Search Results (821)

Background: Endonasal endoscopic approaches to the skull base are still under investigation, with research aiming to achieve minimally invasive procedures that maximize resection while minimizing complications. This study shares our experience with a mononostril technique and compares it with the existing literature on mononostril approaches for sellar lesions. Methods: A systematic review of eight large series, totaling 1520 patients who underwent endoscopic mononostril transsphenoidal surgery, was performed. The surgical technique was detailed, and parameters such as resection completeness, operative time, complications, and nasal symptoms were analyzed. Results: Gross total resection ranged from 56% to 100% for non-functioning adenomas, 54% to 89% for hormone-secreting adenomas, and 83% to 100% for other sellar lesions. The most common complications were CSF leaks (1.5–4.1%) and nasal issues, such as epistaxis or sinusitis (0–6%). Internal carotid artery injury occurred in 0–1% of cases. The average surgical duration was 87 to 168 min. Conclusions: The mononostril approach offers comparable resection rates, CSF leak risks, and morbidity to binostril or microsurgical methods. The mononostril approach is fast, minimally invasive, and preserves the nasal mucosa, making it a viable option for many sellar lesions. Full article

With the growing severity of environmental pollution, people are paying increasing attention to their health. However, naturally occurring wood with health benefits and applications in human healthcare is still scarce. Natural wood exhibits a limited negative oxygen ion release capacity, and this release has a short duration, failing to meet practical application requirements. This study innovatively developed a humidity-responsive, healthy wood material with a high negative oxygen ion release capacity based on fast-growing poplar. Through vacuum cyclic impregnation technology, hexagonal stone powder was infused into the pores of poplar wood, endowing it with the ability to continuously release negative oxygen ions. The healthy wood demonstrated a static average negative oxygen ion release rate of 537 ions/cm³ (peaking at 617 ions/cm³) and a dynamic average release rate of 3,170 ions/cm³ (peaking at 10,590 ions/cm³). The results showed that the particle size of hexagonal stone powder in suspension was influenced by the dispersants and dispersion processes. The composite dispersion process demonstrated optimal performance when using 0.5 wt% silane coupling agent γ-(methacryloxy)propyltrimethoxysilane (KH570), achieving the smallest particle size of 8.93 μm. The healthy wood demonstrated excellent impregnation performance, with a weight gain exceeding 14.61% and a liquid absorption rate surpassing 165.18%. The optimal impregnation cycle for vacuum circulation technology was determined to be six cycles, regardless of the type of dispersant. Compared with poplar wood, the hygroscopic swelling rate of healthy wood was lower, especially in PEG-treated samples, where the tangential, radial, longitudinal, and volumetric swelling rates decreased by 70.93%, 71.67%, 69.41%, and 71.35%, respectively. Combining hexagonal stone powder with fast-growing poplar wood can effectively enhance the release of negative oxygen ions. The static average release of negative oxygen ions from healthy wood is 1.44 times that of untreated hexagonal stone powder, and the dynamic release reaches 2 to 3 times the concentration of negative oxygen ions specified by national fresh air standards. The water-responsive mechanism revealed that negative oxygen ion release surged when ambient humidity exceeded 70%. This work proposes a sustainable and effective method to prepare healthy wood with permanent negative oxygen ion release capability. It demonstrates great potential for improving indoor air quality and enhancing human health. Full article

Background: The consumption of coffee has been widely debated regarding its effects on health. This study aims to analyze the correlations between daily coffee intake and sleep, blood pressure, anthropometric measurements, and biochemical markers in individuals with type 2 diabetes (T2D) and hypertension over a 12-month period. Methods: An observational study was conducted with 40 participants with T2D and hypertension, comprising 20 females and 20 males. Participants were monitored for their daily coffee consumption over a 12-month period, being assessed every 3 months. Linear regression was utilized to assess interactions and relationships between variables, providing insights into potential predictive associations. Additionally, correlation analysis was performed using Pearson’s and Spearman’s tests to evaluate the strength and direction of linear and non-linear relationships. Statistical significance was set at p < 0.05. Results: Significant changes were observed in fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body weight, body mass index, sleep duration, nocturnal awakenings, and waist-to-hip ratio (p < 0.05) over the 12-month study in both sexes. No significant differences were noted in the remaining parameters (p > 0.05). The coffee consumed by the participants was of the “traditional type” and contained sugar (2g per cup) for 100% of the participants. An intake of 4.17 ± 0.360 cups per day was found at baseline and 5.41 ± 0.316 cups at 12 months (p > 0.05). Regarding correlation analysis, a higher coffee intake was significantly associated with shorter sleep duration in women (r = −0.731; p = 0.037). Conversely, greater coffee consumption correlated with lower LDL cholesterol (LDL-C) levels in women (r = −0.820; p = 0.044). Additionally, a longer sleep duration was linked to lower FBG (r = -0.841; p = 0.031), HbA1c (r = -0.831; p = 0.037), and LDL-C levels in women (r = -0.713; p = 0.050). No significant correlations were observed for the other parameters in both sexes (p > 0.05). Conclusions: In women, coffee consumption may negatively affect sleep duration while potentially offering beneficial effects on LDL-C levels, even when sweetened with sugar. Additionally, a longer sleep duration in women appears to be associated with improvements in FBG, HbA1c, and LDL-C. These correlations emphasize the importance of a balanced approach to coffee consumption, weighing both its potential health benefits and drawbacks in postmenopausal women. However, since this study does not establish causality, further randomized clinical trials are warranted to investigate the underlying mechanisms and long-term implications—particularly in the context of T2D and hypertension. Full article

Background: Restrictive lung disease (RLD) is a potential complication in type 2 diabetes (T2D), but its relationship with insulin resistance and liver-related metabolic dysfunction remains unclear. This study evaluated the association between lung function and metabolic markers in T2D and retrospectively assessed whether metabolic improvements from dietary intervention were accompanied by changes in lung function. Methods: This cross-sectional analysis included 184 individuals (101 with T2D, 33 with prediabetes, and 50 glucose-tolerant individuals). Lung function parameters—vital capacity (VC), total lung capacity by plethysmography (TLC-B), and diffusion capacity for carbon monoxide (TL_CO)—were assessed alongside metabolic markers including HOMA2-IR, fatty liver index (FLI), NAFLD score, and Fibrosis-4 index (FIB-4). In a subset of 54 T2D participants, lung function was reassessed after six months following either a fasting-mimicking diet (FMD, n = 14), Mediterranean diet (n = 13), or no dietary intervention (n = 27). Results: T2D participants had significantly lower VC and TLC-B compared to glucose-tolerant and prediabetic individuals, with 18–21% falling below clinical thresholds for RLD. Lung volumes were negatively correlated with HOMA2-IR, FLI, NAFLD score, and FIB-4 across the cohort and within the T2D group. Although the FMD intervention led to significant improvements in HOMA2-IR and FLI, no corresponding changes in lung function were observed over the six-month period. Conclusions: Restrictive lung impairment in T2D is associated with insulin resistance and markers of liver steatosis and fibrosis. While short-term dietary interventions can improve metabolic parameters, their effect on lung function may require a longer duration or additional interventions and targeted follow-up. These findings highlight the relevance of pulmonary assessment in individuals with metabolic dysfunction. Full article

Background/Objectives: Vitamin D supplementation has shown promise in managing type 2 diabetes mellitus (T2DM), while the simultaneous impact on glycemic control and inflammation in T2DM remains poorly understood. This study aimed to investigate the potential role of vitamin D supplementation in managing T2DM using fasting plasma glucose (FPG), insulin levels, HOMA-IR, HOMA-B, HbA1c, and Hs-CRP as the biomarkers. Methods: Original articles from Scopus, Pubmed, Cochrane Library, Epistemonikos, and ScienceDirect published between 2014 and 2024 were the sources. Inclusion criteria included studies conducted as clinical trials or randomized controlled trials involving adult patients diagnosed with T2DM undergoing treatment with vitamin D. The risk of bias was evaluated using the ROB-2 tool and meta-analysis was conducted to quantitatively synthesize the results across the studies using pooled effect sizes and confidence intervals. Results: Nine studies were included in the meta-analysis. Significant differences were found at 12-week follow-up in insulin level (MD(−3.59) [95% CI: −6.93, −0.25]), HOMA-B (MD(−50.35) [95% CI: −92.29, −8.41]), hs-CRP (−2.51 [95% CI: −3.45, −1.57]), and HbA1c level (MD(−0.30) [95% CI: −0.54, −0.06]) and at 24-week follow-up in HOMA-IR (MD(−0.38) [CI: −0.53, −0.24]). The quality of the included studies was generally moderate, with three showing a potential risk of bias. Conclusions: The observed trends in FPG, insulin levels, HOMA-IR, HOMA-B, HbA1c, and hs-CRP indicate that vitamin D may influence glycemic control, insulin sensitivity, and inflammation, but these effects are often modest and may diminish over time. Future studies should explore longer duration randomized trials with standardized dosing and baseline vitamin D status stratification. Full article

Aim: The frontal QRS-T (fQRS-T) angle serves as an electrocardiography indicator that visually represents the disparity between the frontal QRS axis and the T axis. The heterogeneity between cardiac depolarization and repolarization rises with an increase in the fQRS-T angle. Prior research has demonstrated a relationship between the fQRS-T angle and the extent of atherosclerosis, along with the risk of cardiovascular mortality. The non-alcoholic fatty liver disease fibrosis score (NFS) is a non-invasive scoring tool used to quantify the degree of liver fibrosis in individuals with non-alcoholic fatty liver disease (NAFLD). Non-alcoholic fatty liver disease increases the risk of atherosclerotic cardiovascular disease, which can be predicted using the NFS. The objective of this study is to examine the potential correlation between the fQRS-T angle and NFS in patients with stable angina pectoris. Materials and Methods: This cross-sectional study included 177 (48 women) non-alcoholic patients who underwent coronary angiography due to stable angina pectoris. Individual NFS values were calculated using clinical and laboratory data. Patients were categorized into two groups based on a NFS threshold value of 0.67. Following a minimum fasting period of 12 h, biochemical laboratory parameters were acquired using a peripheral venous sample, and electrocardiographic data were recorded. Results: The univariate logistic regression analysis revealed significant associations between hypertension (p = 0.018), coronary artery disease (p = 0.014), neutrophil (p = 0.024), hemoglobin (p = 0.038), and low-density lipoprotein (LDL, p = 0.007) with the NFS. The electrocardiographic variables related to the score included the QRS duration (p = 0.015), Pmax (p = 0.026), QTC interval (p = 0.02), and fQRS-T angle (p < 0.001). In the multivariate logistic regression analysis, NFS was independently associated with LDL (OR: 0.984, 95% CI: 0.970–0.998, p = 0.024) and fQRS-T angle (OR: 3.472, 95% CI: 1.886–6.395, p < 0.001). Conclusions: The FQRS-T angle may exhibit a distinct correlation with NAFLD. Extensive investigations should validate this link, since the fibrosis score can serve as an effective tool for monitoring patients prior to the onset of clinical symptoms associated with liver fibrosis. Full article

Background/Objectives: Evidence-based practice (EBP) has been widely adopted in clinical nursing practice, with nursing education efforts consistently emphasizing its importance in strengthening implementation efforts. Despite these efforts to promote translational research, the level of implementation of evidence-based practice (EBP) in clinical nursing practice remains unsatisfactory. This study aimed to identify specific organizational, individual, and research-related barriers to the utilization of research in clinical practice among nurses in Sabah, Malaysia, to determine factors associated with these perceived barriers and to assess nurses’ awareness and understanding of the implementation of evidence-based practice. Methods: A cross-sectional study was conducted in 2019 using the BARRIERS scale, a validated tool that measures perceived barriers to the utilization of research across four domains: organizational barriers, nurses’ research awareness and values, quality of research, and research communication. This study involved nurses from five tertiary hospitals in Sabah, Malaysia. Results: A total of 562 nurses participated in the study, with a mean age of 34.3 years (SD = 7.96) and mean duration of clinical practice of 10.0 years (SD = 7.58). While 66.5% of the nurses had heard of EBP, only 7.3% reported understanding it very well. The top three barriers to the utilization of research were ‘the nurse does not feel she/he has enough authority to change patient care procedures’ (35.9%), ‘the nurse does not have time to read research’ (27.8%), and ‘research reports/articles are not published fast enough’ (25.8%). Among the four domains, organizational barriers scored highest (mean = 2.7, SD = 0.72), followed by research communication (mean = 2.6, SD = 0.73). Conclusions: The study findings emphasize the challenges nurses encounter in integrating research into clinical practice and highlight the need for ongoing efforts to promote the utilization of evidence-based practice and research among nurses in Sabah, while addressing the identified gaps. Full article

Background/Objectives: Imposed sleep restriction leads to increased feelings of appetite and hedonic eating behaviors (or food rewards). No study to date has assessed home-based measures of sleep with appetite and food rewards exclusively in Black emerging adults (ages 18–28 years), despite higher risks of short sleep and obesity in this population. We examined associations between 6-month changes in sleep with changes in appetite and food reward in Black emerging adults. Methods: Fifteen Black emerging adults (12 females; age, 21 ± 2.5 years; body mass index, 25.7 ± 4.5 kg/m²; body fat, 25.8 ± 11.9%) completed two identical 7-day measurement bursts at baseline and 6 months. Sleep (duration, efficiency, and architecture) was captured via 7 days of actigraphy and 2 nights of in-home polysomnography. During a laboratory visit, participants completed appetite measures (desire to eat, hunger, fullness, and prospective food consumption) via visual analog scales before and for 3 h following standard breakfast intake. The food reward for the fat and sweet categories of food was measured before lunch with the Leeds Food Preference Questionnaire. Results: Fasting fullness scores decreased from baseline to 6 months (−8.9 mm, p < 0.01) despite increases in body weight (2.6 kg, p < 0.01) and waist circumference (2.4 cm, p = 0.03). Increases in actigraph-measured sleep duration were associated with decreases in fasting desire to eat (r = −0.58, p = 0.04). Increases in actigraph-measured sleep efficiency were also associated with decreases in explicit liking for sweet foods (r = −0.60, p = 0.03). Conclusions: Our findings suggest that improvements in sleep duration and sleep efficiency may lead to decreased feelings of appetite and food reward in Black emerging adults. Full article

Background: N^ε-(carboxymethyl)-lysine (CML) is formed in the human body by non-enzymatically driven reactions including glycation, oxidation, and lipoxidation. CML is a ubiquitous product of normal physiology, but its levels are increased under disease conditions like chronic kidney disease (CKD) and diabetes mellitus (DM). Free CML is eliminated from the human body mainly through kidney excretion, and its accumulation in the kidney tissue is linked to CKD pathogenesis. Aim: The main goal of this study was to evaluate the relative contribution of CKD and Type 2 DM (T2DM) to the accumulation of CML in patients’ sera. Methods: The study included 22 patients with CKD without DM, 55 with CKD and comorbid T2DM, and 21 with T2DM without CKD. Serum CML levels were measured by ELISA. The Kruskal-Wallis test was used to detect differences among groups. Spearman correlation analysis was performed, and the one-tailed Dunn test was considered to indicate statistical significance at p < 0.05. Results: The median serum CML levels (CKD, 658.4 ± 434.3 ng/mL; CKD + T2DM, 431.3 ± 327.9 ng/mL; T2DM, 273.9 ± 134.2 ng/mL) differed significantly (p < 0.05) among the three patient groups. A positive correlation was observed between serum CML and microalbuminuria (p = 0.004; r = 0.58), proteinuria (p = 0.002; r = 0.6), and age (p = 0.007; r = 0.52) only in the CKD patients. In all T2DM patients, independent of CKD status, serum CML correlated negatively (p < 0.05) with postprandial glucose and duration of diabetes, while its correlation with fasting glucose and HbA1c was negative only in the T2DM cohort without CKD. Conclusions: In patients with CKD, higher levels of CML were observed compared to those with T2DM. Serum CML correlated positively with proteinuria, albuminuria, and patient age in non-diabetic CKD patients, and negatively with blood glucose, HbA1c, and DM duration of T2DM in patients without CKD. Full article

As designers push engine efficiency closer to thermodynamic limits, the analysis of flow instabilities developed in a high-pressure turbine (HPT) is crucial to minimizing aerodynamic losses and optimizing secondary air systems. Purge flow, while essential for protecting turbine components from thermal stress, significantly impacts the overall efficiency of the engine and is strictly connected to cavity modes and rim-seal instabilities. This paper presents an experimental investigation of these instabilities in an HPT stage, tested under engine-representative flow conditions in the short-duration turbine rig of the von Karman Institute. As operating conditions significantly influence instability behavior, this study provides valuable insight for future turbine design. Fast-response pressure measurements reveal asynchronous flow instabilities linked to ingress–egress mechanisms, with intensities modulated by the purge rate (PR). The maximum strength is reached at PR = 1.0%, with comparable intensities persisting for higher rates. For lower PRs, the instability diminishes as the cavity becomes unsealed. An analysis based on the cross-power spectral density is applied to quantify the characteristics of the rotating instabilities. The speed of the asynchronous structures exhibits minimal sensitivity to the PR, approximately 65% of the rotor speed. In contrast, the structures’ length scale shows considerable variation, ranging from 11–12 lobes at PR = 1.0% to 14 lobes for PR = 1.74%. The frequency domain analysis reveals a complex modulation of these instabilities and suggests a potential correlation with low-engine-order fluctuations. Full article

Grass-covered levees commonly protect river and estuarine areas against flooding. Climate-induced water level changes may increasingly expose these levees to overflow events. This study investigates whether grass-covered levees can withstand such events, and under what conditions failure may occur. Between 2020 and 2022, full-scale overflow tests were conducted at the Living Lab Hedwige-Prosperpolder along the Dutch–Belgian Scheldt Estuary to assess erosion resistance under varying hydraulic conditions and vegetation states. A custom-built overflow generator was used, with instrumentation capturing flow velocity, water levels, and erosion progression. The results show that well-maintained levees with intact grass cover endured overflow durations up to 30 h despite high terminal flow velocities (4.9–7.7 m/s), without structural damage. In contrast, levee sections with pre-existing surface anomalies, such as animal burrows, slope irregularities, surface damage, or reed-covered soft soils, failed rapidly, often within one to two hours. Animal burrows facilitated subsurface flow and internal erosion, initiating fast, retrograde failure. These findings highlight the importance of preventive maintenance, particularly the timely detection and repair of anomalies. Once slope failure begins, the process unfolds rapidly, leaving no practical window for intervention. Full article

The throughput of the pneumatic brake valve is a key parameter in ensuring fast and safe vehicle braking. The instantaneous value of this parameter determines the short response time of the system to an operator’s force. The scientific objective of this paper was to determine the throughput of brake valve tracts using numerical and experimental methods. These tracts are supposed to provide the tracking and acceleration function of the valve depending on the setting of the correction system. The first numerical method was based on polyhedral meshes using computational fluid dynamics (CFD) and Ansys Fluent software. The second research method—experimental tests on the author’s bench using the reservoir method—consisted of identifying throughputs based on pressure waveforms in the measurement tanks. The determined throughputs were averaged over the range of pressure differences tested and allowed the final calculation of the mass flow rate. The analysis of the obtained results showed an average discrepancy between the two research methods for both tracts, in which the flow in both directions was considered to be 9.43%, taking into account the use of a polyhedral numerical mesh ensuring high-quality results with an optimal simulation duration. The analysis of the pressure distribution inside the working chambers showed local areas of increased pressure and negative pressure resulting from the acceleration of the flow in narrow flow channels and the occurrence of the Venturi effect. Full article

Introduction: Emerging research indicates that alterations in the methylation of retrotransposons may contribute to genomic instability and cellular aging in various autoimmune disorders and diabetes mellitus (DM). As relevant information for people with type 1 diabetes mellitus (PwT1D) is limited, we aimed to investigate long interspersed nuclear element-1 (LINE-1) methylation status in this population. Methods: DNA methylation levels and patterns of LINE-1 were examined in the peripheral blood of 35 PwT1D and 28 healthy controls (age- and sex-matched), by using the COmbined Bisulfite Restriction Analysis methodology (COBRA). Results: Total LINE-1 methylation rate (mC) was higher in PwT1D compared to controls [47.3% (46.6–47.8%) vs. 46.5% (44.7–47.3%), p < 0.05]. The partial LINE-1 methylation pattern (uCmC) was less frequently observed in patients vs. controls [28.4% (24.7–33.3%) vs. 33.1% (27.8–37.9%), p < 0.05]. Prevalence of other methylation patterns [partially methylated (mCuC), hypermethylated (mCmC) and hypomethylated (uCuC)] was similar in the two groups. Furthermore, levels of fasting glucose and glycated hemoglobin (HbA1c) were positively associated with total methylation (mC) [Spearman’s rho = 0.380, p = 0.002 and rho = 0.342, p = 0.006, respectively], but negatively associated with the partially methylated (uCmC) pattern [Spearman’s rho = −0.383, p = 0.002 and rho = −0.270, p = 0.033, respectively]. The LINE-1 (uCmC) methylation pattern was negatively associated with the age at diagnosis of T1D [Spearman’s rho = −0.341, p = 0.049], but positively associated with disease duration [Spearman’s rho = 0.388, p = 0.021]. Conclusions: PwT1D were found to have higher total LINE-1 methylation rate (mC) compared to healthy controls. The partial methylation pattern (uCmC) was less frequently observed in these patients and was negatively associated with the glycemic status and the age at diagnosis of T1D, while demonstrating a positive correlation with disease duration. Full article

This paper explores cleaner and techno-economically viable solutions to provide electricity, heat, and cooling using green hydrogen (H₂) and green ammonia (NH₃) across the entire decarbonized value chain. We propose integrating a 100% hydrogen-fueled internal combustion engine (e.g., Jenbacher JMS 420) as a stationary backup solution and comparing its performance with other backup technologies. While electrochemical storage systems, or battery energy storage systems (BESSs), offer fast and reliable short-term energy buffering, they lack flexibility in relocation and typically involve higher costs for extended backup durations. Through five case studies, we highlight that renewable-based energy supply requires additional capacity to bridge longer periods of undersupply. Our results indicate that, for cost reasons, battery–electric solutions alone are not economically feasible for long-term backup. Instead, a more effective system combines both battery and hydrogen storage, where batteries address daily fluctuations and hydrogen engines handle seasonal surpluses. Despite lower overall efficiency, gas engines offer favorable investment and operating costs in backup applications with low annual operating hours. Furthermore, the inherent fuel flexibility of combustion engines eventually will allow green ammonia-based backup systems, particularly as advancements in small-scale thermal cracking become commercially available. Future studies will address CO₂ credit recognition, carbon taxes, and regulatory constraints in developing more effective dispatch and master-planning solutions. Full article

Diseases, including cardiovascular disease, type II diabetes, and metabolic syndrome, are leading causes of morbidity and mortality worldwide. Non-alcoholic fatty liver disease (NAFLD) is commonly associated with these conditions through shared pathophysiological mechanisms such as insulin resistance, chronic inflammation, and dyslipidemia. Emerging evidence suggests that probiotic formulations containing Bifidobacterium species may support cardiometabolic health by modulating gut microbiota composition. This meta-analysis aimed to assess the efficacy of Bifidobacterium-containing probiotic combinations in improving key cardiometabolic parameters, including lipid profiles, blood pressure, glycemic indices, and inflammatory biomarkers among individuals with NAFLD. A systematic literature search was conducted across PubMed, Embase, the Cochrane Library, and Web of Science databases to identify relevant randomized controlled trials (RCTs) published up to December 2024. A total of 24 RCTs involving 1611 participants met the inclusion criteria. The pooled results demonstrated significant reductions in total cholesterol, triglycerides, and low-density lipoprotein cholesterol following probiotic intervention. Improvements were also observed in fasting glucose levels and inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Although modest improvements were noted in NAFLD severity, the effects on liver injury markers were relatively limited. These findings suggest that Bifidobacterium-based probiotic combinations may provide cardiometabolic benefits, particularly in lipid regulation, glucose metabolism, and inflammatory control. Further large-scale, well-designed RCTs are warranted to validate these results and to determine the most effective probiotic strains, compositions, and treatment durations. Full article