Search Results (27,374)

Background: Breast and hematological cancer treatments, especially with anthracyclines, have been shown to be associated with an increased risk of cardiotoxicity (CTX). An accurate prediction of cardiotoxicity risk and early detection of myocardial injury may allow for effective cardioprotection to be instituted and tailored to reverse cardiac dysfunction and prevent the discontinuation of essential cancer treatments. Objectives: The PRoactive Evaluation of Function to Evade Cardio Toxicity (PREFECT) study sought to evaluate the ability of fast-strain-encoded (F-SENC) cardiac magnetic resonance imaging (CMR) and 2D echocardiography (2D Echo) to stratify patients at risk of CTX prior to initiating cancer treatment, detect early signs of cardiac dysfunction, including subclinical CTX (sub-CTX) and CTX, and monitor for recovery (REC) during cardioprotective therapy. Methods: Fifty-nine patients with breast cancer or lymphoma were prospectively monitored for CTX with F-SENC CMR and 2D Echo over at least 1 year for evidence of cardiac dysfunction during anthracycline based chemotherapy. F-SENC CMR also monitored myocardial deformation in 37 left ventricular (LV) segments to obtain a MyoHealth risk score based on both longitudinal and circumferential strain. Sub-CTX and CTX were classified based on pre-specified cardiotoxicity definitions. Results: CTX was observed in 9/59 (15%) and sub-CTX in 24/59 (41%) patients undergoing chemotherapy. F-SENC CMR parameters at baseline predicted CTX with a lower LVEF (57 ± 5% vs. 61 ± 5% for all, p = 0.05), as well as a lower MyoHealth (70 ± 9 vs. 79 ± 11 for all, p = 0.004) and a worse global circumferential strain (GCS) (−18 ± 1 vs. −20 ± 1 for all, p < 0.001). Pre-chemotherapy MyoHealth had a higher accuracy in predicting the development of CTX compared to CMR LVEF and 2D Echo LVEF (AUC = 0.85, 0.69, and 0.57, respectively). The 2D Echo parameters on baseline imaging did not stratify CTX risk. F-SENC CMR obtained good or excellent images in 320/322 (99.4%) scans. During cancer treatment, MyoHealth had a high accuracy of detecting sub-CTX or CTX (AUC = 0.950), and the highest log likelihood ratio (indicating a higher probability of detecting CTX) followed by F-SENC GLS and F-SENC GCS. CMR LVEF and CMR LV stroke volume index (LVSVI) also significantly worsened in patients developing CTX during cancer treatment. Conclusions: F-SENC CMR provided a reliable and accurate assessment of myocardial function during anthracycline-based chemotherapy, and demonstrated accurate early detection of CTX. In addition, MyoHealth allows for the robust identification of patients at risk for CTX prior to treatment with higher accuracy than LVEF. Full article

Soil sealing and land take are increasingly recognised as critical environmental and land use planning challenges across Europe. Although these issues have received limited attention in Baltic policymaking and the academic literature to date, available data indicate ongoing land consumption despite population decline. This study aims to analyse soil sealing patterns in Estonia, Latvia, and Lithuania between 2018 and 2021 using CLC+ Backbone data, linking them to demographic shifts and local planning frameworks. Results reveal that soil sealing increased in nearly all municipalities across the Baltic states, regardless of population trends. The analysis highlights that shrinking municipalities, constrained by limited resources and declining populations, are structurally disadvantaged in terms of land use efficiency, particularly when measured by sealed area per capita. Moreover, this study discusses emerging policy tensions, including the narrowing conceptual gap between land take and soil sealing in the proposed EU Soil Monitoring and Resilience Directive, as well as the risk of overlooking broader land artificialisation. The findings underscore the need for context-sensitive, multi-scalar approaches to land use monitoring and governance, particularly in sparsely populated and demographically imbalanced regions, such as the Baltic states. Full article

This comprehensive study investigates the spatial distribution of metals in surface water, their accumulation in fish tissues, and their impact on the gut microbiome dynamics of fish in the Qi River, Huanggang City, Hubei Province. Three distinct sampling regions were established: the mining area (A), the transition area (B), and the distant area (C). Our results revealed that metal concentrations were highest in the mining area and decreased with increasing distance from it. The bioaccumulation of metals in fish tissues followed the order of gut > brain > muscle, with some concentrations exceeding food safety standards. Analysis of the gut microbiota showed that Firmicutes and Proteobacteria dominated in the mining area, while Fusobacteriota were more prevalent in the distant area. Heavy metal pollution significantly altered the composition and network structure of the gut microbiota, reducing microbial associations and increasing negative correlations. These findings highlight the profound impact of heavy metal pollution on both fish health and the stability of their gut microbiota, underscoring the urgent need for effective pollution control measures to mitigate ecological risks and protect aquatic biodiversity. Future research should focus on long-term monitoring and exploring potential remediation strategies to restore the health of affected ecosystems. Full article

Background: The influence of hospitalization owing to pneumonia on changes in body composition has not been specifically reported. We conducted a prospective cohort study of patients with community-acquired pneumonia (CAP) requiring hospitalization to test the hypothesis that hospitalization affects body composition. Methods: Sixty-four consecutive patients with CAP were recruited. Body composition was measured within 24 h of admission and 24 h before discharge using bioelectrical impedance analysis. The association between changes in body composition and variables obtained at admission was investigated. Index values were calculated as weight divided by height squared. Results: The mean age of the patients was 76.0 ± 8.7 years (78.1% males). The median length of hospitalization was 12.0 days. Weight, body mass index (BMI), skeletal muscle (SM), SM index, fat-free mass (FFM), and FFM index significantly decreased (p < 0.001 for each), but fat mass (FM) and FM index did not. The serum total protein level was the only independent predictor of the lowest quartile of change in SM index (<−0.4) after adjusting for age and sex (p = 0.004). Conclusions: In summary, weight and BMI significantly decreased during hospitalization in patients with CAP, which was attributed to SM reduction. Patients with low serum total protein levels on admission were at risk of an accelerated decrease in the SM index. Nutritional intervention and rehabilitation are important for these patients. Full article

Background: Patients with mastocytosis may present with exacerbated respiratory symptoms and lung diseases resulting from mast cell mediator release. However, their prevalence and severity level remain under debate. The study aims to analyze the prevalence of respiratory symptoms and the usefulness of lung function tests like spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), and high-resolution computed tomography (HRCT) of the chest in mastocytosis patients presenting with dyspnea, cough, and exercise intolerance. Methods: We included 104 patients with mastocytosis and 71 healthy controls. Data collection encompassed patient interview, clinical examination, spirometry, DLCO, and chest HRCT. Diagnosis of mastocytosis included bone marrow biopsies and serum tryptase measurements. Results: Compared to controls, patients with mastocytosis exhibited significantly lower values in FEV1/VC ratio, absolute DLCO/VA, predicted DLCO/VA, absolute DLCOcSB, and predicted DLCOcSB (p < 0.001). Commonly reported respiratory symptoms included dyspnea (36.5%), chest tightness (22.1%), and wheezing (9.6%). Airway obstruction was identified in 7.7% of patients; however, it appeared to be independent of the mastocytosis subtype. A decreased DLCO/VA ratio was observed in 4.8% of patients, but HRCT did not reveal any evidence of underlying lung disease. Conclusions: Mastocytosis appears to be a risk factor for the occurrence and exacerbation of respiratory symptoms. However, airway obstruction and impairment of the alveolar–capillary membrane seem to occur independently of the clinical subtype of mastocytosis. Additionally, the causal relationship between pulmonary involvement, mast cell infiltration of the alveolar–capillary membrane, and the systemic circulation of mast cell mediators remains unclear and requires further research. Full article

Objectives: The aim of this study was to evaluate the impact of four working heights on lumbar biomechanics during wall construction tasks, focusing on work-related musculoskeletal disorders (WMSDs). Methods: Fifteen young male participants performed simulated mortar-spreading and bricklaying tasks while actual body movements were recorded using Inertial Measurement Unit (IMU) sensors. Muscle activities of the lumbar erector spinae (ES), quadratus lumborum (QL), multifidus (MF), gluteus maximus (GM), and iliopsoas (IL) were estimated using a 3D musculoskeletal (MSK) model and measured via surface electromyography (sEMG). The analysis of variance (ANOVA) test was conducted to identify the significant differences in muscle activities across four working heights (i.e., foot, knee, waist, and shoulder). Results: Findings showed that working at foot-level height resulted in the highest muscle activity (7.6% to 40.6% increase), particularly in the ES and QL muscles, indicating an increased risk of WMSDs. The activities of the ES, MF, and GM muscles were statistically significant across both tasks and all working heights (p < 0.01). Conclusions: Both MSK and sEMG analyses indicated significantly lower muscle activities at knee and waist heights, suggesting these as the best working positions (47 cm to 107 cm) for minimizing the risk of WMSDs. Conversely, working at foot and shoulder heights was identified as a significant risk factor for WMSDs. Additionally, the similar trends observed between MSK simulations and sEMG data suggest that MSK modeling can effectively substitute for sEMG in future studies. These findings provide valuable insights into ergonomic work positioning to reduce WMSD risks among wall construction workers. Full article

Background/Objectives: Platelets play a role in bone metabolism and fracture healing. This study aimed to investigate the association between platelet indices and the derived systemic immune inflammation index (SII) with fracture risk in postmenopausal women. Methods: Platelet count, mean platelet volume, platelet distribution width (PDW), platelet crit, percentage of large platelets (P-LCR), platelet–lymphocyte ratio, and the SII, calculated as (NxP)/L, where N, P, and L represented neutrophils, platelets and lymphocytes counts, respectively, were evaluated. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Results: A total of 124 women (mean age 68.4 ± 9 years) were stratified into two groups based on the median platelet count; the “lower platelet count group” (n = 58) had a count of 200,000 (174,000 to 226,000), while the “higher platelet count group” (n = 66) had a count of 281,500 (256,500 to 308,500). The higher platelet count group showed a higher hip fracture risk (7.4 vs. 4.5%, p = 0.08) and lower lumbar spine BMD (0.773 vs. 0.83 gr/cm², p = 0.03). By dividing the participants into two groups with higher SSI (950,848.6 ± 746,097.99) (n = 61) and lower SII (355,751.2 ± 88,662.6) (n = 63), the group with the higher SII showed the higher hip fracture risk (7.4 vs. 3.6%, p = 0.01). Univariate regression analysis revealed correlations between chronological age and PDW (r = 0.188, p = 0.047), and P-LCR (r = 0.208, p = 0.03), as well as associations between vitamin D status and P-LCR (r = −0.301, p = 0.034), and between SII and hip fracture risk (r = 0.12, p = 0.007). Conclusions: Platelet count and SII were associated with fracture risk in postmenopausal women undergoing osteoporosis assessment. Given their reproducibility and cost-effectiveness, these markers warrant further investigation in future prospective studies focused on bone fragility. Full article

Environmental protection has become one of the key challenges of our time. This has led to an increase in pro-environmental activities in the field of cosmetics and household chemicals, where manufacturers are increasingly trying to meet the expectations of consumers who are aware of the potential risks associated with the production of cosmetics and household chemistry products. This is one of the most important challenges of today’s industry, given that some of the raw materials still commonly used, such as surfactants, may be toxic to aquatic organisms. Many companies are choosing to use natural raw materials that have satisfactory performance properties but are also environmentally friendly. In addition, modern products are also characterized by reduced consumption of water, resources, and energy in production processes. These measures reduce the carbon footprint and reduce the amount of plastic packaging required. In the present study, seven formulations of environmentally friendly car shampoo concentrates were developed, based entirely on mixtures of bio-based surfactants. The developed formulations were tested for application on the car body surface, allowing the selection of the two best products. For these selected formulations, an in-depth physicochemical analysis was carried out, including pH, density, and viscosity measurements. Comparison of the results with commercial products available on the market was also performed. Additionally, using the multiple light scattering method, the foamability and foam stability were determined for the car shampoos developed. The results obtained indicate the very high application potential of the products under study, which combine high performance and environmental concerns. Full article

Phubbing, a relatively new phenomenon in the field of digital risks, refers to the act of ignoring someone in favor of focusing on a smartphone during face-to-face interactions. Parental phubbing, a specific form of this behavior, is a prevalent negative parenting practice that can affect parent–child relationships and child development. However, the impact of parental phubbing on the emotional and behavioral development of preschool children remains unclear. This study aims to explore the relationship between parental phubbing and preschoolers’ behavioral problems, as well as test whether parents’ mindful attention awareness (MAA) acts as a mediator between them. Method: A questionnaire was administered to 138 Italian parents (mean age = 38.5, SD = 6.2) of 138 kindergarten preschoolers (mean age = 3.9, SD = 1.03). Questionnaires included the Generic Scale of Phubbing (GSP), the Mindful Attention Awareness Scale (MAAS), and the Strengths and Difficulties Questionnaire (SDQ). Results: Analyses revealed a significant negative correlation between the MAAS and SDQ total scores, a positive correlation between the GSP total score and the SDQ total score, and a negative correlation between the GSP total score and the MAAS total score. The mediation analysis did not show a direct effect of GSP on SDQ, suggesting that parental phubbing did not directly predict children’s behavioral difficulties. Nevertheless, the indirect effect measured by bootstrapping was significant, indicating that parental MAA fully mediated the relationship between parental phubbing and preschoolers’ problematic behaviors. Conclusions: Although further research is needed, parental mindfulness may influence phubbing behaviors in parents providing valuable insights for early interventions aimed at reducing problem behaviors in young children. Full article

Background/Objectives: Hyperlipidemia is a major risk factor for cardiovascular disease and atherosclerosis. Polyphenols found in polyphenol-rich extra virgin olive oil (EVOO) have been shown to possess strong antioxidant, anti-inflammatory, and cardioprotective properties. The present study aimed to assess the effects of two types of EVOO with different polyphenol content and dosages on the lipid profile of hyperlipidemic patients. Methods: In this single-blind, randomized clinical trial, 50 hyperlipidemic patients were randomized to receive either a higher-dose, lower-phenolic EVOO (414 mg/kg phenols, 20 g/day) or a lower-dose, higher-phenolic EVOO (1021 mg/kg phenols, 8 g/day), for a period of 4 weeks. These doses were selected to ensure equivalent daily polyphenol intake in both groups (~8.3 mg of total phenols/day), based on chemical analysis performed using NMR spectroscopy. The volumes used (8–20 g/day) reflect typical daily EVOO intake and were well tolerated by participants. A group of 20 healthy individuals, separated into two groups, also received the two types of EVOO, respectively, for the same duration. Primary endpoints included blood levels of total blood cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, lipoprotein-a (Lpa), and apolipoproteins A1 and B. Measurements were performed at baseline and at the end of the 4-week intervention. Linear mixed models were performed for the data analysis. Results: The higher-phenolic, lower-dose EVOO group showed a more favorable change in total blood cholesterol (p = 0.045) compared to the lower-phenolic, higher-dose group. EVOO intake was associated with a significant increase in HDL (p < 0.001) and reduction in Lp(a) (p = 0.040) among hyperlipidemic patients in comparison to healthy individuals. Conclusions: EVOO consumption significantly improved the lipid profile of hyperlipidemic patients. Higher-phenolic EVOO at lower dosages appears to be more effective in improving the lipid profile than lower-phenolic EVOO in higher dosages. Full article

Background/Objectives: Malnutrition is an imbalance of nutrients required for growth, development, and organ function. Its impact on bone development is known, but its effects on cartilage remain unclear. This study aimed to evaluate the femoral cartilage thickness in children with primary malnutrition. Methods: In this cross-sectional observational study, 83 children with primary malnutrition and 62 age- and sex-matched healthy controls were included. Patients with primary malnutrition were classified as mild, moderate and severe. Femoral cartilage thickness measurements of all children were taken by ultrasound from the femoral lateral condyle, femoral medial condyle and intercondylar area for both knees with the patient in a supine position with the knees flexed 90 degrees. Results: The right lateral, right medial, left lateral, and left medial femoral cartilages were significantly thicker in patients with malnutrition compared to those without malnutrition (p = 0.002, 0.004, <0.001, and 0.001, respectively). A significant negative correlation was found between age, weight Z-score, and height Z-score and triceps skinfold thickness. Conclusions: Distal femoral cartilage thickness is significantly greater in children with primary malnutrition. This demonstrates the effect of nutritional factors on cartilage tissue and suggests that children with chronic malnutrition are at risk for both knee joint problems and short stature later in life. Full article

The premature senescence of red raspberry leaves severely affects plant growth. In this study, the double-season red raspberry cultivar ‘Polka’ was used, with N₁₅₀ (0.10 g N·kg⁻¹) selected as the treatment group (T150) and N₀ (0 g N·kg⁻¹) set as the control (CK). This study systematically investigated the mechanism of premature senescence in red raspberry leaves under different nitrogen application levels by measuring physiological parameters and conducting a combined multi-omics analysis of transcriptomics and metabolomics. Results showed that T150 plants had 8.34 cm greater height and 1.45 cm greater ground diameter than CK. The chlorophyll, carotenoid, soluble protein, and sugar contents in all leaf parts of T150 were significantly higher than those in CK, whereas soluble starch contents were lower. Malondialdehyde (MDA) content and superoxide anion (O₂⁻) generation rate in the lower leaves of T150 were significantly lower than those in CK. Superoxide sismutase (SOD) and peroxidase (POD) activities in the middle and lower functional leaves of T150 were higher than in CK, while catalase (CAT) activity was lower. Transcriptomic analysis identified 4350 significantly differentially expressed genes, including 2062 upregulated and 2288 downregulated genes. Metabolomic analysis identified 135 differential metabolites, out of which 60 were upregulated and 75 were downregulated. Integrated transcriptomic and metabolomic analysis showed enrichment in the phenylpropanoid biosynthesis (ko00940) and flavonoid biosynthesis (ko00941) pathways, with the former acting as an upstream pathway of the latter. A premature senescence pathway was established, and two key metabolites were identified: chlorogenic acid content decreased, and naringenin chalcone content increased in early senescent leaves, suggesting their pivotal roles in the early senescence of red raspberry leaves. Modulating chlorogenic acid and naringenin chalcone levels could delay premature senescence. Optimizing fertilization strategies may thus reduce senescence risk and enhance the productivity, profitability, and sustainability of the red raspberry industry. Full article

Shaken Baby Syndrome (SBS) is one of the primary causes of fatal head trauma in infants and young children, occurring in about 33 per 100,000 infants annually in the U.S., with mortality rates being between 15% and 38%. Survivors frequently endure long-term disabilities, such as cognitive deficits, visual impairments, and motor dysfunction. Diagnosing SBS remains difficult due to the lack of visible injuries and delayed symptom onset. Existing detection methods—such as neuroimaging, biomechanical modeling, and infant monitoring systems—cannot perform real-time detection and face ethical, technical, and accuracy limitations. This study proposes an inertial measurement unit (IMU)-based detection system enhanced with machine learning to identify aggressive shaking patterns. Findings indicate that wearable-based motion analysis is a promising method for recognizing high-risk shaking, offering a non-invasive, real-time solution that could minimize infant harm and support timely intervention. Full article

Infection control and bleeding management in deep wounds remain urgent and unmet clinical challenges that demand innovative, multifunctional, and sustainable solutions. Unlike previously reported sodium alginate and silk fibroin-based gel formulations, the present work introduces a dual-functional system combining antimicrobial and haemostatic activity in the form of conformable aerogel beads. This dual-functional formulation is designed to absorb exudate, promote clotting, and provide localized antimicrobial action, all essential for accelerating wound repair in high-risk scenarios within a single biocompatible system. Aerogel beads were obtained by supercritical drying of a silk fibroin–sodium alginate blend, resulting in highly porous, spherical structures measuring 3–4 mm in diameter. The formulations demonstrated efficient ciprofloxacin encapsulation (42.75–49.05%) and sustained drug release for up to 12 h. Fluid absorption reached up to four times their weight in simulated wound fluid and was accompanied by significantly enhanced blood clotting, outperforming a commercial haemostatic dressing. These findings highlight the potential of silk-based aerogel beads as a multifunctional wound healing platform that combines localized antimicrobial delivery, efficient fluid and exudate management, biodegradability, and superior haemostatic performance in a single formulation. This work also shows for the first time how the prilling encapsulation technique with supercritical drying is able to successfully produce silk fibroin and sodium alginate composite aerogel beads. Full article

The siphon effect between airports has amplified the polarization in passenger throughput, undermining the balanced development and sustainability of airport clusters. The airport siphon effect occurs when one airport attracts a disproportionate share of passengers, concentrating traffic at the expense of others, which affects the overall resilience of the entire airport cluster. To address this issue, this study proposes a siphon index, expands the range of ground transportation options for passengers, and establishes a zero-siphon model to assess the impact of siphoning on the resiliency of airport clusters. Using this framework, four major airport clusters in China were selected as research subjects, with regional aviation accessibility serving as a measure of resilience. The results showed that among the four airport clusters, the siphon effect is most pronounced in the Guangzhou region. To explore the implications of this effect further, three airport disruption scenarios were simulated to assess the resilience of the Pearl River Delta airport cluster. The results indicated that the intensity and timing of disruptive events significantly affect airport cluster resilience, with hub airports being particularly sensitive. This study analyzes the risks associated with excessive route concentration, providing policymakers with critical insights to enhance the sustainability, equity, and resilience of airport clusters. The proposed strategies facilitate coordinated infrastructure development, optimized air–ground intermodal connectivity, and risk mitigation. These measures contribute to building more sustainable and adaptive aviation networks in rapidly urbanizing regions. Full article