Search Results (5,575)

Among the widespread trichothecene mycotoxins, T-2 toxin is considered the most toxic congener. In the present study, we utilized high-resolution magic-angle spinning nuclear magnetic resonance (HRMAS NMR), coupled to the zebrafish (Danio rerio) embryo model, as a toxicometabolomics approach to elucidate the cellular, molecular and biochemical pathways associated with T-2 toxicity. Aligned with previous studies in the zebrafish embryo model, exposure to T-2 toxin was lethal in the high parts-per-billion (ppb) range, with a median lethal concentration (LC₅₀) of 105 ppb. Exposure to the toxins was, furthermore, associated with system-specific alterations in the production of reactive oxygen species (ROS), including decreased ROS production in the liver and increased ROS in the brain region, in the exposed embryos. Moreover, metabolic profiling based on HRMAS NMR revealed the modulation of numerous, interrelated metabolites, specifically including those associated with (1) phase I and II detoxification, and antioxidant pathways; (2) disruption of the phosphocholine lipids of cell membranes; (3) mitochondrial energy metabolism, including apparent disruption of the tricarboxylic acid (TCA) cycle, and the electron transport chain of oxidative phosphorylation, as well as “upstream” effects on carbohydrate, i.e., glucose metabolism; and (4) several compensatory catabolic pathways. Taken together, these observations enabled development of an integrated, system-level model of T-2 toxicity in relation to human and animal health. Full article

Introduction: Obesity is a chronic, relapsing, and progressive disease. The issue of obesity affects 50 to 80% of patients who have been diagnosed with breast cancer. The aim of this study is to assess the scale of the problem of obesity among breast cancer survivors (BCS) older than 60 years, evaluate their physical fitness, and study the relationship between the occurrence of obesity and levels of fitness among breast cancer survivors. The relationship between fitness and sociodemographic factors has also been analyzed. Materials and Methods: This original epidemiological clinical study included a cohort of 88 female breast cancer survivors treated in 2022 in Holycross Cancer Center, Kielce, Poland. A questionnaire involving demographic information and medical data was utilized. The Senior Fitness Test (SFT) battery has been used to assess the physical fitness of the patients. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were also analyzed. Results: More than 70% of the studied breast cancer survivors were classified as overweight or obese, according to BMI and WC indices. Depending on the SFT trial, the regression coefficients indicated worse results in participants who were older, lived in urban areas, were professionally active, less educated, and had higher obesity indices. The analysis of the relationship between obesity indices and fitness components revealed that all obesity indices were significantly associated with lower body flexibility (BMI p = 0.0118, WC p = 0.0092, WHR p = 0.0364, WHtR p = 0.0095). Upper body flexibility was significantly correlated with BMI indices (p = 0.0091, p = 0.0193) and WHtR (p = 0.0095). Agility and balance were significantly associated with WC (p = 0.0193), WHR (p = 0.098), and WHtR (p = 0.0095). Lower body strength was significantly correlated with the WHR index (p = 0.0487). Significant differences were found in upper body strength depending on the WHtR category. Conclusions: In the studied group of breast cancer survivors, there is a high prevalence of overweight and obesity. With increasing obesity rates, older age, and lower education levels, physical activity measured by the SFT decreases. Living in urban areas and being professionally active also predispose to lower physical activity levels. As obesity indices increase, physical fitness decreases in trials assessing upper and lower body strength, upper and lower body flexibility, as well as agility and dynamic balance. Full article

This study examines heat exposure and its impact on the thermal comfort and health of spectators within a semi-outdoor American college football stadium in the southeastern United States. Over 50 sensors were deployed during the 2016 season from late August to late November to measure temperature and humidity across various stadium locations. Significant variations in temperature, heat index, and a modified version of the physiological equivalent temperature (mPET) were found within the stadium, with some areas exceeding National Weather Service heat alert thresholds during certain games. Moreover, mean temperatures in the stadium were higher than those measured at a nearby weather station, while the mean heat index was higher in the seating areas than in other stadium locations and at the nearby weather station. Reductions in modeled wind speed resulted in significant decreases in thermal comfort and greater physical stress among spectators, particularly when the wind was calm. Heat-related illness comprised up to two-thirds of all cases treated by first aid and emergency medical services during particularly hot games. Most of these occurred in the most thermally oppressive parts of the stadium. These results highlight the need for greater monitoring of heat exposure inside stadiums, earlier implementation of heat action plans to raise awareness and educate spectators on heat mitigation strategies, and incorporation of stadium design modifications that improve circulation, increase shade, and reduce crowding. Full article

This exploratory qualitative study involved semi-structured interviews with adults and caregivers of adults at high risk of severe COVID-19, addressing current COVID-19 avoidance and protective behaviors and how these behaviors impacted their lives. Results were interpreted in a separate think tank session. Insights were developed into a conceptual model of COVID-19 avoidance and protective behaviors and the associated impacts on health-related quality of life and overall functioning. Data were interpreted using a hybrid inductive and deductive thematic analysis. Twelve high-risk individuals and two caregivers were interviewed across four focus groups (April–July 2022). Major behavioral themes included physical distancing, physical and medical protection, quality of support services and networks, and information to make decisions. Major impacts included family, social, and emotional functioning; work and finances; and healthcare access. The final conceptual model comprised 13 behaviors to avoid COVID-19 categorized within four themes, and 13 impacts within five themes. Individuals at high risk of severe COVID-19 and their caregivers continue practicing COVID-19 avoidance behaviors post-lockdown and feel left behind by the general population. Our conceptual model may be used to inform health authorities and other governing bodies’ decisions in executing strategies aimed at improving these individuals’ lives. Full article

Background/Objectives: “Return-to-play” and “return-to-learn” after a concussion are familiar concepts due to guidelines proposed by the Concussion in Sport Group and Heads-Up Initiative. The purpose of this commentary is to expand upon the current consensus guidelines for treatment of concussed children and adolescents, as well as provide guidelines for returning to physical education (RT-PE) classes. Proposal: The authors propose one general and four subtype-specific guidelines post-concussion injury. This framework highlights the role of physical therapists in the management of children with prolonged recovery. The final RT-PE determination should occur with documented medical clearance from a licensed healthcare provider trained in the evaluation and management of a concussion. Conclusions: Despite significant gains regarding the management of concussed children and adolescents, confusion remains regarding RT-PE post-concussion. To eliminate ambiguity and promote adherence to a gradual return to activity protocols, the authors developed guidelines based on current evidence and recommendations. Full article

Research on different types of ionizing radiation’s effects has been ongoing for years, revealing its efficacy in damaging cancer cells. Solid tumors comprise diverse cell types, each being able to respond differently to radiation. This study evaluated the radiobiological response of established (MDA-MB-231 (Triple negative breast cancer, TNBC), MCF-7 (Luminal A)) and patient-derived malignant cell lines, cancer-associated fibroblasts, and skin fibroblasts following proton IRR. All cell line types were irradiated with the proton dose of 2, 4, and 6 Gy. The radiobiological response was assessed using clonogenic assay, γH2AX, and p53 staining. It was noticeable that breast cancer lines of different molecular subtypes displayed no significant variations in their response to proton IRR. In terms of cancer-associated fibroblasts extracted from the tumor tissue, the line derived from a TNBC subtype tumor demonstrated higher resistance to ionizing radiation compared to lines isolated from luminal A tumors. Fibroblasts extracted from patients’ skin responded identically to all doses of proton radiation. This study emphasizes that tumor response is not exclusively determined by the elimination of breast cancer cells, but also takes into account tumor microenvironmental variables and skin reactions. Full article

Lung and colon cancer (LCC) is a dominant life-threatening disease that needs timely attention and precise diagnosis for efficient treatment. The conventional diagnostic techniques for LCC regularly encounter constraints in terms of efficiency and accuracy, thus causing challenges in primary recognition and treatment. Early diagnosis of the disease can immensely reduce the probability of death. In medical practice, the histopathological study of the tissue samples generally uses a classical model. Still, the automated devices that exploit artificial intelligence (AI) techniques produce efficient results in disease diagnosis. In histopathology, both machine learning (ML) and deep learning (DL) approaches can be deployed owing to their latent ability in analyzing and predicting physically accurate molecular phenotypes and microsatellite uncertainty. In this background, this study presents a novel technique called Lung and Colon Cancer using a Swin Transformer with an Ensemble Model on the Histopathological Images (LCCST-EMHI). The proposed LCCST-EMHI method focuses on designing a DL model for the diagnosis and classification of the LCC using histopathological images (HI). In order to achieve this, the LCCST-EMHI model utilizes the bilateral filtering (BF) technique to get rid of the noise. Further, the Swin Transformer (ST) model is also employed for the purpose of feature extraction. For the LCC detection and classification process, an ensemble deep learning classifier is used with three techniques: bidirectional long short-term memory with multi-head attention (BiLSTM-MHA), Double Deep Q-Network (DDQN), and sparse stacked autoencoder (SSAE). Eventually, the hyperparameter selection of the three DL models can be implemented utilizing the walrus optimization algorithm (WaOA) method. In order to illustrate the promising performance of the LCCST-EMHI approach, an extensive range of simulation analyses was conducted on a benchmark dataset. The experimentation results demonstrated the promising performance of the LCCST-EMHI approach over other recent methods. Full article

Purpose: To evaluate and compare the deliverability of ‘sawtooth’ proton arc therapy (PAT) plans relative to static intensity modulated proton therapy (IMPT) at a cyclotron-based clinical facility. Methods: The delivery of single and dual arc Sawtooth PAT plans for an abdominal CT phantom and multiple clinical cases of brain, head and neck (H&N) and base of skull (BoS) targets was emulated under the step-and-shoot and continuous PAT delivery regimes and compared to that of a corresponding static IMPT plan. Results: Continuous PAT delivery increased the time associated with beam delivery and gantry movement in single/dual PAT plans by 4.86/7.34 min (brain), 7.51/12.40 min (BoS) and 6.59/10.57 min (H&N) on average relative to static IMPT. Step-and-shoot PAT increased this delivery time further by 4.79 min on average as the delivery was limited by gantry motion. Conclusions: The emulator can approximately model clinical sawtooth PAT delivery but requires experimental validation. No clear benefit was observed regarding beam-on time for sawtooth PAT relative to static IMPT. Full article

Background: Lipedema is a frequently misdiagnosed condition in women, often mistaken for obesity, which significantly deteriorates both quality of life and physical health. Recognizing the necessity for holistic treatment strategies, research has increasingly supported the integration of specific dietary approaches, particularly ketogenic diets focusing on low-carbohydrate and high-fat intake. Objectives: to evaluate the impact of ketogenic diets on women with lipedema through a systematic review and meta-analysis. Methods: A systematic review and meta-analysis were conducted by reviewing published, peer-reviewed studies addressing the implications of a low-carbohydrate, high-fat (LCHF) ketogenic diet in managing lipedema following comprehensive scrutiny of digital medical databases, such as PubMed, PubMed Central, Science Direct, and the Web of Science. This research was governed by specified parameters, including an established search string composed of search terms and an eligibility criterion (PICO) as denoted by the principal authors. Statistical analysis was carried out using RevMan 5.4.1 software with the Newcastle–Ottawa Scale utilized for quality appraisal of the included studies. Results: Seven studies reporting statistical outcomes were included in the systematic review and meta-analysis following a rigorous quality appraisal and data identification process. Three hundred and twenty-nine female participants were diagnosed with lipedema and treated using a low-carbohydrate, high-fat diet. Data analysis identified the high-fat diet with a mean study duration of 15.85 weeks. Mean Differences (MDs) on changes pre- and post-intervention showed significant reductions in BMI and total body weight [4.23 (95% CI 2.49, 5.97) p < 0.00001 and 7.94 (95% CI 5.45, 10.43) p < 0.00001 for BMI and body weight, respectively]. Other anthropometric measurements, such as changes in waist/hip circumferences and waist/hip ratios, showed a significant reduction in these parameters, with an MD of 8.05 (95% CI 4.66, 11.44) p < 0.00001 and an MD of 6.67 (95% CI 3.35, 9.99) p < 0.0001 for changes in waist and hip circumferences from baseline, respectively. Lastly, changes in pain sensitivity were statistically significant post-intervention [MD 1.12 (95% CI, 0.44, 1.79) p = 0.001]. All studies scored fair on the Newcastle–Ottawa Scale. Conclusions: despite the limited studies and low number of study participants, the review observed a significant reduction in anthropometric and body composition metrics, indicating a potentially beneficial association between LCHF ketogenic diets and lipedema management. Full article

Nanofibers, with their high surface area-to-volume ratio and unique physical properties, hold significant promise for a wide range of applications, including medical devices, filtration systems, packaging, electronics, and advanced textiles. However, their development and commercialization are hindered by several key challenges and hazards. The main issues are production cost and yield, high voltage, clogging, and toxic materials driven by complex production techniques, which limit their adoption. Additionally, there are environmental and health concerns associated with nanofiber production and disposal, necessitating the development of safer and more sustainable processes and materials. Addressing these challenges requires continued innovation in materials science and industrial practices, as well as a concerted effort to balance production, material, and surrounding condition parameters. This study emphasizes the challenges and hazards associated with nanofiber materials and their production techniques, including electrospinning, centrifugal spinning, solution blow spinning, electro-blown spinning, wet spinning, and melt spinning. It also emphasizes biopolymers and recycling as sustainable and eco-friendly practices to avoid harming the environment and human beings. Full article

Background: Lower urinary tract (LUT) symptoms are reported in more than 80% of patients with multiple sclerosis (MS), most commonly an overactive bladder (OAB). The relationship between brain white matter (WM) changes in MS and OAB symptoms is poorly understood. Objectives: We aim to evaluate (i) microstructural WM differences across MS patients (pwMS) with OAB symptoms, patients without LUT symptoms, and healthy subjects using diffusion tensor imaging (DTI), and (ii) associations between clinical OAB symptom scores and DTI indices. Methods: Twenty-nine female pwMS [mean age (SD) 43.3 years (9.4)], including seventeen with OAB [mean age (SD) 46.1 years (8.6)] and nine without LUT symptoms [mean age (SD) 37.5 years (8.9)], and fourteen healthy controls (HCs) [mean age (SD) 48.5 years (20)] were scanned in a 3T MRI with a DTI protocol. Additionally, clinical scans were performed for WM lesion segmentation. Group differences in fractional anisotropy (FA) were evaluated using tract-based spatial statistics. The Urinary Symptom Profile questionnaire assessed OAB severity. Results: A statistically significant reduction in FA (p = 0.004) was identified in microstructural WM in pwMS, compared with HCs. An inverse correlation was found between FA in frontal and parietal WM lobes and OAB scores (p = 0.021) in pwMS. Areas of lower FA, although this did not reach statistical significance, were found in both frontal lobes and the rest of the non-dominant hemisphere in pwMS with OAB compared with pwMS without LUT symptoms (p = 0.072). Conclusions: This study identified that lesions affecting different WM tracts in MS can result in OAB symptoms and demonstrated the role of the WM in the neural control of LUT functions. By using DTI, the association between OAB symptom severity and WM changes were identified, adding knowledge to the current LUT working model. As MS is predominantly a WM disease, these findings suggest that regional WM involvement, including of the anterior corona radiata, anterior thalamic radiation, superior longitudinal fasciculus, and superior frontal-occipital fasciculus and a non-dominant prevalence in WM, can result in OAB symptoms. OAB symptoms in MS correlate with anisotropy changes in different white matter tracts as demonstrated by DTI. Structural impairment in WM tracts plays an important role in LUT symptoms in MS. Full article

This paper presents the efficacy of a contrast agent based on H₂N-Fe₃O₄ nanoparticles for the detection of prostate cancer in an animal model using a preclinical 9.4 T MRI system. The relaxivities r₁ and r₂ of the nanoparticles were 6.31 mM⁻¹s⁻¹ and 8.33 mM⁻¹s⁻¹, respectively. Nanoparticles injected in a concentration of 2 mg Fe/mL decreased the tumor-relative T₁ relaxation across all animals from 100 to 76 ± 26, 85 ± 27, 89 ± 20, and 97 ± 16 12 min 1 h, 2 h, and 24 h post injection, respectively. The corresponding T₁ decrease in muscle tissues was 90 ± 20, 94 ± 23, 99 ± 12, and 99 ± 14. The relative T₂ changes in the tumor were 82 ± 17, 89 ± 19, 97 ± 14, and 99 ± 8 12 min, 1 h, 2 h, and 24 h post injection, respectively, while, for muscle tissues, these values were 95 ± 11, 95 ± 8, 97 ± 6, and 95 ± 10 at the corresponding time points. The differences in the relative T₁ and T₂ were only significant 12 min after injection (p < 0.05), although a decrease was visible at each time point, but it was statistically insignificant (p > 0.05). The results showed the potential application of H₂N-Fe₃O₄ nanoparticles as contrast agents for enhanced prostate cancer MRI. Full article

This review summarizes studies dedicated to the assessment of microvascular function based on microcirculatory oscillations monitored by the Flow-Mediated Skin Fluorescence (FMSF) technique. Two approaches are presented. The first approach uses oscillatory parameters measured under normoxic conditions, expressed as flowmotion (FM), vasomotion (VM), and the normoxia oscillatory index (NOI). These parameters have been used for the identification of impaired microcirculatory oscillations associated with intense physical exercise, post-COVID syndrome, psychological stress, and erectile dysfunction. The second approach involves characterization of the microcirculatory response to hypoxia based on the measurement of hypoxia sensitivity (HS). The HS parameter is used to characterize microvascular complications in diabetes, such as diabetic kidney disease and diabetic foot ulcers. Based on research conducted by the authors of this review, the FMSF parameter ranges characterizing microvascular function are presented. The diagnostic approach to assessing microvascular function based on flowmotion monitored by the FMSF technique has a wide range of applications and the potential to be integrated into widespread medical practice. Full article

The information contained in this article is suitable for clinicians practicing in the United States desiring a general overview of the assessment and management of spinal cord injury (SCI), focusing on initial care, assessment, acute management, complications, prognostication, and future research directions. SCI presents significant challenges, affecting patients physically, emotionally, and financially, with variable recovery outcomes ranging from full functionality to lifelong dependence on caregivers. Initial care aims to minimize secondary injury through thorough neurological evaluations and imaging studies to assess the severity of the injury. Acute management prioritizes stabilizing respiratory and cardiovascular functions and maintaining proper spinal cord perfusion. Patients with unstable or progressive neurological decline benefit from timely surgical intervention to optimize neurological recovery. Subacute management focuses on addressing common complications affecting the respiratory, gastrointestinal, and genitourinary systems, emphasizing a holistic, multidisciplinary approach. Prognostication is currently based on neurological assessments and imaging findings, but emerging biomarkers offer the potential to refine outcome predictions further. Additionally, novel therapeutic interventions, such as hypothermia therapy and neuroprotective medications are being explored to mitigate secondary damage and enhance recovery. This paper serves as a high-yield refresher for clinicians for the assessment and management of acute spinal cord injury during index admission. Full article

Radiotherapy (RT)-induced lymphopenia may hinder the anti-tumor immune response. Preoperative RT or chemo-RT (CRT) for locally advanced rectal cancer is a standard therapeutic approach, while immunotherapy has been approved for mismatch repair-deficient rectal tumors. We retrospectively analyzed 98 rectal adenocarcinoma patients undergoing neoadjuvant CRT with VMAT (groups A, B, C) or IMRT (group D) techniques, with four different RT schemes: group A (n = 24): 25 Gy/5 Gy/fraction plus a 0.2 Gy/fraction rectal tumor boost; group B (n = 22): 34 Gy/3.4 Gy/fraction, with a 1-week treatment break after the first five RT fractions; group C (n = 20): 46 Gy/2 Gy/fraction plus a 0.2 Gy/fraction rectal tumor boost; group D (n = 32): 45 Gy/1.8 Gy/fraction followed by 5.4 Gy/1.8 Gy/fraction to the rectal tumor. We examined the effect of the time-corrected normalized total dose (NTD-T) to the BM on lymphopenia. Groups A and B (hypofractionated RT) had significantly higher lymphocyte counts (LCs) after RT than groups C and D (p < 0.03). An inverse association between the LCs after RT and NTD-T was demonstrated (p = 0.01). An NTD-T threshold of 30 Gy delivered to 30% of the BM volume emerged as a potential constraint for RT planning, which could be successfully integrated in the RT plan. Hypofractionated and accelerated RT schemes, and BM-sparing techniques may reduce lymphocytic damage and prove critical for immuno-RT clinical trials. Full article