Search Results (301)

Background/Objectives: Lower urinary tract symptoms (LUTSs), particularly nocturia and urgency, often intensify during the menopause transition and may worsen with caffeine intake and cold exposure. This review aims to synthesize evidence relevant to a hypothesized caffeine–cold interaction in transitional menopause, focusing on water homeostasis and the estrogen–transient receptor potential melastatin 8 (TRPM8) cold-sensory axis, and to propose potentially actionable, nutrition-centered intervention candidates for future testing. Methods: Structured narrative review of PubMed, Embase, Web of Science, and citation tracking (inception–January 2026). Evidence was mapped into a mechanistic framework distinguishing established from hypothesis-generating links; no formal systematic-review study selection or meta-analysis was performed. Results: Caffeine can increase urine output via renal mechanisms (adenosine receptor antagonism and natriuresis) and may lower bladder sensory thresholds. Because half-life is long and variable, afternoon intake can extend into sleep, potentially increasing awakenings and nocturnal voids. Human studies link colder indoor environments to nocturia/overactive bladder, and passive pre-bedtime heating is associated with fewer nocturnal voids. We propose that repeated nighttime cold may amplify caffeine-related diuresis and may shift urine production toward the night, while estradiol decline may heighten TRPM8-mediated cold sensory gain, potentially contributing to urgency/frequency flares. A testable 2 × 2 cold × caffeine framework can operationalize dose, timing, and metabolism, pairing voiding diaries and bedroom temperature sensing with copeptin profiling. Conclusions: Transitional menopause may represent a susceptibility window in which endocrine instability and estradiol decline could plausibly increase sensitivity to indoor cold exposure and caffeine intake, potentially contributing to nocturia and urgency. The hypothesis label ‘dual hormone suppression’ (attenuated nocturnal AVP signal plus estradiol decline) may provide a mechanistic substrate for cold-exacerbated nocturnal polyuria, while an estrogen–TRPM8 axis may amplify cold-evoked urgency. Potentially actionable candidates include chronobiological caffeine timing/management and low-burden thermal strategies; nevertheless, menopause-stage-specific epidemiologic and clinical evidence for a caffeine × cold interaction remains limited and several mechanistic links are extrapolated, so prospective diary- and biomarker-enabled studies and controlled trials are needed to validate mechanisms and refine cold-sensitive endotypes. Full article

Introduction: Acute ischemic stroke demands interventions that restore perfusion and protect neurons within a narrow therapeutic window. We propose a unified theranostic platform that couples adaptive imaging, topology-aware decision-making, and immediate neuroprotective and micro-dosimetric intervention. Methods: The platform integrates three components. First, a topology-preserving MR–PET engine employs adaptive Poisson-disc sampling, partial Fourier constraints, and structured Hankel low-rank priors in a closed loop. Persistent-homology metrics quantify vascular graph uncertainty and guide subsequent k-space and PET projections, reducing acquisition time while preserving collateral topology. Second, immediate post-reperfusion delivery of glycolic acid attenuates glutamate-driven calcium influx and stabilizes mitochondrial function. Third, trace doses of sol–gel-derived, neutron-activated ⁹⁰Y₂O₃ microspheres provide sharply confined beta irradiation for micro-scale metabolic modulation. Results: In a porcine stroke model replicating the human recanalization workflow, the imaging engine maintained vascular Betti-number invariants within three percent of fully sampled reference scans while reducing acquisition time by nearly half. Glycolic acid reduced glutamate-induced intracellular calcium rise by approximately sixty percent in vitro and decreased infarct volume by thirty-eight percent in vivo. Micro-dosimetry confirmed a mean perivascular beta dose of twenty-eight grays, and histology demonstrated a forty-two percent increase in NeuN-positive neuronal survival compared with standard recanalization. Conclusions: These results demonstrate that intelligent compressed-sensing MR–PET, targeted micro-radioembolization, and glycolic acid neuroprotection can act synergistically to bridge diagnostic imaging and immediate intervention. By coupling imaging, decision-making, and therapy in a closed-loop manner and elevating topological fidelity from a reconstruction byproduct to a control variable, the proposed platform reframes MR–PET from passive diagnostics into an active, decision-driven theranostic system and establishes a foundation for future human trials. Full article

Background/Objectives: Reproducible evaluation of aerosol dispersibility remains a key challenge in the development of dry powder inhalers (DPIs), where small variations in particle cohesion, morphology, or device resistance can lead to large differences in aerodynamic performance. In passive DPIs, the forces required for powder fluidization and aerosolization arise from the interaction of patient inspiratory airflow with device geometry and must overcome strong interparticle cohesive forces to enable effective lung delivery. Cascade impaction is the gold standard for determining aerodynamic particle size distribution (APSD), but its low throughput and experimental burden limit its utility for systematic formulation and device screening. Prior studies have explored laser diffraction-based particle sizing under varying dispersion energies as indirect metrics of powder dispersibility. Here, we extend this approach by introducing a mathematically rigorous, distribution-based framework that applies the first-order Wasserstein distance (Earth Mover’s Distance) to quantify relative dispersibility with respect to a material-specific maximally dispersed reference state. Methods: Mannitol, trehalose, and inulin were spray-dried under matched conditions to generate model dry powders. Particle size distributions were measured by laser diffraction (Sympatec HELOS/R) using both a RODOS dry dispersion module to define a maximally dispersed reference state and an INHALER module to generate aerosols under clinically relevant dispersion conditions spanning multiple device resistances and pressure drops. For each condition, the Wasserstein-1 distance (W₁) was computed between cumulative volume-based size distributions obtained under reference and inhaler-based dispersion. Cascade impaction was used as an orthogonal method to characterize aerodynamic performance under a representative dispersion condition. Results: W₁ captured formulation-, device-, and flow-dependent differences in dispersibility that were not readily separable by visual inspection of particle size distributions alone. Crystalline mannitol exhibited the largest and most flow-rate-dependent W₁ values, whereas amorphous trehalose and polymeric inulin showed smaller W₁ values with distinct, non-monotonic pressure responses that depended on device resistance. W₁ qualitatively aligned with cascade impaction metrics, exhibiting a positive association with mass median aerodynamic diameter and an inverse association with fine particle fraction, while also demonstrating that efficient dose emission can occur despite incomplete deagglomeration. Conclusions: This study establishes the Wasserstein distance as a physically interpretable, formulation-agnostic metric for quantifying aerosol dispersibility relative to a material-specific reference state. This framework enables systematic comparison of dispersion efficiency across devices and operating conditions using standard laser diffraction data and provides a reproducible basis for mechanistic optimization of DPI formulations and inhaler designs. Full article

Background: GMK is a bioactive material newly identified from a water extract of mixed mushroom mycelia (Phellinus linteus, Inonotus obliquus, and Ganoderma lucidum). It has shown protective effects against glutamate-induced excitotoxicity and lipopolysaccharide-triggered neuroinflammation. However, whether GMK can ameliorate global cerebral ischemia–reperfusion injury (GCIRI) and its associated cognitive deficit remains to be elucidated. Methods: GCIRI was induced in male Sprague–Dawley rats by bilateral common carotid artery occlusion with hypovolemia (BCCAO/H). GMK (30 or 90 mg/kg, p.o.) was administered once daily for 14 days before surgery. Cognitive functions were evaluated using the Y-maze, Barnes maze, and passive avoidance tests. Hippocampal CA1 neuronal survival and glial activation were analyzed by cresyl violet staining and Iba1/GFAP immunohistochemistry. In parallel, PC12 cells were pretreated with GMK (100 or 200 μg/mL, 24 h) before oxygen–glucose deprivation and reoxygenation (OGD/R), and apoptosis (TUNEL, Bax/Bcl-2), oxidative stress markers (ROS, MDA, and NO), antioxidant enzymes including glutathione peroxidase (GPX) and catalase (CAT), and signaling proteins (p-ERK/ERK, iNOS) were examined. Results: GMK significantly ameliorated GCIRI-induced learning and memory impairments, protected CA1 pyramidal neurons, and reduced microglial and astrocytic activation. In OGD/R-challenged PC12 cells, GMK attenuated apoptosis, suppressed ROS, MDA, and NO production, normalized GPX and CAT activities, and favorably regulated p-ERK and iNOS pathways. Conclusions: These findings suggest that GMK confers dose-dependent behavioral and histopathological protection against GCIRI, potentially by modulating redox- and apoptosis-related signaling (Bax/Bcl-2, GPX/CAT, and ERK/iNOS pathways), with more consistent effects at a higher dose. Full article

Background: Upper-limb spasticity involving the shoulder girdle and elbow flexors often impairs functional hand use, and although Botulinum toxin type A (BoNT-A) is a first-line therapy, severe proximal synergies may persist while higher doses risk distal weakness. Methods: We report a case of a 47-year-old woman with neurodegenerative tetraparesis and marked shoulder and elbow flexor spasticity treated with bilateral percutaneous cryoneurolysis of the lateral pectoral, thoracodorsal, and musculocutaneous nerves, followed by distal BoNT-A injections, and we conducted a scoping review following Arksey and O’Malley, Levac, and PRISMA-ScR methods to contextualize the current evidence. Results: At one-month follow-up, the patient showed a reduction in MAS from 4 to 1–2, complete resolution of pain, improved passive shoulder abduction and elevation, preserved distal dexterity, and high satisfaction with no adverse events. The scoping review identified consistent MAS and range-of-motion improvements across multiple case reports and small series involving similar proximal nerve targets. Conclusions: The combined proximal cryoneurolysis–distal BoNT-A approach appears to be a feasible dual-modulation strategy for complex upper-limb spasticity when the preservation of hand function is essential, and the emerging literature supports its further investigation. Full article

Background: T2 low asthma in children is an emerging yet underexplored endotype that challenges traditional views of type 2 inflammation. Recent data suggest that it is more prevalent than previously thought and is defined by low type 2 biomarkers, non-allergic clinical profiles, and strong associations with modifiable comorbidities such as obesity, passive smoke exposure, and recurrent respiratory infections. This phenotype often shows a poor response to standard inhaled corticosteroid therapy and T2-targeted biologics, underscoring the urgent need for improved diagnostic and therapeutic approaches. Methods: This narrative review conducted a literature search from PubMed and WoS databases (2020–2025), focusing on T2-low asthma defined by low blood eosinophils (<150–300/µL), FeNO (<20–25 ppb), and absent atopy in children under 18. Results: This review highlights the heterogeneity of T2-low asthma, including subtypes from neutrophilic/Th 17-high to paucigranulocytic airway remodeling and metabolic driven forms, as well as diagnostic challenges from biomarker supresssion by high-dose therapies. Pragmatic phenotyping algorithms using routine tests enable identification, directing comorbidity management over ineffective biologics. Conclusions: Systematic T2-low phenotyping in pediatric practice, alongside prospective studies and non-T2 therapy trials, promises precision medicine to enhance outcomes for these children, moving beyond eosinophil-centric care. Full article

Mothers face high depression risks during pregnancy, and untreated depression can harm both mother and baby. Vortioxetine is a novel antidepressant with a multimodal mechanism, unlike traditional ones. However, little is known about its safety and effectiveness in pregnancy due to limited preclinical and clinical data. This study investigated how maternal vortioxetine exposure during pregnancy affects DNA methylation in the brain tissue of mother and offspring rats. It also explored putative structural interactions of vortioxetine through molecular docking with key epigenetic enzymes to provide a hypothesis-generating context. Fifty female Sprague-Dawley rats were screened using a repeated forced-swim paradigm to characterize a passive stress-coping phenotype. They were then mated and randomly assigned to five groups (n = 10 each): vortioxetine at 0.5, 1.0, 2.0 mg/kg/day orally, saline control, and escitalopram (2.6 mg/kg/day orally) as a comparison. Treatments were given throughout pregnancy. On the day of cesarean section (G20), brain tissue was collected from both the mother and fetus. Global 5-mC levels were measured with ELISA (three replicates). The binding affinities and interaction motifs of vortioxetine and escitalopram with TET2, DNMT3A, and DNMT3B were analyzed via molecular docking. Global 5-mC levels in brain tissue did not differ between groups. However, a significant decrease in overall methylation was observed in offspring given the highest dose of vortioxetine (2.0 mg/kg/day). Docking analyses revealed that vortioxetine and escitalopram could bind strongly to TET2 and DNMT3A/3B; the observed reduction in global 5-mC was compatible with the hypothesis of altered de novo methylation pathways. The results show a specific dose threshold for the fetus. Low to moderate maternal exposures were not associated with detectable differences in global 5-mC under the current assay conditions, whereas high exposure was associated with hypomethylation in offspring. These findings underscore the importance of careful dose selection and mechanism validation for vortioxetine. Full article

Background and Objectives: Inadvertent perioperative hypothermia is a common and clinically significant complication during laparoscopic surgery, leading to pain, agitation, shivering, and delayed recovery. This randomized controlled trial evaluated the effect of peri-induction active warming with an electric resistive blanket on postoperative pain and agitation—the primary outcomes—compared with passive insulation. Materials and Methods: This study was registered at ClinicalTrials.gov (Identifier: NCT06022926; date of registration: 15 August 2023) prior to the enrollment of the first patient. One hundred and thirty-two American Society of Anesthesiologists I–II adults undergoing laparoscopic cholecystectomy were randomly allocated (1:1) to two groups: one received active warming with a resistive carbon fiber underbody blanket (Group 1), and the other received passive insulation (Group 2). The tympanic core temperature was measured at four perioperative time points (TT1–TT4). Postoperative agitation (Riker Sedation–Agitation Scale, RSAS) and pain (Numerical Rating Scale, NRS) were assessed 20 min after extubation in the post-anesthesia care unit (PACU). Secondary outcomes included intraoperative and postoperative temperature, postoperative shivering, adverse events (bradycardia, tachycardia, hypotension, hypertension, postoperative nausea and vomiting, and respiratory depression), and the PACU length of stay. Results: Baseline core temperatures (TT1) were similar between the groups (36.5 ± 0.55 °C vs. 36.6 ± 0.54 °C; p = 1.00). However, mean core temperatures at TT2, TT3, and TT4 were significantly higher in the active warming group compared with the control group (TT2: 36.7 ± 0.53 °C vs. 36.5 ± 0.54 °C; TT3: 36.6 ± 0.49 °C vs. 36.4 ± 0.54 °C; TT4: 36.6 ± 0.51 °C vs. 36.2 ± 0.52 °C; all p < 0.001). Active warming markedly reduced postoperative agitation (RSAS ≥ 5: 3.1% vs. 19.4%, p = 0.004) and pain (NRS ≥ 4: 15.4% vs. 49.3%, p < 0.001). The incidence of shivering was lower (20.0% vs. 46.3%, p = 0.006), and the PACU stay was shorter (24 [23–28] min vs. 35 [30–40] min, p < 0.001) with active warming. No significant differences in adverse events were observed between groups. Logistic regression identified the intraoperative fentanyl dose as a predictor of agitation and identified shivering and the PACU duration as predictors of pain. Conclusions: Peri-induction active warming effectively maintained normothermia and improved recovery quality by reducing postoperative agitation, pain, shivering, and PACU stays without increasing adverse events. It should be considered a standard component of thermal management in short- and medium-duration laparoscopic surgeries. Full article

This study evaluated the effects of different UV-C radiation doses combined with modified atmosphere packaging (MAP) on the conservation of minimally processed grated anco squash. The squash, obtained from producers in Santiago del Estero (Argentina), was washed, sanitized, cut, peeled, grated, and centrifuged. It was then subjected to UV-C treatments of 5 kJ/m² (T5), 15 kJ/m² (T15), 30 kJ/m² (T30), and 50 kJ/m² (T50). An immersion treatment with NaClO (100 ppm, 3 min) (TH) and an untreated control (TC) were also included. All samples were packaged in PVC trays and sealed with 35 μm polypropylene film, forming a passive MAP. Treatments T5 and T15 preserved acceptable sensory quality for up to 8 days, and no significant differences in color parameters were observed among treatments during storage. Overall, PC decreased by 12–20% and C by 15–37%, while AC increased by 15–40% after 8 days. Treatments T15, T30, and T50 effectively reduced psychrophilic microorganisms for up to 4 days, achieving reductions of 1–2 log compared to TH and TC (6 log CFU/g). By day 8, all treatments reached the microbial limit. In conclusion, the T15 treatment was the most suitable for preserving grated anco squash for up to 4 days at 5 °C, offering a potential alternative to sodium hypochlorite–based sanitization. Full article

Background: Non-typhoidal Salmonella (NTS) is a major foodborne pathogen, with poultry products, especially eggs, being the primary source of human infections. Current serovar-specific poultry vaccines effectively reduce targeted Salmonella serovars but may inadvertently promote the emergence of untargeted serovars within poultry flocks. Therefore, novel vaccine candidates providing broad cross-serovar protection are needed to improve overall effectiveness of Salmonella control programs. Objectives: This study evaluated the immunogenicity of the novel subunit vaccine candidate InvG and assessed its ability to reduce Salmonella colonization in vaccinated laying hens and their progeny through maternally derived antibodies transferred via egg yolk. Methodology: Three experiments were performed. Experiment I evaluated the immunogenicity of purified recombinant InvG by (a) measuring anti-InvG antibodies using an enzyme-linked immunosorbent assay (ELISA) and (b) completing transcriptomic profiling of immune responses in vaccinated chickens. Vaccinated chickens were subsequently challenged with Salmonella Enteritidis to assess the efficacy of anti InvG antibodies in reducing intestinal colonization of Salmonella. Experiment II involved immunizing hens with InvG, to evaluate passive transfer of antibodies via egg yolk and the protective efficacy of maternally derived antibodies against Salmonella challenge. Passive transfer was assessed by measuring IgY antibodies in hen serum, egg yolk, and progeny serum, as well as secretory IgA (sIgA) antibodies in progeny intestinal washings using ELISA. Protective efficacy was evaluated by orally challenging one-day-old chicks with three different Salmonella serovars. Experiment III assessed the persistence of anti-InvG antibodies in the serum of vaccinated hens and their transfer into eggs following two doses of InvG. Results: InvG vaccination induced robust IgY antibody responses in hens, with efficient maternal antibody transfer to progeny via egg yolk. A statistically significant reduction in Salmonella colonization was observed in both vaccinated hens and their progeny. Conclusions: These findings demonstrate that InvG represents a promising subunit vaccine candidate for Salmonella control in poultry and warrants further investigation towards development as a broadly protective commercial poultry vaccine against Salmonella. Full article

Radon (²²²Rn) is a naturally occurring radioactive noble gas that is a major source of ionising radiation in the environment. Many measurement techniques can be used to monitor ²²²Rn concentrations in the workplace. The main purpose of conducting such measurements is to identify locations of exposure, determine the effective dose for workers and, if necessary, define actions for reducing the exposure. As part of this study, a series of measurements were conducted in the underground tourist route at Książ Castle in Poland. The route has been open to visitors since late 2018. The measurements included long- and short-term tests. Passive and active methods were used to measure the ²²²Rn activity concentration. Additionally, the potential alpha energy concentration and ambient and radioactive aerosol size distributions were measured. Finally, the annual effective dose for workers was estimated. The dose was calculated while factoring in the legal regulations in the Czech Republic and Poland to demonstrate their effect on the final results. The obtained values were low—they did not exceed 0.218 mSv (for the specified exposure time)—indicating the effectiveness of natural ventilation and a low radiation risk to personnel. Full article

Wearable healthcare is shifting from passive tracking to active, closed-loop care by integrating polymeric three-dimensional (3D)-printed microneedle arrays (MNAs) with soft electronics and wireless modules. This review surveys the design, materials, and the manufacturing routes that enable skin-conformal MNA wearables for minimally invasive access to the interstitial fluid and precise but localized drug delivery. Looking ahead, the converging advances in multimaterial printing, nano/biofunctional coatings, and artificial intelligence (AI)-driven control are promising “wearable clinics” that can personalize monitoring and therapy in real time, thus accelerating the translation of MNA-integrated wearables from laboratory prototypes to clinically robust, patient-centric systems. Overall, this review identifies a clear transition from proof-of-concept MNA devices toward integrated, wearable, and closed-loop therapeutic platforms. Key challenges remain in scalable manufacturing, drug dose limitations, long-term stability, and regulatory translation. Addressing these gaps through advances in hollow MNA architectures, system integration, and standardized evaluation protocols is expected to accelerate clinical adoption. However, the realization of closed-loop wearable MNA-based systems remains constrained by challenges related to power consumption, real-time data latency, and the need for robust clinical validation. Full article

Phosphorus recovery from wastewater as struvite via electrochemical magnesium dosing is a promising approach to address the growing demand for fertilizers. However, its large-scale implementation is often constrained by energy requirements. To overcome this limitation, this study investigates electroless struvite precipitation from cheese whey wastewater using sacrificial magnesium anodes. Under optimal conditions, up to 90% of the phosphorus was recovered within 4–6 h. In this process, spontaneous magnesium dissolution acts as the driving force for phosphorus precipitation and is strongly influenced by the wastewater’s ionic composition. To identify conditions that favor efficient recovery, the effects of ammonium, chloride, and sulfate ions were evaluated by monitoring phosphorus removal and magnesium corrosion behavior. Sulfate ions enhanced magnesium corrosion more strongly than chloride during the initial stages, likely due to stronger coulombic interactions with Mg²⁺ at the electrode–electrolyte interface, whereas chloride ions were more effective at disrupting the passivation layer that develops over time. Based on these observations, a mechanistic interpretation of ion-specific effects on anodic corrosion is proposed. Solid-phase analyses using multiple characterization techniques confirmed struvite formation, with ammonium sulfate and ammonium chloride systems yielding the highest product purity. Overall, these findings improve the understanding of electroless struvite precipitation and highlight its potential as an energy-efficient approach for nutrient recovery. Full article

Tetanus is a life-threatening neurological disease affecting vertebrate species, including primates. Here, we present a case of severe generalized tetanus in a juvenile male chimpanzee (Pan troglodytes) that was rescued from the illegal wildlife trade and admitted to a rehabilitation center in the Republic of Congo. Upon arrival, the chimpanzee presented with deep, contaminated constrictive wounds, trismus, generalized rigidity, and stimulus-induced tonic spasms accompanied by transient apnea, while remaining conscious. A presumptive clinical diagnosis was made, after which integrated care began immediately. This included meticulous wound debridement and irrigation, passive immunization with antitoxin, initiation of active immunization, metronidazole with adjunctive penicillin G, diazepam-based spasm control, multimodal analgesia, and low-stimulation nursing with oxygen supplementation, enteral nutrition, and temporary urinary catheterization. Aerobic wound culture yielded mixed flora, and a Gram stain of the feces showed large Gram-positive rods with terminal spores. Hematology tests revealed leucopenia with neutropenia and severe thrombocytopenia. The spasms ceased by day 5, at which point the diazepam dose was reduced and oral intake was increased. By week 8, he had made a full clinical recovery and was successfully reintegrated into his group. This case supports the use of pragmatic, sanctuary-adapted protocols and systematic vaccination. Full article

Soil passivation conditioners effectively reduce cadmium (Cd) bioavailability and limit its accumulation in rice, though their efficacy and stability vary considerably among different types. A three-year paddy field study in southern China evaluated a calcium–silicon–magnesium composite (CSM) applied at 1500 and 3000 kg/ha (CSM1 and CSM2), with a no-CSM control (CK), on Cd behavior, soil properties, and functional groups. Results demonstrated a clear dose–response relationship, with CSM reducing brown rice Cd by 35−74% across sites (2021−2023). High-dose treatments achieved grain safety standards (0.183 mg/kg, p < 0.05). Soil pH increased annually by 0.2−0.37 units, while DTPA-extractable Cd decreased by 2.6−27% over three years. CSM application significantly transformed Cd speciation, reducing exchangeable Cd by 3% while increasing the iron–manganese oxide-bound fraction by 5%. Soil base saturation increased from 42.6% to 73.2% (HS) and 71% to 97.3% (XY). FTIR analysis revealed enhanced silicate polymerization, increased hydroxyl group abundance, and Si-O-Mg/Fe vibrations indicating a significant increase in Cd complexation in treated soil. The CSM passivator immobilizes Cd by elevating soil pH to promote its transformation into stable Fe-Mn-bound forms, enhancing hydroxyl and siloxane complexation with Cd, and synergizing with silicon–calcium ionic antagonism, collectively reducing Cd bioavailability while improving soil fertility through base saturation regulation. Full article