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Diabetic Neuropathy Is Associated With Lower Bone Mineral Density and Higher Fall Risk in Young Elderly Adults With Type 2 Diabetes

Diabetes Metab Res Rev. 2026 Feb;42(2):e70135. doi: 10.1002/dmrr.70135.

ABSTRACT

BACKGROUND AND AIM: Diabetic neuropathy (DN) is a recognised risk factor for fragility fractures. However, the mechanisms linking DN, bone health, and falling risk remain unclear. We aimed to assess bone health and risk of falls, with their contributing factors, in young elderly patients with type 2 diabetes (T2D) and mild-to-moderate DN.

METHODS: We enrolled 144 subjects with T2D, excluding those with severe DN (neuropathy disability score -NDS- ≥ 9) or fracture history. Clinical and biochemical data were collected, including surrogate markers of insulin resistance, such as the triglycerides/HDL (TG/HDL) ratio and triglycerides/glucose (TyG) index. Bone mineral density (BMD) and trabecular bone score (TBS) were evaluated using DXA scans. Falls were self-recorded prospectively over 4 years using diaries.

RESULTS: Subjects with DN (27%) had higher BMI (p = 0.036), fasting blood glucose (p = 0.04), serum triglycerides (p = 0.016), TG/HDL ratio (p = 0.012) and TyG index (p = 0.003) compared with those without DN. After adjustment for gender, age, BMI, HbA1c, TyG index and TG/HDL ratio, subjects with DN showed significantly lower BMD at the femoral neck (0.702 [0.638-0.850] g/cm2 vs. 0.789 [0.717-0.860] g/cm2, p = 0.015) and total femur (0.890 [0.820-1.055] g/cm2 vs. 0.983 [0.889-1.076] g/cm2, p = 0.027). No differences were observed in spine BMD or TBS. However, TBS was negatively correlated with the TG/HDL ratio (r = -0.215, p = 0.013) and visceral adipose tissue (r = -0.310, p < 0.001). After 4 years of follow-up, subjects with painful neuropathy at baseline had a higher rate of falls (p = 0.011).

CONCLUSION: DN is associated with decreased BMD and increased risk of falls. Among factors associated with DN, insulin resistance was also associated with decreased bone quality.

PMID:41655239 | DOI:10.1002/dmrr.70135

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Investigation of systemic inflammatory biomarkers associated with high-density lipoprotein and risk analysis in Xanthelasma Palpebrarum

Cutan Ocul Toxicol. 2026 Feb 8:1-6. doi: 10.1080/15569527.2026.2626680. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to investigate the potential role of systemic inflammatory biomarkers associated with high-density lipoprotein cholesterol (HDL) in the pathogenesis of Xanthelasma Palpebrarum (XP).

METHODS: HDL, low-density lipoprotein cholesterol (LDL), total cholesterol (TC), triglyceride (TG), lymphocyte, neutrophil, monocyte, platelet and red cell distribution width-standard deviation (RDW-SD) values were obtained from peripheral blood samples of patients who underwent XP excision. Monocyte-to-high-density lipoprotein cholesterol ratio (MHR), lymphocyte-to-HDL cholesterol ratio (LHR), platelet-to-HDL cholesterol ratio (PHR), neutrophil-to-HDL cholesterol ratio (NHR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) were calculated and statistically compared. Multivariate logistic regression and ROC analyses were performed to determine predictive values.

RESULTS: The study compared the XP group (63 patients) and the control group (54 healthy individuals), finding no significant differences in age and gender (p = 0.059 and p = 0.406, respectively). Neutrophil, lymphocyte, monocyte, and platelet counts, as well as MHR, LHR, PHR, NHR, and SII values, were significantly higher in the XP group (p < 0.001, p = 0.015, p = 0.042, p = 0.018, p < 0.001, p < 0.001, p < 0.001, p < 0.001, and p = 0.016, respectively). HDL levels were significantly lower in the XP group (p < 0.001). Among all parameters, NHR had the highest predictive value with an area under the curve (AUC) of 0.81. NHR (Odds ratio: 1.07) was identified as a potential risk factor for XP.

CONCLUSION: This study highlights the potential role of systemic inflammation associated with HDL in the pathogenesis of XP by triggering oxidative stress mechanisms, lipid peroxidation, and tissue-level inflammatory damage, and emphasizes the need to investigate treatments that regulate inflammation in XP therapy.

PMID:41655202 | DOI:10.1080/15569527.2026.2626680

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Branched-chain amino acid supplementation and endurance performance: reporting guidelines and systematic review of biochemical vs clinical evidence

Phys Sportsmed. 2026 Feb 8. doi: 10.1080/00913847.2026.2627863. Online ahead of print.

ABSTRACT

BACKGROUND: Branched-chain amino acids (BCAAs) – leucine, isoleucine, and valine – are widely used in sports nutrition, yet their effects on endurance performance remain uncertain. Most studies emphasize biochemical markers without linking them to functional outcomes. This is the first systematic review to evaluate whether biochemical alterations induced by BCAA or leucine supplementation are associated with actual performance or recovery benefits in endurance athletes.

METHODS: A systematic review was conducted in accordance with PRISMA 2020, the Cochrane Handbook for Systematic Reviews of Interventions, and the GRADE approach. Searches were performed in PubMed, Embase, and Web of Science up to 11 July 2024. Eligible studies included endurance runners or athletes, used BCAA or leucine supplementation, and reported outcomes related to performance, recovery, or adverse effects. Risk of bias was assessed using the ROBINS-I tool.

RESULTS: From 152 records, 15 studies met inclusion criteria. No consistent improvement was observed in performance, fatigue, or recovery. Only two studies reported statistically significant differences. One trial found a 42% reduction in muscle soreness (p < 0.05), though with inadequate control for protein intake and confounders. Biochemical changes included: increase 140% valine (p < 0.01), low plasma glucose (p < 0.01), increase free fatty acids (p < 0.001), and raise 25% protein synthesis post-exercise (95% CI: 20-30%, p = 0.01). Mental performance improved after 12 km and 30 km runs (p < 0.05), but no functional performance gains were consistently observed.

CONCLUSION: BCAA and leucine supplementation do not result in meaningful improvements in endurance performance or muscle recovery. Despite biochemical alterations, current evidence – limited by low methodological quality, surrogate outcomes, and risk of bias – does not support the use of BCAA as an effective strategy for endurance athletes.

PMID:41655197 | DOI:10.1080/00913847.2026.2627863

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Microplastic contamination and ecological risk assessment in two tree frog species (Hyla orientalis and Hyla savignyi) across Türkiye

Environ Geochem Health. 2026 Feb 8;48(3):148. doi: 10.1007/s10653-026-03037-7.

ABSTRACT

This study was conducted to investigate the presence of microplastics (MPs) in individuals of Hyla orientalis and Hyla savignyi, two tree frog species naturally distributed in Türkiye, to determine the qualitative and quantitative distribution of these particles in their gastrointestinal tracts (GITs) and to analyze their morphological (color, shape, size) and chemical (polymer type) properties in detail. A total of 276 individuals were examined within the scope of the research, 76 of which belonged to H. orientalis and 200 to H. savignyi. A total of 192 microplastic particles were detected in their GITs, and the average size of these particles was determined to be 206.56 ± 12.88 µm. The most common microplastic type was PET (67.20%), its shape was fiber (76.00%), and its color was navy blue (25.50%). The highest proportion of microplastic-containing individuals was observed in H. savignyi (56.50%), and microplastic was found in only 11.84% of H. orientalis individuals. No statistically significant difference was found between the two species in terms of polymer type, microplastic shape, and color (p > 0.05). Data obtained from 24 different provinces across Türkiye indicate that microplastic contamination has a wide geographical distribution. The highest microplastic amount was recorded from Hatay-Hassa (44 pieces), followed by Kilis and Bitlis provinces. Significant differences were found between provinces in terms of color, shape, and polymer type (p < 0.001). These findings suggest that microplastic pollution is widespread in terrestrial vertebrates and may vary among species and geographic regions, suggesting that amphibians may be important bioindicators for monitoring ecosystem health.

PMID:41655173 | DOI:10.1007/s10653-026-03037-7

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Polycystic ovary syndrome (PCOS) affects relative embryo morphokinetics observed by time-lapse imaging: an observational study

Arch Gynecol Obstet. 2026 Feb 8;313(1):83. doi: 10.1007/s00404-026-08335-0.

ABSTRACT

PURPOSE: To characterise the effect of polycystic ovary syndrome (PCOS) on embryo morphokinetics via time-lapse imaging, including absolute time points, relative time intervals, and ratios representing cleavage synchronicity.

METHODS: This single-centre retrospective observational study examined patients aged 18-45 years undergoing in vitro fertilisation/intracytoplasmic sperm injection with time-lapse imaging (09/2016-12/2019; n = 1433 two-pronuclear oocytes). A group with PCOS (n = 48 embryos) was compared to a control group with uterine, tubal factor or idiopathic infertility (n = 400 embryos). Times from the two-cell stage to blastocyst expansion, eight intervals for embryonic cell cycle (ECC) duration and synchronicity and four cleavage synchronicity (CS) and DNA replication time ratios were analysed.

RESULTS: PCOS patients were younger (P = 0.023) with higher anti-Müllerian hormone levels (P < 0.001) than controls. No statistically noticeable influence of PCOS on absolute times was observed. The intervals from the 3- to 4-cell (synchronicity of cell cycle 2, s2; P = 0.013), the 5- to 8-cell (synchronicity of cell cycle 3, s3; P = 0.032) and the 4- to 8-cell stage (ECC3; P = 0.043) were longer in the PCOS group. The relative CS ratio from the 2- to 8-cell stage (CS2-8) was lower (P = 0.003) and from the 2- to 4-cell stage (CS2-4) was higher (P = 0.001) in PCOS embryos.

CONCLUSION: Whilst absolute times remained unaffected, relative morphokinetic intervals and ratios, potentially indicating poorer cleavage synchronicity, were altered in PCOS embryos. This is the first study examining the influence of PCOS on relative morphokinetic ratios.

PMID:41655163 | DOI:10.1007/s00404-026-08335-0

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Analysis of external dose rate attenuation and its related factors in differentiated thyroid carcinoma patients following I-131 therapy

EJNMMI Phys. 2026 Feb 8. doi: 10.1186/s40658-026-00845-9. Online ahead of print.

ABSTRACT

BACKGROUND: Monitoring the external dose rate (EDR) attenuation serves as a key consideration in supporting discharge decisions for patients with differentiated thyroid cancer (DTC) who have undergone radioiodine therapy. We aimed to study the EDR attenuation and its related factors in DTC patients during I-131 therapy.

METHODS: This study enrolled 886 DTC patients who first underwent I-131 therapy at the Third Bethune Hospital of Jilin University, China. We measured the EDR at approximately 2, 24, 48, and 72 h post-therapy. Two formulas were established to represent the EDR decay with time: 1) EDR =[Formula: see text] and EDR% = [Formula: see text], where EDR is the absolute external dose rate (µSv/h), EDR% is the percentage EDR relative to the initial EDR (100%), SI (speed index, μSv/h2) is the absolute decay rate of I-131 with the time, SI% (%/h) is the relative decay rate with the time, and b is a constant.

RESULTS: The finally fitted SI and SI% from patients’ data were -0.020 μSv/h2 and -0.026%/h, respectively. EDR% exhibited a stronger correlation with administration time than EDR (R2: 0.951 vs. 0.829). Body mass index (BMI), smoking, history of type 2 diabetes mellitus, Follicular Thyroid Carcinoma (FTC) subtype, increasing residual thyroid tissue grading, FT3 and Tg levels positively associated with SI. The factors negatively associated with SI were female sex, a higher N stage and a higher I-131 dose. SI% was positively associated with smoking history, history of type 2 diabetes mellitus, and FTC pathological subtype, and negatively with female sex and higher I-131 dose.

CONCLUSIONS: EDR% had better correlation than EDR with I-131 administration time. The related factors for SI and SI% included I-131 dose, sex, BMI, thyroid cancer pathology, medical history and thyroid function. These findings provide a reference for radiation protection officers in evaluating radioactive activity during I-131 therapy.

PMID:41655156 | DOI:10.1186/s40658-026-00845-9

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Robustness of heart dose against cardiac cycle in breast cancer radiotherapy with deep inspiration breath-hold

Radiol Phys Technol. 2026 Feb 8. doi: 10.1007/s12194-026-01016-2. Online ahead of print.

ABSTRACT

This study evaluated dose differences to the heart, left anterior descending coronary artery (LADCA), and left main coronary artery (LMCA) between diastolic and systolic heart phases in radiation therapy for left-sided breast cancer using deep inspiration breath-hold (DIBH). Diastolic and systolic doses to the heart, LADCA, and LMCA were analyzed using electrocardiogram-gated cardiac computed tomography images from 15 women. Radiation therapy plans were created for a total dose of 50 Gy in 25 fractions. Parameters assessed included volume, Dmean, D2%, V5Gy, V10Gy, V20Gy, and V25Gy for the heart; Dmean, D2%, V5Gy, V10Gy, and V20Gy for the LADCA; and Dmean and D2% for the LMCA. The Dmean of the heart was 5.10 ± 3.04 Gy and 5.03 ± 3.05 Gy for diastole and systole, respectively (mean ± 1 standard deviation), and D2% was 37.44 ± 16.03 Gy and 36.15 ± 16.76 Gy. Statistically significant differences were found in the Dmean. LADCA doses showed no significant differences, possibly due to anatomical variations. The Dmean of the LMCA was 1.88 ± 0.23 Gy and 2.02 ± 0.28 Gy for diastole and systole, and D2% was 2.05 ± 0.28 Gy and 2.21 ± 0.30 Gy, with both parameters being statistically significantly higher during systole. Although small, cardiac-phase-dependent dose variations under DIBH were statistically significant, confirming that current non-ECG-gated DIBH remains adequate for cardiac dose management.

PMID:41655146 | DOI:10.1007/s12194-026-01016-2

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Design-Build-Test-Learn-Guided Engineering of a Whole-Cell Pyruvate Biosensor Based on a Transcription Factor

ACS Synth Biol. 2026 Feb 8. doi: 10.1021/acssynbio.5c00650. Online ahead of print.

ABSTRACT

Whole-cell biosensors are powerful tools for metabolite monitoring, yet challenges such as narrow dynamic range and high leaky expression limit their broader applications. Here, we present a systematic workflow based on two Design-Build-Test-Learn (DBTL) cycles to develop and optimize a transcription factor-based pyruvate biosensor in Escherichia coli. In the first iteration of the cycle, we constructed a biosensor that responded to intracellular pyruvate levels within the 0.05-10 mM range. In the second cycle, we implemented the design of experiments (DoE) to systematically explore combinatorial effects of promoters and ribosome-binding sites (RBSs). A first set of experiments was designed to identify factors with a significant effect on biosensor performance. The results showed that the RBS of the reporter gene significantly influenced the dynamic range by modulating basal and maximum expression, while the RBS of the transcription factor affected the signal span. The Akaike Information Criterion was used to select a model incorporating two main effects and one interaction effect. The best-performing strain exhibited an 18.54-fold increase in the dynamic range and a 37.22-fold reduction in leaky expression. Quantification of intracellular pyruvate confirmed an operational range of 1.23-6.81 μmol/g DCW. Our work demonstrates the power of DBTL cycles with statistical modeling for biosensor engineering, offering potential applications in precise metabolic regulation and screening applications.

PMID:41655136 | DOI:10.1021/acssynbio.5c00650

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Rapid symptomatic improvement with etrasimod in ulcerative colitis: a post-hoc analysis of the ELEVATE UC program

Inflamm Bowel Dis. 2026 Feb 8:izaf333. doi: 10.1093/ibd/izaf333. Online ahead of print.

ABSTRACT

INTRODUCTION: Rapid symptom relief is an important consideration for patients with ulcerative colitis (UC) experiencing a flare. Etrasimod is an oral, once-daily, selective sphingosine 1-phosphate1,4,5 receptor modulator for the treatment of moderately to severely active UC. We evaluated patient-reported symptomatic improvement from patients in the ELEVATE UC program.

METHODS: This study was a post-hoc analysis of pooled daily e-diary data from patients with moderately to severely active UC receiving etrasimod or placebo in the phase III ELEVATE UC 52 and ELEVATE UC 12 trials. During the 12-week induction periods, patients self-reported stool frequency and rectal bleeding on days 1-28. Daily symptomatic response and symptomatic remission were calculated (partial modified Mayo Score).

RESULTS: Overall, 787 patients (527 receiving etrasimod, 260 placebo) were included in the analysis. Etrasimod-treated patients had statistically significantly higher rates of symptomatic response and symptomatic remission during the first 28 days of therapy, with adjusted differences (95% CIs) reaching statistical significance from day 2 (5.6% [0.8-10.3], P = .022) to day 11 (4.7% [0.4-9.0], P = .034), respectively. In patients naïve to biologic/Janus kinase inhibitor therapy, symptomatic response was statistically significantly improved with etrasimod vs placebo from day 3 (8.9% [2.3-15.5], P = .008). Symptomatic improvement rates were similar with and without concomitant corticosteroid use.

CONCLUSIONS: In this post-hoc analysis, improvements in UC symptoms occurred in patients receiving etrasimod vs placebo from as early as day 2. These findings indicate a rapid onset of symptomatic effect with etrasimod treatment for moderately to severely active UC.

CLINICALTRIALS.GOV NUMBERS: NCT03945188, NCT03996369.

PMID:41655066 | DOI:10.1093/ibd/izaf333

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Evaluating the Efficacy and Safety of Edaravone-Dexborneol in Acute Ischemic Stroke: An Updated Systematic Review and Meta-Analysis of 7,846 Chinese Patients

Int J Neurosci. 2026 Feb 7:1-21. doi: 10.1080/00207454.2026.2628832. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the safety and efficacy of Edaravone-Dexborneol as a neuroprotective agent in patients with acute ischemic stroke (AIS).

METHODS: We conducted a comprehensive search in PubMed, Scopus, Web of Science, and Cochrane CENTRAL until January 22, 2026, including clinical trials and observational studies comparing Edaravone-Dexborneol with Edaravone monotherapy, standard treatment, and placebo. Data on functional recovery (Modified Rankin Scale [mRS], National Institutes of Health Stroke Scale [NIHSS], Barthel Index [BI]), safety outcomes, and mortality were extracted. A random effects model was used for statistical analysis.

RESULTS: Overall, 13 studies (5 cohort studies and 8 randomized controlled trials) involving 7,846 patients were included, demonstrating that Edaravone-Dexborneol significantly improved 90-day mRS scores (0-1) compared with Edaravone alone (RD: 0.08, 95% CI: [0.03, 0.13], P = 0.001). When compared with standard treatment, NIHSS scores were significantly lower in the Edaravone-Dexborneol group (MD: -2.18, 95% CI: [-3.75, -0.62], P = 0.006), and no significant difference was observed in mRS (0-1) or the risk of symptomatic intracranial hemorrhage (sICH). Safety outcomes showed a possible dose-dependent adverse event (AE), including hyperhomocysteinemia and hypokalemia.

CONCLUSION: Edaravone-Dexborneol might be an effective treatment for improving functional recovery in patients with AIS and appears to have a relatively favorable safety profile. However, careful dosing is necessary to minimize AEs. Future research should focus on large-scale trials, long-term outcomes, and mechanistic studies to optimize treatment protocols.

PMID:41655025 | DOI:10.1080/00207454.2026.2628832