Search Results (6,385)

Sex-related differences are found not only in the reproductive system but also across various biological systems, such as the cardiovascular system. Compared with premenopausal women, cardiovascular disease (CVD) tends to occur more frequently in adult men and postmenopausal women (Post-MW). Also, during the reproductive years, sex hormones synthesized and released into the blood stream affect vascular function in a sex-dependent fashion. Estrogen (E2) interacts with estrogen receptors (ERs) in endothelial cells, vascular smooth muscle, and the extracellular matrix, causing both genomic and non-genomic effects, including vasodilation, decreased blood pressure, and cardiovascular protection. These observations have suggested beneficial effects of female sex hormones on cardiovascular function. In addition, the clear advantages of E2 supplementation in alleviating vasomotor symptoms during menopause have led to clinical investigations of the effects of menopausal hormone therapy (MHT) in CVD. However, the findings from these clinical trials have been variable and often contradictory. The lack of benefits of MHT in CVD has been related to the MHT preparation (type, dose, and route), vascular ERs (number, variants, distribution, and sensitivity), menopausal stage (MHT timing, initiation, and duration), hormonal environment (progesterone, testosterone (T), gonadotropins, and sex hormone binding globulin), and preexisting cardiovascular health and other disorders. The vascular effects of sex hormones have also prompted further examination of the use of anabolic drugs among athletes and the long-term effects of E2 and T supplements on cardiovascular health in cis- and transgender individuals seeking gender-affirming therapy. Further analysis of the effects of sex hormones and their receptors on vascular function should enhance our understanding of the sex differences and menopause-related changes in vascular signaling and provide better guidance for the management of CVD in a gender-specific fashion and in Post-MW. Full article

Climate variability, intensified by climate change, poses significant challenges to agriculture, affecting crop development and productivity. Integrating seasonal weather forecasts (SWF) into crop growth modelling tools is therefore essential for improving agricultural decision-making. This study assessed the uncertainties of raw (non-bias-corrected) temperature forecasts from the European Centre for Medium-Range Weather Forecasts (ECMWF) SEAS5 seasonal (seven-month forecasts) to estimate the spring–summer maize, melon, sunflower, and tomato crops cycle from 2013 to 2022 in the Caia Irrigation Scheme, southern Portugal. AgERA5 reanalysis data, after simple bias correction using local weather station data, was used as a reference. The growing degree-day (GDD) approach was applied to estimate the crop cycle duration, which was then validated against ground truth and satellite data. The results show that SWF tend to underestimate maximum temperatures and overestimate minimum temperatures, with these biases partially offsetting to improve mean temperature accuracy. Forecast skill decreased non-linearly with lead time, especially after the second month; however, in some cases, longer lead times outperformed earlier ones. Temperature forecast biases affected GDD-based crop cycle estimates, resulting in a slight underestimation of all crop cycle durations by around a week. Nevertheless, the forecasts captured the overall increasing temperature trend, interannual variability, and anomaly signals, but with marginal added value over climatological data. This study highlights the potential of integrating ground truth and Earth observation data, together with reanalysis data and SWF, into GDD tools to support agricultural decision-making, aiming at enhancing yield and resources management. Full article

In aging residential neighborhoods, insufficient public spaces and a weakened sense of belonging have led to declining community vitality. Addressing the widespread idleness of boiler room facilities in cold-region contexts, this study integrates GPS tracking, Wi-Fi probe detection, questionnaire surveys, and field observations to develop a three-dimensional “space–time–behavior” evaluation model comprising five core indicators: activity type, spatial range, duration, frequency, and volatility. Unlike prior studies that rely on single data sources or unidimensional metrics, our multi-source approach enhances spatiotemporal resolution, improves the accuracy of subjective perceptions, and enables cross-validation between objective behavioral trajectories and residents’ self-reports, thereby significantly strengthening the comprehensiveness and reliability of community vitality measurement. The results show that the community service center conversion model maximizes spatial efficiency through functional integration, achieving a vitality score of 3.64—substantially higher than those for recreational renovations (3.16) and non-renovated sites (2.67). This model increases space utilization by 2.2-fold, sustains 12 h daily vitality, reduces residents’ activity radii by 38%, and boosts intergenerational interaction frequency by 43%, effectively bridging age group divides. We identify a “functional hybridization–spatial permeability–usage sustainability” mechanism underlying renovation efficacy and recommend the community service center paradigm as a priority strategy. The quantitative decision support framework established here offers empirical guidance for renewing existing spaces in severe climatic environments. Full article

Biodiesel and 2-methylfuran (MF) exhibit significant potential as alternative fuels due to advancements in their production techniques. Despite this potential, the low cetane number (CN) of biodiesel–MF (BMF) blends limits their practical use in diesel engines due to poor auto-ignition characteristics and extended ignition delays. This study addresses this issue by investigating the impact of the cetane improver 2-ethylhexyl nitrate (2-EHN) on the performance and emissions of a BMF30 blend. The blend consists of 70% biodiesel and 30% MF, with 2-EHN added at concentrations of 1% and 1.5% to enhance ignition properties. The experiments were conducted on a four-cylinder, four-stroke, direct-injection compression ignition (DICI) engine at a constant speed of 1800 rpm with brake mean effective pressures (BMEP) ranging from 0.13 to 1.13 MPa. The results showed that 2-EHN improved the CN of the BMF30 blend, leading to earlier combustion initiation and longer combustion duration. At low BMEP (0.13 MPa), 2-EHN increased the peak rate of heat release and in-cylinder pressure, whereas at higher BMEP (0.88 MPa), these parameters decreased. The key findings include a reduction in brake-specific fuel consumption (BSFC) by 5.49–7.33% and an increase in brake thermal efficiency (BTE) by 3.30–4.69%. Additionally, NOx emissions decreased by 9.4–17.48%, with the highest reduction observed at 1.5% 2-EHN. CO emissions were reduced by 45.1–85.5% and soot emissions also declined. Hydrocarbon (HC) emissions decreased by 14.56–24.90%. These findings demonstrate that adding 2-EHN to BMF30 blends enhances engine performance, reduces key emissions, and offers a promising alternative fuel for diesel engines. Full article

Background/Objectives: This study aimed to observe and compare the real-world total hospitalization costs for patients with chronic heart failure (CHF) and metabolic syndrome (MetS) in Romania. Methods: Data were electronically retrieved from three different internal medicine departments of university hospitals in Bucharest, Romania, including all admissions from December 2023 to June 2024. The collected data included demographics, the cost of hospitalization (EUR), and discharge diagnoses (ICD10 codes were used to calculate the Charleston Comorbidity Index, CCI, and to define a surrogate measure for MetS). Results: The database query retrieved 4732 hospitalizations (median duration: 4 days; median cost: EUR 1002) of unique patients (53.9% women, average age = 68.7 years), of whom 48.0% had CHF and 11.0% were classified as having MetS. The median hospitalization duration and costs were similar for men and women, despite women being significantly older and having a higher prevalence of CHF. Patients with CHF or MetS were significantly older, had more comorbidities (CCI), and had a higher median hospitalization duration, total hospitalization cost, and cost/day than those without CHF or MetS. The total cost of hospitalization increased steadily from a minimum in patients without CHF or MetS to a maximum in patients with both conditions. Conclusions: CHF was highly prevalent among patients admitted to internal medicine wards and was more prevalent among hospitalized women. However, the hospitalization costs did not differ significantly between the sexes. CHF and MetS incrementally increased the total hospitalization costs in these DRG-based reimbursement systems. Full article

Background/Objectives: Individuals with chronic stroke often experience various impairments, including poor balance, reduced mobility, limited physical activity, and difficulty performing daily tasks. In the context of the COVID-19 pandemic, telerehabilitation (TR) can overcome the barriers of geographical and physical distancing, time, costs, and travel, as well as the anxiety about contracting COVID-19. In this retrospective case-control study, we aim to evaluate the motor and cognitive effects of balance TR training carried out with a sensor-based non-immersive virtual reality system compared to conventional rehabilitation in chronic stroke patients. Methods: Twenty chronic post-stroke patients underwent evaluation for inclusion in the analysis through an electronic recovery data system. The patients included in the study were divided into two groups with similar medical characteristics and duration of rehabilitation training. However, the groups differed in the type of rehabilitation approach used. The experimental group (EG) received TR with a sensor-based VR device, called VRRS—HomeKit (n. 10). In contrast, the control group (CG) underwent conventional home-based rehabilitation (n. 10). Results: At the end of the training, we observed significant improvements in the EG in the 10-m walking test (10MWT) (p = 0.01), Timed-Up-Go Left (TUG L) (p = 0.01), and Montreal Cognitive Assessment (MoCA) (p = 0.005). Conclusions: In our study, we highlighted the potential role of sensor-based virtual reality TR in chronic stroke patients for improving lower limb function, suggesting that this approach is feasible and not inferior to conventional home-based rehabilitation. Full article

Background and Objectives: Psoriasis vulgaris (PV) is a chronic inflammatory disease associated with oxidative stress. It has been reported that oxidative stress caused by disruption of redox signaling can cause molecular damage, activate dendritic cells, lymphocytes, and keratinocytes, and lead to angiogenesis, inflammation, cell necrosis, and apoptosis by increasing the levels of lipid peroxidation products. In this study, serum levels of asymmetric dimethylarginine (ADMA), malondialdehyde (MDA), and reduced glutathione (GSH) were analyzed to gain insight into the oxidative balance in patients with PV. Materials and Methods: This prospective study included 59 PV patients and 40 healthy volunteers as the healthy control group. Age, gender, body mass index (BMI), waist circumference, routine hematologic parameters [fasting blood glucose, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), blood lipid levels, hemogram parameters], disease duration, and disease severity were recorded on data forms. The levels of ADMA, MDA, and GSH were analyzed using the high-performance liquid chromatography (HPLC) method. Results: When analyzed in terms of demographic characteristics, no statistically significant difference was observed between the patient and control groups. When examined in terms of biochemical variables, white blood cell (WBC) values were found to be significantly higher in the patient group (t: 2.825; p < 0.05). Although waist circumference, BMI, glucose, CRP, ESR, lipids, platelet count, and systolic and diastolic blood pressure were higher in the patient group, this difference was not statistically significant (p > 0.05). ADMA (t: 4.532; p < 0.05) and MDA (t: 9.598; p < 0.05) values were found to be higher and GSH (t: −4.717; p < 0.05) values were found to be lower in the patient group compared to the control group. When correlation analysis was performed between the parameters, a significant relationship was found only between GSH values and ADMA values (r: −0.256; p < 0.05). Accordingly, as the patients’ GSH values increased, ADMA values decreased. Conclusions: Increased WBC, ADMA, and MDA levels, and decreased GSH levels in PV patients reveal the critical role of oxidative stress and inflammation in the disease process. Evaluation of these biomarkers may contribute to the identification of new targets for the treatment of PV and the development of more effective management strategies. Full article

Background: This study aims to demonstrate the challenges during the treatment of patients with osteoarthritis due to the development of dysplasia, which can be faced by surgeons who treat patients with THA. Our objective is to present our findings from a comparison of patients who underwent total hip arthroplasty (THA) for osteoarthritis secondary to developmental dysplasia of the hip (DDH), with or without a prior periacetabular osteotomy (PAO). Methods: We divided patients into two groups. Group A was adolescents who underwent periacetabular osteotomy and further THA in the orthopedic center (29 hips), and Group B was adolescents who underwent THA without PAO but suffered from DDH (24 hips). We measured blood loss, cup size, cup positioning, cup coverage, inclination and anteversion of the cup, duration of surgery, clinical scores, time of hospitalization, and the presence of ossification. Results: The mHHS score demonstrated significant differences (group A: 89 points vs. group B: 91 points; p = 0.03). The blood loss was expressed in the difference in Hb concentration preoperatively and on the 3rd postoperative day, which was higher by 0.85 mg/dL in group A (group A: 4.4 mg/dl vs. group B: 3.55 mg/dL; p = 0.004). Also, the value of HCT on the 3rd postoperative day was significantly lower in group A (group A: 27% vs. group B: 29.5%; p = 0.02). Radiological measurements showed a statistically significant difference in the Brooker scale (p = 0.005). Thirteen patients from group A after THA expressed first-grade ossifications or higher, and two patients from group B had first- and second-grade ossifications. Furthermore, a notably larger distalization was observed after the PAO procedure compared to those who underwent the procedure without PAO previously (79 mm [IQR = 73–83 mm] vs. 74.5 mm [IQR = 69–77 mm]; p = 0.004). Conclusions: Patients reported lower mHHS results, a higher risk of heterotopic ossifications, prosthesis head distalization, and more significant blood loss during the perioperative period after THA in patients who underwent PAO compared to those without a previously performed osteotomy. Full article

Background: Long-duration aerobic exercise results in a similar, albeit transient rise and fall in oxidative stress and inflammation, making it a useful model to evaluate nutritional supplements targeting these physiological processes. Objective: To evaluate the impact of MSM supplementation on post-exercise immune response-related mRNA expression. Methods: In the present study, we enrolled healthy, experienced runners (five MSM and five placebo) who were supplemented with Methylsulfonylmethane (MSM; 1.0 g/d) or placebo for 30 days prior to a 21.1 km running event (120 to 150 min). Venous blood samples were collected prior to (PRE) the event, as well as 2 h and 4 h after the event to measure the expression of 700 mRNAs associated with generalized immune response. Results: This study is the first to demonstrate significant effects with lower MSM doses (0.5–1.0 g/d) compared to previous work using higher doses (3 g/d). We identified 29 mRNAs in four distinct immune response pathways (peripheral tissue inflammatory response, myeloid immune cell invasion, NK cell invasion/activity, and notch signaling) whose response was statistically changed with MSM at 2 h and/or 4 h. Conclusions: Based on the physiologic actions of the mRNA that changed, some logical potential health effects of MSM may be that it helps with the following: (1) supports muscle recovery by improving macrophage response to exercise, (2) speeds up recovery and restoration of damaged muscle tissue, (3) supports innate immune responsiveness to DAMP, and (4) reduces and/or improves resistance to oxidative stress after exercise. Future research should seek to validate how the changes observed with exercise may model to various chronic inflammatory states. Full article

Background/Objectives: Cluster headache (CH) is a debilitating primary headache disorder characterized by severe unilateral pain attacks. Chronic CH (CCH) poses significant treatment challenges, especially in refractory cases. Neuromodulation, including repetitive transcranial magnetic stimulation (rTMS), offers a potential alternative; however, evidence for its efficacy in CCH is lacking. Methods: A randomized, double-blind, placebo-controlled, crossover pilot study was conducted. Eligibility criteria included patients with refractory CCH (rCCH), who were then randomized to receive two treatment sequences: A, rTMS followed by sham stimulation, or B, sham followed by rTMS, separated by a one-month washout, with a follow-up period of 3 months. The primary endpoint was to analyze efficacy by assessing the change in the number of attacks per week (APW). Secondary endpoints included treatment tolerability and changes in intensity, duration, and use of rescue medication. The trial was registered with ClinicalTrials.gov (NCT06917144). Results: Eight patients were enrolled and randomized with a 50% probability of assignment to either treatment arm. Despite this, five patients were allocated to sequence A and three to sequence B. Three patients completed the entire study; five received treatment with rTMS and six with sham. The APW change during rTMS showed a change of (mean ± SD) +2.2 (10.8) attacks per week (p = 0.672). Two patients achieved complete remission during the rTMS phase, though symptoms returned by the washout period. In comparison with sham, the difference was also not statistically significant. No significant changes were observed in secondary endpoints. Side effects (two cases) were mild and transient. Conclusions: This pilot study suggests that rTMS may provide clinical benefits for rCCH in selected cases, though its effects seem transient. Adherence to treatment remains a critical challenge. Full article

Aerodynamic characteristics of a pitching NACA 0012 airfoil, including the load performance and flow field features, are studied using numerical simulations in this paper. Large Eddy Simulations (LESs) have been performed, and the chord-based Reynolds number is set to $6.6\times {10}^4$. Pitching frequency varies from 3 to 20 Hz, corresponding to a reduced frequency of 0.094–0.628 ($k=\pi f_{p}c/U_{\infty }$, where $f_p$ is the pitching frequency, c is the chord length, and $U_{\infty }$ refers to the incident flow speed). As the pitching frequency increases, the maximum lift coefficient achieved in one pitching cycle decreases, and the direction of the lift hysteresis loop changes as the pitching frequency exceeds a certain value, leading to a change in the lift of the sign at the zero-incidence moment, which is a result of the instantaneous flow patterns on the airfoil surface. As the pitching frequency increases, flow unsteadiness develops less in one pitching cycle, and the time duration in which the turbulence boundary layer can be detected in one pitching cycle shrinks. Additionally, for the pitching airfoil, combinations of the flow patterns on the upper and lower sides, such as laminar separation and the turbulent boundary layer, or laminar separation and the laminar separation bubble, were observed on the airfoil surface, and these were not detected on a static airfoil at the corresponding Reynolds number. This is considered an effect of the pitching motion that is in addition to the phase-lag effect. Full article

Background: Asthma and obesity commonly co-occur in children, with obesity contributing to asthma development through inflammatory and mechanical pathways. A Mediterranean diet may reduce inflammation and improve outcomes. However, research on the effects of nutritional interventions and dietary education in children with asthma and obesity within the Polish population remains limited. Methods: 142 participants were enrolled in the observational study and divided into three groups: children with asthma and overweight/obesity, children with overweight/obesity, and a control group. Anthropometric and clinical data, dietary habits, and lifestyle parameters (sleep duration, physical activity, screen time) were assessed at baseline and after one year of nutritional intervention. The Mediterranean diet was the main dietary model advocated throughout the intervention. Diet quality and adherence to the Mediterranean dietary pattern were evaluated using the KIDMED 2.0 index, reflecting the anti-inflammatory components of the intervention. Nutritional education was delivered every 6–8 weeks. One-way analysis of variance (ANOVA) was used, with significance set at p ≤ 0.05. Results: The nutritional intervention led to significant improvements in metabolic parameters, evidenced by reductions in total cholesterol, triglycerides, and fasting glucose levels. A decrease in C-reactive protein levels indicated reduced inflammation. The adherence index to the Mediterranean diet, measured by the KIDMED 2.0 scale, significantly increased in all groups, with the most favorable effects observed in the obese/overweight group with asthma. Positive behavioral changes were also noted, including increased physical activity, longer sleep duration, and reduced screen time. The intervention also contributed to a significant improvement in participants’ nutritional knowledge. Conclusions: Dietary education and an anti-inflammatory diet improved health in children with asthma and obesity. Early nutritional interventions helped reduce inflammation, improve metabolism, and shape behaviors. The findings stress the need to integrate diet education into therapeutic and preventive strategies for affected pediatric populations. Full article

Background: adenoviruses (AdVs) are DNA viruses that typically cause mild infections in immunocompetent children, and typically involve the respiratory and gastrointestinal tract. Adenoviral pharyngitis is a common paediatric illness, particularly in children under 4 years old. The aim of our 7-year retrospective study, conducted at a tertiary care paediatric emergency department (ED), was to describe the clinical and laboratory characteristics and management of patients with pharyngeal AdV infections. Specifically, we examined how the management of patients with adenoviral pharyngitis has evolved following the introduction of a rapid antigen nasopharyngeal swab test for AdVs, which has been performed directly in the ED since 2023. Methods: in this single-centre retrospective observational study, the demographic and clinical information for children discharged from the ED who had been diagnosed with a pharyngeal AdV infection between 1 January 2017 and 31 December 2023 were retrospectively reviewed. Moreover, we compared data before and after the introduction of rapid AdV antigenic swabs, which have been directly performed in the ED since the beginning of 2023. Statistical analysis was undertaken using the Student’s t-test and Pearson and Fisher’s exact test, as appropriate. Significance was set at p-value < 0.05. Results: during the study period, 172 children were diagnosed with adenoviral pharyngitis based on a positive swab. All patients were febrile, with a median duration of fever of 4 days. Blood tests were requested for 84.9% of patients at admission, resulting in a mean WBC count of 13,250/mmc and a mean CRP of 70.6 mg/L. The highest CRP median values were found on the third day of fever. Out of 383 swabs performed during 2017–2022, 13.6% were positive vs a 32% positive rate for the 372 swabs performed in 2023. The mean duration of observation in the ED before 2023 was 31.4 h vs. 10.4 h in 2023. Similarly, 9% of patients with adenoviral pharyngitis were admitted to a paediatric ward before 2023 and only 0.8% in 2023. Conclusions: the primary reason for ED admission in cases of adenoviral pharyngitis is fever lasting several days due to hyperinflammation. Differential diagnosis with bacterial infection is essential to limit the number of hospitalisations and inappropriate antibiotic therapy. The introduction of the rapid antigen nasopharyngeal swab has simplified the diagnosis of adenoviral pharyngitis, enabling timely and accurate differentiation from bacterial causes. Full article

Background and Objectives: Percutaneous cardiovascular interventions (PCIs) have become a cornerstone in the management of cardiovascular diseases. However, patients often experience significant anxiety and pain during these procedures, which can negatively impact their overall experience and clinical outcomes. Virtual reality (VR) is an emerging non-pharmacological intervention designed to alleviate procedural anxiety and pain through immersive distraction techniques. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) identified from PubMed, CENTRAL, Scopus, Google Scholar, and Web of Science up to November 2024. Primary outcomes were peri-procedural anxiety and pain; secondary outcomes included vital signs, procedure duration, and safety (e.g., delirium). Continuous data were pooled using a random-effect model and reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs) in Stata MP v.17. Certainty of evidence was assessed using the GRADE approach. Results: Ten RCTs involving 890 patients were included. VR distraction significantly reduced peri-procedural anxiety (SMD: –0.70; 95% CI: –1.15 to –0.26; p < 0.001). However, no significant differences were observed between groups for peri-procedural pain (SMD: –0.64; 95% CI: –1.45 to 0.16; p = 0.12), systolic blood pressure (SMD: –0.31; 95% CI: –1.23 to 0.61; p = 0.50), diastolic blood pressure (SMD: –0.25; 95% CI: –1.07 to 0.56; p = 0.54), heart rate (SMD: –0.44; 95% CI: –0.93 to 0.05; p = 0.08), respiratory rate (SMD: –0.93; 95% CI: –2.18 to 0.31; p = 0.14), or procedure duration (SMD: 0.07; 95% CI: –1.14 to 0.28; p = 0.49). Conclusions: VR significantly ameliorated peri-procedure anxiety in patients undergoing PCIs; however, it had no effect on peri-procedure pain or vital signs. This is based on uncertain evidence from heterogeneous studies, warranting further confirmation through large-scale RCTs. Full article

In the present study, groups of 10 adult males from wild-type strain Drosophila melanogaster Canton-S and corresponding mutant tab2^201Y were continuously observed using automatic digitization. Data based on instantaneous movement and cumulated movement positions were obtained for micro-areas providing space for resources (food and moisture) and for activity (edge area and intermediate area [between edge and center-diffusion areas]) within the observation arena for 24 h. The results confirmed the natural tendency of local aggregation among individuals within the observation arena (14 cm × 14 cm) at a relatively low density of ten individuals. For Canton-S, temporal cooccurring patterns among different parameters were observed as time progressed, with two primary patterns identified in the resource supply areas: single peak and double peaks. The single peak was observed with maximum speed and I-index, indicating minimum degree of isolated individuals from groups, during the transition from the photoperiod to the scotoperiod. The double peaks occurred before (mid-to-late photoperiod) and after (end of scotoperiod) the single peak, co-occurring temporally with a number of parameters including duration rates, stop number (total occurrence of pauses), stop time (total duration of pauses), mean crowding (MC), and social space index (SSI), indicating local aggregations for feeding in accordance with maximum durations in resource supply areas. Temporally cooccurring trends in parameters were also found with the stop number and SSI in micro-areas associated with activity, indicating that short pauses were needed to keep balance between attraction and repulsion between nearby individuals. Overall, the measured parameters varied depending on the micro-area, light phase, and strain. In particular, behavioral differences were observed for tab2^201Y, including an increase in speed, especially in the areas related to activity during the scotoperiod. Between strains, behavioral differences in the measured parameters were observed less for tab2^201Y than Canton-S. Full article