Search Results (8,005)

Background/Objectives: Obstructive sleep apnea (OSA) is increasingly observed in patients undergoing supracricoid laryngeal surgery; however, the impact of postoperative anatomical changes on sleep-disordered breathing remains insufficiently characterized. This pilot study aimed to assess the incidence and severity of OSA after Open Partial Horizontal Laryngectomy type II (OPHL II) and to evaluate correlations between polysomnographic parameters and radiologic measurements of the neolarynx. Methods: A prospective observational cohort study was conducted on ten patients who underwent OPHL II between 2019 and 2024 and were evaluated at least one year postoperatively. The sample size was determined using a conservative estimate appropriate for a pilot prospective study, which required a long postoperative follow-up period of at least one year. All patients completed Stop-Bang, Berlin, and Epworth questionnaires and underwent overnight polysomnography. Cervical CT scans were used to measure airway length to the vocal cords (ALVC), supralaryngeal tract horizontal (SVTH) and vertical (SVTV) segments, and the base-of-tongue–to–cervical-body distance (BTCB). Results: OSA was detected in all patients: 40% mild, 30% moderate, and 30% severe. Mean AHI was 25.5 ± 18.9 events/h, and OSA severity strongly correlated with AHI (rho = 0.94; p < 0.0001). Among radiologic parameters, SVTV showed a positive correlation with OSA severity (rho = 0.82; p = 0.0035), while BTCB demonstrated a significant negative correlation (rho = −0.71; p = 0.0207). No significant associations were found for ALVC or SVTH. Conclusions: Supracricoid laryngectomy produces anatomical changes that predispose patients to OSA. Radiologic metrics—particularly SVTV and BTCB—appear to be meaningful predictors of OSA severity. A multidisciplinary approach is essential for early diagnosis and management. Due to the small number of patients enrolled larger multicenter studies are needed to confirm these findings and define radiologic criteria associated with postoperative OSA. Full article

Objectives: Oral health-related quality of life (OHRQoL) reflects the functional and psychosocial impacts of oral conditions on daily life. In low-resource settings such as rural Tanzania, limited access to dental care and preventive services may increase the burden of oral disease. This study assessed the association between clinical oral health conditions and OHRQoL among schoolchildren in rural Tanzania. Methods: A cross-sectional study was conducted among 293 schoolchildren at Igelehezda Primary School, Ilembula, Tanzania. Clinical examinations assessed dental caries using the DMFT index and oral hygiene using the OHI-S index. OHRQoL was measured with the Child Oral Impact on Daily Performances (C-OIDP) questionnaire. Behavioral data included sugar intake, number of daily meals, and toothbrushing-related symptoms. Associations between clinical, behavioral factors and OHRQoL were analyzed using descriptive statistics, bivariate tests, and multiple linear regression (p < 0.05). Results: All 293 children completed the study (mean age 12.2 ± 1.2 years; 157 females, 136 males). Mean DMFT was 2.7 ± 4.1, with 80.5% free of untreated caries, and mean OHI-S indicated good oral hygiene (0.4 ± 0.6). Most participants were periodontally healthy (68.3%). Toothache, gum pain, or bleeding during brushing were reported by 26.0–31.6%. Eating was the most affected daily activity (42.7%). Missing teeth, toothbrushing-related symptoms, and consumption of high-sugar sweets were significantly associated with higher C-OIDP scores (p < 0.05), while a higher number of daily meals was associated with fewer impacts. Conclusions: Missing teeth, toothbrushing-related symptoms, and high sugar intake were associated with greater impairment in daily life, particularly affecting eating. These findings highlight the need for preventive and educational oral health interventions in rural, resource-limited settings. Full article

Unbiased stereology represents the most accurate approach for estimating the total number of neurons of specific brain regions; however, its reliability critically depends on the use of rigorously defined and anatomically appropriate sampling parameters. The brain nucleus Locus Coeruleus (LC) plays a key role in several brain functions. LC impairment has been associated with a range of disorders affecting individuals across the lifespan, from infancy to adulthood. In animal models of these conditions, precise estimation of LC neuronal number is essential. The LC analysis poses specific methodological challenges due to its small size, indistinct anatomical boundaries, and age-dependent changes in neuronal density. In this study, we present a detailed and reproducible stereological workflow for the quantification of LC neurons in the mouse brain across the lifespan. Using C57BL/6J mice at postnatal, adult, and aged stages, we optimized all key components of the Optical Fractionator method, LC neurons were identified by immunoperoxidase staining for tyrosine hydroxylase (TH) and quantified using systematic-random sampling implemented in Stereo Investigator^® software. We show that age-specific adjustment of stereological parameters is necessary to obtain reliable estimates, particularly at early postnatal stages characterized by high neuronal packing density. With the optimized protocols described here, TH+ LC neuron counts consistently met accepted precision criteria, as assessed by the Gundersen coefficient of error. Full article

Background: Respiratory syncytial virus (RSV) is a leading cause of hospitalization for acute respiratory tract infection (ARTI) in young children. Respiratory viral coinfections are frequently identified in RSV-related ARTIs, yet their impact on disease severity remains controversial and may vary according to the co-pathogen involved. In the context of evolving RSV prevention strategies, a clearer understanding of RSV coinfection phenotypes is needed. Methods: We conducted a multicenter retrospective cohort study of children aged ≤ 5 years hospitalized for ARTI at two Italian tertiary-care pediatric hospitals between 1 September 2022 and 30 April 2025. Children with laboratory-confirmed RSV infection detected by multiplex polymerase chain reaction were included. Patients were classified as having RSV monoinfection, RSV–rhinovirus coinfection, or RSV–non-rhinovirus coinfection. Severe disease was defined as a composite outcome including intensive care unit (ICU) admission, need for respiratory or hemodynamic support, or death. Association between infection status and severe disease was evaluated using a Poisson regression model with robust variance, adjusted for age, sex, and comorbidities. Results: Among 231 RSV-related hospitalizations, 118 (51.1%) were classified as RSV monoinfection, 65 (28.1%) as RSV–rhinovirus coinfection, and 48 (20.8%) as RSV–non-rhinovirus coinfection. Children with RSV–rhinovirus coinfection were older and had shorter hospital stays. Severe disease occurred in 80.5% of RSV monoinfections, 70.8% of RSV–rhinovirus coinfections, and 75.0% of RSV–non-rhinovirus coinfections. After adjustment, neither RSV–rhinovirus coinfection (adjusted risk ratio [aRR]: 0.93; 95% confidence interval [95% CI]: 0.80–1.13) nor RSV–non-rhinovirus coinfection (aRR: 0.99; 95% CI: 0.83–1.18) was associated with increased disease severity compared with RSV monoinfection. Conclusions: RSV–rhinovirus and RSV–non-rhinovirus coinfections were not associated with greater disease severity compared with RSV monoinfection in hospitalized children. These findings support pathogen-specific interpretation of multiplex diagnostic results and inform clinical risk stratification in the era of expanding RSV prevention strategies. Full article

Taxanes, such as paclitaxel and docetaxel, are microtubule-stabilizing agents widely used in oncology, either as monotherapy or in combination regimens. While highly effective, these first-generation taxanes face important limitations, including significant toxicity, reduced water solubility, and the emergence of multidrug resistance. To address these challenges, semi-synthetic taxoids have been developed, aiming to improve pharmacological profiles and overcome therapeutic barriers. Central to these efforts is the understanding of structure-activity relationships, which guides the rational design of taxane analogues with enhanced efficacy and safety. This review explores recent advances in taxoid development, highlights findings from clinical trials, and evaluates how these new agents compare with traditional taxanes in terms of therapeutic potential and tolerability. While novel delivery systems offer improved outcomes with existing drugs, the development of new taxane analogues remains a promising approach to address drug resistance, albeit with challenges related to toxicity, high costs, and historically low success rates in drug development. Furthermore, taxanes are already used in certain cardiovascular conditions and show emerging potential in neurodegenerative diseases, although current evidence remains largely limited to preclinical or early-phase clinical studies. These developments mark an important evolution in the field and offer new opportunities for future therapeutic strategies. Full article

Cowpeas are a legume widely consumed in Brazil. Given this, the objective of this study was to investigate the presence of metals (loids) in pods and leaves of Vigna unguiculata located near a highway with high vehicle traffic and a landfill, and to assess possible risks to human health. Pod and leaf samples were collected at nine points between the highway and the landfill. The elements were analyzed by inductively coupled plasma optical emission spectroscopy (ICP-OES) and quantified. The risk to human health was assessed using risk quotient and risk index values. A quantitative analysis of the chemical elements was also performed using the maximum tolerable intake level. Element concentrations were higher in the leaves than in the pods. The human health risk analysis showed that the average daily consumption of both pods (44 g/day) and leaves (67 g/day) may pose a chronic health risk to adult men and women, due to simultaneous exposure to multiple metals. It was concluded that the plant is contaminated and that its ingestion can cause toxicity, warranting warnings against cultivating areas near anthropogenic activities that may be contaminated with heavy metals, thereby affecting nutritional safety. Full article

Background/Objectives: This study aimed to assess the feasibility and acceptability of a 3-month health coaching intervention to promote PNF and healthy diet for men on ADT for PCa. Methods: The study was carried out via a two-armed randomized controlled trial including 40 patients with PCa at a medical center in Philadelphia. During the 3-month period, the intervention group (PNF+) received health coaching utilizing an interactive text message system, and the control group received healthy eating text messages for the same duration. The outcome variables were feasibility and acceptability. Results: The PNF+ group (n = 27) had high adherence to health coaching (82%), picture response (85%) and moderate adherence to the PNF window (69%). The intervention was rated highly acceptable with no reported A/E associated with the intervention, and most participants planning to continue in some capacity. At 3 months, the PNF+ group had numerically lower BMI (29.1) and body weight (195.2 lbs) compared to the control group (n = 13; BMI 31.6, weight 223.3 lbs). Improvements in patient-reported outcomes were observed in both groups. FACIT-F scores (higher scores indicate less fatigue) increased in the PNF+ group (43.6 to 45.2) and in the control group (42.5 to 45.5). FACT-P scores (higher scores indicate better quality of life) increased in the PNF+ group (121.3 to 125.5) but decreased slightly in the control group (121.1 to 119.8). Between-group comparisons of change from baseline showed no statistically significant differences across outcomes (all p > 0.05). Conclusions: The intervention demonstrated partial feasibility and high acceptability. It was associated with numerically lower BMI and body weight and favorable changes in patient-reported outcomes, particularly quality of life; however, no statistically significant differences were observed between groups. These findings should be interpreted cautiously given the small sample size and require confirmation in larger, adequately powered trials. Full article

Latin America faces growing challenges in the management of municipal solid waste (MSW). This is particularly evident in medium-sized and metropolitan cities where rapid urbanization, limited infrastructure, and high proportions of organic waste (40–70%) converge. This review synthesizes the most recent advances in organic waste management, valorization strategies, environmental performance, and policy frameworks in Mexico and Latin America. To provide a comprehensive overview, evidence from studies on informal recycling systems, route optimization, sustainable landfill siting, food waste valorization, life cycle assessments (LCAs), and biogas production is integrated. Techno-economic analyses of energy recovery from organic fractions are specifically reviewed. This review highlights that valorization of organic waste through composting, anaerobic digestion, food supplementation, and bioproduct generation can reduce greenhouse gas emissions by 40–70% compared to landfilling, with AD–composting hybrids achieving the highest reductions of 60–70%. Community composting achieved moderate reductions, 30–50%, but at significantly lower cost and with greater social co-benefits. These alternatives for valorizing the organic fraction extend the lifespan of both confined and open landfills. It also contributes to mitigating the public health impacts related to open dumping, disease vectors, and contaminated leachate. In short, this review also highlights shortcomings in policy coherence, financial mechanisms, source separation, and technology adoption. A strategic framework is proposed that prioritizes decentralized treatment systems, the integration of informal recyclers, tax incentives, community-based waste separation, and planning based on Life Cycle Assessment (LCA). The findings point to a viable strategy for transitioning from landfill dependency to circular waste management systems that improve the quality of life for the population of Latin America and the Caribbean. Full article

Bioplastics are in focus for the development of sustainable materials due to the depletion of fossil resources, generation of solid waste and global climate change. Considering this, the current research is devoted to the valorization of beachcast red seaweed F. lumbricalis for the development of thermoplastically processable bioplastics. The composites have been developed from beachcast red seaweed-derived furcellaran (FUR) and potato-derived thermoplastic starch (TPS) by using an ultrasound-assisted technique. Three different FUR concentrations (10, 30 and 50 wt.%) in relation to potato starch were examined for their thermoplastic processability. Fourier infrared spectroscopy (FTIR) was used to reveal the structural changes in the developed TPS/FUR composites depending on FUR content as well as thermal pre-treatment. Thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and tensile mechanical tests were performed to assess the performance of the developed TPS/FUR composites. It was demonstrated that the ultrasound-assisted manufacturing route allowed TPS/FUR composites with an improved spectrum of properties to be obtained. The highest mechanical stress at break (almost three times higher than for neat TPS) was observed for the TPS + 50 wt.% FUR composite, which also possessed decreased deformability (only ca 10%), reduced thermal resistance at processing temperatures (150 °C) and high shear sensitivity. Thus, the TPS + 30 wt.% FUR and especially the TPS + 10 wt.% FUR composites were recognized as more suitable for thermoplastic processing and the development of TPS-based composites with improved exploitation properties. Full article

Microplastics (MPs) are synthetic polymer particles that are generally less than 5 mm in size and have attracted heightened scrutiny due to their pervasive presence in the environment, along with their toxicological significance. Several research investigations documented its presence in humans as a profound finding in biological tissues and fluids crossing barriers, leading to oxidative and inflammatory pathways alterations associated with blood, placenta, cardiovascular, pulmonary, nephrotic, other systems, and their disorders. Given the ubiquitous utilization of microplastics across diverse sectors, it is imperative to systematically investigate and elucidate their potential toxicological effects on biological systems through rigorous and mechanistically informed research. This review will also provide the synthesis of recent mechanistic data on the toxicity that can be caused by MPs and will determine key gaps that impede efficient human health risk evaluation. A structured literature search was conducted via PubMed, Web of Science, and Scopus databases, mostly from the studies published between 2010 and 2026. The studies of exposure characteristics and biological effects were analyzed in vitro, in vivo, and in human biomonitoring, and the primary focus of the interventions includes oxidative stress, inflammation, apoptosis, hepatotoxicity, and metabolic malfunction. MPs possess various physicochemical properties, such as a low particle size, various shapes, surface area, polymer composition, and the presence of sorbed or intrinsic additives. When MPs are taken up by cells, they can induce oxidative stress via increasing ROS, eventually leading to high lipid peroxidation, mitochondrial malfunction, DNA fragmentation, and eventually cell death. MPs also cause pro-inflammatory cytokine responses, including TNF-α, IL-1β, and IL-6, altering the immune system and cell profile, leading to systemic inflammation. In aquatic and terrestrial organisms, these microplastics have a harmful impact on growth, reproduction, and behavior in a time- and dose-dependent manner. Under conditions of controlled exposure, the organ-specific toxicities that have been reported include hepatic, renal, neurological, reproductive, and cardiovascular systems. Although the fields of mechanistic knowledge are growing, there is still a substantial amount of uncertainty; there is a lack of characterization of the long-term effects of low-dose chronic exposure, the kinetics of bioaccumulation, biodegradation potential, and transgenerational effects. In addition, there are no standardized procedures for the characterization of MPs, nor the reporting of the distribution of size or exposure measurements, which limits the comparability of cross-studies and makes it difficult to assess risks quantitatively. The dynamics of interactions of MPs between co-adsorbed contaminants like heavy metals, polycyclic aromatic hydrocarbons, and endocrine-disrupting chemicals are also yet to be explored. Although all evidence available to date does indicate biologically plausible mechanisms of MP-induced toxicity, integrated research employing standardized analytical protocols, an environmentally relevant exposure model, and human epidemiological data is required to ensure that laboratory results are translated into evidence-based public health and regulatory actions. This review offers an in-depth analysis of the existing molecular understanding of MP-induced toxicity, demonstrates organism-level impacts throughout species, and establishes vital fields for future studies. In order to develop competent guidelines to minimize MP exposure and its adverse health effects, it is crucial to cover these gaps via research that incorporates toxicology and environmental science. Full article

Background: Erectile dysfunction (ED) is increasingly recognized as an early manifestation of systemic vascular disease and might represent a window for cardiovascular risk assessment. Dynamic penile colour Doppler ultrasound (PCDU) provides quantitative arterial and venous parameters that could reflect subclinical vascular impairment. We investigated the association between PCDU parameters and estimated cardiovascular risk in men with ED. Methods: In this single-center retrospective observational study, 275 men undergoing PCDU for ED were evaluated. Clinical characteristics, biochemical data, and QRISK3 10-year cardiovascular risk scores were collected. Mean peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were analyzed. Correlation analyses, logistic regression using a QRISK3 ≥ 10% threshold, linear regression models, age-stratified analyses, and receiver operating characteristic (ROC) curve analyses were performed. Results: Patients with impaired PSV (<35 cm/s) were older and exhibited higher QRISK3 scores and a greater prevalence of diabetes mellitus and previous cardiovascular events. Mean PSV was inversely correlated with QRISK3 (r = −0.203, p < 0.01) and was associated with higher cardiovascular risk categories in unadjusted logistic regression (β = −0.016, p = 0.048), but not after adjustment for age and diabetes mellitus. ROC analysis showed modest discrimination of increased cardiovascular risk (AUC = 0.60). The addition of PSV to a model including age and diabetes resulted in minimal improvement in discrimination (AUC 0.966 vs. 0.968). Age-stratified analysis demonstrated a significant association between lower PSV and higher cardiovascular risk only in patients ≤60 years. A progressive increase in QRISK3 was observed according to the number of abnormal Doppler parameters (p = 0.013). Conclusions: PCDU parameters reflect the overall cardiovascular risk burden in men with ED. Although not independent predictors beyond traditional risk factors, penile Doppler abnormalities might identify a vascular phenotype associated with higher estimated cardiovascular risk, particularly in younger individuals. These findings support the role of comprehensive vascular assessment in selected patients with ED. Full article

Background: Heart transplantation remains the definitive therapy for selected patients with end-stage heart failure, but outcomes are limited by acute rejection, chronic allograft injury, and cardiac allograft vasculopathy. Endomyocardial biopsy (EMB) remains the reference standard for rejection surveillance but is invasive and imperfectly captures diffuse myocardial injury. Cardiovascular magnetic resonance (CMR) offers noninvasive, multiparametric assessment of graft structure, function, tissue composition, and perfusion. We aimed to review current evidence supporting CMR in post-heart transplant surveillance and to evaluate the performance of serial CMR for acute cellular rejection in a prospective cohort. Methods: We performed a focused narrative review of the literature on CMR for detection of acute rejection, assessment of chronic allograft injury and prognosis, and evaluation of cardiac allograft vasculopathy and microvascular disease. In parallel, we conducted a prospective observational study of adult heart transplant recipients undergoing early post-transplant CMR (CMR1) and follow-up CMR (CMR2) with temporally matched EMB. Multiparametric CMR included cine imaging, native T1 and T2 mapping, extracellular volume fraction (ECV), and late gadolinium enhancement (LGE). Clinically significant acute cellular rejection was defined as ISHLT grade ≥ 2R. Results: Eighteen recipients were included (median 53 days to CMR1 and 192 days to CMR2). Baseline CMR parameters correlated with invasive hemodynamic and biomarkers. Two patients had biopsy-proven ≥2R rejection at follow-up. T2 values at CMR2 were significantly higher in rejection versus non-rejection patients (59.0 ± 1.4 ms vs. 51.1 ± 1.9 ms; p = 0.015), with greater LGE burden in rejection (p = 0.029). In longitudinal analyses, rejection was associated with divergent patterns of cardiac remodelling and tissue characterization, including increases in indexed ventricular volumes and T2 over time, whereas non-rejection patients demonstrated stable ventricular volumes and a decline in T2. Conclusions: Multiparametric CMR, anchored by T2 mapping, provides clinically meaningful, non-invasive information for acute rejection surveillance after heart transplantation and complements EMB within a personalized, risk-adapted follow-up framework. Establishing individualized baseline CMR phenotypes and monitoring longitudinal changes may support more personalized, less invasive graft surveillance strategies. Larger multicentre prospective studies are needed to define standardized implementation pathways. Full article

Although urban resilience is a complex concept, several initiatives have made it more tangible. Urban public authorities and policymakers are of utmost importance, as they influence multiple neighbourhoods, stakeholders and aspects of urban resilience. Nevertheless, the role of individual facilities—such as sports fields—should not be overlooked. While their impacts are smaller in scale, they can significantly enhance local resilience and serve as inspirational pilots for broader initiatives. To assess resilience at the facility scale, an existing assessment framework was adapted, aligned with ESG (environmental, social and governance) criteria and climate action pillars and valuing ecosystem services. In the sports field case study, stormwater was reframed from a burden into a resource and integrated with other scheduled resilience-enhancing interventions: water conservation, installation of photovoltaic panels, enhanced tree shading, and circularity through sports equipment reuse. Together, these interventions strengthen urban sustainability, resilience, and climate adaptation while delivering ecological and social benefits. The stormwater drainage system was modelled to simulate naturalization actions. The assessment framework is described, and its application at both neighbourhood and facility scales is discussed. Comparisons between the existing and improved situations show clear resilience gains, and opportunities for extending these measures to the city scale are explored. Full article

Background: The CFTR modulator elexacaftor/tezacaftor/ivacaftor (ETI) has transformed cystic fibrosis (CF) care, but national-level real-world data on long-term effectiveness, durability of response, and treatment de-escalation remain limited. Methods: We conducted a nationwide longitudinal study using the Italian Cystic Fibrosis Registry. People with CF aged ≥6 years who initiated ETI between October 2019 and December 2022 and received ≥3 months of continuous therapy were included. Lung function (percent predicted FEV₁, ppFEV₁), nutritional status (BMI or BMI z-score), hospital days, complications, microbiology, and chronic treatments were assessed during the two years before and up to two years after ETI initiation. Longitudinal changes were analyzed using generalized estimating equations with multiple imputation for missing data. Results: The cohort included 2276 individuals (mean age 27.9 ± 13.3 years; 49% female). Mean ppFEV₁ declined during the pre-ETI period but increased by 9.9 percentage points at 12 months after ETI initiation (p < 0.001) and remained 6.8 percentage points above baseline at 24 months. A decline between 12 and 24 months was observed overall, except in individuals with severe baseline lung disease (ppFEV₁ < 40%), who maintained stable improvements. Mean annual hospital days decreased by approximately 65% and remained low throughout follow-up. Nutritional status improved, with a mean BMI increase of approximately 1.05 kg/m² compared with immediate pre-treatment in adults and a BMI z-score increase of 0.2 SD compared with pre-treatment timepoints in children. Use of most standard CF therapies declined substantially, particularly among individuals with ppFEV₁ ≥ 40%. The prevalence of allergic bronchopulmonary aspergillosis decreased, while liver disease prevalence increased modestly, largely reflecting transient elevations in liver enzymes. Conclusions: In this nationwide real-world cohort, ETI was associated with sustained improvements in lung function, nutritional status, and hospitalization burden. The attenuation of lung function gains after the first year, particularly in less severe disease, supports the need for individualized monitoring and cautious treatment de-escalation in the ETI era. Full article