Search Results (1,122)

Background: Behçet’s Disease (BD) was traditionally classified according to the International Study Group (ISG), where oral ulcers were mandatory. The International Team for the Revision of the International Criteria for BD (ICBD) introduced a scoring system instead. Our aim was to assess (a) sensitivity, (b) concordance between ISG and ICDB criteria in global and severe BD cases (ocular, vascular, and neurological), and (c) evaluate their clinical implications. Methods: Retrospective cohort study including 142 BD patients diagnosed in a well-defined population in Northern Spain, between January 1980 and November 2023. Both ISG and ICBD criteria were compared, sensitivity and concordance were assessed using Prevalence-Adjusted and Bias-Adjusted Kappa (PABAK) and the unadjusted Kappa. Results: A total of 142 BD patients diagnosed by expert rheumatologists (73 men; mean age of 36.4) were studied. Among them, 84 met ISG criteria, while 116 fulfilled ICBD criteria. Sensitivity of ISG and ICBD criteria in the overall cohort was (59.1% and 81.6%), respectively. Among patients with severe manifestations (ocular, vascular, or neurological), sensitivity increased to 71.2% for ISG and 92.5% for ICBD. Overall concordance was moderate (Kappa = 0.490), with 70.4% of patients classified identically. When adjusting prevalence and bias, concordance improved slightly (PABAK = 0.549). Of the 32 patients classified as BD exclusively by ICBD, 7 were receiving anti-TNF therapy, and 2 were receiving apremilast. Conclusions: The ICBD criteria demonstrated higher sensitivity than the traditional ISG criteria in classifying BD, particularly in severe cases. Classifying these additional patients under ICBD facilitated the initiation of on-label biologic treatments, potentially enhancing BD management, especially for severe cases. Full article

Background: Central precocious puberty (CPP), defined as the onset of secondary sexual characteristics before age 8 in girls, is increasingly prevalent worldwide. CPP is often caused by early activation of the HPG axis, leading to accelerated growth and bone maturation. However, the diagnostic accuracy of standard bone age (BA) methods remains uncertain in this context. Objective: To compare the diagnostic accuracy of the Greulich–Pyle atlas (GPA) and Tanner–Whitehouse 3 (TW3) methods in estimating skeletal age in girls with CPP and to assess the predictive value of serum hormone levels for estimating chronological age (CA). Methods: An observational, cross-sectional diagnostic study was conducted, involving n = 109 girls aged 6–12 years with confirmed CPP (Ethics Committee approval: CHUC_2023_86; 13 July 2023). Left posteroanterior hand–wrist (PA–HW) radiographs were assessed using the GPA and TW3 methods. Anthropometric measurements were recorded, and serum concentrations of estradiol, LH, FSH, DHEA-S, cortisol, TSH, and free T4 were obtained. Comparisons between CA and BA estimates were conducted using repeated-measures ANOVA, and ANCOVA was applied to examine the hormonal predictors of CA. Results: Both GPA and TW3 overestimated CA between 7 and 12 years, with the GPA showing larger deviations (up to 4.8 months). The TW3 method provided more accurate estimations, particularly at advanced pubertal stages. Estradiol (η²_p = 0.188–0.197), LH (η²_p = 0.061–0.068), and FSH (η²_p = 0.008–0.023) emerged as the strongest endocrine predictors of CA, significantly enhancing the explanatory power of both radiological methods. Conclusions: The TW3 method demonstrated superior diagnostic accuracy over GPA in girls with CPP, especially between 7 and 12 years. Integrating estradiol, LH, and FSH into BA assessment significantly improved the accuracy, supporting a more individualized and physiologically grounded diagnostic approach. Full article

This study presents the development of Cu-doped NiMo/TiO₂ photoelectrocatalysts for simultaneous green hydrogen production and pharmaceutical pollutant removal under simulated solar irradiation. The catalysts were synthesized via wet impregnation (15 wt.% total metal loading with 0.6 wt.% Cu) and thermally treated at 400 °C and 900 °C to investigate structural transformations and catalytic performance. Comprehensive characterization (XRD, BET, SEM, XPS) revealed phase transitions, enhanced crystallinity, and redistribution of redox states upon Cu incorporation, particularly the formation of NiTiO₃ and an increase in oxygen vacancies. Crystallite sizes for anatase, rutile, and brookite ranged from 21 to 47 nm at NiMoCu400, while NiMoCu900 exhibited only the rutile phase with 55 nm crystallites. BET analysis showed a surface area of 44.4 m²·g⁻¹ for NiMoCu400, and electrochemical measurements confirmed its higher electrochemically active surface area (ECSA, 2.4 cm²), indicating enhanced surface accessibility. In contrast, NiMoCu900 exhibited a much lower BET surface area (1.4 m²·g⁻¹) and ECSA (1.4 cm²), consistent with its inferior photoelectrocatalytic performance. Compared to previously reported binary NiMo/TiO₂ systems, the ternary NiMoCu/TiO₂ catalysts demonstrated significantly improved hydrogen production activity and more efficient photoelectrochemical degradation of paracetamol. Specifically, NiMoCu400 showed an anodic peak current of 0.24 mA·cm⁻² for paracetamol oxidation, representing a 60% increase over NiMo400 and a cathodic current of −0.46 mA·cm⁻² at −0.1 V vs. RHE under illumination, nearly six times higher than the undoped counterpart (–0.08 mA·cm⁻²). Mott–Schottky analysis further revealed that NiMoCu400 retained n-type behavior, while NiMoCu900 exhibited an unusual inversion to p-type, likely due to Cu migration and rutile-phase-induced realignment of donor states. Despite its higher photosensitivity, NiMoCu900 showed negligible photocurrent, confirming that structural preservation and surface redox activity are critical for photoelectrochemical performance. This work provides mechanistic insight into Cu-mediated photoelectrocatalysis and identifies NiMoCu/TiO₂ as a promising bifunctional platform for integrated solar-driven water treatment and sustainable hydrogen production. Full article

The pressure response and structural stability of fluoranthene crystals up to 8 GPa are investigated using Raman spectroscopy. The vast majority of the Raman peaks upshift with pressure, either sublinearly (intermolecular modes) or quasilinearly (intramolecular modes), reflecting the bond hardening upon volume contraction. The frequency shifts, accompanied by intensity redistribution among the Raman peaks, are by far larger for the former than those for the latter vibrations, compatible with their nature: weak intermolecular van der Waals interactions and strong intramolecular covalent bonds. For pressures higher than 2 GPa, changes in the linear pressure coefficients of the Raman peak frequencies, mainly towards lower values, are observed. These are more pronounced for intermolecular and C–H stretching vibrations. For P > 4.7 GPa, the pressure coefficients are further reduced, while all the observed pressure-induced changes are fully reversible upon pressure release. These changes may be interpreted either as two structural transitions at ~2 and ~4.7 GPa or as a single, but sluggish, structural phase transition in the pressure range 2–4.7 GPa, featuring the reorientation and different stacking of the molecules. From the high-pressure Raman data in the low-pressure phase, a bulk modulus of ~7 GPa at ambient pressure is estimated for solid fluoranthene. Full article

Primary amoebic meningoencephalitis (PAM) is a rapidly progressive and fulminant disease that affects the central nervous system caused by the free-living amoeba Naegleria fowleri. The adhesion to extracellular matrix (ECM) proteins is considered as one of the key steps in the success of the infection and could represent an interesting target to be explored in the prevention and treatment of the disease. In this work, the effect of two sesquiterpenes with proven anti-Naegleria activity on the adhesion of the parasite was evaluated using an in vitro ECM-based model, compared with the reference drugs amphotericin B and staurosporine. Both laurinterol and (+)-elatol inhibited the adhesion of the N. fowleri trophozoites to the main proteins of the ECM when treating them at different concentrations and exposure times. This work not only reinforces the therapeutic potential of laurinterol and (+)-elatol against N. fowleri infection but also introduces the application of ECM-based adhesion assays as a novel and valuable tool for screening candidate compounds that disrupt host–pathogen interactions critical to PAM pathogenesis. Full article

Volcanic islands host exceptional geological features that illustrate complex endogenic processes and interactions with climatic and marine forces, while also being particularly vulnerable to the impacts of climate change. Despite their scientific, educational, touristic, and aesthetic values, such islands remain underrepresented within the UNESCO Global Geoparks (UGGp). This study reviews current volcanic island geoparks and evaluates territories with potential for future designation, based on documented geoheritage, geosite inventories, and geoconservation frameworks. Geoparks are categorized according to their dominant narratives—ranging from recent Quaternary volcanism to broader tectonic, sedimentary, and metamorphic histories. Through an analysis of their distribution, management strategies, and integration into territorial planning, this work highlights the challenges that insular territories face, including vulnerability to global environmental change, limited legal protection, and structural inequalities in access to international resources recognition. It concludes that volcanic island geoparks represent strategic platforms for implementing sustainable development models, especially in ecologically and socially fragile contexts. Enhancing their global representation will require targeted efforts in ecologically and socially fragile contexts. Enhancing their global representation will require targeted efforts in capacity building, funding access, and regional cooperation—particularly across the Global South. Full article

This work aims to leverage Shapley values to explain the decisions of convolutional neural networks trained to predict glaucoma. Although Shapley values offer a mathematically sound approach rooted in game theory, they require evaluating all possible combinations of features, which can be computationally intensive. To address this challenge, we introduce a novel strategy that discretizes the input by dividing the image into standard regions or sectors of interest, significantly reducing the number of features while maintaining clinical relevance. Moreover, applying Shapley values in a machine learning context necessitates the ability to selectively exclude features to evaluate their combinations. To achieve this, we propose a method involving the occlusion of specific sectors and re-training only the non-convolutional portion of the models. Despite achieving strong predictive performance, our findings reveal limited alignment with medical expectations, particularly the unexpected dominance of the background sector in the model’s decision-making process. This highlights potential concerns regarding the interpretability of convolutional neural network-based glaucoma diagnostics. Full article

A series of Er³⁺–Tm³⁺–Yb³⁺ tri-doped fluorophosphate glasses with different molar compositions were synthesized using the conventional melt-quenching technique, and their optical properties were measured and analyzed. Under laser excitation at 980 nm, blue, green and red upconverted emissions were observed at around 475, 545 and 660 nm, respectively. Based on the results and the energy level diagrams, energy transfer processes were proposed to explain the population mechanisms of the emitting levels. A final characterization was developed within the framework of the CIE 1931 chromaticity coordinate diagram. Varying the doping concentrations of the optically active rare-earth ions, as well as the laser pumping power, enabled modulation of the three primary colors, resulting in blue, green and relatively close to white light emissions. This tunability of the upconverted emissions highlights the potential of these fluorophosphate glasses as tunable optical devices, laser systems and visual show effects. Full article

Background/Objectives: Truncating mutations in PALB2, a critical component of the BRCA1-PALB2-BRCA2 homologous recombination repair complex, are associated with increased risk and aggressiveness of breast cancer. The consequences of PALB2 truncation on the expression, localization, and functional dynamics of the scaffold protein IQGAP1 were investigated in this study based on two cases of truncated PALB2 human breast invasive ductal carcinoma (IDC), specifically, c.1240C>T (p.Arg414*) and c.2257C>T (p.Arg753*). Methods: Using confocal microscopy, we examined co-expression patterns of IQGAP1 with PALB2, PCNA, CK7, and β-tubulin in tumor tissues from both control cancer and PALB2-mutated cases. Results: In PALB2-truncated tumors, IQGAP1 exhibited enhanced peripheral and plasma membrane localization with elevated co-localization levels compared to controls, suggesting altered cytoskeletal organization. PALB2 truncation increased nuclear and cytoplasmic N-terminal PALB2 immunoreactivity, indicating the presence of truncated isoforms disrupting the homologous recombination repair system. Co-expression analyses with PCNA revealed an inverse expression pattern between IQGAP1 and proliferation markers, suggesting S-phase cell cycle-dependent heterogeneity. Furthermore, the loss of IQGAP1 dominance over CK7 and β-tubulin in mutant tumors, along with persistent intercellular spacing, implied a loss of cell–cell cohesion and the acquisition of invasive traits. Conclusions: These data support a model where PALB2 truncation triggers a reorganization of IQGAP1 that disrupts its canonical structural functions and facilitates tumor progression via enhanced motility and impaired cell–cell interaction. IQGAP1 thus serves as both a functional effector and potential biomarker in PALB2-mutated IDC, opening novel paths for diagnosis and targeted therapeutic intervention. Full article

Background: Multiple Chemical Sensitivity (MCS) is a complex, disabling condition marked by non-specific symptoms in response to low-level chemical exposures. It often leads to substantial impairments in quality of life, psychological health, and daily functioning. Although non-pharmacological approaches—such as lifestyle and psychological interventions—are widely used, their clinical effectiveness remains unclear. Objective: We aim to evaluate the effectiveness of lifestyle-based approaches in improving clinical and psychosocial outcomes in adults with Multiple Chemical Sensitivity. Methods: A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251013537). Literature searches were carried out in MEDLINE (PubMed), CINAHL, Google Scholar, and ResearchGate between March and April 2025. Eligible studies included adults (≥18 years) with a confirmed diagnosis of MCS and reported outcomes such as perceived stress, anxiety, depressive symptoms, or quality of life. Methodological quality and risk of bias were independently assessed using the PEDro scale, NIH Quality Assessment Tool, CEBMa checklist, and Cochrane RoB 2.0. Results: Twelve studies (N = 378) met the inclusion criteria. Cognitive and behavioral therapies demonstrated the most consistent evidence of efficacy, with reductions in symptom severity, maladaptive cognitive patterns, and functional limitations. Mindfulness-based stress reduction showed favorable outcomes, while other mindfulness-based interventions yielded mixed results. Exposure-based therapies contributed to increased chemical tolerance and reduced avoidance behavior. Electromagnetic and biomedical approaches demonstrated preliminary but limited effectiveness. Aromatherapy was well tolerated and perceived as relaxing, though its clinical impact was modest. Conclusions: Cognitive and behavioral therapies appear to be most effective among lifestyle-based interventions for MCS/IEI. However, study heterogeneity limits the generalizability of findings, underscoring the need for more rigorous research. Full article

Background: Research on sex differences in personality disorders profiles among individuals with Alcohol Use Disorder (AUD) remains limited. This study aimed to examine sex differences in personality disorders in AUD individuals attending to an outpatient alcohol and drugs treatment unit. Methods: Persons seeking alcohol detoxification treatment were assessed with the Millon Clinical Multiaxial Inventory-III (MCMI-III) after abstinence. Both dimensional trait scores and cluster personality disorders types distribution were analyzed. A total of 216 subjects, 114 women (53%) and 102 men (47%), participated in the study. Results: No sex differences were found for paranoid, schizoid or schizotypal traits scores of Cluster A types. Women exhibited higher scores on the Cluster B histrionic trait (48 ± 22 vs. 39 ± 23, p = 0.012), with no differences in antisocial, borderline, or narcissistic trait scores. Narcissistic personality disorder was more prevalent in men than women (44% vs. 20%, p = 0.012). Cluster C dependent (52 ± 24 vs. 46 ± 20, p = 0.025) and obsessive-compulsive (54 ± 20 vs. 43 ± 19, p = 0.012) traits scores were elevated in women, but only dependent personality disorder prevalence differed categorically (38% women vs. 15% men, p = 0.012). Conclusions: Employing both dimensional and cluster approaches enriches personality disorder research in AUD. Dependent personality disorder in Cluster C robustly differentiates sexes, while personality disorder patterns in Clusters A and B show minimal sex differences when both approaches are considered. Full article

Background/Objectives: Pressure injuries (PIs), a recognized indicator of care quality, have a higher incidence in intensive care units (ICUs). Our objective was to assess whether critically ill patients identified as “unprotected” (COMHON ≥ 11) developed pressure injuries despite additional preventive measures. Methods: A historical cohort study of an adult ICU was carried out. Of the 811 patients admitted in 2022, 400 were selected. All of them were subjected to the ICU’s PI Prevention Protocol, and those with a moving average of the COMHON Index ≥ 11 were given two additional measures: a multilayer dressing on the sacrum, and anti-equinus and heel-pressure-relieving boots. Results: A total of 36 patients presented with PIs (cumulative incidence of 9%). Significant differences were observed in their mean length of stay and in their disease severity score (APACHE-II). Most of the PIs were located on the sacrum, followed by the heel. Prior to the appearance of the PIs, a sacral dressing was applied to 100% of the patients, while anti-equinus and heel-pressure-relieving boots were only applied to 58.3%. Of the 36 patients with PIs, 52.8% had a PI on the sacrum and 22.2% on the heel. Conclusions: Focusing only on those who presented with PIs, we observed that the considered measures were not effective for preventing PIs in all the patients. Not all PIs are preventable, and individual risk factors should be considered. In the future, we will analyze the individual characteristics of these patients and verify whether the Prevention Protocol was followed, in order to determine how they could have been prevented or whether they were so-called unavoidable PIs. Full article

Volcanic eruptions release gases and particulates that may adversely affect human health. The Tajogaite eruption on La Palma provided a unique opportunity to evaluate inorganic pollutant exposure in a directly affected population. As part of the ISVOLCAN study, blood samples from 393 adults residing in the island’s western region were analyzed for 43 inorganic elements using Inductively Coupled Plasma Mass Spectrometry (ICP-MS), including 20 toxic elements identified by the Agency for Toxic Substances and Disease Registry (ATSDR). The median age of participants was 51 years, and 56.7% were female. Higher levels of Hg and Mn were associated with long-term occupational exposure, while smoking was linked to elevated Cd, Pb, and Sr levels. Participants living within 6.5 km of the volcano had significantly higher concentrations of Al and Ti. Ash cleanup activities were associated with increased levels of Ni and Cu, and those spending over five hours outdoors daily showed elevated Se and Pb. This is the first biomonitoring study to assess blood concentrations of inorganic pollutants in a population exposed to volcanic emissions. The findings highlight key exposure factors and underscore the need for continued research to assess long-term health effects and inform public health measures. Full article

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy. CIPN can lead to a dose reduction and/or the interruption of chemotherapy, limiting its effectiveness, while chronic CIPN decreases patients’ quality of life. Improvements in cancer treatment and patients’ survival have increased the number of patients living with CIPN. The only evidence-based treatment for CIPN-related pain, duloxetine, provides only modest clinical benefit, and there is no effective clinical management option for numbness and tingling. Several experimental studies and clinical reports suggest that adjuvant ozone treatment may be beneficial in managing CIPN. Methods: This narrative review aims to provide an overview of current knowledge regarding CIPN and ozone therapy. Specifically, it summarizes experimental studies (18) and clinical reports (27) published between 1995 and 2025 that offer preliminary evidence supporting the potential role of ozone treatment in managing CIPN, highlighting the need for ongoing randomized clinical trials to establish its efficacy. Additionally, this review highlights existing gaps in the literature and proposes directions for future research. Results: The hypothesized mechanisms of action and experimental findings suggest that ozone therapy may be a valuable intervention for CIPN, a concept supported by preliminary clinical observations. Conclusions: Clinically relevant approaches for established CIPN are currently unavailable. While preliminary data suggest a potential role of ozone therapy, clinical evidence remains limited. Further high-quality randomized controlled trials are needed to confirm its efficacy and safety in this context; several trials are currently ongoing. Full article

Allergic diseases, particularly respiratory allergies like asthma and allergic rhinitis, are a growing public health concern influenced by environmental factors such as climate change and air pollution. The exposome framework enables a comprehensive assessment of how lifelong environmental exposures shape immune responses and allergic sensitization. Peru’s diverse ecosystems and climates provide a unique setting to investigate regional variations in allergic sensitization. This study characterized these patterns in five Peruvian regions with distinct climatic, urbanization, and socioeconomic characteristics. A total of 268 individuals from Lima, Piura, Tarapoto, Arequipa, and Tacna were analysed for allergen-specific IgE responses using a multiplex IgE detection system. The results revealed significant geographical differences in sensitization frequencies and serodominance profiles, based on descriptive statistics and supported by Chi-square comparative analysis. House dust mites were predominant in humid regions, while Arequipa exhibited higher sensitization to cat allergens. In Tacna, olive pollen showed notable prevalence alongside house dust mites. Tarapoto’s high humidity correlated with increased fungal and cockroach allergen sensitization. Notably, some allergens traditionally considered minor, such as Der p 5 and Der p 21, reached sensitization prevalences close to or exceeding 50% in certain regions. These findings provide the most detailed molecular characterization of allergic sensitization in Peru to date, highlighting the importance of region-specific allergy management strategies. Understanding environmental influences on allergic diseases can support more effective diagnostic, therapeutic, and preventive approaches tailored to diverse geographical contexts. Full article