Search Results (345)

Ischemia with non-obstructive coronary arteries (INOCA) is a chronic coronary condition associated with poor prognosis and reduced quality of life. The increasing use of invasive assessments of microcirculatory function and provocative spasm testing has significantly advanced the understanding of INOCA’s pathophysiology, which ranges from coronary microvascular dysfunction to vasomotor disorders. However, the optimal management and therapeutic approach for INOCA remain to be determined. Significant sex-based differences in the pathophysiology of INOCA have been reported, resulting in variations in prevalence, phenotype, and natural history between male and female patients. The aim of this narrative review is to provide a comprehensive overview of the sex-specific pathophysiological mechanisms underlying INOCA and to summarize the differences in INOCA phenotype and prognosis. Additionally, we will explore the current knowledge on management and therapy, with the goal of advancing towards sex-based personalized treatment strategies for INOCA. Full article

The blue shark (Prionace glauca) is a pelagic species widely distributed in the northwestern Pacific Ocean. The trophic roles of blue sharks across different developmental stages and between sexes remain poorly understood. Fifty-four sharks were sampled (October 2022–March 2024) for precaudal length (PCL) and stable isotope levels (δ¹³C, δ¹⁵N) in the muscle tissue (n = 52). Mean PCL varied based on the month of sampling (p = 0.034), with the smallest individuals occurring in July (143.0 ± 4.3 cm) and the largest in October (178.0 ± 2.6 cm). Stable isotope analysis (δ¹³C and δ¹⁵N) indicated consistent offshore habitat use (δ¹³C: from −20.70 to −18.82‰) and significant nitrogen isotopic differences among life history (δ¹⁵N: from 10.23 to 15.72‰; Kruskal–Wallis test, p = 0.037). The elevated δ¹⁵N values observed in the subadult group (relative to juvenile individuals) are likely due to trophic enrichment associated with morphological development. Females exhibited markedly larger isotopic niches (SEAc = 2.42‰²) than did males (0.57‰²), and niche overlap was greater within each sex (40–52%) than between sexes (<21%). These results revealed sex-specific ecological roles and trophic strategies throughout the life history of P. glauca. Understanding these foraging differences can help with catch reduction and habitat-protection measures in the transboundary pelagic fisheries of the northwestern Pacific. Full article

Background: Ulcerative colitis (UC) requires life-long disease management. This study aimed to investigate the disease burden and unmet medical needs in UC patients in Greece. Methods: Between October 2023 and January 2024, adult UC patients who were members of the Hellenic Society of Crohn’s Disease and Ulcerative Colitis Patients (HELLESCC) completed a structured self-reported questionnaire. The survey questionnaire included sociodemographic characteristics, smoking habits, history of comorbidities, disease activity, disease characteristics, medications, and patient-reported outcomes (PROs; Short Inflammatory Bowel Disease Questionnaire [SIBDQ], Work Productivity and Activity Impairment [WPAI], Patient Health Questionnaire-9 [PHQ-9], treatment satisfaction, and treatment adherence). Univariate and multivariate logistic regression analyses were used to identify associated factors. Results: Datasets were obtained from 181 UC patients, of whom 48% were on advanced therapies (biological/small-molecule agents) and 54% had active disease. Around 74% reported impaired quality of life (QoL) (SIBDQ < 60), 25% work productivity loss, and 29% daily activity impairment. About 40% reported moderate to severe depressive symptoms (PHQ-9 ≥ 10). Reduced adherence and treatment dissatisfaction were reported by approximately one-third of patients. Female gender and disease activity were associated with moderately to severely impaired QoL, work productivity, and mental health. Interestingly, three out of four patients receiving advanced therapy reported moderately to severely impaired QoL and had increased odds of experiencing moderate to severe depression. Conclusions: The disease burden remains very high in UC, characterized by poor QoL and increased work impairment, depression, and disease activity among Greek patients. Marked treatment dissatisfaction and non-adherence were observed in approximately one-third of patients. Full article

The Florida softshell turtle, Apalone ferox, is considered common and found in many different types of freshwater habitats throughout its range. However, despite its prevalence where it occurs, little is understood about the species’ life history and population dynamics due to difficulties with capture and long-term marking. Building on a foundational study of the Florida softshell turtle at Wekiwa Springs State Park (WSSP) from 2007 to 2012, we present findings from an extended 16-year mark–recapture study spanning from 2007 to 2023. A total of 31 sampling events were conducted with a median of two capture events per year. Sampling events were spread over a median of 5 days each year (range, 2–11 days), with a total of 88 capture days. One hundred and twenty individual A. ferox were captured over 225 encounters. We estimated an average population size of 135.6 individuals using an annual Schumacher–Eschmeyer ratio estimator. Using a state-space Jolly–Seber model, we estimated that 204 individuals entered the population over the 16 years (the superpopulation), while the average current population size was 40 individuals. The median survival probability was 0.884 but the median detection probability was 0.10, reinforcing the perceived difficulty with capturing A. ferox. The continued influx of new juveniles, recapture of these individuals as adults, and strong female bias support the possibility that the WSSP and Rock Springs greater ecosystem functions as a potential nursery habitat for the Florida softshell. Though population estimates dropped 20% following a two-year sampling gap owing to the COVID-19 pandemic, the population is currently growing slowly and highlights the value of continued, long-term monitoring of elusive freshwater turtle species. Full article

The market for plant-based alternatives to animal foods has increased rapidly in the past decade, mainly due to consumer demand. Little evidence is available regarding nutritional impacts, drivers, and barriers to using these products as substitutes for animal foods in real-life conditions. This pilot study followed 16 Danish adults (30 ± 11 years old; 11 females) for 4 weeks with substituting milk, cheese, and yogurt with plant-based analogues to dairy (PBADs) and assessed their drivers and barriers to applying the intervention with a mixed-method approach. PBADs are constantly compared to their animal counterparts, both regarding product characteristics, such as price and sensory properties, as well as cultural roles and subjective memories. The mixed methods showed dairy attachment, price, and taste were the main barriers to consuming PBAD, while changes in life and social circles were drivers (qualitative data). As for the liking of PBADs, plant-based yoghurt was the preferred intervention product (73.5/100, p < 0.05), followed by plant-based drinks (65.9/100), while plant-based cheese was the lowest rated (47.9/100, p < 0.05). As for dietary changes, a lower average intake of sugars, saturated fatty acids, cholesterol, calcium, phosphorus, and zinc was observed after the intervention. Additionally, this study describes the attachment of the study population to milk and dairy products. It shows that choosing dairy is beyond nourishment but is connected to tradition, culture, pleasure, memories, and a sense of belonging. In contrast, there is no history or attachment to PBADs. Full article

Introduction: Lichen sclerosus (LSc) is a chronic, progressive, inflammatory skin disease that primarily affects the anogenital region in both sexes and across all age groups. Aim: To investigate the relationship between quality of life (QoL) and disease severity, as measured by a newly developed Lichen Sclerosus Score (LSc score), with respect to anatomical site before and after 12 weeks of treatment. Methods: A total of 136 patients diagnosed with LSc (88 men, 48 women) were enrolled between March and September 2022. Patients were clinically evaluated using the LSc score and completed the Dermatology Life Quality Index (DLQI). Treatment was individualized based on clinical findings and history. At 12 weeks, both clinical assessment and DLQI were repeated. Results: LSc scores significantly decreased following treatment (p < 0.001), except in the female subgroup. In men, LSc scores were strongly correlated with DLQI scores both before (r = 0.709; p < 0.001) and after (r = 0.492; p < 0.001) treatment. Among women, a significant correlation was found only before treatment (r = 0.457; p < 0.001). Significant associations were identified between LSc score and DLQI items 1, 8, and 9 in men and the overall cohort. No statistically significant differences in LSc scores or DLQI were observed across anatomical sites after correction for multiple comparisons. Conclusions: Disease severity in genital LSc is closely associated with QoL impairment. This is, to our knowledge, the first study to examine the correlation between a clinical severity score and DLQI. While anatomical site did not significantly affect scores, certain sites may have a disproportionate impact, underscoring the complex ways in which LSc affects patients’ lives. Full article

This literature-based review draws on studies of thirty-four fish species; most are from northern temperate regions. Fish have flexible and indeterminate growth, and often they do not reach their growth and size potential. They may become stunted with impaired growth and early maturity, chiefly as a phenotypically plastic reaction. The main causes of stunted growth are negatively density-dependent food availability and keen intraspecific competition leading to environmental stress. Typically, their growth levels off early in life as energy consumptions approach energy costs of maintenance. Females typically attain maturity soon after the energy surplus from feeding starts to decrease. Males are often more variable in size at maturity owing to alternative mating strategies, and their size at maturity depends on both species-specific mating behaviours and environmental opportunities. In polyphenic/polymorphic populations, one phenotype may be stunted and the other phenotype non-stunted; stunted individuals do not perform the required ontogenetic niche shift needed to grow larger. The adult morphology of stunted fish is typically like the morphology of juveniles. Their secondary sexual characters are less pronounced, and they phenotypically retain adaptation to their early feeding niche, which is different from that of large-growing individuals. There are open questions regarding to what extent genetics and epigenetics regulate the life histories of stunted phenotypes. Full article

Studying the nutritional ecology of Neoseiulus cucumeris (Oudemans) at different temperatures is a fundamental tool for improving mass production for use in biological control of pest mites. The current research studied the impact of both food types and temperatures on the life history and demographic parameters of the predator mite N. cucumeris. Mite cultures in the laboratory were developed using Tetranychus urticae Koch, and N. cucumeris was collected from field plants. The developmental stages of N. cucumeris fed on date palm pollen and the immature stages of T. urticae were investigated in a laboratory setting at different temperatures. Our research revealed that N. cucumeris readily accepted both food types at all the tested temperatures. The developmental stages and adult longevity of N. cucumeris, both female and male, decreased dramatically when the temperature increased from 18 °C to 34 °C. The net reproductive rate (R₀) reached its greatest values of 22.52 and 9.72 offspring/individual at 26 °C, and the intrinsic rate of increase (r_m) reached its maximum values of 0.17 and 0.13 day⁻¹ at 34 °C and minimum of 0.12 and 0.10 day⁻¹ at 18 °C, when fed on date palm pollen and immature stages of T. urticae, respectively. Conversely, the average generation time (T) showed a notable reduction from 22.48 to 16.48 and 20.88 to 16.76 days, accompanied by an upsurge in temperature from 18 °C to 34 °C, when fed on date palm pollen and immature stages of T. urticae, respectively. The finite rate of growth (λ) exhibited distinct variations, reaching its highest value at 34 °C, 26 °C, and 18 °C when fed on date palm pollen and immature stages of T. urticae, respectively. From these results, we can conclude that N. cucumeris was successfully fed date palm pollen as an alternate source of nourishment. In addition, the immature stages of T. urticae are suitable as food sources for N. cucumeris because they shorten the mean generation time. Therefore, the success of mass-rearing the predator mite N. cucumeris on a different, less expensive diet, such as date palm pollen, and determining the most suitable temperature for it has increased its spread as a biocontrol agent. Full article

Background/Objectives: A food allergy (FA) is an immune-mediated hypersensitivity reaction to specific food. FA reactions vary from mild to life-threatening anaphylaxis. Despite the effectiveness of epinephrine auto-injectors (EAIs), barriers such as lack of knowledge, limited access, and fear of needles hinder their use. This study explores EAI possession among children with parent-reported food allergies in Saudi Arabia. Methods: A cross-sectional study conducted from October 2023 to February 2024 included 296 parents of children with reported food allergies under the age of 18. Data were collected through a validated self-administered questionnaire. Results: Among 2102 respondents, 296 (14.1%) reported having a child with a food allergy. Most respondents were female (70%), with asthma being the most common comorbidity (26%). Common allergens included eggs, tree nuts, peanuts, milk, and sesame. Only 23.3% of children had an EAI. Higher EAI possession was associated with parental education, maternal allergy history, and access to specialist care. Conclusions: EAI possession among Saudi children with food allergies is suboptimal. Targeted educational interventions, increased access to allergists, and comprehensive management plans are essential to improve preparedness for anaphylaxis. Full article

Background/Objectives: Obesity among university students is a growing concern, often influenced by biological, psychological, and social factors. Few studies in Saudi Arabia have addressed this issue using a comprehensive framework. This study aims to examine the prevalence of obesity and its biopsychosocial predictors among university students, as well as their perceptions, behaviors, and comorbidities. Methods: A cross-sectional study was conducted at Jazan University during the 2024–2025 academic year. A total of 819 undergraduate students completed a structured, self-administered Arabic questionnaire. The tool assessed sociodemographic variables, body mass index (BMI) (calculated from self-reported height and weight), biological and psychological factors, social influences, lifestyle behaviors, and comorbidities. Bivariate associations were tested using chi-square analyses, and multivariate logistic regression was used to identify independent predictors of obesity. Results: The prevalence of obesity was 19.6%, and 22.6% of students were overweight. Obesity was significantly more prevalent among males (26.7%) than females (9.6%, p < 0.001) and among students aged 24 years and above (24.0%, p = 0.024). Independent predictors of obesity included being overweight in childhood (AOR = 5.23, 95% CI: 3.47–7.90), belief in a genetic predisposition (AOR = 4.66), emotional eating (AOR = 2.57), academic or personal stress (AOR = 5.36), and social pressures related to body image (AOR = 2.96). Comorbidities significantly associated with obesity included high cholesterol (AOR = 5.40), sleep disorders (AOR = 2.99), and joint pain (AOR = 1.96). More than 80% of students with obesity reported current or past weight loss attempts, and nearly 60% received medical advice to lose weight. Conclusions: Obesity among Jazan University students is significantly associated with male gender, early-life weight history, emotional and academic stress, and social pressures. Students with obesity also experience a higher burden of comorbid conditions, even at a young age. These findings highlight the need for integrated, student-centered interventions that address both the psychological and social dimensions of weight management in university settings. Full article

The contents of glucosinolates and erucic acid clearly vary in Brassica napus seeds, but a few studies still focus on the effects of B. napus cultivars on the life table parameters of Myzus persicae. In this study, the life history parameters of M. persicae in six B. napus cultivars were examined at 25 ± 1 °C, 50 ± 10% RH, and a photoperiod of 14 h of light/10 h of dark under laboratory conditions. The results showed that significant differences exist in the life table parameters of M. persicae in six B. napus cultivars. The female fecundity, net reproductive rate, intrinsic rate of increase, finite rate of increase, and total longevity of M. persicae were higher in Xinong 18, Aiganyou 558, and Aiyouku 999. However, the intrinsic rate of increase in M. persicae was significantly lower in Zhongshuang 11 (r_m = 0.28 ± 0.006) and Mianxinyou 78 (r_m = 0.23 ± 0.007), suggesting the host-induced suppression of M. persicae population growth. Among all the cultivars mentioned above, Zhongshuang 11 and Mianxinyou 78 were recommended for planting for decreasing M. persicae population numbers. Additionally, more attention should be paid to Xinong 18, Aiyouku 999, and Aiganyou 558 to control M. persicae populations, and we conclude that Brassica napus cultivars affect the developmental duration and the population dynamics of M. persicae. Full article

Background and Clinical Significance: Evaluating wide complex rhythms in patients with permanent pacemakers can be a diagnostic challenge, particularly when the rhythm is irregular. While pacemaker-mediated rhythms are typically regular and predictable, the appearance of wide complex irregular rhythms raises concerns ranging from lead malfunction to life-threatening arrhythmias, such as ventricular tachycardia. Understanding the interplay between intrinsic cardiac activity and device function is crucial for timely and accurate diagnosis in this increasingly common clinical scenario. Case presentation: We report on a 74-year-old female with a VVI pacemaker implanted for binodal disease, who presented with intermittent palpitations and an irregular rhythm. The patient has a recent history of falling on her right shoulder, which is also the site of the device implantation. We used a clinical step-by-step approach to rule out pacemaker malfunction and to establish the need for an unscheduled device interrogation. Conclusions: This case presentation highlights the important role of clinical reasoning and the approach to such a patient, especially when a key method of pacemaker evaluation, such as device interrogation, is not readily available. Full article

Background and Objectives: Women of the LGBTQ+ community, like heterosexual women, face a wide range of health issues and have a right to comprehensive healthcare. Unfortunately, they often do not seek healthcare due to concerns about possible discrimination or prejudice. The aims of this study were to analyze and compare experiences of LGBTQ+ individuals and heterosexual women during OBGYN appointments in Lithuania as well as to analyze the health of individuals whose biological gender is female and their lifestyle’s effect on their health. Materials and Methods: An anonymous online survey was conducted. Respondents answered questions regarding their gender and social identity; obstetrical, gynecological, and general clinical history; sexual life characteristics; and their experiences of visiting OBGYNs in Lithuania. Results: This study revealed that some lifestyle habits of LGBTQ+ respondents are more similar to those of heterosexuals than is often hypothesized. However, it also underscored such issues as the more common consumption of psychotropic substances, higher rates of depression, and more prevalent risky sexual practices among the LGBTQ+ community, as well as some neglected topics of OBGYN care in Lithuania. Conclusions: This study is the first in Lithuania to analyze the characteristics of LGBTQ+ individuals whose biological sex is female in relation to the field of obstetrics and gynecology. It provides important insights for the further improvement of the healthcare system regarding this topic. Full article

Background/Objectives: Perineal obstetrical trauma sustained during vaginal delivery has a profound impact on female quality of life. The aim of the cross-sectional study was to analyze the association between active bacterial cervical infection and group B Streptococcus (GBS) rectovaginal colonization in the 35th–37th weeks of pregnancy with the degree of delivery perineal trauma. Methods: The study included 778 women after vaginal delivery. Maternal characteristics, including age, concomitant diseases, parity, obstetrical history, and cervical swab results conducted at admission and rectovaginal bacterial swabs at the 35th–37th weeks of pregnancy, were analyzed. The rates of perineal tears were compared between the physiological and pathological cervical swab groups and between the GBS-positive and GBS-negative colonization groups. Results: At admission to delivery, active cervical infection was diagnosed in 269 (35.9%) women. After vaginal delivery, 361 (49.3%) women had an intact perineum, and 288 (39.3%), 78 (10.7%), 4 (0.6%), and 1 (0.1%) had 1st–4th-degree perineal tears, respectively. Statistical analyses of the logistic regression model found that GBS colonization at the 35th–37th weeks of pregnancy (OR 1.56, p = 0.035) and pathological flora at admission (OR 1.54, p = 0.019) were associated with perineal tears. A higher vaginal parity was found to be a protective factor (OR 0.49, p < 0.000). Conclusions: High birthweight, longer second stage of labor duration, and primiparity were associated with increased rates of perineal trauma. Active cervical infection at admission and GBS colonization at the 35th–37th weeks of pregnancy were found to be risk factors for perineal tears. A protective factor for an intact perineum was a higher number of prior vaginal deliveries. Full article

Objective: To clarify the relationship between constipation and depressive symptoms among the elderly. Methods: This single-center, cross-sectional study was performed using baseline data obtained at the time of enrollment in the prospective cohort of the JUSTICE-TOKYO study. Participants underwent assessments including patient profiling, drug use history, the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale 15 (GDS-15), gastrointestinal-related quality of life (QOL), and the constipation scoring system (CSS). Geriatric depressive symptoms were evaluated based on GDS-15. We investigated correlations between GDS-15 scores and various abdominal symptoms and assessed risk factors for geriatric depressive symptoms using multiple regression analysis. Results: A total of 984 elderly participants (57% female, mean age 78.1 ± 6.1 year) were included. The GDS-15 scores were significantly correlated with body mass index (BMI) (r = −0.056) and MMSE (r = −0.092), reflex-related QOL (r = 0.253), pain-related QOL (r = 0.229), fullness-related QOL (r = 0.269), constipation-related QOL (r = 0.329), diarrhea-related QOL (r = 0.264), and CSS (r = 0.285) scores. Multiple regression analysis indicated that BMI (β = −0.069, p = 0.020) and MMSE (β = −0.074, p = 0.013), constipation-related QOL (β = 0.136, p = 0.002), reflex-related QOL (β = 0.126, p < 0.001), diarrhea-related QOL (β = 0.095, p = 0.006), and CSS (β = 0.098, p = 0.016) scores were significantly correlated with GDS-15 scores. Conclusions: Depressive symptoms among older individuals are associated with various abdominal symptoms, particularly constipation. However, the causality between depressive symptoms and constipation cannot be inferred due to the study’s cross-sectional design. Full article