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Search Results (2,579)

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Keywords = disease risk reduction

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20 pages, 2614 KiB  
Article
Porphyrin-Modified Polyethersulfone Ultrafiltration Membranes for Enhanced Bacterial Inactivation and Filtration Performance
by Funeka Matebese, Nonkululeko Malomane, Meladi L. Motloutsi, Richard M. Moutloali and Muthumuni Managa
Membranes 2025, 15(8), 239; https://doi.org/10.3390/membranes15080239 - 6 Aug 2025
Abstract
Municipal wastewaters pose a severe risk to the environment and human health when discharged untreated. This is due to their high content of pathogens, such as viruses and bacteria, which can cause diseases like cholera. Herein, the research and development of porphyrin-modified polyethersulfone [...] Read more.
Municipal wastewaters pose a severe risk to the environment and human health when discharged untreated. This is due to their high content of pathogens, such as viruses and bacteria, which can cause diseases like cholera. Herein, the research and development of porphyrin-modified polyethersulfone (PES) ultrafiltration (UF) membranes was conducted to improve bacterial inactivation in complex municipal wastewater and enhance the fouling resistance and filtration performance. The synthesis and fabrication of porphyrin nanofillers and the resultant membrane characteristics were studied. The incorporation of porphyrin-based nanofillers improved the membrane’s hydrophilicity, morphology, and flux (247 Lm−2 h−1), with the membrane contact angle (CA) decreasing from 90° to ranging between 58° and 50°. The membrane performance was monitored for its flux, antifouling properties, reusability potential, municipal wastewater, and humic acid. The modified membranes demonstrated an effective application in wastewater treatment, achieving notable antibacterial activity, particularly under light exposure. The In-BP@SW/PES membrane demonstrated effective antimicrobial photodynamic effects against both Gram-positive S. aureus and Gram-negative E. coli. It achieved at least a 3-log reduction in bacterial viability, meeting Food and Drug Administration (FDA) standards for efficient antimicrobial materials. Among the variants tested, membranes modified with In-PB@SW nanofillers exhibited superior antifouling properties with flux recovery ratios (FRRs) of 78.9% for the humic acid (HA) solution and 85% for the municipal wastewater (MWW), suggesting a strong potential for long-term filtration use. These results highlight the promise of porphyrin-functionalized membranes as multifunctional tools in advanced water treatment technologies. Full article
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14 pages, 746 KiB  
Article
Long-Term Outcomes of the Dietary Approaches to Stop Hypertension (DASH) Intervention in Nonobstructive Coronary Artery Disease: Follow-Up of the DISCO-CT Study
by Magdalena Makarewicz-Wujec, Jan Henzel, Cezary Kępka, Mariusz Kruk, Barbara Jakubczak, Aleksandra Wróbel, Rafał Dąbrowski, Zofia Dzielińska, Marcin Demkow, Edyta Czepielewska and Agnieszka Filipek
Nutrients 2025, 17(15), 2565; https://doi.org/10.3390/nu17152565 - 6 Aug 2025
Abstract
In the original randomised Dietary Intervention to Stop Coronary Atherosclerosis (DISCO-CT) trial, a 12-month Dietary Approaches to Stop Hypertension (DASH) project led by dietitians improved cardiovascular and metabolic risk factors and reduced platelet chemokine levels in patients with coronary artery disease (CAD). It [...] Read more.
In the original randomised Dietary Intervention to Stop Coronary Atherosclerosis (DISCO-CT) trial, a 12-month Dietary Approaches to Stop Hypertension (DASH) project led by dietitians improved cardiovascular and metabolic risk factors and reduced platelet chemokine levels in patients with coronary artery disease (CAD). It is unclear whether these benefits are sustained. Objective: To determine whether the metabolic, inflammatory, and clinical benefits achieved during the DISCO-CT trial are sustained six years after the structured intervention ended. Methods: Ninety-seven adults with non-obstructive CAD confirmed in coronary computed tomography angiography were randomly assigned to receive optimal medical therapy (control group, n = 41) or the same therapy combined with intensive DASH counselling (DASH group, n = 43). After 301 ± 22 weeks, 84 individuals (87%) who had given consent underwent reassessment of body composition, meal frequency assessment, and biochemical testing (lipids, hs-CRP, CXCL4, RANTES and homocysteine). Major adverse cardiovascular events (MACE) were assessed. Results: During the intervention, the DASH group lost an average of 3.6 ± 4.2 kg and reduced their total body fat by an average of 4.2 ± 4.8 kg, compared to an average loss of 1.1 ± 2.9 kg and a reduction in total body fat of 0.3 ± 4.1 kg in the control group (both p < 0.01). Six years later, most of the lost body weight and fat tissue had been regained, and there was a sharp increase in visceral fat area in both groups (p < 0.0001). CXCL4 decreased by 4.3 ± 3.0 ng/mL during the intervention and remained lower than baseline values; in contrast, in the control group, it initially increased and then decreased (p < 0.001 between groups). LDL cholesterol and hs-CRP levels returned to baseline in both groups but remained below baseline in the DASH group. There was one case of MACE in the DASH group, compared with four cases (including one fatal myocardial infarction) in the control group (p = 0.575). Overall adherence to the DASH project increased by 26 points during counselling and then decreased by only four points, remaining higher than in the control group. Conclusions: A one-year DASH project supported by a physician and dietitian resulted in long-term suppression of the proatherogenic chemokine CXCL4 and fewer MACE over six years, despite a decline in adherence and loss of most anthropometric and lipid benefits. It appears that sustained systemic reinforcement of behaviours is necessary to maintain the benefits of lifestyle intervention in CAD. Full article
(This article belongs to the Special Issue Nutrients: 15th Anniversary)
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17 pages, 294 KiB  
Review
Coffee’s Impact on Health and Well-Being
by Ryan C. Emadi and Farin Kamangar
Nutrients 2025, 17(15), 2558; https://doi.org/10.3390/nu17152558 - 5 Aug 2025
Abstract
Coffee is one of the most widely consumed beverages globally, with over 60% of Americans drinking it daily. This review examines coffee’s multifaceted impact on health and well-being, drawing on decades of research. Overall, the consensus is that moderate coffee intake is more [...] Read more.
Coffee is one of the most widely consumed beverages globally, with over 60% of Americans drinking it daily. This review examines coffee’s multifaceted impact on health and well-being, drawing on decades of research. Overall, the consensus is that moderate coffee intake is more beneficial than harmful across a wide range of health outcomes. Numerous large-scale, prospective cohort studies from around the world have consistently shown that moderate coffee consumption—typically three to five cups per day—is associated with reduced overall mortality and lower risk of major diseases such as cardiovascular diseases, diabetes, stroke, respiratory conditions, cognitive decline, and potentially several types of cancer, including liver and uterine cancers. Both caffeinated and decaffeinated coffee have shown benefits. The addition of sugar and cream to coffee may attenuate coffee’s positive health effects. Despite historical concerns, coffee consumption is not linked to increased risks of cancer, hypertension, or arrhythmia. However, some concerns remain. For pregnant women, coffee consumption should be limited to lower amounts, such that the daily intake of caffeine does not exceed 200 mg/day. Also, excessive caffeinated coffee intake may cause anxiety or sleep disturbances. Coffee’s health-promoting mechanisms include improved glucose balancing, increased physical activity, increased fat oxidation, improved lung function, and reduced inflammation. Beyond mortality and chronic diseases, coffee consumption affects many aspects of well-being: it supports hydration, boosts mental acuity, enhances physical performance, and may aid bowel recovery after surgery. While the field is well-studied via long-term observational cohorts, future research should focus on randomized controlled trials, Mendelian randomization studies, and granular analyses of coffee types and additives. Full article
(This article belongs to the Section Nutritional Epidemiology)
19 pages, 2246 KiB  
Systematic Review
The Association of Poor Preoperative Mental Health and Outcomes After Surgical Correction of Adult Spinal Deformity: A Systematic Review and Meta Analysis
by Yifei Sun, Hariteja Ramapuram, Riyaz Razi, Mohammad Hamo, Sasha Howell, Nicholas M. B. Laskay, Jovanna Tracz, Anil Mahavadi, James Mooney and Jakub Godzik
J. Clin. Med. 2025, 14(15), 5516; https://doi.org/10.3390/jcm14155516 - 5 Aug 2025
Abstract
Background/Objectives: Adult Spinal Deformity (ASD) is a pathologic malalignment of the spine that can lead to significant reductions in quality of life, functional limitations, and increased morbidity. While poor mental health is commonly observed among patients undergoing ASD surgery, its impact on surgical [...] Read more.
Background/Objectives: Adult Spinal Deformity (ASD) is a pathologic malalignment of the spine that can lead to significant reductions in quality of life, functional limitations, and increased morbidity. While poor mental health is commonly observed among patients undergoing ASD surgery, its impact on surgical outcomes remains poorly understood. We conducted a systematic review and meta-analysis to examine the association between preoperative mental health and outcomes following surgical correction for ASD. Methods: A comprehensive search of MEDLINE, Embase, Web of Science, and Scopus was performed from inception to April 2025 to identify studies investigating the relationship between preoperative mental health and postoperative health-related quality of life outcomes or complications. Data was pooled using a restricted maximum likelihood (REML) random-effects model. Heterogeneity was assessed using Cochran’s Q statistic, and between-study variance was reported as τ2. Study quality was assessed with the Newcastle–Ottawa Scale, and risk of bias was evaluated using the ROBINS-I tool. Results: Twenty-four studies comprising a total of 248,427 patients met inclusion criteria. In pooled analyses, patients with poor preoperative mental health showed comparable improvements in health-related quality of life measures after surgery (standardized mean difference [SMD] −0.04, 95% CI −0.30 to 0.22; I2 = 91.5%, τ2 = 0.42) and in pain scores (SMD −0.15, 95% CI −0.42 to 0.11; I2 = 71.8%, τ2 = 0.09). However, patients with poor mental health had significantly higher odds of postoperative complications (odds ratio [OR] 1.44, 95% CI 1.23 to 1.67; I2 = 97.4%, τ2 = 0.08). These patients also demonstrated worse preoperative disease severity (SMD –0.94, 95% CI −1.41 to −0.47; I2 = 95.5%, τ2 = 1.64) and worse postoperative disease severity (SMD –0.34, 95% CI −0.44 to −0.25; I2 = 48.9%, τ2 = 0.03). Conclusions: While patients with poor preoperative mental health have a greater disease severity both before and after ASD surgery, they appear to experience comparable benefits from surgical intervention compared to those without. Recognizing and managing mental health may be useful in preoperative management of ASD patients. Further prospective studies to further elucidate these associations are necessary. Full article
(This article belongs to the Special Issue Optimizing Outcomes in Scoliosis and Complex Spinal Surgery)
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14 pages, 731 KiB  
Article
Effectiveness of the Human Papillomavirus Vaccine in Extended Age Groups: A Real-World Analysis Based on the Korean HPV Cohort Study
by Heekyoung Song, Sanha Lee, Suein Choi and Soo Young Hur
Cancers 2025, 17(15), 2561; https://doi.org/10.3390/cancers17152561 - 3 Aug 2025
Viewed by 272
Abstract
Background/Objectives: This study evaluated the real-world effectiveness of prophylactic Human Papillomavirus (HPV) vaccination in Korean women aged over 26 years, focusing on its impact on persistent HPV infection and disease progression. Methods: This multicenter prospective study analyzed data from the Korea HPV Cohort [...] Read more.
Background/Objectives: This study evaluated the real-world effectiveness of prophylactic Human Papillomavirus (HPV) vaccination in Korean women aged over 26 years, focusing on its impact on persistent HPV infection and disease progression. Methods: This multicenter prospective study analyzed data from the Korea HPV Cohort (2010–2021). After applying exclusion criteria, the final analytical cohort included 1,231 women aged ≥ 27 years with cytologic findings of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions and HPV infection. Propensity score matching was used to compare vaccinated (n = 340) and unvaccinated (n = 891) participants. After matching, 273 vaccinated and 273 unvaccinated individuals were included in the final analysis. The primary outcomes were persistent HPV infection and progression to biopsy-confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Logistic and Cox regression models were employed, with additional age-stratified analyses. Results: Among women aged 27–39 years, vaccination was significantly associated with a 54% reduction in the odds of persistent HPV infection (odds ratio = 0.46; 95% CI: 0.22–0.96; p = 0.040). In the full cohort, vaccinated participants had a 62% lower risk of progression to CIN2+ compared with unvaccinated participants (hazard ratio = 0.38; 95% CI: 0.18–0.81; p = 0.011). Body mass index had a notable impact on HPV persistence in HPV 16/18 genotype groups. Conclusions: HPV vaccination effectively reduced persistent infection and progression to CIN2+ in Korean women, particularly those vaccinated before age 40. These findings support the age-extended HPV vaccination policies in South Korea. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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22 pages, 5182 KiB  
Article
Effects of High-Phenolic Extra Virgin Olive Oil (EVOO) on the Lipid Profile of Patients with Hyperlipidemia: A Randomized Clinical Trial
by Christos Kourek, Emmanouil Makaris, Prokopios Magiatis, Virginia Zouganeli, Vassiliki Benetou, Alexandros Briasoulis, Andrew Xanthopoulos, Ioannis Paraskevaidis, Eleni Melliou, Georgios Koudounis and Philippos Orfanos
Nutrients 2025, 17(15), 2543; https://doi.org/10.3390/nu17152543 - 2 Aug 2025
Viewed by 500
Abstract
Background/Objectives: Hyperlipidemia is a major risk factor for cardiovascular disease and atherosclerosis. Polyphenols found in polyphenol-rich extra virgin olive oil (EVOO) have been shown to possess strong antioxidant, anti-inflammatory, and cardioprotective properties. The present study aimed to assess the effects of two types [...] Read more.
Background/Objectives: Hyperlipidemia is a major risk factor for cardiovascular disease and atherosclerosis. Polyphenols found in polyphenol-rich extra virgin olive oil (EVOO) have been shown to possess strong antioxidant, anti-inflammatory, and cardioprotective properties. The present study aimed to assess the effects of two types of EVOO with different polyphenol content and dosages on the lipid profile of hyperlipidemic patients. Methods: In this single-blind, randomized clinical trial, 50 hyperlipidemic patients were randomized to receive either a higher-dose, lower-phenolic EVOO (414 mg/kg phenols, 20 g/day) or a lower-dose, higher-phenolic EVOO (1021 mg/kg phenols, 8 g/day), for a period of 4 weeks. These doses were selected to ensure equivalent daily polyphenol intake in both groups (~8.3 mg of total phenols/day), based on chemical analysis performed using NMR spectroscopy. The volumes used (8–20 g/day) reflect typical daily EVOO intake and were well tolerated by participants. A group of 20 healthy individuals, separated into two groups, also received the two types of EVOO, respectively, for the same duration. Primary endpoints included blood levels of total blood cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, lipoprotein-a (Lpa), and apolipoproteins A1 and B. Measurements were performed at baseline and at the end of the 4-week intervention. Linear mixed models were performed for the data analysis. Results: The higher-phenolic, lower-dose EVOO group showed a more favorable change in total blood cholesterol (p = 0.045) compared to the lower-phenolic, higher-dose group. EVOO intake was associated with a significant increase in HDL (p < 0.001) and reduction in Lp(a) (p = 0.040) among hyperlipidemic patients in comparison to healthy individuals. Conclusions: EVOO consumption significantly improved the lipid profile of hyperlipidemic patients. Higher-phenolic EVOO at lower dosages appears to be more effective in improving the lipid profile than lower-phenolic EVOO in higher dosages. Full article
(This article belongs to the Section Clinical Nutrition)
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28 pages, 820 KiB  
Systematic Review
The Effects of Nutritional Education and School-Based Exercise Intervention Programs on Preschool and Primary School Children’s Cardiometabolic Biomarkers: A Systematic Review of Randomized Controlled Trials
by Markel Rico-González, Daniel González-Devesa, Carlos D. Gómez-Carmona and Adrián Moreno-Villanueva
Appl. Sci. 2025, 15(15), 8564; https://doi.org/10.3390/app15158564 (registering DOI) - 1 Aug 2025
Viewed by 148
Abstract
Childhood obesity increases chronic disease risk, but no comprehensive synthesis has evaluated the impact of school-based combined nutrition education and physical activity interventions on cardiometabolic biomarkers in children aged 3 to 12 years. This systematic review was conducted in accordance with PRISMA guidelines [...] Read more.
Childhood obesity increases chronic disease risk, but no comprehensive synthesis has evaluated the impact of school-based combined nutrition education and physical activity interventions on cardiometabolic biomarkers in children aged 3 to 12 years. This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251085194). Five databases were systematically searched through June 2025. Twelve randomized controlled trials involving 18,231 children were included and assessed using the PEDro scale. Ten trials demonstrated significant improvements in at least one cardiometabolic biomarker. Blood pressure (8 studies) outcomes showed systolic reductions of 1.41–6.0 mmHg in six studies. Glucose metabolism (5 studies) improved in two studies with reductions of 0.20–0.22 mmol/L. Lipid profiles (7 studies) improved in three studies, including total cholesterol (−0.32 mmol/L). Insulin levels (5 studies) decreased significantly in two investigations. Anthropometric improvements included BMI and body fat. Physical activity increased by >45 min/week and dietary habits improved significantly. Programs with daily implementation (90-min sessions 4x/week), longer duration (≥12 months), family involvement (parent education), and curriculum integration (classroom lessons) showed superior effectiveness. Interventions targeting children with overweight/obesity demonstrated higher changes compared to the general population. However, methodological limitations included a lack of assessor blinding, absence of subject/therapist blinding, and inadequate retention rates. School-based interventions combining nutrition and physical activity can produce significant improvements in cardiometabolic biomarkers, supporting comprehensive, sustained multicomponent programs for early chronic disease prevention. Full article
(This article belongs to the Special Issue Research of Sports Medicine and Health Care: Second Edition)
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13 pages, 453 KiB  
Article
The Path of Bronchiolitis Towards Intensive Care: Risk Factor Analysis in a Large Italian Cohort
by Marco Maglione, Luca Pierri, Fabio Savoia, Camilla Calì, Roberta Ragucci, Marco Sarno, Giulia Ranucci, Emma Coppola, Francesco Nunziata, Antonino Di Toro, Vincenzo Tipo, Antonietta Giannattasio and the BRAND Study
J. Clin. Med. 2025, 14(15), 5420; https://doi.org/10.3390/jcm14155420 - 1 Aug 2025
Viewed by 176
Abstract
Background/Objectives: Bronchiolitis is the leading cause of hospitalization in infants under 12 months. While often self-limiting, a subset of cases evolves into severe disease requiring intensive care. This study aimed to identify risk factors for severe bronchiolitis in two consecutive respiratory syncytial virus [...] Read more.
Background/Objectives: Bronchiolitis is the leading cause of hospitalization in infants under 12 months. While often self-limiting, a subset of cases evolves into severe disease requiring intensive care. This study aimed to identify risk factors for severe bronchiolitis in two consecutive respiratory syncytial virus (RSV) seasons (before and after the introduction of nirsevimab) in Southern Italy. Methods: A retrospective, multicenter cohort study was conducted on all infants ≤12 months hospitalized with bronchiolitis from October 2023 to March 2025. Patients were categorized by disease severity: those requiring Sub-Intensive or Intensive Care (IC group) and others (n-IC group). Demographic and clinical data, virological testing, and therapeutic interventions were analyzed. Multivariable logistic regression was used to identify independent risk factors for severe disease. Results: Among 1056 hospitalized infants, 10.5% required intensive care. RSV was detected in 73.5% of tested patients and was significantly associated with severe outcomes. Independent risk factors for IC admission included younger age (<3 months), comorbidities, and RSV infection. A 33% reduction in bronchiolitis admissions was observed in the second season (post-nirsevimab), although the rate of severe cases remained stable (about 10% in both seasons). Conclusions: Younger age, comorbidities, and RSV infection are significant predictors of severe bronchiolitis. Although overall admissions decreased post-nirsevimab, severe cases persisted. These findings underscore the need for targeted preventive strategies and highlight the potential role of intermediate care approaches in managing bronchiolitis severity. Full article
(This article belongs to the Section Intensive Care)
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14 pages, 267 KiB  
Article
Impact of Short-Term Liraglutide Therapy on Non-Invasive Markers of Liver Fibrosis in Patients with MASLD
by Aleksandra Bołdys, Maciej Borówka, Łukasz Bułdak and Bogusław Okopień
Metabolites 2025, 15(8), 510; https://doi.org/10.3390/metabo15080510 - 31 Jul 2025
Viewed by 454
Abstract
Background/Objectives: Affecting close to one-third of the global population, metabolic dysfunction-associated steatotic liver disease (MASLD) is a highly prevalent chronic liver disorder linked to metabolic risk factors such as obesity and insulin resistance. Liver fibrosis is a key determinant of prognosis, and [...] Read more.
Background/Objectives: Affecting close to one-third of the global population, metabolic dysfunction-associated steatotic liver disease (MASLD) is a highly prevalent chronic liver disorder linked to metabolic risk factors such as obesity and insulin resistance. Liver fibrosis is a key determinant of prognosis, and its progression increases the risk of liver-related and overall mortality. This exploratory research evaluated the potential impact of a 3-month intervention involving dietary counseling and liraglutide therapy on liver fibrosis and related metabolic markers in patients with MASLD and obesity without diabetes. Methods: In this prospective, single-arm exploratory intervention, 28 adult patients with MASLD and obesity received structured dietary counseling and daily subcutaneous liraglutide for 12 weeks. Liver fibrosis was assessed using non-invasive indices (FIB-4, APRI, BARD, ELF) and transient elastography performed with the FibroScan® device (Echosens, Paris, France). Results: After 3 months, a significant reduction in liver stiffness (−7.14%, p < 0.05) and ELF score (from 6.71 to 6.63; −1.2%, p < 0.05) was observed. APRI (p = 0.06) and FIB-4 (p = 0.09) showed trends toward improvement, while the BARD score and AST/ALT ratio remained unchanged. Conclusions: Short-term liraglutide therapy combined with lifestyle modification may improve early-stage liver fibrosis in patients with MASLD and obesity, as indicated by reductions in liver stiffness and ELF score. These preliminary findings highlight the potential of advanced non-invasive fibrosis markers in monitoring treatment response. However, as an exploratory study, results should be interpreted with caution, and larger, long-term trials are needed to confirm these observations and evaluate efficacy in patients with more advanced fibrosis stages. Full article
15 pages, 288 KiB  
Systematic Review
Interventions to Improve Vaccination Uptake Among Adults: A Systematic Review and Meta-Analysis
by Anelisa Jaca, Lindi Mathebula, Thobile Malinga, Kimona Rampersadh, Masibulele Zulu, Ameer Steven-Jorg Hohlfeld, Charles Shey Wiysonge, Julie C. Jacobson Vann and Duduzile Ndwandwe
Vaccines 2025, 13(8), 811; https://doi.org/10.3390/vaccines13080811 - 30 Jul 2025
Viewed by 246
Abstract
Background: Immunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. [...] Read more.
Background: Immunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. Additionally, there has been a remarkable 99.9% reduction in wild poliovirus cases since 1988, decreasing from more than 350,000 cases that year to just 30 cases in 2022. Objectives: The objective of this review was to assess the effects of various interventions designed to increase vaccination uptake among adults. Search Methods: A thorough search was conducted in the CENTRAL, Embase Ovid, Medline Ovid, PubMed, Web of Science, and Global Index Medicus databases for primary studies. This search was conducted in August 2021 and updated in November 2024. Selection Criteria: Randomized trials were eligible for inclusion in this review, regardless of publication status or language. Data Analysis: Two authors independently screened the search outputs to select potentially eligible studies. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for each randomized controlled trial (RCT). A meta-analysis was conducted using a random-effects model, and the quality of the evidence was assessed using the GRADE approach. Main Results: A total of 35 randomized controlled trials met the inclusion criteria and were included in this review, with the majority conducted in the United States. The interventions targeted adults aged 18 and older who were eligible for vaccination, involving a total of 403,709 participants. The overall pooled results for interventions aimed at increasing influenza vaccination showed a risk ratio of 1.41 (95% CI: 1.15, 1.73). Most studies focused on influenza vaccination (18 studies), while the remaining studies examined various other vaccines, including those for hepatitis A, COVID-19, hepatitis B, pneumococcal disease, tetanus, diphtheria, pertussis (Tdap), herpes zoster, and human papillomavirus (HPV). The results indicate that letter reminders were slightly effective in increasing influenza vaccination uptake compared to the control group (RR: 1.75, 95% CI: 0.97, 1.16; 6 studies; 161,495 participants; low-certainty evidence). Additionally, participants who received education interventions showed increased levels of influenza vaccination uptake compared to those in the control group (RR: 1.88, 95% CI: 0.61, 5.76; 3 studies; 1318 participants; low-certainty evidence). Furthermore, tracking and outreach interventions also led to an increase in influenza vaccination uptake (RR: 1.87, 95% CI: 0.78, 4.46; 2 studies; 33,752 participants; low-certainty evidence). Conclusions: Letter reminders and educational interventions targeted at recipients are effective in increasing vaccination uptake compared to control groups. Full article
17 pages, 2337 KiB  
Systematic Review
Optical Coherence Tomography-Guided vs. Angiography-Guided Percutaneous Coronary Intervention for Complex Coronary Lesions: A Systematic Review and Meta-Analysis
by Muhammad Hamza Shuja, Muhammad Ahmed, Ramish Hannat, Laiba Khurram, Hamza Ali Hasnain Sheikh, Syed Hasan Shuja, Adarsh Raja, Jawad Ahmed, Kriti Soni, Shariq Ahmad Wani, Aman Goyal, Bala Pushparaji, Ali Hasan, Raheel Ahmed and Hritvik Jain
Diagnostics 2025, 15(15), 1907; https://doi.org/10.3390/diagnostics15151907 - 30 Jul 2025
Viewed by 348
Abstract
Background: Despite advances in coronary artery disease (CAD) treatment, challenges persist, particularly in complex lesions. While percutaneous coronary intervention (PCI) is widely used, its outcomes can be affected by complications like restenosis. Optical coherence tomography (OCT), offering higher-resolution imaging than angiography, shows [...] Read more.
Background: Despite advances in coronary artery disease (CAD) treatment, challenges persist, particularly in complex lesions. While percutaneous coronary intervention (PCI) is widely used, its outcomes can be affected by complications like restenosis. Optical coherence tomography (OCT), offering higher-resolution imaging than angiography, shows promise in guiding PCI. However, meta-analytical comparisons between OCT-guided and angiography-guided PCI remain limited. Methods: Databases, including PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov, were queried through May 2025 to identify randomized controlled trials (RCTs) comparing OCT-guided PCI with angiography-guided PCI. Data were pooled using risk ratios (RRs) and mean difference (MD) with 95% confidence intervals (CIs) in a random-effects model. Results: Five RCTs involving 5737 patients (OCT: 2738 and angiography: 2999) were included. On pooled analysis, OCT-guided PCI was associated with a notable reduction in major adverse cardiovascular event (MACE) (RR: 0.71, p = 0.0001), cardiac mortality (RR: 0.43, p = 0.003), target lesion revascularization (TLR) (RR: 0.53, p = 0.007), and stroke (RR: 0.17, p = 0.02), compared to angiography-guided PCI. No significant differences were noted for all-cause mortality and myocardial infarction. Conclusions: In patients with complex coronary lesions, OCT-guided PCI reduces the risk of MACE, cardiac mortality, TLR, and stroke, compared to angiography-guided PCI only. This study supports incorporating advanced imaging techniques like OCT to improve clinical outcomes, especially in complex PCIs. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Cardiovascular Diseases)
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17 pages, 536 KiB  
Article
Optimal Vegetable Intake for Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD) Prevention: Insights from a South Italian Cohort
by Maria Noemy Pastore, Caterina Bonfiglio, Rossella Tatoli, Rossella Donghia, Pasqua Letizia Pesole and Gianluigi Giannelli
Nutrients 2025, 17(15), 2477; https://doi.org/10.3390/nu17152477 - 29 Jul 2025
Viewed by 333
Abstract
(1) Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is now the most prevalent chronic liver disease worldwide, posing a growing public health concern. While dietary improvements are key to prevention, the impact of different vegetable types remains unclear. This study focuses on the association [...] Read more.
(1) Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is now the most prevalent chronic liver disease worldwide, posing a growing public health concern. While dietary improvements are key to prevention, the impact of different vegetable types remains unclear. This study focuses on the association between vegetable consumption and the risk of MASLD in a cohort of Southern Italy. (2) Methods: This research involved 1297 participants from the NUTRIHEP study, examining overall vegetable intake and classifying them into color subgroups to determine optimal quantity and variety for risk reduction. (3) Results: Daily consumption of approximately 325 g (two servings) of total vegetables significantly reduces the risk of MASLD (OR: 0.521; 95% CI: 0.317; 0.858). Among the subgroups, green vegetables were most protective at 35 g/day, while red and orange vegetables offered protection at 130 g/day. A higher intake of the other vegetable category, specifically onions, was associated with a reduced probability of MASLD (OR = 0.995; 95%CI: 0.989; 0.999). (4) Conclusions: These findings suggest a threshold effect, where moderate but regular consumption of specific vegetables offers maximal protection. Consuming excessive amounts may not enhance this benefit within this cohort. Cultural and regional dietary patterns should be considered when designing targeted nutritional interventions. Full article
(This article belongs to the Special Issue Mediterranean Diet and Nutrition Literacy)
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27 pages, 4299 KiB  
Article
Causal Relationship Between Serum Uric Acid and Atherosclerotic Disease: A Mendelian Randomization and Transcriptomic Analysis
by Shitao Wang, Shuai Mei, Xiaozhu Ma, Qidamugai Wuyun, Li Zhou, Qiushi Luo, Ziyang Cai and Jiangtao Yan
Biomedicines 2025, 13(8), 1838; https://doi.org/10.3390/biomedicines13081838 - 28 Jul 2025
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Abstract
Background/Objectives: Elevated serum uric acid levels are associated with the occurrence, development, and adverse events of coronary heart disease (CHD) and CHD risk factors. However, the extent of any pathogenic effect of the serum uric acid on CHD and whether CHD risk [...] Read more.
Background/Objectives: Elevated serum uric acid levels are associated with the occurrence, development, and adverse events of coronary heart disease (CHD) and CHD risk factors. However, the extent of any pathogenic effect of the serum uric acid on CHD and whether CHD risk factors play a confounding or mediating role are still unclear. Methods: The potential causal associations of serum uric acid with CHD were evaluated via cross-trait linkage disequilibrium score regression analysis and Mendelian randomization. The pleiotropy of genetic tools was analyzed via a Bayesian colocalization approach. Moreover, we utilized two-step MR to identify risk factors mediating the relationship between uric acid and CHD. Results: Mendelian randomization results derived from two genetic instrument selection strategies support that serum uric acid levels have a significant causal relationship with coronary artery disease, stable angina pectoris, and myocardial infarction. This causal relationship was partially mediated by diastolic blood pressure, mean arterial pressure, and serum triglycerides. Transcriptomic analysis revealed that serum uric acid may directly contribute to the development of atherosclerosis by inducing transcriptomic changes in macrophages. Conclusions: Our findings highlight that the control of serum urate concentration in the long-term management of CHD patients may be necessary. Well-designed clinical trials and foundational research are presently required to furnish conclusive proof regarding the specific clinical scenarios in which adequate reduction in urate concentrations can confer cardiovascular advantages. Full article
(This article belongs to the Special Issue Advances in Genomics and Bioinformatics of Human Disease)
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22 pages, 1781 KiB  
Article
Analyzing Heart Rate Variability for COVID-19 ICU Mortality Prediction Using Continuous Signal Processing Techniques
by Guilherme David, André Lourenço, Cristiana P. Von Rekowski, Iola Pinto, Cecília R. C. Calado and Luís Bento
J. Clin. Med. 2025, 14(15), 5312; https://doi.org/10.3390/jcm14155312 - 28 Jul 2025
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Abstract
Background/Objectives: Heart rate variability (HRV) has been widely investigated as a predictor of disease and mortality across diverse patient populations; however, there remains no consensus on the optimal set or combination of time and frequency domain nor on nonlinear features for reliable prediction [...] Read more.
Background/Objectives: Heart rate variability (HRV) has been widely investigated as a predictor of disease and mortality across diverse patient populations; however, there remains no consensus on the optimal set or combination of time and frequency domain nor on nonlinear features for reliable prediction across clinical contexts. Given the relevance of the COVID-19 pandemic and the unique clinical profiles of these patients, this retrospective observational study explored the potential of HRV analysis for early prediction of in-hospital mortality using ECG signals recorded during the initial moments of ICU admission in COVID-19 patients. Methods: HRV indices were extracted from four ECG leads (I, II, III, and aVF) using sliding windows of 2, 5, and 7 min across observation intervals of 15, 30, and 60 min. The raw data posed significant challenges in terms of structure, synchronization, and signal quality; thus, from an original set of 381 records from 321 patients, after data pre-processing steps, a final dataset of 82 patients was selected for analysis. To manage data complexity and evaluate predictive performance, two feature selection methods, four feature reduction techniques, and five classification models were applied to identify the optimal approach. Results: Among the feature aggregation methods, compiling feature means across patient windows (Method D) yielded the best results, particularly for longer observation intervals (e.g., using LDA, the best AUC of 0.82±0.13 was obtained with Method D versus 0.63±0.09 with Method C using 5 min windows). Linear Discriminant Analysis (LDA) was the most consistent classification algorithm, demonstrating robust performance across various time windows and further improvement with dimensionality reduction. Although Gradient Boosting and Random Forest also achieved high AUCs and F1-scores, their performance outcomes varied across time intervals. Conclusions: These findings support the feasibility and clinical relevance of using short-term HRV as a noninvasive, data-driven tool for early risk stratification in critical care, potentially guiding timely therapeutic decisions in high-risk ICU patients and thereby reducing in-hospital mortality. Full article
(This article belongs to the Section Cardiology)
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17 pages, 451 KiB  
Article
Primary and Recurrent Erysipelas—Epidemiological Patterns in a Single-Centre Retrospective Analysis
by Marta Matych, Agata Ciosek, Karol Miler, Marcin Noweta, Karolina Brzezińska, Małgorzata Sarzała, Joanna Narbutt and Aleksandra Lesiak
J. Clin. Med. 2025, 14(15), 5299; https://doi.org/10.3390/jcm14155299 - 27 Jul 2025
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Abstract
Background/Objectives: Erysipelas is an acute bacterial skin infection, particularly affecting the lower limbs, with a tendency to recur. Despite its clinical importance, data on demographic and epidemiological risk factors, as well as factors influencing hospitalization, remain limited. This study aimed to analyze the [...] Read more.
Background/Objectives: Erysipelas is an acute bacterial skin infection, particularly affecting the lower limbs, with a tendency to recur. Despite its clinical importance, data on demographic and epidemiological risk factors, as well as factors influencing hospitalization, remain limited. This study aimed to analyze the epidemiological and clinical characteristics of patients hospitalized with primary and recurrent erysipelas, focusing on risk factors contributing to disease onset, recurrence, and prolonged hospitalization. Methods: A retrospective single-center analysis was conducted on 239 patients hospitalized for erysipelas at the Department of Dermatology, Pediatric Dermatology, and Oncology at the Medical University of Lodz. Data collected included demographics, lesion location, laboratory markers, comorbidities, and hospitalization outcomes. Statistical analyses were performed to assess associations between risk factors, disease recurrence, and hospitalization duration. Results: The majority of erysipelas cases (85.4%) involved the lower limbs, with a higher prevalence in men. Upper extremities were mostly affected in women, especially those who had undergone breast cancer surgery. Recurrent erysipelas accounted for 75.7% of cases. Most patients (89.1%) had at least one comorbidity, with hypertension, diabetes type 2 (DM2), and obesity being the most common. Higher white blood cell (WBC) count, obesity, atrial fibrillation (AF), and the need for enoxaparin administration were independently associated with prolonged hospitalization. Dyslipidemia was significantly associated with erysipelas recurrence (p < 0.05). Conclusions: Both primary and recurrent erysipelas are associated with specific risk factors. Recurrent erysipelas may be linked to components of metabolic syndrome, particularly obesity and dyslipidemia, which emerged as a significant risk factor in this study. Hospitalization length may be prolonged by inflammation markers (WBC and CRP) and comorbidities such as AF, obesity, or the need for enoxaparin in patients with elevated thrombosis risk. Further multicenter studies with larger cohorts are needed to assess the impact of demographics, biomarkers, metabolic disorders, and treatment strategies on erysipelas recurrence and outcomes. Awareness of these risk factors is essential for effective prevention, management, and recurrence reduction. Full article
(This article belongs to the Special Issue Clinical Epidemiology of Skin Diseases: 3rd Edition)
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