Life

13 pages, 890 KB

Open AccessArticle

Randomized Controlled Trial of Patient Positioning and Operator Radiation Exposure During Lower Extremity Catheter Angiography

by Ákos Bérczi, Fanni Éva Szablics, Anita Nelli Simon, Gabriella Taba, Dóra Ágota Papp, Réka György, Ákos András Pataki, Artúr Hüttl, Balázs Nemes and Csaba Csobay-Novák

Life 2025, 15(9), 1433; https://doi.org/10.3390/life15091433 - 12 Sep 2025

Abstract

Digital subtraction angiography (DSA) remains an important reference modality for evaluating chronic limb-threatening ischemia (CLTI), with left transradial access (TRA) increasingly favored for its lower complication rates and patient comfort. Radiation safety for operators is paramount, yet the impact of patient positioning on [...] Read more.

Digital subtraction angiography (DSA) remains an important reference modality for evaluating chronic limb-threatening ischemia (CLTI), with left transradial access (TRA) increasingly favored for its lower complication rates and patient comfort. Radiation safety for operators is paramount, yet the impact of patient positioning on scatter radiation during lower limb diagnostic catheter angiography (CA) is understudied. This single-center randomized controlled trial evaluated whether head-first (HF) vs. feet-first (FF) supine patient orientation affects operator radiation exposure during lower extremity CA from left TRA. Between February and August 2024, 24 patients with CLTI were enrolled and randomized to HF or FF positions. Operator radiation exposure was measured using thermoluminescent dosimeters (TLDs) at the eye, chest, and left ring finger. Background radiation was subtracted. Procedures were standardized and performed by a single experienced interventional radiologist. Fluoroscopy time, dose area product (DAP), and contrast usage were recorded. No statistically significant differences were found between groups in patient BMI and procedural parameters. Patient positioning (HF vs. FF) did not significantly impact operator radiation exposure. A trend toward higher finger exposure in FF position suggests the need for optimized hand protection. These findings support flexible patient positioning without compromising operator safety, reinforcing adherence to ALARA principles. Full article

(This article belongs to the Special Issue Advances in Vascular Medicine: From Endovascular Innovations to Pathophysiological Insights)

19 pages, 308 KB

Open AccessArticle

Biomarkers for Early Detection of Cisplatin-Induced Nephrotoxicity

by Nikolay Dimov, Antoniya Yaneva, Evelina Valcheva, Gabriela Raycheva, Veselin Popov, Raya Delipavlova, Dimitar Nikolov and Zhanet Grudeva-Popova

Life 2025, 15(9), 1432; https://doi.org/10.3390/life15091432 - 12 Sep 2025

Abstract

Nephrotoxicity is a common complication during antineoplastic therapy, particularly when platinum-based medications are used. Early detection of this condition is crucial for improving risk stratification and management, thereby enhancing decision-making in kidney disease treatment. However, traditional biomarkers for renal assessment lack sensitivity in [...] Read more.

Nephrotoxicity is a common complication during antineoplastic therapy, particularly when platinum-based medications are used. Early detection of this condition is crucial for improving risk stratification and management, thereby enhancing decision-making in kidney disease treatment. However, traditional biomarkers for renal assessment lack sensitivity in identifying early or subclinical damage, underscoring the need for novel and more precise markers. This study aimed to investigate the effectiveness of urinary KIM-1, clusterin, nephrin, and serum cystatin C in detecting nephrotoxicity associated with platinum-based therapies. A total of 43 patients with different oncological diseases participated in the prospective study, divided into two groups based on the nephrotoxic potential of the administered drugs: patients treated with cisplatin (high-risk group for nephrotoxicity) and patients treated with oxaliplatin/carboplatin (low-to-moderate risk group for nephrotoxicity). The results showed that nephrotoxicity, determined as a decrease in eGFR of >10 mL/min/1.73 m² at the sixth month after initiation of platinum-based therapy, occurred in 54.3% of cases, with 80% of these attributable to cisplatin-based therapy. Conventional renal biomarkers, such as the serum creatinine and urine albumin-creatinine ratio, have shown controversial results in the course of the study. In contrast, the patients treated with cisplatin, as well as those who developed nephrotoxicity, showed significant increases in the mean values of cystatin C (p < 0.001, respectively, p < 0.001), urinary KIM-1 (p = 0.005, respectively, p = 0.002), and urinary clusterin (p = 0.001, respectively, p = 0.001). Among the group with a low to moderate risk of nephrotoxicity including those treated with oxaliplatin/carboplatin, no statistically significant changes over time were observed in any of the biomarkers. These findings suggest that the aforementioned biomarkers can be used for the early detection of cisplatin-induced eGFR decline. Full article

(This article belongs to the Special Issue Research Progress in Kidney Diseases)

17 pages, 863 KB

Open AccessReview

When a Woman’s Heart Fails to Contain: Takotsubo Syndrome as a Gendered Collapse of Emotional Regulation

by Giuseppe Marano, Enrico Romagnoli, Giuseppe Biondi-Zoccai, Gianandrea Traversi, Osvaldo Mazza, Roberto Pola, Eleonora Gaetani and Marianna Mazza

Life 2025, 15(9), 1431; https://doi.org/10.3390/life15091431 - 12 Sep 2025

Abstract

Background: Takotsubo Syndrome (TTS), or stress-induced cardiomyopathy, is an acute and typically reversible cardiac condition that mimics acute coronary syndrome without obstructive coronary artery disease. Predominantly affecting postmenopausal women, TTS has been increasingly recognized as a psychobiological disorder involving neuroendocrine dysregulation, autonomic imbalance, [...] Read more.

Background: Takotsubo Syndrome (TTS), or stress-induced cardiomyopathy, is an acute and typically reversible cardiac condition that mimics acute coronary syndrome without obstructive coronary artery disease. Predominantly affecting postmenopausal women, TTS has been increasingly recognized as a psychobiological disorder involving neuroendocrine dysregulation, autonomic imbalance, psychosocial stress, and gendered patterns of emotional regulation. This review aimed to synthesize multidisciplinary evidence to propose an integrative, gender-informed model of TTS. Methods: A narrative literature review was conducted using PubMed/MEDLINE, Scopus, and Web of Science (2000–2025) to identify clinical, neurobiological, psychosocial, and psychoanalytic studies addressing sex/gender differences, psychiatric comorbidities, and emotional regulation in TTS. Results: Evidence indicates that catecholamine surge, hypothalamic–pituitary–adrenal axis dysregulation, estrogen deficiency, and autonomic imbalance provide a biological substrate for stress-induced myocardial stunning. Psychosocial factors, such as caregiving burden, chronic stress, and alexithymia, further decrease resilience. Gendered coping scripts and unconscious symbolic processes may amplify vulnerability and influence clinical presentation. The integrative model combines biological, psychological, and social mechanisms, highlighting the predominance of emotional triggers in women and worse in-hospital outcomes in men. Conclusions: TTS should be approached as both a cardiac and affective disorder. Gender-sensitive, multidisciplinary management, including psychiatric screening, psychocardiology interventions, and psychoanalytically informed care, may improve prevention, diagnosis, and patient outcomes. Full article

(This article belongs to the Special Issue Current and Future Perspectives of Takotsubo Syndrome)

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17 pages, 10054 KB

Open AccessArticle

A Dose-Dependent Study Examining Dexmedetomidine’s Possible Effects Against Oxidative, Fibrotic, and Apoptotic Damage Induced by Radiation Exposure in Spleen Tissue

by Hatice Beyazal Polat, Hamit Yılmaz, Kagan Kilinc, Belemir Gülhan, Sema Yılmaz Rakıcı and Levent Tümkaya

Life 2025, 15(9), 1430; https://doi.org/10.3390/life15091430 - 12 Sep 2025

Abstract

Objective: This study aimed to investigate the potential splenic tissue damage induced by radiotherapy (RT) and the potential protective effect of different doses of dexmedetomidine on this damage at the histopathological, immunohistochemical, and biochemical levels. Materials and Methods: In our study, Sprague Dawley [...] Read more.

Objective: This study aimed to investigate the potential splenic tissue damage induced by radiotherapy (RT) and the potential protective effect of different doses of dexmedetomidine on this damage at the histopathological, immunohistochemical, and biochemical levels. Materials and Methods: In our study, Sprague Dawley rats were randomly divided into four groups: Control, Radiotherapy (RT; 8 Gy), RT + Dexmedetomidine 100 µg/kg (RT-D100), and RT + Dexmedetomidine 200 µg/kg (RT-D200). A single dose of 8 Gy radiotherapy was administered to each RT group. Spleen tissues were examined histologically with hematoxylin-eosin and immunohistochemically with anti-Caspase-3, anti-TGF-β1, and anti-TGF-β3 using light microscopy. TBARS and total thiol levels were also analyzed to assess oxidative stress and antioxidant capacity. Results: Histopathological results showed a significant decrease in white pulp diameter, decreased cellular density, and increased congestion in the red pulp in the RT group. Significant fibrosis, sinusoidal dilatation, vacuolization, and amyloid deposition were detected in the white pulp in the RT group. Regarding anti-caspase-3 immunoreactivity, strong positivity increased in the red pulp in the RT group, while a significant increase was observed in the white pulp in both the RT-D100 and RT groups. While the proportion of TGF-β1 immunopositive cells did not change significantly in the RT group, they increased significantly in both dexmedetomidine groups (especially RT-D200). TGF-β3 expression increased significantly only in the RT-D100 group. In biochemical analyses, TBARS levels increased significantly in the RT-D100 group. Total thiol levels decreased in the RT group and increased in the dexmedetomidine-treated groups. Conclusions: While RT caused histopathological damage and increased oxidative stress in spleen tissue, dexmedetomidine reduced this damage in a dose-dependent manner. The different immunohistochemical profiles of TGF-β1 and TGF-β3 suggest that these cytokines may have different functions in the spleen. 100 µg/kg dexmedetomidine stimulates a regenerative response through TGF-β3, while 200 µg/kg dexmedetomidine may provide immune regulation and antioxidative defense through TGF-β1. Full article

(This article belongs to the Section Cell Biology and Tissue Engineering)

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14 pages, 524 KB

Open AccessArticle

Diabetic Kidney Disease: Evidence from Two Selected Cohorts of Patients from Low–Middle and High Income Countries

by Maria Mattiotti, Matteo Righini, Daniele Vetrano, Danilo Ribichini, Valentina Vicennati, Valeria Aiello, Ermanno Notaro, Paolo Belardi, Noemi Bazzanini, Katunzi Mutalemwa, Emmanuel Ndile, Rehema Itambu, Uberto Pagotto, Gaetano Azzimonti, Giuseppe Cianciolo, Irene Capelli and Gaetano La Manna

Life 2025, 15(9), 1429; https://doi.org/10.3390/life15091429 - 11 Sep 2025

Abstract

Objectives: Diabetic kidney disease (DKD) is the leading cause of kidney failure worldwide. Different phenotypes of DKD are emerging, partially attributable to a better glycemic control, partially to concomitant risk factors for kidney disease. Diabetes belongs to Non-Communicable Diseases (NCDs), but poor data [...] Read more.

Objectives: Diabetic kidney disease (DKD) is the leading cause of kidney failure worldwide. Different phenotypes of DKD are emerging, partially attributable to a better glycemic control, partially to concomitant risk factors for kidney disease. Diabetes belongs to Non-Communicable Diseases (NCDs), but poor data about DKD in Low–Middle Income Countries are currently available. In the present paper we compare two cohorts of patients affected by DKD from Tanzania and from Italy. Study design: Retrospective observational study conducted by NCDs Clinic of Tosamaganga Regional Referral Hospital (Tanzania) and from the Multidisciplinary Diabetological-Nephrological Clinic of Bologna (Italy). Methods: Included patients’ data were analyzed for demographical features, diabetes complications, laboratory findings, and pharmacological therapy at the time of enrollment and after 6-month follow-up. Results: Tanzanian patients were younger (56.65 vs. 67.66 years, p < 0.001), with a higher prevalence of women (66.9% vs. 25.5%, p < 0.001), and showed lower level of BMI (26.39 vs. 30.18 kg/m², p < 0.001). Worsened glycemic control could be observed in the Tanzanian cohort (HbA1c 83.71 vs. 56.92 mmol/mol, p < 0.001) and higher eGFR (70.13 ± 31.93 vs. 52.31 ± 23.37 mL/min, p < 0.001). A sharp reduction in albuminuria was observed in both cohorts with an increase in nephroprotective drugs and better glycemic control. Conclusions: Two phenotypes of diabetic patients have emerged from comparison between two cohorts. Tanzanian patients are mostly female, younger, and with a normal BMI, whereas Italian patients are mainly male, older, and affected by metabolic syndrome and vascular complications. Therapy implementation is associated with a delayed decline of eGFR and downgrading of albuminuria at 6-month follow-up. Full article

(This article belongs to the Special Issue An Update on Diabetic Kidney Disease: Epidemiology, Diagnosis, Treatment)

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18 pages, 2690 KB

Open AccessArticle

Ferreting Out the Effects of Neonatal Hypoxia–Ischemia and Sex on Ferret Cortical Gyrification

by Olivia C. Brandon, Olivia R. White, Kylie A. Corry, Andreea Stanescu, Arian Ariaye, Daniel H. Moralejo, Janessa B. Law, Sarah E. Kolnik, Sandra E. Juul and Thomas R. Wood

Life 2025, 15(9), 1428; https://doi.org/10.3390/life15091428 - 11 Sep 2025

Abstract

Gyrification, the folding of the cerebral cortex, plays a crucial role in brain development and function. Perinatal hypoxia–ischemia (HI) is a leading cause of neonatal brain injury, affecting cortical folding that can be measured by the gyrification index (GI). Using a late-preterm ferret [...] Read more.

Gyrification, the folding of the cerebral cortex, plays a crucial role in brain development and function. Perinatal hypoxia–ischemia (HI) is a leading cause of neonatal brain injury, affecting cortical folding that can be measured by the gyrification index (GI). Using a late-preterm ferret model, our objective was to explore the relationships between HI injury, GI changes, and behavior, as well as the potential moderating effects of sex and treatment. Animals received 3 mg/kg E. coli lipopolysaccharide and underwent bilateral carotid artery ligation followed by alternating hypoxia and hyperoxia (HIH) and were randomized to saline vehicle (n = 25), erythropoietin (n = 20), therapeutic hypothermia (6 h at 33.5 °C, n = 20), and uridine monophosphate (n = 6), with n = 20 unexposed littermates serving as controls. Early reflex testing, CatWalk gait analysis, open-field behavior, and an open-water swim test were performed. Average, peak, motor, and somatosensory strip GIs were then assessed using ex vivo MRI. In control animals, males had lower GI than females; however, HIH exposure resulted in male GI being more similar to females, where HIH animals had significantly higher average GI than controls (p = 0.02). Adjusting for brain volume and injury, GIs in motor and somatosensory areas were associated with faster reflex outcomes in males but not females. In female controls, motor and somatosensory GIs were associated with increased anxiety-like behaviors, such as spending less time in open water during the swim test. By comparison, in male controls, higher GI was associated with decreased anxiety-like behaviors, including higher exploration index in the swim test. These sex-specific relationships between GI and behavior were lost with HIH injury. Treatment did not meaningfully restore the relationship between GI and behavior after HIH, but targeting this outcome may be an important measure for use in future neuroprotection studies in the ferret. Full article

(This article belongs to the Section Medical Research)

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31 pages, 1179 KB

Open AccessArticle

Metabolic Responses of Newly Isolated Microalgal Strains Cultured in an Open Pond Simulating Reactor Under Balanced Conditions and Nutrient Limitation

by Panagiotis Dritsas and George Aggelis

Life 2025, 15(9), 1427; https://doi.org/10.3390/life15091427 - 11 Sep 2025

Abstract

Microalgal strains—Picochlorum costavermella VAS2.5, Picochlorum oklahomense PAT3.2B and SAG4.4, Microchloropsis gaditana VON5.3, and Nephroselmis pyriformis PAT2.7—were evaluated in an Open Pond Simulating Reactor (OPSR) under varied conditions to assess their biomass yield and high-value metabolite production. Overall, the strains produced 269.1–523.0 mg/L [...] Read more.

Microalgal strains—Picochlorum costavermella VAS2.5, Picochlorum oklahomense PAT3.2B and SAG4.4, Microchloropsis gaditana VON5.3, and Nephroselmis pyriformis PAT2.7—were evaluated in an Open Pond Simulating Reactor (OPSR) under varied conditions to assess their biomass yield and high-value metabolite production. Overall, the strains produced 269.1–523.0 mg/L of biomass under balanced growth conditions in modified Artificial Seawater, continuous illumination, and pH 8.5. Phosphorus limitation notably enhanced yields for SAG4.4 and PAT2.7 (529.0 ± 52.2 mg/L and 452.2 ± 21.0 mg/L, respectively). Conversely, nitrogen limitation reduced productivity. In most strains the glycolipid plus sphingolipid fraction was dominant. Significant quantities of 20:5(n-3) were traced in the cultures of VAS2.5 and VON5.3, while the PAT3.2B and SAG4.4 strains produced considerable amounts of 18:3(n-3). In contrast, the most interesting fatty acid synthesized by PAT2.7 was 16:1(n-7), which was also detected in significant quantities in VAS2.5 and VON5.3. Polysaccharide content remained stable across conditions (10–15%), and protein levels reached 45–50% under control and phosphorus-limited environments. Pigment synthesis peaked at control conditions. Overall, the biochemical profiles of these strains revealed their potential for use primarily as feed additives in the aquaculture sector. Full article

(This article belongs to the Section Microbiology)

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Graphical abstract

28 pages, 1161 KB

Open AccessReview

Arrhythmias in Rheumatoid Arthritis: A Call for a Multidisciplinary Team

by Veronica Ungurean, Diana Elena Costan, Monica Claudia Dobos, Anca Ouatu, Paula Cristina Morariu, Alexandru Florinel Oancea, Maria Mihaela Godun, Diana-Elena Floria, Dragos Traian Marcu, Genoveva Livia Baroi, Silviu Marcel Stanciu, Anton Knieling, Daniela Maria Tanase, Codrina Ancuta and Mariana Floria

Life 2025, 15(9), 1426; https://doi.org/10.3390/life15091426 - 11 Sep 2025

Abstract

Background: Rheumatoid arthritis is the most prevalent systemic inflammatory disease, mainly affecting the synovial tissue of small and large joints, also associated with significant extra-articular manifestations. Throughout the progression of the disease, cardiac structures may be affected, including the conducting system, myocardium, endocardium, [...] Read more.

Background: Rheumatoid arthritis is the most prevalent systemic inflammatory disease, mainly affecting the synovial tissue of small and large joints, also associated with significant extra-articular manifestations. Throughout the progression of the disease, cardiac structures may be affected, including the conducting system, myocardium, endocardium, coronary arteries, and valves, potentially resulting in a higher incidence of cardiac arrhythmias. Methods: We performed a narrative review of the most recent studies that highlight the epidemiology, pathophysiology, diagnosis, and management of arrhythmias occurring in patients with rheumatoid arthritis. Furthermore, we examined the impact of disease-modifying antirheumatic drugs (DMARDs)—including conventional synthetic (csDMARDs), biologic (bDMARDs), and targeted synthetic agents (tsDMARDs)—on cardiac electrophysiology. Results: Cardiac immune cells may influence arrhythmogenesis through non-canonical and inflammatory mechanisms by modifying myocardial tissue architecture or by interacting with cardiomyocytes, potentially altering their electrical function. Conclusions: This review emphasizes the essential role of a multidisciplinary approach integrating rheumatology and cardiology expertise in the screening and management of arrhythmias in patients with rheumatoid arthritis. Full article

(This article belongs to the Special Issue Interdisciplinarity in Cardiovascular Diseases: From Pathophysiology to Diagnosis and Treatment—4th Edition)

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18 pages, 1758 KB

Open AccessSystematic Review

Does Nitrate Supplementation Improve Muscle Strength, Power, and Sprint Performance in Females? A Systematic Review and Meta-Analysis

by Fanhao Meng, Yuhang Liu, Bopeng Qiu and Juan Li

Life 2025, 15(9), 1425; https://doi.org/10.3390/life15091425 - 11 Sep 2025

Abstract

Background: Inorganic nitrate (NO₃⁻) may enhance muscle contractility and blood flow via nitric oxide production, offering potential ergogenic benefits. However, most studies have focused on males, and its effects in females during high-intensity, short-duration exercise remain unclear. Objective: This review [...] Read more.

Background: Inorganic nitrate (NO₃⁻) may enhance muscle contractility and blood flow via nitric oxide production, offering potential ergogenic benefits. However, most studies have focused on males, and its effects in females during high-intensity, short-duration exercise remain unclear. Objective: This review assessed the acute effects of nitrate supplementation on muscle strength, power, and sprint performance in healthy females. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, SPORTDiscus, and Cochrane CENTRAL, from inception to July 2025. Randomized controlled trials (RCTs) that examined the effects of oral inorganic nitrate (e.g., beetroot juice or nitrate salts) in healthy females were included. Eligible studies involved (i) healthy women aged 18–30, (ii) nitrate supplementation vs. placebo, and (iii) outcome measures of muscle strength (e.g., MVC), power (e.g., countermovement jump height, peak power), or sprint performance (e.g., sprint time or repeated sprint ability). Studies were excluded if they did not report sex-specific results or lacked relevant physical performance outcomes. Random-effects meta-analyses were conducted for each outcome. Results: Nitrate supplementation had small, non-significant effects on muscle strength (SMD = 0.10, 95% CI: −0.10 to 0.30, p > 0.05) and sprint performance (SMD = 0.14, 95% CI: −0.13 to 0.41, p > 0.05). A statistically significant, small-to-moderate improvement was observed in power (SMD = 0.38, 95% CI: 0.06 to 0.69, p < 0.05). Sensitivity analyses confirmed robustness of the power result. The certainty of evidence ranged from low to moderate based on the GRADE assessment. Conclusions: Inorganic nitrate supplementation may modestly enhance power in healthy females but does not appear to significantly improve muscle strength or sprint performance. These findings highlight the importance of sex-specific research in sports nutrition to guide targeted supplementation strategies for female athletes. Full article

(This article belongs to the Special Issue Focus on Exercise Physiology and Sports Performance: 2nd Edition)

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14 pages, 2000 KB

Open AccessArticle

Following-Up Micro-Rheological and Microcirculatory Alterations During the Early Wound Healing Phase of Local and Rotated Musculocutaneous Flaps in Rats

by Gergo Kincses, Laszlo Adam Fazekas, Adam Varga, Adam Attila Matrai, Nguyen Xuan Loc, Kincso Barabasi, Anna Orsolya Flasko, Tamas Juhasz, Abel Molnar and Norbert Nemeth

Life 2025, 15(9), 1424; https://doi.org/10.3390/life15091424 - 11 Sep 2025

Abstract

In reconstructive surgery, usage of different flaps is essential to cover tissue defects. Twisting, stretching or damaging the vascular pedicle may jeopardize the flaps’ viability. The aim of our experiment was to monitor tissue perfusion parameters of local versus rotated musculocutaneous flaps. In [...] Read more.

In reconstructive surgery, usage of different flaps is essential to cover tissue defects. Twisting, stretching or damaging the vascular pedicle may jeopardize the flaps’ viability. The aim of our experiment was to monitor tissue perfusion parameters of local versus rotated musculocutaneous flaps. In rats, musculus cutaneus maximus-based muscle–skin flaps were prepared bilaterally: one was sutured back to its original position, while the other flap was rotated to the ventral chest region (Flap group). In the Control group, flaps were not prepared. Tissue microcirculation was monitored intraoperatively, and on the 7th and 14th postoperative days. Blood samples were taken for testing hematological and hemorheological parameters. At the end of the observation period, biopsies were taken for biomechanical (tensile strengths) and histological investigations. We found that leukocyte and platelet counts significantly increased in the Flap group, while erythrocyte deformability decreased and aggregation increased. Although both local and rotated flaps survived and wound healing progressed well, in microcirculatory recordings, hypoperfusion and visible red blood cell aggregates were seen mostly in the rotated flaps. The rotated flaps were biomechanically weaker compared to local flaps or intact skin regions. This new model seems to be suitable for studying further flap pathophysiology focusing on tissue perfusion. Full article

(This article belongs to the Special Issue Blood Rheology: Insights & Innovations)

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16 pages, 1652 KB

Open AccessArticle

Evaluation of Dry Eye Disease Signs, Symptoms, and Vision-Related Quality of Life in Patients with Systemic Lupus Erythematosus

by Wojciech Luboń, Anna Agaś-Lange, Ewa Mrukwa-Kominek, Adrian Smędowski and Dorota Wyględowska-Promieńska

Life 2025, 15(9), 1423; https://doi.org/10.3390/life15091423 - 10 Sep 2025

Abstract

Dry eye disease (DED) represents one of the most prevalent ocular manifestations associated with systemic lupus erythematosus (SLE), with reported incidence rates ranging from 15% to 35%. DED constitutes a multifactorial condition that significantly impairs both visual function and health-related quality of life. [...] Read more.

Dry eye disease (DED) represents one of the most prevalent ocular manifestations associated with systemic lupus erythematosus (SLE), with reported incidence rates ranging from 15% to 35%. DED constitutes a multifactorial condition that significantly impairs both visual function and health-related quality of life. The objective of this study was to assess the impact of DED symptoms on vision-related quality of life in patients diagnosed with SLE, employing the Ocular Surface Disease Index (OSDI) as a disease-specific instrument. Additionally, the study aimed to evaluate correlations between clinical diagnostic tests and OSDI scores, and to determine the frequency of abnormalities affecting individual ocular structures. This study included 35 SLE patients, identifying DED in 37.1%. Common ophthalmic abnormalities included lens opacification (22.9%) and hyaloid degeneration (34.3%). Astigmatism (>0.50 D cyl) was prevalent (60.0%), being significantly higher in DED patients. While visual acuity and intraocular pressure were comparable, DED patients showed significantly lower Schirmer I test values, reduced tear break-up time, and higher van Bijsterveld scores, indicating impaired tear film and surface integrity. OSDI scores were significantly elevated in the DED group, with 51.4% reporting moderate to severe dysfunction. Strong, statistically significant correlations between the OSDI and objective tear film parameters confirmed a robust association between subjective symptoms and clinical signs. These findings highlight the significant impact of DED on visual function in SLE patients, underscoring the importance of routine ophthalmological evaluation and timely intervention. Full article

(This article belongs to the Section Medical Research)

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18 pages, 632 KB

Open AccessReview

GLP-1 Receptor Agonists in Mood Disorders: A Psychiatric Perspective

by Pietro Carmellini, Alessandro Cuomo, Maria Beatrice Rescalli and Andrea Fagiolini

Life 2025, 15(9), 1422; https://doi.org/10.3390/life15091422 - 10 Sep 2025

Abstract

Mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD), are among the leading causes of disability worldwide and are frequently associated with treatment resistance, functional impairment, and high comorbidity with metabolic dysfunction. Increasing evidence implicates insulin resistance (IR) as a key [...] Read more.

Mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD), are among the leading causes of disability worldwide and are frequently associated with treatment resistance, functional impairment, and high comorbidity with metabolic dysfunction. Increasing evidence implicates insulin resistance (IR) as a key pathophysiological factor linking metabolic and psychiatric illness. IR is associated with chronic low-grade inflammation, hypothalamic–pituitary–adrenal (HPA) axis dysregulation, impaired neuroplasticity, mitochondrial dysfunction, and altered reward processing mechanisms that may contribute to core depressive features such as anhedonia, cognitive slowing, and emotional dysregulation. These processes are further exacerbated by the metabolic side effects of many psychotropic medications, creating a self-perpetuating cycle that worsens both psychiatric and physical health outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially developed for type 2 diabetes and obesity, have emerged as promising candidates to address this metabolic–psychiatric interface. Beyond improving glycemic control and promoting weight loss, GLP-1 RAs exert central actions relevant to mood disorders, including modulation of dopaminergic reward pathways, enhancement of hippocampal neurogenesis, attenuation of neuroinflammation, and regulation of appetite and energy balance. Preclinical studies demonstrate that GLP-1 RAs reduce microglial activation, promote hippocampal neurogenesis, and normalize stress-induced behavioral changes. Early clinical trials in patients with metabolic disorders suggest improvements in depressive symptoms, quality of life, and cognitive function, with some effects independent of weight loss or glycemic outcomes. Observational evidence also indicates reduced antidepressant use and psychological distress in diabetic and obese populations receiving GLP-1 RAs. While these findings are promising, large randomized controlled trials in primary psychiatric populations are lacking. Key challenges include clarifying dose–response relationships, disentangling central from peripheral effects, and addressing safety and adherence concerns in individuals with comorbid psychiatric conditions. Future research should focus on biomarker-informed stratification, comparative trials with standard treatments, and integration of GLP-1 RAs into multimodal care frameworks. Overall, GLP-1 RAs represent a biologically plausible and clinically relevant approach to bridging metabolic and psychiatric care, with the potential to improve outcomes in patients with mood disorders who carry a high metabolic burden. Full article

(This article belongs to the Special Issue Pharmacology, Diagnosis and Treatments of Psychiatric Diseases)

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22 pages, 3274 KB

Open AccessArticle

Non-Union Treatment in the Shoulder, Arm, Wrist, and Fingers: A Multicentre Retrospective Study Comparing Conventional Treatment with the Human Allogeneic Cortical Bone Screw (Shark Screw^®)

by Elisabeth Huber, Gerd Jakob, Wolfgang Palle, Gudrun H. Borchert and Klaus Pastl

Life 2025, 15(9), 1421; https://doi.org/10.3390/life15091421 - 10 Sep 2025

Abstract

Successful non-union therapy consists of a combination of optimizing mechanical stability and activating biological factors. The conventional method for treating non-union is debridement and stabilization with metal hardware. The human allogeneic cortical bone screw (Shark Screw^®) merges human cortical bone properties [...] Read more.

Successful non-union therapy consists of a combination of optimizing mechanical stability and activating biological factors. The conventional method for treating non-union is debridement and stabilization with metal hardware. The human allogeneic cortical bone screw (Shark Screw^®) merges human cortical bone properties with screw stability, addressing non-union surgery principles by integrating mechanical and biological aspects. The objective of this retrospective study was to compare the clinical and radiological outcomes of the conventional method with those of the new method using the Shark Screw^®. This retrospective, multicentre, level III study included 41 patients with non-unions in upper extremities, 11 treated with the conventional method (metal hardware ± graft), and 30 patients with the Shark Screw^® (±graft). Patient demographics, non-union location, autograft and/or allograft use, follow-up time, complications, union rate, time to union, and time to return to work were recorded. Follow-up was 18 months in the conventional group and 10 months in the Shark Screw^® group. The union rate was 72.7% in the conventional group and 96.7% in the Shark Screw^® group. Time to union was significantly shorter in the Shark Screw^® group. In the conventional group, the complication rate was 36%, and it was 3.4% in the Shark Screw^® group. Hardware removal in the conventional group was 64%, and it was 0% in the Shark Screw^® group. The Shark Screw^® presents a reliable option for treating non-unions in the shoulder, forearm, hand, and fingers. Full article

(This article belongs to the Special Issue Advanced Strategies in Fracture Treatments)

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15 pages, 2693 KB

Open AccessReview

Conservation of Domestic Animal Genetic Resources in China: Overview of the Status, Activities, Policies, and Challenges

by Xiao Chen, Jian Lu, Wenqiang Cheng, Ming Xue and Fuqing Yu

Life 2025, 15(9), 1420; https://doi.org/10.3390/life15091420 - 10 Sep 2025

Abstract

Livestock and poultry biodiversity constitutes an essential element of global biological diversity, playing a pivotal role in sustaining human livelihood and socioeconomic development. Domestic animal genetic resources in China are abundant and various. Especially, local breeds have strong adaptability to the environment and [...] Read more.

Livestock and poultry biodiversity constitutes an essential element of global biological diversity, playing a pivotal role in sustaining human livelihood and socioeconomic development. Domestic animal genetic resources in China are abundant and various. Especially, local breeds have strong adaptability to the environment and exhibit excellent traits. They are the material foundation for both the original innovation in agricultural technology and the development of modern animal husbandry. Conservation of animal genetic resources is the primary action for sustainable use and development of domestic animals. Globally, many national and international institutions have initiated a variety of conservation measures, legislation, and technical strategies. China has likewise undertaken relevant initiatives. In this paper, we summarize the current situation of domestic animal resources in China, including the current status of domestic animals, the conservation measurements, the sustainable utilization, the management policies, challenges, and suggestions for the conservation of domestic animal resources. The sustainable use and protection work on domestic animals can be incorporated with the issues of food security and sustainability, the protection of the environment and climatic change, concepts in which societal interest is continuously increasing. Full article

(This article belongs to the Section Animal Science)

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15 pages, 4131 KB

Open AccessArticle

Deciphering the Complex Intertwining Between Cytopenia and Transfusion Needs After CAR-T-Cell Therapy for B-Cell Malignancies

by Claudio Pellegrino, Eugenio Galli, Patrizia Chiusolo, Rossella Ladiana, Caterina Giovanna Valentini, Marcello Viscovo, Federica Sorà, Simona Sica and Luciana Teofili

Life 2025, 15(9), 1419; https://doi.org/10.3390/life15091419 - 9 Sep 2025

Abstract

Immune-effector-cell-associated hematotoxicity has emerged as the most common CAR-T-cell-related complication in the real-world setting. Therefore, transfusion of blood components remains unavoidable in many patients treated with CAR-T cells to alleviate symptomatic anemia and prevent major bleeding events. This study investigates predictive factors associated [...] Read more.

Immune-effector-cell-associated hematotoxicity has emerged as the most common CAR-T-cell-related complication in the real-world setting. Therefore, transfusion of blood components remains unavoidable in many patients treated with CAR-T cells to alleviate symptomatic anemia and prevent major bleeding events. This study investigates predictive factors associated with the transfusion requirement in patients receiving anti-CD19 CAR-T-cell therapy for B-cell malignancies in a real-world setting and the potential correlation between transfusion needs, ICAHT, and long-term survival outcomes. Among 90 investigated patients, 51 (56.7%) received at least one transfusion in the three months post-infusion (33.4% received only RBC concentrates, and 23.4% received both RBC and platelet transfusions). The highest transfusion needs occurred in the first month post-infusion, with 50 transfused patients (55.5%). Early transfusion-requiring cytopenia was associated with pre-infusion altered bone marrow function, patients-related factors, including female sex, and acute inflammatory toxicities. The incidence of late cytopenia was mainly predicted by the need for pre-infusion transfusion support. Patients receiving platelet transfusions were characterized by an inferior progression-free (p = 0.013) and overall survival (p = 0.005). CAR-T-cell-treated patients can experience a high transfusion burden, impairing their quality of life, potentially affecting survival outcomes, and resulting in overutilization of clinical resources Full article

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27 pages, 5458 KB

Open AccessArticle

Therapeutic Potential of Astrocyte-Derived Extracellular Vesicles in Post-Stroke Recovery: Behavioral and MRI-Based Insights from a Rat Model

by Yessica Heras-Romero, Axayácatl Morales-Guadarrama, Luis B. Tovar-y-Romo, Diana Osorio Londoño, Roberto Olayo-González and Ernesto Roldan-Valadez

Life 2025, 15(9), 1418; https://doi.org/10.3390/life15091418 - 9 Sep 2025

Abstract

Astrocyte-derived extracellular vesicles (ADEVs) have emerged as promising neuroprotective agents for ischemic stroke. In this study, we evaluated the therapeutic potential of hypoxia-conditioned ADEVs (HxEVs) administered intracerebroventricularly in a rat model of transient middle cerebral artery occlusion (tMCAO). Serial magnetic resonance imaging (MRI) [...] Read more.

Astrocyte-derived extracellular vesicles (ADEVs) have emerged as promising neuroprotective agents for ischemic stroke. In this study, we evaluated the therapeutic potential of hypoxia-conditioned ADEVs (HxEVs) administered intracerebroventricularly in a rat model of transient middle cerebral artery occlusion (tMCAO). Serial magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI) was performed at 1, 7, 14, and 21 days post-stroke. HxEV treatment produced a significant reduction in infarct volume from day 1, sustained through day 21, and was accompanied by improvements in motor and sensory recovery. DTI analyses showed progressive normalization of fractional anisotropy (FA) and radial diffusivity (RD), particularly in the corpus callosum and striatum, reflecting microstructural repair. In contrast, mean diffusivity (MD) was less sensitive to these treatment effects. Regional differences in therapeutic response were evident, with earlier and more sustained recovery in the corpus callosum than in other brain regions. Histological findings confirmed greater preservation of dendrites and axons in HxEV-treated animals, supporting the role of these vesicles in accelerating post-stroke neurorepair. Together, these results demonstrate that hypoxia-conditioned ADEVs promote both structural and functional recovery after ischemic stroke. They also highlight the value of DTI-derived biomarkers as non-invasive tools to monitor neurorepair. The identification of region-specific therapeutic effects and the validation of reliable imaging markers provide a strong foundation for future research and development. Full article

(This article belongs to the Special Issue Innovative Applications of Extracellular Vesicles: From Diagnostics to Drug Delivery)

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15 pages, 2988 KB

Open AccessArticle

Prophage Activation: An In Silico Platform for Identifying Prophage Regulatory Elements to Inform Phage Engineering Against Drug-Resistant Bacteria

by Saher Musrrat, Zequan Han, Kai Wang, Yunhai Huang, Yanhui Xiang, Sen Liu and Wen Yin

Life 2025, 15(9), 1417; https://doi.org/10.3390/life15091417 - 9 Sep 2025

Abstract

Multidrug-resistant bacterial infections pose a severe global health threat, highlighting the urgent need for innovative therapeutic options beyond traditional antibiotics. Phage therapy, which employs bacteriophages to infect and eradicate pathogenic bacteria, specifically offers a promising solution. However, the lack of well-characterized therapeutic phages [...] Read more.

Multidrug-resistant bacterial infections pose a severe global health threat, highlighting the urgent need for innovative therapeutic options beyond traditional antibiotics. Phage therapy, which employs bacteriophages to infect and eradicate pathogenic bacteria, specifically offers a promising solution. However, the lack of well-characterized therapeutic phages has limited their broader clinical use. A critical aspect of activating the lytic potential of dormant prophages involves the strategic manipulation of transcription factor binding sites (TFBS), which function as pivotal regulatory nodes governing the transition between lysogenic dormancy and lytic activation. Our platform utilizes advanced bioinformatics tools to accurately identify and analyze TFBS, facilitating the targeted redesign or replacement of these sites to disrupt host-mediated repression. By systematically simulating modifications of these regulatory ‘switches,’ our platform computationally predicts reduced repressor activity, suggesting the potential for prophage activation and bacterial cell lysis. This novel methodology not only broadens the spectrum of therapeutic bacteriophages but also establishes a basis for individualized phage-based therapies, presenting a robust strategy to address the escalating challenge of antibiotic-resistant infections. By enabling the precise identification and engineering of TFBS, our platform signifies a transformative advancement in phage biology, effectively bridging the divide between computational analysis and therapeutic application. Full article

(This article belongs to the Special Issue Synthetic Genetic Elements, Devices, and Systems: 2nd Edition)

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11 pages, 539 KB

Open AccessArticle

Risk Factors for Hypertension in Polycystic Ovary Syndrome: Evidence from a Retrospective Study

by Ralitsa Robeva, Atanaska Elenkova, Georgi Kirilov, Krassimir Kalinov and Sabina Zacharieva

Life 2025, 15(9), 1416; https://doi.org/10.3390/life15091416 - 8 Sep 2025

Abstract

Background: Polycystic ovarian syndrome (PCOS) is a common female endocrinopathy, but its interrelations with arterial hypertension (AH) are still debatable. Therefore, the present study aims to explore the risk factors for hypertension in a large group of well-phenotyped women with PCOS. Methods [...] Read more.

Background: Polycystic ovarian syndrome (PCOS) is a common female endocrinopathy, but its interrelations with arterial hypertension (AH) are still debatable. Therefore, the present study aims to explore the risk factors for hypertension in a large group of well-phenotyped women with PCOS. Methods: The data of 1047 Bulgarian PCOS patients diagnosed according to Rotterdam criteria in the period 2005–2022 were studied retrospectively. The risk factors for hypertension were estimated in the PCOS women with different phenotypes. Results: The prevalence of AH was 17.6% among the PCOS women, with 4.2% of them being on antihypertensive treatment. The AH prevalence was increased in women with the “classic” phenotype compared to others (18.9% vs. 12.9%, p = 0.037). The most important risk factors associated with hypertension were the presence of diabetes mellitus type 2 (DMT2), obesity, family history of AH, and age ≥ 30 years (p < 0.001). The prevalence of impaired glucose tolerance (IGT) but not impaired fasting glucose was also related to the development of AH. Conclusions: The leading independent factors associated with hypertension in PCOS patients are the presence of DMT2, IGT, obesity, family history of hypertension, and age, but not the degree of hyperandrogenism. Population-based studies, including distinct ethnic groups, are needed to reveal the pathophysiology and the optimal clinical management of AH in PCOS. Full article

(This article belongs to the Special Issue Gynecological Endocrinology: From Physiological Mechanisms to Clinical Practice)

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15 pages, 305 KB

Open AccessReview

The Role of Spectacle Lenses in the Control and Management of Myopia Progression: A Narrative Review

by Livio Vitiello, Filippo Lixi, Valerio Calabresi, Mario Troisi, Ilaria De Pascale, Alfonso Pellegrino, Giulia Coco, Aldo Vagge and Giuseppe Giannaccare

Life 2025, 15(9), 1415; https://doi.org/10.3390/life15091415 - 8 Sep 2025

Abstract

The number of people affected by myopia worldwide is estimated to reach two billion and to further grow. Therefore, numerous treatment approaches (pharmacological, behavioral, environmental, and optical) have been put forth to slow the progression of myopia, especially in children. Among these, spectacle [...] Read more.

The number of people affected by myopia worldwide is estimated to reach two billion and to further grow. Therefore, numerous treatment approaches (pharmacological, behavioral, environmental, and optical) have been put forth to slow the progression of myopia, especially in children. Among these, spectacle lenses represent a straightforward and less intrusive therapeutic approach for children and their parents. For this reason, in recent years, several spectacle lenses with different technologies have been developed to slow myopia progression and enhance the quality of life for myopic children, thus trying to reduce the related health care burden. According to the published scientific literature, three different types of spectacle lenses are currently the most validated optical options for myopia management: (i) Defocus Incorporated Multiple Segments lenses (DIMS), (ii) Highly Aspherical Lenslet Target lenses (HALT) and (iii) Cylindrical Annular Refractive Elements (CARE) lenses. The aim of this narrative review is to exclusively discuss the scientific evidence of these three different spectacles lenses, and to point out the potential benefits and drawbacks in their use for myopia control and management. Full article

(This article belongs to the Section Medical Research)

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