Search Results (756)

Background: Enterocutaneous fistulas (ECFs) and enteroatmospheric fistulas (EAFs) are rare but highly morbid complications that most commonly arise after abdominal surgery. Outcomes have improved with advances in multidisciplinary care and with increasing research on how to best manage them; however, they remain associated with significant morbidity, high mortality, and prolonged hospitalization. Optimal timing of definitive repair is unknown, with many high-volume centers waiting 6–12 months, though emerging data suggest that earlier intervention may be feasible in carefully selected patients. Given their complexity and variability in management, a comprehensive review of current evidence is needed. Methods: A narrative review of the literature was conducted with emphasis on the classification, pathophysiology, and multidisciplinary management of ECFs and EAFs. Relevant studies addressing fluid and sepsis control, nutritional optimization, wound care, pharmacologic therapies, and interventional strategies were reviewed. Results: The management of ECFs requires a staged approach focused on fluid resuscitation, sepsis control, wound management, and nutritional optimization. Spontaneous closure can occur, and is most commonly within the first two months. Nutritional optimization through enteral and/or parenteral nutrition or fistuloclysis plays a vital role in improving outcomes. Therapies such as negative pressure wound therapy, biologics, and pharmacologic agents may support spontaneous closure and fistula control. In non-healing fistulas, surgical repair remains necessary, with optimal time for surgery at least 6–12 months from fistula development. Conclusions: ECFs and EAFs remain complex surgical challenges. Outcomes have improved due to advances in nutritional support and wound management, and the emergence of minimally invasive techniques. Standardization of treatment protocols and further research into novel therapy may further enhance outcomes and limit variability in management. Full article

All-trans retinoic acid (atRA) is known to regulate lipid metabolism, adipocyte differentiation, and the immune system in mammals and other aquatic species. However, studies on atRA in crustaceans, especially in Eriocheir sinensis, are still scarce. The present study aimed to investigate the regulatory effects of dietary or injected atRA on female crabs during the fattening period. In the dietary regulation experiment, 270 female crabs were fed diets containing different doses of atRA (0, 150, 300, 600, 1200, and 2400 mg/kg) for a total of 49 days. In the in vivo injection experiment, 90 females were divided into an experimental group (injected with a 0.3 μg/g dose of atRA) and a control group (injected with the same amount of DMSO solvent). Injections were given weekly throughout the 35-day experimental period. Results: Both dietary atRA and atRA injection promoted ovarian development, as evidenced by increased GSI, elevated serum Vg levels, decreased GIH, and upregulated expression of vg, vgr, and rxr genes. In terms of mechanism, dietary atRA promoted ovarian development via the upregulation of pyrimidine nucleotides and dehydroepiandrosterone, which supplied nucleic acid precursors and hormonal support. Furthermore, RXR was identified as a potential key target of atRA in inducing ovarian development, as molecular docking revealed that atRA could spontaneously bind to RXR. Moreover, following atRA injection, the expression of rxr, along with key genes involved in ovarian development, lipid synthesis, and lipid transport, was significantly upregulated. In addition, the atRA diet created a favorable microenvironment for ovarian development by reducing pro-inflammatory lipid levels in the ovary. Transcriptomic and metabolomic analyses revealed that atRA modulates energy and lipid metabolism by activating the AMPK pathway. In terms of the bacterial community structure, the atRA diet significantly decreased Fusobacterium abundance and enriched Parabacteroides as the signature beneficial bacterium. In terms of nutritional quality, the atRA diet markedly reduced saturated and trans-fatty acids while increasing monounsaturated fatty acids and various key essential amino acids. Conclusions: This study revealed that atRA plays a key role in promoting ovarian development, improving nutritional quality, and modulating the structure of the microbiota, thereby providing theoretical support for healthy aquaculture of female crabs during the fattening period. Full article

The gastrointestinal (GI) barrier is a highly coordinated, multilayered defence system that maintains intestinal homeostasis by separating the luminal microbiota from the internal milieu. In liver cirrhosis, this barrier undergoes profound structural and functional disruption, emerging as a central driver of bacterial translocation and infection-related complications. Among these, spontaneous bacterial peritonitis (SBP) represents a major determinant of morbidity, mortality, and disease progression. Barrier failure in cirrhosis is not attributable to a single defect but results from the convergence of multiple interconnected mechanisms. Structural alterations include disruption of epithelial tight junctions and deterioration of the mucus layer, leading to increased intestinal permeability and loss of spatial compartmentalisation. These changes are compounded by microbial dysbiosis, characterised by reduced diversity, depletion of short-chain fatty acid-producing taxa, and expansion of pathobionts. In parallel, cirrhosis-associated immune dysfunction impairs both mucosal and systemic antimicrobial defences, while gut–vascular barrier disruption facilitates systemic dissemination of bacteria and microbial products. The resulting increase in bacterial translocation plays a pivotal role in the pathogenesis of SBP and contributes to systemic inflammation, circulatory dysfunction, and acute decompensation. Importantly, this process establishes a self-amplifying pathogenic loop in which barrier dysfunction, dysbiosis, and immune dysregulation mutually reinforce each other. Recent advances have identified key molecular pathways involved in barrier regulation, including bile acid–FXR signalling and microbiome-derived metabolites, providing novel targets for therapeutic intervention. While current management relies largely on antibiotics and supportive care, emerging strategies aim to restore barrier integrity and modulate the gut–liver axis. A deeper understanding of GI barrier dysfunction offers new opportunities to prevent bacterial translocation and improve clinical outcomes in patients with liver cirrhosis. Full article

Terasi, or fermented shrimp paste, is a staple condiment in Indonesian cuisine, produced through spontaneous fermentation of small crustaceans under high-salt conditions. Despite its widespread culinary use, comprehensive studies examining both the microbiota and volatile compounds in commercial terasi remain scarce. This study aimed to characterize the microbial composition and volatile profiles of ten commercial terasi products sourced from different regions of Indonesia, representing both traditional home industries and large-scale manufacturers. Culture-dependent microbial enumeration and 16S rRNA gene sequencing were employed to assess microbial diversity, while volatile compounds were identified and quantified using gas chromatography–mass spectrometry (GC-MS). Results revealed significant differences in microbial load and community composition among samples, with traditional products showing higher viable counts and microbial diversity, dominated by genera such as Tetragenococcus, Bacillus, Weissella, and Halanaerobium. Industrial samples, by contrast, contained no detectable microorganisms, likely due to sterilization practices for extended shelf life. A wide range of volatiles, including sulfur compounds, short-chain fatty acids, and trimethylamine, were identified across all samples, with a total of 48 detected compounds. Notably, correlation analysis revealed strong associations between specific bacterial genera and key volatile compounds, suggesting that microbial activity plays a central role in shaping terasi’s flavor. This integrative analysis provides new insights into the microbial–chemical interactions underlying fermented shrimp paste and offers potential applications for product standardization, starter culture development, and culinary innovation. Full article

Dietary factors play an important role in cognitive health during aging. Dark tea has shown potential cognitive benefits, but its key bioactive component and underlying mechanisms remain unclear. In a naturally aged C57BL/6J mouse model, instant dark tea (IDT) samples with different fermentation degrees were evaluated together with behavioral outcomes using composition–effect relationship analysis. This analysis identified theabrownin (TB) as the component most strongly associated with improved cognitive performance. Compared with aged controls, TB increased Y-maze spontaneous alternation from 51.91% to 71.59% and reduced escape latency on day 5 of the Morris water maze from 44.84 s to 26.59 s. In contrast, the corresponding TB-depleted fraction produced no comparable cognitive improvement. TB also alleviated hippocampal injury and neuroinflammation. Antibiotic treatment abolished the cognitive benefits of TB, whereas fecal microbiota transplantation partially restored them. Multi-omics analyses suggested that TB treatment was associated with gut microbiota remodeling and increased serum acetate and 3-hydroxybutyrate; both metabolites partially recapitulated these benefits. Together, these findings show that TB attenuates age-related cognitive decline in naturally aged mice and suggest that modulation of gut microbiota and metabolites may contribute to this effect, supporting its potential as a functional food ingredient for healthy brain aging. Full article

Background: the pathophysiological mechanisms underlying spontaneous coronary artery dissection (SCAD) remain incompletely understood. Inflammation may play a pivotal role by promoting vascular susceptibility to SCAD. This study aimed to evaluate pericoronary adipose tissue (PCAT) attenuation, a recognized imaging marker of vascular inflammation, in patients with SCAD. Methods: patients with SCAD who underwent coronary computed tomography angiography (CCTA) within 48 h of the index event and with an identifiable trigger were included. Patients were classified according to the trigger preceding the event (emotional vs. physical). PCAT attenuation was measured in culprit and non-culprit vessels in all patients. Results: A total of 25 SCAD patients were included (mean age 55 ± 11 years, 80.0% female). Emotional triggers were reported in 17 patients (68.0%), while 8 (32.0%) experienced a physical trigger. Type 2 dissections were more common in the emotional trigger group (64.7% vs. 25.0%, p = 0.040). Patients with emotional triggers exhibited higher PCAT attenuation compared with those with physical triggers in the SCAD-related vessel (−62.35 ± 6.46 HU vs. −70.86 ± 8.45 HU; p = 0.028) and in non-culprit vessels (−61.39 ± 7.24 HU vs. −71.16 ± 5.28 HU; p = 0.001). Conclusions: patients with SCAD demonstrated elevated PCAT attenuation, particularly in those with emotional triggers, in both culprit and non-culprit vessels. These findings suggest that vascular inflammation may represent a predisposing factor for SCAD and a target for preventive and therapeutic strategies. Full article

We present a short review dedicated to low-lying meson states. We present all meson nonets, which consist from up, down and strange light quarks. We consider the scalar nonet as a basic nonet. We work in the framework of the massless Nambu–Jona-Lasinio $U_R\left(3\right)\times U_L\left(3\right)$ quark model. The collective meson states are described through initially bare quark–antiquark pairs, whose condensates lead simultaneously to spontaneous breaking of the chiral and the flavour symmetry. After quantisation and the spontaneous breaking of the chiral symmetry, when quarks obtain constituent nonzero masses, they become dressed. We present an explanation of the inverse mass hierarchy of the low-lying nonet of the scalar mesons. The proposed explanation is based on symmetry principles. It is shown that, due to the flavour symmetry breaking, two isodoublets of $K_0^{*}\left(700\right)$ mesons play the role of Goldstone bosons. It is also proven that there exists a solution with almost degenerate masses of the $a_0\left(980\right)$ and $f_0\left(980\right)$ mesons and a zero mass of the $f_0\left(500\right)$ meson. Short description of the physical properties of other meson nonets is provided. In particular unique mass relations among the different nonets, which are experimentally confirmed, are presented. Full article

Promoting the effective use of abandoned farmland has become a key policy priority for strengthening food security in China. However, disentangling the decision-making processes among diverse participating actors is a foundational prerequisite for addressing the governance challenge of abandoned farmland utilization. Building on this, the present study employs a four-actor evolutionary game model and sensitivity analysis of key parameters to systematically examine the interactions among four key actors—local governments, village collectives, family farms, and farmers—and to identify the corresponding evolutionarily stable strategies (ESSs) across different stages of abandoned farmland utilization. The results show that: (1) Multi-actor strategic interactions in abandoned farmland utilization exhibit a multi-stage evolutionary trajectory, in which all actors gradually shift their strategic choices under changing cost–benefit structures, regulatory intensity, and coordination conditions, leading to different evolutionary stable equilibria across governance stages. (2) The configuration in which local governments adopt loose regulation, the village collective plays an active coordinating role, family farms pursue long-term operations, and farmers choose recultivation is a key condition for achieving a Pareto-optimal equilibrium. (3) Although farmers’ production willingness and behavioral choices form the basis for the utilization of abandoned farmland, spontaneous individual action alone is insufficient to address the structural contradictions currently facing abandoned farmland utilization in China. To effectively promote the evolution of abandoned farmland governance toward a stable collaborative equilibrium and ultimately realize sustainable utilization, it is necessary to further optimize governmental administrative control models and incentive mechanisms, strengthen the organizational and coordinating functions of village collectives, and improve long-term operational support systems for family farms. This study systematically elucidates the underlying logic of China’s abandoned farmland utilization from the perspective of multi-actor behavioral decision-making, providing policy-referential insights for optimizing policy design, reducing coordination costs, and improving the efficiency of abandoned farmland utilization. Full article

Background: Endovascular treatment has become the major choice for treating intracranial aneurysm (IA). The development of novel endovascular devices for IA treatment is, therefore, socially important. For this purpose, a preclinical animal model to test a prototype of devices plays a crucial role. The major problems regarding currently used preclinical animal models, mainly in medium-to-large animals, are the expense and the lack of IA pathology, as they only mimic the morphological aspect. Methods: Sprague–Dawley rats were used, and the new bifurcation was formed via end-to-side anastomosis of carotid arteries. An aneurysm lesion induced at the newly formed bifurcation site was macroscopically assessed. Endovascular coiling of the induced aneurysm was then done. Results: An aneurysm lesion with a balloon-like shape, as in human cases, was induced at the newly formed bifurcation site. Some of the induced lesions spontaneously ruptured. Endovascular coiling was successfully done by using the micro-catheter and coil used at the clinical site. Conclusions: The rat model of IAs established here provides a novel platform contributing to the development of endovascular devices to treat IAs and, therefore, significantly facilitates the development of devices to achieve more effective treatment. Full article

The early and widespread access of children to digital technologies has increased the need to develop digital competence from a young age, particularly regarding online safety and digital well-being. While schools play an important role in digital education, the family environment constitutes a key context in which children’s digital practices are shaped. This study analyses children’s digital competence around safety by analyzing parental mediation strategies, family context and patterns of Internet use as perceived by primary education students. Using data from 277 children aged 8–13 and items adapted from the EU Kids Online questionnaire, inferential and correlational analyses were conducted. These analyses focused on Internet use time, active parental mediation, communicative proactivity and parental supervision. The results show that active parental mediation and communication are negatively associated with time spent online. They are positively associated with indicators of responsible and secure Internet use. These findings are discussed within the framework of DigComp 3.0, highlighting the role of the home as a fundamental space for the construction of children’s digital safety competence. The study concludes that children’s digital safety competence is not acquired spontaneously or exclusively through formal education but is directly linked to everyday educational practices developed within the family context. Full article

Urban street greenery plays a crucial role in enhancing biodiversity, environmental quality, and human well-being. However, how different street greening strategies shape urban plant diversity across functional urban contexts remains insufficiently understood. Taking Jinan, a rapidly urbanizing city in China, as a case study, this research investigates the spatial patterns, compositional differences, and driving mechanisms of plant diversity between Green Streets (GS) and Non-Green Streets (NGS) across various Urban Functional Units (UFUs). A 1 km × 1 km grid was used to delineate UFUs, combined with field-based plant surveys, linear regression analyses, and the public space assessment framework of Sustainable Development Goal (SDG) 11.7.1. Results indicate that plant diversity is strongly dependent on urban functional types, with higher species richness observed in residential and recreation/leisure districts, and lower levels in industrial, commercial, and transportation districts. The ecological effects of GS exhibit clear context dependence, being more pronounced in residential, educational, and public service areas, but limited in commercial and industrial zones. NGS recorded a significantly higher total number of plant species (346) than GS (116), with NGS dominated by native spontaneous species and GS characterized by introduced cultivated plants, reflecting the filtering effects of different management intensities. Management variables, particularly watering (positive) and fertilization frequency (negative), is primarily positively associated with plant diversity in GS, whereas diversity in NGS is more closely associated with socio-economic and spatial factors such as UFU area and housing prices. Furthermore, the current SDG 11.7.1 indicator emphasizes the quantity and accessibility of public spaces but insufficiently captures their ecological quality. This study highlights the need to integrate biodiversity and vegetation structural complexity into public space assessments, providing scientific support for quality-oriented urban green infrastructure planning and sustainable urban development. Full article

Autoantibodies (AAbs) play an important role in the development of autoimmune diseases. While many AAbs induce apoptosis of target cells, a distinct subgroup, termed functional autoantibodies (fAAbs) against G protein–coupled receptors (GPCRs), can modulate physiological receptor signaling without inducing cell death. The functional activity of GPCR-fAAbs may be influenced by various cofactors, including inflammation (e.g., inflammatory cytokine, ciliary neurotrophic factor (CNTF)) and ischemia. As ischemia triggers a substantial release of arachidonic acid (AA) from membrane phospholipids, the present study aimed to examine exploratively the influence of AA, eicosapentaenoic acid (EPA), and CNTF on the responses of spontaneously beating neonatal rat cardiomyocytes to GPCR agonists and GPCR-fAAbs. AA and EPA differentially influenced responses in cardiomyocytes induced by GPCR-fAAbs: AA altered the functional responses associated with adrenergic β₂-fAAb, adrenergic α₁-fAAb, angiotensin II (AT1)-fAAb, endothelin A (ETA)-fAAb and angiotensin 1–7 MAS-fAAbs. However, muscarinergic M₂-fAAb responses remained largely unaffected. In contrast, EPA attenuated the responses to β₂-fAAb, α₁-fAAb, AT1-fAAb, and ETA-fAAb, while MAS-fAAb and M₂-fAAb responses were not markedly altered. CNTF acted as a time-dependent modulator of cardiomyocyte chronotropic responses and influenced the magnitude of GPCR-mediated signaling on a cardiomyocyte bioassay. Together, these findings might suggest that lipid mediators such as AA and EPA or CNTF may modulate functional responses of cardiomyocytes associated with GPCR-fAAbs. Full article

The origin of life is, to the best of our knowledge, impossible to imagine without the formation of complex prebiotic biomolecules such as RNA, DNA, proteins and lipids. Lipids play a crucial role in the spontaneous formation of cell membranes, which are responsible for cell integrity, compartmentalization, selective permeability, and providing a microenvironment for biochemical reactions. The goal of the current work is to summarize the current state of the art regarding the abiotic formation of membrane building blocks, such as glycerol, fatty acids, and their phosphorylated version as phospholipid precursors. We describe the necessity of a systems chemistry approach for the complexification and expansion of the prebiotic network, enabling the formation of several membranogenic precursors. We also discuss prebiotic pathways for phosphorylation and acylation that could lead to phospholipid availability in hydrothermal environments and on the early Earth surface. We conclude with the possible spontaneous vesiculation of these molecules as a primitive version of the cell membrane. Thus, we present a comprehensive perspective on prebiotic vesicle formation, starting from simple molecules and developing until the self-assembly of vesicles. Full article

Background: For decades, the ketogenic diet has been successfully used for the treatment of obesity, metabolic syndrome, and type 2 diabetes. The mechanisms through which it affects metabolism are not fully understood, but the hormonal changes that occur during ketogenic nutrition are likely to play an important role. Objectives: To investigate the effect of the ketogenic diet on various hormones associated with obesity and the accompanying metabolic disorders in childhood. Methods: One hundred children aged 8–18 years with obesity were enrolled. After baseline anthropometric, biochemical, and hormonal testing, they followed a 4-month “well-formulated ketogenic diet.” Fifty-eight of them successfully completed the study with follow-up assessments. Among them, 8 girls had polycystic ovary syndrome (PCOS) and 7 children had Hashimoto’s autoimmune thyroiditis. Results: At the end of the 4-month period, there was a significant decrease in basal insulinemia (p < 0.0001) and in mean morning cortisol levels (p = 0.04), as well as an increase in adiponectin levels (p = 0.04). All girls with PCOS experienced spontaneous menstrual cycles, accompanied by a reduction in testosterone levels. TSH levels showed no change for the whole group (p = 0.13), but there was a significant decrease in T3 (p < 0.0001) and a mild increase in T4 (p = 0.05). Among patients with Hashimoto’s thyroiditis, TSH levels were significantly higher at the end of the study. Conclusions: A short-term, well-formulated ketogenic diet in children with obesity is associated with hormonal changes that support weight loss and improve insulin sensitivity. The diet shows particularly beneficial effects in girls with PCOS and may be considered as part of a comprehensive therapeutic approach in these patients. Monitoring thyroid function during ketogenic nutrition is advisable in patients with hypothyroidism and thyroid disorders. Full article

Rumenitis is an inflammatory condition of the rumen, typically seen in adult cattle managed on high-energy diets. In calves, it is uncommon and often linked to ruminal drinking due to esophageal groove dysfunction. Early diagnosis is challenging due to nonspecific clinical signs. A one-month-old male Limousin calf was presented with persistent non-fetid fluid regurgitation, rhythmic mastication, inappetence, and progressive neurological signs. Clinical examination revealed signs of dehydration and neurological dysfunction. Laboratory evaluation demonstrated metabolic acidosis (pH 7.16), hyperkalemia, and elevated serum urea. Endoscopy identified diffuse mucosal hyperemia, erosions, and fluid accumulation in the rumen. Symptomatic and supportive therapy was initiated; however, the calf died spontaneously. Necropsy was therefore performed, and rumen samples were collected for histological and microbiological investigations. Histopathological analysis confirmed acute suppurative rumenitis. The microbiological culture of rumen and reticulum samples yielded mixed bacterial flora, including Escherichia coli and Proteus mirabilis. The fungal culture isolated Penicillium spp., Mucoraceae, Geotrichium spp., and Aspergillus fumigatus. This case details the value of integrating clinical examination, blood gas analysis, endoscopy, histopathology, and microbiology in diagnosing rumenitis in young calves. Although Limousin calves are not considered predisposed, management and feeding practices may play a critical role in disease onset. Rumenitis should be considered in calves presenting persistent regurgitation and neurological signs. Early, minimally invasive diagnostics such as endoscopy can improve diagnostic accuracy and inform timely clinical decision-making. Full article