Search Results (3,350)

Background and Objectives: Right heart failure is a life-threatening complication of pulmonary hypertension (PH), with limited treatment options. Although recombinant human brain natriuretic peptide (rhBNP) is widely used in left heart failure, its effectiveness in right heart failure associated with varying groups of PH (Groups 1, 2, and 4) is unknown. Materials and Methods: 763 patients with varying groups of PH (PH Groups 1, 2, and 4) were enrolled and received both conventional therapy and rhBNP treatment. Therapeutic efficacy and adverse event incidence were evaluated among the PH groups. Results: Significant reductions in variables reflecting cardiac congestion, including NT-proBNP, total bilirubin, and body weight, were observed in all PH subgroups (all p < 0.001). The median percentage changes were −47% (IQR −76 to −24), −21% (IQR −33 to −1), and −3% (IQR −7 to −1), respectively. Alanine transaminase levels presented a decreasing trend (p < 0.001), whereas creatinine levels remained unchanged (p > 0.05), with consistent trends across PH subgroups. The hemodynamic response was heterogeneous, with marked decreases in the mean arterial pressure in Groups 1 and 4 (p < 0.001) but not in Group 2. Improvement in dyspnea and edema of the lower limbs was observed in 49.9% and 66.6% of cases, respectively. The overall incidence of adverse events was 0.66%, with 0.26% (2/763) being serious, all of which were in Group 1 PH. Conclusions: Findings from this exploratory analysis indicated that rhBNP treatment was associated with favorable changes in congestive status and clinical symptoms across different PH subgroups, as well as stable end-organ function. Of note, all patients received comprehensive conventional background therapy; thus, these improvements cannot be exclusively attributed to rhBNP alone. Given the observed hemodynamic fluctuations, close blood pressure monitoring should be considered throughout the treatment course, particularly for patients in Groups 1 and 4, and most notably for high-risk PAH patients (Group 1 PH). Full article

This paper addresses the contemporary challenge of religious disaffiliation and the “supermarket mentality” of liquid religion by proposing a prophetic paradigm shift in evangelisation and catechesis. Utilising Richard Osmer’s practical theological framework as a structure, the study identifies a historical shift from the lived apostolic kerygma (fides qua) toward an over-reliance on formal conciliar definitions and Magisterial formulae (fides quae). This diachronic analysis suggests that the current “apparent failure” of institutional engagement is rooted in a linguistic and methodological disconnect. Drawing on the visionary models of St Augustine and St Benedict, and grounded in Karl Rahner’s transcendental theology, the paper proposes a normative way forward: an inductive pedagogy of the heart. This model prioritises the art of accompaniment and the return to elementary, foundational concepts that address the experiential core of the human person. Ultimately, the study argues that restoring the balance between the lived tradition and the contents of the faith is a theological requirement for helping contemporary believers to live their faith in daily life. Full article

Background: Borrelia miyamotoi is an emerging tick-borne pathogen causing relapsing fever in humans. Although Saint Petersburg and the surrounding Leningrad Oblast harbor a high abundance of ixodid ticks (I. ricinus, I. persulcatus), no integrated assessment has yet simultaneously addressed pathogen circulation in vectors, reservoir hosts, and human populations in this specific northwestern region of Russia. Methods: During 2022–2024, we collected 1518 questing adult ticks and trapped 516 small mammals in Saint Petersburg and Leningrad Oblast. B. miyamotoi DNA was detected by real-time PCR. Sera from 3743 randomly selected volunteers (1553 from Saint Petersburg, 2190 from Leningrad Oblast) were tested for anti-B. miyamotoi IgG/IgM using a protein microarray (antigens: GlpQ, Vmps, flagellin). Infection rates and seroprevalence with 95% Wilson confidence intervals were compared using chi-square tests. Results: The overall tick infection rate was 3.78% (57/1506). I. ricinus had a significantly higher prevalence (4.94%; 95% CI: 3.67–6.60%) than I. persulcatus (2.29%; 95% CI: 1.39–3.74%; p = 0.011). Ticks from Leningrad Oblast also showed markedly elevated infection rates (4.98%; 95% CI: 3.75–6.58%) compared to those from Saint Petersburg (1.89%; 95% CI: 1.06–3.35%; p = 0.004). Small mammals exhibited substantially higher infection rates in Leningrad Oblast (39.44%; 95% CI: 31.78–47.65%) than in Saint Petersburg (13.90%; 95% CI: 10.76–17.78%; p < 0.001). Bank voles (Myodes glareolus) and yellow-necked mice (Apodemus flavicollis) were the main reservoirs; synanthropic rodents trapped within the city were found to be infected for the first time. No significant organotropism was detected, but positive correlations between infection in the heart, liver, and kidney suggested hematogenous dissemination. The overall human seroprevalence of B. miyamotoi was 1.71% (95% CI: 1.34–2.18%) and was significantly higher in Leningrad Oblast (2.19%; 95% CI: 1.66–2.89%) than in Saint Petersburg (1.03%; 95% CI: 0.64–1.67%; p = 0.010). In contrast, the seroprevalence of B. burgdorferi s. l. did not differ between the two regions (approximately 5.1%). Conclusions: This first comprehensive, multi-level investigation in Saint Petersburg and Leningrad Oblast reveals a stable epidemiological gradient: natural foci in Leningrad Oblast sustain higher B. miyamotoi circulation in ticks and rodents, which translates into a two-fold higher exposure of the rural population. The findings highlight the need to include B. miyamotoi in regional tick-borne infection surveillance programs and to adopt differentiated risk assessment strategies for urban and rural settings. Full article

Generative Artificial Intelligence (GenAI) in cardiac surgery refers to the integration of advanced computational models, such as Large Language Models (LLMs), to automate and enhance clinical decision-making, preoperative risk assessment, and surgical education. In the context of surgical training, it functions as a personalized pedagogical tool that supports various learning activities, ranging from information acquisition and clinical inquiry to procedural practice, while requiring rigorous human oversight to ensure patient safety and clinical accuracy. (1) Background: Generative Artificial Intelligence (GenAI) is increasingly integrated into health professions education, offering new opportunities for learning; however, its specific application and pedagogical mapping in high-stakes fields such as cardiac surgery remain underexplored. This systematic review investigates how GenAI is utilized in cardiac surgery and surgical education, aligning these uses with Laurillard’s six learning types. (2) Methods: Following the PRISMA 2020 guidelines, we searched the Web of Science Core Collection for studies on GenAI in cardiac surgery, resulting in 42 studies that met the inclusion criteria. Study quality was appraised using the Medical Education Research Study Quality Instrument (MERSQI). (3) Results: GenAI applications most frequently supported clinical inquiry (93.8%) and practice (68.8%), demonstrating expanding efficiency across commercial and open-source models (including ChatGPT-4o, Gemini AI, and emerging reasoning architectures such as DeepSeek) for knowledge acquisition and medical production. While it significantly improves individualized learning and preoperative assessment workflows, its practical role in Discussion and Collaboration remains heavily underutilized, highlighting a distinct shift toward individualized solo professional workflows. (4) Conclusions: GenAI provides a transformative and scalable approach to cardiac surgical training by offering personalized and accessible knowledge retrieval. However, clinical educators and governance bodies must deliberately balance these immediate productivity benefits with long-term concerns regarding structural “hallucinations,” data verifiability, and the preservation of collaborative competencies within modern multidisciplinary Heart Teams. Full article

Physiotherapy is an evidence-based healthcare occupation aiming to collaborate in the diagnosis, prevention and treatment of a myriad of diseases and clinical scenarios throughout all stages of human life. Its development has been accelerated over the last two decades. The scope of physiotherapy is continuously evolvig. However, the accumulated evidence in the context of rare diseases is scarce. Remarkably, the opportunity for improvement and potential benefit for complex diseases with low prevalence is also very high, both as an isolated approach or within multidisciplinary specialized units. Systemic light-chain (AL) amyloidosis is a rare, chronic, complex, heterogeneous, incurable, and challenging disease, which may involve different organs and systems, including the heart, kidney, liver, peripheral nerves, lung, muscle, skin, and others. Heart is the most frequently involved organ leading to failure and arrhythmias. Peripheral neuropathy is a relatively frequent symptom. Renal, respiratory, and hepatic failure may also occur. The aim of this narrative review is summarizing, updating, and critically underlining potential new avenues of development on the role of physiotherapy in systemic light-chain (AL) amyloidosis, compared with its application in multiple myeloma, a closely related but not so rare entity. Full article

In the context of intensifying global climate change, high-altitude mountain ecosystems play a critical role in climate regulation, biodiversity conservation, and the advancement of sustainable human development. Plateau regions, such as the Qinghai–Tibet Plateau, are particularly sensitive and responsive to global climatic fluctuations and function as essential ecological barriers supporting development across Asia. These areas occupy a strategic position within Asia’s ecological security framework and the broader international community, influencing not only regional ecological stability and social cohesion but also sustainable development pathways. However, owing to their fragile ecosystem structures, limited regenerative capacity, and the ongoing expansion of urbanisation and human activities, these regions frequently suffer from habitat fragmentation and degradation of ecological functions. This issue is especially acute in natural protected areas adjacent to plateau cities. Consequently, there is an urgent need for quantitative assessments of ecological restoration effectiveness within natural protected areas, alongside investigations into development approaches that underpin long-term regional stability and sustainability. Focusing on Chokpori Mountain—the “urban green heart” of Lhasa, a principal city on the Qinghai–Tibet Plateau—this study develops a three-dimensional assessment framework encompassing ecological, economic, and social dimensions. By integrating the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) model, remote sensing inversion techniques, field monitoring, and questionnaire surveys, the research systematically evaluates the effectiveness of ecological restoration and proposes insights for sustainable governance. The findings indicate that ecological restoration elicited positive ecological responses, evidenced by a 69.2% increase in soil retention post-renovation, an increase in vegetation coverage, and modeled total nitrogen (TN) and total phosphorus (TP) export loads demonstrating enhanced nutrient retention potential and improved water purification potential; (2) economic stimulation was evident, as demonstrated by an increase in average weekend daily visitor numbers from 876 to 1567 and a 24.2% rise in average monthly revenue of shops within a 1 km radius; and (3) social well-being improved, with ecological satisfaction reaching 89.2% and recognition of cultural communication attaining 67.3%. An integrated analysis indicates a synergistic enhancement of ecological environmental quality, regional vitality, and public perception. Accordingly, the outcomes of this study provide both theoretical insights and practical guidance for the ecological restoration and sustainable management of urban protected areas in high-altitude plateau regions worldwide. Full article

Background: In rodent models of intracranial tumor development, evaluating the actual burden experienced by animals beyond procedural severity is essential for ethical and legal compliance. This study examined whether voluntary wheel running (VWR) could serve as a sensitive indicator of post-surgical burden following subcutaneous transmitter implantation, tumor cell injection, and tumor resection. It also assessed whether VWR supports the detection of humane endpoints. VWR outcomes were compared with body weight, clinical scores, heart rate, and activity levels recorded via telemetry. Methods: Fourteen male BDIX rats were housed individually in cages equipped with a running wheel. Under general anesthesia, telemetric devices to monitor heart rate and activity were subcutaneously implanted. After recovery, glioblastoma BT4Ca cells were stereotaxically injected into the right frontal cortex. Eight days later, the resulting tumors were microsurgically resected. Body weight, VWR, heart rate, and general activity were continuously monitored until the animals reached humane endpoint criteria, indicated by sudden weight loss and clinical deterioration. Results: On average, body weight and VWR declined significantly after all surgical procedures, with tumor resection causing the most pronounced effect. As animals approached the endpoint, a marked drop in these parameters was observed, along with an increased clinical score (p < 0.05). Activity measures supported these findings, though less consistently than weight and VWR. Conclusions: Monitoring body weight and VWR enables an effective assessment of the actual postoperative burden experienced by rats undergoing surgeries of different procedural complexity. Moreover, VWR is a valuable supplementary tool for identifying humane endpoints alongside body weight and clinical scoring. Full article

This work expands upon Leonardo Polo’s anthropological proposal regarding human work as a distinctive entrustment from Creator to each created person. Situated within philosophical anthropology as a branch of knowledge devoted to a deeper understanding of the human being, it delves into the highest human dimension—the personal act of being—as the heart of this dedication, and breaks down the appeal to destiny. The goals to which human beings aspire are innumerable, but they all ultimately depend on the first, the ultimate one. In light of the manifestative dimension—which in Polo’s framework corresponds to the order of human essence, distinct from yet intrinsically related to the personal act of being, and encompasses the sphere of human actions, possessions, and material, intellectual, and virtuous gains—this study, according to the view of work as an entrustment, offers a philosophical inquiry surrounding the ultimate destiny of work and the roles that other persons and the divine Person play in this search. Full article

Domoic acid (DA) is a well-known seafood toxin produced by some species of marine phytoplankton in the genus Pseudo-nitzschia during harmful algal blooms (HABs). Acute toxic exposures induce overt clinical signs of neuroexcitotoxicity, such as seizures in mammals due to overstimulation of glutamate receptors in the central nervous system (CNS). Acute DA excitotoxicity via the CNS has been well-studied in both field poisoning events and laboratory exposure studies with rodent models, but little is known about the impacts of low-level DA exposures below those that cause outward signs of neurotoxicity; the impacts on other potential target organs, including the heart; or age-related sensitivities. Here, low-level DA exposures in young adult (9 mo) and old (24 mo) mice were conducted over multiple weeks. Mortality, cardiac function, frailty, and protein expression were quantified to assess age-related DA sensitivity and potential impacts on heart function. Echocardiography and proteome data confirm that chronic low-level DA exposure causes irreversible functional cardiomyopathy and protein remodeling in young adult mice that mimics natural cardiac aging. In addition, old mice exhibit higher mortality and frailty than young adult mice with the same low-level DA exposures. These results provide critical information for assessing potential health risks to humans who regularly consume seafood with low levels of DA. Full article

Shuanghuanglian oral liquid (SHL) is widely used in companion animals and poultry, but its molecular mechanism in pneumonia–myocarditis comorbidity and heart–lung inflammatory crosstalk remains largely unclear. This computational study investigated the conserved AKT1/HIF1A-mediated immunoregulatory mechanism of SHL and its cross-species translational potential in veterinary medicine. Network pharmacology was integrated with GO, KEGG, and Reactome enrichment analyses, protein–protein interaction network construction, ADMET evaluation, cross-species sequence homology analysis (human, dog, cattle, and pig), molecular docking, and molecular dynamics simulation. A total of 61 active compounds, 251 putative targets, and 52 common targets associated with pneumonia and myocarditis were identified. These targets were mainly enriched in inflammation- and immune-related pathways, including TNF, IL-17, AGE–RAGE, and PPAR signaling. AKT1 and HIF1A showed high sequence conservation across species (85–98%). Key compounds exhibited favorable binding affinity to AKT1, and molecular dynamics simulation suggested the stability of the Baicalein–AKT1 complex. ADMET analysis suggested favorable pharmacokinetic properties and low predicted toxicity. These findings suggest that SHL may potentially alleviate pneumonia and myocarditis through modulation of the conserved AKT1/HIF1A axis and support its potential as a complementary therapeutic approach for managing heart–lung inflammatory diseases in multiple livestock species. This entirely computational study highlights promising mechanisms that should be further validated in vivo. Full article

Carbonyl stress, chronic inflammation, and progressive tissue injury accompany type 2 diabetes mellitus (T2DM) and obesity. Yet, the molecular systems that connect these processes with cardiac, vascular and neuronal complications are incompletely defined. This review examines the AGE–RAGE–DIAPH1 axis as a mechanistic link between metabolic dysfunction and diabetic myocardial and neuronal injury, with emphasis on vascular and myocardial remodeling and emerging implications for autonomic neuronal vulnerability. We summarize current evidence on the formation and accumulation of advanced glycation end-products and other RAGE ligands in metabolic disease, DIAPH1’s structural and signaling role as an intracellular effector of RAGE, and the cellular consequences of pathway activation in vascular, neural, and cardiac tissues. Across experimental models, this signaling axis promotes oxidative stress and inflammatory activation, leading to endothelial dysfunction and barrier failure. Subsequent fibrotic remodeling provides a biologically plausible route through which metabolic stress may be translated into persistent organ injury. In the heart, these mechanisms are linked to coronary microvascular dysfunction, altered cardiomyocyte phenotype, calcium handling abnormalities, and myocardial fibrosis. In the autonomic nervous system, limited but emerging data connect RAGE activation to oxidative injury and mitochondrial dysfunction, abnormal neuronal excitability, and structural vulnerability. Direct evidence linking DIAPH1 to autonomic neurons is lacking. We also review biomarker candidates related to this pathway, including circulating AGEs and soluble RAGE isoforms, skin AGE measurements, imaging markers of myocardial remodeling, and autonomic functional measures. Finally, we discuss pharmacological and natural compounds that target AGE formation, ligand accumulation, RAGE signaling, or intracellular protein interactions linked to this axis. Overall, the available evidence supports the AGE–RAGE–DIAPH1 axis as a credible mechanistic concept and a potentially informative translational hypothesis in T2DM. However, the AGE–RAGE component is supported more strongly than DIAPH1-specific involvement in human diabetic myocardial disorder or cardiovascular autonomic neuropathy. The value of DIAPH1 as a biomarker or therapeutic target in these neurocardiac complications remains to be established. Full article

Staphylococcus aureus is a major cause of foodborne intoxication through the production of heat-stable enterotoxins (SEs) and is also an important opportunistic pathogen of humans and livestock. Meat and meat products are major vehicles for this pathogen because their protein-rich composition supports bacterial growth and toxin production. However, the combined effects of temperature and nutrient composition on S. aureus growth and virulence expression under food-relevant conditions remain unclear. In this study, we investigated the interactive effects of temperature and nutritional context on the growth and virulence-associated phenotypes under model food-relevant environments with the reference strain S. aureus FRI-S6. Bacterial growth, biofilm formation, staphylococcal enterotoxins A and B (SEA, SEB), and hemolytic activity were evaluated at 25 °C and 37 °C in brain heart infusion (BHI) medium supplemented with NaCl, glucose, or tryptone to simulate diverse food-relevant conditions. Growth was generally faster at 37 °C, whereas glucose-supplemented cultures at 25 °C reached higher cell densities during prolonged incubation. Biofilm formation increased at 37 °C in BHI and glucose conditions. SEA production was enhanced at 37 °C under NaCl and tryptone, but at 25 °C in glucose-rich conditions. In contrast, SEB production and hemolytic activity were consistently higher at 37 °C, particularly in the presence of tryptone and glucose. These findings demonstrate the strong interaction between temperature and nutrient composition in shaping S. aureus virulence in food environments and provide important insights for food safety risk assessment and highlight practical implications for controlling enterotoxin production in meat products and other foods during storage and processing. Full article

Real-time physiological state awareness is central to next-generation wearable computing, yet most existing electrophysiological signal acquisition platforms remain limited to single-modality sensing, high component cost, or bulky form factors that hinder everyday deployment. Here, we present a compact, low-cost wearable platform for simultaneous electroencephalography (EEG), electromyography (EMG), and electrocardiography (ECG) acquisition. The system integrates an analog front-end, a microcontroller, and a Bluetooth wireless link on a compact single-board platform (5.6 × 3.8 cm, approximately 12.8 g with the selected lithium-polymer battery installed), with an estimated bill-of-materials cost of 67.40 USD. Experimental validation across three healthy subjects, with the ECG channel additionally benchmarked against a commercial clinical-grade ambulatory ECG recorder, demonstrates that the platform captures ECG waveforms with recognizable P-QRS-T morphology under controlled recording conditions, supports reliable R-peak detection and heart rate estimation, records stable resting-state EEG spectral features, and distinguishes EMG activation from resting baseline in both time-domain amplitude and time-frequency structure. Leveraging the real-time wireless data link between the wearable hardware and a PC-hosted MATLAB environment, we further explore application-oriented signal processing scenarios. As an offline algorithm-pipeline compatibility demonstration, a CNN-based seizure detection pipeline is applied to the Bonn EEG benchmark for five-class epileptic state classification, achieving 86.60% mean classification accuracy. The proposed system offers a scalable and affordable foundation for wearable human-state-aware interaction, with potential applications in clinical monitoring, rehabilitation, and brain–computer interfaces. Full article

The Apennine wolf (Canis lupus italicus) is a distinct subspecies whose ongoing population recovery in Italy has progressively increased the demand for live capture protocols validated for scientific monitoring and conservation management. Despite the widespread use of mechanical and chemical immobilization in European wolf management, no study has to date systematically evaluated the combined use of the Fremont™ humane foot snare with a medetomidine-ketamine-acepromazine (MKA) protocol in this subspecies, nor characterized the associated cardiorespiratory, thermal, and hematobiochemical parameters under operational field conditions. Between June 2010 and July 2017, thirteen free-ranging Apennine wolves were captured in Maiella National Park (central Apennines, Italy) using the Fremont™ snare and immobilized with a standardized MKA protocol; only animals immobilized with this protocol are reported here, as three additional capture events employed different drug combinations. Cardiorespiratory parameters, body temperature, peripheral oxygen saturation, venous blood gas values, and a comprehensive hematological and serum biochemical panel were recorded during immobilization. Mean heart rate was 100 ± 15 bpm, respiratory rate 24 ± 13 breaths/min, body temperature 38.1 ± 1.3 °C, and mean SpO₂ 88 ± 11% (range: 66–97%; n = 12). No clinically significant hyperthermia requiring active intervention was recorded in the cohort as a whole. Hematological and biochemical values were broadly consistent with published reference ranges for the species, with condition-specific deviations identified in two individuals—one pregnant female and one juvenile presenting signs of transient capture-related myopathy—both of which resolved without clinical sequelae. No capture-related mortality occurred. All thirteen individuals survived the minimum post-capture monitoring period. Preliminary GPS observations in a subset of individuals (n = 3) suggest a transient reduction in movement activity in the immediate post-release period. These findings support the safety and operational feasibility of the combined Fremont™ snare–MKA protocol for the Apennine wolf, and provide baseline physiological and hematobiochemical reference data for Canis lupus italicus relevant to future capture and conservation management programmes. Full article

Heart failure (HF) remains a major cause of morbidity and mortality despite substantial therapeutic progress, and important phenotype-specific treatment gaps persist. Protein S-nitrosylation (SNO) is a reversible cysteine-centered post-translational modification (PTM) whose reported associations with selected HF-relevant contexts, including vascular–endothelial dysfunction, mitochondrial–energetic remodeling, Ca²⁺-handling abnormalities, and selected receptor- or stress-related signaling observations, are supported to varying degrees. In this review, we evaluate reported mechanisms that may regulate cardiac SNO and define the evidentiary boundaries that constrain interpretation across HF-relevant settings. Available studies suggest that altered SNO homeostasis is associated with selected HF-related processes, but the strength of support varies substantially across targets, phenotypes, and disease contexts. Many mechanistic observations derive from animal models, cultured systems, donor-based perturbations, or non-HF settings. These should, therefore, be interpreted as hypothesis-generating rather than as established mechanisms in human HF. We accordingly distinguish findings supported by human HF tissue or HF-relevant in vivo evidence from more preliminary observations and highlight the need for human, site-resolved, and, where feasible, quantitatively grounded datasets. Future studies should prioritize stronger tissue anchoring, better integration of circulating and myocardial readouts, and closer alignment between mechanistic claims and the strength of the supporting evidence. Full article