Search Results (9,743)

Background/Objectives: Low-pressure hydrocephalus (LPH) is an underappreciated pathology in which patients present with ventriculomegaly and intracranial pressures (ICPs) below normal, making traditional pressure-driven cerebrospinal fluid diversion treatment strategies challenging. LPH has been observed in patients following traumatic brain injury (TBI), often within the neurocritical care unit (NCCU). However, its presentation and associated patient characteristics remain unclear. Thus, we sought to compile patients from our institution and the literature to characterize LPH after TBI. Methods: Eleven patients were identified from our institutional chart review. Additionally, we performed a scoping review using PRISMA guidelines, which yielded eight publications, resulting in a total of 46 patients with LPH after TBI. Results: The median age was 34 years (IQR 23 to 50.75), with 86.96% male. When used, ventriculoperitoneal shunt (VPS) valves were programmed to a median pressure setting of 45 mmH₂O (IQR 22 to 45). The median Glascow Outcome Scale-Extended (GOSE) score at 2–6 months post-shunt was 3 (IQR 2.25 to 4), indicating lower-severe disability and a 16.28% mortality. Conclusions: To our knowledge, this is the largest curation of TBI patients with LPH to date. From this pooled cohort, we observed that patients affected by LPH after TBI are often young to middle-aged and undergo multiple neurosurgical procedures prior to LPH diagnosis. Outcomes were poor with significant long-term disability and mortality. Clinicians should consider LPH diagnosis in TBI patients with hydrocephalus, especially if they have undergone prior neurosurgical procedures. Additionally, providers should recognize that these patients may potentially require lower opening pressures or certain pharmacological interventions compared to those with traditional post-traumatic hydrocephalus. Improved recognition of LPH after TBI can advance the understanding of the underlying mechanisms and inform treatment strategies. Full article

Background: Maternal overweight, obesity, and inappropriate gestational weight gain (GWG) are increasingly recognized as major contributors to adverse pregnancy outcomes worldwide. Elevated pre-pregnancy body mass index (BMI) is associated with gestational diabetes mellitus (GDM), hypertensive disorders, cesarean delivery, fetal overgrowth, and long-term cardiometabolic risks for both mother and child. Regional contemporary data from Bulgaria remain limited. Objective: The objective of this study was to evaluate trends in maternal obesity and gestational weight gain among pregnant women in Southeastern Bulgaria between 2021 and 2025, using a regional cohort from Burgas, and to assess associations with maternal and neonatal outcomes. Methods: This retrospective cohort study included 1176 singleton pregnancies registered for antenatal follow-up at MC Prime Clinic–Dr. Kirovakov Ltd., Burgas, Bulgaria, between January 2021 and December 2025. Women were classified according to World Health Organization BMI categories as underweight, normal weight, overweight, and obese. Gestational weight gain was categorized as below, within, or above Institute of Medicine recommendations. Maternal and neonatal outcomes were analyzed using comparative statistics and multivariable logistic regression. Results: The mean maternal age was 30.8 ± 5.4 years, and the mean pre-pregnancy BMI was 25.1 ± 4.8 kg/m². BMI distribution was: underweight 7.6%, normal weight 49.8%, overweight 27.9%, and obesity 14.7%. Overall, 42.6% of women entered pregnancy overweight or obese. Mean total GWG was 13.2 ± 5.6 kg. Excessive GWG occurred in 39.0% of women, while only 39.6% remained within recommended ranges. Excessive GWG was significantly more common among obese women (52.8%) than among women with normal BMI (34.7%, p < 0.001). Compared with women of normal BMI, obese women had significantly higher rates of gestational diabetes mellitus (16.7% vs. 5.8%), hypertensive disorders (12.9% vs. 4.2%), preeclampsia (8.4% vs. 2.1%), cesarean delivery (47.4% vs. 28.6%), macrosomia (14.5% vs. 6.1%), and preterm birth (10.7% vs. 6.9%) (all p < 0.05). In multivariable analysis, maternal obesity independently predicted GDM (aOR 2.94, 95% CI 1.82–4.73), preeclampsia (aOR 3.18, 95% CI 1.87–5.39), cesarean delivery (aOR 2.11, 95% CI 1.42–3.14), macrosomia (aOR 2.46, 95% CI 1.51–4.01), and preterm birth (aOR 1.67, 95% CI 1.02–2.74). Conclusions: Maternal obesity and excessive gestational weight gain were highly prevalent among pregnant women in Southeastern Bulgaria during 2021–2025 and were strongly associated with adverse maternal and neonatal outcomes. These findings support the need for preconception counseling, individualized antenatal weight management, and targeted regional public health strategies. Full article

Water-vapor removal from compressed air is governed by the product pressure dew point (PDP), dynamic bed utilization, hydraulic loss, regeneration demand, and cyclic reliability, yet activated-alumina studies are often interpreted from powder Brunauer–Emmett–Teller (BET) area or equilibrium uptake alone. This critical narrative review evaluates where evidence can and cannot be transferred across material, formed-particle, packed-bed, cycle, and field scales. It distinguishes equilibrium capacity, static test capacity, dynamic breakthrough capacity, and usable cycle capacity; conditionally compares desiccants and regeneration modes; and links PDP-defined breakthrough, mass-transfer-zone (MTZ)/length-of-unused-bed (LUB) measures, non-spherical-particle pressure drop, thermal waves, and regeneration endpoints. The available evidence supports several directional conclusions but not universal design values: alkali modification can increase uptake despite lower surface area; forming and binder chemistry alter accessible pores and strength; wall effects and particle geometry require measured hydrodynamic validation; and reported regeneration savings of approximately 27–40% are architecture-specific relative results rather than matched absolute energy benchmarks. A baseline-normalized diagnostic framework separates reversible regeneration faults and feed contamination from material aging and particle/bed degradation. The review identifies the central evidence gap as the absence of matched datasets reporting formed-body properties, adiabatic breakthrough, segmented pressure drop, regeneration energy, and long-cycle failure for the same material. It concludes with a standards-coverage map, a transparent screening sensitivity analysis, and a prioritized validation agenda. Full article

Common ash (Fraxinus excelsior L.) forms stands of significant ecological and economic importance. However, a progressing phenomenon known as ash dieback has been recorded in Europe since 1992. The cause is primarily attributed to the fungus Hymenoscyphus fraxineus, but the initial factor allowing for the pathogenic role of fungi may be the weakening of the stands related to changing habitat conditions. Standard (ground-based) analysis of habitat conditions is tedious and costly, but remote sensing methods allow for the use of new tools. Among these are spectral indices, including the normalized difference vegetation index (NDVI). The aim of the study was to demonstrate the usefulness of this index in assessing habitat conditions of ash stands in Poland, a country located at the center of the Fraxinus excelsior range. By testing all ash stands in Poland where the share of ash in the stand was at least 80%, habitat conditions diversity covering 19 forest habitat types and 15 soil types was demonstrated. The conducted statistical analyses indicate that the tested habitat parameters affect NDVI in a complex and non-linear manner. The analysis showed that stand age has a minimal impact on NDVI. This means that other factors are responsible for the rapid drops in NDVI values. Differences in NDVI values can be considered the resultant of various habitat factors, illustrating better or worse conditions for a given stand type. Thus, the NDVI index can serve as a decision-support tool for evaluating the extent to which a given forest habitat type meets the ecological requirements of common ash. Full article

Background: Genetic testing in autism spectrum disorder (ASD) can reveal a wide range of chromosomal and sequence-level abnormalities, yet large real-world neurology cohorts rarely report the full spectrum of findings alongside clinical correlates and patterns of testing. We characterized genetic findings in an 1884-patient ASD cohort and examined factors associated with both abnormal findings and the use of genetic testing. Methods: This retrospective cross-sectional study included 1884 patients. Genetic testing was performed in 1011 patients; the primary outcome was an abnormal versus normal genetic result among those tested. All 371 abnormal findings were catalogued in a de-identified supplement. The primary multivariable model included age, sex, seizure history, and EEG abnormality ( N = 901); an MRI-inclusive sensitivity model used 422 complete cases, and a separate full-cohort model evaluated factors associated with genetic testing. Results: Abnormal genetic findings were documented in 371/1011 tested patients (36.7%, 95% CI 33.7–39.8%). In the primary model, female sex (aOR 1.483, 95% CI 1.089–2.018; p = 0.012) and seizure history (aOR 1.634, 95% CI 1.136–2.352; p = 0.008) were independently associated with abnormal findings, whereas EEG abnormality was not significant after adjustment (aOR 1.373, p = 0.084). In the MRI-inclusive sensitivity model, female sex and seizure history remained significant, while MRI abnormality was not independently associated (aOR 1.235, p = 0.302). Genetic testing was more common among patients who also underwent EEG or MRI (both p < 0.001). Conclusions: More than one-third of tested patients had an abnormal genetic finding, spanning a broad range of copy-number, sequence, homozygosity, Fragile X-related, chromosomal, and syndromic findings. Seizure history and female sex were the principal adjusted correlates of abnormal findings. Genetic testing clustered with EEG and MRI use, reflecting observed patterns of neurological work-up within this cohort rather than temporal or causal relationships. Full article

Background: Participation in physical and sports activities is essential for the overall health of persons with disabilities (PWD). However, these individuals encounter multiple environmental and contextual barriers limiting sports engagement. Objective: This study aimed to analyze the perceived barriers to sports participation among PWD in Chile using a socio-ecological framework, evaluating differences by sex and sports practice status while adjusting for potential demographic confounders. Methods: A quantitative, cross-sectional design was conducted with a convenience sample of 245 PWD. Perceptions across four socio-ecological dimensions (intrapersonal, interpersonal, organizational, and community) were measured using the short Spanish version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI). Non-parametric Mann–Whitney U tests were performed as primary bivariate analyses due to non-normal data distribution, followed by Analysis of Covariance (ANCOVA) models controlling for age and sex. Results: Bivariate analyses showed no significant differences by sex. When comparing sports participants versus non-participants, athletes perceived significantly lower barriers in the organizational ($U=5357, p<0.001, r=0.286$) and community ($U=6216, p=0.020, r=0.172$) dimensions. After adjusting for age and sex via ANCOVA, sports practice remained a significant independent predictor of lower organizational barriers ($F=7.814, p=0.006, {\eta }_p^2=0.032$), and a significant interaction between sports practice and sex was identified in the community dimension ($F=4.671, p=0.032, {\eta }_p^2=0.019$). Community-level barriers were rated highest across all groups. Conclusions: Sports participation is associated with a lower perception of organizational barriers, even when controlling for age. The prominent community-level obstacles underscore the need for targeted, context-specific public policies that enhance accessibility and inclusive infrastructure. Full article

Background/Objectives: Diabetes mellitus is characterized by chronic hyperglycemia, insulin resistance, and low-grade inflammation, and adipose-tissue-derived adipokines are increasingly implicated as regulators of glucose homeostasis. This study compared circulating ghrelin, nesfatin-1, and vaspin levels across three glycemic-control categories defined by HbA1c and evaluated their association with glycemic status. Methods: In this cross-sectional comparative study, serum ghrelin, nesfatin-1, and vaspin were measured by enzyme-linked immunosorbent assay (ELISA) in 161 adults stratified into three groups: HbA1c 6.0–8.4% (n = 55), HbA1c ≥ 8.5% (n = 52), and non-diabetic controls with HbA1c < 6.0% (n = 54). Distributional assumptions were tested with the Kolmogorov–Smirnov and Shapiro–Wilk tests. Because all three adipokines deviated from normality, the primary omnibus comparison was the Kruskal–Wallis test, followed by Dunn’s post hoc test with Bonferroni adjustment; effect sizes are reported with 95% confidence intervals. Group differences were additionally examined after adjustment for age and sex, and HbA1c was analysed as a continuous variable. Results: Ghrelin (Kruskal–Wallis p = 0.726) and vaspin (p = 0.364) did not differ among the three groups. Nesfatin-1 differed significantly (H = 15.16, p < 0.001, ε² = 0.095) and non-monotonically: concentrations were higher in the HbA1c 6.0–8.4% group than in controls (median 824 versus 650 pg/mL; Dunn p = 0.018) and than in the HbA1c ≥ 8.5% group (824 versus 600 pg/mL; p < 0.001), whereas the HbA1c ≥ 8.5% and control groups did not differ (p = 0.909). The nesfatin-1 difference persisted after adjustment for age and sex (p < 0.001) and after excluding controls with impaired fasting glucose (p < 0.001). Within the diabetic participants, nesfatin-1 correlated inversely with continuous HbA1c (ρ = −0.373, p < 0.001). Conclusions: Nesfatin-1, but not ghrelin or vaspin, differed significantly between HbA1c-defined glycemic-control categories in a non-monotonic manner, with the highest concentrations in the intermediate-HbA1c group. Because body mass index, diabetes duration, and antidiabetic medication were not available, and because the design is cross-sectional, these between-group differences cannot be interpreted as a within-person trajectory or attributed to glycemic status independently of adiposity. These exploratory findings require confirmation in larger, prospective, BMI- and medication-adjusted cohorts before nesfatin-1 can be considered a candidate biomarker. Full article

Europe faces sustained demographic contraction—sub-replacement fertility and aging—and Ukraine, whose full-scale war triggered Europe’s largest forced-displacement episode, is its sharpest case. We treat demographic security as a measurable state and construct a composite Demographic Security Index from nine indicators across five dimensions (natural change, aging, migration, health, and gender balance), measured identically for the EU-27 and Ukraine, 2014–2024. Construction uses pooled min–max normalization and equal-indicator weighting—so the volatile migration indicator receives one-ninth weight and cannot dominate the composite—with leave-one-out, random-weight, and alternative-scheme sensitivity checks, winsorized migration, and fixed-effects regressions on income. Ukraine ranks 26th–28th during 2014–2021 and reaches the panel’s lowest score, 0.282, in 2022, with the fall concentrated in the migration, gender-balance, and natural-change dimensions. Its limited 2024 uptick to 27th is driven by one projected migration input; removing the migration dimension leaves Ukraine last. Across countries, demographic security and income co-occur strongly (r ≈ 0.81); within countries, the short-run association is weakly negative, shared between the migration and gender-balance channels. Demographic security is thus a structural correlate of the economic dimension of development, not a short-run driver, and crisis-era composites should be read by dimension, not their headline score. Full article

Background/Objectives: To characterize the degenerative vocabulary of 500 consecutive lumbar MRI reports using a transparent, reproducible text extraction pipeline; to quantify which descriptors distinguish included from excluded reports and which factors predict text-derived severity; and to specify a reproducible image analysis pipeline whose formal validation against radiologist Pfirrmann grading is defined as the next step. Methods: We analyzed 500 lumbar MRI reports (386 patients; December 2018–November 2025), extracting morphological and severity keywords, segmental levels (L1–L2 to L5–S1), Modic mentions, and a custom text-derived ordinal severity (0–3). Keyword prevalence differences were tested with the Fisher exact test under Benjamini–Hochberg false discovery rate control, with 95% confidence intervals (CIs) for all odds ratios (ORs) and risk differences; predictors of severity were examined by ordinal logistic regression. Robustness to within-patient clustering was assessed with patient-clustered robust estimation and one-report-per-patient analyses. A MATLAB pipeline derived per-disc candidate imaging features (predicted Pfirrmann grade, normalized disc height, T2 signal index, quality control) across 316 studies. Results: In total, 385/500 reports (77.0%) met the inclusion criteria. The structured morphological keyword field was missing in 49.4% of records, varying by year (58.6% in 2020, 68.7% in 2023, 41.9% in 2024, 33.5% in 2025), indicating systematic reporting drift. Bulge was the dominant descriptor (53.8%); L4–L5 and L5–S1 dominated level mentions. After correction, bulge (OR 6.70, 95% CI 3.86–11.65), mild (5.08, 2.39–10.78), dehydration (9.82, 2.36–40.87) and central (8.63, 2.07–36.01) were enriched among the included reports. All four remained significant in clustering-aware sensitivity analyses. Older age independently predicted higher severity (OR 1.36 per 10 years, 95% CI 1.19–1.56). The image pipeline produced per-disc candidate biomarkers across 316 studies. Conclusions: Free-text lumbar MRI reports encode a recognizable but heterogeneous degenerative vocabulary, sufficient for cohort construction yet inconsistent for quantitative grading; the text-derived severity is a noisy proxy. The reproducible image analysis pipeline yields candidate biomarkers whose formal validation against an adjudicated radiologist Pfirrmann reference standard is the explicit, pre-specified next step. Full article

Background/Objectives: Molar incisor hypomineralization (MIH) is a qualitative enamel defect affecting pediatric populations, predisposing to hypersensitivity, caries, and post-eruptive breakdown, and potentially impacting oral health-related quality of life (OHRQoL). Therefore, the primary aim of the present umbrella review was to evaluate the overall OHRQoL among pediatric subjects with MIH, as well as individual domains from both children and parents. Secondary aims were to evaluate the influence of MIH severity, extent/distribution pattern, age, and dentition status on overall- and domain-specific OHRQoL outcomes, and to assess the impact of different dental treatments on OHRQoL. Methods: Following PRISMA guidelines and PROSPERO registration, six systematic reviews were included. To address metric heterogeneity, mean scores were normalized into a 0–100% descriptive percentage impact index. Treatment-related changes were calculated as percentage improvements. Results: A total of 4028 respondents (3193 children and 835 parents/caregivers) were evaluated for OHRQoL. The overall impact on children and parents was highest in the oral domain (26.43%), followed by the psychological (20.25%), functional (19.50%), and social (11.75%) domains. Parental underestimation of MIH was consistently observed across all domains. Children in early mixed dentition reported a higher perceived impact than those in late mixed/permanent dentition (26.77% vs. 14.43%). In an exploratory subsample (n = 494), MIH severity appeared to impact OHRQoL, particularly in oral and functional domains. Overall, post-treatment OHRQoL improved across all domains, although evaluated in a limited sample (n = 491). Conclusions: MIH showed a relevant impact on pediatric OHRQoL. Notably, children consistently report a greater perceived impact than parents, suggesting potential parental underestimation. However, findings regarding dentition stage, MIH severity, and post-treatment improvements should be interpreted with caution, as heterogeneity in assessment tools, limited subsamples, and variable follow-up intervals precludes definitive conclusions. Full article

Age-related macular degeneration (AMD) is a major cause of irreversible visual impairment, yet identifying effector proteins and tissue-specific mechanisms underlying genome-wide association study (GWAS) loci remains challenging. This study aimed to systematically prioritize candidate causal circulating proteins and delineate their cellular and transcriptional dynamics in AMD. We integrated plasma protein quantitative trait loci (pQTL) summary statistics from the UK Biobank Pharma Proteomics Project (UKB-PPP; $N=\mathrm{53,022}$) with FinnGen AMD GWAS data using proteome-wide association studies (PWAS), summary-data-based Mendelian randomization (SMR) with the HEIDI test, and Bayesian colocalization analysis. Prioritized candidates were mapped across human and murine retinal single-cell/single-nucleus RNA sequencing atlases. Transcriptional responsiveness was validated in an independent clinical microarray dataset (GSE103060) and in human retinal pigment epithelial cells (ARPE-19) via in vitro inflammatory stimulation and RT-qPCR. Target tractability was assessed using pharmacological databases. Multi-stage genetic screening prioritized five candidate proteins stratified into two confidence tiers: three Tier 1 causal drivers supported by colocalization (PP4 > 0.80)—including risk factors CSF2, IL20RB, and WARS1 (also known as WARS)—alongside two Tier 2 candidates supported by SMR and HEIDI, comprising risk factor PILRA and inversely associated metabolic factor ACADSB. Retinal transcriptomic mapping localized PILRA specifically to microglia, ACADSB to inner retinal neurons, and WARS1 to photoreceptors, RPE, and vascular compartments, while IL20RB and CSF2 exhibited low baseline expression. In independent validation cohorts, IL20RB and WARS1 were significantly up-regulated in choroidal neovascularization (CNV) membrane-derived RPE from patients with AMD ($p<0.01$). Exposure of ARPE-19 cells to TNF-$\alpha$ markedly induced mRNA levels of IL20RB ($P=0.0025$) and WARS1 ($p<0.0001$). Dual normalization against ACTB as a secondary internal reference yielded consistent significant induction. Pathway enrichment highlighted cytokine-driven receptor cascades (JAK-STAT signaling) and mitochondrial substrate catabolism (branched-chain amino acid and fatty acid metabolism). Drug–target profiling identified small molecules and nutraceuticals interacting with ACADSB, CSF2, and WARS1. By combining large-scale plasma proteomic genetics with single-cell mapping and experimental validation, this study identifies a prioritized set of candidate causal proteins linking neuroimmune activation, vascular remodeling, and mitochondrial bioenergetics in AMD, providing candidate entry points for mechanistic and therapeutic exploration. Full article

Background: Cerebral endometriosis is an exceptionally rare manifestation of extrapelvic endometriosis and remains a diagnostic challenge because its clinical and imaging features may mimic more common neurological, inflammatory, vascular, or neoplastic disorders. Catamenial neurological symptoms may provide an important diagnostic clue, but histological confirmation is rarely available. Case presentation: We report the case of a 48-year-old woman with epilepsy beginning at 41 years of age, associated with short-term memory loss and a catamenial pattern of seizures. She had no typical symptoms of pelvic endometriosis, including dysmenorrhea, dyspareunia, or cyclic pelvic pain. Neuropsychological test for memory had normal scores. Brain magnetic resonance imaging (MRI) revealed a right hippocampal lesion with T2/FLAIR hyperintensity and later pseudonodular contrast enhancement, raising suspicion of focal cortical dysplasia, infection, tumor infiltration, or a hippocampal tumor. Magnetic resonance spectroscopy (MRS) was inconclusive and did not provide clear support for tumor-like infiltration. Because of the temporal association between symptoms and menstruation, cerebral endometriosis was considered. The patient received hormonal therapy with progestins, including desogestrel and dienogest, after which antiepileptic therapy was discontinued. Neurological symptoms resolved completely. Follow-up MRI demonstrated marked regression or disappearance of the previously described right hippocampal hyperintense lesion, with preserved bilateral hippocampal morphology. Conclusions: This case highlights the importance of considering cerebral endometriosis in women of reproductive or perimenopausal age presenting with catamenial epilepsy and unexplained intracranial lesions, even in the absence of pelvic endometriosis symptoms. Recognition of menstrual cyclicity, careful neuroimaging follow-up, and multidisciplinary evaluation may support diagnosis and guide individualized treatment. The favorable clinical and radiological response to progestin therapy in this case adds to the limited evidence regarding conservative management of presumed cerebral endometriosis. Cerebral endometriosis is a very rare condition, and only eight case reports were found in the literature. Full article

Background/Objectives: Rubidium-82 (⁸²Rb) PET myocardial perfusion imaging (MPI) yields, in a single study, quantitative absolute myocardial blood flow (MBF, mL/min/g), myocardial flow reserve (MFR), and gated left ventricular (LV) function (LVEF, EDV, ESV, SV). These quantitative values depend on the tracer, scanner, kinetic model, software, and underlying population and have been characterised almost exclusively in North American and European cohorts. The Arabian Gulf, where Kuwait has among the highest age-standardised diabetes prevalence worldwide (25.6%), is essentially unstudied, so the distribution and behaviour of these parameters in such a real-world cardiometabolic population are unknown. To evaluate the distribution of the quantitative ⁸²Rb PET parameter set in a real-world Arabian Gulf cohort and, within a small clinically defined normal subgroup, to describe sex- and age-related patterns in absolute MBF, MFR, and LV function. Given the limited size of the normal subgroup, these values are presented as exploratory, hypothesis-generating observations rather than definitive population reference norms. Methods: Retrospective single-centre study of 330 consecutive ⁸²Rb PET/CT studies (analytic cohort n = 292 after exclusion of repeat studies and those with incomplete quantitative output; mean age 63.1 ± 12.1 years) who underwent adenosine-stress ⁸²Rb PET/CT MPI. The clinically defined normal subgroup, normal perfusion (C1), normal global MFR (≥2.0), normal resting LVEF, and no documented cardiac history, comprised 44 patients (25 female, 19 male). Reference values are reported as sex- and age-stratified centiles (5th, 25th, median, 95th percentiles), with the 5th percentile reported for each parameter. Sex differences used Mann–Whitney U with rank-biserial r and Cohen’s d (95% CI); age was examined across broad bands. All analyses followed APA 7 standards with Bonferroni correction. Results: In the clinically defined normal subgroup, median global stress MBF was 2.94 mL/min/g (5th percentile 2.03) and median global MFR was 2.72 (5th percentile 2.06); every value satisfied the C1 definition (MFR ≥ 2.0) by construction, so these limits describe the preselected subgroup and cannot independently validate the 2.0 threshold. Women had higher resting MBF than men (median 1.07 vs. 0.90 mL/min/g; p = 0.007), with numerically lower global MFR that did not survive correction for multiple comparisons (2.57 vs. 2.98; p = 0.022); stress MBF did not differ by sex (3.00 vs. 2.91; p = 0.522). LV volumes were smaller in women, while LVEF was similar between sexes. The 5th percentile for stress LVEF was 54% (women) and 53% (men). These absolute-flow reference values are lower than those reported for Western low-risk cohorts (stress MBF ~3.25 mL/min/g; MFR ~3.18), consistent with the higher cardiometabolic burden of this population. Conclusions: In this exploratory single-centre evaluation, quantitative ⁸²Rb PET flow values in a small clinically defined normal Arabian Gulf subgroup were lower than Caucasian-derived values, while sex-related differences in resting flow were evident and age-related differences were numerically consistent with previously reported trends. Because the normal subgroup is small, these findings are hypothesis-generating and require confirmation in larger, prospectively screened cohorts before use as population reference values; they nonetheless indicate that population- and pipeline-specific calibration is needed when quantitative ⁸²Rb thresholds derived elsewhere are applied locally. Full article

Exposure to hydrochloric acid (HCl) can provoke severe chronic pulmonary injury. Children are particularly vulnerable due to their smaller airways, higher respiratory rate, and stronger inflammatory response; yet no countermeasures exist for HCl-induced chronic lung injury in the pediatric population. We have previously demonstrated the involvement of HSP90 during HCl-induced lung injury in pre-pubertal (p24) mice, who develop stronger persistent inflammation with higher NLRP3 inflammasome activation, but less pulmonary fibrosis compared to adults. Here, we tested the hypothesis that post-treatment with the second-generation HSP90 inhibitor AT13387 (Onalespib), administered subcutaneously beginning 24 h after HCl instillation, would prevent HCl-induced chronic lung injury and pulmonary fibrosis in young (p24) C57BL/6J mice. Pre-pubertal (p24) C57BL/6J mice received a single intratracheal instillation of 0.1 N HCl and were treated with AT13387 (10 mg/kg, s.c., 3×/week for 30 days) beginning 24 h post-exposure. Bronchoalveolar lavage fluid (BALF) analysis, lung function measurements, histological assessment (Ashcroft fibrosis score), and Western blot analysis of key signaling mediators were performed. Additionally, publicly available single-nucleus RNA sequencing (snRNA-Seq) data from a cohort of 13 infants with bronchopulmonary dysplasia (BPD) and 11 age-matched controls were analyzed to evaluate HSP90 isoform expression in human pediatric lung disease. AT13387 significantly reduced BALF white blood cell concentration without affecting total BALF protein levels. Importantly, AT13387 did not impair normal weight gain or development over the 30-day observation period. AT13387 abrogated HCl-induced expression of TGF-β1, phosphorylation of HSP90, ERK1/2, SMAD2, IκBα, and upregulation of the inflammasome NLRP3. Additionally, AT13387 prevented changes in lung function dynamics and reduced the Ashcroft fibrosis score. Analysis of the human snRNA-Seq BPD dataset revealed a widespread pan-overexpression of all three HSP90 isoforms, i.e., HSP90AA1, HSP90AB1, and HSP90B1. These findings suggest that the HSP90 inhibitor AT13387 exhibits strong antidotal properties against HCl-induced chronic lung injury and pulmonary fibrosis in a pre-clinical pediatric model and identify HSP90 as a conserved therapeutic target in pediatric chronic lung disease. Full article

Objective: We aimed to analyze factors associated with body mass index and nutritional status, including oral health, among older adults in Primary Health Care. Methods: We conducted a cross-sectional study of community-dwelling older adults aged ≥ 60 years, selected from five Health Units in a Brazilian city. A questionnaire was applied to collect the following data: sociodemographic data, anthropometric status assessed by Body Mass Index (BMI) (weight and height), oral health (number of teeth and self-perceived chewing ability: good, fair, or poor), cognition assessed using the 10-Point Cognitive Screener (10-CS), nutritional status using the Mini Nutritional Assessment (MNA), health literacy using the 14-item Health Literacy Scale (HLS-14), sarcopenia risk using the SARC-F questionnaire plus calf circumference (SARC-F + CC), and frailty using the Clinical Functional Vulnerability Index-20 (CFVI-20). The outcomes were Body Mass Index (BMI)-defined anthropometric status, dichotomized as non-excess weight (underweight/normal weight) vs. excess weight (overweight/obese), and nutritional status assessed by the Mini Nutritional Assessment (MNA), dichotomized into normal nutritional status vs. nutritional risk or malnutrition. Descriptive, bivariate (Chi-square test), and multiple binary logistic regression analyses were performed for each outcome (p < 0.05). Results: A total of 211 older adults participated in the study. The sample was 72% female, with a mean age of 70.41 (±7.45) years. In the adjusted regression analysis, the use of four or more medications (OR = 2.12; 95% CI: 1.08–4.17), sedentary behavior (OR = 3.09; 95% CI: 1.58–6.04), and absence of sarcopenia risk (OR = 4.99; 95% CI: 2.02–12.34) were associated with higher odds of overweight/obesity. Conversely, usual attendance at the neighborhood PHC unit (OR = 0.23; 95% CI: 0.07–0.72) and possible cognitive impairment (OR = 0.30; 95% CI: 0.08–0.98) were inversely associated with overweight/obesity. Nutritional risk or malnutrition was associated with edentulism (OR = 2.10; 95% CI: 1.05–4.23), poor chewing ability (OR = 2.48; 95% CI: 1.06–5.82), fair chewing ability (OR = 2.88; 95% CI: 1.29–6.47), and the presence of feelings of discouragement, sadness, or hopelessness (OR = 3.52; 95% CI: 1.78–6.96). Among participants with overweight/obesity, 28.4% were also classified as being at nutritional risk or malnourished according to the MNA. Conclusions: Among older adults in Primary Health Care, nutritional risk or malnutrition was associated with oral health and psychosocial characteristics, whereas overweight/obesity was associated with distinct clinical, healthcare-use, behavioral, cognitive, and functional characteristics, even after adjustment for sociodemographic, clinical, functional, and psychosocial characteristics. These findings support the importance of comprehensive multidisciplinary assessment and care to address the heterogeneous and coexisting nutritional challenges of aging. Full article