 2022 and October 2023. Fifty patients received a conventional FCSEMS, and 50 received an FCSEMS with multiple self-made side holes. Technical and clinical success, residual contrast in the IHD, recurrent biliary obstruction (RBO), and adverse events (AEs) were then evaluated. The clinical success rates were 98% and 90% for the side hole and conventional FCEMS groups, respectively. The amount of residual contrast in the IHD was lower in the side hole group (0% vs. 12%, p = 0.027). RBO incidence was significantly lower in the side hole group (8% vs. 30%, p < 0.001), with migration as the primary cause in the conventional group. Early AEs, including segmental cholangitis, occurred only in the conventional group. During reintervention, all stents were safely removed. Conclusions: The FCSEMSs with multiple side holes reduced IHD occlusion and cholangitis, improving biliary drainage and safety. Further studies are needed to confirm these findings. Full article

Background: Short sessions of isometric exercise have been shown to reduce blood pressure (BP) in normotensive and hypertensive subjects. However, there are few data in hypertensive patients with underlying ischemic heart disease (IHD). In the present study, we compared post-exercise hypotension (PEH) induced by isometric versus combined, aerobic plus dynamic resistance exercise in IHD patients. Methods: Twenty-five stable patients with established IHD and with treated hypertension were enrolled. The study had a cross-over design. All patients performed in a random order and on different days: (1) isometric exercise session (IES) consisting of bilateral knee extension, performed at 20% of maximal voluntary contraction and lasting 20 min; (2) combined exercise session (CES) including moderate-intensity continuous exercise at and dynamic resistance exercise performed at 60% of one repetition maximum, and lasting 60 min and (3) control session (no exercise). BP was measured at rest, immediately after the training and then every 15 min up to 90 min. Results: The repeated measures ANOVA analysis showed that systolic BP significantly decreased after the CES session compared to the control (F = 6.2; p 0.001) and IES (F = 4.4; p 0.004). Systolic BP significantly decreased after IES compared to the control (F = 3.6; p 0.036). Diastolic BP did not show significant changes after CES and IES compared to the control (CES vs. control: F = 2.2; p 0.142; IES vs. control (F = 2.5; p 0.062). There were no significant differences in diastolic BP changes between CES and IES (CES vs. IES: F = 1.8; p 0.156). Conclusions: We observed that CES was more effective than IES in reducing systolic BP; IES was as effective as CES in inducing diastolic PEH in hypertensive patients with underlying IHD. Full article

In this study, twelve modified differential evolution algorithms with memory properties and adaptive parameters were proposed to address optimization problems. In the experimental process, these modified differential evolution algorithms were applied to 23 continuous test functions. The results indicate that MBDE2 and IHDE-BPSO3 outperform the original differential evolution algorithm and its extended variants, consistently achieving optimal solutions in most cases. The findings suggest that the proposed improved differential evolution algorithm is highly adaptable across various problems, yielding superior results. Additionally, integrating memory properties significantly enhances the algorithm’s performance and effectiveness. Full article

Background and Objectives: Over the past decades, various epidemiological analyses have reported a significant decrease in the number of deaths related to cardiovascular diseases (CVDs). Trends in acute myocardial infarction (AMI) morbidity and mortality from ischemic heart disease (IHD) were less studied in Eastern and Central Europe. This study aimed to determine and evaluate changes in AMI morbidity and mortality from IHD among the middle-aged urban Lithuanian population during 2000–2023. Materials and Methods: The data source was the Kaunas ischemic heart disease registry for residents aged 25–64. The diagnosis of AMI was based on the proposed epidemiological criteria used in the WHO MONICA project protocol. Age-standardized morbidity and mortality rates were calculated per 100,000 population. The changes in morbidity and mortality rates were calculated using the Joinpoint regression analysis method, and changes presented as a percentage estimate per year. Results: During 2000–2023, it was observed that age-standardized AMI morbidity significantly changed in the 25–64-year-old male and female population (−1.3%/yr., p = 0.006 and −2.3%/yr., p < 0.001, respectively). In males aged 25–54, a significant decrease in AMI morbidity rates by an average of 2.2%/yr. (p < 0.001) was found, contrary to the males aged 55–64, where morbidity was without substantial changes. We found a significant decrease in AMI morbidity in both age groups (the younger and older) of females, by 2.1%/yr. (p = 0.002) and 2.4%/yr. (p < 0.001), respectively. In the 25–64-year-old male population mortality from IHD significantly decreased (−2.0%/yr., p < 0.001), whereas in females it did not significantly change. Mortality from IHD in males aged 25–54 and 55–64 years significantly decreased by an average of 3.3%/yr. (p = 0.002) and 1.2%/yr., (p = 0.004), respectively. No significant trends in mortality from IHD in both age groups of females over the past 24 years were observed. Conclusions: During the study period, the age-standardized AMI morbidity among Kaunas middle-aged males and females significantly decreased. The age-standardized mortality from IHD decreased significantly among Kaunas middle-aged males, but there were no significant changes among females. Full article

Cardiovascular diseases (CVDs) represent a major public health concern globally, being one of the leading causes of illness and death across populations. While physical activity is widely recognized as a protective factor against these diseases, the exact biological mechanisms that explain this relationship are still not fully understood. This study utilized a two-sample Mendelian randomization (MR) method to investigate the potential role of circulating cytokines in mediating the effects of physical activity on major CVD outcomes, including coronary artery disease (CAD), heart failure (HF), and ischemic heart disease (IHD). Our primary MR analysis revealed an inverse association between physical activity and IHD risk. Moreover, a two-step MR mediation approach identified IL10RB (Interleukin-10 receptor subunit beta) as an intermediate mediator, explaining about 6.65% of the observed contribution of physical activity to IHD. These results indicate that physical activity may mitigate CVD risk through modulation of immune pathways, particularly via IL10RB signaling. Our findings underscore the significance of cytokine networks in mediating the cardiovascular benefits of exercise and suggest potential therapeutic strategies for CVD risk reduction through immune system modulation. Full article

Background: Chronic kidney disease–mineral and bone disorder (CKD-MBD) is a key contributor to complications, including ischemic heart disease (IHD), which significantly elevates mortality in patients with chronic kidney disease (CKD). This study aims to identify factors associated with IHD risk in pre-dialysis CKD and establish the minimum parathyroid hormone (PTH) threshold necessary to mitigate this risk. Methods: We retrospectively analyzed data from CKD stage 3–5ND patients aged over 18 years, followed from 2018 to 2022. IHD was identified using ICD-10 codes. An adjusted Cox regression model and joint modeling analysis were used to assess the association between risk factors and IHD. Results: A total of 1210 CKD patients were included in the analysis, with a median follow-up duration of 513.5 days (IQR 189–979). The incidence of IHD was 7.5%. PTH levels ≥166 ng/L (HR 1.87, 95% CI 1.05–3.35, p = 0.03) and age ≥65 years (HR 1.68, 95% CI 1.003–2.81, p = 0.04) were significantly associated with an increased risk of IHD. In joint modeling analysis, time-varying PTH, age ≥65 years, and diabetes mellitus (DM) were significantly associated with an increased risk of IHD, whereas ARB and statin use were associated with a reduced risk. Calcium and phosphate levels did not demonstrate significant associations with IHD risk. Conclusions: Baseline PTH levels ≥166 ng/L and time-varying PTH were independently and significantly associated with an increased risk of IHD. In contrast, calcium and phosphate levels showed no significant association with IHD risk. Full article

The present work aims to verify whether the incremental hole-drilling technique (IHD), a widely accepted technique, is suitable for determining residual stresses in AISI 316L samples obtained by selective laser melting (SLM). The thermo-mechanical effects of cutting during the application of this technique can induce unwanted residual stresses due to the relatively low thermal conductivity of this material, leading to erroneous results. To accomplish this aim, a hybrid experimental-numerical method was implemented to analyze the ability of IHD to determine an imposed stress state. Experimentally, samples were subjected to a tensile calibration stress using a horizontal tensile test machine. To eliminate pre-existing residual stress, the samples were subjected to differential loads, instead of absolute ones. In this way, experimental strain-depth relaxation curves related to the imposed calibration stress were obtained. Based on the experimental data, IHD was numerically simulated using the finite element method. Numerical strain-depth relaxation curves, related to the same calibration stress used in the experimental study, were obtained. The comparison between the experimental and numerical strain-depth relaxation curves, as well as the stresses calculated using the so-called integral method for determining stresses via IHD, shows that IHD is a suitable technique for measuring residual stresses in additively manufactured AISI 316L samples. Full article

Several studies evaluated the association between adipokines, including leptin, in patients with acute coronary syndrome (ACS). Nevertheless, the results have been inconclusive and conflicting. Therefore, we assessed the pertinent published studies and evaluated the association between leptin levels and ACS. In January 2023, we conducted a comprehensive systematic search using Web of Science, PubMed, Scopus, and Embase. Using the Newcastle–Ottawa Scale, we evaluated the quality of all the articles we included. The principal summary outcome was the mean difference (MD) in leptin levels. We included 16 studies in our systematic review, 10 of which were included in meta-analysis. The MD in leptin levels was then evaluated in each subgroup: the patients with ACS versus the controls, the patients with ACS versus the patients with stable angina pectoris (SAP), and the patients with type 2 diabetes mellitus (T2DM) and ACS versus the patients without diabetes, but with ACS. Respectively, the following MDs were obtained: 10.508 (95% CI 3.670–17.346); 2.408 (95% CI −0.150–4.966); and 17.089 (95% CI 5.565–28.612). The leptin levels were significantly higher in the patients with ACS compared to the healthy controls, as well as in the patients with ACS and T2DM compared to those without T2DM. However, no statistically significant increase in leptin levels was observed when comparing the patients with ACS to those with SAP. Full article