Search Results (41,058)

Background: Alcohol-associated liver disease (AALD) represents significant health burdens worldwide. This study aims to provide a comprehensive overview of the AALD outcomes that were incompletely understood. Methods: The current study utilizes data from the National Health and Nutrition and Examination Survey (NHANES) from 2011–2020, using a stratified, multistage probability cluster design. AALD in the NHANES was defined using clinical laboratory data and self-reported alcohol use, among which fibrosis-4 score of >2.67. Analysis is conducted using weighted, logistic, and Cox linear regression. Results: The initial sample included 23,206 participants aged 20 and older, with recorded cardiovascular status and AST/ALT levels. Participants reporting AALD had a higher percentage of college degrees (p < 0.001) and were more likely to be daily smokers. Asians exhibited the highest rates of AALD compared to other demographics (p < 0.001). The prevalence in private insurance is significantly greater than Medicaid, but the usage trends have been increasing in Medicaid. The trends of advanced fibrosis have been increasing in blacks and Asians, while they have been decreasing among whites and Mexicans. Those with AALD also had higher mean systolic and diastolic blood pressure, as well as elevated fasting glucose levels (p < 0.001). The mortality rate among AALD participants with heart diseases was 25%, compared to 3% among those without (p < 0.001). After adjusting for potential confounding variables, no statistically significant associations were found between AALD status and HF or CAD. However, a clinically significant increase in the odds of stroke was observed within the AALD group (p < 0.001). Conclusions: Our findings indicate Asians have the highest rates of AALD. The trends of advanced fibrosis have been increasing in blacks and Asians. There is an increased prevalence of AALD with heart diseases and a significant increase in mortality with stroke. Full article

Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations. Full article

Sex-based immunological differences significantly influence the outcome of vaccination, yet the molecular mediators underpinning these differences remain largely elusive. MicroRNAs (miRNAs), key post-transcriptional regulators of gene expression, have emerged as critical modulators of innate and adaptive immune responses. In this study, we investigated the expression profile of selected circulating miRNAs as potential biomarkers of sex-specific humoral responses to the mRNA COVID-19 vaccine in a cohort of health care workers. Plasma samples were collected longitudinally at a defined time point (average 71 days) post-vaccination and analyzed using RT-qPCR to quantify a panel of immune-relevant miRNAs. Anti-spike (anti-S) IgG titers were measured by chemiluminescent immunoassays. Our results revealed sex-dependent differences in miRNA expression dynamics, with miR-221-3p and miR-148a-3p significantly overexpressed in vaccinated female HCWs and miR-155-5p overexpressed in vaccinated males. MiR-148a-3p showed a significant association with anti-S/RBD (RBD: receptor binding domain) IgG levels in a sex-specific manner. Bioinformatic analysis for miRNA targets indicated distinct regulatory networks and pathways involved in innate and adaptive immune responses, potentially underlying the differential immune activation observed between males and females. These findings support the utility of circulating miRNAs as minimally invasive biomarkers for monitoring and predicting sex-specific vaccine-induced immune responses and provide mechanistic insights that may inform tailored vaccination strategies. Full article

(1) Background: Dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) are persistent organic pollutants (POPs), characterized by high toxicity and strong lipophilicity, which promote their bioaccumulation in human tissues. Their detection in breast milk raises concerns about early-life exposure during lactation. Although dietary intake is the primary route of maternal exposure, environmental pathways—including inhalation, dermal absorption, and residential proximity to contaminated sites—may also significantly contribute to the maternal body burden. (2) Methods: This narrative review examined peer-reviewed studies investigating maternal and environmental determinants of dioxin and dl-PCB concentrations in human breast milk. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science (2000–2024), identifying a total of 325 records. Following eligibility screening and full-text assessment, 20 studies met the inclusion criteria. (3) Results: The included studies consistently identified key exposure determinants, such as high consumption of animal-based foods (e.g., meat, fish, dairy), living near industrial facilities or waste sites, and maternal characteristics including age, parity, and body mass index (BMI). Substantial geographic variability was observed, with higher concentrations reported in regions affected by industrial activity, military pollution, or inadequate waste management. One longitudinal study from Japan demonstrated a declining trend in dioxin levels in breast milk, suggesting the potential effectiveness of regulatory interventions. (4) Conclusions: These findings highlight that maternal exposure to dioxins is influenced by identifiable environmental and behavioral factors, which can be mitigated through public health policies, targeted dietary guidance, and environmental remediation. Breast milk remains a critical bioindicator of human exposure. Harmonized, long-term research is needed to clarify health implications and minimize contaminant transfer to infants, particularly among vulnerable populations. Full article

Background and Objectives: Sarcopenic obesity, or the coexistence of sarcopenia and obesity, carries an additional load of health risks, including functional decline and metabolic disorders. Despite its increasing importance, data on Korean adults’ prevalence and risk factors are poor. The objective of this study was to estimate the prevalence of sarcopenic obesity, sarcopenia, and obesity to identify factors associated with each condition using the most recent nationally representative data. Materials and Methods: This study analyzed data from 4332 adults aged ≥ 40 years who participated in the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Sarcopenia was defined using the appendicular skeletal muscle index (SMI) via bioelectrical impedance analysis (BIA), and obesity by waist circumference per Korean criteria. Participants were categorized into four body composition groups. Complex sample logistic regression was used to identify factors independently associated with each condition. Results: The prevalence rates of sarcopenic obesity, sarcopenia-only, and obesity-only were 1.9%, 14.4%, and 35.5%, respectively. Sarcopenic obesity was significantly more common among older women with low education level, poor subjective health, diabetes, and low HDL-C. They were associated with older age, lower physical activity, lower education level, past smoking, and poor health condition. Obesity was associated with male sex, diabetes, hypertension, dyslipidemia, and moderate-to-poor perceived health. Conclusions: Sarcopenic obesity, while less prevalent, is relatively uncommon and represents a high-risk phenotype associated with metabolic and functional deficits. These results highlight the importance of identifying vulnerable subgroups and implementing targeted strategies that address both muscle loss and adiposity in aging Korean adults. Full article

Circadian rhythms are intrinsic 24 h cycles that regulate metabolic processes across multiple tissues, with skeletal muscle emerging as a central node in this temporal network. Muscle clocks govern gene expression, fuel utilisation, mitochondrial function, and insulin sensitivity, thereby maintaining systemic energy homeostasis. However, circadian misalignment, whether due to behavioural disruption, nutrient excess, or metabolic disease, impairs these rhythms and contributes to insulin resistance, and the development of obesity, and type 2 diabetes mellitus. Notably, the muscle clock remains responsive to non-photic cues, particularly exercise, which can reset and amplify circadian rhythms even in metabolically impaired states. This work synthesises multi-level evidence from rodent models, human trials, and in vitro studies to elucidate the role of skeletal muscle clocks in circadian metabolic health. It explores how exercise entrains the muscle clock via molecular pathways involving AMPK, SIRT1, and PGC-1α, and highlights the time-of-day dependency of these effects. Emerging data demonstrate that optimally timed exercise enhances glucose uptake, mitochondrial biogenesis, and circadian gene expression more effectively than time-agnostic training, especially in individuals with metabolic dysfunction. Finally, findings are integrated from multi-omic approaches that have uncovered dynamic, time-dependent molecular signatures that underpin circadian regulation and its disruption in obesity. These technologies are uncovering biomarkers and signalling nodes that may inform personalised, temporally targeted interventions. By combining mechanistic insights with translational implications, this review positions skeletal muscle clocks as both regulators and therapeutic targets in metabolic disease. It offers a conceptual framework for chrono-exercise strategies and highlights the promise of multi-omics in developing precision chrono-medicine approaches aimed at restoring circadian alignment and improving metabolic health outcomes. Full article

White-tailed deer (Odocoileus virginianus) are a cervid species native to the Americas with ecological, social, and economic significance. Managers must consider several factors when working to maintain the health and sustainability of these wild herds, including reproduction, particularly pregnancy and recruitment rates. White-tailed deer have a variable reproductive capacity, with age, health, and habitat influencing this variability. However, it is unknown whether chronic wasting disease (CWD) impacts reproduction and, more specifically, if CWD infection alters a female deer’s probability of pregnancy. Our study addressed this question using data from 9783 female deer culled in northern Illinois between 2003 and 2023 as part of the Illinois Department of Natural Resources’ ongoing CWD management program. Multilevel Bayesian logistic regression was employed to quantify the relationship between pregnancy probability and covariates like maternal age, deer population density, and date of culling. Maternal infection with CWD was found to have no significant effect on pregnancy probability, raising concerns that the equal ability of infected and non-infected females to reproduce could make breeding, which inherently involves close physical contact, an important source of disease transmission between males and females and females and their fawns. The results also identified that female fawns (<1 year old) are sensitive to county-level deer land cover utility (LCU) and deer population density, and that there was no significant difference in how yearlings (1–2 years old) and adult (2+ years old) responded to these variables. Full article

Cardiovascular diseases (CVDs) are the leading global cause of death, with long-term hospitalization becoming increasingly frequent in advanced or chronic cases. In this context, the interplay between systemic factors such as lipid metabolism, circulating metabolites, gut microbiota, and oral health is gaining attention for its potential role in influencing inflammation, cardiometabolic risk, and long-term outcomes. Despite their apparent independence, these domains are increasingly recognized as interconnected and influential in cardiovascular pathophysiology. Methods: This narrative review was conducted by analyzing studies published between 2015 and 2024 from databases including PubMed, Scopus, and Web of Science. Keywords such as “lipid profile,” “metabolomics,” “gut microbiota,” “oral health,” and “cardiovascular disease” were used. Original research, meta-analyses, and reviews relevant to hospitalized cardiac patients were included. A critical integrative approach was applied to highlight cross-domain connections. Results and Discussion: Evidence reveals significant interrelations between altered lipid profiles, gut dysbiosis (including increased TMAO levels), metabolic imbalances, and oral inflammation. Each component contributes to a systemic pro-inflammatory state that worsens cardiovascular prognosis, particularly in long-term hospitalized patients. Despite isolated research in each domain, there is a paucity of studies integrating all four. The need for interdisciplinary diagnostic models and preventive strategies is emphasized, especially in populations with frailty or immobilization. Conclusions: Monitoring lipid metabolism, metabolomic shifts, gut microbial balance, and oral status should be considered part of comprehensive cardiovascular care. Gut microbiota exerts a dual role in cardiac health: when balanced, it supports anti-inflammatory and metabolic homeostasis; when dysbiotic, it contributes to systemic inflammation and worsened cardiac outcomes. Future research should aim to develop integrative screening tools and personalized interventions that address the multifactorial burden of disease. A systemic approach may improve both short- and long-term outcomes in this complex and vulnerable patient population. Full article

Introduction: The combination of ceftazidime−avibactam (CAZ-AVI) with aztreonam (ATM) may be an option for the treatment of infections due to metallo-β-lactamases (MBLs) producing bacteria, as recommended by current guidelines. MBLs protect the pathogen from any available β-lactam/β-lactamase inhibitor (BL/BLI). Moreover, in vitro and clinical data suggest that double carbapenem therapy (DCT) may be an option for such infections. Materials and Methods: This retrospective study was conducted in two mixed intensive care units (ICUs) at the University Hospital of Larissa, Thessaly, Greece, and the General Hospital of Larissa, Thessaly, Greece, during a three-year period (2022−2024). Mechanically ventilated patients with bloodstream infection (BSI) caused by K. pneumoniae resistant to all BL/BLI combinations were studied. Patients were divided into three groups: in the first, patients were treated with CAZ-AVI + ATM; in the second, with DCT; and in the third, with antibiotics other than BL/BLIs that presented in vitro susceptibility. The primary outcome of the study was the change in Sequential Organ Failure Assessment (SOFA) score between the onset of infection and the fourth day of antibiotic treatment. Secondary outcomes were SOFA score evolution during the treatment period, total duration of mechanical ventilation (MV), ICU length of stay (LOS), and ICU mortality. Results: A total of 95 patients were recruited. Among them, 23 patients received CAZ-AVI + AZT, 22 received DCT, and 50 patients received another antibiotic regimen which was in vitro active against the pathogen. The baseline characteristics were similar. The mean (SE) overall age was 63.2 (1.3) years. Mean (SE) Acute Physiology and Chronic Health Evaluation II (APACHE II) and SOFA scores were 16.3 (0.6) and 7.6 (0.3), respectively. The Charlson Index was similar between groups. The control group presented a statistically lower SOFA score on day 4 compared to the other two groups [mean (SE) 8.9 (1) vs. 7.4 (0.9) vs. 6.4 (0.5) for CAZ-AVI + ATM, DCT and control group, respectively (p = 0.045)]. The duration of mechanical ventilation, ICU LOS, and mortality were similar between the groups (p > 0.05). Comparison between survivors and non-survivors revealed that survivors had a lower SOFA score on the day of BSI, higher PaO₂/FiO₂ ratio, higher platelet counts, and lower lactate levels (p < 0.05). Septic shock was more frequent among non-survivors (60.3%) in comparison to survivors (27%) (p = 0.0015). Independent factors for mortality were PaO₂/FiO₂ ratio and lactate levels (p < 0.05). None of the antibiotic regimens received by the patients was independently associated with survival. Conclusions: Treatment with CAZ-AVI + ATM or DCT may offer similar clinical outcomes for patients suffering from BSI caused by K. pneumoniae strains resistant to all available BL/BLIs. However, larger studies are required to confirm the findings. Full article

This study evaluated the effect of pearl millet subjected to different processing on the intestinal health of rats. The animals were fed a standard iron-free diet (28 days) (hemoglobin depletion: 8.65 + 1.40 g/dL of hemoglobin). Subsequently, they were divided into four groups for hemoglobin repletion (21 days): standard diet + ferrous sulfate (SD + FS); standard diet + non-germinated open-pan cooked millet flour (SD + NGOPCMF); standard diet + germinated open-pan cooked millet flour (SD + GOPCMF); and standard diet + extrusion-cooked millet flour (SD + ECMF). Hemoglobin level did not differ among groups. The SD + NGOPCMF, SD + GOPCMF and SD + ECMF groups demonstrated a higher Chao index in the microbiome and a higher number and area of goblet cells and longitudinal muscle layer width. The SD + NGOPCMF and SD + GOPCMF groups demonstrated increased cecum weight, crypt depth, crypt thickness, and circular muscle layer width; lower fecal pH; and a higher relative abundance of Bacteroidota, while the SD + FS group showed the highest abundance of Actinobacteriota. The SD + GOPCMF group stood out for showing the lowest fecal pH, better α-diversity (Chao and Shannon index), and the highest width of the longitudinal muscle layer. In conclusion, pearl millet subjected to different processing, mainly germination, has the potential to improve the composition of the intestinal microbiota and the intestinal morphology in rats induced to iron deficiency. Full article

(1) Background: The goal of the present study was to evaluate whether the supplementation with a multi-species probiotic in the diet of laying hens can change the microbiota and health status of the oviduct. (2) Methods: A total of 60 cages housing lightweight laying hens (36 weeks old) were randomly assigned to the following two different treatments: a control group fed a diet without probiotic, and a treatment group receiving diets supplemented with 50 g/ton of probiotics. The trial lasted for 26 weeks, after which five layers were slaughtered per treatment for oviduct (magnum) assessment, focusing on microbiome composition, oxidant and antioxidant status, and morphological analyses. Additionally, intestinal (jejunum) samples were collected to determine oxidant and antioxidant status. (3) Results: Probiotic supplementation resulted in lower counts of organisms from the RB41 order (p = 0.039) and Burkholderia genus (p = 0.017), and a total reduction in Bacillus and Corynebacterium (p = 0.050) compared to the control treatment. Genera Burkholderia (p = 0.017), Corynebacterium (p = 0.050), and Bacillus (p = 0.050) were also lower with the probiotic supplementation in relation to the control. Genera Epulopiscium (p = 0.089), Flavobacterium (p = 0.100), Ruminococcus (p = 0.089), and Staphylococcus (p = 0.100) tended to be lower in the probiotic group compared to the control. No significant differences were found between treatments for oviduct lesions. Probiotic treatment resulted in a higher protein thiol level in the intestine compared to the control (p < 0.001). However, the use of probiotics tended to reduce glutathione S-transferase levels in the oviduct compared to the control (p = 0.068). (4) Conclusions: These results suggest that dietary supplementation with probiotics can modulate the oviduct microbiota and improve the antioxidant status of laying hens, without causing tissue damage. Further research is warranted to explore the long-term implications of these changes on reproductive performance and egg quality. Full article

Trace metal pollution in tropical freshwater ecosystems poses growing public health concerns, particularly in regions where fisheries are central to food security; however, little is known about metal exposure risks in the Western Amazon. This study presents the first assessment of trace metal concentrations in fish sold at the main market in El Coca, a rapidly growing city in the Ecuadorian Amazon. We analyzed 11 trace metals in 17 commercially important species and estimated seven health risk indices based on two fish consumption scenarios and international reference dose standards. Our results show that all species exceeded recommended thresholds for arsenic, mercury, and lead, while one species surpassed guidelines for aluminum. Metal concentrations varied by species and river of origin: small catfish from the Payamino River had elevated cadmium, chromium, copper, and manganese levels, potentially linked to upstream gold mining, whereas larger catfish showed higher mercury and arsenic accumulation. Monte Carlo simulations of risk indices suggested overall low disease risk, but the lack of local demographic data limits accurate assessments for vulnerable groups. Despite sampling limitations, our findings offer the first baseline for monitoring trace metal exposure in the northern Ecuadorian Amazon and underscore the need for targeted public health strategies in this understudied region. Full article

With the rising concerns about climate change and continuous increase in the salinity of soil, it is essential to understand the C-cycling functioning of saline soil to better predict the ecological functions and health of soil. Microbes play critical roles in C-cycling. However, limited research has been conducted to understand the impact of soil salinity on the microbial functional genes involved in C-cycling. In this study, effects of varying soil salinity levels in wetlands on the C-cycling functions and diversity of soil microbes were investigated by metagenomic sequencing. The results showed a higher relative abundance of genes related to decomposition of easily degradable organic C at low salinity. On the other hand, higher abundance of genes participating in the decomposition of recalcitrant organic C were observed at high salinity. These findings indicate distinct metabolic bias of soil microbes based on the salinity levels. Proteobacteria and Actinobacteria were dominant in soils with low to medium salinity levels, while Bacteroidetes phyla was prominent in highly saline soils. Furthermore, partial least squares path modeling (PLS-PM) identified electrical conductivity, total nitrogen, and total phosphorus as key regulators of C-cycling gene expression. Overall, the present study highlights the intricate connections between salinity, microbial attributes, and carbon metabolism in soil, suggesting that the soil microbes adapt to saline stress through divergent eco-adaptations. The findings of this study highlight the significance of exploring these microbial interactions for effective management and conservation of saline wetlands. Full article

Zoological environments aim to promote natural behaviours and optimal welfare conditions. Over the past decade, research on the use of artificial ultraviolet-B (UV-B) exposure has improved vitamin D₃ levels and reduced incidences of metabolic bone disease in diurnal primates; however, this has not been investigated in nocturnals. Aye-ayes (Daubentonia madagascariensis), nocturnal lemurs often housed indoors in zoos with little to no exposure to natural sunlight, have been reported to have low vitamin D₃ levels. This study aims to investigate the impacts of artificial UV-B as a supplemental healthcare strategy for aye-ayes, examining its influences on vitamin D₃ levels and positional sleeping behaviour. The 25-hydroxy-vitamin D₃ (25OHD₃) blood levels were tested before and after exposure to different levels of artificial UV-B and heat sources. Statistical analysis showed no correlation between UV-B and 25OHD₃ at group parameter levels. However, one individual showed a positive correlation. Sleeping position duration analysis showed a potential basking behaviour with the use of increased ear exposure and other thermoregulatory responses. Despite representing 8.06% of the European captive aye-aye population, these findings highlight the need for further research on vitamin D₃ parameters and responses to UV-B to optimise captive conditions and support the species’ long-term health. Full article

Soil structural instability in reservoir riparian zones, induced by water level fluctuations, threatens sustainable land use by accelerating land degradation. This study examined the impact of water-level variations on soil aggregate composition and stability based on key indicators, including water-stable aggregate content (WSAC), mean weight diameter (MWD), and geometric mean diameter (GMD). The Savinov dry sieving, Yoder wet sieving, and Le Bissonnais (LB) methods were employed for analysis. Results indicated that, with decreasing water levels and increasing soil layer, aggregates larger than 5 mm decreased, while aggregates smaller than 0.25 mm increased. Rising water levels and increasing soil layer corresponded to reductions in soil stability indicators (MWD, GMD, and WSAC), highlighting a trend toward soil structural instability. The LB method revealed the lowest aggregate stability under rapid wetting and the highest under slow wetting conditions. Correlation analysis showed that soil organic matter positively correlated with the relative mechanical breakdown index (RMI) (p < 0.05) and negatively correlated with the relative slaking index (RSI), whereas soil pH was negatively correlated with both RMI and RSI (p < 0.05). Comparative analysis of aggregate stability methods demonstrated that results from the dry sieving method closely resembled those from the SW treatment of the LB method, whereas the wet sieving method closely aligned with the FW (Fast Wetting) treatment of the LB method. The Le Bissonnais method not only reflected the outcomes of dry and wet sieving methods but also effectively distinguished the mechanisms of aggregate breakdown. The study concluded that prolonged flooding intensified aggregate dispersion, with mechanical breakdown influenced by water levels and soil layer. Dispersion and mechanical breakdown represent primary mechanisms of soil aggregate instability, further exacerbated by fluctuating water levels. By elucidating degradation mechanisms, this research provides actionable insights for preserving soil health, safeguarding water resources, and promoting sustainable agricultural in ecologically vulnerable reservoir regions of the Yangtze River Basin. Full article