Search Results (3,183)

Background/Objectives: Burn injuries are a major public health concern. This study estimated global, regional, and national burn burdens by total body surface area from 1990 to 2021 and projected trends to 2050. Methods: Utilizing data from the Global Burden of Disease Study 2021, we examined the prevalence, mortality, and years lived with disability (YLDs) according to age, sex, and region. Future trends were predicted using Bayesian meta-regression models and Das Gupta decomposition analysis. Results: In 2021, global prevalence was 12.99 million for severe burns and 235.34 million for mild burns, with age-standardized rates of 158.75 and 2815.26 per 100,000. Severe burns were highest in Southern Latin America (7836.51 per 100,000) and mild burns in the Caribbean (626.94 per 100,000). The largest declines from 1990 to 2021 were in high-income North America for severe burns (−38.22%) and East Asia for mild burns (−73.03%). Females had higher severe burn prevalence at younger and older ages, while males had higher mild burn prevalence from early adulthood. Leading risk factors were fire, heat, and hot substances (38.22% of severe burn YLDs; 53.87% for mild burns). By 2050, severe burns are projected to rise by 233.4% and mild burns by 142.5%, with Eastern Europe showing the largest growth. Conclusions: Although age-standardized burn rates are declining, absolute cases are projected to rise due to population growth and aging, particularly in low- and middle-income countries, underscoring the need for stronger prevention and improved burn care infrastructure. Full article

The transition from three-dimensional (3D) to four-dimensional (4D)-bioprinting marks a significant advancement in tissue engineering and drug delivery. 4D-bioprinting offers the potential to more accurately mimic the adaptive qualities of living tissues due to its dynamic flexibility. Structures created with 4D-bioprinting can change shape in response to internal and external stimuli. This article reviews the background, key concepts, techniques, and applications of 4D-bioprinting, focusing on its role in tissue scaffolding and drug delivery. We discuss the limitations of traditional 3D-bioprinting in providing customized and sustained medication release. Shape memory polymers and hydrogels are examples of new responsive materials enabled by 4D-bioprinting that can enhance drug administration. Additionally, we provide a thorough analysis of various biopolymers used in drug delivery systems, including cellulose, collagen, alginate, and chitosan. The use of biopolymers in 4D-printing significantly increases material responsiveness, allowing them to react to stimuli such as temperature, light, and humidity. This capability enables complex designs with programmable shape and function changes. The expansion and contraction of hydrogels in response to temperature changes offer a practical method for controlled drug release. 4D-bioprinting has the potential to address significant challenges in tissue regeneration and medication administration, spurring ongoing research in this technology. By providing precise control over cell positioning and biomaterial integration, traditional 3D-bioprinting has evolved into 4D-bioprinting, enhancing the development of tissue constructs. 4D-bioprinting represents a paradigm shift in tissue engineering and biomaterials, offering enhanced possibilities for creating responsive, adaptive structures that address clinical needs. Researchers can leverage the unique properties of biopolymers within the 4D-printing framework to develop innovative approaches for tissue regeneration and drug delivery, leading to advanced treatments in regenerative medicine. One potential future application is in vivo tissue regeneration using bioprinted structures that can enhance the body’s natural healing capabilities. Full article

Background/Objectives: Preoperative sarcopenia in liver transplantation (LT) recipients is an important prognostic factor of LT outcomes. Systemic inflammatory status (SIS) has been proposed as a unifying mechanism for skeletal muscle loss; thus, considering SIS and sarcopenia together may enhance prognosis assessment in patients undergoing LT. Herein, we aimed to describe the relationship between the SIS and skeletal muscle index (SMI) with short-term and long-term mortality post-living donor LT (LDLT). Methods: In total, 3387 consecutive adult LDLT recipients were retrospectively evaluated. The neutrophil-to-lymphocyte ratio (NLR, using a cut-off of 3) was utilized as an SIS. SMI was calculated using computed tomography scans, measured at the third lumbar vertebra; sex-specific cut-offs were determined from contemporary donors. Univariate and multivariable Cox proportional hazard analyses were performed. Results: Decreasing SMI was associated with increasing NLR. Increasing NLR and decreasing SMI both showed dose-dependent relationships with a risk of 90-day mortality. Within sarcopenic patients, NLR > 3 (vs. NLR ≤ 3) was associated with higher 90-day (9.3% vs. 3.5%, p = 0.049) and overall mortality (28.4% vs. 19.1%, p = 0.045). Sarcopenia and NLR > 3 (vs. neither) were independent predictors of 90-day mortality (hazard ratio [HR] 2.48 [1.40–4.40], p = 0.002) and overall mortality (HR, 1.81 [1.37–2.38], p < 0.001) after multivariable adjustment. When stratified by age, sex, and MELD score, the association between sarcopenia and overall mortality persisted in all subgroups, with the highest risk observed in women (HR 3.43, 95% CI 1.83–6.43). Conclusions: Sarcopenia, with the systemic inflammatory response, nearly doubled the risk of 90-day and overall mortality post-LT, proposing that these readily available biomarkers are a practical index for predicting survival post-LT. Considering that these are potentially modifiable factors, our result may provide a new therapeutic target to improve survival post-LT. Full article

This study analyses how early childhood teachers experience their local curricula-updating process provoked by the national policy changes. This is a relevant problem related to teachers’ agency, which is critical in supporting and developing curriculum policies or opposing them. The hermeneutic phenomenological approach (van Manen) was used to uncover the pre-reflective lived experiences of teachers through phenomenological interviews with 16 teachers. The lived experiences of local curriculum updates triggered by the national preschool curriculum guideline were a dualistic phenomenon manifesting as open and hidden voices of teachers. The open voices metaphor revealed the pre-reflective experiences increasing the openness of teachers to changes, while the hidden voices represented a pre-reflective experience of threat to established concepts and practices resulting in defensive reactions. These dualistic experiences appeared in five emergent categories: resonating body: vitality vs. freezing (Corporeality); teamwork during a critical moment: safe sustainability vs. uncertainty (Relationality); competing spatial perspectives: new possibilities vs. conflicting visions (Spatiality); altered perception of time: third wave vs. lost time (Temporality); and awakened existential questions: intentional self-reflection vs. conflict of roles (Existentiality). This paper highlights tensions between the national policies and the professional authenticity of teachers and the importance of teachers’ agency in the change context. Full article

Background/Objectives: The increasing emphasis on early mobilization in intensive care units (ICUs) has underscored the need for quick, simple, and reliable tools to assess patients’ mobilization levels. The ICU Mobility Scale (IMS) was developed to address this need and has been translated into a Japanese version. This study aimed to evaluate the construct and predictive validity of the Japanese version of the IMS in critically ill patients. Methods: This was a secondary analysis of the EMPICS study, which included patients who stayed in ICUs for at least 48 h. The Japanese version of the IMS and physical function were assessed at ICU discharge. At hospital discharge, outcomes such as walking ability, discharge destination, activities of daily living (ADL) dependency, ICU-acquired weakness, and physical impairment were evaluated. At 90-day follow-up, the presence of post-intensive care syndrome (PICS) was assessed using quality of life scores, and mortality data were collected. Construct and predictive validity were analyzed using Spearman’s rank correlation coefficients, the Mann–Whitney U test, and logistic regression analysis. Results: A total of 193 patients (mean age 68.2 years; 65.8% male) were included. The mean IMS score at ICU discharge was 5.6. The IMS score at ICU discharge showed significant correlations with the Barthel Index (ρ = 0.55, p = 0.001), Medical Research Council sum score (ρ = 0.45, p < 0.001), and grip strength (ρ = 0.44, p < 0.001), but not with body weight or sex. Logistic regression analyses demonstrated that a higher IMS score at ICU discharge was significantly associated with better physical outcomes at hospital discharge, a lower incidence of PICS, and reduced 90-day mortality. Conclusions: The Japanese version of the IMS demonstrated both construct and predictive validity in ICU patients. It is a useful tool for assessing daily mobilization levels in critical care settings. The findings may not be generalizable to all ICU patients due to the strict eligibility criteria. Full article

This on-farm study explored the effects of diverse pasture systems and seaweed bio-stimulants (AgriSea NZ Seaweed Products, Paeroa, New Zealand) on sheep performance, metabolic health, milk composition, and carcass characteristics. A 3 × 2 factorial design was used to compare three pasture systems; ryegrass-white clover (RW), a 23-species diverse mix (DI), and functionally diverse strip swards (ST), with (SW) or without (CO) a seaweed bio-stimulant. Ninety pregnant ewes were stratified by live weight and allocated across six treatment groups (15 ewes per treatment). Lambing occurred on treatment paddocks. At weaning, 90 lambs (15 per treatment) were selected based on body weight and sex balance to continue through to finishing. Pasture chemical composition differed among treatments: ST had lower fibre (neutral detergent fibre, NDF; acid detergent fibre, ADF) than RW and DI, while SW increased dry matter digestibility (DMD) and metabolisable energy (ME), and reduced NDF and ADF (p < 0.05). Strip pastures improved lamb average daily gain (ADG) by 17% from lambing to weaning compared to DI, and by 14% from weaning to finishing compared to RW (p < 0.05). Seaweed bio-stimulant treatment enhanced lamb ADG by up to 12% and improved carcass traits, including loin and shoulder yields (p < 0.05). Ewes and lambs on seaweed-treated pastures exhibited lower serum non-esterified fatty acid (NEFA) concentrations (p < 0.05), indicating better energy balance. Milk from ST and/or SW treated ewes had elevated omega-6 fatty acids and essential amino acids, suggesting enhanced nutritional value. These findings demonstrate that combining botanical diversity with natural bio-stimulants can improve animal growth, metabolic health, and product quality, offering a promising strategy for sustainable and welfare-oriented sheep production systems. Full article

Background: Load carriage is an activity of daily living, can be an occupational risk, and is a popular method of resistance training. Type of carry could be related to vascular and blood pressure (BP) responses and may be related to cardiovascular risk. As physical activity is recommended by clinicians and exercise physiologists, understanding the vascular responses in relation to type of carry is important to consider in terms of risk. The purpose of this study was to compare the vascular health and BP responses to the farmer’s handle (load at the side of the body) and zercher (load in front of the body) carry and to examine sex differences in the responses. Methods: A total of 38 adults (22 females and 16 males) completed farmer’s handle and zercher load carriage with pre- and post-vascular measurements using pulse wave analysis. Results: We found that load carriage with weight in front of the body (zercher) elicits a larger increase in arterial stiffness (AIx@75), and load carriage with the load on the side of the body (farmer’s handle) elicits a larger increase in peripheral systolic BP. There were no sex differences in the responses to carry. Females exercise (3.1 vs. 4.8) and weight train (1.5 vs. 2.6) fewer times per week and had a lower resting systolic BP (121.5 ± 10.3 vs. 131.3 ± 8.3 mmHg) (p < 0.05). Both types of load carriage increased peripheral systolic BP, central systolic BP, and vascular stiffness (p < 0.05). Conclusions: Location of load carriage is important to consider based on potential cardiac risk of patients. Full article

Cisplatin (CIS)-induced peripheral neuropathy and associated comorbidities have a detrimental effect on the lives of cancer patients. Currently, there are no effective therapies to alleviate these symptoms. Duloxetine (DULO) is a recommended treatment, but it is linked with important side effects, thus making it essential to explore novel approaches. We examined the impact of a prophylactic treatment with a low dose of DULO combined with hydrogen-rich water (HRW) on CIS-injected C57BL/6 male and female mice as a possible therapy for allodynia, muscle and body weight deficits, and emotive syndromes accompanying this type of chemotherapy. The prophylactic treatment with DULO and HRW prevented mechanical allodynia caused by CIS in both sexes and had greater effects than either treatment given individually. The combined treatment also prevented cold allodynia in male mice but only reduced it in females. Moreover, the coadministration of DULO with HRW avoided muscular deficits in both sexes. Furthermore, the body weight reduction induced by CIS in both sexes was not entirely mitigated by the combined therapy. However, all treatments avoided the anxiety- and depressive-like behaviors elicited by CIS. The antiallodynic actions and prevention of muscular deficits produced by the combined treatment might be explained by the inhibition of oxidative stress, inflammatory responses, and plasticity alterations provoked by CIS in the dorsal root ganglia of these subjects. This study proposes, for the first time, the cotreatment of DULO with HRW as an effective therapy for CIS-induced peripheral neuropathy and reveals the influence of sex on these actions. Full article

Preterm birth (PTB) is a major global public health concern with substantial impacts on neonatal morbidity and mortality. There is a growing body of evidence linking maternal exposure to fine particulate matter (PM_2.5) with PTB, and national birth cohort data from the Middle East remains sparse. We analyzed 3,839,531 singleton live births in Iran from 2013 to 2018. Monthly PM_2.5 concentrations during pregnancy were estimated using validated spatiotemporal models. Associations between prenatal PM_2.5 exposure and multiple PTB subtypes, moderate to late (MPTB), very (VPTB), and extremely preterm birth (EPTB), were assessed using multivariable logistic regression. A 10 μg/m³ increase in PM_2.5 was associated with increased odds of PTB (odds ratio [OR] = 1.048, 95% confidence interval [CI]: 1.044–1.051), MPTB (OR = 1.046, 95% CI: 1.042–1.049), VPTB (OR = 1.059, 95% CI: 1.048–1.070), and EPTB (OR = 1.064, 95% CI: 1.047–1.081), respectively. Age- and trimester-stratified analyses showed greater exposure-related risks among mothers aged 25–34 and during mid-pregnancy. We observed consistent evidence for a J-shaped exposure–risk pattern in overall and subgroup populations, suggesting a PM_2.5 threshold near 40 μg/m³. From 2013 to 2018, 6716 (95% CI: 5336–8678) PTB cases, representing 2.7% (95% CI: 2.2–3.5%) of total PTB, were attributable to PM_2.5 exposure exceeding the WHO first-stage interim target (IT1, 35 μg/m³). Our results suggested improved ambient PM_2.5 quality may substantially reduce PTB burden in Iran. Full article

Background: To personalize the care for persons with smoking-related lung disease, a thorough understanding of its etiology is essential. The role of pulmonary vessels remains poorly understood. Living at high altitude provides a natural model to investigate the effects of low oxygen levels on pulmonary vessels. This study aims to evaluate the relationship between living at high altitudes and small pulmonary vein and artery volumes. We hypothesize that small vein and artery volumes were independently associated with living at high altitude. Methods: We quantified small pulmonary vein and artery dimensions (ᴓ < 1 mm) on computed tomography (CT) down to 0.2 mm in diameter and normalized the dimensions by body surface area. In 8931 current and former smokers participating in the COPDGene study, we used multivariate regression models corrected for clinical and technical confounders. Results: 1262 residents (14.1%) were defined as high-altitude residents (~1600 m, Denver, CO, USA). Compared to lower-altitude residents, the high-altitude residents had a higher age (62.0 ± 9.1 vs. 59.6 ± 9.0 years), more pack-years smoked (46.8 vs. 44.1) and a lower FEV₁% predicted (64.6 ± 32.4% vs. 76.8 ± 25.2%). Both mean small artery volume (4.09 ± 0.89 mL/m² vs. 3.85 ± 0.90 mL/m²) and mean small vein volume (2.96 ± 0.53 mL/m² vs. 2.67 ± 0.53 mL/m²) were higher in high-altitude residents. Multivariate linear regression showed that, in those without COPD, high-altitude residents have a higher small vein volume (0.129 mL/m², p < 0.001) and higher small artery volume (0.170 mL/m², p = 0.001) compared to lower-altitude residents. There was no significant association in residents with COPD. Conclusions: In current and former smokers without COPD, higher small pulmonary vein and artery volumes were associated with living at high altitude, independent of lung disease or technical CT parameters. A potential cause includes vascular remodeling due to an elevated need for blood oxygen transport, which becomes concealed when COPD develops. Full article

Background/Objectives: Secular trends in children’s physical development are important indicators of population health, nutritional status, and socioeconomic conditions. This study aimed to assess long-term changes in the height, weight, Body Mass Index (BMI), and nutritional status of boys from Eastern Poland between 1986 and 2021. Methods: Anthropometric data were collected from 13,172 boys aged 8, 13, and 17 years at five time points (1986, 1996, 2006, 2016, and 2021). Standardized measurement protocols were used throughout the study. The BMI was calculated and categorized using international cut-off points for age and gender. Secular changes in the height, weight, and Body Mass Index (BMI) were analyzed using an analysis of variance (ANOVA) with post hoc tests, and differences in dietary categories were assessed using chi-square tests (p ≤ 0.05). Results: The height, weight, and BMI increased significantly across all ages. The largest height gain was seen in 13-year-olds, while the greatest BMI increase occurred between 2016 and 2021. The overweight and obesity prevalence rose sharply by an average of 21.70% across age groups, with the normal BMI prevalence decreasing by 18.41%. The underweight prevalence declined, especially among adolescents; however, this likely reflects a general upward shift in the BMI rather than a true nutritional improvement. Conclusions: Strong secular trends are evident, influenced by global and local socioeconomic factors, including Poland’s EU accession and the COVID-19 pandemic. While an increased height suggests better living standards, the rising overweight and obesity rates indicate emerging health risks. Due to the lack of direct lifestyle and socioeconomic data, further research incorporating these factors and the pubertal BMI variability is needed to clarify underlying causes. Targeted regional strategies promoting healthy diets, physical activity, and lifestyles are urgently required. Full article

Optimal commercial conditions have been shown to improve the performance and meat yield of broilers. Also, dietary 25-hydroxycholecalciferol (25OHD₃; crystalline form) has not shown a negative impact on chicken health when it was fed at 10 times (10×) higher than 69 μg/kg. The objectives of this study were to determine the effects of up to 8 times (8×) higher than the commercial level (69 μg/kg of feed) of dietary 25OHD₃ on the performance, breast meat yield, and serum 25OHD₃ concentration of broilers. Eighteen male chicks were randomly assigned to each of 20 pens within each of the two dietary treatments. Treatments were commercial diets containing 250 IU/kg of vitamin D₃ (control) for the starter [(0 to 14 days post-hatch (poh), grower (15 to 28 poh), and finisher (29 to 42 poh) dietary phases; or diets containing Hy-D (water-soluble source of 25OHD₃) that consisted of 552 (8×) μg/kg of 25OHD₃ for the starter, 276 (4×) μg/kg of 25OHD₃ for the grower, and 34.5 (0.5×) μg/kg of 25OHD₃ for the finisher dietary phases. Live performance variables as well as serum 25OHD₃ concentrations were measured in each dietary phase. At 14, 28, and 39 poh, breast meat yield that included pectoralis major (P. major) and pectoralis minor (P. minor) muscle weights was determined in ten replications per dietary treatment. Breast yield was also calculated by adding the values of the P. major and P. minor muscles. From 14 to 42 poh, the Hy-D diets decreased (p < 0.0001) broiler body weight (BW) and BW gain and increased (p < 0.0001) total mortality and feed conversion ratio in comparison to control treatment groups. In addition, birds fed Hy-D diets had significantly (p < 0.0001) lower P. major and breast meat yields from 14 to 39 poh as compared to those birds fed the control diet. Serum 25OHD₃ concentration was significantly (p < 0.0001) higher (10×) in birds that belonged to the Hy-D diet treatment than those in the control diet treatment group. These results indicate that the disproportionally high (8×) level of dietary 25OHD₃ resulted in detrimental effects on the performance and meat yield of broilers. A reduction in both performance and meat yield of broilers in response to the elevated level of dietary 25OHD₃ may have been due to vitamin D₃ toxicity, which can result in an association with the overproduction of the active form of the vitamin in response to elevated serum concentrations of 25OHD₃. Full article

Pain is a fundamental yet complex biological and psychosocial phenomenon. While acute pain serves as a defense mechanism, alerting the body to potential tissue damage, chronic pain loses this protective function and becomes a persistent, independent condition. Chronic pain in the elderly is particularly significant due to age-related changes in pain perception, a higher prevalence of comorbidities, and an increased susceptibility to pharmacological side effects. Diagnosing pain in older adults presents unique challenges owing to cognitive decline, multimorbidity, and impaired communication. This narrative review aims to summarize the current knowledge on chronic pain in the elderly, with a particular emphasis on diagnostic difficulties, therapeutic strategies, and the essential role of nurses in multidisciplinary management. Both objective scales and subjective assessment tools are essential for an accurate evaluation. Effective management requires a multidisciplinary approach that integrates individualized pharmacological and non-pharmacological therapies. Analgesic use must be tailored to account for altered pharmacokinetics and risks such as sedation or falls. Non-drug interventions, including physiotherapy and psychological techniques, are especially valuable in geriatric care. Nurses play a pivotal role in the recognition, assessment, and ongoing management of pain in this population. Developing age-appropriate, personalized strategies is essential for improving the quality of life in older adults living with chronic pain. Full article

Background/Objectives: Betulin is a promising agent in many areas of medicine and is being investigated, particularly in the field of cancer. However, in in vivo experiments, its water insolubility becomes a significant obstacle. This study describes a promising method for the administration of betulin in in vivo experiments and the determination of betulin levels in organ samples. Methods: Betulin was first dissolved in ethanol, and this solution was then mixed with acylglycerols, followed by evaporation of the ethanol. Olive oil and food-grade lard were determined to be suitable lipids for noninvasive application per os. A method for processing the organs of experimental animals for betulin determination was developed. Determination of betulin levels in blood is also likely the only viable option for use in future clinical studies and practice. Results: The maximum amount of betulin usable (i.e., absorbable by organisms) in olive oil (10 mg/mL), suppository mass (6 mg/mL), food lard (4 mg/mL), and cocoa butter (2 mg/mL) carriers was found microscopically. A specific distribution of betulin concentration in the organs of experimental animals (Wistar rats) after a weekly diet containing betulin was discovered. The blood was shown to be particularly advantageous, as it allows continuous monitoring of betulin levels in the body. In these pilot experiments, a statistically significant (p < 0.001) synergistic effect of betulin on solid Ehrlich adenocarcinoma tumors was observed when betulin was combined with cytostatic Namitecan (NMRI mice). The high-purity betulin used in this study is very stable even under fluctuating storage conditions. Conclusions: Our study suggests that both the method of betulin administration and the proposed analytical procedure could greatly increase the reliability and reproducibility of in vivo studies, as well as future preclinical and clinical studies on the effects of betulin and potentially other similar water-insoluble triterpenoids on living organisms. Full article

Obesity and related metabolic disorders are major global health challenges. Postbiotics, such as heat-inactivated probiotics, have attracted attention for their improved safety, stability, and potential metabolic benefits compared to live probiotics. However, the comparative anti-obesity effects and mechanisms of live versus heat-inactivated Lactiplantibacillus plantarum FRT4 remain unclear, so this study systematically evaluated their effects and mechanisms in high-fat-diet-induced obese mice. Mice received oral administration of live or heat-inactivated FRT4 (prepared by heating in a water bath at 80 °C for 5 min) for 16 weeks. Comprehensive analyses included metabolic profiling, histological evaluation, serum and liver biomarkers, gut microbiota composition, liver metabolomics, and transcriptomics. Both live and inactivated FRT4 significantly reduced body weight gain, adiposity, hepatic steatosis, and dyslipidemia, with inactivated FRT4 exhibiting comparable or superior efficacy. Notably, inactivated FRT4 restored gut microbiota composition, increased short-chain fatty acid production, and regulated hepatic metabolic pathways. Multi-omics analyses revealed modulation of lipid biosynthesis, amino acid metabolism, and energy utilization pathways. Specifically, the “biosynthesis of unsaturated fatty acids” pathway was downregulated in metabolomics and significantly enriched in transcriptomics, highlighting its central role in FRT4M-mediated metabolic reprogramming. These findings demonstrate that heat-inactivated Lp. plantarum FRT4 exerts systemic anti-obesity effects via gut–liver axis modulation, supporting its potential as a promising postbiotic intervention for obesity and metabolic dysfunction. Full article