Search Results (35,706)

Celastrol (CSL), a natural triterpenoid extracted from Tripterygium wilfordii, demonstrates a wide range of biological activities. In this study, we explored whether CSL alleviates kidney damage in spontaneously hypertensive rats (SHRs) through the modulation of the Nrf2/Ho-1 pathway, a crucial target in renal injury models. A total of 40 male SHRs, aged 6–8 weeks, were randomly allocated to four groups: the control group (CON, serving as the healthy control), the spontaneously hypertensive rat group (SHR), the SHR group treated with low-dose CSL (L-CSL + SHR, 0.5 mg/kg/d), and the SHR group treated with high-dose CSL (H-CSL + SHR, 1 mg/kg/d). All drugs were formulated using physiological saline as the solvent and administered via intraperitoneal injection. The control group received an equivalent volume of physiological saline via intraperitoneal injection, and all groups underwent continuous daily administration for 6 weeks. The results indicated that, in comparison with the control group, the serum levels of angiotensin, angiotensin-converting enzyme, and aldosterone in the SHR group were relatively high, and CSL treatment further downregulated these indices. Simultaneously, CSL downregulated pro-inflammatory factors (tumor necrosis factor-α and interleukin-1β) and upregulated interleukin-6. Regarding renal function-related indicators, CSL reduced malondialdehyde levels and enhanced the activities of antioxidant enzymes, such as superoxide dismutase, glutathione peroxidase, and catalase. Moreover, CSL inhibited the overexpression of Keap1. Significantly, the mRNA levels of Nrf2, Nqo1, and Ho-1 in the CSL-treated groups were notably higher than those in the SHR group. These findings suggest that CSL mitigates renal pathological damage in SHR by activating the Nrf2/Ho-1 pathway, offering a potential therapeutic approach for hypertension-induced renal injury. Full article

Background: p-Cresyl sulfate (PCS) has been linked to vascular dysfunction through endothelial injury and vascular remodeling. Peripheral artery disease (PAD), identified by a low ankle–brachial index (ABI), is associated with increased mortality in kidney transplant (KT) recipients. This study investigated the association between serum PCS levels and PAD (as defined by ABI) in KT recipients. Methods: This cross-sectional, single-center study included 90 KT recipients. Serum total PCS levels were quantified using liquid chromatography–mass spectrometry. ABI was measured using an automated oscillometric device, and PAD was defined as ABI < 0.9. Results: Among the 90 KT recipients, 20 (22.2%) met the ABI for PAD. Patients with ABI-defined PAD had a significantly higher prevalence of diabetes mellitus (p = 0.036) and serum PCS levels (p = 0.001). Multivariate logistic regression analysis adjusting for potential confounders revealed that serum PCS levels remained independently associated with PAD (odds ratio 1.254, 95% confidence interval 1.108–1.419; p < 0.001). PCS levels were inversely correlated with both left (r = −0.339, p = 0.001) and right (r = −0.357, p < 0.001) ABIs. The association remained consistent in penalized regression models. Conclusions: Higher serum PCS levels were independently associated with ABI-defined PAD in KT recipients. The findings indicate that residual uremic toxin burden may contribute to peripheral vascular disease despite the restoration of renal function following transplantation. Full article

Background: Although ovarian cryopreservation is an essential strategy for fertility preservation, ischemia–reperfusion injury and oxidative stress can significantly compromise graft viability after transplantation. Melatonin is a potent antioxidant capable of modulating redox homeostasis and tissue repair; however, its effects on the ovarian microenvironment after cryopreservation are not fully understood. Objective: To investigate whether melatonin supplementation during ovarian cryopreservation enhances GPx1/2-mediated antioxidant defense, preserves follicular integrity, and modulates the angiogenic balance (assessed via VEGF-A expression) after autologous ovarian transplantation in rats. Methods: Twenty-four Wistar rats were ovariectomized and divided into control (standard cryopreservation) and melatonin-treated (0.1 μM melatonin) groups. Ovaries were cryopreserved, thawed, and autotransplanted. After 30 days, the grafts were analyzed for GPx1/2 expression (immunohistochemistry), VEGF-A levels (ELISA), biochemical markers, and follicular integrity (histomorphometry) Results: The melatonin treatment significantly increased GPx1/2 expression in the corpus luteum (p = 0.002), theca interna (p = 0.007), and interstitium (p = 0.012), and reduced the number of degenerated follicles (p = 0.03). Although absolute VEGF-A levels did not differ between groups, melatonin-treated animals showed higher VEGF/FSH ratios (p = 0.0007) and VEGF/LH (p = 0.0494) ratios. Positive correlations were observed between GPx1/2 expression and VEGF-A expression. Conclusions: Melatonin increases antioxidant defenses in cryopreserved ovarian grafts through the upregulation of GPx1/2 and preservation of follicular morphology. Instead of directly increasing VEGF-A levels, melatonin appears to modulate angiogenic signaling, contributing to a more stable microenvironment for ovarian graft survival. Full article

Background: Wrist pain is frequently reported among housewives and linked to repetitive household tasks, yet the drivers of pain-related disability remain unclear. Beyond physical load, psychosocial factors such as catastrophizing, mood symptoms, and self-efficacy may shape severity and functional impact. Purpose: To evaluate the severity of wrist pain and wrist-related disability in Turkish housewives and to identify the psychosocial and symptom-related factors associated with these outcomes. Methods: This cross-sectional study was conducted with 92 Turkish housewives reporting wrist pain ≥ 3/10 on the Numeric Pain Rating Scale (NPRS) and who have been married for at least 1 year and performing at least 1 h of housework, via Google Forms. Fatigue and wrist pain were measured using the Numeric Rating Scale (NRS), as well as the Patient-Rated Wrist Evaluation–Turkish version (PRWE-T), Pain Self-Efficacy Questionnaire (PSEQ), Patient Health Questionnaire-4 (PHQ-4), and Pain Catastrophizing Scale (PCS). Sociodemographic data were also collected. Associations were analyzed with Spearman’s correlation, and simple linear regression identified factors explaining wrist pain severity and disability. Results: PRWE-T total scores showed strong positive correlations with pain catastrophizing (p < 0.001), PHQ-4 depression (p < 0.001), and PHQ-4 anxiety (p < 0.001), while correlating negatively with pain self-efficacy (p < 0.05). PCS was also strongly correlated with PHQ-4 anxiety (p < 0.001) and PHQ-4 total (p < 0.001), but negatively with PSEQ (p < 0.001). Multivariable regression analyses have shown that PCS and fatigue may be predictory of wrist pain and disability. Additional factors included fatigue severity (p = 0.002), PHQ-4 depression (p < 0.001), and PHQ-4 anxiety (p = 0.001). Conclusions: These findings highlight the multidimensional nature of wrist symptoms in this population. Full article

Thermal hazards in industrial environments often remain undetected until critical failure or injury occurs. Conventional handheld infrared cameras require manual operation and limit continuous situational awareness. This study presents the design and field validation of a wearable helmet-mounted real-time thermal system based on the MLX90640 infrared array sensor and a Raspberry Pi 5 edge computing platform. Experimental validation was performed across multiple scenarios of 400 measurements based on industrial distances of 100 cm and 150 cm. The performance of the system was tested against a pre-calibrated hotspot infrared thermometer using linear regression analysis and standard error metrics to determine proportional agreement. The results indicate a strong proportional relationship between the two systems at both industrial distances, with R² values ranging from 0.9885 to 0.9973 at 100 cm and from 0.9586 to 0.9867 at 150 cm. A moderate increase in mean absolute error (MAE) was observed as the measurement distance increased. Statistically significant increases in error were identified in mechanically dynamic scenarios where statistically significant increases in measurement error were observed (p-value < 0.05), indicating distance-dependent sensitivity under moving mechanical conditions. The higher absolute errors at longer distances mainly result from field-of-view expansion, reduced target occupancy, and mixed-pixel hotspot effects rather than weakened proportional trend stability. An industrial distance-aware linear regression model was developed to describe behavior and support calibrations under different deployment conditions. Despite minor absolute deviations during dynamic operations, the system maintained strong trend-tracking performance, suggesting suitability for daily preliminary hazard monitoring in industrial safety maintenance. Full article

Despite many efforts to curtail drunk driving, alcohol-related traffic fatalities and injuries continue to be a major public health problem in the United States (U.S.) and most of the world. Technologies exist that prevent an automobile from starting if the driver’s breath alcohol exceeds 20 milligrams per deciliter (mg/dL), but these devices are only fitted to vehicles of individuals who have been convicted of Driving Under the Influence (DUI). A new approach must be taken to reduce the incidence of drunk driving by integrating an alcohol sensor system in vehicles as part of the delivered hardware. The system must be fast, accurate, and contactless—meaning that a forced exhalation is not required to measure the concentration of alcohol on the breath. We report on a novel device, the Driver Alcohol Detection System for Safety (DADSS) Breath Alcohol Sensor System, which uses the mid-infrared region of the electromagnetic spectrum to concurrently monitor alcohol and expired carbon dioxide (CO₂) to accurately quantify the breath alcohol concentration in samples that have been diluted in the atmosphere before being measured. The system was validated in a research laboratory with 70 male and female volunteers in 187 individual study days. Participants were given various doses of alcohol to consume and then breath and blood samples were collected simultaneously. Pearson correlation coefficients between the DADSS Breath Alcohol Sensor system and blood samples indicate a strong correlation between the measures, with an overall Pearson correlation of 0.8875 over an alcohol concentration range of 0–220 mg/dL. These results indicate that incorporating the DADSS system into motor vehicles has the potential to reduce the incidence of drunk driving. Full article

Background: Patients with traumatic brain injury (TBI) are often underfed and frequently experience enteral feeding (EF) intolerance. We examined the association between EF timing, caloric intake and EF intolerance, and mortality. Methods: We retrospectively evaluated adult patients with moderate-to-severe TBI in a tertiary-care ICU. In the first 7 days, we recorded daily caloric intake from EF and the occurrence of EF intolerance—defined as a gastric residual volume > 500 mL or >250 mL with vomiting. Results: Among 298 patients, 210 (70.4%) received early EF. The median 7-day cumulative caloric intake was 7766 kcal for the early EF group (64.7% of caloric requirement) and 2783 kcal (23.1% of caloric requirement) for the late (after 48 h) EF group (p < 0.001). EF intolerance occurred in only 24 patients (8.1%), with no significant difference between the early and late groups. Hospital mortality was 13.8% with early EF versus 30.7% with late EF (p = 0.001), 8.5% with caloric intake ≥ 80% of requirement versus 21.3% with lower caloric intake (p = 0.02) and 50% in patients with EF intolerance versus 16.1% in those without intolerance (p < 0.001). In multivariable logistic regression analysis, early EF was associated with lower mortality (odds ratio 0.326; 95% confidence interval 0.165–0.644), whereas EF intolerance was associated with higher mortality (odds ratio 7.451; 95% confidence interval 2.787–19.922). Conclusions: In patients with moderate-to-severe TBI, early EF was associated with higher caloric intake and lower mortality compared to late EF. EF intolerance was uncommon but strongly associated with higher mortality. Full article

Zearalenone (ZEA) is a mycotoxin widely present in cereals, feeds, and foods, posing a persistent threat to human and animal health. Hepatic fibrosis is a pathological process characterized by excessive extracellular matrix (ECM) deposition. Chronic liver injury caused by sustained oxidative stress can initiate the development of early hepatic fibrosis. However, whether liver injury induced by ZEA can trigger hepatic stellate cell (HSC) activation and promote early profibrotic responses remains unclear. The aim of this study was to assess whether ZEA-induced liver injury promotes HSC activation and early profibrotic responses. To address this, we established a BALB/c mouse exposure model and used the murine HSC line (JS-1) for in vitro validation. The results showed that ZEA exposure caused structural damage in hepatic tissue and produced an incomplete bridging pattern of collagen thickening suggestive of an early profibrotic tendency. ZEA shaped a proinflammatory microenvironment by activating the IκBα/NF-κB axis and induced the TGF-β1/Smad2/3 pathway, accompanied by Smad7 suppression, thereby promoting HSC activation and the expression of fibrosis-related genes. ZEA also altered autophagy-related markers in liver tissue and JS-1 cells. Pharmacological inhibition with chloroquine partially attenuated ZEA-induced upregulation of α-SMA and collagen I/III, suggesting that autophagy-related processes may be involved in ZEA-associated HSC activation and early ECM deposition. In summary, ZEA promotes HSC activation and early profibrotic changes in the liver and is associated with inflammatory activation, TGF-β1/Smad signaling, and altered autophagy-related activity. These findings provide a basis for further investigation into the mechanisms underlying ZEA-induced early profibrotic remodeling in the liver. Full article

Mycotoxin contamination is an important threat to food and feed safety as well as human and animal health, with particular emphasis on oxidative stress, apoptosis, autophagy, inflammation, and dysbiosis. Mycotoxins represent major health threats because they disturb cellular homeostasis and induce oxidative damage. Nutritional factors, such as dietary antioxidants and bioactive chemicals, can influence the body’s reaction to mycotoxin exposure, either reducing or increasing its effects. This study discusses how mycotoxins (aflatoxin B1, deoxynivalenol, and ochratoxin A) induce oxidative stress by producing reactive oxygen species (ROS)-mediated DNA damage, which induces cellular damage and activates apoptosis, an intended cell death process that is critical for tissue integrity. Furthermore, mycotoxins alter autophagy, a cellular degradation process that can be beneficial or destructive depending on the situation, affecting cell survival. The inflammatory response is particularly important because mycotoxin-induced oxidative stress and cell damage activate inflammatory pathways, which contribute to tissue injury and disease progression. Nutritional factors high in antioxidants, anti-inflammatory substances (Lycopene, Curcumin, Thyme oil, Gum Arabic, and Ginger), probiotics, and prebiotics show potential in mitigating these negative consequences by reducing oxidative stress and inflammation. Advances in molecular biology and omics technologies (transcriptomics, proteomics, metabolomics, and single-cell sequencing) can lead to better knowledge of the underlying pathways, allowing for more tailored nutritional recommendations and medicinal interventions. Finally, combining dietary modulation with mycotoxin risk management is a viable path for protecting health and increasing resilience to mycotoxin-related toxicities in animals. Full article

Traumatic injuries are a major cause of disability in adults, with long-term consequences that extend beyond acute survival. Understanding the longitudinal trajectory of quality of life (QoL) following trauma is essential for optimising recovery pathways. This study aimed to evaluate changes in QoL over a six-month period after injury and to characterise the most affected health domains. Methods: A longitudinal observational study was conducted including 136 adult trauma patients. QoL was assessed using the EQ-5D-5L at three time points: retrospectively for the pre-trauma state, and prospectively at one and six months post-injury. Statistical analysis included Paired T-Tests and Cohen’s d to evaluate the significance and magnitude of changes across five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Results: The sample was predominantly male (57.4%), and falls were the most common mechanism of injury (57.4%). One month after trauma, a significant decline was observed across all EQ-5D dimensions (p < 0.001), with large effect sizes particularly in usual activities (d = 0.89) and self-care (d = 0.86). At six months, significant improvement was noted in all domains compared to the one-month assessment (p < 0.001). However, only mobility returned to pre-trauma levels (p = 0.137), while persistent impairments remained in pain/discomfort and anxiety/depression. The EQ-VAS score declined from a pre-trauma mean of 82.74 to 69.00 at one month and partially recovered to 77.29 at six months. Notably, only 15.4% of patients received specialized rehabilitation services. Conclusions: Trauma results in a profound immediate reduction in QoL. Although physical mobility tends to recover by six months, functional autonomy and psychological well-being remain compromised. The findings highlight the need for multidisciplinary post-discharge interventions, focusing on pain management and psychological support to bridge the gap in long-term recovery. Full article

Oxidative stress is a key contributor to the pathogenesis of immune-mediated diseases through its effects on cellular metabolism, mitochondrial function, immune signaling pathways, and inflammatory tissue injury. Disruption of redox homeostasis promotes metabolic reprogramming and persistent activation of innate and adaptive immune responses, contributing to disease progression across multiple inflammatory and autoimmune disorders. Recent advances in high throughput molecular technologies have generated large scale multi-omics datasets that enable comprehensive investigation of redox-associated mechanisms at a systems level. Integration of these datasets with computational analytical approaches has facilitated the identification of multidimensional molecular signatures associated with disease development and progression. This systematic review evaluates studies applying computational frameworks to analyze redox-related molecular data in immune-mediated diseases including multiple sclerosis, systemic lupus erythematosus, lupus nephritis, rheumatoid arthritis, Sjögren’s syndrome, and inflammatory bowel disease. Across the reviewed studies, oxidative stress associated with molecular signatures were consistently linked to immune activation, mitochondrial metabolism, and inflammatory signaling pathways. Computational analyses also identified regulatory genes involved in antioxidant defense and metabolic regulation, as well as pathways associated with regulated cell death. These findings highlight the translational potential of computational redox analysis for biomarker discovery, disease stratification, and development of targeted therapeutic strategies aimed at restoring redox balance and improving clinical management of immune-mediated diseases. Full article

Laparoscopic cholecystectomy is now established as the worldwide gold standard for the treatment of benign gallbladder disease. Despite technical advancements, bile duct injury (BDI) remains a major concern, especially in patients with obesity. It is well known that in patients with a Body Mass Index (BMI) ≥ 30 kg/m², identification of Calot’s triangle and the achievement of the Critical View of Safety (CVS) during laparoscopic cholecystectomy (LC) are made more challenging due to excessive visceral adiposity and concomitant hepatic steatosis reducing the workspace. Near-Infrared Fluorescence Cholangiography (NIRF-C) with Indocyanine Green (ICG) has emerged as an innovative, safe and effective technique to visualize the biliary anatomy and minimize the risk of iatrogenic BDI. However, its specific benefit in patients with obesity remains under-discussed compared to the general population. The main aim of this narrative review is to evaluate whether the intraoperative use of ICG in patients with obesity may reduce operative times and the risk of BDI. A focused review of the literature is performed on articles from 2010 to 2025 published on PubMed, Scopus and Web of Science. The application of ICG fluorescence in LC for patients with obesity represents a tangible clinical advantage, not only for anatomical identification and significant improvement of procedural efficiency, but also for the reduction in operative time. Full article

Background: Left ventricular (LV) thrombosis after blunt trauma is uncommon and is most often attributed to traumatic coronary artery injury; however, it can also arise from severe myocardial contusions. Here, we report a case of LV thrombosis due to severe myocardial contusion without coronary artery injury. Case Presentation: A 36-year-old man struck by industrial fan fragments presented with hemorrhagic shock. Focused Assessment with Sonography for Trauma revealed cardiac tamponade. An emergent sternotomy was performed under cardiopulmonary bypass via the femoral vessels, which exposed severe contusion-associated hemorrhage with epicardial–myocardial dissection at the LV apex. On postoperative day (POD) 5, transthoracic echocardiography showed apical akinesia with mural thrombi; prophylactic anticoagulation was escalated and later transitioned to warfarin. Coronary computed tomography on POD 21 and invasive angiography at 6 months revealed negative findings. The thrombi resolved within 3 months; however, apical akinesia persisted. After discontinuing anticoagulation, a transient ischemic event occurring at 9 months prompted direct oral anticoagulant therapy. Apical akinesia persisted for over 7 years without recurrent thrombosis. Conclusion: This case underscores the importance of vigilance for intracardiac thrombosis in severe contusions, as well as the value of stepwise imaging (contrast echocardiography) and cautious, individualized discontinuation of anticoagulation when regional dysfunction persists. Full article

Background: Cemented and cementless fixation techniques in total hip arthroplasty (THA) each present distinct biomechanical properties and perioperative risk profiles. While cementless fixation has gained increasing popularity, large-scale nationally representative comparisons of perioperative outcomes between cemented and cementless elective THA remain limited. This study aimed to compare complication rates, healthcare utilization, and temporal trends between cemented and cementless elective THA using the National Inpatient Sample. Methods: A retrospective cohort study was conducted using the National Inpatient Sample database from 2016 to 2021. Adult patients undergoing elective primary total hip arthroplasty were identified using ICD-10-PCS codes and categorized into cemented and cementless fixation groups. Patient demographics, comorbidities, indications, postoperative complications, length of stay, hospital charges, and in-hospital mortality were compared. Multivariate logistic regression analysis was performed to evaluate the independent association between fixation type and postoperative complications while adjusting for demographic, clinical, and hospital-level variables. Results: A total of 81,668 elective THAs were identified, including 40,290 cemented (49.33%) and 41,378 cementless (50.67%) procedures. Cemented THA was associated with a shorter length of stay (2.09 ± 1.88 vs. 2.26 ± 2.47 days, p < 0.001) and lower total hospital charges ($65,584.53 ± 48,797.21 vs. $72,186.84 ± 49,860.20, p < 0.001). Unadjusted analyses demonstrated higher rates of acute kidney injury and sepsis in the cementless group. After multivariate adjustment, cemented fixation was associated with lower odds of acute kidney injury (OR 0.87, 95% CI 0.79–0.96, p = 0.004). However, cemented THA was associated with higher odds of postoperative delirium (OR 1.20, 95% CI 1.02–1.42, p = 0.030), blood transfusion (OR 1.27, 95% CI 1.17–1.37, p < 0.001), and periprosthetic fracture (OR 1.32, 95% CI 1.02–1.71, p = 0.035). Rates of myocardial infarction, pneumonia, venous thromboembolism, urinary tract infection, and in-hospital mortality were similar between groups. Temporal analysis demonstrated comparable utilization trends, with a decline in elective procedures during 2020–2021. Conclusions: In this nationwide analysis, cemented total hip arthroplasty was associated with lower risk of acute kidney injury, shorter length of stay, and lower hospital charges, but higher odds of postoperative delirium, blood transfusion, and periprosthetic fracture compared with cementless fixation. These findings highlight distinct perioperative risk profiles between fixation strategies and may assist surgeons in individualized decision-making for elective total hip arthroplasty. Full article

Background: Stroke–heart syndrome (SHS), particularly acute myocardial injury, is a critical complication following acute ischemic stroke (AIS). The C-reactive protein–triglyceride–glucose index (CTI) integrates inflammatory and metabolic parameters but remains unexplored in the context of post-stroke cardiac complications. This study investigated whether CTI predicts cardiac injury patterns and 90-day clinical outcomes in AIS patients. Methods: A two-center retrospective cohort study was conducted in AIS patients undergoing endovascular treatment (EVT). Cardiac troponin I (cTnI) trajectories were classified into: no injury, non-dynamic elevation, and dynamic elevation. The primary endpoint was poor functional status at 90 days (modified Rankin Scale [mRS] 3–6); the secondary endpoint was 90-day all-cause death. Results: Among 493 individuals (median age 69 years, 42% female), higher baseline CTI was associated with a greater likelihood of dynamic troponin elevation (adjusted odds ratio [aOR] per 1-unit increase = 1.56 (1.26–1.94); p < 0.001). Patients with dynamic elevation had significantly worse outcomes compared to those with no injury. Elevated CTI was an independent predictor of 90-day poor functional outcome (Q4: aOR = 3.04 (1.53–6.05); p < 0.001) and mortality (Q4: aOR = 2.82 (1.33–6.00); p = 0.007). Conclusions: In EVT-treated AIS patients, the CTI is a predictor of SHS and adverse 90-day outcomes. This easily calculable index may help identify individuals at higher risk of cardiac complications after AIS. Full article