Search Results (1,269)

Heart failure (HF) remains a global health challenge with high rates of hospitalization and mortality, particularly among the elderly. Many episodes of worsening HF occur before symptoms arise, underscoring the need for sensitive monitoring tools. Respiratory Stability Time (RST) is a novel index that quantifies the duration of stable respiration during sleep, reflecting pulmonary congestion and circulatory status. RST can be measured continuously and non-invasively using a contactless under-mattress sensor. Observational cohort studies show that low RST predicts poor prognosis, while its improvement parallels recovery from decompensation. Importantly, recent prospective multicenter observations involving 100 patients demonstrated that sustained RST decline often precedes HF readmission, probably enabling early intervention. A multicenter trial (ITMETHOD-HF III), involving 80 patients, is currently testing whether RST-guided therapy can reduce HF readmissions. RST might substantially enhance current HF management by enabling us to provide proactive therapeutic intervention, though further validation is warranted. Full article

Our study explored the role of serum 25-hydroxyvitamin D [25(OH)D] levels as an indicator of response to intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy in patients with diabetic macular edema (DME), highlighting functional and anatomical outcomes linked to systemic biomarker profiles. In a cohort of treatment-naive diabetic patients, vitamin D status was correlated with post-treatment changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA), illustrating layered therapeutic responses among deficient, insufficient, and sufficient vitamin D groups. Functional gains, measured as improvements in decimal BCVA, and anatomical improvements, defined by CMT reduction via spectral-domain optical coherence tomography (SD-OCT), were primarily detected in patients with sufficient vitamin D levels. Remarkably, patients with serum 25(OH)D ≥ 30 ng/mL revealed complete dual-response rates, while those in the deficient group manifested partial therapeutic efficacy, supporting the immunoangiogenic modulatory role of vitamin D. Statistical associations exposed a tight linear connection between baseline and final visual acuity and a pronounced inverse relationship between CMT and final vision, suggesting that vitamin D may play a role in treatment-mediated structural recovery. These results may imply that low vitamin D levels lead to subclinical endothelial dysfunction and impaired retinal barrier repair, possibly through dysregulated anti–vascular endothelial growth factor (anti-VEGF) signaling, chronic inflammation, and oxidative stress. Our findings underscore the need for and importance of further research of vitamin D status as an adjunctive biomarker in the clinical approach of personalized DME and validates the potential of circulating vitamin D evaluation in therapeutic classification and predictive eye care. Full article

Background/Objectives: The COVID-19 pandemic and related lockdown measures markedly disrupted children’s lives, raising concerns particularly about their weight. We investigated changes in body mass index (BMI) in children by grade and sex, from pre- to post-COVID-19 lockdown, and BMI recovery post-lockdown. Methods: We retrospectively reviewed the height, weight, and BMI of students from a single elementary school from 2019 to 2023, excluding 2020 (the year of the COVID-19 lockdown). We conducted longitudinal and cross-sectional studies to examine changes in BMI according to grade and BMI status pre-lockdown (2019) and post-lockdown (2021–2023). Results: In the entire student body, the BMI Z-score in 2021, 1 year after the COVID-19 lockdown, had increased significantly compared with that in 2019, 1 year pre-lockdown (p = 0.009). However, longitudinal studies in each grade yielded different results. Students who were in the first grade in 2019 experienced a significant decrease in BMI Z-score post-lockdown (p = 0.003). In contrast, students who were in other grades showed a significant increase in BMI Z-score post-lockdown, with those who were in third grade in 2019 showing the most significant increase (p = 0.027). Conclusions: The degree of BMI increase in children and adolescents due to the COVID-19 lockdown was inconsistent. Changes in obesity status post-lockdown varied depending on age and obesity levels pre-COVID-19 lockdown. Therefore, to manage and prevent obesity-related metabolic diseases in the post-COVID-19 era, diverse approaches and strategies tailored to age and obesity grades during the COVID-19 lockdown will need to be adopted. Full article

The increasing demand for renewable energy has intensified research on lignocellulosic biomass pyrolysis as a versatile route for sustainable energy and resource recovery. This study provides a comparative overview of main pyrolysis regimes (slow, intermediate, fast, and flash), emphasizing operational parameters, typical product yields, and technological readiness levels (TRLs). Reactor configurations, including fixed-bed, fluidized-bed, rotary kiln, auger, and microwave-assisted systems, are analyzed in terms of design, advantages, limitations, and TRL status. Key process parameters, such as temperature, heating rate, vapor residence time, reaction atmosphere, and catalyst type, critically influence the yields and properties of biochar, bio-oil, and syngas. Increased temperatures and fast heating rates favor liquid and gas production, whereas lower temperatures and longer residence times enhance biochar yield and carbon content. CO₂ and H₂O atmospheres modify product distribution, with CO₂ increasing gas formation and biochar surface area and steam enhancing bio-oil yield at the expense of solid carbon. Catalytic pyrolysis improves selectivity toward target products, though trade-offs exist between char and oil yields depending on feedstock and catalyst choice. These insights underscore the interdependent effects of process parameters and reactor design, highlighting opportunities for optimizing pyrolysis pathways for energy recovery, material valorization, and sustainable bioeconomy applications. Full article

Water injection development represents the predominant development method for enhancing oil recovery (EOR) efficiency and achieving the balanced utilization of oil reservoirs. In light of the current situation of oilfield water injection technology, a comprehensive overview of the evolution of full-scale water injection technology is given, with particular emphasis on the influence of geological factors, technological advancements, and existing challenges. The principal issues currently encountered include an unequal distribution of layers, the complexity of subdivision, casing deformation, and damage to deep well equipment, which collectively impede the effective implementation of subdivision water injection development technology. The novelty of the research lies in the current development status of full-scale injection wells, which is not only reflected in the depth-scale, but also in the operational difficulty-scale. A thorough exploration of subdivision water injection development technologies has been conducted, and the applicability and limitations of these technologies in diverse reservoir conditions have been evaluated. The proposal is for intelligent injection technology to be adopted for medium–shallow heterogeneous wells, and for ball-pitching plugging profile control technology to be adopted for deep/horizontal/special condition wells. A comparative analysis was conducted to evaluate the characteristics, application scenarios, advantages, and disadvantages of intelligent injection technologies, demonstrating its intelligence, automation, and precision in the practical application. In regard to the ball-pitching plugging profile control technology, the design and performance of the plugging ball, the plugging mechanism, and the application effect were elucidated. Based on the existing challenges in the realm of water injection development, the research prospects for full-scale subdivision water injection development technologies were proposed, and the importance of interdisciplinary cooperation and the integration of artificial intelligence technology were also emphasized. This research would provide a technical foundation for increasing oil displacement efficiency, markedly augmenting EOR, and would also be imperative for improving the economic benefits and alleviating the global oil resource tension. Full article

Background: The COVID-19 pandemic significantly disrupted patterns of physical activity and participation in mass sporting events, with recreational runners in Latin America among the most affected. In Colombia, pre-existing inequalities in access to sport further exacerbated these impacts. Nevertheless, evidence on post-COVID-19 impact and recovery experiences among regional runners remains limited. Objective: We examined the sociodemographic profiles, athletic experience, and perceptions of COVID-19-related impact and recovery among participants in the 2023 Medellín Marathon, and to assess differences by educational attainment, employment status, age group, and geographic origin. Methods: A cross-sectional descriptive study was undertaken involving 2486 registered marathon runners. An ad hoc questionnaire assessed COVID-19 symptoms and sequelae, perceived respiratory and physical limitations, fears associated with group exercise, and self-reported recovery. Analyses included descriptive statistics, bivariate comparisons and one-way ANOVA tests. Results: Older participants, retirees and those with lower educational levels reported significantly greater COVID-19 impact, longer recovery periods and higher perceived physical and respiratory limitations. In contrast, younger runners and those with a college education showed more complete physical recovery and attributed protective benefits, such as improved cardiorespiratory function and a lower incidence of respiratory symptoms, to their training. Additionally, runners originating from smaller municipalities and other Latin American countries reported higher levels of impact and lower perceptions of recovery. Conclusions: Post-COVID-19 effects among marathon runners are not uniform but vary according to sociodemographic and contextual factors. These findings underscore the importance of tailored support and readaptation strategies—particularly for vulnerable subgroups—to ensure their safe and equitable return to mass endurance events. Full article

Driven by both natural and anthropogenic factors, farmland abandonment and recultivation constitute complex and widespread global phenomena that impact the ecological environment and society. In the Inner Mongolia Yellow River Basin (IMYRB), a critical tension lies between agricultural production and ecological conservation, characterized by dynamic bidirectional transitions that hold significant implications for the harmony of human–nature relations and the advancement of ecological civilization. With the development of remote sensing, it has become possible to rapidly and accurately extract farmland changes and monitor its vegetation restoration status. However, mapping abandoned farmland presents significant challenges due to its scattered and heterogeneous distribution across diverse landscapes. Furthermore, subjectivity in questionnaire-based data collection compromises the precision of farmland abandonment monitoring. This study aims to extract crop phenological metrics, map farmland abandonment, and recultivation dynamics in the IMYRB and assess post-transition vegetation changes. We used Landsat time-series data to detect the land-use changes and vegetation responses in the IMYRB. The Farmland Abandonment and Recultivation Extraction Index (FAREI) was developed using crop phenology spectral features. Key crop-specific phenological indicators, including sprout, peak, and wilting stages, were extracted from annual MODIS NDVI data for 2020. Based on these key nodes, the Landsat data from 1999 to 2022 was employed to map farmland abandonment and recultivation. Vegetation recovery trajectories were further analyzed by the Mann–Kendall test and the Theil–Sen estimator. The results showed rewarding accuracy for farmland conversion mapping, with overall precision exceeding 79%. Driven by ecological restoration programs, rural labor migration, and soil salinization, two distinct phases of farmland abandonment were identified, 87.9 kha during 2002–2004 and 105.14 kha during 2016–2019, representing an approximate 19.6% increase. Additionally, the post-2016 surge in farmland recultivation was primarily linked to national food security policies and localized soil amelioration initiatives. Vegetation restoration trends indicate significant greening over the past two decades, with particularly significant increases observed between 2011 and 2022. In the future, more attention should be paid to the trade-off between ecological protection and food security. Overall, this study developed a novel method for monitoring farmland dynamics, offering critical insights to inform adaptive ecosystem management and advance ecological conservation and sustainable development in ecologically fragile semi-arid regions. Full article

Background/Objectives: This study investigates disparities in physical fitness among Connecticut K-12 students post-COVID-19, highlighting persistent inequities across race, socioeconomic status, language proficiency, and dis/ability. Methods: Utilizing state-wide data from Connecticut’s EdSight portal, the research reveals a significant decline in student physical fitness compared to pre-pandemic levels, notably lagging behind academic recovery. Results: Findings underscore stark disparities, with marginalized groups such as students with disabilities, English learners, and racially minoritized students consistently performing lower than their peers. District-level analyses further illustrate pronounced inequities, where affluent, predominantly White districts achieved nearly four times higher fitness scores compared to economically disadvantaged, racially diverse districts. Conclusions: These disparities reflect systemic resource allocation issues and align with the framework of stratification economics, emphasizing structural inequities rather than individual deficits. The study advocates for equity-based funding, mandatory physical education monitoring, culturally responsive teaching practices, and systemic policy reforms to ensure equitable access to physical education resources and holistic student well-being. Full article

Background/Objectives: Acute ischemic stroke is a leading cause of mortality and long-term disability globally, with limited reliable early predictors of functional outcomes and survival. This study aimed to assess the prognostic value of two novel predictors: the hypoperfusion intensity ratio calculated from mean transit time and time-to-drain maps (HIR-MTT–TTD), derived from computed tomography perfusion (CTP) imaging parameters, and the Inflammation–Coagulation Index (ICI), which integrates systemic inflammatory (C-reactive protein and white blood cell count) and hemostatic (D-dimer) markers. Methods: This prospective, single-center observational study included 60 patients with acute ischemic stroke treated with intravenous thrombolysis and underwent pre-treatment CTP imaging. HIR-MTT–TTD evaluated collateral status and perfusion deficit severity, while ICI integrated C-reactive protein (CRP), white blood cell (WBC) count, and D-dimer levels. Functional outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS), Barthel Index, and modified Rankin Scale (mRS) at 24 h, 3 months, and 1 year. Results: Of 60 patients, 53.3% achieved functional independence (mRS 0–2) at 1 year. Unadjusted Cox models showed HIR-MTT–TTD (HR = 6.25, 95% CI: 1.48–26.30, p = 0.013) and ICI (HR = 1.08, 95% CI: 1.00–1.17, p = 0.052) were associated with higher 12-month mortality, worse mRS, and lower Barthel scores. After adjustment for age, BMI, smoking status, and sex, these associations became non-significant (HIR-MTT–TTD: HR = 2.83, 95% CI: 0.37–21.37, p = 0.314; ICI: HR = 1.07, 95% CI: 0.96–1.19, p = 0.211). Receiver operating characteristic (ROC) analysis indicated moderate predictive value, with ICI (AUC = 0.756, 95% CI: 0.600–0.867) outperforming HIR-MTT–TTD (AUC = 0.67, 95% CI: 0.48–0.83) for mortality prediction. Conclusions: The study introduces promising prognostic tools for functional outcomes. Elevated HIR-MTT–TTD and ICI values were independently associated with greater initial stroke severity, poorer functional recovery, and increased 1-year mortality. These findings underscore the prognostic significance of hypoperfusion intensity and systemic thrombo-inflammation in acute ischemic stroke. Combining the use of the presented indices may enhance early risk stratification and guide individualized treatment strategies. Full article

Mold-active prophylaxis has reduced the incidence of invasive pulmonary aspergillosis (IPA) in patients with hematological malignancies (HMs), but breakthrough IPA (Bt-IPA) is increasingly encountered. Therefore, we studied determinants of Bt-IPA risk and its prognostic significance. We retrospectively reviewed culture-positive proven/probable IPA cases in HM patients at MD Anderson Cancer Center (2016–2021). Bt-IPA and non-Bt-IPA cases were compared to characterize risk factors, clinical presentation, and outcomes. Independent predictors of 42-day all-cause mortality were assessed using propensity score-adjusted Cox regression. Among 118 IPA cases, 50 (42.4%) were Bt-IPA. Bt-IPA was associated with acute leukemia/myelodysplastic syndrome, active HM, severe neutropenia (<100/mm³), and graft-versus-host diseases. Uncommon Aspergillus species (non-fumigatus, flavus, terreus, or niger) were more frequent in Bt-IPA than non-Bt-IPA (20.4% vs. 4.8%, p = 0.010). Forty-two-day mortality was higher in Bt-IPA (65.3% vs. 37.3%, p = 0.003), but Bt-IPA itself was not an independent predictor or mortality (p = 0.064), which was instead driven by neutropenia (p = 0.020) and hypoalbuminemia (p = 0.002). In conclusion, Bt-IPA accounted for nearly half of contemporary IPA cases and was linked to host-related risk factors and the recovery of uncommon Aspergillus species. Although not an independent prognostic predictor, Bt-IPA reflected poor host status. Thus, early diagnosis, immune enhancement strategies, and effective first-in-class antifungals may improve outcomes. Full article

Background: Liver cirrhosis is a complex and chronic pathology with the potential to impact a number of factors, including the patient’s health, nutritional status and diet. Proper nutritional intake plays an essential role alongside the necessary medical and recovery treatments. Methods: This study was conducted on a group that included patients of varying age demographics. They were required to undertake a 24 h food recall as well as two other questionnaires (CNAQ and CLDQ-NASH) that reported the level of appetite and nutrition and other aspects that focused on the patient’s general health and quality of life, respectively. Results: The results of the study indicated the presence of reduced appetite and a decrease in quality of life, as reported by questionnaire scores of less than 28 points for appetite and less than 4 points for quality of life. The 24 h dietary recalls revealed that the majority of patients exhibited a preference for meals comprising red and processed meats and traditional foods such as soups and animal foods and a low consumption of white meat, fish, legumes and fiber. Conclusions: The study’s findings reveal an imbalance in the patients’ nutritional intake and underscore the critical importance of nutritional support for patients with liver cirrhosis. However, further research is needed in this regard to determine the factors leading to nutritional deficiencies and the causes leading to refusal of nutritional intervention within the management of this disease. Full article

This study aimed to monitor internal load, well-being, and recovery status in U16 male water polo players during a congested competitive period. Fourteen athletes from an Italian club played 12 matches (seven friendly, five official) over 7 days. The internal match load was measured using the session-RPE method (s-RPE). Perceived enjoyment was measured with the Enjoyment Likert Scale (ENJ), while recovery and well-being were evaluated using the Perceived Recovery Scale (PRS) and the Hooper Index (HI), respectively. No significant main effects were found on s-RPE, PRS, and HI considering friendly and official matches. However, ENJ was significantly higher during official matches (p < 0.005). PRS values were significantly affected by daytime matches (p < 0.005), with better perceived recovery reported for morning matches. Linear mixed model analysis revealed significant associations between s-RPE and HI (p = 0.001), the fatigue item (p = 0.001), and the PRS (p = 0.004). These results suggest that as internal load increases, players experience higher fatigue and report lower recovery and well-being scores. Employing simple, non-invasive tools like the RPE, PRS, and HI can help coaches and support staff to identify early signs of overtraining or insufficient recovery, allowing for more individualized load management and injury prevention in youth water polo athletes. Full article

Background and Objectives: Postoperative physical recovery, particularly the acquisition of independent ambulation, is a critical milestone in rehabilitation following living donor liver transplantation (LDLT). Although liver function markers are conventionally used to assess hepatic physiology, emerging evidence has suggested their potential role as prognostic indicators of physical performance. Materials and Methods: This study investigated the association between liver function parameters at the initiation of postoperative physical therapy (total bilirubin [T-Bil], aspartate aminotransferase [AST], and alanine aminotransferase [ALT]) and the independent walking ability of 63 patients who underwent LDLT. A logistic regression model was constructed using these variables, and a receiver-operating characteristic (ROC) curve analysis was performed to evaluate its discriminative performance. Predicted probabilities of each patient were calculated, and the optimal cutoff value was determined based on the Youden Index. Results: The multivariate logistic regression model demonstrated a statistically significant association between liver function markers and the ambulation status of a cohort of 63 patients. The ROC curve analysis yielded an area under the ROC curve (AUC) of 0.8416 (95% confidence interval [CI]: 0.715–0.968), indicating strong predictive performance. The optimal cutoff value was 0.865, with sensitivity and specificity of 74.1% and 88.9%, respectively. The bootstrap CI for sensitivity at this threshold ranged from 0.6111 to 0.8519. The Hosmer–Lemeshow test indicated good model fit (p = 0.363), and the correct classification rate was 87.3%. Conclusions: Liver function test results may be indicators of hepatic dysfunction as well as functional biomarkers that could predict ambulatory outcomes following LDLT. This predictive model may enhance early clinical decision-making regarding rehabilitation and discharge planning. Future prospective studies should be performed to validate the generalizability of these results to broader clinical contexts. Full article

Background: Benzodiazepine poisoning is a frequent cause of emergency department (ED) visits, often related to suicide attempts. Flumazenil is the only specific antidote, but its continuous infusion protocol remains controversial because of its uncertain outcome benefits and increased risk of adverse events. This study aimed to evaluate the effect of continuous flumazenil infusion on the time to recovery of consciousness and secondary outcomes in patients with benzodiazepine poisoning stratified by hospitalization status. Methods: A retrospective cohort study was conducted at a tertiary hospital in Seoul, Korea, including adults treated for benzodiazepine poisoning in the ED between April 2019 and March 2024. The primary outcome being the time from arrival at the ED to regaining consciousness. Multivariate regression identified independent predictors of delayed recovery. Results: Among the 370 patients, 52.4% were hospitalized. Flumazenil infusion was administered in 46.8% of the patients, more often in hospitalized patients. In this group, flumazenil infusion significantly reduced the median time to regain consciousness (13.7 vs. 19.4 h, p = 0.006) but did not affect the overall hospital stay. In nonhospitalized patients, flumazenil infusion did not shorten the awakening time or prolong the ED stay. Adverse events, mainly agitation, were more frequent with flumazenil infusion. Conclusions: Continuous infusion of flumazenil accelerates the recovery of consciousness only in hospitalized patients who are severely affected by benzodiazepine poisoning but with increased adverse events and no reduction in hospital stay. Individualized patient selection and evidence-based protocols are needed for optimal and safe antidote use. Full article

Drought stress limits seedling growth, hindering morphological development and population establishment. Artocarpus nanchuanensis, a critically endangered species endemic to the karst regions of southwest China, exhibits poor population structure and limited natural regeneration in the wild, with water deficit during the seedling stage identified as a major factor contributing to its endangered status. Elucidating the physiological and molecular mechanisms underlying drought tolerance in A. nanchuanensis seedlings is essential for improving their drought adaptability and facilitating population recovery. In this study, 72 two-year-old seedlings were divided into two groups: drought (PEG) and ethephon (PEG + Ethephon), and subjected to drought-rehydration experiments. The results showed that exogenous application of 100 mg·L⁻¹ ethephon significantly improved stomatal conductance and photosynthetic pigment content in A. nanchuanensis seedlings. Under drought stress, the PEG + Ethephon group exhibited rapid stomatal closure, maintaining water balance and higher photosynthetic pigment levels. After rehydration, the PEG + Ethephon group significantly outperformed the PEG group in terms of photosynthetic rate. Ethephon treatment reduced H₂O₂ and MDA levels, enhanced antioxidant enzyme activity (SOD, CAT, POD, GR), and increased osmotic regulator activity (soluble sugars, soluble proteins, and proline), improving ROS-scavenging capacity and reducing oxidative damage. Ethephon application significantly enhanced ethylene accumulation in seedlings, while drought stress stimulated the concentrations of key ethylene biosynthetic enzymes (SAMS, ACS, and ACO), thereby further contributing to improved drought resistance. Transcriptomic data revealed that drought stress significantly upregulated key ethylene biosynthesis genes, with expression levels increasing with stress duration and rapidly decreasing after rehydration. WGCNA analysis identified eight key drought-resistance genes, providing valuable targets for future research. This study provides the first mechanistic insight into the physiological and molecular responses of A. nanchuanensis seedlings to drought and rehydration, underscoring the central role of endogenous ethylene in drought tolerance. Ethephon treatment effectively enhanced ethylene accumulation and biosynthetic enzyme activity, thereby improving drought adaptability. These findings lay a theoretical foundation for subsequent molecular functional studies and the conservation biology of this endangered species. Full article