Search Results (1,233)

An association between periodontal disease and comorbid disorders, including gastrointestinal signs, has been reported in cats and investigated in humans, where a bidirectional relationship between oral and gastrointestinal microbiomes exists. A 5-year-old neutered female domestic shorthair cat was presented with a 2-year history of small-bowel diarrhoea. The cat’s appetite was reduced, and coat quality had deteriorated. On examination, the cat was found to have periodontal disease affecting multiple teeth and a matted coat. Biochemistry revealed mild hyperproteinaemia, haematology was unremarkable, cobalamin was normal, folate was elevated, and retroviral testing was negative. Abdominal ultrasound showed diffuse muscularis thickening without other abnormalities, and dental examination and radiography revealed missing teeth, a root remnant, stage 4 periodontal disease, and tooth resorption. Multiple extractions were performed, and multimodal analgesia was provided, including locoregional dental blocks. The cat’s appetite, body condition, energy levels, and coat quality improved after the procedure, and the diarrhoea completely resolved within a month of the procedure without any changes in diet, physical, social environment, or the use of any medications, and did not recur during the following 7 months. This case illustrates the potential role of periodontal disease in the development of gastrointestinal disease and the benefits outside the oral cavity of managing dental disease in cats. Full article

This study investigates how cross-linguistic differences in spatial cognition affect Chinese learners’ acquisition of French in the conflict domain of page turning, which is encoded in opposite ways by French and Mandarin. Two hundred and sixty-one Chinese university students completed a video-based spatial task in both languages, comprising both comprehension and production components. The results revealed a marked asymmetry in spatial cognition between the first language (L1) and second language (L2): while learners consistently relied on stabilised Mandarin-based construals, their French responses remained strongly shaped by L1 frames of reference. We found no significant association between global French proficiency and success in the French spatial tasks, indicating that higher proficiency does not automatically entail conceptual restructuring in this domain. Meanwhile, a small to moderate negative correlation between French and Mandarin scores indicated a subtle L2-to-L1 influence, whereby adopting French-conventional spatial construals was accompanied by reduced alignment with Mandarin-conventional patterns. These findings contribute to research on bidirectional cross-linguistic influence in spatial cognition by documenting L2-to-L1 effects in late, classroom-based learners. They also point to the need for pedagogical approaches that explicitly target spatial conceptualisation—through contrastive reflection and embodied practice—rather than focusing solely on the formal properties of spatial expressions. Full article

Background/Objectives: Traumatic brain injury (TBI) is a significant public health concern resulting in physical, cognitive, and behavioral impairments. Emerging evidence highlights a bidirectional relationship between brain injury and gut health, known as the brain–gut axis. This paper provides a comprehensive review of current literature exploring the relationship between TBI and various gastrointestinal (GI) pathologies, examining how brain injuries contribute to GI dysfunction and how gut health influences neurorecovery. Methods: A comprehensive search of peer-reviewed articles was conducted between March and June 2025 using databases including PubMed, Scopus, and Cochrane. Studies from 2010 onwards involving human subjects were screened. Search terms included combinations of “traumatic brain injury,” “TBI,” and “[gastrointestinal pathology].” Data regarding study design, population, GI outcomes, and proposed mechanisms were analyzed. Results: TBI triggers secondary injury cascades, including neuroinflammation, dysautonomia, and gut microbiome dysbiosis. The review identifies a wide spectrum of TBI-associated GI disorders, including dysphagia, esophageal disorders, gastric disorders, and intestinal disorders. Bowel dysfunction, manifesting as constipation or incontinence, is prevalent due to neurogenic factors and cognitive impairments. Additionally, metabolic dysregulation following TBI leads to malnutrition, hyperglycemia, and hypoglycemia, all of which impact morbidity. Conclusions: The GI system is integrally connected to TBI recovery through immune modulation and nutrient absorption. Dysfunction within the brain–gut axis, specifically altered motility, permeability, and inflammation, contributes to secondary brain injury and impedes neurological outcomes. Clinical assessment of GI dysfunction should be integrated into routine TBI care. Therapeutic strategies, including early enteral nutrition, are essential to optimize recovery and reduce systemic inflammation. Full article

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by persistent restriction or avoidance of food intake leading to clinically significant nutritional, medical, and/or psychosocial consequences, without associated body-image disturbance. Although historically described in pediatric populations, ARFID is increasingly recognized in adults, particularly among patients with gastrointestinal (GI) disorders. Emerging data demonstrate a strong bidirectional relationship between ARFID and GI disease—especially disorders of gut–brain interaction—where fear of GI symptoms commonly drives restrictive eating, and chronic undernutrition may worsen GI motility, visceral sensitivity, and symptom severity, reinforcing a self-perpetuating cycle. Despite growing recognition of ARFID in adult gastroenterology patients, evidence guiding nutritional management and the use of nutrition support therapies in this population remains limited. This narrative review synthesizes the current literature on the epidemiology, clinical features, and nutritional consequences of ARFID in adults with GI disease, with a focus on screening and diagnostic considerations relevant to GI clinicians and principles of multidisciplinary management. Particular attention is given to the role of nutrition support therapies, including oral nutritional supplementation, enteral nutrition, and parenteral nutrition. While oral strategies are foundational to nutritional rehabilitation, available evidence supporting enteral or parenteral nutrition in adults with ARFID is sparse and largely extrapolated from pediatric or retrospective studies. Expert guidelines caution against routine or prolonged use of invasive nutrition support due to risks of reinforcing food avoidance, medical complications, and poor long-term outcomes, recommending their use only in carefully selected, medically necessary, and time-limited circumstances. Overall, ARFID represents an underrecognized but clinically significant contributor to malnutrition and symptom burden in adult patients with GI disorders, underscoring the need for routine screening, individualized multidisciplinary care, and high-quality prospective research to inform evidence-based treatment guidelines. Full article

Background: Patients with single-ventricle physiology represent a high-risk group for heart transplantation. Due to complex anatomical and physiological challenges, including multiple prior sternotomies, pulmonary artery abnormalities, and systemic consequences of altered circulation, they represent both a surgical and a clinical challenge. We aimed to analyze perioperative challenges, as well as early and long-term complications, in this specific group of patients. Methods: We performed a retrospective data analysis of a high-volume heart transplant center, focusing on patients with single-ventricle physiology who were scheduled for heart transplantation due to end-stage heart failure. We retrospectively analyzed the period from the beginning of the transplant program in November 1985 to the end of November 2024. Results: Among 1553 transplanted patients (adults and children), 29 were transplanted due to congenital heart disease (congenital valvular disease not included). In this group, nine patients were transplanted due to end-stage heart failure in the course of single-ventricle physiology. Age at transplantation ranged from 7 to 31 years (median, 17 years), and body weight ranged from 15 to 69 kg (median, 47.9 kg). All nine patients referred for heart transplantation presented with single-ventricle physiology. Their underlying congenital heart defects were heterogeneous and included hypoplastic left heart syndrome (HLHS), double-outlet left ventricle (DOLV), transposition of the great arteries (TGA) with associated ventricular septal defects (VSDs), atrial septal defects (ASDs), valvular abnormalities such as tricuspid and or pulmonary valve atresia or stenosis, systemic or atrioventricular valve regurgitation, and vascular abnormalities, including right-sided aortic arch, aortic coarctation, and pulmonary artery hypoplasia, stenosis, or occlusion, as well as associated pulmonary vascular abnormalities such as left pulmonary artery stenosis and MAPCAs. All patients had previously undergone staged palliative procedures, including Norwood, Hemi-Fontan, Fontan, bidirectional Glenn, modified Blalock–Taussig shunts, Bjork–Fontan, or pulmonary artery banding, often with repeated interventions such as balloon angioplasty, stent placement, or MAPCA closure. Extracardiac comorbidities were common and included coagulopathies, protein-losing enteropathy, hepatic dysfunction, and chronic venous insufficiency. Preoperative functional status was markedly impaired in all patients (NYHA III-IV, INTERMACS 3-4), with severely reduced exercise capacity and thrombotic events in several individuals. Perioperative transplant surgical strategies included femoral cannulation in four cases and standard aortic and caval cannulation in five cases. Pulmonary artery reconstruction was required in all patients. Extended donor pulmonary arteries were applied in eight cases, while a bifurcated Dacron prosthesis was utilized in one patient. Perioperative mortality was 33%, with three deaths attributed to bleeding and hemodynamic instability, while overall mortality was 44% including one late death unrelated to transplantation. Protein-losing enteropathy, although persistent in the immediate postoperative period, resolved in all surviving patients, underscoring the transformative impact of transplantation. Conclusions: These findings emphasize the importance of individualized surgical planning, extended donor pulmonary artery harvesting, and careful preoperative coordination. Heart transplantation remains a viable and life-extending option for selected single-ventricle patients, despite the significant technical and clinical challenges involved. Full article

Agrivoltaics offer a sustainable solution to the growing competition between food and energy production. However, their adoption is often constrained by the design and operation challenges associated with optimising the complex trade-off between crop yield and photovoltaic (PV) output. Digital twins can mitigate these risks, yet most agricultural digital twins operate as fragmented digital shadows, lacking high-fidelity modelling, advanced simulation, and bidirectional control capabilities. This study presents a comprehensive, end-to-end digital twin framework to address these limitations. The framework integrates a high-resolution 3D orchard model, reconstructed via UAV photogrammetry, with a CesiumJS-based web interface linked to a modular IoT architecture built on Node-RED, Message Queuing Telemetry Transport (MQTT) protocol and InfluxDB for real-time monitoring and control. A PV simulation engine supports the design, simulation and optimisation of agrivoltaic systems. Bidirectional communication was validated through remote actuation of a physical solar tracker, demonstrating integration among the 3D environment, sensor data and control systems to achieve a closed-loop digital twin. Simulation analyses suggested that panel orientation and row spacing exert a dominant influence on crop-level light distribution. Simulation results demonstrated that a 90° azimuth configuration achieved the highest daily energy yield of 53.97 kWh but reduced peak crop-level irradiance to 205 W/m². In contrast, the baseline 0° configuration offered a balanced output of 40.86 kWh with a peak light availability of 338 W/m². The validated, interoperable digital twin architecture provides a reference model for the design, simulation, monitoring and control of an agrivoltaic system, reducing investment uncertainty and supporting sustainable food–energy co-production. Full article

Landslides triggered by extreme events, such as heavy rainfall, are often unpredictable and cause significant damage to people and infrastructure. Calculating landslide susceptibility and associated risk in real time is challenging on several fronts, but it would provide valuable assistance in the event of major disasters. In this context, this research project aims to present a cutting-edge system for dynamic landslide susceptibility estimation based on open-source software, open data, and Open Geospatial Consortium (OGC) standards. Using real-time precipitation and geospatial data, the system allows for the calculation of susceptibility following extreme rainfall events, combining Analytic Hierarchy Process (AHP) and Random Forest processing. The proposed framework represents a prototypical, Digital Twin-ready terrain system, where dynamic geospatial data and real-time precipitation data are integrated in a predictive machine learning model and published within a WebGIS-based architecture. The system dynamically updates landslide susceptibility information, supporting local authorities and planners in identifying critical areas and enabling timely intervention in the event of imminent danger. The automated WebGIS processing and visualization environment provides a scalable and extensible foundation for future integration of physically based simulations and bidirectional feedback mechanisms, oriented to Digital Twinning Twinning solutions. Full article

In 2023, the terminology of metabolic dysfunction-associated steatotic liver disease (MASLD) was proposed. MASLD uses metabolic abnormalities as an inclusion criterion. On the other hand, sarcopenia is defined by decrease in muscle mass and muscle strength. Skeletal muscle can be affected by insulin resistance (IR), and it is the largest site of insulin-stimulated glucose disposal. In recent years, advances in treatment have extended the life expectancy of patients with chronic liver disease (CLD). Due to the aging population, aging-related primary sarcopenia is expected to increase. On the other hand, liver fibrosis is an important treatment target associated with the onset of serious adverse events and poor prognosis in MASLD. The liver is the central organ for nutrition and metabolism, and patients with CLD may develop secondary sarcopenia due to various nutritional and metabolic disorders unrelated to aging. There is a strong correlation between sarcopenia, muscle fatty degeneration, liver fibrosis and IR in MASLD. MASLD and sarcopenia have a bidirectional relationship, forming a vicious cycle. In this review, we will summarize the relationship between MASLD and sarcopenia based on the current knowledge. Full article

Background and objective: Depression is the most common mental health problem in women during pregnancy, associated with psychological, social, and medical factors characteristic of this stage. However, a lack of knowledge and limited attention to this condition can aggravate its consequences and restrict access to appropriate treatment. This research seeks to fill a gap in the scientific literature by exploring the association between eating habits and dietary diversity with depressive symptomatology in a group with high psychosocial vulnerability: pregnant adolescents. Material and methods: A cross-sectional analytical study was conducted with a sample of 344 pregnant adolescents attending prenatal care at the National Institute of Perinatology (INPer), a tertiary care center. Non-probabilistic sampling was used for recruitment. Relevant information was collected using a pre-validated structured questionnaire administered via interview. Depressive symptomatology was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥12 considered indicative of a higher risk of depression. Eating habits were evaluated based on meal omission, activities performed during meals, and dietary diversity, comparing them with national recommendations. Food group consumption was assessed using a semi-quantitative Food Frequency Questionnaire (FFQ). Robust variance Poisson regression models were employed to evaluate the independent association between undesirable eating habits, inadequate food group intake, and the presence of depressive symptomatology. Results: A significant association was observed between the presence of depressive symptoms (EPDS ≥ 12) and the omission of main meals. Specifically, skipping breakfast was associated with a higher prevalence of EPDS scores ≥ 12 (aPR = 1.55; 95% CI: 1.10–2.19; p = 0.013). Similarly, adolescents who skipped lunch showed a higher prevalence of depressive symptomatology compared to those who did not (aPR = 2.02; 95% CI: 1.11–3.68; p = 0.022). Regarding food groups, only insufficient intake of milk and dairy products was significantly associated with the presence of depressive symptoms (aPR: 1.78; 95% CI: 1.16–2.73; p = 0.008). Conclusions: This cross-sectional study found a significant association between breakfast skipping, distraction while eating, and inadequate dairy intake with a higher prevalence of depressive symptoms in socially vulnerable pregnant adolescents treated at a tertiary care center. However, due to the study’s design, causality or the direction of the relationship cannot be established (it could be bidirectional), and it cannot be affirmed that modifying the diet will necessarily reduce depression. Furthermore, the results are not generalizable to all pregnant adolescents, and future research (longitudinal or interventional) is needed to better understand these associations before developing specific dietary interventions. Full article

Purpose of Review—sleep disturbance is the main complaint associated with patients who suffer acute postoperative pain. Sleep disturbance may also increase the pain sensitivity and contribute to the development and maintenance of chronic pain. The pathophysiology of pain is complex; management of perioperative pain and preventing chronic pain are challenges in clinical. Use of opioids for pain management are still a therapeutic mainstay and generally safe when taken, in a short time, for severe postoperative pain relief. For long-term use tolerance may be developed, and for their euphoric property, addiction, overdose incidents, and even death may be the social problems. Therefore, the opioid-sparing multimodal analgesia (MMA) for pain management is recommended in current postoperative pain management. The successful MMA for pain management will enhance patient recovery after surgery with less chronic CPSP and long-term opioid use disorder (OUD). The present review discusses all currently used analgesics actions and interactions, and opioid-sparing or opioid-free analgesia in perioperative pain management. Acute pain following major trauma or surgery may originate from both nociceptive and neuropathic mechanisms. Approximately 10–50% of surgical patients develop chronic postoperative pain, which not only causes persistent discomfort but also leads to functional limitations and psychological distress. Growing evidence highlights a close and bidirectional relationship between sleep and pain: pain disrupts sleep architecture, while sleep deprivation intensifies pain sensitivity and impairs recovery. This reciprocal interaction forms a vicious cycle that poses challenges for effective pain management. Melatonin—a neurohormone secreted by the pineal gland—plays a crucial role in regulating circadian rhythm and sleep–wake cycles. Beyond its chronobiotic action, melatonin exhibits anti-nociceptive, anti-inflammatory, and opioid-sparing properties. Recent preclinical studies have demonstrated that exogenous melatonin can attenuate nociceptive responses to noxious stimuli and enhance morphine analgesia while attenuating morphine tolerance. Moreover, environmental light manipulation preserving the circadian rhythm has been shown to synergistically maintain melatonin secretion, improve sleep quality, and modulate neuroimmune responses involved in pain regulation. Together, these findings suggest that circadian alignment and melatonin supplementation may represent a promising integrative approach for improving both pain control and sleep health in perioperative and chronic pain conditions. Chronic pain patients frequently experience opioid tolerance during long-term therapy, resulting in diminished analgesic efficacy and a need for escalating doses. Our recent work revealed that constant light exposure suppresses endogenous melatonin, heightens pro-inflammatory cytokines (TNF-α, IL-1β), reduces IL-10, and accelerates morphine tolerance in a neuropathic pain model. In contrast, maintaining circadian light–dark cycles or supplementing melatonin preserves melatonin rhythm, reduces glial activation, and sustains morphine antinociception. Melatonin’s co-administration not only attenuates morphine tolerance but also enhances morphine efficacy through the modulation of inflammatory and glial pathways. These findings underscore melatonin’s multifaceted role as both a chronotherapeutic and neuroprotective agent, integrating circadian regulation with pain modulation. Clinically, the application of melatonin or circadian-aligned strategies could guide personalized pain and sleep management, offering safer and more effective multimodal analgesic protocols with reduced opioid dependence and improved quality of life. Full article

Natural gas pipeline networks are subject to supply instability due to random fluctuations. Current forecasting methodologies often suffer from limited accuracy, inadequate uncertainty quantification, and poor integration with dynamic network evaluation mechanisms. To address these challenges, this study presents an integrated framework that bridges short-term demand forecasting with supply assurance assessment. A deep learning model that combines a graph convolutional network and a bidirectional long short-term memory network is developed to produce accurate 72 h demand forecasts. Forecasting uncertainty is quantified using the cumulative distribution function. Based on the probabilistic forecasts, a supply assurance evaluation model is constructed that accounts for the dynamic regulation capability of line pack. The comprehensive indicator system incorporates key metrics such as user satisfaction and the line pack demand−storage ratio. A case study was conducted with the proposed method based on a regional real-world pipeline network. The results demonstrate that the proposed model outperforms conventional baselines, achieving a mean absolute percentage error of less than 1%. The uncertainty quantification captures the risk probability associated with demand fluctuations. The proposed evaluation method identifies vulnerable sections and assesses supply margins under various scenarios, thus providing effective decision support for operational scheduling and supply assurance. Full article

Autism spectrum disorder (ASD) frequently co-occurs with malnutrition and gut dysbiosis, yet the underlying mechanisms remain poorly understood. Herein, this cross-sectional study first profiles dietary intake differences using dietary records from 210,874 participants (ASD = 232; non-ASD = 210,642; median age = 56.18) from the UK Biobank (UKB). Second, a bi-directional Mendelian Randomization (MR) approach serves to dissect relationships between ASD genetic susceptibility and dietary preferences by leveraging genome-wide association metadata from the iPSYCH-PGC (ASD) and UKB (dietary intake/food-liking traits). The same strategy is implemented to identify ASD-associated gut microbial species. Mediation analyses further assess the role of gut microbiota in the association between ASD and dietary preferences. Subjects with ASD exhibit higher consumption of cheese, processed meat, and oily fish, alongside lower intake of fruits, and demonstrate a preference for high-fat/salt and energy-dense foods. Additionally, the depletion of Turicibacter, Streptococcus, and Lachnospiraceae NK4A136 was causally related with ASD (all false discovery rate < 0.05; β = −0.15, β = −0.10, β = −0.093, respectively), which significantly mediates the ASD-associated elevated preference for high-fat/salt foods. In conclusion, ASD is associated with specific dietary preferences, likely mediated via gut microbiota, highlighting the future potential of gut microbiome-based therapeutics to modify eating disorders for ASD. Full article

Multiple myeloma (MM) is a clonal plasma cell neoplasm characterized by autonomous immunoglobulin overproduction. Despite associations between serum metabolites and MM, causal mechanisms remain unclear. Here, we employed bidirectional Mendelian randomization (MR) using 452 serum metabolites to elucidate causal associations with MM risk. The inverse variance-weighted (IVW) method was prioritized, complemented by MR-Egger and weighted median (WM) analyses to address horizontal pleiotropy. Sensitivity analyses—including Cochran’s Q test, MR-Egger intercept evaluation, and leave-one-out (LOO) robustness checks—confirmed result stability. Pathway enrichment was performed using MetaboAnalyst 6.0. RNA-seq data were integrated to identify transcriptional regulators and signaling pathways mediating serum metabolite-driven MM. Among 21 metabolites significantly associated with MM, 8 exhibited protective inverse correlations, while 13 showed risk-enhancing effects. Sensitivity analyses further confirmed the validity of the observed relationships, while bidirectional MR confirmed no reverse causality. Pathway enrichment highlighted valine/leucine/isoleucine biosynthesis and biotin metabolism as pivotal pathways. Integrating transcriptomic data revealed 11 overlapping genes enriched in metal ion transmembrane transporter activity and glycosaminoglycan biosynthesis—chondroitin sulfate/dermatan sulfate. This study established a causal relationship between specific serum metabolites and MM and revealed that key genes may affect the development of MM through metabolic-epigenetic crosstalk, providing preliminary insights into potential therapeutic targets. Full article

The maintenance of endoplasmic reticulum (ER) Ca²⁺ homeostasis is intrinsically linked to the fidelity of protein folding, forming a functional tether that, when disrupted, triggers the Unfolded Protein Response (UPR). This bidirectional axis serves as a critical rheostat for cellular viability, yet its chronic dysregulation underpins the molecular etiology of numerous pathologies, including neurodegeneration, heart failure, and malignant transformation. This review provides a comprehensive interrogation of the Ca²⁺-ER Stress–UPR network, delineating how primary stress sensors—PERK, IRE1alpha, and ATF6—engage in complex feedback loops that either reinstate equilibrium or commit the cell to apoptosis. We specifically examine the PERK-CHOP-SERCA2b inhibitory circuit as a central driver of persistent Ca²⁺ depletion and discuss the role of Mitochondria-Associated Membranes (MAMs) in governing lethal Ca²⁺ transfer. Notably, we move beyond the classical paradigm of CHOP as a terminal apoptotic executioner, incorporating emerging evidence of its context-dependent adaptive functions. By synthesizing mechanistic insights across diverse disease models, this work highlights the transition from adaptive to maladaptive UPR as a universal pathological checkpoint. Ultimately, we evaluate the therapeutic potential of ‘axis-targeted’ interventions, such as SERCA activators and selective UPR modulators, aimed at resolving the underlying Ca²⁺ signaling defects in ER stress-related disorders. Full article

Inflammatory bone loss is a shared pathological feature of chronic diseases such as periodontitis (PD) and rheumatoid arthritis (RA). Despite affecting distinct tissues, these diseases exhibit a bidirectional association and converge on common immune-mediated mechanisms of bone resorption. To uncover the molecular drivers underlying bone destruction across inflammatory comorbidities, we combined bioinformatic analyses with experimental validation, using PD and RA as clinically relevant models of inflammatory disease comorbidities. Elevated blood lactate levels were observed in murine models of PD and RA and correlated positively with disease severity. Single-cell RNA sequencing data from PD and RA cohorts revealed upregulation of lactate metabolism-related genes in specific monocyte subsets, accompanied by enhanced pro-inflammatory signaling and osteoclastogenic programs. Using multiple machine learning approaches, SAT1, TET2 and HIF1A were identified as core lactate-related genes with strong diagnostic potential for both diseases. In vivo and in vitro experiments further validated that lactate-driven reprogramming of monocytes, marked by activation of core lactate-related genes in circulating monocytes and local macrophages, functionally connects immune activation with exacerbated bone resorption in comorbid PD and RA. Together, these findings define a lactate-driven immunometabolic axis connecting immune responses and bone remodeling and identify SAT1, TET2 and HIF1A as potential biomarkers for inflammation-related bone loss. Full article