Search Results (40,869)

Background/Objectives: Despite advances in public health and medical treatment, the number of patients with type 2 diabetes is increasing and it remains among the top 10 causes of death and a leading cause of disability in the United States. Early interventions with innovative approaches are essential to improving dietary intake and blood glucose control, potentially preventing or delaying type 2 diabetes and related complications. This study examined the effects of integrating real-time feedback from continuous glucose monitoring (CGM) into individualized nutrition therapy (INT) on diet and sleep quality in individuals with prediabetes and overweight or obesity. Methods: Thirty participants were randomized to either the treatment (n = 15) or the control group (n = 15). Both groups received individualized nutrition recommendations tailored to energy needs for weight maintenance and blood glucose control. The treatment group had real-time access to CGM data, while the control group remained blinded. Dietary intake and sleep quality were assessed using ASA24 recall and analyzed via general linear model repeated measures. Results: Incorporating CGM feedback into nutrition therapy significantly increased whole-grain (p = 0.02) and plant-based protein intake (p = 0.02) in the treatment group, with trends toward increased fruit intake (p = 0.07) and a reduced percentage of calories from carbohydrates (p = 0.08). Sleep efficiency also improved significantly by 5% (p = 0.02) following the intervention. Conclusions: These findings support the effectiveness of CGM-enhanced nutrition therapy in improving diet and sleep quality in individuals with prediabetes and overweight or obesity. Further research is needed to assess the sustainability and long-term impact of this approach. Full article

Background/Objectives: Even with improvements in perinatal care, bronchopulmonary dysplasia (BPD) continues to be a major challenge, especially in smaller and more premature infants. Early detection of severe BPD can improve treatment outcomes. This study aims to evaluate the correlation between the oxygen saturation index (OSI) and severe BPD/death in preterm infants, with a focus on the OSI’s predictive value. Methods: In this retrospective observational study, infants with a gestational age of less than 32 weeks who required either invasive or non-invasive mechanical ventilation were included. Ventilator settings and OSI values were collected on days 3, 7, 14, 21, and 28 of life. The correlations between postnatal OSIs and outcomes such as death or severe BPD were analyzed using logistic regression. Results: Out of the 210 eligible infants, 54 (25.7%) either died or were diagnosed with severe BPD. In our study, OSI values on postnatal days 14, 21, and 28 were significantly higher in preterm infants who developed severe BPD or died, with mean OSI-14, OSI-21, and OSI-28 values of 4.9, 3.5, and 2.8, respectively. The OSI showed the highest sensitivity and specificity on postnatal days 14 and 21, with cut-off points of 3.6 and 3.1, respectively. We built a basic chart to predict severe BPD/death with OSI-14 and OSI-21 and delivery room intubation with 86% sensitivity and 84.5% specificity (increasing up to 98.8% specificity). Conclusions: This study showed that the diagnostic power of the OSI in predicting severe BPD or death was highest for OSI-14 and OSI-21. We demonstrated that calculating the OSI, a non-invasive clinical tool, can predict severe BPD/death in infants born before 32 weeks as early as the 14th day of life. Full article

Background: Cancer is a leading cause of death worldwide, and its early detection is crucial for improving patient outcomes. This study aimed to develop and evaluate ensemble learning models, specifically stacking, for the accurate prediction of lung, breast, and cervical cancers using lifestyle and clinical data. Methods: 12 base learners were trained on datasets for lung, breast, and cervical cancer. Stacking ensemble models were then developed using these base learners. The models were evaluated for accuracy, precision, recall, F1-score, AUC-ROC, MCC, and kappa. An explainable AI technique, SHAP, was used to interpret model predictions. Results: The stacking ensemble model outperformed individual base learners across all three cancer types. On average, for three cancer datasets, it achieved 99.28% accuracy, 99.55% precision, 97.56% recall, and 98.49% F1-score. A similar high performance was observed in terms of AUC, Kappa, and MCC. The SHAP analysis revealed the most influential features for each cancer type, e.g., fatigue and alcohol consumption for lung cancer, worst concave points, mean concave points, and worst perimeter for breast cancer and Schiller test for cervical cancer. Conclusions: The stacking-based multi-cancer prediction model demonstrated superior accuracy and interpretability compared with traditional models. Combining diverse base learners with explainable AI offers predictive power and transparency in clinical applications. Key demographic and clinical features driving cancer risk were also identified. Further research should validate the model on more diverse populations and cancer types. Full article

Cardiovascular diseases (CVDs) remain the leading cause of death globally. In recent years, interest in multicomponent interventions has grown as a response to the multifactorial complexity of CVDs. However, the literature still shows little systematic investigation into the effectiveness of multicomponent training (MCT) in the field of CVDs, accompanied by terminological confusion. This study aims to summarize and critically appraise the recent literature through a narrative review. A narrative review was conducted, synthesizing evidence from studies published between 2010 and January 2025. The databases searched included PubMed, Scopus, and Google Scholar using predefined search terms related to CVDs and MCT, and medical subject headings (MeSHs) and Boolean syntax. Two team authors independently extracted relevant information from the included studies. MCT significantly improved hemodynamic parameters in CVD patients, with reductions in systolic, diastolic, mean blood pressure, and heart rate. Physical fitness measures showed consistent enhancements whereas anthropometric improvements often corresponded with blood pressure reductions. Psychological outcomes varied across studies, with intervention duration emerging as a key factor in effectiveness. MCT interventions could lead to improvements in clinical outcomes, risk factor reduction, and patient adherence. Although findings on psychological parameters remain inconsistent, the overall evidence supports their integration into both clinical and community settings. Full article

Rambutan peel is a great source of bioactive compounds, the same that, over the years, has been extracted using conventional technologies which have been proven to be harmful to the environment and potentially toxic to human beings. This study aimed to extract the same compounds using a hybridization of ultrasound/microwave extraction. The results were promising, as a total of 378.48 ± 9.19 mg/g of polyphenols were recovered from this procedure, and the most important molecules (geraniin, corilagin, and ellagic acid) were identified, giving this much more relevance. Furthermore, treatment with rambutan peel extract recovered with green technologies significantly reduced cell viability in HCV-infected liver cells. Notably, higher concentrations (4000 and 5000 ppm) led to more pronounced cell death in huh7 cells. The treatment also led to a significant reduction in viral protein and RNA expression in HCV-infected cells. These findings suggest that rambutan peel extract obtained from the combination of ultrasound and microwave extraction, particularly the ellagitannins present, have potential antiviral properties. Further research is needed to explore its mechanism of action and its potential as a therapeutic agent for Hepatitis C. Full article

Dermacentor nitens (tropical horse tick) is a tick species commonly found parasitizing horses and other equids in the Amazon region, causing economic losses. Currently, tick control is based on chemical acaricides, usually in a power formulation for topical use. However, its indiscriminate use results in the emergence of resistant tick lineages. Several plant compounds have been tested for their acaricide activity. In the Amazon, several plants are used for oil extraction, resulting in the production of solid residue (waste) that may contain chemical molecules with biological activities. Thus, we aimed to test the in vitro acaricidal potential of the ethanolic extract of the industrial residue of andiroba (Carapa sp.) against D. nitens. In a larval immersion test (LIT), D. nitens larvae were tested with 2.5%, 5%, and 10% andiroba extract concentrations in three replicates. Subsequently, the envelopes were kept in a BOD chamber (28 °C ± 1 °C; 80% ± 5% humidity) for 24 h. At the end of this period, live and dead larvae were counted, and efficiency was calculated from the mortality rate caused by the extract and corrected by the Abbot formula. In the three repetitions, the andiroba extract at a concentration of 5% caused the death of 100% of the larvae. At concentrations of 2.5% and 10%, they caused the death of, respectively, 12.38% (±3.5%) and 69.79% (±7.98%) of the larvae. These results indicate that the extract from the industrial residue from the production of andiroba oil has acaricidal activity. It is concluded that the solid waste from industrial andiroba oil extraction has the potential for the development of natural acaricides against D. nitens. Full article

Background: Chronic liver disease (CLD) is a major global health concern, contributing significantly to morbidity and mortality. Cirrhosis and liver cancer are the leading causes of liver-related deaths, with various etiological factors, such as metabolic disorders and alcohol-related and viral hepatitis, driving its global prevalence. Non-invasive biomarkers and scoring systems have emerged as key tools for assessing liver disease severity and differentiating CLD from cirrhosis. This study evaluates biomarkers and non-invasive scores and their utility in distinguishing CLD from cirrhosis. Methods: This retrospective observational study included 250 adult patients hospitalized between January 2021 and December 2023 at Cluj County Emergency Clinical Hospital, Romania. Patients were diagnosed with either cirrhosis or CLD of viral, autoimmune, or primary biliary cholangitis (PBC) etiology. Non-invasive biomarkers, scores, and various hemogram-derived ratios were evaluated. Statistical analysis involved descriptive statistics, comparative tests, and receiver operating characteristic (ROC) curve analysis. Results: Among the 250 patients, 137 had liver cirrhosis (54.8%) and 113 had CLD without cirrhosis (45.2%). Significant differences were observed in laboratory parameters, with cirrhosis patients showing lower hemoglobin, platelet count, and albumin levels alongside higher liver enzymes and INR values. Non-invasive scores such as APRI, FIB-4, and NFS demonstrated higher values in the cirrhosis group, indicating more advanced liver damage. Hemogram-derived ratios, particularly the neutrophil-to-lymphocyte ratio (NLR), were higher in cirrhosis patients. ROC analysis revealed that the Lok index had the highest discriminatory power (AUC 0.89), followed by the King score (AUC 0.864) and the Fibrosis index (AUC 0.856), which effectively distinguished cirrhosis from CLD. Conclusions: This study underscores the utility of non-invasive biomarkers and scoring systems in differentiating CLD from cirrhosis. The Lok index, King score, and Fibrosis index demonstrated excellent diagnostic accuracy, while hemogram-derived ratios, such as NLR, offer insights into systemic inflammation associated with liver disease progression. These findings support the integration of non-invasive markers into clinical practice for improved risk stratification and management of liver diseases. Full article

Progression-free survival (PFS) and overall survival (OS) curves generally approximate first-order kinetics. On log-linear plots, convex curves with downward inflection (indicating late acceleration of progression/death) might arise from stopping effective therapies. We digitized published PFS/OS curves for etoposide/platinum-treated extensive small-cell lung cancer (SCLC) and other malignancies and replotted the curves log-linearly. Of 26 SCLC PFS curves, 21 (81%) were highly convex (with a marked late down-turn), and 26 (100%) were moderately or highly convex vs. 35/888 (4%) highly convex and 186 (21%) moderately/highly convex curves for other cancers (p < 0.0001). For SCLC, all 32 OS curves were moderately or highly convex vs. 87/363 (24%) that were moderately/highly convex for other cancers (p < 0.0001). The SCLC PFS curves had an initial downward inflection at a median of 3.1 months (around the completion of first-line chemotherapy), then a second inflection at 5.4 months, with further acceleration of progression. The median PFS half-life was 11.9 months while receiving treatment vs. 1.7 months after the second inflection point. Immunotherapy benefit appeared to be limited to 6–10% of the population. SCLC PFS/OS curves are more often convex than for other cancers, reflecting SCLC chemotherapy sensitivity but rapid progression following the completion of first-line chemotherapy. Effective maintenance strategies are needed. Full article

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer deaths worldwide. Despite the high incidence of HCC, mortality remains high, with an estimated 5-year survival rate of less than 20%. Surgical resection represents a potential curative treatment for HCC; however, less than 20% of patients with HCC are candidates for surgical resection. In patients with unresectable HCC, Yttrium-90 (Y90) transarterial radioembolization (TARE) has emerged as an innovative treatment option. This locoregional therapy delivers high doses of radiation directly to liver tumors via intra-arterial injection, allowing for the targeted destruction of malignant cells while sparing surrounding healthy tissue. In this review, we will explore the latest advances in Y90 TARE for the treatment of HCC, focusing on key developments such as the following: (1) improvements in radiation lobectomy and segmentectomy techniques, (2) the introduction of personalized dosimetry, (3) the integration of combination therapies, (4) the use of imageable microspheres, (5) pressure-enabled Y90 delivery systems, and (6) the application of Y90 surrogates. Full article

Marek’s disease virus (MDV) causes Marek’s disease (MD) in chickens, characterized by malignant lymphomas and immunosuppression. Sporadic MD outbreaks continue to occur even among vaccinated flocks in certain regions due to the increased virulence of the field strains. However, the mechanisms of tumorigenesis and immunosuppression caused by MDV remain to be fully elucidated. We previously reported that the mRNA expression of programmed cell death 1 (PD-1), an immune checkpoint molecule, was increased in tumor lesions caused by MDV, and its expression was positively correlated with the mRNA expression of Meq, an MDV-specific oncogene. In this study, we characterized PD-1-expressing T-cell subsets in the spleen and tissues of chickens that developed tumors to investigate the association between PD-1 expression and immunosuppression. Flow cytometric analysis revealed that the proportion of PD-1-expressing CD4⁺ T-cells, which are targets of MDV tumorigenesis, increased in the spleen and tumor tissues of chickens with MD. The proportion of PD-1⁺ CD4⁺ T-cells was higher in Meq-expressing cells than in those that were not. In the spleens of chickens with MD, the proportions of PD-1-expressing cells were increased in CD8⁺ and γδ T-cells, which play pivotal roles in defense against MD pathogenesis, relative to those of spleens from uninfected chickens. Moreover, the proportion of PD-1⁺ CD8⁺ T-cells expressing interferon (IFN)-γ did not increase in the spleen of chickens with MD. Additionally, no difference in the proportion of IFN-γ⁺ γδ T-cells expressing and not expressing PD-1 was observed in the spleens of chickens with MD, although the proportion of IFN-γ⁺ γδ T-cells expressing PD-1 in the spleens of uninfected chickens was higher. The function of PD-1-expressing CD8⁺ and γδ T-cells in chickens may be impaired after developing MD, which may cause MDV-induced immunosuppression. Full article

Background: Chondrosarcoma is the second most common bone tumor in adults with an average incidence of 0.1–0.3 individuals per 100,000 per year. These tumors are often resistant to chemotherapy and radiation, and surgical excision is a mainstay of current treatment. However, survival in the setting of metastatic disease is still poor, and research is needed to identify prognostic biomarkers and potential therapeutic targets. Several studies have examined the role of IDH mutations in chondrosarcoma, but the results vary widely. The goal of this analysis was to aggregate individual patient data from these studies and conduct a high-powered analysis of the impact of IDH mutations on survival outcomes in chondrosarcoma. Methods: Chondrosarcoma studies that included data on the IDH mutation status of tumors were queried, and the individual datasets reporting patient and tumor variables were extracted. The data from these studies were added to the internal dataset from the authors’ home institution. Two-sample tests for equality of proportions were used to assess the distribution of sample characteristics between groups. Univariate Kaplan–Meier (KM) curves and multivariate Cox Proportional Hazards (CPH) models were used to assess the relationship between tumor IDH mutations and five and ten-year patient overall survival (OS). Results: The final cohort included 1152 patients sourced from 21 studies and the authors’ internal dataset. IDH mutations were more common in higher grade tumors and were more likely to be found in individuals over 60 years old. Patients with IDH mutant tumors had shorter five-year OS in univariate KM analysis when analyzing all chondrosarcomas combined. However, multivariate CPH models accounting for age and tumor grade, found that the effect of IDH mutation was isolated to patients with dedifferentiated tumors only. Patients with IDH mutant dedifferentiated tumors displayed significantly shorter five-year OS (HR: 1.99, p = 0.02) relative to patients with IDH wild-type (WT) dedifferentiated tumors. The primary predictor of five-year OS in the conventional chondrosarcoma cohort was tumor grade, regardless of IDH mutation status (HR: 2.72, p < 0.005). Discussion: IDH mutations are relatively common in cartilaginous neoplasms (including benign tumors), with the literature reporting rates as high as 50% in chondrosarcomas. Prior studies have investigated the link between IDH1/2 mutation status, tumor grade and overall survival, with mixed results on the effect of IDH mutation on survival. Vuong et al. performed a meta-analysis in 2021 and found that IDH mutation was associated with older patient age, larger tumor size, higher tumor grade, and increased risk of death compared to WT tumors. Our analysis, which builds on the Vuong et al. study, indicates that IDH status itself is not independently predictive of overall survival in conventional chondrosarcoma, however, it does correlate with survival in dedifferentiated tumors. Further analysis is needed to investigate the potential correlation of IDH mutations in higher grade tumors and patients of older age. Full article

Background: Epstein–Barr virus-associated gastric cancer (EBVaGC) represents a distinct molecular subgroup with potential responsiveness to immunotherapy approved for programmed death-ligand 1 (PD-L1)-positive gastric cancer. This retrospective study aimed to assess the prevalence and association between EBVaGC and PD-L1 positivity among patients with gastric adenocarcinoma treated at a university hospital in Southern Thailand from January 2017 to October 2023. Methods: The EBV status of the patients and PD-L1 expression were determined using in situ hybridization and immunohistochemistry, respectively. Results: The prevalence of EBVaGC was 4.5% among 132 patients, whereas 9.1% of patients exhibited a PD-L1 combined positive score (CPS) of ≥1, with no significant association observed between them. EBVaGC was more prevalent in males, non-antral tumors, diffuse/mixed histologic subtypes, and poorly differentiated tumors. Median overall survival for patients with EBVaGC and PD-L1 CPS ≥ 1 was 9.48 and 14.19 months, respectively, compared with 10.32 and 9.79 months for those with non-EBVaGC (hazard ratio: 1.24; 95% CI: 0.50–3.04; p = 0.645) and PD-L1 CPS < 1 (hazard ratio: 0.82; 95% CI: 0.40–1.69; p = 0.590), respectively. Conclusions: Our findings revealed a low prevalence of EBVaGC and PD-L1 positivity in Thailand, with no significant association or survival impact observed. These findings highlight the regional variation in these biomarkers and support EBV as an independent biomarker from PD-L1. However, further research, particularly studies evaluating immunotherapy outcomes, is warranted to clarify the predictive and clinical significance of EBV in gastric cancer. Full article

Lung cancer is the leading cause of cancer deaths among American men, even though various treatments are available. The discovery and use of new alternative drugs to treat lung cancers are needed to reduce lung cancer mortality. Phytochemicals are potentially desirable therapeutic agents due to their better safety profiles. Isorhapontigenin (ISO) is an orally bioavailable dietary stilbene. Our studies show that treatment with ISO inhibits human lung cancer cell growth, angiogenesis, invasion, and migration. Neural precursor cell expressed developmentally downregulated 9 (NEDD9), a multi-domain scaffolding protein, regulates various processes crucial for tumorigenesis and metastasis. Our results show that NEDD9 is upregulated in the lung tissues from human lung adenocarcinomas (LUADs) and squamous-cell carcinomas (LUSCs) compared to normal lungs. Overexpression of NEDD9 elevates the invasion and migration of human lung cancer cells. Treatment of human lung cancer cells with ISO decreases NEDD9 protein levels. Our studies have also demonstrated that NEDD9 positively regulates angiogenesis, an essential factor in cancer progression. ISO treatment reduces angiogenesis. Moreover, ISO reduces the protein levels of hypoxia-inducible factor-1α (HIF-1α), a transcription factor critical for angiogenesis. Aberrant high expression of β-Catenin leads to various diseases including cancer. Our results show that ISO treatment reduces the activation of β-Catenin through the downregulation of NEDD9. Studies indicate that ISO decreases NEDD9, causing the suppression of cell growth, angiogenesis, invasion, and migration of human lung cancer cells. ISO is a potent therapeutic agent for lung cancer treatment. Full article

Background: Chronic disease is the leading cause of death in the United States but can be prevented with lifestyle behaviors, such as physical activity and healthy dietary habits. Experts have developed health programs to promote these behaviors, but they have not led to long-term effects or focused on meeting guidelines and recommendations. Objectives: To determine the effectiveness of a health program in improving participants’ confidence levels, health outcomes, and health behaviors. Methods: Within-subjects analysis was conducted to determine pre-post changes in weight, health, and confidence in achieving step count and fruit and vegetable consumption goals. A between-subjects analysis was conducted to compare program graduates and program dropouts to determine the influence of weight classification, weight, health, and confidence on program completion. Results: After completing the program, program graduates lost an average of six pounds and reported increases in health and confidence in achieving step count and fruit and vegetable goals. Health and confidence levels were significantly lower among program dropouts compared to program graduates. Conclusions: The program had a positive effect on confidence levels and health outcomes among program graduates. Materials to enhance confidence should be considered for distribution during the pre-assessment phase of this program. Full article