Search Results (4,326)

There are no studies that have investigated factors influencing the outcome of dressage horses with suspensory ligament (SL) branch injuries. The aim was to determine if age, breed, work level, injury severity, anatomical localisation of injury, number of injured branches, periligamentous fibrosis, persistence of power Doppler signal or coexistent osteoarthritis of a metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joint influenced the prognosis of 70 dressage horses. Outcome was defined as good (return to pre-injury level of work or higher), poor (return to a lower level of work) or retirement. Chi-squared or Fisher’s exact test and the Kruskal–Wallis test were used to identify relationships between variables of interest and follow-up outcome. Follow-up outcome was good in 44/70 horses (62.9%), poor in 13/70 (18.6.%) and 13/70 horses (19.1%) were retired due to no response to treatment. Ultrasonographic lesion grade (p = 0.07), cross-sectional area (CSA) of the SL (p = 0.96), CSA of the lesion (p = 0.28) and the lesion CSA as a percentage of the SL CSA (p = 0.40) were not associated with outcome. Power Doppler signal was present in 75.8% of injured branches at the initial examination. The severity of power Doppler signal was not associated with outcome (p = 0.20); however, persistence of power Doppler signal was negatively associated with outcome (p < 0.001). Other variables did not influence the follow-up outcome. Early recognition of SL branch injury is likely to result in a more favourable outcome with appropriate treatment and management. Full article

Background: In patients with permanent atrial fibrillation, hypertension and diabetes frequently coexist and contribute to adverse cardiovascular outcomes. Beyond traditional clinical outcomes, health-related quality of life has become an essential measure of disease burden. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a validated patient-reported outcome instrument widely used in cardiovascular populations, but its role in hypertensive diabetics has not been systematically explored. This study aimed to evaluate the impact of diabetes on patient-reported quality of life in hypertensive individuals with permanent atrial fibrillation and identify clinical determinants of impaired health status. Methods: We conducted a retrospective study on hypertensive patients with permanent atrial fibrillation hospitalized between January 2021 and December 2023 at the County Emergency Clinical Hospital of Timișoara. Patients completed the KCCQ during admission and were stratified into hypertension without diabetes (HTN-only, n = 89) and hypertension with type 2 diabetes (HTN + DM, n = 109). Demographic, laboratory, and echocardiographic data were analyzed. The primary outcome was the difference in KCCQ scores between groups. Multivariable regression identified independent predictors of quality of life, and logistic regression with ROC analysis evaluated predictors of low KCCQ (<50). Results: Among 198 patients (109 with diabetes, 89 without), mean KCCQ was lower in HTN + DM versus HTN-only patients (50.9 ± 11.3 vs. 54.9 ± 14.4, p = 0.034). Diabetic patients had worse renal function, higher uric acid, and greater inflammatory burden. KCCQ correlated positively with eGFR (r = 0.43, p < 0.001) and negatively with creatinine, urea, neutrophil percentage, left atrial volume, and age. In multivariable analysis, diabetes was not an independent predictor, whereas reduced eGFR, higher neutrophils, larger atrial volume, and HFrEF were significant determinants. Logistic regression for low KCCQ showed good discrimination (AUC 0.78, 95% CI: 0.72–0.84). Conclusions: Diabetes worsens health-related quality of life in hypertensive patients with permanent atrial fibrillation primarily through renal dysfunction, inflammation, and cardiac remodeling. Targeting these pathways may improve both outcomes and patient-perceived health. Full article

Background: Mitral annular disjunction (MAD) is an anatomical abnormality associated with an increased risk of major arrhythmic events, regardless of the presence of mitral valve prolapse. Cardiac magnetic resonance (CMR) plays a key role in diagnosing MAD and identifying myocardial fibrosis, a marker of arrhythmic vulnerability. Aim: This study reports the experience of the De Gasperis Cardiology Centre at Niguarda Hospital (Milan, Italy) in managing high-risk MAD patients who underwent implantable cardioverter–defibrillator (ICD) implantation and describes their main clinical characteristics. Methods: Between January 2020 and April 2025, five patients with MAD who received ICDs were identified and monitored remotely. Although the small sample size limits generalizability, the objective was to characterize factors associated with arrhythmic susceptibility. Results: Four patients exhibited documented ventricular arrhythmias: two with non-sustained and two with sustained ventricular tachycardia. Notably, CMR did not reveal myocardial fibrosis in two symptomatic cases, suggesting that arrhythmic vulnerability may precede detectable structural abnormalities. The observed coexistence of MAD with arrhythmogenic cardiomyopathies and channelopathies underscores the relevance of comprehensive genetic evaluation in these patients. Conclusions: MAD should be considered a potential arrhythmogenic substrate rather than a benign anatomical variant. A multimodal diagnostic approach and individualized risk stratification—potentially integrating genetic findings—are essential for optimal patient management. Full article

Background: Despite repeated re-emergence of Sudan ebolavirus (SUDV), its long-term human toll remains under-characterised. We assessed multisystem clinical, biochemical, and psychosocial outcomes ~25 years after the 2000 Gulu outbreak. Methods: We conducted a cross-sectional evaluation of 45 survivors of laboratory-confirmed SUDV and 30 age- and gender-matched community controls from the same region. Symptoms were assessed as current at the study visit using a structured checklist; for each symptom present, we recorded severity and duration from onset to the visit date. Standardised clinical examinations, haematological and biochemical assessments, anxiety and depression screening, and structured interviews on social support and stigma were performed. Group comparisons were assessed with Wilcoxon rank-sum and χ²/Fisher’s exact tests; correlations were assessed with Spearman’s ρ. Findings: Core physiological indices (vital signs, BMI, blood pressure, and body temperature) and mental health were comparable between survivors and controls. Nevertheless, survivors reported ongoing symptoms, including joint pain and visual impairment each in 36% (16/45), fatigue in 18% (8/45), and neurological symptoms in 13% (6/45). Subclinical laboratory deviations centred on hepatic and platelet biology: elevated total bilirubin occurred in 14% of survivors versus 6.7% of controls; thrombocytopenia or platelet morphological abnormalities in 12% versus 3.3%; haemoglobin abnormalities in 6% versus 0%. Among survivors, albumin and mean platelet volume declined with age (both p ≤ 0.03). Psychological morbidity was low (normal anxiety 82% (37/45; and normal depression 80% (36/45). Yet a social paradox emerged, despite universal post-outbreak support, 98% (44/45) described enduring stigma. To minimise differential recall bias, symptom inventories were not collected from controls; consequently, between-group comparisons for symptom prevalence were not performed, and symptom inferences are restricted to survivors and framed descriptively. Interpretation: A quarter-century after infection, SUDV survivors show preserved systemic physiology but carry chronic musculoskeletal, sensory, and neurological sequelae, alongside a discrete subclinical profile implicating hepatic function and platelet biology. Psychological resilience coexists with near-universal, persistent stigma, indicating that material support did not achieve full psychosocial reintegration. Given the lack of virological and deep immune profiling, proposed pathogenetic mechanisms, such as antigen persistence or immune-mediated injury, remain speculative and hypotheses-generating only. These findings argue for survivor-centred long-term care, embedded with epidemic preparedness frameworks that integrate musculoskeletal rehabilitation, ophthalmic and neurological services with comprehensive mental health care, and sustained anti-stigma community engagement. This dissociation, including short-lived support alongside enduring stigma, indicates that humanitarian relief alone does not secure durable psychosocial reintegration and should be complemented by long-horizon, survivor-centred services and community engagement. Funding: This study was supported by the Coalition for Epidemic Preparedness Innovations (CEPI) under the Universal Protocol for Standardising Assays and Advancing Vaccine Immunogenicity Assessments for Emerging and Re-emerging Viral Threats, implemented through the Uganda Virus Research Institute (UVRI) as part of CEPI’s Centralised Laboratory Network (CLN). Full article

Forest–wetland ecotones are transitional ecosystems characterized by pronounced hydrological and biogeochemical heterogeneity, yet the microbial mechanisms regulating nutrient cycling in these zones remain insufficiently understood. This study investigated how vegetation transitions across a forest–wetland ecotone in the black-soil region of Northeast China shape soil microbial communities and nitrogen–cycling functions. Soils were collected from four vegetation types: mixed forest (MF), coniferous forest (CF), wetland edge (WE), and natural wetland (NW). Quantitative PCR was used to quantify key nitrogen–cycling functional genes (nifH, amoA, amoB, norB, nosZ), and PICRUSt2 was applied to predict microbial functional potentials. Forest soils (MF and CF) exhibited higher microbial diversity, stronger network connectivity, and greater abundances of nifH and amoA, indicating enhanced nitrogen fixation and nitrification under oxic conditions. In contrast, wetland soils harbored denitrification-enriched communities with higher norB and nosZ abundances but lower diversity. The WE vegetation type acted as a functional hotspot where alternating oxic–anoxic conditions facilitated the coexistence of nitrifiers and denitrifiers, thereby enhancing carbon–nitrogen coupling and functional resilience. Redundancy and Mantel analyses identified soil organic carbon, total nitrogen, water content, and enzyme activities as major environmental drivers of microbial structural and functional variation. This study reveals that vegetation transitions reorganize microbial community assembly and nitrogen-cycling functions through hydrological and biogeochemical heterogeneity, providing mechanistic insights into nutrient turnover and ecological regulation in black-soil ecotones. Full article

Religion has played a significant role in shaping social cohesion by providing stability and support that transcends the human capacity to resolve individual desires, aspirations, and concerns while contributing to national identity and unity. Religion has also become an inseparable element of human history, and the human desire to embody religious imagery has been with human history. Art has historically visualized the complex and subtle relationship between humans and religion directly and profoundly. In this way, religious works have provided a lens for examining how religious ideas permeate everyday life and influence cultural practices. This study explores how Buddhist philosophy and esthetics have influenced and coexisted in contemporary Korean artistic expression to emphasize the rich intersections between Buddhism and modern and contemporary Korean artworks. The concept of consilience, which refers to the integration of knowledge across diverse domains, aims to explain how Buddhist thought has transcended human conflict and promoted harmonious coexistence within Korean visual culture. The dynamic interplay between traditional Buddhist values and contemporary visual practices produces a rich cultural synthesis that highlights the importance of preserving Korea’s artistic heritage and expands and fosters the development of global visual culture today. Full article

Conditional automated driving delegates routine control to automation while keeping drivers responsible for supervision and timely takeovers. In this context, safety and usability hinge on calibrated trust, a state between overtrust and distrust that aligns reliance with actual system capabilities. We investigated how calibrated trust relates to concurrent behavior during conditional automation in a driving-simulator study (n = 26). After a brief familiarization block, drivers completed four takeover request (TOR) exposures while performing a non-driving-related task (NDRT). Trust was assessed with a validated multi-item inventory. NDRT engagement was operationalized as successful Surrogate Reference Task (SuRT) clicks per second, and takeover behavior was indexed by TOR reaction time (TOR-RT) from TOR onset to the first valid control input. The results showed that higher trust was associated with greater ND RT throughput during automated driving, whereas TOR-RT did not change significantly across repeated exposures, consistent with familiarization. In this sample, we did not observe a systematic penalty in TOR-RT associated with higher trust; however, confidence-interval benchmarks indicate that modest delays cannot be ruled out. This suggests that, after brief onboarding, calibrated trust can coexist with timely safety-critical responses within the limits of our design. These findings tentatively support interface and training strategies that promote calibrated trust (e.g., predictable TOR policies, transparent capability boundaries, and short onboarding) to help drivers navigate between overtrust and distrust. Full article

Background: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory dermatosis with substantial quality-of-life impact. HS frequently co-exists with obesity and metabolic comorbidities. Cigarette smoking is highly prevalent and has been linked to heightened inflammatory activity and impaired wound healing. The role of cumulative tobacco exposure (packyears) in relation to metabolic comorbidities in HS is less well defined. We therefore investigated whether lifetime pack-years relate to laboratory parameters and the presence of comorbidities in HS. Methods: We conducted a retrospective, single-center study involving 131 patients with HS. We collected clinical data, including disease severity scores and quality of life indices, along with laboratory markers such as complete blood count and C-reactive protein. Smoking status and cumulative exposure (pack-years) were assessed based on patient history. To compare laboratory parameters between smoking subgroups, we used Mann–Whitney U tests. Additionally, we performed logistic regression analyses to evaluate the association between cumulative cigarette exposure and the presence of comorbidities. Results: Among the cohort, 63.4% were active smokers with a median of 15 pack-years. Smokers had significantly higher leukocyte, neutrophil, lymphocyte, monocyte, eosinophil, and basophil counts, indicating elevated systemic inflammation. Hematocrit, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin were also significantly higher in smokers, while C-reactive protein levels did not differ notably between groups. Subgroup analysis revealed that patients with arterial hypertension, diabetes mellitus, and hypercholesterolemia had significantly more pack-years than those without these conditions. These comorbidities, components of metabolic syndrome, were strongly associated with higher lifetime tobacco exposure in HS patients. Conclusions: Smoking contributes not only to heightened inflammatory activity in HS but is also significantly associated with the presence of metabolic comorbidities. These findings underscore the importance of early interdisciplinary intervention and structured smoking cessation programs to improve outcomes in HS patients. Full article

Efficient O₂ transport through the ionomer film in cathode catalyst layers (CCLs) is a critical factor for the output performance of proton exchange membrane fuel cells (PEMFCs), yet the molecular mechanisms of gas transport in ionomers remain elusive. Herein, molecular dynamics (MDs) simulations are employed to investigate short-side-chain (SSC) and long-side-chain (LSC) perfluorosulfonic acid (PFSA) ionomers on Pt/C surfaces with the coexistence of O₂/N₂. The results reveal that the side-chain structures significantly modulate the ionomer nanostructures and gas transport. SSC ionomers form compact hydrophobic domains and more interconnected hydrophilic–hydrophobic interfaces, thereby facilitating more efficient O₂ transport pathways than LSC ionomers, particularly at low hydration (λ = 3). At high hydration (λ = 11), swelling of water domains attenuates these structural disparities and becomes the dominant factor governing gas transport. In addition, O₂ diffusion consistently exceeds that of N₂, while the diffusion coefficients of O₂, N₂ and H₃O⁺ become larger at high hydration. Collectively, these findings demonstrate the structural advantages of SSC ionomers in facilitating coupled oxygen and proton transport, offering molecular-level insights to inform the rational design of high-performance PEMFCs. Full article

Shrub communities play an irreplaceable role in maintaining ecological security in the stressed habitat areas of Northwest China. In these areas, multiple types of shrublands coexist simultaneously. Their diversity levels and community assembly processes may perform different patterns along different stress gradients. This study using linear model fitting, principal component analysis, analyzed the species and phylogenetic diversity of desert, alpine, and secondary shrublands along the gradients of environmental stress factors such as topography, soil, and climate, which reflect low temperature, human disturbance, and drought stress habitats. The changing trend of the phylogenetic structure of different types of shrublands was also studied with using variance decomposition, and phylogenetic structure analysis, which reveals their diversity maintenance mechanisms along environmental stress gradients. The research shows that (1) the mean annual temperature is the main environmental factor shaping the diversity patterns and maintenance processes of shrub communities because low temperatures may lead to habitat filtering; (2) in the western Loess Plateau, the community assembly of different types of shrublands is dominated by deterministic processes, but the diversity and assembly patterns of different shrublands are inconsistent across different environmental stress gradients. Systematic research on the diversity characteristics and assembly patterns of different shrub communities is of great significance for clarifying the restoration, succession, and stability of stressed habitat areas. Full article

Glycogen metabolism plays a key role in bacterial adaptation. In Streptococcus pneumoniae, the glycogen-degrading enzyme SpuA is widely conserved, but its physiological significance remains unclear. In this study, we investigated how SpuA affects bacterial growth and response to acid stress. We found that the spuA deletion strain (ΔspuA) produced more acidic metabolites under anaerobic conditions than the wild-type strain. In a mouse infection model, bronchoalveolar lavage fluid (BALF) from ΔspuA-infected mice was more acidic on day 1 post-infection, showing a lower bacterial load than wild-type infection—a finding consistent with the early growth delay observed in vitro—but the mutant later exhibited enhanced persistence at 72 h. ΔspuA strains also showed greater tolerance to formic acid and higher intake of serum amyloid A1 (SAA1), which may further contribute to their survival in acidic environments. Transcriptomic analysis revealed reduced utilization of certain amino acids, particularly cysteine, in ΔspuA strains. However, the addition of 0.05% (v/v) formic acid restored amino acid utilization in ΔspuA strains, and co-supplementation with formic acid and cysteine significantly enhanced ΔspuA growth in vitro. These findings suggest that in the absence of SpuA, S. pneumoniae shifts its metabolism toward formic acid production, which may act both as a metabolic signal and a stressor that influences bacterial gene expression. This shift is accompanied by increased expression of tRNAs and growth rescue, suggesting enhanced amino acid utilization capacity. Although our findings reveal a potential link between formic acid metabolism and amino acid utilization through tRNA regulation, further validation using metabolic flux analyses or targeted metabolomics will be required to confirm this relationship. These observations imply a metabolic adaptation that facilitates bacterial growth under low-oxygen, acidic conditions during infection. Our results also raise the possibility that SpuA plays a role in restraining bacterial overgrowth in the host, thereby promoting a more balanced coexistence between pathogen and host. Full article

The SCOBY (Symbiotic Culture of Bacteria and Yeast) is a microbial consortium composed of a diverse range of bacteria and yeasts that coexist symbiotically. The most commonly identified microorganisms include Gluconobacter, Acetobacte, Saccharomyces and Zygosaccharomyces. Its primary objective is to utilize sucrose as a substrate. SCOBY requires specific conditions for its multiplication, such as temperature, pH, and a suitable carbon source. Through its microbial dynamics and proper management, this consortium develops functional properties that are beneficial to health. This microbial consortium has been the subject of numerous studies due to the wide range of benefits it can offer through fermentation-derived products. Among the most frequently mentioned are organic acids, phenolic compounds, and a high concentration of probiotics. Originally, the SCOBY was used as a started culture in the production of the beverage “Kombucha”. However, due to the growing public interest, its use has diversified into fruit-based, dairy-based, and cereal-based beverages. Furthermore, its application has expanded to unconventional substrates. Its potential uses in other fields, such as medicine, as well as its antimicrobial activity, should also be noted. Full article

The eutrophication of natural water is a severe environmental risk faced by coastal marine ecosystems, and the excess nitrogen and phosphorus in aquaculture effluent are one of the main sources of environmental pollution. Effectively reducing as well as controlling the phosphorus content in aquaculture effluent is of great importance for alleviating eutrophication and the governance of coastal environments. This study focuses on addressing phosphorus pollution by developing novel bimetallic Ce-Al-MOFs adsorbents via the microwave-assisted rapid synthesis method, among which the monomer Ce₃Al₃-BDC₃ exhibits excellent phosphate adsorption capacity (136.99 mg P g⁻¹) and great removal efficiency over a wide pH range (2~10). Batch experiments reveal that the adsorption is followed by pseudo-second-order kinetics and the Langmuir isotherm model, indicating monolayer chemisorption. The MOFs material shows high selectivity for phosphorus even under the interference of co-existing anions, as well as excellent reusability, retaining over 65% removal efficiency after six adsorption–desorption cycles. Field tests in coastal areas and indoor aquaculture systems both achieve over 97% phosphate removal, meeting discharge standards. A series of characterization methods identify ligand exchange, electrostatic interactions and surface complexation as key adsorption mechanisms. The Ce-Al-MOFs present a promising solution for mitigating eutrophication and managing aquaculture wastewater sustainably. Full article

In alpine ecosystems, plant growth is often constrained by multiple environmental factors, especially the infertile soils with lower temperature that decelerate the rate of nutrient turnover, thus leading to a diminished availability of nutrients in the soil, notably nitrogen (N), and its different forms, which is a pivotal factor for limiting plant growth and species coexistence in these alpine areas. Androsace tapete (A. tapete) is an endemic species and the most widely distributed cushion plant on the Qinghai–Tibet Plateau (QTP). Its positive interactions can facilitate other associated plants to deal with severe environmental conditions in the alpine grassland ecosystem. The change in soil nutrient availability is one of the main positive interactions, but little is known about how A. tapete changes soil nutrient availability and affects the N uptake pattern of associated plants. This study investigated the N utilization patterns of three associated plant species —Carex atrofusca (C. atrofusca), Cyananthus incanus (C. incanus), and Potentilla saundersiana (P. saundersiana)— growing inside the cushion area A. tapete (CA) and the ambient grassland without cushion plants (CK), using a ¹⁵N labeling method to clarify the effect of A. tapete on the N uptake strategies with NH₄⁺, NO₃⁻, and organic N of its associated species. The results showed the following: (1) compared to CK, the soil total C, total N, and available NH₄⁺ contents under the A. tapete showed a significant 47.82%, 40.96%, and 47.33% increase, respectively; (2) A. tapete showed a stronger preference for NH₄⁺ (>80%), whereas the associated species in CK exhibited a more balanced uptake, deriving 39.29–55.59% of N from NO₃⁻, 25.72–44.00% from NH₄⁺, and 16.15–18.69% from glycine. (3) The three associated plants possessing A. tapete significantly reduced their uptake of glycine by 9.76%, 12.55%, and 7.15%, respectively, while the absorption of NH₄⁺ by C. atrofusca and C. incanus increased by 18.46% and 36.11%; meanwhile, NO₃⁻ uptake decreased by 8.70% in C. atrofusca and 23.55% in C. incanus. These findings indicated that the A. tapete can change the N uptake pattern of the associated plants growing inside the cushion body, such as enhancing the absorption of inorganic N and decreasing the organic N. This adaptive strategy of the associated plants with cushion plant enables them to counteract the N-limited conditions prevalent in alpine environments, and, as a consequence, facilitates their growth and promotes local plant community diversity in the alpine environment. Full article

Water and soil resources (WSRs) determine the healthy development of the socio-economic systems. This research seeks to clarify the spatiotemporal evolution characteristics, spatial spillover effects, and key constraint factors influencing the comprehensive carrying capacity (CCC) of WSR in the Yellow River (YR) Basin from 2012 to 2023, thereby supporting the healthy development of the river basin. Based on the structural relationships among the internal elements of this system, the entropy method and an extensible cloud model are employed in this study to evaluate the WSR-CCC. Based on the estimation theory and spatial econometrics methods, the temporal and spatial evolution process of WSR-CCC was explored, and the obstructive factors were analyzed. We made the following discoveries: (1) The WSR-CCC demonstrates a fluctuating upward tendency, gradually moving from critical overload level IV to sustainable level II, but inter-provincial disparities expand. (2) The spatial pattern exhibits a gradient of higher levels in the western region, lower levels in the eastern region, stronger intensity in the northern region, and weaker intensity in the southern region, with weak spatial correlation. However, the spatial spillover effect is significant, with club convergence and the Matthew effect coexisting. (3) The obstacle factors exhibit a drive–influence–state three-stage dominant characteristic. The findings provide actionable insights for coordinating WSR optimization and ecological conservation. Full article