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10 pages, 470 KiB

Open AccessCase Report

Lost in Transition: Challenges in the Journey from Pediatric to Adult Care for a Romanian DMD Patient

by Maria Lupu, Maria-Alexandra Marcu, Diana Anamaria Epure, Oana Aurelia Vladacenco, Emilia Maria Severin and Raluca Ioana Teleanu

Healthcare 2025, 13(7), 830; https://doi.org/10.3390/healthcare13070830 (registering DOI) - 5 Apr 2025

Abstract

Background: The transition from pediatric to adult care in Duchenne Muscular Dystrophy (DMD) is challenging due to the disease’s complexity and the need for lifelong, comprehensive management. In Romania, ongoing efforts aim to enhance multidisciplinary collaboration, though systemic barriers, such as [...] Read more.

Background: The transition from pediatric to adult care in Duchenne Muscular Dystrophy (DMD) is challenging due to the disease’s complexity and the need for lifelong, comprehensive management. In Romania, ongoing efforts aim to enhance multidisciplinary collaboration, though systemic barriers, such as fragmented healthcare services, persist. Nonsense mutations, including those in exon 30 described here, are often associated with more severe disease progression. Methods: We present the case of a 17-year-old Romanian DMD patient with a nonsense mutation in exon 30 of the dystrophin gene. The patient received multidisciplinary pediatric care addressing his medical needs, including neuromuscular, respiratory, cardiac, and orthopedic management. Transition readiness was assessed using the Transition Readiness Assessment Questionnaire (TRAQ), and the patient’s perspective on the process was documented. Results: Care followed international standards, but the disease progressed predictably, with gradual loss of ambulation, respiratory decline, and cardiac complications. The TRAQ revealed strengths in communication with healthcare providers but moderate confidence in self-management tasks. From the patient’s perspective, fragmented adult services and difficulty accessing specialized neuromuscular support remain major obstacles, underscoring the importance of early, structured transition planning and patient-centered approaches. Conclusions: Transitioning to adult services requires strong communication between pediatric and adult teams and integration of specialized care. Tailored follow-up plans ensure continuity of care and effective disease management. This case reflects broader needs in similar healthcare contexts, highlighting the necessity of robust transition frameworks to respond to patient-specific challenges and ultimately support long-term quality of life. Full article

(This article belongs to the Special Issue Health Service Interventions in Musculoskeletal Disorders)

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11 pages, 580 KiB

Open AccessArticle

Analyzing Clinical Parameters and Bacterial Profiles to Uncover the COPD Exacerbations: A Focus on Intensive Care Unit Challenges

by Dragoș Huțanu, Hédi-Katalin Sárközi, Mara Andreea Vultur, Adrian-Horațiu Sabău, Iuliu Gabriel Cocuz, Corina Mărginean, Andra-Maria Chelemen and Corina Eugenia Budin

Medicina 2025, 61(4), 669; https://doi.org/10.3390/medicina61040669 (registering DOI) - 5 Apr 2025

Abstract

Background and Objectives: Chronic obstructive pulmonary disease (COPD) poses a significant healthcare challenge worldwide, frequently leading to exacerbations necessitating intensive care unit admissions for potentially life-threatening complications. We aimed to investigate correlations between laboratory parameters, bacteriological agents, ventilation mode, and survival rates among [...] Read more.

Background and Objectives: Chronic obstructive pulmonary disease (COPD) poses a significant healthcare challenge worldwide, frequently leading to exacerbations necessitating intensive care unit admissions for potentially life-threatening complications. We aimed to investigate correlations between laboratory parameters, bacteriological agents, ventilation mode, and survival rates among COPD patients admitted to the ICU. Materials and Methods: Data were collected from the Pulmonology Department of Mures Clinical County Hospital, Romania, from 1 January 2022 to 30 October 2023. Eighty-four COPD patients required ICU transfer, except for concurrent SARS-CoV-2 infections. Results: Ventilation modes exhibited a significant correlation with specific bacteriological agents, orotracheal intubation being more prevalent in infections with Acinetobacter baumanii, Staphylococcus aureus, and Streptococcus pneumoniae (p < 0.001). Negative cultures were predominantly found in patients managed with non-invasive ventilation. Laboratory parameters revealed an association between elevated white blood cell counts and bacteriological superinfection, particularly with Escherichia coli (p < 0.001). Different bacteriological agents had different survival rates. Patients infected with Acinetobacter baumanii exhibited the highest mortality rate, while those with Staphylococcus aureus had the lowest (p < 0.01). Conclusions: The importance of prompt evaluation of laboratory parameters and bacteriological findings is underscored by these findings, particularly in ICU settings where ventilation and bacteriological profiles influence patient outcomes. The identification of elevated WBC counts is a marker of bacterial superinfection. The association between specific bacterial agents and ventilation modes highlights the importance of tailored treatment based on microbial profiles. These insights can be applied to refine treatment protocols and enhance survival rates in severe COPD exacerbations that require ICU management. Full article

(This article belongs to the Special Issue Personalized Medicine for Patients with Respiratory Disease)

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13 pages, 2273 KiB

Open AccessCommunication

Sex Ratio Distortion of Aedes aegypti (L.) in El Salvador: Biocontrol Implications for Seasonally Dry Urban Neotropical Environments

by Anna M. Groat-Carmona, Maryory A. Velado Cano, Ana M. González Pérez and Víctor D. Carmona-Galindo

Diversity 2025, 17(4), 257; https://doi.org/10.3390/d17040257 (registering DOI) - 5 Apr 2025

Abstract

Vector-borne diseases (VBDs) remain a major public health burden, particularly in tropical and subtropical regions. Aedes aegypti mosquitoes are primary vectors of several VBDs, and understanding their population dynamics is critical for developing effective control strategies. This study investigates seasonal sex ratio variation [...] Read more.

Vector-borne diseases (VBDs) remain a major public health burden, particularly in tropical and subtropical regions. Aedes aegypti mosquitoes are primary vectors of several VBDs, and understanding their population dynamics is critical for developing effective control strategies. This study investigates seasonal sex ratio variation in A. aegypti populations within urban environments of El Salvador’s seasonally dry neotropical biomes. Using data from an ongoing surveillance program, we analyzed the temporal distribution of male and female mosquitoes across eight sampling events. Our results reveal significant deviations from the expected 1:1 sex ratio, with a pronounced female bias during the dry season and a shift toward parity in the wet season. These findings suggest that environmental and anthropogenic factors influence sex ratio dynamics, potentially affecting reproductive success and population persistence. The observed sex ratio distortion has important implications for vector ecology and biocontrol, emphasizing the need to incorporate seasonal and urban ecological variation into vector management strategies. Integrating these ecological insights into biocontrol programs could enhance the effectiveness of interventions aimed at reducing VBD transmission in seasonally dry tropical regions. Full article

(This article belongs to the Special Issue Ecology and Diversity of Diptera in the Tropics)

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12 pages, 604 KiB

Open AccessArticle

Characterization of Enterobacter cloacae and Citrobacter freundii Species Complex Isolates with Decreased Susceptibility to Cephalosporins from United States Hospitals and Activity of Aztreonam–Avibactam and Comparator Agents (2019–2023)

by Helio S. Sader, Timothy B. Doyle, John H. Kimbrough, Rodrigo E. Mendes and Mariana Castanheira

Antibiotics 2025, 14(4), 382; https://doi.org/10.3390/antibiotics14040382 (registering DOI) - 5 Apr 2025

Abstract

Background: Citrobacter freundii (CFC) and Enterobacter cloacae (ECLC) species complexes represent important causes of hospital-associated infections, frequently are related to outbreaks, and have a great ability to develop antimicrobial resistance. We evaluated a large collection of CFC and ECLC isolates with decreased susceptibility [...] Read more.

Background: Citrobacter freundii (CFC) and Enterobacter cloacae (ECLC) species complexes represent important causes of hospital-associated infections, frequently are related to outbreaks, and have a great ability to develop antimicrobial resistance. We evaluated a large collection of CFC and ECLC isolates with decreased susceptibility to broad-spectrum cephalosporins (Ceph-DS) from United States (US) hospitals. Methods: A total of 43,325 Enterobacterales (1/patient) were collected in 2019–2023 and susceptibility tested by broth microdilution; among those, 5106 (11.8%) were CFC (n = 1374) or ECLC (n = 3732). Ceph-DS CFC (n = 379) and ECLC isolates (n = 1065), defined as isolates with ceftazidime MICs ≥ 16 mg/L and/or cefepime MICs ≥ 2 mg/L, were screened for β-lactamase genes by whole genome sequencing. Results: The most common ESBLs were CTX-M type (n = 98; 47.6% of ESBL producers), SHV type (n = 94; 45.6%), and OXA type (n = 78; 37.9%); ≥2 ESBLs were identified in 65 isolates (31.6%), mainly OXA-1/30 plus a CTX-M. A carbapenemase was identified in 55 of 64 (85.9%) carbapenem-resistant (CB-R) isolates, including KPC type (40 isolates; 62.5% of CB-R) and NDM-1 (16; 23.4% of CB-R). Aztreonam–avibactam was active against 99.6% of Ceph-DS and 100.0% of ESBL producers and CB-R isolates, including NDM producers. Ceftazidime–avibactam and meropenem–vaborbactam were active against 100.0% of ESBL producers (excluding carbapenemase co-producers) and 70.3–71.9% of CB-R isolates. Cefiderocol was active against 82.8% of CB-R isolates but only 46.7% of MBL producers. Conclusions: Aztreonam–avibactam was highly active against cephalosporin-nonsusceptible ECLC and CFC, including MBL producers. The activities of ceftazidime–avibactam, meropenem–vaborbactam, and cefiderocol were compromised against CB-R isolates due to the high frequency of NDM producers. Full article

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22 pages, 367 KiB

Open AccessReview

Hydrogen Peroxide: A Ubiquitous Component of Beverages and Food

by Izabela Sadowska-Bartosz and Grzegorz Bartosz

Int. J. Mol. Sci. 2025, 26(7), 3397; https://doi.org/10.3390/ijms26073397 (registering DOI) - 5 Apr 2025

Abstract

Hydrogen peroxide (H₂O₂) plays a signaling role in the body. Numerous studies demonstrated that H₂O₂, generated mainly by autoxidation of polyphenols, ascorbate and other reduced compounds, is a common component of beverages such as honey, [...] Read more.

Hydrogen peroxide (H₂O₂) plays a signaling role in the body. Numerous studies demonstrated that H₂O₂, generated mainly by autoxidation of polyphenols, ascorbate and other reduced compounds, is a common component of beverages such as honey, tea, coffee, formulated drinks and alcoholic beverages, and is generated in cooked vegetables. It is produced in fresh milk predominantly by xanthine oxidase. The antimicrobial action of honey depends mainly on H₂O₂ generated by glucose oxidase and polyphenol autoxidation. Many components of beverages and food scavenge generated H₂O_2, so its level is a result of the balance between generation and scavenging. This review discusses the mechanisms of hydrogen peroxide formation, collects evidence for the presence and generation of H₂O₂ in beverages and food, discusses its fate in the gastrointestinal tract, evolutionary aspects of human exposure to alimentary hydrogen peroxide, and both adverse action and possible beneficial effects of the consumed hydrogen peroxide. Full article

(This article belongs to the Section Biochemistry)

16 pages, 1968 KiB

Open AccessArticle

Drilling and Completion Condition Recognition Algorithm Based on CNN-GNN-LSTM Neural Networks and Applications

by Gang Wei, Xiyue Yang, Mingming Li, Song Gao, Xiang Wan, Changfang Ji, Xiaoyong Gao and Chaodong Tan

Processes 2025, 13(4), 1090; https://doi.org/10.3390/pr13041090 (registering DOI) - 5 Apr 2025

Abstract

Drilling and completion condition identification is of great significance in improving operational efficiency, reducing safety risks and optimizing resource utilization. However, traditional methods rely on experts’ experience and rules and have low recognition accuracy and poor robustness when facing dynamic working condition changes. [...] Read more.

Drilling and completion condition identification is of great significance in improving operational efficiency, reducing safety risks and optimizing resource utilization. However, traditional methods rely on experts’ experience and rules and have low recognition accuracy and poor robustness when facing dynamic working condition changes. In recent years, deep learning technology has shown great potential in the field of time series data analysis and multimodal data fusion. In this paper, we propose a hybrid deep learning model (CNN-GNN-LSTM) based on a convolutional neural network (CNN), graph neural network (GNN) and long short-term memory network (LSTM). The model extracts the local spatial features of multi-sensors via a CNN module to reduce the noise interference; models the nonlinear dependency between sensors via a GNN module to capture the complex interaction relationship; and mines the long- and short-term time dependencies via an LSTM module to accurately identify the dynamic change and transition process of the working conditions. This significantly improves the classification accuracy under dynamic changes in multi-conditions. This study compares the performance of four models: a CNN, LSTM, CNN-LSTM, and CNN-GNN-LSTM. The results show that the CNN-GNN-LSTM outperforms the other models in key metrics such as the classification accuracy, recall, F1 score, etc., and is more robust to noise interference and changes in complex working conditions. This study verifies the advantages of the hybrid model in multi-sensor complex scenarios and provides technical support for the intelligent development of drilling and completion condition recognition. Full article

(This article belongs to the Section Energy Systems)

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28 pages, 14318 KiB

Open AccessArticle

A Novel Voltage–Current Characteristic Model for Understanding of Electric Arc Furnace Behavior Using Experimental Data and Grey Wolf Optimization Algorithm

by Mustafa Şeker, Emre Ünsal, Ahmet Aksoz and Mahir Dursun

Appl. Sci. 2025, 15(7), 4005; https://doi.org/10.3390/app15074005 (registering DOI) - 5 Apr 2025

Abstract

The control of nonlinear systems cannot be effectively achieved using linear mathematical methods. This paper introduces a novel mathematical model to characterize the voltage–current (V–I) characteristics of the electric arc furnace (EAF) melting process, incorporating experimental field data for validation. The proposed model [...] Read more.

The control of nonlinear systems cannot be effectively achieved using linear mathematical methods. This paper introduces a novel mathematical model to characterize the voltage–current (V–I) characteristics of the electric arc furnace (EAF) melting process, incorporating experimental field data for validation. The proposed model integrates polynomial curve fitting, the modified Heidler function, and double S-curves, with the grey wolf optimization (GWO) algorithm applied for parameter optimization, enhancing accuracy in predicting arc dynamics. The performance of the model is compared against the exponential, hyperbolic, exponential–hyperbolic, and nonlinear resistance models, as well as real-time measurement data, to assess its effectiveness. The results show that the proposed model significantly reduces voltage and current harmonic distortion compared to existing models. Specifically, the total harmonic distortion (THD) for voltage is reduced to 2.34%, closely matching the real-time measured value of 2.30%. Similarly, in the current spectrum, the proposed model achieves a significant reduction in third harmonic distortion and a THD of 11.40%, compared to 13.76% in real-time measurements. Consequently, a more precise characterization of the EAF behavior enables more effective mitigation of harmonics and vibrations, enhancing the stability and power quality of the electrical networks to which they are connected. Full article

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12 pages, 3697 KiB

Open AccessArticle

Ni-Doped Co-Based Metal–Organic Framework with Its Derived Material as an Efficient Electrocatalyst for Overall Water Splitting

by Jingyuan Zhang, Hui Ni, Jianing Yu and Bin Zhao

Catalysts 2025, 15(4), 355; https://doi.org/10.3390/catal15040355 (registering DOI) - 5 Apr 2025

Abstract

Composite catalysts combining a metal–organic framework (MOF) with its derivatives have attracted significant attention in electrocatalysis due to their unique properties. In this study, we report the synthesis of a Ni-doped Co-1,4-benzenedicarboxylate (defined as Co₃Ni₁BDC) metal–organic framework via a [...] Read more.

Composite catalysts combining a metal–organic framework (MOF) with its derivatives have attracted significant attention in electrocatalysis due to their unique properties. In this study, we report the synthesis of a Ni-doped Co-1,4-benzenedicarboxylate (defined as Co₃Ni₁BDC) metal–organic framework via a straightforward solvothermal method, aiming to enhance oxygen evolution reaction (OER) activity. The introduction of Ni modulated the electronic structure, yielding high catalytic activity with an overpotential (η₁₀₀) of 300 mV and excellent stability for the OER. The Co₃Ni₁BDC material was further encapsulated with Co₂P nanoparticles via a controlled phosphating annealing process, forming a hybrid electrocatalyst (Co₃Ni₁BDC@Co₂P) to boost hydrogen evolution reaction (HER) performance. The Co₃Ni₁BDC@ Co₂P catalysts exhibited superior HER performance with low overpotentials of η₁₀ = 20 mV and η₁₀₀ = 127 mV, outperforming the Co₃Ni₁BDC precursor. An alkaline electrolyzer assembled with Co₃Ni₁BDC//Co₃Ni₁BDC@Co₂P achieved a cell voltage of 1.70 V at a current density of 20 mA cm⁻². This work provides a valuable idea for designing efficient electrocatalysts for overall water splitting. Full article

(This article belongs to the Special Issue Catalytic Activity of Two-Dimensional Materials and Their Heterostructures)

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3 pages, 150 KiB

Open AccessEditorial

Mitochondrial Bioenergetics in Different Pathophysiological Conditions 4.0

by Daniela Valenti and Anna Atlante

Int. J. Mol. Sci. 2025, 26(7), 3396; https://doi.org/10.3390/ijms26073396 (registering DOI) - 5 Apr 2025

Abstract

Mitochondria are complex and multifunctional intracellular organelles involved in many aspects of cellular life, with a primary role in energy production via oxidative phosphorylation process [...] Full article

(This article belongs to the Special Issue Mitochondrial Bioenergetics in Different Pathophysiological Conditions 4.0)

12 pages, 418 KiB

Open AccessArticle

Association of Breakfast Consumption Frequency with Depression and Anxiety Symptoms Among School Students: A Cross-Sectional Study in Eastern China

by Hao Wang, Yunqi Guan, Huaidong Du, Pinyuan Dai, Jieming Zhong, Min Yu and Na Li

Nutrients 2025, 17(7), 1271; https://doi.org/10.3390/nu17071271 (registering DOI) - 5 Apr 2025

Abstract

Objective: This study aimed to explore the relationship between breakfast consumption frequency and both depression and anxiety symptoms among middle and high school students in Eastern China. Methods: In this school-based cross-sectional study, 27,001 middle and high school students were investigated [...] Read more.

Objective: This study aimed to explore the relationship between breakfast consumption frequency and both depression and anxiety symptoms among middle and high school students in Eastern China. Methods: In this school-based cross-sectional study, 27,001 middle and high school students were investigated in 2022. Multivariable logistic regression models were used to examine the relationship between breakfast consumption frequency and both depression and anxiety symptoms. Results: The percentages of students who consumed breakfast daily, 6 days/week, 4–5 days/week, and ≤3 days/week were 71.0% (95%CI: 69.9–72.2), 8.3% (95%CI: 7.8–8.6), 11.9% (95%CI: 11.2–12.6), and 8.8% (95%CI: 8.2–9.5), respectively. After adjusting for socio-demographic and lifestyle factors, academic performance, self-reported health, and bullying victimization, compared to those consuming breakfast daily, the odds ratios (95%CI) for depression symptoms were 1.32 (1.15–1.52) for those consuming breakfast 6 days/week, 1.66 (1.49–1.84) for those consuming breakfast 4–5 days/week, and 1.74 (1.54–1.97) for those consuming breakfast ≤3 days/week, respectively (p < 0.001). The corresponding figures for anxiety symptoms were 1.31 (1.14–1.51), 1.35 (1.20–1.52), and 1.43 (1.23–1.66), respectively (p < 0.001). Conclusions: Breakfast skipping is common among middle and high school students in Eastern China. The frequency of breakfast consumption is inversely associated with both depression symptoms and anxiety symptoms among adolescents. Full article

(This article belongs to the Section Nutrition and Metabolism)

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13 pages, 330 KiB

Open AccessArticle

Future Actuality and Truth Ascriptions

by Andrea Iacona and Giuseppe Spolaore

Philosophies 2025, 10(2), 41; https://doi.org/10.3390/philosophies10020041 (registering DOI) - 5 Apr 2025

Abstract

One question that arises in connection with Ockhamism, and that perhaps has not yet received the attention it deserves, is how a coherent formal account of truth ascriptions can be provided by using a suitable truth predicate in the object language. We address [...] Read more.

One question that arises in connection with Ockhamism, and that perhaps has not yet received the attention it deserves, is how a coherent formal account of truth ascriptions can be provided by using a suitable truth predicate in the object language. We address this question and show its implications for some semantic issues that have been discussed in the literature on future contingents. Arguably, understanding how truth ascriptions work at the formal level helps to gain a deeper insight into Ockhamism itself. Full article

(This article belongs to the Special Issue Exploring Concepts of Time and Tense)

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17 pages, 371 KiB

Open AccessArticle

Approximation Properties of a New (p,q)-Post-Widder Operator

by Qiu Lin

Symmetry 2025, 17(4), 553; https://doi.org/10.3390/sym17040553 (registering DOI) - 5 Apr 2025

Abstract

We introduce a new

(p, q)

-Post-Widder operator along with its modified form which preserves the test functions

x^{γ}, γ \in N

. This paper aims to investigate the approximation properties of the

(p, q)

[...] Read more.

We introduce a new

(p, q)

-Post-Widder operator along with its modified form which preserves the test functions

x^{γ}, γ \in N

. This paper aims to investigate the approximation properties of the

(p, q)

-Post-Widder operator while preserving

x^{γ}

. We estimate the convergence rate of the operators with the help of a continuity module and discuss their asymptotic behavior in terms of the weighted modulus of continuity. Also, our numerical results show that the new operator preserving

x^{3}

provides the best approximation. In addition, we establish quantitative estimates of the difference between the two kinds of

(p, q)

-Post-Widder operators. Finally, using numerical examples and graphs, we illustrate that, for particular cases, our results provide improved convergence estimates. Full article

(This article belongs to the Section Mathematics)

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19 pages, 6453 KiB

Open AccessArticle

The Response of Dung Beetle Communities to Land Use Change in the Brazilian Cerrado

by Pedro Gomes Peixoto, Gabriela de Sousa Barbosa, Heytor Lemos Martins, Ana Luíza Franco, Jhansley Ferreira da Mata and Vanesca Korasaki

Land 2025, 14(4), 781; https://doi.org/10.3390/land14040781 (registering DOI) - 5 Apr 2025

Abstract

The transformation of the Cerrado biome into areas with different levels of activity and anthropic pressure negatively impacts biodiversity. This study evaluated the response of the dung beetle community to changes in land use systems: forests, rubber trees, pastures, and soybeans. Five areas [...] Read more.

The transformation of the Cerrado biome into areas with different levels of activity and anthropic pressure negatively impacts biodiversity. This study evaluated the response of the dung beetle community to changes in land use systems: forests, rubber trees, pastures, and soybeans. Five areas were sampled in each system with a minimum distance of 2 km between them. Dung beetles were collected using pitfall traps, and both local (vegetation density, basal area of wooded vegetation, fractal dimension, litter height, electrical conductance (mV), water content in the soil (%), and soil resistance (kPa)) and landscape-related environmental variables (land use and overall composition and configuration of the landscape surrounding the sampling areas) were measured. In total, 2294 specimens were collected and distributed among 34 species and 18 genera. There was no significant difference in abundance between the systems, but differences in the number of species and biomass were observed between forest and soybean systems, as well as a separation of communities between the tree-covered (forest and rubber tree) and open (pasture and soybean) systems. Density and arboreal basal area were the main predictive variables for the diversity of the dung beetle community, reinforcing the importance of vegetation cover for maintaining diversity, whereas local and landscape-related variables influenced community composition. Full article

(This article belongs to the Special Issue Agroforestry Systems for Biodiversity and Landscape Conservation)

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9 pages, 265 KiB

Open AccessOpinion

Proposing Bromo-Epi-Androsterone (BEA) for Stiff Person Syndrome (SPS)

by Coad Thomas Dow

Microorganisms 2025, 13(4), 824; https://doi.org/10.3390/microorganisms13040824 (registering DOI) - 5 Apr 2025

Abstract

SPS is characterized by progressive spasmodic muscular rigidity. SPS is thought to be an autoimmune disease with a prominent feature of antibodies against glutamic acid decarboxylase (GAD). GAD is responsible for the enzymatic conversion of glutamic acid (glutamate) into the inhibitory neurotransmitter gamma-aminobutyric [...] Read more.

SPS is characterized by progressive spasmodic muscular rigidity. SPS is thought to be an autoimmune disease with a prominent feature of antibodies against glutamic acid decarboxylase (GAD). GAD is responsible for the enzymatic conversion of glutamic acid (glutamate) into the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Reduced GABA activity leads to increased excitability in the central nervous system, resulting in muscle rigidity and spasms characteristic of SPS. While SPS is rare, anti-GAD antibodies seen in SPS are also seen in the much more common autoimmune disease, type 1 diabetes (T1D). There is evolving research showing that the anti-GAD antibodies of T1D are produced in response to the presence of mycobacterial heat shock protein 65 (mHSP65), and the mHSP65 is produced in response to an occult infection by a bacterium, Mycobacterium avium subspecies Paratuberculosis (MAP). Humans are broadly exposed to MAP in food, water, and air. There are linear and conformational similarities between the epitopes of GAD and mHSP65. This article proposes that MAP is also an infectious trigger for SPS. Dehydroepiandrosterone (DHEA) is a principal component of the steroid metabolome; it plateaus in young adults and then steadily declines. Bromo-epi-androsterone (BEA) is a potent synthetic analog of DHEA; unlike DHEA, it is non-androgenic, non-anabolic, and an effective modulator of immune dysregulation. BEA is also an anti-infective agent and has been shown to benefit mycobacterial infections, including tuberculosis and leprosy. With the immune stabilizing capacity of BEA as well as its anti-mycobacterial properties, there is reason to believe that a randomized clinical trial with BEA may be beneficial for SPS. Full article

(This article belongs to the Special Issue Advances in Human Infection)

10 pages, 739 KiB

Open AccessArticle

Annual Vitamin D Status of World-Class British Swimmers Following a Standardised Supplementation Protocol for Three Years

by Josh W. Newbury, Richard J. Chessor, Guy M. Evans, Richard J. Allison, Charlie J. Roberts and Lewis A. Gough

Nutrients 2025, 17(7), 1270; https://doi.org/10.3390/nu17071270 (registering DOI) - 5 Apr 2025

Abstract

Background/objectives: British swimmers are at a heightened risk of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D): <50 nmol∙L⁻¹) as their large indoor training volumes often restrict sunlight exposure, especially during the winter when daylight hours are reduced in the United Kingdom. [...] Read more.

Background/objectives: British swimmers are at a heightened risk of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D): <50 nmol∙L⁻¹) as their large indoor training volumes often restrict sunlight exposure, especially during the winter when daylight hours are reduced in the United Kingdom. Previous research has recommended supplementation with 4000 IU∙day⁻¹ vitamin D₃ from October to March to offset vitamin D losses. However, no current study has analysed this approach over multiple seasons to assess if this is an appropriate strategy. Methods: Using a quasi-experimental design, twenty-nine world-class British swimmers (aged 16–30 years) provided a 10 mL venous blood sample (fasted) as part of their routine haematological screening in the September of three consecutive years (2018, 2019, and 2020). Serum 25(OH)D was determined by radioimmunoassay, and this result determined the length of the standardised vitamin D3 protocol (<30 nmol∙L⁻¹: 4000 IU∙day⁻¹ from September to March; 30–79 nmol∙L⁻¹: 4000 IU∙day⁻¹ from October to March; >75 nmol∙L⁻¹: no supplementation). Results: Mean serum 25(OH)D concentrations increased each year (2018: 76.4 ± 28.4 nmol∙L⁻¹, 2019: 91.5 ± 24.8 nmol∙L⁻¹, 2020: 115.0 ± 36.6 nmol∙L⁻¹, p < 0.001), which coincided with the eradication of vitamin D deficiency after one season (prevalence, 2018: 10%, 2019: 0%, 2020: 0%). In September 2020, 35% of swimmers had a serum 25(OH)D > 125 nmol∙L⁻¹, although it is currently debated whether this is a concern or a benefit for athletic populations. Conclusions: Supplementing with 4000 IU∙day⁻¹ of vitamin D₃ throughout the winter can increase the vitamin D status of swimmers. However, more frequent testing may be required to ensure that serum 25(OH)D remains within the sufficient range across the season (75–125 nmol∙L⁻¹). Full article

(This article belongs to the Special Issue Nutrition and Supplements for Athletic Training and Racing)

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27 pages, 106835 KiB

Open AccessArticle

Studying the Impact of the Load Distribution Ratio on the Unsteady Performance of a Dual-Stage Pump-Jet Propulsor

by Jiansheng Zhang, Ning Liang, Jianwei Zhang, Linlin Cao, Dazhuan Wu, Wei Zhao and Hanqiao Han

J. Mar. Sci. Eng. 2025, 13(4), 726; https://doi.org/10.3390/jmse13040726 (registering DOI) - 5 Apr 2025

Abstract

This study investigated the impact of different load distribution ratios between two rotors on the unsteady performance of dual-stage pump-jet propulsors using Computational Fluid Dynamics (CFDs) and experimental methods. The Shear Stress Transport (SST) k-ω model was employed to solve turbulence problems, and [...] Read more.

This study investigated the impact of different load distribution ratios between two rotors on the unsteady performance of dual-stage pump-jet propulsors using Computational Fluid Dynamics (CFDs) and experimental methods. The Shear Stress Transport (SST) k-ω model was employed to solve turbulence problems, and the numerical simulation method used was validated. The following conclusions were drawn: Different load distribution ratios of the dual-stage rotors have no significant impact on the overall propulsion performance of the propulsor. As the load distribution ratio is aft-shifted, the axial unsteady force of the entire propulsor continuously decreases, with a reduction of up to 53.6%. This is due to the gradual reduction in the energy of the first-stage rotor, leading to a more uniform Blade-Passing Frequency Velocity Harmonic Coefficient (BPFVHC) in front of the second-stage rotor, thereby gradually reducing the unsteady force of the second-stage rotor. The experimental results also indicate that the aft-shifted load model can reduce the sound pressure level of the propulsor. Compared to the prototype propulsor, the sound pressure level at the Blade-Passing Frequency decreases by 6.67 dB, or about 78.5%, in sound energy. This study has important implications for the low-excitation design of dual-stage pump-jet propulsors. Full article

(This article belongs to the Section Ocean Engineering)

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1702 KiB

Open AccessArticle

Ten-Year Results After Canaloplasty and Phacocanaloplasty

by Hanga Beres, Bendegúz Gyarmati, Simona Gurzu and Gabor Bernd Scharioth

J. Clin. Med. 2025, 14(7), 2481; https://doi.org/10.3390/jcm14072481 (registering DOI) - 4 Apr 2025

Abstract

Background/Objectives: To evaluate the long-term efficacy and safety of canaloplasty and phacocanaloplasty in patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). Methods: This retrospective observational study included 85 patients with POAG and PEXG who underwent canaloplasty (group 1) or [...] Read more.

Background/Objectives: To evaluate the long-term efficacy and safety of canaloplasty and phacocanaloplasty in patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). Methods: This retrospective observational study included 85 patients with POAG and PEXG who underwent canaloplasty (group 1) or phacocanaloplasty (group 2). Every patient had complete medical records over a 10-year follow-up period. The primary endpoints were the pressure-lowering and drug-sparing effects. The secondary endpoints were intra- and postoperative complications as well as the need for additional surgical interventions. Results: In group 1, the mean baseline intraocular pressure (IOP) of 22.1 ± 0.9 mmHg was reduced to 15.3 ± 0.5 mmHg, 15.7 ± 0.5 mmHg, and 15.9 ± 0.7 mmHg at 1, 5, and 10 years, respectively. The mean medication use decreased from 2.4 ± 1.0 before surgery to 0.1 ± 0.5, 0.8 ± 1.1, and 1.4 ± 1.3 at 1,5, and 10 years, respectively. In group 2, IOP was reduced from 20.4 ± 1.5 to 15.6 ± 1.0, 14.3 ± 0.8, and 14.2 ± 1.2 at 1, 5, and 10 years, respectively. The mean medication use dropped from 2.4 ± 1 to 0.3 ± 0.9, 0.9 ± 1.4, and 0.8 ± 1.1 at 1,5, and 10 years, respectively. Goniopuncture was performed postoperatively in nine cases (13.9%) within the initial 3 months due to IOP spikes (POAG n = 6, PEXG n = 3). Patients with PEXG had a significantly higher likelihood of requiring re-operation (HR = 5.11, HR = 5.11, 95% CI 1.05–24.74, p = 0.043). No serious complications were observed. Conclusions: Canaloplasty is a safe and effective procedure for lowering IOP in eyes with POAG and PEXG, achieving approximately a 30% reduction in IOP. PEXG patients are likelier to have IOP spikes in the late postoperative period therefore careful monitoring and management is required. Full article

(This article belongs to the Section Ophthalmology)

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16 pages, 890 KiB

Open AccessArticle

Baryonic Matter, Ising Anyons and Strong Quantum Gravity

by Michel Planat

Int. J. Topol. 2025, 2(2), 4; https://doi.org/10.3390/ijt2020004 - 4 Apr 2025

Abstract

We find that the whole set of known baryons of spin parity

J^{P} = {\frac{1}{2}}^{+}

(the ground state) and

J^{P} = {\frac{3}{2}}^{+}

(the first excited state) is organized in multiplets which may efficiently be encoded by the [...] Read more.

We find that the whole set of known baryons of spin parity

J^{P} = {\frac{1}{2}}^{+}

(the ground state) and

J^{P} = {\frac{3}{2}}^{+}

(the first excited state) is organized in multiplets which may efficiently be encoded by the multiplets of conjugacy classes in the small finite group

G = (192, 187)

. A subset of the theory is the small group

(48, 29) ≅ G L (2, 3)

whose conjugacy classes are in correspondence with the baryon families of Gell-Mann’s octet and decuplet. G has many of its irreducible characters that are minimal and informationally complete quantum measurements that we assign to the baryon families. Since G is isomorphic to the group of braiding matrices of

S U {(2)}_{2}

Ising anyons, we explore the view that baryonic matter has a topological origin. We are interested in the holographic gravity dual

A d S_{3} / Q F T_{2}

of the Ising model. This dual corresponds to a strongly coupled pure Einstein gravity with central charge

c = 1 / 2

and AdS radius of the order of the Planck scale. Some physical issues related to our approach are discussed. Full article

(This article belongs to the Special Issue Feature Papers in Topology and Its Applications)

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10 pages, 188 KiB

Open AccessArticle

Medical Students’ Knowledge, Attitudes, and Perceptions Toward Vaping and E-Cigarette Use: An Assessment of Their Education and Preparedness

by Heather Hall, John Feest, Sydney Zarate and Martin S. Forde

Int. Med. Educ. 2025, 4(2), 8; https://doi.org/10.3390/ime4020008 - 4 Apr 2025

Abstract

The use of electronic cigarettes (e-cigarettes), or vaping, has risen significantly over the past decade as an alternative to traditional smoking. Despite growing evidence of vaping’s adverse health effects, limited data exist on medical students’ knowledge, attitudes, and behaviors regarding vaping, as well [...] Read more.

The use of electronic cigarettes (e-cigarettes), or vaping, has risen significantly over the past decade as an alternative to traditional smoking. Despite growing evidence of vaping’s adverse health effects, limited data exist on medical students’ knowledge, attitudes, and behaviors regarding vaping, as well as the extent of education they receive on this topic. This study aimed to assess medical students’ perceptions of vaping-related harms and their evaluation of vaping education in medical school. A cross-sectional online survey was conducted among currently enrolled students at St. George’s University’s School of Medicine (n = 5794) over a five-week period from February to March 2024. The survey focused on students’ experiences, behaviors, attitudes, and perceptions toward e-cigarettes and vaping and their assessment of vaping-related education. Of 5794 invited students, 1400 (24%) responded, with 1193 (94%) completing the survey. While 82% had never used conventional tobacco cigarettes, 29% reported having vaped at least once. Nearly all respondents (97%) recognized vaping as a health risk; however, 75% reported receiving no formal education on vaping in their curriculum, and 68% rated their education on the topic as poor or very poor. Despite awareness of vaping’s risks, a notable proportion of medical students have engaged in the practice. The findings highlight a gap in medical education, underscoring the need for improved curriculum coverage to equip future physicians with the knowledge necessary to address vaping-related health concerns. Full article

30 pages, 6159 KiB

Open AccessArticle

Co-Digestion of Cattle Slurry and Food Waste: Perspectives on Scale-Up

by Angela Bywater, Jethro A. H. Adam, Sigrid Kusch-Brandt and Sonia Heaven

Methane 2025, 4(2), 8; https://doi.org/10.3390/methane4020008 - 4 Apr 2025

Abstract

Anaerobic digesters fed with dairy cow slurry struggle to achieve economic viability, particularly when animals are housed seasonally, so additional feedstocks are usually required. This study applied experimentally derived data from the co-digestion of cow slurry (CS) and food waste (FW) to the [...] Read more.

Anaerobic digesters fed with dairy cow slurry struggle to achieve economic viability, particularly when animals are housed seasonally, so additional feedstocks are usually required. This study applied experimentally derived data from the co-digestion of cow slurry (CS) and food waste (FW) to the UK dairy herd as a whole, and at average (AH) and large (LH) herd sizes of 160 and 770 animals, respectively. The experimental data confirmed stable operation at an organic loading rate (OLR) of 5 g VS L⁻¹ day⁻¹ at CS:FW ratios of 3:1 and 6:1 on a wet weight basis, and these parameters were considered for both AH and LH by herd size and country (Scotland, England, Wales, Northern Ireland) in order to provide energy production and policy observations. The results showed that these scenarios could provide between 959 to 23,867 GJ per year, and that a targeted policy intervention could affect slurry treatment from a significant number of animals in a relatively small number of large herds across the UK. For a more detailed analysis, better data are required on non-domestic FW arisings and FW transportation needs. Full article

(This article belongs to the Special Issue Anaerobic Digestion Process: Converting Waste to Energy)

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22 pages, 3340 KiB

Open AccessArticle

Mathematical Modelling of Cancer Treatments, Resistance, Optimization

by Tahmineh Azizi

AppliedMath 2025, 5(2), 40; https://doi.org/10.3390/appliedmath5020040 - 4 Apr 2025

Abstract

Mathematical modeling plays a crucial role in the advancement of cancer treatments, offering a sophisticated framework for analyzing and optimizing therapeutic strategies. This approach employs mathematical and computational techniques to simulate diverse aspects of cancer therapy, including the effectiveness of various treatment modalities [...] Read more.

Mathematical modeling plays a crucial role in the advancement of cancer treatments, offering a sophisticated framework for analyzing and optimizing therapeutic strategies. This approach employs mathematical and computational techniques to simulate diverse aspects of cancer therapy, including the effectiveness of various treatment modalities such as chemotherapy, radiation therapy, targeted therapy, and immunotherapy. By incorporating factors such as drug pharmacokinetics, tumor biology, and patient-specific characteristics, these models facilitate predictions of treatment responses and outcomes. Furthermore, mathematical models elucidate the mechanisms behind cancer treatment resistance, including genetic mutations and microenvironmental changes, thereby guiding researchers in designing strategies to mitigate or overcome resistance. The application of optimization techniques allows for the development of personalized treatment regimens that maximize therapeutic efficacy while minimizing adverse effects, taking into account patient-related variables such as tumor size and genetic profiles. This study elaborates on the key applications of mathematical modeling in oncology, encompassing the simulation of various cancer treatment modalities, the elucidation of resistance mechanisms, and the optimization of personalized treatment regimens. By integrating mathematical insights with experimental data and clinical observations, mathematical modeling emerges as a powerful tool in oncology, contributing to the development of more effective and personalized cancer therapies that improve patient outcomes. Full article

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3 pages, 146 KiB

Open AccessEditorial

Artificial Intelligence in Predicting, Diagnosing and Preventing Sexually Transmitted Infections (STIs)

by Jyoti Taneja, Joyeta Ghosh, Ravi Kant and Myron Christodoulides

Venereology 2025, 4(2), 5; https://doi.org/10.3390/venereology4020005 - 4 Apr 2025

Abstract

Sexually transmitted infections (STIs) are major global health challenges, disproportionately affecting women due to complex biological, social and economic factors [...] Full article

15 pages, 2612 KiB

Open AccessArticle

Molecular and Epidemiological Analysis of Carbapenem-Resistant Klebsiella pneumoniae in a Greek Tertiary Hospital: A Retrospective Study

by Alexandra Myari, Petros Bozidis, Efthalia Priavali, Eleni Kapsali, Vasilios Koulouras, Georgia Vrioni and Konstantina Gartzonika

Microbiol. Res. 2025, 16(4), 81; https://doi.org/10.3390/microbiolres16040081 - 4 Apr 2025

Abstract

Carbapenemase-producing Klebsiella pneumoniae is responsible for multiple serious infections with high mortality rates. K. pneumoniae carbapenemases (KPCs) are the most commonly isolated carbapenemases worldwide. To study the epidemiological and molecular characteristics of KPC-producing K. pneumoniae (KPC-KP), we conducted a retrospective study at the [...] Read more.

Carbapenemase-producing Klebsiella pneumoniae is responsible for multiple serious infections with high mortality rates. K. pneumoniae carbapenemases (KPCs) are the most commonly isolated carbapenemases worldwide. To study the epidemiological and molecular characteristics of KPC-producing K. pneumoniae (KPC-KP), we conducted a retrospective study at the University General Hospital of Ioannina, Greece. A total of 177 K. pneumoniae clinical strains from the period 2014–2015 were confirmed as KPC producers by polymerase chain reaction (PCR) and were further examined for the presence of bla_VIM, bla_NDM, bla_TEM, bla_SHV, and bla_CTX-M genes. Using the amplification refractory mutation system (ARMS) method, we identified the presence of the KPC-2 allele in 130 strains and the KPC-9 allele in 47. Strains from both allele groups belonged to the sequence type 258 (ST258). KPC-9 was responsible for a distinct outbreak, considered part of the broader KPC-2 outbreak. Molecular characterization of selected KPC-KP isolates from the period 2021–2022 revealed their continued presence in our hospital. Comparison of the antimicrobial susceptibility profiles of the two alleles showed a statistically significant increase in minimum inhibitory concentration (MIC) for ceftazidime (p = 0.03) and higher resistance to amikacin (p = 0.012) and colistin (p < 0.001) for KPC-9 compared to the KPC-2 allele. The two KPC alleles had similar mortality rates. This study demonstrates the heterogeneity of resistance genes in carbapenem-resistant K. pneumoniae (CR-KP) within a single-hospital setting and underscores the need for immediate containment measures. Full article

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26 pages, 339 KiB

Open AccessReview

Quantum-Inspired Statistical Frameworks: Enhancing Traditional Methods with Quantum Principles

by Theodoros Kyriazos and Mary Poga

Encyclopedia 2025, 5(2), 48; https://doi.org/10.3390/encyclopedia5020048 - 4 Apr 2025

Abstract

This manuscript introduces a comprehensive framework for augmenting classical statistical methodologies through the targeted integration of core quantum mechanical principles—specifically superposition, entanglement, measurement, wavefunctions, and density matrices. By concentrating on these foundational concepts instead of the whole expanse of quantum theory, we propose [...] Read more.

This manuscript introduces a comprehensive framework for augmenting classical statistical methodologies through the targeted integration of core quantum mechanical principles—specifically superposition, entanglement, measurement, wavefunctions, and density matrices. By concentrating on these foundational concepts instead of the whole expanse of quantum theory, we propose “quantum-inspired” models that address persistent shortcomings in conventional statistical approaches. In particular, five pivotal distributions (normal, binomial, Poisson, Student’s t, and chi-square) are reformulated to incorporate interference terms, phase factors, and operator-based transformations, thereby facilitating the representation of multimodal data, phase-sensitive dependencies, and correlated event patterns—characteristics that are frequently underrepresented in purely real-valued, classical frameworks. Furthermore, ten quantum-inspired statistical principles are delineated to guide practitioners in systematically adapting quantum mechanics for traditional inferential tasks. These principles are illustrated through domain-specific applications in finance, cryptography (distinct from direct quantum cryptography applications), healthcare, and climate modeling, demonstrating how amplitude-based confidence measures, density matrices, and measurement analogies can enrich standard statistical models by capturing more nuanced correlation structures and enhancing predictive performance. By unifying quantum constructs with established statistical theory, this work underscores the potential for interdisciplinary collaboration and paves the way for advanced data analysis tools capable of addressing high-dimensional, complex, and dynamically evolving datasets. Complete R code ensures reproducibility and further exploration. Full article

(This article belongs to the Section Mathematics & Computer Science)

18 pages, 806 KiB

Open AccessReview

Manganese Neurotoxicity: A Comprehensive Review of Pathophysiology and Inherited and Acquired Disorders

by Giuseppe Magro, Vincenzo Laterza, Federico Tosto and Angelo Torrente

J. Xenobiot. 2025, 15(2), 54; https://doi.org/10.3390/jox15020054 - 4 Apr 2025

Abstract

Manganese (Mn) is an essential trace element and a cofactor for several key enzymes, such as mitochondrial superoxide dismutase. Consequently, it plays an important defense role against reactive oxygen species. Despite this, Mn chronic overexposure can result in a neurological disorder referred to [...] Read more.

Manganese (Mn) is an essential trace element and a cofactor for several key enzymes, such as mitochondrial superoxide dismutase. Consequently, it plays an important defense role against reactive oxygen species. Despite this, Mn chronic overexposure can result in a neurological disorder referred to as manganism, which shares some similarities with Parkinson’s disease. Mn levels seem regulated by many transporters responsible for its uptake and efflux. These transporters play an established role in many inherited disorders of Mn metabolism and neurotoxicity. Some inherited Mn metabolism disorders, caused by mutations of SLC30A10 and SLC39A14, assume crucial importance since earlier treatment results in a better prognosis. Physicians should be familiar with the clinical presentation of these disorders as the underlying cause of dystonia/parkinsonism and look for other accompanying features, such as liver disease and polycythemia, which are typically associated with SLC30A10 mutations. This review aims to highlight the currently known Mn transporters, Mn-related neurotoxicity, and its consequences, and it provides an overview of inherited and acquired disorders of Mn metabolism. Currently available treatments are also discussed, focusing on the most frequently encountered presentations. Full article

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