Search Results (217)

The sugar beet (Beta vulgaris L.) industry in China occupies a pivotal position in the national sugar supply, yet drought in its major cultivation areas has become a key limiting factor for its high-quality development. Glycosyltransferases (GTs) play a pivotal role in plant responses to abiotic stress, particularly in the regulation of drought resistance. However, the systematic identification of the BvUGT90 gene family in sugar beet and the functional characterization of its members under drought stress remain largely unexplored. In this study, drought stress was simulated in the sugar beet cultivar ‘HI0466’ using the weighing method to regulate soil moisture. Samples were collected at different stress durations and after rewatering for subsequent experimental analyses. In this study, 121 members of the BvUGT90 family were identified in sugar beet, and a comprehensive analysis was conducted on their gene structures, phylogenetic relationships, promoter cis-acting elements and expression patterns under drought stress. The results showed that these 121 members were unevenly distributed across 9 chromosomes. The proteins they encode had an average amino acid length of 474, with molecular weights ranging from 10.78 to 99.10 kDa and theoretical isoelectric points (pI) from 4.68 to 8.69 (with an average of 5.76). Notably, 110 of these members (accounting for 90.91%) were identified as hydrophilic proteins. Synteny analysis indicated a high degree of homology between the BvUGT90 family members in sugar beet and their orthologous genes in Arabidopsis thaliana. Analysis of promoter cis-acting elements revealed the presence of six major categories of core elements in the promoter regions of BvUGT90 genes, including hormone-responsive elements, stress-responsive elements and pathway regulatory elements. Transcriptomic data showed that 45 BvUGT90 family members exhibited significant responsiveness to drought stress. Proteomic analysis demonstrated that 10 of these members were significantly upregulated at the protein level under drought stress, and these results were further validated by quantitative real-time polymerase chain reaction (qRT-PCR). Integrated transcriptomic and proteomic analyses identified Bv_005070_jjst.t1 and Bv6_140060_stjc.t1 as the family members with the most prominent responses to drought stress. Furthermore, transgenic transformation of sugar beet was performed, which confirmed that Bv_005070_jjst.t1 plays an important role in drought stress resistance. The findings of this study provide direct candidate genes from this family for drought-tolerant sugar beet breeding. Full article

This study aimed to investigate the effects of dietary NFC/NDF ratio on nutrient apparent digestibility, fecal fermentation parameters, microbial diversity, and plasma metabolomics in Yili horses. Twenty-four healthy Yili horses with similar body weights (406 ± 22.73 kg) were divided into four groups, each with six replicates: the Control Group (CG), Low-NFC Group (LG), Medium-NFC Group (MG), and High-NFC Group (HG). The experiment lasted 52 d, comprising a 7-day adaptation period and a 45-day experimental period. Total fecal collection was conducted from days 41 to 45 to calculate nutrient apparent digestibility. On the final day, rectal fecal samples and blood samples were collected for full-length 16S rRNA gene sequencing and plasma metabolomics analysis. The results revealed the following findings: (1) The apparent digestibility of crude protein (CP) in the MG and HG groups was significantly higher than in the CG (p < 0.01), and significantly higher in the LG group compared to the CG (p < 0.05). (2) Significant differences were observed in fecal pH, propionate concentration, and the acetate-to-propionate ratio between the CG and the experimental groups (p < 0.05). (3) At the phylum level, Firmicutes, Bacteroidota, and Verrucomicrobiota were dominant in the fecal microbiota of all groups. PICRUSt2 prediction indicated that the MG and HG groups primarily enhanced energy conversion efficiency through amino acid metabolism and pantothenate and CoA biosynthesis metabolic pathways. (4) A total of 204 differential metabolites were identified between the CG and MG groups, with 98 upregulated and 106 downregulated in the MG group compared to the CG. These metabolites were mainly enriched in pantothenate and CoA biosynthesis, fructose and mannose metabolism, pyruvate metabolism, and starch and sucrose metabolism pathways. In summary, appropriately increasing NFC/NDF content influences the gut microbiota composition and energy metabolism of Yili horses, thereby effectively improving their digestion and absorption of dietary nutrients. Full article

Background/Objectives: Pediatric shock is a final common pathway of cardiovascular failure across diverse emergencies, yet data from mixed emergency cohorts outside intensive care units remain limited. This study aimed to describe the distribution, etiologic subtypes, and clinical correlates of shock in children presenting within a diagnosis-based emergency cohort. Methods: A retrospective single-centre study was conducted in children aged 0–16 years presenting with selected acute pediatric emergencies, among whom cases with and without shock were compared. Shock was defined using documented diagnoses and compatible hemodynamic features, and multiple etiologic types of shock were analyzed, including hypovolemic, septic, cardiogenic, and anaphylactic shock. Demographic and diagnostic variables—age, length of stay, organ support, age strata, and selected comorbidities—and baseline clinical features were compared between children with and without shock using non-parametric and χ²/Fisher’s exact tests. Results: Within the prespecified diagnosis-based analytic cohort, 36/128 children (28.1%) met the study criteria for shock and occurred across all prespecified acute pediatric emergency groups, with the highest proportional burden in heart failure and meningitis; this proportion should not be interpreted as an emergency-department prevalence estimate. Children with shock were younger, with clustering in infants < 1 year and those aged 5–9 years, and tended to stay longer in hospital. Pre-existing cardiac disease, severe dehydration, and altered mental status/coma were more frequent among children with shock. Septic and cardiogenic shock required the most intensive organ support. Conclusions: In this pediatric emergency cohort, shock emerged as a clinically relevant and etiologically heterogeneous complication across diverse acute presentations, with a distinct age-related vulnerability pattern and consistent associations with readily identifiable bedside clinical features. Simple bedside information—particularly cardiac comorbidity, dehydration, and altered consciousness—may assist the early recognition of children with evolving circulatory failure and support closer monitoring and timely escalation of care. By focusing on a mixed emergency population outside the intensive care unit, this study provides a real-world clinical perspective that may help refine early bedside assessment and improve vigilance for shock in pediatric emergency departments. Full article

Objectives: Cardiac point-of-care ultrasound (cPOCUS) enables rapid bedside cardiac assessment and may facilitate early identification of potential cardiac sources of embolism in patients with acute ischemic stroke (AIS). This study aimed to evaluate whether neurologist-performed cPOCUS is associated with reduced hospital length of stay (LOS) in patients admitted to a Stroke Unit (SU). Methods: We conducted a retrospective observational study including consecutive patients with AIS admitted between 2020 and 2021 who required cardiac ultrasound for etiological evaluation. Patients underwent cPOCUS and/or transthoracic echocardiography (TTE) and were classified into two groups: those evaluated with cPOCUS (with or without TTE) and those evaluated exclusively with TTE (control group). The availability of cPOCUS depended on predefined weekly schedules rather than individual clinical decision-making, partially mitigating selection bias. The primary outcome was LOS. Multivariable linear regression analysis was performed to adjust for potential confounders. Results: Among 808 patients with AIS, 332 underwent cardiac ultrasonography during hospitalization: 219 in the cPOCUS group and 113 in the control group. Overall, 60.4% were male, the mean age was 68.4 years (SD 13.3), and the median National Institutes of Health Stroke Scale score at admission was 5 (IQR 9), with no significant differences between groups. Median LOS was shorter in the cPOCUS group than in the control group [7 days (IQR 4) vs. 8 days (IQR 5); p = 0.015]. After adjustment for confounders, cPOCUS evaluation remained independently associated with shorter LOS (β −1.49, standard error 0.73, 95% CI −2.93 to −0.05; p = 0.04). Conclusions: Neurologist-performed cPOCUS is independently associated with reduced LOS in patients with AIS admitted to an SU. These findings suggest that cPOCUS may facilitate more efficient in-hospital workflows and support its potential integration into routine stroke care pathways. Full article

Background: Family and friend caregivers provide essential support across health and social care systems but remain inconsistently identified, assessed, and supported in routine practice. Although numerous caregiver needs’ assessment instruments exist, many focus on burden, distress, or preparedness rather than explicitly eliciting caregiver-defined support needs, limiting their utility for care planning, care transitions, and system integration. Methods: We conducted a rapid scoping review to identify and characterize caregiver needs’ assessment tools developed for family and friend caregivers. Searches were conducted in MEDLINE, PsycINFO, CINAHL, Web of Science, Health and Psychosocial Instruments, and the Cochrane Library. Eligible studies described the development, validation, or implementation of instruments designed to assess caregiver needs. Data were extracted on tool characteristics, domains assessed, administration methods, and implementation-relevant features. Item-level content analysis distinguished caregiver-defined support needs from related constructs, including burden, strain, preparedness, and care-recipient monitoring. Results: Forty-three studies describing caregiver needs’ assessment instruments were included (19 instruments; 17 instrument families). Tools varied widely in length, administration, and conceptual framing. Seven domains of caregiver-defined support needs were identified: caregiver health and self-care; emotional and psychological support; information, communication, and navigation; practical and instrumental support; social and relational support; autonomy and life participation; and spiritual, cultural, and existential support. Information and navigation needs were most frequently assessed, while autonomy and spiritual domains were least consistently represented. Many instruments demonstrated construct drift, assessing stressors or impacts rather than explicitly eliciting caregiver-defined support needs. Few tools were designed for longitudinal reassessment, workflow integration, or documentation within electronic medical records. Conclusions: Existing caregiver needs’ assessment tools inadequately support routine, system-integrated caregiver-centered care. Advancing caregiver-centered practice requires tools that explicitly elicit caregiver-defined support needs and are designed for workflow integration, longitudinal use, and interdisciplinary care pathways. Full article

The exceptional mechanical strength and toughness of collagen arise from its well-defined hierarchical architecture. Conventional methods for obtaining collagen aggregates (CAs), such as direct extraction from native tissues or acid swelling followed by mechanical processing, offer limited control over dimensional uniformity and provide little insight into the underlying exfoliation mechanisms. To overcome these challenges, this study introduces a novel strategy that leverages insights into the hierarchical interactions within collagen. We employ the ionic liquid 1-allyl-3-methylimidazolium chloride ([AMIM]Cl) as an exfoliating agent to successfully isolate fibrous CAs from native bovine tendon. By precisely modulating temperature and processing time, we achieve CAs with tunable mesoscale dimensions (diameter 0.9–1.1 μm, length > 160 μm). Molecular dynamics simulations reveal that [AMIM]Cl disrupts the intramolecular hydrogen-bonding network within collagen, thereby facilitating controlled exfoliation. These exfoliated aggregates serve as fundamental building blocks for fabricating collagen films. The resulting materials exhibit robust mechanical integrity, high transparency, reversible pH-responsive behavior, and excellent biocompatibility as verified by cytotoxicity assays, which together underscore their potential as versatile biomaterial platforms. Furthermore, the integration of single-walled carbon nanotubes yields conductive composites with confirmed electrical functionality. This study thus presents an innovative pathway for the precision processing of collagen and advances the design of high-performance collagen-based biomaterials. Full article

Background: Pulmonary rehabilitation (PR) is increasingly used across the lung-cancer care pathway, but the scope, effectiveness, and optimal delivery of programmes remain variably reported. Objective: To examine the effectiveness of PR in adults undergoing lung cancer surgery across preoperative perioperative, and post operating settings. Methods: We conducted a narrative synthesis of studies evaluating PR interventions in patients undergoing lung cancer resection. Eligible designs included randomised, non-randomised trials and observational studies published between 2021 and 2025. Interventions were classified by timing (preoperative, perioperative, postoperative) and by completeness of PR content. Full PR was defined as programmes including structured exercise training, at least one respiratory-specific component, and structured education and/or supportive interventions. Outcomes of interest included postoperative pulmonary complications (PPCs), length of stay (LOS), functional capacity, ventilatory function, symptoms and health-related quality of life (HRQoL). Results: Across perioperative phases, PR was feasible and safe, with consistent improvements in functional capacity and patient-reported outcomes. Preoperative PR reliably improved presurgical fitness with reductions in PPCs and LOS most evident in supervised and physiologically targeted programmes. Perioperative PR integrated within enhanced recovery pathways supported early mobilisation and respiratory recovery. Postoperative PR accelerated recovery of exercise capacity, respiratory symptoms, and HRQoL beyond expected natural recovery. Programmes classified as Full PR demonstrated more consistent and broader benefits across outcome domains compared with Partial PR. Substantial heterogeneity in intervention design and outcome measurement was observed. Conclusions: Pulmonary rehabilitation is an effective, multidimensional intervention across the surgical lung cancer continuum. Comprehensive, multimodal programmes appear to confer the greatest clinical benefit. Standardisation of PR content and outcome measurement is needed to strengthen evidence synthesis and guide implementation in perioperative lung cancer care. Full article

Introduction: Recurrent inguinal hernia remains a clinically relevant outcome that is difficult to quantify in the absence of national prospective registries. In Romania, structural differences between public and private hospitals may further influence recurrence-related care, access to minimally invasive surgery, and resource utilization. This study aimed to assess recurrence patterns after inguinal hernia repair at a national level, with emphasis on reinterventions, patient-related risk factors, and health system disparities. Methods: A nationwide retrospective cohort study was conducted using administrative DRG data from the Romanian National Health Insurance House. All adult patients undergoing inguinal hernia repair in 2019 were identified and followed for five years (2019–2023). Reintervention was used as a proxy for recurrence. Surgical approach, hospital sector, length of stay, reimbursement, patient migration, geographic distribution, and comorbidities were analyzed using descriptive statistics and multivariable logistic regression to explore factors associated with laparoscopic approach and reintervention. Results: Among the 18,185 patients who underwent inguinal hernia repair in 2019, reintervention rates during follow-up ranged from 0.58% to 4.88%, a variability that reflects inherent limitations of administrative coding. Most reinterventions occurred in the year of the index surgery, suggesting early technical failure. Public hospitals managed the majority of cases and disproportionately absorbed recurrent and clinically complex patients. Access to laparoscopic repair was uneven and concentrated in large academic centers. Length of hospital stay declined gradually in public hospitals but remained consistently shorter in private institutions, reflecting differences in patient selection and care pathways. Reimbursement by The National Health Insurance House was similar for open and laparoscopic procedures. Conclusions: Recurrent inguinal hernia care in Romania is shaped by system-level disparities extending beyond surgical technique. Further progress requires reimbursement reform, establishment of a national hernia registry, and expansion of laparoscopic training to ensure equitable access to high-quality hernia care. Full article

Background/Objectives: Emergency department length of stay (ED LOS) is a key indicator reflecting emergency department crowding, patient safety, and healthcare resource efficiency. Among injured patients, ED LOS may be prolonged depending on injury severity and disposition pathways (admission and inter-hospital transfer). This nationwide study using the Korean National Emergency Department Information System (NEDIS) aimed to (1) describe the distribution and determinants of ED LOS among injured patients and (2) quantify the mediating effects of disposition (admission and transfer) on the association between injury severity measured by the International Classification of Diseases-based Injury Severity Score (ICISS) and ED LOS. Methods: We analyzed NEDIS injury-related ED visit records collected from the date of IRB approval through 12 January 2026. We conducted a retrospective observational study using NEDIS data. Of 1,048,575 injury-related ED visits, 1,035,484 visits with valid ED LOS and eligible records were included after excluding missing key variables and implausible time values. ED LOS was calculated in minutes using arrival and departure timestamps. Injury severity was assessed using ICISS (primary: based on 15 diagnoses; sensitivity: based on 20 diagnoses). Determinants of ED LOS were evaluated using gamma regression with a log link. Disposition was categorized as discharge, admission, and inter-hospital transfer; admission and transfer were modeled as binary mediators. Causal mediation analyses estimated the average causal mediation effect (ACME), average direct effect (ADE), total effect, and proportion mediated. Multiple sensitivity analyses (outlier handling, missing-data approaches, alternative log-linear modeling, and EMS arrival subgroup analyses) assessed robustness. Results: The median ED LOS was 150 min (IQR 90–260). ED LOS differed substantially by disposition: 120 min for discharged patients, 420 min for admitted patients, and 360 min for transferred patients. Overall, 17.9% of visits had an ED LOS ≥ 6 h, and prolonged stays were concentrated among admitted (≥6 h: 55.0%) and transferred (≥6 h: 45.0%) patients. In gamma regression, a 0.05 decrease in ICISS (greater severity) was associated with longer ED LOSs in the unadjusted model (Ratio 1.34) and remained significant in the fully adjusted model (Ratio 1.12, 95% CI 1.11–1.13). Admission and transfer were strong determinants of ED LOS in the final model (ratios of 2.35 and 2.05, respectively). In mediation analyses, admission mediated 36.8% of the severity–ED LOS association (ACME 0.085; ADE 0.146), and transfer mediated 14.3% (ACME 0.033; ADE 0.198). Findings were consistent across sensitivity analyses. Conclusions: In this nationwide cohort of injured patients, ED LOS showed a right-skewed distribution, with prolonged stays concentrated in admission and transfer pathways. Injury severity (ICISS) was independently associated with longer ED LOS, and a substantial proportion of this association was mediated through admission and transfer. Reducing ED LOS among severely injured patients likely requires not only streamlining diagnostic and treatment processes but also system-level interventions targeting output-stage bottlenecks, including inpatient bed operations/boarding management and transfer coordination. Full article

This study systematically measured gross hair weight and hair length traits across five body regions of 759 Tianzhu White Yak individuals. The BSL trait exhibited moderate heritability, while the BL trait demonstrated high heritability (h² = 0.450). All other traits showed low heritability. GWASs were conducted using whole-genome resequencing data comprising 22,566,255 high-quality SNP loci. The MLM model identified 519 genome-wide significant loci and 767 chromosome-wide significant loci. Chromosome 6 harbored the highest number of significant SNP loci, while the remaining significant loci were distributed across multiple autosomes. Strong long-range linkage disequilibrium (r² > 0.7) was observed between numerous significant SNPs on chromosome 6 associated with Gw and HL traits. A total of 73 candidate genes were annotated, including FGF5, CFAP299, and PRDM8. Functional enrichment analysis based on the GO and KEGG databases revealed significant enrichment in cytoplasm and the MAPK signaling pathway. Sanger sequencing results revealed that mutations in the FGF5, CFAP299, PRDM8, ANTXR2, and GPHB5 genes significantly affected the Gw, HL, and BSL traits of Tianzhu White Yak (p < 0.01). Linkage disequilibrium analysis indicated strong linkage disequilibrium (r² > 0.6) among Sanger-sequenced SNP loci on the same chromosome. From a biological perspective, multiple candidate genes such as FGF5 and CFAP299 are involved in hair follicle cycle regulation, cell proliferation, and metabolic control, suggesting its potential role in hair follicle development and hair shaft growth. This study identifies candidate loci and genes for gross hair weight and hair length traits in Tianzhu White Yak, contributing to elucidating the genetic mechanisms underlying hair production performance. Full article

Background/Objectives: Robot-assisted radical prostatectomy (RARP) is widely used in contemporary prostate cancer surgery; however, surgeons enter robotic practice through heterogeneous training pathways. This study aimed to compare early oncological and functional outcomes after RARP between two experienced robotic surgeons with different surgical backgrounds after completion of the learning curve. Methods: We conducted a retrospective, consecutive, single-center study including patients undergoing RARP after completion of the learning curve (> 40 cases) by two experienced robotic surgeons with different surgical backgrounds. Baseline characteristics, perioperative variables, and early oncological and functional outcomes were compared between surgeons. Pentafecta achievement was assessed as an exploratory composite outcome. Appropriate non-parametric and categorical statistical tests were applied as appropriate. Results: Ninety-three patients were included (55 operated on by surgeon A and 38 by surgeon B). Preoperative clinical and pathological characteristics were largely comparable between groups, except for prostate volume. Median operative time was significantly shorter for surgeon A (70 vs. 120 min, p < 0.001). Postoperative morbidity was low, with no major complications and no differences in length of hospital stay. At 6 months, urinary continence and erectile function recovery rates were high and comparable between surgeons. Oncological outcomes, including positive surgical margin rates and biochemical recurrence, did not differ significantly, although recurrence events were infrequent and follow-up was limited. Overall pentafecta achievement was modest and similar between groups (23.6% vs. 21.1%, p = 0.77), with positive surgical margins emerging as the main limiting factor. Conclusions: In this exploratory post-learning curve analysis, early oncological and functional outcomes after RARP were similar between surgeons with different surgical backgrounds. These findings should be interpreted cautiously and considered hypothesis-generating. Full article

Background: Pediatric burns cause considerable morbidity and hospital resource use. Advanced dressings on moderate-degree pediatric burns that accelerate healing may offset acquisition costs by shortening length of stay (LOS). Objective: The aim of this study was to assess the budget impact of introducing an oxygen-enriched olive-oil dressing for pediatric burns (grade I–IIG; total body surface area < 20%) at a tertiary children’s hospital. Methods: A hospital-perspective budget impact analysis was conducted according to ISPOR guidance over a 4-year horizon (2022–2025). The study population included 32 inpatients (<18 years) with non-extensive, moderate-degree burns treated between 2022 and 2023. Two scenarios were modeled: (i) standard of care (SoC) and (ii) SoC plus the oxygen-enriched olive-oil dressing (OEoD), with annual caseload projections to 2025. Costs combined treatment (dressings, drugs, and devices) and hospitalization data provided by the hospital’s Control & Management Unit. The average daily hospitalization cost was €1438.99. Results: Compared with SoC, the OEoD scenario increased per-patient dressing costs (mean €271.4 vs. €121.9) but reduced LOS (mean 7.3 vs. 16.6 days), leading to lower overall hospitalization expenditure. Total annual costs decreased by 7%, 13%, 16%, and 18% across 2022–2025, respectively (for example, 2025: €612,516 vs. €751,445; Δ −€138,929). Cumulative 4-year savings reached €337,399. Deterministic sensitivity analysis confirmed the robustness of these findings, with savings persisting under variable assumptions. Conclusions: Despite higher acquisition costs, oxygen-enriched olive-oil dressings were associated with shorter LOS and meaningful budget savings in pediatric burn care. These results support their integration into multidisciplinary burn management pathways and call for further prospective multicenter validation. Full article

Efficient resource allocation during fruit expansion and ripening is critical for enhancing mango (Mangifera indica L.) productivity and fruit quality. A study was conducted to quantify the effects of foliar-applied GA₃ at concentrations of 0 (control), 50 (GA50), 100 (GA100) and 200 (GA200) mg L⁻¹, applied at 15, 25 and 35 days after full bloom, on fruit physiochemical attributes during the fruit expansion and ripening phases. In addition, metabolic profiling and pathway analysis were conducted after fruit ripening. Compared with the control, GA₃ application at 50, 100, and 200 mg L⁻¹ increased fruit length by 8, 12, and 14%, and fruit diameter by 5, 11, and 14%, respectively. The mean single-fruit weight was increased by 5–11% at physiological maturity. During the fruit expansion phase, GA₃ treatment decreased starch and total acidity by up to 11% and 29%, respectively, while increasing the soluble sugar content by 21%. Furthermore, enhanced antioxidant enzyme activities (SOD, POD, and CAT), accompanied by a reduction in malondialdehyde (MDA) contents in leaves, were observed. At the ripening stage, GA₃-treated fruits exhibited lower weight loss, higher firmness, more uniform color development, and reduced disease incidence, although vitamin C content and total soluble solids declined. PCA analysis identified GA100 as the optimal treatment. Metabolomics analysis revealed 287 differentially regulated metabolites between GA100 and the control. Sweet, fruity, and floral compounds were upregulated, whereas terpenoids and aldehydes were downregulated. KEGG pathway analysis indicated that GA100 modulated key resource-related metabolic pathways, including nitrogen, carbon and energy metabolism, thereby promoting efficient resource allocation toward fruit growth, quality, and aroma development. Overall, preharvest foliar application of GA₃, particularly at a concentration of 100 mg L⁻¹ (GA100), markedly improved mango fruit growth and quality but tended to simplify the aroma profiles by favoring ester production over complex terpenoid-derived notes. Full article

Background: Melanoma outcomes have improved in recent years as a result of modern systemic therapies. A major molecular feature of melanoma is abnormal telomerase activation; this is most often caused by telomerase reverse transcriptase (TERT) promoter mutations, which occur in 50–82% of cases and are the most common noncoding alteration in this cancer. Telomerase maintains telomere length, allowing melanoma cells to avoid senescence and continue dividing. However, how telomerase activity influences melanoma cell doubling time remains unclear, and the pathways linking TERT expression to faster cell-cycle progression require further study. Although telomerase inhibitors show promise in preclinical models, their clinical use is limited by delayed cytotoxicity and resistance. Materials and Methods: A scoping review was conducted using Scopus, ScienceDirect, MEDLINE/PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). Keywords included “telomerase,” “melanoma,” “cancer,” “cell proliferation,” and “doubling time,” using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Telomerase-related biomarkers were found to correlate with disease stage and survival. Suggested therapeutic strategies include enzyme inhibitors, cytotoxic nucleotide incorporation, telomere destabilization, and immunotherapies such as peptide or dendritic cell vaccines, etc. Conclusions: Understanding both telomere-dependent and -independent TERT functions is essential for developing effective biomarkers and therapies that overcome resistance and slow melanoma progression. Full article

Background/Objectives: Patients with WPW syndrome have a risk of sudden cardiac death that can be assessed using an electrophysiological study. In symptomatic patients, the preferred route is intracardiac, whereas in asymptomatic children, transesophageal. Our study aimed to evaluate the risk using a transesophageal study, considering a threshold age of 12 years for sedation. Methods: We investigated 41 asymptomatic WPW children with a mean age of 12.5 ± 4.4 years (range 1 to 18 years old), with 48.8% being male. We determined three values: (1) the accessory pathway effective refractory period (APERP), (2) the minimal cycle length demonstrating 1:1 conduction through the accessory pathway, and (3) the shortest RR interval between two consecutive pre-excited beats during atrial fibrillation. Results: Children under 12 years had a mean age of 7.5 ± 2.5 years, while those over 12 years had a mean age of 15.5 ± 1.9 years. Sedation was administered exclusively to children under 12 years of age. Orthodromic reentrant tachycardia was induced in four children, and atrial fibrillation was induced in 14 children. Comparing the group under 12 with the group over 12, the mean APERP was 296 ± 38 ms vs. 286 ± 45 ms (p = 0.48), the average 1:1 conduction over the accessory pathway was 287.3 ± 41 ms vs. 282 ± 46 ms (p = 0.71), and the average shortest pre-excited RR interval during atrial fibrillation was 280 ms vs. 262 ms years (p = 0.75). Conclusions: Asymptomatic children under 12 years of age showed a lower incidence of inducible atrial fibrillation. They had accessory pathways with reduced risk, except one, and no children under 12 years underwent catheter ablation. Full article