Search Results (123)

The effects of long-term adjustments in body weight on the lipid balance in patients with severe obesity are not well understood. This study aimed to evaluate a non-invasive lipidomic approach to identifying biomarkers that could help predict which patients may require additional therapies before and after weight loss. Using mass spectrometry, 275 lipid species were analysed in non-obese controls, patients with severe obesity, and patients one year after bariatric surgery. The results showed that severe obesity disrupts lipid pathways, contributing to lipotoxicity, inflammation, mitochondrial stress, and abnormal lipid metabolism. Although weight loss improved these disturbances, surgery did not fully normalise the lipid profiles of all patients. Outcomes varied depending on their baseline liver health and genetic differences. Persistent alterations in cholesterol handling, membrane composition, and mitochondrial function were observed in partial responders. Elevated levels of sterol lipids, glycerophospholipids, and sphingolipids emerged as markers of complete metabolic recovery, identifying candidates for targeted post-surgical interventions. These findings support the use of lipidomics to personalise obesity treatment and follow-up. Full article

Earthquakes can severely disrupt power distribution networks, causing extensive outages and disconnection from the transmission grid. This paper proposes a two-stage restoration method tailored for post-earthquake distribution systems. First, earthquake-induced damage is modeled using ground motion prediction equations (GMPEs) and fragility curves, and degraded network topologies are generated by Monte Carlo simulation. Then, a time-domain generator start-up model is developed as a mixed-integer linear program (MILP), incorporating cranking power and radial topology constraints. Further, a prioritized load recovery model is formulated as a mixed-integer second-order cone program (MISOCP), integrating power flow, voltage, and current constraints. Finally, case studies demonstrate the effectiveness and general applicability of the proposed method, confirming its capability to support resilient and adaptive distribution network restoration under various earthquake scenarios. Full article

Since the outbreak of the Russia–Ukraine conflict in 2022, Ukraine’s agricultural production has faced significant disruption, leading to widespread cropland abandonment. These croplands were abandoned at different stages, primarily due to war-related destruction and displacement of people. Existing methods for detecting abandoned cropland fail to account for crop type differences and distinguish abandonment stages, leading to inaccuracies. Therefore, this study proposes a novel framework combining crop-type classification with the Bias-weighted Time-Weighted Dynamic Time Warping (BTWDTW) method, distinguishing between sowing and harvest abandonment. Additionally, the proposed framework improves accuracy by integrating a more nuanced analysis of crop-specific patterns, thus offering more precise insights into abandonment dynamics. The overall accuracy of the proposed method reached 88.9%. The results reveal a V-shaped trajectory of cropland abandonment, with abandoned areas increasing from 28,184 km² in 2022 to 33,278 km² in 2024, with 2023 showing an abandoned area of 24,007.65 km². Spatially, about 70% of sowing abandonment occurred in high-conflict areas, with hotspots of unplanted abandonment shifting from southern Ukraine to the northeast, while unharvested abandonment was observed across the entire country. Significant variations were found across crop types, with maize experiencing the highest rate of unharvested abandonment, while wheat exhibited a more balanced pattern of sowing and harvest losses. The proposed method and results provide valuable insights for post-conflict agricultural recovery and decision-making in recovery planning. Full article

Burn injuries result in complex physiological and psychological sequelae, including hypermetabolism, muscle wasting, mobility impairment, scarring, and disrupted body image. While advances in acute care have improved survival, comprehensive rehabilitation strategies are critical for restoring function, appearance, and psychosocial well-being. Structured physical activity, including resistance and aerobic training, plays a central role in counteracting muscle atrophy, improving cardiovascular function, enhancing scar quality, and promoting psychological resilience and body image restoration. This narrative review synthesizes the current evidence on the effects of exercise-based interventions on post-burn recovery, highlighting their therapeutic mechanisms, clinical applications, and implementation challenges. In addition to physical training, emerging technologies such as virtual reality, aquatic therapy, and compression garments offer promising adjunctive benefits. Notably, artificial intelligence (AI) is gaining traction in burn rehabilitation through its integration into wearable biosensors and telehealth platforms that enable real-time monitoring, individualized feedback, and predictive modeling of recovery outcomes. These AI-driven tools have the potential to personalize exercise regimens, support remote care, and enhance scar assessment and wound tracking. Overall, the integration of exercise-based interventions with digital technologies represents a promising, multimodal approach to burn recovery. Future research should focus on optimizing exercise prescriptions, improving access to personalized rehabilitation tools, and advancing AI-enabled systems to support long-term recovery, functional independence, and positive self-perception among burn survivors. Full article

Despite decades of intense interest and investment in cognitive science, there remains a not only incomplete but also highly inconsistent body of evidence regarding how adult brains recover from even the most focal injuries associated with stroke. In this paper, I provide a broad narrative review of the studies of post-stroke aphasia recovery that have sought to identify the mechanisms of language recovery through longitudinal functional imaging. I start with studies that used functional imaging in groups of neurotypical individuals that have revealed areas of the brain that are reliably activated by language tasks and are functionally connected, referred to here as the “language network.” I then review group studies in which functional imaging data were averaged across groups of people with post-stroke aphasia to characterize the neurobiology of recovery. These group studies of post-stroke aphasia have yielded very different results and have led to conflicting conclusions. Subsequently, I examine results of studies of single subjects that have employed longitudinal functional imaging to identify mechanisms of language recovery. Together, these single subject studies make it clear that mechanisms of neural recovery are far from uniform, even in people with very similar lesions and time since stroke. On this basis, I argue that it is not justifiable to average functional imaging data across individuals with post-stroke aphasia to draw meaningful insights into how brain networks change to support language recovery. Each individual’s brain networks change over time, but in divergent ways that depend on the extent of disruption to the normal language network, interventions to facilitate recovery, the health of the intact brain, and other variables yet to be identified. While averaging results across participants with post-stroke aphasia might be able to identify certain changes in the networks that are correlated with specific language gains, uncovering the range of mechanisms and dynamics of language recovery after stroke requires longitudinal imaging of individuals. Full article

Hurricanes are powerful tropical storms that can severely damage mangrove forests through uprooting trees, sediment erosion, and saltwater intrusion, disrupting their critical role in coastal protection and biodiversity. After a hurricane, evaluating mangrove damage helps prioritize rehabilitation efforts, as these ecosystems play a key ecological role in coastal regions. Thus, we analyzed the defoliation of mangrove forest canopies and their early recovery, approximately 2.5 years after the landfall of Category 3 Hurricane Roslyn in October 2002 in Marismas Nacionales, Mexico. The following mangrove traits were analyzed: (1) the yearly time series of the Combined Mangrove Recognition Index (CMRI) standard deviation from 2020 to 2025, (2) the CMRI rate of change (slope) following the hurricane’s impact, and (3) the canopy height model (CHM) before and after the hurricane using satellite and UAV-LiDAR data. Hurricane Roslyn caused a substantial decrease in canopy cover, resulting in a loss of 47,202 ha, which represents 82.8% of the total area of 57,037 ha. The CMRI standard deviation indicated early signs of canopy recovery in one-third of the mangrove-damaged areas 2.5 years post-impact. The CMRI slope indicated that areas near the undammed rivers had a maximum recovery rate of 0.05 CMRI units per month, indicating a predicted canopy recovery of ~2.5 years. However, most mangrove areas exhibited CMRI rates between 0.01 and 0.03 CMRI units per month, anticipating a recovery time between 40 months (approximately 3.4 years) and 122 months (roughly 10 years). Unfortunately, most of the already degraded Laguncularia racemosa forests displayed a negative CMRI slope, suggesting a lack of canopy recovery so far. Additionally, the CHM showed a median significant difference of 3.3 m in the canopy height of fringe-type Rhizophora mangle and Laguncularia racemosa forests after the hurricane’s landfall. Full article

Background/Objectives: Caesarean section (CS) accounts for over 20% of global births and routinely involves perioperative antibiotic prophylaxis (PAP) to reduce surgical site infections. While the impact of such prophylaxis on neonatal microbiome development is well described, effects on the maternal gut microbiome remain underexplored. This systematic review synthesizes current evidence on how antibiotic prophylaxis during CS affects maternal gut microbiome composition and diversity—an underrepresented, but clinically relevant aspect of maternal–fetal medicine. Methods: A systematic literature search was conducted in Medline (PubMed), the Cochrane Library, and the WHO International Clinical Trials Registry Platform (ICTRP) through November 2024. Inclusion criteria were defined according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies used molecular techniques to report maternal gut microbiome outcomes (alpha- and beta-diversity). The search concentrated on beta-lactam antibiotics. Reference lists were screened, but no additional grey literature was searched. Synthesis followed the Synthesis Without meta-analysis (SWiM) approach. No review protocol was registered. The review received no external funding. Results: Out of 1011 records, three studies (total 286 mothers) met the inclusion criteria. All reported maternal microbiome outcomes secondarily to infant-focused research. Only one study provided pre- and post-birth stool samples. Applied antibiotic regimens, sequencing methods, and reported microbiome metrics for alpha- and beta-diversity varied considerably, thus limiting comparability of results. Due to high heterogeneity, no formal risk of bias was assessed. While taxonomic diversity changes were inconsistent, significant shifts in functional diversity metrics were observed postpartum. Conclusions: Evidence on maternal microbiome disruption following perioperative antibiotic prophylaxis in CS is methodologically fragmented and limited by small sample sizes and inconsistent antibiotic protocols. Nonetheless, functional diversity appears sensitive to antibiotic exposure. To improve clinical understanding and safety, maternal-focused studies using standardized protocols are urgently needed. The maternal microbiome may play a key role in both recovery and shaping the newborn’s early microbial environment. Full article

Background: Marburg virus disease (MVD) is a highly lethal filoviral infection, yet its long-term health consequences remain poorly understood. We present one of the most temporally distant evaluations of MVD survivors, conducted 13 years post-outbreak in Uganda, offering novel insights into chronic physiological, biochemical, haematological, and psychosocial outcomes. Methods: A cross-sectional, community-based study compared ten MVD survivors with nineteen age- and sex-matched unexposed controls. Clinical evaluations included vital signs, anthropometry, mental health screening, and symptom reporting. Laboratory analyses covered electrolytes, inflammatory markers, renal and liver function tests, haematology, and urinalysis. Standardised psychological assessments measured anxiety, depression, perceived stigma, and social support. Findings: Survivors exhibited an elevated body mass index (BMI), higher systolic and diastolic blood pressure, and lower respiratory rates compared to controls, indicating ongoing cardiometabolic and autonomic changes. These trends may reflect persistent cardiometabolic stress and potential alterations in autonomic regulation, warranting further investigation. Biochemically, survivors exhibited disruptions in serum chloride, bilirubin, and total protein levels, suggesting subclinical hepatic and renal stress. Haematological analysis revealed persistent reticulocytosis despite normal haemoglobin levels, indicating long-term erythropoietic modulation. Despite these physiological changes, survivors reported minimal psychological morbidity, sharply contrasting with the post-recovery profiles of other viral haemorrhagic fevers. Stigma was prevalent during the outbreak; however, strong family support alleviated long-term psychosocial distress. Interpretation: Thirteen years post-infection, MVD survivors demonstrate multisystem physiological perturbations without marked psychological sequelae. These findings challenge assumptions of universal post-viral trauma and highlight the necessity for tailored survivor care models. Future longitudinal studies should investigate the mechanistic pathways underlying cardiometabolic and haematological reprogramming to inform intervention strategies in resource-limited settings. Full article

Critical transportation networks in developing countries often lack structural robustness and functional redundancy due to insufficient planning and preparedness. These deficiencies increase vulnerability to disruptions and impede effective post-disaster response and recovery. Understanding how such networks perform under stress is essential to improving resilience in hazard-prone urban environments. This paper presents an integrated predictive methodology for assessing the operational resilience of urban transportation networks under extreme events, specifically tailored to data-scarce and high-risk contexts. By combining Geographic Information Systems (GISs) with complex network theory, the framework captures both spatial and topological dependencies. The methodology is applied to Beirut, the capital of Lebanon, a densely populated and disaster-prone Mediterranean city, through scenario-based simulations that account for interdependent stressors such as traffic dynamics, structural fragility, and geophysical hazards. Results reveal that the network exhibits low redundancy and high sensitivity to even minor disruptions, leading to rapid performance degradation. These findings indicate that the network should be classified as highly vulnerable. The study offers a robust framework for assessing infrastructure resilience and supporting evidence-based decision-making in critical urban network management. Full article

The COVID-19 pandemic has disrupted the progress toward Sustainable Development Goal 3, particularly in developing countries, exacerbating existing health disparities and creating new challenges for health systems worldwide. This study explores the role of university research in advancing SDG 3 targets in a post-pandemic context using the University of the Western Cape as a case study. Through qualitative data analysis of research titles and abstracts registered between 2020 and 2022, we applied the WHERETO model of McTighe and Bloom’s Taxonomy to categorize research according to the SDG 3 targets and indicators. This approach provides insight into which health priorities were addressed through scholarly research at UWC in alignment with the UN 2030 Agenda, particularly during pandemic recovery. Our findings indicate that research priorities largely corresponded with South Africa’s health challenges, with the highest concentration of studies addressing non-communicable diseases and mental health (Target 3.4), infectious diseases (Target 3.3), and medicine development (Target 3.b). These priorities align with the National Health Research Committee’s identified health priorities for disadvantaged communities in the Western Cape. Notably, research on mental health and emergency preparedness (Target 3.d) increased significantly during the pandemic period, reflecting shifting priorities in response to COVID-19. This study offers critical insights into how university research shifted priorities adapted during the pandemic and identifies areas requiring focused attention to support post-pandemic recovery. By highlighting research gaps and opportunities, our findings provide a foundation for developing more comprehensive approaches to health research that address the disparities exacerbated by COVID-19 while advancing the 2030 agenda. This model could inform research prioritization at other institutions facing similar challenges in both local and global contexts. Full article

Intracranial tumors such as gliomas, meningiomas, and brain metastases induce complex alterations in brain function beyond their focal presence. Modern connectomic and neuroimaging approaches, including resting-state functional MRI (rs-fMRI) and diffusion MRI, have revealed that these tumors disrupt and reorganize large-scale brain networks in heterogeneous ways. In adult patients, diffuse gliomas infiltrate neural circuits, causing both local disconnections and widespread functional changes that often extend into structurally intact regions. Meningiomas and metastases, though typically well-circumscribed, can perturb networks via mass effect, edema, and diaschisis, sometimes provoking global “dysconnectivity” related to cognitive deficits. Therefore, this review synthesizes interdisciplinary evidence from neuroscience, oncology, and neuroimaging on how intracranial tumors disrupt functional brain connectivity pre- and post-surgery. We discuss how functional heterogeneity (i.e., differences in network involvement due to tumor type, location, and histo-molecular profile) manifests in connectomic analyses, from altered default mode and salience network activity to changes in structural–functional coupling. The clinical relevance of these network effects is examined, highlighting implications for pre-surgical planning, prognostication of neurocognitive outcomes, and post-operative recovery. Gliomas demonstrate remarkable functional plasticity, with network remodeling that may correlate with tumor genotype (e.g., IDH mutation), while meningioma-related edema and metastasis location modulate the extent of network disturbance. Finally, we explore future directions, including imaging-guided therapies and “network-aware” neurosurgical strategies that aim to preserve and restore brain connectivity. Understanding functional heterogeneity in brain tumors through a connectomic lens not only provides insights into the neuroscience of cancer but also informs more effective, personalized approaches to neuro-oncologic care. Full article

Background/Objectives: The COVID-19 pandemic exposed critical vulnerabilities in healthcare systems, especially in ensuring continuity of care for patients with chronic diseases. Rehabilitation services, essential for recovery following SARS-CoV-2 infection, were among the most disrupted. This exploratory study aimed to assess Romanian patients’ perceptions of the accessibility and quality of post-COVID-19 rehabilitation services, focusing on individuals with chronic conditions. Methods: This exploratory cross-sectional study was conducted over a 12-month period in 2024. Data were collected from 76 adult patients diagnosed with at least one chronic condition (hypertension, diabetes mellitus, ischemic heart disease, cancer, or chronic obstructive pulmonary disease) and with confirmed prior SARS-CoV-2 infection. Most participants were recruited during outpatient specialty consultations, with a smaller number included from hospital settings, all located in Bucharest. A structured questionnaire was administered by the principal investigator after obtaining informed consent. Quantitative data were analyzed using non-parametric methods following confirmation of non-normal distribution via the Shapiro–Wilk test (p < 0.05). Satisfaction scores were reported as medians with interquartile ranges (IQR), and group comparisons were performed using the Mann–Whitney U test. A mixed-methods approach was employed, including thematic analysis of open-ended responses. Results: Patient satisfaction with rehabilitation services was consistently low. The median satisfaction scores [IQR] were accessibility 1.0 [0.0–2.0], quality of services 0.0 [0.0–4.0], staff empathy 0.0 [0.0–5.0], and perceived effectiveness 0.0 [0.0–5.0]. The median score for perceived difficulties in access was 1.0 [1.0–2.0], indicating widespread barriers. No statistically significant differences were observed between urban and rural participants or across chronic disease categories. Thematic analysis (n = 65) revealed key concerns including lack of publicly funded services, cost barriers, limited physician referral, service scarcity in rural areas, and demand for home-based rehabilitation options. Conclusions: Romanian patients with chronic illnesses and previous SARS-CoV-2 infection continue to face substantial barriers in accessing post-COVID-19 rehabilitation services. These findings highlight the need for more equitable and integrated recovery programs, especially for vulnerable populations in underserved settings. Full article

Background/Objectives: Maintaining high childhood vaccination coverage is essential to prevent outbreaks of vaccine-preventable diseases. In Italy, Law No. 119/2017 introduced mandatory childhood immunizations, leading to significant improvements. However, the COVID-19 pandemic disrupted routine services, potentially jeopardizing these gains. This study aimed to evaluate national and regional trends in vaccine coverage across three phases: post-mandate (2015–2016 vs. 2017–2019), pandemic (2017–2019 vs. 2020–2021), and post-pandemic recovery (2020–2021 vs. 2022–2023). Methods: National and regional administrative data on vaccination coverage at 24 months of age were obtained from the Italian Ministry of Health. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs), and absolute changes in coverage (Δ) were calculated across defined periods. Pearson correlation coefficients were used to assess associations between baseline coverage and subsequent changes. Results: After the 2017 mandate, coverage increased significantly for varicella (APC = +28.6%), MenB (+22.6%), and measles (+3.4%). Regionally, varicella coverage rose by up to +58.4% in Emilia-Romagna and measles by +11.1% in Campania. During the pandemic, coverage declined for polio (−2.4% in the South) and measles (−6.2% in Abruzzo), while MenB increased in regions with lower initial uptake (r = −0.918, p < 0.001). Post-pandemic, coverage rebounded, with varicella improving by +20.1% in central regions and measles by +13.9% in Abruzzo. A strong inverse correlation between baseline coverage and improvement was observed for varicella across all periods (r from −0.877 to −0.915). Conclusions: Mandatory vaccination policies led to substantial coverage improvements, and despite the disruption caused by the pandemic, recovery trends were observed for most vaccines. The consistent association between low baseline coverage and stronger gains highlights the resilience of the system, but also the ongoing need for regionally tailored strategies to reduce geographic disparities and ensure equitable immunization across Italy. Full article

Prolonged conflicts in Iraq over the past four decades have profoundly disrupted environmental systems, not only through immediate post-conflict emissions—such as residues from munitions and explosives—but also via long-term infrastructural collapse, population displacement, and unsustainable resource practices. Despite growing concern over air quality in conflict-affected regions, comprehensive assessments integrating long-term data and localized measurements remain scarce. This study addresses this gap by analyzing the environmental consequences of sustained instability in Mosul, focusing on air pollution trends using both remote sensing data (1983–2023) and in situ monitoring of key pollutants—including PM_2.5, PM₁₀, TVOCs, NO₂, SO₂, and formaldehyde—at six urban sites during 2022–2023. The results indicate marked seasonal variations, with winter peaks in combustion-related pollutants (NO₂, SO₂) and elevated particulate concentrations in summer driven by sandstorm activity. Annual average concentrations of all six pollutants increased by 14–51%, frequently exceeding WHO air quality guidelines. These patterns coincide with worsening meteorological conditions, including higher temperatures, reduced rainfall, and more frequent storms, suggesting synergistic effects between climate stress and pollution. The findings highlight severe public health risks and emphasize the urgent need for integrated urban recovery strategies that promote sustainable infrastructure, environmental restoration, and resilience to climate change. Full article

Traumatic brain injury (TBI) in the elderly is frequently associated with worsened neurological outcomes and prolonged recovery, yet the age-specific molecular mechanisms driving this vulnerability remain poorly understood. Aging is characterized by increased oxidative stress and chronic neuro-inflammation, both of which may amplify the brain’s susceptibility to injury. In this study, we identify spermine oxidase (SMOX), a polyamine-catabolizing enzyme that produces reactive oxygen species, as a key mediator linking oxidative stress and neuro-inflammation to age-dependent TBI susceptibility. Using a mouse model of controlled cortical impact (CCI), we found that SMOX expression was significantly upregulated in aged brains, primarily in neurons and microglia, and this increase correlated with greater microglial activation, elevated pro-inflammatory cytokine expression, and widespread neuronal degeneration. Notably, SMOX upregulation also impaired astrocytic glutamate clearance by disrupting the membrane localization of the transporter GLT-1, contributing to excitotoxic stress. Importantly, analysis of postmortem human brain samples and transcriptomic data revealed a parallel age-related increase in SMOX expression, supporting its translational relevance. The pharmacological inhibition of SMOX with JNJ-9350 in aged mice reduced oxidative and inflammatory markers, preserved neuronal viability, and improved motor, cognitive, and emotional outcomes up to 30 days post-injury. These findings establish SMOX as a critical molecular driver of age-related vulnerability to TBI and highlight its inhibition as a promising therapeutic strategy for improving outcomes in elderly TBI patients. Full article