Search Results (26,182)

This study explores the association of vitamin D-binding protein (VDBP) gene polymorphisms, vitamin D levels, and the severity of COVID-19, including the need for intensive care unit (ICU) hospitalization. We analyzed a cohort of 56 consecutive age- and gender-matched adult COVID-19-positive patients and categorized them into three groups: outpatients with mild illness, inpatients with moderate disease, and ICU patients. We measured levels of free, total, and bioavailable 25-hydroxyvitamin D [25(OH)D], VDBP, and albumin. VDBP polymorphisms rs5488 and rs7041 were identified using real-time PCR. A significant proportion of ICU patients were vitamin D-deficient (56.25%) compared to outpatients (10%) and inpatients (5%) (p = 0.0003). ICU patients also had notably lower levels of VDBP (median: 222 mg/L) and total 25(OH)D (median: 18.8 ng/mL). Most patients carried heterozygous rs7041 (60.7%) and wild-type rs4588 (58.9%) genotypes. The distribution of rs7041 SNP varied significantly among groups (p = 0.0301), while rs4588 SNP distribution did not (p = 0.424). Heterozygous rs4588 patients had significantly lower VDBP levels (p = 0.029) and reduced bioavailable 25(OH)D compared to those with wild-type rs4588 (p = 0.020). Our findings indicate that VDBP gene polymorphisms, particularly rs7041 and rs4588, are associated with vitamin D status and the severity of COVID-19. The lower VDBP levels and bioavailable vitamin D in ICU patients suggest that these genetic variants may influence disease severity and hospitalization needs. These results highlight the potential role of VDBP polymorphisms in COVID-19 severity, suggesting that genetic screening could be valuable in assessing the risk of severe outcomes and guiding personalized treatment strategies. Full article

Background and Objectives: It has been seen that jaw opening is associated with neck extension and jaw closing is associated with neck flexion. This natural association between the jaw and neck can be used as a novel approach to treat chronic non-specific neck pain, although the effects of this concept have never been previously evaluated as a treatment strategy. This article intends to study the effects of integrating jaw opening and closing movements along with active neck exercises versus active neck exercises alone in the management of chronic non-specific neck pain. Materials and Methods: A total of 80 patients, aged 20 to 50, with chronic non-specific neck pain were included in a double-blind randomized controlled trial, conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan from 2018 to 2022. The patients were divided into two groups: Group A patients were assigned jaw movements with active neck exercises, while Group B patients were assigned only active neck exercises. Both groups were assigned isometric neck strengthening exercises as a home plan. The study used various outcome measures, including the numerical pain rating scale (NPRS), neck disability index (NDI), neck flexion endurance (NFE), neck extension endurance (NEE), the neck proprioception error (NPE), neck flexion proprioception error (NFPE), neck extension proprioception error (NEPE), neck right rotation proprioception error (NRRPE), and neck left rotation proprioception error (NLRPE), with measurements taken at week 1 and week 6, respectively; the mean differences between the groups were measured using a two-way repeated ANOVA. Results: The experimental group showed better improvements compared to the control group, NPRS (73%), NDI (57%), NFE (152%), NEE (83%), NFPE (58%), NEPE (65%), NRRPE (65%), and NLRPE (62%), with a significant difference (p < 0.05). Conclusions: Active neck extension and flexion movements combined with jaw opening and closing are more effective in reducing pain and disability in patients with chronic neck pain. Full article

This review focuses on the pivotal role of radiotracers in breast cancer imaging, emphasizing their importance in accurate detection, staging, and treatment monitoring. Radiotracers, labeled with radioactive isotopes, are integral to various nuclear imaging techniques, including positron emission tomography (PET) and positron emission mammography (PEM). The most widely used radiotracer in breast cancer imaging is ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), which highlights areas of increased glucose metabolism, a hallmark of many cancer cells. This allows for the identification of primary tumors and metastatic sites and the assessment of tumor response to therapy. In addition to ¹⁸F-FDG, this review will explore newer radiotracers targeting specific receptors, such as estrogen receptors or HER2, which offer more personalized imaging options. These tracers provide valuable insights into the molecular characteristics of tumors, aiding in tailored treatment strategies. By integrating radiotracers into breast cancer management, clinicians can enhance early disease detection, monitor therapeutic efficacy, and guide interventions, ultimately improving patient outcomes. Ongoing research aimed at developing more specific and sensitive tracers will also be highlighted, underscoring their potential to advance precision medicine in breast cancer care. Full article

Weeds compete for environmental resources, leading to reduced soybean yield. In this context, integrated weed management strategies related to cultural control with the use of cover crops are necessary. Our aim was to evaluate weed occurrence in soybean systems with different cover crops. Field studies were conducted at Júlio de Castilhos, Santa Maria, Capão do Leão, Barra do Ribeiro, and Santo Ângelo, Rio Grande do Sul, Brazil. A randomized complete block design with four replications was used. Treatments consisted of black oats (Avena strigosa Schreb.), white oats (Avena sativa L.), rye (Secale cereale L.), hairy vetch (Vicia sativa L.), forage turnip (Raphanus sativus L.), and white clover (Trifolium repens L.) in pure stands or in mixtures. The analyzed variables were relative frequency, density, abundance, and importance value index, similarity index of weeds, dry shoot mass of cover crop, and soybean yield. Cover crops containing white or black oats reduced the relative importance value index of weeds, such as Lollium multiforum, Conyza spp., and Bidens pilosa. Forage turnip, hairy vetch, and white clover showed distinct responses. Black oats and forage turnip did not differ from cover crop mixtures in terms of dry shoot mass and grain yield, being superior to fallow, white clover, and hairy vetch. Full article

Background: As primary care is an important infrastructure for the entire health system, the employment structure choices of family physicians—whether to work in a managed care organization or be self-employed, can impact all effectiveness parameters of healthcare: quality, access, health equity, patients’ experiences, and cost-effectiveness. The aim of this study is to assess the push and pull factors influencing family physicians’ employment choices. Methods: This study employed a qualitative approach to explore the experiences of family physicians (FPs) who choose to work a self-employment practice. We conducted semi-structured interviews with twenty-seven self-employed FPs in Israel, selected through purposive and snowball sampling. The interviews were conducted via Zoom, recorded, and transcribed verbatim. Data analysis followed thematic analysis framework. The analysis yielded 10 themes, which were organized into two categories: pull and push factors. Results: Pull factors, i.e., factors that attract family physicians to become self-employed, included professional self-fulfillment, higher income, professional and business autonomy, working with secretaries according to one’s personal choice, designing the space of the clinic, and flexibility in working hours. Push factors, i.e., factors that demotivated family physicians to work under managed care and pushed them to choose self-employment included low control over the work environment, workload, decreased professional and organizational autonomy, managerial pressures on quality measures, engagement in marketing activities, and tensions with non-medical staff in the Health Maintenance Organization. Conclusions: There are obvious implications of this work for Health Maintenance Organizations’ policy makers. Balancing managerial pressure and tensions between family physicians and non-medical administration and ensuring suitable working conditions increased physicians’ control over the work environment, and professional autonomy may decrease push factors and retain family physicians as Health Maintenance Organization-employed. Understanding pull factors may help to develop a strategy for maximizing cooperation with self-employed family physicians and reinforce physicians’ linkage to the healthcare system’s treatment objectives. Full article

Meropenem is a broad-spectrum antibiotic used for the treatment of multi-drug-resistant infections. Due to its pharmacokinetic profile, meropenem’s activity is optimized by maintaining a specific time the serum concentration remains above the minimum inhibitory concentration (MIC) via extended infusion (EI), continuous infusion, or intermittent infusion dosing strategies. The available literature varies regarding the superiority of these dosing strategies. This study’s primary objective was to determine the difference in time to clinical stabilization between intravenous push (IVP) and EI administration. We performed a retrospective pilot cohort study of 100 critically ill patients who received meropenem by IVP (n = 50) or EI (n = 50) during their intensive care unit (ICU) admission. There was no statistically significant difference in the overall achievement of clinical stabilization between IVP and EI (48% vs. 44%, p = 0.17). However, the median time to clinical stability was shorter for the EI group (20.4 vs. 66.2 h, p = 0.01). EI administration was associated with shorter hospital (13 vs. 17 days; p = 0.05) and ICU (6 vs. 9 days; p = 0.02) lengths of stay. Although we did not find a statistically significant difference in the overall time to clinical stabilization, the results of this pilot study suggest that EI administration may produce quicker clinical resolutions than IVP. Full article

This research proposes an efficient alternative for dehydrating cassava bagasse to address the inherent challenges in the handling, transportation, storage, and preservation of this agro–industrial residue generated in cassava starch production plants. This residue is characterized by high moisture retention, considerable volume, and hydrophilic nature, complicating conventional drying methods. This study evaluates the impact of emerging ultrasound (US) and pulsed electric field (PEF) technologies prior to convective drying to enhance the dehydration efficiency of cassava bagasse, aiming at its valorization and contributing to the sustainability of the cassava starch industry. The findings reveal that pretreatment with ultrasound (US) and pulsed electric fields (PEF) significantly reduces the drying time of cassava bagasse compared to convective drying alone. With probe ultrasound at 26 kHz for 30 min, the drying time is reduced by 72% (3.83 h vs. 14.0 h); with bath ultrasound at 37 kHz for 30 min, it is reduced by 56.0% (6.16 h vs. 14.0 h); and with PEF at 7.5 kV/cm for 30 min, it is reduced by 52.4% (6.66 h vs. 14.0 h). These emerging technologies increased the effective diffusivity and modified the molecular structure of the bagasse, thereby improving mass transfer and drying process efficiency. These results are particularly useful for developing more efficient and sustainable strategies for drying agricultural by-products, with direct implications for the post-industrial treatment of agro–industrial residues with high water content. Full article

The classification of missense variant pathogenicity continues to pose significant challenges in human genetics, necessitating precise predictions of functional impacts for effective disease diagnosis and personalized treatment strategies. Traditional methods, often compromised by suboptimal feature selection and limited generalizability, are outpaced by the enhanced classification model, MissenseNet (Missense Classification Network). This model, advancing beyond standard predictive features, incorporates structural insights from AlphaFold2 protein predictions, thus optimizing structural data utilization. MissenseNet, built on the ShuffleNet architecture, incorporates an encoder-decoder framework and a Squeeze-and-Excitation (SE) module designed to adaptively adjust channel weights and enhance feature fusion and interaction. The model’s efficacy in classifying pathogenicity has been validated through superior accuracy compared to conventional methods and by achieving the highest areas under the Receiver Operating Characteristic (ROC) and Precision-Recall (PR) curves (Area Under the Curve and Area Under the Precision-Recall Curve) in an independent test set, thus underscoring its superiority. Full article

Mitochondria, vital organelles that generate ATP, determine cell fate. Dysfunctional and damaged mitochondria are fragmented and removed through mitophagy, a mitochondrial quality control mechanism. The FDA-approved drug IMQ, a synthetic agonist of Toll-like receptor 7, exhibits antitumor activity against various skin malignancies. We previously reported that IMQ promptly reduced the level of the antiapoptotic Mcl-1 protein and that Mcl-1 overexpression attenuated IMQ-triggered apoptosis in skin cancer cells. Furthermore, IMQ profoundly disrupted mitochondrial function, promoted mitochondrial fragmentation, induced mitophagy, and caused cell death by generating high levels of ROS. However, whether Mcl-1 protects mitochondria from IMQ treatment is still unknown. In this study, we demonstrated that Mcl-1 overexpression induced resistance to IMQ-induced apoptosis and reduced both IMQ-induced ROS generation and oxidative stress in cancer cells. Mcl-1 overexpression maintained mitochondrial function and integrity and prevented mitophagy in IMQ-treated cancer cells. Furthermore, IL-6 protected against IMQ-induced apoptosis by increasing Mcl-1 expression and attenuating IMQ-induced mitochondrial fragmentation. Mcl-1 overexpression ameliorates IMQ-induced ROS generation and mitochondrial fragmentation, thereby increasing mitochondrial stability and ultimately attenuating IMQ-induced cell death. Investigating the roles of Mcl-1 in mitochondria is a potential strategy for cancer therapy development. Full article

Introduction: Colorectal cancer (CRC) is the third most common cancer globally and a leading cause of cancer-related deaths. While liver metastasis is common, brain metastasis (BM) is rare, occurring in 0.1% to 14% of cases. Risk factors for BM include lung metastasis at diagnosis, rectal cancer, and mutations in RAS and KRAS genes. Due to its rarity, guidelines for BM screening and treatment are limited. The aim of this study is to identify the clinical characteristics and predictors of BM at the time of the initial diagnosis of CRC. Methods: We evaluated patients ≥18 years old with metastatic colorectal cancer and brain metastases at diagnosis from the SEER database (2010–2021). A retrospective cohort study was conducted to analyze overall survival and predictive factors for brain metastasis, utilizing multivariate logistic regression, Kaplan–Meier survival analysis, and the Cox proportional hazards models, with p-values < 0.05 considered significant. Results: Out of 24,703 patients with metastatic colorectal cancer (mCRC), 228 (0.92%) had brain metastasis (BM) at diagnosis. BM was more prevalent in average-onset mCRC (≥50 years) compared to early-onset (<50 years) (1% vs. 0.55%, p = 0.004). Certain factors, such as older age and adenocarcinoma subtype, were associated with BM. Additionally, Asians/Pacific-Islanders (HR 1.83 CI: 1.01-3-33, p = 0.045) and American Indians/Alaska Natives (HR 4.79 CI 1.15–19.97, p = 0.032) had higher mortality rates, while surgical treatment and chemotherapy were linked to decreased mortality. Patients with BM had significantly worse overall survival (6 months vs. 21 months, p < 0.001). Conclusion: BM in mCRC is uncommon, but it is associated with significantly worse outcomes, including markedly reduced overall survival. Our study highlights several critical factors associated with the presence of BM, such as older age and specific racial/ethnic groups, which may inform risk stratification and early-detection strategies. Our findings emphasize the need for heightened awareness and screening for BM in high-risk mCRC patients, as well as the inclusion of these patients in clinical trials to explore tailored therapeutic approaches aimed at improving survival and quality of life. Full article

Wandering spleen (WS) is a rare condition often linked with torsion or infarction, but its association with Bochdalek hernia, acute appendicitis, and thrombocytopenia is exceptionally rare. We present a case of a nine-year-old girl who was admitted with acute abdominal pain, later diagnosed with WS, Bochdalek hernia, and acute appendicitis. A literature search was performed on PubMed and Google Scholar on 30 May 2024 with keywords including “Wandering spleen” and (“Bochdalek Hernia” OR “Sepsis” OR “Acute Appendicitis” OR “Thrombocytopenia”). The management was complicated by severe thrombocytopenia and post-operative sepsis, with Klebsiella pneumoniae as the causative agent. Imaging revealed an abnormally located spleen and significant splenic enlargement over time. The patient’s condition was managed non-operatively concerning the WS, avoiding splenectomy due to the risks of post-splenectomy sepsis. Instead, laparotomy was performed to address the appendicitis and diaphragmatic hernia. The patient experienced post-operative complications, including a seizure and persistent fever, which resolved with appropriate antibiotic therapy. This case underscores the complexity of managing WS with concurrent severe conditions, highlighting the importance of individualised treatment strategies. It also emphasises the need for further studies to explore optimal treatment modalities for such rare and complex presentations. This case serves as an educational example in clinical settings, demonstrating the challenges and considerations when treating multiple rare pathologies simultaneously. Full article

Liraglutide, a glucagon-like peptide-1 receptor agonist, is effective in the treatment of type 2 diabetes mellitus (T2DM) and obesity. Despite its benefits, including improved glycemic control and weight loss, the common metabolic changes induced by liraglutide and correlations between those in rodents and humans remain unknown. Here, we used advanced machine learning techniques to analyze the plasma metabolomic data in diet-induced obese (DIO) mice and patients with T2DM treated with liraglutide. Among the machine learning models, Support Vector Machine was the most suitable for DIO mice, and Gradient Boosting was the most suitable for patients with T2DM. Through the cross-evaluation of machine learning models, we found that liraglutide promotes metabolic shifts and interspecies correlations in these shifts between DIO mice and patients with T2DM. Our comparative analysis helped identify metabolic correlations influenced by liraglutide between humans and rodents and may guide future therapeutic strategies for T2DM and obesity. Full article

Strawberry cultivation requires strategies that maintain or improve its yield within a scheme in which reducing fertilizers and other chemical products can make its consumption safer and more environmentally friendly. This study aims to evaluate the effect of Bacillus subtilis and Rhizophagus intraradices on strawberry growth, yield, and fruit quality. B. subtilis and R. intraradices were inoculated and co-inoculated under three fertilization levels of 225-100-250, 112-50-125, and 0-0-0 kg∙ha⁻¹ of N, P₂O₅ and K₂O. Vegetative growth was evaluated in plant height (cm), leaf area (cm²), aerial fresh weight (g), aerial dry weight (g), and plant coverage (%) variables. Fruit quality parameters such as total acidity (g∙100 mL⁻¹), soluble solids (Brix°), and firmness (kg) were also determined, as well as the number of fruits per m² and yield (t∙ha⁻¹). The results showed that the pre-treatment of root immersion in a nutrient solution with B. subtilis and the fractionation of 6 L B. subtilis inoculation per plant at a concentration of 10⁷ CFU∙mL⁻¹, in combination with 225-100-250 kg∙ha⁻¹ of N, P₂O_5, and K₂O, achieved the highest accumulation of dry matter (12.9 ± 1.9 g∙plant⁻¹), the highest number of fruits (28.2 ± 4.5 fruits∙m⁻²), and the highest yield (7.2 ± 1.4 t∙ha⁻¹). In addition, this treatment increased the soluble sugar content by 34.78% and fruit firmness by 26.54% compared to the control without inoculation. This study highlights the synergistic effect of mineral nutrition and microbial inoculation with B. subtilis in increasing strawberry yield and fruit quality. Full article

This study was aimed at monitoring the occurrence and potential sources of emerging contaminants in water sources within the Modder River catchment. Selected water quality indicators were analysed by Hanna multi-parameter meters. Emerging contaminants such as acetaminophen, carbamazepine, ibuprofen, atrazine, simazine, metolachlor, terbuthylazine, 17-alpha-ethinyl-estradiol, estradiol, progesterone, and testosterone were analysed by high performance liquid chromatography mass spectrometry. The sources of emerging contaminants were determined by statistical methods such as Pearson correlation and hierarchical cluster analysis. Results showed that all the sampled water sources have some level of questionable drinking water quality and necessitate some amount of treatment to reduce the contamination before consumption, especially DO, EC, and pH. The 17-alpha-ethinyl-estradiol mean values in rivers (7.79 and 31.55 µg/L), dams (1.83 and 6.90 µg/L), and treated drinking water (0.2 and 0.73 µg/L) were the highest in summer and autumn seasons, respectively. Wastewater effluents, domestic sewage, urban surface runoff, agricultural runoff, and illegal dumping were identified as the possible sources of emerging contaminants pollution. Waste management education, proper application of herbicides, and advance wastewater treatment methods were some of the suggested mitigation strategies. The outcomes may be relevant for environmental protection and water sustainability in the catchment. Full article

Oropharyngeal squamous-cell carcinoma (OPSCC) poses significant challenges in diagnosis, treatment, and management and has important medico-legal and forensic implications. In particular, the management of OPSCC and its treatment-related complications can often be challenging. In cases with advanced OPSCC, a loco-regional extension of the tumor can contribute to the destruction of oral cavity tissues, while the radiotherapy treatment can induce profound changes in tissue morphology and structure. These changes, which resemble tumor neoplasms and endovascular effects, are related to a higher risk of fatal bleeding, as reported in the case study illustrated, in which a hemorrhage occurred from a lingual artery, originating from an ulcerative, necrotic, hemorrhagic lesion on the tongue. Bleeding complications in OPSCC and prolonged radiotherapy are associated with high mortality and require comprehensive management strategies to improve survival and quality of life. Autopsy investigations, contributing to the definition of post-mortem diagnosis, can provide valuable insights into the pathogenetic mechanisms underlying bleeding and guide therapeutic decisions and preventive measures. The integration of autopsy and histopathological investigation into clinical practice should be considered as a necessary support to optimize the management of complications in advanced OPSCC patients, emphasizing the importance of a patient-centered approach and continued research. Full article