Search Results (1,172)

Background/Objectives: Chronic inflammation and Western-style diets elevate colorectal cancer (CRC) risk, particularly in individuals with colitis, a feature of inflammatory bowel disease (IBD). Diets rich in polyphenol-containing functional foods, such as cocoa, may reduce gut inflammation and modulate the gut microbiome. This study investigated the impact of cocoa polyphenol (CP) supplementation on inflammation and microbiome composition in mice with colitis, fed either a healthy or Western diet, before, during, and after the onset of disease. We hypothesized that CPs would attenuate inflammation and promote distinct shifts in the microbiome, especially in the context of a Western diet. Methods: A 2 × 2 factorial design tested the effects of the basal diet (AIN93G vs. total Western diet [TWD]) and CP supplementation (2.6% w/w CocoaVia™ Cardio Health Powder). Inflammation was induced using the AOM/DSS model of colitis. Results: CP supplementation did not reduce the severity of colitis, as measured by disease activity index or histopathology. CPs did not alter gene expression in healthy tissue or suppress the colitis-associated pro-inflammatory transcriptional profile in either of the two diet groups. However, fecal microbiome composition shifted significantly with CPs before colitis induction, with persistent effects on several rare taxa during colitis and recovery. Conclusions: CP supplementation did not mitigate inflammation or mucosal injury at the tissue level, nor did it affect the expression of immune-related genes. While CPs altered microbiome composition, most notably in healthy mice before colitis, these shifts did not correspond to changes in inflammatory signaling. Basal diet remained the primary determinant of inflammation, mucosal damage, and colitis severity in this model. Full article

Background/Objectives: Pseudohypoparathyroidism (PHP) is a group of genetic disorders characterized by end-organ resistance to multiple hormones, short stature, brachydactyly, subcutaneous ossifications, obesity, and developmental delays. The tissue specific imprinting of GNAS in the hypothalamus may lead to different eating behavior phenotypes in maternally inherited (PHP1A, PHP1B) vs. paternally inherited (PPHP) variants. In this exploratory study, we aimed to evaluate differences in eating behaviors in a cohort of patients with PHP1A, PPHP and PHP1B. Methods: Assessments included caregiver-reported measures (hyperphagia questionnaire, children’s eating behavior questionnaire, child feeding questionnaire) and self-reported measures (three factor eating behavior questionnaire). Results: A total of 58 patients with PHP1A, 13 patients with PPHP and 10 patients with PHP1B contributed data, along with 124 obese pediatric controls. An increased risk of obesity was found in PHP1A vs. PPHP (adult body mass index (BMI) 39.8 ± 8.7 vs. 30.2 ± 7.4 kg/m², p = 0.03). Parents reported significantly earlier onset of interest in food in children with PHP1A (2.0 ± 2.3 years) and PHP1B (1.1 ± 1.3 years) compared with controls (5.2 ± 3.2 years, p < 0.001). Measures of hyperphagia, satiety and other feeding behaviors were all similar to controls. The highest hyperphagia questionnaire scores were seen prior to adolescence. In a multi-year, longitudinal assessment of 11 pediatric patients with PHP1A, hyperphagia scores were stable and 25% showed an improvement in symptoms. Conclusion: Patients with PHP1A/1B may have hyperphagia symptoms from a young age but they do not worsen over time. Patients may overeat when allowed access to food, but do not usually have disruptive food seeking behaviors. Early diagnosis can give clinicians the opportunity to provide anticipatory diagnosis on the increased risk of obesity in PHP1A/1B and need for scheduled meals and controlled portions. Further studies with larger cohorts are needed to confirm these findings. Full article

Drought is one of the most complex natural hazards, characterized by its slow onset, persistent nature, diverse sectoral impacts (e.g., agriculture, water resources, ecosystems), and dependence on meteorological, hydrological, and socioeconomic factors. Over the years, significant scientific effort has been devoted to developing methodologies that address its multifaceted nature, reflecting the interdisciplinary challenges of drought analysis. However, previous reviews have typically focused on individual methods, while this study presents a unified, multidisciplinary framework that integrates multiple drought analysis methods and links them to key factors guiding method selection. To address this gap, five widely used methods—index-based, remote sensing, threshold-level methods (TLM), impact-based methods, and the storyline approach—are critically evaluated from a multidisciplinary perspective. In addition, the study examines spatial and temporal trends in scientific publications, illustrating how the application of these methods has evolved over time and across regions. The primary objective of this review is twofold: (1) to provide a holistic, state-of-the-art synthesis of these methods, their applications, and their limitations; and (2) to evaluate and prioritize the critical decision-making factors, including drought type, data type/availability, study scale, and management objectives that influence method selection. By bridging this gap, the paper offers a conceptual decision-support framework for selecting context-appropriate drought analysis methods. However, challenges remain, including the vast diversity of methods beyond the scope of this review and the limited consideration of less influential factors such as user expertise, computational resources, and policy context. The paper concludes with insights and recommendations for optimizing method selection under varying circumstances, aiming to support both drought research and effective policy implementation. Full article

There is growing interest in the use of herbicide for the silvicultural practice of tree thinning (i.e., chemical thinning or e-thinning) in New Zealand. Potential benefits of this approach include improved stability of the standing crop in high winds, and safer and lower-cost operations, particularly in steep or remote terrain. As uptake grows, tools for monitoring treatment effectiveness, particularly during the early stages of stress, will become increasingly important. This study evaluated the use of UAV-based multispectral and hyperspectral imagery to detect early herbicide-induced stress in a nine-year-old radiata pine (Pinus radiata D. Don) plantation, based on temporal changes in crown spectral signatures following treatment with metsulfuron-methyl. A staggered-treatment design was used, in which herbicide was applied to a subset of trees in six blocks over several weeks. This staggered design allowed a single UAV acquisition to capture imagery of trees at varying stages of herbicide response, with treated trees ranging from 13 to 47 days after treatment (DAT). Visual canopy assessments were carried out to validate the onset of visible symptoms. Spectral changes either preceded or coincided with the development of significant visible canopy symptoms, which started at 25 DAT. Classification models developed using narrow band hyperspectral indices (NBHI) allowed robust discrimination of treated and non-treated trees as early as 13 DAT (F1 score = 0.73), with stronger results observed at 18 DAT (F1 score = 0.78). Models that used multispectral indices were able to classify treatments with a similar accuracy from 18 DAT (F1 score = 0.78). Across both sensors, pigment-sensitive indices, particularly variants of the Photochemical Reflectance Index, consistently featured among the top predictors at all time points. These findings address a key knowledge gap by demonstrating practical, remote sensing-based solutions for monitoring and characterising herbicide-induced stress in field-grown radiata pine. The 13-to-18 DAT early detection window provides an operational baseline and a target for future research seeking to refine UAV-based detection of chemical thinning. Full article

Introduction: Leptospirosis is an under-recognized zoonosis that affects both tropical and temperate regions. While it is often associated with exposure to contaminated water or infected animals, its presentation and epidemiology in Mediterranean countries remain incompletely understood. This retrospective cohort study investigates the clinical and epidemiological profile of leptospirosis in Crete, Greece, a region where data are scarce. Methods: All adult patients with laboratory-confirmed leptospirosis admitted to three major public hospitals in Crete, Greece, between January 2019 and December 2023 were included in the analysis. Diagnosis was made through serologic testing along with compatible clinical symptoms. Results: A total of 17 patients were included. Their median age was 48 years, with a predominance of males (70.6%). Notably, more than half of the patients had no documented exposure to classic risk factors such as rodents or standing water. Clinical presentations were varied but commonly included fever, fatigue, acute kidney injury, and jaundice. Of the patients who underwent imaging, most showed hepatomegaly. The median delay from symptom onset to diagnosis was 11 days, underscoring the diagnostic challenge in non-endemic areas. Ceftriaxone was the most frequently administered antibiotic (76.5%), often in combination with tetracyclines or quinolones. Despite treatment, three patients (17.6%) died, all presenting with severe manifestations such as ARDS, liver failure, or shock. A concerning increase in cases was noted in 2023. Conclusions: Leptospirosis can present with severe and potentially fatal outcomes even in previously healthy individuals and in regions not traditionally considered endemic. The relatively high mortality and disease frequency noted emphasize the importance of maintaining a high index of suspicion. Timely diagnosis and appropriate antimicrobial therapy are essential to improving patient outcomes. Additionally, the need for enhanced public health awareness, diagnostic capacity, and possibly environmental surveillance to control this neglected but impactful disease better, should be emphasized. Full article

The Central Asian Orogenic Belt (CAOB) represents a crucial area for understanding the tectonic evolution of the Paleo-Asian Ocean and surrounding orogenic systems. This study investigates the petrology, geochronology, and geochemistry of volcanic and clastic rocks from Well HFD3 in the northern Songliao Basin, which provides key insights into the tectonic development of this region. Zircon U–Pb dating of tuff samples from the Linxi Formation provides an accurate age of 251.1 ± 1.1 Ma, corresponding to the late Permian. Geochemical analyses show that the clastic rocks are rich in SiO₂ (63.5%) and Al₂O₃ (13.7%), with lower K₂O/Na₂O ratios (0.01–1.55), suggesting low compositional maturity. Additionally, the trace element data reveal enrichment in light rare earth elements (LREEs) and depletion in Nb, Sr, and Ta, with a negative Eu anomaly, which indicates a felsic volcanic arc origin. The Chemical Index of Alteration (CIA) values (53.2–65.8) reflect weak chemical weathering, consistent with cold and dry paleo-climatic conditions. These findings suggest that the Linxi Formation clastic rocks are derived from felsic volcanic arcs in an active continental margin environment, linked to the subduction of the Paleo-Asian Ocean slab. The sedimentary conditions reflect a gradual transition from brackish to freshwater environments, corresponding with the final stages of subduction or the onset of orogeny. Full article

Traditional taco preparation methods, such as oil immersion and steaming, can significantly affect the nutritional and metabolic characteristics of the final product. This study evaluated tacos made with five commercial nixtamalized maize flours and four common fillings (chicharron, beef skirt, potato, and refried beans), processed using three different methods: Plain, Full-Fat, and Patted-Dry. We assessed their chemical composition, starch digestibility, and thermal properties, and measured satiety-related hormone responses in mice. Fillings had a stronger influence on protein, fat, and moisture content than tortilla type. Full-fat tacos exhibited increased amylose–lipid complex formation and a lower gelatinization enthalpy, whereas plain tacos retained more retrograded starch and a crystalline structure. In vitro digestion revealed that Plain tacos, especially those with plant-based fillings, had the highest resistant starch content and the lowest predicted glycemic index. Hierarchical clustering showed that resistant starch, moisture, and gelatinization onset temperature were closely linked in the Plain samples, whereas lipid-driven variables dominated in the Full-Fat tacos. In mice, tacos with a higher resistant starch content led to greater GLP-1 levels, lower ghrelin levels, and reduced insulin responses, suggesting improved satiety and glycemic control. Patted-Dry tacos showed intermediate hormonal effects, supporting their potential as a balanced, health-conscious alternative. These findings demonstrate how traditional preparation techniques can be leveraged to enhance the nutritional profile of culturally relevant foods, such as tacos. Full article

Background and Objectives: COVID-19 may have long-term adverse effects on bone health, particularly in individuals aged ≥50 years with obesity or diabetes, who are predisposed to impaired bone quality. Materials and Methods: This retrospective cohort study used TriNetX data from 141 healthcare organizations across North America and Western Europe. Patients aged ≥50 years with overweight (body mass index 25–30 kg/m²), obesity (body mass index ≥ 30 kg/m²), or type 2 diabetes (T2DM) and COVID-19 (2019–2024) were propensity score-matched to non-COVID-19 controls. Exclusion criteria included prior overweight, obesity, diabetes, osteoporosis, T-score ≤ −2.5, Z score ≤ −2.0, fractures, pneumonia, tuberculosis, and cancer. Outcomes included new-onset osteoporosis, fragility fractures, and low T-scores (≤−2.5). Cox regression estimated hazard ratios (HRs); sensitivity analyses assessed lag effects (1–4 years). Results: Among 327,933 matched pairs, COVID-19 was linked to increased osteoporosis risk at 3 years (HR, 1.039; 95% CI, 1.003–1.077) and 6 years (HR, 1.095; 95% CI, 1.059–1.133). Sensitivity analysis showed rising risk with longer lag times: HRs were 1.212, 1.379, 1.563, and 1.884 at 1 to 4 years, respectively. Subgroup analyses confirmed consistent trends. Conclusions: COVID-19 is independently associated with elevated long-term osteoporosis risk in older adults with new-onset overweight, obesity, or T2DM, peaking at 4 years post-infection and persisting through 6 years. Full article

Background/Objectives: To investigate the incidence of new-onset diabetic retinopathy (DR) in individuals with pre-existing type 2 diabetes (T2D) up to 3 years post SARS-CoV-2 infection. Methods: This retrospective study consisted of 5151 COVID-19 and 5151 propensity-matched non-COVID-19 patients with T2D in the Montefiore Health System between 1 March 2020 and 17 January 2023. The primary outcome was new-onset DR at least 2 months after the index date up to 17 January 2023. Matching for index date between groups was also used to ensure the same follow-up duration. Hazard ratios (HRs) were computed, adjusted for competing risks. Results: T2D patients with COVID-19 had a higher cumulative incidence of DR than T2D patients. The unadjusted HR for COVID-19 status for developing new DR was 2.44 [1.60, 3.73], p < 0.001. The adjusted HR was 1.70 [1.08, 2.70], p < 0.05, and the adjusted HR for prior insulin use was 3.28 [2.10, 5.12], p < 0.001. Sex, ethnicity, and major comorbidities had no significant association with outcome. Conclusions: T2D patients who contracted COVID-19 exhibited a significantly higher risk of developing DR within three years post infection compared to propensity-matched controls. The increased incidence was primarily driven by greater pre-existing insulin usage and SARS-CoV-2 infection in the COVID-19 positive cohort. Full article

Background: The global impact of the COVID-19 pandemic has significantly influenced elderly functionality, particularly in terms of balance, gait, and independence in daily activities. This study sought to evaluate how these aspects have changed over the course of the health crisis. Methods: We employed the Tinetti scale for assessing balance and gait, and the Barthel Index for measuring functional independence, conducting a comparative analysis of scores before and after the onset of the pandemic in a sample of elderly individuals. Results: Our findings indicated an increase in Tinetti scores, suggesting some improvement in balance and mobility, albeit with marked variability across participants. On the other hand, Barthel scores showed a significant decline, pointing to a reduction in functional independence. Conclusions: These results suggest that the impact of COVID-19 on elderly functionality is not uniform, highlighting the need for personalized rehabilitation strategies. Such strategies should not only focus on physical recovery but also consider the psychological and social repercussions of the pandemic to fully address the diverse needs of this vulnerable population. Full article

Background: Dietary assessment in inflammatory bowel disease (IBD) is moving away from individual food and nutrient analyses and towards dietary patterns (e.g., Mediterranean diet, Western diet) and diet quality assessment that are increasingly implicated in IBD onset and course. However, an IBD-specific diet quality index (DQI) does not exist. This review aimed to identify current DQIs and assess their suitability for an IBD population. Methods: MEDLINE and EmCare databases were systematically searched for a-priori, food-based DQI reflecting current dietary guidelines and/or nutrition science. Data extracted were adapted from optimal DQI criteria, including quality measures of adequacy, moderation, variety and balance and DQI evaluation. Results: Twenty-four DQI were identified. No DQI included all optimal DQI criteria. The Dietary Guideline Index 2013 (DGI-2013) most closely met the criteria, followed by the Dutch Healthy Diet Index-2015 (DHD-Index 2015), Planetary Health Diet Index (PHDI) and Healthy Eating Index for Australian Adults-2013 (HEIFA-2013). Most DQI assessed adequacy (22/24, 92%) and moderation (21/24, 88%), half assessed balance (12/24) while few assessed variety (8/24, 33%). Application of other optimal DQI criteria varied. Food frequency questionnaire (13/24) and 24 h diet recall (12/24) were the most common dietary assessment methods used. Most DQI (17/24, 71%) were validated; however, not for an IBD population. Few were evaluated for reliability (6/24) or reproducibility (1/24). Conclusions: No DQI meets all optimal criteria for an IBD-specific DQI. The DGI-2013 met the most criteria, followed by the DHD Index-2015, PHDI and HEIFA-2013 and may be most appropriate for an IBD population. An IBD-specific DQI is lacking and needed. Full article

Background: Hypotension following epidural labor analgesia (ELA) is its most common complication, affecting approximately 20% of patients and posing risks to both maternal and fetal health. As digital tools and predictive analytics increasingly shape perioperative and obstetric anesthesia practices, real-world implementation data are needed to guide their integration into clinical care. Current monitoring practices rely on intermittent non-invasive blood pressure (NIBP) measurements, which may delay recognition and treatment of hypotension. The Hypotension Prediction Index (HPI) algorithm uses continuous arterial waveform monitoring to predict hypotension for potentially earlier intervention. This clinical trial evaluated the feasibility, acceptability, and efficacy of continuous HPI-guided treatment in reducing time-to-treatment for ELA-associated hypotension and improving maternal hemodynamics. Methods: This was a prospective randomized controlled trial design involving healthy pregnant individuals receiving ELA. Participants were randomized into two groups: Group CM (conventional monitoring with NIBP) and Group HPI (continuous noninvasive blood pressure monitoring). In Group HPI, hypotension treatment was guided by HPI output; in Group CM, treatment was based on NIBP readings. Feasibility, appropriateness, and acceptability outcomes were assessed among subjects and their bedside nurse using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM) instruments. The primary efficacy outcome was time-to-treatment of hypotension, defined as the duration between onset of hypotension and administration of a vasopressor or fluid therapy. This outcome was chosen to evaluate the clinical responsiveness enabled by HPI monitoring. Hypotension is defined as a mean arterial pressure (MAP) < 65 mmHg for more than 1 min in Group CM and an HPI threshold < 75 for more than 1 min in Group HPI. Secondary outcomes included total time in hypotension, vasopressor doses, and hemodynamic parameters. Results: There were 30 patients (Group HPI, n = 16; Group CM, n = 14) included in the final analysis. Subjects and clinicians alike rated the acceptability, appropriateness, and feasibility of the continuous monitoring device highly, with median scores ≥ 4 across all domains, indicating favorable perceptions of the intervention. The cumulative probability of time-to-treatment of hypotension was lower by 75 min after ELA initiation in Group HPI (65%) than Group CM (71%), although this difference was not statistically significant (log-rank p = 0.66). Mixed models indicated trends that Group HPI had higher cardiac output (β = 0.58, 95% confidence interval −0.18 to 1.34, p = 0.13) and lower systemic vascular resistance (β = −97.22, 95% confidence interval −200.84 to 6.40, p = 0.07) throughout the monitoring period. No differences were found in total vasopressor use or intravenous fluid administration. Conclusions: Continuous monitoring and precision hypotension treatment is feasible, appropriate, and acceptable to both patients and clinicians in a labor and delivery setting. These hypothesis-generating results support that HPI-guided treatment may be associated with hemodynamic trends that warrant further investigation to determine definitive efficacy in labor analgesia contexts. Full article

Background/Objectives: This study aimed to evaluate adipose tissue dysfunction, assessed through adipocytokines and proinflammatory cytokines, in relation to hepatic steatosis (HS) in patients with newly diagnosed type 2 diabetes (T2D). Methods: An observational study evaluated 155 consecutive patients with new-onset T2D; 118 (76.1%) were found to have HS, while the remaining 37 served as the control group without steatosis. Anthropometric status and body mass index (BMI) were evaluated. The biochemical assessment encompassed the measurements of fasting serum lipids, fasting plasma glucose (FPG), liver function tests, adiponectin, leptin, resistin, tumor necrosis factor (TNF-α), and interleukin 6 (IL-6). Insulin resistance (IR) was determined using the homeostasis model assessment (HOMA). HS was evaluated using ultrasonographic criteria. Quantitative evaluation of HS was performed by calculating the hepatic steatosis index (HSI). Results: There were statistically significant differences between the groups for age, BMI, weight, waist circumference (WC) and hip circumference, HSI, glucose profile (fasting plasma glucose (FPG), HOMA-IR), liver function tests, adiponectin, leptin, resistin, TNF-α, and IL-6. In multivariate logistic regression analysis, age, smoking, BMI, WC, HOMA-IR, and hypoadiponectinemia were the only independent factors associated with HS. Conclusions: The adipose tissue dysfunction assessed through adipocytokines and proinflammatory cytokines is part of the associated disorders in HS and new-onset T2D. In patients with newly diagnosed T2D, age, smoking, and hypoadiponectinemia consistently emerged as independent predictors of hepatic steatosis. More prospective trials are needed to clarify the “the temporal onset” of adipose tissue dysfunction. Full article

Objective: To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and clinical, hormonal, and auxological features in girls with idiopathic central precocious puberty (CPP). Methods: This retrospective study included 122 girls diagnosed with idiopathic CPP. Participants were stratified into three groups based on serum 25(OH)D concentrations: deficient (<20 ng/mL), insufficient (20–30 ng/mL), and sufficient (>30 ng/mL). Clinical and hormonal parameters were compared across groups. Spearman’s correlation and multiple linear regression analyses were used to explore the relationship between vitamin D levels and peak luteinizing hormone (LH) response to gonadotropin-releasing hormone (GnRH) stimulation. Results: No significant differences were observed among the vitamin D groups in terms of age at diagnosis, body mass index (BMI), or other auxological measures. However, serum 25(OH)D levels showed a weak but significant positive correlation with LH peak values (rho = 0.23, p = 0.037). In multivariable regression analysis, vitamin D levels remained an independent predictor of LH peak (β = 0.125, p = 0.036), whereas BMI standard deviations (SDS), growth velocity SDS, and age at diagnosis did not show significant associations. Conclusions: Higher serum vitamin D levels are independently associated with greater LH peak responses in girls with idiopathic CPP. These findings support a potential modulatory role of vitamin D in the neuroendocrine mechanisms underlying pubertal onset and warrant further prospective studies to clarify its clinical relevance. Full article

Muscle activity during exercise is typically assessed using oximeters, to evaluate local oxygen saturation (SmO₂), or surface electromyography (sEMG), to analyze electrical activation. Despite the importance of combining these analyses, no study has evaluated both of them during specific swimming exercises in combination with mechanical power output. This study aimed to assess muscle activity during an incremental test on a swim-bench utilizing oximeters and sEMG. Nine male swimmers performed a five-steps test: PRE (3 min at rest), STEP 1, 2, and 3 (swimming at a frequency of 25, 30, and 40 cycle/min for a duration of 2, 2, and 1 min, respectively), and POST (5 min at rest). Each swimmer wore two oximeters and sEMG, one for each triceps brachii. Stroke frequency and arm mechanical power (from ~13 to ~52 watts) estimated by the swim-bench were different among all steps, while no differences between arms were found. SmO₂ (from ~70% to ~60%) and sEMG signals (from ~20 to ~65% in signal amplitude) showed a significant increase among all steps. In both arms, a large/very large correlation was found between mechanical power and SmO₂ (r < −0.634), mechanical power and sEMG onset/amplitude (r > 0.581), and SmO₂ and sEMG amplitude (r > 0.508). No correlations were found between the slope of the sEMG spectral indexes and the slope of SmO₂; only sEMG detected electrical manifestation of muscle fatigue through the steps (p < 0.05). Increased muscle activity, assessed by both oximeters and sEMG, was found at mechanical power increases, revealing both devices can detect effort variation during exercise. However, only sEMG seems to detect peripheral manifestations of fatigue in dynamic conditions. Full article