Search Results (29,632)

Rationale and objectives: Parkinson’s disease (PD) significantly affects visual function, especially convergence and eye movements, impacting tasks such as reading. The objective was to investigate preliminarily the impact of the use of digital visual training in PD patients with associated convergence insufficiency (CI). Materials and methods: Pre–post pseudo-experimental pilot study to evaluate the impact of a novel digital therapy system (video game for use on a mobile phone or tablet) in 13 patients with PD and CI, with a mean age of 67 years. A comprehensive visual assessment was performed before and after a 6-week home-based visual rehabilitation, including measurement of near point of convergence (NPC), near positive fusional vergence (PFV), oculomotor tests (NSUCO and King-Devick tests), and symptom assessments with two validated questionnaires (CISS and SQVD). Results: Treatment adherence was variable, ranging from 0.8% to 124.7%. Despite this, significant improvements were found after therapy in break (p = 0.022) and recovery points of the NPC (p = 0.007), as well as break (p = 0.003) and recovery points in near PFV (p < 0.001). In the NSUCO test, the total score improved significantly from 23.9 ± 4.2 to 26.2 ± 3.7 after therapy (p = 0.003). Furthermore, a significant reduction in the total King-Devick test time was observed, decreasing from 79.4 ± 28.8 s to 69.0 ± 21.5 s with therapy (p = 0.034). Finally, symptom questionnaire scores also decreased significantly with therapy (CISS p = 0.037, SQVD p < 0.001). Conclusions: The digital vision therapy system evaluated seems to improve oculomotor control and reduce visual symptoms associated with CI in PD patients. Studies with larger sample sizes and a control group are needed to fully validate the therapeutic effectiveness of this tool. Full article

Background/Objectives: Nutritional rickets is a childhood bone disorder leading to skeletal deformities and life-long disabilities. Early-stage diagnosis remains challenging due to the limited availability of non-invasive tools. This study explores metabolic variation associated with the active disease stages and with etiological factors, such as nutritional deficiencies and biochemical alterations. Methods: Untargeted ¹H NMR spectroscopy-based metabolomics were performed on urine and plasma samples collected from Bangladeshi children with radiologically active rickets (AR; n = 24; aged 2.98 ± 1.19 years), inactive rickets (IR; n = 36; aged 3.39 ± 1.87 years), and healthy matched controls (n = 58; aged 3.58 ± 1.59 years). This analysis also integrated corresponding clinical biochemistry and dietary intake data previously collected from the cohort. Results: Orthogonal Partial Least Squares-Discriminant Analysis (OPLS-DA) identified the 24 h urinary excretion of 13 metabolites to vary with AR, including those previously associated with bone metabolism such as β-aminoisobutyrate, N-methylnicotinamide, taurine and hypoxanthine. Biochemically, AR was strongly characterized by increased plasma alkaline phosphatase and decreased iFGF23. The multi-block integration of metabolomic, biochemical, and nutritional data achieved an 18.6% classification error rate. Children with IR exhibited metabolic profiles similar to healthy controls, aligning with their clinical resolution. Conclusions: Active nutritional rickets presents a distinct metabolic profile, highlighting novel biologically relevant metabolites. These exploratory signals provide insights into the physiological impact of the disease and warrant further targeted investigation to assess their potential for informing early non-invasive detection and preventive interventions. In the long term, such tools are vital to prevent irreversible skeletal damage and to help mitigate lifelong physical disability and the resulting social vulnerability for affected children. Full article

Alcohol and psychoactive substance use represent a major burden for global public health, increasing the risk of non-communicable diseases, violence, road traffic injuries, dependence, and mental disorders, and generating impacts on productivity and social welfare. This study aimed to estimate the burden of disease attributable to alcohol and other psychoactive substances in the departments of Colombia from 2016 to 2022. A burden-of-disease study was conducted using the Disability-Adjusted Life Years (DALYs) indicator, following the methodology of the World Health Organization Global Health Estimates. Official morbidity and mortality databases were used. An estimated 236,154.42 DALYs were attributable to alcohol and psychoactive substance use in Colombia during the study period, increasing from 14,158.7 DALYs in 2016 to 40,190.7 DALYs in 2022. The burden was heterogeneous across departments, with values above 1000 DALYs in Quindío (1779.5), Nariño (1624.3), and Norte de Santander (1008.0) and below 132 DALYs in La Guajira, Casanare, and Vaupés. Men accounted for 73.5% of total DALYs. The mean age of morbidity records associated with alcohol and psychoactive substance use disorders was 30.67 years in men and 32.37 years in women. The burden associated with psychoactive substance use is increasing in Colombia, with differences by sex and department of residence. Full article

With the rapid development of global aquaculture, the frequent occurrence of fish diseases has had a serious impact on the efficiency of aquaculture and the ecological environment. Antimicrobial peptides, as a kind of natural immune active substance existing in organisms, participate in innate immunity and adaptive immunity. Due to their extensive antibacterial properties and low toxicity, they have gradually become a hot topic in scientific research. This article reviews the classification, tissue distribution, mechanism of action, extraction, and synthesis techniques of antimicrobial peptides (AMPs) derived from fish, as well as their applications in disease prevention in aquaculture, product preservation, and antibiotic substitution. Although antimicrobial peptides are expected to become alternatives to antibiotics, challenges such as environmental stability, production costs, and regulatory frameworks remain to be addressed. This article holds that antimicrobial peptides derived from fish are a feasible strategy for sustainable aquaculture. The future development direction lies in biotechnology-driven optimization, carrier innovation, and combined application with traditional antibiotics. Full article

Background: Lung adenocarcinoma is morphologically heterogeneous, composed of various histological patterns. The International Association for the Study of Lung Cancer (IASLC) grading system, based on the predominant pattern and the presence of high-grade components, underscores this heterogeneity’s prognostic relevance. However, the specific impact of the non-predominant “second component” on survival outcomes in early-stage disease remains inadequately characterized. Methods: We conducted a retrospective, single-center study including 95 patients with pathological stage 0, I, and II (TNM 8th edition) lung adenocarcinoma who underwent complete anatomical resection (lobectomy or segmentectomy) between January 2020 and December 2021. Histopathological evaluation followed the WHO 5th edition classification, with patterns quantified in 5% increments. The second predominant component was defined as the second most represented histological pattern, irrespective of a fixed percentage threshold. Overall survival (OS) and disease-free survival (DFS) were analyzed. Results: A second predominant component was identified in 55 patients (57.9%). The most common second components were lepidic (30.5%), solid (18.9%), and micropapillary (10.5%). With a median follow-up of 36 months, the presence of a lepidic second component was an independent factor for improved OS (Hazard Ratio [HR] 0.70, 95% CI 0.52–0.95, p = 0.022) and DFS (HR 0.62, 95% CI 0.41–0.93, p = 0.021). Conversely, a micropapillary second component was a strong independent predictor of worse OS (HR 1.81, 95% CI 1.24–2.64, p = 0.002) and DFS (HR 2.03, 95% CI 1.32–3.12, p = 0.001). The solid second component showed an intermediate adverse effect on DFS (HR 1.45, 95% CI 1.01–2.08, p = 0.043). Conclusions: The second predominant histological pattern provides additional prognostic information beyond the IASLC grading system and may improve postoperative risk stratification in early-stage lung adenocarcinoma. A lepidic second component portends a favorable prognosis, while micropapillary and solid components denote aggressive tumor biology and higher recurrence risk. Incorporating the evaluation of second components into routine pathological reporting and clinical decision-making could enhance postoperative risk stratification and personalize adjuvant therapy strategies. Full article

Gut microbiome composition influences cardiovascular drug efficacy and safety, yet its integration into heart failure (HF) management remains underexplored. Alterations in intestinal microbial communities have been linked to atherosclerosis, coronary artery disease, heart failure, and hypertension through multiple mechanisms. Dysbiosis disrupts the balance between commensal and pathogenic bacterial species, impairing gut barrier function and activating inflammatory pathways. The altered microbial ecosystem modulates the production of key metabolites—such as trimethylamine-N-oxide (TMAO), short-chain fatty acids (SCFAs), and secondary bile acids (BAs)—that directly impact cardiovascular function. This narrative review synthesizes current evidence on bidirectional interaction between heart failure pharmacotherapy and gut microbiome composition. Commonly used drugs in heart failure management show microbiome-dependent pharmacokinetics. Digoxin undergoes bacterial inactivation by Eggerthella lenta, while angiotensin converting enzyme inhibitors and beta-blockers demonstrate enhanced efficacy with specific Firmicutes populations. Conversely, certain probiotic strains attenuate drug-induced gut barrier injury and restore gut homeostasis. Sodium–glucose cotransporter 2 inhibitors (SGLT2i), mineralocorticoid receptor antagonists, and angiotensin receptor–neprilysin inhibitors exhibit beneficial microbiome-modulating effects beyond their primary cardiovascular actions. These findings underscore the potential for microbiome-informed precision medicine in heart failure. However, significant methodological challenges must be addressed, including lack of standardization in microbiome profiling, small sample sizes, and limited longitudinal data. Future research should focus on identifying specific microbial signatures that predict drug response, developing targeted probiotic interventions, and conducting prospective clinical trials to validate pharmacomicrobiomics approaches in heart failure management. Full article

Background/Objective: Psoriasis is a systemic inflammatory disease often associated with metabolic comorbidities, including hyperuricemia. While biological therapies effectively target inflammatory pathways, their specific impact on serum uric acid (SUA) levels remains debated. This study aimed to evaluate whether biological therapy, while reducing systemic inflammation, influences SUA levels in patients with moderate-to-severe plaque psoriasis. Methods: A prospective longitudinal cohort study was conducted involving 30 patients with moderate-to-severe plaque psoriasis. Patients received biological treatment (adalimumab, secukinumab or ustekinumab) and tsDMARDS (apremilast). Clinical severity was assessed using the Psoriasis Area and Severity Index (PASI). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), SUA levels and other laboratory markers were measured at baseline and after 48 weeks of therapy. Results: Biological therapy led to a significant reduction in PASI scores (from 21.6 ± 10.7 at baseline to 0.4 ± 0.86 after 48 weeks of therapy, p < 0.001), and CRP decreased from a median of 5.75 mg/L at baseline to 3.55 mg/L, p < 0.001. ESR also declined from 26.2 ± 11.4 mm/h to 19.0 ± 8.06 mm/h, p < 0.001. However, no statistically significant change was observed in mean SUA levels 5.49 ± 1.55 vs. 5.55 ± 1.60 mg/dL; p = 0.758. Subgroup analysis revealed that SUA levels remained stable regardless of the specific biological agent used or the degree of clinical improvement. Conclusions: Our findings suggest that while biological therapy is highly effective in controlling skin and systemic inflammation in psoriasis, it does not modify SUA levels. These results imply that hyperuricemia in psoriasis may be driven by metabolic factors independent of the primary inflammatory pathways targeted by current biologics. Full article

Background/Objectives: As a global chromatin organizer, SATB1 is increasingly implicated in neurodevelopmental disorders (NDDs). This study aims to delineate the clinical and molecular characteristics of a novel de novo SATB1 variant in a patient presenting with epilepsy-dominant NDDs phenotypes. Methods: Triggered by the onset of seizures, trio-based whole-exome sequencing (Trio-WES) was performed to identify the genetic etiology. Subsequent sleep electroencephalogram (EEG) and magnetic resonance imaging (MRI) were then conducted to further characterize the patient’s clinical phenotypes. Pathogenicity was assessed through structural modeling and functional characterization. Nonsense-mediated mRNA decay (NMD) status, protein expression profiles, and subcellular localization were determined by reverse-transcription quantitative PCR (RT-qPCR), Western blotting, and immunofluorescence staining. The transcriptional regulatory impacts of the variant were quantified using dual-luciferase reporter system targeting known downstream regulatory elements. Clinical responses to antiepileptic intervention was also monitored. Results: We identified a novel de novo heterozygous pathogenic frameshift variant in SATB1 (NM_002971.5: c.1718_1719insCA; p.Val574Argfs*134) in a patient presenting with early-onset epilepsy, mild intellectual developmental disorder (IDD), speech delay, and dental anomalies. Functional assays demonstrated that the variant-derived transcript escaping NMD, yielding a truncated protein that forms irregular punctate aggregates within nuclei. Dual-luciferase assays revealed significantly increased transcriptional activity, indicating a loss of the protein’s innate transcriptional regulatory capacity. Clinically, treatment with sodium valproate (VPA) successfully stabilized seizures of the patient, markedly reducing both frequency and intensity. Conclusions: The study reports a novel SATB1 frameshift variant that exerts pathogenicity significant functional impairment by disrupting protein localization and transcriptional regulation. These findings expand the genetic spectrum of SATB1-related NDDs and underscore the efficacy of targeted antiepileptic management in genetic diseases. Full article

Background: Dining out has become increasingly prevalent in China, which is associated with higher intakes of energy, fat and sodium, elevating the risk of diet-related non-communicable diseases. However, evidence on color-coded nutrition labels for onsite prepared meals remains scarce. This study aimed to examine consumers’ perceptions of Dish-Choice, a three-color-coded onsite label, in comparison with the standard Nutrition Facts Label (NFL), to evaluate subjective perceptions of this novel label. Methods: A self-controlled trial was conducted among 3008 diners from canteens in Shanghai, with completing questionnaires twice: first on NFL perceptions, then three months later on Dish-Choice. Logistic regression and paired-sample comparison were used for analysis. Results: Compared with the NFL, Dish-Choice was associated with higher perceptual scores, with greater changes in overweight/obese, males, lower socio-economic status (SES) groups and those with poor dietary quality. Conclusions: The Dish-Choice label elicits more positive perceptual responses across multiple perceptual constructs. It is particularly well-received among vulnerable populations with lower health literacy, including men, lower-SES groups, and individuals with poor dietary habits. This supports its potential as a public health tool for on-site dining settings, though further research is needed to confirm its impact on actual food choices. Full article

Sanfilippo syndrome type B, also known as mucopolysaccharidosis type IIIB (MPS IIIB), is a rare autosomal recessive lysosomal storage disorder caused by mutations in the N-acetyl-α-D-glucosaminidase (NAGLU) gene, which encodes the enzyme α-N-acetylglucosaminidase. This enzyme is essential for degrading heparan sulfate. The deficiency leads to toxic accumulation within cells. To investigate the impact of NAGLU mutations, mutational data were retrieved from public databases including NCBI, UniProt, and HGMD. A total of 162 variants were evaluated using sequence-based prediction tools to identify deleterious mutations, followed by structure-based in silico analyses to assess changes in protein stability, biophysical properties, and ligand-binding potential. Among the analyzed mutations, the I154R variant was identified as the most deleterious, showing disease-associated characteristics, structural instability, and impaired functional properties. Molecular docking with N-acetylglucosamine (NAG) revealed binding affinities of −4.17 kcal/mol for the native protein and −3.97 kcal/mol for the I154R mutant, suggesting a retained yet slightly reduced binding potential. Molecular dynamics simulations supported these findings, indicating stable trajectories, favorable interaction profiles, and moderate flexibility for both complexes. These results enhance our understanding of NAGLU-related pathogenicity in MPS IIIB, contributing to improved health care strategies and offering a valuable foundation for future therapeutic developments targeting enzyme dysfunction in Sanfilippo syndrome type B. Full article

Background: Dry eye disease (DED) is a multifactorial disease. Numerous risk factors might cause DED, including indoor air pollution, such as incense. Incense (Bakhoor) is widely used in many cultures, including Saudi Arabia, although its smoke contains toxic chemicals that pose serious health hazards. This research investigates the link between the Schirmer II test and tear fluid proteins in DED patients. The study focuses on identifying the ocular examinations, hypothesizing that incense smoke, particularly from synthetic types, exacerbates DED. Methods: This pilot cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Participants were recruited from the Cornea and Ophthalmology Clinics. Eye assessments analyzed tear protein concentrations, including tear collection using Schirmer II test strips and tear break-up time (TBUT). The study included DED patients who used incense. Tear fluid from the Schirmer test of 20 randomly selected patients was used for protein analysis of total protein, lactoferrin, and Immunoglobulin E. Inclusion criteria were male and female subjects aged 18 years or older, diagnosed with DED, and using incense. The sample size was 55 participants, selected via convenience sampling. Subjective data were collected through questionnaires, as well as objective data from the tear test and the sample and analyzed with SPSS. Descriptive and inferential statistics were used, with statistical significance set at p-value < 0.05. Results: The Ocular Comfort Index (OCI) categories showed that 21.8% had no symptoms, 40.0% had low symptoms, 30.9% had moderate symptoms, and 7.3% reported high symptoms. TBUT values and Schirmer test scores decreased with increasing OCI severity, with no statistical significance. The mean (SD) of total protein in the right and left eyes for high OCI was 7.19 (1.39) and 7.42 (0.91), respectively, with no statistical significance. The immunoglobulin E levels in the right and left eyes for high OCI were 301.71 (55.97) and 301.71 (47.14), respectively, with no statistical significance. The mean (SD) of lactoferrin in the right and left eyes for high OCI was 163.77 (10.42) and 159.43 (1.68), respectively, with no statistical significance. Conclusions: The study findings demonstrate alignment in incense-using patients between subjective OCI symptom scores and objective clinical diagnostic measures. Specifically, higher OCI scores are associated with lower TBUT and Schirmer II test values, as well as changes in tear biomarkers such as IgE and lactoferrin. These findings emphasize the potential of using simple screening methods combined with bioanalytical markers for early detection of ocular surface disease. This highlights the potential health risks associated with incense exposure, particularly for individuals predisposed to DED. The urgency for further research to explore the long-term effects of incense on ocular health and to raise awareness about its potential impact on populations with high incense usage cannot be overstated. Full article

Severe early childhood caries (SECC) in preschool children is a progressive, multifactorial disease with far-reaching consequences for child health, family functioning, and health systems. Minimally invasive dentistry (MID), particularly 38% silver diamine fluoride (SDF), is increasingly used to arrest lesions and “buy time” when definitive restorative care is delayed. This narrative review synthesizes current evidence-based guidelines and real-world utilization data to clarify the appropriate role and limits of SDF in SECC management. Professional guidance supports SDF for lesion arrest within an ongoing caries management plan, but does not endorse it as a universal long-term substitute for durable restorative care. Observational studies show that many SDF-treated primary teeth receive additional intervention within approximately 2 years, and any delay in sedation/general anesthesia is typically measured in weeks to months. A large recent private practice study found that 35% of children with caries progressed to higher-intensity treatment (restoration or extraction) over a median of 547 days, reinforcing the time-limited nature of interim stabilization. We propose a “preservation-to-precision” framework that prioritizes child-centered outcomes—freedom from pain and infection, durable function, and acceptable psychosocial impact—through risk-based, tooth- and child-specific planning, realistic follow-up assessment, and clear exit criteria for transition to definitive care. In high-income settings, the ethical value of “buying time” depends on whether systems use that time to advance children toward timely, definitive care rather than normalizing prolonged temporization as routine practice. Full article

Cystic echinococcosis (CE) is a zoonotic disease caused by the larval stage of the Echinococcus granulosus sensu lato (s.l.) complex. The disease is globally distributed, with particularly high prevalence in Central Asian countries, including Kazakhstan. Despite its significant impact on public health and livestock production, data on CE in sheep in Kazakhstan remain limited. This study investigated the prevalence and genetic diversity of Echinococcus granulosus sensu stricto (s.s.) in sheep across Kazakhstan, addressing an important zoonotic disease affecting both livestock and human health. Over the course of one year, a total of 31,389 sheep were examined, and cystic echinococcosis cysts were collected from the livers and lungs of 550 infected sheep across 14 regions of Kazakhstan. Molecular analyses targeting mitochondrial genes (nad1, cox1) were performed to determine genetic diversity. The results revealed a higher occurrence of CE in the southern regions of the country. Among the genotyped isolates (57), genotype G1 was dominant, accounting for 84.2% (48) of the samples, whereas genotype G3 (9) was detected at a lower frequency in three regions. A total of 11 distinct haplotypes were identified, indicating considerable genetic diversity among the isolates. Haplotype network analysis suggested gene flow among populations and revealed the widespread presence of the most common haplotype (EgKZ-2) across multiple regions. These findings highlight the need for continuous monitoring and targeted control strategies for cystic echinococcosis, emphasizing the importance of understanding parasite genetic diversity for public health interventions and livestock management in endemic areas. Overall, this study contributes to the understanding of the genetic diversity and transmission dynamics of E. granulosus s.s. in Central Asia. Full article

Background/Objectives: Testicular cancer accounts for approximately 1% of all male malignancies, with an incidence ranging from 1 to 10 per 100,000 men and it predominantly affects young individuals, with nearly 60% of cases diagnosed between 15 and 35 years of age. In recent decades, the incidence of testicular cancer has markedly increased, paralleling a global rise in male infertility rates. Although chemotherapy is known to adversely affect fertility, the extent to which the tumor itself and its different histological subtypes impact semen quality remains incompletely understood. The aim of this study was to evaluate semen parameters in men diagnosed with testicular cancer prior to oncological treatment and to assess the possible association between tumor histology and semen quality. Methods: This retrospective study included data from 284 men diagnosed with testicular cancer who underwent semen cryopreservation prior to surgery, chemotherapy, or radiotherapy. Data were collected between January 2016 and June 2022 at the Maternal and Child Department of the University of Naples Federico II. Histopathological classification was available for 278 patients and revealed the following distribution: 59% (165/278) classic seminoma, 14.7% (41/278) seminomatous mixed germ cell tumors, 13.3% (37/278) non-seminomatous mixed germ cell tumors, and 12.6% (35/278) non-seminomatous germ cell tumors. Results: No significant association was observed between tumor histology and abnormal semen parameters. According to World Health Organization (WHO) reference values, semen parameters in patients with testicular cancer were predominantly distributed between the 5th and 25th percentiles. Microscopic semen analysis revealed significantly lower sperm concentration, total motility, and normal morphology in cancer patients (p < 0.001; p < 0.001; and p < 0.002, respectively). Logistic regression analysis showed a significant association between age and testicular cancer risk (p < 0.001), with a negative coefficient indicating that the likelihood of developing the disease decreases with increasing age. Additionally, patients with seminoma were significantly older than those with non-seminomatous tumors: on average, 4.07 years older than those with pure non-seminoma (p = 0.007) and 5.60 years older than those with mixed non-seminoma (p < 0.001). No statistically significant age differences were observed among non-seminomatous subtypes. Conclusions: These findings underscore the importance of systematic semen evaluation in young men diagnosed with testicular cancer and highlight the critical role of fertility preservation strategies in the comprehensive management of these patients. Full article

The COVID-19 pandemic has had a profound impact on global health, especially among patients with cardiovascular disease (CVD) and the existence of additional conditions such as diabetes (DM), hypertension (HT), and chronic kidney disease (CKD) can have a significant impact on survival rates. The aim of this study was to determine the mortality rate in patients with CVD and the impact of other comorbidities on the death of patients with COVID-19. This systematic review was conducted using PubMed, EMBASE, and Google Scholar databases from August 2020 to June 2025. Inclusion criteria were patients with cardiovascular disease and associated comorbidities during the COVID-19 pandemic. Article selection was limited to articles published in English and Polish. Statistical analysis using a random-effects model was performed using STATA software. Heterogeneity between studies was examined, and a funnel plot for publication bias was generated. The higher mortality rates (OR = 3.00, 95% CI: 2.06–4.38) for patients with cardiovascular disease were observed. In the group of patients with comorbidities such as hypertension and diabetes mellitus the risk of death was also determined and for HT was OR = 1.94, 95% CI, 1.50–2.52 and for DM OR = 2.17, 95% CI: 1.64–2.86. The mortality in the chronic kidney disease group was higher than for HT and DM (OR = 3.91, 95% CI: 2.50–6.10). The risk of death is three times higher for patients with COVID-19 and CVD. High mortality risk is also linked to diabetes and hypertension but for chronic kidney disease patients increased up to four times. Full article