Search Results (18,142)

A remarkably well-preserved skeleton of a male Mammuthus meridionalis, approximately 60 years old, from the Early Pleistocene that is housed at the Castle of L’Aquila (Italy) exhibits a fractured left tusk with severe bone erosion of the alveolus and premaxillary bone, as well as marked spinal deformities. The cranial region underwent ultrasonographic, radiological, and histological examinations, while morphological and biomechanical analyses were conducted on the vertebral column. Microscopic analysis revealed intra vitam lesions, including woven bone fibers indicative of early bone remodeling and lamellar bone with expanded and remodeled Haversian systems. These findings are consistent with osteomyelitis and bone sequestration, likely resulting from chronic pulpitis following the tusk fracture, possibly due to an accident or interspecific combat. The vertebral column shows cervical scoliosis, compensatory curves, fusion between the first cervical vertebrae, and asymmetric articular facets, suggesting postural adaptations. Evidence of altered molar wear and masticatory function also support long-term survival post-trauma. Additionally, lesions compatible with spondyloarthropathy, an inflammatory spinal condition not previously documented in Mammuthus meridionalis, were identified. These findings provide new insights into the pathology and adaptive responses of extinct proboscideans, demonstrating the critical role of (paleo)histological methods in reconstructing trauma, disease, and aspects of life history in fossil vertebrates. Full article

The Florida softshell turtle, Apalone ferox, is considered common and found in many different types of freshwater habitats throughout its range. However, despite its prevalence where it occurs, little is understood about the species’ life history and population dynamics due to difficulties with capture and long-term marking. Building on a foundational study of the Florida softshell turtle at Wekiwa Springs State Park (WSSP) from 2007 to 2012, we present findings from an extended 16-year mark–recapture study spanning from 2007 to 2023. A total of 31 sampling events were conducted with a median of two capture events per year. Sampling events were spread over a median of 5 days each year (range, 2–11 days), with a total of 88 capture days. One hundred and twenty individual A. ferox were captured over 225 encounters. We estimated an average population size of 135.6 individuals using an annual Schumacher–Eschmeyer ratio estimator. Using a state-space Jolly–Seber model, we estimated that 204 individuals entered the population over the 16 years (the superpopulation), while the average current population size was 40 individuals. The median survival probability was 0.884 but the median detection probability was 0.10, reinforcing the perceived difficulty with capturing A. ferox. The continued influx of new juveniles, recapture of these individuals as adults, and strong female bias support the possibility that the WSSP and Rock Springs greater ecosystem functions as a potential nursery habitat for the Florida softshell. Though population estimates dropped 20% following a two-year sampling gap owing to the COVID-19 pandemic, the population is currently growing slowly and highlights the value of continued, long-term monitoring of elusive freshwater turtle species. Full article

The increasing prevalence of chronic metabolic diseases poses a significant challenge in the modern world, impacting healthcare systems and individual life expectancy. The World Health Organization (WHO) recommends that older adults (65+ years) engage in 150–300 min of moderate-intensity or 75–150 min of vigorous-intensity physical activity, alongside muscle-strengthening and balance-training exercises at least twice a week. However, nearly one-third of the adult population (31%) is physically inactive, which increases the risk of developing obesity, type 2 diabetes, cardiovascular diseases, hypertension, and psychological issues. Physical activity in the form of aerobic exercise, resistance training, or a combination of both is effective in preventing and managing these metabolic diseases. In this review, we explored the effects of exercise training, especially on respiratory and pulmonary factors, including oxygen consumption, pulmonary ventilation, and blood gas analyses among adults. During exercise, oxygen consumption can increase up to 15-fold (from a resting rate of ~250 mL/min) to meet heightened metabolic demands, enhancing tidal volume and pulmonary efficiency. During exercise, the increased energy demand of skeletal muscle leads to increases in tidal volume and pulmonary function, while blood gases play a key role in maintaining the pH of the blood. In this review, we explored the influence of age, body composition (BMI and obesity), lifestyle factors (smoking and alcohol use), and comorbidities (diabetes, hypertension, neurodegenerative disorders) in the modulation of these physiological responses. We underscored exercise as a potent non-pharmacological intervention for improving cardiopulmonary health and mitigating the progression of metabolic diseases in aging populations. Full article

The market for plant-based alternatives to animal foods has increased rapidly in the past decade, mainly due to consumer demand. Little evidence is available regarding nutritional impacts, drivers, and barriers to using these products as substitutes for animal foods in real-life conditions. This pilot study followed 16 Danish adults (30 ± 11 years old; 11 females) for 4 weeks with substituting milk, cheese, and yogurt with plant-based analogues to dairy (PBADs) and assessed their drivers and barriers to applying the intervention with a mixed-method approach. PBADs are constantly compared to their animal counterparts, both regarding product characteristics, such as price and sensory properties, as well as cultural roles and subjective memories. The mixed methods showed dairy attachment, price, and taste were the main barriers to consuming PBAD, while changes in life and social circles were drivers (qualitative data). As for the liking of PBADs, plant-based yoghurt was the preferred intervention product (73.5/100, p < 0.05), followed by plant-based drinks (65.9/100), while plant-based cheese was the lowest rated (47.9/100, p < 0.05). As for dietary changes, a lower average intake of sugars, saturated fatty acids, cholesterol, calcium, phosphorus, and zinc was observed after the intervention. Additionally, this study describes the attachment of the study population to milk and dairy products. It shows that choosing dairy is beyond nourishment but is connected to tradition, culture, pleasure, memories, and a sense of belonging. In contrast, there is no history or attachment to PBADs. Full article

Background: Maxillary sinus puncture (MSP), once a cornerstone for diagnosing and treating acute rhinosinusitis (ARS), has declined with the rise in less invasive techniques. This study explores MSP trends, its association with age, and long-term effects on quality of life using data from the Study of Health in Pomerania (SHIP). Methods: Data from SHIP-START-2 (n = 2332), SHIP-START-3 (n = 1717), and SHIP-TREND-0 (n = 4420) cohorts were analyzed to assess MSP prevalence, demographic correlations, and quality- of-life impacts using SNOT-20-D, EQ-5D-3L, and SF-12. Results: MSP prevalence was higher in older SHIP-START cohorts (11.2% in START-2) compared to SHIP-TREND-0 (9.5%), reflecting its historical decline. The procedure was more frequently reported by participants aged > 60 years (e.g., 14.0% in START-2) than by younger groups (<40 years: 3.5% in START-2). MSP was associated with increased SNOT-20-D scores across cohorts (e.g., +0.28 in START-2, p < 0.001) and minor reductions in EQ-5D-3L and SF-12 mental health scores, indicating greater symptom burden but limited general health impact. The age- and time-related decline in MSP highlights its diminishing role in modern practice. Conclusions: While MSP offers diagnostic insights and serves as an indicator for ARS, its modest impact on long-term quality-of-life underscores the need for alternative, minimally invasive techniques for sinonasal conditions. Full article

Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. Although traditionally considered a disease of older men, the incidence of early-onset PCa (diagnosis < 55 years) is steadily rising. Advances in screening and therapy have significantly improved survival, creating a growing cohort of younger survivors for whom post-treatment quality of life—notably reproductive function—is paramount. Curative treatments such as radical prostatectomy, pelvic radiotherapy, androgen-deprivation therapy (ADT), and chemotherapy often cause irreversible infertility via multiple mechanisms, including surgical disruption of the ejaculatory tract, endocrine suppression of spermatogenesis, direct gonadotoxic injury to the testes, and oxidative sperm DNA damage. Despite these risks, fertility preservation is frequently overlooked in pre-treatment counseling, leaving many patients unaware of their options. This narrative review synthesizes current evidence on how PCa therapies impact male fertility, elucidates the molecular and physiological mechanisms of iatrogenic infertility, and evaluates both established and emerging strategies for fertility preservation and restoration. Key interventions covered include sperm cryopreservation, microsurgical testicular sperm extraction (TESE), and assisted reproductive technologies (ART). Psychosocial factors influencing decision-making, novel biomarkers predictive of post-treatment spermatogenic recovery, and long-term offspring outcomes are also examined. The review underscores the urgent need for timely, multidisciplinary fertility consultation as a routine component of PCa care. As PCa increasingly affects men in their reproductive years, proactively integrating preservation into standard oncologic practice should become a standard survivorship priority. Full article

Petroglyph motifs from 23 sites and 37 panels in northern Georgia and western North Carolina foothills and mountains are analyzed within their archaeological, ethnographic, and landscape contexts. The Track Rock Tradition comprises 10 chronologically sequenced marking categories: (1) Cupules/Meanders/Open Circles; (2) Soapstone Extraction cars; (3) Vulva Shapes; (4) Figures; (5) Feet/Hands/Tracks; (6) Nested Circles; (7) Cross-in-Circles; (8) Spirals; (9) Straight Lines; and (10) Thin Incised Lines. Dating spans approximately 3800 years. Early cupules and meanders predate 3000 years ago, truncated by Late Archaic soapstone extraction. Woodland period (3000–1050 years ago) motifs include vulva shapes, figures, feet, tracks, and hands. Early Mississippian concentric circles date to 1050–600 years ago, while Middle Mississippian cross-in-circles span 600–350 years ago. Late Mississippian spirals (350–200 years ago) and post-contact metal tool incisions represent the most recent phases. The Track Rock Tradition differs from western Trapp and eastern Hagood Mill traditions. Given the spatial overlap with Iroquoian-speaking Cherokee territory, motifs are interpreted through Cherokee beliefs, supplemented by related Muskogean Creek ethnography. In Cherokee cosmology, the matrilocal Thunderers hierarchy includes the Female Sun/Male Moon, Selu (Corn Mother)/Kanati (Lucky Hunter), Medicine Woman/Judaculla (Master of Game), and Little People families. Ritual practitioners served as intermediaries between physical and spirit realms through purification, fasting, body scratching, and rock pecking. Meanders represent trails, rivers, and lightning. Cupules and lines emphasize the turtle appearance of certain rocks. Vulva shapes relate to fertility, while tracks connect to life-giving abilities. Concentric circles denote townhouses; cross-in-circles and spirals represent central fires. The tradition shows continuity in core beliefs despite shifting emphases from hunting (Woodland) to corn cultivation (Mississippian), with petroglyphs serving as necessary waypoints for spiritual supplicants. Full article

Millions of puppies are welcomed into the homes of families around the world each year. However, understanding the ways in which puppies are bred and raised by their breeders, as well as the perspectives and perceptions underpinning these practices, is still in its infancy. The current study administered an online survey to 200 Australian dog breeders to investigate their breeding program characteristics, breeding dog selection, understanding of the importance of early experiences in puppyhood, and the extent and diversity of their puppy rearing and socialisation practices. Results indicated that breeders were motivated by breed improvement and producing dogs for themselves rather than providing companion dogs, despite most of their puppies being placed in companionship roles. The participating breeders also acknowledged the important role they play in shaping puppies’ behaviour and temperament, which was reflected in both their breeding dog selection and in their rearing and socialisation practices. The majority of breeders housed their litters within their residence for the initial weeks of life but the socialisation experiences they provided were variable in type and frequency. Longer-term breeders and those with larger, more intensive programs reported providing human-focused socialisation experiences less frequently, though the correlational nature of these findings require cautious interpretation. Whilst future research should endeavor to explore these results more comprehensively among a more diverse sample, these findings provide valuable insight into the breeding, rearing, and socialisation process undertaken by dog breeders in Australia. Full article

Background/Objectives: Dry eye (DE) can cause persistent eye rubbing, contributing to keratoconus (KC) development and progression. Both keratoconus (KC) and dry eye (DE) significantly impact patients’ functional and emotional well-being, with KC patients exhibiting a higher prevalence of DE symptoms and signs. This study examined whether functional (KEPAQ-F) and emotional (KEPAQ-E) quality of life, assessed by the Keratoconus End-Points Assessment Questionnaire, differ when influenced by symptoms and clinical signs of general DE versus meibomian gland dysfunction (MGD) in KC patients. Methods: Volunteers with KC (ages 18–70) underwent DE and MGD assessments, completing OSDI, MGD (MGDQ), and KEPAQ questionnaires. Clinical measures included NITBUT, Schirmer, and meibography. Pearson correlations and path analysis assessed relationships between DE and MGD symptoms and KEPAQ-F/E. Results: Forty-five KC participants (mean age: 45 ± 13, range: 20–69 years, 25 males) were enrolled; 22 (49%) had DE, and 15 (33%) had MGD. Significant correlations were observed between KEPAQ-E (2.9 ± 3.0 Logit) and KEPAQ-F (1.7 ± 3.0 Logit) scores with OSDI (26.5 ± 26.7) and MGDQ (3.3 ± 2.2) scores, and all Belin outcome measures A-D for all participants. In participants with diagnosed dry eye, KEPAQ E and F were also significantly correlated with loss of meibomian glands in the lower eyelids (R = −0.44, p = 0.04). Path analysis showed both DE and MGD were negatively correlated with lower KEPAQ-E and KEPAQ-F scores, with DE symptoms were more influential (p < 0.05). The model explained 42% of the KEPAQ-E variance and 41% of the KEPAQ-F variance. Conclusions: Emotional and functional quality of life in KC is significantly and negatively related to DE and MGD symptoms, with DE symptoms exhibiting a greater impact. Furthermore, greater loss of meibomian glands in the lower eyelids is significantly associated with reduced emotional and functional KEPAQ scores in DE patients. These results underscore the critical importance of evaluating DE in KC to improve patient-reported outcomes. Full article

Background and Objectives: Transcatheter heart valve (THV) selection is challenging as self-expanding valves (SEVs) are associated with lower post-procedural mean aortic gradients, while balloon-expandable valves (BEVs) have lower rates of paravalvular leak (PVL) and permanent pacemaker implantation (PPI). We aimed to compare the 30-day and 1-year outcomes following Myval BEV (Meril Life Sciences, Vapi, Gujarat, India) and intra-annular Portico SEV (Abbott, St. Paul, MN, USA) implantation. Materials and Methods: We retrospectively analyzed the data from the all-comer TAVI registry of the University Medical Centre Ljubljana, Slovenia, from October 2017 to August 2023. Safety and efficacy outcomes following Myval BEV and Portico SEV implantation were compared overall and after propensity score matching. Results: Of the total 1152 THVs implanted, 97 patients (8%) received a Myval BEV and 47 (4%) a Portico SEV. After propensity score matching, there were no significant differences between the two patient cohorts regarding 30-day (Myval 0.0% vs. Portico 2.9%, p = 1.000) and 1-year mortality (Myval 0.0% vs. Portico 5.9%, p = 0.492). Likewise, the rates of new PPI, device failure (mean aortic gradient and more than mild PVL), and periprocedural in-hospital complications were comparable between the two groups. Conclusions: In this retrospective analysis of two intra-annular THVs, the Myval BEV was associated with comparable short- and mid-term outcomes as the Portico SEV. Full article

Anomalies of coronary artery origins are rare but significant conditions that can range from benign to life-threatening. Early detection through imaging is crucial in preventing adverse outcomes. The treatment strategy varies depending on the type and severity of the anomaly, ranging from pharmacological treatment to surgery. A 22-year-old male patient, after syncope, after excluding other causes, had an exercise drill test, which was clinically negative and ECG-positive. Angio-CT revealed an undeveloped left main coronary artery (LMCA), and the circulation was supplied through the right coronary artery (RCA). The RCA provides the left anterior descending artery (LAD), and the LAD retrogradely supplies the left circumflex artery (LCX). The myocardial perfusion scintigraphy showed a slight lack of perfusion in the anterior wall (6% of total perfusion). The patient was qualified for further observation. A 77-year-old female underwent cardiac CT due to stenocardia. CT showed a lack of LMCA. The initial segment of the RCA gave rise to the left coronary artery (LCA), which encircled the aortic bulb posteriorly and bifurcated into branches resembling the LCX and LAD. After the Heart Team consultation, the patient was deemed eligible for conservative treatment. Angio-CT is a valuable tool for detecting coronary artery anomalies. Full article

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

Approximately 185,000 people in the United states experience limb loss each year. There is a need for an intuitive neural interface that can offer high-fidelity control signals to optimize the advanced functionality of prosthetic devices. Regenerative peripheral nerve interface (RPNI) is a pioneering advancement in neuroengineering that combines surgical techniques with biocompatible materials to create an interface for individuals with limb loss. RPNIs are surgically constructed from autologous muscle grafts that are neurotized by the residual peripheral nerves of an individual with limb loss. RPNIs amplify neural signals and demonstrate long term stability. In this narrative review, the terms “Regenerative Peripheral Nerve Interface (RPNI)” and “RPNI surgery” are used interchangeably to refer to the same surgical and biological construct. This narrative review specifically focuses on RPNIs as a targeted approach to enhance prosthetic control through surgically created nerve–muscle interfaces. This area of research offers a promising solution to overcome the limitations of existing prosthetic control systems and could help improve the quality of life for people suffering from limb loss. It allows for multi-channel control and bidirectional communication, while enhancing the functionality of prosthetics through improved sensory feedback. RPNI surgery holds significant promise for improving the quality of life for individuals with limb loss by providing a more intuitive and responsive prosthetic experience. Full article

Background: Neurogenic bladder (NB) in children may lead to recurrent urinary tract infections (UTIs), renal deterioration, and a reduced quality of life. Clean intermittent catheterization (CIC) is the standard of care, but in some patients, CIC may be unfeasible due to anatomical, sensory, or compliance issues. Button cystostomy (BC) has emerged as a minimally invasive, bladder-preserving alternative. This study aimed to assess the feasibility, safety, and outcomes in the long-term of BC in pediatric NB patients. Methods: Retrospective analysis was conducted on children with NB who underwent endoscopic BC placement between January 2020 and December 2024 in a tertiary pediatric center. Demographic data, operative time, complications, and follow-up outcomes were collected. All procedures used an endoscopic approach with cystoscopic guidance for safe device placement. Results: Thirty-three patients (25 males; median age 7.96 years) underwent BC placement. Most had spinal dysraphism (63.6%). The mean operative time was 48.5 ± 6 min. During a mean follow-up of 2.1 ± 1.4 years, five patients (15.2%) had febrile UTIs and two had minor leakage. No major complications occurred. Four buttons were removed due to clinical improvement (N = 1), the fashioning of a continent derivation (N = 1) and implantation of a sacral neuromodulator (N = 2); two patients accepted CIC. Satisfaction was reported by 93.9% of families. Conclusions: BC is an effective, minimally invasive alternative for urinary drainage in children with NB, even when compared to continent diversion techniques such as the Mitrofanoff, due to its lower invasiveness, greater feasibility, and lower complication rate. Broader adoption may be warranted, but prospective studies are needed to confirm long-term outcomes. Full article

Sustainable investments in construction are essential for the development of communities and for reducing environmental impacts. This study analyzes two scenarios: rehabilitation of an existing building and construction of a new NZEB-compliant building, based on a life cycle cost–benefit analysis. The results show that both scenarios generate negative Net Present Values (NPVs) due to the social nature of the project, but the new NZEB building presents superior performance (NPV: USD –2.61 million vs. USD –3.05 million for rehabilitation) and lower operational costs (USD 1.49 million vs. USD 1.92 million over 30 years). Key financial indicators (IRR, CBR), sensitivity analysis, and discount rate variation support the conclusion that the NZEB scenario ensures greater economic resilience. This study highlights the relevance of extended LCCBA in guiding sustainable investment decisions in social infrastructure. Full article