Search Results (21,023)

The increase in population and demand for the various needs of citizens increases the interaction with the geo-environment. Thus, the rate of natural events affecting daily human life increases. Such an event occurred on a rock cliff in a densely populated area in İstanbul (Türkiye). More than four rock blocks (approximately 3–5 m³) belonging to the Paleozoic sequence of İstanbul, composed of nodular limestone with sandy-clay interlayers, detached and fell. The blocks traveled along a path of approximately 60 m and stopped by crushing a couple of buildings downslope. The path was rough and contained various surface conditions (e.g., bedrock, talus, and plants). This study was initiated by the examination of the dimensions of failed rock blocks, their paths, and topographic conditions. Unmanned vehicles (drones) facilitated the generation of 3D numerical models of topographic changes on the site. Quantifying discontinuity properties (such as persistence, spacing, roughness, etc.) and defining weathering properties comprises the second stage, along with sampling. Based on digital topographic data and field observations, cross-sections were defined by means of possible rockfall areas within the area of potentially unstable blocks. Numerical analysis and rockfall analysis were conducted along these critical sections. Interpretation of laboratory data and results obtained from numerical studies leads to an understanding of the mechanism of the recent rockfall event and demonstrates the most critical areas to be considered and reinforced. The research comprises proposing appropriate reinforcement techniques due to the strong Turkish regulations along the “Bosphorus Waterfront Protected Zone”. The study advises pre-cleaning of potentially unstable blocks after a fence production on paths where rocks could fall, and rock anchors in some localities with varying lengths. The latest part of the research covers the re-assessment of mitigation processes with numerical models, which shows that the factor of safety increased to the desired levels. The reinforcement applications at the site match well with the proposed prevention methods. Full article

Population size estimates are essential for investigating numerous aspects of the ecology, evolution, and conservation of wildlife. However, the life cycles of many species include cryptic life stages that are difficult to detect or sample, such as the non-breeding fractions typical of many bird populations. Quantifying the proportions of breeders and non-breeders is crucial to better assess their conservation status and population trends. We propose a simple method applicable to species that show phenotypic differences between adults and juveniles. By quantifying the proportion of ages, the size of the whole population, and its productivity, the size of the non-breeding and breeding fractions can be inferred. We applied this approach to the red-spectacled amazon, Amazona pretrei, a threatened parrot endemic to the Brazilian Atlantic Forest. The entire global population aggregates in winter in a few localities to feed on the seeds of the Parana pine Araucaria angustifolia, a critically endangered tree whose range has declined >97% due to massive exploitation. From a global population of ~16,000 individuals in 2015 and ~20,000 individuals in 2017, our methodology allowed us to estimate a low proportion of juveniles (14%) and a large proportion of non-breeders (80%) within the adult population, with narrow confidence intervals. These proportions did not change between years, but the estimated number of breeding pairs increased, from ca. 1300 to 1700 pairs, in parallel with the global population increase. Our methodology, with its possible improvements to reduce uncertainty in estimates, can be applied to the long-term monitoring of this and many other species, to better understand their conservation challenges and inform effective management strategies. Full article

African American (AA) women often experience earlier onset and more severe menopause symptoms, especially vasomotor symptoms (VMSs) like hot flashes, compared to other groups. However, limited research has examined the effectiveness and acceptability of menopause treatments in this population. This scoping review synthesized evidence on pharmacological (e.g., hormone replacement therapy [HRT], SSRIs, venlafaxine, nitroglycerin) and holistic (e.g., dietary changes, physical activity [PA], supplementation) approaches for managing menopause symptoms in AA women. Using Joanna Briggs Institute and PRISMA-ScR guidelines, a scoping review was conducted, guided by the PCC framework. Four databases (CINAHL, PsycInfo, PubMed, Scopus) were searched for English-language studies (2010–2025) involving AA women aged 40–65. Eligible studies included RCTs and observational designs with ≥10% AA participants. Data were charted and synthesized descriptively. Fourteen U.S.-based studies (11–53% AA representation) were included. Pharmacological treatments—especially HRT and SSRIs—were effective for VMSs and mood symptoms. Holistic approaches showed mixed outcomes; PA and magnesium offered modest benefit, while phytoestrogens sometimes worsened memory. Race-specific results were rarely reported. Effective pharmacological options exist, but evidence tailored to AA women is lacking. Future research must ensure greater AA representation and culturally responsive approaches to menopause care. Full article

Joint acidosis is increasingly recognized as an important determinant of cellular behavior in osteoarthritis (OA). Declines in extracellular pH (pHe) occur across cartilage, meniscus, synovium, and subchondral bone, where they influence inflammation, matrix turnover, and pain. Among proton-sensing G protein-coupled receptors, GPR68 responds to the acidic pH range characteristic of human OA joints. The receptor is activated between pH 6.8 and 7.0, couples to Gq/PLC-MAPK, cAMP-CREB, G12/13-RhoA-ROCK signaling pathways, and is expressed most prominently in articular cartilage, with additional expression reported in synovium, bone, vasculature, and some neuronal populations. These pathways regulate transcriptional programs relevant to cartilage stress responses, inflammation, and matrix turnover. GPR68 expression is increased in human OA cartilage and aligns with regions of active matrix turnover. We previously reported that pharmacologic activation of GPR68 suppresses IL1β-induced MMP13 expression in human chondrocytes under acidic conditions, indicating that increased GPR68 expression may represent a microenvironment-responsive, potentially adaptive signaling response rather than a driver of cartilage degeneration. Evidence from intestinal, stromal, and vascular models demonstrates that GPR68 integrates pH changes with inflammatory and mechanical cues, providing mechanistic context, although these effects have not been directly established in most joint tissues. Small-molecule modulators, including the positive allosteric agonist Ogerin and the inhibitor Ogremorphin, illustrate the tractability of GPR68 as a drug target, although no GPR68-directed therapies have yet been evaluated in preclinical models of OA. Collectively, current data support GPR68 as a functionally relevant proton sensor within the acidic OA joint microenvironment. Full article

Background: Structural and functional adaptation of the heart to chronic exercise is dependent on multiple factors, including the volume and type of training, and has direct implications for pre-participation cardiac screening (PPCS). Sailing is a unique multi-training modality sport with limited prior description of cardiac adaptation to training. The aims of this study are (1) to describe electrocardiogram (ECG) changes in sailors, informing PPCS guidelines; (2) to assess structural and functional cardiac changes in sailors; and (3) to examine sex- or discipline-specific cardiac adaptations in sailors. Methods: Seventy elite sailors (33 females) underwent standard ECG and echocardiography. Echocardiographic data were compared to population norms and analysed by sex and sailing discipline based on training type: isometric (IG), pumping (PG), and movement (MG). Results: One sailor presented with abnormal ECG findings (T wave inversion) which warranted further investigation. Primary training-related ECG changes noted were early repolarisation (24%) and sinus bradycardia (30%). The left ventricular volume index was dilated in 18% of all sailors compared to reference values, with similar findings noted on right ventricular parameters for 22% of the study population, although in males only. The impact of predominant training stimulus (IG, PG, MG) did not mediate differences in the structure of any cardiac chambers (p > 0.05). Ejection fraction was lower in the PG (Δ4%, p ≤ 0.001), whereas global longitudinal strain was higher (Δ2%, p = 0.02) compared to MG and IG. Conclusions: Elite-level sailors present with electrical and structural cardiac phenotypes associated with exercise adaptation, with dilation of both left- and right-sided chambers. These data should be considered when interpreting results of PPCS in male and female sailors from different, specific disciplines. Full article

Both obesity and chronic kidney disease (CKD) are increasingly recognized as global epidemics. Their escalating incidence and far-reaching health implications highlight the urgent need for comprehensive prevention and management strategies. This review aims to clarify how obesity interacts with end-stage kidney disease (ESKD) and how to improve the management of obese patients receiving kidney replacement therapy. It also explores underlying mechanisms, current treatments, future directions, and ongoing controversies. By highlighting this intricate relationship, the review seeks to enhance clinical practice and promote further research toward more personalized care for this vulnerable population. Obesity is frequent in dialysis patients and creates challenges related to body composition, metabolism, and treatment. While higher body mass index (BMI) may appear to improve survival, this paradox does not offset the cardiovascular and functional risks of visceral and sarcopenic obesity. Obesity also increases post-transplant complications and can limit access to transplantation. Lifestyle changes rarely achieve lasting weight loss, whereas bariatric surgery—especially sleeve gastrectomy—can improve transplant eligibility with fewer complications. Weight-loss medications may be used before transplantation but remain insufficiently studied in ESKD. After transplantation, weight-reduction efforts should continue, with pharmacotherapy preferred over bariatric surgery. Comprehensive assessment strategies and individualized management approaches in ESKD patients are essential to optimize outcomes in this growing patient population. Full article

Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week core-focused plank exercise program on fatigue and HRQoL in women with LC, using validated patient-reported measures. Materials and Methods: A pilot quasi-experimental design was implemented, with non-randomized group allocation. Thirty-nine women with LC were recruited from the Madrid Long COVID Association. Participants were assigned to either an intervention group (n = 20), which completed a supervised plank-based motor control program, or a control group (n = 19), which maintained usual activity. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and HRQoL was measured using the EQ-5D-5L and EQ Visual Analog Scale (EQ-VAS). Body composition was evaluated via bioelectrical impedance analysis. Results: The intervention group showed significant reductions after intervention in the MFIS total scores compared to the control group, particularly in the physical (21.26 ± 6.76 vs. 25.21 ± 6.06; p < 0.001) and psychosocial domains (4.51 ± 0.41 vs. 5.21 ± 0.38; p < 0.001), without triggering PESE. EQ-VAS scores improved significantly (63.94 ± 15.33 vs. 46.31 ± 14.74; p = 0.034). No significant changes were found in body composition parameters, suggesting that benefits were driven by neuromuscular adaptations rather than morphological changes. Conclusions: A core-focused, non-aerobic exercise program effectively reduced fatigue and improved perceived health status in women with LC. These findings support the use of motor control-based interventions as a safe and feasible strategy for LC rehabilitation, particularly in populations vulnerable to PESE, suggesting clinical applicability for the rehabilitation of women with LC. Further randomized trials are warranted to confirm these results and explore long-term outcomes. Full article

Background: Oral potentially malignant disorders (OPMDs) often exhibit heterogeneous clinical features, making the early detection of dysplasia very difficult. Several chemiluminescence-based devices, like ViziLite^®, have been suggested as non-invasive adjuncts that can enhance the visualization of suspicious mucosal changes. However, their true diagnostic value remains unclear. Methods: A systematic review and meta-analysis were conducted in line with PRISMA 2020 guidelines. Thirteen clinical studies met the inclusion criteria, necessitating chemiluminescence as index test and histopathology as reference standard, with extractable 2 × 2 diagnostic data. For all OPMDs and leukoplakia-only subgroups, pooled sensitivity and specificity, DOR, SROC curves, and device-specific diagnostic accuracy were determined. Results: Of all the OPMDs, chemiluminescence demonstrated a high pooled sensitivity of 0.82 and a low specificity of 0.48 with considerable heterogeneity among studies. The results in the leukoplakia subgroup improved sensitivity of 0.87 and a specificity of 0.51 were recorded with a more concave SROC curve, which illustrated a better discriminative ability in keratinized lesions. Comparison of devices illustrates accuracy was best for ViziLite + Lugol iodine (~0.82) followed by standard ViziLite (~0.62) and ViziLite Plus (~0.53). Conclusions: Chemiluminescence, while it may demonstrate good sensitivity, has repeatedly shown to have limited specificity in a consistent manner, particularly in populations with mixed OPMD where inflammatory and benign lesions inflate the false-positive rates. Notably, diagnostic performance was higher in leukoplakia, suggesting that keratinized lesions benefit most from this adjunctive tool. Overall, chemiluminescence may facilitate lesion visualization and biopsy site selection but cannot supplant histopathological examination as a definitive diagnostic modality. Full article

In recent years, there has been increasing interest in the study of the gut–brain axis. Furthermore, there appears to be a relationship between abdominal pain, selective eating patterns, emotional instability, and intestinal disorders in Autism Spectrum Disorder (ASD). This work describes the development and accessibility evaluation of the INCE mobile app. This mobile app allows users to obtain levels of gut–brain interaction severity using two scientifically proven scales: The Gastrointestinal Symptom Severity Scale (GSSS) and the Pain and Sensitivity Reactivity Scale (PSRS). The validity of both instruments was established in previous studies in neurotypical and autistic populations. Statistically significant improvements were found following post-design changes in the use and accessibility of the INCE app (.NET Maui 9 Software) reported by professionals (p = 0.013), families (p = 0.011), and adolescents (p = 0.004). INCE represents an important contribution to evidence-based applications and clearly translates into society. Full article

Gait analysis is a non-invasive, cost-effective method for detecting subtle motor changes in neurodegenerative disorders. This study uses an exploratory approach to identify temporal–kinetic gait feature relationships specific to amyotrophic lateral sclerosis (ALS) and Huntington (HUNT) and Parkinson (PARK) disease versus healthy controls (CONTROL) using recent advances in InterCriteria Analysis (ICrA). The novelty lies in the (i) comprehensive temporal–kinetic feature set, (ii) use of ICrA to characterize inter-feature coordination patterns at population and disease-group levels and (iii) interpretation in a neuromechanical context. Forty-one temporal/kinetic features were extracted from left/right leg ground reaction force and rate-of-force-development signals, considering laterality, gait phase (stance, swing, double support), magnitudes, waveform correlations, and inter-/intra-limb asymmetries. The analysis included 14,580 steps from 64 recordings in the Gait in Neurodegenerative Disease Database: 16 CONTROL (4054 steps), 13 ALS (2465), 20 HUNT (4730), 15 PARK (3331). Sensitivity analysis identified strict consonance thresholds (μ ≥ 0.75, ν ≤ 0.25), selecting <5% strongest inter-feature relations from 820 feature pairs: population level (16 positive, 14 negative), group-level (15–25 positive, 9–14 negative). ICrA identified group-specific consonances—present in one group but absent in others—highlighting disease-related alterations in gait coordination: ALS (15/11 positive/negative, disrupted bilateral stride coordination, prolonged stance/double-support, decoupled stride/cadence, desynchronized force-generation patterns—reflecting compensatory adaptations to muscle weakness and instability), HUNT (11/7, severe temporal–kinetic breakdown consistent with gait instability—loss of bilateral coordination, reduced swing time, slowed force development), PARK (1/2, subtle localized disruptions—prolonged stance and double-support intervals, reduced force during weight transfer, overall coordination remained largely preserved). Benchmarking vs. Pearson correlation showed strong linear agreement (R² = 0.847, p < 0.001), confirming that ICrA captures dominant dependencies while moderating the correlation via uncertainty. These results demonstrate that ICrA provides a quantitative, interpretable framework for characterizing gait coordination patterns and can guide principled feature selection in future predictive modeling. Full article

Background/Objectives: Accumulation of cerumen (earwax) in the auditory canal is a common condition, particularly in children and older adults, and often causes temporary hearing loss. While chronic hearing loss is known to affect mood and cognition, little is known about the psychological impact of short-term auditory deprivation. This pilot study aimed to examine the emotional and cognitive effects of simulated temporary hearing loss. Methods: Thirty healthy adults (16 females, aged 18–60) participated. Temporary hearing loss was simulated by placing earplugs in both ears for two hours. Participants completed four tests, assessing anxiety, mood, and attention at three time points: before wearing earplugs, during the blocked condition, and after earplug removal. Results: Participants showed a significant increase in state anxiety and a decrease in mood during the earplug condition. Interestingly, visual attention performance improved while hearing was obstructed and remained elevated even after earplug removal. Conclusions: Short-term simulated hearing loss produces measurable emotional and cognitive changes, including increased anxiety but enhanced visual attention. Clinicians should consider these effects when assessing patients with temporary hearing obstruction, such as those with cerumen impaction. The results carry implications for the broader population wearing earplugs on a temporary basis including musicians, construction employees, and, in general, people working in noisy environments. Full article

Background/Objectives: Functional dyspepsia (FD) is a gastrointestinal disorder typically treated by changes in diet and lifestyle. However, in the Colombian population, few studies have addressed its etiology and diagnosis. This exploratory study aimed to identify predictive variables associated with the presence of dyspeptic symptoms (DS). Methods: To address this, a self-survey was conducted evaluating sociodemographic characteristics, clinical history, and dietary habits. A DS index was calculated using participant’s clinical history to explore the characteristics of the groups with more and less DS (MDS and LDS groups). Additionally, a regression model was applied to identify the predictors of higher DS scores. Pooled data from the rolling, cross-sectional eating habits and DS survey between May and July of 2024. We enrolled 102 Colombian participants between 18 and 65 years old. Results: Significant differences were identified between MDS and LDS groups in occupation and dietary habits, with students exhibiting a higher DS index. Moreover, MDS exhibited greater consumption of fatty and fried foods than LDS groups. Regression analysis revealed that high intake of fatty foods and sesame were the best predictors of higher DS index. In contrast, the consumption of Saccharomyces boulardii probiotic and white onion was associated with better gastrointestinal health. Conclusions: Changes in dietary habits are associated with lower DS; the effect and its etiology might also depend on the participants’ occupation and nutritional habits. Full article

Background: Although Capacitive–Resistive Electric Transfer (TECAR) and vibration therapy (VT) are increasingly used in sports recovery, their effects on muscle oxygenation remain unclear. Objectives: This study compared the short-term influence of TECAR and VT on muscle oxygenation following eccentric exercise in young, active adults. We hypothesized that both interventions would support early metabolic recovery, as reflected by changes in muscle oxygenation, and potentially reduce the risk of musculoskeletal overuse. Methods: Forty-one young, recreationally active adults (age: 19 ± 2 years; height: 168 ± 9 cm; body mass: 63 ± 13 kg) were randomized into two groups: TECAR therapy and VT. Muscle oxygenation was assessed at baseline, post-exercise, and post-intervention using the arterial occlusion method with a MOXY muscle oxygenation monitor (Fortiori Design LLC, USA). The primary variables were mVO₂ (muscle oxygen consumption), ΔSmO₂ (change in oxygen saturation during occlusion), and ΔtHb (change in hemoglobin level during occlusion). Data were analyzed using a two-way repeated-measures ANOVA with post hoc Tukey tests, and statistical significance was set at p < 0.05. Results: Eccentric exercise significantly reduced mVO₂ in both groups (VT: −0.18 ± 0.40 to −1.62 ± 0.70; TECAR: −0.12 ± 0.40 to −1.24 ± 0.70), indicating decreased metabolic demand. Following recovery, mVO₂ increased in both groups (VT: −0.86 ± 0.50; TECAR: −0.35 ± 0.40), with no significant between-group differences (p > 0.05). ΔSmO₂ also decreased after exercise (VT: −0.7 ± 0.4 to −3.2 ± 0.9; TECAR: −0.9 ± 0.6 to −3.45 ± 0.7). After recovery, ΔSmO₂ partially returned to baseline (VT: −2.6 ± 0.8; TECAR: −1.35 ± 0.4), with no significant between-group differences. ΔtHb increased following exercise in both groups (VT: 0.03 ± 0.04 to 0.13 ± 0.09; TECAR: 0.03 ± 0.04 to 0.15 ± 0.07) and decreased after recovery to similar levels (VT: −0.05 ± 0.05; TECAR: −0.06 ± 0.04; p > 0.05). Conclusions: Both TECAR and VT were associated with improved muscle oxygenation during early recovery after eccentric exercise, as reflected by increases in mVO₂ and comparable ΔtHb responses. Although ΔSmO₂ tended to decrease more after VT, this difference was not statistically significant and should be interpreted cautiously. Overall, both modalities appear to be effective recovery-supporting strategies, while further controlled studies are needed to clarify their role in different athletic populations and exercise contexts. Full article

Background and Objectives: SGLT2 inhibitors are foundational in heart failure therapy, yet their impact on left ventricular (LV) remodeling immediately following acute coronary syndrome (ACS) remains less defined. This study evaluated the association between early SGLT2 inhibitor initiation and structural recovery in a real-world post-ACS cohort. Materials and Methods: We conducted a retrospective observational study including 238 revascularized ACS patients, stratified into an SGLT2 inhibitor group (n = 71) and a control group (n = 167). Changes in LV ejection fraction (LVEF) and indexed LV mass (LVMi) were assessed by echocardiography at baseline and follow-up (mean 286 days). Multivariable regression models were adjusted for baseline imbalances and tested for interactions with diabetes status. Results: A significant “confounding by indication” was observed; the SGLT2 group presented a high-risk phenotype with higher diabetes prevalence (56.3% vs. 25.7%, p < 0.001), lower baseline LVEF (38.3% vs. 43.3%), and greater hypertrophy. After adjustment, statistical independence was attenuated by baseline severity, yet the SGLT2 group achieved follow-up structural outcomes comparable to lower-risk controls. Interaction analysis indicated these trends were consistent regardless of diabetes status (p > 0.05). Conclusions: In this high-risk ACS population, early SGLT2 inhibitor therapy was associated with stabilization of cardiac structure. Despite a profound baseline disadvantage, the recovery trajectory effectively aligned with that of a lower-risk population, highlighting a clinically relevant pattern of structural stabilization consistent across metabolic subgroups. Full article

Background: Persistent liver pathology despite a sustained virologic response (SVR) to hepatitis C virus (HCV) therapy is a major clinical concern. This is particularly relevant for people with HIV (PWH) with HCV coinfection, a population prone to accelerated liver disease progression. This study aimed to characterize the plasma miRNA profile in PWH with cirrhosis one year after successful completion of HCV therapy, and to explore their relationship with metabolite alterations. Methods: This cross-sectional study enrolled 47 PWH who achieved HCV clearance with antiviral therapy. Using plasma samples collected approximately one year after completion of HCV therapy, participants were stratified into two groups based on liver stiffness measurement (LSM): compensated cirrhosis (n = 32, LSM ≥ 12.5 kPa) and non-cirrhosis (n = 15, LSM < 12.5 kPa). Plasma miRNAs and metabolites were determined using small RNA sequencing and untargeted capillary electrophoresis-mass spectrometry (CE-MS), respectively. Significantly differentially expressed (SDE) miRNAs were identified using generalized linear models (GLM) with a negative binomial distribution, and their correlation with metabolite levels was quantified using Spearman’s correlation. Results: In the cirrhosis group (n = 32), we identified a distinct signature of 15 SDE miRNAs (9 upregulated, 6 downregulated) compared to the non-cirrhotic group (n = 15), showing hsa-miR-10401-3p, hsa-miR-548ak, hsa-miR-141-3p, and hsa-miR-3940-3p the largest expression changes. miRNA-gene interaction and pathway enrichment analysis suggested that these 15 SDE miRNAs potentially regulate multiple genes involved in immune response and amino acid metabolism. In addition, correlation analyses with our metabolomic data revealed significant associations between specific SDE miRNAs and amino acids and their derivatives. Specifically, the expression of upregulated miRNAs (e.g., hsa-miR-10401-3p and hsa-miR-16-5p) was positively correlated with plasma levels of L-methionine and its derivatives, while downregulated miRNAs (e.g., hsa-miR-625-5p) were inversely correlated with L-tryptophan. Conclusions: In cirrhotic PWH with history of HCV coinfection, a distinct plasma miRNA signature linked to dysregulated amino acid metabolism is found one year after completion of HCV therapy. This underscores that the HCV cure does not equate to complete hepatic recovery, highlighting the critical need for long-term monitoring in this high-risk population. Full article