Search Results (5,392)

Objectives: This study aimed to assess the incidence, nature, and clinical relevance of medication discrepancies identified during the perioperative period in polymedicated surgical patients, and to examine factors associated with the occurrence of real discrepancies. Methods: A cross-sectional study was conducted in scheduled surgical patients admitted to the General Surgery department of a tertiary-care hospital. Eligible adults were required to be taking ≥4 chronic medications, have restored oral tolerance, and remain hospitalized for more than 48 h. Medication reconciliation was performed using hospital and primary care electronic records, complemented by a structured patient interview. Discrepancies were classified as justified or real according to SEFH criteria. Statistical analysis included descriptive methods, normality testing, correlation analyses, and generalized linear models. Results: Out of 270 assessed patients, 43 met inclusion criteria. A total of 282 medications were analyzed, with 243 (86%) showing discrepancies. 44% were real discrepancies, primarily due to unjustified omission. The average number of real discrepancies per patient was 5.7 (95% CI: 4.8–6.5). Cardiovascular (35.2%) and nervous system drugs (23.2%) were most affected. Real discrepancies with potential clinical severity accounted for 36.8%, including cases of asthma exacerbation, withdrawal syndromes, insomnia, and hypertensive crises. In 73% of pre-anesthesia reports, no specific recommendations regarding chronic medication management were provided. Conclusions: Medication reconciliation revealed frequent and clinically relevant discrepancies in this high-risk cohort of polymedicated surgical patients. Larger, more representative studies are needed to confirm these findings and to inform broader perioperative safety strategies. Full article

Weissella viridescens has been proposed as a probiotic candidate, but strain-level multi-omics evidence remains limited. The complete genome of the human-derived W. viridescens strain Wv2365 was sequenced through a hybrid assembly of Illumina and PacBio sequencing reads and compared with eight publicly available W. viridescens genomes. Pangenome analysis and functional annotation were performed, and metabolites were profiled by broadly targeted metabolomic analysis. In addition, the acid and bile tolerance, auto-aggregation and cell surface hydrophobicity, and antioxidant activity of the strain, as well as both in silico and phenotypic safety, were assessed. Wv2365 carries a single chromosome of 1.57 Mb with 41.3% G+C content. The species has an open pangenome with 803 core genes. Genomic and metabolomic features converged on carbohydrate and amino acid metabolism, including glycolysis/tricarboxylic acid (TCA) cycle and arginine pathways, and a carbohydrate-active enzyme (CAZyme) repertoire dominated by glycosyltransferases. In vitro, Wv2365 tolerated pH 3.0 and 0.3% bile, showed auto-aggregation, surface hydrophobicity, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) and hydroxyl radical scavenging. The strain was susceptible to 10 antibiotics tested except for its intrinsic vancomycin non-susceptibility and was non-hemolytic and gelatinase negative. No acquired antimicrobial resistance or virulence genes were found in the genome. These findings indicate that W. viridescens Wv2365 is safe with probiotic traits relevant to gastrointestinal survival, colonization, and redox balance. Full article

The vegetative mycelium of Pleurotus ostreatus (oyster mushroom) exhibits the ability to reduce nematode populations. This property may be utilized in integrated management programs targeting harmful nematodes such as Heterodera schachtii, a major pest of sugar beet crops. In addition to sugar beet, many other plant species serve as hosts for this nematode; susceptible plants promote H. schachtii development and population growth. Current control strategies rely on integrated plant protection methods, including the use of tolerant cultivars, fallowing, and trap crops such as oilseed radish and white mustard. This study aimed to determine whether sugar beet cv. Janetka or nematocidal plants—oilseed radish cv. Romesa and white mustard cv. Bardena—affect the nematocidal activity of P. ostreatus mycelium when applied together. Specifically, the influence of root or seed secretions from these plants on the activity of ten P. ostreatus mycelial strains was assessed using the model nematode Caenorhabditis elegans and the target pest H. schachtii. Experiments were conducted under laboratory conditions on water agar media colonized by P. ostreatus mycelium. Seeds or root exudates of the tested plants were applied to the mycelial surface. Following incubation, nematode mobility (C. elegans) and cyst entwining by the mycelium (H. schachtii) were evaluated, along with the ability of the mycelium to produce toxocysts. The results indicate that trap plants did not significantly alter the nematocidal activity of the mycelium. However, certain mycelial strains were slightly stimulated by seed diffusates or root exudates. Oilseed radish moderately influenced the nematocidal activity of four mycelial strains against C. elegans, whereas in the case of H. schachtii, similar effects were observed with white mustard. The mycelial elimination of H. schachtii occurred through cyst entwining, which was generally more effective in the presence of plant exudates. Overall, the findings demonstrate that incorporating trap crops such as oilseed radish cv. Romesa or white mustard cv. Bardena, as green manure in crop rotation systems, does not interfere with the nematocidal activity of P. ostreatus mycelium and simultaneously may enrich the soil with nutrients. The study further confirms that P. ostreatus maintains its ability to effectively entwine and eliminate H. schachtii cysts even in the presence of sugar beet, supporting its potential role as a biological control agent. To our knowledge, this is the first experiment that integrates the activities of trap plants and sugar beet with the nematocidal effects of P. ostreatus mycelium. Full article

This study assessed the effect of slicer-made interlocking joints on 3D printed sandwich panels manufactured through fused filament fabrication (FFF) in terms of flexural properties and energy absorption. Composites were prepared with thermoplastic polyurethane (TPU) as the core material and polyamide (PA), polylactic acid (PLA), polyethylene terephthalate (PET) as skin materials for each of the three composites, respectively. In order to assess the implications of internal geometry, 3D printing was done on five infill topologies (Cross-3D, Grid, Gyroid, Line and Honeycomb) at 20% density. All samples had 20% core density and underwent three point bending testing for flexural testing. It was noted that the Grid and Gyroid cores had the best performance in terms of maximum load capacity based on stretch-dominated behavior while Cross-3D and Honeycomb had lower strengths but stable moments during the bending process. Since Cross-3D topology offered the lowest deflection, it was selected for further experiments with slicer added interlocks at the face–core interface. This study revealed the most notable improvements as gains of up to 15% in peak load, 48% in maximum deflection, and 51% in energy absorption compared with the non-interlocked designs. The PET/TPU interlocked demonstrated the best performance in terms of the energy absorption (2.45 J/mm³) and peak load (272.6 N). In contrast, the PA/TPU interlocked exhibited the best flexibility and ductility with a mid-span deformation of 21.34 mm. These results confirm that slicer-generated interlocking interfaces lead to better load capacity and energy dissipation, providing a lightweight, damage-tolerant design approach for additively manufactured sandwich beams. Full article

Dipeptidyl peptidase-4 (DPP-4) is a protease that degrades incretin and inhibits the secretion of insulin. Consequently, DPP-4 inhibition promotes insulin secretion and prevents the onset of type 2 diabetes. Given the growing interest in food-derived DPP-4 inhibitory peptides as potential functional ingredients, buckwheat (Fagopyrum esculentum) represents a promising source; however, few studies have investigated the bioactivity of peptides derived from buckwheat flour hydrolysates. In this study, two DPP-4 inhibitory peptides, Ile-Pro-Trp and Ile-Pro-Leu, were identified through purification of buckwheat flour hydrolysate and liquid chromatography–tandem mass spectrometry analysis. In a rat oral glucose tolerance test (OGTT), a fraction of buckwheat flour hydrolysate, crudely purified by reverse-phase column chromatography, showed a non-significant trend toward reducing increases in blood glucose. To our knowledge, this study is the first to show that Ile-Pro-Trp isolated from food protein hydrolysates exhibits considerable DPP-4 inhibitory activity. Moreover, this is the first study identifying Ile-Pro-Ile as a DPP-4 inhibitor from a plant source. Full article

Vitamin B1 (thiamine) is a water-soluble B vitamin. As a cofactor of many enzymes, it is essential for the proper functioning of many body systems and organs, including metabolic and energy metabolism. In extreme cases, vitamin B1 deficiency causes neurodegenerative disorders, including beri-beri, or cognitive impairment resulting from encephalopathy. B1 avitaminosis may result from increased demand, dietary errors, malabsorption, or excessive loss. Thiamine supplementation is used in cases of vitamin B1 deficiency or for preventative measures in situations of increased demand. Vitamin B1 can be administered enterally or parenterally (intravenously, intramuscularly, subcutaneously). The route and dose depend on the individual patient’s clinical situation. Hypersensitivity to vitamin B1 is rare and appears to be primarily associated with rapid intravenous infusion of large doses of thiamine hydrochloride over a short period (intravenous bolus). Hypersensitivity to thiamine administered by routes other than intravenous or intramuscular injection appears to be an incidental phenomenon. Thiamine should also be considered as an occupational allergen. The mechanism of thiamine hypersensitivity has not been clearly elucidated. However, considering the clinical nature and dynamics of the reaction, the most likely reaction seems to be an immediate type of hypersensitivity reaction (immunoglobulin E (IgE)-dependent), in which thiamine (but not its metabolites) acts as a hapten. Diagnosing hypersensitivity to vitamin B1 is difficult due to the lack of validated tests for additional testing. In individuals requiring thiamine supplementation who have experienced hypersensitivity to intramuscular or intravenous administration of this vitamin, switching to oral administration may be considered (provided this does not reduce treatment efficacy). This form of supplementation is usually well tolerated by individuals allergic to parenteral thiamine. However, if enteral supplementation does not guarantee the maintenance of therapeutic potential, thiamine desensitization may be considered, which seems to be an effective therapeutic method in such a clinical situation. Full article

Background and Objectives: Japan’s aging population faces growing challenges related to oral frailty, a condition characterized by the decline of oral function associated with physical and nutritional deterioration. Impaired oral function contributes to reduced chewing, swallowing, and saliva secretion, leading to poor appetite and frailty progression. Ninjin’yoeito (NYT), a traditional Kampo formula, has been clinically used to improve systemic weakness and oral symptoms. This study aimed to evaluate the efficacy and safety of NYT in improving oral health among elderly individuals with impaired oral function. Materials and Methods: In this open-label prospective study, patients received NYT daily for 12 weeks. Assessments included oral symptom scores, mucosal moisture, repetitive saliva swallowing tests (RSST), gustatory function by visual analogue scale (VAS), an 11-item oral questionnaire, and immune profiling by flow cytometry. Safety was assessed through hematological and biochemical tests. Results: Symptom scores decreased from 8.27 at baseline to 3.64 at 12 weeks (p = 0.006), while oral condition scores improved from 5.09 to 1.36 (p = 0.006). Mucosal moisture increased (25.1 to 28.1, p = 0.03), and RSST frequency improved (2.18 to 4.55, p = 0.046). Questionnaire scores declined from 5.1 to 2.0 (p < 0.001). VAS-taste was unchanged overall (p = 0.21) but improved in low baseline patients. Laboratory findings showed no adverse changes, with favorable lipid trends. Immune analysis revealed a decline in NKG2D expression (p = 0.02), whereas other activating and inhibitory markers remained stable. Conclusions: NYT was well tolerated and associated with gradual improvements in oral and physical symptoms among elderly individuals with impaired oral function. These findings provide preliminary evidence supporting the feasibility of Kampo-based approaches for maintaining oral health in aging populations and warrant further validation in larger controlled trials. Full article

Glycyrrhiza glabra L. is an economically significant plant that naturally grows in arid regions and is widely used in the cosmetics, food, and pharmaceutical industries. Its roots are the economically important part. However, it has weak drought tolerance during the seedling stage, and water scarcity has become a major limiting factor for improving the yield and quality of cultivated licorice. Therefore, this study conducted a pot experiment in which melatonin was applied via root irrigation to examine its effects on alleviating drought stress in G. glabra seedlings and on enhancing the yield and quality of its valuable parts. The results showed that under drought conditions, applying 100 μM melatonin yielded the most significant improvements in both yield and quality. Specifically, melatonin treatment increased root biomass by 138.10% and significantly boosted the levels of key bioactive compounds, including glycyrrhizic acid, liquiritin, glabridin, liquiritigenin, and isoliquiritigenin by 60.51%, 72.08%, 182.03%, 83.86%,and 30.68%, respectively. This study uniquely combined the Mantel test and random forest modeling for a comprehensive analysis of the experimental data. The analysis indicated that these effects were attributable to exogenous melatonin, which markedly enhanced antioxidant enzyme activities in G. glabra seedlings and reduced membrane lipid peroxidation products, thereby strengthening their antioxidant defense capabilities. Additionally, melatonin promoted the accumulation of osmotic adjustment substances and effectively improved photosynthetic performance. Our research provides a scientific basis for increasing both the quality and yield of G. glabra under drought conditions. Full article

Background: Early prediction of gestational diabetes mellitus (GDM) remains a major clinical challenge, and the current oral glucose tolerance test (OGTT) is time-consuming and inconvenient for clinical routine. This study aimed to develop a novel predictive model for postprandial hyperglycemia GDM (pp-GDM) and postprandial glucose elevation using fasting serological and metabolic profiles. Method: We used High-Performance Liquid Chromatography-Mass Spectrometry (HPLC-MS) to analyze fasting plasma amino acid profiles at 24–28 weeks of gestation for 60 pp-GDM patients and 120 controls. Binary logistic regression model was constructed to identify potential biomarkers for pp-GDM prediction. Results: By incorporating amino acid indicators such as isoleucine, phenylalanine, threonine, and aspartate into the predictive model alongside traditional predictors (including BMI at sampling, fasting insulin, glycated hemoglobin, and uric acid), the overall predictive performance was significantly improved from 78.2% to 91.1%. A clinically practical nomogram for risk assessment was subsequently developed. Conclusions: This fasting metabolite-based model provides a reliable tool for early prediction of pp-GDM and postprandial hyperglycemia, which may reduce the need for OGTT and facilitate timely clinical decision making. Full article

Background: Recovery following incomplete spinal cord injury (iSCI) remains challenging, with conventional rehabilitation often emphasizing compensation over functional restoration. As most new spinal cord injury cases preserve some motor or sensory pathways, there is increasing interest in therapies that harness neuroplasticity. Robotic exoskeletons provide a promising means to deliver task-specific, repetitive gait training that may promote adaptive neural reorganization. This feasibility study investigates the feasibility, safety, and short-term effects of exoskeleton-assisted walking in individuals with degenerative iSCI. Methods: Two cooperative male patients (patients A and B) with degenerative iSCI (AIS C, neurological level L1) participated in a four-week intervention consisting of one hour of neuromotor physiotherapy followed by one hour of exoskeleton-assisted gait training, three times per week. Functional performance was assessed using the 10-Meter Walk Test, while gait quality was examined through spatiotemporal gait analysis. Vendor-generated surface electromyography (sEMG) plots were available only for qualitative description. Results: Patient A demonstrated a clinically meaningful increase in walking speed (+0.15 m/s). Spatiotemporal parameters showed mixed and non-uniform changes, including longer cycle, stance, and swing times, which reflect a slower stepping pattern rather than improved efficiency or coordination. Patient B showed a stable walking speed (+0.03 m/s) and persistent gait asymmetries. Qualitative sEMG plots are presented descriptively but cannot support interpretations of muscle recruitment patterns or neuromuscular changes. Conclusions: In this exploratory study, exoskeleton-assisted gait training was feasible and well tolerated when combined with conventional physiotherapy. However, observed changes were heterogeneous and do not allow causal or mechanistic interpretation related to neuromuscular control, muscle recruitment, or device-specific effects. These findings highlight substantial inter-individual variability and underscore the need for larger controlled studies to identify predictors of response and optimize rehabilitation protocols. Full article

Membranous nephropathy (MN) is an immune complex-mediated glomerular disease defined by sub-epithelial deposits that trigger complement activation and podocyte injury. Its pathogenesis reflects loss of immune tolerance and may present as a kidney-limited autoimmune process or in association with underlying conditions (e.g., malignancy, infection, drugs, or systemic autoimmunity). Current diagnostic work-up integrates circulating antibodies—most commonly anti–phospholipase A2 receptor 1 (PLA2R1)—and kidney biopsy, which remains essential in PLA2R1-negative or atypical presentations and for antigen confirmation when serology is negative. In PLA2R1-negative MN, an expanding list of antigens is being recognized, potentially refining phenotyping and risk assessment; however, dedicated studies remain limited, and the clinical weight of many newly described antigens likely requires further validation before supporting an antigen-based classification. Uneven access to advanced diagnostics particularly affects PLA2R1-negative cases, underscoring the need for centralized testing and the development of reliable non-invasive biomarkers. Treatment has advanced with rituximab and other targeted therapies, but resistant and relapsing cases remain challenging, and the evidence base for PLA2R1-negative forms is comparatively limited. This review summarizes recent diagnostic and therapeutic advances, focusing on PLA2R1-negative MN. Full article

This study evaluates the impact of high ambient temperature (HT) on milk production in Tunisian local goats using both fixed and random regression models with quadratic and cubic Legendre polynomials. Daily minimum (Tmin), maximum (Tmax), and average (Tavg) temperatures were tested as heat load indicators, measured on the milking day and averaged over the 1–3 preceding days. The deviance information criterion (DIC) consistently showed that models including temperature effects provided a better fit than a baseline model without heat load. Cubic polynomials showed superior accuracy compared with quadratic models, even if the differences were relatively small. The best model was obtained with Tavg on the milking day, followed closely by Tmax averaged across one or two preceding days. The population response showed a thermoneutral plateau at lower temperatures, followed by declines beyond the HT thresholds. For Tmax, moderate and severe thresholds were detected at 20–23 °C and 25–27 °C, respectively, while for Tavg, thresholds occurred at 11–13 °C and 16–19 °C. Milk losses ranged from 22 to 85 g/°C depending on the temperature indicator, representing an average 4–5% decline in daily yield per degree above thermoneutrality. High variability in individual responses was observed. Some goats maintained stable production, while others showed steep declines under HT, with slope differences reaching over 150 g/°C. Correlations of milk yield across contrasting thermal environments were low, indicating that animal ranking changes with temperature. High-producing goats are more affected by heat, showing the need for a balance between production and heat tolerance. Full article

The application of volumetric modular construction using Cross-Laminated Timber (CLT) has emerged as a sustainable and efficient alternative to traditional building methods, especially in residential and mid-rise structures. However, the widespread adoption of this technology remains limited due to the lack of standardized inter-modular connection systems. This paper presents a comprehensive state-of-the-art review of inter-modular connections used in volumetric CLT modular buildings. This review aims to evaluate the inter-modular connections by developing performance objectives and identifying gaps in knowledge of volumetric CLT inter-modular connections. It begins with an overview of global CLT modular construction trends, highlighting geographic distribution, structural demands, and environmental hazards such as seismic and wind exposure. Seven representative connection systems were identified from the literature and assessed using a multi-criteria framework comprising structural performance, manufacturing feasibility, on-site construction efficiency, and experimental and numerical evaluation. Each connection was scored according to defined evaluation metrics, and the results were provided to identify key strengths and limitations. The top-performing systems demonstrated superior resilience, modular adaptability, and validation through experimental testing and simulation. The paper identified critical research gaps, including limited performance data available for seismic applications, challenges in disassembly and reuse specifications, and the need for adaptable, damage-tolerant systems to enhance building structural performance. These findings provide a reference evaluation methodology for future development of inter-modular connections, to expand the applicability of volumetric CLT modular construction in moderate and high seismic and wind hazard regions. Full article

In our previous work, we reported for the first time the presence of enterocin-encoding genes in novel Lacticaseibacillus paracasei (L. paracasei) and Levilactobacillus brevis (Lev. brevis) strains isolated from artisanal dairy products made from raw cow milk. The aim of this study was to isolate enterocin-positive lactic acid bacteria (LAB) from artisanal dairy products and assess their technological characteristics and safety for potential application in food systems. LAB isolates were characterized using phenotypic tests, Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) identification, and PCR detection of enterocin genes, followed by evaluation of their physiological and technological properties and a comprehensive safety assessment, including antimicrobial resistance, virulence, biogenic amine, and integron genes. Two strains, L. paracasei S2 and Lev. brevis S62, carried enterocin genes (entAS-48 and entQ) and exhibited strong acidifying and proteolytic activities, along with antibacterial effects against foodborne pathogens and reference strains. Both isolates tolerated environmental stresses, including low pH, and lacked virulence factors, clinically relevant antibiotic resistance genes, biogenic amine production, and integron elements. These results indicate that the strains are safe, multifunctional, and suitable for developing regionally adapted dairy products, highlighting artisanal dairy products as a valuable source of novel LAB with promising biotechnological applications. Full article

This study examines the occurrence of bacteria resistant to antibiotics and heavy metals in Terra Nova Bay, a coastal area of the Ross Sea in Antarctica that is increasingly recognised as vulnerable to human influence. During the 37th Italian Antarctic Expedition (2021–2022), researchers collected seawater, sediment, and fish samples from the notothenioid species Trematomus bernacchii to evaluate microbial resistance in an environment once considered largely pristine. Fifty heterotrophic bacterial isolates were obtained and tested against twenty-eight antibiotics, revealing a notable presence of multidrug resistance. These multidrug-resistant isolates were then assessed for their tolerance to eight heavy metal salts to understand whether resistance traits extended beyond antimicrobials. Twelve isolates showing resistance to both antibiotics and metals were selected for further genetic screening, targeting key resistance genes linked to tetracycline, vancomycin, sulphonamides, and other antimicrobial classes. The detection of multiple resistance genes in genera such as Pseudomonas, Pseudoalteromonas, and Psychrobacter indicates that both natural selective pressures and local, human-related contamination may be shaping resistance patterns in this region. Overall, the study demonstrates that even remote Antarctic marine ecosystems can host bacteria with complex resistance profiles. While these ecosystems are largely isolated, human activities such as scientific research, tourism, and the introduction of pollutants may contribute to the dissemination of antibiotic resistance genes, raising important ecological and potential public health considerations regarding the spread of resistance in polar environments. Full article