Search Results (337)

Hemoglobin plays a critical role in diagnosing various medical conditions, including infections, trauma, hemolytic disorders, and Mediterranean anemia, which is particularly prevalent in Mediterranean populations. Conventional measurement methods require blood sampling and laboratory analysis, which are often time-consuming and impractical during emergency situations with limited medical infrastructure. Although portable oximeters enable non-invasive hemoglobin estimation, they still require physical contact, posing limitations for individuals with circulatory or dermatological conditions. Additionally, reliance on disposable probes increases operational costs. This study presents a non-contact and automated approach for estimating total hemoglobin levels from facial video data using three-dimensional regression models. A dataset was compiled from 279 volunteers, with synchronized acquisition of facial video and hemoglobin values using a commercial pulse oximeter. After preprocessing, the dataset was divided into training, validation, and test subsets. Three 3D convolutional regression models, including 3D CNN, channel attention-enhanced 3D CNN, and residual 3D CNN, were trained, and the most successful model was implemented in a graphical interface. Among these, the residual model achieved the most favorable performance on the test set, yielding an RMSE of 1.06, an MAE of 0.85, and a Pearson correlation coefficient of 0.73. This study offers a novel contribution by enabling contactless hemoglobin estimation from facial video using 3D CNN-based regression techniques. Full article

Background/Objectives: Type 2 diabetes mellitus (T2DM) is frequently associated with depressive disorder (DD), which negatively impacts glycemic control and overall metabolic outcomes. Recent evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may exert neuroprotective effects and modulate mood. Likewise, it is unknown whether the presence of a DD, due to increased brain inflammation, could lead to a poorer response to GLP-1 RAs in terms of weight loss. This study evaluates the impact of DD on metabolic outcomes in individuals treated with GLP-1 RAs. Methods: We conducted a retrospective longitudinal study including 115 patients with T2DM treated with GLP-1 RAs for at least six months. DD was identified based on a documented clinical diagnosis, chronic antidepressant use, or a Beck Depression Inventory (BDI) score ≥16. Metabolic parameters, including glycated hemoglobin (HbA1c), fasting glucose, the body mass index (BMI), the waist circumference, and triglycerides, were compared between patients with and without DD. Results: Patients with DD had significantly higher baseline HbA1c (7.5% vs. 6.9%, p = 0.01), fasting glucose, and triglyceride levels. The waist circumference was also higher in the DD group (p = 0.001). However, no significant differences were observed in weight loss or BMI reductions following the GLP-1 RA treatment. Final HbA1c levels remained higher in the DD group (7.2% vs. 7.0%, p = 0.01). Conclusions: While DD is associated with a poorer baseline metabolic control in T2DM, it does not appear to impair the weight loss efficacy with GLP-1 RAs. However, patients with DD maintain higher post-treatment HbA1c levels, underscoring the need for integrated metabolic and psychiatric care in diabetes management. Full article

Background and Objectives: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder with diverse subtypes. Recent evidence has suggested a link between vitamin D deficiency and IBS; however, the associations between vitamin D levels, IBS subtypes, and hematological–biochemical parameters remain unclear. The aim of this research was to investigate the associations between vitamin D status, IBS subtypes, and sex, along with their relationships with biochemical and hematological parameters. Materials and Methods: This retrospective study included 240 patients diagnosed with IBS according to the Rome IV criteria at Van Yüzüncü Yıl University Medical Faculty Hospital. The patients were classified as diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), or mixed-type (IBS-M). The patients’ serum vitamin D levels and hematological (hemoglobin, white blood cell and platelet counts, and mean corpuscular volume) and biochemical (ferritin, iron, calcium, magnesium, and vitamin B12 levels) parameters were evaluated at baseline and after vitamin D supplementation. Sex-related differences were assessed. Results: Baseline vitamin D levels were low in all IBS subtypes, with no significant differences between the groups. Vitamin D supplementation resulted in a significant increase in serum vitamin D levels across all subtypes (p = 0.001). No significant correlations were identified between vitamin D levels and hematological or biochemical parameters. Sex differences in vitamin D levels were only significant in the IBS-M group, both at baseline and post-treatment (p < 0.05). Conclusions: Vitamin D deficiency is prevalent among all IBS subtypes and significantly improves with supplementation, independently of the subtype. Although no associations were found between vitamin D levels and laboratory parameters, the observed sex differences in patients with IBS-M highlight the need for further research into potential sex-related pathophysiological mechanisms. These findings support the integration of routine vitamin D assessment and supplementation into the clinical management of IBS, especially in patients with the IBS-M subtype and female sex, to potentially improve patient outcomes. Full article

Background: Anemia, a common health disorder affecting populations globally, demands timely and accurate diagnosis for treatment to be effective. The aim of this paper is to detect and classify four types of anemia: hgb, iron-deficiency, folate-deficiency, and B12-deficiency anemia. Methods: This paper proposes an ontology-enhanced machine learning (ML) framework to classify types of anemia from CBC data obtained from Kaggle, which contains 15,300 patient records. It evaluates the effects of classical versus deep classifiers on imbalanced and oversampled training samples. Tests include KNN, SVM, DT, RF, CNN, CNN+SVM, CNN+RF, and XGBoost. Another interesting contribution is the use of ontological reasoning via SPARQL queries to semantically enrich clinical features with categories like “Low Hemoglobin” or “Macrocytic MCV”. These semantic features were then used in both classical (SVM) and deep hybrid models (CNN+SVM). Results: Ontology-enhanced and CNN hybrid models perform competitively when paired with ROS or ADASYN, but their performance degrades significantly on the original dataset. There were tremendous performance gains with ontology-enhanced models in that Onto-CNN+SVM achieved an F1-score (1.00) for all the four types of anemia under ROS sampling, while Onto-SVM exhibited more than 20% improvement in F1-scores for minority categories like folate and B12 when compared to baseline models, except XGBoost. Conclusions: Ontology-driven knowledge coalescence has been shown to improve classification results; however, XGBoost consistently outperformed all other classifiers across all data conditions, making it the most robust and reliable model for clinically relevant decision-support systems in anemia diagnosis. 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

Background/Objectives: This study assesses the prevalence of diabulimia in Greek children and adolescents with Type 1 Diabetes Mellitus (T1DM) by using the Diabetes Eating Problem Survey—Revised (DEPS-R) questionnaire and addresses a gap in the literature on eating disorders (EDs) and disordered eating behaviors (DEBs) in this population. The DEPS-R threshold score of ≥20, although originally established in international studies, has also been applied in Greek adult validation studies. However, it has not yet been formally validated in Greek youth. Methods: Participants aged 9–18 years, diagnosed with T1DM a minimum of one year before the start of the study, were recruited from three pediatric departments in Thessaloniki and were asked to complete the Greek version of the DEPS-R questionnaire. Appropriate statistical analysis was employed to investigate the association of the DEPS-R score with anthropometric, demographic, and glycemic variables derived from the clinical assessment and the patient’s medical records. Results: Girls had significantly higher DEPS-R scores compared with boys. Significant positive associations were observed between the DEPS-R score and both age (r = 0.212, p = 0.020) and Body Mass Index (BMI) (r = 0.419, p < 0.001). A significant association with Glycated Hemoglobin (HbA1c) (r = 0.182, p = 0.047) suggested that poorer glycemic control may be linked to disordered eating, although no significant associations were identified with physical activity or type of insulin therapy. Conclusions: Older age, higher Body Mass Index (BMI) and elevated Glycated Hemoglobin (HbA1c) levels are associated with increased risk of disordered eating in youth with T1DM, especially in girls. Therefore, the implementation of early screening and targeted interventions is imperative. Full article

Background/Objectives: Postpartum depression (PPD), the most common and prevalent psychiatric disorder after birth, is a prevalent yet underdiagnosed psychiatric condition that remains insufficiently understood, particularly in terms of its biological basis. While epidemiological data are extensive, few studies have systematically investigated their underlying biological mechanisms. The purpose of this study was to explore the potential links between blood biomarker levels and postpartum depressive symptoms, contributing to the development of a unified biological model of PPD. Methods: We conducted a cross-sectional study between 2023 and 2025 at a tertiary academic hospital in Timisoara, Romania, involving 860 postpartum women recruited at hospital discharge (1–2 weeks after childbirth). The participants completed the Edinburgh Postnatal Depression Scale (EPDS) and provided peripheral blood samples, which were analyzed using standardized protocols. The blood levels of pregnancy-related hormones (estrogen and progesterone), vitamin D, biochemical markers of inflammatory response (white blood cell count, C-reactive protein, fibrinogen, neutrophil count, lymphocyte count, and ferritin), anemia indicators (hemoglobin, red blood cell count, hematocrit, and ferritin), thyroid hormones (TSH, FT3, and FT4) and markers of coagulation abnormalities (D-dimer, platelets, fibrinogen, APTT, and INR) were evaluated. The data were analyzed with JASP v0.19.3. The statistical methods included multivariate linear regression, the Kruskal–Wallis and Mann–Whitney U tests, and Spearman correlation, with significance set at p < 0.05. Results: The analysis revealed that postpartum depression (PPD) is associated with distinct biological profiles, reflecting the unique hormonal and physiological changes in the peripartum period. Significant associations were identified between EPDS scores and the levels of estrogen, progesterone, thyroid hormones (TSH, FT3, and FT4), inflammatory markers (CRP and ferritin), vitamin D, and coagulation parameters (APTT and INR). These findings support the notion that PPD has a multifactorial biological basis and highlight the potential of these biomarkers as early predictors of risk. Conclusions: Integrating biochemical assessments into postpartum care may enhance early identification and inform targeted preventive interventions, such as hormone monitoring, vitamin D and iron supplementation, or thyroid function correction. Full article

Background: As societies rapidly age, the prevalence of mental health disorders and chronic kidney disease (CKD) is simultaneously rising, and data on the link between these conditions remain inconclusive. This study aimed to investigate the associations among cognitive impairment, depression, and kidney involvement in elderly patients. Methods: A cross-sectional analysis was conducted among hospitalized patients aged ≥65 years. Standardized tools such as the geriatric depression scale (GDS) and Montreal Cognitive Assessment (MoCA) were used to assess depression and cognitive impairment, and kidney function was evaluated using eGFR and albuminuria. Bivariate and multivariate logistic regressions were performed to identify associations. Results: The study population consisted of 719 participants with a median age of 80 years. Kidney and mental health issues were highly prevalent: CKD was identified in 59.4%, cognitive impairment in 74%, and depression in 61.9% of patients. Patients with CKD were older and exhibited lower MoCA scores (p = 0.001), higher GDS scores (p = 0.007), reduced albumin (p < 0.001), lower hemoglobin levels (p < 0.001), and elevated C-reactive protein (p < 0.001). Increased albuminuria was associated with poorer cognition (p < 0.001) but showed no correlation with GDS scores. Additionally, worse cognitive scores (p = 0.001) and increased depression symptoms (p < 0.001) were correlated with declining estimated glomerular filtration rate (eGFR). Conclusions: Cognitive impairment and depressive symptoms are highly prevalent among elderly hospitalized patients. Cognitive decline correlates with increased albuminuria and reduced eGFR, while depression worsens with declining kidney function. These findings highlight the complex interplay between renal health and neuropsychiatric conditions in aging populations. Full article

Background/Objectives: Iron plays an important role in cognitive, behavioral, and motor development. This study aims to assess the iron nutritional status of Bulgarian children with cerebral palsy (CP) and autism spectrum disorder (ASD), focusing on iron deficiency (ID) and its impact on children’s development. We hypothesized that children with CP and ASD suffer from iron deficiency. Methods: The cross-sectional study includes 95 children from northeastern Bulgaria. Data were collected in two periods (2017–2018 and 2023–2024). Demographic questionnaires, food frequency questionnaires, and laboratory tests for hemoglobin, serum iron, serum ferritin, serum albumin, and CRP were conducted. Anthropometric measurements were evaluated. The Gross Motor Function Classification System scale was used to assess motor function in children with CP. Statistical analysis was performed using Jamovi software, ver. 2.6.44, with a significance level of p < 0.05. Results: Of the 95 children, 62.1% had CP and 37.9% had ASD. Most children had normal hemoglobin and serum iron levels, but 62.7% of those with CP and 36.8% of those with ASD had low serum ferritin levels, indicating latent ID. A higher proportion of children with CP than those with ASD consumed meat daily, while fish was more commonly consumed by children with ASD. Anthropometric data showed delayed growth and lower height-for-age scores in children with CP. Conclusions: The study identifies latent ID in children with CP and ASD. An evaluation of dietary habits highlights the need for interventions to improve nutritional status and development. The observed deficiencies emphasize the need for regular monitoring and targeted dietary programs for children in these groups. Full article

Sickle-cell disease (SCD) is a group of inherited blood disorders in which a mutation in the β-globin (HBB) gene causes red blood cells to produce abnormal hemoglobin, known as Hb S. SCD is characterized by an autosomal-recessive pattern of inheritance, implying that for a child to manifest the condition, they must inherit an Hb S allele from both parents (HbSS) or one Hb S allele and another β-globin variant, such as Hb C or β-thalassemia (HbSC, HbS/β-thal). It has been observed that (heterozygote) carriers of one copy of the sickle-cell trait (HbAS) are typically healthy and can even gain partial protection from severe malaria. The term “severe and complicated malaria” is delineated based on specific clinical and laboratory characteristics in the presence of Plasmodium falciparum parasitemia. The prevalent forms of severe malaria among African children include cerebral malaria, respiratory distress, and severe malaria anemia. Cerebral malaria is a rare complication of malaria infection and is associated with a high mortality rate. Full article

Background/Objectives: Attention-Deficit Hyperactivity Disorder (ADHD) is an immensely heterogeneous developmental disorder, uniquely impacting each individual. Physical movement is a promising adjunct behavioral treatment that can promote executive functioning in children with ADHD. The current study used neuroimaging and behavioral techniques to investigate the impact of movement during executive functioning on dorsolateral prefrontal cortical (DLPFC) activity and inhibitory control in children with ADHD, with particular focus on key individual difference factors in ADHD, such as subtype, severity, and gender. Methods: Twenty-eight children with ADHD completed a Stroop task while remaining stationary (stationary condition) and while desk cycling (movement condition). Simultaneous functional near-infrared spectroscopy (fNIRS) recorded oxygenated and deoxygenated changes in hemoglobin within the left DLPFC. Participants were categorized into ADHD subtype (hyperactive/impulsive, inattention, combined), ADHD severity (low, moderate, high), and gender (male, female). Results: Those with the hyperactive and combined ADHD subtypes, those with high ADHD severity, and males with ADHD showed greater DLPFC activation when engaging in movement during executive functioning compared to remaining stationary. In contrast, those with the inattentive ADHD subtype, those with low-to-moderate ADHD severity, and females with ADHD showed greater DLPFC activation when remaining stationary during executive functioning compared to engaging in movement. Inhibitory control improved in the stationary condition for females who were predominantly inattentive. Conclusions: This work underscores the importance of considering individual difference factors in ADHD when designing physical activity interventions, as treatment efficacy may vary. Full article

Testicular orphan receptors TR2 and TR4 serve as central regulators of erythropoiesis, orchestrating the entire continuum of erythroid progenitor cell proliferation, differentiation, and maturation. As core components of the direct repeat erythroid determinant (DRED) complex, they activate erythroid-specific transcriptional programs to dynamically control the spatiotemporal expression of globin genes. These nuclear receptors not only engage in functional interactions with key erythroid transcription factors GATA1 and KLF1 to coregulate erythroid differentiation and maturation but also recruit epigenetic modifier complexes such as DNMT1 and LSD1 to modulate chromatin states dynamically. Research has established that dysfunctions in TR2/TR4 are implicated in β-thalassemia and sickle cell disease (SCD): β-thalassemia is associated with the defective silencing of γ-globin genes, while in SCD, TR2/TR4 antagonizes BCL11A to reactivate fetal hemoglobin (HbF) expression. This review systematically dissects the molecular regulatory networks of TR2/TR4 in erythroid cells, interprets their dual regulatory properties across different stages of erythroid differentiation, and explores the therapeutic potential of targeting TR2/TR4 for treating erythroid-related disorders such as β-thalassemia and SCD, thereby providing novel directions for hematological disorder therapy. Full article

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder associated with systemic inflammation, immune dysregulation, and malnutrition, all of which may influence surgical outcomes. Subthalamic nucleus deep brain stimulation (STN DBS) is a widely used treatment for advanced PD, yet postoperative complications remain a concern. This study evaluates the predictive value of preoperative immunonutritional markers—including the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, Aggregate Index of Systemic Inflammation (AISI), Lymphocyte-to-Monocyte Ratio (LMR), and systemic inflammatory response syndrome (SIRS)—for the risk of extracranial complications following STN DBS. Methods: A retrospective cohort study was conducted on 138 PD patients who underwent STN DBS. Clinical and laboratory data were analyzed to assess the association between preoperative immunonutritional markers and postoperative complications, including infections, wound healing disturbances, and surgical revisions. Logistic regression and receiver operating characteristic (ROC) analysis were performed to evaluate the predictive power of these markers. Results: SIRS emerged as the strongest predictor of complications (aOR = 6.99, 95% CI = 1.844–26.509), emphasizing the critical role of systemic inflammation in surgical outcomes. HALP, AISI, and LMR also demonstrated significant predictive potential, with HALP (AUC = 0.69) and LMR (AUC = 0.73) being the most robust predictors of complications. While albumin alone was not a significant predictor, it correlated with inflammatory markers and comorbidities, underscoring its role in broader risk assessments. Conclusions: This study underscores the value of preoperative immunonutritional markers in predicting complications following STN DBS in PD patients. Incorporating these markers into clinical risk stratification may enhance preoperative planning and personalized postoperative care, ultimately improving surgical outcomes. These findings, while promising, warrant validation through prospective, multicenter studies to refine predictive models and enhance patient outcomes. Full article

Effective multidisciplinary pain management involves an in-depth knowledge not only of diagnosis and treatment but of how interventional procedures affect patients across all health domains. One of the most common pharmacological tools utilized in patients suffering from chronic pain disorders is corticosteroids. Corticosteroids are leveraged for their anti-inflammatory properties across a wide range of disorders. This review examines the role of corticosteroids and pain management with a specific focus on their metabolic impact regarding glucose metabolism. Corticosteroids have been shown to increase gluconeogenesis, resulting in reduced insulin sensitivity and an impaired peripheral glucose uptake. These varied responses to corticosteroids are especially concerning given the high prevalence of diabetes mellitus in chronic pain patients. There is well-documented evidence of not only transient hyperglycemia but emerging literature on prolonged glycemic disturbances that may have a greater effect on patients than previously recognized. A review of the available literature reveals variations in hyperglycemia depending on corticosteroid type, dose, and various patient-specific factors. Some research does suggest that lower corticosteroid dosages can provide similar therapeutic benefits and potentially reduce glycemic aberrations. Given the current evidence, clinicians should closely monitor patients’ hemoglobin A1C levels when determining the risks and benefits of an interventional procedure and consider alternative pain management strategies when appropriate. Future research should focus on optimizing corticosteroid selection and dosing to balance the safety, particularly in diabetic or prediabetic patient populations. Full article

Sotatercept selectively binds free activins and growth differentiation factors by reproducing the binding domain of the activin receptor type IIA (ACTRIIA). The sequester of activins blunts the downstream signaling pathway, resulting in the reactivation of the bone morphogenic protein (BMP) receptor type 2 signaling and inhibition of pathological remodeling in pulmonary circulation. The balance between proliferative and antiproliferative pathways is restored, with a favorable impact on the progression of pulmonary arterial hypertension (PAH). Sotatercept, first approved for the treatment of hematological disorders such as anemia, has recently received approval as a drug in the treatment of group 1 PAH, either in United States or Europe. In this review, we will discuss the application of sotatercept and its cross reactivity in function alone or in combination with other drugs currently used for PAH. We will try also to further discuss what is known regarding the hematological effects of sotatercept, both from preclinical and clinical studies points of view, since they are the root of the side effects seen in PAH trials, such as bleeding and increased hemoglobin. Full article