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16 pages, 306 KB  
Perspective
Optimizing Autologous Serum Tear Therapy for Dry Eye Disease: Strategies and Innovations
by Konstantinos Christodoulou, Brayden Buras and Sotiria Palioura
J. Clin. Med. 2026, 15(3), 1181; https://doi.org/10.3390/jcm15031181 - 3 Feb 2026
Abstract
Autologous serum (AS) tears are an effective therapeutic option for advanced DED, mimicking the biochemical composition of natural tears. However, the absence of universally accepted guidelines has resulted in variability in AS tear concentration, diluents, processing of collected blood, and storage conditions, raising [...] Read more.
Autologous serum (AS) tears are an effective therapeutic option for advanced DED, mimicking the biochemical composition of natural tears. However, the absence of universally accepted guidelines has resulted in variability in AS tear concentration, diluents, processing of collected blood, and storage conditions, raising questions regarding the optimal parameters for AS tear use. This perspective provides a framework to inform clinical implementation and to guide future research on AS tear therapy optimization. PubMed, Scopus, and the Cochrane Library were searched for English-language articles from January 2022 through September 2025 using the terms “autologous serum,” “dry eye disease,” “dry eye syndrome,” “dry eye,” and “DED.” Evidence suggests that AS tears diluted to 20% are widely used for moderate DED, whereas higher concentrations may provide faster, more pronounced and more durable improvements, particularly in severe cases. Levofloxacin-containing eye drops, artificial tears without emphasis on a specific component, sodium hyaluronate (SH)-containing eye drops, cyclosporine A (CsA)-containing ultra-nano emulsions, and methylcellulose have been investigated as alternatives to conventional diluents. Standardization of clotting, centrifugation and storage parameters is expected to enhance efficacy of AS tears and ensure stability of growth factors. Combination with estrogen replacement therapy in perimenopausal women or with topical insulin eye drops, as well as perioperative prophylactic use in patients with graft-versus-host disease (GVHD)-associated dry eye undergoing cataract surgery, represent emerging applications of AS tears that demonstrate potential to improve therapeutic outcomes. Overall, this perspective highlights the need for consensus protocols, supports severity-based concentration tailoring, and notes that diluents and processing methods require further refinement. Full article
(This article belongs to the Section Ophthalmology)
25 pages, 456 KB  
Review
The Slovenian Nutrition Guidelines 2025: A Comparison with the Prior Slovenian FBDG, Dietary Intake, and the EAT–Lancet Diet
by Nataša Fidler Mis, Boštjan Jakše and Zlatko Fras
Foods 2026, 15(3), 524; https://doi.org/10.3390/foods15030524 - 3 Feb 2026
Abstract
Background: The Slovenian Nutrition Guidelines 2025 (SNG2025) provide a quantified, plant-forward framework aligned with the EAT–Lancet diet, whereas previous Slovenian FBDGs were qualitative. Objectives: (i) To compare SNG2025 with the EAT–Lancet diet and previous Slovenian FBDGs and (ii) to assess the [...] Read more.
Background: The Slovenian Nutrition Guidelines 2025 (SNG2025) provide a quantified, plant-forward framework aligned with the EAT–Lancet diet, whereas previous Slovenian FBDGs were qualitative. Objectives: (i) To compare SNG2025 with the EAT–Lancet diet and previous Slovenian FBDGs and (ii) to assess the alignment of food intake among Slovenian adults with the SNG2025. Methods: The SNG2025 food group targets were mapped to the EAT–Lancet diet and previous Slovenian FBDGs and evaluated against a nationally representative intake (Si. Menu 2017/18; 18–64 years; sex-specific). Sodium intake was corroborated by 24-h urinary sodium levels (2022). Results: The SNG2025 introduces numeric targets across more than 16 food groups, with national adaptations (e.g., potatoes, oils and fats from foods, and dairy being optional via milk-calcium equivalents and beverage specifications). The alignment reveals very low consumption of legumes; limited consumption of vegetables, whole grains, and nuts/seeds (and fruit in men); and excess consumption of total and red/processed meat, ultra-processed foods (UPFs), free sugars/sugar-sweetened beverages, sodium, and alcohol. Biomarkers indicate a mean salt intake approximately two times the <5 g/day limit. Trans fatty acid (TFA) levels ≥ 0.5% persist in a substantial percentage of adults, predominantly from ruminant-derived TFAs. Sex-specific patterns are more adverse for men (e.g., meat, SSBs, alcohol, and sodium), whereas women have a higher intake of sweet UPFs. Conclusions: Slovenian diets are misaligned with the SNG2025. Priorities include increasing the intake of legumes, whole grains, vegetables, and nuts/seeds, while shifting protein sources away from red and processed meat. Additional priorities include reducing the intake of alcohol, sodium, free sugars, and UPFs through reformulation, procurement, and pricing/marketing measures, alongside routine biomarker and UPF surveillance. The SNG2025 enable monitoring and targeted implementation. Considering the limitations of the Si. Menu 2017/18 dataset, which includes food-group aggregation and limited information on food preparation, the results should be interpreted with caution with respect to the magnitude of deviations from SNG2025 targets, while the overall direction of misalignment remains robust. Full article
(This article belongs to the Special Issue Food Choice, Nutrition, and Public Health: 2nd Edition)
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18 pages, 621 KB  
Article
Nutritional Status and Dietary Intakes of a Community of Rural Women in Bárcena Villa Nueva, Guatemala: A Small-Scale Observational Study
by Sara Basilico, Angeliki Sofroniou, Maria Vittoria Conti, Paola Dieguez and Hellas Cena
Nutrients 2026, 18(3), 512; https://doi.org/10.3390/nu18030512 - 2 Feb 2026
Abstract
Background/Objectives: Rural communities in Guatemala face a growing double-burden of malnutrition. Women of reproductive age are a key population to address, as their health and nutritional status influence not only their own well-being but also that of their children and families. However, [...] Read more.
Background/Objectives: Rural communities in Guatemala face a growing double-burden of malnutrition. Women of reproductive age are a key population to address, as their health and nutritional status influence not only their own well-being but also that of their children and families. However, they often experience greater exposure to nutritional risks due to gendered inequalities in access to resources, education, and health care. This small-scale observational study aimed to describe the dietary habits and nutritional status of a sub-group of women living in a rural area of Bárcena Villa Nueva, Guatemala. Methods: An observational study was conducted between March and April 2025 among women aged ≥18 years from two rural communities. Dietary data were collected through structured interviews, 24 h dietary recall (24-hR), and a validated food frequency questionnaire (FFQ). Anthropometric and biochemical measurements were also collected. Results: A total of 22 women were included (mean age: 41.3 ± 16.3 years). The prevalence of obesity and central obesity was 45.5% and 86.0%, respectively. Quantitative dietary assessment based on the 24 h recall showed a mean energy intake approximately 35% higher than the recommended values, with a high contribution from fats and carbohydrates and an excessive sodium intake. In contrast, intakes of potassium, zinc, and folic acid were below the recommended levels. The qualitative analysis of the food frequency questionnaire indicated a dietary pattern characterized by high consumption of carbohydrates, animal-based protein sources, traditional energy-dense foods, and ultra-processed products, alongside a limited intake of vegetables and fruits. Datary diversity was low (4.9, SD: 1.1). Conclusions: This small-scale observational scale study provides a preliminary overview of dietary patterns and nutritional status among women living in a rural community in Guatemala. Although the findings are not generalizable, they suggest the coexistence of excessive energy intake, suboptimal micronutrient intake, and low dietary diversity. These results underscore the need for further research using larger and more representative samples and may help inform the development of context-specific nutrition education initiatives in similar underserved settings. Full article
(This article belongs to the Special Issue Women's Nutrition, Metabolism and Reproductive Health)
11 pages, 3287 KB  
Article
Ultrashort Echo Time Double Echo Steady-State MRI for Quantitative Conductivity Mapping in the Knee: A Feasibility Study
by Sam Sedaghat, Jin Il Park, Eddie Fu, Youngkyoo Jung and Hyungseok Jang
Tomography 2026, 12(2), 18; https://doi.org/10.3390/tomography12020018 - 2 Feb 2026
Viewed by 40
Abstract
Background/Objectives: Tissue conductivity reflects ionic composition (e.g., sodium), providing critical insights into various diseases. Ultrashort echo time quantitative conductivity mapping (UTE-QCM) offers a method to obtain this information, which is particularly effective for musculoskeletal (MSK) tissues with short T2 relaxation times. The aim [...] Read more.
Background/Objectives: Tissue conductivity reflects ionic composition (e.g., sodium), providing critical insights into various diseases. Ultrashort echo time quantitative conductivity mapping (UTE-QCM) offers a method to obtain this information, which is particularly effective for musculoskeletal (MSK) tissues with short T2 relaxation times. The aim of this study is to develop a UTE-QCM framework using ultrashort echo time double echo steady-state (UTE-DESS) and validate its feasibility in the knee. Methods: An ultrashort echo time double echo steady-state (UTE-DESS) sequence was used to acquire S+ and S− images and estimate the transmit radiofrequency field (B1+) phase at 3T. The B1+ phase was derived by canceling the phase evolution in the free induction decay using these images. This phase data was then processed using two widely used QCM reconstruction methods for comparison: parabolic fitting and an integral-based method. The proposed UTE-QCM framework was validated using a phantom containing three different concentrations of sodium chloride (0%, 0.5%, and 1%). Additionally, three healthy volunteers were recruited to validate UTE-QCM in knee imaging. Results: In both phantom and in vivo experiments, the integral-based QCM demonstrated improved robustness to noise compared to parabolic fitting. In the sodium phantom, the estimated conductivity showed high linearity with sodium concentrations. In the in vivo knee, the generated conductivity maps successfully visualized both long and short T2 tissues. Conclusions: We demonstrated the feasibility of UTE-QCM as a novel quantitative imaging tool targeting short T2 tissues in the MSK system. This technique may facilitate the diagnosis and prognosis of joint disorders. Full article
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20 pages, 5710 KB  
Article
Steel Slag-Enhanced Cement-Stabilized Recycled Aggregate Bases: Mechanical Performance and PINN-Based Sulfate Diffusion Prediction
by Guodong Zeng, Hao Li, Yuyuan Deng, Xuancang Wang, Yang Fang and Haoxiang Liu
Materials 2026, 19(3), 546; https://doi.org/10.3390/ma19030546 - 29 Jan 2026
Viewed by 174
Abstract
The application of cement-stabilized recycled aggregate (CSR) in pavement bases is constrained by the high porosity and low strength of recycled aggregate (RA), whereas sulfate transport and durability mechanisms are less reported. To address this issue, this study incorporated high-strength and potentially reactive [...] Read more.
The application of cement-stabilized recycled aggregate (CSR) in pavement bases is constrained by the high porosity and low strength of recycled aggregate (RA), whereas sulfate transport and durability mechanisms are less reported. To address this issue, this study incorporated high-strength and potentially reactive steel slag aggregate (SSA) into CSR to develop steel slag-enhanced cement-stabilized recycled aggregate (CSRS). The mechanical performance of the mixtures was evaluated through unconfined compressive strength (UCS) and indirect tensile strength (ITS) tests, and their durability was assessed using thermal shrinkage and sulfate resistance tests. In addition, a sulfate prediction model based on a physics-informed neural network (PINN) was developed. The results showed that, compared with CSR, the 7-day and 28-day UCS of CSRS increased by 6.7% and 16.0%, respectively, and the ITS increased by 4.3% and 5.9%. Thermal shrinkage tests indicated that CSR and CSRS, incorporating RA and SSA, exhibited slightly higher thermal shrinkage strain than cement-stabilized natural aggregate (CSN). During sulfate attack, SSA significantly improved the sulfate resistance of CSR, with the sulfate resistance coefficient of CSRS increasing by 18.8% compared to CSR. Furthermore, the PINN model predicted that, in 3%, 5%, and 7% sodium sulfate solutions, the sulfate concentration at a 1 mm depth in CSRS was reduced by 35.6%, 21.8%, and 29.4%, respectively, compared to CSR, with an average relative error below 14%, confirming its reliability. Therefore, these findings demonstrate that the incorporation of SSA markedly enhances the mechanical properties and sulfate resistance of CSR, and that the PINN model provides an effective tool for accurate simulation and prediction of sulfate diffusion. Full article
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23 pages, 3052 KB  
Review
Targeting Nav Channels for Pain Relief: Structural Insights and Therapeutic Opportunities
by Yuzhen Xie, Xiaoshuang Huang, Fangzhou Lu and Jian Huang
Int. J. Mol. Sci. 2026, 27(3), 1180; https://doi.org/10.3390/ijms27031180 - 23 Jan 2026
Viewed by 270
Abstract
Pain is an unpleasant but essential sensory experience that serves as a protective mechanism, yet it can also manifest maladaptively in a wide range of pathological conditions. Current analgesic strategies rely heavily on opioid medications and non-steroidal anti-inflammatory drugs (NSAIDs); however, concerns regarding [...] Read more.
Pain is an unpleasant but essential sensory experience that serves as a protective mechanism, yet it can also manifest maladaptively in a wide range of pathological conditions. Current analgesic strategies rely heavily on opioid medications and non-steroidal anti-inflammatory drugs (NSAIDs); however, concerns regarding addiction, tolerance, and dose-limiting adverse effects highlight the urgent need for safer and more effective therapeutics. Voltage-gated sodium (Nav) channels, which govern the initiation and propagation of action potentials, have emerged as promising targets for mechanism-based analgesic development. In particular, the Nav1.7–Nav1.9 subtypes have attracted substantial interest owing to their enrichment in the peripheral nervous system—despite broader expression elsewhere—and their central roles in nociception, offering the potential for non-addictive, subtype-selective pain modulation. This review summarizes the physiological roles of these channels in nociception, examines how disease-associated mutations shape pain phenotypes, and highlights recent advances in drug discovery targeting Nav1.7 and Nav1.8. The recent FDA approval of VX-548 (suzetrigine), a first-in-class and highly selective Nav1.8 inhibitor, marks a major milestone that validates peripheral Nav channels as clinically actionable targets for analgesia. We also discuss the remaining challenges and emerging opportunities in the pursuit of next-generation, mechanism-informed analgesics. Full article
(This article belongs to the Special Issue Role of Ion Channels in Human Health and Diseases)
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22 pages, 2428 KB  
Article
Prevalence, Characterization and Genetic Diversity of Listeria monocytogenes in Ready-to-Eat Raw Salmon (Salmo salar) and Trout (Oncorhynchus mykiss) Products
by Yujie Gong, Lin Yao, Meng Qu, Fengling Li, Yingying Guo, Na Li, Wenjia Zhu, Lianzhu Wang, Peng Wang and Yanhua Jiang
Foods 2026, 15(2), 385; https://doi.org/10.3390/foods15020385 - 21 Jan 2026
Viewed by 156
Abstract
Listeria monocytogenes is a high-risk pathogenic bacterium associated with ready-to-eat foods and poses a potential threat to consumer health. This study aimed to investigate the prevalence, characterization and genetic diversity of L. monocytogenes in ready-to-eat raw salmon and trout products obtained from physical [...] Read more.
Listeria monocytogenes is a high-risk pathogenic bacterium associated with ready-to-eat foods and poses a potential threat to consumer health. This study aimed to investigate the prevalence, characterization and genetic diversity of L. monocytogenes in ready-to-eat raw salmon and trout products obtained from physical stores and online stores in China. Out of 150 samples analyzed, 23 (15.3%) were positive for L. monocytogenes. Among these positive samples, three (12%) were from Japanese restaurants, four (16%) from farmers markets, one (2.9%) from large supermarkets and fifteen (30%) from e-commerce platforms, and only one sample showed a contamination level exceeding 100 most probable number (MPN)/g. The isolates from positive samples demonstrated a concrete public health risk through several findings: twenty-three L. monocytogenes exhibited varying degrees of cytotoxicity, ranging from 7.6% to 71.8%. Compared with the reference strain ATCC 19115, five of these isolates were highly cytotoxic, a result that was validated by mouse survival rate experiment, which also confirmed their high virulence at tested dose. All isolates were resistant to cefuroxime sodium, ceftriaxone, cefepime and nalidixic acid, and 13% showed resistance to sulphamethoxazole-trimethoprim. Three serogroups were identified, with serogroup Ⅰ.1 (1/2a, 3a) being the most prevalent (65.2%). These isolates were grouped into eight sequence types, with ST8 (34.8%) and ST87 (30.4%) dominating. All isolates carried virulence genes associated with LIPI-1 andmultiple internalin genes (inlA, inlB, inlJ and inlK), confirming their potential pathogenicity. Additionally, the isolates harbored antimicrobial resistance genes lin and FosX. The five highly virulent isolates exhibited the highest genetic similarity to J2-031 (GCA_000438645.1) and C1-387 (GCA_000438605.1). The results provided valuable information for Chinese regulatory authorities to strengthen the risk monitoring of L. monocytogenes in ready-to-eat raw salmon and trout products. Full article
(This article belongs to the Section Food Microbiology)
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13 pages, 739 KB  
Article
Electrophoretic Profile of Urinary Proteins in Goats During the Peripartum Period
by Berihu Gebrekidan Teklehaymanot, Marilena Bolcato, Gloria Isani, Angelica Lembo, Tolulope Grace Ogundipe, Giulia Ballotta, Francesco Dondi, Arcangelo Gentile and Sabrina Fasoli
Animals 2026, 16(2), 322; https://doi.org/10.3390/ani16020322 - 21 Jan 2026
Viewed by 161
Abstract
Background: Urinary proteins may reflect physiological changes occurring during the periparturient period, but reference data for goats are still lacking. This study investigated urinary protein patterns around parturition to help fill this gap and generate baseline information. Methods: Ten pregnant Alpine goats were [...] Read more.
Background: Urinary proteins may reflect physiological changes occurring during the periparturient period, but reference data for goats are still lacking. This study investigated urinary protein patterns around parturition to help fill this gap and generate baseline information. Methods: Ten pregnant Alpine goats were sampled by spontaneous voiding 22 ± 3 days before delivery (T0), 7 days postpartum (T7), and 30 days postpartum (T30). Physical and chemical urine analyses were performed, and urinary proteins were separated using one-dimensional sodium dodecyl sulfate–polyacrylamide gel electrophoresis. Statistical tests (Shapiro–Wilk, repeated-measures ANOVA, or Friedman) were applied to evaluate differences among time points. Results: Significant temporal changes were observed: urine pH decreased at T30, the urine protein-to-creatinine ratio increased at T7 and T30, and urinary creatinine concentration was highest at T0. Most samples showed common protein bands at approximately 80, 70, 62, 50, 37, 29, 25, 22, and below 13 kDa, with the 62, 50, and <13 kDa bands present in all samples. Bands between 18 and 64 kDa and above 60 kDa appeared only in some samples. Protein bands between 23 and 42 kDa were more frequent at T0, suggesting immune-related variations associated with pregnancy. Conclusions: This study provides the first description of urinary protein electrophoretic profiles in goats during the periparturient period and highlights measurable changes across time. These findings offer a starting point for developing future research and may contribute to establishing reference parameters for clinical and physiological monitoring in goats. Full article
(This article belongs to the Section Small Ruminants)
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17 pages, 2230 KB  
Article
Direct Production of Na2WO4-Based Salt by Scheelite Smelting
by Baojun Zhao
Minerals 2026, 16(1), 90; https://doi.org/10.3390/min16010090 - 17 Jan 2026
Viewed by 116
Abstract
Tungsten is one of the critical materials with important applications in many areas. Electrolysis of Na2WO4-based salt is a short and green process for the production of tungsten metal and alloys. The conventional process for producing Na2WO [...] Read more.
Tungsten is one of the critical materials with important applications in many areas. Electrolysis of Na2WO4-based salt is a short and green process for the production of tungsten metal and alloys. The conventional process for producing Na2WO4 is expensive and time-consuming. Scheelite (CaWO4) is becoming the most important resource for the extraction of tungsten. Based on thermodynamic calculations and phase equilibrium studies, a novel process is proposed to prepare Na2WO4-based salt directly from scheelite through a high-temperature process. By reacting with silica and sodium oxide, immiscible layers of liquid salt and slag are formed from scheelite between 1200 and 1300 °C. High-density salt containing Na2WO4 is separated from the silicate slag, which is composed of impurities and fluxes. The effects of fluxing agents, smelting temperature, and reaction time on the direct yield of WO3 and purity of sodium tungsten are investigated in combination with thermodynamic calculations and high-temperature experiments. The salt containing up to 99% Na2WO4 is obtained directly in a single process, which can be used for the production of other tungsten chemicals. This study provides a novel research method and detailed information to produce low-cost sodium tungstate directly from scheelite. Full article
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16 pages, 421 KB  
Article
Assessing the Performance of Bio-Based Nitrogen Fertilisers Under Salinity and Drought Stress in Spinach: A Preliminary Trial
by Amrita Saju, Ivona Sigurnjak and Erik Meers
Nitrogen 2026, 7(1), 14; https://doi.org/10.3390/nitrogen7010014 - 16 Jan 2026
Viewed by 299
Abstract
Recently, the EU approved RENURE-criteria materials to be used as substitutes for synthetic N fertilisers. Several studies have been performed on the agronomic efficacy and potential environmental impacts of different bio-based fertilisers (BBFs) from biomass recovery, including the RENURE-criteria materials. But information is [...] Read more.
Recently, the EU approved RENURE-criteria materials to be used as substitutes for synthetic N fertilisers. Several studies have been performed on the agronomic efficacy and potential environmental impacts of different bio-based fertilisers (BBFs) from biomass recovery, including the RENURE-criteria materials. But information is lacking about their effectiveness under abiotic stress conditions like salinity and drought. The predictions for climate change-induced increased drought and soil salinisation for the European soils have also increased, making it inevitable to understand BBF performance in these impending situations. Two RENURE-criteria top-priority materials (ammonium nitrate (AN) and ammonium sulphate (AS) and another commercially used BBF—an evaporator concentrate (CaE)) were evaluated in a pot trial growing spinach under salinity and drought stress with a reference ‘no stress’ condition to examine crop growth, nutrient uptake, and nitrogen fertiliser replacement value (NFRV). Agronomically, BBFs performed at par with the synthetic fertiliser (SF) under unstressed and salt-stressed conditions, whereas, under drought stress, BBFs outperformed the SF treatment. AS exhibited the highest yield and nutrient uptake, displaying an NFRV of 3.1 and 1.8 under no-stress and salt-stress conditions, respectively. Salt stress did not negatively impact the crops grown in this trial, potentially due to the higher potassium content in the system, which alleviated the possible negative impacts of high sodium. This study delves into the agronomic response, without evaluating crop physiological changes, and, hence, should be taken as a preliminary step into further investigation of observed elemental interactions (that could be potentially driving stress mitigation) while also examining the crop physiology during the duration of stress. Full article
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22 pages, 1186 KB  
Article
Diagnostic and Prognostic Utility of DNI and CRP in Patients with Dilated Cardiomyopathy
by Nihat Söylemez, Özkan Karaca, Burak Toprak, Samet Yılmaz and Ahmet Turhan Kılıç
Int. J. Mol. Sci. 2026, 27(2), 871; https://doi.org/10.3390/ijms27020871 - 15 Jan 2026
Viewed by 184
Abstract
Dilated cardiomyopathy is characterized by progressive left ventricular dilation and impaired systolic function, with inflammation recognized as a key contributor to disease onset and adverse outcomes. C-reactive protein reflects systemic biochemical inflammation, whereas Delta Neutrophil Index represents the circulating immature neutrophil fraction and [...] Read more.
Dilated cardiomyopathy is characterized by progressive left ventricular dilation and impaired systolic function, with inflammation recognized as a key contributor to disease onset and adverse outcomes. C-reactive protein reflects systemic biochemical inflammation, whereas Delta Neutrophil Index represents the circulating immature neutrophil fraction and provides a cellular dimension of inflammatory burden. The combined diagnostic and prognostic value of these two biomarkers in dilated cardiomyopathy has not been adequately explored. This retrospective study included one hundred and fifty patients with dilated cardiomyopathy and one hundred and fifty age-, diabetes-, and hypertension-matched controls. Demographic, laboratory, and echocardiographic measurements were analyzed. The diagnostic and prognostic performances of C-reactive protein, Delta Neutrophil Index, and their combined model were assessed using logistic regression, receiver operating characteristic curve analysis, reclassification metrics, calibration testing, and decision curve analysis. Additional analyses were performed for patients with left ventricular ejection fraction below twenty percent, and mortality predictors were examined within the dilated cardiomyopathy cohort. Both C-reactive protein and Delta Neutrophil Index levels were significantly higher in patients with dilated cardiomyopathy than in controls and were further elevated in those with severely reduced ejection fraction. Delta Neutrophil Index remained independently associated with severe left ventricular dysfunction (ejection fraction ≤ 20%) in multivariable analysis (odds ratio 2.51). Each biomarker showed an independent association with the presence of dilated cardiomyopathy, and their combined model achieved the highest diagnostic accuracy. In receiver operating characteristic analysis, the area under the curve was 0.895 for Delta Neutrophil Index, 0.691 for C-reactive protein, and increased to 0.920 for the combined model, with a sensitivity of 81.3% and specificity of 92.0%. Delta Neutrophil Index was independently associated with severe left ventricular dysfunction and mortality, while C-reactive protein, age, ejection fraction, urea, and sodium also contributed to mortality risk. Delta Neutrophil Index was independently associated with mortality (odds ratio 2.51), while C-reactive protein, age, ejection fraction, urea, and sodium also contributed to mortality risk. The combined model provided significant improvement in risk reclassification and demonstrated superior calibration and greater net clinical benefit across a wide range of decision thresholds. C-reactive protein and Delta Neutrophil Index offer complementary diagnostic and prognostic information in dilated cardiomyopathy. Their combined use enhances diagnostic discrimination, strengthens risk stratification, and improves identification of patients at high risk for severe ventricular dysfunction and mortality. Incorporation of these accessible biomarkers into clinical evaluation may support earlier recognition and more tailored management of high-risk individuals. Full article
(This article belongs to the Special Issue Cardiomyopathy: From Molecular Pathology to Treatment)
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17 pages, 1975 KB  
Article
Comparative Longitudinal Evaluation of Systemic Inflammatory Markers in Type 2 Diabetes Treated with Four Oral Antidiabetic Drug Classes
by Mehmet Yamak, Serkan Çakır, Sami Uzun, Egemen Cebeci, Özlem Menken and Savas Ozturk
J. Clin. Med. 2026, 15(2), 688; https://doi.org/10.3390/jcm15020688 - 15 Jan 2026
Viewed by 192
Abstract
Background: Systemic inflammation plays a central role in the pathogenesis and progression of type 2 diabetes mellitus (T2DM). Hematologic inflammatory indices-such as the Systemic Immune-Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Monocyte-to-Lymphocyte Ratio (MLR)-have emerged as accessible markers of chronic [...] Read more.
Background: Systemic inflammation plays a central role in the pathogenesis and progression of type 2 diabetes mellitus (T2DM). Hematologic inflammatory indices-such as the Systemic Immune-Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Monocyte-to-Lymphocyte Ratio (MLR)-have emerged as accessible markers of chronic inflammation, yet longitudinal comparisons across oral antidiabetic therapies remain limited. This study uniquely integrates longitudinal correlation and network analyses in a large real-world T2DM cohort, allowing assessment of the temporal stability and class-specific inflammatory patterns across four oral antidiabetic therapies. Methods: This retrospective, longitudinal study analyzed 13,425 patients with T2DM treated with Biguanidines, Dipeptidyl Peptidase-4 (DPP-4) inhibitors, Sodium–Glucose Cotransporter-2 (SGLT-2) inhibitors or Thiazolidinediones (TZDs) between 2020 and 2024. Data were retrieved from the Probel® Hospital Information System and included baseline, early (30–180 days), and late (180–360 days) follow-up laboratory results. Systemic inflammatory indices were computed from hematologic parameters, and correlations among inflammatory and biochemical markers were assessed using Spearman’s coefficients. Results: At baseline, all hematologic indices were strongly intercorrelated (SII–NLR r = 0.83, p < 0.001; SII–PLR r = 0.73, p < 0.001), with moderate associations to C-reactive protein (CRP; r ≈ 0.3–0.4) and weak or no correlations with Ferritin (r ≈ −0.1). These relationships remained stable throughout follow-up, confirming reproducibility of systemic inflammatory coupling. Longitudinally, SII and NLR showed modest early increases followed by significant declines at one year (p < 0.05), while PLR and MLR remained stable. Class-specific differences were observed: SGLT-2 inhibitors and TZDs demonstrated stronger and more integrated anti-inflammatory networks, whereas Biguanidines and DPP-4 inhibitors exhibited moderate coherence. Principal Component Analysis (PCA) explained 62.4% of total variance and revealed distinct clustering for TZD and SGLT-2 groups, reflecting class-specific inflammatory modulation. Conclusions: Systemic inflammatory indices (SII, NLR, PLR) provide reproducible and accessible measures of low-grade inflammation in T2DM. Despite overall inflammation reduction with treatment, drug-specific patterns emerged-SGLT-2 inhibitors and TZDs showed greater anti-inflammatory coherence, while Biguanidines and DPP-4 inhibitors maintained moderate effects. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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15 pages, 563 KB  
Article
Assessment of Juniper Ash Elemental Composition for Potential Use in a Traditional Indigenous Dietary Pattern
by Julie M. Hess, Madeline E. Comeau, Derek D. Bussan, Kyra Schwartz and Claudia PromSchmidt
Nutrients 2026, 18(2), 260; https://doi.org/10.3390/nu18020260 - 14 Jan 2026
Viewed by 291
Abstract
Background/Objectives: Ash made from juniper trees and added to cornmeal-based dishes may have provided calcium (Ca) to traditional Indigenous diets. Few studies have quantified the mineral content of juniper ash, including its Ca content. The objective of this study was to determine whether [...] Read more.
Background/Objectives: Ash made from juniper trees and added to cornmeal-based dishes may have provided calcium (Ca) to traditional Indigenous diets. Few studies have quantified the mineral content of juniper ash, including its Ca content. The objective of this study was to determine whether juniper ash could serve as a safe source of non-dairy Ca in an intervention study. Methods: Branches from two varieties of Juniper (Rocky Mountain Juniper, or Juniperus scopulorum and Eastern Red Cedar, or Juniperus virginiana) were harvested and burned to ash in a laboratory setting. Juniper ash from the southwestern U.S. available for retail purchase was used for comparison. All samples were tested for content of 10 nutritive elements (Ca, copper, iron, potassium, magnesium, manganese, sodium, phosphorus, selenium, and zinc) and 20 potentially toxic elements (silver, aluminum, arsenic, barium, beryllium, cadmium, cobalt, chromium, mercury, lithium, molybdenum, nickel, lead, antimony, tin, strontium, thallium, uranium, and vanadium) as well as n = 576 pesticide residues. Results: All samples contained both nutritive and potentially toxic elements. Each teaspoon of ash contained an average of 445 ± 141 mg Ca. However, the samples also contained lead in amounts ranging from 1.09 ppm to 15 ppm. Conclusions: Information on the nutritive and potentially toxic elemental content of juniper ash and how it may interact within a food matrix is insufficient to determine its safety as a Ca source. Further investigation is needed on the bioavailability of calcium oxide and its interaction with other dietary components to clarify the potential role of juniper ash in contemporary food patterns. Full article
(This article belongs to the Special Issue Mineral Nutrition on Human Health and Disease—2nd Edition)
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19 pages, 1083 KB  
Article
Cluster-Based Evaluation of Dietary Guideline Adherence and Food Literacy Among Adolescents: Implications for Tailored Diets
by Jimin Lim and Jieun Oh
Nutrients 2026, 18(2), 241; https://doi.org/10.3390/nu18020241 - 12 Jan 2026
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Abstract
Background: Adolescence is a formative period for lifelong dietary patterns, yet Korean adolescents show low fruit and vegetable intake, high sugar and sodium consumption, and rising obesity, highlighting the importance of multidimensional assessment that integrates behavioral, cultural, environmental, and competency-related factors. Methods: A [...] Read more.
Background: Adolescence is a formative period for lifelong dietary patterns, yet Korean adolescents show low fruit and vegetable intake, high sugar and sodium consumption, and rising obesity, highlighting the importance of multidimensional assessment that integrates behavioral, cultural, environmental, and competency-related factors. Methods: A total of 1010 adolescents aged 12–18 years completed an online cross-sectional survey assessing food intake, dietary and physical activity behaviors, dietary culture, and Food Literacy (FL) competencies. Standardized scores were used for hierarchical and K-means clustering to identify dietary practice patterns, and between-cluster differences were examined using ANOVA. Correlation and regression analyses were conducted to examine associations between Dietary Guideline Adherence (DGA) and FL. Results: Four clusters were identified—selective intake–low support (20.4%), regular habits–unbalanced intake (33.3%), high adherence (23.2%), and low adherence (23.1%)—with significant differences in DGA total and domain scores (p < 0.001). The high-adherence cluster showed balanced intake, regular routines, and strong household support, whereas the low-adherence cluster showed poor diet quality, irregular behaviors, and lower socioeconomic status. FL differed across clusters (p < 0.001) and correlated with DGA (r = 0.496, p < 0.01). Total FL predicted DGA (β = 0.496, p < 0.001), explaining 25% of its variance (R2 = 0.246). Conclusions: Adolescent diet quality appears to be associated with behavioral, cultural, and competency-related factors. These findings suggest that cluster-specific strategies—such as fat–sugar–sodium reduction, promotion of low-sodium and diverse diets, and maintenance of balanced-dietary patterns—may support tailored school- and community-based nutrition programs and inform further longitudinal and intervention research. Full article
(This article belongs to the Special Issue Environmental Impacts on Human Nutrition and Health)
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Article
Simultaneous Quantitative Analysis of Polymorphic Impurities in Canagliflozin Tablets Utilizing Near-Infrared Spectroscopy and Partial Least Squares Regression
by Mingdi Liu, Rui Fu, Guiyu Xu, Weibing Dong, Huizhi Qi, Peiran Dong and Ping Song
Molecules 2026, 31(2), 230; https://doi.org/10.3390/molecules31020230 - 9 Jan 2026
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Abstract
Canagliflozin (CFZ), a sodium–glucose cotransporter 2 (SGLT2) inhibitor, is extensively utilized in the management of type 2 diabetes. Among its various polymorphic forms, the hemi-hydrate (Hemi-CFZ) has been selected as the active pharmaceutical ingredient (API) for CFZ tablets due to its superior solubility. [...] Read more.
Canagliflozin (CFZ), a sodium–glucose cotransporter 2 (SGLT2) inhibitor, is extensively utilized in the management of type 2 diabetes. Among its various polymorphic forms, the hemi-hydrate (Hemi-CFZ) has been selected as the active pharmaceutical ingredient (API) for CFZ tablets due to its superior solubility. However, during the production, storage, and transportation of CFZ tablets, Hemi-CFZ can undergo transformations into anhydrous (An-CFZ) and monohydrate (Mono-CFZ) forms under the influence of environmental factors such as temperature, humidity, and pressure, which may adversely impact the bioavailability and clinical efficacy of CFZ tablets. Therefore, it is imperative to develop rapid, accurate, non-destructive, and non-contact methods for quantifying An-CFZ and Mono-CFZ content in CFZ tablets to control polymorphic impurity levels and ensure product quality. This research evaluated the feasibility and reliability of using near-infrared spectroscopy (NIR) combined with partial least squares regression (PLSR) for simultaneous quantitative analysis of An-CFZ and Mono-CFZ in CFZ tablets, elucidating the quantifying mechanisms of the quantitative analysis model. Orthogonal experiments were designed to investigate the effects of different pretreatment methods and ant colony optimization (ACO) algorithms on the performance of quantitative models. An optimal PLSR model for simultaneous quantification of An-CFZ and Mono-CFZ in CFZ tablets was established and validated over a concentration range of 0.0000 to 10.0000 w/w%. The resulting model, YAn-CFZ/Mono-CFZ = 0.0207 + 0.9919 X, achieved an R2 value of 0.9919. By analyzing the relationship between the NIR spectral signals selected by the ACO algorithm and the molecular structure information of An-CFZ and Mono-CFZ, we demonstrated the feasibility and reliability of the NIR-PLSR approach for quantifying these polymorphic forms. Additionally, the mechanism of PLSR quantitative analysis was further explained through the variance contribution rates of latent variables (LVs), the correlations between LVs loadings and tablets composition, and the relationships between LV scores and An-CFZ/Mono-CFZ content. This study not only provides a robust method and theoretical foundation for monitoring An-CFZ and Mono-CFZ content in CFZ tablets throughout production, processing, storage, and transportation, but also offers a reliable methodological reference for the simultaneous quantitative analysis and quality control of multiple polymorphic impurities in other similar drugs. Full article
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