Search Results (2,614)

Background and Clinical Significance: Hemophilia A presents a considerable challenge in cardiac surgery due to the elevated risk of perioperative bleeding, particularly during procedures involving cardiopulmonary bypass. Standard management typically involves standard half-life (SHL) factor VIII (FVIII) concentrates, which require frequent dosing. Extended half-life (EHL) FVIII products offer theoretical advantages, including prolonged action and reduced infusion frequency, but their use in cardiac surgery remains largely undocumented. Case Presentation: We report the case of a 73-year-old male with mild Hemophilia A who underwent successful aortic valve replacement using a 25 mm Carpentier-Edwards Magna Ease biological prosthesis. The patient was managed perioperatively with an anti-hemorrhagic protocol based on EHL recombinant FVIII. The surgery and postoperative course were uneventful, with no bleeding complications or need for transfusion. Conclusions: This case illustrates the potential role of EHL FVIII in safely managing hemophilic patients undergoing major cardiac surgery. Given the lack of existing reports in the literature, further studies are warranted to evaluate the efficacy and safety of EHL FVIII in this setting and to potentially optimize perioperative care protocols for this patient population. Full article

This study explores the development of a topical film-forming spray infused with phytobiotic herbs to extend egg shelf life and maintain its quality. Unlike traditional surface treatments, film-forming sprays provide uniform drug distribution, better bioavailability, effective CO₂ retention by sealing pores, and antibacterial effects. The spray includes a polymer to encapsulate phytoconstituents and form the film. The resulting film is highly water-resistant, glossy, transparent, and dries within two minutes. SEM analysis showed a fine, uniform morphology, while zeta analysis revealed a negative potential of −0.342 mV and conductivity of 0.390 mS/cm, indicating stable dispersion. The spray’s effectiveness was tested on 640 chicken eggs stored at varying temperatures. Eggs treated and kept at 2–8 °C showed the best results, with smaller air cells, higher specific gravity, and superior quality indicators such as pH, albumen weight, albumen height and index, Haugh unit, yolk weight, and yolk index. Additionally, the spray significantly reduced microbial load, including total plate count and E. coli. Eggs stored at 28 °C remained safe for 24–30 days, while those at 2–8 °C lasted over 42 days. This innovative film-forming spray offers a promising approach for preserving internal and external egg quality during storage. Full article

Ultrafine bubbles (UFBs) represent an emerging technology with unique physicochemical properties. This study investigated the effects of air-filled UFBs infused in drinking water on gut microbiota composition and the associated health markers in Sprague Dawley rats over a 12-week period. Using a two-phase design, UFB concentration was increased from 1.7 × 10⁶ to 6.5 × 10⁹ UFBs/mL at week 7 to assess dose-dependent effects. Administration of UFBs in drinking water induced significant shifts in gut microbiome populations, characterized by increased Bacteroidetes (+122% weeks 8–12) and decreased Firmicutes (−43% weeks 8–12) compared to controls. These microbial shifts coincided with enhanced short-chain fatty acid production (butyrate +56.0%, p ≤ 0.001; valerate +63.1%, p ≤ 0.01) and reduced inflammatory markers (TNF-α −84.0%, p ≤ 0.05; IL-1β −41.0%, p ≤ 0.05; IL-10 −69.8%, p ≤ 0.05). UFB effects demonstrated systematic concentration-dependent threshold responses, with 85.7% of parameters exhibiting directional reversals between low (1.7 × 10⁶ UFBs/mL) and high (6.5 × 10⁹ UFBs/mL) concentration phases rather than linear dose–response relationships. The systematic nature of these threshold effects, with 71.4% of parameters achieving statistical significance (p ≤ 0.05), indicates concentration-dependent biological mechanisms rather than random effects on gut biology. Despite current metagenomic techniques identifying only 25% of the total gut microbiome, the observed changes in characterized species and metabolites demonstrate UFB technology’s therapeutic potential for conditions requiring microbiome modulation, providing new insights into UFB influence on complex biological systems. Full article

Three-dimensional printed polycaprolactone (PCL) tissue engineering scaffolds have drawn increasing interest from the medical industry due to their excellent biocompatibility and biodegradability, yet PCL’s poor mechanical performance has limited their applications. This study introduces a biocompatible and biodegradable polylactic acid (PLA) fiber reinforced PCL (PLA/PCL) composite as the filament for 3D printed scaffolds to significantly enhance their mechanical performance: Special-made PLA short fiber mat was infused with PCL matrix and rolled into PLA/PCL filaments through a “Vacuum Assisted Resin Infusion” (VARI) process. The investigation revealed that the PLA fibers are highly oriented along the printing direction when using this filament for 3D printing due to the unique microstructure formed during the VARI process. At the same PLA fiber content, the percentage increase in Young’s modulus of the 3D printed strands using the filaments produced by the VARI process is 127.6% higher than the 3D printed strands using the filaments produced by the conventional melt blending process. The 3D printed tissue engineering scaffolds using the PLA/PCL composite filament with 11 wt% PLA fiber content also achieved an exceptional 84.2% and 143.3% increase in peak load and stiffness compared to the neat PCL counterpart. Full article

Traditional map style transfer methods are mostly based on GAN, which are either overly artistic at the expense of conveying information, or insufficiently aesthetic by simply changing the color scheme of the map image. These methods often struggle to balance style transfer with semantic preservation and lack consistency in their transfer effects. In recent years, diffusion models have made significant progress in the field of image processing and have shown great potential in image-style transfer tasks. Inspired by these advances, this paper presents a method for transferring real-world 3D scenes to a cartoon style without the need for additional input condition guidance. The method combines pre-trained LDM with LoRA models to achieve stable and high-quality style infusion. By integrating DDIM Inversion, ControlNet, and MultiDiffusion strategies, it achieves the cartoon style transfer of real-world 3D scenes through initial noise control, detail redrawing, and global coordination. Qualitative and quantitative analyses, as well as user studies, indicate that our method effectively injects a cartoon style while preserving the semantic content of the real-world 3D scene, maintaining a high degree of consistency in style transfer. This paper offers a new perspective for map style transfer. Full article

Endotoxemia is commonly observed in donkeys, secondary to colic, pleuropneumonia, or diarrhea among other disorders. Hematologic ratios are new biomarkers widely used in the diagnosis and prognosis of multiple conditions in human medicine, including sepsis. While the utility of these ratios has been proved in septic foals, no data are available on donkeys. Moreover, reference intervals (RIs) have not been studied in this species. In this study, RIs of the most commonly reported hematologic ratios were determined in 73 healthy adult donkeys. In addition, variations in these ratios in response to LPS infusion were also evaluated in six healthy adult donkeys. Most of the ratios evaluated showed significant variations after induced endotoxemia, with most of them showing values outside of the established RIs. Similarly to septic foals, the neutrophil to lymphocyte ratio was significantly reduced after LPS infusion. No significant changes were observed in the red cell distribution width to platelet ratio, contrary to reports on septic foals. Previously reported cut-off values for both of these ratios should not be extrapolated to donkeys. Future studies evaluating these ratios in natural endotoxemia or other diseases in donkeys, as well as establishing species-specific cut-off values, are necessary. Full article

With the growing severity of environmental pollution, people are paying increasing attention to their health. However, naturally occurring wood with health benefits and applications in human healthcare is still scarce. Natural wood exhibits a limited negative oxygen ion release capacity, and this release has a short duration, failing to meet practical application requirements. This study innovatively developed a humidity-responsive, healthy wood material with a high negative oxygen ion release capacity based on fast-growing poplar. Through vacuum cyclic impregnation technology, hexagonal stone powder was infused into the pores of poplar wood, endowing it with the ability to continuously release negative oxygen ions. The healthy wood demonstrated a static average negative oxygen ion release rate of 537 ions/cm³ (peaking at 617 ions/cm³) and a dynamic average release rate of 3,170 ions/cm³ (peaking at 10,590 ions/cm³). The results showed that the particle size of hexagonal stone powder in suspension was influenced by the dispersants and dispersion processes. The composite dispersion process demonstrated optimal performance when using 0.5 wt% silane coupling agent γ-(methacryloxy)propyltrimethoxysilane (KH570), achieving the smallest particle size of 8.93 μm. The healthy wood demonstrated excellent impregnation performance, with a weight gain exceeding 14.61% and a liquid absorption rate surpassing 165.18%. The optimal impregnation cycle for vacuum circulation technology was determined to be six cycles, regardless of the type of dispersant. Compared with poplar wood, the hygroscopic swelling rate of healthy wood was lower, especially in PEG-treated samples, where the tangential, radial, longitudinal, and volumetric swelling rates decreased by 70.93%, 71.67%, 69.41%, and 71.35%, respectively. Combining hexagonal stone powder with fast-growing poplar wood can effectively enhance the release of negative oxygen ions. The static average release of negative oxygen ions from healthy wood is 1.44 times that of untreated hexagonal stone powder, and the dynamic release reaches 2 to 3 times the concentration of negative oxygen ions specified by national fresh air standards. The water-responsive mechanism revealed that negative oxygen ion release surged when ambient humidity exceeded 70%. This work proposes a sustainable and effective method to prepare healthy wood with permanent negative oxygen ion release capability. It demonstrates great potential for improving indoor air quality and enhancing human health. Full article

Breast milk can provide passive immunity to infants, serving as a valuable source of maternal antibodies while remaining a non-invasive sample for investigating maternal immune responses. To date, no studies have evaluated SARS-CoV-2 and potentially cross-reactive HCoV antibodies in breast milk following bamlanivimab administration. A 36-year-old postpartum female was PCR-positive for SARS-CoV-2 four days post-delivery. Bamlanivimab was administered intravenously two days later. Breast milk was collected before bamlanivimab infusion, daily for two weeks post-infusion, then weekly until 102 days post-infusion. Mother and infant sera were collected only at 102 days post-infusion. All milk and serum samples were tested for IgG antibodies against SARS-CoV-2 and HCoV. We observed two distinct SARS-CoV-2 antibody peaks at days 3 and 29 post-infusion, likely representing bamlanivimab transfer and the post-infection antibody response. Beta-HCoV antibodies showed two peaks at days 6 and 29, potentially representing backboosted beta-HCoV responses and/or antibody cross-reactivity with SARS-CoV-2. Infant seropositivity for SARS-CoV-2 102 days post-infusion may represent antibodies from passive transfer via breastfeeding or a subclinical infection. This case highlights the value of breast milk as a non-invasive and repeatable sample to help understand maternal immune responses post-infection, exogenous antibody infusion, and passive antibody transfer during breastfeeding, which can provide insights into maternal–infant health research. Full article

Background/Objectives: Compared to in the general pregnant population, pregnancy in women with type 1 diabetes (T1D) is still associated with an increased number of perinatal complications affecting both the fetus and the mother. The Great Orchestra of Christmas Charity Foundation (GOCCF) program enables the use of continuous subcutaneous insulin infusion (CSII) enhanced by a hypo-stop function and real-time continuous glucose monitoring (rtCGM) during the preconception or early pregnancy period in patients with T1D. This observational study aimed to analyze the association between pregnancy planning and pregnancy outcomes in patients who qualified for the GOCCF program. Methods: Ninety-eight women with T1D, aged 21–41 years, who began using the CSII + rtCGM system at the planning/early pregnancy stage or at a later stage in the case of an unplanned pregnancy, were eligible for this study. We analyzed glucose control, the insulin requirements, the pregestational BMI, the maternal weight gain, the occurrence of preterm births, congenital malformations and the birthweight of newborns. Results: Women who planned their pregnancies had significantly better glycemic control before and throughout the entire pregnancy, and a significantly higher proportion of them achieved a TIR (time in range) > 70% (58.7% vs. 28.9%, p = 0.014) and TAR (time above range) < 25% (65.2% vs. 24.4%, p < 0.001). Their glucose variability at the end of the pregnancy was significantly lower (29.4 ± 5.5 vs. 31.9 ± 5.1, p = 0.030). They also gave birth later, at a mean of 37.8 ± 0.9 weeks compared to 36.9 ± 1.8 weeks in the non-planned group (p = 0.039). Preterm birth occurred in five women (10.4%) who planned their pregnancies and in fifteen women (30%) who did not, with p = 0.031. Conclusions: Pregnancy planning in women with type 1 diabetes (T1D) is associated with better glucose control before conception and throughout the entire pregnancy, resulting in better pregnancy outcomes. Full article

Background: Intravenous vancomycin remains a key agent in the treatment of complex orthopedic infections, particularly those involving methicillin-resistant Staphylococcus aureus (MRSA). However, its use is associated with significant risks, most notably nephrotoxicity. Despite guideline recommendations, standardized dosing and monitoring protocols are often absent in orthopedic settings, leading to inconsistent therapeutic drug exposure and preventable adverse events. This study evaluated the clinical impact of implementing a structured standard operating procedure (SOP) for intravenous vancomycin therapy in orthopedic inpatients. Methods: We conducted a single-center, pre-post cohort study at a university orthopedic department. The intervention consisted of a standard operating procedure (SOP) for intravenous vancomycin therapy, which mandated weight-based loading doses, renal function-adjusted maintenance dosing, trough level monitoring, and defined dose adjustments. Patients treated before SOP implementation (n = 58) formed the control group; those treated under the SOP (n = 56) were prospectively included. The primary outcome was the incidence of vancomycin-associated acute kidney injury (VA-AKI) defined by KDIGO Stage 1 criteria. Secondary outcomes included therapeutic trough level attainment and infusion-related or ototoxic adverse events. Results: All patients in the post-SOP group received a loading dose (100% vs. 31% pre-SOP, p < 0.001). The range of measured vancomycin trough levels narrowed substantially after SOP implementation (7.1–36.2 mg/L vs. 4.0–80.0 mg/L). The proportion of patients reaching therapeutic trough levels increased, although this was not statistically significant. Most notably, VA-AKI occurred in 17.2% of patients in the control group, but in none of the patients after SOP implementation (0%, p = 0.0013). No cases of ototoxicity were observed in either group. Infusion-related reactions decreased after the implementation of the SOP, though not significantly. Conclusions: The introduction of a structured vancomycin protocol significantly reduced adverse drug events and improved dosing control in orthopedic inpatients. Incorporating such protocols into routine practice represents a feasible and effective strategy to strengthen antibiotic stewardship and clinical quality in surgical disciplines. Full article

Disruption of circadian rhythms by abnormal light exposure and reduced melatonin secretion has been linked to heightened pain sensitivity and opioid tolerance. This study evaluated how environmental light manipulation and exogenous melatonin supplementation influence pain perception and morphine tolerance in a rat model of neuropathic pain induced by partial sciatic nerve transection (PSNT). Rats were exposed to constant darkness, constant light, or a 12 h/12 h light–dark cycle for one week before PSNT surgery. Behavioral assays and continuous intrathecal (i.t.) infusion of morphine, melatonin, or their combination were conducted over a 7-day period beginning immediately after PSNT. On Day 7, after discontinued drugs infusion, an acute intrathecal morphine challenge (15 µg, i.t.) was administered to assess tolerance expression. Constant light suppressed melatonin levels, exacerbated pain behaviors, and accelerated morphine tolerance. In contrast, circadian-aligned lighting preserved melatonin rhythms and mitigated these effects. Melatonin co-infusion attenuated morphine tolerance and enhanced morphine analgesia. Reduced pro-inflammatory cytokine expression and increase anti-inflammatory cytokine IL-10 level and suppressed astrocyte activation were also observed by melatonin co-infusion during morphine tolerance induction. These findings highlight the potential of melatonin and circadian regulation in improving opioid efficacy and reduced morphine tolerance in managing neuropathic pain. Full article

Providing inclusive education and engaging all students in reading and writing activities presents an ongoing challenge for teachers, not necessarily resolved by implementing digital technology. This study addresses the need to better understand teacher competencies within the digitally infused classroom, specifically in relation to inclusive education and reading and writing practices. The study investigates the competencies and supportive strategies of middle school teachers who perceive themselves as successful in this area. The study employs the Delphi technique, using iterative surveys through which these teachers describe and rate aspects of their competencies and strategies. The results are analyzed through a modified version of the Technological, Pedagogical, and Content Knowledge (TPACK) framework, with particular attention to how teachers support students using their content knowledge and digital competency. Findings reveal a range of strategies and competency aspects related to both proactive accessibility and reactive individualization, using a variety of digital tools and text modalities. The teachers describe a dual orientation in their ability to curiously explore digital tools while simultaneously being able to critically appraise their usefulness. The findings contribute insights on what can support teachers when collaboratively developing knowledge of local practices and their agency in relation to available digital tools. Full article

The objective of this study was to evaluate the effects of feeding a combination of chicory–plantain silage and supplementing Se yeast on the response of early-lactating ewes to induce subclinical mastitis. Polypay ewes (n = 32) were fed either chicory–plantain silage or grass silage and supplemented with 3.6 mg Se yeast/ewe/day for approximately 2 months prior to the infusion of S. uberis into both mammary glands (i.e., intramammary infection or IMI). The ewes had a typical subclinical mastitis response with an 8-fold increase in milk somatic cell count within 24 h post-IMI, a decrease in milk yield, and changes in all milk components measured. The ewes experienced a mild systemic inflammation post-IMI as determined by an increase in rectal temperature and decrease in feed and water intake and, in blood, by an increase in the concentration of ceruloplasmin, haptoglobin, and myeloperoxidase and a decrease in paraoxonase, Zn, advanced oxidation protein products, and hematocrit with no effect on pro-inflammatory cytokines. No effect of silage type, likely due to a low concentration of secondary compounds, or Se supplementation was detected in response to IMI. In summary, the subclinical mastitis model used was effective in mounting an inflammatory response, although this was mild; however, feeding chicory–plantain silage with a low concentration of secondary compounds and supplementing Se yeast had no significant effect on the response of ewes to mammary infection. Full article

Background/Objectives: Current dosing recommendations for piperacillin/tazobactam suggest adjustments only for patients with creatinine clearance (CrCl) below 40 mL/min, potentially neglecting the variability in drug exposure among patients with a CrCl greater than 40 mL/min. This study aimed to develop a population pharmacokinetic (PK) model for piperacillin/tazobactam and explore optimal dosage regimens tailored by renal function and pathogen susceptibility. Methods: Twelve healthy adults received a single intravenous dose of piperacillin/tazobactam (4 g/0.5 g). Population PK models were developed using nonlinear mixed-effects modeling. Monte Carlo simulations were conducted to identify optimal dosing regimens across various renal functions and MIC levels, guided by pharmacodynamic targets defined as the percentage of time that free drug concentrations exceed the minimum inhibitory concentration (fT_>MIC). Results: PK profiles of both drugs were best described by two-compartment models. Estimated glomerular filtration rate (eGFR) adjusted by body surface area and body weight were identified as significant covariates influencing drug clearance and peripheral volume of distribution. Simulations showed that the standard dosing regimen (4/0.5 g q6h with 30 min infusion) achieved a 90% probability of target attainment (PTA) for 50%fT_>MIC at MIC values up to 4 mg/L in patients with normal renal function. However, this regimen often did not achieve a 90% PTA for stringent targets (100%fT_>MIC, 100%fT_>4MIC) or higher MICs, particularly in patients with eGFR ≥ 130 mL/min. Conclusions: These findings suggest current dosing regimens may be inadequate and highlight the potential of alternative strategies, such as extended or continuous infusion, which warrant further investigation in clinical populations to optimize therapeutic outcomes. Full article

Background/Objectives: Parenteral nutrition (PN) supports patients unable to receive nutrients via the gastrointestinal tract, but it lacks the health-promoting natural bioactive compounds found in a typical oral diet. This study aimed to develop a human serum albumin-based intravenous delivery system for lutein (an antioxidant carotenoid with vision-supportive and hepatoprotective properties) as a PN additive. Methods: An albumin–lutein nanosuspension (AlbLuteN) was synthesized using a modified nanoparticle albumin-bound (nab^TM) technology and characterized physicochemically. The nanoformulation was added to four commercial PN admixtures to assess the supplementation safety throughout the maximum infusion period. Visual inspection and measurements of fat globules larger than 5 µm (PFAT5) and the mean hydrodynamic diameter (Z-average), zeta potential, pH, osmolality, and lutein content were performed to detect potential interactions and evaluate the physicochemical stability. Results: AlbLuteN consisted of uniform particles (Z-average of 133.5 ± 2.8 nm) with a zeta potential of −28.1 ± 1.8 mV, lutein content of 4.76 ± 0.39%, and entrapment efficiency of 84.4 ± 6.3%. Differential scanning calorimetry confirmed the amorphous state of lutein in the nanosuspension. AlbLuteN was successfully incorporated into PN admixtures, without visible phase separation or significant changes in physicochemical parameters. The PFAT5 and Z-average values remained within pharmacopeial limits over 24 h. No substantial shifts in zeta potential, pH, or osmolality were observed. The lutein content remained stable, with losses below 3%. Conclusions: AlbLuteN can be safely added to representative PN admixtures without compromising their stability. This approach offers a novel strategy for intravenous lutein delivery and may contribute to improving the nutritional profile of PN. Full article