Search Results (2,353)

Helicobacter pylori (H. pylori) eradication with bismuth-containing quadruple therapy (BQT) is effective but often accompanied by adverse gastrointestinal reactions and gut microbiota disturbances, while the impact of probiotic supplementation and the predictive value of the gut microbiota remain incompletely understood. In this single-center prospective randomized controlled trial, 109 H. pylori-positive patients were assigned to receive a 14-day BQT alone treatment or BQT combined with compound Lactobacillus acidophilus (LBQT). Fecal samples were collected before treatment, at the end of therapy, and four weeks after completion for 16S rDNA amplicon sequencing to assess microbiota dynamics. Although the addition of compound L. acidophilus did not significantly alter eradication rates, it markedly reduced the incidence of gastrointestinal adverse reactions, accelerated the recovery of gut microbial diversity and abundance, and delayed the overgrowth of potentially pathogenic bacteria, as well as increased short-chain fatty acid-producing bacteria. We further predicted the success of H. pylori eradication using ROC curves, and found that the combined baseline fecal microbiota markers (o_Lactobacillales, o_Enterobacterales, and f_Enterobacteriaceae) achieved an AUC of 0.849 at the start of treatment; at 4 weeks after eradication, the AUC of the microbiota combined with o_Peptostreptococcales, c_Bacilli, o_Lactobacillales, and g_Streptococcus predicted successful eradication up to 0.776. These findings indicate that compound L. acidophilus supplementation alleviates the side effects of BQT and promotes the restoration of gut microbiota homeostasis, and that gut microbiota signatures may serve as noninvasive predictors of treatment tolerance and therapeutic outcome. Full article

Tumor-draining lymph nodes (TDLNs) are important immune organs linking primary tumors with systemic immune responses. They support tumor antigen presentation, T-cell priming, and effector immune responses, but under sustained tumor influence they can also be remodeled into microenvironments that promote immune escape and metastatic colonization. Conventional methods, including flow cytometry, bulk RNA sequencing, and routine immunohistochemistry, have advanced our understanding of TDLN immunity but cannot simultaneously preserve tissue architecture, cell identity, and spatial cell–cell relationships. Recent advances in spatial transcriptomics, spatial proteomics, and multiplexed imaging enable in situ analysis of immune cells, stromal cells, vascular structures, and their interactions within TDLNs. Emerging evidence suggests that TDLNs are not immunologically homogeneous organs, but gradually develop spatially distinct immune-activation and immunosuppressive regions during tumor progression. Activation regions are associated with HEV-mediated lymphocyte entry, DC–T-cell priming, B-cell follicles, and germinal-center reactions, whereas suppressive regions are enriched in Treg cells, exhausted T cells, suppressive myeloid cells, tumor-reprogrammed FRCs, and myeloid–CAF niches. This review summarizes spatial multi-omics studies of TDLN functional compartmentalization and discusses the potential value of TDLN spatial immune states in predicting immunotherapy response, assessing metastatic risk, and guiding precision treatment, thereby providing a reference for future spatial multi-omics studies of TDLNs. Full article

Objectives: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, yet population-specific evidence regarding the contribution of MIA3 genetic variation in Middle Eastern populations remains limited. This study investigated the association of the MIA3 rs17465637 polymorphism with CAD susceptibility and its relationship with lipid-related phenotypes in a Saudi population. Methods: A case–control study was conducted between June 2020 and August 2022, including 200 patients with angiographically confirmed CAD and 200 age- and sex-matched healthy Saudi controls. Genotyping of rs17465637 was performed using a TaqMan real-time polymerase chain reaction assay. Genotype distributions were evaluated using chi-square analysis under multiple inheritance models. Multivariable logistic regression was subsequently performed to estimate adjusted odds ratios after controlling age, BMI, smoking, physical inactivity, systolic BP, diastolic BP, blood glucose, triglycerides, total cholesterol, LDL-C, and HDL-C. Associations between rs17465637 genotypes and serum lipid parameters were also examined. Results: Genotype frequencies of rs17465637 differed modestly between cases and controls; however, unadjusted comparisons under codominant, dominant, recessive, and allelic inheritance models did not reach statistical significance, and none remained significant after Bonferroni correction. In contrast, multivariable logistic regression demonstrated an independent association between the rs17465637 C allele and CAD after adjustment for conventional cardiovascular risk factors. In genotype–phenotype analyses, carriers of the C allele exhibited higher association with low-density lipoprotein cholesterol concentrations and less favorable lipid profiles than AA homozygotes, supporting a relationship between the variant and lipid metabolism. These findings are consistent with a potential contribution of rs17465637 to CAD susceptibility through lipid-related pathways. Conclusions: Although unadjusted genotype comparisons were not statistically significant after correction for multiple testing, multivariable analysis provides evidence supporting an independent association between the MIA3 rs17465637 variant and CAD susceptibility in this Saudi cohort. The observed associations with adverse lipid profiles further provide evidence linking this specific locus to the molecular mechanisms underlying cardiovascular disease. Replication in larger, multi-center studies incorporating genome-wide ancestry-informative markers and functional investigations is warranted to further minimize the possibility of residual population stratification, confirming these findings and clarifying the biological mechanisms underlying this association. Full article

Alpha-gal syndrome (AGS) is an acquired allergy characterized as a delayed hypersensitivity reaction to the galactose-alpha-1,3-galactose carbohydrate, which is present on mammalian meat. AGS can cause severe anaphylactic reactions and has been implicated in intraoperative reactions to medications or surgical products that are derived from mammalian meat. This narrative review will describe the current literature on alpha-gal etiology, epidemiology, and perioperative management. Additionally, our institution is present in Suffolk County, New York, US, a highly endemic area, and we share our centers’ recommendations for managing AGS patients from their initial preoperative presentation throughout the perioperative period. We propose a detailed pathway for detection, preparedness, and intraoperative management of AGS patients undergoing elective surgery as well as alternative management suggestions for AGS patients undergoing emergency surgery. Full article

Mass measurements of isotopes around the $A=184$ region near stability were performed at the KEK Isotope Separation System within the RIKEN Nishina Center, Japan. The isotopes were produced via multi-nucleon transfer reactions with a ¹³⁶Xe beam of 7.2 MeV/u impinging on a natural tungsten target. We report the first direct mass measurement of ¹⁸⁴Ta, showing a 62(27) keV deviation compared to previous indirect measurements. Full article

Ascorbate (AsA), or vitamin C, is a central redox metabolite that functions as an antioxidant, enzyme cofactor, and electron donor. Its cellular function depends not only on biosynthesis or dietary uptake, but also on rapid recycling from its oxidized forms, monodehydroascorbate (MDHA) and dehydroascorbate (DHA). This requirement is especially evident in high-demand systems such as plant chloroplasts, which face continuous photosynthetic reactive oxygen species (ROS) production under illumination, and human neutrophils, which accumulate millimolar ascorbate to withstand NADPH oxidase-driven oxidative bursts in pathogen defense. Here, we revisit ascorbate recycling from a sulfur-centered perspective. Historical studies of plant, animal, and solution-chemistry pathways show that many DHA-reducing systems converge on sulfur chemistry, including glutathione (GSH), cysteine-dependent enzymes, H₂S, and modified thiols. We propose that ascorbate recycling is organized as a multilayered system in which nonenzymatic reactions are accelerated by enzymes, localized within cellular or extracellular compartments, and integrated with broader NAD(P)H-, glutathione-, sulfur-, and diet-dependent redox networks. Within this framework, the AsA/DHA couple can be viewed as a molecular redox capacitor that buffers transient oxidative pressure. Reactive sulfur species (RSS), including persulfides and polysulfides, represent chemically plausible but experimentally unresolved contributors to DHA reduction. Full article

Background/Objective: Polypharmacy, conventionally defined as the concurrent use of five or more medications, has emerged as a critical public health challenge in aging populations worldwide. Polypharmacy in older adults, driven by multimorbidity and age-related physiological changes, increases the risk of adverse drug reactions, drug interactions, falls, cognitive impairment, non-adherence, and preventable hospitalization. This study aims to provide a structured narrative synthesis of the current evidence on the incidence, risk factors, and clinical management of polypharmacy in elderly patients, with particular emphasis on deprescribing strategies, interdisciplinary care models, patient education, and digital clinical decision support technologies. Methods: A structured narrative literature review was conducted across PubMed, Scopus, and Web of Science using Boolean combinations of MeSH and free text terms including ‘polypharmacy,’ ‘elderly,’ ‘deprescribing,’ and ‘medication review.’ Eligible sources were peer-reviewed primary studies published between January 2016 and June 2026 that enrolled adults aged ≥65 years and reported validated prescribing review approaches, such as the STOPP/START criteria. The review drew on 40 primary studies spanning randomized controlled trials (RCTs) and observational, qualitative, and mixed-methods designs, which were interpreted and synthesized narratively across the principal thematic domains of polypharmacy management. Results: Polypharmacy was independently and consistently associated with DDIs, preventable hospitalizations, and functional decline across diverse clinical settings. Pharmacist-led medication reviews and interdisciplinary, team-based interventions produced the most robust improvements in prescribing appropriateness and meaningful reductions in potentially inappropriate medications (PIMs). Electronic clinical decision support systems (CDSSs) have demonstrated measurable benefits for safe deprescribing at scale, although usability limitations, incomplete workflow integration, and clinician resistance are significant implementation obstacles. Conclusions: Effective management of polypharmacy in older adults requires a multicomponent, patient-centered strategy that integrates evidence-based deprescribing algorithms, principally the STOPP/START criteria, sustained interdisciplinary collaboration, structured patient education, and technology-assisted decision support. Full article

Electrochemical CO₂ reduction reactions (CO₂RR) offer a viable approach to mitigating anthropogenic CO₂ while simultaneously generating value-added chemicals. Among diverse electrocatalyst classes, metal–organic framework (MOF)-based materials have been extensively explored owing to their excellent tunability of chemical structure, high surface area, and the ability to tailor the coordination/electronic environment of active centers. This state-of-the-art review provides a critical assessment of recent progress in the development of pristine Cu-based MOFs, Cu MOF-derived catalysts, and hybrid Cu@MOFs for the selective production of C₁ products such as CO, CH₄, and formate/formic acid. Theoretical investigations into the roles of the copper center, ligands, pore structures, and interfacial effects reveal that product selectivity is influenced by more than just the oxidation state of Cu sites. Mixed-valence Cu⁺/Cu⁰ junctions, defect-rich surfaces, conductive frameworks, and coordination site tuning constitute fundamental design strategies for steering CO₂ reduction pathways. In addition to electrocatalytic performance, this review emphasizes the importance of life cycle assessment (LCA). Current studies identify electricity demand, separation steps, and operational lifetime as the dominant environmental impact factors in LCA analyses. Combining molecular-level catalyst design with systems-level sustainability considerations, this review highlights key challenges and future prospects for advancing Cu-MOF electrocatalysts toward efficient and sustainable C₁ formation from CO₂. Full article

Cationic lanthanide luminophores remain underexplored compared with their neutral analogues, despite attractive features for solution-processed electroluminescent devices. Here we report the synthesis and characterization of five europium(III) cationic complexes of the type [Eu(L^{N,N})₂(L^{O,O})₂][PF₆], where L^{N,N} = 2,2′-bipyridine, 1,10-phenanthroline, or bathophenanthroline and L^{O,O} = acetylacetonate (acac) or hexafluoroacetylacetonate (hfac). These complexes are obtained in good yield via one-pot reactions from EuCl₃·6H₂O, β-diketonates, and diimine ligands, and are confirmed by FT-IR and RAMAN spectroscopies, elemental analysis, and single-crystal X-ray diffraction to possess well-defined EuO₄N₄ coordination spheres with PF₆ counterions. UV–Vis spectra show intense ligand-centered π–π* bands below ~300 nm and weak visible tails, consistent with efficient antenna sensitization and negligible direct Eu(III) f–f absorption. All complexes exhibit characteristic Eu(III) emission between ~575 and 725 nm, dominated by the ⁵D₀ → ⁷F₂ transition near 610–620 nm for all complexes and ⁵D₀ → ⁷F_3,4 transitions for 4 and 5, with similar line patterns but markedly different intensities. Replacing acac with hfac dramatically enhances performance with the quantum yields increasing from 15–18% to 85–93%, and excited-state lifetimes from 1.01–1.53 ms to 2.50–3.25 ms. These gains are attributed to improved ligand triplet to Eu(III) ⁵D₀ energy matching and reduced multiphonon relaxation, establishing these cationic Eu(III) complexes as promising emitters for solution-processable photonic devices. Full article

Oxidative desulfurization (ODS) is a promising alternative to conventional desulfurization methods because it operates under relatively mild conditions. Mixing-assisted oxidative desulfurization (MAOD), a variant of ODS, uses high-shear mixing to improve mass transfer between immiscible phases, enhancing sulfur conversion efficiency. This study reviews recent developments in MAOD for the removal of dibenzothiophene (DBT) and benzothiophene (BT) through a research matrix synthesizing the current literature. MAOD has demonstrated excellent performance, achieving up to 100% sulfur conversion in both model and real fuels, with DBT consistently showing higher conversion than BT. Response Surface Methodology (RSM) was commonly applied for process optimization, identifying typical operating conditions of 40–70 °C, 30 min reaction time, and 10,000 rpm as sufficient for complete sulfur conversion. The choice of oxidant and catalyst system strongly influences process efficiency, with polyoxometalates and hydrogen peroxide frequently achieving 100% conversion. Sustainable oxidants, including Fe(VI) and Mn(IV) derived from wastewater treatment sludge, have also shown promising results. However, the inability of model fuels to fully represent real fuel complexity and the limited use of RSM designs beyond Box–Behnken and Face-Centered Central Composite Designs highlight areas for future research. Overall, MAOD is a developing but highly promising desulfurization technology. Full article

Background: Peripheral artery disease (PAD) is clinically heterogeneous, complicating identification, treatment selection, and prediction of therapeutic benefit. Gait biomechanics provide high-resolution, objective digital biomarkers that can be used in routine care. Methods: We built a computational framework for three tasks: (1) distinguish controls versus PAD; (2) predict clinician-selected treatment (nonoperative vs. revascularization); and (3) forecast post-treatment ground-reaction force (GRF) from baseline GRF features. The dataset included 55 unique patients with PAD and 42 controls. Standard classifiers and regressors were evaluated, and performance was measured by accuracy, balanced accuracy, Matthew’s correlation coefficient (MCC), and mean absolute error. Results: A single GRF feature (propulsive peak) achieved 90.9% accuracy, 86.7% balanced accuracy, and 0.868 MCC for distinguishing PAD from controls and predicting treatment, outperforming patient-reported outcomes and kinematics. For outcome forecasting, a Random Forest model predicted changes in the propulsive peak with 80% accuracy and low error. Conclusions: GRF-based models accurately identify PAD, anticipate this clinical team’s treatment selection, and forecast functional recovery within this single-center cohort; generalization to other practice patterns and settings remains untested. The approach relies on minimal features and modest computation and is readily generalized to other medical conditions that affect gait. Because it is compatible with wearable sensors, it is well suited to real-time, remote assessment and can advance personalized, data-driven decision support in vascular care. Full article

The development of efficient electrocatalysts for hydrogen generation is crucial for advancing clean and renewable energy technologies, yet the cooperative behavior governing dual-atom catalytic sites remains poorly clarified. In this study, an anti-sandwich dual-atom architecture supported on a BC₃ monolayer is examined through comprehensive first-principles modeling. By jointly assessing hydrogen adsorption thermodynamics, metal anchoring strength, and dynamic stability under elevated-temperature ab initio molecular dynamics conditions, two structurally resilient configurations with nearly ideal hydrogen binding characteristics are identified. Detailed orbital-resolved electronic analyses, incorporating projected electronic states, bonding population evaluation, and charge redistribution visualization, indicate that hydrogen adsorption and reaction activity are predominantly controlled by interatomic electronic coupling and orbital hybridization within the dual-atom centers. These insights reveal the electronic essence of dual-atom synergy and establish a transferable design principle for developing high-efficiency anti-sandwich catalysts for hydrogen evolution. Full article

This review summarizes recent progress in the catalytic conversion of glycerol to glycerol carbonate (GC) via transesterification with alkyl carbonates, a sustainable route for valorizing surplus glycerol from biodiesel production. Emphasis is placed on mixed and promoter-modified metal oxide catalysts, which exhibit high activity, selectivity, and stability due to their tunable balance of basic and Lewis acidic sites. Systems such as Mg-Fe, Mg-Al, Mg-Zr, CaO-CeO₂, and Mg-Ba oxides have achieved over 90% glycerol conversion and 90–96% GC selectivity under mild, often solvent-free conditions. Mechanistic insights, increasingly supported by density functional theory (DFT), reveal that the reaction proceeds via base-assisted glycerol deprotonation, carbonate activation at Lewis acidic centers, and subsequent cyclization to GC. These findings underscore the importance of acid–base cooperation and promoter effects in enhancing turnover frequency, reducing energy barriers, and mitigating catalyst deactivation due to carbonate deposition or leaching. By integrating experimental results with theoretical modelling, this review provides a comprehensive understanding of catalyst design principles, offering guidance for the development of efficient and robust systems for scalable glycerol upgrading. Full article

A tetraphenylethylene-based salen-type Schiff base ligand and its Fe(III) coordination complex were synthesized and characterized using spectroscopic, electrochemical, mass spectrometric, and single-crystal X-ray diffraction techniques. The ligand features an N₂O₂ donor set and was obtained via Schiff base condensation with ethylenediamine, while reaction with FeCl₃ afforded a di-μ-phenoxo-bridged dinuclear Fe(III) complex under mild conditions. Unlike previously reported Fe(III)-salen electrochromic systems, which are predominantly mononuclear and exhibit ligand-centered redox processes with limited modulation of intraligand electronic communication, the present system incorporates a rigid tetraphenylethylene scaffold and forms a centrosymmetric di-μ-phenoxo-bridged Fe(III) dimer. This structural motif enables coordination-induced electronic coupling between phenolate units, resulting in a distinct splitting of ligand-centered oxidation processes. Single-crystal X-ray diffraction confirmed a di-μ-phenoxo-bridged Fe(III) dimer with distorted octahedral geometry. Electrochemical studies show a quasi-reversible ligand-centered oxidation in the free ligand, which splits into two separate redox events upon complexation, indicating the emergence of electronically non-equivalent redox sites. Spectroelectrochemical analysis reveals the formation of phenoxyl radical species accompanied by ligand-centered intervalence charge–transfer transitions and the appearance of a near-infrared absorption band upon oxidation. A reversible color change from red to blue is observed, reflecting redox-driven modulation of the electronic structure. Overall, this work demonstrates that incorporation of a tetraphenylethylene-based salen framework and formation of a di-μ-phenoxo-bridged Fe(III) dimer enables coordination-triggered intraligand electronic communication, leading to fundamentally different redox behavior compared to previously reported Fe(III)-salen electrochromic complexes, while no reversible metal-centered redox processes were detected within the experimentally investigated potential window. Full article

Despite the need for immediate treatment during acute allergic reactions (AARs), many patients do not consistently carry medication. A new mouth-dissolving dexamethasone film offers a portable, easily administered alternative to corticosteroid tablets. This non-randomized, open-label, low-interventional real-world trial assessed satisfaction (accessibility and safety/security) with the mouth film versus betamethasone tablets in adults prescribed tablets for moderate to severe AARs at a Swedish primary care center. Over six months, participants had access to both treatments and reported monthly via an electronic diary; qualitative responses were converted to Likert scales where applicable. Of 50 enrolled, 44 provided diary data (mean age 50 years, 74% female, 58% had an epinephrine autoinjector). In total, 189 responses were collected: 98% stated that the participant was satisfied or very satisfied with mouth film accessibility versus 58% for tablets (mean Likert scores 3.5–3.7 vs. 2.5–2.8; p < 0.001). A higher feeling of safety with the mouth film versus tablets was reported in 78% of responses and improved medication carriage compliance in 77%. At six months, 69% preferred the film. Of 18 AARs in total reported by 13 participants, the mouth film was chosen for treatment of 16 (11 participants); in 94%, the mouth film was found immediately accessible, and in 94%, the efficacy was rated as good or very good. In conclusion, the mouth film improved perceived accessibility, safety/security, and medication-carriage compliance compared with tablets for the treatment of AARs. Full article