Search Results (22,669)

This study proposes a low-cost, wearable multimodal system for comprehensive cardiovascular monitoring, integrating electrocardiogram (ECG), phonocardiogram (PCG), and photoplethysmogram (PPG) signals. By leveraging the complementary strengths of these modalities, the system extracts key physiological markers: pre-ejection period (PEP) from ECG–PCG fusion to assess myocardial electromechanical timing; pulse transit time (PTT) from PCG–PPG fusion to reflect arterial stiffness; and pulse arrival time (PAT) from ECG–PPG fusion to characterize heart–arterial coupling. Experimental results show that PEP is significantly associated with body mass index (BMI) but not age, suggesting that age-related changes primarily affect the arterial system rather than myocardial function. In contrast, both PTT and PAT demonstrate moderate negative correlations with age and BMI, supporting their relevance as noninvasive indicators of vascular aging. Additionally, PAT exhibits a significant sex-based difference, highlighting physiological disparities between male and female cardiovascular systems. Overall, the proposed fusion-based approach demonstrates technical feasibility and clinical potential for scalable, preventive cardiovascular healthcare, enabling early risk detection, continuous at-home monitoring, and improved long-term health management. Full article

Amyloid cardiomyopathy (ACM), driven by transthyretin (TTR) and immunoglobulin light chain (LC) amyloid fibrils, remains a major clinical challenge due to limited mechanistic understanding and insufficient preclinical models. Human-induced pluripotent stem cells (iPSCs) have emerged as a transformative platform to model ACM, offering patient-specific and genetically controlled systems. In this review, we summarize recent advances in the use of iPSC-derived cardiomyocytes (iPSC-CMs) in both two-dimensional (2D) monolayer cultures and three-dimensional (3D) constructs—including spheroids, organoids, cardiac microtissues, and engineered heart tissues (EHTs)—for disease modeling, mechanistic research, and drug discovery. While 2D culture of iPSC-CMs reproduces hallmark proteotoxic phenotypes such as sarcomeric disorganization, oxidative stress, and apoptosis in ACM, 3D models provide enhanced physiological relevance through incorporating multicellularity, extracellular matrix interactions, and mechanical load-related features. Genome editing with Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-Cas9 further broadens the scope of iPSC-based models, enabling isogenic comparisons and the dissection of mutation-specific effects, particularly in transthyretin-related amyloidosis (ATTR). Despite limitations such as cellular immaturity and challenges in recapitulating aging-associated phenotypes, ongoing refinements in differentiation, maturation, and dynamic training of iPSC-cardiac models hold great promise for overcoming these barriers. Together, these advances position iPSC-based systems as powerful human-relevant platforms for modeling and elucidating disease mechanisms and accelerating therapeutic development to prevent ACM. Full article

Background and Objectives: Therapeutic goals for ulcerative colitis (UC) have expanded beyond symptom control to include mucosal and histological healing. However, the long-term prognostic value of achieving both targets remains uncertain, particularly in Asian populations. This study aimed to evaluate long-term outcomes and relapse predictors in patients with UC who achieved both endoscopic and histologic remission. Materials and Methods: This prospective observational study consecutively enrolled adults with clinically inactive UC who attained endoscopic remission (Mayo endoscopic subscore = 0) and histologic remission (Nancy index ≤1) between June 2014 and May 2018. Demographic, clinical, and laboratory data—including fecal calprotectin—were collected. Clinical relapse was defined as a Mayo score increase >3 or initiation of systemic corticosteroids or biologics. Patients were followed longitudinally for a median of 55 months (minimum 12 months), and relapse risk was evaluated using Kaplan–Meier and univariate Cox regression analyses. Results: A total of 41 patients were included (mean age 54 ± 14 years; 56% male). The median follow-up was 54 months (range 17–78). Ten patients (24.4%) relapsed during follow-up, with cumulative relapse rates of 9.8%, 10.3%, 15.8%, and 24.1% at 12, 24, 36, and 48 months, respectively. Kaplan–Meier analyses demonstrated significantly higher relapse in patients with non-E1 disease (E2 + E3, p = 0.021), immunomodulator use (p = 0.008), and biologics use (p = 0.007). In univariate Cox regression, immunomodulator (HR 4.7, 95% CI 1.3–16.4, p = 0.02) and biologics use (HR 4.9, 95% CI 1.4–17.5, p = 0.01) were significant predictors of relapse, whereas disease extent showed only a non-significant trend with wide CIs. Baseline fecal calprotectin was higher in the relapse group (182 ± 370 μg/g vs. 108 ± 164 μg/g) but was not statistically significant. Conclusions: Approximately one-quarter of UC patients who achieved dual remission relapsed within 4 years. These findings highlight the limitations of using dual remission as the sole therapeutic endpoint and underscore the need for additional prognostic factors. High-risk subgroups—such as those with extensive disease or prior exposure to advanced therapies—may require closer monitoring and individualized strategies. Future multicenter studies integrating clinical, endoscopic, histologic, and biomarker data are needed to refine relapse prediction. Full article

Low-fishmeal feed is increasingly being adopted across the global aquaculture industry. This study evaluated dietary Clostridium butyricum and alanyl-glutamine (Ala-Gln) supplementation in juvenile triploid rainbow trout (Oncorhynchus mykiss) with a low-fishmeal diet. Four diets were tested: basal diet (SBM, 15% fishmeal and 21.6% soybean meal), SBM + 0.5% C. butyricum (CB), SBM + 1.0% Ala-Gln, and SBM + 0.5% C. butyricum + 1.0% Ala-Gln (CB-AG). Fish were fed in 500 L tanks in recirculating aquaculture systems for 8 weeks (62.52 ± 0.47 g). Each group comprised three tanks, with each tank housing 30 fish. Then 10 fish per tank were challenged with Aeromonas salmonicida. CB-AG showed significantly higher weight gain and specific growth rates than the SBM group (p < 0.05). Mortality was significantly lower in CB-AG and AG than in SBM after A. salmonicida challenge. Histomorphology revealed significant differences (p < 0.05) between CB-AG and SBM in muscularis thickness, villus width, and height. SBM sections showed inflammatory infiltration and border damage were attenuated in supplemented groups. Serum malondialdehyde (MDA) and dioxygenase (DAO) were significantly lower in CB-AG than SBM (p < 0.05), while serum and hepatic lysozyme (LZM) and hepatic superoxide dismutase (SOD) were higher. Digestive enzymes indicated significantly higher trypsin and lipase activities in CB-AG (p < 0.05). CB-AG upregulated intestinal tight junction proteins and PepT1 and downregulated pro-inflammatory mediators. Combined 0.5% C. butyricum and 1.0% Ala-Gln inclusion effectively preserved growth performance, antioxidant capacity, gut microbiome homeostasis, and intestinal health in rainbow trout on low-fishmeal diets. Full article

Background: Vaccination reduces Coronavirus disease-19 (COVID-19) infection severity. We evaluated COVID-19 vaccine uptake and effectiveness in people with immune mediated inflammatory diseases (pIMIDs) versus the general population. Methods: Using population-based administrative health records, we identified cohorts between 2004 and 2022 with an IMID (rheumatoid arthritis n = 10,405, systemic autoimmune rheumatic disease n = 5888, inflammatory bowel disease n = 7911, multiple sclerosis n = 3665, psoriasis n = 23,948) who were matched (1:5) by age, sex, and region to general population comparators (n = 243,490) without these IMIDs. Between 1 January 2021 and 31 March 2022, rates of COVID-19 vaccine administration, hospitalizations with COVID-19 (Hosp-C), and all-cause mortality were assessed amongst pIMIDs and comparators using multivariable models. Results: More pIMIDs were vaccinated than comparators (87.3% vs. 84.7%, p < 0.0001). IMID diagnosis, increasing age, female sex, higher socioeconomic status, urban residence, immunotherapy use, and comorbidities were associated with increased odds of receiving at least two vaccine doses. pIMIDs had higher rates of Hosp-C (79 per 100,000, 95% confidence interval (CI) 77.8–80.2) than comparators (51 per 100,000, 95% CI 50.5–51.3; rate ratio 1.55; 95% CI 1.53, 1.58) and greater mortality [pIMID 1758 deaths, 3.61%; comparators (6346 deaths, 2.61%), RR 1.39 95% CI 1.32, 1.46)]. In multivariable analyses, vaccinated status was associated with less Hosp-C (OR 0.27, CI 0.23, 0.32) and death (HR 0.27 CI 0.24, 0.29); the association did not differ between IMID and comparator groups. Conclusions: Although COVID-19 vaccination reduced the risk of Hosp-C and death in both pIMIDs and comparators, pIMIDs remained at higher risk for both. Since SARS-CoV-2 is now endemic, these findings may inform ongoing vaccination recommendations. Full article

Helicobacter pylori is a gastric pathogen that induces chronic gastritis, which may progress to neutrophilic activity, glandular atrophy, intestinal metaplasia, and gastric carcinoma. The aim of this study was to evaluate H. pylori-induced tissue damage. A total of 602 gastric biopsy samples were collected, categorized, and analyzed using hematoxylin and eosin and Giemsa staining, followed by molecular confirmation through PCR targeting the species-specific 16S rRNA gene. H. pylori density and histopathological features were evaluated and graded according to the updated Sydney classification system. H. pylori was detected in 55% (n = 334) of cases, and the antrum (50.83%, p < 0.00001) was the predominant site. A slightly higher prevalence was observed in females, accounting for 56.9% compared to males at 43.1%, which was attributed to sociocultural exposure differences. Individuals aged 11–40 years accounted for 58.3% (n = 195), highlighting early-age acquisition of infection. H. pylori infection was significantly linked to moderate-to-severe inflammation (63.2%, p < 0.00001) and neutrophilic activity (53.3%, p < 0.00001). Intestinal metaplasia and atrophy were infrequent, present in 0.6% (95% CI, 0.02, p = 0.149) and 0.9% (95% CI, 0.05, p = 0.430) of individuals. H. pylori infection causes chronic inflammation and neutrophilic infiltration of the stomach mucosa. Early identification and histopathological examination are essential in assessing H. pylori-related gastric pathology. Full article

This study evaluated the inclusion of increasing levels of xylanase in reduced-energy diets for commercial laying hens. A total of 280 Lohmann LSL white laying hens were equally allocated one of five dietary treatments, with seven replicates of eight hens each being a positive control: a wheat and soybean meal-based diet (PC, ME 2725 kcal/kg), a negative control diet (NC, PC minus 100 kcal) and three diets with increasing xylanase levels of 50, 100 and 150 g/MT (NC + XM50, NC + XM100 and NC + XM150, respectively). The hens were monitored from 20 to 40 weeks of age to assess productive performance, egg quality and intestinal health, including histomorphometry, permeability and microbiota composition. Xylanase inclusion at 50 and 100 g/MT significantly improved egg production and egg mass, as well as shell strength and thickness, while maintaining feed intake and feed conversion efficiency, while xylanase inclusion at 150 g/MT decreased egg production and egg mass. Additionally, intestinal permeability was significantly reduced, and positive changes were observed in the gut microbiota. Higher doses of xylanase (100 and 150 g/MT) increased bacterial abundance and diversity, with a greater presence of beneficial phyla such as Bacteroidota, which play an important role in gut health. There was also a reduction in Actinobacteriota, indicating a lower presence of potential pathogens. Changes in Campylobacterota, Cyanobacteria and Proteobacteria were observed, especially with the highest xylanase dose. These findings suggest that xylanase can improve laying hen performance and promote intestinal integrity and microbial balance when included in energy-reduced diets, offering a promising strategy to enhance health and productivity in commercial egg production systems. Full article

Objectives: To describe the outcomes of patients with refractory noninfectious ocular inflammatory diseases who underwent treatment with repository corticotropin injection (RCI). Methods: A retrospective cohort study was conducted. Patients who failed treatment with corticosteroids and were subsequently treated with RCI were included. Primary outcome measures were intraocular inflammatory activity, intraocular pressure (IOP), and the development of complications. Results: A total of 19 eyes from 10 patients were included. Most of the patients were women (70.0%) and the median age at presentation was 49.0 years (30.0–84.0 years). The ocular diagnoses were anterior/intermediate uveitis, intermediate/posterior uveitis, panuveitis, ocular cicatricial pemphigoid, and anterior scleritis. Seventeen (89.5%) eyes had active disease. The median duration of RCI treatment was 16.0 months (6.0–28.0 months). Nine (90.0%) patients, representing 17 (89.5%) eyes, achieved disease inactivity and remained quiescent at the last visit. No patient was on systemic corticosteroids at the last evaluation. The mean IOP was lower under RCI than corticosteroid at one month (16.0 mmHg ± 6.1 vs. 20.8 mmHg ± 9.5, p = 0.033) and four months (15.6 mmHg ± 2.9 vs. 17.8 mmHg ± 3.7, p = 0.046); however, the overall difference was not significant (16.2 mmHg ± 1.1 vs. 17.3 mmHg ± 1.8, p = 0.057). Incidence rates were the highest for posterior subcapsular cataracts (44.4% per eye-year). Relative risk analysis (RR) showed a 40.0% risk reduction for cystoid macular edema (RR = 0.60, p = 0.054). Conclusions: RCI may be an alternative treatment for refractory noninfectious ocular inflammatory diseases in patients who have failed treatment with corticosteroids. Full article

This study investigates the effect of different sintering parameters on the surface roughness and fracture resistance of different CAD/CAM lithium disilicate ceramics before and after thermocycling and simulated toothbrushing. Sixty lithium disilicate ceramic samples were categorized according to ceramic type (AMB: Amber Mill, ECAD: IPS e.max CAD) and level of translucency (LT: low and HT: high) into four groups: AMB_LT, AMB_HT, ECAD_LT and ECAD_HT. Specimens were prepared to 2 mm thickness, crystallized, polished, and subjected to thermocycling to simulate five years of clinical aging. Simulated toothbrushing was performed using a soft-bristled mechanical brushing system under controlled force and strokes. Surface roughness was assessed using a profilometer before and after brushing, and fracture resistance was measured using a universal testing machine. Data were statistically evaluated using paired t-tests, one-way ANOVA with Bonferroni post hoc correction (p ≤ 0.05). LT lithium disilicate specimens exhibited significantly smoother surfaces than high-translucency counterparts. After thermocycling and brushing simulation, all groups showed a statistically significant increase in surface roughness, ranging between 0.239 ± 0.012 μm (AMB_LT) and 0.486 ± 0.014 μm (ECAD_HT). In terms of fracture resistance, the highest values were recorded for ECAD_HT (636 ± 8.29 N), and the lowest in the AMB_HT group (546.3 ± 21.9 N) with significant differences observed between materials and translucency levels. Sintering parameters and artificial aging significantly influenced the surface roughness and fracture resistance of lithium disilicate ceramics. Low-translucency variants demonstrated smoother surfaces and higher strength than high-translucency groups, while all materials exhibited increased roughness after aging. These findings provide guidance for the selection of lithium disilicate ceramics, balancing esthetic and mechanical requirements in anterior and posterior restorations. Full article

The danwei community emerged as a basic socio-spatial unit in China’s urban landscape, primarily constructed in the mid-20th century. Today, amid population aging and the deterioration of service facilities supporting health environment, the mental and physical conditions of danwei residents are increasingly challenged. Through an investigation of the built environment history and physical activity patterns in Community Hua, a typical case of former danwei community in Chengdu, China, this paper indicates that danwei communities have accumulated health-promoting legacies rooted in their historical spatial planning and collective lifestyle. The tangible legacy includes an open space system centered around green facilities, while the intangible legacy encompasses a diverse range of well-organized sports and cultural events. Following the reform of unit society in China in the late 1990s, these health-promoting legacies continue to exist within the danwei communities. Consequently, this study suggests that future renewal of open spaces within danwei neighborhood should be based on community history, thus the spatial legacy benefiting residents’ health can be preserved and utilized. Full article

Rapid evolution in electrified transportation and, in general, sustainability of electrical and electronic assets is turning the traditional power supply and utilization into something more complex and less known. This transition involves increasing operating voltage and specific power, as well as various types of power supply sources, from AC sinusoidal to DC and power electronics. This revolution, beneficial for asset efficiency and resilience, does come at the cost of increased risk of failure for electrical insulation systems. Intrinsic and extrinsic aging mechanisms are not completely known under DC and power electronics, and the risk of inception of partial discharges, PD, which is the most harmful extrinsic aging factor for electrical insulation, is as high, or even higher, compared with AC. To complicate the picture, electrical and electronic components can be used at different pressure levels, such as in aerospace, and it is known that partial discharge inception voltage, PDIV, drops down, and PD magnitude increases, lowering pressure. Models to predict PDIV for surface and internal discharges, as function of pressure, have been proposed recently, but they cannot be applied straightforwardly on practical asset components where type and locations of defects generating PD is unknown. This paper wants to close this application gap. Derivation and validation of an approximate, heuristic model able to predict PDIV at various pressure levels below and above the standard atmospheric pressure, SAP, are dealt with in this paper, referring to typical asset components such as cables, motors, printed circuit-boards, PCB, and under sinusoidal AC voltage. The good capability of the model to predict PDIV and any investigated pressure, from 3 to 0.05 bar, is validated by PD measurements performed using an innovative, automatic PD analytics software able to identify the typology of defect generating PD, i.e., whether surface or internal. Full article

The central purpose of this study is to develop and validate an advanced numerical model capable of simulating the vibrational behavior of the operator’s seat in a tractor-type agricultural vehicle designed for operation in protected horticultural environments, such as vegetable greenhouses. The three-dimensional (3D) model of the seat was created using SolidWorks 2023, while its dynamic response was investigated through Finite Element Analysis (FEA) in Altair SimSolid, enabling a detailed evaluation of the natural vibration modes within the 0–80 Hz frequency range. Within this interval, eight significant natural frequencies were identified and correlated with the real structural behavior of the seat assembly. For experimental validation, direct time-domain measurements were performed at a constant speed of 5 km/h on an uneven, grass-covered dirt track within the research infrastructure of INMA Bucharest, using the TE-0 self-propelled electric tractor prototype. At the operator’s seat level, vibration data were collected considering the average anthropometric characteristics of a homogeneous group of subjects representative of typical tractor operators. The sample of participating operators, consisting exclusively of males aged between 27 and 50 years, was selected to ensure representative anthropometric characteristics and ergonomic consistency for typical agricultural tractor operators. Triaxial accelerometer sensors (NexGen Ergonomics, Pointe-Claire, Canada, and Biometrics Ltd., Gwent, UK) were strategically positioned on the seat cushion and backrest to record accelerations along the X, Y, and Z spatial axes. The recorded acceleration data were processed and converted into the frequency domain using Fast Fourier Transform (FFT), allowing the assessment of vibration transmissibility and resonance amplification between the floor and seat. The combined numerical–experimental approach provided high-fidelity validation of the seat’s dynamic model, confirming the structural modes most responsible for vibration transmission in the 4–8 Hz range—a critical sensitivity band for human comfort and health as established in previous studies on whole-body vibration exposure. Beyond validating the model, this integrated methodology offers a predictive framework for assessing different seat suspension configurations under controlled conditions, reducing experimental costs and enabling optimization of ergonomic design before physical prototyping. The correlation between FEA-based modal results and field measurements allows a deeper understanding of vibration propagation mechanisms within the operator–seat system, supporting efforts to mitigate whole-body vibration exposure and improve long-term operator safety in horticultural mechanization. Full article

The COVID-19 pandemic exposed the fragility of global health systems, as physicians faced extremely challenging conditions including excessive workloads, infection risk, and high patient mortality. We conducted a cross-sectional survey that aimed to assess the post-pandemic prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in a sample of Greek physicians who worked on the frontline during the SARS-CoV-2 (COVID-19) pandemic. An online survey was conducted between 1 March and 31 July 2023, in which 200 Greek physicians were invited via e-mail to voluntarily answer a confidential online questionnaire, and 58 of them responded. The survey included two clinically validated tools: the Patient Health Questionnaire-4 (PHQ-4) and the Impact of Event Scale—Revised (IES-R). Univariate correlations of 26 exposure variables with anxiety, depression, combined anxiety/depression, and PTSD were performed. In total, 58 eligible physicians (46.6% female) participated in this study. The rates of anxiety, depression, combined anxiety/depression, and PTSD were 27.5% (95% CI: 16.7–40.9), 31.0% (19.5–44.5), 22.4% (12.5–35.3), and 24.1% (13.9–37.2), respectively. Notably none of the physicians working in a laboratory developed any mental health symptoms. The following factors were found to be associated with the development of higher mental health symptoms: age ≤ 30, employment in healthcare ≤ 10 years, working in COVID-19 wards, working in intensive care units or COVID-19 wards, a history of mental health symptoms, a history of physical conditions, shortages of materials and equipment for diagnosing or treating patients, development of a disease other than COVID-19, and the development of a new mental health condition during the pandemic (p < 0.05 for all associations). Our findings highlight the need to better prepare physicians with adequate materials, infrastructure, and psychological support such that, in a potential future health crisis, they will not be at such high risk of mental health problems. Full article

We compared oxidative markers and their links to inflammation in diabetic nephropathy and hemodialysis to identify independent determinants. We studied 180 adults, 90 patients with type 2 diabetes and diabetic nephropathy and 90 patients on hemodialysis. We measured serum advanced oxidation protein products (AOPP) and thiobarbituric acid reactive substances (TBARS) by enzyme-linked immunosorbent assay (ELISA). Partial correlations were adjusted for age, sex, and albumin with false discovery rate (FDR) control. Principal component analysis (PCA) summarized inflammatory indices and linear models tested predictors of AOPP and TBARS. Oxidative damage was higher in hemodialysis, with AOPP median 25.80 versus 5.06 and TBARS 8.49 versus 1.89, p less than 0.0001. C reactive protein (CRP) and mean corpuscular volume-to-lymphocyte ratio (MCVL) were higher in patients ongoing hemodialysis; systemic immune-inflammation index (SII) was higher in diabetic nephropathy. PCA yielded a dominant inflammation axis in both cohorts, 74.73 percent in hemodialysis and 85.20 percent in diabetic nephropathy. In regression, creatinine (β = 2.47, p = 0.026) predicted AOPP in hemodialysis. Dialysis vintage inversely predicted TBARS, beta minus 0.2305, p = 0.0209. In diabetic nephropathy, the PCA inflammation score predicted AOPP, β = 1.134, p = 0.0003. Protein oxidation tracked systemic inflammation in diabetic nephropathy, but not in hemodialysis. AOPP outperformed TBARS as an inflammatory partner and a practical monitoring candidate in diabetic kidney disease. Prospective studies should test for prognostic value and therapy sensitivity. Full article

Oral mucosal wound healing is a rapid, precisely regulated process distinct from cutaneous repair due to the specialized anatomical, microbial, and physiological features of the oral cavity. This review outlines the sequential healing phases—hemostasis, inflammation, proliferation, and remodeling—and examines the coordinated roles of keratinocytes, fibroblasts, endothelial cells, and immune cell subsets in tissue restoration. Central molecular pathways, including PI3K/Akt, JAK/STAT, Ras/MAPK, TGF-β/SMAD, and Wnt/β-catenin, along with growth factors such as TGF-β, FGF, EGF, and VEGF, are discussed in relation to their regulatory influence on cell behavior and extracellular matrix dynamics. Unique intraoral factors—namely saliva-derived histatins and a distinct resident microbiota—promote accelerated re-epithelialization and attenuated fibrosis. Systemic conditions such as diabetes, aging, and tobacco exposure are identified as key modulators that compromise repair efficiency. Emerging therapeutic strategies, including stem-cell-based interventions, microbiota modulation, bioengineered scaffolds, and photobiomodulation, offer translational potential to enhance clinical outcomes in oral tissue regeneration. Full article