Search Results (2,046)

The global prevalence of myopia is increasing, and the combination of myopia and glaucoma is widely expected to become an important clinical and public health issue. Myopic eyes undergo axial elongation and posterior pole remodeling, leading to optic disc tilt, peripapillary deformation, choroidal thinning, and altered spatial relationships between the optic nerve head and its vascular supply. Glaucomatous optic neuropathy is associated with retinal ganglion cell damage, lamina cribrosa deformation, and ocular blood flow impairment. Recent advances in optical coherence tomography angiography and laser speckle flowgraphy have enabled noninvasive assessment of retinal, peripapillary, choroidal, and optic nerve head circulation. These modalities have revealed reduced radial peripapillary capillary density, choroidal microvasculature dropout, and reduced optic nerve head tissue blood-flow signal in glaucomatous eyes. In eyes with myopia and glaucoma, myopia-related structural deformation and glaucoma-associated perfusion abnormalities may coexist and show sectoral correspondence with neural damage, particularly in regions related to the central visual field. This review summarizes the anatomical background of ocular blood flow, myopia-induced structural and vascular changes, glaucoma-associated blood flow impairment, and their interaction in eyes with myopia and glaucoma. Potential therapeutic approaches targeting ocular blood flow are also discussed, although evidence beyond intraocular pressure reduction remains limited. Full article

Background: Giant African Land Snails originate from Africa. Although these snails are becoming more popular as exotic pets in Europe, there is a lack of comprehensive information about their diseases and how to treat them. Reported medical issues included failures in husbandry and feeding (often leading to aestivation, calcium deficiency or renal disease), trauma, poison, prolapse, and ecto- and endoparasites, as well as bacterial and fungal infections. Although their reproductive system has been well studied, dystocia has not yet been reported in terrestrial snail species. Patient Presentation: Two cases of dystocia in pet Giant African Land Snails are presented. Case 1 involved a 5.5-year-old Lissachatina fulica with esophageal prolapse and severe chronic dystocia, as indicated by radiographic and computed tomographic findings, ultimately leading to euthanasia. Case 2 involved a 3-year-old Lissachatina albopicta also affected by dystocia, with computed tomography again showing findings consistent with the diagnosis, but subsequently laying most of the pathological clutch with supportive, conservative treatment. Conclusion: Dystocia in Giant African Land Snails is a significant health concern that can lead to severe complications and mortality. Early diagnosis using imaging techniques is crucial for identifying reproductive issues and determining appropriate treatment strategies. However, because these terrestrial snails have an open circulatory system and vascular anatomy remains incompletely characterized, the reproductive tract remains difficult to access surgically. Furthermore, there is currently insufficient evidence to support hormonal induction of oviposition as a therapeutic approach for egg retention in this species. Consequently, conservative management remains the primary supportive therapy. Full article

Erythropoiesis-targeted doping remains a major challenge for sports medicine because pharmacological and genetic manipulation of erythropoiesis can improve oxygen transport and endurance performance while increasing the risk of serious cardiovascular complications. Erythropoiesis-targeting strategies extend beyond recombinant erythropoietin (EPO) to include hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), modified erythropoietin receptor (EPOR) agonists, transforming growth factor beta (TGF-β) signaling inhibitors, cytoprotective EPO derivatives, and gene- or cell-based approaches, and require complementary detection strategies based on direct analytical methods and the Athlete Biological Passport (ABP). Although they may enhance oxygen delivery and endurance performance, excessive stimulation of erythropoiesis may increase blood viscosity, impair vascular function, and elevate the risk of hypertension, thromboembolic complications, and other cardiovascular (CV) events. Erythropoiesis-targeted doping has evolved beyond recombinant EPO into a diverse group of pharmacological and genetic strategies that require increasingly sophisticated detection approaches. A thorough understanding of their molecular mechanisms and cardiovascular consequences is essential for improving anti-doping surveillance and protecting athlete health. This review summarizes current erythropoiesis-targeting agents, their mechanisms of action, detection strategies, cardiovascular risks, and implications for anti-doping practice. Full article

Background/Objectives: Microvascular dysfunction is an early manifestation of vascular impairment in type 1 diabetes (T1D). Although physical activity may improve vascular health, the relationship between integrated 24 h physical behavior patterns and microvascular function remain unclear. This study evaluated the association between 24 h physical behavior patterns and cutaneous microvascular reactivity in adults living with T1D, and examined their relationship with endothelium-dependent microvascular function. Methods: This cross-sectional study included 92 adults with T1D. Physical activity and sedentary behavior were assessed through accelerometry and combined with self-reported sleep duration. Participants were classified into three clusters using partitioning around medoids. Cutaneous microvascular reactivity was assessed through laser speckle contrast imaging, with post-occlusive reactive hyperemia (PORH) peak and amplitude of cutaneous vascular conductance (CVC) as primary outcomes. Acetylcholine (ACh)-induced responses were evaluated as exploratory outcomes. Generalized linear models with progressive adjustment were used to examine the associations. Results: Three distinct behavioral patterns were identified. In the fully adjusted model, compared with Cluster 3, the estimates for PORH peak CVC were β = −0.02 (95% CI: −0.16 to 0.11) for Cluster 1 and β = 0.01 (95% CI: −0.13 to 0.16) for Cluster 2. Similar null findings were observed for PORH amplitude CVC and ACh-derived outcomes. Sensitivity analyses including microvascular burden did not alter the findings. Conclusions: In adults living with T1D, 24 h physical behavior patterns were not associated with microvascular reactivity or endothelium-dependent function. These findings suggest that daily behavior distribution may not be strongly related to microvascular responses, although subtle effects cannot be excluded. Longitudinal studies using fully device-based 24 h assessments are warranted. Full article

Introduction: The development of bivalent mucosal vaccines capable of providing protection against both influenza and SARS-CoV-2 is a major public health focus. While most COVID-19 vaccines target the spike (S) protein, the highly conserved nucleocapsid (N) protein represents a strategic target for cross-reactive, cell-mediated immunity. This study evaluates Corfluvec, an intranasal vaccine candidate based on an attenuated NS1-truncated influenza vector expressing a fragment of the SARS-CoV-2 N protein. Methods: Protective efficacy, including viral load and pathomorphological changes in the lungs and vessels, was evaluated in Syrian hamsters challenged with high and low doses of SARS-CoV-2 (lineage B.1.1). Cross-protective efficacy against homologous and heterologous influenza A strains (H1N1pdm09, H3N2, and A/PR/8/1934) was tested in a lethal murine model. Additionally, immunogenicity of Corfluvec applied via human-compatible delivery device was tested in cynomolgus macaques (Macaca fascicularis). Results: In Syrian hamsters, vaccination significantly reduced viral loads in the lungs and nasal turbinates. Histopathological analysis revealed a preservation of lung vascular integrity: vaccinated animals showed stable CD31 expression and controlled Ki-67 proliferative activity, accompanied by a marked reduction in vasculitis and perivascular edema compared to placebo controls. In mice, the vaccine provided 100% protection against homologous and heterologous influenza virus challenges. In macaques, the two-dose intranasal immunization was well-tolerated and induced significant systemic IgG and mucosal sIgA responses, alongside robust N-specific IFNγ+ T-cell activation. Conclusions: Corfluvec is a promising bivalent vaccine candidate that provides dual protection against influenza and COVID-19. Its ability to limit viral shedding from the upper respiratory tract and to mitigate SARS-CoV-2-induced pulmonary pathology, contributing to the preservation of lung vascular integrity, underscores the utility of mucosal immunization with Corfluvec as a valuable intranasal complement to current systemic vaccination strategies. Full article

Within the emerging field of nutritional neuroscience, omega-3 fatty acids are among the most extensively investigated dietary bioactive compounds with potential relevance to cognitive aging. As populations continue to age worldwide, identifying modifiable nutritional factors that support cognitive health has become an important public health priority. Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), obtained primarily from marine sources, are integral components of neuronal membranes and serve as precursors of specialized pro-resolving lipid mediators. This narrative review integrates concepts from nutritional neuroscience and geroscience to examine how dietary omega-3 fatty acids may influence biological pathways involved in age-related cognitive decline. Current evidence suggests that DHA and EPA affect multiple processes linked to brain aging, including neuroinflammation, synaptic plasticity, mitochondrial function, oxidative stress, cerebrovascular integrity, cellular senescence, and gut–brain axis signaling. These mechanisms overlap with several hallmarks of aging and may contribute to the maintenance of cognitive function during later life. Observational studies generally associate higher dietary intake or circulating omega-3 status with better cognitive performance and a lower risk of cognitive decline and dementia. Findings from randomized controlled trials are less consistent, although benefits appear more likely in individuals with low baseline omega-3 status, mild cognitive impairment, or increased biological vulnerability. Beyond their established anti-inflammatory effects, omega-3 fatty acids may influence multiple aging-related pathways, particularly inflammaging, vascular aging, and mitochondrial dysfunction. Although heterogeneity in study design, dosage, intervention timing, and participant characteristics precludes firm conclusions, viewing omega-3 fatty acids through a geroscience lens offers a useful framework for interpreting existing evidence and informing future research. Overall, omega-3 fatty acids represent a promising nutritional strategy for supporting cognitive health across the lifespan, warranting further investigation in well-characterized populations and precision nutrition approaches. Full article

The rapid growth in plastic production and consumption has led to the widespread contamination of the environment with microplastics (MPs), raising increasing concerns about their potential impacts on human health. In recent years, advances in analytical techniques have revealed the presence of MPs in a wide range of human biological samples, suggesting that these particles can enter, circulate within, and accumulate throughout the human body. This narrative review provides a comprehensive overview of the current evidence on the occurrence and distribution of MPs in human tissues, organs, and biological fluids. MPs have been detected in blood, urine, stool, semen, breast milk, amniotic fluid, ocular fluids, and lavage fluids, as well as in several organs and tissues including the lungs, placenta, heart, kidneys, liver, vascular tissues, and reproductive organs. Among the identified polymers, polyethylene (PE), polypropylene (PP), polyethylene terephthalate (PET), polystyrene (PS), and polyvinyl chloride (PVC) are reported most frequently. This narrative review also summarizes the major analytical techniques used for MP detection and characterization, including Raman spectroscopy, μ-FTIR, LDIR spectroscopy, and Py-GC/MS, which highlight their advantages and limitations. Collectively, the available evidence demonstrates that MPs are not confined to the external environment but are now detectable in multiple compartments of the human body, including highly protected biological systems. However, important questions remain regarding their long-term persistence, transport mechanisms, biological fate, and potential health effects. Further methodological standardization and large-scale human studies are needed to better understand the extent of human exposure and the implications of MP accumulation for human health. Full article

How physical activity may modify the health consequences of a pro-inflammatory diet remains an important but unresolved question. This hypothesis-generating narrative review examines this question by integrating evidence on dietary inflammatory potential, physical activity, physiological capacity, and inflammation-related health outcomes, and by proposing an Inflammatory Resilience Framework to guide future research. Current evidence strongly supports systemic inflammation, adiposity, insulin resistance, and vascular dysfunction as relevant pathways linking dietary inflammatory exposure to disease vulnerability, while redox- and gut-related mechanisms remain more indirect. Physical activity and higher physiological capacity may influence several of these pathways through metabolic, vascular, muscular, and inflammatory regulation. Preliminary human joint-association evidence suggests that physical activity may partially attenuate selected consequences of pro-inflammatory dietary exposure, but it does not establish a consistent modifying effect or full compensation. The proposed framework positions physical activity, cardiorespiratory fitness, skeletal muscle function, adiposity, metabolic flexibility, vascular function, and baseline health status as factors that may modify the association between dietary inflammatory exposure and disease vulnerability. Rather than asking whether exercise cancels dietary risk, the framework provides a testable structure for future studies integrating objective physical activity, fitness, physiological reserve, inflammatory and metabolic markers, and longitudinal interaction analyses to determine when, how, and in whom physical activity modifies diet-related inflammatory risk. Full article

Currently, emerging pharmaceutical contaminants (EPCs) pose a significant risk to aquatic biodiversity on both a global and regional scale. Their accumulation in the environment presents several challenges to both human health and ecological integrity. Among EPCs, cyclophosphamide (COP), a widely used alkylating cytotoxic and immunosuppressive drug in human and veterinary oncology, has become one of the most frequently detected environmental contaminants. It has been reported to impair the immune system, induce oxidative stress, and exhibit genotoxic and cytotoxic effects in various fish species. However, limited research has evaluated its toxicity in the Siamese fighting fish (Betta splendens), an endemic significant aquatic species in Thailand. This study evaluated the acute toxicity of COP in Betta splendens by assessing systemic oxidative stress responses, alterations in gene expression, and localized histopathological changes within both hepatic and renal tissues. The 96 h of median lethal concentration (LC₅₀) value for COP in Betta splendens was determined to be 793.4 mg/L. High-concentration exposure (800 mg/L) induced severe systemic oxidative stress, evidenced by a significant reduction in superoxide dismutase (SOD) activity and a marked elevation in malondialdehyde (MDA) levels across both liver and kidney. At the transcriptomic level, acute COP exposure significantly upregulated pro-inflammatory (interleukin-1β, IL-1β and tumor necrosis factor, TNF-α), cellular stress (heat shock protein 70, HSP70), and apoptotic (caspase-3, Casp3) genes. Semi-quantitative histopathological evaluation revealed severe concentration-dependent structural damage. Hepatic lesions peaked at 800 mg/L characterized by diffuse vacuolation, vascular congestion, and extensive necrosis. Similarly, severe renal damage occurred at 800 mg/L, featuring marked vascular congestion, melanomacrophage aggregation, and widespread tubular necrosis. Overall, these findings demonstrate that acute waterborne COP exposure induces severe hepatotoxicity and nephrotoxicity in Betta splendens driven by oxidative stress, pro-inflammatory signaling, and apoptotic pathways. This study provides essential baseline toxicity thresholds and highlights the physiological risks COP spills pose to tropical freshwater labyrinth fish. Full article

Background/Objectives: Diabetes mellitus is associated with complex behavioral, psychosocial, and functional challenges that may influence disease burden and complication profiles. This study aimed to identify latent dimensions of diabetes self-management and health-related functioning and to evaluate their association with the type of diabetes-related complications. Methods: A cross-sectional study was conducted in 300 patients with type 2 diabetes, classified into microvascular and macrovascular complication groups. A questionnaire comprising DSMQ (diabetes self-management questionnaire) derived items, SF-36-derived items, and other questions was administered to all participants. Exploratory factor analysis was performed to identify latent dimensions related to self-management, emotional burden, dietary behavior, glycemic control challenges, glucose monitoring, and functional status. Composite scores were calculated for factors with acceptable internal consistency. Between-group comparisons, Spearman correlation analysis, and binary logistic regression models adjusted for age, sex, residence area, marital status, education, diabetes duration, and treatment type were applied. Results: Six latent factors were identified: Emotional Burden, Dietary Self-Management, Functional Limitations, Glycemic Control Challenges, Glucose Monitoring, and General Health Perception. However, only the factors demonstrating acceptable internal consistency were retained for subsequent analyses: Emotional Burden, Functional Limitations, and Glycemic Control Challenges. Functional Limitations showed the strongest association with complication type, with patients with macrovascular complications reporting greater functional impairment. After adjustment for potential confounders and correction for multiple comparisons, higher adherence to the recommended meal plan (DSMQ2) and greater functional limitations remained the principal differences between the complication groups. Functional Limitations Score remained independently associated with complication type in both unadjusted and adjusted logistic regression models. Conclusions: These cross-sectional findings support the integration of functional, psychosocial, and behavioral assessment into comprehensive diabetes care and highlight differences in patient-reported outcomes across complication groups. Full article

Lameness is a major welfare and economic disorder in dairy production and a clinical sign with multiple causes. This review focuses on claw horn disruption lesions (CHDL), a major cause of periparturient lameness. Although hoof-centered prevention and treatment remain essential, preclinical systemic alterations, recurrence, and clustering with other transition-period disorders suggest that CHDL may sometimes represent the local expression of broader pathophysiology. We propose the Lameness Triad, in which three mechanisms converge: sustained endotoxemic pressure and TLR4-mediated innate immune activation, endothelial glycocalyx degradation and vascular dysfunction, and metabolic triage that reallocates resources from production toward defense. Their combined pathogenic pressure is proposed to produce clinical disease when it exceeds a cow-specific Susceptibility–Resilience Gate comprising mucosal barrier integrity, hepatic endotoxin clearance, immune calibration, redox reserve, hoof structural reserve, and prior damage. Ruminal dysbiosis, mammary involution, and postpartum uterine contamination may contribute to inflammatory and endotoxemic pressure, whereas the confined, continuously loaded digital corium may become a principal site of clinical expression. Longitudinal multi-omics studies identified inflammatory, urinary, and milk-metabolite alterations before diagnosis, with within-cohort serum and urine models discriminating cows that later became lame as early as eight weeks prepartum. These findings require prospective validation and do not establish the complete causal sequence. The framework extends, rather than replaces, established hoof-health programs and provides testable hypotheses for earlier detection, prevention, and selection for resilience. Full article

Cardiovascular diseases remain a major global health burden. Plant-derived extracellular vesicles (PDEVs) are increasingly being investigated as potential therapeutic and drug-delivery platforms for cardiovascular disease. PDEVs are natural nanovesicles carrying bioactive lipids, proteins, nucleic acids, and phytochemicals. Preclinical studies suggest that selected PDEV preparations may exert protective effects in cardiovascular disease-related models by modulating inflammation, oxidative stress, lipid metabolism, and endothelial repair. In experimental models, selected PDEVs have shown preliminary improvements in cargo stability, lesion accumulation, controlled release, and local retention through drug loading, surface ligand modification, responsive design, and integration with biomaterials. This review summarises the biogenesis, isolation, characterisation, and cardiovascular actions of PDEVs, with emphasis on their engineering and targeted delivery applications in atherosclerosis, myocardial infarction, ischaemia–reperfusion injury, vascular calcification, restenosis, and cardiotoxicity. Current challenges, including insufficient standardization, uncertain regulatory classification, unclear mechanisms, and limited pharmacokinetic and long-term safety data, are also discussed. Addressing these issues is essential for reliably evaluating the clinical translation potential of PDEVs. Full article

Dementia is a growing global health challenge, yet many determinants of late-life cognitive decline emerge decades before symptoms appear. Midlife is a practical window for prevention because hypertension, diabetes, obesity, dyslipidemia, smoking, physical inactivity, unhealthy diet, sleep disturbance, and social isolation can be identified and modified before substantial brain injury becomes apparent. This narrative review synthesizes evidence linking midlife vascular and lifestyle exposures to late-life cognitive impairment and dementia. The most consistent data support a life-course model in which cumulative vascular, metabolic, inflammatory, and behavioral risks interact with neurodegenerative pathology and cognitive reserve. Vascular and metabolic factors act largely through small-vessel disease, endothelial dysfunction, and inflammation, whereas physical activity, healthy diet, sleep, and social engagement may strengthen resilience. Although observational evidence is vulnerable to confounding and single-risk trials may underestimate cumulative benefit, multidomain prevention remains biologically plausible and clinically actionable, as recent trials reaffirm. These priorities are especially salient in the rapidly transitioning Gulf Cooperation Council (GCC) countries, where midlife cardiometabolic risk is high and local evidence is limited. Dementia prevention should be embedded in routine midlife care, with vascular risk management and sustained lifestyle support treated as core elements of lifelong brain health. Full article

Background: Cardiometabolic risk is shaped not only by the amount of food intake and physical activity but also by their timing and regularity across the 24 h cycle. We propose rhythm coherence as a hypothesis-generating framework describing the temporal stability and alignment of eating, physical activity, and sleep. Its vascular and glycemic relevance has not yet been prospectively validated. Methods: This semi-structured narrative review was supported by a transparent, staged evidence-identification process using PubMed, Scopus, and Web of Science Core Collection. Main searches used a 2020–2026 window, with a broader 2018–2026 window for targeted athlete-focused searches. After cross-database deduplication, 1081 unique records entered broad screening; 694 underwent strict screening, yielding 257 core candidate records. A targeted athlete-focused search contributed 46 additional records, producing a 303-record candidate evidence pool for topic mapping. From this pool, 131 high-priority records underwent full-text narrative synthesis, and 92 sources were ultimately cited directly in the manuscript. These counts represent successive review stages rather than a PRISMA-defined systematic-review inclusion set. Results: Earlier or more regular eating patterns, postprandial physical activity, and stable sleep–wake schedules were associated with more favorable cardiometabolic profiles in selected studies. However, the evidence was heterogeneous and included mechanistic studies, observational analyses, and intervention trials. These findings support further investigation but do not establish an effect of integrated eating–activity–sleep coherence. Numerical effects reported for individual interventions should not be attributed to the proposed integrated framework or to the Rhythm Coherence Index (RCI). Conclusions: Coordinated assessment of eating, activity, and sleep timing may offer a useful research direction. The RCI is an author-proposed candidate composite, not an existing validated instrument or clinical decision rule. Its formula, component weights, missing-data procedures, thresholds, reliability, responsiveness, predictive value, and external validity require prospective evaluation before clinical application can be considered. Full article

Exercise training is frequently examined in relation to cognitive and brain health in aging populations. Yet many exercise–cognition studies remain difficult to interpret mechanistically because cognitive outcomes are often assessed without sufficient alignment with exercise dose, biological endpoints, or participant vulnerability. This mechanism-informed narrative review argues that future research in cognitive aging should move beyond outcome-based interpretation alone and more explicitly connect the exercise stimulus with cerebrovascular endpoints, supportive biological markers, baseline vulnerability, and cognitive or translational outcomes. The review treats cerebrovascular endpoints, including cerebral blood flow, cerebrovascular reactivity, endothelial function, vascular compliance, and neurovascular coupling, as primary mechanistic anchors because they are closely related to vascular cognitive vulnerability and are more proximal to biological adaptation than cognitive test scores alone. Immune–inflammatory markers, blood–brain barrier-related indicators, myokines, neurotrophic factors, and exercise-induced circulating factors are considered supportive endpoints because they may clarify broader biological responsiveness when selected according to a clear hypothesis. The review also considers how exercise modality, delivered dose, adherence, baseline fitness, vascular risk, cognitive status, sex, comorbidity, and recovery capacity may shape responder heterogeneity. The purpose of this review is to develop a mechanism-informed framework for interpreting exercise–cognition studies in aging by aligning the delivered exercise stimulus, participant vulnerability, biological responsiveness, and cognitive or translational outcomes. Based on this synthesis, we propose a five-layer endpoint framework that positions cerebrovascular measures as primary mechanistic anchors and supportive biological markers as hypothesis-dependent contextual endpoints. Its distinct contribution is to integrate these elements within a single interpretive structure rather than considering exercise exposure, biological responses, participant characteristics, and cognitive outcomes as separate domains. Rather than serving as a clinical prescription model or formal reporting guideline, the framework is intended to improve hypothesis–endpoint alignment and the mechanistic interpretation of exercise–cognition studies in aging. Full article