Lactobacillus species play a key role in maintaining vaginal microbial homeostasis and protecting against genital infections. Disruption of this microbial balance can increase susceptibility to vaginitis. Population-specific variations in the composition of vaginal Lactobacillus communities may influence disease risk and therapeutic responses. This study aimed to evaluate the distribution of major vaginal Lactobacillus species in healthy Iranian women and those with vaginitis using species-specific molecular assays.

In this case-control study, 100 women with clinically confirmed vaginitis and 100 healthy controls were enrolled. Vaginal swabs were examined by Gram staining, followed by DNA extraction and PCR amplification using universal and species-specific 16S rRNA primers targeting L. iners, L. crispatus, L. acidophilus, L. gasseri, and L. jensenii. Associations between bacterial species and clinical status were evaluated using Odds Ratio (OR), Relative Risk (RR), Phi coefficient (Φ), and Chi-square tests.

Lactobacillus spp. were detected in 97% of healthy women compared with 53% of symptomatic participants. L. jensenii and L. acidophilus were significantly more prevalent in healthy individuals, demonstrating strong protective associations with vaginal health. In contrast, L. iners was more frequently detected in women with vaginitis, consistent with its proposed role as a transitional species associated with microbiome instability. Although L. crispatus is often reported as protective in other populations, it did not show a statistically significant protective association in this study population.

Our findings highlight the protective association of dominant Lactobacillus species, particularly L. jensenii and L. acidophilus, in maintaining vaginal microbial balance. The higher prevalence of L. iners among symptomatic women further supports its association with disturbed vaginal microbiota. These results suggest the presence of population-specific microbial patterns and underscore the importance of considering regional microbiome characteristics when developing diagnostic approaches and probiotic-based interventions.

The objective of this study was to assess the wound healing traits of Valeriana officinalis and Chelidonium majus hydro-alcoholic (HA) extracts on surgical wounds in Wistar rats. The HA root extracts were separated using percolator and 96 degree alcohol in desiccator device. Additionally, 24 Wistar rats (six months old, 200 g) were divided into three groups: control, V. officinalis, and C. majus. Wound creation (2 cm in diameter) was developed by initial intraperitoneal injection of anesthetic drugs (5% ketamine and 5mg/kg of diazepam) and hair shaving. 24 hours after wound creation, treatment was initiated using ointment containing 5% of each V. officinalis and C. majus HA extract, applied for 21 days. Wound imaging on days 4, 7, 14 and 21 was performed using a digital camera. Histopathologic examination of the wounds was conducted at 4, 7, 14 and 21-day intervals. Microscopic and macroscopic observations revealed significantly higher wound healing rates in treated groups compared to the control. Histopathologic examinations indicated sufficient angiogenesis, existence of collagen and fibroblast cells and reduction in the inflammatory cells. Moreover, wound contraction was observed in the treated groups. Noticeably, the C. majus HA extract treated the wounds more efficiently. The wound healing in Wistar rats using HA extracts from V. officinalis and C. majus was promising though more investigations are required. Additionally, C. majus HA extract demonstrated healing effect compared to that of V. officinalis. It is proposed to evaluate the cytotoxic levels of extracts and formulate them in future studies to achieve more efficient and rapid healing of wounds. In addition, combination of extracts from various herbal medicines and with synthetic drugs can be studied for wound healing applications.

Antimicrobial resistance has posed considerable health and economic burdens globally (approximately five million deaths annually), particularly in developing countries. The estimated annual treatment costs in the United States include US$4.6 billion. Vast antibiotic resistance among Gram-negative and Gram-positive bacterial species has spread from healthcare to the environment, community, and animals. These conditions have limited and in some cases, failed infection eradication options and facilitated the distribution of drug-resistant organisms. The spread of drug-resistant bacterial infections is a major human health concern, hence, seeking novel antibacterial agents is crucial. This study used nanoemulsions of Citrus aurantium and Artemisia annua essential oils (EOs) as natural antibacterial agents. Gas chromatography mass spectrometry (GC-MS) analysis showed that limonene (31.4%) and artemisia ketone (26.2%) were major components, respectively. After that, their nanoemulsion dosage forms with mean droplet sizes of 181 ± 7 and 160 ± 5 and zeta potential values 3.1 ± 0.8 and -4.9 ± 0.5 mV were prepared. Meanwhile, successful loading of the EOs in nanoemulsion was confirmed by Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) analysis. A. annua nanoemulsion with 40% antioxidant effect was significantly more potent than C. aurantium nanoemulsion. Meanwhile, nanoemulsions' antibacterial and antibiofilm activity against clinical and standard strains, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumonia, were investigated. The best efficiency was related to the effect of C. aurantium nanoemulsion against S. aureus; minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC) were 500 and > 2000 µg/mL. In addition, no biofilm was formed after treatment with both nanoemulsions. Therefore, C. aurantium and A. annua EO nanoemulsions may act as natural antioxidant and antibacterial agents in complementary medicine.

The global incidence of early-onset (EO) cancers-defined as malignancies diagnosed in individuals under the age of 50-has increased significantly over recent decades, particularly in high-income countries. However, epidemiological data from Latin America remain fragmented and underexplored. This study protocol describes a scoping review designed to systematically map and synthesize the available evidence on EO cancer incidence trends in Latin American populations.

The review will be conducted in accordance with the JBI Manual for Evidence Synthesis and reported following PRISMA-ScR guidelines. A comprehensive search will be performed across multiple databases (PubMed, Embase, Scopus, LILACS, Cochrane, Web of Science), clinical trial registries, and gray literature sources without language or date restrictions. Studies reporting incidence data on solid tumors diagnosed before age 50 in Latin American countries will be included. Study selection and data extraction will be performed independently by four reviewers using a standardized form. Data will be analyzed through descriptive statistics and qualitative synthesis. The findings aim to highlight incidence patterns by cancer type, population characteristics, and methodological approaches.

The final scoping review will present the search results, the study inclusion process, and the data analysis.

This review will provide a consolidated epidemiological overview to inform public health policy, improve cancer surveillance, and identify research gaps in the region.

This protocol was registered on the Open Science Framework (OSF). The registry number is OSF.IO/TZ67D. This registration ensures the transparency and credibility of our research process, as it provides a public record of our study design and methods.

The prevalence of diabetes continues to increase - more than 38 million people in the US now have diabetes and 84 million have prediabetes. Because many new cases of incident diabetes may be attributed to suboptimal dietary quality, novel programs and policies to encourage healthy eating choices represent promising population-level approaches to reduce the number of new cases of diabetes.

To help estimate the potential impact of such programs and policies, we created the Microsimulation of Nutrition, Diabetes, and Cardiovascular Disease (MONDAC), a model to estimate the impact of simulated population-level dietary changes on downstream outcomes: body mass index, diabetes incidence, cardiovascular disease (CVD) incidence, all-cause mortality, quality-adjusted life years, direct medical costs, and cost-effectiveness.

We used 24-hour recall data from the National Health and Nutrition Examination Survey to categorize food and beverage consumption into 51 mutually exclusive categories to understand the effects of dietary changes. We simulated the energy intake and dietary quality effects that result from increasing, decreasing, or reallocating intake of these 51 food categories. Reductions in calories induce weight loss via an energy balance model. Weight loss and improvements in dietary quality drive annual reductions in diabetes and CVD risk. Mortality was modeled using a lifetable approach, and direct medical care costs were applied using estimates from the literature. We cross-validated MONDAC with existing models to assess reliability of estimates. We provide an example simulation for MONDAC, modeling a reduction in sugar-sweetened beverage consumption at the national level in the US.

MONDAC provides a flexible approach to policy analysis to allow the user to simulate various food-related policies.

We aimed to examine the individual and combined impact of prehypertension, prediabetes, and predyslipidemia on all-cause and cardiovascular disease (CVD) mortality in community-dwelling adults. A retrospective cohort study of 11 986 US adults from the 1999-2018 National Health and Nutrition Examination Survey was conducted. Participants were categorized into four mutually exclusive groups based on the cumulative number of these conditions. Multivariate Cox proportional hazards models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes. The prevalences of no, one, two, and all three preclinical conditions were 37.20%, 38.39%, 19.86%, and 4.55%, respectively. Over a median follow-up of 10 years, 636 (3.83%) deaths occurred, including 170 (26.73%) from CVD. In a dose-response manner, the adjusted HRs (95%CIs) for all-cause mortality among those with one, two, and three conditions were 1.87 (1.38-2.52), 2.49 (1.80-3.44), and 2.62 (1.76-3.90), respectively, compared to those with none. The corresponding HRs (95%CIs) for CVD mortality were 3.09 (1.66-5.78), 3.89 (2.06-7.36), and 4.20 (2.04-8.69), respectively. Thus, an increasing cumulative number of preclinical conditions is associated with graded elevated risk of all-cause and CVD mortality, underscoring the potential for early intervention during the preclinical phase to improve long-term health outcomes.

Ramadan fasting involves prolonged daily abstinence from food and water and may affect blood pressure (BP) regulation, particularly in individuals with chronic conditions. Evidence focusing specifically on ambulatory BP characteristics during Ramadan remains limited. This study evaluated 24-hour ambulatory BP monitoring (ABPM) parameters obtained during Ramadan in fasting and non-fasting individuals. In this prospective cross-sectional study, 231 adults underwent 24-hour ABPM during Ramadan between 2021 and 2023. Participants were classified as fasting or non-fasting and as hypertensive or non-hypertensive. Demographic characteristics, comorbidities, laboratory findings, and echocardiographic parameters were recorded. Ambulatory BP values were analyzed for 24-hour, daytime, and nighttime periods. Of the participants, 117 were fasting and 114 were non-fasting. Baseline demographic characteristics and cardiovascular comorbidities were similar between groups, although diabetes mellitus (DM) and chronic kidney disease (CKD) were more frequent in non-fasting individuals. No significant differences were observed in 24-hour or daytime systolic and diastolic BP values. Mean nighttime BP was lower in fasting participants (p = 0.032). Echocardiographic parameters were comparable. Fasting individuals had higher serum albumin levels (p = 0.027) and lower neutrophil counts (p = 0.030), while other biochemical markers did not differ significantly. Ramadan fasting was not associated with adverse ambulatory BP changes in hypertensive or normotensive individuals and may be considered safe in appropriately selected patients with well-controlled hypertension (HT).

Diabetic kidney disease (DKD) is a severe microvascular complication of diabetes characterized by complex pathogenesis in which renal cellular senescence is a critical pathological element. Traditionally, hyperglycemia has been regarded as a uniform stressor inducing cellular senescence; however, significant heterogeneity exists in different renal cell types' responses to high glucose (HG) stimulation. This review systematically elucidates mechanisms underlying senescence of major renal cell types under hyperglycemic conditions. Hyperglycemia acts as a common initiator triggering senescence via shared pathways, including oxidative stress and metabolic dysregulation. However, owing to distinct structural, functional, and molecular profiles across cell types, divergent senescence programs are activated. Specifically, podocyte senescence centers on GSK3β-mediated collapse of metabolic homeostasis and GPR124 axis-related mechanosensing dysfunction; mesangial cell (MC) senescence manifests as STAT5- and Caveolin-1 signaling-mediated "senescence-fibrosis" vicious cycles; glomerular endothelial cell (GEC) senescence is characterized by dysregulation of the NOS/NO signaling axis and glycocalyx damage; and renal tubular epithelial cell (TEC) senescence is initiated by mitochondrial damage under metabolic overload, promoting interstitial fibrosis through the senescence-associated secretory phenotype (SASP). By revealing this heterogeneous mechanism shifting from "common stress" to "specific responses," this review offers a novel perspective on DKD pathogenesis and establishes a theoretical foundation for developing targeted anti-senescence therapies. It further discusses implications for the clinical translation of renal protective agents.

The haemoglobin glycation index (HGI) reflects individual variations in glycation tendency and may offer additional value beyond HbA1c in predicting diabetes-related complications. This study aimed to evaluate the association and predictive value of HGI for diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).

A total of 400 T2DM patients were enrolled. Predicted HbA1c was calculated using a linear regression equation (R2=0.454) derived from fasting plasma glucose (FPG) and HGI was defined as the difference between measured and predicted HbA1c. Paired t-tests and Pearson correlation assessed the relationship between measured and predicted HbA1c. Multivariate logistic regression and receiver operating characteristic (ROC) analysis used to evaluate HGI as a predictor of DKD.

A strong positive correlation observed (r=0.674, p<0.001) between measured and predicted HbA1c and no significant difference observed (p=0.964) among the T2DM population. DKD was identified in 192 participants, who demonstrated significantly higher HGI compared to non-DKD patients (p=0.002). Multivariate analysis showed HGI (OR: 1.249, 95% CI: 1.053-1.482, p=0.011) and eGFR (OR: 0.964, 95% CI: 0.952-0.976, p<0.001) were independent risk factors for DKD. ROC analysis showed HGI as a moderate predictor of DKD (AUC=0.722, p<0.001), with an optimal cutoff of 0.53 carries 56.3% sensitivity and 81.2% specificity.

HGI is independently associated with DKD in T2DM and may serve as a useful adjunct marker, complimenting HbA1c and urinary albumin-to-creatinine ratio (UACR) for early identification of those at increased risk of kidney complications.

This study aimed to evaluate the effect of a 50% reduction in preprandial bolus insulin (50%-B) on plasma glucose (PG) responses during postprandial exercise of continuous moderate intensity (CONT) and intermittent high intensity (INT) in individuals with type 1 diabetes (T1D).

Sixteen adults with T1D (31% male), treated with multiple daily insulin injections (MDI), participated in a randomized crossover study comprising four experimental conditions, separated by a washout period of at least 48 hours. Participants performed two 30-minute, preceded by a 3-minute warm-up without weights:• CONT: continuous cycling at 60% of maximal aerobic power (MAP).• INT: 2-minute intervals alternating between 40% and 80% of MAP, repeated for 7 intervals, with the last interval adjusted so that the total exercise time is exactly 30 minutes. Each exercise modality was performed under two insulin conditions: a full preprandial bolus (100%-B) and a 50% reduction (50%-B). Plasma glucose, insulin, and cortisol were measured before, during, and after exercise. Linear mixed models were used to analyze temporal changes and condition effects.

Blood glucose decreased significantly over time for both exercise types (p < 0.001). During CONT, the decline in PG was similar between doses (Δ100%-B: -3.01 ± 2.96 vs. Δ50%-B: -2.82 ± 2.28 mmol/L; p = 0.18), However, the nadir PG was higher with 50%-B compared to 100%-B (8.59 ± 4.07 vs. 5.69 ± 3.06 mmol/L, respectively; β = +2.91 mmol/L; p = 0.026), and hypoglycemia was less frequent (2 vs. 18 episodes; p = 0.028). During INT, PG decreased less with 50%-B than with 100%-B (Δ: -2.03 ± 1.63 vs. -3.62 ± 2.76 mmol/L; p = 0.022), with no hypoglycemic episodes under 50%-B compared to six with 100%-B. Mean PG remained higher with 50%-B across both exercise types (p < 0.01). Plasma insulin decreased over time (p = 0.038) regardless of bolus condition, while cortisol increased more during INT with 100%-B than with 50%-B (p = 0.02).

Reducing the preprandial bolus insulin by 50% effectively attenuates exercise-induced declines in plasma glucose and substantially reduces hypoglycemia risk, particularly during intermittent high-intensity exercise. These results emphasize the clinical relevance of personalized insulin adjustments to enhance metabolic safety during exercise in individuals with T1D.