Search Results (7,919)

Background/Objectives: This study aimed to assess the incidence of diabetic retinopathy (DR) in patients with type 2 diabetes (T2DM) treated in primary-care settings in Catalonia, Spain, and identify key risk factors associated with DR development. Methods: A retrospective cohort study was conducted using the SIDIAP (System for Research and Development in Primary Care) database. Patients aged 30–90 with T2DM who underwent retinal screening between 2010 and 2015 were included. Multivariable Cox regression analysis was used to assess the impact of clinical variables, including HbA1c levels, diabetes duration, and comorbidities, on DR incidence. Results: This study included 146,506 patients, with a mean follow-up time of 6.96 years. During this period, 4.7% of the patients developed DR, resulting in an incidence rate of 6.99 per 1000 person-years. Higher HbA1c levels were strongly associated with an increased DR risk, with patients with HbA1c > 10% having more than four times the risk compared to those with HbA1c levels < 7% (hazard ratio: 4.23; 95% CI: 3.90–4.58). Other significant risk factors for DR included greater diabetes duration, male sex, ex-smoker status, macrovascular disease, and chronic kidney disease. In contrast, obesity appeared to be a protective factor against DR, with an HR of 0.93 (95% CI: 0.89–0.98). Conclusions: In our real-world setting, the incidence rate of DR was 6.99 per 1000 person-years. Poor glycemic control, especially HbA1c < 10%, and prolonged diabetes duration were key risk factors. Effective management of these factors is crucial in preventing DR progression. Regular retinal screenings in primary care play a vital role in early detection and reducing the DR burden for T2DM patients. Full article

Background: Urinary incontinence (UI) is a prevalent health concern among women globally. However, its prevalence, associated risk factors, and impact on quality of life among Saudi women remain underexplored. Objective: This study aimed to assess the prevalence of UI, identify its risk factors, and understand its impact on the quality of life among Saudi women. Methods: In this cross-sectional study, we surveyed Saudi women aged between 18 and 50 years. Participants were recruited from shopping malls to reflect a diverse demographic. The questionnaire included detailed questions about the participants’ experiences with urinary incontinence, their lifestyle and health-related risk factors, and the impact of the condition on various aspects of their daily lives. Results: The study found a 32.4% prevalence of urinary incontinence (UI) among 516 women. Risk factors included age, marital status, BMI, childbirth, and vaginal surgery. UI prevalence increased with age and was more common in married women, women who had children, and those with vaginal surgery history. However, only 29.3% sought medical advice, and 55.2% reported no improvement after consultation. Urinary incontinence impacted respondents’ lives in several ways with 38.9% reporting limitations in social activities, approximately 50% experiencing some degree of impact on household tasks, and about 19.4% facing significant or extreme impact on job or daily activities. Conclusions: UI has a substantial prevalence among Saudi women and significantly affects their quality of life. The study underscores the need for increased awareness, routine screening, and timely medical consultation for the effective management of UI. Full article

Background/Objectives: To describe social and psychological needs, such as poverty, early trauma, or adverse childhood events, of caregivers with a child newly diagnosed with cerebral palsy (CP) or receiving a designation of high-risk for cerebral palsy (HRCP). Methods: Caregiver self-report questionnaires screening for unmet social needs, adverse childhood experiences (ACEs), depression symptoms, and trauma were collected from 97 caregivers of children with CP/HRCP seen in a high-risk infant follow-up clinic (adjusted age range 1–24 months). We compared their responses to those of 97 caregivers of age-matched controls seen in the same clinic with similar risk factors over the equivalent time period. Results: Income insecurity and positive screening rate for depressive and trauma symptoms were high for both groups (CP/HRCP, matched control group); no differences were found between CP/HRCP and control groups. Rates of food and housing insecurity and caregiver ACEs were not different between groups. All families received referrals to appropriate community support at the visit. Conclusions: Caregivers of children with CP/HRCP in high-risk infant follow-up clinics may face difficult conversations and decision-making in the context of high psychological and social adversity. Comprehensive support should be considered as early as possible. Full article

Considerable studies have demonstrated that osteoarthritis (OA) is a risk factor for dementia. The precise mechanisms underlying the association between OA and increased risk for cognitive dysfunction, however, remain unclear. This study aimed at exploring the associations between pro-inflammatory cytokines/chemokines, biomarkers of Alzheimer’s disease (AD), pain intensity, and cognitive decline in knee joint OA patients. A total of 50 patients (26 in OA group and 24 in non-OA control group) were enrolled in this prospective, observational study. The visual analogue scale (VAS) score for pain intensity and Cognitive Abilities Screening Instrument (CASI) score for cognitive functions were examined in both groups. The plasma and cerebrospinal fluid (CSF) levels of pro-inflammatory molecules (IL-1β, IL-6, TNF-α, fractalkine, BDNF, MCP-1, and TGF-β), as well as biomarkers of AD (Aβ₄₀, Aβ₄₂, total-tau, and phospho-tau), were measured by multiplex immunoassay. Correlations among plasma or CSF biomarkers and questionnaire scores were assessed using Pearson’s correlation coefficient and simple linear regressions. There were more patients in the OA group whose CASI cutoff percentiles were <P5 or at P5 than in the control group. VAS pain scores were negatively correlated with cognitive domains, including total score, short term memory, attention, mental manipulation, abstract thinking, and judgment, of the CASI score. VAS scores were positively correlated with fractalkine, Aβ₄₀, and Aβ₄₂ in CSF of OA patients. The CSF levels of Aβ₄₀ and Aβ₄₂ in OA patients were negatively correlated with attention and abstract scores in CASI. The findings of this study suggest that knee OA is associated with poor cognitive performance, and this association is particularly pronounced in OA patients with chronic pain. Higher levels of brain AD biomarkers, such as Aβ₄₀ and Aβ₄₂, may partially mediate this relationship. Full article

Objectives: Titanium miniplates and screws are commonly used in the surgical management of dentofacial deformities. Despite the opinion of the biocompatibility of these bone fixations, some patients experience symptoms of chronic inflammation around titanium implants even many years after their application. The aim of this study was to examine the levels of cytokines, chemokines, and growth factors released from the maxilla and mandible periosteum surrounding titanium fixations 11 months after the implantation procedure. Methods: From the study group (n = 20) consisting of patients with maxillofacial defects who underwent bimaxillary osteotomy, fragments of the periosteum of the maxilla and mandible adjacent to the titanium miniplates and screws were taken during routine bone fixation removal procedures. From the control group subjects (n = 20), fragments of healthy maxillary and mandibular periosteum were taken prior to surgical treatment of dentofacial deformities. The examination of cytokines, chemokines, and growth factors levels released from the periosteum of jaws was performed using the Bio-Plex Pro Human Cytokine Screening Panel (48-Plex). Results: The study group was characterized by a significant increase in the concentration of most of the tested-for proinflammatory cytokines/chemokines/growth factors compared to the control group, with greater amounts of inflammatory factors released from the periosteum covering the titanium implants in the mandible than from the periosteal cells surrounding the titanium implants in the maxilla. Conclusions: Prolonged exposure to titanium miniplates and screws leads to a disturbance of immune homeostasis in the periosteal cells of the maxilla and mandible. The data obtained indicate the need to remove fixations after the bone fragments have healed. Full article

Recent research has used virtual environments (VEs), as presented via virtual reality (VR) headsets, to study human behavior in hypothetical fire scenarios. One goal of using VEs in fire scenarios is to elicit patterns of behavior which more closely align to how individuals would react to real fire emergency situations. The present study investigated whether elicited behaviors and perceived risk varied during fire scenarios presented as VEs via two viewing conditions. These included a VR condition, where the VE was rendered as 360-degree videos presented in a VR headset, and a screen condition, where VEs were rendered as fixed-view videos via a computer monitor screen. We predicted that the selection of actions during the scenario would vary between conditions, that participants would rate fires as more dangerous if they developed more quickly and when smoke was rendered as thicker, and that participants would report greater levels of immersion in the VR condition. A total of 159 participants completed a decision-making task where they viewed videos of an incipient fire in a residential building and judged what action to take. Initial action responses to the fire scenarios varied between both viewing and smoke conditions, with those assigned to the thicker smoke and screen conditions being more likely to take protective action. Risk ratings also varied by smoke condition, with evidence of higher perceived risk for thicker smoke. Several factors of self-reported immersion (namely ‘interest’, ‘emotional attachment’, ‘focus of attention’, and ‘flow’) were associated with risk ratings, with perceived presence associated with initial actions. The present study provides evidence that enhancing immersion and perceived risk in a VE contributes to a different pattern of behaviors during simulated fire decision-making tasks. While our investigation only addressed the ideas of presence in an environment, future research should investigate the relative contribution of interactivity and consequences within the environment to further identify how behaviors during simulated fire scenarios are affected by each of these factors. Full article

Brassinazole-resistant (BZR) transcription factors are important transcription factors in Brassinosteroid (BR)-responsive gene expression. However, limited knowledge exists regarding the BZR genes in wheat and a limited number of BZR family genes have been previously reported in wheat. In this study, the synteny analyses of the TaBZR genes suggested that gene duplication events have played an essential role in the TaBZR family during evolution. The results of RT-qPCR and transcriptome data analyses exhibited remarkable expression patterns in the BZR genes in different tissues and under different treatments. The yeast two-hybrid (Y2H) screen result showed that the TaBZR2.1 protein interacts with Argonaute 4 (AGO4). Taken together, our results not only provide us a basis for understanding the molecular characteristics and expression patterns of the TaBZR family genes but also offered the functional characterization of TaBZR2.1 in wheat. Full article

Background: Ketamine HCl, an FDA-approved therapeutic, is administered through various routes, including intranasal delivery. Administering an adequate therapeutic dose of intranasal ketamine HCl is challenging due to the limited volume that can be delivered intranasally given the current commercially available concentrations. Objectives: This study investigates solubilizing strategies to enhance the aqueous solubility of ketamine HCl for intranasal administration. Methods: We assessed the solubility profile of ketamine HCl by evaluating factors such as pH, co-solvents, and surfactants. Additionally, we developed and validated a UV-Vis spectroscopy method for ketamine HCl analysis. Results: Our solubility screening in various organic co-solvents revealed the following order of effectiveness in enhancing solubility: methanol > water > propylene glycol > ethanol > dimethyl sulfoxide (DMSO) > N-methyl-2-pyrrolidone (NMP). Despite methanol’s superior solubility, its potential toxicity, coupled with the relatively lower effectiveness of other solvents compared to water, suggests that a co-solvency approach is not advantageous for ketamine HCl. We found that ketamine HCl solubility increased with medium acidity, with pH 3.5 being the optimal for further formulation studies. The impact of pharmaceutical surfactants on ketamine HCl solubility at an acidic pH was also evaluated. Surfactants tested included SDS, PEG 400, PVP, Tween 20, poloxamer 188, and lecithin. Notably, PEG 400 and PVP reduced solubility due to a salting-out effect, whereas Tween 80, lecithin, and poloxamer 188 slightly improved solubility through micelle formation. Among the surfactants tested, 1% SDS emerged as the most effective in enhancing ketamine HCl solubility. Conclusions: These outcomes highlight the potential of these solubilization strategies to address the solubility limitations of ketamine HCl, enabling the preparation of highly concentrated ketamine HCl formulations for intranasal delivery. Full article

Mesenchymal stem/stromal cells (MSCs) are becoming increasingly important for biomedical applications, such as cell therapy, disease modeling, and drug screening. At the same time, long-term cultivation, which is necessary to prepare a sufficient amount of cellular material for therapeutic and research purposes, is accompanied by the development of replicative senescence. Partial reprogramming emerged as a novel method that shows promising results in the rejuvenation of cells in vitro and in vivo; however, it has not yet been applied for human MSCs that have undergone replicative senescence in culture. In the present study, we subjected senescent human endometrial MSCs to partial reprogramming using Sendai virus vectors containing genes encoding Yamanaka transcription factors Oct4, Sox2, Klf4, and c-Myc. Characterization of the MSCs 5 days after transduction showed the loss of key markers of senescence: the youthful morphology was restored, the expression of senescent-associated β-galactosidase and the number of double-strand DNA breaks decreased, proliferation was activated, and the DNA damage response was enhanced. Further, using an in vitro wound-healing assay, we demonstrated that conditioned medium from partially reprogrammed MSCs showed higher therapeutic activity than that from senescent cells. However, a biosafety test revealed the presence of viral components in conditioned medium, which caused the agglutination of erythrocytes. Collectively, our data suggest that partial reprogramming is a potentially effective strategy for the rejuvenation of cultured MSCs in late passages but requires the use of virus-free protocols, such as chemical reprogramming. Full article

Background: Diabetic retinopathy (DR) is one of the leading causes of blindness among diabetic patients, particularly in areas with an increase in diabetes epidemics, such as Saudi Arabia. Notwithstanding the significant public health implications, data on the prevalence and risk factors of DR in Saudi Arabia are few and scattered, limited to certain geographic areas. Our study objective is to conduct a systematic review of the literature and a meta-analysis of the prevalence and predictors for DR in Saudi Arabia, within both type 1 and type 2 diabetes. Methods: A systematic review and meta-analysis were constructed according to PRISMA guidelines. We searched PubMed, Embase, Web of Science, and Google Scholar electronic databases for studies published from 2000–2023. Any study related to the prevalence of diabetic retinopathy in T1DM or T2DM among adult patients aged ≥18 years that was conducted in Saudi Arabia was included. Pooling prevalence estimates were calculated using a random-effects model, and heterogeneity across the studies was tested by the I² statistic and Cochran’s Q test. Results: A total of 11 studies published between 2006 and 2019 met the inclusion criteria, with sample sizes ranging from 99 to over 50,000 participants. The overall pooled prevalence of DR was estimated to be 31% (95% CI: 24–39%), with substantial heterogeneity observed across studies (I² = 99%). Prevalence estimates ranged from 16.7% to 69.8% and were influenced by variables such as study design, duration of diabetes, and glycemic control. Among individuals with type 2 diabetes, the pooled prevalence was 24% (95% CI: 20–28%). Poor glycemic control and longer diabetes duration were consistently identified as significant predictors of DR, while other factors, such as obesity and hypertension, were also associated with an increased risk of DR. Conclusions: The high prevalence of DR in Saudi Arabia highlights the critical need for focused public health initiatives, especially among those with type 2 diabetes. To minimize the effects of DR, early intervention, routine DR screening programs, and optimal diabetes control are essential. The increasing prevalence of DR in Saudi Arabia requires careful consideration of healthcare policy and resource allocation, which is made possible by our results. Full article

Since the 1950s, the screening of the body volatilome has proven to be a powerful tool for preventing diseases from spreading. Following the COVID-19 crisis, several studies began investigating the connection between viruses and the body volatilome, gradually identifying potential biomarkers, which varied depending on the study. To try to elucidate potential sources of inconsistency in biomarker findings, we decided to set up a study taking into consideration the factors often overlooked in previous studies. The VOCs constituting the body volatilomes of 40 COVID-19 patients and 13 healthy subjects were sampled by using PowerSorb^® as the sorbent phase. Thermodesorption, followed by comprehensive two-dimensional gas chromatography combined with time-of-flight mass spectrometry (TD-GC×GC/TOF MS), was utilized for the analysis. A non-targeted biomarker research methodology compared Covid(+) and Covid(−) chromatograms, assessing statistical significance and peak area changes. Out of the 25 compounds highlighted, 13 associated with cosmetic products were excluded, and 8 linked to air pollution in urban settings were also excluded. Finally, after having quantitatively evaluated the potential sources of the compounds (cosmetic or environmental), 4 compounds remained and their relevance was assessed using ROC curves. Among them, hexanoic acid, 2-ethyl- identification was confirmed with standard and led to an area-under-the-curve value of 92%. More in-depth studies are needed to investigate the specificity of the biomarker in relation to COVID-19, but the strategy of this study shows how to avoid obtaining data that are biased by exogenous factors. Full article

Introduction: Anemia and dyslipidemia are significant health concerns that affect individual health and societal development. This study aimed to determine the prevalence of iron deficiency anemia and dyslipidemia among nurses in a university hospital in Turkey and explore potential relationships between these conditions. Methods: This cross-sectional study was conducted among 712 nurses who underwent periodic health examinations. Data on demographic characteristics, hemoglobin, iron parameters, ferritin, transferrin saturation, and lipid profile were analyzed. People with all four hemoglobin, iron, ferritin, and transferrin saturation values lower than normal ranges at the same time were considered to have iron deficiency anemia. Results: Iron deficiency anemia prevalence was 10.7%, with no cases observed in male nurses or those aged 51 and older. Among the nurses, approximately 16.3% had low hemoglobin levels, 16.6% had low hematocrit levels, 30.6% had low ferritin levels, 36.0% had low transferrin saturation, 40.3% had low iron levels, and 24.9% high iron-binding capacity. Elevated total cholesterol was observed in 34.8%, high LDL in 29.6%, low HDL in 27.0%, and elevated triglycerides in 15.0%. Nurses with iron deficiency anemia had significantly lower triglyceride levels than those without. Weak positive correlations were found between triglycerides and hemoglobin, iron, ferritin, and transferrin levels. Additionally, higher total cholesterol, LDL, and triglyceride levels were associated with increased hemoglobin levels. Conclusions: This study highlights the high prevalence of iron deficiency anemia and dyslipidemia among hospital nurses, with a notable association between these conditions and factors such as age, gender, and dietary habits. Our findings underscore the need for healthcare services to prioritize the prevention, diagnosis, and management of these health issues in healthcare workers. A comprehensive approach, including regular screenings, dietary improvements, and addressing workplace factors could improve health outcomes and enhance healthcare delivery. Full article

Background/Objectives: Childhood obesity is a consistent public health issue, which often persists into adulthood. This study determined risk factors of childhood obesity and associated comorbidities in German school children. Methods: Data of 1956 primary school children (7.1 ± 0.6 years) were analysed. Anthropometrics were taken on site, other (health) parameters were assessed using a parental questionnaire. Binary logistic regression models were calculated, controlling for age, gender, family education level, and migration background. Results: Father’s physical illness (OR 1.092 [1.177; 3.073], p = 0.009) and a child’s chronic illness (OR 1.687 [1.077; 2.644], p = 0.022), maternal and paternal overweight (OR 2.180 [1.492; 3.185]; OR 2.494 [1.547; 4.022], p < 0.001, respectively), as well as maternal and paternal smoking (OR 1.942 [1.306; 2.889]; OR 1.972 [1.334; 2.917], p = 0.001, respectively) were significantly associated with the child being overweight. Also associated with the child being overweight were physical activity, regular screen media use (OR 0.605 [0.408, 0.896], p = 0.012; OR 2.029 [1.306; 3.152], p = 0.002, respectively), the mother and/or father thinking their child is too fat (OR 2.213 [1.504; 3.258], p < 0.001; OR 1.537 [1.048; 2.253], p = 0.028), the father’s physical inactivity (OR 1.69 [1.133; 2.521], p = 0.010), and if the child has not been breastfed (OR 1.632 [1.056; 2.521], p = 0.027), the mother smoked during pregnancy (OR 1.992 [1.224; 3.246], p = 0.006) as well as if the mother and/or father admonished their child about their weight (OR 25.521 [14.578; 44.680]; OR 19.448 [11.865; 31.877], p < 0.001, respectively). Children of unemployed mothers and in low-income households had an increased risk of being overweight (OR 4.811 [1.642; 14.096], p = 0.004; OR 2.203 [1.360; 3.568], p = 0.001, respectively). Conclusions: This study shows that parental health, lifestyle, and social behaviours matter in determining childhood obesity. Understanding those is essential to promoting a healthy lifestyle. Full article

Biomarkers play a crucial role in various stages of disease management, including screening, diagnosis, prediction, prognosis, treatment, and safety monitoring. Although they are powerful tools in disease diagnosis, management, and drug development, identifying and validating reliable biomarkers remains a significant challenge. Among potential microbiome-derived biomarkers, trimethylamine N-oxide (TMAO) has gained notable attention for its link to atherosclerosis and cardiovascular risk. However, despite the growing body of research on TMAO, its practical application in clinical settings for disease management and patient outcome enhancement is still not a reality. This paper presents recent data on the utility of TMAO as a cardiovascular biomarker, categorized by its various roles: diagnostic, prognostic, susceptibility/risk, monitoring, pharmacodynamic/response, predictive, and safety. It also briefly discusses research on TMAO’s potential role in cardiovascular disease development. While TMAO shows promise, particularly in prognostic applications, its reliability as a biomarker has been inconsistent across studies. These variances may result from several confounding factors that affect TMAO plasma levels, including diet, kidney function, and demographic variables. The review aims to elucidate the specific contexts in which TMAO can be valuable, potentially leading to more personalized and effective management of cardiovascular disease. Full article

The corrosion of oil and gas pipelines represents a significant factor influencing the safety of these pipelines. The extant research on intelligent algorithms for assessing corrosion rates in pipelines has primarily focused on static evaluation methods, which are inadequate for providing a comprehensive dynamic evaluation of the complex phenomenon of corrosion in buried oil and gas pipelines. This paper proposes a novel approach to predicting the corrosion rate of buried oil and gas pipelines. The method is based on the combination of an improved Beluga Optimization algorithm (IBWO) and Random Forest (RF) optimization with BiLSTM and gated cycle unit (GRU), which are used to classify corrosion rates as high or low. Initially, a feature screening of corrosion factors was conducted via RF, whereby variables exhibiting a strong correlation were extracted. Subsequently, IBWO was employed to optimize the feature selection process, with the objective of identifying the optimal feature subset to enhance the model’s performance. Ultimately, the BiLSTM method was employed for the purpose of predicting the occurrence of low corrosion. A GRU method was employed for prediction in the context of high corrosion conditions. The RF–IBWO-BiLSTM–GRU model constructed in this paper demonstrates high prediction accuracy for both high and low corrosion rates. The verification of 100 groups of experimental data yielded the following results: the mean square error of this model is 0.0498 and the R² is 0.9876, which is significantly superior to that of other prediction models. The combined model, which incorporates an intelligent algorithm, is an effective means of enhancing the precision of buried pipeline corrosion rate prediction. Furthermore, it offers a novel approach and insight that can inform subsequent research on the prediction of corrosion rates in buried oil and gas pipelines. Full article