bluuebunny/crossref_metadata_2025 huggingface dataset:
Disentangling Sources of Multifractality in Time Series
Authors: Kluszczyński Robert , Drożdż Stanisław , Kwapień Jarosław , Stanisz Tomasz , Wątorek Marcin
Published: January 2025

This contribution addresses the question commonly asked in the scientific literature about the sources of multifractality in time series. Two primary sources are typically considered. These are temporal correlations and heavy tails in the distribution of fluctuations. Most often, they are treated as two independent components, while true multifractality cannot occur without temporal correlations. The distributions of fluctuations affect the span of the multifractal spectrum only when correlations are present. These issues are illustrated here using series generated by several model mathematical cascades, which by design build correlations into these series. The thickness of the tails of fluctuations in such series is then governed by an appropriate procedure of adjusting them to q-Gaussian distributions, and q is treated as a variable parameter that, while preserving correlations, allows for tuning these distributions to the desired functional form. Multifractal detrended fluctuation analysis (MFDFA), as the most commonly used practical method for quantifying multifractality, is then used to identify the influence of the thickness of the fluctuation tails in the presence of temporal correlations on the width of multifractal spectra. The obtained results point to the Gaussian distribution, so q=1, as the appropriate reference distribution to evaluate the contribution of fatter tails to the width of multifractal spectra. An appropriate procedure is presented to make such estimates.
Application of Generalized Finite Difference Method and Radial Basis Function Neural Networks in Solving Inverse Problems of Surface Anomalous Diffusion
Authors: Shi Luchuan , Xi Qiang
Published: January 2025

In this study, a new hybrid method based on the generalized finite difference method (GFDM) and radial basis function (RBF) neural network technologies is developed to solve the inverse problems of surface anomalous diffusion. Specifically, the GFDM is utilized to compute the time-fractional derivative model on the surface, whereas RBF neural networks are employed to invert the diffusion coefficient, source term coefficient, and the fractional order within the anomalous diffusion equation governing the surface. The results of four examples show that for the three parameters of diffusion coefficient, source term coefficient, and fractional order, the errors of inversion results are in the order of 10−2 under different conditions. Therefore, this method can obtain the required parameters quickly and accurately under different conditions.
Is the Use of Tourniquets More Advantageous than Other Bleeding Control Techniques in Patients with Limb Hemorrhage? A Systematic Review and Meta-Analysis
Authors: Cirocchi Roberto , Prigorschi Dominica , Properzi Luca , Matteucci Matteo , Duro Francesca , Tebala Giovanni Domenico , Cirillo Bruno , Sapienza Paolo , Brachini Gioia , Lauricella Sara , Cassini Diletta , Rizzuto Antonia , Mingoli Andrea
Published: January 2025

Background and Objectives: Trauma, particularly uncontrolled bleeding, is a major cause of death. Recent evidence-based guidelines recommend the use of a tourniquet when life-threating limb bleeding cannot be controlled with direct pressure. Prehospital hemorrhage management, according to the XABCDE protocol, emphasizes the critical role of tourniquets in controlling massive bleeding. The aim of this systematic review and meta-analysis was to summarize data from the available scientific literature on the effectiveness of prehospital tourniquet use for extremity bleeding. Materials and Methods: A systematic review and meta-analysis was performed between March 2022 and March 2024, adhering to PRISMA guidelines, to determine whether prehospital tourniquets are clinically effective. The protocol was published on PROSPERO (ID number: CRD42023450373). Results: A comprehensive literature search yielded 925 articles and 11 studies meeting the inclusion criteria. The analysis showed a non-statistically significant reduction in mortality risk with tourniquet application (4.02% vs. 6.43%, RR 0.70, 95% CI 0.46–1.07). Analysis of outcomes of amputation of the traumatized limb indicated a statistically higher incidence of initial amputation in the tourniquet group (19.32% vs. 6.4%, RR 2.07, 95% CI 1.21–3.52), while delayed amputation showed no difference (9.39% vs. 3.66%, RR 0.93, 95% CI 0.42–2.07). Tourniquet use demonstrated a non-significant reduction in the number of blood components transfused (MD = −0.65; 95% CI −5.23 to 3.93 for pRBC, MD = −0.55; 95% CI −4.06 to 2.97 for plasma). Conclusions: Despite increasing use in civilian settings, this systematic review and meta-analysis showed no significant reduction in mortality or blood product use associated with prehospital tourniquet use. Further research, including high-quality randomized controlled trials, is required, as well as awareness and education campaigns relating to proper tourniquet use in the prehospital setting.
Evaluating the Impacts of Procedural and Patient-Specific Factors on the Outcomes of Transcatheter Aortic Valve Implantation (TAVI)
Authors: Kurmanaliyev Abilkhair , Braukylienė Rima , Aldujeli Ali , Zhumagaliyev Rassul , Aitaliyev Serik , Unikas Ramunas
Published: January 2025

Background: Transcatheter aortic valve implantation (TAVI) has emerged as a pivotal intervention for managing severe aortic stenosis in high-risk surgical patients. Objective: This study aimed to evaluate the impacts of procedural factors and patient characteristics on TAVI outcomes, with a focus on survival rates, cardiac mortality, and associated complications. Methods: A retrospective, single-center study involving 224 patients who underwent TAVI at the Lithuanian University of Health Sciences from September 2021 to April 2023 was conducted. Data encompassing demographic characteristics, medical history, procedural specifics, and follow-up outcomes were analyzed. Survival and adverse events were assessed at 30 days, 6 months, and 12 months post-TAVI. Results: The study included 224 patients. The mean age in the non-death group was 80 ± 6.17 years (range, 49–91), while that in the cardiac death group was 81.5 ± 6.14 years (range, 70–94; p = 0.079). Males accounted for 37.7% of the non-death group and 50% of the cardiac death group (p = 0.304). Statistical analyses identified factors significantly associated with mortality and complications. The overall survival rate was 88.8%, with cardiac-related mortality observed in 8% of patients. Increased fluoroscopy time (p < 0.001), a higher contrast volume (p = 0.005), and less improvement in aortic valve velocity post-TAVI (p = 0.031) were significantly associated with cardiac mortality. Advanced age and a reduced left ventricular ejection fraction (<50%) were prominent predictors of adverse outcomes. Patients with non-coronary cusp calcification exhibited lower cardiac mortality (p = 0.005), while mitral valve regurgitation was linked to poorer outcomes (p = 0.015). Logistic regression analysis underscored the incremental risks posed by procedural complexities and comorbidities. Conclusions: Procedural factors such as fluoroscopy duration and contrast volume, along with patient-specific attributes including age, left ventricular function, and valve calcification patterns, critically influence TAVI outcomes. These findings emphasize the need for tailored procedural strategies and patient management protocols to mitigate risks and enhance the efficacy of TAVI interventions.
Leadership and Entrepreneurial Choices: Understanding the Motivational Dynamics of Women Entrepreneurs in Iran
Authors: Goncalves Marcus , Sartipi Sadaf , Asadi Damavandi Ghazale
Published: January 2025

This study explores the motivations and constraints of Iranian women entrepreneurs within a restrictive socioeconomic and cultural landscape. It adopts a qualitative approach and utilizes semi-structured interviews to investigate the complex interplay between financial limitations, gender biases, and regulatory challenges entrepreneurs face. These findings underscore the importance of resilience, adaptability, and creativity for entrepreneurial success. Women entrepreneurs in Iran adopt incremental growth strategies, utilize digital platforms for market access, and cultivate informal networks to manage risks and scale their ventures. They also creatively integrate family responsibilities into their business models, highlighting the cultural shaping of their entrepreneurial activities. The concept of regulatory adaptation was introduced to illustrate how entrepreneurs restructure their operations to comply with stringent government regulations while sustaining growth. The emotional burden of navigating these hurdles is also evident, emphasizing the need for support mechanisms that address mental health and well-being. Policy implications are discussed, and enhancements in financial access, gender equality, digital entrepreneurship, and mental health support for women entrepreneurs are recommended. This study contributes to the entrepreneurship theory by understanding how sociocultural contexts influence women’s entrepreneurial activities and resilience strategies.
Prevalence of HDV, HCV, and HIV Infection in the Population of Patients Infected with HBV in a Romanian Cohort
Authors: Curici Antoanela , Ilie Olivia Mioara , Mindru Dana Elena
Published: January 2025

Hepatitis B virus (HBV) infections remain a significant global health challenge, especially in low- and middle-income countries where access to healthcare services is often limited. This study aimed to assess the prevalence of hepatitis B virus (HBV), hepatitis delta virus (HDV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) co-infections in a cohort of 426,528 patients tested for HBsAg in Romania between 2018 and 2023. Of the 17,082 HBsAg-positive individuals (4.0% prevalence), the highest HBV positivity rates were observed in the 30–39 and over 60 age groups. Chronic HBV infection was identified in 13.2% of the cohort, with 3.6% testing positive for HBeAg, indicating active viral replication. Co-infection rates were 11.3% for HDV, 1.4% for HCV, and 0.45% for HIV. The incidence of HDV co-infection increased significantly from 2018 to 2023, particularly in older populations. HCV co-infection was more prevalent in individuals aged 50–59 and over 60, with a declining trend from 2020 onward. The study also revealed a weak correlation between liver enzyme levels (ALT and AST) and HBV viral load, suggesting that liver function tests may not fully reflect the severity of HBV infection. HIV co-infection was notably rare compared to other regions, likely due to regional healthcare interventions. The findings from our study highlight the need for targeted interventions, particularly for high-risk groups such as older adults and middle-aged individuals, to reduce the burden of chronic HBV and its complications.
Unveiling Microbiota Profiles in Saliva and Pancreatic Tissues of Patients with Pancreatic Cancer
Authors: Uguz Alper , Muftuoglu Can , Mert Ufuk , Gumus Tufan , Ece Deniz , Asadi Milad , Bagci Ozlem Ulusan , Caner Ayse
Published: January 2025

The pancreas, previously considered a sterile organ, has recently been shown to harbor its own microbiota that may influence tumor biology and patient outcomes. Despite increasing interest in the impact of the microbiome on cancer, the relationship between pancreatic tissue and oral microbiomes in pancreatic ductal adenocarcinoma (PDAC) remains limited. In this study, the oral and pancreas tissue microbiomes of patients with PDAC were compared to patients with other periampullary cancers (DC/AC) and a healthy control group using 16S rRNA gene sequence analysis. The results showed a significant reduction in microbial diversity in the saliva of cancer patients compared to healthy controls, while the PDAC patients exhibited a distinct microbial profile in their pancreatic tissues, consisting predominantly of Firmicutes, Proteobacteria, and Actinobacter, after filtering the microbiome of the indoor environment. Notably, the presence of oral bacteria such as Anoxybacillus, Clostridium, and Bacillus in pancreatic tissues suggests potential translocation from the oral cavity. This study emphasizes the importance of understanding the role of body fluid and tissue microbiota in pancreatic cancer, proposing that oral dysbiosis may contribute to disease progression. Moreover, the results suggest that the microbiome of the indoor environment in which samples are collected and analyzed is also important in microbiota analysis studies.
Anti-Methanogenic Potential of Seaweeds and Impact on Feed Fermentation and Rumen Microbiome In Vitro
Authors: Malik Pradeep Kumar , Kolte Atul Purshottam , Trivedi Shraddha , Tamilmani Govindan , Mohapatra Archit , Vaswani Shalini , Belevendran Johnson , Sahoo Artabandhu , Gopalakrishnan Achamveetil , Bhatta Raghavendra
Published: January 2025

A series of in vitro studies were conducted to explore the anti-methanogenic potential of five seaweeds collected from the Indian sea and to optimize the level(s) of incorporation of the most promising seaweed(s) into a straw and concentrate diet to achieve a significant reduction in methane (CH4) production without disturbing rumen fermentation characteristics. A chemical composition analysis revealed a notable ash content varying between 55 and 70% in seaweeds. The crude protein content was highly variable and ranged between 3.25 and 15.3% of dry matter. Seaweeds contained appreciable concentrations of tannins and saponins. Among the seaweeds, Spyridia filamentosa exhibited significantly higher CH4 production, whereas the percentage of CH4 in total gas was significantly lower in the cases of Kappaphycus alvarezii and Sargassum wightii. The ranking of seaweeds in terms of CH4 production (mL/g OM) is as follows: Sargassum wightii < Kappaphycus alvarezii < Acanthophora specifera < Padina gymnospora < Spyridia filamentosa. A remarkable decrease of 31–42% in CH4 production was recorded with the incremental inclusion of Kappaphycus alvarezii at levels of 3–5% of the dry matter in the diet. The addition of Sargassum wightii led to a significant decrease of 36–48% in CH4 emissions when incorporated at levels of 4–5% of dry matter, respectively. The findings of this study revealed a significant decrease in the numbers of total protozoa and Entodinomorphs, coupled with increasing abundances of sulfate-reducing microbes and minor methanogens. Metagenome data revealed that irrespective of the seaweed and treatment, the predominant microbial phyla included Bacteroidota, Bacillota, Pseudomonadota, Actinomycetota, Fibrobacterota, and Euryarchaeota. The prevalence of Methanobrevibacter was similar across treatments, constituting the majority (~79%) of the archaeal community. The results also demonstrated that the supplementation of Kappaphycus alvarezii and Sargassum wightii did not alter the feed fermentation pattern, and therefore, the reduction in CH4 production in the present study could not be attributed to it. Animal studies are warranted to validate the extent of reduction in CH4 production and the key processes involved by supplementation with Kappaphycus alvarezii and Sargassum wightii at the recommended levels.
Research Progress on the Extraction and Separation of Rare-Earth Elements from Waste Phosphors
Authors: Tian Guocai , Xu Zhongbin , Li Xiaofen , Hu Zhiqiang , Zhou Baichuan
Published: January 2025

Rare earth is an important strategic resource and a key mineral resource for global competition. As the depletion of primary rare-earth resources increases, a great number of rare-earth secondary resources, such as waste phosphor powder collected from fluorescent lamps, cathode-ray tubes, and other luminescent materials, continue to be generated and accumulated. How to achieve the low-carbon extraction and green and efficient utilization of these resources has become an urgent problem to be solved. In recent years, preliminary enrichment methods, such as flotation, magnetic separation, and adsorption, chemical methods, such as acid leaching and alkaline fusion, external-field-enhanced methods (including mechanical activation, microwave and oxidant, green solvent, etc.), and solvent extraction have been used for the separation and extraction of rare-earth elements (REEs), such as Y, Eu, Ce, Tb, La, and Ga, from waste phosphors. In this article, we systematically summarized the research progress of commonly used separation and extraction methods for REEs in waste phosphor powders, analyzed the advantages, disadvantages, and existing problems of different methods, and proposed potential directions for future research.
Encapsulation of Vecuronium and Rocuronium by Sugammadex Investigated by Surface-Enhanced Raman Spectroscopy
Authors: Kenđel Adriana , Piantanida Ivo , Miljanić Snežana
Published: January 2025

Aiming toward a novel, noninvasive technique, with a real-time potential application in the monitoring of the complexation of steroidal neuromuscular blocker drugs Vecuronium (Vec) and Rocuronium (Roc) with sugammadex (SDX, medication for the reversal of neuromuscular blockade induced by Vec or Roc in general anesthesia), we developed proof-of-principle methodology based on surface-enhanced Raman spectroscopy (SERS). Silver nanoparticles prepared by the reduction of silver ions with hydroxylamine hydrochloride were used as SERS-active substrates, additionally aggregated with calcium nitrate as needed. The Vec and Roc SERS spectra were obtained within the biorelevant 5 × 10−7–1 × 10−4 M range, as well as the SERS of SDX, though the latter was observed only in the presence of the aggregating agent. SDX/drug complexes at a 1/1 molar ratio revealed significant spectral changes in the vibrational bands of the SDX glucose rings and the drug steroid rings, implying that the insertion of Vec and Roc molecules into the SDX cavity was not only driven by attractive electrostatic interactions between the positively charged cyclic unit of the drug and the negative carboxylate groups of cyclodextrin but also supported by hydrophobic interactions between the host cyclodextrin and the guest drug molecule. The observed changes in SERS signals are applicable in biorelevant conditions and support further studies of SDX/drug complexes in vivo.
Enhanced Antibacterial Activity of Hydrophobic Modified Lysozyme Against Gram-Negative Bacteria Without Accumulated Resistance
Authors: Li Zhenhui , Lin Song , Zhu Mei , Liu Xiaoman , Huang Xin
Published: January 2025

Macromolecule bactericides present challenges such as low biocompatibility and not being biodegradable, so broad-spectrum bactericides without accumulated bacteria resistance are now in urgent demand all over the world. Lysozyme, a kind of wide-spread natural enzyme easily extracted from nature, has become attractive for agriculture and medicine use. However, Gram-negative bacterial strains are highly resistant to natural lysozymes, which limits their practical application. In this study, rather than directly modifying antibacterial-active substance with lysozyme, we show an effective way to improve antibacterial performance by altering the hydrophobic functional groups of natural lysozymes and synthesize a type of hydrophobic modified lysozyme (HML). Compared with other modification methods, the antibacterial performance has been increased by over 50%. We investigated its antibacterial mechanism against Gram-negative bacteria and showed that HML could be used to treat pathogenic bacteria without obvious accumulated resistance appearance, which is a great advantage over commercial antibiotics. Overall, it is anticipated that HML could be potentially applied to food safety, infection therapy, and enzyme-medicine applications.
Effect of Drying Methods on the Phenolic Profile and Antioxidant Capacity of Pithecellobium dulce (Roxb.) Benth. Aril and Its Inhibitory Properties on Human SW480 Colon Adenocarcinoma Cells
Authors: Vargas-Madriz Ángel Félix , Kuri-García Aarón , Luzardo-Ocampo Ivan , Ferriz-Martínez Roberto Augusto , García-Gasca Teresa , Saldaña Carlos , Vargas-Madriz Haidel , Guzmán-Maldonado Salvador Horacio , Chávez-Servín Jorge Luis
Published: January 2025

Pithecellobium dulce (P. dulce) is a Mexican plant that is consumed raw or in different preparations, and its anti-inflammatory and antioxidant properties have traditionally been useful in treating several conditions. However, the post-harvest drying process can alter the content of bioactive compounds in P. dulce. This study aims to evaluate the impact of different drying methods on the phenolic profile and antioxidant capacity of this plant, as well as its inhibitory effect on human SW480 colon adenocarcinoma cells. After oven drying, the samples showed a higher amount (p < 0.05) of phenolic compounds, up to 1149.45 ± 69.27 mg GAE/100 g LE, which is 80% more than the freeze-dried samples. Also, the antioxidant capacity was higher in oven-dried samples, with 44.63 ± 2.00 µmol Trolox equivalents/g LE, 108% more than the freeze-dried method. Methanolic extraction, in turn, yielded better results than aqueous and ethanolic extractions. Up to 14 polyphenolic compounds were detected in oven-dried samples. For in vitro assays in SW480 cells, the 50% v/v methanolic extract was used. From this extract, the median lethal concentration (LC50) was determined to be 13.76 mg/mL, which represents the concentration necessary to inhibit the growth of half of the cancer cells of this cell line. The extract led to cell cycle arrest in the G1 phase and an increase in apoptosis-induced cell death. The P. dulce extract augmented p53 and decreased KRAS gene expressions. Results suggested pro-apoptotic mechanisms in colon cancer cells in vitro linked to P. dulce bioactive compounds, which are better preserved when oven-dried plants are subjected to methanolic extraction.
Recent Advances in the Evaluation of the Toxicological and Ecotoxicological Risks of Polymer, Zinc Oxide, Titanium Dioxide and Graphene Oxide Nanoparticles
Authors: Vinardell Maria Pilar
Published: January 2025

Nanotechnology has substantial potential for advancements in the fields of biology and medicine [...]
Impact of Flash Glucose Monitoring in Adults with Inherited Metabolic Disorders at Risk of Hypoglycemia
Authors: Amuedo Sandra , Dios-Fuentes Elena , Benítez-Ávila Rosa , Remón-Ruiz Pablo , Soto-Moreno Alfonso , Venegas-Moreno Eva
Published: January 2025

Background: This study addresses hypoglycemia in adults with inherited metabolic disorders (IMDs), highlighting the importance of intermittently scanned continuous glucose monitoring (isCGM). Despite the elevated risk of hypoglycemia in an important group of these diseases, the use of isCGM remains uncommon and there is limited evidence supporting its effectiveness. Methods: A longitudinal quasi-experimental study was performed in 18 adults with IMDs, evaluating the use of isCGM for 2 months. Time in hypoglycemia (TBR), hyperglycemia (TAR), and time in range (TIR) were monitored, in addition to symptomatic and asymptomatic hypoglycemic events. Follow-up visits were performed at 7 days, 14 days, and 2 months. Results: TBR < 70 mg/dL was significantly reduced from 1.5% at baseline to 0% at 2 months. A decrease in the number and duration of hypoglycemic events was also observed. In some IMD subgroups, isCGM enabled detection of asymptomatic hypoglycemia and adjustment to dietary management, improving glycemic control. Conclusions: isCGM is effective in detecting and reducing hypoglycemia in adults with IMDs, optimizing nutritional therapy, and improving the quality of life of patients and their families.
Effects of Quercetin and Citrulline on Nitric Oxide Metabolites and Antioxidant Biomarkers in Trained Cyclists
Authors: Kurtz Jennifer A. , Feresin Rafaela G. , Grazer Jacob , Otis Jeff , Wilson Kathryn E. , Doyle J. Andrew , Zwetsloot Kevin A.
Published: January 2025

Background: Quercetin (QCT) and citrulline (CIT) have been independently associated with improved antioxidant capacity and nitric oxide (NO) production, potentially enhancing cardiovascular function and exercise performance. This study aimed to evaluate the combined and independent effects of QCT and CIT supplementation on NO metabolites and antioxidant biomarkers in 50 trained cyclists undergoing a 20 km cycling time trial (TT). Methods: In a randomized, double-blind, placebo-controlled design, forty-two male and eight female trained cyclists were assigned to QCT + CIT, QCT, CIT, or placebo (PL) groups. Supplements were consumed twice daily for 28 days. Biochemical assessments included NO metabolites (nitrate/nitrite), ferric reducing antioxidant power (FRAP), superoxide dismutase (SOD) activity, and antioxidant capacity, measured pre- and post-TT. Results: NO metabolites were significantly elevated post-supplementation (p = 0.03); however, no significant interaction effects were observed for NO metabolites, FRAP, SOD, or antioxidant capacity across the groups (p > 0.05). Post-hoc analyses revealed that QCT significantly reduced FRAP concentrations compared to PL (p = 0.01), while no significant changes in SOD or antioxidant capacity were found across any groups. Conclusions: These findings suggest that combined and independent QCT and CIT supplementation did not significantly improve these biomarkers, suggesting that baseline training adaptations, supplementation timing, and individual variability may influence the efficacy of these compounds in enhancing exercise performance and oxidative stress markers. The ergogenic efficacy of QCT + CIT on antioxidant-related markers remains inconclusive.
Relative Energy Deficiency in Sport—Multidisciplinary Treatment in Clinical Practice
Authors: Meyer Andrea , Haigis Daniel , Klos Bea , Zipfel Stephan , Resmark Gaby , Rall Katharina , Dreser Katharina , Hagmann Daniela , Nieß Andreas , Kopp Christine , Mack Isabelle
Published: January 2025

Background/Objectives: The primary aim of this study was to characterize athletes approaching an outpatient interdisciplinary and multidisciplinary consultation structure for athletes with a suspected relative energy deficiency in sport (REDs) cross-sectionally and longitudinally to prove treatment efficacy. Methods: Data of 58 athletes suspected of REDs were collected at the onset (t0) and completion (t1) of interdisciplinary and multidisciplinary REDs treatment (clinical practice) between January 2019 and December 2022. The data included extracted information from medical records, anthropometric characteristics, physical performance diagnostics, laboratory values, dietary records, and partially gynecological and psychosomatic diagnostics. Results: The sample primarily consisted of female athletes (97%) under 18 years of age (66%) who were underweight with a body mass index (BMI) < 18.5 kg/m2 and BMI percentile below the 10th percentile for their age and gender-specific norms (59%), and experienced menstrual disorders (93%). The dietary behavior is characterized by plant-based and low-energy-dense foods. Eating disorders (anorexia nervosa and bulimia nervosa) were diagnosed in 40% of the athletes according to the International Statistical Classification of Diseases and Related Health Problems 11th revision criteria. During the program, 64% of the athletes exhibited a mean weight gain of 7 (±6) kg (p < 0.001), excluding those still undergoing treatment (36%). Conclusions: The proposed interdisciplinary and multidisciplinary treatment approach proved effective and holds promise for future evidence-based developments in REDs treatment.
Herbal and Dietary Supplements as Adjunctive Treatment for Mild SARS-CoV-2 Infection in Italy
Authors: Licata Anna , Seidita Aurelio , Como Silvia , de Carlo Gabriele , Cammilleri Marcella , Bonica Roberta , Soresi Maurizio , Veronese Nicola , Chianetta Roberta , Citarrella Roberto , Giannitrapani Lydia , Barbagallo Mario
Published: January 2025

During the COVID-19 pandemic, several observational studies proved a certain efficacy of nutraceuticals, herbal products, and other dietary supplements as adjuvant therapies used alongside antiviral drugs. Although their use has not been widespread in Italy, according to preliminary evidence, many supplements with demonstrated immunomodulatory effects, such as vitamins C and D, herbal medicines and essential oils, might relieve the respiratory symptoms of COVID-19, since SARS-CoV-2 can activate inflammasome-mediated inflammatory signaling pathways. Other observational studies have shown that herbal treatments, such as Echinacea purpurea and ginseng, help alleviate respiratory symptoms and reduce serum levels of inflammatory cytokines, which are typically overexpressed in both adult and pediatric SARS-CoV-2 patients. Further, vitamins C and D can attenuate the immune response thanks to their cytokine suppression ability and to their known antimicrobial activity and potential to modulate T helper cell response. The strong immune response triggered by SARS-CoV-2 infection is responsible for the severity of the disease. Preliminary data have also shown that L-arginine, an endothelial-derived relaxing factor, is able to modulate endothelial damage, which appears to be one of the main targets of this systemic disease. Finally, some essential oils and their isolated compounds, such as eucalyptol, may be helpful in reducing many of the respiratory symptoms of COVID-19, although others, such as menthol, are not recommended, since it can lead to an undervaluation of the clinical status of a patient. In this narrative review, despite the lack of strong evidence in this field, we aimed to give an overview of the current available literature (mainly observational and cross-sectional studies) regarding herbal products and dietary supplements and their use in the treatment of mild disease from SARS-CoV-2 infection. Obviously, dietary supplements and herbal products do not constitute a standardized treatment for COVID-19 disease, but they could represent an adjunctive and useful treatment when used together with antivirals.
Balancing Performance and Health in Elite Hungarian Athletes: The Relationship Among Disordered Eating Risk, Body Composition, and Nutrition Knowledge
Authors: Kovács Réka Erika , Alpay Merve , Karsai István , Tornóczky Gusztáv József , Petróczi Andrea , Boros Szilvia
Published: January 2025

Background: disordered eating (DE) and eating disorders (ED) can negatively impact athletes’ health, wellbeing, and athletic performance. Objective: this cross-sectional study aims to assess DE risk, body composition, and nutrition knowledge among elite Hungarian athletes. Methods: DE risk was assessed using DESA-6H and EAT-26 scales, nutrition knowledge through the Abridged Nutrition for Sport Knowledge Questionnaire (A-NSKQ), and body composition with the OMRON BF511 device. The data were analyzed using Kendall’s tau correlations, Mann–Whitney U tests, and ROC analysis. Results: a total of 71 athletes participated (39.4% males, mean age = 24.8 years, SD = 4.8 years and 60.6% females, mean age = 24.3 years, SD = 4.3 years). At-risk scores on the DESA-6H scale were recorded for nine athletes (12.7%), while 32.4% scored in the risk zone on the EAT-26, with female athletes in aesthetic, endurance and weight-dependent sports being most affected. Low BF was observed in four males and four females. Nutrition knowledge (49.1%) was below the acceptable threshold. DESA-6H significantly correlated with EAT-26 scores, BMI, sports nutrition knowledge, and A-NSKQ total scores. A statistically significant difference by gender was found in the EAT-26 total score (p = 0.019, d = 0.65). Risk groups significantly differed in A-NSKQ scores (p = 0.026, d = 0.511) and sport nutrition knowledge, specifically (p = 0.016, d = 0.491). Using EAT-26 to identify at-risk athletes and the DESA-6H recommended cut-off, the ROC analysis showed a sensitivity of 29.1% and a specificity of 95.7%. Conclusions: insufficient nutrition knowledge plays a role in being at-risk for DE and ED. These results underscore the need for early detection, early sport nutrition education across all elite athletes, with particular attention to female athletes in aesthetic, endurance and weight-dependent sports, and for monitoring these athletes to prevent DE. Further work is warranted to optimize screening tools such as EAT-26 and DESA-6H for elite athletes.
Gender Differences in Physical Activity Levels Among Overweight and Obese Medical Students During and After the COVID-19 Pandemic: A Single-Center Cross-Sectional Study
Authors: Adamczak Bartosz Bogusz , Kosendiak Aureliusz Andrzej , Kuźnik Zofia , Makles Szymon , Hariasz Weronika
Published: January 2025

The COVID-19 pandemic profoundly affected the physical activity (PA) patterns of various social groups, including medical students. This study aims to compare the levels of PA, expressed in metabolic equivalent of task minutes per week (MET-m/w), among overweight and obese medical students, during and after the pandemic. The pandemic period was defined as spanning from 2020 to 16 May 2022, while the post-pandemic period covered the second half of 2022 through the end of 2023. PA levels were assessed using the International Physical Activity Questionnaire (IPAQ), and Body Mass Index (BMI) was calculated based on self-reported weight and height. Only individuals with a BMI ≥ 25 kg/m2 were included. In total, 233 medical students from Wroclaw Medical University were assessed during the pandemic, and 217 post-pandemic. PA was categorized into walking, moderate, and vigorous with total MET-m/w calculated. During the pandemic, no significant gender differences were observed in walking, moderate, vigorous, or total PA. Post-pandemic, males demonstrated significantly higher levels of vigorous PA (p < 0.001) and total MET-m/w (p < 0.0001) compared to females. These findings underscore the necessity for targeted interventions promoting PA among overweight and obese medical students, especially among females.
Highly Precise Time Compensation Algorithm for Synchronous Communication System Based on Least Squares
Authors: Su Jin , Li Changshui , Liu Qingbo , Zhao Sheng , Wang Xiangyu
Published: January 2025

Time synchronization is an important technology in synchronous communication systems to ensure the accuracy of data transmission. Precise time synchronization allows the receiver to correctly interpret the signal at the correct moment. However, as communication rates increase and application scenarios diversify, pulse signal reception quality is often affected by factors such as noise interference and clock stability. In order to address these challenges, we propose a pulse signal recovery method utilizing the least squares algorithm to complete time compensation. By fitting and optimizing the received signal, we can obtain estimated values that closely approximate the actual time, thereby achieving enhanced precision in time synchronization. The results demonstrate that this method effectively reduces estimation errors, improving the system’s time synchronization accuracy to the ns level. This method not only provides an effective solution for enhancing time synchronization precision but also lays the foundation for time synchronization performance in the future.
Comparative Outcomes of Minimally Invasive Versus Open Hallux Valgus Surgery: A Systematic Review and Meta-Analysis
Authors: Kafagi Abdul-Hadi , Kafagi Abdul-Rhaman , Tahoun Marwan , Al Zareeni Omar Tariq , El Aloul Khaled , Ahmad Mohammad Usman , Pillai Anand
Published: January 2025

Objectives: To compare the safety and efficacy of open surgery (OS) and minimally invasive surgery (MIS) techniques in the correction of symptomatic hallux valgus (HV). Methods: A systematic review of studies up to January 2024 was conducted, identifying all the relevant literature comparing OS and MIS for symptomatic HV. Searches were performed across major databases including MEDLINE, Cochrane and EMBASE. A total of 32 studies were included, comprising randomised control trials, prospective and retrospective cohort studies as well as grey literature. Key outcomes assessed included radiographic measures such as the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA), with preoperative and postoperative angles analysed to calculate the power of correction. Secondary outcomes included American Orthopaedic Foot and Ankle Society (AOFAS) scores, operative time, hospital stay duration, radiation exposure and complication rates. Both fixed-effect and random-effects models were applied based on the observed heterogeneity in the data. Results: Thirty-two studies with 2423 patients contributed to the summative outcome. Postoperative HVA and IMA were comparable between OS and MIS groups. However, MIS showed a significantly lower DMAA angle (MD = −0.90, CI: −1.55 to −0.25, p = 0.01). In radiographic correction analysis, MIS demonstrated significantly greater DMAA correction (MD = 1.09, CI: 0.43 to 1.75, p = 0.001). The odds of hardware removal were significantly higher with MIS (OR = 2.37, CI: 1.41 to 4.00, p = 0.001). Functional analysis showed that MIS achieved significantly higher postoperative AOFAS scores (MD = 2.52, CI: 0.92 to 4.13, p = 0.002). MIS was associated with a shorter operative (MD = −12.07 min, CI: −17.02 to −7.11, p < 0.00001) and a significantly shorter hospital stay (MD = −0.76, CI: −1.30 to −0.21, p = 0.007). MIS was linked to higher radiation exposure (MD = 51.18, CI: 28.71 to 73.65, p < 0.00001). Conclusions: There is no definitive superiority between MIS and OS for hallux valgus correction. While MIS offers benefits such as improved DMAA correction, higher functional AOFAS scores, shorter operative times and reduced hospital stays, it also carries risks like increased radiation exposure and a higher rate of hardware removal. The decision between MIS and OS should be personalised, taking into account the specific needs and circumstances of each patient. Larger studies are warranted to validate these findings as newer MIS techniques continue to emerge and evolve.
In Vivo Assessment of Healing Potential of Ointments Containing Bee Products, Vegetal Extracts, and Polymers on Skin Lesions
Authors: Andritoiu Calin Vasile , Lungu Cristina , Iurciuc (Tincu) Camelia Elena , Andriescu Corina Elena , Havarneanu Corneliu , Popa Marcel , Cuciureanu Magdalena , Tarţău Liliana Mititelu , Ivanescu Bianca
Published: January 2025

Background/Objectives: The present experiment aimed to formulate four ointments that included mixtures of plant extracts (Hippophae rhamnoides, Calendula officinalis, Arctium lappa, and Achillea millefolium), apitherapy products (honey, propolis, and apilarnil) and natural polymers (collagen, chitosan, and the lyophilisate of egg white) in an ointment base. Methods: In order to investigate the therapeutic properties of the ointments, experimental in vivo injury models (linear incision, circular excision, and thermal burns) were performed on laboratory animals, namely Wistar rats. The treatment was applied topically, once a day, for 21 days. Clinical and macroscopic evaluation, determination of lesion shrinkage rate, re-epithelialization period, and histopathological examination were performed. Results: The results demonstrate that the tested ointments have a significant effect in healing skin lesions. On the ninth day of treatment, the wound contraction rate was 98.17 ± 0.15% for the mixed ointment group, compared to the negative control group’s rate of 14.85 ± 2.95%. At day 21, dermal collagenization and restoration of histological structure occurred for all treated groups. Conclusions: The tested ointments exerted in vivo wound healing and re-epithelialization effects on incision, excision, and thermal burn injuries.
Targeting the Heart of Mycobacterium: Advances in Anti-Tubercular Agents Disrupting Cell Wall Biosynthesis
Authors: Diab Ahmad , Dickerson Henry , Al Musaimi Othman
Published: January 2025

Mycobacterium tuberculosis infections continue to pose a significant global health challenge, particularly due to the rise of multidrug-resistant strains, random mycobacterial mutations, and the complications associated with short-term antibiotic regimens. Currently, five approved drugs target cell wall biosynthesis in Mycobacterium tuberculosis. This review provides a comprehensive analysis of these drugs and their molecular mechanisms. Isoniazid, thioamides, and delamanid primarily disrupt mycolic acid synthesis, with recent evidence indicating that delamanid also inhibits decaprenylphosphoryl-β-D-ribose-2-epimerase, thereby impairing arabinogalactan biosynthesis. Cycloserine remains the sole approved drug that inhibits peptidoglycan synthesis, the foundational layer of the mycobacterial cell wall. Furthermore, ethambutol interferes with arabinogalactan synthesis by targeting arabinosyl transferase enzymes, particularly embB- and embC-encoded variants. Beyond these, six promising molecules currently in Phase II clinical trials are designed to target arabinan synthesis pathways, sutezolid, TBA 7371, OPC-167832, SQ109, and both benzothiazinone derivatives BTZ043 and PBTZ169, highlighting advancements in the development of cell wall-targeting therapies.
The Promising Effect of Tocilizumab on Chronic Antibody-Mediated Rejection (cAMR) of Kidney Transplant
Authors: Świątek Łukasz , Miedziaszczyk Miłosz , Lewandowski Dominik , Robakowski Filip , Tyburski Piotr , Jakubowska Marta , Karczewski Marek , Idasiak-Piechocka Ilona
Published: January 2025

Background: Chronic antibody-mediated rejection (cAMR) constitutes a serious challenge in the long-term success of organ transplantation. It is associated with donor-specific antibodies (DSAs) which activate a complement pathway in response to the presence of human leukocyte antigens (HLAs) on the graft, which results in chronic inflammation and leads to graft dysfunction. One of the recent promising methods of cAMR treatment is a recombinant humanized anti-interleukin-6 receptor (IL-6R) monoclonal antibody referred to as Tocilizumab (TCZ). The aim of the presented systematic review is to explore the existing knowledge regarding the effect of tocilizumab treatment on cAMR and to perform a meta-analysis of the available data. Methods: A systematic review was performed using the PRISMA 2020 Checklist and Flow diagram. A systematic review protocol was registered in PROSPERO: CRD42024510996. The bias assessment was obtained with Methodical Index for Non-Randomized Studies (MINORS), whereas meta-analysis was performed using MedCalc. Results: Five clinical trials with a total number of 105 patients were included in our review. The mean loss of eGFR in time was −0.141 mL/min/1.73 m2 (95% CI: −0.409 to 0.126; p = 0.298) and was found to be statistically insignificant. The heterogeneity was low and was equal to I2 = 0.00%. The authors demonstrated a reduction in DSA titer by TCZ (−0.266 MFI (95% CI: −0.861 to 0.329; p = 0.377)). In the majority of studies, eGFR stabilization was associated with a reduction in DSAs. Conclusions: TCZ pharmacotherapy insignificantly reduced DSA titer and eGFR. Despite promising outcomes of potential eGFR stabilization, there is a need for large randomized controlled trials comparing standard management of cAMR and tocilizumab treatment.
Targeted Polymer–Peptide Conjugates for E-Selectin Blockade in Renal Injury
Authors: Milošević Nenad , Rütter Marie , Ventura Yvonne , Feinshtein Valeria , David Ayelet
Published: January 2025

Background/Objectives: Leukocytes play a significant role in both acute kidney injury (AKI) and chronic kidney disease (CKD), contributing to pathogenesis and tissue damage. The process of leukocyte infiltration into the inflamed tissues is mediated by the interactions between the leukocytes and cell adhesion molecules (CAMs, i.e., E-selectin, P-selectin, and VCAM-1) present on the inner surface of the inflamed vasculature. Directly interfering with these interactions is a viable strategy to limit the extent of excessive inflammation; however, several small-molecule drug candidates failed during clinical translation. We hypothesized that a synthetic polymer presenting multiple copies of the high-affinity E-selecting binding peptide (P-Esbp) could block E-selectin-mediated functions and decrease leukocytes infiltration, thus reducing the extent of inflammatory kidney injury. Methods: P-Esbp was synthesized by conjugating E-selecting binding peptide (Esbp) to N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer with reactive ester groups via aminolysis. The effects of P-Esbp treatment on kidney injury were investigated in two different models: AKI model (renal ischemia—reperfusion injury—RIRI) and CKD model (adenine-induced kidney injury). Results: We found that the mRNA levels of E-selectin were up-regulated in the kidney following acute and chronic tissue injury. P-Esbp demonstrated an extended half-life time in the bloodstream, and the polymer accumulated significantly in the liver, lungs, and kidneys within 4 h post injection. Treatment with P-Esbp suppressed the up-regulation of E-selectin in mice with RIRI and attenuated the inflammatory process. In the adenine-induced CKD model, the use of the E-selectin blocking copolymer had little impact on the progression of kidney injury, owing to the compensating function of P-selectin and VCAM-1. Conclusion: Our findings provide valuable insights into the interconnection between CAMs and compensatory mechanisms in controlling leukocyte migration in AKI and CKD. The combination of multiple CAM blockers, given simultaneously, may provide protective effects for preventing excessive leukocyte infiltration and control renal injury.
Effects of Combined Plyometric and Sprint Training on Sprint Performance in Youth Soccer Players
Authors: Niering Marc , Heckmann Jennifer , Seifert Johanna , Ueding Elisa , von Elling Linus , Bruns Antonia , Beurskens Rainer
Published: January 2025

Background/Objectives: Plyometrics is a widely used method to enhance the physical performance of athletes. Studies have demonstrated that the effectiveness of plyometrics increases when combined with other training methods. This study aims to determine whether the direct combination of plyometric and sprint training improves linear sprint speed and change-of-direction speed in youth soccer players. Methods: Twenty-eight male youth soccer players were randomly assigned to an intervention group (INT, n = 14, 12.9 ± 0.4 years) and a control group (CON, n = 14, 12.9 ± 0.7 years). The INT group performed two sessions per week, each including nine drop jumps, followed by a hurdle jump and one sprint. The CON group only performed nine sprints without any jumps. Both groups continued their regular soccer training over the 20-week intervention period. Pre- and post-intervention tests included 5 m, 10 m, and 30 m linear sprints and a modified agility t-test for change-of-direction speed. Results: Largest improvements were observed in the INT group (5 m = 6.7%, 10 m = 4.8%, 30 m = 2.7%, change-of-direction speed = 3.6%, 3.1%). A significant difference between the groups was noted for the 10 m sprint distance (p = 0.02). Furthermore, moderate to large correlations between linear sprint speed and change-of-direction speed were found in both groups (r = 0.33–0.82). Conclusions: Results suggest that the direct combination of plyometric training and sprint training over a 20-week period can improve both linear sprint speed and change-of-direction speed in youth soccer players, thus enhancing physical performance.