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Diabetic foot ulcers (DFUs) are the fastest growing chronic complication of diabetes mellitus, with more than 400 million people diagnosed globally, and the condition is responsible for lower extremity amputation in 85% of people affected, leading to high-cost hospital care and increased mortality risk. Neuropathy and peripheral arterial disease trigger deformities or trauma, and aggravating factors such as infection and edema are the etiological factors for the development of DFUs. DFUs require identifying the etiology and assessing the co-morbidities to provide the correct therapeutic approach, essential to reducing lower-extremity amputation risk. This review focuses on the current treatment strategies for DFUs with a special emphasis on tissue engineering techniques and regenerative medicine that collectively target all components of chronic wound pathology.

Ceramides are bioactive sphingolipids increasingly recognized as mediators of cardiometabolic disease and residual cardiovascular risk. Accumulating evidence from experimental and clinical studies indicates that specific ceramide species contribute to insulin resistance, endothelial dysfunction, myocardial injury, and adverse cardiovascular outcomes. In particular, long-chain ceramides (C16:0, C18:0, C20:0 Cer) are consistently associated with myocardial infarction, heart failure, and cardiovascular mortality, whereas very-long-chain ceramides (C22:0, C24:0 Cer) exhibit neutral or potentially protective associations. This narrative review integrates biochemical, experimental, and clinical evidence to examine ceramide metabolism, molecular diversity, and their emerging role as biomarkers for cardiovascular risk stratification. We also discuss ceramide-based risk scores and their potential clinical utility beyond traditional lipid parameters. Understanding the structure–function relationships of ceramides may support the development of novel diagnostic and therapeutic strategies in cardiovascular prevention.

Kawasaki Disease (KD) is an acute vasculitis affecting children under five years of age, with atypical presentations posing diagnostic challenges and a higher risk of coronary complications when untreated. We report on a 2-year-old girl with persistent fever, limb edema, erythema, and non-purulent conjunctivitis, without cervical lymphadenopathy or the typical rash. Inflammatory markers were assessed, and a cytokine expression profile was obtained using qRT-PCR. Laboratory analysis showed elevated C-reactive protein (11.1 mg/dL), high fibrinogen (468 mg/dL), borderline D-dimer (484 ng/mL), and a normal platelet count. The cytokine profile revealed marked upregulation of IFN-α, IFN-β, IFN-γ, IL-1α, IL-1β, IL-5, IL-8, and IL-12, with downregulation of IL-2 and IL-4, as well as low TNF-α levels. These findings, although not pathognomonic, were consistent with an inflammatory profile compatible with atypical KD, in which a preceding viral infection may have played a role, although causality cannot be established. This case highlights the diagnostic utility of cytokine profiling in suspected atypical KD, particularly when clinical criteria are incomplete. The integration of immunological data may aid in earlier recognition and therapeutic intervention, thereby helping to prevent cardiovascular sequelae. Cytokine analysis may serve as a promising adjunct for atypical KD diagnosis, although confirmation in larger cohorts is needed.

The use of derivatives of natural and synthetic origin has gained attention because of their therapeutic effects against human diseases. Coumarins are one of the most common organic molecules and are used in medicine for their pharmacological and biological effects, such as anti-inflammatory, anticoagulant, antihypertensive, anticonvulsant, antioxidant, antimicrobial, and neuroprotective, among others. In addition, coumarin derivates can modulate signaling pathways that impact several cell processes. The objective of this review is to provide a narrative overview of the use of coumarin-derived compounds as potential therapeutic agents, as it has been shown that substituents on the basic core of coumarin have therapeutic effects against several human diseases and types of cancer, including breast, lung, colorectal, liver, and kidney cancer. In published studies, molecular docking has represented a powerful tool to evaluate and explain how these compounds selectively bind to proteins involved in various cellular processes, leading to specific interactions with a beneficial impact on human health. We also included studies that evaluated molecular interactions to identify potential biological targets with beneficial effects against human diseases.

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Background: Acute appendicitis is the most common abdominal surgical emergency, with diagnostic uncertainty greatest in resource-limited settings. Objectives: To develop and internally validate an interpretable, laboratory-driven machine learning approach to assist clinical decision-making in suspected appendicitis, including diagnosis, perforation detection, and surgical severity stratification. Methods: A retrospective cohort of 246 patients with histopathologically confirmed appendicitis and 45 controls with similar abdominal pain was analyzed at a secondary-level hospital in Mexico. After cleaning and imputation, 41 laboratory variables were used to train three models: Random Forest for appendicitis detection and perforation identification, and Support Vector Machine for surgical severity stratification. Class imbalance was addressed with synthetic oversampling, and feature selection prioritized clinical interpretability. Results: Appendicitis detection achieved excellent discrimination (AUC = 0.94), correctly identifying 90% of cases, with 100% specificity. The perforation model reached 100% sensitivity (AUC = 0.875), prioritizing safe detection of high-risk cases, while severity stratification showed moderate performance (AUC = 0.721), correctly identifying 81% of complicated cases without imaging. Conclusions: Laboratory-based ML models accurately detected acute appendicitis and identified all perforated cases using routine data alone, while surgical severity stratification showed moderate discrimination in the absence of imaging. These findings demonstrate the feasibility of laboratory-driven decision support for early risk assessment in resource-limited emergency settings and support further external validation.

Background: Bullying in university settings is a significant yet understudied contributor to psychological distress. Differentiating the sources of victimization, may reveal distinct risk profiles associated with mental health and substance use outcomes. Objective: To evaluate the frequency and risk factors associated with bullying victimization among medical students, and to identify associations with mental disorders and substance use. Methods: A nested case–control cohort study was conducted with 124 medical students. Participants completed nine validated psychometric instruments evaluating neurobehavioral traits, emotional distress, substance use, and scholar bullying. Bivariate and multivariate regression models were used to estimate coefficients and odds ratios for key outcomes. Results: 42.7% of the students reported victimization, with teacher harassment (37.1%) more frequent than peer harassment (27.4%); 22.6% experienced both. Teacher harassment was primarily characterized by intentional harm (78%); peer harassment involved abuse of authority (63%). ADHD, severe stress, and substance use were associated with teacher-related victimization, while peer victimization was linked to ADHD, stress, impulsivity, and suicide risk. Childhood abuse, high stress levels, and non-heterosexual orientation as predictors of teacher harassment (p < 0.05). Notably, students with a non-heterosexual orientation were over six times more likely to report teacher harassment, highlighting the disproportionate vulnerability of sexual minorities within academic power dynamics. Conclusions: Teacher- and peer-related harassment are prevalent and often co-occur, with teacher-perpetrated bullying emerging as both more frequent and more strongly associated with mental health and identity-based vulnerabilities. Students with ADHD, high stress levels, and non-heterosexual orientation are at significantly greater risk. These findings emphasize the need for institutional accountability, inclusive academic policies, and targeted mental health support to protect vulnerable students and prevent harm within educational environments.

Introduction: The COVID-19 pandemic created an urgent need for safe and accessible outpatient treatments. Polymerized type I collagen (PTIC) has demonstrated potential immunomodulatory effects, but its clinical utility in patients with COVID-19 remains underexplored. This study aimed to evaluate the clinical evolution and health outcomes of a cohort of patients with COVID-19 treated with standard medical care plus PTIC during the pandemic emergency, in order to explore its potential role as an adjuvant therapy. Methods: A retrospective cohort study was conducted in 46 outpatients with confirmed COVID-19 treated with PTIC (Fibroquel®) plus standard care, and 15 controls with standard care alone. Clinical and laboratory data were collected on Days 1 and 10. Patients were stratified by COVID-19 severity and SARS-CoV-2 variant. Analyses included odds ratios and Kaplan–Meier survival curves. Results: Oxygen saturation levels increased significantly from 88.5 ± 5.22 to 95.1 ± 2.07 after PTIC treatment. Supplemental oxygen was required for 26.1% of patients receiving treatment, compared to 60% of those in the untreated group (p < 0.05). Complete recovery was observed in all patients treated with PTIC, compared with 80% recovery in the standard care group. There were no deaths from COVID-19 in the PTIC group. In contrast, 20% of the participants in the untreated group died due to complications from the disease (p = 0.013). PTIC improved the survival rate of patients with the disease. Conclusions: PTIC significantly improved clinical parameters in patients with COVID-19. It improves oxygen saturation levels, decreases the need for supplemental oxygen, and improves survival compared to patients who are not treated with PTIC. Additional studies are needed to validate the use of PTIC as an adjunctive therapy for patients with COVID-19.

Nursing students face emotional and psychological challenges stemming from early clinical exposure, intense academic pressure, and persistent social stigmas. These stressors can contribute to mental health deterioration and increase the risk of suicidal thoughts and behavior. To evaluate the psychosocial context and identify risk and protective factors contributing to suicidal behavior in undergraduate nursing students. This cross-sectional study included 433 undergraduate nursing students and utilized validated psychological instruments to assess suicidal behavior, emotional distress, impulsivity, anhedonia, mental health, and perceived social support. Data were analyzed using descriptive statistics, bivariate tests, exploratory factor analysis, and multivariate modeling to identify key predictors of suicidal behavior. Network visualization was used to integrate significant point-biserial correlations with factor loadings. Among 433 nursing students (77.8% women, 93.8% cisgender, mean age 19), 15.2% showed clinically significant suicidal risk. Suicidal behavior was more frequent among women and students living away from home ( < 0.05). Higher levels of impulsivity, ADHD symptoms, and especially moderate-to-severe hopelessness ( < 0.001) were strongly associated. Hazardous alcohol use was also a significant risk factor ( < 0.01), while strong material and emotional support showed a protective effect ( < 0.05). Two psychological dimensions, emotional distress/impulsivity and hopelessness/low support, explained most of the variance. 1 in 7 nursing students show clinically relevant suicidal risk, particularly those with heightened hopelessness, emotional dysregulation or hazardous alcohol use. Protective social support plays a key mitigating role. These results underline the urgent need for tailored mental health interventions that specifically address emotional regulation and hopelessness, while reinforcing social support systems within nursing education contexts.

Aedes aegypti is a major vector of arboviruses, including dengue, Zika, chikungunya, yellow fever, and Mayaro. The extensive use of insecticides has led to resistance, complicating vector control efforts. MicroRNAs (miRNAs) are post-transcriptional regulators involved in detoxification and stress adaptation; however, their role in the insecticide response of Ae. aegypti remains unclear. This study analyzed miRNA expression in Ae. aegypti following imidacloprid exposure, comparing a field strain, Martinez de la Torre from Mexico (MT), and a susceptible reference strain, New Orleans (NO). Small RNA sequencing identified 96 miRNAs, with miR-1, miR-281-5p, miR-100, and miR-184 being consistently expressed across all conditions. In contrast, let-7, miR-124, and miR-13-3p were exclusively detected in wild mosquitoes exposed to imidacloprid, while miR-14 and miR-275-3p showed condition-specific expression. Distinct miRNA expression patterns were observed between the field and susceptible strains, with specific miRNAs showing condition-dependent expression. These findings suggest that certain miRNAs may serve as potential biomarkers for resistance monitoring, contributing to a better understanding of insecticide response mechanisms and informing novel vector control strategies.