Search Results (1,037)

Tenrecs are heterothermic burrowing mammals, which are capable of withstanding extreme environmental stressors, including during hibernation. Their phylogenetic position as reminiscent of an ancestral placental mammal makes tenrecs a unique model for evolutionarily conserved traits, with potential translatability to human physiology and pathobiology, including adaptations to extreme environments. In this study, we compared tenrec plasma for post-translational protein citrullination profiles (citrullinomes) and extracellular vesicle (EV) characteristics, including selected microRNA cargoes (miR-21, miR-155, miR-206, miR-210), between baseline active and hibernating states at low (12 °C) and high (28 °C) ambient temperatures. Our findings show considerable changes in citrullinome plasma profiles and associated Gene Ontology and KEGG pathway analysis linked to physiological and inflammatory processes, comparing hibernating and active states, also differing between the two ambient temperature groups. We furthermore identified modified EV profiles with respect to stress-related (miR-21, miR-155), hypoxia (miR-210) and metabolic/muscle related (miR-206) microRNA cargoes, which showed significant differences between active and hibernating animals, also comparing the two ambient temperature groups. Our findings show novel roles for post-translational protein citrullination in regulating immune and metabolic associated pathways in the tenrec, and highlight EV profiles, based on microRNA cargoes, as indicators for stress and metabolic responses in active versus hibernating states, including at different temperatures. Collectively our data highlights the tenrec as an evolutionary model for regulating pathobiological responses in extreme environments and may have translatable potential for human physiology and pathologies. Full article

Background: While Asian American individuals are well represented in medical schools in the United States, their advancement to senior positions within the field of orthopaedic surgery is disproportionately low. This underrepresentation not only limits diversity in leadership but also constrains the development of people-centred systems that reflect the needs of an increasingly diverse patient population. Objectives: This study systematically examines Asian American representation across the orthopaedic surgery professional pipeline, focusing on disparities between training-level representation and advancement into both faculty and leadership positions., and framing these gaps as a health equity concern. Methods: A comprehensive literature search for peer-reviewed original research articles was conducted via PubMed, EBSCO Open Research, Wiley Online Library, Google Scholar, and ScienceDirect. The potential articles were screened against prespecified eligibility criteria, and risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Data were then systematically extracted and analysed. Results: This analysis included 20 research articles investigating Asian American representation in orthopaedic surgery. The results demonstrated an underrepresentation of Asian Americans in orthopaedic leadership positions despite improvements in training programme representation with subspecialty clustering in adult reconstruction and spine. Asian American surgeons were less likely to occupy academic and leadership roles than their non-Asian American peers. Across studies, underrepresentation was consistently observed, with effect size estimates indicating a substantial disparity (e.g., pooled risk difference = 0.19; 95% CI [0.12, 0.28]) in those studies reporting comparative outcomes. Similarly, while Asian Americans in residency programmes increased, this growth did not translate proportionally to faculty advancement. In contrast, Asian women face compounded barriers, particularly in subspecialties like spine surgery. These inequities undermine workforce inclusivity and may reduce cultural and linguistic concordance with patients. Conclusions: Despite having strong representation in orthopaedic training programmes, Asian Americans are disproportionately absent from leadership positions. This poses a challenge to equity in surgical education and patient-centred care. To promote equity in leadership, focused mentorship, clear promotion processes, and institutional reform are necessary to address structural barriers to career advancement, this will reflect the diversity of both the workforce and populations served. Full article

Objectives: Depressive symptoms are highly prevalent among individuals with chronic kidney disease (CKD). This study explores their associated factors and gender differences among middle-aged and older CKD patients in China. Methods: Based on the health ecology model (HEM), this study utilized the 2018 cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) to examine gender differences in CKD patients across demographic groups. A multivariate logistic regression identified factors associated with depressive symptoms and gender differences among middle-aged and older patients with CKD in China. Additionally, a random forest model was constructed to rank the importance of key predictors based on the Gini index. Results: Among 1422 CKD patients, 50.35% reported depressive symptoms (42.97% of males and 59.56% of females). Factors significantly associated with higher depressive symptoms included female gender, rural residence, poor self-reported health, sleep duration < 7 h, and limitations in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The association of smoking and ADLs on depressive symptoms in CKD patients varied considerably between genders. Self-reported health and life satisfaction were the two variables most strongly associated with depressive symptoms among CKD patients. Conclusions: The study shows that female CKD patients have a higher prevalence of depressive symptoms than males. Several factors are significantly associated with depressive symptoms in patients with CKD. These findings provide valuable insights that potentially inform the development of targeted prevention and management strategies for depressive symptoms in middle-aged and older CKD patients in China. Full article

Background/Objectives: College and undergraduate students around the world struggle with stress, anxiety, and depression, which have a significant negative influence on their academic performance, social interactions, and general well-being. Creating successful preventative and intervention plans requires an understanding of the many, multi-level factors that contribute to psychological discomfort. The objective of this scoping review was to use the Socio-Ecological Model (SEM) to map the determinants of psychological distress among college students in a comprehensive manner. Methods: A total of 15 review publications published between 2015 and 2024, including narrative reviews, systematic reviews, meta-analyses, and umbrella reviews, were analyzed under the guidance of PRISMA ScR. These studies synthesized evidence across various countries, including China, Iran, India, Canada, Egypt, Nigeria, Saudi Arabia, and the United States. Results: Academic pressure, financial stress, poor sleep, unhealthy coping mechanisms, and pre-existing mental health issues were all individual-level concerns, with female and minority students being more vulnerable. Strong familial ties and friendships served as protective interpersonal support. Heavy academic workloads, strict grading guidelines, a lack of mental health resources, and unwelcoming campus environments were among the institutional factors. Stigma and socioeconomic disparities are examples of community-level variables that make mental health issues worse. Conclusions: Student mental health is shaped by interrelated factors across all SEM levels. Integrated, multi-level strategies are essential to fostering supportive campuses, strengthening community networks, and implementing inclusive policies that promote mental health equity. Full article

Severe COVID-19 infection resulting in hospitalization shares features with cytokine storm syndromes (CSSs) such as hemophagocytic lymphohistiocytosis (HLH). Various published criteria were explored to define CSS among patients (n = 32) enrolled in a COVID-19 clinical trial. None of the patients met HLH-04 or HScore criteria, but the ferritin to erythrocyte sedimentation rate (ferritin–ESR) ratio and the COVID-19 cytokine storm score (CSs) identified 84% and 81% of patients, respectively. As 30–40% of patients in published secondary HLH cohorts possess rare heterozygous mutations in familial HLH (fHLH) genes, whole genome sequencing was undertaken to explore immunologic gene mutation associations among 20 patients enrolled in the trial. Rare mutations in fHLH genes were identified in 6 patients (30%), and 4 patients (20%) possessed rare mutations in DOCK8 (a novel CSS gene). Foamy viral transduction of the 3 DOCK8 missense mutations into NK-92 natural killer (NK) cells diminished NK cell cytolytic function, a feature of HLH. This severe COVID-19 cohort, like others, shares CSS features but is best identified by the ferritin–ESR ratio. Rare heterozygous CSS gene (fHLH genes and DOCK8) mutations were frequently (45%) identified in this severe COVID-19 cohort, and DOCK8 missense mutations may contribute to CSS via diminished lymphocyte cytolytic activity. Full article

Background: Variability and low volume yield in breast aesthetic outcomes utilizing fat grafting promoted a search for surgical technique improvement. Aim: Using evidence-based information to optimize a surgical technique for aesthetic breast augmentation using stem cell-enriched fat grafting. Methods: Retrospective study of consecutive women (n = 118) from 2008 to 2025 requesting breast fat grafting using centrifugation–filtration fat processing combined with platelet-rich plasma and autologous adipose-derived stem cell-enriched fat. Results: Most surgical indications were for primary breast augmentation (65.8%), followed by fat grafting after implant removal (13.6%), during or after mammoplasty (13.6%), or simultaneously with implant exchange (12.7%). The mean volume per breast of purified, enriched fat grafted was 192 to 206 cc. Each patient had fat grafted into the subcutaneous plane with some patients having additional fat placed submuscularly in those without a dual plane or submuscularly placed implant, or where an implant capsule was absent. Most patients were either very satisfied or satisfied (95.8%), with 4.2% dissatisfied. Those dissatisfied were mainly those with insufficient breast volume and one with a suspected atypical mycobacteria infection. There was a 11.9% complication rate, with seroma formation at the harvested site the most common at 5.1% (n = 6). Palpable fibrotic areas were second in frequency at 3.4% (n = 4), but with no instances of breast oil cyst formation. The average number of fat grafting sessions per indication was only one, with 6.8% requesting a second staged fat grafting procedure. The revision procedures were only in patients with a sole augmentation indication, except for one mastopexy patient with severe breast size asymmetry. An estimated 75–85% grafted volume take was confirmed by a previous diagnostic ultrasound measurement study. Conclusions: Breast fat grafting incorporating learned knowledge of optimal harvesting, processing, storing, enrichment, and administration techniques yielded superior consistent breast enhancement aesthetic outcomes with a high patient and surgeon satisfaction rate through increased adipocyte survival, while minimizing complications including a low incidence of fibrotic areas and no oil cyst formation. Full article

Introduction: Finger injuries are common in pediatric patients and typically heal well with conservative management. However, rare fracture patterns involving significant displacement and physeal injury, such as the one described in this case, require specialized surgical intervention to ensure proper healing and prevent long-term complications. Case Presentation: A 12-year-old left-hand-dominant female presented with pain, swelling, and deformity at the distal interphalangeal (DIP) joint following hyperextension of the left fifth digit. Initial radiographs revealed a volar displaced intra-articular fracture with physis involvement, confirmed by computed tomography (CT) imaging. Conservative management with closed reduction and splinting failed to achieve adequate alignment. Surgical intervention was performed via a dorsal approach, utilizing ORIF with K-wire fixation to restore joint congruity and ensure anatomic alignment. Outcomes: Postoperative follow-up demonstrated satisfactory healing, maintained reduction, and resolution of pain with no complications. The patient regained functional use of the digit with minimal stiffness, and the growth plate remained uninvolved during the recovery period. Discussion: This case underscores the importance of advanced imaging, early referral, and tailored surgical intervention for rare mallet fractures involving volar displacement and physeal injury. ORIF provided reliable stabilization and optimal outcomes in this complex case. Conclusions: Volar displaced Salter–Harris III fractures of the DIP joint are rare and challenging injuries in pediatric patients. This case highlights the role of ORIF in achieving successful outcomes and emphasizes the importance of precise reduction and stabilization to prevent long-term complications. Full article

The aim of this study was to prevent the development of microorganisms in the refrigerated storage of tench by releasing allyl isothiocyanate (AITC) produced by black mustard seeds. Tench reared in an aquaculture centre were sacrificed and the fillets were separated. Different amounts of defatted mustard seed (300, 400 and 500 mg) were added to hermetic polypropylene trays. Microbiological, sensory, and gas chromatography with MS detection analysis were done. AITC release increased progressively until the third day of storage, significantly delaying the development of microorganisms in samples with higher mustard seed content. The tasting panel detected positive aromas at the beginning of the study, but these decreased and negative aromas appeared. The mustard seed treatment resulted in a higher positive aroma at the end of the storage, reducing rotting and ammonia odours. A total of 31 volatile compounds were detected and grouped into hydrocarbon, alcohol, benzenoid, isothiocyanate, ketone, acetate, aldehyde, and others. Butylated hydroxytoluene, an indicator of bacterial contamination, was the major aromatic compound found during storage. The release of AITC resulted in fewer organic compounds with negative aromas appearing during storage. PCA analysis allowed us to classify the assays during storage according to their volatile profiles, confirming the differences observed between treatments. Thus, adding mustard seed to fish packaging could be a viable alternative to extending the product’s shelf life and ensuring food safety. Full article

Background: Current food systems contribute significantly to poor public health and environmental degradation. With increasing rates of chronic disease and undernutrition globally and in the United States of America (U.S.), transforming food systems toward sustainability is a critical public health priority. Objectives: This narrative review aimed to summarize U.S. policies from the past decade relevant to sustainable food systems, focusing on four domains—availability, accessibility, affordability, and desirability—proposed by the 22nd Annual Harvard Nutrition Obesity Symposium. Methods: Systematic searches were conducted using MEDLINE (PubMed), Scopus, U.S. Congress websites, and Google searches. Studies and policies published between 2013 and 2023 that addressed at least one of the four domains were included. Policies were reviewed according to their alignment with the policy lifecycle framework, encompassing formulation through implementation. Results: A review of the final 632 articles explained that, despite growing interest in sustainable food systems, there is a lack of comprehensive U.S. policies that address the four domains in an integrated manner. Most initiatives were limited in scope, often school-based, and not explicitly sustainability-focused. Food availability and accessibility policies exist but remain fragmented, while affordability and desirability domains are severely underrepresented. Few laws or bills have been enacted or evaluated for population-level or environmental outcomes. Conclusions: Transforming U.S. food systems requires more robust evidence-based policy development and evaluation. There is an urgent need for integrated multisectoral policy frameworks to ensure health, equity, and sustainability across all food system domains. Full article

The application of extended reality (XR) in design education has grown substantially; however, empirical evidence on its educational benefits remains limited. This two-year study examines the impact of incorporating a virtual reality (VR) learning module into undergraduate landscape architecture (LA) construction courses, focusing on brick masonry instruction. A conventional learning sequence—lecture, sketching, CAD, and 3D modeling—was supplemented with an immersive VR experience developed using Unreal Engine 5 and deployed on Meta Quest devices. In Year 1, we piloted a preliminary version of the module with landscape architecture students (n = 15), and data on implementation feasibility and student perception were collected. In Year 2, we refined the learning module and implemented it with a new cohort (n = 16) using standardized VR evaluation metrics, knowledge retention tests, and self-efficacy surveys. The findings suggest that when sequenced after a theoretical introduction, VR serves as a pedagogical bridge between abstract construction principles and physical implementation. Moreover, the VR module enhanced student engagement and self-efficacy by offering experiential learning with immediate feedback. The findings highlight the need for intentional design, institutional support, and the continued development of tactile, collaborative simulations. Full article

Simulation has become a pivotal tool in the design, analysis, and optimization of the built environment, and has been widely adopted by professionals in architecture, engineering, and urban planning. These techniques enable stakeholders to test hypotheses, evaluate design alternatives, and predict performance outcomes prior to construction. Applications span energy consumption, airflow, thermal comfort, lighting, structural behavior, and human interactions within buildings and urban contexts. This study maps the scientific landscape of simulation research in the built environment through a bibliometric analysis of 12,220 publications indexed in Scopus. Using VOSviewer 1.6.20, it conducted citation and keyword co-occurrence analyses to identify key research themes, leading countries and journals, and central publications in the field. The analysis revealed seven primary thematic clusters: (1) human-focused simulation, (2) building-scale energy performance simulation, (3) urban-scale energy performance simulation, (4) sustainable design and simulation, (5) indoor environmental quality simulation, (6) building aerodynamics simulation, and (7) computing in building simulation. By synthesizing these trends and domains, this study provides an overview of the field, facilitating greater accessibility to the simulation literature and informing future interdisciplinary research and practice in the built environment. Full article

With increasing global challenges related to water scarcity and phosphorus depletion, the recovery and reuse of wastewater-derived nutrients offer a sustainable path forward. This study evaluates the dual role of lanthanides (Ce³⁺ and La³⁺) in recovering phosphorus from municipal wastewater and supporting corn (Zea mays) cultivation through lanthanide phosphate (Ln-P) and lanthanide-reclaimed wastewater (LRWW, wastewater spiked with lanthanide). High-purity precipitates of CePO₄ (98%) and LaPO₄ (92%) were successfully obtained without pH adjustment, as confirmed by X-ray photoelectron spectroscopy (XPS) and energy-dispersive spectroscopy (EDS). Germination assays revealed that lanthanides, even at concentrations up to 2000 mg/L, did not significantly alter germination rates compared to traditional coagulants, though root and shoot development declined above this threshold—likely due to reduced hydrogen peroxide (H₂O₂) production and elevated total dissolved solids (TDSs), which induced physiological drought. Greenhouse experiments using desert-like soil amended with Ln-P and irrigated with LRWW showed no statistically significant differences in corn growth parameters—including plant height, stem diameter, leaf number, leaf area, and biomass—when compared to control treatments. Photosynthetic performance, including stomatal conductance, quantum efficiency, and chlorophyll content, remained unaffected by lanthanide application. Metal uptake analysis indicated that lanthanides did not inhibit phosphorus absorption and even enhanced the uptake of calcium and magnesium. Minimal lanthanide accumulation was detected in plant tissues, with most retained in the root zone, highlighting their limited mobility. These findings suggest that lanthanides can be safely and effectively used for phosphorus recovery and agricultural reuse, contributing to sustainable nutrient cycling and aligning with the United Nations’ Sustainable Development Goals of zero hunger and sustainable cities. Full article

Metabolic analysis systems require binary sex input, conflating biological sex with gender, limiting inclusivity. This study aimed to determine whether sex input altered metabolic or pulmonary variables during self-paced walking and running. Twenty adults completed two 5-min walking and running trials under both female (FC) and male (MC) input conditions in randomized order. Dependent t-tests determined differences between conditions; p-values < 0.05 were considered significant, and effect sizes were calculated. No significant within-participant differences were found between FC and MC for any variable. During walking, mean relative VO₂ (mL/kg/min) was 11.13 ± 2.73 (FC) and 10.81 ± 2.39 (MC), p = 0.08, R² = 0.93; mean energy expenditure (kcal) was 18.28 ± 4.74 (FC) and 17.86 ± 4.33 (MC), p = 0.12, R² = 0.94. During running, mean relative VO₂ was 28.80 ± 5.89 (FC) and 28.82 ± 6.06 (MC), p = 0.90, R² = 0.98; mean energy expenditure was 45.79 ± 13.08 (FC) and 45.55 ± 12.26 (MC), p = 0.99, R² = 0.98. Binary sex input in the TrueOne 2400 system did not affect variables, supporting inclusive sex and gender data collection to improve research ethics, accuracy, and representation of gender-diverse people without compromising integrity. Full article

This study aimed to evaluate the impregnation process of apple slices with bioactive compounds (BCs) that were obtained from the richest antioxidant fruit powder extracts. Acaí, beetroot, blueberry, cranberry, dragon fruit, and pomegranate powders were assessed on their main BCs, antioxidant capacity (AC), and reducing power (RP) before and after heat treatment to select the extract with the highest and most stable BCs and AC. The effect of pH (3–7) and the total soluble solids (TSSs) (5–15%) on the BCs and AC of selected fruit powder extracts were also evaluated to decide which one should be used to impregnate apple slices. Results indicate that the pomegranate extract presented the highest BCs, AC, and RP among the fruit powders tested, even after heat treatment. Moreover, the TSSs did not affect the BCs from the pomegranate extract; however, pH affected the stability, showing higher values of BCs as the pH was reduced. Apple slices impregnated with pomegranate extract (pH 2) showed an increase in their total phenolic compounds, total anthocyanins, AC, and RP at 25.94, 3085.00, 19.80, and 56.94%, respectively, compared to control apple slices. This study indicates that reducing the pH of pomegranate extracts may increase their antioxidant compounds, showing a higher impregnation of them on apple slices. Full article