Search Results (179)

Background/Objective: Executive functions (EFs) are essential in the daily management of arthritis, as they influence treatment adherence, decision-making, and the ability to cope with disease-related challenges. The objective of this study was to compare EFs alongside functional status and quality of life in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) and examine their associations with disease activity and clinical variables. Methods: In this cross-sectional study, 140 patients (70 RA, 70 PsA) were assessed using the Stroop-TBAG, Wisconsin Card Sorting Test (WCST), and Adult Executive Functioning Inventory (ADEXI). Functional status and quality of life were measured with the Health Assessment Questionnaire (HAQ) and WHOQOL-BREF, respectively. Correlations with disease activity (DAS28-CRP), age, and disease duration were examined. Results: RA patients had significantly higher disease activity and longer disease duration. They showed poorer performance on the Stroop Test (color–word time: 61.6 ± 14.8 vs. 52.4 ± 10.9 s, p < 0.001; errors: 3.2 ± 2.1 vs. 2.1 ± 1.5, p = 0.001), more WCST perseverative errors (p = 0.002), and higher ADEXI inhibition scores (13.9 ± 2.5 vs. 12.9 ± 3.0, p = 0.013). DAS28-CRP was correlated with EF impairments, disability, and poorer quality of life in RA (p < 0.05). In PsA, EFs remained relatively stable, although higher disease activity was associated with worse HAQ scores (p = 0.001). Treatment type was not linked to EF, but patients on combination therapy reported lower physical (p = 0.009) and psychological (p = 0.014) quality of life, along with higher HAQ scores (p = 0.016). Conclusions: This study revealed that patients with RA exhibit more pronounced executive dysfunction, along with lower ADL skills and quality of life compared to those with PsA. These findings highlight the need for multidimensional assessment strategies in inflammatory arthritis, especially in RA, where cognitive and functional outcomes are closely tied to clinical burden. Full article

The rapid growth of the global population and associated increases in resource consumption have accelerated environmental degradation, making sustainable design and construction processes increasingly essential. The construction sector holds significant potential for reducing environmental impacts, especially through sustainability-focused certification systems such as LEED. This study evaluates the projected energy efficiency and sustainability performance of the Surgical Sciences Building at Istanbul University’s Çapa Campus, which was designed with the goal of achieving LEED Gold certification. The assessment is based on design-phase data and conducted prior to construction. Energy performance analyses were carried out using DesignBuilder software, supported by the LEED Assessment Report and Energy Audit Report. According to simulation results, approximately 30% savings in energy consumption and water usage are expected. In addition, the process-oriented LEED approach is expected to result in a total CO₂ emission savings of approximately 570 tonnes, while renewable energy systems are expected to meet approximately 13% of the building’s primary energy demand and reduce CO₂ emissions by approximately 151 tonnes per year. Waste management strategies developed for both the construction and operational phases are aligned with LEED criteria and aim to achieve up to 80% recycling rates. The findings demonstrate that LEED certification, when employed as a process-oriented design and decision-making tool rather than a result-oriented label, can enable sustainable strategies to be integrated from the earliest stages of project development. Particularly for complex healthcare buildings, embedding LEED principles into the design process has strong potential to enhance environmental performance. Although based on a single case study, this research provides valuable insight into the broader applicability of LEED in diverse building types and geographic contexts. Full article

Background/Objectives: Elderly patients who suffer a hip fracture often have a high risk of complications and mortality, which can be made worse by anemia during and after surgery. Although restrictive transfusion strategies are recommended, the role of preoperative intravenous iron, particularly ferric carboxymaltose (FCM), remains unclear. This study aimed to investigate whether preoperative IV FCM reduces mortality and transfusion requirements in geriatric hip fracture patients managed under a restrictive transfusion strategy. Methods: A study was conducted in which 220 patients aged 65 years and over who had undergone surgery for a hip fracture were included. These patients were allocated to receive either a single 1000 mg dose of intravenous FCM approximately 12 h before surgery or no iron supplementation. All the patients were managed with a standardized restrictive transfusion strategy. The primary outcome was all-cause mortality at 6 and 12 months. The secondary outcomes included perioperative transfusion requirement, hemoglobin trends, and length of hospital stay. Results: The FCM group demonstrated significantly lower mortality at both 6 months (22.9% vs. 39.0%, p = 0.011) and 12 months (28.4% vs. 42.9%, p = 0.028) compared to the control group. Multivariate logistic regression identified preoperative FCM administration as one of the independent protective factors for mortality. The FCM group had significantly lower transfusion rates (30.9% vs. 45.5%, p = 0.02). No significant difference was observed at the 6-week follow-up in terms of the higher discharge hemoglobin levels seen in the control group. The difference in hospital stay duration did not reach statistical significance. Conclusions: Preoperative intravenous FCM administration could reduce both short- and long-term mortality and transfusion needs in geriatric hip fracture patients managed under a restrictive transfusion protocol. These findings support further investigation of high dose IV iron as a component of perioperative blood management in this high-risk population. Full article

In vitro maturation (IVM) of oocytes retrieved from ovum pick-up (OPU) or ovarian tissue (OT) is a standard approach for patients with specific conditions where prior hormonal stimulation is contraindicated. However, the developmental competence of oocytes matured in vitro is still inferior to that of oocytes matured in vivo. Capacitation IVM (CAPA-IVM) includes an extra step of pre-maturation culture (PMC) with c-type natriuretic peptide (CNP) as a meiotic arrestor to better synchronize cytoplasmic and nuclear maturity in oocytes by allowing the cytoplasm additional time to acquire essential components critical for optimal competency. This study aims to evaluate the effect of CAPA-IVM on equine oocyte quality and developmental competence. Immature cumulus–oocyte complexes (COCs) were retrieved from slaughterhouse ovaries and matured in vitro either in CAPA-IVM (short 6 h, long 24 h pre-maturation) or standard IVM. Mature oocytes from each group were analyzed for calcium-releasing potential (n = 52) and single-oocyte proteomics (n = 44), and embryo development (n = 229) was assessed after fertilization with piezo-drilled intracytoplasmic sperm injection (ICSI). Genetic analysis of developed blastocysts (n = 41) was performed to detect chromosomal aberrations. Our findings demonstrate that CAPA-IVM of equine COCs yields significantly higher maturation rates than controls. Moreover, short CAPA-IVM with six hours pre-maturation culture showed substantially higher embryo development potential than the control group (20/69 vs. 9/63, respectively). Genetic analysis revealed a high euploidy rate in equine blastocysts regardless of the maturation conditions. Live calcium imaging of the fertilized oocytes demonstrated that the majority of oocytes displayed non-continuous calcium oscillation patterns, irrespective of maturation conditions. Single-oocyte proteomics reveals a comparable proteomic landscape between mature oocytes subjected to short CAPA-IVM and standard IVM. However, we identified four enriched gene sets with positive enrichment scores after short CAPA-IVM, related to cytoskeleton regulation, ribosomal function, and cytosolic components. Our findings indicate that CAPA-IVM holds the potential to improve oocyte quality and competence in horses. However, further fine-tuning of culture conditions would benefit the effective use of these IVM systems. Moreover, given that the mare serves as an excellent model for human reproduction, the molecular trends identified in this study could provide valuable insights for advancing human artificial reproductive technologies. Full article

This study aimed to (i) identify soil management practices implemented by farmers at the local level, (ii) determine the local soil fertility indicators recognized by farmers along an altitudinal gradient, (iii) evaluate the influence of altitude on soil properties, and (iv) integrate local and scientific knowledge of soil indicators and soil management. A total of 368 surveys were conducted to document traditional knowledge, visible indicators of soil fertility, and perceptions of soil health. These were compared with field-based measurements of soil organic carbon, texture, and environmental variables. A significant convergence was found between farmers’ perception of soil texture and scientific classification. A moderate correlation was observed between soil color and soil carbon stocks. Altitude showed a clear influence on carbon stocks, with soil at a higher elevation, characterized by greater rainfall and lower temperatures, storing more carbon. This integration of local and scientific knowledge offers practical value for farmers, extension agents, and institutions by supporting context-specific soil management decisions. It empowers farmers to actively participate in the design of sustainable agricultural practices that are both ecologically sound and culturally relevant. The study demonstrates that combining experiential knowledge with scientific data contributes to more resilient agroecosystems in mountainous rural areas. Full article

Background/Objectives: In this study, we aimed to analyze the validity, based on the internal structure of the construct, measurement invariance by sex, and reliability of the scores for the “Knowledge in Basic Cardiopulmonary Resuscitation in Peruvian children/adolescents” (KBCPR_P21) and “Attitudes in Basic Cardiopulmonary Resuscitation in Peruvian children/adolescents” (ABCPR_P21) instruments in Spanish. Methods: A cross-sectional and instrumental methodological study was conducted between February and August 2021, with the participation of 415 Peruvian elementary school students between 8 and 13 years of age. Participants responded to surveys on knowledge and attitudes toward CPR. For both instruments, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was used as the estimation method for categorical data. Results: All of the items for both scales have high discriminative capacity (>0.30), and both scales showed high internal consistency (Cronbach’s alpha > 0.87 and McDonald’s omega > 0.90). The validity, based on the internal structure of the construct, implied the existence of a single factor grouping all the items in the two scales (CFI and TLI > 0.95; RMSEA and SRMR < 0.08). Multigroup confirmatory factor analysis also allowed us to satisfactorily verify measurement invariance by sex at the four levels (configural, metric, scalar, and strict) for both scales. Conclusions: We can conclude that the values obtained in our evaluation of the scales favor considering them as valid and reliable instruments with which to measure knowledge and attitudes toward basic cardiopulmonary resuscitation in children/adolescents in Peru, given prior learning. The scales could also be used in the evaluation of knowledge and attitudes around basic cardiopulmonary resuscitation in other countries, providing trainers with rapid feedback on the knowledge and attitudes transmitted in training courses, thus allowing better control over the training activities carried out in these courses. Finally, the availability of the scales would allow researchers to empirically test their psychometric properties in other countries. Full article

Background/Objectives: Magnetic resonance imaging (MRI) is crucial in detecting suspicious lesions and diagnosing clinically significant prostate cancer (csPCa). However, variability in MRI-targeted diagnostic pathways arises due to factors such as patient characteristics, imaging protocols, and radiologist expertise. Artificial intelligence (AI) offers potential solutions to these challenges by enhancing diagnostic accuracy and efficiency. Methods: This narrative review explores AI techniques, particularly machine learning and deep learning, in the context of prostate cancer diagnosis. It examines their application in improving MRI scan quality, detecting artifacts, and assisting radiologists in lesion detection and interpretation. It also considers how AI helps to reduce reading time and inter-reader variability. Results: AI has demonstrated sensitivity that is generally comparable to experienced radiologists, although specificity tends to be lower, potentially increasing false-positive rates. The clinical impact of these results requires validation in larger, prospective multicenter studies. AI is effective in identifying artifacts, assessing MRI quality, and assisting in diagnostic efficiency by providing second opinions and automating lesion detection. However, variability in study methodologies, datasets, and imaging protocols can impact AI’s generalizability, limiting its broader clinical application. Conclusions: While AI shows significant promise in enhancing diagnostic accuracy and efficiency for csPCa detection, challenges remain, particularly with the generalizability of AI models. To improve AI robustness and integration into clinical practice, multicenter datasets and transparent reporting are essential. Further development, validation, and standardization are required for AI’s widespread clinical adoption. Full article

Poor air quality within hospitals can contribute to a range of health issues, collectively known as sick hospital syndrome, encompassing respiratory, skin, and nonspecific symptoms. Aspergillus poses a significant risk of severe respiratory infections, particularly within intensive care unit (ICU) patients often with compromised immune systems. This study was conducted in the intensive care units of three selected hospitals in Cracow, Poland. Air samples were obtained using the single-stage impactor MAS-100 NT Ex (Merck). The air samples were taken from each ward, seasonally, four times a year. Sampling of intensive care units’ air for Aspergillus revealed the significant diversity in fungal concentration and unveiled seasonal fluctuations in culturable fungi levels. The highest concentration of Aspergillus species complexes was detected during autumn, while the lowest was in spring. The disturbing occurrence of Aspergillus in hospitals’ air emphasizes the importance of monitoring fungal air bioburden and assessing air control efficiency and highlights the urgent need to develop and validate microbiological standards for fungal air contamination in hospitals. Full article

Min and max matrices are structured matrices that appear in diverse mathematical and computational applications. Their inherent structures facilitate highly accurate numerical solutions to algebraic problems. In this research, the total positivity of generalized Min and Max matrices is characterized, and their bidiagonal factorizations are derived. It is also demonstrated that these decompositions can be computed with high relative accuracy (HRA), enabling the precise computations of eigenvalues and singular values and the solution of linear systems. Notably, the discussed approach achieves relative errors on the order of the unit roundoff, even for large and ill-conditioned matrices. To illustrate the exceptional accuracy of this method, numerical experiments on quantum extensions of Min and L-Hilbert matrices are presented, showcasing their superior precisions compared to those of standard computational techniques. Full article

Electrical Resistivity Tomography (ERT) is a widely used geophysical technique for imaging subsurface resistivity variations, providing critical insights for geological engineering and hazard assessment applications. While open-source inversion tools such as BERT and PyGIMLi offer accessible solutions for geoelectrical modeling, their comparative performance across different electrode configurations and noise conditions remains underexplored. This study evaluates the effectiveness of these software packages in reconstructing subsurface anomalies related to cavity detection and landslide assessment. Four commonly used electrode configurations—dipole–dipole, Schlumberger, Wenner-Alpha, and Wenner-Beta—were tested on two synthetic models designed to simulate real geological conditions: one representing cavity detection and the other simulating a landslide scenario. Inversions were conducted under both ideal conditions and with synthetic noise to assess their robustness against measurement uncertainties. Results indicate that while all configurations successfully identified major subsurface features, the dipole–dipole array provided the highest resolution for detecting small-scale anomalies. BERT demonstrated superior accuracy under ideal conditions, while PyGIMLi showed consistent performance across multiple configurations, particularly in resolving smaller features under noisy conditions. These findings emphasize the importance of selecting appropriate electrode configurations to enhance imaging accuracy and ensure reliable geo-electrical data interpretation. This study highlights the robustness of open-source geophysical software for subsurface investigations and provides practical insights into optimizing geoelectrical survey configurations for shallow hazard detection. Full article

The human T-cell lymphotropic viruses of type 1 and 2 (HTLV 1/2) are retroviruses with estimations of 10 million people infected worldwide. HTLV 1/2 viruses are endemic in South America where Indigenous and Afro American populations are considered of high risk. Although several case reports of HTLV 1/2 associated pathologies and some prevalence studies have been reported in Ecuador, the country lacks a national surveillance and control program, and no screening of blood or organ donors is currently done. We discuss the problems associated to HTLV 1/2 in Ecuador and propose a strategy to improve a surveillance and control program. Full article

Patients with hematological malignancies (HMs) are at higher risk of severe COVID-19 and secondary infections, which further complicate their outcomes. This study evaluated the impact of secondary infections (SIs) on mortality in hospitalized HM patients with SARS-CoV-2 infection and identified risk factors associated with SIs. We included 217 patients with HMs and COVID-19 admitted to a tertiary hospital in Rome, from April 2020 to September 2022. SIs occurred in 44.2% of patients, with bloodstream infections (42.7%) and respiratory infections (30.5%) being most frequent; among the latter, COVID-19-associated pulmonary aspergillosis (CAPA) was observed in 41.4% of cases. Viral reactivations, predominantly CMV, occurred in 9.2% of patients. The overall mortality rate was 29%, with higher mortality observed in patients with SIs (47.4% vs. 14.7%, p < 0.01). Risk factors for SIs included severe COVID-19 (OR = 2.957, p < 0.05) and prolonged hospitalization (OR = 1.095, p < 0.001). Severe COVID-19 (OR = 8.229, p < 0.001), intensive care unit (ICU) admission (OR = 15.232, p < 0.001), chronic steroid therapy (OR = 2.803, p < 0.05), SIs (OR = 2.892, p < 0.05), and viral reactivation (OR = 6.269, p < 0.01) were independent predictors of mortality. SIs and viral reactivations are common in patients with HMs and SARS-CoV-2 infection and significantly increase mortality, highlighting the need for timely management and preventive strategies in this vulnerable population. Full article

Caffeic acid phenethyl ester (CAPE) is a phenolic natural product with diverse biological activities, notably anticancer properties. However, its ester group is metabolically unstable. The amide derivative, CAPA, offers improved metabolic stability to esterases but still possesses a metabolically liable catechol group. In this work, we describe the synthesis of a novel CAPA analogue in which the catechol is replaced with a benzimidazole bioisostere via a water-mediated Wittig reaction. Full article

Background and Objectives: Transverse maxillary deficiency is an important maxillary anomaly that is very common in society and remains current in orthodontics. The maxillary expansion has been used in treatment for a long time. While maxillary expansion can be performed with rapid maxillary expansion in young adults, it is performed with surgically assisted rapid maxillary expansion (SARME) in individuals who have reached skeletal maturity. No consensus has been reached on the most successful surgical technique or the ideal appliance for treating transverse maxillary deficiency. Accordingly, we aimed to evaluate various surgical techniques and orthodontic appliances for treating transverse maxillary deficiency using the finite element method (FEM) to identify the treatment protocol that minimizes stress on the maxillary bone and teeth. Materials and Methods: On the virtual models obtained from the cone beam computed tomography of a patient, two different incisions (the pterygomaxillary junction is separated and not separated) were made and combined using three different orthodontic appliances (tooth, bone, and hybrid assisted). Then, stresses over the maxillary bone and maxillary teeth were calculated by FEM. Results: Our results showed that when the pterygomaxillary plates were separated, fewer stresses were observed on the bone and teeth. Although hybrid-supported appliances created less stress on the teeth than tooth-supported appliances and no difference was found between bone-supported appliances, it was found that hybrid-supported appliances created less stress on the bone than the other appliances. Conclusions: The separation of the pterygomaxillary junction in the SARME operation and the use of a bone-supported or hybrid-supported appliance would place less stress on the bone and teeth. Full article

Caffeic acid phenethyl ester (CAPE) is a phenolic natural product with a wide range of biological activities, including anticancer activity; however, the ester group of CAPE is metabolically labile. The corresponding amide, CAPA, has improved metabolic stability but limited anticancer activity relative to CAPE. We report the synthesis using flow and on-water Wittig reaction approaches of five previously reported and five novel CAPA analogues. All of these analogues lack the reactive catechol functionality of CAPA and CAPE. Cytotoxicity studies of CAPE, CAPA, and these CAPA analogues in HeLa and BE(2)-C cells were carried out. Surprisingly, we found that CAPA is cytotoxic against the neuroblastoma BE(2)-C cell line (IC₅₀ = 12 µM), in contrast to the weak activity of CAPA against HeLa cells (IC₅₀ = 112 µM), and the literature reports of the absence of activity for CAPA against a variety of other cancer cell lines. One novel CAPA analogue, 3f, was identified as having cytotoxic activity similar to CAPE in HeLa cells (IC₅₀ = 63 µM for 3f vs. 32 µM for CAPE), albeit with lower activity against BE(2)-C cells (IC₅₀ = 91 µM) than CAPA. A different CAPA analogue, 3g, was found to have similar effects against BE(2)-C cells (IC₅₀ = 92 µM). These results show that CAPA is uniquely active against neuroblastoma cells and that specific CAPA analogues that are predicted to be more metabolically stable than CAPE can reproduce CAPA’s activity against neuroblastoma cells and CAPE’s activity against HeLa cells. Full article