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18 pages, 2393 KiB  
Review
Aggressive Mating Behavior in Roosters (Gallus gallus domesticus): A Narrative Review of Behavioral Patterns
by Mihnea Lupu, Dana Tăpăloagă, Elena Mitrănescu, Raluca Ioana Rizac, George Laurențiu Nicolae and Manuella Militaru
Life 2025, 15(8), 1232; https://doi.org/10.3390/life15081232 - 3 Aug 2025
Viewed by 35
Abstract
This review explores sexual aggression in broiler breeder males, aiming to synthesize existing scientific evidence regarding its causes, behavioral manifestations, and consequences, while addressing the genetic, neuroendocrine, and environmental mechanisms involved. Through an extensive analysis of scientific literature, the paper highlights that intensive [...] Read more.
This review explores sexual aggression in broiler breeder males, aiming to synthesize existing scientific evidence regarding its causes, behavioral manifestations, and consequences, while addressing the genetic, neuroendocrine, and environmental mechanisms involved. Through an extensive analysis of scientific literature, the paper highlights that intensive genetic selection aimed at enhancing growth and productivity has resulted in unintended behavioral dysfunctions. These include the reduction or absence of courtship behavior, the occurrence of forced copulations, and a notable increase in injury rates among hens. Reproductive challenges observed in meat-type breeder flocks, in contrast to those in layer lines, appear to stem from selection practices that have overlooked traits related to mating behavior. Environmental and managerial conditions, including photoperiod manipulation, stocking density, nutritional imbalances, and the use of mixed-sex rearing systems, are also identified as contributing factors to the expression of sexual aggression. Furthermore, recent genetic findings indicate a potential link between inherited neurobehavioral factors and aggressive behavior, with the SORCS2 gene emerging as a relevant candidate. Based on these insights, the review emphasizes the importance of considering behavioral parameters in breeding programs in order to reconcile productivity objectives with animal welfare standards. Future research may benefit from a more integrative approach that combines behavioral, physiological, and genomic data to better understand and address the multifactorial nature of sexual aggression in poultry systems. Full article
(This article belongs to the Section Animal Science)
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11 pages, 216 KiB  
Article
Risk Factors and Clinical Outcomes of Deep Surgical Site Infections in Trauma Patients: A National Database Analysis
by Musaed Rayzah
Healthcare 2025, 13(15), 1808; https://doi.org/10.3390/healthcare13151808 - 25 Jul 2025
Viewed by 208
Abstract
Background: Deep surgical site infections (SSIs) represent a serious complication following abdominal trauma surgery; however, comprehensive risk factor analysis in large trauma populations remains limited. Although surgical site infections are recognized as preventable complications, little is known about the specific risk factors and [...] Read more.
Background: Deep surgical site infections (SSIs) represent a serious complication following abdominal trauma surgery; however, comprehensive risk factor analysis in large trauma populations remains limited. Although surgical site infections are recognized as preventable complications, little is known about the specific risk factors and clinical outcomes associated with deep SSIs in trauma patients at the national level. Methods: A retrospective cohort study analyzed data from the National Trauma Data Bank from 2020–2022, including 1,198,262 trauma patients with complete demographic, injury severity, and surgical procedure data. Deep SSI development, length of hospital stay, intensive care unit utilization, duration of mechanical ventilation, discharge disposition, and in-hospital mortality were assessed. Multivariate logistic regression was used to identify independent risk factors and quantify associations between patient characteristics and deep SSI occurrence. Results: Deep SSIs occurred in 601 patients (0.05%). Affected patients were younger (median 41 vs. 54 years, p < 0.001), predominantly male (73.7% vs. 61.8%, p < 0.001), and exhibited higher injury severity scores (median 17.0 vs. 5.0, p < 0.001). Major abdominal surgery was the strongest independent predictor (OR 3.08, 95% CI: 2.21–4.23, p < 0.001), followed by injury severity score (OR 1.05, 95% CI: 1.04–1.06, p < 0.001) and ICU length of stay (OR 1.04 per day, 95% CI: 1.03–1.05, p < 0.001). Patients with deep SSIs demonstrated dramatically increased hospital stays (89.5% vs. 4.5% exceeding 21 days, p < 0.001), reduced home discharge rates (28.5% vs. 48.9%, p < 0.001), and higher mortality (4.2% vs. 1.2%, p < 0.001). Conclusions: Major abdominal surgery and injury severity are primary risk factors for deep SSIs in trauma patients, with profound impacts on clinical outcomes and healthcare resource utilization. These findings highlight the importance of targeted prevention strategies for high-risk trauma patients undergoing major abdominal procedures and emphasize the significant burden that deep SSIs place on healthcare systems. Full article
(This article belongs to the Section Critical Care)
17 pages, 1840 KiB  
Article
Epigenomic Interactions Between Chronic Pain and Recurrent Pressure Injuries After Spinal Cord Injury
by Letitia Y. Graves, Melissa R. Alcorn, E. Ricky Chan, Katelyn Schwartz, M. Kristi Henzel, Marinella Galea, Anna M. Toth, Christine M. Olney and Kath M. Bogie
Epigenomes 2025, 9(3), 26; https://doi.org/10.3390/epigenomes9030026 - 23 Jul 2025
Viewed by 306
Abstract
Background/Objectives: This study investigated variations in DNA methylation patterns associated with chronic pain and propensity for recurrent pressure injuries (PrI) in persons with spinal cord injury (SCI). Methods: Whole blood was collected from 81 individuals with SCI. DNA methylation was quantified using Illumina [...] Read more.
Background/Objectives: This study investigated variations in DNA methylation patterns associated with chronic pain and propensity for recurrent pressure injuries (PrI) in persons with spinal cord injury (SCI). Methods: Whole blood was collected from 81 individuals with SCI. DNA methylation was quantified using Illumina genome-wide arrays (EPIC and EPICv2). Comprehensive clinical profiles collected included secondary health complications, in particular current PrI and chronic pain. Relationships between recurrent PrI and chronic pain and whether the co-occurrence of both traits was mediated by changes in DNA methylation were investigated using R packages limma, DMRcate and mCSEA. Results: Three differentially methylated positions (DMPs) (cg09867095, cg26559694, cg24890286) and one region in the micro-imprinted locus for BLCAP/NNAT are associated with chronic pain in persons with SCI. The study cohort was stratified by PrI status to identify any sites associated with chronic pain and while the same three sites and region were replicated in the group with no recurrent PrI, two novel, hypermethylated (cg21756558, cg26217441) sites and one region in the protein-coding gene FDFT1 were identified in the group with recurrent PrI. Gene enrichment and genes associated with specific promoters using MetaScape identified several shared disorders and ontology terms between independent phenotypes of pain and recurrent PrI and interactive sub-groups. Conclusions: DMR analysis using mCSEA identified several shared genes, promoter-associated regions and CGI associated with overall pain and PrI history, as well as sub-groups based on recurrent PrI history. These findings suggest that a much larger gene regulatory network is associated with each phenotype. These findings require further validation. Full article
(This article belongs to the Special Issue Features Papers in Epigenomes 2025)
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20 pages, 1466 KiB  
Article
Understanding Chilling Injury and Sugar Metabolism-Related Genes and Metabolites in ‘Red Haven’ Peaches
by Macarena Farcuh
Plants 2025, 14(14), 2133; https://doi.org/10.3390/plants14142133 - 10 Jul 2025
Viewed by 402
Abstract
Although cold storage is commonly used to extend peach fruit shelf-life, chilling injury (CI) can develop during low-temperature storage conditions and be expressed during exposure to ambient temperature. Therefore, the objectives of this study were to characterize and compare the differences in CI [...] Read more.
Although cold storage is commonly used to extend peach fruit shelf-life, chilling injury (CI) can develop during low-temperature storage conditions and be expressed during exposure to ambient temperature. Therefore, the objectives of this study were to characterize and compare the differences in CI occurrence as well as sugar metabolism-related genes and metabolites in ‘Red Haven’ peaches stored at 0 °C and 5 °C, followed or not by storage for 3 days (d) at 20 °C (to simulate retail shelf conditions for the evaluation of CI incidence), together with fruit stored at 20 °C, and to identify significant associations between peach CI and sugar metabolism via multivariate analysis. Fruit collected at commercial maturity was stored at 0 °C, 5 °C, and 20 °C and assessed at harvest (0 d) and at 1, 3, 5, 15, and 30 d of storage, followed or not by storage for 3 d at 20 °C. Peaches kept for 30 d at 5 °C plus 3 d at 20 °C exhibited CI, expressed as decreased expressible juice. CI susceptibility was associated with reduced sucrose and increased glucose and fructose, while sorbitol contents were also lower in fruit stored at 5 °C, compared to those stored at 0 °C. This was paralleled by decreased expression of sucrose biosynthesis-related genes and by increased expression of sucrose and sorbitol breakdown-related genes as early as after 5 d of storage at 5 °C. Sugar metabolism changes that occurred during cold storage were maintained after exposure for 3 d to a temperature of 20 °C. The correlations between the evaluated features implied that alterations in sugar metabolism can modulate changes in CI susceptibility. These findings suggest that storage at 0 °C better preserves the sucrose homeostasis of ‘Red Haven’ peaches, reducing CI risk. Full article
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16 pages, 719 KiB  
Article
Evaluating In-Hospital Arrhythmias in Critically Ill Acute Kidney Injury Patients: Predictive Models, Mortality Risks, and the Efficacy of Antiarrhythmic Drugs
by Wanqiu Xie, Henriette Franz and Toma Antonov Yakulov
J. Clin. Med. 2025, 14(13), 4552; https://doi.org/10.3390/jcm14134552 - 26 Jun 2025
Viewed by 423
Abstract
Background: Acute kidney injury (AKI) in critically ill patients is often complicated by arrhythmias, potentially affecting outcomes. This study aimed to develop predictive models for arrhythmias in AKI patients and assess the impact of antiarrhythmic drugs on in-hospital mortality. Methods: We conducted a [...] Read more.
Background: Acute kidney injury (AKI) in critically ill patients is often complicated by arrhythmias, potentially affecting outcomes. This study aimed to develop predictive models for arrhythmias in AKI patients and assess the impact of antiarrhythmic drugs on in-hospital mortality. Methods: We conducted a multi-database retrospective cohort study using MIMIC-IV and eICU databases. XGBoost and Bayesian Information Criterion (BIC) models were employed to identify key predictors of arrhythmias. Weighted log-rank and Cox analysis evaluated the effect of amiodarone and metoprolol on in-hospital mortality. Results: Among 14,035 critically ill AKI patients, 5614 individuals (40%) developed arrhythmias. Both XGBoost and BIC showed predictive power for arrhythmias. The XGBoost model identified HR_max, HR_min, and heart failure as the most important features, while the BIC model highlighted heart failure had the highest odds ratio (OR 1.18, 95% CI 1.16–1.20) as a significant predictor. Patients experiencing arrhythmia is associated with in-hospital mortality (arrhythmia group: 636 (11.3%) vs. non-arrhythmia group: 587 (7.0%), p < 0.01). Antiarrhythmic medications showed a statistically significant effect on in-hospital mortality (amiodarone: HR 0.28, 95% CI 0.19–0.41, p < 0.01). Conclusions: Our predictive models demonstrated a robust discriminatory ability for identifying arrhythmia occurrence in critically ill AKI patients, with identified risk factors showing strong clinical relevance. The significant association between arrhythmia occurrence and increased in-hospital mortality underscores the clinical importance of early identification and management. Furthermore, amiodarone therapy effectively reduced the risk of in-hospital mortality in these patients, even after accounting for time-dependent biases. The findings highlight the necessity of precise arrhythmia definition, careful consideration of time-dependent covariates, and comprehensive model validation for clinically actionable insights. Full article
(This article belongs to the Section Nephrology & Urology)
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21 pages, 1721 KiB  
Article
Methodology for Identification of Occupational Hazards Using Their Characteristic Features in Hard Coal Mining
by Zbigniew Burtan, Dagmara Nowak-Senderowska and Paweł Szczepański
Appl. Sci. 2025, 15(13), 7079; https://doi.org/10.3390/app15137079 - 23 Jun 2025
Viewed by 264
Abstract
Ensuring employee safety is a top priority for every enterprise, and it is especially critical in high-risk industries like coal mining. To achieve this goal, it is essential to focus efforts on identifying existing hazards and thoroughly assessing the associated risks. Accurate identification [...] Read more.
Ensuring employee safety is a top priority for every enterprise, and it is especially critical in high-risk industries like coal mining. To achieve this goal, it is essential to focus efforts on identifying existing hazards and thoroughly assessing the associated risks. Accurate identification and detailed characterization of occupational hazards play a pivotal role in the occupational risk assessment process, providing the foundation for effective safety strategies. This article presents an analysis of the process of identifying occupational hazards in hard coal mining, based on applicable legal regulations and a review of the relevant literature. The analysis reveals, on the one hand, a diversity of approaches to hazard classification, and on the other, a limited use of the characteristic features of hazards in classification processes. The findings of this review form the basis for proposing a systematic classification of occupational hazards in hard coal mining, taking into account the specific features of hazards in relation to their sources and potential consequences. The proposed classification not only categorizes hazards but also describes the specifics of hazard sources, such as environmental conditions, machinery, chemicals, and human factors, as well as the possible outcomes of these hazards, including physical injury, health impacts, and even fatalities. The aim of this article is to present a proposed classification of occupational hazards in hard coal mining and to provide a detailed characterization of these hazards based on the description of their sources and potential consequences. The proposed approach, grounded in the identification of characteristic features of hazards, facilitates the effective selection of preventive measures that can be implemented to reduce risk and improve workplace safety. Due to the presence of the full spectrum of natural hazards in Polish hard coal mining, the analysis draws on available statistical data, focusing on those hazards that contribute most significantly to fatal accidents and serious injuries. In conclusion, the article emphasizes the importance of a structured and systematic approach to identifying and assessing occupational hazards in the coal mining industry. By drawing on legal and literature-based insights, it aims to contribute to the development of more effective safety practices that protect workers and minimize the occurrence of workplace accidents and illnesses. Full article
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17 pages, 766 KiB  
Article
Development of the GDF-TRACK-AKI Score for Predicting Acute Kidney Injury in Patients with Rhabdomyolysis Due to Excessive Exercise or Trauma
by Oğuzhan Zengin, Burak Göre, Melike Yakut, Mustafa Yaylalı, Muhammet Göv, Safa Dönmez, Gülhan Kurtoğlu Çelik, Gül Pamukçu Günaydın, Esma Andaç Uzdoğan, Emra Asfuroğlu Kalkan and İhsan Ateş
Medicina 2025, 61(7), 1116; https://doi.org/10.3390/medicina61071116 - 20 Jun 2025
Viewed by 445
Abstract
Background and Objectives: Rhabdomyolysis is a disorder in which skeletal muscle tissues are damaged, resulting in the escape of their internal substances into the blood circulation. Acute kidney injury (AKI) is a serious complication of rhabdomyolysis that necessitates early recognition to ensure [...] Read more.
Background and Objectives: Rhabdomyolysis is a disorder in which skeletal muscle tissues are damaged, resulting in the escape of their internal substances into the blood circulation. Acute kidney injury (AKI) is a serious complication of rhabdomyolysis that necessitates early recognition to ensure effective clinical management. The objective of this research was to create a practical scoring tool for forecasting AKI in patients experiencing rhabdomyolysis due to trauma or excessive exercise. Materials and Methods: A novel scoring system, termed the growth differentiation factor-15-trauma-creatine kinase acute kidney injury score (GDF-TRACK-AKI score), was established. The model integrates serum levels of growth differentiation factor-15 (GDF-15), creatine kinase (CK), and occurrence of rhabdomyolysis associated with trauma. Clinical and biochemical data were prospectively collected, and the model’s predictive performance was evaluated using receiver operating characteristic ROC curve analysis. Results: Among patients with rhabdomyolysis, those who developed AKI had significantly higher GDF-TRACK-AKI scores (median: 3.00 (IQR: 2.00)) compared to patients without AKI (median: 0.48 (IQR 0.89); p < 0.001). Serum CK and GDF-15 levels were also markedly elevated in the AKI group (p < 0.001). ROC analysis identified a cut-off value of 2.5, providing 67% sensitivity and 98% specificity. Patients with scores ≥ 2 demonstrated a significantly increased risk of AKI. Conclusions: Designed as a practical and dependable tool, the GDF-TRACK-AKI score facilitates prompt identification of kidney injury in patients whose rhabdomyolysis is linked to either trauma or vigorous activity. The integration of trauma history with GDF-15 and CK biomarker data improves risk stratification precision and supports timely treatment decisions. To verify its practical utility and prognostic capabilities, the GDF-TRACK-AKI score should undergo additional evaluation across expansive and demographically varied clinical populations. Full article
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32 pages, 717 KiB  
Article
Long-Term-Effects of Training-Accompanied Myofascial Self-Massage on Health Complaints, Symptoms of Overload, and Training Compatibility in Recreational Cyclists
by Doris Posch, Markus Antretter, Michael Zach, Martin Faulhaber and Martin Burtscher
Healthcare 2025, 13(11), 1337; https://doi.org/10.3390/healthcare13111337 - 4 Jun 2025
Viewed by 510
Abstract
Background/Objectives: Cycling has become a popular recreational sport, but it can lead to injuries and overload syndromes. The goal of this study is to evaluate the effectiveness of a training-accompanied myofascial self-massage intervention on two primary outcomes: injury occurrence and perceived training intensity. [...] Read more.
Background/Objectives: Cycling has become a popular recreational sport, but it can lead to injuries and overload syndromes. The goal of this study is to evaluate the effectiveness of a training-accompanied myofascial self-massage intervention on two primary outcomes: injury occurrence and perceived training intensity. Methods: To achieve this goal, we conducted a randomized controlled trial (RCT) with 35 cyclists. A difference-in-differences (DiD) regression analysis was employed to analyze the effects of the intervention. Results: The DiD analysis revealed, on the one hand, no statistically significant effect of the intervention on the overall injury score. On the other hand, the intervention group showed a significantly smaller increase in perceived training intensity compared to the control group, supporting the hypothesis that myofascial self-massage decreases the perception of training intensity. In one of our strongest models, which estimated the impact of the intervention from baseline to the second post-test, we observed an adjusted R-squared value of 0.89 and an interaction term coefficient of 1.35 at a significance level of p < 0.01. This indicates that, on average, the increase in perceived training intensity was 1.35 points higher (on a scale of 0 to 10) in the control group than in the intervention group. Conclusions: This study found no evidence to support the effectiveness of a training-accompanied myofascial self-massage in reducing injury levels, but it demonstrated that the intervention may reduce perceived training intensity. Future studies with larger sample sizes and more objective injury tracking methods are needed to further explore these findings and their long-term implications for injury prevention in cycling. Full article
(This article belongs to the Special Issue Sports Injury Prevention)
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15 pages, 812 KiB  
Article
CrossFit® and Its Influence on Health Behaviors, Functional Capacity, and Psychosocial Outcomes: An Explorative Study of Gender Differences in Athlete Perspectives
by Alessandra Amato, Luca Petrigna, Leonardo Di Gregorio and Giuseppe Musumeci
J. Funct. Morphol. Kinesiol. 2025, 10(2), 196; https://doi.org/10.3390/jfmk10020196 - 28 May 2025
Viewed by 1840
Abstract
Objectives: This explorative study aimed to evaluate athletes’ perceptions of how CrossFit® affects physical, psychological, and social well-being, exploring gender differences. CrossFit® is a high-intensity functional training modality aimed at enhancing overall fitness and health. Limited research has explored its perceived [...] Read more.
Objectives: This explorative study aimed to evaluate athletes’ perceptions of how CrossFit® affects physical, psychological, and social well-being, exploring gender differences. CrossFit® is a high-intensity functional training modality aimed at enhancing overall fitness and health. Limited research has explored its perceived impact on broader aspects of well-being, particularly considering gender differences. Methods: A total of 202 participants (age 34.3 ± 10.0 years) with at least 6 months of CrossFit® experience completed an online self-reported questionnaire not previously published but created following published guidelines. The questions explore athletes’ perceptions of their improvements in physical fitness, injury occurrence, and the effects on mental well-being. Statistical analysis included descriptive statistics and parametric and non-parametric tests to investigate gender differences. Results: In total, 81.2% of participants perceived improvements in strength, while 83.2% reported enhanced aerobic capacity. Significant body composition improvements were noted by 68.3% of the sample, and 87.6% reported changes in eating habits. Injury incidence was lower among women (30.2%) than men (45.3%) (p = 0.02). Regarding psychological outcomes, 95% of respondents indicated a reduction in stress levels, 73.3% reported better sleep quality, and over 90% perceived improvements in self-esteem and daily energy. Furthermore, 98.5% of participants formed new social connections through CrossFit®, with 79.2% acknowledging a positive impact on social relationships. No significant gender differences were found across most psychological and social outcomes. Conclusions: CrossFit® is perceived positively by participants, with similar views across genders, except for injury rates. It enhances physical fitness, mental health, and social well-being, with high training adherence and relatively low injury risk. Full article
(This article belongs to the Section Physical Exercise for Health Promotion)
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15 pages, 507 KiB  
Article
Monitoring Plasma Concentrations of Intravenously Administered Fosfomycin to Prevent Drug-Related Adverse Events: A Retrospective Observational Study
by Kathrin Marx, Nina Malmström, Marie Quast, Annette Glas, Ralph Wendt, Martina Kinzig, Fritz Sörgel, Maike Fedders, Thilo Bertsche and Christoph Lübbert
Antibiotics 2025, 14(6), 548; https://doi.org/10.3390/antibiotics14060548 - 27 May 2025
Viewed by 639
Abstract
Background: Fosfomycin is used as a combination partner for the treatment of severe non-urinary tract infections. Individualized dosing of fosfomycin based on therapeutic drug monitoring (TDM) has the potential to reduce drug-related adverse events (AEs). Methods: This retrospective study used routine data from [...] Read more.
Background: Fosfomycin is used as a combination partner for the treatment of severe non-urinary tract infections. Individualized dosing of fosfomycin based on therapeutic drug monitoring (TDM) has the potential to reduce drug-related adverse events (AEs). Methods: This retrospective study used routine data from patients receiving intravenous fosfomycin therapy. Plasma concentrations of fosfomycin were categorized into three different ranges: <64 mg/L, 64–128 mg/L, and >128 mg/L. Subsequently, the influence of acute kidney injury (AKI) on reaching the specific plasma concentration ranges and the occurrence of AEs was analyzed. Results: The study included 143 patients (median age 73 years, 66.4% male) with fosfomycin plasma measurements. Beta-lactam antibiotics were most frequently used in combination (62.2%), followed by tetracyclines (12.2%), cotrimoxazole (8.1%), and other agents (17.5%). Fosfomycin concentrations were >128 mg/L in 45% (36/80) of patients with normal renal function, 70.4% (38/54) of patients with AKI stages I to III, and 77.8% (7/9) of patients with renal replacement therapy. AEs occurred in 54% (77/143), mainly hypernatremia (42.6%), hypokalemia (39.9%), and gastrointestinal symptoms (19.6%), with the median fosfomycin plasma concentration being significantly higher in patients with AEs (158 mg/L vs. 131 mg/L, p = 0.01). Multivariate logistic regression analysis revealed that patients aged ≥70 years (OR 3.70, 95% CI 1.24–11.5; p = 0.02) and patients with fosfomycin plasma concentrations > 128 mg/L (OR 3.30, 95% CI 1.09–10.4; p = 0.04) had a higher risk of AEs. Conclusions: There was a significant association between high plasma exposure and the occurrence of AEs. In particular, the impact of acute renal insufficiency on fosfomycin plasma concentrations should be considered. Individualized fosfomycin dosing based on TDM and the intensive monitoring of renal function contribute to reducing drug-related side effects. Full article
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9 pages, 1003 KiB  
Proceeding Paper
Electrophysiological Biomarkers to Understand the Compensatory Mechanisms of Hamstring Tears: A Narrative Review
by Gonzalo Daniel Gerez, Manuel Parajón Víscido, Fernando Daniel Farfán and Leonardo Ariel Cano
Eng. Proc. 2024, 81(1), 18; https://doi.org/10.3390/engproc2024081018 - 24 May 2025
Viewed by 446
Abstract
Hamstring muscle tears are among the most prevalent sports injuries. The occurrence of muscle injuries has been demonstrated to result in alterations to the movement control system, thus prompting the implementation of compensatory strategies. The potential for in-depth study of these adaptive or [...] Read more.
Hamstring muscle tears are among the most prevalent sports injuries. The occurrence of muscle injuries has been demonstrated to result in alterations to the movement control system, thus prompting the implementation of compensatory strategies. The potential for in-depth study of these adaptive or compensatory strategies for injuries is made possible by the use of electrophysiological biomarkers. The aim of this study was to evaluate the current evidence concerning the analysis of electrophysiological biomarkers in research conducted on subjects with a history of hamstring injury (HSI) on sprinting tasks. A comprehensive literature review was conducted, and five articles were selected based on a rigorous set of selection criteria. The heterogeneity of the results precludes the establishment of broad generalisations regarding hamstring muscle activity during running or sprinting. Notwithstanding these discrepancies, individuals with a history of hamstring injury have been shown to consistently exhibit altered EMG patterns. In order to enhance our comprehension of the neural strategies underpinning movement, it is imperative to employ methodologies that transcend the limitations of EMG amplitude measures. Full article
(This article belongs to the Proceedings of The 1st International Online Conference on Bioengineering)
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20 pages, 4613 KiB  
Article
Osilodrostat Safety Profile: Findings from Real-World Data in the FAERS Database
by Ioana Rada Popa Ilie, Anca Butuca, Calin Homorodean, Carmen Maximiliana Dobrea, Claudiu Morgovan, Adina Frum and Steliana Ghibu
J. Clin. Med. 2025, 14(10), 3518; https://doi.org/10.3390/jcm14103518 - 17 May 2025
Viewed by 866
Abstract
Background/Objectives: Cushing’s syndrome (CS), including Cushing’s disease (CD)—the most common type—has a substantial negative impact on morbidity, mortality, and patients’ quality of life. Medical management of CS is essential for controlling hypercortisolism as part of preoperative preparation for definitive surgical treatment and for [...] Read more.
Background/Objectives: Cushing’s syndrome (CS), including Cushing’s disease (CD)—the most common type—has a substantial negative impact on morbidity, mortality, and patients’ quality of life. Medical management of CS is essential for controlling hypercortisolism as part of preoperative preparation for definitive surgical treatment and for managing residual or relapsed hypercortisolism post-surgery. Osilodrostat, a dual inhibitor of glucocorticoid and mineralocorticoid biosynthetic pathways, has been approved for the medical treatment of CS since early 2020. However, real-world data on its adverse effects remain limited. We mined the FAERS database and analyzed the reports associated with osilodrostat up to 1 October 2024. Methods: Descriptive and disproportionality methods based on Relative Odds Ratio (ROR), Chi-square (χ2), and Proportional Reporting Ratio (PRR), were used to discern potential safety signals and assess the significance of osilodrostat-associated adverse events. Results: This study identified 782 reports in which osilodrostat was the primary suspected drug, containing 593 preferred terms (PTs) and 2481 occurrences. The most frequently registered events belonged to the following SOCs: “General disorders and administration site conditions” (n = 457, 18.4%), “Injury, poisoning and procedural complications” (n = 311, 12.5%), “Gastrointestinal disorders” (n = 278, 11.2%), “Investigations” (n = 260, 10.5%), and “Nervous system disorders” (n = 184, 7.4%). Among PTs, off-label use was the most commonly reported, aligning with the fact that the vast majority of cases originated from the U.S. (84%), where osilodrostat is officially approved only for the treatment of CD. Disproportionality analysis confirmed previously known and new potential adverse drug reactions associated with osilodrostat treatment, including reports of cardiac flutter (n: 4; PRR: 19.42; χ2: 49.57), ventricular extrasystoles (n: 4; PRR: 11.85; χ2: 29.62), muscular weakness (n: 8; PRR: 2.25; χ2: 4.38), rib fracture (n: 4; PRR: 6.66; χ2: 13.99), spinal fracture (n: 3; PRR: 4.66; χ2: 5.35), sepsis (n: 9; PRR: 2.63; χ2: 7.56), fungal infections (n: 4; PRR: 3.67; χ2: 5.33), and COVID-19 (n: 32; PRR: 5.07; χ2: 101.16). Conclusions: This study highlights new risks and offers valuable insights into osilodrostat use; however, further research and validation are necessary, particularly for adverse reactions not yet explicitly documented in the summary of product characteristics. Full article
(This article belongs to the Special Issue Endocrine Tumors: Diagnosis, Treatment, and Management)
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22 pages, 600 KiB  
Article
Exploring the Principle of Multi-Dimensional Risk Analysis and a Case Study in Two-Dimensional Risk
by Yundong Huang
Risks 2025, 13(4), 79; https://doi.org/10.3390/risks13040079 - 21 Apr 2025
Viewed by 729
Abstract
By examining the significant flaws in multivariate risk analysis and integrated risk analysis, this article introduces a new approach to evaluating the total risk within complex risk systems: the principle of multi-dimensional risk (MDR) analysis. Under this framework, the scope of each individual [...] Read more.
By examining the significant flaws in multivariate risk analysis and integrated risk analysis, this article introduces a new approach to evaluating the total risk within complex risk systems: the principle of multi-dimensional risk (MDR) analysis. Under this framework, the scope of each individual risk is first defined, and the risk-bearing entity is identified. Each risk is then analyzed independently, and the results are subsequently integrated to provide a comprehensive view of MDR. Multivariate risk analysis becomes increasingly impractical as the number of factors grows, due to the correspondingly large sample size required—often unattainable in real-world conditions. Integrated risk analysis methods, such as weighted combinations and Copula techniques, are heavily influenced by subjective factors, which compromise the reliability of their results. In contrast, MDR analysis involves fewer variables per individual risk, reducing the sample size requirement and making data collection more feasible. Individual risks can be quantified using objective physical indicators such as economic loss or physical injury, enabling more accurate calculations of the total risk across the system. A case study involving two-dimensional risks—flood and earthquake—demonstrated that these events often have vastly different occurrence cycles. When these risks are entangled in conventional analysis, the resulting annual total risk value can be severely distorted. By analyzing individual risks separately, maintaining the focus on overall system risk, and treating the total risk as an MDR problem, a more reliable foundation for policy-making and risk management can be established. There are at least three types of MDR relationships: independent, compounding, and negatively correlated. As a result, no universal MDR analysis model exists. Full article
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28 pages, 4479 KiB  
Systematic Review
Risk Factors of Ankle Sprain in Soccer Players: A Systematic Review and Meta-Analysis
by Amir Human Hoveidaei, Amir Reza Moradi, Amin Nakhostin-Ansari, Mohammad Mehdi Mousavi Nasab, Seyed Pouya Taghavi, Shayan Eghdami, Bijan Forogh, Masumeh Bagherzadeh Cham and Christopher J. Murdock
Sports 2025, 13(4), 105; https://doi.org/10.3390/sports13040105 - 28 Mar 2025
Viewed by 2690
Abstract
Background: Soccer is associated with substantial injury risk, with reported between 13 to 35 injuries per 1000 player-hours of competitive play. Notably, approximately 77% of soccer-related ankle injuries are attributed to ankle sprain injuries (ASIs). ASI can lead to chronic ankle instability, obesity, [...] Read more.
Background: Soccer is associated with substantial injury risk, with reported between 13 to 35 injuries per 1000 player-hours of competitive play. Notably, approximately 77% of soccer-related ankle injuries are attributed to ankle sprain injuries (ASIs). ASI can lead to chronic ankle instability, obesity, and post-traumatic osteoarthritis. This study focuses on identifying factors such as gender, age, body mass index (BMI), and a history of ASIs, which contribute to the development of ASI in soccer players. Methods: A systematic literature search was conducted in October 2023 across databases, including PubMed, Web of Science, Scopus, Cochrane Library, and ProQuest, without applying any filters. Keywords included ankle, ankle joint, sprain, risk factors, etc. Data extraction was performed on the included studies, with findings standardized and analyzed using Stata Statistical Software: Release 17 to determine a weighted treatment effect. Results: Our systematic review included 26 studies. The meta-analysis revealed that a history of ankle sprain is the most significant risk factor for future ASIs. BMI emerged as a risk factor in three out of seven studies, while age and height were significant in one out of six studies each. Gender and weight were not found to significantly affect ASI occurrence. Other factors identified but not subjected to a meta-analysis due to methodological heterogeneity or insufficient studies included playing surface, joint laxity, muscle weakness, match congestion, strength asymmetries, ground reaction forces, balance maintenance, skill level, and playing position. Conclusions: This research contributes valuable insights into the prevention of ASIs in soccer, highlighting the importance of previous ankle sprains and playing surface quality. These findings assist sports professionals in developing optimal conditions and strategies for effective ankle sprain prevention. Full article
(This article belongs to the Special Issue Advances in Sports Injury Prevention and Rehabilitation Strategies)
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Article
Interleukin-6 and Leukocyte Cell Population Data in Newly Diagnosed Sepsis—A Prospective Study
by Sara Šundalić, Iva Košuta, Ivana Baršić Lapić, Ivana Rako, Dunja Rogić, Radovan Radonić and Ana Vujaklija Brajković
Medicina 2025, 61(3), 468; https://doi.org/10.3390/medicina61030468 - 7 Mar 2025
Cited by 2 | Viewed by 1262
Abstract
Background and Objectives: Sepsis still represents a syndrome with a high mortality. A timely sepsis diagnosis and an early intervention are crucial for the disease outcomes. Sepsis-associated acute kidney injury (SA-AKI) is highly prevalent but often diagnosed late. We aimed to investigate whether [...] Read more.
Background and Objectives: Sepsis still represents a syndrome with a high mortality. A timely sepsis diagnosis and an early intervention are crucial for the disease outcomes. Sepsis-associated acute kidney injury (SA-AKI) is highly prevalent but often diagnosed late. We aimed to investigate whether serum interleukin-6 (IL-6) and leukocyte cell population data (CPD) could be adequate biomarkers for the prediction of survival and SA-AKI development. Materials and Methods: We conducted a prospective observational study in a medical intensive care unit of a tertiary hospital centre in Zagreb, Croatia from June 2020 to October 2023. Adult patients with newly diagnosed sepsis were included and classified as immunocompetent or immunocompromised. Blood samples were collected upon admission. Results: A total of 150 patients were included in the study. Ninety-six (64%) patients were immunocompetent and fifty-four (36%) were immunocompromised. The median SOFA score was 8 (6–11). SA-AKI was diagnosed in 108 (72%) patients. ICU and hospital mortality was 27.3% and 37.3%, with no significant difference between groups. Significantly higher serum IL-6 levels were noted in the immunocompromised group, while neutrophil granularity intensity was higher in the immunocompetent group. According to logistic regression analyses, elevated IL-6 levels predicted a lethal ICU outcome, while elevated IL-6 levels and neutrophil reactivity intensity were predictors of SA-AKI development. A cluster analysis revealed two patient groups with different IL-6 concentrations, and further studies indicated that the group with higher IL-6 values had significantly higher SA-AKI occurrence and increased lethal outcomes. Conclusions: An early serum IL-6 measurement regardless of the patients’ immune status indicates disease severity. Its measurement in the early phase of disease presentation, potentially in the emergency department, might facilitate ICU admission. Further research is warranted in the field of leukocyte CDP application. Full article
(This article belongs to the Section Intensive Care/ Anesthesiology)
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