Search Results (1,009)

Background and Clinical Significance: Neuroleptic malignant syndrome (NMS) is a life-threatening condition usually caused by the exposure to antipsychotics. This case report presents a catatonia syndrome that may have developed in the context of a moderate NMS. Case Presentation: An 18-year-old male patient presented with a treatment-resistant catatonia syndrome that debuted 2 weeks prior to the presentation (creatin kinase levels = 4908 U/lL maximum temperature = 38.9°C, white blood count = 13.20 × 10⁹/L, Bush–Francis Catatonia Rating Scale = 30 points). Possible organic causes of catatonia were ruled out, according to the negative results obtained. The patient’s condition improved under benzodiazepine treatment and he was later discharged. After discharge, the catatonia was attributed to a possible NMS with moderate severity. The diagnosis was supported by NMS Diagnosis Criteria Score = 85 points and the presence of Levenson’s triad. Conclusions: This case highlights the concomitant manifestation of both catatonia and NMS in the same patient and the difficulty of establishing a correct diagnosis involving both entities. Full article

The barbel chub (Squaliobarbus curriculus) exhibits remarkable resistance to grass carp reovirus (GCRV), a devastating pathogen in aquaculture. To reveal the molecular basis of this resistance, we investigated complement factor D (DF)—a rate-limiting serine protease governing alternative complement pathway activation. Molecular cloning revealed that the barbel chub DF (ScDF) gene encodes a 1251-bp cDNA sequence translating into a 250-amino acid protein. Crucially, bioinformatic characterization identified a unique N-glycosylation site at Asn¹³⁹ in ScDF, representing a structural divergence absent in grass carp (Ctenopharyngodon idella) DF (CiDF). While retaining a conserved Tryp_SPc domain harboring the catalytic triad (His⁶¹, Asp¹⁰⁹, and Ser²⁰⁴) and substrate-binding residues (Asp¹⁹⁸, Ser²¹⁹, and Gly²²¹), sequence and phylogenetic analyses confirmed ScDF’s evolutionary conservation, displaying 94.4% amino acid identity with CiDF and clustering within the Cyprinidae. Expression profiling revealed constitutive ScDF dominance in the liver, and secondary prominence was observed in the heart. Upon GCRV challenge in S. curriculus kidney (SCK) cells, ScDF transcription surged to a 438-fold increase versus uninfected controls at 6 h post-infection (hpi; p < 0.001)—significantly preceding the 168-hpi response peak documented for CiDF in grass carp. Functional validation showed that ScDF overexpression suppressed key viral capsid genes (VP2, VP5, and VP7) and upregulated the interferon regulator IRF9. Moreover, recombinant ScDF protein incubation induced interferon pathway genes and complement C3 expression. Collectively, ScDF’s rapid early induction (peaking at 6 hpi) and multi-pathway coordination may contribute to barbel chub’s GCRV resistance. These findings may provide molecular insights into the barbel chub’s high GCRV resistance compared to grass carp and novel perspectives for anti-GCRV breeding strategies in fish. Full article

Insulin resistance (IR), a core component in the development of type 2 diabetes mellitus (T2DM), is increasingly recognized for its role in cardiovascular and pulmonary complications. This review explores the relationship between IR, right ventricular dysfunction (RVD), and decreased lung volume in patients with T2DM. Emerging evidence suggests that IR contributes to early structural and functional alterations in the right ventricle, independent of overt cardiovascular disease. The mechanisms involved include oxidative stress, inflammation, dyslipidemia, and obesity—factors commonly found in metabolic syndrome and T2DM. These pathophysiological changes compromise right ventricular contractility, leading to reduced pulmonary perfusion and respiratory capacity. RVD has been associated with chronic lung disease, pulmonary hypertension, and obstructive sleep apnea, all of which are prevalent in the diabetic population. As RVD progresses, it can result in impaired gas exchange, interstitial pulmonary edema, and exercise intolerance—highlighting the importance of early recognition and management. Therapeutic strategies should aim to improve insulin sensitivity and cardiac function through lifestyle interventions, pharmacological agents such as SGLT2 inhibitors and GLP-1/GIP analogs, and routine cardiac monitoring. These approaches may help slow the progression of RVD and its respiratory consequences. Considering the global burden of diabetes and obesity, and the growing incidence of related complications, further research is warranted to clarify the mechanisms linking IR, RVD, and respiratory dysfunction. Understanding this triad will be crucial for developing targeted interventions that improve outcomes and quality of life in affected patients. Full article

This study used all-atom molecular dynamics simulations to investigate the structural dynamics of Ves a 1, a phospholipase from Vespa affinis venom, and its interactions within a lipid membrane environment, both alone and in the presence of the inhibitor voxilaprevir. Simulations conducted over 1 $\mathsf{\mu }$s for triplicate runs demonstrated system stability and convergence of structural properties. Our findings reveal that Ves a 1 engages in dynamic interactions with the lipid bilayer, involving key regions such as its lids, catalytic triad, and auxiliary site. The presence of voxilaprevir was observed to subtly alter these membrane interaction patterns and influence the enzyme’s catalytic area, reflecting the inhibitor’s impact within its physiological context. These results emphasize the crucial role of the lipid bilayer in shaping enzyme function and highlight voxilaprevir as a promising candidate for further inhibitor development, offering vital insights for rational drug design targeting membrane-associated proteins. Full article

Background and Clinical Significance: Antisynthetase syndrome (ASyS) is a rare autoimmune entity defined by the presence of anti-aminoacyl-t ribonucleic acid (RNA) synthetase autoantibodies and classically associated with a triad of interstitial lung disease (ILD), inflammatory myopathy, and arthritis. Additional clinical features may include Raynaud’s phenomenon and “mechanic’s hands”. Among antisynthetase antibodies, anti-PL-12 is notably associated with predominant or isolated ILD and may occur in the absence of clinically evident myositis, thereby complicating timely diagnosis. Case Presentation: We are presenting a 45-year-old non-smoking female patient with a prior diagnosis of seronegative rheumatoid arthritis (RA) who developed progressive dyspnea, dry cough, and sicca symptoms. High-resolution computed tomography revealed a nonspecific interstitial pneumonia (NSIP) pattern. Despite normal creatine kinase and lactate dehydrogenase levels, serological work-up revealed positive anti-PL-12 and anti-Ro52 antibodies, supporting a diagnosis of antisynthetase syndrome without myositis, fulfilling the diagnostic criteria for ASyS per Connors and Solomon. Treatment with corticosteroids and cyclophosphamide induced clinical and functional respiratory improvement, while azathioprine was initiated for maintenance. Conclusions: This case underscores the clinical heterogeneity of antisynthetase syndrome and highlights the diagnostic challenge posed by anti-PL-12–associated ILD in the absence of myositis. Importantly, it demonstrates that in patients with pre-existing rheumatologic diagnoses, the emergence of atypical pulmonary manifestations warrants repeat serologic evaluation to assess ASyS and other autoimmune conditions. Early diagnosis and immunosuppressive treatment are essential to optimize outcomes. Full article

Background: Sarcopenic obesity, characterized by reduced skeletal muscle mass and excess adiposity, is strongly associated with chronic pain and functional decline in older adults. Objective: This prospective controlled trial without randomization investigated the effects of a structured, three-phase rehabilitation program on physical performance, pain, and sarcopenia-specific quality of life in elderly patients with sarcopenic obesity and chronic pain. Methods: In this study, 82 participants were enrolled and allocated to a study group (SG, n = 40), receiving supervised rehabilitation, nutritional counseling, and supplementation, or to a control group (CG, n = 42), which did not receive rehabilitation. The final analysis included 35 patients in SG and 36 in CG. Outcomes were assessed at baseline and six months using the Sarcopenia Quality of Life Questionnaire (SarQoL), Short Physical Performance Battery (SPPB), Numeric Rating Scale (NRS), and Pressure Pain Threshold (PPT). Results: The SG showed significant improvements in all outcomes: SarQoL increased from 57.02 to 63.98, SPPB increased from 7.14 to 8.4, PPT increased from 69.31 to 78.05, and NRS decreased from 6.94 to 4.65 (all p < 0.001). The CG showed no significant changes. Conclusions: The implementation of a structured, three-phase rehabilitation program resulted in clinically and statistically significant improvements in physical performance, pain perception, and sarcopenia-related quality of life in older adults with sarcopenic obesity and chronic pain. Full article

Background: Postoperative pulmonary embolism (PPE) is a critical complication that can significantly affect patient outcomes. This study aimed to assess knowledge, attitudes, and practices (KAP) of thoracic healthcare professionals toward PPE. Methods: A cross-sectional study was conducted from September to December 2022. Results: A total of 222 thoracic healthcare professionals participated in the study; the majority were aged 30–40 years (40.54%) and had over 10 years of work experience (47.75%). Participants completed a self-designed questionnaire assessing demographic data and KAP scores: knowledge (0–11), attitudes (11–55), and practices (9–45). The main measures included the mean scores for knowledge, attitudes, and practices, along with correlation analyses and path analysis to assess relationships among the KAP components. Mean scores were 9.03 ± 1.13 for knowledge, 50.09 ± 4.23 for attitudes, and 35.78 ± 7.85 for practices. Participants showed strong awareness of PPE definitions and risk factors, but only 24.77% correctly identified its classic clinical triad. Attitudinally, while most expressed a willingness to engage in PPE training and risk assessment, 55.41% remained cautious about anticoagulation due to bleeding risks. In practice, although 72.52% consistently supported postoperative mobilization, only 30.63% frequently acquired updated PPE knowledge. Significant positive correlations were found between knowledge and attitudes (r = 0.218, p < 0.001) and between attitudes and practices (r = 0.234, p < 0.001). Path analysis showed that knowledge positively influenced attitudes (path coefficient 0.748, p = 0.002), and attitudes positively influenced practices (path coefficient 0.374, p = 0.003). Conclusions: Thoracic healthcare professionals exhibited adequate knowledge, positive attitudes, and proactive practices regarding PPE, indicating a strong foundation for enhancing postoperative care. Full article

Background: Female collegiate runners may be at high risk for disordered eating and poor bone health, which are characteristics of the female athlete triad. Intuitive eating can promote healthy eating behavior and adequate calorie intake, central variables in calculating energy availability, an underlying cause of low bone mass in athletes. Poor bone health can contribute to injury, preventing optimal performance for athletes. The purpose of this study was to assess intuitive eating, energy availability, and bone mineral density in female college runners with comparison to non-athletes. Methods: Female college athletes (n = 13, 19.5 ± 1.4 yrs) and non-athletes (n = 12, 19.9 ± 1.3 yrs) completed the Intuitive Eating Scale, Eating Disorder Examination Questionnaire, and menstrual history survey. Bone mineral density and body composition were measured using a dual-energy X-ray absorptiometer (DEXA). A 3-day diet record and exercise log were used to assess dietary intake, estimate energy expenditure, and calculate energy availability. Results: Intuitive eating was inversely correlated with disordered eating (r = −0.596, p = 0.002). Intuitive eating scores were not correlated to calorie intake, energy availability, bone mass, or percent body fat. Runners consumed significantly more calories, calcium, magnesium, phosphorus, and protein (g/kg) than non-athletes. Energy availability and bone mineral density were not significantly different between runners and non-athletes. Conclusions: Intuitive eating is associated with healthy eating behaviors in college-age females and was not related to energy availability, bone density, or body composition in this population. Future research could explore the use of intuitive eating principles in reducing disordered eating and addressing low energy availability in female runners and non-athletes. Full article

Ruminant livestock contribute significantly to methane emissions, necessitating sustainable mitigation strategies. Essential oils (EOs) show promise for modulating ruminal fermentation, but their synergistic effects remain underexplored. Two 24 h in vitro experiments evaluated the synergistic effects of EO blends on rumen microbial fermentation. Exp. 1 screened five oils using two triad combinations. Triad 1 tested 10 combinations of thyme (THY), peppermint (PPM), and cinnamon leaf (CIN) oils. Triad 2 tested 10 combinations of anise (ANI), clove leaf (CLO), and peppermint (PPM) oils. Each blend was tested at 400 mg/L, using batch culture methods measuring: pH, ammonia-N (NH₃-N), and volatile fatty acids (VFAs). The two most effective blends, designated as T1 and T2, were selected for Exp. 2 to assess total gas and methane (CH₄) production using pressure transducer methods. All treatments were incubated in a rumen fluid–buffer mix with a 50:50 forage-to-concentrate substrate (pH 6.6). In Exp. 1, data were analyzed according to the Simplex Centroid Design using R-Studio. In Exp. 2, an analysis was conducted using the MIXED procedure in SAS. Mean comparisons were assessed through Tukey’s test. The results from Exp. 1 identified CIN+PPM (80:20) and ANI+CLO (80:20) as optimal combinations, both increasing total VFAs while reducing acetate/propionate ratios and NH₃-N concentrations. In Exp. 2, both combinations significantly reduced total gas and CH₄ productions compared to the control, with CIN+PPM achieving the greatest methane reduction (similar to monensin, the positive control). Specific essential oil combinations demonstrated synergistic effects in modulating rumen fermentation and reducing methane emissions, offering potential for sustainable livestock production. Further in vivo validation is required to optimize dosing and assess long-term effects on animal performance. Full article

Background: Bambusaoldhamii is an important economic bamboo species. However, flowering occurred after its introduction and cultivation, resulting in damage to the economy of bamboo forests. Currently, the molecular mechanism of flowering induced by introduction stress is still unclear. This study systematically explored the key genes and regulatory pathways of flowering in Bambusaoldhamii under introduction stress through field experiments combined with transcriptome sequencing and weighted gene co-expression network analysis (WGCNA), with the aim of providing a basis for flower-resistant cultivation and molecular breeding of bamboo. Results: The study conducted transcriptome sequencing on flowering and non-flowering Bambusaoldhamii bamboo introduced from Youxi, Fujian Province for 2 years, constructed a reference transcriptome containing 213,747 Unigenes, and screened out 36,800–42,980 significantly differentially expressed genes (FDR < 0.05). The results indicated that the photosensitive gene CRY and the temperature response gene COR413-PM were significantly upregulated in the flowering group; the expression level of the heavy metal detoxification gene MT3 increased by 27.77 times, combined with the upregulation of the symbiotic signaling gene NIN. WGCNA analysis showed that the expression level of the flower meristem determination gene AP1/CAL/FUL in the flowering group was 90.38 times that of the control group. Moreover, its expression is regulated by the cascade synergy of CRY-HRE/RAP2-12-COR413-PM signals. Conclusions: This study clarifies for the first time that the stress of introducing Bambusaoldhamii species activates the triad pathways of photo-temperature signal perception (CRY/COR413-PM), heavy metal detoxification (MT3), and symbiotic regulation (NIN), collaboratively driving the AP1/CAL/FUL gene expression network and ultimately triggering the flowering process. Full article

Background/Objectives: Early graft loss within the first year is a rare complication of renal transplantations. In some cases, venous congestion may cause renal dysfunction, but, so far, this syndrome has been assessed by the presence of the triad of an unexplained decrease in renal function together with severe volume overload, relevant heart disease, and a typical histopathological pattern of tubular injury. This study aimed to determine the proportion of patients with early allograft loss due to venous congestion within the first year after transplantation. Additionally, we characterized typical renal vein flow profiles to identify patients at risk of early graft loss due to postrenal venous congestion and prerenal perfusion deficit. Methods: In this retrospective, single-center study, patients who underwent kidney transplantations between 2010 and 2020 and experienced early graft loss within the first year after transplantation were included. Clinical data and renal vein blood flow profiles were collected retrospectively. Results: A total of 579 patients received kidney transplants between 2010 and 2020. Of these, 43 patients (7.4%) lost their grafts within the first year of transplantation. Nine of these 43 patients (20.9% with early graft loss) lost their graft due to a suspected cardiorenal syndrome. Besides graft loss, cardiorenal patients had a significantly higher risk of death than other patients. All cardiorenal patients could be identified using a distinct renal vein blood flow profile (100%). Conclusions: We characterized the typical renal vein blood flow profiles in patients at risk of premature graft loss due to venous congestion. The early identification of such patients is crucial in improving outcomes after renal transplantation. Full article

Core stability is fundamental to posture, balance, and force transmission throughout the kinetic chain. Although traditionally associated with athletic performance, emerging research highlights its broader applicability to recreational fitness. This study investigates the effects of an eight-week core training program on muscle hypertrophy, static balance, and neuromuscular control in recreationally active, non-athletic adults. Participants will undertake a structured intervention comprising progressive triads targeting core stability, strength, and power. Assessment methods include surface electromyography (EMG), ultrasound imaging, three-dimensional force plates, Kinovea motion analysis, and the Satisfaction With Life Scale (SWLS) questionnaire. Expected outcomes include enhanced core muscle activation, improved static balance, and increased core-generated force during overhead medicine ball slam trials. Additionally, the intervention aims to facilitate hypertrophy of the transverse abdominis, internal oblique, and lumbar multifidus muscles, contributing to spinal resilience and motor control. This protocol bridges gaps in core training methodologies and advances their scalability for recreational populations. The proposed model offers a structured, evidence-informed framework for improving core activation, postural stability, muscle adaptation, movement efficiency, and perceived quality of life in recreationally active individuals. Full article

Amidst the dual challenges of escalating ecological environmental pressures and economic transformation globally, green innovation emerges as a pivotal pathway toward achieving high-quality sustainable development. To elucidate how digitalization and novel productive forces synergistically drive the green transition, the research utilizes panel data from 30 provincial-level administrative regions in China spanning 2009 to 2022, constructing a green innovation efficiency measurement frame-work grounded in the Super Slack-Based Measure (Super-SBM)model, alongside a novel productive forces evaluation system based on the triad of laborers, labor objects, and means of production. Employing spatial difference-in-differences and double machine learning methodologies within a quasi-natural experimental design, the research investigates the causal mechanisms through which digital empowerment and novel productive forces influence regional green innovation efficiency. The findings reveal that both digital empowerment and novel productive forces significantly enhance regional green innovation efficiency, exhibiting pronounced positive spatial spillover effects on neighboring regions. Heterogeneity analyses demonstrate that the promotive impacts are more pronounced in eastern provinces compared to central and western counterparts, in provinces participating in carbon trading relative to those that do not, and in innovation-driven provinces versus non-innovative ones. Mediation analysis indicates that digital empowerment operates by fostering the aggregation of innovative talent and elevating governmental ecological attentiveness, whereas new-type productivity exerts its influence primarily through intellectual property protection and the clustering of high-technology industries. The results offer empirical foundations for policymakers to devise coordinated regional green development strategies, refine digital transformation policies, and promote industrial structural optimization. Furthermore, this research provides valuable data-driven insights and theoretical guidance for local governments and enterprises in cultivating green innovation and new-type productivity. Full article

In informal economic contexts, migrant entrepreneurs have been extolled as highly resilient and adaptable. This study critically investigates the adverse psychological foundations inherent in such enterprises, focusing on how dark triad personality traits emerge in the leadership orientations of marginal migrant entrepreneurs. Following a qualitative ethnographic approach, this research engaged 10–15 migrant employees through participant observation, field notes, and semi-structured interviews in an informal economic context. Thematic analysis revealed five dominant patterns: narcissistic leadership with entitlement and emotional disrespect; Machiavellian behavior of manipulation and deception; psychopathic detachment in emotional callousness; absence of light triad actions such as empathy, humility, and selflessness; and moral disengagement through rationalizations such as “everyone does it” or system blame. Migrant business owners prefer to rationalize their exploitative acts as being necessary for economic survival, thus legitimizing immoral conduct and suppressing moral self-regulation. The findings indicate that marginality not only drives entrepreneurial innovation, but also has the potential to create exploitative inclinations that are institutionally and morally unchecked. Solving this issue requires not only mere psychological awareness, but also systematic reforms that foster ethical robustness and emotional sensitivity. This study ultimately asserts the need to reframe migrant entrepreneurship discourse, including both ethical and psychological accountability. Full article

Immune checkpoint inhibitor diabetes mellitus (ICI-DM) is an emerging phenomenon in the adult oncology population, with an increased incidence reflecting the increased use of immunotherapy; however, risk factors for ICI-DM have not been fully identified. The aim of this integrated literature review was to synthesize the published literature on ICI-DM and the factors associated with an increased risk for its development. The review was guided by Sanieszko’s Epidemiology Triad theoretical framework. We conducted a literature search using the Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PubMed databases. The analysis included 2030 studies that met the search criteria, 23 of which were peer-reviewed articles that met the inclusion criteria. The results demonstrated a positive relationship between older age, medical history of diabetes, the presence of susceptible alleles, and exposure to immunotherapy, with an increased risk for ICI-DM. Future studies should include larger samples, more diverse populations, and a broad range of institutions to confirm the risk factors associated with ICI-DM. Full article