Search Results (17,176)

Background/Objectives: Pediatric allogeneic hematopoietic stem cell transplantation (allo-HSCT) is complicated by iron overload and hypomagnesemia, both contributing to immune dysfunction and post-transplant morbidity. The combined impact of these metabolic disturbances on pediatric allo-HSCT outcomes remains unexplored. This study aims to determine whether hypomagnesemia can serve as a prognostic biomarker for delayed immune reconstitution and explores its interplay with iron overload in predicting post-transplant complications and survival outcomes. Methods: A retrospective analysis was conducted on 163 pediatric allo-HSCT recipients. Serum magnesium levels were measured at defined intervals post-transplant, and outcomes were correlated with CD4+ T cell recovery, time to engraftment, incidence of graft-versus-host disease (GVHD), and survival within 12 months. Iron status, including siderosis severity, was evaluated using imaging and laboratory parameters obtained from clinical records. Results: Patients who died within 12 months post-transplant exhibited significantly lower magnesium levels. Hypomagnesemia was associated with delayed CD4+ T cell recovery, prolonged engraftment, and an increased risk of acute GVHD. A strong inverse correlation was observed between magnesium levels and the severity of siderosis. Iron overload appeared to exacerbate magnesium deficiency. Additionally, the coexistence of hypomagnesemia and siderosis significantly increased the risk of immune dysfunction and early mortality. No significant association was found with chronic GVHD. Conclusions: Hypomagnesemia is a significant, early predictor of poor outcomes in pediatric allo-HSCT, particularly in the context of iron overload, underscoring the need for early intervention, including iron chelation and MRI, to improve outcomes. Full article

Background/Objectives: Romania remains a tuberculosis (TB) hotspot in the European Union, yet host-derived factors of poor outcomes are poorly characterised. We quantified circulating pro-inflammatory cytokines and examined their interplay with behavioural risk factors, the nutritional status, and the clinical course in adults hospitalised with pulmonary TB. We analysed 80 adults with microbiologically confirmed pulmonary TB and 40 respiratory symptom controls; four TB patients (5%) died during hospitalisation, all within 10 days of admission. Methods: A retrospective analytical case–control study was conducted at the Constanța regional TB referral centre (October 2020—October 2023). Patients with smear- or culture-confirmed TB were frequency-matched by sex, 10-year age band, and BMI class to culture-negative respiratory controls at a 2:1 ratio. The patients’ serum interferon-γ (IFN-γ), interleukin-1α (IL-1α), interleukin-1β (IL-1β), and tumour-necrosis-factor-α (TNF-α) were quantified within 24 h of admission; the neutrophil/lymphocyte ratio (NLR) was extracted from full blood counts. Independent predictors of in-hospital mortality were identified by multivariable logistic regression; factors associated with the length of stay (LOS) were modelled with quasi-Poisson regression. Results: The median TNF-α (24.1 pg mL⁻¹ vs. 16.2 pg mL⁻¹; p = 0.009) and IL-1β (5.34 pg mL⁻¹ vs. 3.67 pg mL⁻¹; p = 0.008) were significantly higher in the TB cases than in controls. TNF-α was strongly correlated with IL-1β (ρ = 0.80; p < 0.001), while NLR showed weak concordance with multiplex cytokine patterns. Among the patients with TB, four early deaths (5%) exhibited a tripling of TNF-α (71.4 pg mL⁻¹) and a doubling of NLR (7.8) compared with the survivors. Each 10 pg mL⁻¹ rise in TNF-α independently increased the odds of in-hospital death by 1.8-fold (95% CI 1.1–3.0; p = 0.02). The LOS (median 29 days) was unrelated to the smoking, alcohol, or comorbidity load, but varied across BMI strata: underweight, 27 days; normal weight, 30 days; overweight, 23 days (Kruskal–Wallis p = 0.03). In a multivariable analysis, under-nutrition (BMI < 18.5 kg m⁻²) prolonged the LOS by 19% (IRR 1.19; 95% CI 1.05–1.34; p = 0.004) independently of the disease severity. Conclusions: A hyper-TNF-α/IL-1β systemic signature correlates with early mortality in Romanian pulmonary TB, while under-nutrition is the dominant modifiable determinant of prolonged hospitalisation. Admission algorithms that pair rapid TNF-α testing with systematic nutritional assessment could enable targeted host-directed therapy trials and optimise bed utilisation in high-burden settings. Full article

Coatings that are tolerant of poor surface preparation are often used for rapid, real-time maintenance of aging steel surfaces. In this study, a modified epoxy (EP) anti-rust coating was proposed, utilizing methyl gallate (MG) as a rust conversion agent, graphene oxide (GO) as an active functional material, and epoxy resin as the film-forming material. The anti-rust mechanism was investigated using potentiodynamic polarization (PDP), electrochemical impedance spectroscopy (EIS), scanning electron microscopy (SEM), laser scanning confocal microscopy (LSCM), and the scanning vibration electrode technique (SVET). The results demonstrated that over a period of 21 days, the impedance of the coating increases while the corrosion current density decreases with prolonged soaking time. The coating exhibited a maximum impedance of 2259 kΩ, and a lower corrosion current density of 8.316 × 10⁻³ A/m², which demonstrated a three-order magnitude reduction compared to the corrosion current density observed in mild steel without coating. LSCM demonstrated that MG can not only penetrate the tiny gap between the rust particles, but also effectively convert harmful rust into a complex. SVET showed a much more uniform current density distribution in the micro-zones of mild steel with the anti-rust coating compared to uncoated mild steel, indicating that the presence of GO not only enhanced the electrical conductivity of the coating, but also improved the structure of the coating, which contributed to the high performance of the modified epoxy anti-rust coating. This work highlights the potential application of anti-rust coating in the protection of metal structures in coastal engineering. Full article

Modern life, characterized by constant exposure to artificial light from electronic devices, such as light-emitting diodes (LEDs), disrupts the natural circadian rhythm and induces important metabolic changes. The impact of blue light exposure on male and female rat’s onset of puberty, hormonal and biochemical parameters was assessed by comparison between the four study groups: the control group (CTRL) maintained under normal light conditions, the group exposed to blue light from a mobile phone (MP), the group subjected to blue light from a computer screen (PC), and the group exposed to blue light from an LED lamp (LED). Both female and male rats exposed to PC and LED failed to thrive, with a significantly lower body weight intake than the CTRL group. All three distinct sources of blue light interfered with the cyclicity of the estrous cycle in female rats. A marked decrease in the number of complete estrous cycles and the highest incidence of incomplete cycles were noticed in the LED group. Elevated ALT, AST, glucose, and insulin levels were influenced in a gender-specific manner, and depending on the source of emitted light. Prolonged blue light exposure induces significant metabolic disruptions and possesses important future research potential in identifying explicit pathways regarding this environmental stressor. Full article

The advancement of next-generation lubricants is pivotal for enhancing energy efficiency and mitigating environmental impacts across diverse industrial applications. This review systematically examines recent developments in lubricant technologies, with a particular focus on sustainable strategies incorporating bio-based feedstocks, nanostructured additives, and hybrid formulations. These innovations are designed to reduce friction and wear, decrease energy consumption, and prolong the operational lifespan of mechanical systems. A critical assessment of tribological behavior, environmental compatibility, and functional performance is presented. Furthermore, the integration of artificial intelligence (AI) into lubricant formulation and performance prediction is explored, highlighting its potential to accelerate development cycles and enable application-specific optimization through data-driven approaches. The findings emphasize the strategic role of eco-innovative lubricants in supporting low-carbon technologies and facilitating the transition toward sustainable energy systems. Full article

Background/Objectives: Alectinib, a second-generation tyrosine kinase inhibitor indicated for the treatment of non-small-cell lung cancer (NSCLC), exhibits suboptimal oral bioavailability, primarily attributable to its inherently low aqueous solubility and limited dissolution kinetics. This study aimed to enhance Alectinib’s solubility and therapeutic efficacy by formulating a G4-NH2-PAMAM dendrimer complex. Methods: The complex was prepared using the organic solvent evaporation method and characterized by DSC, FTIR, dynamic light scattering (DLS), and zeta potential measurements. A validated high-performance liquid chromatography (HPLC) method quantified the Alectinib. In vitro drug release studies compared free Alectinib with the G4-NH2-PAMAM dendrimer complex. Cytotoxicity against NSCLC cell line A549 was assessed using MTT assays, clonogenic assay, and scratch-wound assay. Xenograft effect was investigated in the H460 lung cell line. Pharmacokinetic parameters were evaluated in rats using LC–MS/MS. Results: Alectinib exhibited an encapsulation efficiency of 59 ± 5%. In vitro release studies demonstrated sustained drug release at pH 6.8 and faster degradation at pH 2.5. Anticancer activity in vitro showed comparable efficacy to free Alectinib, with 98% migration inhibition. In vivo tumor suppression studies revealed near-complete tumor regression (~100%) after 17 days of treatment, compared to 75% with free Alectinib. Pharmacokinetic analysis indicated enhanced absorption (shorter Tmax), prolonged systemic circulation (longer half-life), and higher bioavailability (increased AUC) for the dendrimer-complexed drug. Conclusions: These findings suggest that the G4-NH2-PAMAM dendrimer system significantly improves Alectinib’s pharmacokinetics and therapeutic potential, making it a promising approach for NSCLC treatment. Full article

Background: The rising demand for aesthetic dental treatments has spurred interest in peroxide-free color correctors as alternatives to traditional hydrogen peroxide formulations, which are associated with tooth sensitivity and potential enamel demineralization. This systematic review evaluates the whitening efficacy and safety profile of hydrogen peroxide-free color corrector (HPFCC) products, focusing on color change metrics, enamel and dentin integrity, and adverse effects. Methods: Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Science throughout January 2025 for randomized controlled trials, observational studies, and in vitro experiments comparing HPFCC to placebo or peroxide-based agents. The data extraction covered study design, sample characteristics, intervention details, shade improvement (ΔE00 or CIE Lab), enamel/dentin mechanical properties (microhardness, roughness, elastic modulus), and incidence of sensitivity or tissue irritation. Risk of bias was assessed using the Cochrane tool for clinical studies and the QUIN tool for in vitro research. Results: Six studies (n = 20–80 samples or subjects) met the inclusion criteria. In vitro, HPFCC achieved mean ΔE00 values of 3.5 (bovine incisors; n = 80) and 2.8 (human molars; n = 20), versus up to 8.9 for carbamide peroxide (p < 0.01). Across studies, HPFCC achieved a mean ΔE00 of 2.8–3.5 surpassing the perceptibility threshold of 2.7 and approaching the clinical acceptability benchmark of 3.3. Surface microhardness increased by 12.9 ± 11.7 VHN with HPFCC (p < 0.001), and ultramicrohardness rose by 110 VHN over 56 days in prolonged use studies. No significant enamel erosion or dentin roughness changes were observed, and the sensitivity incidence remained below 3%. Conclusions: These findings derive from one clinical trial (n = 60) and five in vitro studies (n = 20–80), encompassing violet-pigment serums and gels with differing concentrations. Due to heterogeneity in designs, formulations, and outcome measures, we conducted a narrative synthesis rather than a meta-analysis. Although HPFCC ΔE00 values were lower than those of carbamide peroxide, they consistently exceeded perceptibility thresholds while maintaining enamel integrity and causing sensitivity in fewer than 3% of subjects, supporting HPFCCs as moderate but safe alternatives for young patients. Full article

Continuous monitoring of respiratory patterns is essential for disease diagnosis and daily health care. Contact medical devices enable reliable respiratory monitoring, but can cause discomfort and are limited in some settings. Radar offers a noncontact respiration measurement method for continuous, real-time, high-precision monitoring. However, it is difficult for a single radar to characterize the coordination of chest and abdominal movements during measured breathing. Moreover, motion interference during prolonged measurements can seriously affect accuracy. This study proposes a dual radar system with customized narrow-beam antennas and signals to measure the chest and abdomen separately, and an adaptive dynamic time warping (DTW) algorithm is used to effectively suppress motion interference. The system is capable of reconstructing respiratory waveforms of the chest and abdomen, and robustly extracting various respiratory parameters via motion interference. Experiments on 35 healthy subjects, 2 patients with chronic obstructive pulmonary disease (COPD), and 1 patient with heart failure showed a high correlation between radar and respiratory belt signals, with correlation coefficients of 0.92 for both the chest and abdomen, a root mean square error of 0.80 bpm for the respiratory rate, and a mean absolute error of 3.4° for the thoracoabdominal phase angle. This system provides a noncontact method for prolonged respiratory monitoring, measurement of chest and abdominal asynchrony and apnea detection, showing promise for applications in respiratory disorder detection and home monitoring. Full article

This study examines the use of a mass-abatement scalable system with managed aquifer recharge (MAR-MASS) as a sustainable solution for restoring salinized aquifers and improving water quality by removing dissolved salts. It offers a practical remediation approach for aquifers affected by salinization in coastal regions, agricultural areas, and contaminated sites, where variable-density flow poses a challenge. Numerical simulations assessed hydrogeological properties such as hydraulic conductivity, anisotropy, specific yield, mechanical dispersion, and molecular diffusion. A conceptual model integrated hydraulic conditions with spatial and temporal discretization using the FLOPY API for MODFLOW 6 and the IFM API for FEFLOW 10. Python algorithms were run within the high-performance computing (HPC) server, executing simulations in parallel to efficiently process a large number of scenarios, including both preprocessing input data and post-processing results. The study simulated 6950 scenarios, each modeling flow and transport processes over 3000 days of method implementation and focusing on mass extraction efficiency under different initial salinity conditions (3.5 to 35 kg/m³). The results show that the MAR-MASS effectively removed salts from aquifers, with higher hydraulic conductivity prolonging mass removal efficiency. Of the scenarios, 88% achieved potability (0.5 kg/m³) in under five years; among these, 79% achieved potability within two years, and 92% of cases with initial concentrations of 3.5–17.5 kg/m³ reached potability within 480 days. This study advances scientific knowledge by providing a robust model for optimizing managed aquifer recharge, with practical applications in rehabilitating salinized aquifers and improving water quality. Future research may explore MAR-MASS adaptation for diverse hydrogeological contexts and its long-term performance. Full article

Legume crops are sensitive to shifting environmental conditions, as they depend on a narrow range of climatic stability for growth and nitrogen fixation. This research sought to assess the sustainability of Faba Asturiana (FA) cultivation under current and future climatic scenarios by establishing generalized linear mixed models (GLMMs). Specifically, it aimed to (1) investigate the effects of significant climatic stressors, including higher nighttime temperatures and extended drought periods, on crop viability, (2) analyze future scenarios based on Representative Concentration Pathways (RCP 4.5 and RCP 8.5), and (3) recommend adaptive measures to mitigate threats. Six spatial GLMMs were developed, incorporating variables such as extreme temperatures, precipitation, and the drought duration. Under present-day conditions (1971–2000), all the models exhibited strong predictive performances (AUC: 0.840–0.887), with warm nights (tasminNa20) consistently showing a negative effect on suitability (coefficients: −0.58 to −1.16). Suitability projections under future climate scenarios revealed considerable variation among the developed models. Under RCP 4.5, Far Future, Model 1 projected a 7.9% increase in the mean suitability, while under RCP 8.5, Far Future, the same model showed a 78% decline. Models using extreme cold, drought, or precipitation as climatic stressors (e.g., Models 2–4) revealed the most significant suitability losses under RCP 8.5, with the reductions exceeding 90%. In contrast, comprising variables less affected by severe fluctuations, Model 6 showed relative stability in most of the developed scenarios. The model also produced the highest mean suitability (0.130 ± 0.207) in an extreme projective scenario. The results highlight that high night temperatures and prolonged drought periods are the most limiting factors for FA cultivation. ecological niche models (ENMs) performed well, with a mean AUC value of 0.991 (SD = 0.006) and a mean TSS of 0.963 (SD = 0.024). According to the modeling results, among the variables affecting the current distribution of Protected Geographical Indication-registered AF, prspellb1 (max consecutive dry days) had the highest effect of 28.3%. Applying advanced statistical analyses, this study provides important insights for policymakers and farmers, contributing to the long-term sustainability of PGI agroecosystems in a warming world. Full article

Background/Objectives: Erysipelas is an acute bacterial skin infection, particularly affecting the lower limbs, with a tendency to recur. Despite its clinical importance, data on demographic and epidemiological risk factors, as well as factors influencing hospitalization, remain limited. This study aimed to analyze the epidemiological and clinical characteristics of patients hospitalized with primary and recurrent erysipelas, focusing on risk factors contributing to disease onset, recurrence, and prolonged hospitalization. Methods: A retrospective single-center analysis was conducted on 239 patients hospitalized for erysipelas at the Department of Dermatology, Pediatric Dermatology, and Oncology at the Medical University of Lodz. Data collected included demographics, lesion location, laboratory markers, comorbidities, and hospitalization outcomes. Statistical analyses were performed to assess associations between risk factors, disease recurrence, and hospitalization duration. Results: The majority of erysipelas cases (85.4%) involved the lower limbs, with a higher prevalence in men. Upper extremities were mostly affected in women, especially those who had undergone breast cancer surgery. Recurrent erysipelas accounted for 75.7% of cases. Most patients (89.1%) had at least one comorbidity, with hypertension, diabetes type 2 (DM2), and obesity being the most common. Higher white blood cell (WBC) count, obesity, atrial fibrillation (AF), and the need for enoxaparin administration were independently associated with prolonged hospitalization. Dyslipidemia was significantly associated with erysipelas recurrence (p < 0.05). Conclusions: Both primary and recurrent erysipelas are associated with specific risk factors. Recurrent erysipelas may be linked to components of metabolic syndrome, particularly obesity and dyslipidemia, which emerged as a significant risk factor in this study. Hospitalization length may be prolonged by inflammation markers (WBC and CRP) and comorbidities such as AF, obesity, or the need for enoxaparin in patients with elevated thrombosis risk. Further multicenter studies with larger cohorts are needed to assess the impact of demographics, biomarkers, metabolic disorders, and treatment strategies on erysipelas recurrence and outcomes. Awareness of these risk factors is essential for effective prevention, management, and recurrence reduction. Full article

Work-related musculoskeletal disorders (WMSDs) are among the most prevalent occupational health issues, particularly affecting public transport drivers due to prolonged sitting, constrained postures, and poorly adaptable cabins. This study addresses the ergonomic risks associated with tram driving, aiming to evaluate biomechanical load and postural stress in relation to drivers’ anthropometric characteristics. A combined methodological approach was applied, integrating two standardized observational tools—RULA and REBA—with anthropometric modeling based on three representatives European morphotypes (SmallW, MidM, and TallM). ErgoFellow 3.0 software was used for digital posture evaluation, and lumbar moments at the L4/L5 vertebral level were calculated to estimate lumbar loading. The analysis was simulation-based, using digital human models, and no real subjects were involved. The results revealed uniform REBA (Rapid Entire Body Assessment) and RULA (Rapid Upper Limb Assessment) scores of 6 across all morphotypes, indicating moderate to high risk and a need for ergonomic intervention. Lumbar moments ranged from 51.35 Nm (SmallW) to 101.67 Nm (TallM), with the tallest model slightly exceeding the recommended ergonomic thresholds. These findings highlight a systemic mismatch between cabin design and user variability. In conclusion, ergonomic improvements such as adjustable seating, better control layout, and driver education are essential to reduce the risk of WMSDs. The study proposes a replicable methodology combining anthropometric, observational, and biomechanical tools for evaluating and improving transport workstation design. Full article

Background/Objectives: Breastmilk offers numerous benefits for the health and development of preterm infants, while prolonged hospitalization may impair neurodevelopment. At our institution, the implementation of enhanced family-centered care (FCC) has enabled earlier discharge of preterm infants. This study aimed to assess the impact of early discharge on breastfeeding and breastmilk provision. Methods: This analysis is based on data from a prospective single-center longitudinal cohort study conducted from October 2020 to November 2023, involving six consecutive cohorts (one baseline and five intervention cohorts; n = 184). FCC was progressively enhanced across cohorts. The primary outcome of the main study was postmenstrual age (PMA) at discharge. In this secondary analysis, breastfeeding and breastmilk provision were assessed at four time points: 4 weeks postnatal age, at discharge, 4 weeks post-discharge, and at 3 months PMA. Results: From baseline to intervention cohort 5, the PMA at discharge declined significantly from 37.8 ± 2.1 to 35.7 ± 0.91 weeks (p = 0.03), while the percentage of infants necessitating home nasogastric tube feeding increased from 6.3% to 66.7% (p < 0.01). The proportion of breastmilk of daily feeding volume remained unchanged at 4 weeks postnatal age (0.66 ± 0.42 vs. 0.9 ± 0.28) and at discharge (0.6 ± 0.45 vs. 0.79 ± 0.36). At 4 weeks post-discharge, 65.8% vs. 62.5% of the infants were on partial or exclusive breastmilk (p = 0.91) feeding. Similarly, the percentage of exclusively breastfed infants at 4 weeks post-discharge (23.7% vs. 19.8%) and at 3 months PMA (20% vs. 28.6%) did not differ significantly between baseline and intervention cohort 5. Conclusions: Early discharge did not reduce breastmilk supply or exclusive breastfeeding. However, the persistently low rate of exclusive breastfeeding post-discharge highlights the need for additional support strategies during and after hospitalization. Full article

Bio-based polyurethane asphalt binder (PUAB) derived from castor oil (CO) is environmentally friendly and exhibits extended allowable construction time. However, CO imparts inherently poor mechanical performance to bio-based PUAB. To address this limitation, attapulgite (ATT) with fibrous nanostructures was incorporated. The effects of ATT on bio-based PUAB were systematically investigated, including cure kinetics, rotational viscosity (RV) evolution, phase-separation microstructures, dynamic mechanical properties, thermal stability, and mechanical performance. Experimental characterization employed Fourier transform infrared spectroscopy, Brookfield viscometry, laser scanning confocal microscopy, dynamic mechanical analysis, thermogravimetry, and tensile testing. ATT incorporation accelerated the polyaddition reaction conversion between isocyanate groups in polyurethane (PU) and hydroxyl groups in ATT. Paradoxically, it reduced RV during curing, prolonging allowable construction time proportionally with clay content. Additionally, ATT’s compatibilizing effect decreased bitumen particle size in PUAB, with scaling proportionally with clay loading. While enhancing thermal stability, ATT lowered the glass transition temperature and damping properties. Crucially, 1 wt% ATT increased tensile strength by 71% and toughness by 62%, while maintaining high elongation at break (>400%). The cost-effectiveness and significant reinforcement capability of ATT make it a promising candidate for producing high-performance bio-based PUAB composites. Full article

New approach methodologies (NAMs), including microphysiological systems (MPSs), can recapitulate structural and functional complexities of organs. Vanoxerine was reported to induce cardiac adverse events, including torsade de points (TdP), in a Phase III clinical trial. Despite earlier nonclinical animal models and Phase I–II clinical trials, events of QT prolongation or proarrhythmia were not observed. Here, we utilized cardiac NAMs to evaluate the functional consequences of vanoxerine treatment on human cardiac excitation–contraction coupling. The cardiac MPS used in this study was a microfabricated fluidic culture platform with human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) capable of evaluating voltage, intracellular calcium handling, and contractility. Likewise, the hiPSC-CM comprehensive in vitro proarrhythmia assay (CiPA) was employed based on multielectrode array (MEA). Vanoxerine treatment delayed repolarization in a concentration-dependent manner and induced proarrhythmic events in both NAM platforms. The complex cardiac MPS displayed a frequency-dependent vanoxerine response such that EADs were eliminated at a faster pacing rate (1.5 Hz). Moreover, exposure analysis revealed a 99% vanoxerine loss in the cardiac MPS. TdP risk analysis demonstrated high to intermediate TdP risk at clinically relevant concentrations of vanoxerine and frequency-independent EAD events in the hiPSC-CM CiPA model. These findings demonstrate that nonclinical cardiac NAMs can recapitulate clinical outcomes, including detection of vanoxerine-induced delayed repolarization and proarrhythmic effects. Moreover, this work provides a foundation to evaluate the safety and efficacy of novel compounds to reduce the dependence on animal studies. Full article