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Prevalence and characteristics of metabolic dysfunction-associated steatohepatitis among pediatric patients in the MarketScan Databases

Introduction There are few epidemiologic studies of the prevalence of metabolic dysfunction-associated steatohepatitis (MASH) among pediatric populations. Objective To estimate the cross-sectional prevalence of MASH in the pediatric (<18 years) populations of Merative TM MarketScan® Commercial Database (Commercial) and Merative TM MarketScan® Multi-State Medicaid Database (Medicaid). Methods Pediatric patients with ≥1 medical encounter from 1/1/2020 to 12/31/2020 and ≥6 months of continuous enrollment before the most recent medical encounter were included. MASH was confirmed by an ICD-10-CM diagnosis code for MASH (K75.81) in the medical history since 1/1/2016. Results A total of 1,476 and 410 pediatric MASH patients were identified in Medicaid and Commercial databases respectively, with a prevalence of 0.036% (95% confidence interval (CI): 0.034%, 0.038%) in Medicaid, as compared to 0.011% (95% CI: 0.010%, 0.012%) in Commercial. Prevalence of MASH increased by age. MASH was more prevalent in those who were male, obese, had T2D, and had metabolic syndrome. Among all pediatric MASH patients, the majority were ≥10 years old, male, and obese. Discussion MASH is more prevalent among pediatric patients with comorbid conditions such as metabolic syndrome, obesity, and T2D, which appears to be similar to young adults. Rising prevalence of childhood obesity and related comorbid conditions, and the progressive nature of MASH, make this an area of increasing medical need. Prescreening MASH among high-risk patients with these comorbidities is needed for target intervention.

Assessment of the water and energy nexus in the energy supply subsystem of water stressed countries like Iran

A HAZOP-based hazard identification model for urban gas accidents: Development and empirical validation

Urban gas accidents pose significant threats to public safety and urban infrastructure, with traditional hazard identification methods often relying on manual inspections and experience-based judgments, leading to incomplete or inconsistent results. To address these issues, this study proposes a structured hazard identification model based on Hazard and Operability Analysis (HAZOP) deviation theory for urban gas systems. By integrating four key dimensions—human, machine, environment, and management—a comprehensive framework was developed to define system nodes, select relevant parameters, and apply guide words to identify potential hazards in a standardized manner. This approach allows for dynamic adjustment of influencing factors according to different application scenarios. The model was validated through a case study involving a restaurant, where it identified 65 potential gas-related hazards, over eight times more than traditional inspection approaches. Results demonstrate significant improvements in comprehensiveness, accuracy, and efficiency of hazard identification. This model provides a practical tool for urban gas safety management, supporting standardized hazard screening across various sectors including restaurants, residential buildings, schools, and commercial complexes. Furthermore, it lays the foundation for future integration of quantitative risk assessment and artificial intelligence-driven risk analysis, contributing to the digitalization and standardization of urban gas safety governance.

Modulation of the blood–brain barrier permeability by patient-derived glioblastoma stem cell secretome

Prediction of immunogenicity of Rh antigens using in silico analysis of binding to human leukocyte antigen peptide, Basic/Translational Research

The association between human leukocyte antigen (HLA) types and blood group alloimmunization remains unclear. Previous studies have predominantly focused on predicting immunization events in cancer immunotherapy, but not blood group antigens. In this study, we investigated whether HLA peptide binding could predict the immunogenicity of blood group antigens. We performed in silico binding analysis of Rh antigens and representative HLA class II alleles using NetMHCpan-4.1 and NetMHCIIpan-4.1 algorithms. The distribution of strong binding regions (hotspots) differed across HLA loci and ethnic groups. In particular, the RhD and RhCE antigens showed several distinct hotspots for the HLA-DRB, -DQA-DQB, and -DPA-DPB HLA class II peptides. A hotspot of RHD*01W.1 in HLA-DRB had a substitution in p.Val270Gly. The number of hotspots and core amino acids was different for each HLA locus, and the amino acid regions (exofacial, transmembrane, and intracellular region) differed among the hotspots. Our findings underscore the significance of immunogenicity between the Rh antigens and HLA-DR, suggesting the potential clinical utility of predicting antibody development in blood transfusions. This in silico approach offers novel insights into understanding and managing alloimmunization events, particularly in patients with multiple alloantibodies when blood transfusion is required.

The association between aromatic amino acids consumption and the severity of pemphigus vulgaris: a cross-sectional study

Implementation and survey evaluation of a new safety concern escalation pathway among nursing team members

Introduction Escalating patient safety concerns is a critical component of healthcare delivery and can be impeded by organizational barriers including power hierarchies and fear of retaliation. Nursing team members are pivotal in identifying and addressing real-time safety issues. The existing literature on increasing “speaking-up” behaviors among nursing team members predominantly focuses on communication training rather than simplifying the escalation process. The current project aimed to evaluate the awareness and perceptions of a newly implemented pathway to streamline concern escalation among nursing team members at a tertiary academic medical center. Although the pathway was embraced and regularly utilized by nursing supervisors, we sought to determine whether front-line staff were aware of, and confident in, the use of the pathway. Methods A new escalation pathway for communicating concerns was developed and implemented in response to a patient safety event and subsequent root cause analysis. An investigator-developed electronic survey was distributed to nursing team members and assessed (1) demographic data, (2) experiences with escalating safety concerns, and (3) awareness, use, and attitudes toward the new pathway. Recruitment and data collection occurred in two stages, and responses were collected via REDCap. Data were analyzed using descriptive statistics and qualitative thematic analysis of free-text response items. Results 128 of 129 total responses were analyzed. Of 89 (69.5%) participants who indicated they had ever encountered a situation requiring escalation, 48 of them (53.9%; 37.5% of all respondents) reported hesitating to act because they were uncertain how to escalate the concern. 25.6% of respondents had already used the new pathway for escalating concerns, and 79% thought they would use the pathway in the future. However, 41% expressed ambivalence about its impact on their confidence in escalating concerns and 47% were still unsure how to use the matrix/pathway. Thematic analysis of 51 free-text response items identified five key themes which provided useful provided useful insights to guide ongoing education and support for the escalation process. Conclusion The new escalation pathway was positively received and improved confidence for many, though some gaps in awareness and training persist.

High-altitude mountaineering induces adaptive gut microbiome shifts associated with dietary intake and performance markers

Abstract This study examined how high-altitude exposure and expedition-specific dietary changes influence gut microbiome composition, functional pathways, and their relationships with performance and health markers in alpinists. Seventeen male mountaineers (age 30.29 ± 5.8 years) participating in multi-week expeditions (> 3,000 MASL) were assessed before and after their climbs. Assessments included dietary intake analysis, blood and urine biomarkers, aerobic and anaerobic performance tests, and metagenomic sequencing of the gut microbiome. Bioinformatic and statistical analyses evaluated changes in microbiome composition and function and their correlations with physiological and dietary parameters. High-altitude exposure was associated with significant shifts in gut microbial composition and functional capacity. While the total number of bacterial species and functions remained stable, the glucose degradation pathway increased post-expedition. Participants with greater microbiome shifts showed improved performance and had richer baseline microbiomes. Pre-expedition, certain microbial functions were associated with vitamin B₆ and C intake, while post-expedition correlations involved specific macronutrients and micronutrients. Additionally, some microbiome changes correlated with blood markers, indicating links to nutrient metabolism and electrolyte balance. The gut microbiome of alpinists adapts to extreme environmental stress and dietary changes, influencing metabolic, immune, and performance-related processes. Optimizing dietary strategies to support a beneficial microbiome profile may enhance resilience and performance in challenging high-altitude environments.

The effects of physical activity and platelet-high-density lipoprotein cholesterol ratio on the risk of anxiety disorders: A cross-sectional study based on NHANES 2015–2023

Anxiety disorders are a global mental health issue that is strongly associated with lifestyle factors. Physical activity (PA) could benefit anxiety symptoms, though the precise effect remains controversial. The platelet-to-high-density lipoprotein cholesterol (HDL-C) ratio (PHR) is an emerging biomarker and has gained attention for its link to mental health. This study used data from the 2015−2023 National Health and Nutrition Examination Survey (NHANES) to examine the effects of PA and PHR on the risk of anxiety disorders. NHANES 2015−2023 data were used to examine participants’ PA, PHR, and their relationship to anxiety symptoms using a cross-sectional design. Moreover, logistic regression, subgroup, and unrestricted cubic spline analyses were employed in this study. The analysis results indicated that higher intensity PA significantly reduced the risk of anxiety disorders (OR = 0.824, 95% CI: 0.716–0.948, p  < 0.05). Both moderate PHR (OR = 0.769, 95% CI: 0.664–0.891, p  < 0.001) and higher PHR (OR = 0.781, 95% CI: 0.670–0.911, p  < 0.05) were significantly associated with reduced anxiety risk compared to the lowest quartile of PHR. A non-linear relationship was observed, and the risk was reduced when PHR ranged between 4.51 and 10.18, and increased when PHR was outside this range. Subgroup analysis results revealed significant variations in effects across age, gender, lifestyle, and chronic disease groups. This study confirmed the significant role of PA and PHR in regulating anxiety disorder risk. Future interventions should tailor PA intensity and PHR levels to individual differences to improve the prevention and treatment of anxiety disorders.

Microwave assisted green synthesis of silver nanoparticles using Trigonella Hamosa L.plant extract for the photodegradation of some water pollutants

Abstract Biological techniques are regarded as more sustainable to synthesize nanoparticles compared to physical and chemical ones due to their environmentally friendly characteristics and cost efficiency. In this research, silver nanoparticles (AgNPs) were synthesized using aqueous extracts of Trigonella hamosa Leave via conventional and microwave-assisted methods. The leaf extract of Trigonella hamosa L. was effectively employed as both a reducing and stabilizing agent in the preparation of AgNPs. Microwave-assisted synthesis of AgNPs shows average size of crystal (14 nm) less than that obtained without microwave (16 nm). The prepared AgNPs was characterized using XRD, FTIR, HR-TEM, and UV–vis. The UV–visible spectrophotometer identified the formation of AgNPs by observing the surface plasmon resonance absorption (SPR) band peak at approximately 430 nm. The HR-TEM and XRD studies show that the AgNPs particles have an average diameter of 14 nm and are nearly spherical, as indicated by the TEM. Synthesized AgNPs have been successfully used as a catalyst for photodegradation of methylene blue dye (MB) and paracetamol under sunlight and/or visible lamp irradiation. The MB dye experienced degradation rates of 96.2 and 94.9%, whereas paracetamol showed degradation percentages of 94.5 and 92% when subjected to sunlight and visible lamp irradiation, respectively. The results of this research indicate that AgNPs may serve as a viable alternative for the effective and safe elimination of hazardous organic pollutants.

Acute and chronic effects of plyometric exercise performed with hypoxia on post-activation performance enhancement (PAPE)

In the literature, no study is available either to investigate the effects of conditioning activity (CA) applied in hypoxic conditions on post-activation performance enhancement (PAPE) or to examine whether hypoxic long-term training can affect PAPE. This study aims to test the effects of plyometric exercise applied under hypoxia on PAPE, which is the acute effect; and to test the same effect again after an 8-week plyometric training, which is a potential chronic effect on the acute performance improvement after an adaptation with training. Nineteen team-sports athletes received 8-week drop-jump (DJ) training in Low-Normobaric Hypoxia (Low-NH, n = 8), Normobaric-Normoxia (NN, n = 6), or High-Normobaric Hypoxia (High-NH, n = 5) conditions (SpO 2 of 90%, 97–100%, and 80%, respectively) two times per week. PAPE was tested at the 2 nd and 4 th minutes of recovery after normoxic and hypoxic CA with 1x5 DJs at the pre-test, and tested after an 8-week training period following a normoxic and hypoxic CA with 1x8 DJs at the post-test. As a result of repeated measures ANOVA to identify the acute effects, only under normoxic conditions, DJ-height was significantly higher in the 2 nd (31.7 ± 4.9 cm) and 4 th minute (31.6 ± 4.3 cm) than baseline (30.1 ± 4.7 cm) (p < 0.05). Regarding the chronic-effect results, only the High-NH group significantly increased DJ-height from baseline (31.6 ± 4.5 cm) to the 2 nd (33.7 ± 5.9 cm) and 4 th minutes (34.5 ± 4.6 cm) (p < 0.05), without testing condition (hypoxic/normoxic) separately, at the end of the 8-week training period. It is concluded that plyometrics with acute hypoxic CA have no beneficial effect on PAPE responses, but 8 weeks of plyometric training with normobaric hypoxia may lead to an adaptation to induce improved PAPE.

SynergyFit energy recovery framework for human-centric power generation in multi-modal fitness environments

Abstract The demand for sustainable energy solutions has driven interest in capturing power from physical activity in fitness settings. This study introduces the SynergyFit Energy Recovery Model, a comprehensive theoretical framework for estimating and optimizing energy recovery across resistance, cardiovascular, and functional training. The model addresses the challenge of effectively harvesting energy in multi-modal exercise environments by identifying distinct recovery patterns: resistance training provides steady yields through consistent force application, while cardiovascular and functional training scale more rapidly with duration due to dynamic movement profiles. Validation against reported energy recovery values confirms the model’s strong predictive robustness and alignment with established trends. For a training session with an average mass (plate and trainer) of 80 kg, the energy recovery results are as follows: Resistance training yields energy recoveries from 9324 J at 1.5 min to 4827.76 J at 5.0 min; Cardio training shows a marked increase, with energy recoveries ranging from 860.82 J at 1.5 min to 31,882.50 J at 5.0 min; Functional training produces energy recoveries from 466.93 J at 1.5 min to 7130.64 J at 5.0 min. The total energy recovery across these modalities ranges from 10,651.76 J to 43,840.90 J, depending on the exercise duration. The sensitivity analysis further demonstrates that increasing exercise mass, higher cardio training velocities, and longer resting periods significantly enhance energy recovery. Notably, cardio training exhibits the highest energy recoverable potential, with cumulative recovery reaching approximately 43.8 kJ per session. These insights highlight the critical role of optimizing exercise duration and parameters to maximize energy recovery. Overall, the novel SynergyFit Energy Recovery Model offers a significant advancement in understanding and improving energy recovery in fitness environments. By integrating multiple exercise modes, this model contributes to more efficient energy utilization and underscores the benefits of parameter optimization for enhanced sustainability in fitness facilities.

Integrative GWAS and RNA-Seq analysis for target identification and virtual drug screening in colorectal cancer

Background Colorectal cancer (CRC) is a leading cause of global cancer-related mortality, necessitating the identification of novel therapeutic targets. Integrating genetic and transcriptomic data may reveal key molecular drivers of CRC progression and treatment opportunities. Methods We performed a multiomics analysis combining genome-wide association study (GWAS) data (p < 1e-6) and RNA-seq data from the TCGA. Differential expression analysis (Limma) identified 24 consistently dysregulated genes (17 mRNAs, 7 lncRNAs) in CRC. Survival analysis was used to evaluate their prognostic impact on overall survival (OS), relapse-free survival (RFS), and post progression survival (PPS). Drug‒gene interactions were explored via Enrichr, and virtual screening (PubChem) prioritized high-affinity compounds that target PYGL, a metabolic regulator. Results Integration of GWAS and RNA-seq revealed that 24 CRC-associated genes, including PYGL , SMAD7 , and TCF7L2 , are involved in tumor metabolism and Wnt/TCF signaling. Survival analysis revealed that five genes ( CDKN2B , BOC , METRNL , etc.) were significantly correlated with OS, RFS, and PPS. Ten small-molecule candidates targeting PYGL exhibited high binding affinity, suggesting their therapeutic potential. Conclusion This study identified CRC-linked genes through GWASs and transcriptomics, highlighting their prognostic and druggable relevance. Computational drug repurposing pinpoints PYGL inhibitors as promising candidates, offering a translational framework for CRC therapy development.

Effect of bleaching materials on optical properties and surface roughness of discolored dental ceramics

Cytomegalovirus reactivation in mechanically ventilated patients with or without SARS-CoV-2 infection: A retrospective cohort study

Background Data comparing the incidence, risk factors and outcomes of cytomegalovirus (CMV) reactivation in SARS-CoV-2 positive and negative patients remain controversial. Design A retrospective cohort study in a tertiary center. Patients Patients admitted to the intensive care unit between December 2019 and May 2021, under invasive mechanical ventilation for 4 days or more and screened for CMV reactivation were included. Measurements The primary outcome was the incidence of CMV reactivation in SARS-CoV-2 negative and positive patients. Secondary outcomes included risk factors for CMV reactivation in both populations and survival analysis according to CMV reactivation in SARS-CoV-2 negative and positive patients. Results CMV reactivation occurred in 34.7% (n = 51/147) of SARS-CoV-2 negative patients and in 45.4% (83/183) of SARS-CoV-2 positive patients ( p  = 0.08). When considering competing factors, SARS-CoV-2 infection was not associated with CMV reactivation (sub-hazard ratio (SHR) = 1.01 [0.68–1.49], p  = 0.98). Treatment with methylprednisolone was significantly associated with CMV reactivation in the unadjusted and adjusted analysis (SHR 2.81 [2.01–3.93] p  < 0.001; SHR 2.84 [1.94–4.15] p < 0.001 respectively). Patients combining SARS-CoV-2 infection and CMV reactivation had a significantly higher all-cause mortality. Among patients presenting a CMV reactivation, the administration of ganciclovir was a protective factor for day-60 mortality (HR = 0.4; [0.22–0.74] p =  0.004). Conclusion In this large retrospective cohort, CMV reactivation was not significantly associated with SARS-CoV-2 infection in patients undergoing invasive mechanical ventilation for at least 4 days. The major risk factor for CMV reactivation was treatment with methylprednisolone. The combination of CMV reactivation with SARS-CoV-2 infection was associated with a higher mortality whereas ganciclovir treatment reduced mortality.

Exploring the predictive potentials of IL-1β and TNFR1 in atherogenic risk in prediabetes

Zoonotic bacteria in invasive California Kingsnake Lampropeltis californiae from Gran Canaria, Canary Islands, Spain

Introduction Invasive species can spread pathogens to newly colonised areas and indirectly affect animals and humans. In the Canary Islands territory (Spain), the California kingsnake ( Lampropeltis californiae ) is one of the most relevant invasive species because its predatory habits, however, there is scarce information about the microorganisms they carry and the risk to human health, for that reason, and considering previous data on the pathogens harboured by exotic reptiles in the archipelago, the aim of this study was to analyse the presence of pathogenic bacteria in these animals. Methods Fifty L. californiae specimens from Gran Canaria Island (Canary Islands, Spain) were examined for zoonotic bacteria. For that purpose, faecal samples were obtained during the necropsy of the animals and inoculated in different selective agar media. If bacterial growth was observed, bacterial colonies were subjected to DNA extraction. The species were confirmed using PCR methods and band pattern comparison. Results Almost all, 49 out of 50 (98%), of the studied animals were positive for at least one of the selected bacteria. Salmonella spp. (76.0%, 38/50), Yersinia enterocolitica (58.0%, 29/50), Pseudomonas aeruginosa (42.0%, 21/50), Campylobacter spp. (34.0%, 17/50) and Escherichia coli virulence genes ( stx and eae ) (16.0%, 8/50) were identified. Conclusions The presence of well-known zoonotic bacteria in L. californiae from Gran Canaria suppose a threat to people that use them as pets, especially children, elderly, and animal handlers, since they cause gastrointestinal symptoms that can lead to severe complications and invasive infections. In addition to that, these colubrids could also spread pathogens to other animals and the environment, adding to the notorious problem of biodiversity losses due to predation of native fauna.

Multilayer and crushed stent visualization using photon- counting detector computed tomography – a proof of concept

Abstract Photon‑counting detector CT (PCD‑CT) enables ultra‑high resolution (UHR, 0.2 mm) and may improve visualization of coronary stents compared with standard‑resolution (SR, 0.4 mm). In this ex- vivo study, we utilized a phantom heart model to simulate physiological attenuation and imitated the most common coronary bifurcation stenting techniques by creating multiple stent layers and stent- crush situations (single layer, crushed, two‑ and three‑layer). We compared UHR and SR PCD‑CT using Bv72 and Bv56 kernels. Objective endpoints were in‑stent lumen visibility, signal-to-noise ratio, and percentage change in stent attenuation; subjective image quality was rated on a 5‑point Likert scale (1 = excellent to 5 = non‑diagnostic). Depending on distribution, two‑sided t‑tests (mean ± SD) or Mann–Whitney U tests (median[IQR]) were applied, p‑values were Bonferroni‑corrected for multiple comparisons. In the pooled Crush cohort, UHR Bv72 improved in‑stent lumen visibility when compared with both, SR Bv72 (single-layer: 68.08 ± 4.30% vs. 79.03 ± 3.79%; crushed: 63.62 ± 4.97% vs. 74.73 ± 2.51%) and SR Bv56 (single-layer: 63.63 ± 4.47% vs. 79.03 ± 3.79%; crushed: 62.18 ± 3.55% vs. 74.73 ± 2.51%), all p < 0.01. The effect was even more pronounced in small stents (single‑layer 65.45 ± 1.91% (SR) vs. 77.11 ± 2.55% (UHR) and crushed 60.67 ± 2.67% vs. 74.00 ± 2.67%), both p < 0.01. Regarding subjective image quality, UHR was associated with better sharpness and less blooming, e.g., UHR Bv72 vs. SR Bv56 (multilayer: sharpness 1[0] vs. 2[0], blooming 1[0] vs. 2[0]; crush: sharpness 1[0] vs. 2[0], blooming 1[0] vs. 2[1]; all p ≤ 0.01) and UHR Bv72 vs. SR Bv72 (multilayer: sharpness 1[0] vs. 1[1], blooming 1[0] vs. 1[1]; crush: sharpness 1[0] vs. 1[1]; all p ≤ 0.05). These findings indicate that UHR PCD‑CT with Bv72 might enable assessment of complex stents in a phantom setting; even though clinical studies are warranted.

Detection of PDR5-mediated alachlor efflux using a chemically induced dimer biosensor

The development of herbicide-resistant crops is a key strategy for achieving efficient and sustainable agriculture. Herbicide tolerance can be conferred by transporters that mediate the efflux of herbicides, making them of particular interest for resistance development. However, identifying a transporter for a specific compound can be a challenging task. Here, we demonstrate the use of a synthetic, yeast two-hybrid-based molecular biosensor to identify transporter activity. A previously engineered biosensor responsive to the herbicide alachlor was utilized to monitor cytosolic alachlor levels in yeast, allowing for the evaluation of candidate transporters. A biosensor-reported shift in alachlor accumulation indicated the Saccharomyces cerevisiae transporter PDR5 as a potential mediator of alachlor efflux. PDR5’s effect on alachlor accumulation was suppressed by a known competing substrate of the transporter, validating its alachlor efflux activity. The ability of the biosensor yeast platform to report transporter activity and its inhibition via a fluorescence output underscores its potential as a tool for transporter-focused research.

Photon-counting CT outperforms dental CBCT in detecting small accessory canals in root-filled teeth in a phantom study

Abstract Accurate visualization of dental structures in root-filled teeth is critical for endodontic assessment but challenging due to artifacts from root canal (RC) fillings. This study compares photon-counting-detector CT (PCD-CT) and cone-beam CT (CBCT) for detecting small accessory canals in the presence of RC fillings. A phantom model with four bovine teeth containing RC fillings and five artificial accessory canals (1000–200 μm) per tooth was embedded in a bovine rib. The phantom was scanned with clinical PCD-CT (ultra-high-resolution protocol) and dental CBCT (endodontic protocol). Canal visibility was evaluated using signal-to-noise criteria, and canal diameters were compared with micro-CT measurements, serving as the reference. Blooming artifacts from RC fillings were quantified using the full width at half maximum (FWHM) of attenuation profiles. PCD-CT detected all canals down to 400 μm and 81.5% at 200 μm, while CBCT reliably detected canals ≥ 800 μm, with detection dropping to 47.2% at 400 μm and none at 200 μm. Measurement errors for canal diameters were lower with PCD-CT. Artifact widths varied between modalities, with no clear superiority. PCD-CT provided higher detectability and measurement fidelity for small accessory canals in root-filled teeth compared to a dental CBCT, with similar filling-related blooming, supporting the potential of PCD-CT in post-treatment endodontic imaging.