Search Results (34,805)

Background and Objectives: Effective perioperative pain management remains a key goal of enhanced recovery protocols, especially in minimally invasive urologic surgery, where optimizing comfort while limiting opioid exposure is essential. Intravenous lidocaine has gained attention for its multimodal analgesic and anti-inflammatory properties, yet evidence in robotic prostatectomy remains limited. This study evaluated whether intraoperative lidocaine infusion was associated with lower early postoperative pain scores and reduced opioid use in patients undergoing robotic-assisted radical prostatectomy. Materials and Methods: A retrospective, single-center analysis was conducted at Pelican Clinical Hospital, Oradea, Romania, including 112 patients operated on between January 2020 and December 2023. All procedures were performed by the same surgical and anesthetic teams using standardized ERAS-based protocols. Patients were divided into two groups: the Lidocaine Group (LG, n = 51), who received a bolus of 1.5 mg/kg lidocaine followed by an infusion of 1.5 mg/kg/h during surgery, and the Control Group (CG, n = 61), who received standard anesthesia without lidocaine. Postoperative pain was measured using the visual analog scale (VAS) at 0, 4, 12, and 24 h, and opioid use was converted into morphine milligram equivalents (MME). Secondary outcomes included time to ambulation, gastrointestinal recovery, oral intake, hospital stay, and complications. Results: Pain intensity was significantly lower in the lidocaine group at 4 h postoperatively (VAS 3.5 ± 1.1 vs. 4.3 ± 1.3; p = 0.01), with similar scores later. Total opioid use was reduced by about 18% in the lidocaine group (25.7 ± 9.4 vs. 31.2 ± 10.5 MME; p = 0.03). Recovery parameters and complication rates were comparable between groups, and no lidocaine-related adverse events were recorded. Conclusions: Intraoperative intravenous lidocaine was associated with lower early postoperative pain scores and reduced opioid requirements after robotic-assisted radical prostatectomy without affecting recovery or safety. Its favorable profile and low cost support its inclusion as a practical adjunct in multimodal analgesia within ERAS pathways. Full article

The spirochete Borrelia is responsible for Lyme disease, a multisystemic infection and growing public health concern. This study aimed to evaluate host response dynamics to Borrelia bavariensis by analyzing hematological parameters as potential immuno-inflammatory markers in a murine model. Forty C3He/HeNCrl mice were inoculated intradermally with B. bavariensis (5 × 10⁵ spirochetes/100 µL/mouse) and monitored for 90 days. Samples were collected at defined intervals for microbiological examination, hematology, and qPCR. Microbiological and qPCR testing revealed infection between days 7–21; results were negative on days 28–42. At later stages (days 60 and 90), Borrelia was only detectable by qPCR, highlighting differences in diagnostic sensitivity. Hematological analysis showed that the neutrophil-to-lymphocyte ratio (NLR) and systemic immuno-inflammatory index (SII) peaked on day 7 (p < 0.0001), followed by gradual normalization until day 35. These markers reflected the intensity of the inflammatory response and defined three distinct phases of host reaction. Overall, results demonstrate the complexity of immune responses in B. bavariensis infection and underscore the value of monitoring hematological indices for understanding host–pathogen interactions. This approach supports the potential use of simple blood markers in diagnostic strategies with translational relevance for clinical practice. Full article

This study examines the impact of technological progress on food price dynamics and supply stability across the 27 European Union Member States during 2011–2024. Using a balanced panel dataset, the analysis explores four dependent indicators—consumer food prices, food price inflation, price volatility, and food supply variability—while controlling for trade openness, GDP per capita growth, and population. Technological progress is estimated through panel least squares regression with fixed effects. The results reveal that technological advancement significantly reduces food prices and inflation, suggesting that innovation-driven productivity and efficiency gains stabilize consumer markets. However, its influence on food price volatility and supply variability is statistically insignificant, indicating that innovation alone cannot fully mitigate systemic risks in the European food system. The results provide policy-relevant evidence supporting the integration of technological innovation into food system governance across the European Union. They underline the need for targeted investment and regulatory coordination to translate innovation gains into tangible resilience outcomes, thus offering practical guidance for policymakers and stakeholders involved in implementing the European Green Deal and the Farm to Fork Strategy. Full article

Bee venom (BV) molecules, including melittin (Mlt), are known to modify the permeability of membranes. This paper assessed red blood cell (RBC) shape (by phase contrast microscopy) in relation to some of the parameters (haematology data) and calculated the RBC membranes’ water diffusional permeability (P_d) with ¹H-NMR spectroscopy. Rats were injected for 30 days with either small daily doses of BV (VST) or Mlt (MST) or with high single doses of BV (VSLT) or Mlt (MSLT). The RBCs displayed aberrant shapes, all of the analysed parameters significantly changed, and the values of P_d were higher (and increased with temperature) in all of the treated groups compared to the control group. The RBCs in the venom-treated groups had the highest mean values (expressed in cm × s⁻¹ × 10³) of P_d at 37 °C—8.95 in the VSLT group and 8.69 in the VST group—which were followed by the MST and MSLT groups and the control group. Our results demonstrated the ability of Mlt to retain the ability to interact with the RBC membrane in vivo and proved that Mlt is the most important BV molecule involved in this process. Full article

We theoretically study plasmon dispersion within the random-phase approximation in two-dimensional systems, including undoped and doped monolayer graphene at zero and finite temperatures, and hole- and electron-doped monolayer $X\mathrm{Se}$ ($X=\mathrm{In},\phantom{0.16em0ex}\mathrm{Ga}$) and disordered two-dimensional electron gas at zero temperature, in the presence of a non-Coulomb interaction of the form $\sim r^{-\eta }$. Our findings show that the parameter $\eta$, which characterizes the non-Coulombic nature of the interaction, strongly affects the dependence of the plasmon frequency on the wave vector in the long-wavelength limit. Furthermore, the carrier density dependence of the plasmon frequency is unaffected by the parameter $\eta$ in this regime. For $\eta =1$, corresponding to the Coulomb case, the well-known results are fully recovered for all systems studied here. Full article

Background/Objectives: Precise evaluation of mandibular morphology is essential for orthodontic diagnosis, growth assessment, and treatment planning. While lateral cephalograms are traditionally used for angular measurements, orthopantomograms (OPGs) allow side-specific assessment of mandibular structures. This study aimed to analyze bilateral gonial angles, bigonial width, and ramus heights on OPGs using artificial intelligence (AI)–assisted tracing, with a focus on symmetry, sex-related differences, and clinical applicability. Methods: A cross-sectional study was conducted on 78 Romanian patients (46 females, 32 males; mean age 22.8 ± 8.7 years) seeking orthodontic treatment. Standardized OPGs were obtained and analyzed using WebCeph AI-driven software. Bilateral gonial angles, bigonial width, and ramus heights were measured. Symmetry between sides and differences between sexes were evaluated, and correlation analyses were performed. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs). Results: The mean right and left gonial angles were 126.3° and 127.1°, respectively, with no significant sex- or side-related differences (p > 0.05). Bigonial width averaged 134.9 mm, being slightly larger in males, although not statistically significant (p = 0.240). Ramus heights were comparable bilaterally (right: 48.4 mm; left: 48.3 mm), with males showing slightly greater values. Correlation analysis demonstrated strong bilateral symmetry for gonial angles (r = 0.795) and ramus heights (r = 0.895). Negative correlations were observed between gonial angles and both bigonial width and ramus height, whereas bigonial width correlated strongly with ramus height. Measurement reproducibility was high (ICC > 0.75). Conclusions: OPGs, when combined with AI-assisted analysis, provide reliable and reproducible measurements of gonial angles and ramus heights, comparable to cephalometric values. Their ability to assess right and left sides separately enhances clinical utility in detecting asymmetries and monitoring mandibular growth. However, caution is advised when interpreting transverse parameters such as bigonial width, where CBCT remains the gold standard. AI-driven OPG analysis represents a cost-effective, accessible, and low-radiation diagnostic tool with significant potential for precision orthodontics. Full article

Background: Cesarean section (CS) frequently results in abdominal scarring, affecting recovery, aesthetics, and quality of life. Platelet-rich plasma (PRP), an autologous concentrate rich in growth factors, may enhance wound healing. This pilot trial assessed the effect of intraoperative PRP on CS scar outcomes. Methods: In this single-center, single-blind randomized controlled trial (February 2023–December 2024), 100 women undergoing elective CS were randomized to PRP treatment (n = 50) or standard care (n = 50). PRP, prepared from 20 mL autologous blood, was infiltrated into uterine incision margins and subcutaneously before skin closure. Scar healing was evaluated at day 7 and day 40 postpartum using the Patient and Observer Scar Assessment Scale (POSAS; physician and patient), Vancouver Scar Scale, Manchester Scar Scale, REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) Scale, Visual Analog Scale (VAS), and Numeric Rating Scale (NRS). Mann–Whitney U tests and Cohen’s d effect sizes were calculated. Results: Follow-up was complete for all participants. On day 7, PRP-treated patients had lower mean scores across most scales (e.g., Vancouver: 1.74 ± 1.58 vs. 2.54 ± 2.30; p = 0.063). At day 40, improvements persisted, with POSAS Patient scores significantly lower in the PRP group (7.24 ± 1.81 vs. 8.00 ± 2.06; p = 0.029). Effect sizes were small-to-moderate (<0.5), suggesting underpowering. No adverse events occurred. Conclusions: PRP administration during CS showed favorable trends toward improved scar quality and reduced patient-reported discomfort, with statistical significance for POSAS Patient scores at 40 days. Larger, multicenter trials with extended follow-up are needed to confirm these findings. Full article

The agricultural sector has a significant impact on the global carbon cycle, contributing substantially to greenhouse gas (GHG) emissions through various practices and processes. This review paper examines the significant role of the agricultural sector in the global carbon cycle, highlighting its substantial contribution to GHG emissions through diverse practices and processes. The study explores the trends and spatial distribution of agricultural GHG emissions at both the global level and within the European Union (EU). Emphasis is placed on the principal gases released by this sector—methane (CH₄), nitrous oxide (N₂O), and carbon dioxide (CO₂)—with detailed attention to their sources, levels, environmental impacts, and key strategies to mitigate and control their effects, based on the latest scientific data. The paper further investigates emissions originating from livestock production, along with mitigation approaches including feed additives, selective breeding, and improved manure management techniques. Soil-derived emissions, particularly N₂O and CO₂ resulting from fertilizer application and microbial activity, are thoroughly explored. Additionally, the influence of various agricultural practices such as tillage, crop rotation, and fertilization on emission levels is analyzed, supported by updated data from recent literature. Special focus is given to the underlying mechanisms that regulate these emissions and the effectiveness of management interventions in reducing their magnitude. The research also evaluates current European legislative measures aimed at lowering agricultural emissions and promoting climate-resilient, sustainable farming systems. Various mitigation strategies—ranging from optimized land and nutrient management to the application of nitrification inhibitors and soil amendments are assessed for both their practical feasibility and long-term impact. Full article

Osteoprotegerin (OPG) is a glycoprotein involved in bone metabolism and cardiovascular health, with emerging evidence suggesting its role in heart failure (HF). Despite its potential as a biomarker, the association between circulating OPG levels and HF severity remains unclear. This systematic review and meta-analysis aimed to evaluate OPG levels in HF patients and their relationship with disease severity according to the New York Heart Association (NYHA) classification. A comprehensive search of PubMed, EMBASE, and Scopus was conducted to identify observational studies assessing OPG levels in HF patients. Studies were included if they reported OPG levels in HF patients and controls, with subgroup analyses according to NYHA classification when available. Risk of bias assessment was performed using the Newcastle–Ottawa Scale (NOS). The principal outcome was the mean difference (MD) in circulating OPG levels between HF patients and controls. Random-effects meta-analysis models were used to pool the data. Thirteen studies with a total of 1387 participants were included in the quantitative and qualitative synthesis. Overall, OPG levels were significantly elevated in HF patients compared to healthy controls (2.490 [95% CI 0.531, 4.449]). Subgroup analysis showed a significant decrease in OPG levels in controls versus NYHA II patients (−1.503 [95% CI −2.402, −0.604]). However, no statistically significant difference was found when comparing OPG levels between the combined NYHA II/III group and controls (−1.019 [95% CI −2.451, 0.412]). OPG levels are significantly elevated in HF patients compared to controls, with a progressive increase in NYHA II patients. However, the lack of significance in the NYHA II/III group highlights the need for further studies with a more comprehensive NYHA classification breakdown. Full article

Background and Objectives: Spinal cord lesion is a severe disorder of the central nervous system, leading to partial or complete interruption of nerve impulse transmission between the brain and the periphery and causing severe neurological and functional deficits. Conventional rehabilitation offers limited outcomes, while robotic gait training (Lokomat^®) and Vojta Therapy have shown benefits individually. Evidence on their combined effect remains scarce. To evaluate the combined effect of Vojta Therapy and Lokomat-assisted gait training on motor recovery, functional independence, and quality of life in SCL patients. Materials and Methods: A retrospective clinical study was conducted on 205 patients with traumatic and non-traumatic SCL. Patients were allocated to four groups: (F)—conventional rehabilitation; (V)—conventional + Vojta; (L)—conventional + Lokomat; (VL)—conventional + Vojta + Lokomat. Assessments included the ASIA Impairment Scale (AIS), ASIA motor/sensory scores, spasticity (Modified Ashworth Scale, MAS), functional independence (Functional Independence Measure, FIM), and health-related quality of life (EQ-5D), performed at admission and discharge. Statistical analyses comprised paired t-tests, Wilcoxon signed-rank tests, chi-square tests, Kruskal–Wallis with Dunn’s post hoc corrections, and linear regression. Results: The most frequent lesion levels were C7 (21%) and L1 (20%). All groups showed improvement in FIM scores, with the greatest gains in the VL group (from 79.25 to 84.79, p < 0.05). Post hoc analysis confirmed significantly higher FIM outcomes in VL compared with L. Regression analysis identified the ASIA motor score as the strongest predictor of functional independence (β = 0.76, p < 0.001), with VL group membership adding +10.3 points (p = 0.004). EQ-5D indicated persistent deficits in mobility and self-care, especially in VL patients, consistent with higher lesion severity. Conclusions: Combining Vojta Therapy with Lokomat training provides additional functional benefits compared with Lokomat or Vojta alone. Multimodal individualized rehabilitation appears promising for patients with spinal cord lesions. Prospective randomized controlled trials with long-term follow-up are warranted. Full article

Background and Objectives: Hyperuricemia is frequent in patients with uncontrolled type 2 diabetes (T2D) and may reflect intertwined renal and metabolic dysfunction. Simple tools to identify those at highest risk are lacking. Materials and Methods: We retrospectively analyzed 253 adults with uncontrolled T2D (HbA1c ≥ 7%) hospitalized at a tertiary center (2022–2023). Patients were stratified by hyperuricemia status (serum uric acid >7.0 mg/dL in men and >6.0 mg/dL in women). Demographic, clinical, biochemical, and pharmacological data were compared. Independent predictors were explored with multivariable modeling. A two-parameter Renal–Metabolic Risk Score (serum urea and triglyceride-to-LDL cholesterol ratio [TG/LDL]) was derived and evaluated by ROC analysis. Results: Compared with non-hyperuricemic patients (n = 20), those with hyperuricemia (n = 233) had higher serum urea (32.15 ± 21.21 vs. 19.76 ± 10.02 mg/dL; p < 0.001) and numerically higher TG/LDL (2.94 ± 6.73 vs. 1.95 ± 1.28; p = 0.062). Serum uric acid was lower in the hyperuricemia group due to categorical definition thresholds and treatment effects (5.69 ± 1.87 vs. 6.77 ± 2.12 mg/dL; p = 0.038). The derived Renal–Metabolic Risk Score showed an AUC = 0.67 and differed significantly between groups (p ≈ 1.2 × 10⁻⁵). Conclusions: The derived RMRS, based on simple and inexpensive laboratory parameters, offers a preliminary tool for assessing hyperuricemia risk in uncontrolled T2D. From a clinical and assistive practice perspective, this score may help nephrology nurses and multidisciplinary teams identify high-risk patients who require closer monitoring of renal and metabolic complications. It could further guide early dietary counseling, pharmacological optimization, and frailty assessment in chronic kidney disease care. Future studies are needed to validate the score in larger and more diverse populations before its integration into routine practice. Full article

Background/Objectives: Women who have genetic predisposition to breast cancer often opt for risk-reducing mastectomy with immediate reconstruction. Evaluating their satisfaction and quality of life is essential for guiding shared decision-making. Methods: This exploratory study assessed quality-of-life outcomes in two cohorts of patients undergoing bilateral prophylactic nipple-sparing mastectomy with immediate prepectoral implant-based reconstruction. Only patients without postoperative complications (necrosis, infection) were included. Each patient completed the BREAST-Q questionnaire both preoperatively (1–2 days before surgery) and postoperatively. Results: Postoperative BREAST-Q scores demonstrated significant improvement, with self-confidence increasing from 40.75 to 44.33, satisfaction with breast size and appearance from 50.42 to 58.50, and general esthetic/functional satisfaction from 26.92 to 33.17 (all p < 0.01). In contrast, physical comfort decreased from 48.00 to 32.42 (p < 0.001). Preoperative responses may have been influenced by anticipatory stress related to the imminent surgery and concern regarding the breast area to be operated. In contrast, postoperative results reflect psychological relief and satisfaction following a successful surgery, with no complications. Conclusions: Nipple-sparing mastectomy with immediate prepectoral reconstruction is associated with high patient-reported satisfaction and perceived improvements in quality of life, particularly regarding body image and emotional well-being. However, functional limitations such as reduced physical comfort should also be acknowledged. These findings further support evidence-based recommendations for prophylactic surgery in high-risk patients. Full article

In the context of natural beverages used for human nutrition, our study explored the potential of Myrcianthes hallii leaves (rich in bioactive compounds) as a raw material for the production of non-traditional craft beer. We hypothesized that the phenological stage affects essential oil yield and bioactivity, which in turn influences the functional properties of fortified beer. In our case, M. hallii leaves collected during the flowering stage yielded the highest amount of essential oil (0.5 v/m/%) and exhibited the greatest concentrations of total phenolics (7.7149 ± 0.02143 mg GAE/mL) and flavonoids (1.6531 ± 0.03355 mg QE/mL), correlating with increased antioxidant capacity. These findings suggest this stage as the most suitable period for harvesting M. hallii leaves for nutraceutical and pharmaceutical applications. This non-traditional beer demonstrated notable antioxidant activity, and sensory analysis revealed high acceptance regarding aroma, taste, and color, supporting its potential as a functional beverage. Full article

Background/Objectives: Multidrug-resistant (MDR) Escherichia coli is a critical One Health challenge, with rising resistance in both humans and animals. The present study aimed to compare antimicrobial resistance (AMR) profiles of E. coli isolates from hospitalized patients and food-producing animals in Satu Mare, a county located in northwestern Romania. Methods: Between 2022–2023, 701 samples were collected, leading to 571 non-duplicate E. coli isolates (420 human, 151 animal). Human strains were recovered from 21 hospital departments and originated from feces, urine, blood, sputum, ear secretions, cerebrospinal fluid, purulent wound secretions, and puncture fluids. Animal isolates were obtained from ceca collected at local slaughterhouses serving farms in north-west Romania, including samples from turkeys, broilers, and pigs. Antimicrobial susceptibility testing was performed against eight antimicrobials (amikacin, ampicillin, cefotaxime, ceftazidime, cefepime, ciprofloxacin, gentamicin, sulfamethoxazole/trimethoprim) using standardized methods. Resistance classification followed international definitions of MDR. Statistical associations between host species and resistance were assessed with chi-square tests. Results: Resistance levels were consistently higher in E. coli strains isolated from animals compared with those from humans (p < 0.05). Among human isolates, resistance to ampicillin (41.9%), ciprofloxacin (41.4%), and sulfamethoxazole/trimethoprim (45.7%) approached, but did not exceed 50%. In contrast, E. coli strains recovered from animals showed markedly higher resistance, exceeding 50% for ampicillin (78.8%), ciprofloxacin (65.6%), and cefotaxime (55.0%). Amikacin retained full activity against all animal isolates, whereas 2.8% of human strains were resistant. Overall, multidrug resistance (MDR) was observed in 70.0% of E. coli isolates from humans and 79.7% from animals, with the highest resistance burden in pig-derived isolates. Conclusions: The study underscores the veterinary sector as a key contributor to the maintenance and spread of MDR E. coli. Even in clinically healthy animals, resistance levels exceeded those observed in human isolates. These findings emphasize the need for coordinated One Health monitoring and stricter antimicrobial use policies in livestock to reduce transmission risks across human and animal populations. Full article