Life

11 pages, 1370 KiB

Open AccessArticle

Correlation Between Fixed-Luminance Flicker Full-Field Electroretinogram Response and Macular Cone Density in Healthy Individuals

by S. Saeed Mohammadi, Woong-Sun Yoo, Negin Yavari, Hassan Khojasteh Jafari, Christopher Or, Azadeh Mobasserian, Vahid Bazojoo, Amir Akhavanrezayat, Dalia El Feky, Osama Elaraby, Jia-Horung Hung, Cigdem Yasar, Ankur Gupta, Tanya Jain, Battuya Ganbold, Trung Ba Nguyen, Anadi Khatri, Zheng Xian Thng, Diana Do and Quan Dong Nguyen

Life 2025, 15(5), 694; https://doi.org/10.3390/life15050694 - 24 Apr 2025

Abstract

This is the studyto investigate the correlation between macular cone density (MCD) and flicker electroretinogram (ERG) response in healthy eyes. In this exploratory study, 23 eyes from 12 healthy subjects were enrolled in this study. The fixed-luminance flicker full-field electroretinogram (ffERG) responses of [...] Read more.

This is the studyto investigate the correlation between macular cone density (MCD) and flicker electroretinogram (ERG) response in healthy eyes. In this exploratory study, 23 eyes from 12 healthy subjects were enrolled in this study. The fixed-luminance flicker full-field electroretinogram (ffERG) responses of the retina and MCDs at 24 locations were measured using the Diopsys^® NOVA™ system and the rtx1 adaptive optics retinal camera, respectively. Regression analysis was employed to evaluate the correlations. The mean age of the subjects was 30 ± 3 years. The average magnitudes of the flicker response and phase response were 13.44 ± 4.88 μV and 332.63 ± 22.12°, respectively. The MCDs for all 24 locations were 15,043 ± 3511 cones/mm². Among all locations, regression analysis revealed a significant correlation only at one specific location (0, −4°) between cone density and both the mean magnitude and phase of the flicker response, with p-values of 0.005 and 0.004, respectively.In conclusion, we identified a significant correlation between MCD and ffERG responses at a specific retinal locus (0, −4°). This finding may be attributed to the distribution of different cone types throughout the retina and the possibility that various cone types may contribute differently to ERG. Further studies are required to investigate this finding. Full article

(This article belongs to the Section Medical Research)

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11 pages, 1188 KiB

Open AccessArticle

Assessment of Body Morphometry to Classify Two Colombian Creole Pigs Using Statistical and Machine Learning Methods

by Arcesio Salamanca-Carreño, Mauricio Vélez-Terranova, Pere M. Parés-Casanova, Paula A. Toalombo-Vargas, David E. Rangel-Pachón and Andrés F. Castillo-Pérez

Life 2025, 15(5), 693; https://doi.org/10.3390/life15050693 - 24 Apr 2025

Abstract

Creole pigs (Sus scrofa domestica), descendants of Iberian breeds, possess significant genetic and cultural importance but are under-researched and at risk due to the dominance of improved breeds for commercial production. The aim of this study was to identify the most [...] Read more.

Creole pigs (Sus scrofa domestica), descendants of Iberian breeds, possess significant genetic and cultural importance but are under-researched and at risk due to the dominance of improved breeds for commercial production. The aim of this study was to identify the most representative body morphometric measurements for the differentiation of two Creole pig breeds, using statistical and machine learning methods. A sample of “Casco de Mula” (n = 54) and San Pedreño (n = 30) Creole pigs, aged between 2 and 6 months, belonging to seven traditional farms located in the department of Meta (Colombia), was studied. A total of 14 morphometric variables were recorded, as well as the animal’s sex. Four algorithms—linear discriminant analysis, quadratic discriminant analysis, logistic regression, and classification trees—were used to classify the breeds. The results indicated that head width, height at the withers, and right ear length measurements could be used to differentiate the “Casco de Mula” and San Pedreño Creole pigs. The decision tree was the most accurate algorithm (accuracy = 92%, sensitivity = 96%, specificity = 83%, and Matthews correlation coefficient = 0.82), and its performance can be improved by increasing the number of animals. Non-parametric supervised learning methods like decision trees can be used to morphometrically differentiate Creole pigs raised in the same or different environments in order to characterize animal genetic resources. Full article

(This article belongs to the Special Issue Feature Papers in Animal Science: 4th Edition)

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17 pages, 3686 KiB

Open AccessHypothesis

On an RNA-Membrane Protogenome

by Michael Yarus

Life 2025, 15(5), 692; https://doi.org/10.3390/life15050692 - 24 Apr 2025

Abstract

Efficient evolution exists before DNA, else the DNA genome itself could not evolve. Current data suggest RNA-membranes for this role. Selected RNAs bind well to phospholipid bilayers; randomized sequences do not. No repeated sequences are evident in selected binding RNAs. This implies small [...] Read more.

Efficient evolution exists before DNA, else the DNA genome itself could not evolve. Current data suggest RNA-membranes for this role. Selected RNAs bind well to phospholipid bilayers; randomized sequences do not. No repeated sequences are evident in selected binding RNAs. This implies small and varied membrane-affinity motifs. Such binding sequences are partially defined. Phospholipid-bound RNAs require divalents like Mg²⁺ and/or Ca²⁺, preferring more ordered bilayers: gel, ripple, or rafted membranes, in that order. RNAs also bind and stabilize bent or sharply deformed bilayers. RNA binding without divalents extends to negatively charged membranes formed from simpler anionic phospholipids and to plausibly prebiotic fatty acid bilayers. RNA-membranes frequently retain RNA solution functions: base pairing, passive transport of tryptophan, specific affinity for arginine side chains, and ribozymic ligase catalysis. Membrane-bound RNAs with several biochemical functions, linked by specific base-pairing, are readily constructed. Given these data, genetic roles seem feasible. RNA activities often require few nucleotides, easily joined in a small RNA. Base-paired groups of such RNAs can also be purposeful, joining related functions. Complex functions can therefore require only replication of short RNAs. RNA-membranes potentially segregate accurately during cell division and quickly evolve through new base pairings. Accordingly, ancient RNA-membranes could act as a protogenome, supporting encoded RNA expression, inheritance, and evolution before the DNA genome: for example, supporting organized biochemistry, coded translation, and a Standard Genetic Code. Full article

(This article belongs to the Section Origin of Life)

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10 pages, 1090 KiB

Open AccessArticle

The Cut-Off Value for the Triglyceride–Glucose Index (TyG) Discriminating Insulin Resistance Based on the SHBG Level and HOMA-IR Values in Women with Polycystic Ovary Syndrome

by Tahar Ben Rhaiem, Aleksander Jerzy Owczarek, Mariusz Wójtowicz, Dariusz Ciura, Paweł Madej, Jerzy Chudek and Magdalena Olszanecka-Glinianowicz

Life 2025, 15(5), 691; https://doi.org/10.3390/life15050691 - 23 Apr 2025

Abstract

The triglyceride–glucose (TyG) index was recently suggested as a surrogate marker of liver steatosis and insulin resistance. However, the TyG index cut-off value may be affected by age, sex, and race. Therefore, this study aimed to estimate the cut-off value for the TyG [...] Read more.

The triglyceride–glucose (TyG) index was recently suggested as a surrogate marker of liver steatosis and insulin resistance. However, the TyG index cut-off value may be affected by age, sex, and race. Therefore, this study aimed to estimate the cut-off value for the TyG index discriminating insulin resistance based on the previously established cut-offs for HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) and serum level of SHBG (sex hormone-binding globulin) in Caucasian women with polycystic ovary syndrome (PCOS). The medical records of 311 unselected Caucasian women diagnosed with PCOS were included. Finally, due to the exclusion of patients with diabetes and hypertension, a cohort of 264 (84.9%) women with PCOS were analyzed. The following data were retrieved from the medical history: age, body weight, waist circumference, height, serum levels of glucose, triglycerides, insulin, and SHBG. HOMA-IR was calculated with a standard formula. The TyG index was calculated according to the formula TyG = ln(triglycerides[mg/dL] × glucose [mg/dL]/2). The cut-off value for the TyG index was calculated using ROC analysis. The empirical optimal of the TyG index cut-off, corresponding to HOMA-IR ≥ 2.1, was >8.31 (AUC 0.77, accuracy 0.70, sensitivity 61.2%, specificity 75.3%, PPV—positive predictive value 59.4%, NPV—negative predictive value 76.7%). The corresponding TyG index cut-off values for a SHBG level < 41.5 nmol/L was >8.31 (AUC 0.67, accuracy 0.65, sensitivity 54.9%, specificity 73.9%, PPV 64.4%, NPV 65.6%). Our study suggests that the cut-off point for the TyG index in young Caucasian women with PCOS, which discriminates against insulin resistance, is 8.31 (based on both HOMA-IR and SHBG values). In addition, our data confirm the usefulness of the TyG index as an initial assessment of insulin resistance, which should be confirmed by assessing the HOMA-IR value or SHBG concentration. Full article

(This article belongs to the Section Physiology and Pathology)

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16 pages, 535 KiB

Open AccessReview

Pain Medication in Chronic Low Back Pain

by Ali Jerjir, Frederik Nietvelt, Iris Smet, Nina D’hondt and Jean-Pierre Van Buyten

Life 2025, 15(5), 690; https://doi.org/10.3390/life15050690 - 23 Apr 2025

Abstract

Chronic low back pain (CLBP) significantly impacts individuals’ quality of life and functional abilities. In non-oncological settings, CLBP is often treated for long periods using pharmacotherapy. This paper provides a comprehensive overview of pharmacological treatments for CLBP, detailing their mechanisms of action, adverse [...] Read more.

Chronic low back pain (CLBP) significantly impacts individuals’ quality of life and functional abilities. In non-oncological settings, CLBP is often treated for long periods using pharmacotherapy. This paper provides a comprehensive overview of pharmacological treatments for CLBP, detailing their mechanisms of action, adverse effects, and evidence supporting their use. We discuss various medication classes, including NSAIDs, acetaminophen, antidepressants, gabapentinoids, tramadol, major opioids, corticosteroids, antispasticity drugs, benzodiazepines, and antibiotics. Special emphasis is given to the opioid crisis, examining its history, the pathophysiology of opioid tolerance and dependence, the need for cautious opioid use, the key challenges in treatment and emerging medications for CLBP. We also share insights from our experiences with polypharmacy, commonly seen in CLBP patients, at a specialized pain centre in Belgium. Full article

(This article belongs to the Special Issue Chronic Low Back Pain: Symptoms, Pain Mechanisms and Treatment)

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13 pages, 419 KiB

Open AccessReview

Lipid Metabolism and Breast Cancer: A Narrative Review of the Prognostic Implications and Chemotherapy-Induced Dyslipidemia

by Ionut Flaviu Faur, Amadeus Dobrescu, Ioana Adelina Clim, Paul Pasca, Cosmin Burta, Marco Marian, Dan Brebu, Andreea-Adriana Neamtu, Vlad Braicu, Talpai Tamas, Ciprian Duta and Bogdan Totolici

Life 2025, 15(5), 689; https://doi.org/10.3390/life15050689 - 23 Apr 2025

Abstract

Introduction: Lipid metabolism plays a crucial role in breast cancer’s progression, treatment response, and prognosis. Alterations in triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) have been implicated in tumor aggressiveness and chemotherapy outcomes. This review examines the relationship between [...] Read more.

Introduction: Lipid metabolism plays a crucial role in breast cancer’s progression, treatment response, and prognosis. Alterations in triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) have been implicated in tumor aggressiveness and chemotherapy outcomes. This review examines the relationship between dyslipidemia and breast cancer, with a focus on chemotherapy-induced lipid alterations and their prognostic significance. Methods: A comprehensive literature search was conducted in PUBMED, Web of Science, and Google Scholar, identifying 108 unique studies. After applying the inclusion criteria, 21 studies were selected for analysis, covering lipid profile changes before, during, and after chemotherapy, as well as their impact on treatment response and clinical outcomes. Results: Breast cancer patients exhibited lower baseline TC, TG, and LDL-C levels compared to healthy controls; however, chemotherapy significantly increased these markers while decreasing HDL-C from 1.1 to 0.9 mmol/L. The incidence of dyslipidemia rose from 42.98% pre-treatment to 58.28% post-treatment. Chemotherapy-induced lipid alterations were most pronounced in anthracycline- and taxane-based regimens, leading to a 38% increase in TGs and a 23% reduction in HDL-C. While some studies reported that lipid levels normalized post-treatment, others indicated persistent dyslipidemia up to 12 months later. High baseline HDL-C was associated with a better chemotherapy response, whereas elevated TGs and LDL-C correlated with increased tumor aggressiveness, lower pathological complete response rates, and a higher relapse risk. Patients with persistently high post-treatment TGs had significantly worse disease-free survival, with a 30% relapse rate compared to 18% in those with normal TG. Preliminary evidence suggests that lipid-lowering therapies, such as statins, may offer therapeutic benefits in breast cancer by targeting the cholesterol synthesis pathways involved in tumor growth, though further clinical trials are required. Conclusions: Dyslipidemia is a key metabolic factor influencing breast cancer’s progression, treatment response, and long-term prognosis. Chemotherapy-induced lipid alterations may persist, increasing cardiovascular risk and potentially affecting therapeutic efficacy. Routine lipid monitoring and metabolic interventions could enhance treatment outcomes and survivorship. Future research should focus on developing lipid-targeted strategies to optimize breast cancer management. Full article

(This article belongs to the Special Issue Lipid Metabolism Pathways: From Life to Disease)

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29 pages, 2228 KiB

Open AccessSystematic Review

Effects of Resistance Training on Sarcopenia Risk Among Healthy Older Adults: A Scoping Review of Physiological Mechanisms

by Karuppasamy Govindasamy, Chythra R. Rao, Baskaran Chandrasekaran, Koulla Parpa and Urs Granacher

Life 2025, 15(5), 688; https://doi.org/10.3390/life15050688 - 23 Apr 2025

Abstract

Sarcopenia, characterized by progressive loss of muscle mass and strength, significantly increases health risks in healthy older adults. Resistance training (RT) is believed to counteract sarcopenia through a variety of physiological mechanisms, many of which remain underexplored by public health and physiotherapy professionals. [...] Read more.

Sarcopenia, characterized by progressive loss of muscle mass and strength, significantly increases health risks in healthy older adults. Resistance training (RT) is believed to counteract sarcopenia through a variety of physiological mechanisms, many of which remain underexplored by public health and physiotherapy professionals. This scoping review aims to consolidate studies that have explored RT programs in mitigating sarcopenia among healthy older adults. A systematic search in four knowledge databases (Web of Science, Scopus, Embase, Cumulative Index for Nursing and Allied Health Sciences Complete) was conducted on 30 April 2024 to consolidate the evidence of RT programs to mitigate sarcopenia risk among healthy older adults. Two reviewers independently screened, consolidated, and synthesized the results based on the Arksey and O’Malley framework. We included 36 studies supporting the RT program for reducing sarcopenia risk among healthy older people. Current evidence, predominantly derived from studies with high selection bias and non-randomized designs, indicates that RT programs may enhance muscle strength in healthy older adults. However, their impact on muscle morphology and mobility appears less pronounced. The dosage and intensity of RT are critical factors influencing these health outcomes. To substantiate the health benefits of RT in healthy older adults and facilitate the translation of research findings into policy-level recommendations, further high-quality, randomized controlled trials are warranted. Full article

(This article belongs to the Special Issue Resistance Training Is Medicine)

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16 pages, 1329 KiB

Open AccessArticle

Comparison of Postoperative Analgesic Profiles Between Transversus Abdominis Plane Block and Local Wound Infiltration in Living Donor Kidney Transplantation Recipients: A Propensity Score-Matched Analysis

by Min Suk Chae, Kyung Kwan Lee, Jin-Oh Jeong, Wonwoo Jeong, Young Wook Moon and Ji Young Min

Life 2025, 15(5), 687; https://doi.org/10.3390/life15050687 - 23 Apr 2025

Abstract

Effective postoperative pain management is crucial for optimizing recovery and clinical outcomes in living donor kidney transplantation (LDKT). This retrospective study compared the efficacy and safety of transversus abdominis plane (TAP) block and local wound infiltration (LWI) for postoperative analgesia. A total of [...] Read more.

Effective postoperative pain management is crucial for optimizing recovery and clinical outcomes in living donor kidney transplantation (LDKT). This retrospective study compared the efficacy and safety of transversus abdominis plane (TAP) block and local wound infiltration (LWI) for postoperative analgesia. A total of 524 LDKT recipients, matched through propensity scoring, were analyzed (262 per group). Pain intensity was assessed using the visual analog scale (VAS) at multiple postoperative time points, while opioid consumption was evaluated based on intravenous patient-controlled analgesia (IV-PCA) usage and rescue fentanyl doses. The TAP block group had significantly lower VAS pain scores at 1, 4, and 8 h postoperatively (p < 0.001) and required fewer opioids, as evidenced by reduced IV-PCA usage (55.9 ± 10.2 mL vs. 69.7 ± 18.2 mL; p < 0.001) and lower rescue fentanyl doses (67.7 ± 30.6 µg vs. 119.1 ± 71.8 µg; p < 0.001). Despite these differences in analgesic efficacy, no significant differences were observed between the groups in terms of postoperative nausea and vomiting or complications such as systemic toxicity and nerve injury. These findings suggest that the TAP block provides more effective early postoperative pain relief and reduces opioid requirements without increasing adverse events. Given its favorable safety profile and effectiveness, the TAP block is a valuable component of multimodal analgesia in LDKT recipients, supporting enhanced recovery while minimizing opioid-related complications. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 3rd Edition)

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14 pages, 7469 KiB

Open AccessArticle

Autofluorescence-Guided Surgery in the Management of Osteonecrosis of the Jaw: Correlation Between Bone Autofluorescence and Histopathological Findings in 56 Samples

by Ilaria Giovannacci, Aurora Andrea Venuti, Luigi Corcione, Samir Nammour and Paolo Vescovi

Life 2025, 15(5), 686; https://doi.org/10.3390/life15050686 - 23 Apr 2025

Abstract

(1) Background: Osteonecrosis of the jaw (ONJ) remains a challenging condition without a universally accepted treatment protocol. Surgical therapy, particularly Er:YAG laser-assisted surgery, has shown more predictable long-term results compared with non-surgical options. However, the identification of resection margins in ONJ surgery is [...] Read more.

(1) Background: Osteonecrosis of the jaw (ONJ) remains a challenging condition without a universally accepted treatment protocol. Surgical therapy, particularly Er:YAG laser-assisted surgery, has shown more predictable long-term results compared with non-surgical options. However, the identification of resection margins in ONJ surgery is complex and currently relies on the surgeon’s intraoperative assessment, without standardization. Bone autofluorescence (AF) has been proposed as an intraoperative diagnostic tool for visualizing necrotic bone; under VELscope (LED Medical Diagnostics Inc., Barnaby, BC, Canada) illumination, healthy bone exhibits hyperfluorescence, while pathological bone appears dark brown/black (loss of autofluorescence, LAF). (2) Methods: 22 patients with ONJ requiring surgical therapy were included. After bone exposure, VELscope system was used to induce and visualize bone AF. Areas exhibiting absent or pale AF were identified as necrotic and removed; additional samples were collected from adjacent hyperfluorescent regions. (3) Results: Histopathologic evaluation of 56 specimens were conducted; 35 hypofluorescent samples were found to be necrotic bone tissue; in the 21 hyperfluorescent samples, 86% demonstrated normal, vital bone. The correlation between fluorescence and bone vitality was highly significant (p < 0.0000001). (4) Conclusions: Our data show that AF-guided surgical resection, combined with Er:YAG laser-assisted surgery, may improve clinical outcomes. Full article

(This article belongs to the Special Issue New Restorative Technologies in the Management and Characterization Techniques of the Hard and Soft Tissues of Oral Cavity)

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10 pages, 1077 KiB

Open AccessOpinion

Sleeping Spermatozoa: The Symbolism of Gamete Cryopreservation in the Context of Cancer in AYAs

by Isabelle Koscinski, Céline Mazzoleni, France Verhaeghe, Jean-Philippe Klein and Célia Ravel

Life 2025, 15(5), 685; https://doi.org/10.3390/life15050685 - 23 Apr 2025

Abstract

For adolescents and young adults (AYAs) with cancer, fertility preservation is recommended before starting gonadotoxic treatments. This is an important aspect of psychological support in the treatment of the disease. However, the enormous psychological impact of this procedure on adolescents and young adults [...] Read more.

For adolescents and young adults (AYAs) with cancer, fertility preservation is recommended before starting gonadotoxic treatments. This is an important aspect of psychological support in the treatment of the disease. However, the enormous psychological impact of this procedure on adolescents and young adults with cancer needs to be addressed by professionals. The traumatic nature of cancer diagnosis disrupts the psychosocial development of AYAs. A young adolescent’s perception of reproduction, and in particular of sperm freezing, is greatly altered by the disease. For a teenager, the success of sperm banking results from a positive balance between facilitators and barriers, which are mentioned here. Moreover, this article proposes a symbolic interpretation of sperm banking, referring to landmarks integrated during childhood, especially in fairytales. Furthermore, it offers an original video documentary that can be used as an information support to help AYAs adhere to the process of preserving their fertility through sperm freezing. Full article

(This article belongs to the Special Issue Clinical Research in Male Reproduction)

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18 pages, 1299 KiB

Open AccessSystematic Review

Comprehensive Overview of Cytokine Interplay in Vitiligo: A Decade of Meta-Analyses Systematically Reviewed

by Alessia Paganelli, Cristina Cristofoletti, Francesco Moro, Alessandra Corrente, Laura Colonna, Emanuele Scala and Mauro Picardo

Life 2025, 15(5), 684; https://doi.org/10.3390/life15050684 - 23 Apr 2025

Abstract

(1) Background: Vitiligo is an autoimmune skin disorder characterized by melanocyte destruction. Despite metabolic disturbances and oxidative stress also playing a key role in its pathogenesis, accumulating evidence highlights a prominent role for cytokine dysregulation. (2) Methods: A systematic search was conducted to [...] Read more.

(1) Background: Vitiligo is an autoimmune skin disorder characterized by melanocyte destruction. Despite metabolic disturbances and oxidative stress also playing a key role in its pathogenesis, accumulating evidence highlights a prominent role for cytokine dysregulation. (2) Methods: A systematic search was conducted to identify meta-analyses published in the last decade that investigated cytokine involvement in vitiligo. (3) Results: Based on predefined inclusion criteria, nine meta-analyses were retrieved and reviewed. The findings confirm a central role for interferon-gamma (IFN-γ) in vitiligo pathogenesis, although recent meta-analyses suggest that IFN-γ gene polymorphisms are more broadly associated with autoimmunity rather than being vitiligo-specific. Elevated interleukin-17 (IL-17) levels have been consistently reported in vitiligo patients, supporting its contribution to immune-mediated melanocyte destruction. Regulatory T cell dysfunction appears to play a crucial role in disease progression. Additionally, TNF-α-308 G/A polymorphism has been linked to a genetic susceptibility to vitiligo, particularly in specific populations, reinforcing the role of TNF-α in immune dysregulation. Lastly, chemokines involved in immune cell recruitment to melanocytes further illustrate the complex inflammatory network underlying the disease. (4) Conclusions: This systematic review consolidates evidence from a decade of meta-analyses, underscoring the significance of cytokine dysregulation in vitiligo and highlighting potential therapeutic targets. Full article

(This article belongs to the Special Issue Feature Paper in Physiology and Pathology: 2nd Edition)

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21 pages, 375 KiB

Open AccessReview

Current Evidence Supporting the Role of miRNA as a Biomarker for Lung Cancer Diagnosis Through Exhaled Breath Condensate Collection: A Narrative Review

by Paolo Albino Ferrari, Cosimo Bruno Salis and Antonio Macciò

Life 2025, 15(5), 683; https://doi.org/10.3390/life15050683 - 22 Apr 2025

Abstract

Lung cancer, the leading cause of cancer-related mortality, has brought exhaled breath condensate (EBC) into focus as a promising non-invasive sample for detecting molecular biomarkers, particularly microRNAs, which regulate gene expression and contribute to tumorigenesis. Ten key studies encompassing approximately 866 subjects consistently [...] Read more.

Lung cancer, the leading cause of cancer-related mortality, has brought exhaled breath condensate (EBC) into focus as a promising non-invasive sample for detecting molecular biomarkers, particularly microRNAs, which regulate gene expression and contribute to tumorigenesis. Ten key studies encompassing approximately 866 subjects consistently demonstrated distinct patterns of miRNA dysregulation in lung cancer. Notably, several reported panels achieved diagnostic sensitivity and specificity exceeding 75% through the identification of distinct miRNA signatures in EBC, with oncogenic miRNAs (e.g., miR-21) upregulated and tumor-suppressor miRNAs (e.g., miR-486) downregulated in lung cancer patients. Analytical advancements, including next-generation sequencing (NGS), have improved miRNA detection sensitivity and specificity, addressing prior limitations of low yield and variability. NGS enabled the identification of novel miRNAs and proved especially effective in overcoming the low RNA yield associated with EBC samples. However, challenges persist regarding standardization of collection, sample dilution, and potential contamination. Moreover, the reproducibility of miRNA signatures across diverse patient populations remains a critical issue. Large-scale, multicenter validation studies are needed to establish robust diagnostic algorithms integrating EBC-derived miRNAs with existing clinical tools. The potential of EBC miRNA profiling to support current screening strategies could significantly improve early lung cancer detection and patient outcomes. Nevertheless, its clinical transition requires further methodological optimization and biomarker validation. This review critically evaluates current evidence on miRNA detection in EBC for lung cancer diagnosis. Full article

(This article belongs to the Special Issue Enhancements in Screening Pathways for Early Detection of Lung Cancer)

18 pages, 14619 KiB

Open AccessReview

Severe Rectal Stenosis as the First Clinical Appearance of a Metastasis Originating from the Bladder: A Case Report and Literature Review

by Claudiu Daha, Eugen Brătucu, Ioan Burlănescu, Virgiliu-Mihail Prunoiu, Hortensia-Alina Moisă, Ștefania Ariana Neicu and Laurențiu Simion

Life 2025, 15(5), 682; https://doi.org/10.3390/life15050682 - 22 Apr 2025

Abstract

While locally advanced rectal cancer is the first clinical suspicion for severe rectal stenosis, in extremely unusual cases a lower bowel obstruction may be related to bladder metastasis. We present the case of a 64-year-old male who was admitted for occlusive rectal tumor [...] Read more.

While locally advanced rectal cancer is the first clinical suspicion for severe rectal stenosis, in extremely unusual cases a lower bowel obstruction may be related to bladder metastasis. We present the case of a 64-year-old male who was admitted for occlusive rectal tumor (4 cm from the anal verge), for which an emergency loop-colostomy was performed. After two inconclusive endoscopic biopsies, a transanal rectal tru-cut biopsy allowed for the detection of high-grade urothelial carcinoma with signet ring cells. Furthermore, primary origin was detected in a small bladder tumor. In imaging reassessment after neoadjuvant chemotherapy, regression of the lesions both from the bladder and rectum was observed. Radical surgery with total pelvic exenteration was considered in the absence of other secondary tumors, but the patient declined and continued with radiotherapy. Subsequently he developed malignant chylous ascites and unfortunately died three months later. Reviewing the literature, we found twenty-five cases of urothelial metastasis to the rectum, originating from the bladder, including this newly present case. Rectal metastasis of urothelial origin poses a two-fold challenge in terms of both diagnosis and treatment. Determining the specific features of this uncommon manifestation of a common disease will improve future approaches. Full article

(This article belongs to the Special Issue Pathophysiology, Diagnosis, and Treatments of Intestinal Diseases)

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26 pages, 850 KiB

Open AccessReview

Omalizumab in Food Allergy in Children: Current Evidence and Future Perspectives

by Cristiana Indolfi, Alessandra Perrotta, Giulio Dinardo, Angela Klain, Carolina Grella, Paola Palumbo and Michele Miraglia del Giudice

Life 2025, 15(5), 681; https://doi.org/10.3390/life15050681 - 22 Apr 2025

Abstract

Omalizumab (OMA) is gaining recognition as a promising therapeutic approach for IgE-mediated food allergies in pediatric patients. We conducted a review analyzing 22 studies, including randomized controlled trials, observational studies, and case reports, to evaluate the efficacy and safety of OMA in food [...] Read more.

Omalizumab (OMA) is gaining recognition as a promising therapeutic approach for IgE-mediated food allergies in pediatric patients. We conducted a review analyzing 22 studies, including randomized controlled trials, observational studies, and case reports, to evaluate the efficacy and safety of OMA in food allergy management in children and adolescents. The results indicate that OMA, whether used as monotherapy or in combination with oral immunotherapy (OIT), significantly increases allergen tolerance, reduces the severity of allergic reactions, and improves patients’ quality of life. When used alongside OIT, OMA reduced adverse reactions during dose escalation and maintenance phases, facilitating safer and more effective desensitization. Additionally, OMA demonstrated benefits beyond food allergy management, including improved asthma control and a reduction in food allergy-related anxiety. However, challenges remain, including high costs, the need for standardized treatment protocols, and limitations related to total IgE thresholds for eligibility. While OMA has been FDA-approved for food allergy treatment in the United States, further research is needed to establish long-term efficacy, optimal dosing strategies, and its role in sustained tolerance development. Future research should focus on optimizing treatment protocols and identifying which patients will benefit the most. Integrating omalizumab into food allergy management could revolutionize pediatric care, offering hope for a safer, more effective approach to desensitization. Full article

(This article belongs to the Special Issue Feature Paper in Physiology and Pathology: 2nd Edition)

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15 pages, 4920 KiB

Open AccessArticle

Chemical Constituents and α-Glucosidase Inhibitory Activities of the Leaves of Embelia parviflora—In Vitro and In Silico Studies

by Sy Danh Thuong, Mai Thi Hoang Anh, Nguyen Van Phuong, Chu Hoang Mau, Nguyen Huu Quan, Nguyen Thanh Cong and Le Nguyen Thanh

Life 2025, 15(5), 680; https://doi.org/10.3390/life15050680 - 22 Apr 2025

Abstract

Phytochemical investigation of the methanol extract of Embelia parviflora Wall. Ex A. DC. leaves (Primulaceae family) led to the isolation of sixteen compounds including three sterols (1–3), one triterpene (4), four flavonoids (5–8), [...] Read more.

Phytochemical investigation of the methanol extract of Embelia parviflora Wall. Ex A. DC. leaves (Primulaceae family) led to the isolation of sixteen compounds including three sterols (1–3), one triterpene (4), four flavonoids (5–8), four megastigmanes (9–12), three phenolic compounds (13–15), and one furan derivative (16). Their chemical structures were determined based on ESI-MS and NMR spectral data. This is the first chemical study of E. parviflora. Compounds 3, 8–13, and 16 were found in the Embelia genus for the first time. Compounds 9–11, 13, and 16 represent the first isolation from the Primulaceae family. In the α-glucosidase activity assay, MeOH extract, compounds 4 and 5 strongly inhibited enzyme α-glucosidase activity. A molecular docking study revealed that compounds 4 and 5 showed different interactions with enzyme α-glucosidase. Full article

(This article belongs to the Section Pharmaceutical Science)

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10 pages, 520 KiB

Open AccessArticle

Effects of Acute Fatigue on Balance Control of Alpine Skiing Athlete

by Javier Riscart-López, Elena Jiménez-Herranz, Isabel Mendoza-Puente, Miguel Ángel Rosety-Rodríguez, Jorge Bastos-García, Manuel Rodríguez-Huguet and Juan José Ramos-Álvarez

Life 2025, 15(5), 679; https://doi.org/10.3390/life15050679 - 22 Apr 2025

Abstract

Background: Great physical requirements are necessary to maintain the entire body in a streamlined and aerodynamic position during downhill skiing. Balance control has an important role in alpine skiing and depends on muscle endurance and strength. The central processing of proprioception and the [...] Read more.

Background: Great physical requirements are necessary to maintain the entire body in a streamlined and aerodynamic position during downhill skiing. Balance control has an important role in alpine skiing and depends on muscle endurance and strength. The central processing of proprioception and the force capacity of muscle are altered by fatigue. The objective of this study was to assess the effects of fatigue and visual input on balance control in alpine skiing. Methods: Eleven male professional skiers participated in the study. Balance control with eyes open and eyes closed was assessed before and after performing a maximal effort specific alpine ski test. Variables: the total travel distance (TTD) (mm), radial area (RA) (mm²), ratio between TTD and RA (TTD/RA) (1/mm), mean center of pressure (COP) velocity (total length of the COP path per unit time) (mm/s), the mean mediolateral (ML) COP oscillation velocity (Lat_Vel) (mm/s), the mean anteroposterior (AP) COP oscillation velocity (AP_Vel) (mm/s), mean ML (MLD) (mm) and mean AP (APD) (mm) displacements of the COP and the distance from the ordinate origin (mean X and mean Y) (theoretical point where the COP should be) to the point at which the COP is located, and heart rate were measured. Results: The results showed differences in the variables related to postural control and balance before and after the stress test (p = 0.002–0.037). However, no differences were found when the results obtained with open and closed eyes were compared. Conclusions: The results showed that performance in alpine skiing could be negatively affected by fatigue. However, the dynamic parameters are not decreased by visual input during muscle fatigue. Full article

(This article belongs to the Special Issue Recent Advances in Physiotherapy for Musculoskeletal)

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9 pages, 211 KiB

Open AccessArticle

The Role of Polysomnography for Children with Attention-Deficit/Hyperactivity Disorder

by Chien-Heng Lin, Po-Yen Wu, Syuan-Yu Hong, Yu-Tzu Chang, Sheng-Shing Lin and I-Ching Chou

Life 2025, 15(4), 678; https://doi.org/10.3390/life15040678 - 21 Apr 2025

Abstract

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsive behavior. In recent years, studies have shown that patients with ADHD often experience sleep problems, raising clinical interest in the potential role of polysomnography (PSG) in [...] Read more.

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsive behavior. In recent years, studies have shown that patients with ADHD often experience sleep problems, raising clinical interest in the potential role of polysomnography (PSG) in the diagnosis and management of ADHD. This study examines polysomnographic findings in children with ADHD who present with diverse sleep complaints. Methods: A cohort of children aged younger than 18 years, diagnosed with ADHD based on DSM-5 criteria, underwent overnight polysomnography. The study assessed various sleep parameters, including sleep latency, sleep efficiency, total sleep time, and the presence of sleep-disordered breathing. Results: A retrospective analysis was conducted on 36 children (29 boys and 7 girls) aged 6 to 14 years, diagnosed with ADHD, who underwent polysomnography between 2021 and 2024. Polysomnographic findings revealed that 77.78% of the children demonstrated significant snoring. Furthermore, 50.0% were diagnosed with obstructive sleep apnea syndrome (OSAS). In addition, eight children exhibited parasomnias. Among them, six had bruxism, three were diagnosed with periodic limb movement disorder (PLMD), and two experienced sleep talking. Other notable sleep-related conditions included two cases of narcolepsy, one case of prolonged sleep onset latency, and one case of central apnea syndrome. Total sleep time (TST) was significantly longer in females compared to males (400.71 ± 32.68 min vs. 361.24 ± 41.20 min, p = 0.0215), whereas rapid eye movement (REM) latency was longer in males compared to females (118.62 ± 55.60 min vs. 78.57 ± 27.82 min, p = 0.0194). These findings highlight the high prevalence of sleep-disordered breathing (SDB) in children with ADHD who present with sleep disturbances. Furthermore, sleep quality, as indicated by longer TST and shorter REM latency, appears to be better in females with ADHD. Conclusions: The findings of this study underscore the critical role of polysomnography (PSG) in the assessment of children with ADHD. PSG provides an objective evaluation of sleep abnormalities commonly associated with ADHD, which may influence symptom manifestation and treatment outcomes. Notably, the results suggest that females with ADHD exhibit better sleep quality, as indicated by longer total sleep time (TST) and shorter rapid eye movement (REM) latency compared to males. We recommend incorporating polysomnography (PSG) into the comprehensive assessment of children with ADHD who present with significant sleep disturbances. Further research is warranted to investigate the impact of targeted interventions for sleep abnormalities on ADHD symptoms, prognosis, and potential sex-specific differences. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea and Related Disorders: Pathophysiological Traits and Strategies for Treatment)

36 pages, 739 KiB

Open AccessReview

Primary Hyperparathyroidism: An Analysis Amid the Co-Occurrence of Type 2 Diabetes Mellitus

by Ana-Maria Gheorghe, Mihaela Stanciu, Claudiu Nistor, Ioana Codruta Lebada and Mara Carsote

Life 2025, 15(4), 677; https://doi.org/10.3390/life15040677 - 21 Apr 2025

Abstract

Background: Apart from classical elements in primary hyperparathyroidism (PHPT), non-classical complications, including type 2 diabetes mellitus (T2DM), are reported in some patients, but currently, they do not represent a parathyroidectomy (PTx) indication. Objective: to explore the latest data regarding glucose profile, particularly, T2DM [...] Read more.

Background: Apart from classical elements in primary hyperparathyroidism (PHPT), non-classical complications, including type 2 diabetes mellitus (T2DM), are reported in some patients, but currently, they do not represent a parathyroidectomy (PTx) indication. Objective: to explore the latest data regarding glucose profile, particularly, T2DM and metabolic syndrome (MetS) in PHPT, including post-PTx. Methods: PubMed-based review included English-published original studies between January 2020 and December 2024 (n = 20). Results: Studied population: 764,485 subjects (female-to-male ratio of 1.26:1; 23,931 were PHPT patients vs. 740,502 controls). T2DM prevalence (n = 13; N = 763,645 patients; 55.92% females): 4–60% (higher vs. controls); for the largest study (N = 699,157) of 31.3%. Age-based analysis: higher T2DM prevalence at >50 vs. <50 years (14.4% vs. 2.6%, p < 0.001), but not all studies agreed. Concurrent vitamin D deficiency as a contributor to a higher risk had limited evidence. The association MetS-PHPT (n = 2) had no clear conclusion. Post-PTx showed the following: lower glycaemia, fasting insulin, insulin resistance (HOMA-IR) improvement, and reduced rate (but not all studies agreed). PHPT patients with prediabetes might represent the population sub-group with the highest post-PTx benefit. Conclusions: The panel of PHPT-T2DM interplay remains heterogeneous. Data regarding post-PTx improvement of glucose disorders are still conflicting, recent findings suggested that surgery has beneficial effects, especially in patients with confirmed pre-existing prediabetes. Patients with the normocalcemic variant seemed to be less affected by the glucose-related disturbances, but further studies are needed. A better understanding of the intricate relationship between PHPT and glucose metabolism anomalies will help in providing optimal management to reduce the overall disease burden. Full article

(This article belongs to the Special Issue Management of Patients with Diabetes)

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13 pages, 1249 KiB

Open AccessArticle

Prevalence and Prognostic Significance of Chloride Levels in Patients with Acute Medical Conditions: A Prospective Observational Study

by Rhita Bennis Nechba, Jihane Belayachi, Mina Agrou, Elmostapha El Fahime, Nawal Meknassi, Maha Louriz, Naoufel Madani and Redouane Abouqal

Life 2025, 15(4), 676; https://doi.org/10.3390/life15040676 - 21 Apr 2025

Abstract

Chloride plays a considerable role in physiology. This study aimed to assess the association between serum chloride and prognosis in the population of adults with acute medical conditions. A prospective cohort study was conducted in an acute medical unit. Chloride levels at admission [...] Read more.

Chloride plays a considerable role in physiology. This study aimed to assess the association between serum chloride and prognosis in the population of adults with acute medical conditions. A prospective cohort study was conducted in an acute medical unit. Chloride levels at admission were the main exposure factor, categorized into hypochloremia, normochloremia, and hyperchloremia. The outcomes were in-hospital mortality and length of hospital stay (LOHS). A total of 798 patients were included. The mean age was 57.3 ± 18.3 years. The prevalence of dyschloremia was 40.9%. Restricted cubic splines revealed a linear association between hypochloremia and in-hospital mortality, as well as between hypochloremia and LOHS. After adjusting for age, sex, heart failure, diabetes, sodium, bicarbonates, creatinine, and diuretic use, hypochloremia was significantly associated with in-hospital mortality (OR = 2.23; 95% CI: 1.29, 3.86, p = 0.006), but not hyperchloremia (p = 0.57). Similarly, it was associated with a longer LOHS (β = 2.19; 95% CI: 0.01, 4.39, p = 0.05), but not hyperchloremia (p = 0.8). The interaction between chloride and sodium levels was not significant (p = 0.61). Subgroup analysis showed that the effect of hypochloremia on in-hospital mortality was consistent across subgroups. The prevalence of dyschloremia in this study was high at 40.9%. Hypochloremia increased the risk of in-hospital mortality and extended the LOHS. Differentiating the effects of chloride levels from those of sodium can enhance clinical risk stratification and enable a more targeted management approach for acutely ill patients. Recognizing this distinction is essential for optimizing prognostic assessment and tailoring treatment strategies accordingly. Full article

(This article belongs to the Special Issue Common and Novel Markers of Inflammation and Tissue Damage in Various Pathological Conditions)

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