Search Results (3,119)

The effects of long-term adjustments in body weight on the lipid balance in patients with severe obesity are not well understood. This study aimed to evaluate a non-invasive lipidomic approach to identifying biomarkers that could help predict which patients may require additional therapies before and after weight loss. Using mass spectrometry, 275 lipid species were analysed in non-obese controls, patients with severe obesity, and patients one year after bariatric surgery. The results showed that severe obesity disrupts lipid pathways, contributing to lipotoxicity, inflammation, mitochondrial stress, and abnormal lipid metabolism. Although weight loss improved these disturbances, surgery did not fully normalise the lipid profiles of all patients. Outcomes varied depending on their baseline liver health and genetic differences. Persistent alterations in cholesterol handling, membrane composition, and mitochondrial function were observed in partial responders. Elevated levels of sterol lipids, glycerophospholipids, and sphingolipids emerged as markers of complete metabolic recovery, identifying candidates for targeted post-surgical interventions. These findings support the use of lipidomics to personalise obesity treatment and follow-up. Full article

The thermo-chemical treatment of dental implants leads to the formation of sodium titanate crystals on their surface. When in contact with blood, these crystals dissolve and trigger an ionic exchange cascade, resulting in the formation of a calcium apatite layer. This study, carried out both in vitro and in an animal model, aimed to determine whether the cooling rate of the treatment affects the size of the deposited crystals, and whether this in turn influences wettability and early bone-to-implant contact (BIC). A total of 50 dental implants and 50 titanium discs were treated using four different cooling rates, along with a control group. Crystal size was analyzed on implant surfaces using scanning electron microscopy, and wettability was assessed on titanium discs using a goniometer. Finally, the implants were placed in the tibiae of 13 rabbits, and histological analysis was performed after three weeks to compare BIC among groups. Results suggest that a cooling rate of 75 °C/h produces smaller sodium titanate crystals, which are associated with significantly improved surface wettability and a higher percentage of bone-to-implant contact after 3 weeks of healing (p < 0.05). Full article

A multidisciplinary study was conducted to reconstruct the paleoenvironmental evolution of Maladroxia Bay, one of the principal bays of the islet of Sant’Antioco in southwestern Sardinia, over the past eight millennia. As part of an archaeological landscape project, this study explores the paleogeography and environment of the bay from a diachronic perspective to gain insights into the Holocene relative sea level history, shoreline displacements, and the environmental conditions during different phases. This study is based on an analysis of four sediment cores in conjunction with a chronological model that is based on radiocarbon dates. Four relative sea level indicators were produced. These are the first such indicators from the early and middle Holocene for the island of Sant’Antioco. The results indicate that in the early Holocene, the area was a terrestrial, fluvial environment without marine influence. In the 6th millennium BCE, the rising sea level and marine transgression resulted in the formation of a shallow inner lagoon. It reached its maximum extent in the middle of the 5th millennium BCE. Afterwards, a gradual transition from lagoon to floodplain, and a seaward shift of the shoreline occurred. The lagoon potentially served as a valuable source of food and resources during the middle Holocene. During the Nuragic period (2nd to 1st millennium BCE), the Bay of Maladroxia was very similar to how it is today. Its location was ideal for use as an anchorage, due to the calm and sheltered conditions that prevailed. Full article

Diagnosing hypermobility disorders and Ehlers-Danlos syndrome (EDS) in children is challenging due to overlapping features with generalized joint hypermobility (GJH) and the lack of biomarkers. Background/Objectives: This study aims to describe the clinical and genetic features of pediatric EDS patients and identify key comorbidities and correlations. Methods: This is a single-center observational study of patients under 18 diagnosed with suspicion of EDS (2018–2024) at a tertiary pediatric hospital. Diagnoses were made using 2017 criteria. Results: Forty-one patients (46% female; mean age 11.1 ± 2.8 years) were included. Based on 2017 criteria, 61% had hypermobile EDS (hEDS)/hypermobility spectrum disorder (HSD), 22% classical EDS, 7.3% vascular, and 9.7% other subtypes. Musculoskeletal (90.2%), cutaneous (68.3%), and psychiatric (56.1%) symptoms were most frequent. Significant associations included older age with psychiatric symptoms (p = 0.029), Beighton score with dislocations (p = 0.026), and less atrophic scarring in hEDS (p < 0.008). Genetic testing (73% performed) confirmed pathogenic variants (11 novel) in EDS with a known molecular cause. Conclusions: This study proposes a clinically guided approach and diagnostic algorithm for youth hypermobility, emphasizing precision medicine principles, while highlighting the urgent need for further research to identify hEDS biomarkers. Full article

Background/Objectives: Agricultural workers in Spain with a migratory background face challenging working and living conditions that significantly affect their health. This study aimed to explore how professionals in healthcare, social services, civil society organisations, and labour institutions perceive that the working conditions affect the physical health of this population. Methods: A qualitative descriptive study was conducted through 92 semi-structured interviews with professionals from six provinces in Spain. Data were analysed using thematic analysis following Braun and Clarke’s six-phase framework. Rigour was ensured through triangulation, independent coding, and interdisciplinary consensus. Results: Two overarching themes were identified: (1) the health consequences of workplace demands and environmental hazards, and (2) navigating health services such as sick leave and disability permits. These findings highlight how the impact of precarious working conditions and limited access to healthcare affect the physical health of migrant agricultural workers. Conclusions: The professionals interviewed described and relate precarious working conditions with adverse health outcomes among migrant agricultural workers. Their insights reveal the need for systemic reforms to enforce labour rights, ensure access to health services, and address the structural factors that contribute to exclusion and vulnerability. Full article

Developing innovative, low-cost halochromic materials for diagnosing microbial contamination in wounds and burns can effectively facilitate tissue regeneration. Here, we combine the pH-sensing capability of highly colorful red cabbage anthocyanins (RCAs) with their healing potential within a unique cellulose polymer film that mimics the skin matrix. Biological activities of RCA extract in bacterial cellulose (BC) showed no cytotoxicity and skin-sensitizing potential to human cells at concentrations of RCAs similar to those released from BC/RCA dressings (4.0–40.0 µg/mL). A decrease in cell viability and apoptosis was observed in human cancer cells with RCAs. The invisible eye detection of the early color change signal from RCAs in response to pH alteration by bacteria was recorded with a smartphone application. The incorporation of RCAs into BC polymer has altered the morphology of its matrix, resulting in a denser cellulose microfibril network. The complete coincidence of the vibrational modes detected in the absorption spectra of the cellulose/RCA composite with the modes in RCAs most likely indicates that RCAs retain their structure in the BC matrix. Affordable, sensitive halochromic BC/RCA hydrogels can be recommended for online monitoring of microbial contamination, making them accessible to patients. Full article

Marine ecosystems are characterized by an immense biodiversity and represent a rich source of biological compounds with promising potential for the development of novel therapeutic drugs. This review describes the most promising marine-derived neuroprotective compounds with strong potential for the treatment of neurodegenerative disorders. We focus specifically on the retina and brain—two key components of the central nervous system—as primary targets for therapeutic interventions against neurodegeneration. Alzheimer’s disease and retinal degeneration diseases are used here as a representative model of neurodegenerative disorders, where complex molecular processes such as protein misfolding, oxidative stress, and neuroinflammation drive disease progression. We also examine gene therapy approaches inspired by marine biology, with particular attention to their application in retinal diseases, aimed at preserving or restoring photoreceptor function and vision. Full article

Background/Objectives: Pain assessment scales provide a clear clinical benefit in patients who are unable to self-report. The Nociception Coma Scale-Revised—adapted for Intubated patients (NCS-R-I) was developed to assess pain in patients with acquired brain injury who are unable to self-report. However, this instrument has not yet been translated and validated for use in Spain. The objective was to translate the Nociception Coma Scale-Revised—adapted for Intubated patients (NCS-R-I) into Spanish and to assess the reliability and validity of the Spanish version in patients with brain injury. Methods: This study was carried out in two phases. First, the scale was translated into Spanish. Next, a psychometric analysis was performed to determine the reliability and validity of the Spanish version of the NCS-R-I in 207 critically ill patients with acquired brain injury and disorders of consciousness. Two blinded observers administered the scale at three time points: 5 min before, during, and 15 min after a series of nociceptive and non-nociceptive procedures. Results: The internal consistency of the NCS-R-I was acceptable (ordinal alpha = 0.60–0.90). Interobserver agreement was good (kappa = 0.80; intraclass correlation coefficient = 0.90). In terms of discriminant validity, the AUC was 0.952 (95% CI: 0.931–0.973). NCS-R-I scores increased significantly during performance of nociceptive procedures compared to scores obtained before and after these procedures, confirming the scale’s sensitivity to change. Similarly, during the performance of nociceptive procedures, scores on the NCS-R-I were significantly higher (p < 0.001) than those observed during non-nociceptive procedures. Conclusions: The results of this study demonstrate that the NCS-R-I is a valid, reliable tool for the assessment of pain in patients with acquired brain injury who are unable to self-report. Full article

Background/Objectives: This study explores the perspectives of mental health professionals on tailoring the Mentis Plus intervention to enhance positive mental health (PMH) in individuals experiencing First-Episode Psychosis (FEP). Although the Mentis Plus Program has been previously implemented in other contexts, it has not yet been applied to FEP care. Therefore, this study aimed to adapt the intervention for future implementation through expert consultation. Methods: A qualitative exploratory-descriptive design was employed. Data were collected via three focus groups comprising multidisciplinary professionals experienced in FEP care. Qualitative content analysis was used to examine the data. Results: Participants viewed the tailored Mentis Plus intervention as a valuable, recovery-oriented tool. Key recommendations included a flexible, group-based format with eight weekly sessions. Suggested intervention components encompassed gratitude journaling, emotional regulation techniques, and collaborative problem-solving exercises. Group delivery was highlighted as essential for mitigating isolation and promoting peer support. Practical implementation strategies included phased session structures and routine emotional check-ins. Identified barriers to implementation included the need for specialized training, limited therapeutic spaces, and the heterogeneity of participant needs. Facilitators included a person-centered approach, institutional backing, and sufficient resources. Conclusions: The findings support the feasibility and clinical relevance of a tailored Mentis Plus FEP Program—Brief Version. Expert-informed insights provide a foundation for adapting mental health interventions to early-psychosis care and inform future research and implementation strategies. Full article

Background/Objective: This study aimed to evaluate the effectiveness of very early oral transition in Enterobacterales bloodstream infections (E-BSIs), identify factors associated with it, compare the effectiveness of different oral options, and assess its economic and ecological benefits. Methods: Retrospective, observational cohort study including monomicrobial E-BSI in clinically stable adult patients by day 3 of bacteremia with oral antibiotic options. Transition to oral antibiotics by day 3 or earlier (early oral (EO) group) was compared to later transition or remaining on intravenous therapy (nEO group). Early oral transition-associated factors were analyzed. Oral high-dose beta-lactams (BLs) were compared to quinolones (QLs) or trimethoprim/sulfamethoxazole (TS). Economic and ecological costs were assessed. Results: Of 345 E-BSI, 163 (47.2%) were in the EO group, characterized by more urinary tract infections (UTIs) and shorter hospital stays. The nEO group had higher Charlson Comorbidity Index (CCI), extended-spectrum beta-lactamase (ESBL) production, greater source control need, and longer time to clinical stability. There were no significant differences in mortality and relapse. UTIs were associated with early oral transition (OR 2.02, IC 95% 1.18–3.48), while higher CCI (0.85, 0.77–0.95), source control need (0.39, 0.19–0.85), longer time to clinical stability (0.51, 0.39–0.66), and ESBL isolates (0.39, 0.19–0.80) hindered this practice. High-dose BLs and QL/TS were equally effective. Early oral transition resulted in 38.794 KgCO₂eq reduction and EUR 269,557.99 savings. Conclusions: Very early oral transition at day 3 or before in stable E-BSI patients is effective, eco-sustainable, and cost-effective; UTI is related with the early oral switch, while comorbidities, ESBL production, source control need, or longer time to clinical stability hinder this practice. Full article

Background/Objectives: Magnetic resonance imaging (MRI) is a powerful, non-invasive diagnostic tool capable of capturing detailed anatomical and physiological information. MRI contrast agents enhance image contrast but, especially linear gadolinium-based compounds, have been associated with safety concerns. This has prompted interest in alternative contrast agents. Manganese-based contrast agents offer a promising substitute, owing to manganese’s favorable magnetic properties, natural biological role, and strong T1 relaxivity. This review aims to critically assess the structure, mechanisms, applications, and challenges of manganese-based contrast agents in MRI. Methods: This review synthesizes findings from preclinical and clinical studies involving various types of manganese-based contrast agents, including small-molecule chelates, nanoparticles, theranostic platforms, responsive agents, and controlled-release systems. Special attention is given to pharmacokinetics, biodistribution, and safety evaluations. Results: Mn-based agents demonstrate promising imaging capabilities, with some achieving relaxivity values comparable to gadolinium compounds. Targeted uptake mechanisms, such as hepatocyte-specific transport via organic anion-transporting polypeptides, allow for enhanced tissue contrast. However, concerns remain regarding the in vivo release of free Mn²⁺ ions, which could lead to toxicity. Preliminary toxicity assessments report low cytotoxicity, but further comprehensive long-term safety studies should be carried out. Conclusions: Manganese-based contrast agents present a potential alternative to gadolinium-based MRI agents pending further validation. Despite promising imaging performance and biocompatibility, further investigation into stability and safety is essential. Additional research is needed to facilitate the clinical translation of these agents. Full article

Background/Objectives: Frenotomy is the procedure of choice for treating ankyloglossia. The literature reports that readhesion of the frenulum occurs in 2.6–13% of cases. There is no published evidence to support performing tongue exercises to prevent it. We aimed to determine the readhesion rate of ankyloglossia, the benefits of tongue exercises to prevent it, and the characteristics of patients who experienced readhesion. Methods: This is a prospective, observational study of neonates who underwent a frenotomy between January and August 2024. Following the frenotomy, we recommended that all parents perform a series of exercises 6–8 times daily over 15 days. Patients were re-evaluated 10–15 days post-procedure for signs of ankyloglossia using the Hazelbaker tool and clinical variables such as nipple pain or cracks. Results: We enrolled 212 patients; thirty patients underwent a refrenotomy (14.1%). The raw risk of readhesion in our study was 0.335 (95%CI 0.275–0.401), and for symptomatic readhesion, 0.156 (95%CI 0.113–0.211). Adjusted by sex, the risk of readhesion for female patients was 0.236 (95%CI 0.155–0.344), and for males, 0.390 (95%CI 0.312–0.474). The appearance and function Hazelbaker scores were significantly lower before the frenotomy than post-procedure in all cases. In females, not following the exercise protocol multiplied the risk of readhesion by 1.61 (95%CI 1.03–2.56), whereas in males the risk was multiplied by 1.47 (95%CI 1.03–2.08). Symptomatic readhesion was significantly correlated with age at frenotomy and Hazelbaker score. Conclusions: Readhesion of tongue-tie was higher than previously published (33.5%); however, symptomatic readhesion was less frequent (15.6%). Proper adherence to post-frenotomy exercises significantly reduces the risk of readhesion, although it has less impact on symptomatic readhesion. Full article

Soil contamination with toxic inorganic elements poses a major challenge to rice cultivation, affecting plant physiology, yield, and grain safety. While natural variation in tolerance exists among rice genotypes and related species, recent advances in genomics, breeding, and biotechnology offer new opportunities to enhance adaptation. This review synthesizes the current knowledge on the physiological effects of toxic elements and explores strategies to improve tolerance, from harnessing genetic diversity to genome editing and transgenic approaches. Attention is also paid to the role of microbiota in mitigating toxicity and reducing translocation to seeds, highlighting emerging solutions for sustainable rice production in contaminated environments. Full article

The Retabit platform is a data-driven tool designed to bridge the gap between building rehabilitation and urban regeneration by integrating energy, economic, and social dimensions into a single framework. Leveraging multiple public data sources, the platform provides actionable insights to local and national authorities, public housing agencies, urban planners, energy service providers, and research institutions, helping to align renovation initiatives with broader urban transformation goals and climate action objectives. The platform consists of two main components: Analyse, for examining building conditions through multidimensional indicators, and Plan, for designing and simulating renovation projects. Retabit contributes to more transparent and informed decision-making, encourages collaboration across sectors, and addresses long-term sustainability by incorporating participatory planning and impact evaluation. Its scalable structure makes it applicable across diverse geographic areas, policy contexts, and domains linked to sustainable urban development. Full article

Background/Objectives: We evaluated the diabetic foot ulcer (DFU) microbiome in clinical situations identified as risk factors for a worse outcome and explored the roles of the most abundant microorganisms. Methods: A prospective multicenter cohort of diabetic patients with DFU were followed up for 6 months. We obtained a DFU tissue biopsy for microbiome analysis at the baseline visit. Genomic DNA was extracted (QIAamp DNA Mini Kit, Qiagen, Hilden, Germany) and quantified (QuantiFluor dsDNA System, Promega, Madison, WI, USA), with analysis of bacterial communities focusing on relative abundances (RA) and on alpha and beta diversity. Results: Overall, 59 DFUs were analyzed. DFUs of long duration (≥4 weeks) presented a higher RA of Gammaproteobacteria compared with ulcers of short duration (p = 0.02). Non-infected DFUs had a higher proportion of Actinobacteriota phyla than infected DFUs and, particularly, a higher RA of Corynebacterium genera (means ± SD: 0.063 ± 0.14 vs. 0.028 ± 0.13, respectively; p = 0.03). Regarding the pathogenic role of Staphylococcus aureus, DFUs with low S. aureus bacterial loads (<10⁶ CFU/mL) compared with those with high loads (≥10⁶ CFU/mL) showed a higher Corynebacterium RA (0.045 ± 0.08 vs. 0.003 ± 0.01, respectively; p = 0.01). Conclusions: In clinical situations associated with poor DFU outcomes, we observed a predominance of Gammaproteobacteria in the microbiome of long-duration ulcers and a higher RA of Corynebacterium in non-infected DFUs. An inverse relationship between the predominance of Corynebacterium and the S. aureus bacterial load in DFUs was also noted, which may suggest these commensals have a modulatory role. Further studies should explore the clinical utility of microbiome analysis for DFUs. Full article