Search Results (13,041)

Background and Objectives: The optimal timing of orthodontic intervention in children remains debated, particularly during the mixed dentition phase. Despite potential benefits, variability in clinical decision-making persists. This study explored orthodontists’ perceptions, clinical practices, and clinical decision-making regarding the timing of early orthodontic intervention in Saudi Arabia. Materials and Methods: An interpretive qualitative study was conducted using semi-structured interviews with nineteen licensed orthodontists practicing in Saudi Arabia. Participants were purposively sampled to ensure diversity in clinical experiences and practice settings. Interviews were conducted in English and Arabic, using detailed contemporaneous field notes that were subsequently expanded for analysis. Data were analyzed using thematic analysis following Braun and Clarke’s framework, with iterative coding supported by investigator triangulation, reflexive memoing, and participant validation. Data collection continued until thematic saturation was achieved. Results: Four major themes were identified. Early intervention was widely perceived as beneficial, particularly for functional problems, Class III malocclusions, and crossbites. However, decision-making was highly individualized, with many clinicians adopting a selective approach and deferring treatment in mild cases. Variation in clinical reasoning was observed across individual participant accounts, reflecting clinical judgment and contextual influences. Key barriers included limited parental awareness, financial constraints, and delayed referrals. System-level factors, such as variability in insurance coverage, referral pathways, and the lack of structured early screening programs, were identified as important influences on access to timely care. Conclusions: Early orthodontic intervention should be applied selectively, based on clinical indications and patient-specific factors. The context-specific findings highlight the need for appropriately tailored guidance, improved referral systems, structured early screening, and consideration of clinical, practitioner-related, and healthcare system factors to support consistent, patient-centered orthodontic care. Full article

Background/Objectives: Novel (immune) therapies are needed to stabilize the disease or achieve remissions in AML. We already demonstrated that DCleus can be generated ex vivo from AML patients’ blasts in WB using approved drugs (GM-CSF and PGE-1 (Kit-M) or GM-CSF and Picibanil (OK-432), Kit-I). The generated DCleus induce antileukemia-directed immune cells of the adaptive and innate immune system, enabling leukemia-specific immune activation after MLC. Methods: We compared the effects of Kit-I vs. Kit-M by quantifying (1) their potential to produce DCs/DCleus from WB samples from 6 healthy individuals and 28 AML patients’ WB in different stages of the disease and (2) the activation of adaptive and innate leukemia-specific IFNγ-producing or degranulating antileukemic cells after MLC with and without Kit-I/Kit-M-pretreated WB. Furthermore, we correlated the obtained results with the achieved improved cells’ antileukemic functionality and patients’ clinical data. Results: In AML samples we found significantly higher frequencies of (mature) DCleus generable without induction of blast proliferation in Kit-M as well as (although less pronounced) in Kit-I-treated vs. untreated samples, a significant increase in the frequency of (leukemia- specific) immunoreactive cells, and improved blast cytotoxicity after MLC with Kit-M and with Kit-I-treated vs. untreated samples (potentially with higher induction of CD4 and CIK IFNγ + cells in Kit-I-pretreated samples). These data might suggest that both Kits work via different pathways. Conclusions: We show that Kit-M and Kit-I produce DCs/DCleus and subsequently enhance (potentially via a different mode of action) antileukemic immune cell activation after MLC. Our findings point to a possibility to enhance antileukemic treatment in vivo by combining agents or identifying criteria for selecting an appropriate agent (combination) for the respective patient in the course of a personalized treatment strategy. Full article

The development of bioactive hybrid coatings for biomedical implants requires materials exhibiting suitable thermal stability, bioactivity, and biocompatibility. In this study, hybrid organic–inorganic sol–gel coatings based on silica (SiO₂) and polyethylene glycol (PEG, 24 wt%) were functionalized with different concentrations of caffeic acid (CafA 5, 10, and 15 wt%) and deposited onto AISI 304 and AISI 316 stainless steel substrates by dip-coating without surface pre-treatment. The proposed approach enabled the formation of homogeneous hybrid coatings on untreated stainless steel substrates through a simple and scalable deposition process. A thermal analysis demonstrated the stability of the hybrid network and the effective integration of the organic and inorganic phases. Bioactivity was evaluated by in vitro immersion in simulated body fluid (SBF), while SEM observations revealed the formation of mineral deposits on the coating surface, and an EDX analysis confirmed the presence of calcium and phosphorus within the deposited layer. The formation of crystalline hydroxyapatite (HA) was subsequently confirmed by X-ray diffraction (XRD), confirming that all investigated formulations retained their ability to induce apatite formation after SBF immersion. In addition, in vitro biocompatibility assays confirmed that the developed materials exhibited concentration-dependent cytocompatibility, with the cellular response being influenced by the amount of incorporated CafA. Overall, the results demonstrate that the proposed hybrid materials combine thermal stability, bioactivity, and cytocompatibility, highlighting their potential as bioactive coatings for biomedical applications. Full article

Background and Objectives: Pre-eclampsia (PE) is an obstetric complication defined by placental insufficiency, including intrauterine growth restriction and placental abruption. Timely and accurate detection and treatment of pre-eclampsia are difficult because its diagnostic criteria are still based on nonspecific signs and symptoms and because the association between common severity criteria, and unfavorable outcomes for mother and fetus remain unclear. Therefore, the aim of this study was to evaluate the potential use of blood and urine PE risk markers—soluble Fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), sFlt-1/PlGF ratio, and albumin/creatin ratio—in predicting and managing PE in groups at risk for preterm and term PE (gestational weeks 24–37) and to correlate the levels of blood and urine PE markers with pregnancy outcome indicators. Materials and Methods: This study was conducted at the Department of Obstetrics and Gynecology and at the Center of Laboratory Diagnostics and Nuclear Medicine, University Clinical Center of Vojvodina. This study included 166 pregnant women (GW 24–37) divided into two groups: study group P (n = 52), consisting of pregnant women who were identified as a high-risk group for PE according to clinical signs and medical history and who subsequently developed PE; control group C (n = 114), consisting of pregnant women who had risk factors in their medical history but did not eventually develop PE symptoms. The evaluated parameters included two groups: blood and urine PE risk indicators—biochemical markers such as PlGF, sFlt-1, and sFlt-1/PlGF ratio; urine risk indicators such as albumin/creatine ratio; and pregnancy outcome indicators—gestational age of delivery (GW) and neonatal birth weight (NW). Results: The results of the analysis support that the PE risk biochemical indicators (PlGF, sFlt-1, sFlt-1/PlGF ratio, and albumin/creatine ratio) show statistically significant differences between the analyzed groups, that they correlate with PE occurrence, and that they have good predictive value. As expected, sFlt-1/PlGF ratio and albumin/creatine ratio, as the most valuable PE risk indicators, show good predictive value. However, our results also demonstrate that pro- and antiangiogenic indicators alone, especially sFlt-1 (high values), may play roles in risk evaluation and prediction of preterm and term PE (GW 24–37). Conclusions: In our study, all evaluated blood and urine indicators (PlGF, sFlt-1, sFlt-1/PlGF ratio, and albumin/creatine ratio) show high predictive value for PE in a PE risk group of pregnancies between GW 24 and 37. The results suggest that sFlt-1 alone has equal predictive value to sFlt-1/PlGF ratio and outperformed PlGF in predicting PE onset. The combined use of pro- and antiangiogenic biochemical markers, indices, and urine markers in blood, together with patient history and clinical parameters, shows potential as a more effective means of predicting PE than a single biochemical parameter such as sFlt-1/PlGF ratio. Full article

Zirconia orthodontic brackets exhibit favorable mechanical and esthetic properties; however, their chemically inert surfaces can limit adhesion to resin cements. This study evaluated the effect of multi-gas atmospheric plasma irradiation on the shear bond strength (SBS) of zirconia brackets. Zirconia brackets were treated with nitrogen (N₂), argon (Ar), or air plasma for 3 and 10 s and compared with untreated controls and conventional alumina-sandblasted specimens. Surface wettability was assessed by contact angle measurements, and surface chemical changes were analyzed using Fourier transform infrared (FT-IR) spectroscopy. After 10 s of plasma treatment, the water-contact angle decreased from 64.3° ± 8.4° in the untreated group to 17.9° ± 6.4°, 18.8° ± 2.7°, and 16.8° ± 5.3° with Ar, N₂, and air, respectively. For SBS testing, zirconia brackets were bonded to bovine enamel, stored in distilled water at 37 °C for 24 h, and subsequently tested (n = 12–15 per group). The mean SBS was 20.99 ± 2.87 MPa for the untreated group, 25.50 ± 2.40 MPa for the sandblasted group, and 23.63 ± 3.33, 23.99 ± 3.26, and 23.98 ± 3.58 MPa after 10-s Ar, N₂, and air plasma treatment, respectively. FT-IR revealed no new absorption peaks. Within the limitations of this study, multi-gas atmospheric plasma treatment markedly reduced the apparent water-contact angle measured on flat zirconia specimens, whereas its effect on SBS relative to the untreated group was not statistically significant. Full article

Background/Objectives: Surgical indications for spondylodiscitis are controversial, particularly when epidural extension and evolving neurological compromise are present. This study aimed to describe the clinical, neurological, pain-related, and inflammatory outcomes of patients with spondylodiscitis treated with decompressive laminectomy without spinal stabilization, at a single tertiary center. Methods: We retrospectively reviewed 15 consecutive patients with spondylodiscitis who underwent decompressive laminectomy at the University Hospital of Trieste between January 2017 and December 2023. Inclusion required at least 6 months of clinical and laboratory follow-up. Patients treated with acute vertebral stabilization were excluded. Collected data included spinal level, timing from diagnosis to surgery, visual analog scale (VAS) pain score, Cooper Scale grade, modified Japanese Orthopedic Association score (mJOA), white blood cell count, and C-reactive protein (CRP). Assessments were performed preoperatively (T0), 1 week after surgery (T1), and at 6 months (T2). Imaging findings from representative cases were reviewed to illustrate the radiographic evolution after decompression combined with antibiotic therapy and orthotic support. Results: The cohort included 8 women and 7 men with a mean age of 57.33 years. Twelve patients (80%) underwent surgery within 48 h because of neurological deterioration or urgent compressive findings. Thoracic involvement was predominant (11 cases, 73%), whereas cervical and lumbar disease accounted for 1 and 3 cases, respectively. Intraoperative cultures were positive in 9 patients (60%), and Staphylococcus aureus was isolated in 7 of these 9 cases (77.8%). Mean VAS pain score improved from 6.3 at T0 to 4.3 at T1 and 1.4 at T2. Mean lower-extremity Cooper Scale grade improved from 2.7 to 2.1 to 0.6; mean upper-extremity Cooper Scale grade improved from 1.3 to 1.0 to 0. Mean mJOA improved from 10.3 to 11.4 to 16.0. Mean white blood cell count declined from 11.58 to 8.35 to 6.14 × 10³/µL, and mean CRP declined from 123.9 to 72.81 to 19.44 mg/L. No patient worsened neurologically after surgery. No patient required acute stabilization or delayed arthrodesis during follow-up. Conclusions: In our case series of patients with compressive or progressive neurological spondylodiscitis, decompressive laminectomy combined with antibiotic treatment, bracing, and rehabilitation was associated with early neurological stabilization, substantial pain relief, and marked reduction in inflammatory markers, without subsequent need for instrumented stabilization. These data support the role of spinal decompression as part of a personalized, effective treatment strategy in patients with neurological decline. Full article

Blast-induced traumatic brain injury is a prevalent and underreported condition, particularly among military service members, for whom effective prophylactic interventions are lacking. Nano-pulsed laser therapy (NPLT) is a non-invasive neuromodulatory approach that delivers short pulses of near-infrared light to generate optoacoustic effects within cerebral tissue and has previously demonstrated therapeutic benefit following TBI. In this study, we evaluated whether a single pre-exposure application of NPLT could confer protection against neurological, cognitive, and cellular sequelae of mild blast injury. Adult male Sprague-Dawley rats were randomized to receive NPLT or Sham treatment 24 h prior to either Sham or mild blast exposure using the Advanced Blast Simulator. Neurological reflexes and vestibulomotor function were assessed on post-injury days (PIDs) 1–5, while cognitive performance was evaluated using the Morris Water Maze on PIDs 13–17. Histological analyses of microglia, astrocytes, and myelination were performed on PID 17. A single mild blast did not significantly alter gross neurological function but was associated with deficits in fine motor coordination and cognitive performance. Pre-exposure NPLT modestly attenuated blast-associated fine motor dysfunction, with a significant improvement compared with TBI on PID 4. In the Morris Water Maze, TBI animals exhibited significantly increased latency compared with Sham on PIDs 13 and 17, whereas NPLT + TBI animals did not significantly differ from Sham across the testing period, consistent with preservation of cognitive performance. Histological responses were regionally heterogeneous: NPLT alone produced distinct glial alterations, while NPLT + TBI animals exhibited a mixture of treatment- and injury-associated responses rather than uniform normalization to uninjured controls. NPLT did not prevent localized blast-associated reductions in corpus callosum myelin staining. In naive animals, NPLT significantly increased hippocampal brain-derived neurotrophic factor (BDNF) mRNA expression 24 h after treatment. A single pre-injury application of NPLT was associated with functional resilience following mild blast exposure despite persistent and regionally heterogeneous histopathological alterations. Increased hippocampal BDNF 24 h after NPLT, together with region-specific glial changes following NPLT in the absence of injury, demonstrates that a single treatment produces sustained molecular and cellular effects before blast exposure. These findings are consistent with the hypothesis that prophylactic NPLT establishes an altered pre-injury biological state that may modify the subsequent response to blast and support further investigation of NPLT as a prophylactic strategy and of the mechanisms underlying NPLT-associated preconditioning. Full article

Background: High-altitude hypobaric hypoxia (HH) is a major environmental stressor that impairs cognitive function, yet effective and widely available therapeutics remain limited. Although Rhodiola rosea has shown neuroprotective effects, its resource scarcity restricts large-scale application. Cistanche tubulosa (Schrenk) Wight, a traditional Chinese functional food, has been increasingly used in health supplements due to its anti-fatigue, anti-dementia, and memory-enhancing properties, suggesting potential benefits against hypoxia-induced cognitive impairment. Objective: This study aimed to investigate the effects of C. tubulosa ethanol extract (CTE) on hippocampal tissue and gut microbiota upon chronic HH exposure using SPF male Sprague–Dawley (SD) rats. Methods: A total of 60 male SD rats were randomly assigned to six experimental groups (n = 10 per group): normoxic control, untreated HH model, positive control (R. rosea), and low-, medium-, high-dose CTE treatment groups. Behavioral tests (Morris water maze), hippocampal histopathology, serum and hippocampal oxidative stress markers (SOD, GSH-Px, MDA), expression of PI3K/Akt/mTOR-HIF-1α signaling pathway proteins (by immunohistochemistry), and gut microbiota composition (by 16S rRNA sequencing) were evaluated. Results: The results demonstrated that CTE significantly improved cognitive function, enhanced SOD and GSH activities, and reduced MDA levels in both hippocampus and serum. CTE also modulated the expression of PI3K/Akt/mTOR-HIF-1α pathway proteins in the hippocampus. Furthermore, CTE altered gut microbial diversity and abundance, increasing the proportion of beneficial bacteria, which may further influence hippocampal function via the gut–brain axis. Conclusion: These findings provide scientific evidence for the application of C. tubulosa as a potential health supplement for high-altitude adaptation and lay a foundation for subsequent research. Full article

Valorizing peach pruning residues into alternative feed is a potentially sustainable strategy. In this study, we evaluated the effects of extrusion puffing (EX) and white-rot fungi (Phanerochaete chrysosporium, Irpex lacteus, and Phlebia acerina) on the lignocellulose composition of peach branches. We selected I. lacteus as the best-performing fungus for subsequent investigations of its effects on enzyme activities, in vitro rumen fermentation, and metabolomic analyses. Compared with the control, EX alone reduced the concentrations of cellulose, hemicellulose, and lignin by 27.3%, 22.4%, and 9.0%, respectively. The EX combined with I. lacteus (EI) treatment showed high selectivity for lignin degradation relative to cellulose degradation and increased β-glucosidase activity in the middle stage (days 14 and 21) compared with I. lacteus treatment (p < 0.05). Through metabolomic analysis, we identified organic acids and their derivatives (mainly carboxylic acids) as the most abundant superclass. On day 28, betaine and L-leucine were enriched in the fermented samples, and their abundances appeared to be descriptively associated with the enzyme activity patterns observed at this time point. In conclusion, the EI treatment represents a potential approach for altering the composition of peach branches; however, its practical benefits must be weighed against the energy input required and the complexity of the process. In this work, we provide a theoretical foundation for feed-oriented valorization of orchard pruning residues. Further studies are needed to assess economic feasibility and scale-up performance. Full article

To evaluate how composted agricultural and forestry organic materials function as components of horticultural growing media, a pot experiment was conducted with chrysanthemum (Chrysanthemum morifolium Ramat.) grown in a cinnamon-soil-based medium. The composted material, produced from chestnut shells, chicken manure, and spent mushroom substrate, was incorporated at 0%, 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, and 50% (v/v). Water-extractable dissolved organic matter (WE-DOM) was characterized by excitation-emission matrix fluorescence spectroscopy coupled with parallel factor analysis (EEM-PARAFAC), together with the fluorescence index (FI), biological index (BIX), humification index (HIX), and fluorescence regional integration (FRI). Growing-medium physicochemical properties, chrysanthemum traits, and an entropy-weighted comprehensive evaluation were also assessed. Compost amendment increased soil organic matter (SOM), dissolved organic carbon (DOC), total nitrogen, and total phosphorus, lowered pH, and was associated with improved porosity and water-retention characteristics. FI ranged from 1.810 to 2.371 and exceeded 1.9 at amendment rates of 30–35%, suggesting a greater contribution from microbially derived DOM. BIX, HIX, and P_V,n/P_Ⅲ,n were generally higher in amended treatments than in the control, although their responses were non-monotonic across amendment rates, suggesting greater contributions from recently produced DOM and stronger humification-related fluorescence signals. EEM-PARAFAC resolved five fluorescent components. C1, C2, C3, and C5 were predominantly humic-like, whereas C4 displayed both protein-like and humic-like features. With increasing amendment rate, the relative contributions of C1–C4 generally increased, whereas that of C5 declined, suggesting a shift from the native soil fluorescence profile toward a more complex DOM composition influenced by compost inputs and subsequent biological transformation. Chrysanthemum height, stem diameter, flower number, and biomass were generally more favorable at amendment rates of 30–40%. The entropy-weighted evaluation yielded the highest overall response score at 30%, while the 35% treatment also maintained a high score. Considering WE-DOM fluorescence characteristics, growing-medium properties, and plant performance together, a volumetric amendment rate of 30–35% represents a relatively favorable range for the tested composted material under the present pot-experiment conditions. Full article

Background: Enterococcus faecalis is the third leading cause of infective endocarditis (IE) and remains the predominant enterococcal species involved in this condition, particularly among older patients with multiple comorbidities and healthcare-associated exposure. Its diagnosis may be challenging because the disease often follows a subacute course and may initially present with atypical extracardiac manifestations. Case presentation: We report the case of a 76-year-old man admitted with a 5-day history of fever, chills, profuse diaphoresis, myalgia, abdominal pain, and progressive confusion. On admission, he was febrile, hypotensive, disoriented, and presented with neck stiffness, a grade IV aortic murmur, suprapubic tenderness, hepatomegaly, and hemorrhagic lesions of the left hand. Initial transthoracic echocardiography did not reveal valvular vegetations. Cerebrospinal fluid analysis showed inflammatory changes with marked granulocytic predominance, whereas the multiplex PCR panel for meningitis/encephalitis pathogens and conventional cerebrospinal fluid cultures remained negative. In contrast, all blood cultures yielded E. faecalis. Repeat cranial computed tomography demonstrated a focal parasagittal frontal lesion involving the rostrum and genu of the corpus callosum, consistent with septic embolic involvement. Transesophageal echocardiography performed on hospital day 5 confirmed aortic valve IE, showing vegetative lesions on all cusps, the largest measuring approximately 8 mm, and severe aortic regurgitation. The clinical course was further complicated by cardiac decompensation and acute inflammatory involvement of the left knee, with synovial fluid analysis demonstrating a neutrophil-predominant inflammatory effusion, although cultures remained sterile. The patient received ampicillin plus vancomycin, followed by ampicillin plus linezolid after vancomycin-associated renal impairment. Follow-up blood cultures became negative after 3 weeks of treatment, but persistent severe aortic valve involvement required referral for cardiac surgical evaluation. The patient was readmitted to the cardiology department and subsequently developed multi-organ system failure, resulting in death one week after discharge. Conclusions: This case highlights the diagnostic complexity of. E. faecalis IE when meningocerebral and osteoarticular manifestations dominate the initial presentation, emphasizing the importance of repeated blood cultures and early transesophageal echocardiography. Full article

Background: Subjective cognitive complaints (SCCs) are common in middle-aged and older adults and may reflect early cognitive changes, alongside alterations in stress, mood, sleep, and quality of life. N-PEP-12 is a peptide-based nutritional supplement with potential neuroprotective effects, but evidence of its benefits in healthy adults with SCCs remains limited. Objective: To evaluate the effects of N-PEP-12 supplementation on attention, cognitive function, and mental wellbeing in healthy middle-aged and older adults with SCCs. Methods: In this prospective, randomized, double-blind, placebo-controlled trial, 276 participants aged 50–75 years with SCCs and no clinically significant cognitive impairment were randomized to placebo, N-PEP-12 45 mg, or N-PEP-12 90 mg. Assessments were performed at baseline and after 30, 90, and 180 days. Primary outcomes included Test of Attentional Performance measures. Secondary outcomes included WAIS-IV Digit Span Forward and Backward, perceived stress, mood, sleep quality, and EQ-5D-5L visual analog scale. Results: Across the three primary attention outcomes analyzed jointly in a multivariate repeated-measures model, there was a significant group-by-visit interaction (p = 0.003) and a significant effect of visit (p < 0.001), without a significant main effect of treatment arm (p = 0.133), indicating a time-dependent treatment effect. This result was obtained in a sensitivity analysis population in which missing values were imputed under assumptions least favorable to the active arms. In exploratory endpoint-specific comparisons at 90 days, both N-PEP-12 groups showed greater improvements than placebo in alertness, attention omissions and memory omissions, and Digit Span Forward and Backward scores also improved. In a subsequent uncontrolled extension phase, in which all participants received active treatment, participants initially assigned to placebo showed comparable improvements after switching to N-PEP-12 90 mg. These observations are exploratory. Adverse events were infrequent and similarly distributed across groups. Conclusions: N-PEP-12 supplementation was associated with improvements in attention, working memory, and mental wellbeing in healthy middle-aged and older adults with subjective cognitive complaints. These findings support further investigation of N-PEP-12 as a nutritional intervention for early subjective cognitive changes associated with aging. Full article

Glucagon-like peptide (GLP)-1 receptor agonists (GLP-1RAs) (including medications that contain GLP-1 and other RAs), hereafter referred to as GLP-1 medicines, have significantly advanced the management of metabolic disease and weight management. Obesity is highly prevalent among cancer survivors at the time of diagnosis, and cancer treatments are associated with subsequent changes in weight, either gain or loss. Research has shown that obesity can adversely affect cancer treatment outcomes and survivorship, leading researchers to investigate the potential integration of GLP-1 medicines into oncology care. There is growing interest in understanding the effects of GLP-1 medicines on weight loss and cancer-related outcomes among individuals with obesity who are taking anticancer therapies, as well as individuals treated for cancer in the past who are long-term survivors. This review examines the literature to characterize what is known about GLP-1 medicine use among cancer survivors. The current literature, though limited and largely retrospective, suggests that GLP-1 medicines may contribute to weight loss among cancer survivors, with outcomes varying by cancer stage and type of anticancer therapy. It is important for healthcare providers to consider the potential negative impact of these GLP-1 medications on their patients, especially those with cancer cachexia or sarcopenic obesity, as well as those undergoing anticancer treatments that often lead to weight loss. While there is preclinical evidence suggesting that there are weight-loss independent effects that may be beneficial to individuals with cancer, use of GLP-1 medicines in patients of normal weight for reasons other than treatment of type 2 diabetes should be initiated with caution. On the positive side, these agents may help mitigate therapy-related toxicities, such as cardiotoxicity, with the potential to enhance survivorship outcomes. Unfortunately, there is a notable lack of well-designed randomized controlled trials evaluating the effects of GLP-1 medicines on weight loss, clinical endpoints, and cancer-related outcomes. Advancing the field requires a focus on elucidating the interactions between GLP-1 medicines and anticancer therapies, particularly their impact on treatment efficacy, nutritional status, and overall patient outcomes, both during treatment and in the long term. Full article

This research study focused on the use of technologies such as high-pressure processing (400 MPa for 15 min, HPP) and enzymatic hydrolysis (with cellulase) to process eucalyptus pulp, subsequently the pulp submitted to carboxymethylation to produce cellulose films and investigate their properties. The results revealed that the combination of HPP and cellulase resulted in the production of partially transparent and smoother films. As for mechanical properties, this combination resulted in a 2.7-fold increase in the tensile strength (TS) value, a 35.5-fold increase in the elongation at break (EAB) value, and a 1.4-fold increase in the moisture content of the films. The crystallinity index (CrI) was also increased by HPP and enzymes, resulting in a 6.6-fold increase, compared to the control film. On the other hand, the combined use of HPP and enzymatic hydrolysis resulted in similar contact angle (CA) values on both sides of the films, but in the bottom side, when compared to the control film, a 2.1-fold decrease was observed. Furthermore, the water vapor permeability (WVP) of the films increased 1.8-fold. Finally, the thermal resistance of the films was slightly reduced when either HPP, enzymatic or both treatments were used on the cellulose pulp. In general, this work showed a new potential way to produce cellulose films with novel and potentially tailor-made properties. Full article

Background/Objectives: Vitamin D deficiency remains common in UVB-constrained, pollution-exposed, sedentary, and ageing populations, yet recent guidelines discourage routine screening and empiric high-dose supplementation in generally healthy adults. This review clarifies the clinical distinction between untargeted population supplementation and monitored repletion of documented deficiency in high-risk individuals. Methods: We conducted a focused narrative review of PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. The focused evidence search supporting the narrative synthesis was completed in June 2026. References published subsequently were included during manuscript preparation only when relevant for contextual purposes and were not incorporated retrospectively into the evidence-selection process underlying the review’s clinical conclusions. Evidence was interpreted according to baseline and achieved 25-hydroxyvitamin D [25(OH)D], dosing schedule, route, body composition, endpoint, and population risk. No formal risk-of-bias assessment, certainty grading, or systematic meta-analytic synthesis was performed. Key Findings: The strongest rationale for vitamin D repletion remains musculoskeletal, particularly for osteomalacia, muscle function, osteoporosis care, and fracture-related vulnerability in deficient or high-risk patients. Management should separate generally healthy adults from patients with an indication for testing or treatment. Historical and regional expert frameworks describe time-limited higher-dose repletion for documented deficiency, but these regimens should not be interpreted as a current universal Endocrine Society treatment standard. Short-term trials using moderate cumulative oral doses suggest broadly comparable biochemical repletion with daily, weekly, or monthly schedules; equivalence has not been established for long-term clinical outcomes, frail populations, or large intermittent doses. Extra-skeletal associations remain less trial-supported. Conclusions: Vitamin D deficiency should be managed using clinically indicated assessment, explicit repletion and maintenance regimens, and selective biochemical reassessment. Targets above conventional skeletal adequacy thresholds remain investigational and should not be applied as universal treatment goals. Full article