Background: Musculoskeletal injuries(MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during...Background: Musculoskeletal injuries(MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during initial training,operational training, and deployment and have a direct negative impact on overall troop readiness. Currently, a systematic overview of all risk factors for MSkIs in the military is not available.Methods: A systematic literature search was carried out using the PubMed, Ovid/Medline, and Web of Science databases from January 1, 2000 to September 10, 2019. Additionally, a reference list scan was performed(using the “snowball method”). Thereafter, an international, multidisciplinary expert panel scored the level of evidence per risk factor, and a classification of modifiable/non-modifiable was made.Results: In total, 176 original papers and 3 meta-analyses were included in the review. A list of 57 reported potential risk factors was formed. For 21 risk factors, the level of evidence was considered moderate or strong. Based on this literature review and an in-depth analysis, the expert panel developed a model to display the most relevant risk factors identified, introducing the idea of the “order of importance” and including concepts that are modifiable/nonmodifiable, as well as extrinsic/intrinsic risk factors.Conclusions: This is the qualitative systematic review of studies on risk factors for MSkIs in the military that has attempted to be all-inclusive. A total of 57 different potential risk factors were identified, and a new, prioritizing injury model was developed. This model may help us to understand risk factors that can be addressed, and in which order they should be prioritized when planning intervention strategies within military groups.展开更多
Chloroquine(CQ)and hydroxychloroquine(HCQ),originally developed as anti-malarial drugs,have found a new purpose in treating various autoimmune dis-eases due to their immunomodulatory properties.These drugs work throug...Chloroquine(CQ)and hydroxychloroquine(HCQ),originally developed as anti-malarial drugs,have found a new purpose in treating various autoimmune dis-eases due to their immunomodulatory properties.These drugs work through mu-ltiple mechanisms,including inhibiting Toll-like receptor signaling,suppressing antigen presentation,and modulating autophagy.This review article provides a comprehensive analysis of the immunomodulatory effects of CQ and HCQ in several autoimmune diseases such as systemic lupus erythematosus,rheumatoid arthritis,systemic sclerosis,and others.We delve into the intricate mechanisms of action,highlighting the key immune cells involved and discussing the clinical implications of these drugs in managing autoimmune conditions.Our review covers the latest research and clinical trials,offering a comprehensive under-standing of the therapeutic potential of CQ and HCQ in autoimmune diseases.We also discuss the challenges and controversies surrounding the use of these drugs,such as their long-term side effects and the need for personalized treatment approaches.By synthesizing current knowledge and identifying areas for future research,this review aims to provide a valuable resource for healthcare profes-sionals and researchers involved in the management of autoimmune diseases.展开更多
In this paper,the property degradation micromechanism of Al-5.10Cu-0.65 Mg-0.8Mn(wt%)alloy induced by 0.5 wt%Fe minor addition was revealed by atomic-scale scanning transmission electron microscopy and energy-dispersi...In this paper,the property degradation micromechanism of Al-5.10Cu-0.65 Mg-0.8Mn(wt%)alloy induced by 0.5 wt%Fe minor addition was revealed by atomic-scale scanning transmission electron microscopy and energy-dispersive X-ray spectroscopy coupled with first-principles calculations.The results show that the Fe minor addition to the Al-Cu-Mg-Mn alloy leads to a slight reduction of grain size and the formation of coarse Al7Cu2Fe constituent particles.Fe tends to segregate into the T-phase dispersoids,θ'-,and S-phase precipitates by preferentially occupying Cu or Mn sites in these phase structures.The apparent Fe segregation contributes to an increase in stiffness of the T-phase and S-phase but decreased stiffness of theθ'phase.Formation of the coarse Al7Cu2Fe constituent particles and decreased stiffness of main precipitatesθ'containing Fe result in the degraded strength of the Al-Cu-Mg-Mn-Fe alloy.Further study reveals that corrosion resistance degradation of the Al-Cu-Mg-Mn-Fe alloy is associated with the increased width of precipitation free zones and consecutive grain boundary precipitates.The obtained results have significant implications for the usage of recycled Al alloys and the potential design strategies of high-performance alloys containing Fe.展开更多
Autoimmune diseases are complex clinical conditions that present significant therapeutic challenges due to their intricate immunological mechanisms.Conventional treatment strategies,such as immunosuppressive drugs and...Autoimmune diseases are complex clinical conditions that present significant therapeutic challenges due to their intricate immunological mechanisms.Conventional treatment strategies,such as immunosuppressive drugs and anti-inflammatory therapies,often demonstrate limited efficacy and are associated with considerable side effects.Recently,mesenchymal stem cells(MSCs)have attracted growing interest as a promising therapeutic approach,owing to their immunomodulatory properties and ability to promote tissue repair.However,the direct application of MSCs faces several limitations,including the risk of immunogenicity and difficulties in large-scale production.In this context MSC-derived exosomes(MSC-Exos),nano-sized extracellular vesicles secreted by MSCs,have emerged as a compelling alternative to cell-based therapies.Enriched with proteins,lipids,and nucleic acids,these exosomes exhibit potent anti-inflammatory and immunomodulatory effects.Their primary mechanisms of action include enhancing the population of regulatory T cells,modulating macrophage polarization,and suppressing proinflammatory cytokines such as interleukin-6 and tumor necrosis factor-α.The therapeutic potential of MSC-Exos extends beyond individual conditions,encompassing a wide range of autoimmune diseases.For instance in Behçet’s disease,they have been shown to regulate vasculitis and inflammatory processes by inhibiting proinflammatory cytokines and promoting endothelial cell regeneration.Moreover,MSC-Exos have demonstrated promising immunomodulatory effects in other autoimmune diseases,including systemic lupus erythematosus,rheumatoid arthritis,and multiple sclerosis.Through mechanisms such as inflammation suppression,vascular repair,and the restoration of immune homeostasis,MSC-Exos represent a versatile and innovative approach to autoimmune disease therapy.This review explored the molecular and therapeutic effects of MSCs and MSC-Exos in autoimmune diseases,with particular emphasis on their clinical potential in Behçet’s disease,systemic lupus erythematosus,rheumatoid arthritis,and multiple sclerosis.展开更多
In semi-arid regions where climatic limitations hinder open-field vegetable production,greenhouse-based lettuce(Lactuca sativa L.)cultivation plays a vital role in ensuring off-season supply.In this study,the potentia...In semi-arid regions where climatic limitations hinder open-field vegetable production,greenhouse-based lettuce(Lactuca sativa L.)cultivation plays a vital role in ensuring off-season supply.In this study,the potential of sustainable input combinations was evaluated to enhance lettuce productivity,quality,and profitability under unheated greenhouse conditions in Southeastern Türkiye.Treatments included farmer practice and a mycorrhizal biofertilizer(ERS,a water-soluble arbuscular mycorrhizal fungus product)applied alone or in combination with organic-based biostimulants(IS and NM).Evaluated parameters were plant height,leaf pigmentation(a^(*),h°),SPAD values,vitamin C,nitrogen and phosphorus content,and gross margin.The ERS2+IS&NM treatment significantly enhanced plant height(32.5 cm),vitamin C content(28.63 mg 100 g^(−1) FW),and gross margin($616.09 da^(−1)),along with improved nutrient uptake and leaf coloration.These findings highlight the synergistic benefits of integrating mycorrhizal inoculants with organic-based biostimulants in greenhouse-grown lettuce systems.The results contribute to the development of eco-friendly,climate-resilient production strategies for protected cultivation in semi-arid environments.展开更多
BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their...BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.展开更多
In this editorial,we comment on the article by Sá-Oliveira et al.We focus specifi-cally on the role of platelet-rich fibrin(PRF)in modulating innate immunity to enhance wound repair.The process of wound healing i...In this editorial,we comment on the article by Sá-Oliveira et al.We focus specifi-cally on the role of platelet-rich fibrin(PRF)in modulating innate immunity to enhance wound repair.The process of wound healing is complex and involves a coordinated series of biological events,including inflammation,cell proliferation,and tissue remodeling.The innate immune system is important in the early stages of wound repair,with inflammation being a crucial initial phase in tissue rege-neration.However,the inflammatory response should be regulated,as excessive or dysregulated inflammation can impair healing.Platelet concentrates,specifi-cally PRF,have originated as promising tools to optimize the tissue repair process.PRF is a second-generation platelet concentrate,and the release of growth factors(GFs)plays a determining role in several aspects of wound healing,including promoting cell proliferation,stimulating angiogenesis,and modulating inflam-mation.PRF forms a fibrin matrix that entraps platelets and GFs.This structure allows for their sustained release over time,which is believed to provide a more favorable microenvironment for tissue repair.Recent research by Sá-Oliveira et al has provided valuable evidence supporting the efficacy of PRF in promoting wound healing.Their study,conducted on an animal model,demonstrated that PRF-based dressings were more effective in accelerating wound closure in the early stages of the healing process,enhancing tissue repair,and modulating the inflammatory response.We explore how PRF's unique properties contribute to a more controlled and effective healing process.By examining these findings,we aim to highlight PRF's potential as a promising therapeutic strategy for improved wound management.展开更多
BACKGROUND Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.AIM To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced rad...BACKGROUND Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.AIM To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced radiological and endoscopic methods and serological,cytological,and microbiological examinations and,therefore,underwent diag-nostic laparoscopy.METHODS This retrospective analysis evaluated 82 patients who underwent diagnostic laparoscopy due to unexplained ascites.Patients’medical records were obtained from the hospital database.Their age,sex,complaints at admission,laboratory results,radiological imaging results,diagnostic laparoscopy reports,and pa-thology reports were analyzed.RESULTS The serum-ascites albumin gradient was<1.1 in 96.3%of the patients(n=79).Among patients,22(26.8%)had benign diagnoses and 60(73.2%)had malignant diagnoses.In addition,55(67.1%)were deceased,and the median follow-up time from diagnosis to death was four months.The overall follow-up time ranged from 1 to 142 months,with a median of 14 months.Patients’diagnoses were significantly associated with their survival(P<0.05,χ2 test).The mortality rate was 86.7%among patients with malignant diagnoses and 13.6%among patients with benign diagnoses.CONCLUSION Diagnostic laparoscopy is minimally invasive,has a low complication rate,and requires a short hospital stay.It can be safely performed to diagnose and treat ascites that remain unexplained after advanced radiological and endoscopic examinations.展开更多
Groundwater is considered a vital source for agriculture,especially in areas that suffer from a shortage of surface water resources.Accordingly,this study was conducted to evaluate the concentrations of some polluting...Groundwater is considered a vital source for agriculture,especially in areas that suffer from a shortage of surface water resources.Accordingly,this study was conducted to evaluate the concentrations of some polluting elements and some chemical properties of well water north of Babylon city to show its suitability for irrigation purposes.The(pH,EC,calcium,magnesium,sodium,potassium,chloride,carbonates,bicarbonates,sulfates,nitrates,and boron)and some heavy elements(cadmium,lead,copper,and nickel)were estimated over four time periods(July 2023,October 2023,January 2024,April 2024)and for the regions(Latifiya,Al-Musayyab,Haswa,and Alexandria).The results showed that the electrical conductivity of well water falls within the category that causes a severe salinity problem,according to Ayera and Westcot,and the pH of the water was within the normal range,tending toward light alkalinity.The sodium values fell within the category that causes a severe problem,and that the chloride concentrations were high and within the category of water that causes a severe problem according to the classification of Marsh.The concentration of boron was low to moderate for sensitive crops.Regarding the nitrate content,well water is classified as no problem.The concentrations of all heavy metals were within the permissible limits,except for cadmium,which exceeded the permissible limits according to the global specifications of the World Health Organization.展开更多
Alcohol-associated liver disease(ALD)is a major global health concern,contributing to liver injury,morbidity,and mortality.Elafibranor(EFN),a dual peroxisome proliferator-activated receptorα/δagonist,has shown promi...Alcohol-associated liver disease(ALD)is a major global health concern,contributing to liver injury,morbidity,and mortality.Elafibranor(EFN),a dual peroxisome proliferator-activated receptorα/δagonist,has shown promise as a therapeutic candidate in preclinical studies.EFN reduces liver fibrosis by inhibiting lipid accumulation,apoptosis,and inflammatory pathways(LPS/TLR4/NF-κB),while enhancing autophagy and antioxidant responses.It also improves intestinal barrier function and modulates gut microbiota,reducing endotoxin-producing bacteria and increasing beneficial species.By strengthening the intestinal barrier and suppressing pro-inflammatory mediators like tumor necrosis factor-alpha and interleukin-6,EFN mitigates hepatic stellate cell activation and fibrogenic signaling.Macrophages play a central role in ALD progression,and EFN’s ability to modulate macrophage activity further highlights its anti-inflammatory properties.This review emphasizes EFN’s dual-targeted approach,addressing both hepatic and intestinal dysfunctions,distinguishing it from conventional ALD treatments.While preclinical results are promising,EFN remains under clinical investigation,with ongoing trials evaluating its safety and efficacy.Future research should focus on elucidating EFN’s molecular mechanisms and advancing its clinical application to establish its therapeutic potential in human populations.EFN represents a novel,comprehensive strategy for ALD management,targeting both liver and gut pathologies.展开更多
Extracorporeal membrane oxygenation(ECMO)has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional therapies.ECMO allows blood to b...Extracorporeal membrane oxygenation(ECMO)has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional therapies.ECMO allows blood to be extracted from a patient and introduced to a machine that oxygenates blood and removes carbon dioxide.This blood is then reintroduced into the patient’s circulatory system.This process makes ECMO essential for treating various medical conditions,both as a standalone therapy and as adjuvant therapy.Veno-venous(VV)ECMO primarily supports respiratory function and indicates respiratory distress.Simultaneously,veno-arterial(VA)ECMO provides hemodynamic and respiratory support and is suitable for cardiac-related complications.This study reviews recent literature to elucidate the evolving role of ECMO in trauma care,considering its procedural intricacies,indications,contraindications,and associated complications.Notably,the use of ECMO in trauma patients,particularly for acute respiratory distress syndrome and cardiogenic shock,has demonstrated promising outcomes despite challenges such as anticoagulation management and complications such as acute kidney injury,bleeding,thrombosis,and hemolysis.Some studies have shown that VV ECMO was associated with significantly higher survival rates than conventional mechanical ventilation,whereas other studies have reported that VA ECMO was associated with lower survival rates than VV ECMO.ECMO plays a critical role in managing trauma patients,particularly those with acute respiratory failure.Further research is necessary to explore the full potential of ECMO in trauma care.Clinicians should have a clear understanding of the indications and contraindications for the use of ECMO to maximize its benefits in treating trauma patients.展开更多
Connective tissue is a dynamic structure that reacts to environmental cues to maintain homeostasis,including mechanical properties.Mechanical load influences extracellular matrix(ECM)—cell interactions and modulates ...Connective tissue is a dynamic structure that reacts to environmental cues to maintain homeostasis,including mechanical properties.Mechanical load influences extracellular matrix(ECM)—cell interactions and modulates cellular behavior.Mechano-regulation processes involve matrix modification and cell activation to preserve tissue function.The ECM remodeling is crucial for force transmission.Cytoskeleton components are involved in force sensing and transmission,affecting cellular adhesion,motility,and gene expression.Proper mechanical loading helps to maintain tissue health,while imbalances may lead to pathological processes.Active and passive movement,including manual mobilization,improves connective tissue elasticity,promotes ECM-cell homeostasis,and reduces fibrosis.In rehabilitation,understanding mechanical-regulation processes is necessary for ameliorating and developing treatments aimed at preserving tissue elasticity and preventing fibrosis.In this commentary,we aim to globally describe the biological processes involved in mechanical force transmission in connective tissue as support for translational studies and clinical applications in the rehabilitation field.展开更多
This editorial highlights the critical role of viral RNA signatures encapsulated within circulating exosomes as a potential missing link in the early diagnosis of gastrointestinal(GI)cancers.Current diagnostic methods...This editorial highlights the critical role of viral RNA signatures encapsulated within circulating exosomes as a potential missing link in the early diagnosis of gastrointestinal(GI)cancers.Current diagnostic methods for virus-associated GI malignancies often fall short in detecting infections at subclinical or pre-cancerous stages.We propose that viral RNA-loaded exosomes,by offering stable,specific,and non-invasive biomarkers,can bridge this gap and revolutionize early de-tection compared to conventional approaches.As highlighted by Zhang et al in their recent review,viral infections,such as hepatitis B and C viruses,Epstein-Barr virus,and human papillomavirus,are well-established contributors to the pathogenesis of various GI malignancies.However,current diagnostic methods often underperform in detecting these infections at subclinical or pre-cancerous stages.We highlight the shared points between virology,exosome biology,and oncology,reinforcing the importance of viral RNA-loaded exosomes as a“missing link”in the early detection of virus-associated GI cancers.We also discuss current challenges,translational opportunities,and the requirements for clinical vali-dation of these promising biomarkers.展开更多
BACKGROUND Relieving pain is central to the early management of knee osteoarthritis,with a plethora of pharmacological agents licensed for this purpose.Intra-articular corticosteroid injections are a widely used optio...BACKGROUND Relieving pain is central to the early management of knee osteoarthritis,with a plethora of pharmacological agents licensed for this purpose.Intra-articular corticosteroid injections are a widely used option,albeit with variable efficacy.AIM To develop a machine learning(ML)model that predicts which patients will benefit from corticosteroid injections.METHODS Data from two prospective cohort studies[Osteoarthritis(OA)Initiative and Multicentre OA Study]was combined.The primary outcome was patientreported pain score following corticosteroid injection,assessed using the Western Ontario and McMaster Universities OA pain scale,with significant change defined using minimally clinically important difference and meaningful within person change.A ML algorithm was developed,utilizing linear discriminant analysis,to predict symptomatic improvement,and examine the association between pain scores and patient factors by calculating the sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and F2 score.RESULTS A total of 330 patients were included,with a mean age of 63.4(SD:8.3).The mean Western Ontario and McMaster Universities OA pain score was 5.2(SD:4.1),with only 25.5%of patients achieving significant improvement in pain following corticosteroid injection.The ML model generated an accuracy of 67.8%(95%confidence interval:64.6%-70.9%),F1 score of 30.8%,and an area under the curve score of 0.60.CONCLUSION The model demonstrated feasibility to assist clinicians with decision-making in patient selection for corticosteroid injections.Further studies are required to improve the model prior to testing in clinical settings.展开更多
Deuterium is a heavy isotope of hydrogen,with an extra neutron,endowing it with unique biophysical and biochemical properties compared to hydrogen.The ATPase pumps in the mitochondria depend upon proton motive force t...Deuterium is a heavy isotope of hydrogen,with an extra neutron,endowing it with unique biophysical and biochemical properties compared to hydrogen.The ATPase pumps in the mitochondria depend upon proton motive force to catalyze the reaction that produces ATP.Deuterons disrupt the pumps,inducing excessive reactive oxygen species and decreased ATP synthesis.The aim of this review is to develop a theory that mitochondrial dysfunction due to deuterium overload,systemically,is a primary cause of Parkinson’s disease(PD).The gut microbes supply deuterium-depleted short chain fatty acids(SCFAs)to the colonocytes,particularly butyrate,and an insufficient supply of butyrate may be a primary driver behind mitochondrial dysfunction in the gut,an early factor in PD.Indeed,low gut butyrate is a characteristic feature of PD.Mitochondrial dysfunction is a factor in many diseases,including all neurodegenerative diseases.Biological organisms have devised sophisticated strategies for protecting the ATPase pumps from deuterium overload.One such strategy may involve capturing deuterons in bis-allylic carbon atoms present in polyunsaturated fatty acids(PUFAs)in cardiolipin.Cardiolipin uniquely localizes to the inner membrane of the intermembrane space,tightly integrated into ATPase proteins.Bis-allylic carbon atoms can capture and retain deuterium,and,interestingly,deuterium doping in PUFAs can quench the chain reaction that causes massive damage upon lipid peroxidation.Neuronal cardiolipin is especially rich in docosahexaenoic acid(DHA),a PUFA with five bisallylic carbon atoms.Upon excessive oxidative stress,cardiolipin migrates to the outer membrane,where it interacts withα-synuclein(α-syn),the amyloidogenic protein that accumulates as fibrils in Lewy bodies in association with PD.Such interaction leads to pore formation and the launch of an apoptotic cascade.α-syn misfolding likely begins in the gut,and misfoldedα-syn travels along nerve fibers,particularly the vagus nerve,to reach the brainstem nuclei,where it can seed misfolding ofα-syn molecules already present there.Mitochondrial dysfunction in the gut may be a primary factor in PD,and low-deuterium nutrients may be therapeutic.展开更多
This research presents a numerical simulation methodology for optimizing circular composite overlays’dimensions and pressure characteristics with orthotropic mechanical properties,specifically,for metal conduits with...This research presents a numerical simulation methodology for optimizing circular composite overlays’dimensions and pressure characteristics with orthotropic mechanical properties,specifically,for metal conduits with temperature-dependent elastoplastic behavior.The primary objective of the proposed method is to prevent crack propagation during pressure surges from operational to critical levels.This study examines the“Beineu-Bozoy-Shymkent”steel gas conduit,examining its performance across a temperature range of−40 to+50℃.This work builds on prior research on extended avalanche destruction in steel gas conduits and crack propagation prevention techniques.Theanalysis was conducted using a dynamic finite-element approach with the ANSYS-19.2/ExplicitDynamics software.Simulations of unprotected conduits revealed that increasing gas-dynamic pressure can convert a partial-depth crack into a through-crack,extending longitudinally to approximately seven times its initial length.Notably,at T=+50℃,the developed crack length was 1.2%longer than that at T=−40℃,highlighting the temperature sensitivity of crack progression.The modeling results indicate that crack propagation can be effectively controlled using a circular composite overlay with a thickness between 37.5%and 50%of the crack depth and a length approximately five times that of the initial crack,centered symmetrically over the crack.In addition,preliminary stress analysis indicated that limiting the overlay-induced pressure to 5%of the operational pressure effectively arrested crack growth without generating significant stress concentrations near the overlay boundaries,thereby preventing conduit integrity.展开更多
文摘Background: Musculoskeletal injuries(MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during initial training,operational training, and deployment and have a direct negative impact on overall troop readiness. Currently, a systematic overview of all risk factors for MSkIs in the military is not available.Methods: A systematic literature search was carried out using the PubMed, Ovid/Medline, and Web of Science databases from January 1, 2000 to September 10, 2019. Additionally, a reference list scan was performed(using the “snowball method”). Thereafter, an international, multidisciplinary expert panel scored the level of evidence per risk factor, and a classification of modifiable/non-modifiable was made.Results: In total, 176 original papers and 3 meta-analyses were included in the review. A list of 57 reported potential risk factors was formed. For 21 risk factors, the level of evidence was considered moderate or strong. Based on this literature review and an in-depth analysis, the expert panel developed a model to display the most relevant risk factors identified, introducing the idea of the “order of importance” and including concepts that are modifiable/nonmodifiable, as well as extrinsic/intrinsic risk factors.Conclusions: This is the qualitative systematic review of studies on risk factors for MSkIs in the military that has attempted to be all-inclusive. A total of 57 different potential risk factors were identified, and a new, prioritizing injury model was developed. This model may help us to understand risk factors that can be addressed, and in which order they should be prioritized when planning intervention strategies within military groups.
基金Supported by the Oman Ministry of Higher Education,Research,and Innovation,No.BFP/RGP/HSS/24/015.
文摘Chloroquine(CQ)and hydroxychloroquine(HCQ),originally developed as anti-malarial drugs,have found a new purpose in treating various autoimmune dis-eases due to their immunomodulatory properties.These drugs work through mu-ltiple mechanisms,including inhibiting Toll-like receptor signaling,suppressing antigen presentation,and modulating autophagy.This review article provides a comprehensive analysis of the immunomodulatory effects of CQ and HCQ in several autoimmune diseases such as systemic lupus erythematosus,rheumatoid arthritis,systemic sclerosis,and others.We delve into the intricate mechanisms of action,highlighting the key immune cells involved and discussing the clinical implications of these drugs in managing autoimmune conditions.Our review covers the latest research and clinical trials,offering a comprehensive under-standing of the therapeutic potential of CQ and HCQ in autoimmune diseases.We also discuss the challenges and controversies surrounding the use of these drugs,such as their long-term side effects and the need for personalized treatment approaches.By synthesizing current knowledge and identifying areas for future research,this review aims to provide a valuable resource for healthcare profes-sionals and researchers involved in the management of autoimmune diseases.
基金supported by the National Natural Science Foundation of China(Nos.U20A20274 and 52061003)the Natural Science Foundation of Yunnan Province(No.202301AT070209)the Science and Technology Major Project of Yunnan Province(No.202102AG050017).
文摘In this paper,the property degradation micromechanism of Al-5.10Cu-0.65 Mg-0.8Mn(wt%)alloy induced by 0.5 wt%Fe minor addition was revealed by atomic-scale scanning transmission electron microscopy and energy-dispersive X-ray spectroscopy coupled with first-principles calculations.The results show that the Fe minor addition to the Al-Cu-Mg-Mn alloy leads to a slight reduction of grain size and the formation of coarse Al7Cu2Fe constituent particles.Fe tends to segregate into the T-phase dispersoids,θ'-,and S-phase precipitates by preferentially occupying Cu or Mn sites in these phase structures.The apparent Fe segregation contributes to an increase in stiffness of the T-phase and S-phase but decreased stiffness of theθ'phase.Formation of the coarse Al7Cu2Fe constituent particles and decreased stiffness of main precipitatesθ'containing Fe result in the degraded strength of the Al-Cu-Mg-Mn-Fe alloy.Further study reveals that corrosion resistance degradation of the Al-Cu-Mg-Mn-Fe alloy is associated with the increased width of precipitation free zones and consecutive grain boundary precipitates.The obtained results have significant implications for the usage of recycled Al alloys and the potential design strategies of high-performance alloys containing Fe.
文摘Autoimmune diseases are complex clinical conditions that present significant therapeutic challenges due to their intricate immunological mechanisms.Conventional treatment strategies,such as immunosuppressive drugs and anti-inflammatory therapies,often demonstrate limited efficacy and are associated with considerable side effects.Recently,mesenchymal stem cells(MSCs)have attracted growing interest as a promising therapeutic approach,owing to their immunomodulatory properties and ability to promote tissue repair.However,the direct application of MSCs faces several limitations,including the risk of immunogenicity and difficulties in large-scale production.In this context MSC-derived exosomes(MSC-Exos),nano-sized extracellular vesicles secreted by MSCs,have emerged as a compelling alternative to cell-based therapies.Enriched with proteins,lipids,and nucleic acids,these exosomes exhibit potent anti-inflammatory and immunomodulatory effects.Their primary mechanisms of action include enhancing the population of regulatory T cells,modulating macrophage polarization,and suppressing proinflammatory cytokines such as interleukin-6 and tumor necrosis factor-α.The therapeutic potential of MSC-Exos extends beyond individual conditions,encompassing a wide range of autoimmune diseases.For instance in Behçet’s disease,they have been shown to regulate vasculitis and inflammatory processes by inhibiting proinflammatory cytokines and promoting endothelial cell regeneration.Moreover,MSC-Exos have demonstrated promising immunomodulatory effects in other autoimmune diseases,including systemic lupus erythematosus,rheumatoid arthritis,and multiple sclerosis.Through mechanisms such as inflammation suppression,vascular repair,and the restoration of immune homeostasis,MSC-Exos represent a versatile and innovative approach to autoimmune disease therapy.This review explored the molecular and therapeutic effects of MSCs and MSC-Exos in autoimmune diseases,with particular emphasis on their clinical potential in Behçet’s disease,systemic lupus erythematosus,rheumatoid arthritis,and multiple sclerosis.
文摘In semi-arid regions where climatic limitations hinder open-field vegetable production,greenhouse-based lettuce(Lactuca sativa L.)cultivation plays a vital role in ensuring off-season supply.In this study,the potential of sustainable input combinations was evaluated to enhance lettuce productivity,quality,and profitability under unheated greenhouse conditions in Southeastern Türkiye.Treatments included farmer practice and a mycorrhizal biofertilizer(ERS,a water-soluble arbuscular mycorrhizal fungus product)applied alone or in combination with organic-based biostimulants(IS and NM).Evaluated parameters were plant height,leaf pigmentation(a^(*),h°),SPAD values,vitamin C,nitrogen and phosphorus content,and gross margin.The ERS2+IS&NM treatment significantly enhanced plant height(32.5 cm),vitamin C content(28.63 mg 100 g^(−1) FW),and gross margin($616.09 da^(−1)),along with improved nutrient uptake and leaf coloration.These findings highlight the synergistic benefits of integrating mycorrhizal inoculants with organic-based biostimulants in greenhouse-grown lettuce systems.The results contribute to the development of eco-friendly,climate-resilient production strategies for protected cultivation in semi-arid environments.
基金Supported by the Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0019Chongqing Municipal Education Commission’s 14th Five-Year Key Discipline Support Project,No.20240101 and No.20240102。
文摘BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.
基金Supported by The Oman Ministry of Higher Education,Research,and Innovation,No.BFP/RGP/HSS/24/015.
文摘In this editorial,we comment on the article by Sá-Oliveira et al.We focus specifi-cally on the role of platelet-rich fibrin(PRF)in modulating innate immunity to enhance wound repair.The process of wound healing is complex and involves a coordinated series of biological events,including inflammation,cell proliferation,and tissue remodeling.The innate immune system is important in the early stages of wound repair,with inflammation being a crucial initial phase in tissue rege-neration.However,the inflammatory response should be regulated,as excessive or dysregulated inflammation can impair healing.Platelet concentrates,specifi-cally PRF,have originated as promising tools to optimize the tissue repair process.PRF is a second-generation platelet concentrate,and the release of growth factors(GFs)plays a determining role in several aspects of wound healing,including promoting cell proliferation,stimulating angiogenesis,and modulating inflam-mation.PRF forms a fibrin matrix that entraps platelets and GFs.This structure allows for their sustained release over time,which is believed to provide a more favorable microenvironment for tissue repair.Recent research by Sá-Oliveira et al has provided valuable evidence supporting the efficacy of PRF in promoting wound healing.Their study,conducted on an animal model,demonstrated that PRF-based dressings were more effective in accelerating wound closure in the early stages of the healing process,enhancing tissue repair,and modulating the inflammatory response.We explore how PRF's unique properties contribute to a more controlled and effective healing process.By examining these findings,we aim to highlight PRF's potential as a promising therapeutic strategy for improved wound management.
文摘BACKGROUND Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.AIM To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced radiological and endoscopic methods and serological,cytological,and microbiological examinations and,therefore,underwent diag-nostic laparoscopy.METHODS This retrospective analysis evaluated 82 patients who underwent diagnostic laparoscopy due to unexplained ascites.Patients’medical records were obtained from the hospital database.Their age,sex,complaints at admission,laboratory results,radiological imaging results,diagnostic laparoscopy reports,and pa-thology reports were analyzed.RESULTS The serum-ascites albumin gradient was<1.1 in 96.3%of the patients(n=79).Among patients,22(26.8%)had benign diagnoses and 60(73.2%)had malignant diagnoses.In addition,55(67.1%)were deceased,and the median follow-up time from diagnosis to death was four months.The overall follow-up time ranged from 1 to 142 months,with a median of 14 months.Patients’diagnoses were significantly associated with their survival(P<0.05,χ2 test).The mortality rate was 86.7%among patients with malignant diagnoses and 13.6%among patients with benign diagnoses.CONCLUSION Diagnostic laparoscopy is minimally invasive,has a low complication rate,and requires a short hospital stay.It can be safely performed to diagnose and treat ascites that remain unexplained after advanced radiological and endoscopic examinations.
文摘Groundwater is considered a vital source for agriculture,especially in areas that suffer from a shortage of surface water resources.Accordingly,this study was conducted to evaluate the concentrations of some polluting elements and some chemical properties of well water north of Babylon city to show its suitability for irrigation purposes.The(pH,EC,calcium,magnesium,sodium,potassium,chloride,carbonates,bicarbonates,sulfates,nitrates,and boron)and some heavy elements(cadmium,lead,copper,and nickel)were estimated over four time periods(July 2023,October 2023,January 2024,April 2024)and for the regions(Latifiya,Al-Musayyab,Haswa,and Alexandria).The results showed that the electrical conductivity of well water falls within the category that causes a severe salinity problem,according to Ayera and Westcot,and the pH of the water was within the normal range,tending toward light alkalinity.The sodium values fell within the category that causes a severe problem,and that the chloride concentrations were high and within the category of water that causes a severe problem according to the classification of Marsh.The concentration of boron was low to moderate for sensitive crops.Regarding the nitrate content,well water is classified as no problem.The concentrations of all heavy metals were within the permissible limits,except for cadmium,which exceeded the permissible limits according to the global specifications of the World Health Organization.
文摘Alcohol-associated liver disease(ALD)is a major global health concern,contributing to liver injury,morbidity,and mortality.Elafibranor(EFN),a dual peroxisome proliferator-activated receptorα/δagonist,has shown promise as a therapeutic candidate in preclinical studies.EFN reduces liver fibrosis by inhibiting lipid accumulation,apoptosis,and inflammatory pathways(LPS/TLR4/NF-κB),while enhancing autophagy and antioxidant responses.It also improves intestinal barrier function and modulates gut microbiota,reducing endotoxin-producing bacteria and increasing beneficial species.By strengthening the intestinal barrier and suppressing pro-inflammatory mediators like tumor necrosis factor-alpha and interleukin-6,EFN mitigates hepatic stellate cell activation and fibrogenic signaling.Macrophages play a central role in ALD progression,and EFN’s ability to modulate macrophage activity further highlights its anti-inflammatory properties.This review emphasizes EFN’s dual-targeted approach,addressing both hepatic and intestinal dysfunctions,distinguishing it from conventional ALD treatments.While preclinical results are promising,EFN remains under clinical investigation,with ongoing trials evaluating its safety and efficacy.Future research should focus on elucidating EFN’s molecular mechanisms and advancing its clinical application to establish its therapeutic potential in human populations.EFN represents a novel,comprehensive strategy for ALD management,targeting both liver and gut pathologies.
文摘Extracorporeal membrane oxygenation(ECMO)has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional therapies.ECMO allows blood to be extracted from a patient and introduced to a machine that oxygenates blood and removes carbon dioxide.This blood is then reintroduced into the patient’s circulatory system.This process makes ECMO essential for treating various medical conditions,both as a standalone therapy and as adjuvant therapy.Veno-venous(VV)ECMO primarily supports respiratory function and indicates respiratory distress.Simultaneously,veno-arterial(VA)ECMO provides hemodynamic and respiratory support and is suitable for cardiac-related complications.This study reviews recent literature to elucidate the evolving role of ECMO in trauma care,considering its procedural intricacies,indications,contraindications,and associated complications.Notably,the use of ECMO in trauma patients,particularly for acute respiratory distress syndrome and cardiogenic shock,has demonstrated promising outcomes despite challenges such as anticoagulation management and complications such as acute kidney injury,bleeding,thrombosis,and hemolysis.Some studies have shown that VV ECMO was associated with significantly higher survival rates than conventional mechanical ventilation,whereas other studies have reported that VA ECMO was associated with lower survival rates than VV ECMO.ECMO plays a critical role in managing trauma patients,particularly those with acute respiratory failure.Further research is necessary to explore the full potential of ECMO in trauma care.Clinicians should have a clear understanding of the indications and contraindications for the use of ECMO to maximize its benefits in treating trauma patients.
文摘Connective tissue is a dynamic structure that reacts to environmental cues to maintain homeostasis,including mechanical properties.Mechanical load influences extracellular matrix(ECM)—cell interactions and modulates cellular behavior.Mechano-regulation processes involve matrix modification and cell activation to preserve tissue function.The ECM remodeling is crucial for force transmission.Cytoskeleton components are involved in force sensing and transmission,affecting cellular adhesion,motility,and gene expression.Proper mechanical loading helps to maintain tissue health,while imbalances may lead to pathological processes.Active and passive movement,including manual mobilization,improves connective tissue elasticity,promotes ECM-cell homeostasis,and reduces fibrosis.In rehabilitation,understanding mechanical-regulation processes is necessary for ameliorating and developing treatments aimed at preserving tissue elasticity and preventing fibrosis.In this commentary,we aim to globally describe the biological processes involved in mechanical force transmission in connective tissue as support for translational studies and clinical applications in the rehabilitation field.
基金Supported by the Oman Ministry of Higher Education,Research,and Innovation,No.BFP/RGP/HSS/24/015.
文摘This editorial highlights the critical role of viral RNA signatures encapsulated within circulating exosomes as a potential missing link in the early diagnosis of gastrointestinal(GI)cancers.Current diagnostic methods for virus-associated GI malignancies often fall short in detecting infections at subclinical or pre-cancerous stages.We propose that viral RNA-loaded exosomes,by offering stable,specific,and non-invasive biomarkers,can bridge this gap and revolutionize early de-tection compared to conventional approaches.As highlighted by Zhang et al in their recent review,viral infections,such as hepatitis B and C viruses,Epstein-Barr virus,and human papillomavirus,are well-established contributors to the pathogenesis of various GI malignancies.However,current diagnostic methods often underperform in detecting these infections at subclinical or pre-cancerous stages.We highlight the shared points between virology,exosome biology,and oncology,reinforcing the importance of viral RNA-loaded exosomes as a“missing link”in the early detection of virus-associated GI cancers.We also discuss current challenges,translational opportunities,and the requirements for clinical vali-dation of these promising biomarkers.
基金Supported by National Institute For Health and Care Research,No.NIHR302632.
文摘BACKGROUND Relieving pain is central to the early management of knee osteoarthritis,with a plethora of pharmacological agents licensed for this purpose.Intra-articular corticosteroid injections are a widely used option,albeit with variable efficacy.AIM To develop a machine learning(ML)model that predicts which patients will benefit from corticosteroid injections.METHODS Data from two prospective cohort studies[Osteoarthritis(OA)Initiative and Multicentre OA Study]was combined.The primary outcome was patientreported pain score following corticosteroid injection,assessed using the Western Ontario and McMaster Universities OA pain scale,with significant change defined using minimally clinically important difference and meaningful within person change.A ML algorithm was developed,utilizing linear discriminant analysis,to predict symptomatic improvement,and examine the association between pain scores and patient factors by calculating the sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and F2 score.RESULTS A total of 330 patients were included,with a mean age of 63.4(SD:8.3).The mean Western Ontario and McMaster Universities OA pain score was 5.2(SD:4.1),with only 25.5%of patients achieving significant improvement in pain following corticosteroid injection.The ML model generated an accuracy of 67.8%(95%confidence interval:64.6%-70.9%),F1 score of 30.8%,and an area under the curve score of 0.60.CONCLUSION The model demonstrated feasibility to assist clinicians with decision-making in patient selection for corticosteroid injections.Further studies are required to improve the model prior to testing in clinical settings.
基金funded in part by Quanta Computer,Inc.,in Tanyuan,Taiwan,under contract number 6950759,as part of the AIR project.
文摘Deuterium is a heavy isotope of hydrogen,with an extra neutron,endowing it with unique biophysical and biochemical properties compared to hydrogen.The ATPase pumps in the mitochondria depend upon proton motive force to catalyze the reaction that produces ATP.Deuterons disrupt the pumps,inducing excessive reactive oxygen species and decreased ATP synthesis.The aim of this review is to develop a theory that mitochondrial dysfunction due to deuterium overload,systemically,is a primary cause of Parkinson’s disease(PD).The gut microbes supply deuterium-depleted short chain fatty acids(SCFAs)to the colonocytes,particularly butyrate,and an insufficient supply of butyrate may be a primary driver behind mitochondrial dysfunction in the gut,an early factor in PD.Indeed,low gut butyrate is a characteristic feature of PD.Mitochondrial dysfunction is a factor in many diseases,including all neurodegenerative diseases.Biological organisms have devised sophisticated strategies for protecting the ATPase pumps from deuterium overload.One such strategy may involve capturing deuterons in bis-allylic carbon atoms present in polyunsaturated fatty acids(PUFAs)in cardiolipin.Cardiolipin uniquely localizes to the inner membrane of the intermembrane space,tightly integrated into ATPase proteins.Bis-allylic carbon atoms can capture and retain deuterium,and,interestingly,deuterium doping in PUFAs can quench the chain reaction that causes massive damage upon lipid peroxidation.Neuronal cardiolipin is especially rich in docosahexaenoic acid(DHA),a PUFA with five bisallylic carbon atoms.Upon excessive oxidative stress,cardiolipin migrates to the outer membrane,where it interacts withα-synuclein(α-syn),the amyloidogenic protein that accumulates as fibrils in Lewy bodies in association with PD.Such interaction leads to pore formation and the launch of an apoptotic cascade.α-syn misfolding likely begins in the gut,and misfoldedα-syn travels along nerve fibers,particularly the vagus nerve,to reach the brainstem nuclei,where it can seed misfolding ofα-syn molecules already present there.Mitochondrial dysfunction in the gut may be a primary factor in PD,and low-deuterium nutrients may be therapeutic.
基金supported by the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan(Grant No.AP19680589).
文摘This research presents a numerical simulation methodology for optimizing circular composite overlays’dimensions and pressure characteristics with orthotropic mechanical properties,specifically,for metal conduits with temperature-dependent elastoplastic behavior.The primary objective of the proposed method is to prevent crack propagation during pressure surges from operational to critical levels.This study examines the“Beineu-Bozoy-Shymkent”steel gas conduit,examining its performance across a temperature range of−40 to+50℃.This work builds on prior research on extended avalanche destruction in steel gas conduits and crack propagation prevention techniques.Theanalysis was conducted using a dynamic finite-element approach with the ANSYS-19.2/ExplicitDynamics software.Simulations of unprotected conduits revealed that increasing gas-dynamic pressure can convert a partial-depth crack into a through-crack,extending longitudinally to approximately seven times its initial length.Notably,at T=+50℃,the developed crack length was 1.2%longer than that at T=−40℃,highlighting the temperature sensitivity of crack progression.The modeling results indicate that crack propagation can be effectively controlled using a circular composite overlay with a thickness between 37.5%and 50%of the crack depth and a length approximately five times that of the initial crack,centered symmetrically over the crack.In addition,preliminary stress analysis indicated that limiting the overlay-induced pressure to 5%of the operational pressure effectively arrested crack growth without generating significant stress concentrations near the overlay boundaries,thereby preventing conduit integrity.
