Search Results (5,065)

The grain-level heterogeneity of fruit morphological characteristics significantly determines their sensory performance and intrinsic quality, providing a quantitative basis for commercial grading. This study utilized “Liuyuehong” soft-seeded pomegranate (Punica granatum L.) as experimental material. Fruits were classified into three size grades based on individual fresh weight: large (107–125 g), medium (74–92 g), and small (47–67 g). Fresh weights of whole fruits, exocarp, and outer seed coat were measured for each grade, followed by analysis of key quality indicators, including seed count, 100-seed weight, Brix degrees, pH, single-seed dimensions, vitamin C content, and edible fraction. Subsequently, correlation analysis, principal component analysis (PCA), and the entropy weight-TOPSIS method were employed to evaluate the integrated quality of different fruit grades comprehensively. The results indicate that the fruit morphological characteristics of “Liuyuehong” soft-seed pomegranate have a significant impact on its sensory and physicochemical qualities. (1) Large and medium fruits are superior to small fruits in terms of single fruit size, exocarp color uniformity, seed color, and mouthfeel, with large fruits having the highest comprehensive evaluation score (0.7). (2) Mouthfeel is correlated with the number of seeds in the fruit; the number of seeds in large and small fruits shows a significant negative correlation with Brix degrees (p < 0.05). (3) Small fruits exhibit greater individual variation within the group, with outliers and a tendency for late maturation. In conclusion, the fruit morphological characteristics of “Liuyuehong” soft-seed pomegranate significantly affect seed maturity and quantity, thereby determining the fruit’s sensory quality and physicochemical properties. The results indicate that fruits with a single- weight below 70 g commonly exhibit delayed development. It is therefore recommended to raise the lower threshold for commercial grading to above 75 g to enhance overall fruit quality and market consistency. Full article

Background/Objectives: Urinary incontinence (UI) remains a common and distressing complication following radical prostatectomy (RP). This prospective observational study aimed to assess the effectiveness of structured pelvic floor rehabilitation and to identify clinical and surgical predictors of continence recovery. Methods: A total of 182 patients undergoing RP received standardized physiotherapist-guided pelvic floor muscle training (PFMT), including supervised sessions before and after surgery, as well as individualized home exercise programs. UI severity was evaluated using a 1 h pad test and a four-level UI stage classification at three time points. The primary outcomes were changes in UI stage and the achievement of full continence, defined as a pad test result ≤2 g. Results: Following three rehabilitation sessions, 80.2% of patients regained full continence. Preoperative PFMT (β = −1.27, p = 0.0061) and shorter time to rehabilitation (β = −0.04, p = 0.0026) were associated with greater improvement in continence outcomes. Patients treated with robot-assisted RP showed a higher probability of continence recovery compared to those undergoing laparoscopic RP, particularly in the presence of moderate to severe baseline incontinence. Higher baseline urinary leakage significantly decreased the odds of treatment success (β = −0.01, p = 0.0001). ISUP grade and extraprostatic extension were not independently associated with outcomes. Conclusions: Despite the absence of a control group, this study demonstrates the effectiveness of structured and personalized pelvic floor rehabilitation in improving post-RP continence. Early initiation and preoperative training should be prioritized to optimize recovery in routine clinical practice. Full article

Background/Objectives: To investigate the role of hepatobiliary phase (HBP) signal intensity (SI) on Gadoxetic acid (GA)-enhanced liver magnetic resonance imaging (MRI) in improving the diagnostic accuracy of the histological grade of fibrosis in patients with chronic hepatitis B (CHB). Methods: This retrospective study enrolled patients with CHB who underwent biopsies from the highest and lowest intensity areas identified on HBP images obtained from GA-enhanced MRI. The patients were divided into two groups based on segmental SIs: Group 1 (maximum SI) and Group 2 (minimum SI). An ultrasound-guided tru-cut biopsy was performed in these two segments. Forty patients undergoing histopathological examination were included in the study. Group comparisons were examined using Chi-square and independent-sample t-tests, and receiver operating characteristic curve analysis (ROC) was performed to determine the cutoff values of the SI for modified histologic activity index (mHAI) and fibrosis grading. Results: There were no histopathological differences between the groups (p > 0.05), but significant inflammation and fibrosis were observed in hepatic segments with an SI value of <617 (p < 0.001). The ROC results showed that the predictive cutoff value of SI for mHAI and fibrosis grading were 606 (AUC: 0.83, 95% CI 0.737–0.921, p < 0.001) and 599 (AUC: 0.85, 95% CI 0.766–0.935, p < 0.001), respectively. Conclusions: In patients with CHB, performing a biopsy from the liver segment with the lowest SI on GA-enhanced MRI increases the diagnostic accuracy for assessing the histological severity of hepatic inflammation and fibrosis. Full article

Background: Chronic pelvic toxicity induced by radiotherapy and/or chemotherapy (R/CIPT) is a debilitating sequela in gynecological cancer survivors, often refractory to conventional treatments and potentially linked to gut microbiota dysbiosis. Ozone therapy (OT), particularly rectal insufflation, demonstrates anti-inflammatory and redox-modulating effects through hormetic mechanisms (Nrf2 activation/NF-κB inhibition). We hypothesize that its clinical benefit is mediated, in part, by restoring gut microbial homeostasis. Objective: This manuscript proposes a clinical study to evaluate the impact of rectal OT on the gut microbiota of patients with gynecological cancers and chronic R/CIPT. Proposed Methods: A prospective, observational study of 38 patients is outlined: 19 with CTCAE v5.0 Grade ≥2 chronic R/CIPT receiving compassionate rectal OT (~40 sessions over 4 months), and 19 matched controls without toxicity. Stool samples for 16S rRNA sequencing will be collected from the OT group pre- and post-intervention and once from controls. Primary endpoints are changes in microbiota composition/diversity and pelvic toxicity scores (CTCAE v5.0, EORTC QLQ-CX24). Secondary endpoints include quality of life (EORTC QLQ-C30, EQ-5D-5L), anxiety/depression (HADS), and serum inflammatory/oxidative stress biomarker analysis. Anticipated Results and Conclusion: This will be the first study to prospectively investigate whether rectal OT’s effect correlates with a beneficial shift in the gut microbiota, specifically an increase in commensals (e.g., short-chain fatty acids producers) and a decrease in pathobionts. If successful, OT could be assessed as a novel, microbiota-targeting intervention for R/CIPT. The findings from this pilot study will provide the necessary groundwork for a future randomized controlled trial to definitively establish causality and efficacy. Full article

Lycium barbarum L. (abbreviated to L. barbarum), a traditional dual-use plant as food and medicine, contains polysaccharides from Lycium barbarum L. (LBPs) as its key bioactive component. This study aimed to examine the phenotypic characteristics, polysaccharide content, and their correlation with activity across various commercial grades of L. barbarum. Five commercial grades of L. barbarum were selected for analysis to determine their phenotypic characteristics and polysaccharide content. High-performance liquid chromatogram-diode array detection (HPLC-DAD) and ¹H NMR were employed to analyze the monosaccharide composition of LBPs, of which their hypoglycemic activity was further valuated. Results revealed significant differences in fruit weight and diameter among different grades (p < 0.05), while floating rate and bulk density remained unaffected by grades. Variations were observed in the chromaticity coordinates, with the c values showing notable differences (p < 0.01). Polysaccharide content tended to increase with higher grades and smaller fruit sizes, ranging from 1.94% to 5.69%. The polysaccharides in different contained monosaccharides of Man, Rha, Ara, Gal, Glc, GalA, GlcA and Xyl, with Ara and Gal being predominant. Identified through ¹H NMR spectra, the peak intensity of Ara increased from lower to higher grades, and the arrangement of the chemical shifts reflected distinct commercial grade characteristics. The inhibitory concentration (IC₅₀) against α-amylase and α-glucosidase ranged from 0.418 to 1.345 mg/mL, and 0.474 to 1.052 mg/mL, respectively, indicating good hypoglycemic activity within this range. The main monosaccharide groups Ara, Gal, and GalA were identified as key contributors to enzyme inhibition. Collectively interpreting the phenotypic features, polysaccharide content, monosaccharide composition, NMR data and activity profiles, Ara, Gal and GalA emerge as signature monosaccharide components of LBPs. These results provide novel theoretical insights for L. barbarum quality assessment. Full article

Background/Objectives: Oxidative stress contributes to the pathogenesis of cirrhosis, but its value as a clinical biomarker remains uncertain. Methods: We retrospectively analysed 90 patients with decompensated cirrhosis. Serum malondialdehyde (MDA) and 8-epi-prostaglandin F2α (8-iso-PGF2α) were measured at admission. Biomarker levels were compared between Child–Pugh classes B and C, across hepatic encephalopathy grades, and ascites severity, using Mann–Whitney, Kruskal–Wallis, and Spearman correlation tests. Results: Median MDA did not differ significantly between Child–Pugh classes B and C (2.67 [2.10–3.20] vs. 2.45 [1.98–3.05] μmol/L; p = 0.331), nor across ascites categories (p = 0.453). Similarly, 8-iso-PGF2α values did not vary between Child–Pugh classes (255.8 [220.0–310.0] vs. 250.1 [210.0–295.0] pg/mL; p = 0.784) or ascites groups (p = 0.828). Spearman analysis showed no significant correlations with albumin, INR, bilirubin, creatinine, or age, except for a non-significant trend with bilirubin (ρ = −0.18, p = 0.09). Importantly, MDA levels increased significantly across encephalopathy grades (p = 0.021), suggesting a link between systemic oxidative stress and neuropsychiatric impairment. Conclusions: In this clinical cohort, oxidative stress biomarkers did not provide discriminatory value for staging by Child–Pugh or ascites, but MDA was associated with encephalopathy severity. These findings highlight both the limitations and potential clinical relevance of oxidative stress markers in cirrhosis management. Full article

Background/Objectives: While robot-assisted radical prostatectomy (RARP) is the standard surgical treatment for localized prostate cancer, patients with marked prostatomegaly may experience worse outcomes. The current literature lacks generalizable, multi-surgeon data examining surgical complications in this population. Methods: We conducted a retrospective cohort study of 2030 patients who underwent RARP at a tertiary academic referral center. Perioperative complications and oncologic outcomes were compared between patients with marked prostatomegaly (defined as a prostate volume >100 grams (g)) and those with average-sized glands (<100 g). Logistic regression was used to compare groups. Results: Patients with marked prostatomegaly had a lower PSA density (0.10 vs. 0.20, p < 0.001), but there were no significant differences in pathologic NCCN grade groups, margin status, or lymph node involvement between groups. Patients with marked prostatomegaly had 60% higher odds of experiencing perioperative complications (OR 1.60, 95% CI 1.25–2.07, p < 0.0003) and were over twice as likely to have an ED visit or hospital readmission following surgery (OR 2.16, 95% CI 1.79–2.61, p < 0.001). They were also 25% more likely to undergo non-nerve-sparing or unilateral nerve-sparing procedures (OR 1.25, 95% CI 1.11–1.42, p < 0.001). Conclusions: Marked prostatomegaly is associated with higher rates of perioperative complications following RARP, with more frequent emergency room visits and readmissions. While nerve-sparing procedures were less commonly performed, oncologic outcomes remained comparable. Further prospective, multicenter studies are warranted to validate these results, which impact preoperative counseling. Full article

The objective of this study was to evaluate the effects of 25-hydroxy-vitamin D₃ (25OHD₃) supplementation on reproductive performance, nutrient digestibility, lameness score, milk composition, and blood profiles in sows, as well as the performance and blood profiles of their offspring. From day 110 of gestation to 21 days of weaning, a total of 30 multiparous sows (Landrace × Yorkshire) were randomly assigned to one of three dietary treatments, with ten sows per treatment. The dietary treatments were: (1) CON, basal diet; (2) TRT1, CON diet plus 1114 IU 25OHD₃/kg (13.92 µg 25OHD₃/kg feed); and (3) TRT2, CON diet plus 2227 IU 25OHD₃/kg (27.84 µg 25OHD₃/kg feed). The reproduction performance and nutrient digestibility of sows were not affected by 25OHD₃ supplementation. However, the inclusion of graded levels of 25OHD₃ in the sow diet had significantly reduced their farrowing time (p < 0.001) compared to those fed the CON diet. Also, sows fed 25OHD₃ produced significantly higher (p < 0.05) number of piglets compared to the CON group. Piglets from supplemented sows exhibited greater (p < 0.05) average daily gain and weaning body weight. Moreover, colostrum protein content was higher (p < 0.05) in sows fed 25OHD₃ compared with the CON group. Similarly, the concentration of 25OHD₃ in colostrum and milk at weaning was markedly (p < 0.001) elevated. Furthermore, serum 25OHD₃ levels were significantly higher (p < 0.05) in both sows and piglets, and piglet serum immunoglobulin G (IgG) concentrations were also elevated (p < 0.05) in the supplemented groups. In summary, dietary 25OHD₃ in the sow diet not only improves their reproductive performance and milk quality but also enhances piglet growth, immunity, and overall vitality, suggesting that 25OHD₃ is a valuable nutritional strategy for optimizing sow productivity and promoting healthier offspring. Full article

Background/Objectives: This systematic review aimed to evaluate the effectiveness, caregiver satisfaction, and accessibility of telehealth-delivered speech–language pathology (SLP) services for children with cleft palate and/or velopharyngeal dysfunction (VPD). Methods: Based on PRISMA 2020, we searched PubMed, CINAHL, Scopus, PsycINFO, and the Cochrane Library (2000–31 May 2025) for studies enrolling participants ≤ 18 years of age with cleft/VPD who received telehealth services (assessment, therapy, counseling/follow-up), with or without in-person comparators. Screening and data extraction were performed in duplicate. Risk of bias was appraised using RoB 2 (randomized) and CASP checklists (non-randomized/service designs). To account for heterogeneity, we conducted a SWiM-aligned narrative synthesis and summarized certainty with GRADE. Results: Eleven studies met the inclusion criteria. Telehealth delivery of SLP services was feasible and generally acceptable to families. Caregiver-mediated interventions frequently showed within-group improvements in speech outcomes, while remote assessment demonstrated moderate agreement with in-person ratings. However, the overall certainty of evidence was rated as very low to low because of small sample sizes, single-center designs, and heterogeneous outcomes. Conclusions: Telehealth is a feasible and acceptable mode for delivering SLP in pediatric cleft/VPD patients, with encouraging signals for caregiver-mediated articulation therapy and maintaining multidisciplinary follow-up. Implementation is best embedded within hybrid pathways, reserving in-person visits for complex assessments. Adequately powered comparative studies with standardized outcomes, longer follow-up, and equity-focused implementation are needed. Full article

Adverse effects of transportation arise from the buildup of various stressors, which collectively compromise animal welfare. This study aimed to assess short-term behavioral responses, physiological stress, and meat quality as indicators of welfare in Japanese Black cattle on arrival at the slaughter facility. A total of 154 animals from different production farms were observed. Generalized linear mixed models were used, with fixed effects including animal type, weight, season, source, loading size, distance, transport experience, and their interaction with time periods. Significant post-transport behaviors and elevated cortisol concentration were observed, particularly in heifers, lighter animals, those transported in summer, from multiple farms, at high loading sizes, or without prior transport experience. Steers, heavier animals, and the same farm groups yielded higher carcass weights, while cattle transported under low loading size had improved marbling scores and a higher probability of achieving A5-grade carcasses. These findings suggest that management practices should focus on animals most susceptible to transport stress and strategies such as mitigating heat stress, transporting animals from the same production farm, and reducing loading sizes should be implemented to improve welfare and meat quality upon arrival. Full article

Purpose: This study evaluates a novel, non-invasive method using a virtual reality (VR) headset with integrated eye trackers to assess retinal function by measuring the recovery of the pupillary response after light adaptation in patients with age-related macular degeneration (AMD). Methods: In this pilot study, fourteen patients with clinically confirmed AMD and 14 age-matched healthy controls were exposed to alternating bright and dark stimuli using a VR headset. The dark stimulus duration increased incrementally by 100 milliseconds per trial, repeated over 50 cycles. The pupillary response to the re-onset of brightness was recorded. Data were analyzed using a linear mixed-effects model to compare recovery patterns between groups and a convolutional neural network to evaluate diagnostic accuracy. Results: The pupillary response amplitude increased with longer dark stimuli, i.e., the longer the eye was exposed to darkness the bigger was the subsequent pupillary amplitude. This pupillary recovery was significantly slowed by age and by the presence of macular degeneration. Test diagnostic accuracy for AMD was approximately 92%, with a sensitivity of 90% and a specificity of 70%. Conclusions: This proof-of-concept study demonstrates that consumer-grade VR headsets with integrated eye tracking can detect retinal dysfunction associated with AMD. The method offers a fast, accessible, and potentially scalable approach for retinal disease screening and monitoring. Further optimization and validation in larger cohorts are needed to confirm its clinical utility. Full article

Background: Partial nephrectomy (PN) and radical nephrectomy (RN) are surgical options for localized renal cell carcinoma; however, PN is p referred for preserving renal function in patients with chronic kidney disease (CKD). This study compares the risks of end-stage renal disease (ESRD), hemodialysis, and cardiovascular complications between PN and RN in patients with stable stage 4 CKD, with a further focus on postoperative electrolyte imbalances as outcome predictors. Methods: This retrospective cohort study used TriNetX data (between 2005 and 2023). Patients with stable stage 4 CKD undergoing nephron-sparing procedures or RN were included. Propensity-score matching ensured balanced baseline characteristics. The analyzed outcomes included renal function, hemodialysis, electrolyte imbalances, and cardiovascular events. Statistical analyses were hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs). Results: The PN and RN groups showed no statistically significant differences in their progression to ESRD or need for long-term hemodialysis. Patients undergoing RN had a higher risk of pulmonary embolism (HR: 2.60; 95% CI: 1.12–6.02). Electrolyte imbalances, particularly abnormal calcium and phosphate levels, were more common in the RN cohort in the early postoperative period, but they stabilized over time. Notably, these electrolyte imbalances were associated with an increased risk of cardiovascular complications. The study limitations include the absence of tumor grade, tumor staging, and pathological information. Conclusions: Nephron-sparing PN did not reduce ESRD risk compared with RN, but provided a lower incidence of certain postoperative complications, such as pulmonary embolism and early electrolyte disturbances. Early postoperative electrolyte imbalances, especially abnormal calcium and phosphate levels, may predict adverse renal and cardiovascular outcomes. Full article

Aging is associated with changes in body composition that lead to low-grade chronic inflammation, compromising the health of the elderly. This condition can be mitigated by resistance training (RT) and vitamin D supplementation, promoting the health of this population. This study aimed to investigate the effects of 12 weeks of RT combined with vitamin D supplementation on body composition, muscle strength, and inflammatory status in older adults. A total of 26 participants were randomly assigned to an Experimental Group (EG: n = 12; 11 Female; 70.6 ± 4.7 years; RT + 2000 IU/day of vitamin D) and a Control Group (EG: n = 14; 11 Female; 69.6 ± 4.6 years; RT + placebo). Both groups performed the same RT program (8 exercises; 2 sets; 10 RM, twice per week). Before and after the intervention, participants were assessed using DEXA, strength tests (sit-to-stand test and handgrip strength), and serum biomarkers (IL-6, TNF-α, 25(OH)D). Both groups showed significant strength gains, particularly in the lower limbs (p < 0.05 for all tests and groups), with no between-group differences in body composition or inflammatory markers (p > 0.05 for all tests and groups). A time × group interaction was observed for IL-6 (p = 0.03), with a slight reduction in the EG and an increase in the CG, although post-intervention differences were not statistically significant (p = 0.49). No statistically significant between-group difference in 25(OH)D change (p = 0.11). These findings suggest that vitamin D supplementation at the tested dose did not enhance adaptations to resistance training in older adults with normal baseline vitamin D levels. Further studies are warranted to explore potential benefits in deficient populations and with alternative dosing strategies. Full article

Background/Objectives: Cervical intraepithelial neoplasia grade 3 and worse (CIN3+) is a robust surrogate for cervical cancer risk. In Norway, organized cervical screening starts at 25 years of age (25–69 years). Norway introduced school-based HPV vaccination with the quadrivalent vaccine for 12-year-old girls in 2009 (birth cohorts ≥ 1997) with high 3-dose completion, and a catch-up program with the bivalent vaccine for women born 1991–1996 in 2016–2019 with lower uptake. We assessed whether increasing birth-cohort vaccination coverage (defined as ≥1 dose) was followed by reductions in CIN3+ at the age of entry to organized screening (25–29 years). Methods: We conducted a retrospective, population-based time-series of women aged 25–29 years in Troms and Finnmark screened in 2010–2024. CIN3+ was counted per unique woman and expressed per 1000 screened women per year. Cohort-level vaccination exposure was proxied by birth-year eligibility and national coverage (≥1 dose) by calendar year. Temporal trends were assessed using segmented linear regression (2010–2017; 2017–2024). Results: Among 42,253 screening tests, 865 women had CIN3+. CIN3+ rates were stable in 2010–2016 (≈15–24 per 1000), peaked in 2017–2018 (≈26–28 per 1000), and declined to 6.6 per 1000 in 2024 (~75% reduction from the peak). The 2010–2017 trend was not significant (p = 0.244), whereas 2017–2024 showed a significant annual decline (slope −3.04 per 1000 per year; p = 7.4 × 10⁻⁵). The decline coincided with an increase in the vaccinated share of the age group from an estimated 12% in 2017 to 78% in 2024. Cervical cancer was rare throughout and absent in 2024, and the 2023 transition to primary HPV testing did not interrupt the downward trend. Conclusions: As vaccinated birth cohorts—especially those vaccinated before sexual debut—entered organized screening at age 25, CIN3+ in women aged 25–29 years fell markedly. Estimates are based on coverage defined as ≥1 dose; future linkage to individual dose data and HPV type–specific CIN3+ is warranted. Full article

Background/Objectives: Long COVID (LC) causes persistent symptoms, including fatigue, musculoskeletal (MSK) pain, and a lower quality of life. It is hypothesised that chronic low-grade inflammation in LC could impact bone, joints, and muscle microcirculation, but evidence is limited. Our aim is to assess health-related quality of life (HRQoL) and circulating inflammation, bone turnover markers (BTM), and vitamin D in LC individuals to explore their potential association with MSK function. Methods: Prospective longitudinal cohort; LC n = 45, well-recovered (WR) n = 40; 12 ± 2 months follow-up. Baseline and follow-up assessments included evaluations of HRQoL and pain-rating questionnaires, and blood analysis of inflammatory and bone turnover markers (BTM). Results: More females were in the LC group. LC reported significantly lower HRQoL compared to WR, with no change over 12 months. LC had higher vitamin D levels at baseline, median 29.46 ng/mL (23.75; 35.06) compared to WR 20.36 ng/mL (15.995; 27.65) (p = 0.0021). Both groups experienced significant increases in vitamin D after 12 months: WR median from 21.4 ng/mL (16.34; 27.89) to 29.58 ng/mL (25.33; 41.74), (p =< 0.001) and LC median from 32.695 ng/mL (23.665; 35.1) to 35.89 ng/mL (30.1; 41.2), (p = 0.0023). Pain rating showed LC also experienced more hand pain at baseline median 1 (0; 5), (p = 0.003). There were no differences between groups in BTM or cytokines over time. Conclusions: This feasibility cohort showed that LC is associated with a reduction in HRQoL and joint symptoms; however, no significant changes were observed in the inflammatory markers, indicating the need for ongoing monitoring. Future studies should explore MSK, muscle function via imaging, and ways to enhance musculoskeletal health and well-being. Full article