Search Results (30)

Background/Objectives: This study aimed to evaluate a regional implementation project for rural emergency care (RuralRescue) and to examine how its components and outcomes may support personalized approaches in emergency medicine. While not originally designed as a personalized medicine intervention, the project combined digital, educational, and organizational innovations that enable patient-specific adaptation of care processes. Methods: Conducted in the rural district of Vorpommern-Greifswald (Mecklenburg–Western Pomerania, Germany), the intervention included (1) standardized cardiopulmonary resuscitation (CPR) training for laypersons, (2) a geolocation-based first responder app for medically trained volunteers, and (3) integration of a tele-emergency physician (TEP) system with prehospital emergency medical services (EMSs). A multi-perspective pre–post evaluation covered medical, economic, and organizational dimensions. Primary and secondary outcomes included bystander CPR rates, responder arrival times, telemedical triage decisions, diagnostic concordance, hospital transport avoidance, economic simulations, workload, and technology acceptance. Results: Over 12,600 citizens were trained in CPR and the responder app supported early intervention in hundreds of cases. TEPs remotely assisted 3611 emergency calls, including delegated medication in 17.8% and hospital transport avoidance in 24.3% of cases. Return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) was achieved in 35.6% of cases with early CPR. Diagnostic concordance reached 84.9%, and documentation completeness 92%. Centralized coordination of TEP units reduced implementation costs by over 90%. Psychological evaluation indicated variable digital acceptance by role and experience. Conclusions: RuralRescue demonstrates that digitally supported, context-aware, and regionally integrated emergency care models can contribute significantly to personalized emergency medicine and can be cost-effective. The project highlights how intervention intensity, responder deployment, and treatment decisions can be tailored to patient needs, professional capacity, and regional structures—even in resource-limited rural areas. Full article

Electromagnetic hyper-sensitivity (EHS) and its causal link with radio-frequencies raise a major question of public health. In the frame of the clinical study DEMETER, 26 adult volunteers self-diagnosed as EHS-positive agreed to reply to a self-assessment questionnaire and to provide a skin biopsy sampling to establish a primary fibroblast cell line. The questionnaire and the biological data revealed, independently, 2 subsets of donors associated each with a low background, highly responsive (LBHR) and a high background, lowly responsive (HBLR) phenotype. A couple of subsets based on questionnaire data and based on the yield of spontaneous DNA double-strand breaks were found to be composed of the same donors at 64% identity. After exposure to X-rays, and application of anti-γH2AX, pATM, and MRE11 immunofluorescence, all the DEMETER fibroblasts (26/26) elicited a delayed radiation-induced ATM nucleoshuttling (RIANS). The use of RIANS biomarkers showed that the 2 phenotypes described above corresponded to DEMETER donors with a high risk of cancer (LBHR) or high risk of accelerated aging (HBLR). By exposing DEMETER cells to H₂O₂ followed by an antioxidative agent, we confirmed that EHS may be related to the management of DNA strand breaks. A preliminary molecular model of EHS inspired by the RIANS model was proposed. Full article

Background: During the initiation of routine orthodontic treatment with fixed appliances, placing elastic separators (ESs) may lead to the patient experiencing considerable pain. Earlier studies evaluating the effects of low-level laser therapy (LLLT) on reducing pain caused by orthodontic ESs have reported contradictory results. The aim of our study was to evaluate the effect of a single application of LLLT on the experience of pain following ES placement. Methods: A double-blind, placebo-controlled randomized controlled trial was performed—with implementation of the split-mouth technique—where n = 33 volunteers (12 male and 21 female; aged between 19 and 36 years) were enrolled. ESs were placed at the mesial and distal surfaces of the first permanent molars in the upper or lower jaws. Jaws were divided into two quadrants; the treatment group received LLLT (using a GaAlAs diode laser, at a 980 nm wavelength, with 100 mW producing 6 J of energy; continuous wave), while the other quadrant served as the placebo side receiving a similar treatment, but without laser irradiation, immediately after separation. A questionnaire with a visual analogue scale (VAS; 0–100) was used for the assessment of pain (spontaneous pain and pain on mastication) scored for each first permanent molar directly after separation and after 6, 24, 48 and 72 h of both laser and placebo treatment application. Results: Mean VAS values were lower, but not significantly different, between the treatment vs. placebo groups for spontaneous pain at either measurement point (p > 0.05). Mean VAS values were significantly lower in the treatment groups for pain on mastication at the 6 (9.29 ± 12.65 vs. 19.07 ± 20.99; p = 0.025), 24 (21.96 ± 21.11 vs. 37.19 ± 26.35; p = 0.012) and 48 h (28.01 ± 21.40 vs. 42.60 ± 26.29; p = 0.016) measurement points. The analgetic effect of LLLT was most effective after 6 h, both in the resting position (−49% decrease) and during mastication (−51% decrease). Conclusions: A single application of LLLT with 6 J of energy may have beneficial effects on reducing the pain caused by orthodontic ESs used at the initiation of treatment with fixed appliances, especially during mastication, after 6–48 h following the separation procedure. Trial registration: clinicaltrials.gov ID NCT06816537 (date of registration: 7 February 2025, retrospectively registered). Full article

Background: Citizenship plays a fundamental role in the management of socio-natural disaster risk, especially given the increasing impact and frequency of these events. In this context, disaster response is marked by both formal and spontaneous volunteerism. Method: Using a non-probabilistic sample of 101 volunteers and comparing the social representation of formal volunteers with spontaneous volunteers, prototypical and categorical analyses of social representations were conducted. Results: Differences were identified between formal volunteers, whose social representation reflects a strong value-oriented and collaborative vision focused on social capital, and spontaneous volunteers, whose social representation is directed toward prosocial values, emotions, and the heroic actions associated with volunteerism. Conclusions: New avenues are proposed for exercising and strengthening formal volunteerism, accompanied by processes that enable the identification of common value axes and suitability for risk-related work. Additionally, the motivations and actions of spontaneous volunteers are discussed. Finally, sustained coordination is proposed among institutions involved in risk management, formal volunteers, and spontaneous volunteers to optimize human resource management in emergencies. Full article

Spices and aromatic herbs are important components of everyday nutrition in several countries and cultures, thanks to their capability to enhance the flavor of many dishes and convey significant emotional contributions by themselves. Indeed, spices as well as aromatic herbs are to be considered not only for their important values of antimicrobial agents or flavor enhancers everybody knows, but also, thanks to their olfactory and gustatory spectrum, as drivers to stimulate the consumers’ memories and, in a stronger way, emotions. Considering these unique characteristics, spices and aromatic herbs have caught the attention of consumer scientists and experts in sensory analysis for their evaluation using semi-quantitative approaches, with interesting evidence. In this pilot study as a first step, each studied botanical, belonging to Piperaceae or aromatic herbs, has been subjected to headspace solid phase micro-extraction (HS-SPME) coupled with gas-chromatography mass spectrometry (GC-MS) analysis to assess their spontaneous volatile emission, representing the complex chemical pattern, which encounters the consumers’ olfactory perception. Furthermore, the present investigation, performed on 12 individuals, outlines the administration of a pilot study, merging the typical sensory analysis with emotional data collection and the innovative contribution related to the study around the Autonomic and Central Nervous System activation in consumers, performed using wearable technologies and related signal processing. The results obtained by our study, beyond demonstrating the feasibility of the approach, confirmed, both in terms of emotional responses and biomedical signals, the significant emotional potential of spices and aromatic herbs, most of which featuring an overall positive valence, yet with inter-subjects’ variations. Future investigations should aim to increase the number of volunteers evaluated with such an approach to draw more stable conclusions and attempting a customization of product preferences based on both implicit and explicit sensory responses. Full article

Background: Intense exercise leads to neutrophil extracellular traps (NETs) formation, which triggers cell disintegration. NET, as well as other processes of apoptosis, necrosis, and spontaneous secretion, result in increased levels of cell-free DNA (cf-DNA) in the circulation. An increment of cf-DNA is also observed in autoimmune diseases, such as type 1 diabetes mellitus (T1DM). Repeated exhaustive exercises are an impulse for physiological adaptation; therefore, in this case–control study, we compared the exercise-induced increase in cf-DNA in men with T1DM and healthy controls to determine the development of the tolerance to exercise. Methods: Volunteers performed a treadmill run to exhaustion at a speed matching 70% of their personal VO2 max at three consecutive visits, separated by a 72 h resting period. Blood was collected before and after exercise for the determination of plasma cell-free nuclear and mitochondrial DNA (cf n-DNA, cf mt-DNA) by real-time PCR, blood cell count and metabolic markers. Results: Each bout of exhaustive exercise induced a great elevation of cf n-DNA levels. An increase in cf mt-DNA was observed after each run. However, the significance of the increase was noted only after the second bout in T1DM participants (p < 0.02). Changes in cf-DNA concentration were transient and returned to baseline values during 72 h of resting. The exercise-induced increment in circulating cf n-DNA and cf mt-DNA was not significantly different between the studied groups (p > 0.05). Conclusions: Cf-DNA appears to be a sensitive marker of inflammation, with a lower post-exercise increase in individuals with T1DM than in healthy men. Full article

The targeted delivery of a hydrophilic Tripeptide-3 to the skin using microemulsions or nanoemulsions for facial oil reduction was the focus of this study. The impact factors affecting oil/water transparent dispersion formation, such as the surfactant system, HLB value, and co-solvent, were identified through the water titration method and pseudoternary phase diagram plots. The interfacial tension between caprylic/capric triglyceride (CCT oil) and water was significantly reduced by the surfactant/co-surfactant combination (S_mix) of Cremophore^® RH40 and a double-tails co-surfactant, polyglycerol-3-diisostearate, at an HLB of 13 together with a water-to-co-solvent (PG) ratio of 1:1. A two-level full factorial design of experiment (FFD-DoE) emphasized the independent variables of the HLB value, co-solvent, and CCT oil contents affecting the optimal compositions for micro- or nanoemulsion formation. The low-energy spontaneous emulsification of the optimized combination at a low S_mix content (10%) yielded the translucent oil-in-water Tripeptide-3 nanoemulsions with an internal droplet size of 25.7 ± 1.20 nm, a narrow polydispersity index of 0.237 ± 0.129, and 70.6 ± 0.58% transmittance. The in vitro skin permeation study revealed a significantly higher skin penetration and retention of the Tripeptide-3 nanoemulsions compared to the high surfactant microemulsions and coarse emulsions. Skin irritation and oil control efficacy were evaluated in healthy volunteers before and after product application for 28 days. The obtained nanoemulsions not only decreased sebum production but also enhanced skin moisture levels. In conclusion, the meticulously designed nanoemulsions, incorporating suitable excipients, show a promising delivery system for hydrophilic peptides to control sebum overproduction in oily facial skin. Full article

The floods in 2021 in Germany laid bare the need to better integrate volunteers into official disaster management. An online survey with 1767 valid interviews after the floods in July 2021 reveals the shared experiences of professional and non-professional groups. Communication and coordination problems are the main results of the survey analysis. Overall satisfaction was a bit lower for the volunteers than for the professionals. The behavior of the superiors could have been more satisfactory. The preparation and opportunity for reflection could have been better after the operation. The information provision before and during the flood operation could have been more satisfactory. Worries were higher about elderly persons, and misinformation was a perceived danger. Problems experienced in the flood operations ranged from psychological stress to hygiene, self-endangerment, assignment of tasks, and misinformation, both from the media and official sources. Infrastructure-related problems included electricity, water, communication lines, roads, and rail. The suggestions for improvements ranged from communication and information about warnings and behavior to persons that transfer knowledge between organizations, digital exchange platforms, and exchange between countries. Full article

Background: Combined oral contraceptives (COCs) work mostly by preventing the pre-ovulatory gonadotropin surge, but the action of COCs on spontaneous episodic and GnRH (gonadotropin-releasing hormone)-induced LH (luteinizing hormone) release has been poorly evaluated. Oral contraceptives are known to act on the spontaneous hypothalamic–pituitary functions reducing both GnRH and gonadotropin release and blocking ovulation. Aim: To evaluate spontaneous and GnRH-induced LH release during both phases of the menstrual cycle or under the use of the contraceptive pill. Methods: A group of 12 women, subdivided into two groups, volunteered for the study. Group A (n = 6, controls) received no treatments, while Group B (n = 6) received a 21 + 7 combination of ethinyl-estradiol (EE) 30 µg + drospirenone (DRSP) 3 mg. Both groups were evaluated twice: Group A during follicular and luteal phases, Group B during pill assumption and during the suspension interval, performing a pulsatility test, GnRH stimulation test, and hormonal parameters evaluation. Spontaneous and GnRH-induced secretory pulses were evaluated, as well as the instantaneous secretory rate (ISR). Results: COC treatment lowered LH and FSH (follicle stimulating hormone) levels significantly if compared to the follicular phase of spontaneous cycles. During the suspension interval, hormone levels rapidly rose and became comparable to those of the follicular phase of the control group. The LH pulse frequency under COC administration during the suspension interval was similar to that observed during the follicular phase (2.6 ± 0.3 pulses/180 min and 2.3 ± 0.2 pulses/180 min, respectively). The GnRH-induced LH peaks were greater in amplitude and duration than those observed after ISR computation in both groups. The GnRH-induced LH release during the luteal phase of the control subjects was higher than in the follicular phase (51.2 ± 12.3 mIU/mL and 14.9 ± 1.8 mIU/mL, respectively). Conversely, subjects under COC showed a GnRH-induced LH response similar during COC and during the suspension interval. Conclusions: Our data support that the EE + DRSP preparation acts on both spontaneous pulsatile release and GnRH-induced LH release during the withdrawal period of the treatment, and that after 5–7 days from the treatment suspension, steroidal secretion from the ovary is resumed, such as that of androgens. This suggests that in hyperandrogenic patients, a suspension interval as short as 4 days might be clinically better. Full article

Treatment-emergent sexual dysfunction (TESD) is one of the most frequent and persistent adverse effects of antidepressant medication. Sexual dysfunction (SD) secondary to SSRIs occurs in >60% of sexually active patients and >80% of healthy volunteers, with this causing treatment discontinuation in >35% of patients. However, this factor is rarely addressed in routine examinations, and only 15–30% of these events are spontaneously reported. A strategy of switching to a different non-serotonergic antidepressant could involve a risk of relapse or clinical worsening due to a lack of serotonergic activity. Vortioxetine appears to have less impact on sexual function due to its multimodal mechanism of action. No studies have been published on the effectiveness of switching to vortioxetine in patients with poorly tolerated long-term antidepressant-related SD in naturalistic settings. Study objectives: To determine the effectiveness of switching to vortioxetine due to SD in a routine clinical practice setting. Methodology: observational pragmatic and naturalistic study to determine the effectiveness of the switch to vortioxetine (mean dosage 13.11 ± 4.03) in 74 patients aged 43.1 ± 12.65 (54% males) at risk of discontinuing treatment due to sexual dysfunction. The PRSexDQ*- SALSEX scale (* Psychotropic-Related Sexual Dysfunction Questionnaire) was applied at two moments: baseline visit and after 3 months of follow-up. Results: global Sexual Dysfunction (SD) measured with the SALSEX scale decreased significantly between the baseline visit (10.32; SD 2.73) and the follow-up visit (3.78; SD 3.68), p < 0.001. There was a significant improvement (p < 0.001) at the endpoint including decreased libido, delay of orgasm, anorgasmia and arousal difficulties in both sexes. After switching to vortioxetine, 83.81% of patients experienced an improvement in sexual function (43.2% felt greatly improved). Most patients (83.3%) who switched to vortioxetine continued treatment after the follow-up visit. A total of 58.1% of patients showed an improvement in depressive symptoms from the baseline visit. Conclusion: switching to vortioxetine is an effective and reliable strategy to treat patients with poorly tolerated previous antidepressant-related sexual dysfunction in real-life clinical settings. Full article

Background: Primary dysmenorrhea (PD) is one of the most common diseases in women of reproductive age. Our aim was to examine whether a twice-weekly thirty-minute exercise intervention could result in a difference in the pulsatility index (PI) of the uterine arteries (UAs) and level of menstrual pain in patients with PD. Methods: In our prospective observational trial, the observation period included one spontaneous menstrual cycle and the consecutive time of the next menstruation of all participants, aged 18–44, with no extensive sports experience. In total, 73 volunteers were enrolled: 38 persons in the intervention group (IG) and 35 in the control group (CG). The intervention program was accompanied by music, performed in groups under the supervision of a qualified instructor in Hungary. The primary outcome was the difference between the IG and CG regarding the PI values of UAs at the 1st and the 2nd ultrasound (US) Doppler flowmetry. The secondary outcome was the difference between the IG and CG regarding the PI of UAs and menstrual pain measured by using the Numeric Rating Scale and adherence to the intervention. Statistical tests such as an independent-samples t-test, chi-square test, Mann–Whitney test and analysis of covariance (ANCOVA) were used during the analyses. Results: Examining the mean of the PI of UAs in the IG and the CG at the 1st and the 2nd US measurement, a significant difference was found in the change in the measured value (Z = −2.545; p = 0.011). The IG showed a significantly higher increase in the mean of the PI of UAs (Median = 0.825) than the CG (Median = 0.130). The difference in the PI of the UAs of the IG and the CG is not related to the level of pain in any group (p = 0.336) and not related to the whole sample (p = 0.354); furthermore, the level of pain did not significantly differ between the two groups. Conclusions: Our study is the first to document the significant effects of mild-to-moderate exercise training on the change in the PI of the UAs in individuals with PD. The IG had a reduced blood flow due to circulatory redistribution after exercise. The level of menstrual pain of primary dysmenorrhea patients is independent of the level of blood circulation regarding the PI of the UAs. Randomized controlled studies with more participants and a longer research period are needed to confirm our findings regarding the association between regular exercise and the PI of UAs. The study was registered at clinicaltrials.gov: NCT04618172. Full article

The goal of this study was to analyze instability during stepping at different speeds in young and older adults. To this aim, the anteroposterior and the mediolateral distances between the body center of mass (COM) and the minimum moment axis (MMA) were computed. A total of 15 young adults (25 y.o. [19–29]) and 15 older adults (68.7 y.o. [63–77]) volunteered for this study. For the computation of the distances, a complete biomechanical protocol combining two force platforms and a 3D motion capture analysis system was setup. The subjects were equipped with 47 reflective markers and were modeled as a frictionless multibody system with 19 segments, 18 joints and 42 degrees of freedom. They were asked to perform a series of stepping tasks at fast and spontaneous speeds. The stepping was divided into five phases, with successive swing and double-stance phases. Greater instability was observed during the swing phases. The distances reveal a significant higher instability at fast speed for both groups (p < 0.001) for all the phases compared with spontaneous speeds. The anteroposterior distance was significantly greater for older adults, highlighting greater instability compared to young adults, while no differences were observed for the mediolateral distance all along the five phases, suggesting higher risks of backward and forward falls during stepping. Full article

Ligelizumab is a highly potent, humanized IgG1, anti-IgE monoclonal antibody. To explore its optimal subcutaneous delivery, the pharmacokinetics (PK), pharmacodynamics (PD), and tolerability of ligelizumab from two Phase 1 studies in healthy volunteers (HVs) and four Phase 2 and 3 studies in patients with chronic spontaneous urticaria (CSU) were assessed. Using different injection volumes or durations of a liquid-in-vial (LIVI) formulation or different formulations (LIVI vs. prefilled syringe (PFS)), single-dose ligelizumab showed comparable PK exposure in HVs. Steady-state exposure of ligelizumab was also comparable between LIVI and PFS following multiple dosing in CSU patients. The total IgE level (a PD marker) and tolerability were similar between the two formulations in both HVs and patients. Furthermore, the PK, total IgE, and tolerability were comparable for PFS administered either by patients or healthcare providers (HCPs). Collective evidence demonstrated that the injection duration or volume, formulation, or administrator had no apparent impact on the PK, PD, and tolerability of ligelizumab, supporting no clinically relevant difference between LIVI and PFS, and that PFS can be administered by patients or HCPs. This report provides a comprehensive assessment based on data of multiple clinical endpoints from both HVs and patients to inform formulation development and commercial use of a monoclonal antibody. Full article

Extreme precipitation poses significant threats to economic development and social security. In order to tackle this formidable issue, the Chinese government has invested substantial investments to promote the “sponge city” project. However, extreme precipitation in Zhengzhou on 21 July 2021 proved that this effort fell far short of its goal, highlighting the difficulty in relying solely on the government to respond to severe disasters. Collaborations between the public and the government have become essential for effectively managing extreme precipitation risk. However, bridging the gap between the public and the government remains a challenging task in China. Interestingly, an Online Collaborative Document (OCD) emerged without any financial investment from the government yet went on to save countless lives. The key lies in that the OCD greatly promoted the cooperation between spontaneous volunteering and official response. This study aims to explain how an OCD encourages effective collaboration between spontaneous volunteering and official responses in tackling extreme precipitation risk. This study employs the method of the case study about the extreme precipitation and analyzes the directed survey on the spontaneous volunteers, grassroots government officials, and affected individuals who used the OCD. Additionally, a variety of data collection techniques, including focus groups and one-on-one interviews, are used to examine the relevant information. This study explores how the OCD eliminated the paradox of collaboration between spontaneous volunteering and the official response thereby fostering coordination between them. Full article

Objective: The goal was to compare Speckle plethysmography (SPG) and Photoplethysmography (PPG) with non-invasive finger Arterial Pressure (fiAP) regarding Pulse Wave Morphology (PWM) and Pulse Arrival Time (PAT). Methods: Healthy volunteers (n = 8) were connected to a Non-Invasive Blood Pressure (NIBP) monitor providing fiAP pulse wave and PPG from a clinical transmission-mode SpO₂ finger clip. Biopac recorded 3-lead ECG. A camera placed at a 25 cm distance recorded a video stream (100 fps) of a finger illuminated by a laser diode at 639 nm. A chest belt (Polar) monitored respiration. All signals were recorded simultaneously during episodes of spontaneous breathing and paced breathing. Analysis: Post-processing was performed in Matlab to obtain SPG and analyze the SPG, PPG and fiAP mean absolute deviations (MADs) on PWM, plus PAT modulation. Results: Across 2599 beats, the average fiAP MAD with PPG was 0.17 (0–1) and with SPG 0.09 (0–1). PAT derived from ECG–fiAP correlated as follows: 0.65 for ECG–SPG and 0.67 for ECG–PPG. Conclusion: Compared to the clinical NIBP monitor fiAP reference, PWM from an experimental camera-derived non-contact reflective-mode SPG setup resembled fiAP significantly better than PPG from a simultaneously recorded clinical transmission-mode finger clip. For PAT values, no significant difference was found between ECG–SPG and ECG–PPG compared to ECG–fiAP. Full article