Search Results (162)

Background: Early-onset neonatal sepsis (EONS), defined as systemic infection occurring within the first 72 hours of life, remains a major cause of morbidity and mortality in preterm infants. Increasing evidence indicates that the gut may play an active role in systemic inflammation, yet the temporal behavior of fecal short-chain fatty acids (SCFAs) during EONS has not been characterized. SCFAs and branched-chain fatty acids (BCFAs) are key microbial metabolites involved in epithelial maturation and immune regulation and may provide a non-invasive window into early inflammatory vulnerability. Methods: This pilot prospective longitudinal cohort study enrolled 49 preterm infants (≤32 weeks’ gestation) originally identified as at high risk for necrotizing enterocolitis (NEC) and subsequently stratified into EONS and non-sepsis groups. Serial stool samples were collected at predefined timepoints (TPs; TP1 ≈ 3 days of life [DoL], TP2 ≈ 7 DoL, TP3 ≈ 14 DoL, TP4 ≈ 21 DoL, and TP5 ≈ 28 DoL). Samples were analyzed using gas chromatography–mass spectrometry (GC–MS) to quantify a panel of 12 SCFAs, including BCFAs and medium-chain fatty acids (MCFAs). Both absolute concentrations and relative fractions were evaluated, with emphasis on ratio-based metrics (e.g., acetic/propionic acid ratio) and timepoint-specific group contrasts, complemented by partial least squares discriminant analysis (PLS–DA). Results: At the earliest sampling window (TP1), infants with EONS exhibited distinct early changes in SCFA composition, including a significantly lower median relative fraction of acetic acid (86.6% vs. 94.5% in non-sepsis), while several non-acetate components—including propionic, valeric, and branched-chain acids—were relatively enriched. Acetate-to-non-acetate ratios were markedly reduced in EONS (e.g., acetic/propionic and acetic/isobutyric ratios), indicating an early shift away from acetate dominance. PLS–DA at TP1 demonstrated partial separation between groups, with acetic-acid depletion and non-acetate enrichment among the strongest contributors to discrimination. By later TPs, these early differences narrowed to a small subset of BCFA-related ratios and largely attenuated by the end of the first month. Conclusions: In this pilot cohort of preterm infants, EONS was associated with early, structured alterations in fecal SCFA profiles, characterized by reduced acetic-acid dominance and relative enrichment of non-acetate acids. Dynamic, ratio-based assessment proved more informative than absolute concentrations alone, revealing transient intestinal metabolic signatures accompanying systemic infection. These findings provide the first longitudinal evidence of gut metabolic involvement in EONS and lay the groundwork for larger, multi-center studies integrating SCFA trajectories with microbiome and immune profiling to refine early risk stratification for systemic infection in high-risk neonatal populations. Full article

This study aimed to investigate the effects of pineapple pomace as a functional feed additive on growth performance, fecal microbiota composition, short-chain fatty acids (SCFAs), and odor substance emissions in weaned piglets. The experiment utilized 90 weaned three-way crossbred piglets (Duroc–Yorkshire–Guoshou Black Pig) at 28 days of age, randomly divided into three groups of 10 pigs each: the control group (CON, basal diet), the fish meal group (FM, basal diet + 2% imported fish meal), and the pineapple pomace group (PPC, basal diet + 2% pineapple pomace compound). The results indicated the PPC group exhibited significantly higher average daily gain (ADG) (p < 0.05) and significantly lower feed conversion ratio (FCR) (p < 0.05) than the CON group. 16S rRNA sequencing analysis revealed that the PPC group significantly increased fecal microbiota species richness and diversity (p < 0.01) while enriching beneficial bacteria including Lactobacillus, Bifidobacterium, and butyrate-producing bacteria such as Blautia. Concurrently, acetic acid and butyric acid levels in feces were significantly elevated in the PPC group (p < 0.05), with butyric acid production markedly higher than in the FM group (p < 0.05). However, no significant differences were observed in the levels of branched-chain fatty acids (BCFAs), such as isobutyric acid and isovaleric acid (p < 0.05). Moreover, PPC supplementation led to a significant decrease in fecal levels of indole and 3-methylindole (skatole) (p < 0.05). In summary, dietary inclusion of 2% pineapple pomace improves growth performance and intestinal health in weaned piglets by modulating the fecal microbiota, promoting beneficial SCFA production, and inhibiting protein putrefaction. These findings support PPC as an effective and sustainable alternative to fish meal, contributing to the development of environmentally friendly feeding strategies in pig production. Full article

Bidens pilosa L. is a cosmopolitan and invasive weed that strongly impacts agricultural systems in tropical regions. In Veracruz, Mexico, its presence extends mainly across mid-elevation zones where coffee, maize, and sugarcane are cultivated. This study characterized the bioclimatic and edaphic determinants of B. pilosa distribution using 581 georeferenced occurrences combined with 19 bioclimatic variables, elevation, and soil data. A Maxent model revealed the highest habitat suitability (0.65–1.0) in the central mountainous region between 800 and 1500 m.a.s.l., particularly under temperate–humid climates (Cfa, Cfb) and Acrisol–Leptosol soils. Principal component and redundancy analyses showed that annual precipitation (BIO12), precipitation of the driest month (BIO14), and temperature seasonality (BIO4) explained 74.7% of the total environmental variance. Cluster analysis identified four distinct ecological groups, confirming broad ecological plasticity. These findings indicate that B. pilosa is not randomly distributed but structured along climatic and soil gradients, with precipitation and elevation as major determinants of its ecological niche. Understanding these relationships provides a quantitative framework for predicting its expansion under future climate scenarios and for designing targeted management strategies in tropical agroecosystems. Full article

Canine hepatocellular carcinoma (HCC), the most common primary liver malignancy in dogs, shares many clinicopathological and molecular similarities with human HCC. However, its molecular characteristics remain insufficiently defined, and reliable diagnostic biomarkers are lacking. Elucidating dysregulated microRNAs (miRNAs) may aid in both disease characterization and comparative oncology research. Small RNA sequencing datasets from canine HCC were analyzed to identify significantly dysregulated miRNAs with high expression and biomarker potential. The top candidate was validated in clinical tissues, cell lines, patient’s plasma and plasma exosomes using RT-qPCR. Comparative analyses were conducted using human HCC datasets (TCGA and GEO), followed by target prediction and functional enrichment to identify conserved molecular pathways. Among the 59 differentially expressed miRNAs, cfa-miR-10a showed the highest average expression level and yet was significantly downregulated in canine HCC tissues. RT-qPCR confirmed reduced expression of cfa-miR-10a in canine HCC tissues, whereas plasma exosomes showed significant enrichment, demonstrating excellent diagnostic performance (AUC = 0.94). The mature sequence of cfa-miR-10a is highly conserved with hsa-miR-10a-5p. TCGA datasets confirmed downregulation of hsa-miR-10a-5p in HCC tissues, whereas a GEO dataset showed no significant change in serum exosome levels. Target prediction and functional annotation identified 59 overlapping genes, with the Proteoglycans in cancer pathways being conserved in both species, mediated by ACTG1, SDC1, FRS2, and WNT9B. Collectively, these findings demonstrate distinct intra-tumoral and exosomal expression pattern of miR-10a in canine HCC and support its potential as a non-invasive biomarker with translational relevance. Full article

Background/Objectives: Perceived ageism has been increasingly recognized as a critical determinant of the health and well-being of older adults. However, the cross-cultural validation of instruments measuring ageism remains limited. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Turkish version of the Perceived Ageism Questionnaire (PAQ-TR). Methods: Content validity was assessed by a multidisciplinary expert panel. Construct validity was examined using exploratory (EFA) and confirmatory factor analyses (CFA). Convergent validity was tested through correlations with the Brief Aging Perceptions Questionnaire (B-APQ). Reliability was evaluated using Cronbach’s alpha, McDonald’s omega, and test–retest intraclass correlation coefficients (ICC). Statistical analyses were performed using IBM SPSS Statistics v27 (IBM Corp., Armonk, NY, USA) and AMOS v22 (IBM Corp., Chicago, IL, USA). Results: A total of 307 older adults (137 men and 170 women) participated in the study. The mean age was 71.19 (6.96) years, and 55.7% of the participants were female. An EFA confirmed the original two-factor structure, explaining 61.2% of the total variance, which was subsequently verified by a CFA, showing a good model fit. EFA confirmed the original two-factor structure, explaining 61.2% of the total variance (Kaiser-Meyer–Olkin = 0.82; Bartlett’s χ²(28) = 412.5, p < 0.001). The structure was subsequently verified by CFA, which demonstrated an excellent model fit (Comparative Fit Index = 0.97; Tucker–Lewis Index = 0.96; Root Mean Square Error of Approximation = 0.052; Standardized Root Mean Square Residual = 0.041). The Negative subscale showed high internal consistency (Cronbach’s alpha (α) = 0.84; McDonald’s Omega (ω) = 0.85), whereas the Positive subscale indicated moderate reliability (α = 0.58; ω = 0.60). The test–retest reliability was excellent, reflecting strong temporal stability (Intraclass Correlation Coefficient = 0.91). Convergent validity showed that the positive subscale was related to positive aging perceptions and less to negative ones, while the negative subscale showed the opposite pattern. Conclusions: The PAQ-TR demonstrated adequate psychometric properties for assessing perceived ageism among older adults in Türkiye. While the Negative subscale showed robust reliability, the positive subscale required refinement. These findings highlight both the cross-cultural validity of the PAQ and the influence of cultural norms on positive aging perception. The PAQ-TR is a valuable tool for research and clinical practice. Full article

Butyrate is a key short-chain fatty acid (SCFA) essential for maintaining colon health, immune homeostasis, and metabolic balance. Its synthesis primarily depends on the fermentation of dietary substrates by the gut microbiota. In a healthy state, carbohydrate fermentation sustains the stability of the gut microbiota; however, in chronic diseases, the diversity of the microbiota decreases, and the metabolic pathway shifts from carbohydrate fermentation to protein fermentation, thereby inhibiting butyrate production. Polysaccharides and proteins play key roles in regulating butyrate synthesis. As fermentable carbon sources, polysaccharides promote the proliferation of probiotics, lower colonic pH, and inhibit anaerobic fermentation of proteins. However, excessive protein fermentation produces branched-chain fatty acid (BCFA), ammonia, phenols, and other metabolites that inhibit butyrate production. The structural characteristics of polysaccharides and the digestibility of proteins can determine the substrate selection of gut microbiota. This review systematically elucidates the biosynthetic pathways of butyrate in the gut and the host metabolic signaling pathways in which it participates, focusing on the interactions between dietary proteins and polysaccharides and their key regulatory mechanisms affecting butyrate production by the gut microbiota. Full article

Current clinical approaches for managing inflammatory pain are frequently accompanied by adverse effects, significantly compromising patients’ quality of life. This study investigates the analgesic potential of Heat Shock Protein Family A Member 1A (HSPA1A) in alleviating Complete Freund’s Adjuvant (CFA)-induced inflammatory pain. The immunomodulatory mechanisms were elucidated through behavioral studies, flow cytometry, transcriptomics, proteomics, and cellular metabolic analyses. Findings indicate that HSPA1A mitigates CFA-induced mechanical allodynia, an effect independent of T or B lymphocytes and neutrophils but positively correlated with macrophage abundance. Transcriptomic RNA sequencing suggests involvement of inflammation-associated pathways. In vitro experiments demonstrate that HSPA1A suppresses the polarization of bone marrow-derived macrophages toward the pro-inflammatory M1 phenotype in an inflammatory model, with decreased mRNA expression of pro-inflammatory cytokines Interleukin-1β (Il1b) and Tumor Necrosis Factor (TNF). Macrophage metabolism undergoes reprogramming, characterized by reduced glycolysis and enhanced oxidative phosphorylation. Proteomic pathway analysis reveals suppression of pro-inflammatory and glycolytic proteins, coupled with upregulation of anti-inflammatory and tricarboxylic acid cycle-related proteins. In summary, HSPA1A likely exerts its analgesic effects by inhibiting glycolysis in macrophages, providing novel insights into inflammatory pain management and highlighting potential therapeutic targets for future clinical drug development with substantial translational potential. Full article

Cannabis sativa (C. sativa) is a psychoactive plant that has been used for millennia for medicinal, recreational, and industrial purposes. The main constituents of cannabis are the cannabinoids, with other constituents including terpenes and flavonoids that contribute to its bioactivity. Among the flavonoid class, there is a subclass, specific to cannabis, namely the cannflavins (A, B, and C), which are biologically active. This study is directed to the analysis of these constituents in various cannabis chemovars. In this study, an HPLC-PDA method was validated and applied to determine the content of cannflavins, namely, cannflavin A (CF-A), cannflavin B (CF-B), and cannflavin C (CF-C), in six different cannabis chemovars. The HPLC separation was achieved using a Luna^® C18 (150 × 4.6 mm × 3 μm) with isocratic elution using a mobile phase consisting of acetonitrile and water (65:35, v/v), both containing 0.1% formic acid at a flow rate of 1 mL/min, with the detector set at 342.4 nm. The method was validated according to the ICH guidelines and exhibited a linear relationship in the 5–500 ppm range with R² > 0.99. The method showed good recovery, ranging from 82% to 98%. The intra-day and inter-day relative standard deviations (% RSDs) were ≤5.29%. Consequently, the method was applied for the determination of all these cannflavins in the different cannabis chemovars. CF-A was the most abundant cannflavin in the examined samples (15.2–478.38 ppm). The method was shown to be simple, accurate, and selective. Full article

Short-chain fatty acids (SCFAs) are involved in metabolism and physiological processes. We decided to investigate whether SCFAs are engaged in the metabolic programming of the offspring by the mother’s microbiota, which interact during pregnancy, delivery, and breastfeeding. We decided to determine whether there are correlations between 4-week-old infant feces SCFA concentrations, their weight at birth, and mothers’ anthropometric measurements. The study included 82 women with four-week-old newborns from whom stools were collected. SCFAs were determined using gas chromatography with a flame ionization detector. Correlations were observed between SCFA content in newborns’ feces and mothers’ weight and body mass index (BMI) before delivery and at the time of delivery. In addition, associations were identified between weight gain of pregnant women and SCFAs. Analysis of neonatal data showed associations between fatty acid content and infants’ weight and diet, including breastfeeding. We provide indirect evidence for the association of infant SCFA levels with metabolic programming by maternal gut microbiota metabolites. At the same time, we confirm the influence of increased SCFA levels on higher maternal and neonatal body weight and branched-chain short-chain fatty acids (BCFAs) on neonatal body weight. We provide new preventive and intervention directions for future efforts to improve the health care of pregnant women and their offspring. Full article

A 2 × 3 factorial design was used to examine the effects of maternal probiotic supplementation (Bacillus subtilis and Bacillus amyloliquefaciens) and/or piglet dietary Trp levels on sow performance and fecal microbiota composition, as well as offspring pre-weaning performance and intestinal health parameters on the day of weaning. On day 83 of gestation, 48 sows were allocated to either: (1) control, or (2) control + probiotic (1.1 × 10⁹ colony forming units/kg of feed). Their litters were assigned to 0.22, 0.27, or 0.33% standardized ileal digestible (SID) Trp diets (0.17, 0.21 and 0.25 SID ratio of Trp to lysine (Trp:Lys), SID lysine = 1.3%). At weaning, one piglet per litter was sacrificed for intestinal health analysis. Diet had no effect on sow reproductive or offspring growth performance pre-weaning (p > 0.05). Maternal probiotic supplementation led to distinct microbial communities in the sow feces on day 114 of gestation, increasing the relative abundance of Anaerocella and Sporobacter, while decreasing Lactobacillus, Ruminococcus, and Christensenella (p < 0.05). In the offspring colonic digesta, maternal probiotic supplementation increased Dorea, Sporobacter, and Anaerobacterium, while reducing the potentially harmful phylum Proteobacteria, specifically the family Enterobacteriaceae (p < 0.05), with a tendency for a reduction in the genus Escherichia (p < 0.1). Maternal probiotic supplementation enhanced duodenal morphology and modulated the expression of genes in the ileum, including a downregulation of certain immune and barrier defense genes (p < 0.05). Piglets from probiotic sows had reduced branch chain fatty acids (BCFA) in the cecal digesta and an increase in the total VFA and acetate in the colonic digesta (p < 0.05). There were limited effects of Trp level in the offspring’s creep diet or maternal × creep interactions, though this analysis was likely confounded by the low creep feed intake (total of ~0.83 kg/litter). Full article

Renewable energy sources (RESs) are increasingly combined into the power system due to market liberalization and environmental and economic benefits, but their weather-dependent variability causes power production and demand mismatches, leading to issues like frequency and regional power transmission fluctuations. To maintain synchronization in power systems, frequency must remain constant; disruptions in the proper balance of production and load might produce frequency variations, risking serious issues. Therefore, a mechanism known as load frequency control (LFC) or automated generation control (AGC) is needed to keep the frequency and tie-line power within predefined stable limits. In this study, advanced proportional–integral–derivative PID controllers such as fractional-order PID (FOPID), cascaded PI(PDN), and PI(1+DD) for LFC in a two-area power system integrated with RES are optimized using the catch fish optimization algorithm (CFA). The controllers’ optimal gains are attained through using the integral absolute error (IAE) and ITAE objective functions. The performance of LFC with CFA-tuned PID, PI, cascaded PI(PDN), and FOPID, PI(1+DD) controllers is compared to other optimization techniques, including sine cosine algorithm (SCA), particle swarm optimization (PSO), brown bear algorithm (BBA), and grey wolf optimization (GWO), in a two-area power system combined with RESs under various conditions. Additionally, by contrasting the performance of the PID, PI, cascaded PI(PDN), and FOPID, PI(1+DD) controllers, the efficiency of the CFA is confirmed. Additionally, a sensitivity analysis that considers simultaneous modifications of the frequency bias coefficient (B) and speed regulation (R) within a range of ±25% validates the efficacy and dependability of the suggested CFA-tuned PI(1+DD). In the complex dynamics of a two-area interconnected power system, the results show how robust the suggested CFA-tuned PI(1+DD) control strategy is and how well it can stabilize variations in load frequency and tie-line power with a noticeably shorter settling time. Finally, the results of the simulation show that CFA performs better than the GWO, BBA, SCA, and PSO strategies. Full article

Background/Objectives: Chronic craniofacial inflammation is recognized as a factor in anxiety-like behaviors, yet effective therapeutic options remain limited. Agmatine, a dietary bioactive compound found in fermented foods such as sake lees, exhibits modulatory effects on neural functions, alleviating psychological distress like anxiety associated with local inflammation. Methods: We investigated both the therapeutic and preventive effects of agmatine on anxiety-like behaviors and the related neural basis in a mouse model of persistent craniofacial inflammation induced by complete Freund’s adjuvant (CFA). Results: Comprehensive behavioral assessments, including the elevated plus maze, open field, dark–light box, social interaction, and novel object recognition tests, revealed that therapeutic agmatine administration (1.0 and 30 mg/kg) significantly reduced CFA-induced anxiety-like behaviors, with the higher dose showing more robust and sustained effects across multiple time points. These behavioral improvements were paralleled by reductions in acetylated histone H3, FosB, and c-Fos expression in key anxiety-related brain regions, suggesting a reversal of craniofacial inflammation-associated neural changes. In contrast, preventive agmatine treatment exerted modest and time-dependent behavioral benefits with minimal molecular normalization. Notably, preventive agmatine did not affect general locomotor activity (indicated by total movement distance), indicating that its anxiolytic effects were not confounded by altered locomotor activity. Metabolomic analysis confirmed the presence of agmatine in sake lees (~0.37 mM), supporting the hypothesis that fermented food products might offer dietary routes to emotional resilience. Conclusions: These findings underscore agmatine’s promise as a context-specific epigenetic modulator capable of mitigating anxiety-like behaviors by normalizing inflammation-driven molecular dysregulation in the brain. Full article

Preschool teachers’ self-efficacy is essential to improve their professional development and the quality of early childhood education. This study adapted and validated the Scale for Chinese Preschool Teachers’ Self-Efficacy (SCPTSE) based on the Ohio State Teacher Efficacy Scale (OSTES), in accordance with Bandura’s Social Cognitive Theory. Following a rigorous four-stage cross-cultural adaptation procedure, the 21-item SCPTSE was administered to 882 in-service preschool teachers from Zhejiang, Henan, and Shaanxi provinces in China (M age = 30.41, SD = 6.05). Both CTT and IRT frameworks were employed to evaluate the scale’s psychometric properties. Under CTT, the SCPTSE demonstrated high internal consistency (α = 0.980), and CFA supported a robust three-factor structure—instructional strategies, classroom management, and child engagement—with excellent model fit (RMSEA = 0.079; SRMR = 0.025; CFI = 0.953; TLI = 0.947; NFI = 0.945; IFI = 0.953; PNFI = 0.837; PGFI = 0.700). Under IRT, all three sub-scales demonstrated strong unidimensionality (H_IS = 0.812, H_CM = 0.800, H_CE = 0.818), the SCPTSE’ items demonstrate excellent discrimination capabilities(all a > 1.70), overall reasonable difficulty(b₁ < b₂ < b₃ < b₄), and balanced information distribution. Nevertheless, the relatively low-difficulty design (e.g., b₁) indicates room for improvement. Notably, cultural adaptation efforts ensured the scale’s contextual relevance to China’s preschool education system. The SCPTSE thus offers a valid, reliable, and culturally responsive tool for assessing self-efficacy of Chinese in-service preschool teachers and holds promise for informing targeted professional development and comparative international research. Full article

This study examined branched-chain fatty acids (BCFAs)’ effects on oxidative stress, energy metabolism, inflammation, tight junction disruption, apoptosis, and Toll-like receptor 4/nuclear factor kappa-B (TLR4/NF-κB) signaling in lipopolysaccharide (LPS)-induced calf small intestinal epithelial cells (CSIECs). Eight groups were used: a control group, an LPS-induced group, and six BCFA treatment groups (12-methyltridecanoic acid (iso-C14:0), 13-methyltetradecanoic acid (iso-C15:0), 14-methylpentadecanoic acid (iso-C16:0), 15-methylhexadecanoic acid (iso-C17:0), 12-methyltetradecanoic acid (anteiso-C15:0), and 14-methylhexadecanoic acid (anteiso-C17:0)) with LPS. The BCFA pretreatments significantly increased CSIEC activity compared to the LPS-induced group, with iso-C14:0 showing the highest activity (89.73%). BCFA reduced Reactive Oxygen Species (ROS) generation and malondialdehyde (MDA) levels and improved the superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activities and glutathione (GSH) levels. Iso-C16:0 optimized total antioxidant capacity (T-AOC). BCFA enhanced the mitochondrial membrane potential, Adenosine Triphosphate (ATP) enzyme activity, and ATP content, with iso-C14:0 increasing ATP by 27.01%. BCFA downregulated interleukin (IL)-1β, IL-8, tumor necrosis factor (TNF)-α, and interferon (INF)-γ gene expression, reduced IL-6 levels, and increased IL-10 expression. Myeloid differentiation factor 88 (MyD88) mRNA levels were reduced. BCFA alleviated Zonula Occludin (ZO-1), Claudin-1, and Claudin-4 decrease and increased Occludin levels. BCFA mitigated LPS-induced increases in Caspase-3 and BCL2-Associated X (BAX) mRNA levels, reduced Caspase-8 and Caspase-9 expression, and increased B-Cell Lymphoma-2 (BCL-2) mRNA levels. The Entropy Weight-TOPSIS method was adopted, and it was discovered that iso-C15:0 has the best effect. In summary, BCFA supplementation mitigated oxidative stress and enhanced mitochondrial function. BCFA inhibited TLR4/NF-κB signaling pathway overactivation, regulated inflammatory cytokine gene expression, reduced cellular apoptosis, preserved tight junction integrity, and supported barrier function. Full article

Background: Approximately 20% of patients with irritable bowel syndrome (IBS) link symptoms to food intake; a low-FODMAP diet is effective in managing these symptoms. Aims: To evaluate the effectiveness of the Mediterranean version of the low-FODMAP Diet (MED–LFD) compared to NICE guidelines for IBS and to assess changes in stool volatile compound levels. Methods: 108 patients with Rome IV IBS without constipation were randomized into the MED–LFD or NICE group. Primary endpoints included changes in symptom severity and responder rate (reduction of >50 IBS-SSS points) after intervention and at 6 months. Secondary endpoints assessed quality of life, symptom burden, adequate relief, anxiety/depression levels, and adherence. Volatile compound levels were measured using Gas Chromatography/Mass Spectrometry. Results: At both time points, the MED–LFD group showed a significantly greater improvement in symptom severity (159 ± 80 vs. 253 ± 94 and 168 ± 117 vs. 245 ± 98), responder rates (84.6% vs. 60.8% and 79.1% vs. 52.3%), and adherence (75% vs. 41% and 45% vs. 7%). Similar results were observed for all secondary endpoints, with no serious adverse events reported. The MED–LFD intervention was the strongest independent predictor of being a responder at the first (OR = 6.66; 95%CI = 1.46, 30.4) and second follow-up (OR = 4.85; 95%CI = 1.31, 17.96). Short and branched-chain fatty acids were significantly reduced at both follow-ups. Conclusions: The MED–LFD is superior to NICE recommendations in managing non-constipated IBS symptoms and quality of life. It remains to be proven that reduced volatile compound levels might be an objective marker of response to dietary interventions. ClinicalTrials.gov ID: NCT03997708. Full article