Search Results (303)

Background: Leukemic non-nodal variant mantle cell lymphoma (nnMCL) is an uncommon subtype of mantle cell lymphoma that lacks lymphadenopathy and generally follows an indolent clinical course. Adverse genetic alterations such as TP53 inactivation and del(13q) may have prognostic significance. Clinical findings such as splenomegaly may serve as a clue to the diagnosis and should prompt further evaluation. Case Presentation: We describe a 91-year-old woman who presented with a one-month history of anemia (hemoglobin 12.3 g/dL), mild thrombocytopenia (platelets 136 × 10⁹/L), isolated splenomegaly and no palpable lymphadenopathy. Despite a normal total white blood cell count, intermittent relative lymphocytosis with atypical lymphocytes (4%) and smudge cells was detected on the complete blood count. Peripheral blood flow cytometry demonstrated a monoclonal kappa-restricted B-cell population negative for CD5 and CD10, comprising approximately 20% of lymphocytes. Conventional karyotyping and fluorescent in situ hybridization (FISH) analysis identified del(13q), del(17p)/TP53, and IGH-CCND1 rearrangement in 8–19.5% of peripheral blood leukocytes. A month after the initial assessment, the patient presented following a fall. CT imaging of the abdomen revealed marked splenomegaly, a large subcapsular/perisplenic hematoma, and moderate-to-large hemoperitoneum. Emergent laparotomy showed an enlarged spleen (1490 g, 23 × 16 × 7.5 cm) with laceration. Histologic evaluation showed atypical lymphoid cells positive for CD20 and cyclin D1, with strong p53 expression, negative for CD5 and SOX11, and a low Ki-67 index. Similar involvement was identified in the small bowel and appendix. Targeted sequencing of splenic tissue, performed as part of a retrospective molecular characterization, identified a pathogenic TP53 variant (p.His179Gln). Conclusions: This case provides a rare opportunity to evaluate splenic and small intestinal involvement by nnMCL at both the gross and histologic levels. It highlights the importance of integrating clinical findings with flow cytometry, imaging, cytogenetic, and molecular data in establishing the diagnosis. Even when peripheral blood findings suggest a low disease burden, imaging may better define the extent of disease and support appropriate clinical assessment, particularly in elderly patients at risk for complications related to splenomegaly. Full article

Background/Objectives: This study evaluated carotid baroreflex sensitivity (cBRS) during graded exercise tests to exhaustion in healthy individuals. It aimed to elucidate whether the augmented blood pressure response during heavy- and maximal-intensity dynamic exercise alters carotid baroreflex control of heart rate and contributes to exercise intolerance. Methods: Thirteen healthy males (age 33 ± 2 yrs, body mass 74.6 ± 2.4 kg, and $\dot{V}$O_2max 54.12 ± 1.88 mL·kg⁻¹·min⁻¹) performed a 4 min constant-load cycling exercise at low—(30% PPO), moderate—(60% PPO), high—(80% PPO), and maximal—(100% PPO) intensity, in two experimental conditions: (a) with unrestricted muscle blood flow (no-BFR) and (b) with partial muscle blood flow restriction (BFR). Results: A significant decline in cBRS was observed during the graded maximal exercise test compared to baseline (p < 0.001), accompanied by an upward and rightward relocation of the linear relationship between systolic blood pressure (SBP) and heart rate (HR). However, the magnitude of cBRS reduction was attenuated towards maximum exercise. Application of BFR during exercise exaggerated the blood pressure rise (p < 0.01), the perceptual response (p < 0.001), the exercise-induced cBRS reduction (p < 0.001), and induced a further relocation of the SBP-HR relationship. Additionally, BFR limited the HR increase and resulted in reduced exercise performance compared to the no-BFR condition. Conclusions: These findings suggest that the pronounced increase in blood pressure during heavy- and maximal-intensity exercise may limit further increases in heart rate through arterial baroreflex activation. This may contribute to reduced exercise tolerance, as evidenced by the lower peak power output and attenuated maximal heart rate observed in muscle BFR condition. Full article

Computational fluid dynamics (CFD)-based simulation of coronary blood flow provides valuable hemodynamic markers, such as pressure gradients, for diagnosing coronary artery disease (CAD). However, CFD is computationally expensive, time-consuming, and difficult to integrate into large-scale clinical workflows. These limitations restrict the availability of labeled hemodynamic data for training AI models and hinder the broad adoption of non-invasive, physiology-based CAD assessment. To address these challenges, we develop an end-to-end pipeline that automates coronary geometry extraction from coronary computed tomography angiography (CCTA), streamlines simulation data generation, and enables efficient learning of coronary blood pressure distributions. The pipeline reduces the manual burden associated with traditional CFD workflows while producing consistent training data. Furthermore, we introduce a diffusion-based regression model. Specifically, the inverted conditional diffusion (ICD) model is designed to predict coronary blood pressure directly from CCTA-derived features, thereby bypassing the need for computationally intensive CFD during inference. The proposed model is trained and validated on two CCTA datasets using the Adam optimizer with a weight decay of $1\times {10}^{-3}$, a learning rate of $1\times {10}^{-5}$, a batch size of 100, and Huber loss. It is then evaluated on a test set of ten simulated coronary hemodynamic cases. Experimental results demonstrate state-of-the-art performance. Compared with Long Short-Term Memory (LSTM), the proposed model improves the $R^2$ score by 19.78%, reduces the root mean squared error (RMSE) by 19.44%, and lowers the normalized root mean squared error (NRMSE) by 18%. Compared with a multilayer perceptron (MLP), it improves the $R^2$ score by 8.38%, reduces RMSE by 4.3%, and reduces NRMSE by 5.4%. This work represents a first step toward a scalable and accessible framework for rapid, non-invasive, CFD-based blood pressure prediction, with the potential to support CAD diagnosis. Full article

Background: Blood flow restriction training (BFRT) is a low-load resistance training modality capable of inducing muscle hypertrophy and strength adaptations that are comparable to traditional high-load resistance training. Beyond athletic performance settings, BFRT has growing relevance for musculoskeletal health, rehabilitation and populations unable to tolerate high mechanical loads. However, substantial inter-individual variability in adaptive responses has been reported. Genetic and molecular factors may partly contribute to this variability and inform more individualised exercise strategies. Other intrinsic and extrinsic factors, including age, sex, training status, nutrition, and protocol-related differences, may also influence adaptive responses. Objective: This scoping review aimed to map available evidence on molecular modulators of adaptation to BFRT and to identify gaps in the literature regarding genetic influences on BFRT responses. Methods: A structured search of PubMed, Web of Science and Google Scholar was conducted till 1 February 2026. Experimental and quasi-experimental studies examining BFRT in relation to genetic polymorphisms, gene expression, and molecular signalling pathways associated with strength and hypertrophy outcomes were included. Primary outcomes were genetic and molecular factors relevant to BFRT adaptation, including genetic polymorphisms, gene expression, and molecular signalling markers. Secondary outcomes included muscle strength, hypertrophy, vascular responses, and related functional outcomes where reported. Study selection and data extraction were conducted according to PRISMA-ScR guidelines. The methodological quality of randomised controlled trials was assessed using the PEDro scale. This scoping review was registered retrospectively in the Open Science Framework on 17 March 2026, after completion of the literature search. Results: From an initial 47 records, only three studies (n = 3) met the inclusion criteria. The included studies reported molecular responses associated with BFRT, including downregulation of proteolytic genes, suppression of myostatin expression, and upregulation of angiogenic markers. Notably, no studies directly examined genetic polymorphism or genotype–BFRT interactions, highlighting a clear need for these studies in this field. Conclusions: This scoping review therefore identifies a critical evidence gap, with genotype-informed BFRT prescription remaining unsupported by the current literature. Limited evidence supports the possible role of BFRT in molecular responses associated with muscle adaptation. Future research should prioritise well-designed studies integrating both genetic and molecular analyses to better understand inter-individual variability in BFRT adaptations. Full article

Background: Blood flow restriction (BFR) resistance exercise has emerged as a training methodology capable of inducing muscular adaptations comparable to traditional high-load training despite substantially lower mechanical loads. While low-load BFR protocols (20–50% 1RM) are well-established, emerging evidence supports applications across the full loading spectrum, including moderate-to-high loads (>50–90% 1RM), contralateral training effects, and proximal–distal adaptations. In this second installment of the Blood Flow Restriction in Athletic Populations series, we review current evidence on BFR resistance exercise in athletic populations, with emphasis on morphological, neuromuscular, and functional adaptations across diverse application contexts. Methods: A narrative review of research examining BFR resistance exercise in trained and athletic populations was conducted via a PubMed/MEDLINE search. Search terms: (“blood flow restriction” OR “BFR” OR “occlusion training” OR “KAATSU”) AND (“resistance training” OR “resistance exercise” OR “strength training”) AND (“athletes” OR “athletic” OR “trained” OR “elite” OR “sport”) AND (“cross-education” OR “contralateral” OR “cross transfer” OR “proximal” OR “distal”). Studies investigating low-load (20–50% 1RM) and moderate-to-high load (>50% 1RM) protocols, contralateral cross-education effects, and proximal–distal adaptations were evaluated. Primary outcomes included muscle hypertrophy, strength, power, and sport-specific performance measures. Results: Low-load BFR resistance exercise has been shown to produce significant improvements in muscle hypertrophy and strength gains over 4–12 week interventions compared to low-load control conditions. Moderate-to-high load BFR enhanced barbell velocity and power output, particularly at loads > 80% 1RM with intermittent inflation protocols. Contralateral and cross-transfer effects of BFR training demonstrate variable efficacy across muscle groups, with the most consistent evidence supporting cross-transfer enhancement of training adaptations when BFR is applied to one body region while exercising another. Proximal BFR application induced adaptations in both proximal and distal musculature, suggesting systemic mechanisms beyond local vascular restriction. Conclusions: BFR resistance exercise represents a versatile training modality producing meaningful morphological and neuromuscular adaptations across the loading spectrum. Contralateral and proximal–distal effects expand practical applications for injury rehabilitation and targeted adaptation. These findings support BFR integration within periodized training programs when mechanical load management is prioritized. Full article

Background: Blood flow restriction (BFR) training induces morphological and neuromuscular adaptations using low-intensity exercise (20–40% 1RM), offering a reduced mechanical load alternative to traditional high-load resistance training. Safe and effective implementation, however, requires a clear understanding of physiological mechanisms, contraindications, and pressure determination methodologies. In this three-part series, we provide a comprehensive review of BFR for athletic populations and provide strength and conditioning coaches with a structured framework for screening, safety, and methodological considerations to support BFR integration in high-performance settings. Methods: A narrative review of the literature examining BFR safety, contraindication screening, adverse event reporting, and occlusion pressure determination was conducted using a PubMed and MEDLINE search. Search terms included combinations of (“blood flow restriction” OR “BFR” OR “occlusion training” OR “KAATSU”) AND (“safety” OR “contraindications” OR “risk stratification”) AND (“arterial occlusion pressure” OR “limb occlusion pressure” OR “occlusion pressure” OR “Doppler” OR “handheld Doppler” OR “pulse oximetry” OR “cuff width” OR “capillary refill time” OR “monitoring”). Studies examining contraindication screening systems, arterial occlusion pressure calculation methods, and real-time monitoring protocols were evaluated. Primary considerations included risk stratification frameworks, pressure determination accuracy, and control parameter validation for ensuring vascular safety during application. Results: Risk stratification systems can effectively identify absolute and relative contraindications requiring medical clearance prior to BFR use. Epidemiological data indicate that adverse events are transient and non-serious, while serious events appear rare when evidence-informed protocols are applied. Doppler-based assessment remains a criterion approach for determining inflation pressure, although validated estimation methods using limb circumference and systolic blood pressure offer a pragmatic and comparable alternative for applied environments. Inflation pressures of 50–80% arterial occlusion, adjusted for cuff width, produce effective and safe stimulus. Real-time monitoring through capillary refill time, pulse strength palpation, and skin coloration can support iterative pressure optimization and help identify excessive restriction pressures. Conclusions: BFR implementation in athletic populations requires systematic screening protocols, individualized inflation pressure determination using validated methods, and real-time monitoring parameters. These foundations provide the essential safety infrastructure required before progressing to specific training applications across resistance, cardiovascular, and other performance and rehabilitation modalities. Full article

Brain metastases are the third most common metastatic site in melanoma patients, with 40% of melanoma patients developing melanoma brain metastasis (MBM). Symptomology of MBM ranges from headaches, neurological deficits, cognitive changes, and seizures, resulting from MBM embedding in areas of highest blood flow following the breakdown of the blood–brain barrier (BBB) via genetic, cytokine, and molecular processes. The BBB is highly restrictive, making MBM difficult to treat. Challenges in MBM treatment are evident in adverse therapeutic effects, such as neurocognitive decline with whole-brain radiation therapy (WBRT), increased risk of radiation necrosis with stereotactic radiosurgery (SRS), and reduced penetration into the brain, which can lead to drug resistance with prolonged use of MAPK inhibitors. This review investigates current and novel treatments against MBM, including radiotherapy, chemotherapy, targeted therapies such as BRAF/MAPK inhibitors, and immunotherapy. Full article

Remote photoplethysmography (rPPG) extracts physiological signals from facial videos by analyzing subtle skin color variations caused by blood flow. While this technology enables contactless health monitoring, it also raises privacy concerns because facial videos reveal both identity and sensitive biometric information. Existing privacy-preserving techniques, such as blurring or pixelation, degrade visual quality and are unsuitable for practical rPPG applications. This paper presents rePPG, a framework that inserts a desired rPPG signal into facial videos while preserving the original facial appearance. The proposed method disentangles facial appearance and physiological features, enabling replacement of the physiological signal without altering facial identity or visual quality. Skin segmentation restricts modifications to skin regions, and a cycle-consistency mechanism ensures that the injected rPPG signal can be reliably recovered from the generated video. Importantly, the extracted rPPG signals are evaluated against the injected target physiological signals rather than the subject’s original physiological state, ensuring that the evaluation measures signal rewriting accuracy. Experiments on the PURE and UBFC datasets show that rePPG successfully embeds target PPG signals, achieving 1.10 BPM MAE and 95.00% PTE6 on PURE while preserving visual quality (PSNR 24.61 dB, SSIM 0.638). Heart rate metrics are computed using a 5-second temporal window to ensure a consistent evaluation protocol. Full article

Protein-losing enteropathy (PLE) is an uncommon and often underrecognized manifestation of lymphoproliferative disorders and may be difficult to diagnose when conventional gastrointestinal investigations are unrevealing. We present an 82-year-old woman with recurrent hospital admissions initially spanning six months for diarrhea, weight loss, peripheral edema, and persistent hypoalbuminemia. Initial upper gastrointestinal endoscopy was normal, and colonoscopy was deferred due to intercurrent infection. Despite extensive laboratory and radiologic evaluation, including routine biochemical testing and imaging, the etiology of PLE remained unclear. Peripheral blood flow cytometry subsequently identified a small kappa-restricted monoclonal B-cell population compatible with marginal zone lymphoma, later confirmed on bone marrow biopsy, raising suspicion for gastrointestinal involvement. Video capsule enteroscopy demonstrated diffuse erosive and ulcerative disease throughout the small intestine, providing an anatomical explanation for the patient’s protein loss. Following lymphoma-directed therapy, repeat capsule enteroscopy showed complete normalization of the small bowel mucosa. This case highlights the diagnostic value of combining peripheral blood flow cytometry and capsule endoscopy in unexplained protein-losing enteropathy, a rare and diagnostically challenging presentation of indolent lymphoma, and illustrates the role of capsule imaging in both disease localization and treatment monitoring. As a single-case report, these findings are not generalizable, and further studies are required to evaluate the broader applicability of this diagnostic approach. Full article

Background/Objectives: Glioblastoma multiforme (GBM) is the most infiltrative, treatment-resistant, and deadly brain tumor in adults. Given the extremely malignant phenotype of the GBM cells, the high intratumoral heterogeneity, and the limited efficacy of the vast majority of chemotherapeutics due to the restrictive nature of the blood–brain barrier, GBM remains largely incurable. Methods: Utilizing the U87, U251, and T98G GBM cell lines, diverse in vitro approaches (Western blotting, quantitative real-time PCR, flow cytometry, immunofluorescence, Luc-reporter analysis, microscopic examination, and scanning electron microscopy), and pharmacological inhibition, we investigated for the first time the cell death decisions in the GBM cells in response to the LCS1269 treatment. Results: We showed that LCS1269 collapsed the mitochondrial potential and triggered both intrinsic and extrinsic apoptosis. Importantly, our findings demonstrated that LCS1269-mediated apoptosis was paralleled by an induction of both MLKL-dependent necroptosis and caspase-3/GSDME-dependent pyroptosis. Using a combination of specific inhibitors, we further demonstrated that apoptosis, necroptosis, and pyroptosis provoked by LCS1269 occur simultaneously and orchestrate a peculiar form of programmed cell death, which is known as PANoptosis. We subsequently found that LCS1269-induced PANoptosis may be initiated either through the RIPK1-PANoptosome alone or through the integrated ZBP1-, AIM2-, and RIPK1-PANoptosomes. Additionally, we revealed that LCS1269-mediated PANoptosis may be closely related to micronuclei formation. Conclusions: Taken together, our results confirm that LCS1269 is a promising anti-glioblastoma agent that is capable of effectively promoting GBM cell death via PANoptosis. Full article

Articular cartilage, a highly specialised and avascular tissue, exhibits limited regenerative potential following trauma or degenerative conditions such as osteoarthritis (OA). Conventional surgical interventions, including microfracture and autologous chondrocyte implantation (ACI), have shown limited long-term efficacy due to donor site morbidity and restricted cell proliferation. In this context, mesenchymal stromal cells (MSCs) have emerged as a promising alternative owing to their multipotency, self-renewal capacity, and low immunogenicity. While bone marrow (BM) remains the traditional source of MSCs, recent studies have reported that peripheral blood-derived mesenchymal stromal cells (PB-MSCs) may possess chondrogenic, osteogenic, and adipogenic potential comparable to that of BM-derived MSCs. PB-MSCs can be harvested through minimally invasive methods, thereby avoiding the complications associated with BM aspiration. Experimental evidence indicates that PB-MSCs exhibit strong cell viability, proliferative potential, and the ability to synthesise cartilage-specific extracellular matrix proteins, such as type II collagen and sulphated glycosaminoglycans, within three-dimensional scaffolds. Immunophenotypically, PB-MSCs express mesenchymal markers including CD29, CD44, CD90, and CD105 while lacking hematopoietic markers CD34 and CD45. Flow cytometry analyses reveal that CD105⁺ populations increase following cryopreservation, highlighting their clinical utility. In contrast to these experimentally defined PB-MSCs, the term peripheral blood stem cells (PBSCs) is used in clinical studies to describe heterogeneous, non-cultured peripheral blood-derived cell preparations, typically enriched in hematopoietic stem and progenitor cells following granulocyte colony-stimulating factor (G-CSF) mobilisation, without full mesenchymal characterisation. In vitro studies confirm successful tri-lineage differentiation, whereas in vivo investigations have demonstrated effective cartilage regeneration using PB-based clinical approaches, including postoperative intra-articular administration of hyaluronic acid (HA) combined with PBSCs, as well as implantation of PBSCs covered with a collagen membrane. Furthermore, advancements in biomaterial engineering, such as poly(ethylene glycol)–cysteine–arginine–glycine–aspartic acid (PEG-CRGD) hydrogels, have enhanced PB-MSC adhesion, proliferation, and chondrogenic differentiation while promoting immunomodulation through M2 macrophage polarisation. Despite these promising outcomes, the available evidence remains limited and heterogeneous, with substantial variability in cell definitions, experimental models, and clinical study designs, which currently constrains definitive conclusions regarding clinical efficacy. Future research should focus on optimising isolation protocols, understanding molecular pathways governing PB-MSC chondrogenesis, and standardising clinical applications. Overall, PB-MSCs represent a viable, less invasive, and translationally relevant cell source for cartilage regeneration and regenerative orthopaedic therapies Full article

Normal pregnancy is associated with uterine and vascular remodeling by matrix metalloproteinases (MMPs) to facilitate placental blood flow and uterine expansion for the growing fetus. Increases in MMP-2 and MMP-9 in response to estrogen and progesterone promote placentation, uteroplacental vascularization and fetal growth during healthy pregnancy, but are altered in preeclampsia (PE). PE is characterized by hypertension in pregnancy (HTN-Preg) and fetal growth restriction (FGR). Predisposing genetic, demographic and environmental factors alter uteroplacental MMPs, immune response and integrins leading to apoptosis of invasive trophoblasts, inadequate spiral arteries remodeling, and reduced uteroplacental perfusion pressure (RUPP). Ensuing placental ischemia causes imbalance between anti-angiogenic soluble fms-like tyrosine kinase-1 (sFlt-1) and pro-angiogenic placental growth factor (PlGF) and promotes the release of tumor necrosis factor-α (TNF-α), hypoxia-inducible factor, reactive oxygen species, and angiotensin AT₁ receptor agonistic autoantibodies. Systemically, these bioactive factors target vascular endothelial cells, smooth muscle cells, and extracellular matrix, causing endothelial dysfunction, vasoconstriction, inadequate vascular remodeling, and HTN-Preg, while locally they diminish uteroplacental remodeling and cause FGR. In support, animal models of HTN-Preg induced by RUPP or infusion of sFlt-1 or TNF-α show decreases in vascular MMP-2, MMP-9 and vasodilation, increases in MMP-1, MMP-7 and vasoconstriction, collagen accumulation, and arterial stiffness. Also, decreases in uterine MMP-2 and MMP-9 could impede uterine expansion and lead to preterm birth. Conversely, PlGF and TNF-α antagonist reversed MMPs imbalance and collagen accumulation, and improved vascular function, blood pressure, and pup weight in HTN-Preg models. Persistent postpartum changes in MMPs could affect maternal hemorrhage, future pregnancies, and HTN, and cause fetal programming of cardiovascular and metabolic diseases. Understanding the aberrant uteroplacental and vascular signaling and remodeling by MMPs could help design new biomarkers and remedies for PE. Targeting bioactive factors and rectifying MMP imbalance could improve vascular and uteroplacental remodeling, and manage HTN-Preg, FGR and PE. Full article

Background: Meniscal injuries are common athletic injuries, and isolated meniscal repair is a critical procedure for restoring knee function. However, rehabilitation protocols after meniscal repair remain controversial. This systematic review aimed to evaluate rehabilitation protocols to determine the best strategies for enhancing recovery following isolated meniscal repair. Objectives: Analyze current rehabilitation protocols following isolated meniscal repair, focusing on the efficacy of approaches in improving functional outcomes and reducing recovery time. This study also aims to identify gaps in the existing literature and provide recommendations for future studies. Data sources: Search was conducted using PubMed, Scopus, and Web of Science databases, covering studies published between May 2015 and May 2024. Inclusion criteria: Studies reporting on isolated meniscal repair with defined postoperative rehabilitation protocols and quantifiable outcome measures. Data extraction: Focused on patient demographics, meniscal tear types, repair techniques, and rehabilitation outcomes. The methodological quality of the included studies was assessed, and narrative synthesis was conducted. Results: The review included 13 studies with significant variability in rehabilitation protocols and outcomes. Early weight-bearing and range of motion exercises have been associated with improved recovery in some studies for stable meniscal tears. However, conservative approaches have better outcomes in patients with complex tears. The use of adjunctive therapies such as blood flow restriction training has demonstrated potential in enhancing muscle preservation and overall recovery. Conclusions: Rehabilitation protocols after meniscal repair surgery should be individualized. Although innovative protocols show promise, further research is needed to standardize rehabilitation approaches and optimize long-term outcomes. Full article

Background: Adipose tissue is a crucial endocrine organ, and obesity, due to its associated chronic inflammation and oxidative stress, disrupts adipokine secretion. These adipokines can be detected not only in blood but also in saliva. Dietary changes are a crucial part of managing obesity, encompassing a balanced diet, increased physical activity, and lifestyle modifications. Moreover, adding functional foods like amaranth and canola oils, recognized for their health benefits, may further improve metabolic and inflammatory health. These products have anti-inflammatory effects and may help reduce the pro-inflammatory activity of adipose tissue, thereby improving systemic and oral health. The study aimed to assess the impact of a 3-week calorie-restricted diet, supplemented with canola or amaranth oil on salivary adipokines, i.e., serpin A12, plasminogen activator inhibitor-1 (PAI-1), and tumor necrosis factor receptor-1 (TNF-R1), pH, and salivary flow in obese patients. Methods: A total of 115 adults with obesity (BMI > 30 kg/m²) were enrolled and placed on a 3-week calorie-restricted diet. The study group (n = 44) received additional supplementation: 21 participants received 20 mL of canola oil daily, and 23 received 20 mL of amaranth oil. The control group (n = 71) followed the same calorie-restricted diet without oil supplementation. Non-stimulated saliva was collected twice, for 20 min each time, before and after the intervention, to evaluate flow rate, pH, and concentrations of serpin A12, PAI-1, and TNF-R1. Concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Results: An increase in saliva flow rate was observed in patients supplemented with amaranth oil (p = 0.0367). Both the amaranth oil and canola oil groups showed a significant rise in salivary pH (p = 0.0425). Across all participants, the 3-week calorie-restricted diet resulted in a reduction in salivary PAI-1 (p = 0.0339), serpin A12 (p = 0.0001), and TNF-R1 (p = 0.0058). Conclusions: The 3-week calorie-restricted diet contributed to a decrease in the concentration of adipokines in saliva. The low-calorie diet, combined with supplementation of amaranth and canola oils, increased salivary flow and resulted in higher pH values, indicating greater alkalinity. Full article

Fluorescence emission-guided blood flow and lymph node location detection are important observation methods in cancer removal surgery, where near-infrared LED illumination is used to induce fluorescence emission. However, conventional LED light sources have narrow beam widths, resulting in a limited excitation area and a restricted field of view (FOV). In this study, we propose a balanced optical illumination module that combines a beam-focusing condenser lens and a beam-diffusing lens to expand the beam width while efficiently redistributing optical energy. When only the LED was used, the beam diameter and central irradiance were 4.0 cm and 1.43 mW/cm², respectively. With the condenser lens, the beam diameter remained nearly unchanged (3.98 cm), while the central irradiance decreased to 0.91 mW/cm². When the condenser was combined with the proposed diffuser structure, the beam diameter increased to 14.1 cm, corresponding to an approximately 3.5-fold expansion, while the central irradiance was measured at 0.72 mW/cm², reflecting the redistribution of optical energy from an initially Gaussian-like irradiance distribution into a wider and more uniform illumination area. This irradiance level exceeds the minimum threshold of 0.6 mW/cm² required to induce fluorescence emission, as defined for the experimental working distance of 30 cm and LED power of 200 mW. By integrating the irradiance distributions of both the bare LED and the proposed structure over their respective illuminated surfaces, the measured total power is physically consistent with energy conservation, showing an expected transmission loss of 18.8% due to optical absorption and scattering. These results demonstrate that the proposed beam diffusion-concentration approach provides an effective and practical solution for wide-field fluorescence-guided lesion observation during cancer removal surgery. Full article