Search Results (4,006)

Background: Interventional physiatry is a branch of medicine that uses minimally invasive ultrasound-guided techniques for diagnosis and treatment in the musculoskeletal system. The aim of this scoping review is to investigate the sterilisation techniques used and the rate of infection with ultrasound-guided injections. Methods: PubMed was searched up to 30 September 2024 using the following search terms (“Ultrasound, Interventional”[mesh]) AND “Injections, Intra-Articular”[mesh]; “Ultrasound-guided intra-articular injection”. The inclusion criteria were randomised clinical trials, written in English, involving US-guided mini-invaexercissive procedures. Results: The search identified a total of 256 potentially relevant publications. After screening for duplication, inclusion, and exclusion criteria, 105 articles were eligible for data extraction. In 51 studies, the method of skin disinfection was not specified, 18 RCT reported a ’sterile condition’, 9 studies used povidone–iodine solution, 5 used alcohol, and 2 used chlorhexidine 0.5%. In 64 trials, the method of probe preparation was not specified, 11 trials described the use of sterile gel, 10 trials reported the use of a probe cover, sterile pad, or barrier, and 2 trials reported the use of chlorhexidine 0.5%; 41 studies reported mild adverse events and 4 serious adverse events. Conclusions: Taken together, the findings of this scoping review did not show a clear relationship between current sterilisation protocols and the prevention of the microbial contamination of the probes or the patient’s skin. The variation in protocols highlights the need for standardised guidelines and more rigorous studies to accurately determine the most effective disinfection practices. Full article

Background/Objectives: Primary obstructive megaureter (POM) is a rare congenital urological condition usually diagnosed prenatally or in early childhood. Conservative management is increasingly preferred due to a high potential for spontaneous resolution. However, reliable predictors of spontaneous resolution remain controversial, complicating clinical decision-making. This study aimed to identify the demographic, clinical, and imaging parameters predictive of spontaneous resolution in patients with primary obstructive megaureter. Methods: We retrospectively analyzed 21 pediatric patients diagnosed with primary obstructive megaureter, who were treated conservatively at the Maria Sklodowska Curie Emergency Clinical Hospital for Children from January 2015 to December 2024. Clinical parameters, imaging findings, and renal function were evaluated. Statistical analyses included univariate comparisons and multivariate logistic regression modeling. Results: Spontaneous resolution occurred in 12 (57%) patients, at a median age of 45.75 months. The only statistically significant predictor identified was the initial hydronephrosis grade (p = 0.046). Patients with mild-to-moderate dilation (Grades I–II) had a significantly higher resolution rate (11 of 15 cases) compared with those with severe dilation (1 of 6 cases). Ureteral diameter showed a trend toward predicting outcomes, with unresolved cases having larger median diameters (15 mm vs. 10.5 mm, p ≈ 0.08). Age at diagnosis, sex, bilateral involvement, and history of urinary infections did not significantly influence resolution rates. Conclusions: The initial severity of hydronephrosis significantly predicts spontaneous resolution in primary obstructive megaureter. Conservative management is particularly justified in mild-to-moderate cases, whereas patients with severe dilation may require early intervention due to lower resolution likelihood. Full article

Biogas (primarily biomethane), as a carbon-neutral renewable energy source, holds great potential to replace fossil fuels for sustainable hydrogen production. Conventional biogas reforming systems adopt strategies similar to industrial natural gas reforming, posing challenges such as high temperatures, high energy consumption, and high system complexity. In this study, we propose a novel multi-product sequential separation-enhanced reforming method for biogas-derived hydrogen production, which achieves high H₂ yield and CO₂ capture under mid-temperature conditions. The effects of reaction temperature, steam-to-methane ratio, and CO₂/CH₄ molar ratio on key performance metrics including biomethane conversion and hydrogen production are investigated. At a moderate reforming temperature of 425 °C and pressure of 0.1 MPa, the conversion rate of CH₄ in biogas reaches 97.1%, the high-purity hydrogen production attains 2.15 mol-H₂/mol-feed, and the hydrogen yield is 90.1%. Additionally, the first-law energy conversion efficiency from biogas to hydrogen reaches 65.6%, which is 11 percentage points higher than that of conventional biogas reforming methods. The yield of captured CO₂ reaches 1.88 kg-CO₂/m³-feed, effectively achieving near-complete recovery of green CO₂ from biogas. The mild reaction conditions allow for a flexible integration with industrial waste heat or a wide selection of other renewable energy sources (e.g., solar heat), facilitating distributed and carbon-negative hydrogen production. Full article

This study investigates the extraction, isolation, and chemical modification of cellulose from coffee ground residues using TEMPO-NaBr-NaClO oxidation. These residues represent a promising renewable source of cellulose, which is obtained after the removal of impurities such as lignin (24%), hemicellulose (42%), and other compounds. The TEMPO (2,2,6,6-tetramethylpiperidine-1-oxyl radical)-catalyzed oxidation selectively converts primary hydroxyl groups into carboxylate groups (-COOH) under mild conditions in aqueous media, achieving an oxidation yield of up to 67%. Structural and morphological analyses, including scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, and X-ray diffraction (XRD), confirm the successful chemical modification of the cellulose. The results indicate a reduction in crystallinity index from native cellulose (80%) to oxidized cellulose (65%), reflecting partial disruption of the microfibril structure and the introduction of new chemical functionalities. FTIR analysis reveals the appearance of characteristic carboxylate bands, confirming the conversion of hydroxyl groups into carboxyl groups. Energy-dispersive X-ray (EDX) analysis further highlights a significant increase in oxygen content, indicating the efficiency of the oxidation process. The TEMPO-oxidized cellulose is water-soluble, enabling the production of valuable polyelectrolytes and intermediates. These chemical modifications improve the cellulose’s reactivity, broadening its potential applications in various fields, including biocomposites, sustainable packaging materials, and functional films. This work demonstrates the feasibility of utilizing coffee ground residues as a renewable, eco-friendly source of modified cellulose for high-value applications. Full article

This study evaluated the impact of heat treatment on the microbiological, chemical, and functional properties of hard cider enriched with cryo-concentrate over 180 days of storage. The experimental protocol for the hard cider was assessed under three conditions: room temperature (18–23 °C, CA), refrigeration (7–8 °C, CR), and pasteurization at 60 °C for 15 min (P60) and 80 °C for 15 min (P80). The heat treatment employed was mild to preserve the hard cider’s quality. Microbiological results confirmed proper processing conditions. Pasteurization reduced the initial populations of molds and yeasts by 92.9% (P80) and 83.3% (P60), while lactic acid bacteria decreased by over 99.0%. Microbial counts in P60 and P80 continued to decline during storage. Sugar content was the main indicator of instability in P60, particularly at 60 days. Both P60 and P80 ciders exhibited similar reductions in antioxidant activity, with DPPH showing a reduction of 43–45% and ABTS exhibiting a decrease of 50–51%. Additionally, a twofold increase in color intensity (darkening) was observed during storage in heat-treated samples. These findings demonstrate that pasteurization at 80 °C for 15 min effectively extends the shelf life of hard cider with cryo-concentrate to six months at room temperature, offering a practical solution for commercial production. Full article

Background: Spinal subarachnoid hemorrhage (sSAH) is a very rare disease. Detailed information about the natural course, pathogenesis, radiological manifestation, and therapeutic management is lacking. This study aimed to analyze patients diagnosed with sSAH, focusing on the origin, management strategies, and therapeutic approaches to sSAH. Methods: The study included a cohort of patients admitted to the Department of Neurosurgery, LMU University Hospital, LMU Munich, between January 2021 and December 2024 with a confirmed diagnosis of spinal subarachnoid hemorrhage and, among other things, spinal aneurysms. Data on the included patients were recorded with emphasis on demographics, radiological examination (CT, MRI, and DSA), aneurysm-specific characteristics, and clinical outcome. Results: The study included six patients diagnosed with spinal subarachnoid hemorrhage via multimodal imaging. The etiology of sSAH was identified in all cases, encompassing spinal aneurysms in three patients, anticoagulation therapy in two cases, and bony microspurs in one case, with management strategies tailored as either conservative (monitoring and imaging) or surgical (aneurysm resection, arterial feeder coagulation, or evacuation of intraspinal bleeding). No major adverse events were observed, and all the patients demonstrated neurological improvement or exhibited only mild-to-moderate disability during follow-up. Conclusions: Spinal subarachnoid hemorrhage can be due to a ruptured spinal aneurysm, but in some cases, other underlying causes should be considered as the source of the hemorrhage. Given the scarcity of literature on this condition, it is crucial to identify the correct diagnosis and implement a patient-tailored therapeutic approach. Full article

In these times and with the pace of life that we have developed, many people need help falling asleep due to poor sleep hygiene, among other reasons. Thus, in mild cases, it is recommended to use natural therapies, such as phytotherapy, avoiding in the first instance the use of drugs. Melatonin is considered a versatile molecule widely used today. It is included as a main ingredient in dietary supplements that are, in some cases, accompanied by medicinal plants as botanical mixes, generating beneficial products for sleep disorders among other conditions. The dietary phytotherapeutic supplements evaluated in this work contain various concentrations of melatonin and other products, resulting in different effects on sleep therapy. The aim of this work is to reveal the quantitative differences that exist between the melatonin contents labeled in the products and those analyzed. The degradation rate of this hormone at three years in the phytotherapeutic supplements is also studied in order to re-evaluate the expiration dates of these products. In conclusion, the mixture between synthetic melatonin and different botanical mixes is very common in the supplements studied here and aimed at improving sleep. However, the most natural thing would be to be able to use only plants with sufficient phytomelatonin content to eliminate the inclusion of chemically synthesized melatonin in preparation. We propose the use of a particular raw plant material with excellent characteristics for this purpose. Full article

Background: The preparation of antibodies in powder form without changing their physicochemical properties may enable their use in new drug delivery system therapies or non-refrigerated storage. The variable domain of heavy-chain antibodies (VHHs) is more suited for this purpose than that of conventional antibodies because of VHHs’ high thermal stability and ability to refold. Methods: In this report, the fine droplet drying (FDD) process was selected as the powderization technique because of its favorable features, such as mild drying conditions and the generation of uniform particle sizes. The aggregation, binding, particle, and in vitro inhalation properties of the prepared VHH powders (VHHps) were evaluated. Results: The amount of aggregated VHHs present in the VHHps depended on the flow temperature during the FDD process, with higher temperatures yielding a higher aggregation ratio. In contrast, no significant difference in binding activity was observed between each VHHp preparation and the native VHHs. However, this process degraded VHHs or inactivated their function, and ultimately, only about 30% of the original VHHs were functional, whereas the remaining VHHs that were not degraded showed little loss of functionality, even after storage at room temperature for more than two years. Analysis of the VHHp samples revealed that the particles were uniformly spherical with a single-micron size. The VHHps showed fine inhalation properties in the inhalation property test. Conclusions: These findings suggest that the FDD process affords various VHH powder formulations, including pharmaceutical formulations. Full article

Water scarcity can negatively affect crop yield, posing a significant threat to global food security, such as drought. Plant growth-promoting rhizobacteria (PGPR), either as single strains or synthetic communities (SynComs), has shown promise in alleviating drought stress in various plant species. In this study, we examined the effects of water limitation on Salvia officinalis and the potential of a SynCom composed of five phosphate-solubilizing, auxin-producing, and/or nitrogen-fixing Gram-negative bacteria to enhance plant growth and drought tolerance. Plant growth, morphology, physiology, and leaf metabolomic profiles were assessed using a combination of physiological measurements and LC-MS untargeted metabolomics. Mild water stress induced a conservative water-use strategy in S. officinalis, characterized by increased root-to-shoot ratio and altered leaf morphology, without compromising photosynthetic performance. SynCom inoculation under well-watered conditions elicited drought-like responses, including transient reductions in stomatal conductance. Leaf metabolomic analysis revealed that inoculation influenced the abundance of several metabolites, including biogenic amines and dipeptides, under both irrigation regimes. Notably, drought stress and SynCom inoculation increased histamine and α-ketoglutaric acid levels, highlighting potential impacts on food quality. Under reduced irrigation, inoculation further modulated leaf morphology and biomass allocation, promoting thicker leaves and increased root biomass allocation. These results demonstrate the ability of the SynCom to modulate plant physiology and metabolism in response to both optimal and reduced irrigation, potentially enhancing drought resilience without directly improving growth. The study also highlights the complex interactions among microbial inoculation, plant stress responses, and leaf metabolite profiles, emphasizing the importance of considering the effects on the production of bioactive compounds when developing microbial inoculants for edible plants. Full article

This paper introduces a model that automates the diagnosis of a patient’s condition, reducing reliance on highly trained professionals, particularly in resource-constrained settings. To ensure data consistency, the dataset was preprocessed for uniformity in size, format, and color channels. Image quality was further enhanced using histogram equalization to improve the dynamic range. Lung regions were isolated using segmentation techniques, which also eliminated extraneous areas from the images. A modified segmentation-based cropping technique was employed to define an optimal cropping rectangle. Feature extraction was performed using persistent homology, deep learning, and hybrid methodologies. Persistent homology captured topological features across multiple scales, while the deep learning model leveraged convolutional transition equivariance, input-adaptive weighting, and the global receptive field provided by Vision Transformers. By integrating features from both methods, the classification model effectively predicted severity levels (mild, moderate, severe). The segmentation-based cropping method showed a modest improvement, achieving 80% accuracy, while stand-alone persistent homology features reached 66% accuracy. Notably, the hybrid model outperformed existing approaches, including SVM, ResNet50, and VGG16, achieving an accuracy of 82%. Full article

This study introduces a visible light-mediated synthesis of 2,3-chalcogenil-dihydrobenzofuran through the oxyselenocyclization of 2-allylphenols in the presence of chalcogenides. Emphasizing sustainability, this method is notably enhanced by proceeding under mild conditions, facilitated by a straightforward I₂/SnCl₂ as a promoter and blue LED irradiation to activate the process. A variety of functional groups were effectively tolerated under our developed approach, leading to the desired products with yields ranging from good to excellent, demonstrating in this way the versatility of the method. In addition, the synthesized compounds were characterized using ¹H and ¹³C NMR techniques. Full article

Background: Many athletes experience sleep difficulties, and prior research within this cohort suggests that acute supplementation of alpha-lactalbumin (ALAC), a whey protein rich in the amino acid tryptophan, may improve sleep and performance. Therefore, this study investigated whether sub-chronic ALAC supplementation in the evening would improve sleep and physical performance within a poor-sleeping athletic population. Methods: In total, 24 athletically trained participants with sleep difficulties (Athlete Sleep Screening Questionnaire: 8.6 ± 2.2; Pittsburgh Sleep Quality Index: 10.0 ± 3.0) completed this double-blinded, randomised controlled, crossover trial. The participants were supplemented with 40 g of ALAC or control 2 h pre-sleep for seven consecutive nights within habitual settings, with sleep measured via actigraphy. Performance was assessed following the 1-week supplementation period, with the 30 s countermovement jump test, Yo-Yo Intermittent Recovery Test Level 1, and reaction time testing performed in a standardised sequence under controlled conditions. Results: During the ALAC condition, the objective number of awakenings increased (CON: 10.25 ± 5.28, ALAC: 11.01 ± 5.79; p = 0.031), the average jump height reduced (CON: 28.58 ± 5.53 cm, ALAC: 27.68 ± 5.14 cm; p = 0.037), the subjective physical and mental performance capabilities declined in the evening (p < 0.001), and evening negative emotional states (p = 0.001) were reduced. Conclusions: Seven days of ALAC supplementation may not improve the sleep and physical performance of an athletically trained population with mild–moderate sleep difficulties. Future research should recruit populations with more severe sleep difficulties and measure sleep architecture over an extended period to fully ascertain the effects, and potential benefits, of ALAC supplementation for athletes. Full article

Background and Objectives: Stroke is a leading cause of disability worldwide. Recent studies have suggested the feasibility and potential utility of remotely supervised transcranial direct current stimulation (RS-tDCS) to improve different types of impairments in various neurological conditions. This scoping review provides a critical appraisal of RS-tDCS as an adjunct therapy to enhance recovery after stroke. Materials and Methods: A comprehensive literature review was systematically conducted using PubMed through Nested Knowledge software. A supplementary search was conducted in Google Scholar. Two independent authors screened and identified related studies investigating RS-tDCS in patients with stroke from inception to February 2025. Results: Studies showed that RS-tDCS was safe, with only mild side effects. Additionally, it was feasible, with high adherence rates likely due to ease of use. Regarding efficacy, RS-tDCS preliminarily yielded improvements in upper- and lower-limb motor functions and increased language and cognitive performance. However, the studies were underpowered and heterogeneous, limiting generalization of findings. Conclusions: RS-tDCS is safe and feasible, affording beneficial effects in the motor, language, and cognitive functions of patients with post-stroke impairments. RS-tDCS has the potential to improve access and reduce disparities for post-stroke experimental treatments. However, adequately powered randomized trials are needed to further investigate the efficacy. Full article

Enzymatic biofuel cells (EBFCs) have emerged as a transformative solution in the quest for sustainable energy, offering a biocatalyst-driven alternative for powering wearable and implantable self-powered biosensors. These systems harness renewable enzyme activity under mild conditions, positioning them as ideal candidates for next-generation biosensing applications. Despite their promise, their practical deployment is limited by challenges such as low power density, restricted operational lifespan, and miniaturization complexities. This review provides an in-depth exploration of the evolving landscape of EBFC technology, beginning with fundamental principles and the latest developments in electron transfer mechanisms. A critical assessment of enzyme immobilization techniques, including physical adsorption, covalent binding, entrapment, and cross-linking, underscores the importance of optimizing enzyme stability and catalytic activity for enhanced bioelectrode performance. Additionally, we examine advanced bioelectrode materials, focusing on the role of nanostructures such as carbon-based nanomaterials, noble metals, conducting polymers, and metal–organic frameworks in improving electron transfer and boosting biosensor efficiency. Also, this review includes case studies of EBFCs in wearable self-powered biosensors, with particular attention to the real-time monitoring of neurotransmitters, glucose, lactate, and ethanol through sweat analysis, as well as their integration into implantable devices for continuous healthcare monitoring. Moreover, a dedicated discussion on challenges and trends highlights key limitations, including durability, power management, and scalability, while presenting innovative approaches to address these barriers. By addressing both technical and biological constraints, EBFCs hold the potential to revolutionize biomedical diagnostics and environmental monitoring, paving the way for highly efficient, autonomous biosensing platforms. Full article

Sitagliptin, an important anti-diabetic drug, can be obtained using transaminase (TA) enzymes, which are known to be promising biocatalysts for the production of highly enantiopure amines under mild reaction conditions. In an industrial context, the use of immobilized enzymes can provide several advantages, such as the improved stability of the biocatalyst and easy product recovery. In this study, a new commercially available transaminase enzyme to produce sitagliptin was immobilized on inorganic and organic supports using two different approaches: adsorption and covalent bond formation. Among the inorganic media, non-functionalized silica gel was chosen for its stability and competitive cost. A range of commercially available resins with different functionalities have also been selected for their characteristics that can meet industrial standards. The immobilized biocatalysts were first tested in the transamination of acetophenone as a model substrate, which obtains, in most cases, higher conversions with respect to soluble enzymes. The best results in the enantioselective synthesis of sitagliptin were achieved with the sample immobilized on the epoxy- and octadecyl-functionalized methacrylic resin, which allowed the complete conversion of the corresponding ketone and high enantioselectivity (>99% ee). Moreover, the recycling of the supported enzyme could be performed in a continuous flow system without loss of activity for five consecutive runs. Full article