Search Results (3,622)

This study aimed to evaluate the effects of several minor components of extra virgin olive oil (EVOO) on platelet thromboxane and vascular prostacyclin production in rat aortic rings under high-glucose conditions (300 mg/dL), in relation to their potential antioxidant actions. Under hyperglycaemic conditions, thromboxane production was 1.3 times higher, while prostacyclin production was 40.9% lower than in samples with 100 mg/dL glucose in aortic rings, accompanied by marked oxidative stress (65.6% higher than in samples with 100 mg/dL glucose). The compounds tested inhibited thromboxane production in a concentration-dependent manner, with relative potencies (secoiridoid derivatives (IC₅₀ range: 10⁻⁶ M) = triterpenes (10⁻⁶ M) > alcoholic phenols (10⁻⁵ M for hydroxytyrosol and 10⁻⁴ M for the rest)), while preserving prostacyclin production (5–20% inhibition). All compounds also exerted vascular antioxidant effects, reducing oxidative stress markers and enhancing antioxidant parameters (IC₅₀ range: 10^−6–10⁻⁵ M), and these effects were observed under both normoglycaemic (100 mg/dL) and hyperglycaemic (300 mg/dL) conditions. Full article

Background/Objectives: The clinical determinants and functional relevance of persistent lung ultrasound (LUS) abnormalities after COVID-19 pneumonia remain poorly characterized. We aimed to identify determinants of qualitative LUS abnormalities and global lung involvement assessed by the LUS score, and to evaluate their association with persistent dyspnoea. Methods: We conducted a prospective observational study that included 261 patients who were hospitalized for COVID-19 pneumonia and were assessed 1–6 months after discharge. A standardized 14-zone LUS protocol was used to assess qualitative abnormalities (pleural line irregularity, ≥3 B-lines, and subpleural consolidations) and to calculate the LUS score. Associations with clinical variables, including dyspnoea assessed by the modified Medical Research Council (mMRC) scale, were analyzed using multivariable logistic regression. Results: The severity of the acute pneumonia episode emerged as the strongest determinant of qualitative LUS abnormalities and elevated LUS score (>6). Increasing age was independently associated with ultrasound findings. Persistent dyspnoea (mMRC ≥ 1) was associated with all qualitative abnormalities and with a higher prevalence of elevated LUS score (56.6% vs. 22.1%; p < 0.001). A graded association was observed between dyspnoea severity and both qualitative findings and LUS score. An increase in dyspnoea from baseline (ΔmMRC ≥ 1) remained independently associated with an elevated LUS score. Conclusions: Persistent LUS abnormalities are strongly associated with the severity of the acute episode. The LUS score provides a robust, clinically meaningful measure of residual lung involvement and shows a stronger association with persistent dyspnoea than qualitative findings, supporting its role in follow-up and risk stratification. Full article

Background/Objectives: Hospitalisations in systemic lupus erythematosus (SLE) reflect disease severity, accumulated damage, and the burden of comorbidity, remaining a major determinant of healthcare utilisation. Recent evidence suggests a shift from flare-driven admissions toward complications related to infections, comorbidities, and long-term treatment effects. We aimed to analyse the causes, characteristics, and outcomes of hospital admissions in patients with systemic lupus erythematosus (SLE) over a 30-year period in a tertiary referral centre in Catalonia (Spain) and to evaluate changes over time and prognostic factors associated with adverse outcomes. Methods: A retrospective observational study was conducted including all SLE patients admitted to the Department of Autoimmune Diseases at Hospital Clínic de Barcelona between June 1995 and December 2024. Admissions lasting less than 48 h or lacking clinical documentation were excluded. Variables analysed included demographics, disease duration, comorbidities, cause of admission, treatments, and outcomes. A composite outcome was defined as intensive care unit (ICU) admission, 30-day readmission, or prolonged hospital stay. Statistical analyses included univariate and multivariate regression models. Results: Among the 1216 hospital admissions, SLE flares and infections were the most frequent causes. Over the study period, admissions due to infections increased significantly and, in the last five years, exceeded those related to disease flares (33.7% vs. 26.1%). Patients hospitalized for flares were younger and had a shorter disease duration, whereas infection-related admissions were more common among older patients, those with overlap syndromes, and those with higher damage scores. Vascular events and SLE flares were independently associated with poorer outcomes. Although antimalarial use increased over time, it remained suboptimal, largely due to drug toxicity and newly diagnosed cases (from 45.2% to 69.7%; p < 0.001). Treatment strategies also evolved, with a shift toward lower glucocorticoid doses (from 14.5% to 38.3%; p < 0.001), and mycophenolate mofetil replacing cyclophosphamide as the preferred immunosuppressive agent. Conclusions: Hospitalisation patterns in SLE have shifted over time, with infections emerging as the leading cause of admission. This trend reflects an evolving patient profile characterized by older age, greater accumulated damage, comorbidities, and increased exposure to immunosuppressive therapies. These findings underscore the need for optimized infection prevention strategies and individualized treatment approaches to improve outcomes in contemporary SLE care. Full article

Background/Objectives: Malnutrition in cancer adversely affects treatment outcomes and survival. Early intervention through oral nutritional supplements (ONSs) and dietary counseling can improve outcomes. This study evaluated the evolution of nutritional and morphofunctional parameters over three months in malnourished patients with cancer undergoing a comprehensive nutritional support program comprising dietary counseling, physical activity, and a novel concentrated high-protein, high-calorie ONS (cHPHC-ONS) with a high intrinsic leucine content. Methods: A prospective, observational, multicenter cohort study was conducted across 18 public hospitals in Spain. Two hundred thirty malnourished patients with cancer were enrolled: 147 naïve (no ONS treatment in the last three months) and 83 non-naïve (who transitioned to cHPHC-ONS after inadequate response to initial ONSs). Nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria and morphofunctional parameters via bioelectrical impedance analysis, nutritional ultrasound, handgrip strength, the Timed Up and Go (TUG) test, and analysis of biochemical parameters. Results: After three months, 23.8% achieved normal GLIM nutritional status (p < 0.0001), with a greater improvement seen in non-naïve patients (28.4%, p < 0.0001). Weight loss ceased in 42.6% (p < 0.0001). and inflammation resolved for 10.3% (p = 0.0015). Non-naïve patients experienced a significant increase in fat-free mass index (p = 0.0159), appendicular skeletal muscle index (p = 0.0248), and rectus femoris cross-sectional area (p = 0.0016). Muscle strength increased significantly by +1.7 kg (p = 0.0025), and TUG test time decreased by 1.13 s (p = 0.0003) overall. Conclusions: The comprehensive nutritional support program—including a novel cHPHC-ONS, along with dietary and physical activity guidance—significantly improved the nutritional and morphofunctional status of malnourished patients with cancer, with benefits particularly evident in non-naïve individuals. Limitations: Observational design, no control group, short follow-up, and unadjusted non-multivariable comparisons, limiting causal inference. Full article

Bleeding risk assessment is a critical component of the management of patients with ST-segment elevation myocardial infarction (STEMI), yet the optimal approach to risk stratification remains controversial. Although several bleeding risk scores have been developed, their predictive performance in STEMI populations is still evolving. Importantly, bleeding risk in STEMI is dynamic and influenced by clinical status, procedural factors, and antithrombotic strategies, underscoring the need for continuous reassessment throughout hospitalization. Bleeding avoidance measures—including radial access, judicious use of anticoagulation, and individualized antiplatelet therapy—play a pivotal role in reducing complications. Balancing ischemic and hemorrhagic risks is particularly challenging in patients with concomitantly high thrombotic and bleeding risks, requiring tailored management strategies. As bleeding remains a major determinant of prognosis, refining risk stratification tools and integrating evidence-based bleeding prevention strategies into clinical practice are essential. This narrative review summarizes the current evidence regarding the identification of high bleeding risk in hospitalized patients with STEMI and discusses its clinical implications. Also, this review proposes a dynamic, phase-specific framework for in-hospital bleeding risk assessment and management in patients with STEMI. Full article

Objective: The aim of this study will be to evaluate the effectiveness of a task-oriented training program in improving functional performance and health outcomes in patients with MS. Methods: A pilot randomized clinical trial will be conducted according to SPIRIT guidelines. Participants will be randomly assigned to the experimental group or the control group. Assessment and treatment will take place at patient association facilities or research center. Participants diagnosed with MS by a neurologist and meeting the inclusion criteria will be invited to participate voluntarily. The experimental group will undergo an 8-week TOT intervention, twice weekly, 45 min. The control group will maintain usual care and be given a fatigue management pamphlet. The main variable in this study will be the Canadian Occupational Performance Measure. The level of fatigue will be assessed with the Modified Impact Fatigue Scale and the Fatigue Severity Scale, upper limb strength using the Arm Curl Test, hand and pinch dynamometer, motor speed with the Finger Tapping Test, manual dexterity with the Nine Hole Peg Test, Purdue Pegboard Test and the Coin Rotation Test. Satisfaction and adherence with the intervention will be recorded with the Sport Injury Rehabilitation Adherence Scale. Results: The results will be published as a peer-reviewed article. Conclusions: The present protocol aims to fill a relevant gap in the literature, offering a structured intervention based on task-oriented training principles, specifically tailored to the functional and occupational needs of people with MS. Full article

Free-space optical (FSO) communication is an attractive high-capacity wireless technology for terrestrial, aerial, and satellite links. However, FSO performance is strongly affected by multiple impairments, including path loss, turbulence attenuation, pointing errors, and equipment loss. Therefore, accurate performance evaluation requires channel modelling that accounts for both deterministic power losses and stochastic channel effects. This paper presents a comprehensive and structured review of FSO channel modelling, covering the transmission, propagation medium, and receiver sections. The composite channel response is represented using a mathematical formulation. Commonly used FSO models are reviewed and organised, including Beer–Lambert and geometrical loss, Kim and Kruse path loss models, Lognormal, Gamma–Gamma, K, and Málaga distributions, along with pointing-error and angle-of-arrival models. Each model is explained in terms of its physical meaning, assumptions, and applicable operating conditions. Lastly, a numerical example is presented to demonstrate how deterministic losses and stochastic channel effects can be combined in FSO performance evaluation. Full article

This study examines the roles of startup hubs within the cultural and creative industries (CCIs) and their implications for cultural innovation and tourism in European cities. Despite the growing importance of CCIs in urban development and destination branding, few studies have explored the organisational, social and communicative dynamics of cultural startup hubs. To address this gap, a comparative mixed-methods approach is applied to analyse 91 incubated startups in three European hubs: 104factory (Paris, France), Makerversity (London, UK) and A Lab (Amsterdam, The Netherlands). This study integrates structural variables (sustainability and institutionalisation), social variables (gender representation in leadership) and communication variables (activity and engagement on Instagram). The results reveal distinct organisational models, from highly institutionalised structures to more flexible, community-oriented approaches, with notable differences in terms of sustainability and gender distribution. In terms of communication, greater engagement is associated with content focused on community, identity and collective creativity, rather than promotional strategies. These findings highlight the role of startup hubs as hybrid intermediaries that not only support cultural entrepreneurship, but also contribute to the symbolic positioning and tourist appeal of the cities in which they are located. This study offers theoretical and practical insights for the development of more inclusive, sustainable and effectively communicative cultural ecosystems. Full article

Introduction: Intraoperative hypotension (IOH) is a frequent manifestation of haemodynamic instability during general anaesthesia. Advances in arterial waveform analysis have led to two distinct monitoring strategies: flow-derived platforms and predictive algorithms designed to anticipate hypotension. However, prospective comparisons and their associations with IOH and postoperative outcomes remain limited. The objective was to compare predictive haemodynamic monitoring using the Hypotension Prediction Index (HPI) with flow-derived monitoring using the Vigileo/FloTrac system and to evaluate their associations with IOH and postoperative outcomes. Methods: In this single-center prospective observational study, 101 adults undergoing elective major abdominal surgery under general anaesthesia were monitored using either the HPI system (n = 49) or the Vigileo/FloTrac system (n = 52). Primary outcomes were cumulative duration and frequency of IOH (mean arterial pressure < 65 mmHg). Secondary outcomes included postoperative complications, organ injury biomarkers (troponin, creatinine, eGFR), and hospital length of stay. Multivariable regression models adjusted for predefined confounders were used to estimate associations. Results: Vigileo/FloTrac monitoring, compared with HPI, was independently associated with a greater cumulative duration of IOH (adjusted β = 1.66; 95% CI, 0.63–2.72) and a higher number of hypotensive episodes (adjusted β = 0.53; 95% CI, 0.10–0.95). Monitoring strategy was not associated with surgical site, respiratory, or neurological complications. However, Vigileo/FloTrac monitoring was associated with higher odds of vascular complications (adjusted OR = 4.36; 95% CI, 1.13–20.41). No significant associations were observed between monitoring strategy and postoperative organ injury biomarkers or length of hospital stay. Conclusions: Predictive haemodynamic monitoring using the HPI system was associated with lower IOH burden compared with the Vigileo/FloTrac system. However, these differences were not consistently accompanied by improvements in postoperative outcomes. Haemodynamic optimisation should be considered as one component within a broader, integrated perioperative management strategy. Further large-scale, multicenter prospective studies are warranted to clarify its impact on patient-centered outcomes. Full article

Power transformers are fundamental devices in electrical power transmission and distribution systems as they regulate voltage levels, which helps reduce system losses. However, their operation can be affected by temperature, with increases in temperature causing a decrease in their efficiency and lifetime. In addition, the presence of harmonics in the electrical current can cause overheating and distortions in transformer performance. A significant proportion of these harmonics are caused by the increasingly widespread use of DC renewable energies. To control such renewable sources, power inverters are used, which generate harmonics and cause overheating in transformers connected to the grid. One solution to this problem is to reduce the harmonic content generated by these converters to avoid transformer overheating and improve their lifetime. In this work, a modulation technique for H-bridge multilevel inverters is presented with the aim of reducing both harmonics and transformer heating. To test the technique’s effectiveness, the recommendations of a standard have been followed, which include the use of a dry transformer prototype for temperature measurements. The proposed technique has been compared with classical techniques for H-bridge multilevel inverters, and the experimental results indicate a reduction in the hottest-spot temperature. Full article

The emergence of multidrug-resistant Pseudomonas strains poses a serious threat to public health. Essential oil components, such as thymol (TH), exhibit potent antibacterial activity. However, the effects of continuous sublethal TH exposure and resulting changes to antibiotic susceptibility remain poorly understood. Here, we investigated a multi-resistant Pseudomonas psychrophila strain after TH adaptation using an integrated transcriptomic and metabolomic approach. Treatment with TH caused a significant decrease in MIC values for aminoglycosides (streptomycin, gentamicin, kanamycin) and tetracycline and increased susceptibility to five other antibiotics. Multi-omics analyses revealed coordinated changes in fatty acid metabolism (FabI downregulation and accumulation of unsaturated fatty acids), lipid A biosynthesis (LpxC downregulation), peptidoglycan synthesis (Mur genes downregulated, accompanied by increased spermine levels), and stress response pathways (such as GABA, GadA, maltose, and MalK). These results suggest that metabolic alterations and envelope remodeling potentially affect cell wall integrity and growth, which could, in turn, contribute to increased antibiotic susceptibility and re-sensitization. Overall, our findings highlight the potential of TH-mediated sensitization as a complementary strategy to restore antibiotic efficacy. Full article

The CO₂ storage–regeneration (CO₂-SR) process represents a promising strategy for integrating CO₂ capture and catalytic conversion within a single cyclic operation using multifunctional catalysts. In this concept, CO₂ is first stored on basic sites and subsequently converted through methane activation, enabling the coupling of CO₂ capture and reforming reactions in a single reactor. In this work, a series of unsupported Ni–Ba catalysts were investigated as model multifunctional materials for the CO₂-SR process. Catalysts with different Ni/Ba ratios were prepared to analyze how the distribution of storage and catalytic sites influences the cyclic CO₂ capture–conversion behavior. In addition, Rh was introduced as a promoter either during synthesis by co-precipitation or ex situ by impregnation, allowing to evaluate the influence of Rh location and surface enrichment on the catalytic properties. Rh incorporation in the NiBa catalyst (Ni/Ba = 10/1 and Ni/Rh = 100/1) increased the specific surface area (BET area 64 m²·g⁻¹ vs. 55 m²·g⁻¹ for NiBa) and reduced the NiO crystallite size from 250.4 Å to 231.5 Å, indicating improved dispersion of the metallic phase. XPS analysis revealed the coexistence of Rh⁰ and Rh³⁺ species, suggesting that Rh acts as a redox mediator that facilitates hydrogen activation and promotes hydrogen spillover to neighboring Ni sites. Raman and CO₂-TPD results show that Ba-derived domains stabilize carbonate species responsible for CO₂ storage, while Rh enhances catalyst reducibility and modifies the kinetics of carbonate decomposition during the regeneration stage. Transient CO₂–CH₄ pulse experiments demonstrate that the CO₂-SR process proceeds through a dynamic surface cycle involving reversible carbonate formation on Ba-derived basic sites coupled with methane activation on Ni-containing interfacial sites. The results indicate that catalyst performance is governed by a hierarchical surface architecture composed of Ni–O–Ba interfacial domains, reversible Ba–O–Ba carbonate storage sites, and more stable Ba-rich domains. The distribution of these domains, controlled by the Ni/Ba ratio and the dispersion of the metallic phase, determines the reversibility of carbonate formation and the efficiency of the cyclic CO₂ storage–regeneration process. Full article

Background: Families caring for children with medical complexity (CMC) face sustained psychosocial demands that may impair health-related quality of life (HRQoL) and mental health. A clear map of how these outcomes are assessed and which factors shape them is needed to guide family-centered care. Methods: We conducted a scoping review following the Joanna Briggs Institute guidelines, and reports were prepared according to the PRISMA guidelines. Searches were conducted in PubMed, CINAHL, and EMBASE (January 2011 to December 2023) to find studies reporting on health-related quality of life (HRQoL) and/or mental health outcomes (anxiety, depression, burden) of family members and/or caregivers of CMC, including operationalization based on complex chronic condition (CCC) classifications, technology dependency, or the Pediatric Medical Complexity Algorithm (PMCA). Two reviewers independently screened records and recorded data, and the findings were synthesized narratively and thematically. Results: Sixty-seven studies met the inclusion criteria and spanned cross-sectional, cohort, case–control, pre–post and qualitative designs across conditions such as epilepsy, congenital heart disease, cerebral palsy, technology dependence and cancer. Common measures were PedsQL™ Family Impact Module, SF-36/12, HADS, Beck inventories and Zarit burden scales. Across the included studies, caregivers, predominantly mothers, frequently reported poorer HRQoL and higher levels of anxiety, depressive symptoms, or burden than comparison groups when these were available. Six recurrent themes emerged: (1) gendered caregiving with disproportionate maternal burden; (2) socio-economic gradients and financing models shaping outcomes; (3) culture, religion and spirituality as coping resources; (4) family and social support buffering distress; (5) school participation and coordinated services potentially reducing burden; and (6) interdependence between caregiver and child outcomes. Conclusions: Heterogeneous CMC definitions, outcome measures, and study designs limited comparability across studies. The mapped evidence suggests that family HRQoL and mental health outcomes are shaped by interacting clinical, social, and contextual factors. These findings may inform more family-centered and equity-oriented approaches to care. Future research should harmonize CMC definitions, standardize outcome measures, and prospectively evaluate multicomponent interventions. Full article

Riparian ecosystems are being increasingly threatened by hydrological alteration and biological invasions, yet the role of local environmental heterogeneity in shaping invasion dynamics remains poorly understood. To address this, we tested the hypothesis that invasion patterns are spatially structured and therefore cannot be fully captured by global statistical models. We evaluated this hypothesis by analysing the relationship between soil sand content and the abundance of Gleditsia triacanthos in a riparian forest of the Esteros de Farrapos and Islands of the Uruguay River National Park, Uruguay. Generalized Linear Mixed Model revealed no significant relationship between soil sand content and G. triacanthos abundance (χ² = 1.93, p = 0.17). In contrast, spatially explicit analyses showed that relationships between sand content and abundance were spatially contingent. Positive linear relationships predominated in areas with low sand content (mean 24.5%, n = 12), while negative relationships were restricted to the highest sand levels (mean 87.6%, n = 3). Intermediate sand-content zones (mean 47%, n = 16) showed no consistent patterns. These results suggest that invasion patterns vary across spatial contexts and may reflect the influence of different processes operating locally, indicating that relying solely on global analyses risks misinterpreting drivers and overlooking fine-scale variation. Our findings emphasize that understanding invasive species in heterogeneous systems requires considering whether mechanisms operate at local or broad scales, and that explicitly analyzing spatial structure can guide both hypothesis formulation and field study design. Full article

The fig tree (Ficus carica L.) is one of the oldest cultivated fruit trees in the Mediterranean region and represents an important genetic resource for both traditional and emerging production systems. Despite its agronomic and economic relevance, modern fig breeding remains limited, and large-scale phenotypic evaluations across Mediterranean germplasms are still scarce. The objective of this study was to assess phenotypic diversity and identify key agronomic traits relevant for fig breeding. A total of 257 female fig genotypes conserved in germplasm banks located in Spain, Turkey, and Tunisia were used. Over two consecutive seasons (2021 and 2022), a total of 27 morphological, phenological, and pomological traits were assessed according to the International Union for the Protection of New Varieties of Plants (UPOV) descriptors for fig (TG265/1), with 23 phenotypic traits retained for statistical analyses. Linear mixed models were used to estimate marginal means and to partition genetic and environmental variance, while multivariate analyses and trait correlations were employed to explore the structure of phenotypic diversity. The germplasm exhibits remarkable variation in productive type, reproductive behaviour, harvesting date, and fruit quality traits. Harvesting date spans nearly three months. Fruit weight ranges from 11.7 to 134.5 g, total soluble solids from 9 to 39 °Brix, and maturation index values reached high levels, indicating pronounced sweetness during fruit ripening. Most genotypes showed high skin scratch resistance, absence of cracking at maturity, and medium or small ostiole size, highlighting the presence of ideotypes specifically suited for fresh market production. Heritability estimates indicate strong genetic control of key traits, such as fruit weight, fruit size, and total soluble solids, highlighting their suitability for selection in breeding programs. Stakeholder prioritisation further confirmed the relevance of fruit size, sweetness, firmness, and ostiole characteristics, helping to identify best genotypes for breeding and agronomic purposes. Overall, this study demonstrates the value of Mediterranean fig germplasm as a reservoir of valuable agronomic and commercial traits and provides a robust phenotypic framework to support future breeding, conservation, and cultivar selection strategies. Full article