Search Results (79,329)

Background: Knee osteoarthritis (KOA) affects over 300 million people globally, yet current therapies face limitations in efficacy and safety. Chitosan, a natural polysaccharide, has shown conflicting evidence in KOA management. This systematic review evaluates chitosan’s clinical effectiveness and defines its optimal application scenarios. Methods: Randomized controlled trials (RCTs) published before the end of November 2024 on chitosan and knee osteoarthritis were systematically retrieved from PubMed, Web of Science, Cochrane Library, EBSCO, PsycINFO, ClinicalTrials.gov, SINOMED, Chinese Medical Journal Network, CNKI, VIP, Wanfang Data, Embase, and SCOPUS. After screening the references, publications meeting the inclusion and exclusion criteria was selected. RevMan5.4 software was used to perform the meta-analysis of the data. Results: A total of 231 articles were retrieved, and 14 RCTs involving 1504 participants were included. For the primary efficacy outcome, pooled analysis of 10 RCTs showed a significantly higher overall clinical response rate in the chitosan group compared with the control group (OR = 5.43, 95% CI = 3.21, 9.18, p < 0.001), with no observed heterogeneity (I² = 0%). Additionally, meta-analysis of 12 RCTs demonstrated a significant reduction in visual analog scale (VAS) pain scores (MD = −1.06, 95% CI = −1.38, −0.73, p < 0.001) in patients receiving intra-articular chitosan injection. Subgroup analysis of VAS scores showed that pain reduction varied significantly by follow-up duration (I² for subgroup differences = 62.5%, p = 0.03). Conclusions: Intra-articular injection of medical chitosan shows potential benefits for pain relief and clinical efficacy in patients with knee osteoarthritis, with a low incidence of adverse reactions. Nevertheless, the evidence remains promising but preliminary. Full article

Background/Objectives: Disability in relapsing–remitting multiple sclerosis (RRMS) reflects multiple pathological processes that may not be fully captured by individual MRI markers. Because an EDSS score ≥ 3 represents a clinically meaningful threshold of moderate-to-higher disability, this study evaluated the cross-sectional ability of brain volumetric measures and IVIM-DWI parameters to identify patients with RRMS who had EDSS ≥ 3. Methods: This retrospective cross-sectional study included 189 patients with RRMS who had complete EDSS, lesion count, IVIM-DWI, and brain volumetric MRI data. Patients were stratified into EDSS < 3 and EDSS ≥ 3 groups. Single-marker ROC analyses were performed for lesion count, IVIM-DWI parameters, absolute volumetric measures, and fractional volumetric measures. Combined ROC models were constructed to assess the discriminatory performance of integrating lesion burden, volumetric MRI, and IVIM-DWI metrics. Internal model stability was evaluated using 5-fold cross-validation. Results: Patients with EDSS ≥ 3 had higher lesion count, higher ADC and D values, lower gray matter, white matter, and brain parenchymal volumes, higher CSF volume, higher CSF fraction, and lower brain parenchymal fraction (BPF). In single-marker ROC analysis, BPF and CSF fraction showed the strongest discriminatory performance (AUC = 0.705), followed by lesion count (AUC = 0.696), whereas absolute BV showed minimal discriminatory value (AUC = 0.503). The core lesion count + BPF model achieved an AUC of 0.757 and a cross-validated AUC of 0.737. Adding perfusion fraction (f) produced the numerically highest cross-validated performance, with an AUC of 0.769 and a cross-validated AUC of 0.746, although the incremental improvement over lesion count + BPF was modest and not statistically significant. Conclusions: Fractional volumetric measures showed stronger discriminatory performance than absolute BV for EDSS ≥ 3 stratification in RRMS. The lesion count + BPF + f model achieved the highest cross-validated performance among the evaluated MRI models; however, overall discrimination was moderate, and the incremental improvement associated with f was not statistically significant. These exploratory findings require evaluation in larger longitudinal cohorts with external validation. Full article

Bacterial wide genomic GC variation poses numerous interesting scientific questions, which center on the role evolution plays in shaping genome content and the mechanisms that abruptly alter such processes. In this study, eleven Kordiimonas genomes were obtained and processed for comparative genomic, phylogenetic, evolutionary, and statistical analyses. The phylogenomic reconstruction based on single-copy orthologous cluster protein sequences and overall genomic relatedness index calculations showed that the genus Kordiimonas could be separated into GC-rich (56.3 to 59.9%) and -poor (46.2 to 49.6%) groups, and Ca. Kordiimonas sp. UBA4487 should be reclassified to remove it from this genus. Comparisons of amino acid frequencies in the genus also indicated that the GC-rich and -poor groups had several significantly different amino acid usages. Evolutionary analysis revealed that the GC-poor group had significantly higher nonsynonymous and synonymous substitution rates than the GC-rich group did, and evolved from the GC-rich ancestor. Comparative genomics also demonstrated that the GC-rich group encoded more genes related to nitrogen metabolism and transport than the GC-poor group did, leading to ecological niche diversification of the two groups, which could reduce inter-species competition in similar environments. Our study characterized the evolutionary patterns involved in nucleotide substitutions and their trends, as well as metabolic changes at the genus level, which can shed light on the understanding of bacterial microevolution in the future. Full article

Although perioperative oxygen therapy is a routine component of general anesthesia, its early biological consequences remain incompletely understood. This prospective randomized study evaluated whether perioperative oxygen concentration influences early biomarker responses in adults undergoing elective laparoscopic lower abdominal surgery. Patients received either normoxia (FiO₂ 0.35) or hyperoxia (FiO₂ 0.80) under standardized anesthesia. Clear physiological separation between groups was confirmed by arterial blood gas analysis. The primary biomarker finding was that circulating surfactant protein-A (SP-A) increased significantly in the normoxia group, whereas no comparable increase was observed under hyperoxia. Syndecan-1 and sialic acid showed descriptively similar directional patterns; however, these secondary biomarker findings were interpreted as exploratory and were not robust after Holm correction. By contrast, tumor necrosis factor-alpha (TNF-α) levels were higher postoperatively in the hyperoxia group, while ischemia-modified albumin (IMA) and total protein did not differ significantly between groups. These findings suggest that perioperative hyperoxia was associated with different early circulating biomarker trajectories across pulmonary epithelial and glycocalyx-related domains, without establishing pulmonary or endothelial protection. Further studies are needed to determine whether these early mechanistic findings translate into clinically meaningful outcomes. Full article

Background/Objectives: Borderline ovarian tumor (BOT) is an ovarian neoplasm of low malignant potential that lacks stromal invasion. The aim of this study was to compare intraoperative frozen section analysis (IFSA) findings with final pathology results in patients diagnosed with BOT on frozen sections and to identify risk factors associated with cancer. Methods: This study included data from patients who underwent surgery for an ovarian mass between 2020 and 2024 and were diagnosed with BOT on IFSA. Demographic, obstetric, and clinical characteristics, as well as frozen section and final pathology findings, were recorded. The CAR, NLR, and PNI scores were calculated. Patients were grouped as premenopausal or postmenopausal and compared. Based on the final pathology report, patients were also classified as having BOT or cancer and compared. Results: A total of 92 patients were included in the study, and 53 (57.6%) were postmenopausal. The prevalence of cancer was significantly higher in the postmenopausal group (p = 0.022). Final pathology revealed cancer in 11 patients (11.9%). Age group > 45 years (OR = 12.50) and serous subtype on IFSA (OR = 10.77) were significant risk factors for cancer detection. Cutoff values for distinguishing carcinoma from BOT were identified for CAR (≥1.75), NLR (≥2.64), and PNI (≤48.64). Conclusions: In this study, the rate of invasive carcinoma on final pathology among patients diagnosed with BOT on IFSA was 11.9%. Age group > 45 years and serous subtype on IFSA were independent risk factors. The cutoff values for CAR, NLR, and PNI may support risk stratification for carcinoma. Full article

Emigration remains an important socio-economic challenge for Latvia, affecting labour market development, human capital availability, and long-term economic growth prospects. This study aims to quantitatively assess the relative importance of selected socio-economic factors influencing emigration in Latvia over the period 2004–2024 using an integrated index method. This research is based on an integrated index method, combining selected socio-economic, demographic, and labour market indicators into multidimensional and integral indices. The empirical analysis applies normalisation, weighting, and correlation analyses_ to identify the intensity of influence between groups of emigration-influencing factors and the emigration coefficient (number of emigrants per inhabitant). The results show that the selected factor groups are associated with emigration dynamics in Latvia. Among the analysed dimensions, labour market factors demonstrate the strongest influence intensity, indicating that employment opportunities, wage levels and labour market quality are among the key conditions affecting emigration. The findings also suggest that emigration should be interpreted not only as a response to socio-economic disparities, but also as a factor influencing economic growth potential through changes in human capital, demographic structure, and labour market capacity. This research contributes to the empirical literature by providing an integrated assessment framework for analysing emigration-related factors in a small open economy. Full article

This study aimed to evaluate the nutritional composition and fermentation quality of feed fermented by Bacillus amyloliquefaciens and Bacillus licheniformis as well as their effects on growth performance, meat quality, blood parameters, and gut microbiota in fattening pigs. A total of 72 healthy Duroc × Landrace × Large White crossbred barrows (68.78 ± 1.41 kg, p > 0.05 for initial body weight among groups) were randomly assigned to three dietary treatments, with four replicates pens per treatment and six pigs per pen. The pigs were fed one of three diets: (1) CK: 100% basal diet; (2) YR1: 50% basal diet + 50% feed fermented with Bacillus amyloliquefaciens YR3.2; and (3) YR2: 50% basal diet + 50% feed fermented with Bacillus licheniformis YR3.1. The experiment consisted of a 7-day adaptation period and a 50-day treatment period. The results showed that the crude protein, starch, lactic acid, acetic acid, and propionic acid contents were significantly higher in the treatment groups than in the control group (p < 0.05). The final body weight of fattening pigs, serum superoxide dismutase activity, and redness value of the longissimus dorsi muscle were significantly higher in the treatment groups than in the control group (p < 0.05). The carcass weight of the YR1 group was significantly higher than that of the other groups (p < 0.05). Moreover, the shear force of pork was significantly lower in the treatment groups than in the control group (p < 0.05). Microbial analysis showed that Firmicutes dominated the jejunum and cecum in all groups (>80%). In the YR1 group, the abundance of Clostridium increased in the jejunum, whereas the abundance of Terrisporobacter decreased. In the YR2 group, the abundances of both Clostridium and Terrisporobacter increased in the jejunum and cecum. In conclusion, fermented feed prepared with Bacillus amyloliquefaciens and Bacillus licheniformis has a positive effect on the growth performance of fattening pigs, but fermented feed prepared by Bacillus amyloliquefaciens YR3.2 has a more significant effect on improving growth performance, feed conversion efficiency and some meat quality indicators. Full article

As the information environment evolves, social media has become the primary channel through which the public accesses and shares information, and perceived credibility has emerged as a critical influence on how users evaluate the credibility of information. Existing research suggests that heuristic credibility cues can enhance users’ perceived credibility, yet the findings remain inconsistent. Consequently, it is necessary for researchers to systematically examine whether heuristic credibility cues can effectively enhance perceived credibility. This study employed a meta-analysis to analyse 18 studies meeting the selection criteria, involving a total sample size of 14,188 participants. The aim was to assess the overall effect of social media heuristic credibility cues on perceived credibility and to explore the influence of potential moderating mechanisms on perceived credibility. The results indicate that manipulating source cues and social cues, which serve as heuristic credibility cues on social media, significantly increased perceived credibility (g = 0.307, p < 0.001). Effect sizes varied across moderating variables such as the type of heuristic credibility cue, participant type, method of measuring perceived credibility, experimental design, sample size, and year of publication. Among these, the type of heuristic cue and participant type were significant moderators; specifically, authoritative sources were more effective than other types of information sources in enhancing perceived credibility; the impact of different types of social cues on perceived credibility was also significant to varying degrees. Furthermore, student groups were more susceptible to the influence of heuristic credibility cues than non-student groups. These findings provide theoretical and practical insights for the design of information dissemination and the construction of perceived credibility on social media. It should be noted that, given the limited number of studies included in this meta-analysis and the restricted range of moderator variables, the above conclusions require further empirical research to be tested and confirmed. Full article

Background: Platinum-based doublets are standard first-line therapy for advanced gastric cancer (GC) in the Western Pacific region, but oxaliplatin frequently induces persistent peripheral sensory neuropathy (PSN). Whether residual PSN compromises the feasibility and efficacy of subsequent paclitaxel (PTX)-based therapy remains unclear. Methods: The IVY study was a prospective, multicenter observational trial conducted across 16 Japanese institutions. Patients with advanced GC progressing after fluoropyrimidine–platinum therapy received second-line PTX ± ramucirumab. Baseline PSN was assessed by CTCAE, PNQ, and FACT/GOG-Ntx. The primary endpoint was the incidence of grade ≥ 3 PSN during second-line therapy. Secondary endpoints included progression-free survival (PFS), overall survival (OS), time to treatment failure (TTF), tumor response, and patient-reported outcomes. Results: Among 156 patients (90 PSN-positive, 66 PSN-negative), grade ≥ 3 PSN occurred more frequently in the PSN-positive group (16.7% vs. 4.5%; p = 0.02). Median PFS was 4.0 vs. 3.9 months (p = 0.20), and median OS was 10.3 vs. 8.1 months (p = 0.04). In multivariable analysis, residual PSN was not an independent predictor of OS (HR = 0.68 for PSN-positive vs. PSN-negative, 95% CI [0.46–1.01]; p = 0.06). Patient-reported instruments captured greater and earlier QoL impairment in PSN-positive patients, though trajectories stabilized by 12 weeks. Conclusions: Residual PSN increases the risk of clinically relevant neurotoxicity—particularly in patients with baseline grade ≥ 2—but, in this cohort, did not appear to preclude paclitaxel-based second-line therapy when monitoring and dose modification were available. The apparent survival difference was exploratory and, after adjustment for baseline imbalance, should not be interpreted as a benefit attributable to residual PSN. Residual neuropathy should therefore prompt structured baseline assessment and early-cycle monitoring rather than routine reassurance. Full article

Percutaneous coronary intervention (PCI) using drug-coated balloons (DCBs) may provide outcomes comparable to drug-eluting stents (DESs) due to the absence of a permanent implant and improved coronary artery remodelling. This study compared clinical outcomes of DCB-only angioplasty with DESs in a real-world setting. All patients undergoing PCI with DCBs or DESs for de novo disease were included in a propensity score-matched analysis using prospective and retrospective collected data from a single centre. The primary outcome was target lesion revascularisation (TLR) at 12 months. The secondary outcomes were major adverse cardiac events (MACEs) defined as a composite of all-cause death, myocardial infarction, or TLR at 12 months. Propensity matching produced 904 DCB lesions (719 patients) matched to 1424 DES lesions (1271 patients). The DCB group had smaller coronary arteries, shorter treated segments, and more bifurcation lesions. The mean age was 65 years, 22% of patients had prior MI, 16% had diabetes, and 58% had acute coronary syndromes. The rate of TLR at 12 months was as follows: 2.3% with DCBs; 2.5% with DESs (OR 0.86, p = 0.726, 95% CI 0.37–2.02). MACE was 8.2% with DCBs and 7.3% for DESs (OR 1.04, 95% CI 0.73–1.47). Results suggest comparable outcomes in patients who received paclitaxel DCBs compared to DESs without excess MACE, highlighting the need for randomised controlled trials. Full article

The menopausal transition is a key period marked by changes in cardiometabolic health and adrenal function, representing an important window for targeted interventions to improve women’s health. Glucagon-like peptide-1 receptor agonists improve metabolic parameters, while physical exercise provides well-established benefits; however, their effects during the menopausal transition remain insufficiently explored. This study examined the effects of liraglutide (0.186 mg/kg; corresponding to the human equivalent dose of 1.8 mg/day used for type 2 diabetes treatment) and exercise on the adrenal gland in a rat model of menopausal transition. Three-month-old females served as young controls (CY), while 16-month-old acyclic females were assigned to control (C), liraglutide (L), exercise (E), or combined treatment (L+E). Compared with CY, the C group showed increased body mass and adrenal alterations, including reduced adrenal weight and volume, cortical atrophy, increased collagen content, decreased STAR, and increased pAMPKα optical density (p ≤ 0.05). Sf1 and Star were upregulated in L, E, and L+E compared with C, most prominently in L (p ≤ 0.05), while Cyp11b2 was increased in L and L+E (p ≤ 0.05). Hormone analysis showed reduced 17β-estradiol, corticosterone, and aldosterone in C compared with CY. Corticosterone was further reduced in L compared with C, while aldosterone increased in L and L+E compared with C (p ≤ 0.05). In conclusion, the menopausal transition induced adrenal morpho-functional remodeling. Liraglutide intervention had the greatest impact on steroidogenic output, both alone and in combination with exercise, while exercise alone showed no significant effect. Full article

Background: Febrile seizures (FSs) are the most common neurological emergency in early childhood; however, the biological basis of disease heterogeneity remains poorly understood. Although growing evidence suggests that gut–brain axis dysregulation contributes to seizure susceptibility, it remains unclear whether gut microbiota-associated metabolic disturbances are linked to clinical phenotypes, particularly simple FS (SFS) and complex FS (CFS). Methods: An integrated multiomics study was conducted in clinically characterized pediatric cohorts, comprising 50 children with FS and 50 healthy controls, and their gut microbiota was profiled via 16S rRNA sequencing. As some pediatric serum specimens did not meet the minimum volume requirement of the analytical platform, serum amino acid profiling was performed in a subset of samples using an equal-volume pooling strategy. In brief, two individual serum samples from the same study group were combined into one composite sample, yielding 25 pooled samples in the FS group and 25 in the control group. Subsequently, untargeted fecal metabolomics was performed in an expanded cohort of 53 healthy controls, 50 children with SFS, and 42 children with CFS. Additionally, the central metabolic profiles of the CFS and SFS groups were compared using untargeted cerebrospinal fluid metabolomics. Given the variation in sample sizes across omics platforms, each dataset was analyzed within its corresponding eligible subset, and cross-omics integration was interpreted primarily at the pathway and phenotype levels. Results: Children with FS exhibited reduced gut microbial diversity and altered microbial composition, characterized by the enrichment of Streptococcus, Enterococcus, and Escherichia–Shigella, along with the depletion of beneficial taxa, including Faecalibacterium, Lachnoclostridium, and Parasutterella. Functional prediction indicated significant changes in amino acid-related pathways, especially arginine and proline metabolism, amino acid metabolism, and glutathione metabolism. Serum profiling showed elevated levels of phenylalanine, kynurenine, and γ-aminobutyric acid, along with reduced levels of tryptophan, threonine, lysine, glutamine, taurine, citrulline, 3-methylhistidine, α-aminobutyric acid, hydroxyproline, and phosphoethanolamine. Correlation analysis identified Lachnoclostridium and Parasutterella as key taxa associated with neuroactive metabolites. Additionally, fecal metabolomics revealed that both SFS and CFS samples exhibited significant metabolic divergence from the controls, with arginine biosynthesis emerging as a shared altered pathway and L-arginine reduced in both phenotypes. Notably, cerebrospinal fluid metabolomics demonstrated clear metabolic separation between CFS and SFS, signifying phenotype-specific central metabolic signatures. Conclusions: FS is related to gut microbiota dysbiosis, systemic amino acid remodeling, and phenotype-associated metabolic stratification. Arginine metabolism may represent a shared mechanistic hub across FS phenotypes, while central metabolic divergence may contribute to the biological distinction between SFS and CFS. These findings establish a multiomics framework for understanding FS pathogenesis and identifying potential biomarkers and therapeutic targets. Full article

Background/Objectives: Colorectal cancer (CRC) disproportionately affects Romania, where mortality exceeds the EU average and screening uptake remains low. Diet is among the most modifiable CRC risk factors, yet no validated instrument for assessing nutritional knowledge, attitudes, and practices (KAP) related to CRC prevention exists for the Romanian population. We developed and pilot-tested the EduNutriCRC questionnaire and characterised the corresponding nutritional KAP profile of Romanian adults. Methods: In a cross-sectional pilot study (April–May 2026), a convenience sample of 301 Romanian adults aged 18–74 years completed the 51-item self-administered questionnaire. The instrument was evaluated for internal consistency and dimensional structure (exploratory factor analysis), with non-parametric tests used for group comparisons. Results: The composite knowledge score (C1–C9; maximum 9) was 6.12 ± 2.25 with wide item-level variation. Internal consistency was acceptable, and the Attitudes subscale resolved into two factors (Motivation & Self-Efficacy and Perceived Barriers). Screening engagement was critically low (92.4% never tested; 81.7% unaware of the national programme). Although 64.1% expressed willingness to change their diet, 46.2% reported consuming processed meat at least weekly. Motivation & Self-Efficacy, but not the knowledge score, was inversely correlated with risk-food consumption (ρ = −0.39, p < 0.001). Conclusions: EduNutriCRC demonstrated acceptable psychometric properties at the pilot stage. The study identified prevalent nutritional misconceptions, a marked knowledge–behaviour gap, low screening awareness, and a structural mismatch between information sources used and those trusted. Attitudes and self-efficacy, rather than factual knowledge, were the more proximal correlates of dietary behaviour, supporting the development of self-efficacy-focused, culturally adapted educational interventions for CRC prevention in Romania, with EduNutriCRC serving as a baseline and monitoring instrument. Full article

Background/Objectives: Post-procedural permanent pacemaker implantation (PPMI) and cardiac damage are individually associated with adverse outcomes following transcatheter aortic valve replacement (TAVR). However, their joint impact has not been systematically evaluated. Methods: Individuals who underwent TAVR procedures between 2013 and 2024 were retrospectively enrolled and classified into four groups based on their PPMI and cardiac damage status. Univariate and multivariable Cox regression were used to analyze the association of these factors with long-term outcomes, while receiver operating characteristic (ROC) curves, decision curve analysis (DCA), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to further assess their predictive performance. Results: A total of 1274 patients met the inclusion criteria. Compared to non-PPMI patients with early cardiac damage stage, those with PPMI and advanced stage had higher all-cause mortality (HR: 2.98; 95% CI: 1.60–5.56; p value < 0.001) and more cardiac deaths (HR: 3.85; 95% CI: 1.36–11.10; p = 0.012). Multivariable analysis confirmed PPMI and cardiac damage stage as independent prognostic factors. Notably, the predictive model incorporating both variables achieved the best performance (AUC = 0.703) with significant NRI and favorable DCA results, suggesting incremental value for identifying high-risk patients and acceptable clinical utility. Conclusions: The current study is among the first to explore whether post-procedural cardiac damage may identify a subgroup in whom PPMI carries a particularly adverse long-term prognosis, highlighting the need for integrated risk assessment for post-TAVR lifelong management. Full article

Background/Objectives: Severe mitral regurgitation (MR) is associated with chronic atrial stretch, chamber enlargement, pulmonary pressure elevation, and atrial fibrosis, yet the relationship between tissue inflammatory/profibrotic signaling, histologically quantified fibrosis, and echocardiographic remodeling remains incompletely characterized. This study aimed to compare biatrial tissue remodeling in patients with severe MR undergoing mitral valve surgery with a practical non-valvular surgical comparator group undergoing isolated coronary artery bypass grafting (CABG). Methods: This single-center, observational, cross-sectional comparative study included 36 elective cardiac-surgery patients: 22 with severe MR and 14 undergoing isolated CABG without significant valvular disease. Left- and right-atrial tissue samples were collected intraoperatively. IL-6, TNF-α, and TGF-β expression was assessed by quantitative real-time PCR using pooled atrial samples stratified by atrial side and study group, whereas atrial fibrosis was quantified histologically on individual tissue specimens using Masson’s trichrome staining and digital image analysis. Clinical, laboratory, and echocardiographic parameters were compared between groups, and exploratory associations were assessed with cautious interpretation. Results: Compared with the CABG comparator group, patients with severe MR showed a pooled molecular profile compatible with higher aggregate atrial expression of IL-6, TNF-α, and TGF-β; because qPCR was performed on pooled tissue preparations, these molecular findings were interpreted descriptively and were not used for patient-level inferential statistics. Histologically quantified fibrosis was significantly increased in severe MR in both the left atrium (29.69 ± 12.26% vs. 12.17 ± 4.56%, p < 0.0001) and the right atrium (25.25 ± 11.33% vs. 9.01 ± 4.46%, p < 0.0001). The MR group also showed more pronounced echocardiographic remodeling, including larger estimated left atrial volume, higher pulmonary artery systolic pressure, and greater right ventricular diameter. Exploratory individual-level analyses were restricted to histological fibrosis and echocardiographic variables. Conclusions: Severe MR was associated with marked echocardiographic remodeling and significantly greater histologically quantified biatrial fibrosis compared with a CABG surgical comparator group. Pooled qPCR findings support an aggregate inflammatory/profibrotic signal, but they should be interpreted descriptively because individual-level molecular variability could not be assessed. These findings are hypothesis-generating and do not establish causality. Full article