Search Results (243)

Introduction: This study aimed to evaluate the diagnostic and prognostic value of soluble intercellular adhesion molecule-1 (sICAM-1) and galectin-3 in patients with type 2 diabetes mellitus (T2D) diagnosed with coronavirus disease 2019 (COVID-19). Participants and Method: This prospective observational study included 45 adult patients (≥18 years) with T2D and confirmed COVID-19 who were followed in the Infectious Diseases and Clinical Microbiology departments between May and June 2022. The control group consisted of 45 healthy volunteers without chronic illness who were presented to the internal medicine outpatient clinic. In addition to routine laboratory biomarkers assessed at hospital admission, the serum levels of sICAM-1 and galectin-3 were measured via ELISA kits. Results: The median age of the patients was 66 years (range: 41–77), and 23 (51.1%) were male. Hypertension was the most common comorbidity in addition to diabetes. Compared with those in the control group, the serum levels of both galectin-3 and sICAM-1 were significantly elevated in patients with COVID-19 and T2D (p < 0.001). However, there was no significant difference in galectin-3 or sICAM-1 levels between survivors and nonsurvivors (p = 0.240 and p = 0.266, respectively). Conclusion: Galectin-3 and sICAM-1 demonstrated stronger diagnostic utility than conventional biomarkers in T2D patients with COVID-19. The elevated levels of these markers may reflect the underlying systemic inflammation observed in diabetic patients with COVID-19. The strong correlation between galectin-3 and sICAM-1 suggests a potential link in their inflammatory regulation, although causality cannot be inferred. Full article

The social and civic participation of older adults has proven to be an asset that positively influences the dynamics of social inclusion that affect them, and expert opinion from international organisations calls for its inclusion in the development of public policies in response to the increasing longevity worldwide. However, the characteristics of this participation have not been sufficiently analysed. The main objective of this study was to test the explanatory capacity of an operational proposal relating to the participation of older people based on a multidimensional participation structure. Four dimensions were established: two relating to social participation (associations and volunteering and public sociability) and two linked to citizen participation (political and electoral participation, as well as active citizenship and civic engagement). Based on the proposal, a technical expert panel (TEP) was asked to identify the main participation challenges faced by older people across the four dimensions identified. Consensus was sought using prioritisation matrices. The results showed, among other issues, the key role of the dimensions of citizen participation in identifying participation challenges that have an impact on social inclusion. The political and electoral participation dimension had a specific weight regarding the challenges linked to current problems and characteristics. On the other hand, the active citizenship and civic engagement dimension was oriented towards the challenges linked to desirable conditions and recommended initiatives in the future to improve the impact of older people’s participation. The expert panel’s statements coincide with the recommendations of international organisations on the need to involve older persons in policymaking from a perspective of comprehensive and person-centred care. This provides a concrete response to people’s demands and fosters bottom-up planning policies that contribute to social cohesion. Full article

Background: Locally acting gastrointestinal (GI) drugs present challenges for generic drug development because traditional bioequivalence measures, which rely on systemic drug levels, do not reflect local efficacy. This review examines regulatory guidelines for establishing therapeutic equivalence for such drugs, using rifaximin—a minimally absorbed, gut-localized antibiotic—as a case study. Methods: We reviewed bioequivalence guidelines from the United States Food and Drug Administration (FDA) and European Medicines Agency (EMA), along with the literature on rifaximin’s biopharmaceutical and clinical properties, to identify strategies and challenges for establishing equivalence for locally acting GI drugs. Results: Rifaximin exemplifies the limitations of standard bioequivalence methods: as a Biopharmaceutics Classification System (BCS) class IV drug with minimal absorption and low solubility, in vitro dissolution may not predict local drug availability. Clinical endpoint trials (e.g., traveler’s diarrhea, hepatic encephalopathy, IBS-D) are resource-intensive and insensitive to formulation differences. Pharmacokinetic (PK) studies in healthy volunteers show low, variable plasma levels, which may inaccurately discriminate between formulations. The EMA requires evidence of non-saturable absorption to accept PK data, a difficult-to-establish but potentially irrelevant criterion. Differences between FDA and EMA approaches highlight a lack of harmonization, complicating global generic development. Conclusions: A tailored, multifaceted approach is needed to demonstrate bioequivalence for GI-localized drugs like rifaximin. This case underscores the need for more sensitive surrogate methods (e.g. advanced in vitro or pharmacodynamic models) and flexible regulatory criteria. Harmonization across international guidelines and innovative bioequivalence study designs are key to facilitating the approval of safe and effective generic alternatives in this drug class. Full article

Background: The rising consumption of ultra-processed foods, especially those high in added sugars, poses a growing public health concern. Although several tools exist to assess food addiction, there is a lack of validated instruments specifically designed to measure addiction-like behaviors related to sweet food intake. Objectives: This study evaluates the psychometric properties of the FitMIND Foundation Sweets Addiction Scale (FFSAS), adapted from the Yale Food Addiction Scale 2.0 (YFAS 2.0), using data from Polish adults recruited through the FitMIND Foundation. Methods: The FFSAS was evaluated by 11 expert judges on four criteria: clarity, content validity, linguistic appropriateness, and construct representativeness. Afterwards, 344 adult volunteers (mean age 40.6 ± 10.7 years, 78% female, mean body mass index (BMI) 27.86 kg/m²) completed online FFSAS and provided demographic data, BMI, and self-reported sweets consumption. Internal consistency was assessed with Cronbach’s alpha and external validity was examined through Spearman’s correlations. Moreover, we conducted Exploratory and Confirmatory Factor Analyses (EFA and CFA). Results: Content validity of the FFSAS was supported by expert validation. The scale demonstrated good overall internal consistency (α = 0.85), with specific criteria such as tolerance (α = 0.916) and withdrawal (α = 0.914) showing particularly high reliability. The FFSAS total score was moderately correlated with sweets consumption frequency (ρ = 0.39, p < 0.05) and feelings of guilt (ρ = 0.35, p < 0.05). Exploratory factor analysis (EFA) revealed a robust three-factor structure, explaining 68.6% of the variance; the individual factors (subscales) derived from this structure demonstrated excellent internal consistency (Cronbach’s α ranging from 0.951 to 0.962). Sampling adequacy was high based on Kaiser–Meyer–Olkin measure (KMO = 0.956). Confirmatory factor analysis (CFA) indicated suboptimal model fit (Comparative Fit Index (CFI) = 0.74, Tucker–Lewis Index (TLI) = 0.69, Root Mean Square Error of Approximation (RMSEA) = 0.14), with a significant chi-square test (χ² = 3761.76, p < 0.001). Conclusions: This pilot study demonstrated that the FFSAS may be a promising tool for assessing sweet food addiction in adults. Future research should focus on assessing the FFSAS’ suitability on more diverse populations in other countries for further validation. Full article

The investigation of the two phenomena of Space Weather, i.e., Forbush decreases in the cosmic ray intensity and geomagnetic storms, is a highly developing field of modern scientific research, since these two phenomena can affect not only technological activities, e.g., electronics, telecommunications, navigations, etc., but also, as evidenced by recent studies, human life as well. This study analyses data of heart rate of volunteers of the Polyclinico Tor Vergata, Rome, Italy, with regard to geomagnetic field’s variations (i.e., geomagnetic storms) and cosmic ray intensity’s fluctuations (i.e., Forbush decreases). Data concerning geomagnetic (Dst- and Ap-index values) and cosmic ray activity derived from the Rome Cosmic Ray Station (Studio Variazioni Intensità Raggi Cosmici: S.V.I.R.CO.) were analyzed. The analysis expands from 24 April 2003 to 12 May 2004 and includes October–November 2003, which was a period of severe activity, when extreme events were recorded (i.e., the Great Halloween Solar Storms and the super storm on November 2003). The variations in heart rate were studied using the ANalysis Of Variance—ANOVA (for various levels of activity of the geophysical environment) and the superimposed epochs methods (during an event’s temporal evolution). Results revealed that high geomagnetic (defined by Dst-index values) and cosmic rays activity is related to heart rate increase. Moreover, the most significant heart rate variations are observed two days before until two days after the development of an event (either geomagnetic storm or a variation in the cosmic ray intensity). The results are in agreement with conclusions presented in the international scientific literature. Full article

Background: Efforts have been joined to set the parameters for the reliability of glucometers, yet once they are on the market, they are not further tested for the maintenance of accuracy, specificity, or precision. Methods: This comparative analytical study investigated the precision of commonly used glucometers in Saudi Arabia, namely Accu-Chek Instant^®, On-Call Sharp^®, and ConTour^®, as well as the effects of vitamin C, acetaminophen, and maltose on glucose readings. Ten milliliters of blood was drawn in lithium heparin from healthy volunteers (n = 9). Six samples were divided into two groups of three. One group was designed for normal glucose levels. The second group was designed for high glucose levels by adding a dextrose solution. The last three samples were designed for low glucose levels by leaving the sample for 24 h at room temperature and then following with centrifuge and plasma extraction. Results: This study showed that only Accu-Chek Instant met the International Organization for Standardization (ISO) standard for precision across all dextrose concentrations, along with intra-class correlation values ranging from 0.95–1 (p < 0.001). By spiking the plasma samples with sub-therapeutic, therapeutic, and overdose concentrations of the metabolites, we found that vitamin C had a more evident interference on glucose readings compared to acetaminophen and maltose. Conclusions: The ascertainment of the precision of glucometers and the effects of interferences on them are vital in preventing the improper administration of insulin, which can lead to serious complications. Full article

The rapid increase in plastic production and consumption has intensified research into human exposure to micro- and nanoplastics (MNPs) and their health effects. This study quantitatively assessed MNP internal exposure levels in non-invasive human samples, focusing on the four most common types of MNPs (≥300 nm): polyethylene terephthalate (PET), polypropylene (PP), low-density polyethylene (LDPE), and polystyrene (PS). Urine samples from 18 volunteers (4 males, 14 females) were analyzed using pyrolysis–gas chromatography–mass spectrometry (Py-GC/MS) with P(E-¹³C₂) as an internal standard. The study developed a straightforward yet effective analytical approach for quantifying MNPs in biological fluids. MNPs were detected in all urine samples, with concentrations ranging from 0.098 to 0.986 μg/mL and an average concentration of 0.268 ± 0.235 μg/mL. LDPE, 0.074 μg/mL (interquartile range: 0.030–0.243 μg/mL), was the most abundant polymer, accounting for 67.72% of the total MNPs, followed by PS at 21.17%, while PP and PET accounted for 7.06% and 4.05%, respectively. The results also suggest that drinking water type may serve as a distinct source of MNPs in urine. This study provides novel evidence on MNP (≥300 nm) internal exposure in humans and the influence of drinking habits, highlighting the application prospects of this method in assessing the potential health risks of MNPs. Full article

This paper presents my personal experiences of cross-disciplinary national and international academic mentoring over 30 years in a higher education setting, supporting 605 mentees in public health, health education, and the health services. I supported mentees at diverse career stages through (a) one-to-one mentoring relationships (n = 231 mentees; from the UK, Europe, Middle East, Africa, Asia, and Australasia; academics, industry, and healthcare professionals), (b) a cross-faculty structured mentoring programme (n = 52; junior faculty), (c) a cross-institutional interprofessional internship programme including mentoring and public health placements (n = 302 interns; from five universities), and (d) an interprofessional learning programme in workplace health called WHIRL, which was embedded within Test@Work, a public health innovation bridging health promotion practice, research, and industry and involving peer mentoring and mentor support (n = 20; volunteer healthcare trainees). In this paper, I outline the broader concept of mentoring, together with an overview of mentoring types, uses, and benefits. The diverse contexts in which mentoring occurs are discussed: (i) micro-mentoring, (ii) inducting new staff, (iii) peer mentoring, (iv) career transition moments, (v) career advancement mentoring, (vi) diversity mentoring, (vii) knowledge sharing mentoring, (viii) collaborative learning and support mentoring, and (ix) leadership development mentoring. The challenges of mentoring are presented alongside suggested actions to take. I advocate for mentoring evaluation and provide a worked example of measuring the outcomes of one-to-one mentoring using The Career Support and Psychosocial Support Scales (online survey; n = 103 mentees; from 22 countries). Finally, I reflect upon the diversity of mentoring experiences, with activities and benefits categorised into six key areas: interpersonal relationships; networking opportunities; enhancing knowledge and skills; employment, reward and recognition; support for under-served groups; and convening communities of practice. Full article

Background and Objectives: Acute pancreatitis (AP) is an inflammatory disorder of the pancreas, with severe cases linked to a higher mortality rate. The prognosis of AP is influenced by factors such as necrosis, secondary infections, and organ failure. Tissue damage in AP is driven by the activation of leukocytes and the release of inflammatory mediators. Angiopoietin-like protein 8 (ANGPTL8), also known as betatrophin, is a recently discovered protein that regulates lipid metabolism. This study aimed to investigate the relationship between ANGPTL8 levels and disease severity in AP patients, and to explore the potential of ANGPTL8 as a biomarker. Materials and Methods: This prospective study included 50 patients diagnosed with AP who were admitted to the Department of Internal Medicine at Dr. Cemil Taşcıoğlu City Hospital between September 2021 and February 2022. Additionally, 39 healthy volunteers who underwent a check-up at the same hospital served as the control group. The Glasgow–Imrie (GI) score was used to assess the severity of pancreatitis. Results: ANGPTL8 levels were found to be significantly lower in the AP group compared to the control group, with a statistically significant correlation between ANGPTL8 levels and the severity of AP (p < 0.05). The cut-off level of ANGPTL8 based on the GI score was determined to be 70.9 ng/L. The GI score for ANGPTL8 was 0.749 (95% CI: 0.606–0.861) (p < 0.001). The overall cut-off value for ANGPTL8 was 179.2 ng/L, with an overall classification rate of 0.936 (95% CI: 0.864–0.977) (p < 0.001). Conclusions: This study demonstrates that ANGPTL8 levels vary between patients with and without AP, with lower levels observed in AP patients. Our research is the first to identify decreased ANGPTL8 levels as an independent predictor of AP severity. ANGPTL8 may play a crucial role in regulating inflammation or metabolic dysfunction in AP. However, further studies are needed to confirm these findings in larger populations and investigate ANGPTL8’s mechanistic role in AP. Longitudinal studies could help determine whether ANGPTL8 levels act as a biomarker for disease progression or treatment response, potentially paving the way for targeted therapies to improve outcomes for AP patients. Full article

Kidney injury encompasses a broad spectrum of structural and functional abnormalities, directly associated with stem cell transplantation. Acute kidney injury and chronic kidney disease represent perilous complications of hematopoietic stem cell transplantation (HSCT), with an elevated risk of mortality and progression to end-stage renal disease. The early detection of these complications is, therefore, paramount, and research is increasingly focused on the identification of novel biomarkers of kidney damage. Recently, proenkephalin (PENK), a monomeric peptide that is freely filtered by the glomerulus and thus reflects glomerular filtration very well, has been shown to be an additional useful predictor of the occurrence of acute kidney injury and heart failure. Dickkopf-3 (DKK3) is a glycoprotein secreted by the renal tubular epithelium in response to stress and has been implicated in the development of interstitial fibrosis. It has therefore been evaluated primarily as a marker of fibrosis in chronic kidney disease (CKD), but may also help predict the development of acute kiney injury. Uromodulin is regarded as a renal marker. Previous studies have examined the potential of PENK, DKK-3 and uromodulin as a biomarker in individuals with preserved renal function. However, the urinary levels of PENK, DKK-3 and uromodulin in patients following HSCT have not yet been established. The objective of the present study was to assess urinary PENK, DKK-3, and uromodulin concentrations in patients who had been under ambulatory care of the Hematology, Transplantation and Internal Medicine Department for a minimum of three months following HSCT, and to investigate their correlations with kidney function, as reflected by serum creatinine and eGFR. The study population comprised 80 patients who had undergone allogeneic HSCT for various reasons, primarily hematological malignancies such as acute leukemias and lymphomas. In addition, 32 healthy volunteers were included in order to establish normal ranges for the biomarkers of interest. Urine concentrations of proenkephalin, DKK-3, and uromodulin were evaluated using a commercially available sandwich ELISA immunoassay. Demographic and clinical data were retrieved from the patients’ records. Statistical analyses were conducted using XLSLAT 2022 (Lumivero, Denver, CO, USA) and STATISTICAv13.0 (StatSoft, Tulsa, OH, USA). The results showed that PENK and DKK-3 levels were significantly higher in patients after HSCT compared to healthy volunteers. Furthermore, when patients were divided according to kidney function (below and over 60 mL/min/1.72 m²), it was found that the concentration of PENK and DKK-3 were significantly higher in 23 patients with CKD stage 3 relative to patients with eGFR over 60 mL min 1.72 m². In univariate correlations, PENK demonstrated an inverse relationship with eGFR (r: −0.21, p < 0.05), while DKK-3 exhibited no significant correlation with creatinine or eGFR.Patients following allogeneic HSCT, despite having normal or near-normal kidney function, exhibited evidence of kidney injury. However, further research is necessary to ascertain the clinical utility of the novel biomarker. Full article

Background/Objectives: In overhead throwing sports such as baseball and softball, upper extremity injuries are prevalent at both collegiate and high school levels. Currently, there is no universal assessment protocol to identify athletes at risk for injury or to determine their readiness to return to sport. This study aimed to investigate the relationship between shoulder internal rotation (IR) and external rotation (ER) isometric strength in a throwing position and three upper extremity functional tests among collegiate baseball players. It was hypothesized that there would not be significant correlations between shoulder IR and ER peak isometric force and the following functional assessments: the Upper Quarter Y Balance Test (YBT-UQ), seated single-arm shot put, and Closed Kinematic Chain Upper Extremity Strength Test (CKCUEST). Methods: Forty healthy collegiate baseball players volunteered for the study. After completing a self-guided warm-up, participants performed bilateral isometric shoulder IR and ER strength tests at 90 degrees of shoulder abduction and elbow flexion, followed by the three functional tests in random order. Relationships were analyzed using Pearson’s correlation coefficients (r), with a significance level set at p < 0.05. Results: Correlations were generally low, ranging from r = 0.001 to r = 0.551. Significant correlations were observed between the CKCUEST and dominant IR strength (r = 0.345, p = 0.031), dominant ER strength (r = 0.407, p = 0.010), and non-dominant ER strength (r = 0.551, p < 0.001). Additionally, a significant correlation was found between the dominant ER/IR strength ratio and the dominant arm superolateral reach on the YBT-UQ (r = −0.352, p = 0.026). No significant correlations were identified between isometric shoulder strength and the single-arm shot put. Conclusions: Most correlations were low to moderate, and only significant correlations between shoulder rotation isometric strength and one direction of the YBT-UQ and the CKCUEST were observed. Thus, shoulder rotation strength in a position similar to the cocking phase of overhead throwing may be valuable for return-to-sport criteria and injury screening for overhead athletes. However, further research is needed to validate these findings. Full article

Introduction: The relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and thyroid hormones has been established, but the direct effects of TSH on the liver, potentially leading to steatosis, and insulin resistance remain unclear. Objective: To investigate the association of TSH levels with MASLD and insulin resistance. Methods: We conducted a cross-sectional study of 8825 euthyroid individuals. Subjects were volunteers or patients referred to the International Center for Nutritional Status Assessment (University of Milan, Italy) undergoing clinical examination and blood drawing for thyroid function tests and liver indices calculation. Liver outcomes were fatty liver index (FLI), hepatic steatosis index (HSI), and FIB-4. All associations were adjusted for fT4 and confounders. Results: We found a positive association of TSH levels with FLI (β = 2.76; p < 0.001) and HSI (β = 0.58, p < 0.001). This relationship remained significant when stratifying by sex and BMI category, except for HSI in normal weight individuals. No significant association was found between TSH and hepatic fibrosis or insulin resistance. Conclusions: We found a positive association between TSH levels and MASLD in euthyroid individuals independently of fT4, sex, and BMI. Insulin resistance and hepatic fibrosis appear unrelated to TSH, independent of fT4 and BMI. The specific role of TSH in MASLD warrants further investigation. Full article

Background/Objectives: Regular consumption of dietary fiber (DF) has been associated with non-communicable disease prevention and health benefits. As a result, having the ability to quickly and correctly estimate DF intake would allow the identification of at-risk groups and the development of public programs aimed at improving their intake. In this study, the authors translate and cross-culturally adapt a validated short food frequency questionnaire for the assessment of DF intake, thus adapting it to the Italian population. Methods: The process followed a six-step standardized protocol, and the pre-final version was tested among 40 volunteers. Six experts in nutrition performed the content validity study: Scale-level Content Validity Indexes based on Average (S-CVI/Ave) and Universal Agreement (S-CVI/UA) were calculated (cut-off = 0.83). Results: Both S-CVI/Ave and S-CVI/UA were 1.00 ± 0.0, higher than the cut-off value. The preliminary qualitative analysis showed an average DF intake of 21.5 ± 7.2 g/day, which is below the suggested national and international dietary targets, and mainly derives from fruits, vegetables, bread, and cereals. Based on their DF intake, subjects were classified as low (40%), moderate (37.5%), and high (22.5%) consumers. Conclusions: The translation and cross-cultural adaptation of a validated short food frequency questionnaire to assess DF intake provided us with a tool suitable for the Italian population. Its application in a real case has enabled the identification of three consumption classes, which can support the design of future studies and interventions. Full article

The global fight against pandemics is a major public health issue. Epidemiological studies showed a reduced risk of the coronavirus disease 2019 (COVID-19) severity with the practice of regular physical activity (PA) in clinical populations. Here, we investigated the effect of PA against COVID-19 in a young general population. Methods: Two hundred ninety volunteers over 18 years old from Reunion Island responded to an online survey concerning sociodemographic, lifestyle and clinical information. Daily PA was studied using the International Physical Activity Questionnaire short version (IPAQ) and classified by overall score and intensities of PA. Results: Among 290 responders [179 women, median age = 27.5 years (interquartile range = 21.3 years)], 141 (48.6%) reported COVID-19 infection. Multivariate logistic analysis adjusted for age, sex, body mass index, chronic disease and alcohol consumption showed that the number of days per week of regular intense PA was independently associated with a low risk of COVID-19 infection [odds ratio (OR) 0.86; 95% confidence interval (CI) 0.24 to 0.99; p = 0.030], while regular moderate PA was not [OR 1.10; 95%CI 0.97 to 1.23; p = 0.137]. Conclusions: In a population of young adults, regular intense PA could offer a protective effect against COVID-19. Additional research is required to confirm this association in various viral infections and elucidate the fundamental mechanisms involved. Full article

This study explores the integration of a custom-designed pneumatic spring into a car-seat cushion and its interaction with a simplified human body model using the Finite Element Method (FEM). A 3D half-symmetry FEM framework, developed from experimental data, ensured computational efficiency and convergence. This research bridged experimental and numerical approaches by analyzing the contact pressure distributions between a seat cushion and a volunteer with representative biometric characteristics. The model incorporated two material groups: (1) human body components (bones and muscles) and (2) seat cushion materials (polyurethane foam, latex, and fabric tape). Mechanical properties were obtained from both the literature and experiments, and simulations were conducted using MSC.Marc software under realistic boundary and initial conditions. The simulation results exhibited strong agreement with experimental data, validating the model’s reliability in predicting contact pressure distribution and optimizing seat cushion designs. Contrary to the conventional notion that uniformly distributed contact pressure inherently enhances comfort, this study emphasizes that the precise localization of pressure plays a crucial role in static and long-term seating ergonomics. Both experimental and simulation results demonstrated that modulating the pneumatic spring’s internal pressure from 0 kPa to 25 kPa altered peak contact pressure by approximately 3.5 kPa (around 20%), significantly influencing pressure redistribution and mitigating high-pressure zones. By validating this FEM-based approach, this study reduces dependence on physical prototyping, lowering design costs, and accelerating the development of ergonomically optimized seating solutions. The findings contribute to a deeper understanding of human–seat interactions, offering a foundation for next-generation automotive seating innovations that enhance comfort, fatigue reduction, and adaptive pressure control. Full article