Search Results (3,206)

Background/Objectives: Subsequent musculoskeletal injuries are frequent among physically active young adults, yet the roles of body composition, training weekly load (TWL), and physical activity intensity in subsequent injury occurrence remain unclear. This study examined the associations of body composition indices and training-related variables with subsequent injuries in university students and explored whether combining key markers from body composition and training exposure improves discrimination compared with single markers. Methods: The analysis included 418 students from two cohorts merged after confirming negligible between-cohort differences. Participants completed questionnaires on injury history and physical activity and underwent standardized anthropometric and body composition assessments. Intrinsic factors included fat mass index (FMI) and skeletal muscle mass index (SMI), while extrinsic factors comprised training weekly load (TWL), total physical activity (TPA), and vigorous activity percentage (VPA%). Subsequent injury (yes/no) served as the primary outcome. Injuries were assessed retrospectively over the preceding 12 months; subsequent injury was defined as ≥1 injury occurring after a previous (index) injury within this recall period. Analyses used univariate and multivariable logistic regression and exploratory Receiver Operating Characteristic (ROC) analyses for individual markers and combined models. Results: SMI was associated with subsequent injury (OR = 1.09, 95% CI: 1.03–1.15). TWL showed a weak, non-significant association (OR = 1.03, p = 0.307). Models combining SMI and TWL, including their interaction, did not meaningfully improve discrimination compared with SMI alone. ROC analyses indicated limited discriminatory ability across models (AUCs < 0.65), suggesting poor accuracy for identifying individuals with subsequent injury based on these markers. Conclusions: The examined body composition, training weekly load (TWL), and physical activity measures alone or combined showed limited discriminatory utility for subsequent injury status in this cross-sectional sample. These findings support the multifactorial nature of injury susceptibility and indicate that simple anthropometric or TWL-based measures are not suitable as standalone screening tools for subsequent injury in active university populations. Full article

Background/Objectives: Maternal immune activation (MIA) increases the risk of Autism Spectrum Disorders (ASD). Experimental models demonstrate that maternal exposure to bacterial endotoxin or the viral mimic polyinosinic:polycytidylic acid [poly (I:C)] reliably recapitulates ASD-like behavioral abnormalities in offspring, yet the underlying neurobiological mechanisms linking MIA to altered neurodevelopment remain incompletely understood. Increasing evidence highlights the placenta as a critical mediator in shaping fetal brain development through immunological and hormonal regulation. Likewise, disruption of placental regulatory functions upon MIA may therefore represent a mechanistic pathway. Here, we investigated how alterations in placental cytokine profiles, innate immune cell composition, and endocrine outputs relate to neuroinflammation and neurogenesis in the offspring. Methods: Pregnant mice at gestational day 12.5 received a single intraperitoneal injection of poly (I:C). Placental macrophages, neutrophils, inflammatory cytokines, and nerve growth factor (NGF) expression were examined 72 h later. Neurodevelopmental outcomes, including microglial activity and neurogenic markers, were evaluated in mouse offspring at postnatal day (P) 1 and 6. Results: MIA induced a significant accumulation of monocytes and neutrophils in the placenta, which was associated with elevated levels of a broad spectrum of inflammatory mediators, including Th17-biased proinflammatory cytokines, chemokines, and adhesion proteins, in the placenta and amniotic fluid. In contrast, the placenta-derived NGF levels were significantly reduced. MIA induced strong and sustained microglial activation in the fetal and neonatal brain. This inflammatory milieu was accompanied by disrupted cortical neurogenesis, characterized by a marked increase in Ki67+ neuronal progenitor cells (NPCs) in the subventricular zone (SVZ), overproduction of early-born Tbr1+ neurons at P1, later-born Satb2+ neurons at P6. Conclusions: Collectively, these findings suggest that heightened Th17 inflammatory signaling, coupled with impaired placental endocrine function, contributes to dysregulated cortical neurogenesis in the offspring. Full article

Hepatitis C virus (HCV) still lacks a licensed vaccine. The envelope glycoprotein E2 is a key neutralizing target, but its dense N-glycan shield can hinder epitope exposure. In this study, we revisit E2 glycan editing and examine whether single-site deletion preserves antigen integrity while improving immune responses in mice under a DNA immunization setting. Using a secreted E2 ectodomain (sE2384–661), we generated five N to D mutants at conserved sites (N1, N2, N4, N6, and N11) and evaluated them in a unified DNA immunization model with identical CpG content and delivery conditions across groups. The N2 mutant (N423, sE2-N2) maintained expression, secretion, and ER localization; furthermore, in mice, it was associated with higher anti-E2 titers and greater inhibition of H77 (genotype 1a) HCVcc at the tested dilutions, with limited activity against Con1 (1b). Cellular analyses showed increased IFN-γ ELISPOT counts and higher frequencies of granzyme B⁺/perforin⁺ CD8⁺ T cells after N2 immunization, while IL-4 remained low. Functionally, N2 elicited stronger specific lysis of CT26-sE2 targets in vitro and slowed CT26-sE2 tumor growth in vivo. In HCV-infected ICR^4R+ mice, therapeutic vaccination with sE2-N2 reduced blood HCV RNA and hepatic readouts compared with sE2. A monoclonal antibody isolated from sE2-N2-immunized mice (1C1) neutralized HCVcc in vitro and, after passive transfer, lowered viremia and liver signals in infected mice. Collectively, these findings indicate that selective removal of the N2 glycan preserves antigen properties and is associated with improved humoral and cellular immunity and measurable in vivo activity, supporting targeted glycan editing as a practical strategy to refine E2-based HCV vaccines. Full article

Objective: The number of operators performing mechanical thrombectomy (MT) may influence procedural outcomes; however, evidence remains limited and conflicting. This study aimed to comprehensively evaluate the impact of single versus dual operators on procedure time, radiation dose, and angiographic success in patients undergoing MT for acute ischemic stroke. Methods: In this single-center, retrospective cohort study, 285 consecutive patients who underwent MT for large-vessel occlusion between January 2020 and December 2024 were included. Patients were grouped according to institutional workflow: single-operator procedures (n = 157) and dual-operator procedures (n = 128). The primary endpoints were procedure time and radiation dose parameters, including total Kerma-Area Product (PKA). Secondary endpoints included successful reperfusion (TICI ≥ 2b), complete reperfusion (TICI 3), and first-pass success (FPS, defined as TICI 2c/3 with a single pass). Results: Baseline characteristics were comparable between groups. The dual-operator group had significantly shorter median procedure times (52.5 vs. 85.0 min, p < 0.001) and lower total PKA (p < 0.001). Reperfusion rates were significantly higher in the dual-operator group, both for successful reperfusion (TICI ≥ 2b: 80.5% vs. 64.3%, p = 0.004) and complete reperfusion (TICI 3: 76.6% vs. 58.5%, p = 0.002). First-pass success was also more frequent (60.0% vs. 44.5%, p = 0.0146), and the mean number of passes was lower (1.66 vs. 2.00, p = 0.0057). Conclusions: Mechanical thrombectomy performed with two experienced operators was associated with greater procedural efficiency, reduced patient radiation exposure, and higher angiographic success compared with single-operator procedures. These findings support considering the dual-operator model as an approach that may inform workforce planning and workflow decisions in stroke centers. Full article

SARS-CoV-2, the causative virus of the COVID-19 pandemic, is a highly transmissible, enveloped, single-stranded RNA virus that has mutated into several variants, complicating vaccine strategies and drug resistance. Novel treatment modalities targeting conserved structural vulnerable points are essential to combat these variants. The primary aim of the current study is to test the mechanical vulnerability of the SARS-CoV-2 virus envelope and spike proteins to focused, high-frequency ultrasound waves (25 MHz) in vitro. Utilizing a preliminary pretest and posttest study design, the study was conducted on a virus sample within a distilled water matrix, under controlled laboratory biosafety conditions. Since detailed imaging tools were unavailable, viral disruption was indirectly measured using real-time PCR cycle threshold (Ct) values. Ct values increased significantly after high-frequency ultrasound exposure, indicating a reduction in amplifiable viral genomic material. A paired t-test indicated a significant difference between the pretest and posttest Ct (p < 0.001), which is supported by Monte Carlo test results that revealed statistically significant shifting in viral load categories (p = 0.001, two-sided). Specifically, 85.7% of high-viral-load samples converted to low or moderate content, 46.7% of low or moderate samples were shifted to negative content. This intervention produced a large effect size (Cohen’s d = 2.422). These results indicate that ultrasound may offer a promising non-pharmacological approach to destroy or inactivate SARS-CoV-2 variants in an aqueous environment. Full article

We introduce the Onco-Hem Connectome (OHC), a patient similarity network (PSN) designed to organize real-world hemato-oncology inpatients by exploratory phenotypes with potential clinical utility. Background: Polypharmacy and drug–drug interactions (DDIs) are pervasive in hemato-oncology and vary with comorbidity and treatment intensity. Methods: We retrospectively analyzed a 2023 single-center cohort of 298 patients (1158 hospital episodes). Standardized feature vectors combined demographics, comorbidity (Charlson, Elixhauser), comorbidity polypharmacy score (CPS), aggregate DDI severity score (ADSS), diagnoses, and drug exposures. Cosine similarity defined edges (threshold ≥ 0.6) to build an undirected PSN; communities were detected with modularity-based clustering and profiled by drugs, diagnosis codes, and canonical chemotherapy regimens. Results: The OHC comprised 295 nodes and 4179 edges (density 0.096, modularity Q = 0.433), yielding five communities. Communities differed in comorbidity burden (Kruskal–Wallis ${\epsilon }^2$: Charlson 0.428, Elixhauser 0.650, age 0.125, all FDR-adjusted p < 0.001) but not in utilization (LOS, episodes) after FDR (${\epsilon }^2$ ≈ 0.006–0.010). Drug enrichment (e.g., enoxaparin $\Delta$ = +0.13 in Community 2; vinblastine $\Delta$ = +0.09 in Community 3) and principal diagnoses (e.g., C90.0 23%, C91.1 15%, C83.3 15% in Community 1) supported distinct clinical phenotypes. Robustness analyses showed block-equalized features preserved communities (ARI 0.946; NMI 0.941). Community drug signatures and regimen signals aligned with diagnosis patterns, reflecting the integration of resource-use variables in the feature design. Conclusions: The Onco-Hem Connectome yields interpretable, phenotype-level insights that can inform supportive care bundles, DDI-aware prescribing, and stewardship, and it provides a foundation for phenotype-specific risk models (e.g., prolonged stay, infection, high-DDI episodes) in hemato-oncology. Full article

With the continuous expansion of high-density urban forms, residents’ opportunities for daily contact with natural environments have been increasingly reduced, making the equity of urban green space allocation a critical challenge for sustainable urban development. Existing studies have largely focused on green space quantity or accessibility at single time points, lacking systematic investigations into the spatiotemporal evolution of green space exposure (GSE) and its equity from the perspective of residents’ actual environmental experiences. GSE refers to the integrated level of residents’ contact with urban green spaces during daily activities across multiple dimensions, including visual exposure, physical accessibility, and spatial distribution, emphasizing the relationship between green space provision and lived environmental experience. Based on this framework, this study takes the central urban area of Hangzhou as the study area and integrates multi-temporal remote sensing imagery with large-scale street view data. A deep learning–based approach is developed to identify green space exposure, combined with spatial statistical methods and equity measurement models to systematically analyze the spatiotemporal patterns and evolution of GSE and its equity from 2013 to 2023. The results show that (1) GSE in Hangzhou increased significantly over the study period, with accessibility exhibiting the most pronounced improvement. However, these improvements were mainly concentrated in peripheral areas, while changes in the urban core remained relatively limited, revealing clear spatial heterogeneity. (2) Although overall GSE equity showed a gradual improvement, pronounced mismatches between low exposure and high demand persisted in densely populated areas, particularly in older urban districts and parts of newly developed residential areas. (3) The spatial patterns and evolutionary trajectories of equity varied significantly across different GSE dimensions. Composite inequity characterized by “low visibility–low accessibility” formed stable clusters within the urban core. This study further explores the mechanisms underlying green space exposure inequity from the perspectives of urban renewal patterns, land-use intensity, and population concentration. By constructing a multi-dimensional and temporally explicit analytical framework for assessing GSE equity, this research provides empirical evidence and decision-making references for refined green space management and inclusive, sustainable urban planning in high-density cities. Full article

Distributed acoustic sensing (DAS) systems have been widely employed in oil and gas resource exploration, pipeline monitoring, traffic and transportation, structural health monitoring, hydrophone usage, and perimeter security due to their ability to perform large-scale distributed acoustic measurements. Conventional DAS relies on Rayleigh backscattering (RBS) from standard single-mode fibers (SMFs), which inherently limits the signal-to-noise ratio (SNR) and sensing robustness. Ultra-weak fiber Bragg grating (UWFBG) arrays can significantly enhance backscattering intensity and thereby improve DAS performance. This review provides a comprehensive overview of recent advances in UWFBG arrays for high-performance DAS. We introduce major inscription techniques for UWFBG arrays, including the drawing tower grating method, ultraviolet (UV) exposure through UV-transparent coating fiber technologies, and femtosecond laser direct writing methods. Furthermore, we summarize the applications of UWFBG arrays in DAS systems for the enhancement of RBS intensity, suppression of fading, improvement of frequency response, and phase noise compensation. Finally, the prospects of UWFBG-enhanced DAS technologies are discussed. Full article

Plesiomonas shigelloides, an aquatic Gram-negative bacillus often associated with self-limiting gastroenteritis, has been reported worldwide. However, to date, no reviews have specifically investigated P. shigelloides bacteremia, which is rare and potentially fatal. This scoping review aimed to examine the existing literature to identify the epidemiology, clinical characteristics, antimicrobial susceptibility, and outcomes of P. shigelloides bacteremia. A PRISMA-ScR-guided search of PubMed, Scopus, Web of Science, and Embase identified 22 published cases, all reported as single-patient case reports. Cases were globally distributed, with the majority reported from the Americas and Europe. The median patient age was 46 years. The case fatality rate was 27.3% (n = 6/22). Most patients had identifiable host risk factors, particularly hematological disorders, neonatal status, or immunocompromised status, and environmental exposure such as raw seafood consumption or contact with freshwater. Clinical presentations were heterogeneous, commonly including fever and sepsis or septic shock. Microbiologically, P. shigelloides demonstrated consistent intrinsic resistance to ampicillin while retaining susceptibility to multiple antimicrobial classes. Poor outcomes were more closely associated with host factors and delayed presentation than with antimicrobial resistance. Early diagnosis, targeted therapy, and antimicrobial stewardship are essential for optimizing outcomes in this rare but severe infection. Full article

Colorectal cancer (CRC) progression and therapy resistance are driven in part by metabolic reprogramming and the persistence of cancer stem-like cells (CSCs). The seven in absentia homolog 2 (SIAH2)/with-no-lysine kinase 1 (WNK1) signaling axis has emerged as a potential regulator of these processes, yet its functional role in CRC metabolism and tumor–stroma crosstalk remains incompletely understood. Integrated analyses of The Cancer Genome Atlas–Colon Adenocarcinoma (TCGA-COAD) and Gene Expression Omnibus (GEO, GSE17538) datasets revealed significant upregulation of SIAH2 and WNK1 in CRC tissues, with strong positive correlations to glycolysis- and hypoxia-associated genes, including PFKP, LDHA, BPGM, ADH1A, ADH1B, and HIF-1α. Single-cell and clinical profiling further demonstrated preferential enrichment of SIAH2 in undifferentiated, stem-like tumor cell populations. Functional studies across multiple CRC cell lines showed that SIAH2 silencing suppressed proliferation, clonogenic growth, tumor sphere formation, and cell-cycle progression, whereas SIAH2 overexpression exerted opposite effects. Seahorse extracellular flux analyses established that SIAH2 promotes glycolytic capacity and metabolic flexibility. At the protein level, SIAH2 regulated glycolytic enzymes and WNK1/hypoxia-inducible factor-1α (HIF-1α) signaling, effects that were amplified by cancer-associated fibroblast (CAF)-derived conditioned medium. CAF exposure enhanced SIAH2 expression, CSC spheroid growth, and resistance to fluorouracil, leucovorin, and oxaliplatin (FOLFOX) chemotherapy, whereas SIAH2 depletion effectively abrogated these effects. Collectively, these findings identify the SIAH2/WNK1 axis as a central metabolic regulator linking glycolysis, CSC maintenance, and microenvironment-driven therapy resistance in CRC, highlighting its potential as a therapeutic target. Full article

Background/Objectives: Optimizing routine neurointerventional workflow and minimizing exposure to ionizing radiation during coil-only endovascular treatment of intracranial aneurysms depend on operator experience, reduced frame rates during both fluoroscopy and digital subtraction angiography (DSA), and the use of advanced angiographic systems. The low-dose protocol implemented in this study used the lowest available fluoroscopy frame rate (3.125 frames per second [fps]) and a nominal acquisition rate of 2 fps (actual = 2.45 fps) for DSA, three-dimensional (3D) rotational angiography, two-dimensional (2D)/3D mapping, and roadmapping. Methods: This retrospective analysis encompassed 245 coil-only procedures performed at a single tertiary center from 2018 to 2024. Data collected for each procedure included dose-area product (DAP), reference air kerma (K_a,r), fluoroscopy time (FT), and the total number of DSA frames. Local diagnostic reference levels (DRLs; 75th percentile [P75]) and typical values (50th percentile [P50]) were determined and descriptively compared with values reported in the literature. Results: The P75 values, representing DRLs, were 22.4 Gy·cm² for DAP (literature range, 123–272.8 Gy·cm²), 268 mGy for K_a,r (1171–4240 mGy), 18 min 56 s for FT, and 285 DSA frames. The P50 values were 13.8 Gy·cm² for DAP (78.7–179.0 Gy·cm²), 196 mGy for K_a,r (801–2804 mGy), 13 min 25 s for FT, and 208 DSA frames. Conclusions: In this single-center cohort, dose metrics for coil-only intracranial aneurysm treatment were within the lower range of published values. Cross-study comparisons are descriptive and require cautious interpretation. The proposed local DRLs may support quality assurance, dose optimization, and patient safety in comparable clinical settings. Further multi-center and multi-operator studies are warranted to evaluate transferability and applicability beyond coil-only procedures. Full article

Background: Prostate cancer in the Middle East and North Africa (MENA) region is shaped by a complex interplay of behavioral and environmental risk factors, yet comprehensive estimates of preventable cases remain scarce. To address this gap, we estimated population-attributable fractions (PAFs) for a range of modifiable exposures among men aged 50 years and older and assessed potential reductions in incidence under feasible intervention scenarios. Methods: Regional prevalence data were combined with relative risks from meta-analyses to compute closed-form PAFs for tobacco smoking, obesity, physical inactivity, high dairy and calcium intake, heavy alcohol use, drinking water nitrates, trihalomethanes, arsenic, lead, selenium status, ambient PM_2.5 and NO₂, and occupational diesel exhaust, covering an estimated 47 million men. Estimates were validated using a synthetic cohort simulation of 100,000 individuals, with uncertainty quantified through Monte Carlo sampling. Results: Results showed that drinking water nitrate exposure accounted for the largest single fraction (17.4%), followed by tobacco smoking (9.5%), physical inactivity (6.7%), and trihalomethane exposure (5.0%), while other exposures contributed smaller but meaningful shares. Joint elimination of all exposures projected a 45.5% reduction in incidence, and simultaneous feasible reductions in four targeted exposures yielded a combined potential impact fraction of 12.1%. Conclusions: These findings suggest that integrated water quality management, tobacco control, lifestyle interventions, and targeted environmental surveillance should be prioritized to reduce prostate cancer burden in the MENA region. However, estimates of drinking-water nitrate exposure rely on limited evidence from a single case–control study with a relatively small sample size, and should therefore be considered exploratory and primarily hypothesis-generating. Full article

Background/Objectives: Following the cessation of breastfeeding, cereal-based complementary foods are commonly introduced into the diet of infants. Among these products, dairy-free infant porridges constitute an important component of early complementary feeding. This study aimed to evaluate dietary exposure to selected essential (Zn, Fe, Mn, and Cu) and potentially toxic (Pb, Cd, and Hg) trace elements resulting from the consumption of dairy-free infant porridges by children aged six months and older. Products with different cereal compositions available on the Polish market were analyzed. Methods: Trace element concentrations were determined after microwave-assisted digestion using inductively coupled plasma atomic emission spectrometry (ICP-AES) and atomic absorption spectrometry for mercury (Hg-AAS). Results: A single recommended serving of dairy-free infant porridge contributed to the intake of essential trace elements, providing approximately 50% of the RDA for copper, 21% for zinc, 15% of the AI for manganese, and 5.7% of the RDA for iron. The concentrations of potentially harmful elements were low (Pb: 0.002–0.004 mg/kg; Cd: <0.001–0.003 mg/kg; Hg: <0.001–0.001 mg/kg). The estimated daily intake of these elements did not exceed 0.01 µg/kg body weight per day. Conclusions: Dairy-free infant porridges may contribute to the intake of essential trace elements in infants, while exposure to lead, cadmium, and mercury appears to remain low when products are consumed according to recommended serving sizes. Full article

Background/Objectives: The triglyceride-to-High-density lipoprotein cholesterol (TG/HDL) ratio is an established marker of atherogenic dyslipidaemia and insulin resistance. Although its association with subclinical atherosclerosis has been reported, the relative contributions of long-term TG/HDL burden and visit-to-visit variability to carotid intima media thickness (CIMT) remain unclear. This study aimed to evaluate the differential associations of the longitudinal mean and temporal variability of the TG/HDL ratio with CIMT. Methods: This retrospective single-center observational cohort study included 260 adult patients with at least three years of longitudinal lipid measurements and a standardized carotid ultrasonography assessment. The longitudinal mean TG/HDL ratio and variability indices, including standard deviation, coefficient of variation, average real variability and variability independent of the mean, were calculated. CIMT was measured using B-mode ultrasonography. Associations were assessed using correlation analyses, multivariable linear regression, joint category analyses and stratified analyses according to statin therapy. Results: The longitudinal mean TG/HDL ratio was independently associated with increased CIMT after adjustment for traditional cardiovascular risk factors. In contrast, TG/HDL variability indices showed no independent association with CIMT and did not improve model performance beyond the mean TG/HDL ratio. Restricted cubic spline analysis demonstrated a significant non-linear association between TG/HDL mean and CIMT, suggesting a threshold-dependent relationship. Joint category analyses demonstrated higher CIMT values in groups with elevated TG/HDL mean regardless of variability status. A significant interaction was observed between TG/HDL variability and statin therapy (p for interaction = 0.011). Conclusions: These findings indicate that cumulative exposure to atherogenic dyslipidaemia, reflected by the long-term mean TG/HDL ratio, is more strongly associated with subclinical carotid atherosclerosis than short-term lipid fluctuations. Full article

Frontline workers across health, emergency, and social care sectors are repeatedly exposed to distressing events and chronic stressors as part of their occupational roles. Unlike single-event trauma, these cumulative exposures accrue over time, generating persistent psychological and physiological strain. Traditional diagnostic frameworks, particularly post-traumatic stress disorder (PTSD), were not designed to capture the layered and ongoing nature of this occupational trauma. This commentary introduces the concept of Persistent Traumatic Stress Exposure (PTSE), a framework that reframes trauma among frontline workers as an exposure arising from organisational and systemic conditions rather than solely an individual disorder. It aims to reorient understanding, responsibility, and intervention from a purely clinical lens toward systems, cultures, and organisational duties of care. PTSE is presented as an integrative paradigm informed by contemporary theory and evidence on trauma, moral injury, organisational stress, and trauma-informed systems. The framework synthesises findings from health, emergency, and social care settings, illustrating how repeated exposure, ethical conflict, and institutional pressures contribute to cumulative psychological harm. PTSE highlights that psychological injury may build across shifts, careers, and lifetimes, requiring preventive, real-time, and sustained responses. The framework emphasises that effective support is dependent on both organisational readiness, the structural conditions that enable trauma-informed work, and organisational preparedness, the practical capability to enact safe, predictable, and stigma-free responses to trauma exposure. PTSE challenges prevailing stigma by framing trauma as a predictable occupational hazard rather than a personal weakness. It aligns with modern occupational health perspectives by advocating for systems that strengthen psychological safety, leadership capability and access to support. By adopting PTSE, organisations can shift from reactive treatment models toward proactive cultural and structural protection, honouring the lived realities of frontline workers and promoting long-term wellbeing and resilience. Full article