Search Results (9,283)

Background: Diabetes mellitus (DM) is a significant factor affecting prognosis and functional capacity in patients after cardiovascular events. This study aimed to assess the impact of coexisting diabetes on exercise tolerance and hemodynamic parameters in patients qualified for cardiac rehabilitation. Methods: A total of 452 patients (86 women, 366 men; mean age 63.21 ± 7.16 years) who had experienced cardiovascular incidents, including 226 individuals with coexisting DM (DM group) and 226 age- (±1 year) and sex-matched individuals without DM (non-DM group), were included in the analysis. All participants underwent an exercise test using a bicycle ergometer. Clinical data, comorbidities, medication use, left ventricular ejection fraction, and exercise test parameters were evaluated. Results: Patients with DM displayed a higher number of comorbidities (4.29 ± 1.26 vs. 3.19 ± 1.30; p < 0.001), greater medication use (8.71 ± 2.16 vs. 7.83 ± 2.05; p < 0.001), higher body mass (86.93 ± 13.35 kg vs. 80.92 ± 15.25 kg; p < 0.001), and a lower left ventricular ejection fraction (48.78 ± 8.99% vs. 50.01 ± 8.40%; p = 0.002) compared to those in the non-DM group. Diabetic patients also exhibited lower exercise capacity, expressed as peak power per kilogram of body mass (1.05 ± 0.27 W/kg vs. 1.16 ± 0.31 W/kg; p < 0.001). No significant differences were observed regarding absolute peak power or maximum heart rate. Conclusions: In patients after cardiovascular incidents, the presence of diabetes is associated with reduced relative exercise capacity and lower ejection fraction. Full article

Invasive candidiasis (IC), characterized by the most common clinical manifestation of candidemia, is a fungal infection with a high mortality rate and a significant impact on global public health. It is estimated that each year there are between 227,000 and 250,000 hospitalizations related to IC, with more than 100,000 associated deaths. In Latin America and the Caribbean (LA&C), the absence of a standardized surveillance system has led to multicenter studies documenting incidences ranging from 0.74 to 6.0 cases per 1000 hospital admissions, equivalent to 50,000–60,000 hospitalizations annually, with mortality rates of up to 60% in certain high-risk groups. Armed conflicts and structural violence in LA&C cause forced displacement, the collapse of health systems, and poor living conditions—such as overcrowding, malnutrition, and lack of sanitation—which increase vulnerability to opportunistic infections, such as IC. Insufficient specialized laboratories, diagnostic technology, and trained personnel impede pathogen identification and delay timely initiation of antifungal therapy. Furthermore, the empirical use of broad-spectrum antibiotics and the limited availability of echinocandins and lipid formulations of amphotericin B have promoted the emergence of resistant non-albicans strains, such as Candida tropicalis, Candida parapsilosis, and, in recent outbreaks, Candidozyma auris. Full article

Background/Objectives: Mumps remains a relevant vaccine-preventable disease globally, especially in settings where immunization coverage fluctuates or vaccine-induced immunity wanes. This study aimed to assess long-term trends in mumps incidence, vaccination coverage, clinical outcomes, and demographic characteristics in the Autonomous Province of Vojvodina (AP Vojvodina), Serbia, over a 47-year period. Methods: We conducted a retrospective observational study using surveillance data from the Institute of Public Health of Vojvodina. Analyses included annual mumps incidence rates (1978–2024), coverage with mumps-containing vaccines (MuCVs; 1986–2024), monthly case counts, and individual-level case data for the 1997–2024 period. Variables analyzed included age, month of notification, gender, vaccination status, presence of clinical complications, and the method used for case confirmation. Results: Following the introduction of MuCV in 1986, the mumps incidence markedly declined, with limited resurgences in 2000, 2009, and 2012. Between 1997 and 2024, a total of 1358 cases were reported, with 62.7% occurring in males. Over time, the age distribution shifted, with adolescents and young adults being increasingly affected during the later (2011–2024) observed period. In 2012, the highest age-specific incidence was observed among individuals aged 10–19 and 20–39 years (49.1 and 45.5 per 100,000, respectively). Vaccination coverage for both MuCV doses was suboptimal in several years. The proportion of unvaccinated cases decreased over time, while the proportion with unknown vaccination status increased. Mumps-related complications—such as orchitis, pancreatitis, and meningitis—were rare and predominantly affected unvaccinated individuals: 84.2% of orchitis, 40.0% of pancreatitis, and all meningitis cases. Only two pancreatitis cases (40.0%) were reported after one MMR dose, while fully vaccinated individuals (two doses) had one orchitis case (5.3%) and no other complications. Laboratory confirmation was applied more consistently from 2009 onward, with 49.6% of cases confirmed that year (58 out of 117), and, in several years after 2020, only laboratory-confirmed cases were reported, indicating improved diagnostic capacity. Conclusions: Despite substantial progress in controlling mumps, gaps in vaccine coverage, waning immunity, and incomplete vaccination records continue to pose a risk for mumps transmission. Strengthening routine immunization, ensuring high two-dose MuCV coverage, improving vaccination record keeping, and enhancing laboratory-based case confirmation are critical. Consideration should be given to booster doses in high-risk populations and to conducting a seroepidemiological study to estimate the susceptible population for mumps in AP Vojvodina. Full article

Colorectal cancer (CRC) constitutes a major global health concern, ranking as the third most common cancer and the second leading cause of cancer-related mortality. The current review explores sex-based differences in CRC epidemiology, risk factors, tumor biology, and clinical outcomes. Males exhibit a higher incidence and mortality rate, with left-sided (distal) CRC predominating, while females are more frequently diagnosed with right-sided (proximal) tumors, which tend to be more aggressive and less responsive to conventional chemotherapy. Genetic disparities, including microsatellite instability and X-chromosome tumor suppressor genes, contribute to sex-specific differences in tumor progression and treatment response. Immune variations also influence disease outcomes, with females exhibiting stronger immune surveillance but higher exhaustion markers. Lifestyle factors such as body mass index (BMI), smoking, and hormonal influences further modulate CRC risk. While males are more vulnerable to obesity-related CRC, central obesity (waist-to-hip ratio) emerges as a stronger predictor in females. Additionally, smoking increases CRC risk differentially by tumor location. These findings underscore the importance of sex-specific approaches in CRC prevention, screening, and treatment, advocating for personalized medicine strategies tailored to gender-based biological and clinical distinctions. Full article

This comprehensive review examines the role of septoplasty in the pediatric population, emphasizing its therapeutic significance in relieving nasal obstruction and facilitating normal craniofacial growth. Despite the evident advantages of septoplasty, its application in young patients remains a subject of ongoing debate. This issue is primarily characterized by concerns regarding the still-developing immaturity of nasal cartilage, potential intraoperative and postoperative risks, and the current absence of robust data on long-term outcomes following septoplasty. Common complications such as bleeding, septal perforation, saddle nose deformity, and persistent nasal obstruction are reported in the literature; however, many studies lack long-term follow-up data on the incidence of these adverse events and revision rates, which may be higher compared to adult populations, often leading to the need for secondary surgical interventions. Strict inclusion criteria and comprehensive patient selection are paramount to maximize therapeutic success while minimizing complications. Current evidence suggests that appropriately indicated septoplasty can improve airway patency, support optimal facial development, and reduce the risk of secondary sinonasal pathology. There is a significant necessity for additional prospective, large-scale studies to establish standardized therapeutic guidelines and management strategies for this specific population, thereby ensuring effective and evidence-based pediatric otolaryngologic care. Full article

Background: RSV remains a leading cause of infant hospitalization worldwide, and the recently approved nirsevimab could represent an effective and safe prophylactic strategy to prevent severe infections in the general neonatal population. Objectives: We conducted a retrospective observational monocentric pilot study in a mixed preterm/term birth cohort to add real-world evidence of the efficacy and safety of nirsevimab in preventing severe RSV infection. Methods: We included a total of 2035 consecutive infants admitted to the Neonatal Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy, from November 2024 to April 2025. We evaluated 30-day safety profiles and season-wide RSV infection rates, and the outcomes were also compared to newborns’ birth rate in the two previous seasons (2022–2023 and 2023–2024). Results: After the introduction of nirsevimab, a lower RSV infection rate was reported compared to previous seasons, and no adverse effects were observed. Compared to previous seasons, the clinical outcomes were more favorable, as only one unvaccinated neonate with RSV infection required invasive ventilation. Conclusions: In this real-world analysis, we demonstrated a good short-term safety profile of nirsevimab, as well as a potentially high efficacy in the general neonatal population with lower RSV infection incidence. However, future studies are needed to better assess its long-term safety and season-wide efficacy. Full article

Background/Objectives: The increasing incidence rates of keratinocyte carcinoma (KC), particularly in fair-skinned populations, call for efforts to intensify health education of the general population in addressing this prevalent skin cancer type. As a preparatory step, this systematic review summarizes the published research on the knowledge and risk perception regarding KC among individuals without medical training. Methods: The review was registered in PROSPERO (CRD42024618851) and adheres to PRISMA guidelines. The databases PubMed, Scopus, Web of Science, PsycArticles, and PsycINFO were searched on 30 July 2024. Studies were eligible if knowledge and/or risk perception was assessed in lay people. Risk of bias (ROB) was assessed with the Joanna Briggs Institute checklist for prevalence studies. Comparable outcomes (e.g., awareness of terms for KC) were meta-analyzed. Results: Included reports (n = 17) were published between 1991 and 2024 with 16,728 individuals assessed. Awareness for the most common type of KC, basal cell carcinoma (BCC), was low (20.75% of respondents (95% confidence interval (CI): 15.24–27.61)), while more respondents were familiar with colloquial terms (60.9–72.8%). Meta-analysis indicated an underestimation of the frequency of KC, with only 7.21% (CI: 4.03–12.58) identifying BCC as the most common type of skin cancer. Furthermore, concern about developing KC as assessed in only two overlapping studies was reported by only 25–30% of respondents, indicating a significant gap in risk awareness and a lack of research on risk perception regarding KC. Conclusions: This review highlights the need for targeted health education interventions to improve knowledge and preventive behaviors regarding KC. Given the limitations of the included studies, characterized by high ROB, heterogeneity of results, and a lack of standardized assessment tools, further research is essential to enhance the understanding and awareness of KC in diverse populations. Full article

Early weaning of piglets elicits weaning stress, which in turn induces oxidative stress and consequently impairs growth and development. Hydrogen-rich water (HRW), characterized by selective antioxidant properties, mitigates oxidative stress damage and serves as an ideal intervention. This study aimed to evaluate the effects of HRW on weaned piglets, specifically investigating its impact on growth performance, diarrhea incidence, antioxidant function, intestinal morphology, gut microbiota, and hepatic metabolites. The results demonstrate that HRW significantly increased the average daily feed intake and significantly reduced the diarrhea rate in weaned piglets. Analysis of serum oxidative stress indicators revealed that HRW significantly elevated the activities of total antioxidant capacity and total superoxide dismutase while significantly decreasing malondialdehyde concentration. Assessment of intestinal morphology showed that HRW significantly increased the villus height to crypt depth ratio in the duodenum, jejunum, and ileum. Microbial analysis indicated that HRW significantly increased the abundance of Prevotella in the colon. Furthermore, HRW increased the abundance of beneficial bacteria, such as Akkermansia, in the jejunum and cecum, while concurrently reducing the abundance of harmful bacteria like Escherichia. Hepatic metabolite profiling revealed that HRW significantly altered the metabolite composition in the liver of weaned piglets. Differentially abundant metabolites were enriched in oxidative stress-related KEGG pathways, including ABC transporters; pyruvate metabolism; autophagy; FoxO signaling pathway; glutathione metabolism; ferroptosis; and AMPK signaling pathways. In conclusion, HRW alleviates diarrhea and promotes growth in weaned piglets by enhancing antioxidant capacity. These findings provide a scientific foundation for the application of HRW in swine production and serve as a reference for further exploration into the mechanisms underlying HRW’s effects on animal health and productivity. Full article

X-ray and EUV solar flare emission cause increases in the Earth’s dayside ionospheric electron density. While the response of the lower ionosphere to X-rays is well studied, the delay between EUV flare emission and the response of the ionospheric F-region has not been investigated. Here, we calculate the delays between incident He II 304 Å emission, and the TEC response for 10 powerful solar flares, all of which exhibit delays under 1 min. We assess these delays in relation to multiple solar and geophysical factors, and find a strong negative correlation (∼−0.85) between delay and He II flux change and a moderate negative correlation (∼−0.55) with rate of increase in He II flux. Additionally, flare magnitude and the X-ray-to-He II flux ratio at peak He II emission show strong negative correlations with delay (∼−0.80 and ∼−0.75, respectively). We also identify longer delays for flares occurring closer to the summer solstice. These results may have applications in upper-ionospheric recombination rate calculations, atmospheric modelling, and other solar–terrestrial studies. We highlight the importance of incident EUV and X-ray flux parameters on the response time of the ionospheric electron content, and these findings may also have implications for mitigating disruptions in communication and navigation systems. Full article

According to the Transportation Safety Board of Canada, between 2013 and 2023, 62% of aviation accidents occurred during the approach, landing, and post-impact phases of flight. Hence, this study targets factors contributing to increased accident rates during the final stages of flight. It will review how pilot experience influences decision-making and identifies mitigation strategies, focusing on go-arounds to prevent accidents during these critical phases. Surveys and roundtable discussions were conducted to identify factors influencing pilot performance during approach, landing, and go-around manoeuvres. By using a mixed-methods approach that combined thematic and statistical analyses, key safety factors were identified, including situational awareness, decision-making, and operational complexity. The study also examined the relationship between experience and decision-making, highlighting areas for targeted interventions to improve safety. The research emphasises the importance of integrating decision-making considerations into training programmes and connecting these to human factors. Through identifying areas for improvement, this study offers a safety-driven framework to address decision-making challenges during approach, landing, and go-around phases, with the objective of reducing accident and incident rates in general aviation. Full article

To improve the postharvest preservation of cherry tomatoes and combat pathogenic, both bacterial and fungal contamination (particularly Alternaria alternata), a novel biodegradable coating was developed based on a water-in-water (W/W) Pickering emulsion system. The emulsion was stabilized by L. plantarum (Lactobacillus plantarum), with maltodextrin (MD) as the dispersed phase and hydroxypropyl methylcellulose (HPMC) as the continuous phase. Characterization of emulsions at varying concentrations revealed that the optimized W/W-PL^8 film exhibited superior stability, smooth morphology, and low water vapor permeability (WVP = 220.437 g/(m²·24 h)), making it a promising candidate for fruit and vegetable preservation. Furthermore, the coating demonstrated strong antioxidant activity, with scavenging rates of 58.99% (ABTS) and 94.23% (DPPH), along with potent antimicrobial effects, showing inhibition rates of 12.8% against Escherichia coli and 23.7% against Staphylococcus aureus. Applied to cherry tomatoes, the W/W-PL^8 coating significantly reduced respiration rates, minimized decay incidence, and maintained nutritional quality during storage. Remarkably, the coating successfully controlled Alternaria alternata contamination, enhancing the storage duration of cherry tomatoes. These findings highlight the potential of W/W-PL^8 as an eco-friendly and functional packaging material for fresh produce preservation. Full article

Cancer is a major global health issue, with rising incidence rates highlighting the urgent need for more effective treatments. Despite advances in cancer therapy, challenges such as adverse effects and limitations of existing treatments remain. Immunotherapy, which harnesses the body’s immune system to target cancer cells, offers promising solutions. Gamma delta (γδ) T cells are noteworthy due to their potent ability to kill various cancer cells without needing conventional antigen presentation. Recent studies have focused on the role of γδ T cells in α-galactosylceramide (α-GalCer)-mediated immunity, opening new possibilities for cancer immunotherapy. We engineered humanized T cell receptor (HuTCR)-T1 γδ mice by replacing mouse sequences with human counterparts. This study investigates the cytotoxic activity of humanized γδ T cells against several human cancer cell lines (A431, HT-29, K562, and Daudi) in vitro, aiming to elucidate mechanisms underlying their anticancer efficacy. Human cancer cells were co-cultured with humanized γδ T cells, with and without α-GalCer, for 24 h. The humanized γδ T cells showed enhanced cytotoxicity across all tested cancer cell lines compared to wild-type γδ T cells. Additionally, γδ T cells from HuTCR-T1 mice exhibited higher levels of anticancer cytokines (IFN-γ, TNF-α, and IL-17) and Granzyme B, indicating their potential as potent mediators of anticancer immune responses. Blocking γδ T cells’ cytotoxicity confirmed their γδ-mediated function. These findings represent a significant step in preclinical development of γδ T cell-based cancer immunotherapies, providing insights into their mechanisms of action, optimization of therapeutic strategies, and identification of predictive biomarkers for clinical application. Full article

Background/Objectives: Vitamin D testing has increased significantly in developed countries in recent decades. We aimed to describe trends in vitamin D testing rates and factors associated with testing and vitamin D deficiency in Queensland, Australia (2011–2019). Methods: We used data from the QSkin Sun and Health Study (n = 40,417), a prospective population-based cohort study with linkage to the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, and pathology laboratories. Main outcomes included age-standardized incidence rate of vitamin D testing; having ≥1 vitamin D test during follow-up; vitamin D deficiency (25-hydroxyvitamin D concentration <50 nmol/L) in the first vitamin D test; and repeat vitamin D tests. Results: The age-standardized incidence rate of testing increased by 2% per quarter during follow-up. Of the 35,250 participants analyzed for associations with testing (median age of 57 years, 52% female), 45% had ≥1 vitamin D test. Among those tested, 56% had no apparent clinical indication for their initial vitamin D test, 21% were vitamin D deficient in their initial test, and 58% had a repeat test. Repeat testing occurred in 56% who were not deficient in their prior test, while only two-thirds of those deficient received a follow-up assessment. Participants who visited a general practitioner ≥2 times in the year prior to follow-up were 60% more likely to have ≥1 vitamin D test compared with those with no visit, but general practitioner (GP) visits were not associated with risk of vitamin D deficiency. Conclusions: These results suggest that initiatives are needed to help clinicians target vitamin D testing in alignment with clinical guidelines. Full article

Metamaterial absorbers in terahertz (THz) based bands have garnered significant attention for their potential applications in military stealth, terahertz imaging, and other fields. Nevertheless, the limited bandwidth, low absorption rate, and heavy weight greatly reduce the further development and wide application of terahertz absorbers. To solve these problems, we propose a polystyrene (PS)-based ultra-broadband metamaterial absorber integrated with a polyethylene terephthalate (PET) double-sided adhesive layer and a patterned indium tin oxide (ITO) film through the simulation method, which operates in the THz band. The electromagnetic wave absorption properties and underlying physical absorption mechanisms of the proposed metamaterial absorbers are comprehensively modeled and rigorously numerically simulated. The research demonstrates the metamaterial absorber can achieve absorption performance of over 90% for fully polarized incident waves in the ultra-wideband range of 1.2–10 THz, especially achieving perfect absorption characteristics of over 99.9% near 1.8–1.9 THz and 5.8–6.2 THz. The proposed absorber has a lightweight physical property of 0.7 kg/m² and polarization-insensitive characteristic, and it achieves a broad-angle that allows a range of incidence angles up to 60°. The simulation research results of this article provide theoretical support for the design of terahertz absorbers with ultra-wideband absorption characteristics. Full article

The high incidence of melanoma leading to a poor prognosis rate endorses the development of alternative and innovative approaches in the treatment of melanoma. Therefore, the present study aims to develop and characterize, in terms of physicochemical features and biological impact, an aqueous suspension of magnetite (Fe₃O₄) coated with β-cyclodextrin (Fe₃O₄@β-CD) as a potential innovative alternative nanosystem for melanoma therapy. The nanosystem exhibited physicochemical characteristics suitable for biological applications, revealing a successful complexation of Fe₃O₄ NPs with β-CD and an average size of 18.1 ± 2.1 nm. In addition, the in vitro evaluations revealed that the newly developed nanosystem presented high biocompatibility on a human keratinocyte (HaCaT) monolayer and selective antiproliferative activity on amelanotic human melanoma (A375) cells, inducing early apoptosis features when concentrations of 10, 15, and 20 μg/mL were employed for 48 h and 72 h. Collectively, the Fe₃O₄@β-CD nanosystem reveals promising features for an adjuvant approach in melanoma treatment, mainly due to its β-cyclodextrin coating, thus endorsing a potential co-loading of therapeutic drugs. Furthermore, the intrinsic magnetic core of Fe₃O₄ NPs supports the magnetically based cancer treatment strategies. Full article