Search Results (1,885)

Implantable biomaterials are widely used in modern medicine, especially in orthopaedics, cardiovascular surgery, dentistry, and plastic and reconstructive surgery. The issue of the interaction of implants with body tissues and the risk of infection associated with them is one of the most studied and topical issues in medicine. It is very important to find a biomaterial that effectively combines both microbiology and tissue compatibility aspects. The aim of this research work was to determine the adhesion and colonization rates of Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans on smooth, microtextured, and macro-textured silicone biomaterials in an in vitro study. A total of 90 silicone biomaterial samples were used, 30 for each type of biomaterial. In each of the biomaterial groups, half of the samples (n = 15) were used to determine the adhesion intensity and the other half to determine the colonization intensity on the active surface of the biomaterial samples. The study found that Staphylococcus epidermidis and Pseudomonas aeruginosa had the highest adhesion intensity on the macro-textured implant, while Candida albicans adhered best to smooth. Among the microorganisms, Pseudomonas aeruginosa demonstrated the highest colonization rate, followed by Staphylococcus epidermidis and then Candida albicans. The most intensive colonization of microorganisms was on the macro-textured implant, then on the micro-textured, and then on the smooth. The smooth and micro-textured implants did not show statistically significant differences in the intensity of adhesion and colonization. The biomaterials did not show pro-oxidant or anti-oxidant properties, and no lipid peroxidation was induced by the biomaterials. Full article

Antihypertensive drugs are widely used for the treatment of hypertension, and the choice of drug and dosage is based on trial and error. The variability in drug response and adverse reactions leads to the poor adherence to treatment. Epigenetic modulation is one of the major mechanisms that may contribute to the variability in drug responses, and microRNAs (miRNAs) can serve as crucial epigenetic regulators and have also been reported to be associated with hypertension pathogenesis. The objective of this study is to investigate the regulatory effects of commonly used antihypertensive drugs on the endothelial miRNome in human aortic endothelial cells. We aim to integrate miRNA expression data with proteomic analyses to elucidate drug-induced molecular mechanisms relevant to hypertension treatment. Whole genome small RNA sequencing was performed, followed by whole proteome analysis using LC-MS/MS comparing between control and treated samples. The treatments induced significant differential regulation of several miRNAs and proteins; among these, a few reflected reverse relationships with miRNA regulation and protein expression. Certain miRNAs and their corresponding target proteins seem to distinguish between good therapeutic outcomes and potential side effects. This study unravels the potential role of drug-induced miRNAs in inducing post-transcriptional modifications to cause the differential expression of certain proteins that may induce not only therapeutic effects or drug side effects but can also indicate the potential for drug-repurposing in other diseases. Full article

In advanced economies, most food waste occurs at the downstream stages of the supply chain; within the EU, it has been estimated that 64.57% of food waste occurs at the consumption stage, with about 5.4 million tons (9.45% of the total) being generated in food service. This study aims to contribute to this stream of research by providing evidence about the quantity of food waste produced in Italian primary schools and discussing the results against the evidence available in other EU countries. This research is based on a large-scale study involving 78 primary schools and over 11,000 students for a total number of almost 110,000 monitored meals. The results show that the amount of food not consumed at lunch is 21.7% of the food prepared every day. Plate waste accounts for almost 90 g/day per capita and the total amount of wasted food, including unserved food, accounts for 117 g/day per capita. To our knowledge, this study represents the largest sample size monitored in Italy under the framework of the EC Delegated Decision (EU) 2019/1597 on food waste measurement. Given its scale and adherence to the EU’s standardized methodology, this dataset should serve as the reference data for Italy reported to Eurostat, as it is based on direct measurements rather than estimates or secondary data sources. This underscores the importance of systematic, comparable data collection for tracking progress on food waste reduction at both national and European levels. Full article

Background: Unhoused individuals face significant health disparities and encounter numerous barriers to accessing adequate healthcare, resulting in high rates of chronic disease, mental illness, and untreated conditions in Houston, TX. The purpose of this study was to identify prevalent health conditions within a sample of unhoused adults and to identify patterns in patient characteristics and clinical health outcomes. Methods: This study utilized clinical and demographic data from n = 191 patients who received care at a student-run clinic embedded within a homeless drop-in center in Houston, TX. Data included patient demographics, chief complaints, social determinants of health (SDOHs), past medical history, on-site diagnoses, and provider actions. Results: The most prevalent issues were housing insecurity (36.1%), cardiovascular conditions (38.7%), and substance use (17.8%). Nearly half of all patients (46.6%) declined treatment or left before receiving care. Significant associations were found between patient demographics and provider responses, including differences by gender and age in treatment type and diagnostic categorization. Conclusions: These findings underscore critical challenges in treatment adherence, diagnostic bias, and retention among unhoused populations. The study provides actionable recommendations for improving care coordination and continuity in low-barrier, student-run clinics serving medically underserved communities. Full article

Background/Objectives: Metabolic/bariatric surgery is currently the most successful treatment for patients with obesity; however, a fifth of patients undergoing surgery may not lose enough weight to be considered successful. Recent studies have shown that bariatric/metabolic surgery alters the epigenome and may explain postoperative improvements in metabolic health. The primary objective is to consolidate published differentially methylated CpG sites in pre- and post-metabolic/bariatric surgery female patients and associate them with the respective genes and pathways. Methods: This systematic review adhered to the PRISMA-P guidelines and was registered with the PROSPERO (CRD42023421852). Following an initial screening of 541 studies using COVIDENCE, six studies were selected, comprising three epigenome-wide association studies (EWAS) and three candidate gene methylation studies. The published studies collected DNA samples from female patients with obesity before and after surgery (3 months, 6 months, 9–31 months, and 2 years). KEGG pathway analysis was performed on genes where the extracted CpG sites were located. Results: The meta-analysis showed that 11,456 CpG sites are differentially methylated after a successful weight loss surgery, with 109 sites mapped to genes involved in key metabolic pathways, including FoxO, mTOR, insulin, cAMP, adipocytokine, Toll-like receptor, and PI3K-Akt. Conclusion: The highlighted differentially methylated CpG sites can be further used to predict the molecular signature associated with successful metabolic/bariatric surgery. Full article

Background/Objectives: Parkinson’s disease (PD) and multiple sclerosis (MS) are neurological conditions that result in debilitating non-motor symptoms, such as anxiety and depression, which significantly reduce quality of life and often persist despite pharmacological treatment. As a result, effective alternative treatment strategies are needed. Exercise therapy—particularly aerobic training—has shown promise in alleviating non-motor symptoms, potentially through neuroplastic adaptations. However, traditional aerobic exercise is often time-consuming and monotonous, limiting long-term adherence. High-intensity interval training (HIIT) offers a time-efficient and potentially more engaging alternative, though its effects on non-motor symptoms in PD and MS remain understudied. Methods: This transdiagnostic randomized controlled trial will enroll 48 participants (24 PD, 24 MS) with clinically significant affective symptoms (hospital anxiety and depression scale [HADS] ≥ 8). The participants will be randomly assigned to one of three 8-week interventions: (1) HIIT, 5–6 intervals of 45 s of high-intensity cycling; (2) continuous aerobic training (CAT), 50 min of low-intensity cycling; (3) movement advice (MA), step goals, and physical education. The primary (affective symptoms) and secondary outcomes (cognition, fatigue, sleep, motor function) will be assessed at four time points: 4 and 1 weeks pre intervention, and 1 and 4 weeks post intervention. Weekly blood samples and pre/post brain imaging will be collected to study biofluid and MRI measures for potential neuroplasticity. Linear mixed models will analyze the time and group effects. Discussion: This trial will assess whether HIIT can more effectively improve non-motor and motor symptoms in PD and MS than CAT or MA. A multimodal approach will explore both the clinical outcomes and underlying mechanisms, informing scalable and engaging rehabilitation strategies. Full article

Multiple sclerosis (MS) is a chronic disease of the central nervous system that significantly impairs gait and mobility, contributing to a high risk of falls, reduced participation in daily activities, and diminished quality of life. Despite existing interventions such as exercise programs and pharmacological treatments, challenges such as fatigue, pain, and limited accessibility underscore the need for alternative therapies. Focal vibration therapy (FVT) has shown promise in improving gait, reducing spasticity, and enhancing mobility in people with MS (PwMS). However, further research is required to evaluate its long-term feasibility and optimize its parameters. This study examined the feasibility and preliminary efficacy of a home-based four-week wearable FVT device on gait and explored how FVT parameters impact gait and mobility outcomes. In this pilot double-blind randomized controlled trial, 22 PwMS were randomized into control and vibration groups (four FVT groups with varying vibration intensities/durations). Participants wore Myovolt^® vibrators on distal quadricep muscles near the rectus femoris insertion (approximately 2 cm from the medial edge of the patella), gastrocnemius/soleus, and tibialis anterior muscles (10 min/muscle, 3 days/week, 4 weeks). Feasibility was evaluated via adherence and satisfaction (QUEST 2.0, interviews). Gait (3D motion analysis) and mobility (T25FW) were assessed at baseline and post-intervention. Data were analyzed using descriptive/inferential statistics and thematic analysis. Of 22 participants, 17 completed post-intervention (16 intervention, 1 control). Wearable FVT showed promising feasibility, with high satisfaction despite minor adjustability issues. Intervention groups improved gait speed (p = 0.014), stride length (p = 0.004), and ankle angle (p = 0.043), but T25FW was unchanged (p > 0.05). High-intensity FVT enhanced knee/hip moments. This study’s results support the feasibility of wearable FVT for home-based management of mobility symptoms in MS with high participant satisfaction and acceptance. Notable gains in gait parameters suggest FVT’s potential to enhance neuromuscular control and proprioception but may be insufficient to lead to mobility improvements. Subgroup analyses highlighted the impact of vibration intensity and duration on knee joint mechanics, emphasizing the need for personalized dosing strategies. Challenges included participant retention in the control group and burdensome biomechanical assessments, which will be addressed in future studies through improved sham devices and a larger sample size. Full article

Background/Objectives: Uropathogenic Escherichia coli (UPEC) is the leading cause of urinary tract infections in both community and hospital settings worldwide. Antimicrobial-resistant UPEC strains pose a significant challenge for effective antibiotic therapy. In this study, 50 bacterial isolates recovered from urine samples of patients attended in different sectors of a public hospital in Rio de Janeiro over five months were analyzed to assess antimicrobial resistance and virulence profiles through broad gene screening. Methods: Biofilm production was assessed using a semi-quantitative adherence assay. PCR was employed to investigate 27 resistance genes, 6 virulence genes, sequence types (STs), and phylogroups. Susceptibility to 25 antimicrobial agents was determined by disk diffusion testing. Furthermore, the pathogenic potential was evaluated in vivo using the Tenebrio molitor larvae infection model. Results: Most UPEC isolates were moderate or strong biofilm producers (41/50; 82%). The sul1 and sul2 resistance genes were the most frequently detected (58%). Two virulence gene patterns were identified: fyuA, iutA, fimH, cnf1 and fyuA, iutA, fimH (13 isolates; 26%). ST131 and ST73 were the most common sequence types (16% each), and phylogroup B2 was the most prevalent (50%). Thirty isolates (60%) were multidrug-resistant, most of which belonged to phylogroup B2. UPEC exhibited dose-dependent lethality, causing 100% mortality at 2.6 × 10⁸ CFU/mL within 24 h. Conclusions: These findings reinforce the urgent need for surveillance strategies and effective antimicrobial stewardship in clinical practice. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE—session template set to 50% of the day’s maximal sustained effort; 6 levels × 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT—spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within ≤30 min. Sham—valve set to minimal resistance (9 cmH₂O); 36 inspirations within ≤30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 ± 12.9 years), Threshold n = 12 (67.4 ± 6.9 years), Sham n = 12 (67.3 ± 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 ± 7.5 kg/m². The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p < 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted. Full article

The COVID-19 pandemic unprecedentedly challenged families worldwide, yet little is known about how parents from diverse cultural contexts retrospectively interpret their parenting roles and coping strategies. This study explores parenting adjustments two years after the pandemic’s onset among five cultural groups: Bulgarian and Spanish (Eastern and Western Europe), Israeli Arabs and Jews (Middle East), and U.S. families. Fifty parents, primarily mothers of children aged 2–8, were recruited through snowball sampling. Semi-structured interviews were conducted using the Parenting Pentagon Model (PPM), which includes five constructs: Partnership, Parental Leadership, Love, Encouraging Independence, and Adherence to Rules. Data were analyzed using grounded theory and directed content analysis. Across cultures, Love and Parental Leadership were central to maintaining emotional stability and family cohesion. Partnership showed cultural variation: Bulgarian and Spanish parents often shared responsibilities, while U.S. mothers reported handling childcare alone, heightening work–life tension. Israeli-Arab fathers became more involved in caregiving, while Israeli-Jewish mothers described both strengthened and strained partnerships. Coping strategies were shaped by cultural values and family demographics (e.g., family size). The findings emphasize parents’ vital role in fostering family resilience during crises and stress the importance of culturally sensitive support to enhance families’ adaptive capacity for future challenges. Full article

Background: Lifestyle behaviours, such as dietary patterns, sleep quality, perceived stress, and physical activity, are closely interconnected and play a critical role in maintaining health and well-being. Among school teachers, a profession marked by high psychosocial demands, the interplay between these factors warrants further exploration. Objective: This pilot study aimed to explore the associations between adherence to the Mediterranean Diet (MD), sleep quality, perceived stress, and physical activity levels among Portuguese primary and secondary school teachers. Methods: A cross-sectional study was conducted between April and December 2023. Participants completed validated self-reported instruments, including the MD Adherence Screener (MEDAS), the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS-10), and the short form of the International Physical Activity Questionnaire (IPAQ-SF). Correlational analyses and multivariable linear regression models were applied to explore the relationships among the variables. Results: Among the 50 teachers, 32% demonstrated high adherence to the MD, 60% reported good sleep quality, 62% experienced moderate stress, and 44% engaged in high physical activity. Women were more likely to adhere strongly to the MD (p = 0.012). Higher MD adherence was positively associated with physical activity (ρ = 0.343; p = 0.015). A positive correlation was observed between perceived stress and poorer sleep quality (ρ = 0.346, p = 0.014), and a negative correlation between perceived stress and physical activity levels (ρ = −0.297, p = 0.036). Despite reporting good sleep quality, these participants had higher perceived stress scores (p = 0.015). In adjusted models, sleep quality was the only significant predictor of perceived stress (B = 0.708; p = 0.003), and vice versa (B = 0.267; p = 0.003), suggesting a bidirectional relationship. Conclusions: The findings highlight the interrelation between dietary pattern, sleep stress, and physical activity in a professional group vulnerable to lifestyle-related health challenges. Although the sample size limits generalisability, this study provides preliminary evidence supporting the need for integrated health promotion strategies targeting stress reduction and lifestyle optimisation among educators. Full article

Industrial structure upgrading serves as an important driving force for the sustained and healthy development of the economy, and it has a positive effect on reducing carbon emission intensity. This study uses provincial panel data from China from 2004 to 2019, starting from the dual perspectives of green total factor productivity and labor misallocation, and employs a four-stage mediation regression model to estimate the mechanism of industrial structure upgrading on carbon emission intensity. The research findings show that: for every 1% increase in industrial structure upgrading, carbon emission intensity will decrease by 0.296%; the central region shows the most significant effect, followed by the western region, while the eastern region shows no significant effect. From the view of the influencing mechanism, industrial structure upgrading will promote green total factor productivity and labor misallocation. When each of the two mediating variables increase by 1%, carbon emission intensity will decrease by 0.12% and 0.054%, respectively. Under the influence of industrial structure upgrading, the inhibitory effects of green total factor productivity and labor misallocation on carbon emission intensity have weakened, and the two factors have made it difficult to form a mediating superposition effect within the sample period. The research conclusion provides the policy implications for China to continuously adhere to industrial structure upgrading, pay attention to improving green total factor productivity, and enhance the low-carbon technical level of workers to achieve the “dual carbon” goals. Full article

Introduction: Osteoarthritis (OA) is a chronic degenerative joint disease with limited treatment options focused primarily on symptom management. Emerging evidence suggests that dietary interventions may influence inflammation and pain through modulation of the gut microbiome and metabolome. Methods: We conducted a 4-week open-label pilot trial evaluating the effects of an anti-inflammatory dietary intervention (ITIS diet) in 20 patients with knee OA (ClinicalTrials.gov ID: NCT05559463, registered prior to enrollment; sponsor: University of California, San Diego; responsible party: Monica Guma; study start date: 1 October 2021). The following were assessed before and after the intervention: (1) clinical outcomes; (2) gut and salivary microbiomes; and (3) salivary, stool, and plasma metabolomes. Responders were defined as patients achieving ≥30% reduction in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scores. Results: The ITIS diet was well-tolerated, with good adherence (66.2%) and a significant improvement in clinical outcomes, including reduced pain and improved overall health measured with the visual analog scale (VAS). Responders (n = 8) showed distinct gut microbiome and metabolome profiles compared to non-responders (n = 12). Notably, taxa within the Lachnospiraceae family exhibited dynamic, bidirectional shifts post-intervention: Anaerostipes and Limivivens were enriched among responders and negatively correlated with pain scores, while Oliverpabstia and Fusicatenibacter were depleted following dietary intervention. These taxa also showed strong correlations with anti-inflammatory metabolites, including hydroxydecanoic acid derivatives and pyridoxine. Furthermore, subsequent network analysis revealed more structured and selective microbiome–metabolome interactions in responders, specifically post-intervention. Conclusions: This pilot study shows that a short-term anti-inflammatory dietary intervention was associated with meaningful changes in the gut microbiome and metabolome. Members of the Lachnospiraceae family emerged as key taxa associated with pain reduction and anti-inflammatory metabolite production. Our findings suggest that specific microbial responses—rather than global diversity changes—may underlie dietary responsiveness in OA. Although exploratory and limited by sample size, our results support further investigation into personalized, microbiome-informed nutritional strategies for OA management. Full article

Dry powder inhalers (DPIs) are the mainstay in the treatment of obstructive pulmonary diseases. However, the performance of DPI formulations is highly dependent on the used inhaler device and the patient’s inspiratory effort. This study aimed to evaluate and compare the aerosolization behavior of three commercially available capsule-based DPI medications—formoterol (Foradil^®), glycopyrronium (Seebri^® Breezhaler), and tiotropium (Spiriva^®)—delivered using three different capsule-based inhalers (Aerolizer, Breezhaler, and Handihaler), under varying flow conditions. Methods: The aerodynamic performance of each formulation–inhaler combination was assessed using the Next-Generation Impactor (NGI) and Dosage Unit Sampling Apparatus (DUSA) methodology. Fine particle dose (FPD) and aerodynamic particle size distribution (APSD) were determined at fixed flow rates of 15, 30, 60, and 100 L/min, as well as at inhaler-specific flow rates corresponding to a 4 kPa pressure drop. Chromatographic quantification of active ingredients was performed using validated HPLC methods specific to each drug. Results: The FPD values increased consistently with higher flow rates across all tested formulations and inhalers. At a 4 kPa pressure drop, Aerolizer and Breezhaler achieved significantly higher FPDs compared to Handihaler. Notably, in some instances, non-dedicated inhalers produced greater respirable fractions than the originally intended devices. APSD profiles revealed that drug deposition shifted toward smaller NGI stages at higher inspiratory flows, supporting enhanced deep lung delivery potential under optimal conditions. Conclusions: Device resistance, capsule orientation, and piercing mechanics substantially influence drug aerosolization. Although non-dedicated inhalers may offer improved FPDs in vitro, clinical use should adhere to approved drug–device combinations, as these have been validated for efficacy and safety under real-world conditions. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in childhood and adolescence, characterized by symptoms of inattention, hyperactivity, and impulsivity. These symptoms often interfere with academic, social, and family functioning. In recent years, the use of digital tools and video games has garnered attention as an innovative and engaging approach for neurocognitive rehabilitation. The primary objective of this randomized controlled study was to investigate the comparative effects of two cognitive intervention approaches—one based on new technologies and one using traditional methods—on attention, inhibitory control, and processing speed in children and adolescents diagnosed with ADHD. Thirty-three participants aged 6–17 years were randomly assigned to either an experimental group (n = 17), which received Nintendo Switch-based therapy, or a control group (n = 16), which received traditional board game therapy. Both interventions lasted 8 weeks and included 16 sessions. Outcomes were assessed using the WISC-V, STROOP, and CARAS-R tests. Results showed significant within-group improvements in both groups. The control group exhibited gains in sustained attention and inhibitory control (CARAS-R and STROOP tests, p < 0.05), while the experimental group improved significantly in processing speed, as measured by the WISC-V (p = 0.001). However, no significant differences were found between groups. These findings suggest that both interventions may be effective for enhancing different cognitive processes in children with ADHD. Importantly, the use of familiar digital technologies like the Nintendo Switch may promote greater motivation and adherence to treatment. Further research with larger samples and long-term follow-up is warranted to validate and extend these preliminary findings, as the current sample size was not powered to detect medium or small effects. Full article