Search Results (284)

Diet is a key modulator of the gut microbiota, thereby influencing host physiology. Microbial colonization begins early in life, influenced by maternal sources, mode of birth, diet, and environmental exposures, and stabilizes into an adult-like microbiome during early childhood. This maturation yields a microbial ecosystem dominated by Firmicutes and Bacteroidetes that contributes to host physiological homeostasis. Gut microorganisms function as an integrated metabolic system that transforms dietary substrates into bioactive metabolites, including short-chain fatty acids (SCFAs), amino acid-derived compounds, and microbial lipids. These metabolites regulate glucose and lipid metabolism, intestinal barrier integrity, and immune modulation. Although many metabolic functions are conserved, their activity is shaped by diet, microbial cross-feeding, and local intestinal conditions, enabling functional specialization within the gut. Disruption of this system, known as dysbiosis, is associated with alterations in microbial diversity and metabolic output that have been linked to metabolic diseases, including obesity and related disorders. Evidence from experimental models and observational studies suggests that these associations may involve interconnected inflammatory and metabolic mechanisms, such as impaired intestinal barrier function, low-grade inflammation, and altered dietary energy harvest; however, causal relationships in humans remain incompletely understood. Beyond peripheral effects, the gut microbiome influences host metabolism via the gut–brain axis, a bidirectional network that integrates neural, endocrine, immune, and metabolic signaling. Microbiota-derived metabolites and gut hormone modulation contribute to appetite regulation, energy balance, and glucose homeostasis, while central neuroendocrine signaling can reciprocally shape the intestinal microbial niche. Collectively, these findings highlight the gut microbiome as a central regulator of host metabolism, whose disruption may contribute to the development of metabolic disease. Full article

Background and Objectives: Pregnancy and the postpartum period profoundly affect female sexual function, yet longitudinal data integrating obstetric and psychosocial domains are scarce. We aimed to chart sexual-function trajectories from early pregnancy to 12 months postpartum and identify predictors of persistent dysfunction. Materials and Methods: In this single-center prospective cohort, 187 pregnant women were eligible to complete the FSFI at three trimesters and at 6–8 weeks, 3 months, and 6–12 months postpartum, plus postpartum PHQ-9, WHOQOL-BREF, and body-image scales. Associations with FSFI-defined dysfunction (FSFI < 26.55) and continuous FSFI were examined, of which 90 women were included for having documented dysfunction. Results: Mean FSFI declined from 27.4 ± 3.9 (first trimester) to a nadir of 20.1 ± 4.2 at 6–8 weeks postpartum, with partial recovery to 25.5 ± 4.0 at 6–12 months (p < 0.001). Depressive symptoms were higher in women with dysfunction (PHQ-9 8.8 ± 3.3 vs. 6.7 ± 3.5; p < 0.001) and correlated inversely with FSFI (r = −0.39; p < 0.001). A multivariable model explained 19% of FSFI variance, with each 1 SD PHQ-9 increase predicting a 1.2-point FSFI decrease (p = 0.005). Body-image disturbance exerted a partially PHQ-9-mediated effect, and three FSFI trajectory clusters showed postpartum dysfunction rates from 28.6% to 89.7%. A combined psychosocial prediction model achieved an AUC of 0.9 with a sensitivity and specificity of 0.8. Conclusions: Postpartum sexual dysfunction was common and persisted in many women at one year; depressive symptoms, body image, and psychological quality of life were more influential than mode of birth, breastfeeding, or pelvic-floor symptoms. Full article

Per- and polyfluoroalkyl substances (PFAS) are synthetics prized for their chemical stability and functionality. Legacy PFAS such as perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) have been phased out due to their persistence and toxicity. This study assessed exposure to both legacy and emerging PFAS in 281 urine samples from 8-year-old children participating in the (Infancia y Medio Ambiente) INMA Asturias birth cohort (northwest Spain), a region with a strong industrial background. Dietary and household information was collected via questionnaires, and urine samples were analysed using ultra-high-performance liquid chromatography (UHPLC) coupled with high-resolution mass spectrometry (HRMS) with full-scan acquisition in independent all-ion fragmentation mode. A suspected screening approach was applied to discover previously unreported PFAS and expand the detectable chemical profile, complemented by targeted analysis of 29 compounds selected for their persistence and regulatory relevance. Among them, 17 compounds were confirmed and quantified. The combined targeted and suspect-screening approach also identified novel PFAS, including fluorotelomer carboxylic acids, demonstrating the value of LC-HRMS for detecting unregulated compounds. Emerging PFAS showed the highest detection frequencies and concentrations: trifluoroacetic acid (TFA) and hexafluoropropylene oxide dimer acid (HFPO-DA, GenX) were detected in 63% and 27% of samples, respectively, with GenX reaching 10.1 ng/mL, whereas PFOA and PFOS were detected less frequently (8.5% and 3.2%) and at concentrations below 1 ng/mL, highlighting the need for epidemiological studies to achieve comprehensive PFAS exposure assessments. Associations with dietary habit exposure estimates point to dairy, protein-rich foods, vegetables, and drinking water as the main contributors. Full article

Background and Objectives: Respiratory syncytial virus (RSV) is a leading cause of hospitalization among infants and young children. The clinical course of RSV infection varies considerably depending on age and selected clinical factors. The objective of this study was to identify demographic and clinical variables associated with the course of hospitalization in children admitted due to laboratory-confirmed RSV infection. Materials and Methods: A retrospective observational study was conducted based on the medical records of 100 immunocompetent pediatric patients hospitalized due to RSV infection in the Department of Pediatrics of Hospital in Wadowice, Poland, between December 2021 and April 2023. Inclusion criteria were age ≤ 5 years and laboratory-confirmed RSV infection. Patients with congenital heart disease, chronic lung disease (including cystic fibrosis), immunodeficiency, or other severe chronic conditions were excluded. Collected data included age, gestational age at birth, mode of delivery, vaccination status, clinical presentation, length of hospital stay, C-reactive protein (CRP) levels, seasonality of infection, and use of antibiotic therapy. Results: The median length of hospitalization was 6 days (range: 0–18). Younger age was significantly associated with longer hospital stay (p < 0.05) and higher CRP levels (p < 0.05). No significant associations were observed between hospitalization duration and mode of delivery or vaccination status. Gestational age at birth did not influence the number of clinical symptoms. The need for antibiotic therapy differed significantly according to the season of infection (p < 0.05). Conclusions: In children hospitalized with RSV infection, age and seasonality were the primary factors influencing the course of hospitalization, whereas perinatal factors such as mode of delivery and vaccination status had no significant impact. These findings underscore the importance of age-oriented clinical assessment and support efforts to optimize antimicrobial stewardship during RSV seasons. Full article

Background/Objectives: In this study, we aimed to evaluate whether neonatal ischemia-modified albumin (IMA) and umbilical venous cord blood gas parameters are associated with antenatal markers of fetal well-being, including the umbilical coiling index (UCI) and umbilical artery (UA) and middle cerebral artery (MCA) Doppler indices. Methods: For this prospective observational study, sixty-five low-risk term pregnancies (≥37 weeks) were included. Prenatal ultrasound was used to measure the UCI and UA/MCA Doppler indices. At delivery, umbilical venous cord blood gas and serum IMA analyses were performed. Maternal and neonatal data (birth weight, 5 min Apgar score, NICU admission, sex, and delivery mode) were recorded, and correlations and group comparisons were performed (p < 0.05). Results: The UCI ranged from 0.210 to 0.471 coil/cm (mean 0.337). The UA and MCA Doppler indices were within the reference ranges. The UCI showed no significant correlation with umbilical venous blood gas values, IMA, UA/MCA Doppler indices, gestational age/weeks, or 5 min Apgar score. The UA S/D ratio and UA resistive index (RI) were negatively correlated with birth weight (p < 0.05). Umbilical venous pH was positively correlated with the 5 min Apgar score, whereas venous pCO₂ was negatively correlated with the 5 min Apgar score (both p < 0.05). Newborns with venous pH < 7.32 had higher cesarean delivery rates and higher rooming-in rates. Newborns admitted to the NICU had higher mean UA systolic velocity/diastolic velocity (S/D) and UA pulsatility index (PI) and lower venous pH. Conclusions: In low-risk term pregnancies, the UCI was not associated with cord blood gas parameters, IMA, or UA/MCA Doppler indices. These results suggest that the UCI may have limited clinical utility as a predictor of early neonatal acidosis or oxidative stress in a strictly low-risk population. Full article

Background and Objectives: To evaluate pregnancy outcomes and transthoracic echocardiographic (TTE) findings during the antenatal and postpartum periods in women with repaired Tetralogy of Fallot (ToF) who delivered at Çukurova University Faculty of Medicine, Balcalı Hospital, between 2011 and 2025 and to interpret these findings in the context of the 2025 European Society of Cardiology (ESC) recommendations. Materials and Methods: This single-center retrospective cohort study undertaken between 2011 and 2025 included 11 pregnant women with surgically repaired ToF. Maternal demographic characteristics, obstetric outcomes, mode of delivery, neonatal outcomes, and antenatal TTE parameters were recorded. Cardiac measurements obtained during pregnancy were compared with postpartum TTE findings performed 3–6 months after delivery to assess pregnancy-related cardiac adaptation and recovery. Results: A total of 11 pregnancies in women with repaired ToF were analyzed. Nine pregnancies resulted in live births, while one ended in missed abortion at 9 + 2 weeks and one in intrauterine fetal demise at 34 + 2 weeks. Among live births, the mean gestational age was 36 + 2 weeks and the mean birthweight was 2865 g, with a preterm delivery rate of 55.6%. Cesarean section was performed in 70% of cases, while 30% delivered vaginally. During pregnancy, the mean left ventricular ejection fraction was 62.6%, and residual tricuspid regurgitation was the most frequently observed echocardiographic finding. Postpartum TTE evaluations indicated that echocardiographic parameters were largely stable over the observation period, with no numerical change and no clear evidence of deterioration in ventricular function or progression of valvular regurgitation. Conclusions: Despite successful surgical repair, pregnancy may still pose potential risks for women with ToF, underscoring the importance of individualized, multidisciplinary management. In this cohort, pregnancy appeared to be generally well-tolerated when care was provided in accordance with contemporary ESC recommendations. The observation of preserved ejection fraction and overall stable right ventricular function in the early postpartum period suggests that favorable maternal cardiac adaptation may be achievable in carefully selected patients. Early postpartum echocardiographic assessment may be useful for identifying functional changes and informing structured long-term follow-up strategies. Full article

Marine isopods are the ancestors of the harmless herbivorous woodlouse species often found in piles of leaves. In contrast to woodlice, marine isopods of the family Cirolanidae (cirolanid isopods) are scavengers and predatory carnivores that form swarms and can cause damage to fishing and aquaculture industries. Furthermore, these animals are known to bite swimming and diving humans and therefore may have negative effects on recreational activities in areas where swarms form. One cirolanid isopod species, Cirolana harfordi, displays social behaviour, an attribute that may facilitate the formation of swarms. This species gives live birth, a highly unusual mode of reproduction for an invertebrate and isopod. The rate of viviparous reproduction in C. harfordi is sped up by warmer conditions, indicating the threat that cirolanid isopods pose to ocean resources may intensify with global warming. Full article

Background: Adolescent pregnancy remains a major global public health issue, often linked to socioeconomic and educational disparities rather than biological immaturity. This study aimed to identify sociodemographic factors associated with adolescent pregnancies and to evaluate their impact on maternal and neonatal outcomes in a tertiary hospital in Northeastern Romania. Methods: A retrospective analysis was conducted at the “Cuza Vodă” Obstetrics-Gynecology Clinic Hospital, Iași, over two periods: 2013–2017 and January–October 2025. Records of 637 mothers aged <20 years were reviewed. Variables included age, education, prenatal monitoring, gestational age, delivery mode, neonatal outcomes, and obstetric complications. Statistical analyses were performed using SPSS v26, employing ANOVA, Welch ANOVA, and post hoc tests (p < 0.05). Ethical approval was obtained from the institutional ethics committee. Results: The mean maternal age was 17.26 ± 1.5 years, with 82.6% from rural areas. Most had only primary or lower secondary education. Fully monitored pregnancies were associated with significantly higher birth weights (mean = 3249 g) compared with unmonitored pregnancies (mean = 3009 g; p < 0.001). Infants of mothers with low education had the lowest mean birth weights (2963 g; p = 0.002). Preterm births represented 14.3% of cases, and cesarean deliveries accounted for 34.5%. A slight but significant increase in maternal age was observed between 2013–2017 and 2025 (p < 0.001), suggesting delayed adolescent childbearing. Conclusions: Low educational attainment and inadequate prenatal monitoring remain major determinants of adverse neonatal outcomes among adolescent mothers. Comprehensive sexual education, improved prenatal care accessibility, and social support programs are essential to reduce adolescent pregnancy rates and improve reproductive health in Romania. Full article

Objectives: To evaluate the association between antenatal betamethasone exposure and neonatal respiratory morbidity among late-preterm births. We further examined whether gestational age at delivery and the exposure-to-delivery interval modify this association. Methods: We conducted a retrospective cohort study of singleton live births at 34–36 + 6 weeks in a tertiary center (2011–2023). Betamethasone exposure was classified as none, early (<34 weeks), or late (34–36 + 6 weeks). Among exposed pregnancies, the interval from first dose to delivery was categorized as ≤7 or >7 days and evaluated separately at 34, 35, and 36 weeks. Primary outcomes were RDS and composite respiratory morbidity (RDS, TTN, or ≥3 days of respiratory support); neonatal hypoglycemia was secondary. Adjusted odds ratios were estimated using multivariable logistic regression including maternal age, parity, delivery mode, and birthweight. Results: The study included 2668 late-preterm infants, of whom 2356 (88.3%) were unexposed and 312 (11.7%) were exposed to antenatal corticosteroids (ACSs). Among exposed pregnancies, 138 (44.2%) received early ACS and 174 (55.8%) late ACS; 163 (52.2%) delivered ≤7 days and 149 (47.8%) >7 days after administration. Late ACS exposure was associated with lower odds of RDS (aOR 0.37, 95% CI 0.17–0.69) and composite respiratory morbidity (aOR 0.55, 95% CI 0.31–0.92), but with increased odds of neonatal hypoglycemia (aOR 2.72, 95% CI 1.26–5.31). Among pregnancies delivering at 34 weeks, exposure within ≤7 days was associated with a marked reduction in RDS (aOR 0.25, 95% CI 0.07–0.79; NNT ≈ 3), whereas no respiratory benefit was observed at 35 or 36 weeks or when the interval exceeded 7 days. Conclusions: Antenatal betamethasone exposure among late-preterm births was not uniformly associated with neonatal respiratory outcomes, with associations varying by gestational age at delivery and the exposure-to-delivery interval. These findings may be interpreted in the context of potential respiratory benefit alongside accompanying metabolic risk, with exploratory analyses suggesting a more pronounced signal among deliveries at 34 weeks within ≤7 days. Full article

(1) Background/Objectives: Human papillomavirus (HPV) testing is hypothesised to detect cervical intraepithelial neoplasia grade 3 (CIN3) earlier than cervical cytology, which could translate into several clinical benefits. This study aimed to confirm that HPV testing detects CIN3 lesions of smaller size (or linear extension) and to assess whether this is associated with a decreased risk of stromal microinvasion (≤3 mm) (microinvasive or stage IA1 cervical carcinoma). (2) Methods: The study was conducted in a referral centre for cervical pathology in Italy. Eligible were 3744 patients aged 30–64 years who underwent local excision of the cervix between 1992 and 2021 and were diagnosed with CIN3, with or without microinvasion. Data were analysed using logistic and multinomial regression models. (3) Results: Overall, 1156 (30.9%) CIN3 cases were detected by the HPV test, and 2588 (69.1%) by cervical cytology. The lesion size was smaller in HPV test-detected CIN3 (median, 6 mm; interquartile range (IQR), 4–8 mm) than in cytology-detected CIN3 (median, 7 mm; IQR, 5–9 mm; p < 0.001). HPV test-detected CIN3 was over 50% less likely to have a size >6 mm combined with massive glandular crypt involvement. Stromal microinvasion occurred in 20/1156 (1.7%) HPV test-detected lesions versus 87/2588 (3.4%) cytology-detected lesions (p = 0.006), corresponding to an approximately 50% lower age-adjusted risk. The smaller size of HPV test-detected CIN3 and its lower degree of glandular crypt involvement interacted additively, rather than multiplicatively, in reducing the risk of stromal microinvasion. Over 46% of the association between detection mode and stromal microinvasion was explained by the size/involvement composite variable. (4) Conclusions: HPV testing detects CIN3 lesions of smaller size than cervical cytology. HPV test-detected CIN3 has a lower risk of stromal microinvasion. This association is mediated to a substantial extent by the smaller lesion size and the less extensive glandular crypt involvement, which interact in an additive manner. These findings may have other important clinical implications. First, the prevalence of disease persistence after treatment may decrease. Second, smaller lesions are likely to be treated with more limited excisions. Third, this may contribute to a lower rate of preterm birth in subsequent pregnancies. Full article

Background/Objectives: Volatile organic compounds (VOCs) have emerged as promising non-invasive biomarkers for assessing metabolic and reproductive health. In the context of assisted reproductive techniques (ARTs), the volatilomic composition of follicular fluid (FF) may reflect the biochemical environment surrounding the oocyte, influencing fertilization success and embryo development. This study aimed to characterize the volatilomic profile of FF in women undergoing ARTs and to explore associations between specific VOCs and female fertilization-related parameters (FFRPs). Methods: A total of 54 Caucasian women aged 19–39 years, enrolled between October 2015 and July 2019, were recruited at the Assisted Reproduction Laboratory of the Local Health Unit of Cova da Beira, Covilhã. FF samples were analyzed via gas chromatography–mass spectrometry (GC–MS) in scan mode, identifying 136 VOCs, of which 72 were selected based on prevalence. Sixteen FFRPs were evaluated, including age, body mass index (BMI), smoking habits, infertility factor, oocyte yield, embryo quality, β-hCG levels, country of birth, and reproductive history. Associations between VOCs and FFRPs were assessed using the Chi-square (χ²) test. Results: Significant correlations (p ≤ 0.05) were identified between 45 VOCs and 11 FFRPs. The detected compounds comprised alkanes, siloxanes, aromatics, alcohols, ketones, aldehydes, carboxylic acids and esters, fatty acid derivatives, epoxides, acrylates, nitriles, and sterols. Several VOCs were associated with more than one FFRP, indicating overlapping metabolic pathways that may influence reproductive performance. Conclusions: The volatilomic profile of FF demonstrates significant variability linked to individual reproductive and metabolic factors. VOC analysis may provide novel insights into follicular physiology, representing a promising approach for identifying potential biomarkers of infertility and ART outcomes. Full article

Background and Objectives: Early mother–newborn skin-to-skin contact (SSC) after birth is widely recommended to support neonatal physiological stabilization, including thermoregulation. Under routine clinical practice, however, SSC may be brief or interrupted, and its effectiveness in maintaining neonatal body temperature under such conditions is less well described. This study aimed to evaluate early neonatal temperature changes under routine post-birth care practices that included brief SSC followed by separation for incubation care. Materials and Methods: This retrospective cohort study included 620 term mother–infant dyads delivered at a single regional teaching hospital. Newborns were managed according to routine clinical practice and were allocated to either a brief early SSC group or a control group without SSC. SSC duration differed by mode of delivery (approximately 10 min after cesarean section and 20 min after vaginal birth). Infant body temperature was recorded at predefined time points from birth through early incubation care. Associations between temperature changes and clinical factors, including mode of delivery, gestational age, parity, and birth weight, were analyzed. Results: No significant difference was observed between the SSC and control groups in overall changes in infant body temperature from birth to the beginning of incubation care (p = 0.245). After one hour of incubation, mean body temperature was comparable between groups (p = 0.357). Within the SSC group, infant body temperature decreased significantly during the SSC period (change from birth: −0.68 °C ± 0.35 °C; p < 0.001). At the start of incubation care, a significantly lower proportion of infants in the SSC group (22%) had body temperatures below 36.5 °C compared to the control group (32%) (p = 0.018). Multivariable analysis identified mode of delivery, reflecting differences in post-birth care routines and SSC duration, as the only factor independently associated with temperature changes during SSC. Conclusions: Under routine clinical conditions, brief and interrupted SSC was associated with transient reductions in neonatal body temperature; however, brief SSC was associated with a lower proportion of hypothermia compared with immediate incubation care, suggesting that even short periods of SSC may support early neonatal thermoregulation. Full article

Background/Objectives: Preterm birth remains a major cause of neonatal morbidity and mortality, particularly in multiple pregnancies and in cases of cervical shortening. While cervical cerclage is established in singleton pregnancies, its efficacy in multiple gestations remains uncertain. This study compares pregnancy and neonatal outcomes following second-trimester cerclage in singleton and multiple pregnancies with a short cervix. Methods: In this retrospective cohort study, 96 women underwent second-trimester cerclage at a tertiary perinatal center between 2020 and 2024. All had a cervical length ≤ 25 mm or prolapsed membranes without infection or premature rupture. Primary outcomes included term delivery rate, gestational age, mode of delivery, and neonatal outcomes; secondary outcomes comprised surgical complications and rehospitalization, defined as the need for renewed inpatient care due to threatened preterm labor or procedure-related complications. Results: In total, 79 singleton and 17 multiple pregnancies were analyzed. Term delivery occurred more often in singletons (54%) than multiples (18%, p = 0.006). Mean gestational age at birth was 258 ± 25 days in singletons versus 228 ± 28 days in multiples (p < 0.001). Birth weight was significantly lower in multiples (1985 g vs. 2943 g; p < 0.001), and neonatal infections were more frequent (53% vs. 26%; p = 0.008). Caesarean delivery was more common in multiples (82% vs. 33%; p < 0.001). Apart from increased postoperative contractions in multiples (24% vs. 5%; p = 0.031), complication rates and rehospitalization (27% vs. 29%; p = 0.8) were similar. Conclusions: Second-trimester cerclage is less effective in preventing preterm birth in multiple pregnancies compared to singleton pregnancies; however, it appears to be associated with a stabilizing clinical course and may facilitate outpatient management in selected high-risk cases. These findings support individualized counseling and shared decision-making, particularly in multifetal gestations. Full article

The speckled smooth-hound Mustelus mento is an endemic coastal shark from the southeastern Pacific, currently listed as “Critically Endangered” due to intense fishing pressure and the absence of species-specific management across its distribution range. Between November 2021 and October 2023, 925 individuals were examined from artisanal landings in northern Chile to describe their reproductive biology and embryonic development characteristics. The total length ranged from 27.6–159.3 cm in females and 14.2–165.0 cm in males, with a sex ratio of 1:1.2, which was slightly biased towards females. The estimated size at 50% maturity was 53.6 cm for females and 48.7 cm for males, with 70.6% of females and 66.0% of males caught below these thresholds, indicating a predominance of immature individuals in landings. Nine gravid females (106–139 cm) contained 71 embryos, which were classified into five developmental stages (encapsulated ovum, early organogenesis, fin differentiation, pigmentation and growth, and pre-partum) based on their external morphology and yolk sac reduction. The litter size ranged from 4 to 12 embryos, and the estimated size at birth was 13–14 cm in length. Embryos were recorded only during the summer months, suggesting a seasonal reproductive cycle with parturition in the early autumn. The persistent yolk sac connection throughout development and the absence of placental structures confirm that M. mento exhibits aplacental viviparity. These results document the first population-level description of the reproductive biology of M. mento, redefine its reproductive mode, and provide baseline information essential for implementing species-specific management and conservation measures in Chilean waters. Full article

The reduced scattering coefficient (μ_s′), measured using time-resolved near-infrared spectroscopy (TR-NIRS) has been linked to brain water diffusion assessed by diffusion tensor imaging, suggesting its potential as a bedside marker of cerebral microstructure. However, the physiological determinants of μ_s′ and its early postnatal changes remain unclear. This study examined clinical associations with cerebral μ_s′ in healthy term newborn infants during the first 2 postnatal days. Eighteen newborn infants underwent TR-NIRS at 6 and 36 h postnatally. Associations between μ_s′ and 14 clinical variables were analysed using generalised estimating equations. Median μ_s′ was 7.395 cm⁻¹ (IQR: 6.140–8.159) at 6 h and 7.112 cm⁻¹ (IQR: 6.473–7.410) at 36 h, with no significant difference (p = 0.327). Male sex was associated with higher μ_s′ (regression coefficient = 0.895, p = 0.007), whereas caesarean delivery (regression coefficient = −0.969, p = 0.012) was associated with lower μ_s′. A significant interaction between caesarean delivery and postnatal age indicated that the negative effect diminished between 6 and 36 h after birth (difference = 0.057, p = 0.016). These findings suggest delivery mode transiently influences brain scattering, whereas the effect of sex remains stable, supporting further investigation of TR-NIRS as an acute-phase cerebral marker. Full article