Search Results (7,162)

Background: Botulinum toxin type A (BoNT/A) is widely used in both clinical and aesthetic settings to induce temporary neuromuscular paralysis by inhibiting acetylcholine release. Although generally regarded as safe and effective, complications such as iatrogenic ptosis or facial asymmetry may occur and persist for several weeks or even months, with no standardized method currently available to accelerate recovery. Objective: This article explores the hypothesis that photobiomodulation (PBM)—a non-invasive modality recognized for its neuroregenerative potential—may facilitate the reversal of BoNT/A-induced neuromuscular blockade. Discussion: PBM enhances mitochondrial activity by stimulating cytochrome c oxidase in nerve and muscle tissues, thereby increasing ATP production and modulating intracellular signaling pathways associated with neuroplasticity, cell survival, and synaptogenesis. Preclinical studies have demonstrated that PBM can upregulate neurotrophic factors (e.g., BDNF, NGF), enhance SNAP-25 expression, and promote structural remodeling of neurons in both young and aged brains. These mechanisms are biologically consistent with the regenerative processes required for recovery from BoNT/A-induced effects. While controlled clinical trials for this specific application are currently lacking, anecdotal clinical reports suggest that PBM may accelerate functional recovery in cases of BoNT/A-related complications. Conclusions: Although this approach has not yet been tested in clinical trials, we propose that photobiomodulation may hypothetically serve as a supportive strategy to promote neuromuscular recovery in patients experiencing adverse effects from BoNT/A. This hypothesis is grounded in robust preclinical evidence but requires validation through translational and clinical research. Full article

Background and Clinical Significance: Serratus Anterior Muscle Pain Syndrome (SAMPS) is an underdiagnosed cause of anterior chest wall pain, often attributed to myofascial trigger points of the serratus anterior muscle (SAM) or dysfunction of the Long Thoracic Nerve (LTN), leading to significant disability and affecting ipsilateral upper limb movement and quality of life. Current diagnosis relies on exclusion and physical examination, with limited treatment options beyond conservative approaches. This case report presents a novel approach to chronic SAMPS, successfully diagnosed using Sonoguided Digital Palpation (SDP) and treated with ultrasound-guided hydrodissection of the LTN using 5% dextrose in water (D5W) without local anesthetic (LA), in a patient where conventional treatments had failed. Case Presentation: A 72-year-old male presented with a three-year history of persistent left chest pain radiating to the upper back, exacerbated by activity and mimicking cardiac pain. His medical history included two percutaneous coronary interventions. Physical examination revealed tenderness along the anterior axillary line and a positive hyperirritable spot at the mid axillary line at the 5th rib level. SDP was used to visualize the serratus anterior fascia (SAF) and LTN, and to reproduce the patient’s concordant pain by palpating the LTN. Ultrasound-guided hydrodissection of the LTN was then performed using 20–30cc of D5W without LA to separate the nerve from the surrounding tissues, employing a “fascial unzipping” technique. The patient reported immediate pain relief post-procedure, with the pain reducing from 9/10 to 1/10 on the Numeric Rating Scale (NRS), and sustained relief and functional improvement at the 12-month follow-up. Conclusions: Sonoguided Digital Palpation (SDP) of the LTN can serve as a valuable diagnostic adjunct for visualizing and diagnosing SAMPS. Ultrasound-guided hydrodissection of the LTN with D5W without LA may provide a promising and safe treatment option for patients with chronic SAMPS refractory to conservative management, resulting in rapid and sustained pain relief. Further research, including controlled trials, is warranted to evaluate the long-term efficacy and generalizability of these findings and to compare D5W to other injectates. Full article

Background/Objective: Sepsis is a leading cause of death in noncoronary intensive care units (ICUs). Fluids for intravascular resuscitation include crystalloids and colloids. There is extensive clinical evidence on colloid use, but large trials comparing gelatine with crystalloid regimens in ICU and septic patients are lacking. This study aimed to determine whether early, protocol-driven volume resuscitation using a gelatine-based regimen achieves hemodynamic stability (HDS) more rapidly than a crystalloid-based regimen in septic patients. Methods: This prospective, controlled, randomised, double-blind, multinational phase IV study compared two parallel groups of septic patients receiving a gelatine-based regimen (Gelaspan^® 4% and Sterofundin^® ISO, B. Braun Melsungen AG each, at a 1:1 ratio) or a crystalloid regimen (Sterofundin^® ISO). Primary endpoint was time to first HDS within 48 h after randomisation. Secondary endpoints included fluid overload, fluid balance, and patient outcomes. Results: 167 patients were randomised. HDS was achieved after 4.7 h in the gelatine group and after 5.8 h in the crystalloid group (p = 0.3716). The gelatine group had a more favourable fluid balance at 24 h (medians: 3463.00 mL vs. 4164.00 mL; p = 0.0395) and less fluid overload (medians: 4296.05 vs. 5218.75%; p = 0.0217). No differences were observed in serious adverse events or mortality. Conclusions: The study provided clinical evidence of balanced gelatine solution for volume resuscitation in septic patients, although it was terminated prematurely. The early and protocol-based administration of gelatine was safe and effective in the enrolled patient population. Time to HDS was not different between groups but the gelatine-based regimen led to better fluid balance and less fluid overload. Full article

As the primary biological risk threatening safe dairy production, bovine mastitis control highly relies on environmental disinfection measures. However, the mechanisms by which chemical disinfectants influence host–environment microbial interactions remain unclear. This study systematically investigated the disinfection efficacy and regulatory effects on microbial community composition and diversity of glutaraldehyde-benzalkonium chloride (BAC) and glutaraldehyde-didecyl dimethyl ammonium bromide (DAB) at recommended concentrations (2–5%), using 80 environmental samples from intensive dairy farms in Xinjiang, China. Combining 16S rDNA sequencing with culturomics, the results showed that BAC achieved a disinfection rate of 99.33%, higher than DAB’s 97.87%, and reduced the environment–gut microbiota similarity index by 23.7% via a cationic bacteriostatic film effect. Microbiome analysis revealed that BAC selectively suppressed Fusobacteriota abundance (15.67% reduction) and promoted Bifidobacterium proliferation (7.42% increase), enhancing intestinal mucosal barrier function through butyrate metabolism. In contrast, DAB induced Actinobacteria enrichment in the environment (44.71%), inhibiting pathogen colonization via bioantagonism. BAC’s long-acting bacteriostatic properties significantly reduced disinfection costs and mastitis incidence. This study first elucidated the mechanism by which quaternary ammonium compound (QAC) disinfectants regulate host health through “environment-gut” microbial interactions, providing a critical theoretical basis for developing precision disinfection protocols integrating “cost reduction-efficiency enhancement-risk mitigation.” Full article

Background/Objectives: Tension-type headache (TTH) is the most prevalent form of primary headache. The etiology of TTH is not yet fully understood, although it is associated with the presence of myofascial trigger points (MTPs) in cervical and facial muscles. Dry needling (DN) therapy has emerged as an effective and safe non-pharmacological option for pain relief, but there are a lack of systematic reviews focused on its specific characteristics in TTH. The aim of this paper is to examine the characteristics and methodologies of DN in managing TTH. Methods: A scoping review was conducted with inclusion criteria considering studies that evaluated DN interventions in adults with TTH, reporting target muscles, diagnostic criteria, and technical features. The search was performed using PubMed, Embase, Scopus, and the Web of Science, resulting in the selection of seven studies after a rigorous filtering and evaluation process. Results: The included studies, primarily randomized controlled trials, involved a total of 309 participants. The most frequently treated muscles were the temporalis and trapezius. Identification of MTPs was mainly performed through manual palpation, although diagnostic criteria varied. DN interventions differed in technique. All studies included indicated favorable outcomes with improvements in headache symptoms. No serious adverse effects were reported, suggesting that the technique is safe. However, heterogeneity in protocols and diagnostic criteria limits the comparability of results. Conclusions: The evidence supports the use of DN in key muscles such as the temporalis and trapezius for managing TTH, although the diversity in methodologies and diagnostic criteria highlights the need for standardization. The safety profile of the method is favorable, but further research is necessary to define optimal protocols and improve reproducibility. Implementing objective diagnostic criteria and uniform protocols will facilitate advances in clinical practice and future research, ultimately optimizing outcomes for patients with TTH. 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

Communication delay, as a key factor restricting the rapid and accurate transmission of data in the smart grid, will affect the collaborative operation of power electronic devices represented by the Distributed Power Flow Controller (DPFC), and further affect the construction and safe and stable operation of the new power system. Aiming at the problem of DPFC communication delay prediction, this paper proposes a new SAR-ARIMA-LSTM hybrid prediction model. This model introduces the spatial autoregressive model (SAR) on the basis of the traditional ARIMA-LSTM model to extract the spatial correlation between devices caused by geographical location and communication load, and then combines ARIMA-LSTM prediction. The experimental structure shows that compared with the traditional ARIMA-LSTM model, the model proposed in this paper predicts that RMSE decreases from 1.59 to 1.2791 and MAE decreases from 1.27 to 1.0811, with a reduction of more than 14%. The method proposed in this paper can effectively reduce the communication delay prediction data of DPFC at different spatial positions, has a stronger ability to handle high-delay fluctuations, and provides a new technical approach for improving the reliability of the power grid communication network. Full article

Objectives: Older adults who worry about not being able to stand up from the floor after a fall, reduce their physical activity, which leads to a higher risk of falling. The Backward Chaining Method (BCM) was developed specifically for this population to safely teach and practice the movement sequence required to stand up from the floor. Our aim is to evaluate the effectiveness of using the BCM to teach older adults how to stand up from the floor, and to determine whether this training has an impact on functional mobility, muscle strength, fear of falling, and life-space mobility. Methods: A total of 26 residents of a long-term care facility were randomly allocated to two groups. Residents in the intervention group (IG, n = 13) participated in a seven-week training program to learn how to stand up from the floor with BCM, in addition to the usual care generally offered in long-term care facilities. The participants in the control group (CG, n = 13) received the usual care alone. The primary outcome measure was functional mobility, assessed by the Timed Up and Go test. Secondary outcome measures included functional lower limb strength, grip strength, fear of falling, and life-space mobility. The outcomes were measured at baseline and after the seven-week intervention period. Results: We found no significant between-group differences in functional mobility, lower limb strength and grip strength; however, IG subjects demonstrated significantly lower fear of falling scores, and significantly higher life-space mobility and independent life-space mobility scores compared to CG subjects after the training program. Conclusions: This study demonstrates that the Backward Chaining Method is a feasible, well-tolerated intervention in a long-term care setting and it may have meaningful benefits, particularly in lessening fear of falling and improving life-space mobility and independent life-space mobility when incorporated into the usual physiotherapy interventions. Full article

The concept of “more is better” has long dominated cancer treatment, emphasizing aggressive therapies despite their toxicity. However, the rise of personalized medicine has fostered treatment de-escalation strategies aimed at minimizing toxicity, improving quality of life, and reducing costs. This position paper highlights key applications of de-escalation in medical oncology, with a primary focus on breast cancer and notable examples in colorectal, head and neck, ovarian, lung, and prostate cancers. Various approaches, including dose reduction, treatment duration shortening, and regimen optimization, have demonstrated efficacy without compromising clinical outcomes. Advances in molecular diagnostics, such as Oncotype Dx in breast cancer and circulating tumor DNA (ctDNA) analysis in colorectal cancer, have facilitated patient selection for de-escalation. While these strategies present promising results, challenges remain, particularly in balancing treatment intensity with oncologic control. The review underscores the need for further prospective trials to refine de-escalation approaches and ensure their safe integration into standard oncologic care. Full article

The aquaculture industry has experienced considerable growth in recent decades, stimulating research into sustainable and functional feed formulations, mainly related to using high-quality, safe, and environmentally friendly feed ingredients. The employment of immunomodulatory additives is a promising strategy to enhance fish health and performance. In this study, the effects of the ghrelin analog GHRP-6 peptide included in the diet (500 µg/kg of feed) on the endocrine and immune responses of Sparus aurata following Incomplete Freund’s adjuvant (IFA) treatment were assessed. After 97 days, fish were intraperitoneally injected with 100 µL of saline solution or IFA/100 g fish and sampled 72 h post-injection. Our results indicated that fish fed GHRP-6 maintained stable plasma levels of lactate, triglycerides, and cortisol after IFA treatment, in contrast to control-fed fish, which showed significant metabolic stress. Circulating immunoglobulin levels enhanced significantly in the GHRP-6/IFA group, suggesting a stimulated humoral immune response. Transcriptomics analysis revealed that the anterior intestine was the most responsive tissue, with upregulation of il10, il15, il34, and mx1, indicating mucosal immune activation. In the spleen, GHRP-6-fed fish increased il8, il10, and ighm expression, highlighting a balanced pro- and anti-inflammatory response and support for adaptive immunity. Multivariate analysis confirmed that dietary GHRP-6 modulates immune gene expression in a tissue- and stimulus-specific manner, without inducing histological alterations in the intestine or spleen. Taken together, these preliminary results indicate that this peptide is a viable and safe dietary supplement to improve immune resilience and increase the production efficiency of S. aurata and suggest a protective effect on the fish’s immune system in this species. Full article

Background/Objectives: Septoplasty is a commonly performed surgical procedure aimed at correcting nasal septal deviations, to improve nasal airflow and respiratory function. Traditional approaches to septal correction rely on either direct visualization or endoscopic guidance. Recently, a novel technology known as exoscopy has been introduced into surgical practice. Exoscopy is an “advanced magnification system” that provides an enlarged, three-dimensional view of the operating field. In this article, we present our experience with exoscope-assisted septoplasty, developed over the last two years, and compare it with our extensive experience using the endoscopic approach. Methods: Our case series includes 26 patients, predominantly males and young adults, who underwent exoscope-assisted septoplasty. We discuss the primary advantages of this technique and, most importantly, provide an analysis of its learning curve. The cohort of patients treated using the exoscopic approach was compared with a control group of 26 patients who underwent endoscope-guided septoplasty, randomly selected from our broader clinical database. Finally, we present a representative surgical case that details all phases of the exoscope-assisted procedure. Results: Our surgical experience has demonstrated that exoscopy is a safe and effective tool for performing septoplasty. Moreover, the learning curve associated with this technique exhibits a rapid and progressive improvement. Notably, exoscopy provides a substantial educational benefit for trainees and medical students, as it enables them to share the same visual perspective as the lead surgeon. Conclusions: Although further studies are required to validate this approach, we believe that exoscopy represents a promising advancement for a wide range of head and neck procedures, and certainly for septoplasty. Full article

There is a global demand for reducing the adoption of traditional chemical insecticides in agriculture. Among the most promising alternatives, botanical insecticides have been increasingly gaining attention due to their efficacy combined with a more environmentally safe impact. Among the different botanical insecticides commercially available, oxymatrine is an alkaloid found in the roots of Sophora flavescens which exhibits wide insecticide activity. However, their side-effects on non-target organisms have not been extensively evaluated. Therefore, this study aimed to investigate in laboratory conditions the insecticidal potential of a commercial botanical insecticide (Matrine^®) based on ethanolic extract of S. flavescens roots at 0.2; 0.6; 1.0; 1.4; 1.8; and 2.2 L of commercial product per hectare to control third-instar larvae of Rachiplusia nu and its selectivity in the egg parasitoid Trichogramma pretiosum. Overall, our results showed that the ethanolic extract of S. flavescens is an efficient tool to control R. nu from 0.6 to 2.2 L/ha, with similar R. nu mortality at 48 and 72 h after spraying (close to 100% mortality) associated with no impact to pupae and minimum impact to adults (slightly harmful) of the egg parasitoid. The botanical insecticide was classified as harmless to the pupae and slightly harmful to the adults of T. pretiosum according to the International Organization for Biological Control (IOBC) protocols. Thus, the use of the ethanolic extract of S. flavescens emerges as a relevant alternative to control R. nu, which needs to be confirmed in future field trials. Full article

Foodborne diseases are the most common causes of illness worldwide. Bacterial pathogens, including Staphylococcus aureus, are often involved in foodborne disease and pose a serious threat to human health. S. aureus is commonly found in humans and a variety of animal species. Staphylococcal enteric disease, specifically staphylococcal food poisoning (SFP), accounts for numerous gastrointestinal illnesses, through the contamination of food with its enterotoxins, and its major impact on human health imposes a heavy economic burden in society. Commonly, antibiotics and antimicrobials are used to treat SFP. However, a range of complications may arise with these treatments, impeding the control of S. aureus diseases specifically caused by methicillin-resistant S. aureus (MRSA). Natural alternative options to control S. aureus diseases, such as bacteriophages, plant-based antimicrobials, nanoparticle-based or light-based therapeutics, and probiotics, are promising in terms of overcoming these existing problems as they are environmentally friendly, abundant, unlikely to induce resistance in pathogens, cost-effective, and safe for human health. Recent findings have indicated that these alternatives may reduce the colonization and infection of major foodborne pathogens, including MRSA, which is crucial to overcome the spread of antibiotic resistance in S. aureus. This review focuses on the present scenario of S. aureus in foodborne disease, its economic importance and current interventions and, most importantly, the implications of natural antimicrobials, especially probiotics and synbiotics, as alternative antimicrobial means to combat pathogenic microorganisms particularly, S. aureus and MRSA. Full article

Diabetic wounds are a devastating complication that cause chronic pain, recurrent infections, and limb amputations due to impaired healing. Despite advances in wound care, existing therapies often fail to address the underlying molecular dysregulation, highlighting the need for innovative and safe therapeutic approaches. Among these, D-amino acids such as D-tryptophan (D-Trp) have emerged as key regulators of cellular processes; however, their therapeutic potential in diabetic wounds remains largely unexplored. Here, we investigate the therapeutic potential of D-Trp in streptozotocin (STZ)-induced diabetic mice, comparing it with phosphate-buffered saline (PBS) controls and vascular endothelial growth factor (VEGF) as a positive control. Wound healing, inflammation, and histopathology were assessed. Protein and gene expression were analyzed via Western blot and RT-qPCR, respectively. Biolayer interferometry (BLI) measured the binding of D-Trp to hypoxia-inducible factor-1α (HIF-1α). D-Trp accelerated wound healing by modulating extracellular matrix (ECM) remodeling, signaling, and apoptosis. It upregulated matrix metalloproteinases (MMP1, MMP3, MMP-9), Janus kinase 2 (JAK2), and mitogen-activated protein kinase (MAPK) proteins while reducing pro-inflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin-1β [IL-1β], IL-6). D-Trp also suppressed caspase-3 and enhanced angiogenesis through HIF-1α activation. These findings suggest that D-Trp promotes healing by boosting ECM turnover, reducing inflammation, and activating MAPK/JAK pathways. Thus, D-Trp is a promising therapeutic for diabetic wounds. Full article

Background/Objectives: Aging is often accompanied by physical and cognitive decline, affecting older adults’ mobility. Virtual reality (VR) offers innovative opportunities to safely practice everyday tasks, such as street crossing. This study was designed as a feasibility and pilot study to explore acceptance, usability, and preliminary effects of a VR-based road-crossing intervention for older adults. It investigates the use of virtual reality (VR) as an innovative training tool to support senior citizens in safely navigating everyday challenges such as crossing roads. By providing an immersive environment with realistic traffic scenarios, VR enables participants to practice in a safe and controlled setting, minimizing the risks associated with real-world road traffic. Methods: A VR training application called “Wegfest” was developed to facilitate targeted road-crossing practice. The application simulates various scenarios commonly encountered by older adults, such as crossing busy streets or waiting at traffic lights. The study applied a single-group pre-post design. Outcomes included the Timed Up and Go test (TUG), Falls Efficacy Scale-International (FES-I), and Montreal Cognitive Assessment (MoCA). Results: The development process of “Wegfest” demonstrates how a highly realistic street environment can be created for VR-based road-crossing training. Significant improvements were found in the Timed Up and Go test (p = 0.002, d = 0.784) and fall-related self-efficacy (FES-I, p = 0.005). No change was observed in cognitive function (MoCA, p = 0.56). Participants reported increased subjective safety (p < 0.001). Discussion: The development of the VR training application “Wegfest” highlights the feasibility of creating realistic virtual environments for skill development. By leveraging immersive technology, both physical and cognitive skills required for road-crossing can be effectively trained. The findings suggest that “Wegfest” has the potential to enhance the mobility and safety of older adults in road traffic through immersive experiences and targeted training interventions. Conclusions: As an innovative training tool, the VR application not only provides an engaging and enjoyable learning environment but also fosters self-confidence and independence among older adults in traffic settings. Regular training within the virtual world enables senior citizens to continuously refine their skills, ultimately improving their quality of life. Full article