Search Results (223)

Diabetic foot ulcers (DFUs) are complex to heal and can lead to amputations and high healthcare costs. To address this, a promising alternative is the creation of electrospun fiber scaffolds for wound dressings. This study fabricated these scaffolds using a blend of natural polymers—chitosan (CTS), polyvinyl alcohol (PVA), and hyaluronic acid (HA)—along with antibacterial silver (Ag) and zinc oxide (ZnO) nanoparticles. The researchers conducted comprehensive analyses, including physicochemical, morphological, and biological assessments. The Ag structures showed potential as microbicidal agent, while the ZnO nanoparticles demonstrated photoactivity and the ability to generate reactive oxygen species (ROS) for antibacterial action. The resulting PVA-CTS-HA-Ag-ZnO scaffolds were found to be both hemocompatible and non-hemolytic, meaning they are safe for use with blood. The cytotoxicity evaluation using the ISO 10993-5 standard showed that the incorporation of CTS and HA decreased cytotoxicity of pure PVA, obtaining non-cytotoxic scaffolds (viability > 70%). Electrospun scaffolds composed with Ag-ZnO NPs in 50-50 and 70-30 ratios also maintained this biocompatibility, while the 30-70 ratio (Ag-ZnO) showed a cytotoxic effect, suggesting a ZnO concentration-dependent effect. These findings confirm that these materials are suitable for supporting skin cell regeneration, having a high potential for use as interactive dressings for treating chronic wounds. Full article

Background and Objectives: Thrombophilia is a prothrombotic disorder that increases the risk of blood clotting and can pose serious health problems. It is considered a condition of gene–gene or gene–environment interactions. Variation in the prevalence of thrombophilia mutations and their interaction among populations necessitates localized genetic assessments. However, population-based genetic data remains limited for developing effective preventive strategies. Materials and Methods: This cross-sectional observational study was conducted over five years (2020–2024) at a tertiary university hospital in Northern Greece. A total of 2961 individuals aged 18–85 years (mean: 50.5) were registered based on family or medical history of venous thromboembolism (VTE) or clinical symptoms of VTE. The final analysis included 2078 participants comprising 1143 males (55%) and 935 females (45%), who met all the inclusion criteria. Inclusion criteria were absence of acute illness or malignancy, informed consent, and an adequate DNA quantity for genotyping, whereas excluded criteria included incomplete laboratory data, active inflammatory or malignant disease, and cognitive or psychiatric conditions. Peripheral blood samples were collected in 2 mL K₃-EDTA tubes, and genomic DNA was analyzed using real-time polymerase chain reaction (PCR) with melting curve analysis and hybridization probes (LightMix^® in vitro diagnostics, TIB MolBiol, Berlin, Germany). Five thrombophilia-related polymorphisms, Factor V Leiden (F5 G1691A), prothrombin (F2 G20210A), methylenetetrahydrofolate reductase (MTHFR C677T and MTHFR A1298C), and Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G, were examined for allele and genotype frequencies, Hardy–Weinberg equilibrium testing, pairwise linkage disequilibrium (D′ and r²), and power analysis. For subjects tested for Factor V Leiden (n = 1476), the activated protein C resistance (APC) ratio was additionally evaluated using the ACL TOP 750 analyzer. Results: Allele frequencies were 7.3% for FV Leiden and 3.7% for FII. The PAI-1 allele was distributed at 44%, while the MTHFR (C677T and A1298C) alleles were each present at 33%. Significant linkage disequilibrium was identified between MTHFR (C677T and A1298C) and between MTHFR A1298C and PAI-1. No evolutionary pressure or demographic bias was found in the Hardy–Weinberg equilibrium. The APC ratio demonstrated a high sensitivity (99.2%) and specificity (96.6%), indicating that it may serve as a reliable screening method. Conclusions: Our findings highlight informative patterns in the genetic predisposition to thrombophilia, which may help develop rule-based strategies for implementing thromboprophylaxis guidelines and personalized medical interventions. Full article

Background: Obesity is a leading cause of type 2 diabetes (T2D), with particularly high prevalence in Hispanic populations residing in the USA. However, how genetic variation influences obesity-related blood metabolite levels which, in turn, contribute to T2D progression, is not well understood. Our goal was to identify and understand genetic and dietary connections between obesity and T2D in a Hispanic cohort of older adults. Materials and Methods: We conducted a genome-wide association study on 13 specific metabolites previously associated with T2D and characteristic of individuals with abdominal obesity within the Boston Puerto Rican Health Study cohort. We further examined associations of identified metabolite quantitative trait loci (mQTLs) and their interactions with targeted dietary factors on T2D prevalence and related traits. We used gene set and pathway analysis with protein–protein interaction networks to explore the molecular mechanisms underlying the metabolic connections between obesity and T2D. Results: We identified 30 single-nucleotide polymorphisms (SNPs) acting as mQTLs for these 13 metabolites. These mQTLs were located within 19 gene regions, associated with processes such as linoleic acid metabolism, alpha-linolenic acid metabolism, and glycerophospholipid biosynthesis. Although no mQTLs were directly associated with T2D or related traits, 12 demonstrated interactions with certain food groups that affect T2D risk. Moreover, gene set and pathway analysis with protein–protein interaction networks indicated that alpha-linolenic acid metabolism, lipid metabolism, and glycerophospholipid biosynthesis and metabolism among other pathways are potential connections between T2D and obesity. Conclusions: This study identifies biochemical relationships between genetic susceptibility and dietary influences, contributing to our understanding of T2D progression in Hispanic people with obesity. Full article

Micro-housing has gained prominence as a sustainable urban residential solution, yet the impact of its spatial design on occupants’ perceptual and physiological responses remains underexplored. This study employs a multimodal approach to investigate how three key spatial elements—spatial scale (SS), window-to-wall ratio (WWR), and interface material (IM)—influence human perception in micro-housing environments. A full-factorial experimental design with 12 distinct conditions was implemented in a controlled laboratory setting. We collected both subjective evaluations and multimodal physiological data—including electroencephalography (EEG), electromyography (EMG), skin conductance (SC), and blood volume pulse (BVP)—from 30 participants. Subjective results indicate that all three spatial elements significantly affect spatial perception and overall comfort, with the influence hierarchy being SS > WWR > IM. Notably, a compensatory effect was observed: increasing the WWR enhanced the perceived spatial area, particularly in mid-sized spaces. Physiologically, SS significantly influenced SC, WWR affected the EEG beta power ratio (BR), and IM impacted the EEG alpha/beta (A/B) ratio, corroborating the subjective findings. Interaction effects were also identified: SS interacted with WWR in area evaluation, and with IM in both area and window size evaluations. This study provides empirical evidence that spatial form elements directly and interactively shape human perception, offering practical insights for enhancing livability in micro-housing through design optimization. The integration of subjective and physiological metrics also establishes a robust methodological framework for future research on human-centered spatial design. Full article

Background and Objectives: The pathogenesis of thyroid eye disease (TED) is driven by interactions between orbital fibroblasts and immune cells. Lymphocyte-activation gene 3 (LAG-3) is an immune checkpoint molecule with a similar structure to the T lymphocyte CD4 receptor but with higher affinity for MHC class II, and LAG-3–MHC class II interaction inhibits T lymphocyte activity. Lymphocytes shed LAG-3, generating soluble LAG-3 (sLAG-3), whose function is unclear. We investigated sLAG-3 involvement in Graves’ disease (GD) and GD-associated TED pathogenesis. Materials and Methods: Patients with GD-associated TED (n = 47) and GD without TED (n = 35) were enrolled alongside 37 healthy controls (HCs). Peripheral blood serum sLAG-3 levels were measured using enzyme-linked immunosorbent assays and compared across the three groups. The effect of intravenous glucocorticosteroid (IVGC) treatment (12 weeks) on sLAG-3 concentrations in patients with GD-associated TED was monitored, and associations of sLAG-3 levels with clinical characteristics were analyzed. Disease activity before and after IVGC treatment was assessed using Clinical Activity Score. Results: Relative to those in HCs, serum sLAG-3 levels were significantly higher in GD patients both with (p < 0.001) and without (p = 0.0129) TED. No significant difference in sLAG-3 levels was observed between the two patient groups (p = 1.000), and no significant change in sLAG-3 levels was detected in patients with TED after IVGC therapy (p = 0.0536). Conclusions: The higher sLAG-3 levels in patients compared to HCs suggest that sLAG-3 dysregulation may contribute to GD and GD with orbitopathy development and the pathomechanisms underlying these conditions. Metalloproteinase-mediated cleavage of LAG-3 from the lymphocyte surface enables T lymphocyte proliferation and activation, while released sLAG-3 may enhance the immune response. Further studies of sLAG-3’s mechanisms of action are needed to establish clear cut-off values and to define the diagnostic role of sLAG-3 in GD diagnosis. Full article

The widespread production and poor management of plastic waste have led to the pervasive presence of microplastics (MPs) in environmental and biological systems. Among various polymers, polyethylene (PE) is the most widely produced plastic globally, primarily due to its use in single-use packaging. Its persistence in ecosystems and resistance to degradation processes result in the continuous formation of PE-derived MPs. These particles have been detected in human biological matrices, including blood, lungs, placenta, and even the brain, raising increasing concerns about their bioavailability and potential health effects. Once internalized, PE MPs can interact with cellular membranes, induce oxidative stress, inflammation, and apoptosis, and interfere with epigenetic regulatory pathways. In vitro studies on epithelial, immune, and neuronal cells reveal concentration-dependent cytotoxicity, mitochondrial dysfunction, membrane disruption, and activation of pro-inflammatory cytokines. Moreover, recent findings suggest that PE MPs can induce epithelial-to-mesenchymal transition (EMT), senescence, and epigenetic dysregulation, including altered expression of miRNAs and DNA methyltransferases. These cellular changes highlight the potential role of MPs in disease development, especially in cardiovascular, metabolic, and possibly cancer-related conditions. Despite growing evidence, no standardized method currently exists for quantifying MPs in human samples, complicating comparisons across studies. Further, MPs can carry harmful additives and environmental contaminants such as bisphenols, phthalates, dioxins, and heavy metals, which enhance their toxicity. Global estimates indicate that humans ingest and inhale tens of thousands of MPs particles each year, yet long-term human research remains limited. Given these findings, it is crucial to expand research on PE MP toxicodynamics and to establish regulatory policies to reduce their release. Promoting alternative biodegradable materials and improved waste management practices will be vital in decreasing human exposure to MPs and minimizing potential health risks. Full article

The aim of this study was to evaluate the haemostatic potential and biocompatibility of a newly developed composite material for its use in blood-contacting applications. Based on promising reports on polylactide (PLA), sodium alginate (ALG), and bioactive additives such as hardystonite (HT) and zinc sulphide (ZnS), a melt-blown PLA nonwoven was modified via dip-coating using an ALG solution as a matrix for incorporating HT and ZnS particles, resulting in the PLA-ALG-ZnS-HT composite. The material was characterised in terms of surface morphology, specific surface area, pore volume, average pore size, and zeta potential (pH~7.4). Haemostatic activity was assessed by measuring blood coagulation parameters, while biocompatibility was evaluated through the viability of human peripheral blood mononuclear (PBM) cells and human foreskin fibroblasts (Hs68). Genotoxicity was analysed using the comet assay and plasmid relaxation test. Results confirmed a uniform alginate coating with dispersed HT and ZnS particles on PLA fibres. The modification increased the surface area and pore volume and caused a shift toward less negative zeta potential. Haemostatic testing showed prolonged activated partial thromboplastin time (aPTT), likely due to Zn²⁺ interactions with clotting factors. Biocompatibility tests showed high cell viability and no genotoxic effects. Our findings suggest that the PLA-ALG-ZnS-HT composite is safe for blood and skin cells and may serve as an anticoagulant material. Full article

The design and development of scaffolds play a crucial role in tissue engineering. In this regard, the study aims to establish the influence of porosity on the morpho-structural, physical–chemical, and biochemical characteristics of the polylactic acid (PLA) and/or polycaprolactone (PCL) scaffolds, in order to be considered candidates for tissue reconstruction. The results indicated that binary PLA-PCL and PCL matrices are more suitable than PLA, due to their higher crystallization degree, this contributing to the superior mechanical properties and lower network defects. The preponderance of molecular interactions decreases with porosity. Porosity induced a decrease in the degree of crystallization of PLA-PCL and an increase in water, glucose and blood components uptake by 188, 178, and 28%, respectively. The PLA-PCL scaffold was found to be more stable to lipase action than neat PLA as a result of the reduced enzyme access due to the higher crystallinity and thermodynamic stability of the hydrocarbon linear chain in PCL, which is higher than that of the side methyl group in PLA. Lactobacillus growth increases with porosity and was more pronounced on the PLA-PCL matrix. All these results show that varying the porosity and composition of the polymer mixture leads to valuable materials with nutrient absorption capacity and biodegradability superior to neat PLA or PCL materials. Full article

Polymers and polymer composites offer versatile possibilities for engineering the physico-chemical properties of materials on micro- and macroscopic scales. This review provides an overview of polymeric and polymer-decorated particles that can serve as drug-delivery vectors: linear polymers, star polymers, diblock-copolymer micelles, polymer-grafted nanoparticles, polymersomes, stealth liposomes, microgels, and biomolecular condensates. The physico-chemical interactions between the delivery vectors and biological cells range from chemical interactions on the molecular scale to deformation energies on the particle scale. The focus of this review is on the structure and elastic properties of these particles, as well as their circulation in blood and cellular uptake. Furthermore, the effects of polymer decoration in vivo (e.g., of glycosylated plasma membranes, cortical cytoskeletal networks, and naturally occurring condensates) on drug delivery are discussed. Full article

Capacitive sensors are platforms that enable label-free, real-time detection at low non-perturbing voltages. These sensors do not rely on Faradaic processes, thereby eliminating the need for redox-active species and simplifying system integration for point-of-care diagnostics. However, their sensitivity in high-ionic-strength solutions, such as bodily fluids, is limited due to a reduced Debye length and non-specific interactions. The present review highlights advances in material integration, surface modification, and signal enhancement techniques to mitigate the challenges of deploying capacitive sensors in biofluids (sweat, saliva, blood, serum). This work further expands on the promise of such sensors for advancing liquid biopsies and highlights key technical challenges in translating capacitive systems to clinics. Full article

Background and Objectives: This study investigated whether the interaction between heavy alcohol use and depression amplifies the risk of hyperglycemia in psychiatric patients. Materials and Methods: We conducted a cross-sectional study on 172 patients (aged 18–65) hospitalized at the “Elisabeta Doamna” Clinical Psychiatric Hospital, Romania. The data included fasting blood glucose, gamma-glutamyl transferase (GGT), Beck Depression Inventory (BDI), and Alcohol Use Disorders Identification Test (AUDIT) scores. Results: Moderate positive correlations were observed between depression scores and blood glucose (r = 0.44) and between alcohol consumption and blood glucose (r = 0.43). The interaction term (BDI × AUDIT) was statistically significant in multiple regression (β = 0.012, p = 0.001), and the model explained 39.1% of glucose variability. Logistic regression analysis revealed that neither high alcohol consumption (OR = 1.38, p = 0.441) nor severe depression alone (OR = 1.30, p = 0.582) were significantly associated with hyperglycemia. However, their interaction demonstrated a strong and statistically significant effect (OR = 19.3, 95% CI: 3.22–115.81, p = 0.001). The prevalence of hyperglycemia reached 95.8% in patients with both risk factors. Conclusions: The combined presence of high alcohol consumption and severe depression significantly increases the risk of hyperglycemia. These findings highlight the importance of integrated screening and interventions in psychiatric settings. Full article

Introduction: The vascular architecture of the vocal folds plays a critical role in sustaining the dynamic demands of phonation. Disruptions in this microvascular system are linked to various pathological conditions, including Reinke’s edema, hemorrhage, and laryngeal carcinoma. This review explores the structural and functional components of vocal fold microvascularization, with emphasis on pericytes, endothelial interactions, and neurovascular regulation. Materials and Methods: A systematic review of the literature was conducted using databases such as PubMed, Scopus, Web of Science, and Embase. Keywords included “pericytes”, “Reinke’s edema”, and “vocal fold microvascularization”. Selected studies were peer-reviewed and met criteria for methodological quality and relevance to laryngeal microvascular physiology and pathology. Results: The vocal fold vasculature is organized in a parallel, tree-like pattern with distinct arterioles, capillaries, and venules. Capillaries dominate the superficial lamina propria, while transitional vessels connect to deeper arterioles surrounded by smooth muscle. Pericytes, present from birth, form tight associations with endothelial cells and contribute to capillary stability, vessel remodeling, and mechanical protection during vibration. Their thick cytoplasmic processes suggest a unique adaptation to the biomechanical stress of phonation. Arteriovenous anastomoses regulate perfusion by shunting blood according to functional demand. Furthermore, neurovascular control is mediated by noradrenergic fibers and neuropeptides such as VIP and CGRP, modulating vascular tone and glandular secretion. The limited lymphatic presence in the vocal fold mucosa contributes to edema accumulation while also restricting carcinoma spread, offering both therapeutic challenges and advantages. Conclusions: A deeper understanding of vocal fold microvascularization enhances clinical approaches to voice disorders and laryngeal disease, offering new perspectives for targeted therapies and regenerative strategies. Full article

Background and Objectives: Hyperthermia significantly limits endurance performance in hot environments. To enhance heat loss and optimize athletic performance, pre-cooling interventions can be employed to accelerate body cooling. Therefore, the aim of this study was to evaluate the effects of an internal pre-cooling intervention combined with external pre-cooling or hydrogen-rich water on endurance performance in the heat. Materials and Methods: In a double-blind crossover with counterbalanced trials, all participants underwent a shuttle run test after 30 min under the following conditions: (1) hydrogen-rich cold water ingestion (HRCW); (2) cold water ingestion and external pre-cooling (IEPC); and (3) cold-water ingestion (control). Maximal aerobic speed (MAS), number of shuttle run repetitions, dehydration, temperature, heart rate (HR), rate of perceived exertion (RPE), blood lactate, and feeling scale (FS) were measured during the 20 m shuttle run test. Results: Our results revealed a significant variation in dehydration, MAS, number of shuttle run repetitions, blood lactate, RPE, and FS (p = [0.001–0.036]); additionally, a significant group × time interaction was found for body temperature (p = 0.021). Post hoc tests revealed a significant change for MAS (HRCW: p < 0.001), number of shuttle run repetitions (HRCW: p < 0.001), dehydration (HRCW: p= 0.009; IEPC: p = 0.008), blood lactate (HRCW: p < 0.001; IEPC: p < 0.001), RPE (HRCW: p = 0.05; IEPC: p = 0.004), and FS (HRCW: p = 0.05; IEPC: p = 0.004), as well as a significant decrease in body temperature (IEPC: p < 0.001; HRCW: p = 0.028) compared to the control condition after the test. However, no significant differences were reported in HR among the different conditions. Conclusions: In conclusion, findings from this study suggest that ingesting hydrogen-rich cold water effectively mitigates the effects of heat stress, thereby improving endurance performance, enhancing mood, and reducing ratings of perceived exertion. Full article

Background and Objectives: Percutaneous liver radiofrequency ablation (RFA) under monitored anesthesia care (MAC) carries a risk of hypoxia due to respiratory depression. Ensuring adequate oxygenation during such procedures is essential for patient safety. This study aimed to evaluate whether a high-flow nasal cannula (HFNC) improves oxygenation compared to a simple facemask during RFA. Materials and Methods: In this prospective, randomized controlled trial, 51 patients undergoing ultrasound-guided RFA under MAC were allocated to receive oxygen via an HFNC (30 L/min) or a facemask (6 L/min). Arterial blood gases were collected at the baseline and 5 min after oxygenation. The primary outcome was the arterial partial pressure of oxygen (PaO₂). Secondary outcomes included hypoxia incidence (SpO₂ < 95%), the difference in the ratio of the arterial partial pressure of oxygen to the fraction of inspired oxygen concentration (ΔP/F ratio), the difference in the arterial partial pressure of carbon dioxide (ΔPaCO₂), respiratory rate (RR) changes, and patient satisfaction. Results: After adjustment for the baseline PaO₂, the HFNC group showed significantly higher intra-procedural PaO₂ compared to the facemask group (299 ± 18.6 vs. 194 ± 19.0 mmHg, p < 0.001). No significant differences were found in the ΔP/F ratio, ΔPaCO₂, or patient satisfaction. Among the secondary outcomes, RR was more stable in the HFNC group throughout the procedure (Group × Time interaction, p = 0.003). Conclusions: The HFNC significantly improved intra-procedural PaO₂ during RFA under MAC but did not reduce hypoxia incidence or improve other clinical outcomes compared to facemask oxygenation. The stability of RR observed with the HFNC may reflect a physiological advantage, though further studies are needed to determine its clinical relevance. Full article

Extracorporeal membrane oxygenation (ECMO) is a crucial life support therapy for patients with severe cardiac and respiratory failure. However, the complications associated with venoarterial ECMO (VA-ECMO), including thrombus formation, bleeding, and hemolysis, remain significant challenges that impact patient outcomes and healthcare costs. These complications primarily arise from blood–material interactions within the ECMO circuit, necessitating the development of biocompatible materials to optimize hemocompatibility. This review provides an updated overview of the latest advancements in VA-ECMO materials, focusing on cannula, oxygenators, and centrifugal pumps. Various surface modifications, such as heparin coatings, nitric oxide-releasing polymers, phosphorylcholine (PC)-based coatings, and emerging omniphobic surfaces, have been explored to mitigate thrombosis and bleeding risks. Additionally, novel oxygenator membrane technologies, including zwitterionic polymers and endothelial-mimicking coatings, offer promising strategies to enhance biocompatibility and reduce inflammatory responses. In centrifugal pumps, magnetic levitation systems and hybrid polymer-composite impellers have been introduced to minimize shear stress and thrombogenicity. Despite these advancements, no single material has fully addressed all complications, and further research is needed to refine surface engineering strategies. This review highlights the current progress in ECMO biomaterials and discusses future directions in developing more effective and durable solutions to improve patient safety and clinical outcomes. Full article