Search Results (245,490)

Background: In hemodialysis patients, precise hemoglobin (Hb) monitoring is essential for anemia management. Point-of-care blood gas analyzers (BGAs), such as the ABL800 Flex, offer rapid Hb determinations, but their accordance and comparability with central laboratory measurements remains to be assessed in the hemodialysis setting. Methods: We performed a retrospective analysis (April 2017–February 2024) of 10,802 paired Hb measurements from 291 hemodialysis patients. BGA and laboratory values within 90 min were compared using paired t-tests, non-inferiority testing (margin 0.5 g/dL), a Bland–Altman analysis, and linear regression. Results: The mean ± standard deviation Hb (g/dL) values were 10.14 ± 1.64 (BGA) versus 9.90 ± 1.55 (laboratory). The overall mean difference (BGA—laboratory) was 0.24 ± 0.49 g/dL (95% CI: 0.23–0.25), demonstrating non-inferiority (p < 0.0001). Measurement delay correlated with increasing analysis discrepancies (mean difference in g/dL: 0.22 at <30 min vs. 0.27 at 60–90 min; p < 0.001). We derived the equation of laboratory Hb = 0.90 × BGA Hb + 0.72; a simplified correction (BGA−0.3 g/dL) produced a mean absolute error (MAE) of 0.30 g/dL and root mean square error (RMSE) of 0.50 g/dL, and patient-level 10-fold cross-validation yielded MAE ≈ 0.30 and RMSE ≈ 0.49 g/dL. The Bland–Altman analysis confirmed a small systematic bias of 0.24 g/dL with 95% limits of agreement ranging from −0.73 to +1.21 g/dL. Conclusions: BGA Hb measurements via the ABL800 Flex are non-inferior to central laboratory values across clinical scenarios, with minimal bias. After regression correction, the estimated total error was ≈0.78 g/dL. If hemodialysis centers accept this level of total error and apply confirmatory testing near decision points, BGA could be used to guide anemia management. Full article

Hyaluronidase is a hydrolytic enzyme that cleaves β-1,4-glycosidic linkages in high-molecular-weight hyaluronic acid, generating low-molecular-weight oligosaccharides with enhanced biological functions. These products exhibit immunomodulatory, antioxidant, and tissue-regenerative properties, making them valuable in pharmaceutical, cosmetic, and functional food applications. However, most commercial hyaluronidases originate from pathogenic bacteria or recombinant hosts, raising concerns over their biosafety and regulatory acceptance, particularly in food-grade applications. In this study, we report the isolation and characterization of a novel non-pathogenic soil bacterium, Paenibacillus residui BSSK58, which produces an extracellular hyaluronidase. Whole-genome sequencing revealed the absence of known virulence factors and antibiotic resistance genes. Phenotypic safety evaluations confirmed that there was no hemolytic activity, biogenic amine production, or cytotoxicity against human intestinal epithelial cell lines (Caco-2 and HT-29). The purified BSSK58 hyaluronidase exhibited a molecular weight of approximately 170 kDa, with optimal activity at pH 8.0–9.0 and 50 °C. The enzyme showed broad substrate specificity toward hyaluronic acid, chondroitin sulfate, and alginate, and its depolymerizing activity was confirmed using gel permeation chromatography. Furthermore, a 13-week oral repeated-dose toxicity study under Good Laboratory Practice conditions demonstrated no adverse effects. These findings support the use of BSSK58 hyaluronidase as a safe, non-recombinant biocatalyst suitable for industrial applications under regulatory-compliant frameworks. Full article

Background/Objectives: Fulminant myocarditis (FM) is an uncommon but potentially reversible form of myocardial inflammation that can rapidly progress to cardiogenic shock (CS). In patients who are refractory to conventional treatment, venoarterial extracorporeal membrane oxygenation (VA-ECMO) represents an effective life support strategy. However, the factors that determine functional recovery remain uncertain. The primary objective of this study was to characterize patients who recover ventricular function. Secondary objectives included analyzing VA-ECMO-related complications and overall patient survival. Methods: This was a retrospective, single-center, observational study including all consecutive patients diagnosed with FM between 2008 and 2025 who were supported with VA-ECMO (n = 22). Clinical, biochemical, echocardiographic, and imaging variables were collected. Patients were classified based on their outcomes as either recovery or death/transplantation. Differential factors potentially affecting myocardial recovery, survival, and complications were analyzed. Results: The mean age was 49.7 ± 11 years, with 36% being male. Severe cardiogenic shock was the most common initial presentation (86%), and the average time from symptom onset to hospital admission was 5.7 days. Regarding mechanical support, the non-recovery group required longer ECMO support (328 ± 225 h vs. 188 ± 103 h; p = 0.03). The presence of fibrosis on cardiac magnetic resonance imaging (MRI) was associated with a lower probability of recovery (100% vs. 44.4%; p = 0.03). Renal failure and vascular complications were more frequent in the non-recovery group, with a significantly higher rate of surgical reintervention (50% vs. 10%; p = 0.04). Echocardiography performed before discharge (recovery group) vs. before death/transplant (non-recovery group) showed significant differences in left ventricular ejection fraction (51.1% vs. 29.5%; p = 0.04), along with better levels of creatinine, N-terminal pro-B-type natriuretic peptide (NT-proBNP), leukocytes, and C-reactive protein (CRP) in the recovery group. In-hospital survival for the entire cohort was 63.6%, significantly higher in the recovery group (100% vs. 33.3%; p < 0.01). One-year survival was 59%, which was also greater among those who recovered (90% vs. 33.3%; p = 0.02). Conclusions: FM is associated with an acceptable in-hospital survival rate. The presence of myocardial fibrosis on MRI and longer ECMO support duration were observed to be associated with a lower likelihood of cardiac recovery. Patients who recovered showed better ventricular function at discharge, as well as reduced systemic inflammation and renal dysfunction. These findings highlight the importance of early identification of predictors of myocardial recovery to optimize management and therapeutic decision making in this high-risk population. Full article

Background: Chronic pain represents a major therapeutic challenge due to the limited efficacy and tolerability of conventional pharmacological treatments. Equisetum arvense L., a medicinal plant with potent antioxidant properties, and palmitoylethanolamide (PEA), an endogenous fatty acid amide with well-established anti-inflammatory and analgesic effects, are increasingly recognised as promising nutraceutical agents. Methods: This prospective, single-centre clinical trial aimed to evaluate the efficacy and safety of a novel oral supplement (Assonal^®PEA) combining 600 mg of PEA and 300 mg of Equisetum arvense L. in improving the reduction of pain and quality of life in patients with chronic pain, also obtaining information on the patient’s state of satisfaction after the treatment. Fifty patients suffering from chronic pain (low back pain and radiculopathy) for two months were enrolled and received the supplement over eight weeks in a tapered regimen (two tablets daily for two weeks, followed by one tablet daily). Results: Clinical outcomes were evaluated using validated instruments, including the Numeric Pain Rating Scale (NPRS), Verbal Rating Scale (VRS), Short-Form McGill Pain Questionnaire (SF-MPQ), Global Perceived Effect (GPE), and EuroQol-5D-5L. Results showed a significant decrease in pain intensity (NPRS: −3.8 points; VRS: −2.1 points; p < 0.0001), along with meaningful improvements in patient-perceived benefit, pain descriptors, and quality of life (EQ-5D-5L: +35%; p < 0.0001). Conclusions: These findings endorse the use of this novel PEA–Equisetum arvense formulation as a safe, well-tolerated, and potentially effective supplementary intervention for managing chronic pain. No adverse events were reported, and the overall response rate reached 94%. Full article

The asymmetry of seismic rupture significantly dictates the intensity and spatial distribution of the radiated stress waves during mining-induced tremors, exerting a pivotal influence on the dynamic instability of roadways triggered by mining-induced tremors. In this study, a method for simulating arbitrary rupture patterns based on the theory of moment tensors is proposed. Based on the engineering context of strong seismicity-induced roadway dynamic instability at the Xinjulong coal mine, the entire process, from the excitation and propagation of seismic stress waves to the subsequent destabilization and destruction of the roadway, is reproduced. The effects of seismic source, including rupture patterns, seismic energy, fault plane angles, and the dominant frequency of stress waves, on the stability of a roadway are analyzed. Research indicates that a strong mining-induced tremor is characterized by tensile failure, with the radiated P-waves playing a predominant role in the destabilization and collapse of the roadway compared to S-waves. The P-waves exert a repetitive tensile and compressive effect on the perturbed medium, whereas S-waves contribute through compressive shear actions. The stability of a roadway is influenced by various characteristics of the seismic source. The rupture pattern of the seismic source affects the spatial distribution of stress waves. The seismic energy influences the kinetic energy transmitted to the roadway, with an increase in energy leading to a greater contribution of S-waves to roadway destruction. The fault plane angle similarly affects the propagation pattern of stress waves, particularly at 45° and 60° angles, where the maximum radiation of P-waves is directed towards the roadway, causing the most severe damage. The dominant frequency affects the attenuation of stress waves, with lower frequencies resulting in less attenuation and a higher likelihood of roadway damage. Full article

Background: Time-limited eating (TLE) improves body weight and metabolic health in adults; however, little is known about effects in younger populations (YP). TLE in adolescents can reduce calorie consumption, but studies have not demonstrated superior weight loss compared to other dietary practices. Minimal research exists into associations between eating window (EW) in YP and health outcomes. Methods: Three-day diet diaries (ages 7, 13 years) collected in the Avon Longitudinal Study of Parents and Children (ALSPAC) were used to calculate EW. Height, weight, body composition, blood pressure, and fasting bloods were recorded during clinic visits at ages 7, 13, and 24. Linear or logistic regression models were used to analyse cross-sectional and longitudinal associations, accounting for potential confounders. Results: Mean EW was 10.9 h (standard deviation 1.1) and 11.1 h (1.8) at ages 7 and 13, respectively. At age 7 (N = 4799), a longer EW was positively associated with body mass index z-score (BMIz) (beta coefficient (β) 0.04 (95% confidence interval 0.01, 0.07) p = 0.01), whilst at age 13 (N = 4712) a longer EW showed inverse associations with BMIz (β −0.026 (−0.046, −0.006) p = 0.01), waist to height ratio (WtHR) (β −0.001 (−0.002, −0.000) p = 0.005), waist circumference (WC) (cm) (β −0.211 (−0.370, −0.053) p = 0.009), diastolic blood pressure (DBP) (mmHg) (β −0.132 (−0.254, −0.009) p = 0.04), and fat mass (FM) (%) (β −0.447 (−0.607, −0.286) p < 0.001). Longitudinally, a longer EW at age 13 (N = 2534) was inversely associated with FM (%) at age 24 (β −0.307 (−0.487, −0.127) p < 0.001). Conclusions: A longer EW in adolescence was associated cross-sectionally with lower BMIz, WtHR, WC, DBP, and FM and longitudinally with lower FM at age 24, albeit with small effect sizes. Full article

Background: Sickle cell disease (SCD) is among the most prevalent inherited hemoglobinopathies and is strongly associated with numerous coagulation abnormalities, hence constituting a severe hypercoagulable state. Methods: We conducted a single-center retrospective observational study of patients with SCD who were monitored at Hippokration Hospital of Thessaloniki between 1999 and 2024. Demographic characteristics, hemoglobin (Hb) genotype, medical history, anticoagulant and antiplatelet therapy, dosage of anticoagulant treatment, recurrence of the first episode of venous thromboembolism (VTE) and relevant laboratory values were examined as possible risk factors. Results: Among 46 patients, 12 (26.1%) developed thrombosis with the majority (75%) carrying the HbS/β-thal genotype. The prevalence of VTE in this study was 17.4%. Variables significantly associated with an increased risk of thrombosis included age at the time of thrombosis, patient age, use of anticoagulant treatment, anticoagulant dosage, antiplatelet therapy and type of transfusion (p < 0.05). On multivariate analysis, anticoagulant treatment and its dosage retained statistical significance (p < 0.05). Conclusions: These findings reinforce the strong association between SCD and thrombotic events. Despite the availability of a broad therapeutic armamentarium and increasing knowledge of the underlying disease mechanisms, the prevention and management of thrombosis in these patients remains a challenge. Full article

Background: The global surge in obesity has reignited the need for larger cuff sizes to avoid inaccurate blood pressure (BP) readings and inappropriate antihypertensive treatment. More precise methods are essential. Forearm BP measurement has emerged as a promising alternative, showing strong correlation with noninvasive beat-to-beat monitoring. This study aimed to validate the digital oscillometric method on the forearm, comparing results to brachial artery readings in hypertensive patients with prediabetes and obesity. Methods: A non-randomized, open, cross-sectional observational study was conducted with 72 hypertensive individuals presenting with obesity and prediabetes. BP was measured using oscillometric devices on both the arm and forearm, following standardized protocols. Data were analyzed using Pearson correlation and Bland–Altman agreement tests. Results: Arm and forearm BP readings showed high agreement: r = 0.86 for systolic BP (SBP), r = 0.93 for diastolic BP (DBP), and r = 0.90 for mean arterial pressure (MAP). Bland–Altman analysis confirmed equivalence (SBP: p = 0.8, DBP: p = 0.3, MAP: p = 0.2). Conclusions: Forearm BP measurement is a reliable and effective alternative, particularly for hypertensive patients with prediabetes and obesity. It offers accurate readings, reduces treatment risks, and supports better clinical decisions. Broader studies are needed for generalization. Full article

To elucidate the mechanisms governing hydrocarbon accumulation and phase evolution in the deep–ultradeep reservoirs of the Mo-Yong area, this study integrated 2D basin modeling and multi-component phase state simulation techniques, investigating the differences in maturity and hydrocarbon generation history between the Fengcheng Formation (P₁f) and the Lower Wuerhe Formation (P₂w) source rocks, as well as their coupling relationship with fault activity in controlling hydrocarbon migration, accumulation, and phase evolution. The results indicate that the P₁f and P₂w in the Mo-Yong area source rocks differ in thermal maturity and hydrocarbon generation evolution. The dual-source charging from both the P₁f and P₂w significantly enhances hydrocarbon accumulation number, volume, and saturation. The temporal-spatial coupling between peak hydrocarbon generation and multi-stage fault reactivation not only facilitates extra-source accumulation but also drives condensate reservoir formation through gas-oil ratio elevation and light-component enrichment. Based on these results, a model of hydrocarbon accumulation and phase evolution of deep reservoirs was proposed. The model elucidates the fundamental geological principle that source-fault spatiotemporal coupling controls hydrocarbon enrichment degree, while phase differentiation determines reservoir fluid types. Full article

A liquid-sealed single-mode–no-core–single-mode (SNS) structure fiber temperature sensor based on polyvinyl alcohol (PVA) partial replacement coating is proposed. Using a liquid-sealed glass capillary structure, the PVA solution is introduced into the SNS structure and avoids its influence by environmental humidity. Temperature can be obtained by measuring the shift of the multimode interference spectrum, which is affected by the thermal optical effect of the PVA solution. Through theoretical simulation of the sensor, the optimal NCF fiber length and coating stripped length are obtained by comprehensively considering the transmitted loss and output spectrum signal-to-noise ratio (SNR). The optimal PVA solution concentration is selected by measuring the thermo-optic coefficient (TOC) and refractive index (RI). Based on the theoretical optimization results, a PVA solution-coated SNS fiber optic temperature sensor is experimentally fabricated, and temperature-sensing characteristics are measured within −3.6 to 73.2 °C. The experimental results show that the sensor has a high sensitivity (nm/°C, maximum is 21.713 nm/°C) and has a resolution of 10⁻³ °C. ${\lambda }_{dip}$ has a stable negative linear relationship with temperature, and the correlation coefficient of the fitting curve exceeds 95%. The temperature cycling experiment and long-term stability test show that the temperature sensor has good repeatability and stability. The experimental results also show the nonlinear relationship between the temperature measurement range and sensitivity, clarify the important factors affecting the response performance of fiber temperature sensors, and provide important reference values for optical fiber temperature sensors. Full article

Emerging evidence suggested a potential link between lipid-lowering therapies and neurocognitive effects, raising concerns regarding the possible adverse impact of PCSK9 inhibitors on memory loss. We extracted adverse events associated with memory loss for PCSK9 inhibitors from the Food and Drug Administration Adverse Event Reporting System (FAERS), covering the period from the first quarter (Q1) of 2022 to Q1 of 2025. Reporting odds ratio (ROR), Medicines and Healthcare Products Regulatory Agency (MHRA), empirical Bayesian geometric mean (EBGM), and information component (IC) were used for pharmacovigilance analysis. Drug target Mendelian randomization (MR) was utilized to assess the causal association between PCSK9 inhibitors and memory loss. A total of 389 occurrences of memory loss associated with PCSK9 inhibitors were recorded among 388 patients. In the pharmacovigilance analysis, memory loss did not show a significant signal for PCSK9 inhibitors in both the full dataset [ROR (95% CI): 0.79 (0.72, 0.88); PRR = 0.79, χ² = 20.64; EBGM05 = 0.73; IC025 = −2.00] and the lipid-lowering targets dataset [ROR (95%CI): 0.59 (0.53, 0.66); PRR = 0.59, χ² = 95.33; EBGM05 = 0.59; IC025 = −2.30]. The drug target MR revealed no causal association between PCSK9 inhibitors and memory loss (p < 0.05). The present study failed to establish a causal relationship between PCSK9 inhibitors and memory loss. By providing both real-world and genetic evidence, our findings might help alleviate concerns and support the notion that PCSK9 inhibitors were relatively safe regarding memory function. Full article

Background/Objectives: Preventive oral health education plays a key role in preparing future healthcare professionals to promote and maintain good oral hygiene. Individually Trained Oral Prophylaxis (iTOP) is a structured, personalized educational program that emphasizes correct brushing techniques and interdental cleaning. This study aimed to evaluate the long-term effectiveness of a single-session iTOP intervention on clinical oral health outcomes among medical and dental students. Methods: A 2-year prospective cohort study included 82 first- and fourth-year medical and dental students at the University of Mostar, Bosnia and Herzegovina. The researchers randomly assigned participants to an iTOP intervention group or a control group. The primary analysis used multivariable linear mixed-effects models for repeated measures, adjusted for study program, academic year, smoking status, and baseline oral-hygiene habits, with effect sizes reported alongside 95% confidence intervals. Clinical periodontal parameters—plaque index, bleeding on probing, and probing depth—were assessed at baseline, three months, and two years. All participants received professional cleaning and oral hygiene kits. Only the intervention group received personalized iTOP training, consisting of a single session with brief reinforcement at the 3-month follow-up. This study was registered at ClinicalTrials.gov (NCT07085013). Results: Seventy-six students completed the follow-up. The iTOP group had significantly lower plaque index and bleeding scores at both follow-up points (p < 0.001) compared to the control group. Baseline differences were observed between subgroups (medical vs. dental; younger vs. older students), but these diminished over time. At the 2-year follow-up, only the plaque index remained significantly improved, while other clinical parameters returned to values comparable to baseline. Conclusions: The iTOP program resulted in significant short-term improvements in oral health among medical and dental students. For sustained long-term outcomes, iTOP or similar structured oral health education programs should be integrated into medical and dental curricula. Enhancing oral health awareness among healthcare providers may ultimately contribute to improved public oral health outcomes. Given the single-center design and the single-session nature of the intervention, the results should be interpreted with caution. Full article

Southern Chile has become a prominent region for sweet cherry production. However, environmental constraints and low P availability can adversely affect fruit quality and conditions in southern Chile. Therefore, the aim of this study was to evaluate the effects of foliar phosphorus (P) on fruit quality, condition, and antioxidant content at harvest and postharvest storage in sweet cherry (Prunus avium L.) cv. Regina was cultivated under a plastic cover in Southern Chile. For this, sweet cherry trees were subjected to three treatments: control (no P), 1.5 L ha⁻¹, and 2.2 L ha⁻¹ foliar P. In our study, no significant effects were observed on average fruit weight, size, or total soluble solids among P treatments. However, P applications increased the proportion of large fruit (>32 mm), enhanced dark mahogany coloration, and pulp antioxidant content (total phenols and anthocyanins). Interestingly, the 2.2 L ha⁻¹ treatment reduced postharvest disorders, including pitting (70%), dehydration (31%), orange peel (56%), and internal browning (29%) compared to the control trees. These results suggest that foliar P application could be an agronomic tool to improve fruit quality and condition in sweet cherry production under plastic covers cultivated in soils with low P availability. Full article

Background: Three-dimensional (3D) printing has emerged as a valuable tool in dentistry for producing provisional restorations with high precision and reduced costs. However, the limited mechanical strength of temporary 3D-printed resins remains a clinical concern. This in vitro study aimed to enhance the mechanical properties of a 3D-printed temporary resin by incorporating functionalized niobium (Nb) nanoparticles and to compare its performance with a conventional resin composite and a permanent 3D-printed resin. Methods: Six groups were evaluated: bisacrylic resin (Protemp), resin composite (Z350), temporary 3D resin (Temp 3D), permanent 3D resin (Perm 3D), Temp 3D + 0.05% Nb, and Temp 3D + 0.1% Nb. Niobium oxyhydroxide nanoparticles were synthesized using a hydrothermal method, silanized, and incorporated into the Temp 3D at 0.05% and 0.1% by weight. The tested variables included flexural strength (FS), elastic modulus (EM), surface hardness (SH), and color stability (ΔE). Results: The Z350 resin showed the best mechanical results. The addition of 0.1% Nb nanoparticles significantly improved the FS, EM, and SH of the Temp 3D, reaching values comparable to the Perm 3D (p > 0.05). Color stability remained unaffected across all groups. Conclusions: These findings suggest that Nb reinforcement at a low concentration is a promising strategy for improving the performance of 3D-printed temporary restorations. Full article

Background: Postoperative wound complications following total joint arthroplasty (TJA) significantly impact patient outcomes and healthcare costs. Reliable preoperative biomarkers for identifying patients at increased risk are critical for optimizing patient management and reducing complication rates. This study evaluated the predictive utility of the C-reactive protein to albumin ratio (CAR) and the prognostic nutritional index (PNI) for periprosthetic joint infection (PJI) and postoperative wound complications in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods: We retrospectively studied patients who underwent primary THA and TKA in our department from March 2019 to April 2024. The study included a total of 842 patients (568 knees and 274 hips). Preoperative blood samples were assessed for serum CRP, albumin, and total lymphocyte count, facilitating the calculation of CAR and PNI values. Patient outcomes were monitored, identifying PJI and aseptic wound complications such as persistent wound drainage, hematoma, seroma, skin erosion, and wound dehiscence within 2 weeks post-surgery. Results: The average follow-up time for patients was 39.2 months (range 13–73 months). PJI was significantly linked with elevated admission CAR and diminished PNI ratio (p < 0.001 and p < 0.001). ROC analysis demonstrated optimal predictive cut-off values for CAR at 3.1 (Area under curve [AUC]: 0.92, specificity 97.4%, sensitivity 92.3%) and PNI at 49.4 (AUC: 0.93, specificity 94.7%, sensitivity 91.7%). Furthermore, both CAR (Odds ratio [OR]: 3.84, 95% confidence interval [CI]: 1.6–9.1, p = 0.002) and PNI (OR: 21.8, 95% CI: 9–48.6, p < 0.001) were identified as two independent risk factors associated with the development of PJI following THA or TKA. Further subgroup analysis revealed distinct predictive thresholds for CAR and PNI according to surgical procedure type (TKA and THA), enhancing diagnostic accuracy. Conclusions: Preoperative admission elevated CAR and decreased PNI effectively predict PJI and postoperative wound complications in THA and TKA, supporting their utility as simple, cost-effective biomarkers in clinical practice. Incorporating CAR and PNI evaluations into preoperative assessments can enhance patient stratification and preventive strategies, thus mitigating risks and improving surgical outcomes. Full article