Search Results (1,720)

Soil heavy metal contamination has emerged as a global environmental and public health challenge. Among them, cadmium (Cd) is of particular concern due to its high mobility and ecotoxicity. To identify the key limiting factors and their nonlinear threshold effects for Cd accumulation in maize grains (Grain-Cd) in heterogeneous soil environments, a coordinated sampling campaign of soil and maize was conducted at the municipal scale in Chongqing, China. A total of 499 paired soil–maize samples were obtained, and the correlations between Grain-Cd concentrations and soil physicochemical properties, as well as soil Cd pollution characteristics, were quantitatively evaluated using the integrated Random Forest (RF) model and SHAP (SHapley Additive exPlanations) algorithm instead of traditional linear statistical methods. The results showed that the average Cd content in the soil of maize-growing areas in Chongqing City was 0.30 mg·kg⁻¹, with a variation coefficient (CV) of 53%, and the spatial heterogeneity was significant. The average Cd content in maize grains was 0.03 mg·kg⁻¹, with an exceedance rate of 9.6% over the Chinese National Standard (0.10 mg·kg⁻¹), indicating a certain food safety risk. The RF model achieved a high predictive accuracy for Grain-Cd (R² = 0.815, RMSE = 0.028 mg·kg⁻¹, MAE = 0.013 mg·kg⁻¹), which was significantly superior to the traditional linear regression model (R² = 0.526, RMSE = 0.0459 mg·kg⁻¹). The available Cd (avlCd) in the soil was identified as the core controlling factor for the Grain-Cd content, while total soil Cd (SCd) only showed its positive contribution at contents higher than 0.5 mg·kg⁻¹. Soil pH, CEC (cation exchange capacity), and total phosphorus (TP) exerted significant influences on the Grain-Cd by regulating soil avlCd. The dependence of Grain-Cd on these soil factors was typically nonlinear, and an obvious turning point (threshold) existed for each factor with its occurring level in soil, determined by SHAP analyses as avlCd: 0.29 mg·kg⁻¹, pH: 6.58, CEC: 18.9 cmol (+)/kg, and TP: 0.5 g·kg⁻¹, respectively. This study clarifies the nonlinear regulatory mechanisms of key soil factors on Cd accumulation in maize grains in Chongqing, and the established RF-SHAP framework and identified soil factor thresholds lay a scientific foundation for the interpretable quantification of the soil–maize Cd system, while providing a scientific basis for the precise, targeted remediation of Cd-contaminated dryland farmland and the assurance of regional maize production safety. Full article

Background: Sickle cell disease (SCD) is a hereditary disorder affecting red blood cells’ shape and functional capacity. Individuals with SCD report relatively high co-occurrence of neurodevelopmental disorders (NDDs). In addition, these children also have higher rates of enuresis (incontinence) and pica, disorders prevalent in children with developmental delays. Both enuresis and pica can have negative effects on mental health, but their pathophysiology, especially in SCD, remains unclear. Objectives: The objective of this study was to determine the rates of pica and enuresis in a pediatric SCD clinic to compare the co-occurrence of NDDs and enuresis/pica. Methods: To do so, we performed a cross-sectional explanatory retrospective chart review of 275 pediatric SCD patients. Results: Our SCD cohort had a 27% prevalence of enuresis, 9% prevalence of pica, and 24% prevalence of one or more NDDs. We noted significant inter-group overlap between pica/enuresis and other risk SCD severity factors. NDDs were approximately twice as frequent in SCD patients with pica or enuresis compared to those without. While pica was associated with HbSβ⁺, it was not linked to disease severity indicators. Enuresis was associated with hydroxyurea usage (66.7% vs. 42.6%, p = 0.001) and reticulocyte counts, indicative of higher disease severity. Conclusions: Clinically, these results are the first to show co-occurrence between pica, enuresis, and NDDs in SCD. We suggest that the occurrence of pica or enuresis may serve as an indicator for previously unknown NDD risk. Together, these results underscore the need for targeted screenings of pica and enuresis in SCD populations. Full article

Background/Objectives: Abdominal sepsis remains a major contributor to morbidity and mortality among surgical and critically ill patients worldwide. Timely diagnosis is frequently hindered by the overlapping clinical and biochemical features of postoperative inflammatory responses and evolving intra-abdominal infections, which may resemble systemic sepsis. Conventional biomarkers, including C-reactive protein (CRP) and procalcitonin (PCT), are widely implemented in clinical practice but demonstrate suboptimal specificity in differentiating infectious from sterile inflammatory conditions in the early postoperative phase. Presepsin (soluble CD14 subtype, sCD14-ST), a circulating fragment released during monocyte–macrophage activation in response to bacterial endotoxins, has emerged as a biomarker reflecting innate immune engagement. This review aims to critically evaluate the current evidence regarding the diagnostic accuracy, prognostic relevance, and potential clinical role of presepsin in abdominal sepsis. Methods: A comprehensive narrative review of the biomedical literature was performed using MEDLINE (via PubMed) and supplementary academic sources. Studies assessing the diagnostic performance, prognostic associations, and clinical applicability of presepsin in abdominal infections, postoperative infectious complications, and sepsis were systematically examined. Where available, comparative analyses with established biomarkers such as CRP and PCT were evaluated to contextualize its incremental value within existing diagnostic frameworks. Results: The accumulated evidence indicates that presepsin concentrations increase early during bacterial infections and correlate with validated severity indices, organ dysfunction scores, and mortality outcomes. Across multiple surgical and intensive care settings, presepsin demonstrated moderate-to-high diagnostic performance, frequently comparable to and occasionally exceeding that of traditional inflammatory biomarkers, particularly in distinguishing septic from non-septic inflammatory states. Moreover, dynamic changes in circulating levels appear to provide additional prognostic information and may support longitudinal clinical assessment. Nonetheless, substantial heterogeneity in study design, patient populations, sampling strategies, and reported cut-off values limits direct cross-study comparability and constrains definitive clinical recommendations. Conclusions: Presepsin represents a biologically plausible and clinically promising biomarker for the early identification and risk stratification of abdominal sepsis. Although current findings are encouraging, further large-scale, methodologically standardized prospective investigations are required to define optimal diagnostic thresholds and to clarify their role within multimodal biomarker strategies in contemporary sepsis management. Full article

In traditional medicine, laboratory tests are essential tools used to evaluate practices in healthcare that use natural products, particularly when there are few established treatments such as in the case of chronic diseases like sickle cell disease (SCD). SCD is a genetic hemoglobin disorder associated with hemolysis, oxidative stress, inflammation, and vaso-occlusive complications. This study aims to document medicinal plants used in the management of SCD and the traditional practices associated with their use, in order to assess their added value in relation to biological activities relevant to SCD. First, this study carried out an ethnobotanical survey at Kisangani, with 384 participants. A total of 201 respondents, 58% of whom were women, identified 45 medicinal plant species from 30 families. They reported the use of sugar, caramel, ash, and lemon juice as additives in traditional remedies. Based on several criteria, Alchornea cordifolia Müll. Arg. and Hibiscus tiliaceus L. were selected for laboratory evaluation. Their leaves were collected from arid and marshy soils and prepared according to the respondents’ descriptions for antioxidant and anti-inflammatory assessments. A. cordifolia showed significantly higher activities than H. tiliaceus regarding antioxidant (p = 0.001) and anti-inflammatory (p = 0.01) properties. Soil type was observed to influence the bioactivity of H. tiliaceus, with better performance in marshy soil samples. Sugar and caramel were found to reduce antioxidant activity, whereas ash and lemon juice preserved it without markedly altering anti-inflammatory effects. These findings are promising for supporting local knowledge about these two plant species. Full article

This experiment investigated the effects of dietary Artemisia ordosica Krasch. (AOK) supplementation on the n3-polyunsaturated fatty acid (n3-PUFA) profile of subcutaneous adipose tissue (SADT) in Arbas cashmere goats and explored the underlying transcriptional mechanisms. Forty healthy, weaned kids (120 ± 10 days of age; similar body weight) were randomly allocated to two groups (n = 20): a control group (CON, basal diet) and an AOK group (AOK, basal diet with 3% of the roughage replaced by AOK). The feeding trial spanned 104 days, consisting of a 14-day adaptation period and 90 days of data acquisition. Compared with the CON group, AOK significantly reduced the content of saturated fatty acids (SFAs) and n6-polyunsaturated fatty acids (n6-PUFAs)/n3-PUFAs (n6/n3). In contrast, the levels of n3-PUFAs in the SADT of cashmere goats increased markedly (p < 0.05). Compared with the CON group, AOK exhibited significantly higher activities of hormone-sensitive lipase (HSL) (p = 0.027), adenylyl cyclase 2 (ADCY2) (p = 0.010), adenylyl cyclase 5 (ADCY5) (p = 0.046), cluster of differentiation 36 (CD36) (p = 0.013), solute carrier family 27 member 4 (SLC27A4) (p = 0.021), and fatty acid binding protein 4 (FABP4) (p = 0.040), along with significantly lower activities of fatty acid synthase (FAS) (p = 0.002), lipoprotein lipase (LPL) (p = 0.048), and stearoyl-coa desaturase (SCD) (p = 0.026) in SADT. Compared with the CON group, the activities of superoxide dismutase (SOD) (p = 0.032), catalase (CAT) (p = 0.010), glutathione peroxidase (GSH-PX) (p = 0.029), and total antioxidant capacity (T-AOC) (p = 0.002) were significantly increased in the AOK group. Transcriptomic profiling revealed that AOK supplementation downregulated mRNA levels of ADCY2, ADCY5, LPL, FAS, SCD, stearoyl-CoA desaturase 1 (SCD1), stearoyl-CoA desaturase 2 (SCD2), glycogen synthase 1 (GYS1), acyl-CoA oxidase 1 (ACOX1), acetyl-CoA carboxylase (ACC), diacylglycerol acyltransferase 1 (DGAT1), fatty acid desaturase 1 (FADS1), solute carrier family 27 member 2 (SLC27A2), erythroblastic leukemia viral oncogene homolog 4 (ERBB4), and carnitine palmitoyltransferase 1B (CPT1B) (p < 0.05). It also markedly induced acyl-CoA synthetase long-chain family member 4 (ACSL4) (p < 0.01) in SADT. Genes significantly enriched in the adenosine-monophosphate-activated protein kinase (AMPK) signaling pathway included LPL, SCD1, CPT1B, and GYS1 (p = 0.010). Genes significantly enriched in the phosphatidylinositol 3-kinase-akt (PI3K-Akt) signaling pathway included GYS1 and ERBB4 (p = 0.015). CPT1B, ADCY2, and GYS1 were identified as the genes significantly enriched in the insulin resistance signaling pathway (p = 0.048). LPL was the only gene significantly enriched in the cholesterol metabolism pathway (p = 0.049). Genes showing a tendency toward significant enrichment in the peroxisome-proliferator-activated receptor (PPAR) signaling pathway included ACSL4, CPT1B, SCD1, and LPL (p = 0.051). These interconnected cascades improve insulin sensitivity, stimulate triglyceride (TG) hydrolysis, and modulate n3-PUFA levels. Supplementation with AOK enhances n3-PUFA content by accelerating TG breakdown while simultaneously restraining FA oxidation in SADT. Consequently, AOK supplementation can be effectively used to enhance the nutritional value of cashmere goat meat through improved n3-PUFA deposition in SADT. Full article

Background and Objectives: Although conventional semen analysis remains central in male infertility evaluation, the biological relationship between sperm morphology and genomic integrity remains incompletely defined. Sperm DNA fragmentation (SDF) has emerged as a clinically relevant marker of genomic instability; however, its relationship with composite morphological indices of spermatogenic dysfunction remains debated. This study aimed to evaluate the relationship between sperm DNA fragmentation assessed in the post-swim-up fraction and composite sperm morphological indices derived from raw semen, using a multivariable analytical framework that accounts for conventional semen parameters. Materials and Methods: This observational study included 183 semen samples from men undergoing fertility evaluation. SDF was assessed using a sperm chromatin dispersion (SCD)-based assay in the post-swim-up fraction. Sperm morphology was evaluated in raw semen according to World Health Organization criteria, and composite morphological indices, namely the Teratozoospermia Index (TZI), Sperm Deformity Index (SDI), and Multiple Anomalies Index (MAI), were calculated. Associations were examined using Spearman correlation and multivariable linear regression models adjusted for sperm concentration and progressive motility. Exploratory distributional analyses were performed across clinically defined SDF categories. Results: Bivariate analyses demonstrated weak, non-significant positive correlations between SDF and all composite morphological indices. None of the morphological indices independently predicted SDF after adjustment for sperm concentration and progressive motility in multivariable regression models. In contrast, sperm concentration showed a consistent inverse association with SDF. Distributional analyses revealed substantial overlap between morphological severity and SDF categories, indicating heterogeneity in the co-occurrence of structural abnormalities and DNA fragmentation at the individual sample level. Conclusions: Composite sperm morphological indices were not independently associated with sperm DNA fragmentation after adjusting for quantitative semen parameters in the present analytical framework. These findings suggest that structural abnormalities and genomic instability may capture complementary aspects of male infertility rather than representing interchangeable markers. SDF assessment may therefore provide complementary diagnostic information beyond morphology-based evaluation, particularly in assisted reproductive contexts. Full article

Background/Objectives: Non-typhoidal Salmonella (NTS) species are well-recognized causes of invasive infection in patients with sickle cell disease (SCD), with a particular predilection for the musculoskeletal system. Although Salmonella osteomyelitis is well described in this population, septic arthritis is uncommon, especially involving the shoulder joint. We describe a case of NTS bacteremia complicated by native shoulder septic arthritis in a patient with SCD and review its clinical implications. Methods: We report the clinical course, diagnostic evaluation, microbiologic findings, imaging studies, and management of a 22-year-old man with homozygous SCD who presented with a vaso-occlusive pain crisis and subsequently developed severe sepsis with persistent Salmonella enterica bacteremia following ingestion of undercooked poultry. Persistent bacteremia prompted further evaluation for metastatic infection using advanced imaging and diagnostic arthrocentesis. Results: Whole-body imaging identified septic arthritis of the native right shoulder, which was confirmed by synovial fluid cultures growing Salmonella species. The patient underwent arthroscopic irrigation and debridement for source control. Antimicrobial therapy was narrowed to intravenous ceftriaxone based on susceptibility data and continued for six weeks. The patient demonstrated clinical improvement with resolution of bacteremia and was discharged to rehabilitation to complete therapy. Conclusions: This case highlights the importance of a careful exposure history, including foodborne sources, in patients with SCD presenting with invasive Salmonella infection. Persistent bacteremia should prompt early investigation for metastatic foci, and timely surgical source control combined with targeted antimicrobial therapy is essential for optimal outcomes in this population. Full article

Background: Sudden cardiac death (SCD) is a major challenge in dilated (DCM) and non-dilated left ventricular cardiomyopathy (NDLVC). Current management strategies, based on left ventricular ejection fraction (LVEF), the presence or extent of myocardial scar, and selected high-risk genetic variants, are insufficient to accurately identify patients at risk. Mechanical dispersion (MD), derived from speckle-tracking echocardiography, is a potential marker of arrhythmic risk that reflects variability in regional myocardial contraction timing. Aim: The purpose of this narrative review is to synthesize current evidence on the predictive role of MD for ventricular arrhythmias (VA) and SCD in DCM and NDLVC, with particular emphasis on its relationship to myocardial fibrosis (MF) and established echocardiographic markers. Results: Across prospective and retrospective cohorts of DCM patients, increased MD has consistently identified individuals at higher arrhythmic risk, often independently of LVEF and global longitudinal strain (GLS). Reported threshold values for risk prediction range from 50 ms to 90 ms, with hazard ratios confirming incremental prognostic accuracy. The relationship between MD and MF assessed by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) remains uncertain: some patients experience VA in the absence of LGE, while others display elevated MD despite no detectable focal MF, suggesting that additional mechanisms contribute to the arrhythmogenic substrate in DCM and NDLVC. Conclusions: MD may enhance SCD risk stratification in DCM and NDLVC by reflecting components of the arrhythmic substrate that are not detected by conventional markers. Full article

Background: Sickle cell disease (SCD) patients have increased susceptibility to infections, particularly encapsulated bacterial pathogens such as Streptococcus pneumoniae and Haemophilus influenzae type b. Hyposplenism as well as immune defects in SCD result in increased risks for infections; these are the most frequent complications in individuals with SCD. This study was performed within the African Research and Innovative initiative for Sickle cell Education (ARISE, EC GA No 824021) project to develop best practices in the clinical management of SCD. In this retrospective study we aimed to determine the most prevalent reported infections among SCD patients’ records during clinic visits at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methods: The medical records of 1961 paediatric SCD patients from 1998 to 2023 were extracted and reviewed from a pilot electronic registry using a structural query. The data analysed patterns of infections reported during clinic visits at the ABUTH, Zaria, Nigeria. Results: 458 subjects (23.4%) manifesting at least one infection, of whom 392 (19.9%) subjects had a single infection (bacterial or parasitic) and 173 (8.8%) had more than one infection (bacterial and parasitic). Conclusions: Bacterial and parasitic infections are a significant complication of SCD patients attending a tertiary institution in northern Nigeria. Full article

Background/Objectives: Altered lipid metabolism is a key feature of type 2 diabetes mellitus (T2DM), yet its impact on early spinal cord involvement remains poorly understood. Distinguishing between pathological lipid accumulation and adaptive metabolic responses is essential for interpreting initial stages of neural alteration in T2DM. This study aimed to characterize spinal cord lipid composition and ATPase activities in a rat model of T2DM. Methods: Zucker diabetic fatty (ZDF) rats were used as a model of T2DM and divided into diabetic and obese groups, with lean Zucker rats as controls. ATPase activities in spinal cord tissue were measured spectrophotometrically, and lipid profiling was performed using gas chromatography with flame-ionization detection. Indices of stearoyl-CoA desaturase-1 (SCD1) and delta-5 desaturase activity (D5D) were calculated from specific fatty acid ratios as estimates of enzyme-related activity. Results: Diabetic rats exhibited significantly higher levels of free monounsaturated fatty acids (MUFAs) compared with controls, while the obese group showed a moderate increase. Elevated SCD1 indices were indicative of increased estimated MUFA synthesis. Levels of free polyunsaturated fatty acids (PUFAs), including those crucial for myelin stability, as well as ATPase activities, remained unchanged, suggesting preserved basal membrane-associated enzyme function. Conclusions: This study identifies lipid alterations in the spinal cord preceding overt neurodegenerative changes in T2DM, characterized by increased free MUFA abundance, without evidence of altered ATPase activities. These findings support the interpretation that lipid changes observed at this stage are more consistent with adaptive metabolic remodeling than with overt structural or functional neural impairment. Full article

We introduce Self-Competitive Distillation (SCD), a parameter-neutral training strategy aimed at influencing optimization dynamics without increasing model size or relying on external teachers. Two identical instances of the same architecture, initialized with different random seeds, are trained jointly and dynamically exchange asymmetric teacher–student roles based on instantaneous performance, enabling knowledge transfer between diverging optimization trajectories. Under fixed parameter and training budgets, SCD is observed to improve the realized effective capacity of lightweight architectures, yielding a higher test accuracy at matched epochs. Across multiple lightweight vision models and datasets, SCD demonstrates gains in both in-domain performance and cross-domain generalization, as measured by xScore. These results suggest that, within the evaluated experimental conditions, SCD can help mobile models make more effective use of training dynamics, while the underlying architecture remains the primary determinant of effective capacity in resource-constrained settings. Full article

Background/Objectives: Western and Mediterranean diets have divergent effects on the brain. The gut microbiome may mediate diet effects, and specific microbes may be particularly significant contributors to these processes. Oscillospira, a genus of gut-dwelling bacteria, has been implicated as a key microbial target. Other peripheral contributors may include short-chain fatty acids (SCFAs), branched-chain amino acids (BCAAs), insulin resistance, and microbial translocation. Methods: We determined the effects of long-term (31 months, ~9 human years) consumption of a Mediterranean or Western-type diet on Oscillospira abundance, fecal SCFAs, plasma BCAAs, soluble CD14 (sCD14), and insulin responses in a randomized trial of 38 middle-aged female cynomolgus macaques (Macaca fascicularis). We determined diet effects and associations between dependent variables. For variables that were affected by diet composition and significantly associated with Oscillospira, we tested whether Oscillospira abundance mediated the effects of diet. Results: The Mediterranean diet resulted in higher Oscillospira (p = 0.004) and SCFAs (acetate p = 0.002; propionate p = 0.049) and lower BCAAs (isoleucine p = 0.035; leucine p = 0.007; valine p < 0.001). The Western diet increased insulin resistance (p = 0.040) and WM loss (p = 0.011). Oscillospira abundance was negatively associated with BCAAs (leucine p = 0.007; valine p = 0.005) and insulin resistance (insulin AUC: p = 0.024; increase in insulin AUC from pretreatment: p = 0.020), with trends for isoleucine (p = 0.066) and sCD14 (p = 0.103). Oscillospira abundance was positively associated with acetate (p = 0.032) and WM volume changes (p = 0.012). Oscillospira abundance significantly mediated the effects of diet on white matter volume changes (p = 0.020) and on insulin resistance (insulin AUC: p = 0.012 at study end; increase in insulin AUC during study: p = 0.020), presenting potential pathways through which diet may influence the brain. Conclusions: These findings suggest that diet-driven differences in Oscillospira are linked to metabolic regulation and white matter integrity, and Oscillospira may mediate the relationships. The results highlight a potential role for diet–microbiome interactions in shaping metabolic and brain aging trajectories. Full article

This research investigates the optimization of surface integrity in powder-mixed electrical discharge machining (PMEDM) through the innovative use of Jatropha biodielectric fluid enhanced with titanium dioxide (TiO₂) nanoparticles. A comprehensive experimental framework was developed using design expert software (DOE) with Response Surface Methodology (RSM) to systematically analyze the machining of AISI D2 tool steel using copper electrodes. The study examined five critical process parameters, gap current (Ip), pulse-on duration (Ton), pulse-off time (Toff), gap voltage (V), and powder concentration, evaluating their combined effects on surface roughness (SR), surface crack density (SCD), and residual stress characteristics. Advanced characterization techniques including scanning electron microscopy (SEM) were employed to analyze surface topography and subsurface microstructural changes. The optimization process successfully identified optimal machining conditions of current = 9 A, Ton = 100 µs, Toff = 10 µs, and gap voltage = 65 V, achieving exceptional surface quality with a minimum surface roughness of 3.22 µm. Remarkably, these optimized parameters resulted in crack-free surfaces with zero surface crack density and minimal residual stress values across the 2θ range of 90° to 180°. To enhance predictive capabilities, supervised machine learning algorithms were implemented to model surface roughness behavior. Comparative analysis of classification algorithms demonstrated that Support Vector Machine (SVM), k-Nearest Neighbors (kNNs), and Gaussian Naïve Bayes achieved superior performance with F1-scores of 0.88 and prediction accuracies of 90%. The integration of sustainable Jatropha biodielectric with TiO₂ nanoparticles represents a significant advancement in environmentally conscious precision machining, while the machine learning approach establishes a robust framework for intelligent process optimization and quality prediction in advanced manufacturing applications. Full article

Background/Objectives: Sarcoidosis is a granulomatous disease with no widely accepted circulating biomarkers for routine diagnostics. Soluble CD14 (sCD14) and lipopolysaccharide-binding protein (LBP), identified through extracellular vesicle proteomics, have been proposed as candidates. We aimed to compare the diagnostic accuracy of serum sCD14 and LBP with the established biomarker soluble interleukin-2 receptor alpha chain (sCD25). Methods: A matched case–control study included 46 newly diagnosed, untreated sarcoidosis patients and 46 age- and sex-matched healthy controls. Serum sCD14, sCD25, and LBP were quantified by ELISA. BMI was included as a covariate in multivariable logistic regression. Diagnostic performance was evaluated by ROC analysis and stepwise AIC model selection. Longitudinal biomarker dynamics were assessed in 32 patients under treatment. Results: sCD25 demonstrated superior diagnostic discrimination (AUC 0.92, 95% CI 0.87–0.98), compared with LBP (AUC 0.71, 95% CI 0.60–0.82) and sCD14 (AUC 0.61, 95% CI 0.49–0.73). In multivariate analysis, only sCD25 (OR per +100 pg/mL: 1.53; p < 0.001) remained an independent predictor of sarcoidosis. Neither LBP nor sCD14 improved model fit. All biomarkers significantly decreased following therapy. Conclusions: Among routinely measurable serum markers, sCD25 outperformed sCD14 and LBP in sarcoidosis diagnosis. Further studies should explore immunometabolic interactions to refine diagnostic algorithms. Full article

Increased intestinal permeability has been implicated in metabolic dysfunction-associated steatotic liver disease (MASLD), but its relationship with liver fibrosis independent of metabolic risk factors remains unclear. The aim of this study was to investigate the relationship between markers of gut-derived immune activation and liver fibrosis in individuals with metabolic disease. We enrolled 139 adults (48.8 ± 11 years; BMI 33.7 ± 9.5 kg/m²; 50% type 2 diabetes); liver steatosis and fibrosis were estimated using the Hepatic Steatosis Index (HSI) and Fibrotic NASH Index (FNI); liver biopsies were available in a bariatric subgroup. Plasma soluble CD14 (sCD14) and lipopolysaccharide-binding protein (LBP) levels were measured by ELISA kits, and the LBP/sCD14 ratio was calculated. MASLD was present in 78% of participants; in these individuals, sCD14 levels correlated with HSI and FNI (both p < 0.01). In multivariable analysis adjusting for age, sex, BMI, waist circumference, and type 2 diabetes, sCD14 was independently associated with advanced fibrosis (OR: 3.16, 95% CI 1.32–7.55; p = 0.010). This association was confirmed by histology (p = 0.02). Overall, these findings point to a link between gut-derived immune activation and fibrotic burden in MASLD and provide insight into the pathophysiological relevance of the gut–liver axis in metabolic disease. Full article