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When Bladder Cancer Treatment Strikes Back: Mycotic Aneurysms After Intravesical BCG Therapy

by Sarah Blackwell, Kevin Yinkit Zhuo, Andrew Jensen and Balasubramanian Indrajit

Soc. Int. Urol. J. 2025, 6(5), 61; https://doi.org/10.3390/siuj6050061 (registering DOI) - 20 Oct 2025

Intravesical Bacillus Calmette-Guerin (BCG) remains the gold standard adjuvant therapy for intermediate and high-risk non-muscle invasive bladder cancer (NMIBC) [...] Full article

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15 pages, 1323 KB

Open AccessArticle

The Impact of Patient Navigators on Overactive Bladder Care: Real-World Practice Patterns from a US National Database

by Ekene Enemchukwu, Jennifer Miles-Thomas, Nitya Abraham, Diane K. Newman, Marc Schwartz, Kimberly Becker Ifantides, Mariana Nelson and Raveen Syan

Soc. Int. Urol. J. 2025, 6(5), 60; https://doi.org/10.3390/siuj6050060 (registering DOI) - 20 Oct 2025

Abstract

Background/Objectives: We here describe the impact of navigated care on utilization patterns of pharmacologic and minimally invasive overactive bladder therapies. Methods: This retrospective observational cohort study used electronic medical record data from the Precision Point Specialty Analytics Portal in the United States. Eligible [...] Read more.

Background/Objectives: We here describe the impact of navigated care on utilization patterns of pharmacologic and minimally invasive overactive bladder therapies. Methods: This retrospective observational cohort study used electronic medical record data from the Precision Point Specialty Analytics Portal in the United States. Eligible patients were adults (≥18 years) newly diagnosed and treated for non-neurogenic overactive bladder (1 January 2015 to 31 December 2019). Categorical endpoints were analyzed by chi-square test or Fisher exact test. Of 170,000 eligible patients, 8982 (≈5%) were randomly selected and stratified by navigation status (navigated: 1150 [12.8%]; non-navigated: 7832 [87.2%]). Results: Overall, 60.0% of patients were female, 69.9% were White, and 42.7% had Medicare coverage. Navigated care was more common among women, Black patients, and those covered by Medicaid/Medicare. Initial pharmacologic treatment rates were similar between navigated and non-navigated groups (anticholinergic: 57.0% vs. 57.4%; beta-3 agonist: 43.0% vs. 42.6%). Greater percentages of navigated versus non-navigated patients received minimally invasive therapy (23.8% vs. 10.8%, respectively; p < 0.0001). Discontinuation rates were lower for navigated versus non-navigated patients undergoing pharmacologic treatment (62.5% vs. 71.3%; p < 0.0001). Conclusions: Patient navigation for overactive bladder may help increase access to minimally invasive therapies and may be a tool to address treatment disparities. Full article

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9 pages, 1094 KB

Open AccessArticle

The Clinical Integration of ChatGPT Through an Augmented Patient Encounter in a Real-World Urological Cohort: A Feasibility Study

by Shane Qin, Emre Alpay, Bodie Chislett, Joseph Ischia, Luke Gibson, Damien Bolton and Dixon T. S. Woon

Soc. Int. Urol. J. 2025, 6(5), 59; https://doi.org/10.3390/siuj6050059 (registering DOI) - 20 Oct 2025

Abstract

Background/Objectives: To evaluate the viability of using ChatGPT in a real clinical environment for patient education during informed consent for flexible cystoscopy, assessing its practicality, patient perceptions, and clinician evaluations within a urological cohort. Methods: A prospective feasibility study was conducted at a [...] Read more.

Background/Objectives: To evaluate the viability of using ChatGPT in a real clinical environment for patient education during informed consent for flexible cystoscopy, assessing its practicality, patient perceptions, and clinician evaluations within a urological cohort. Methods: A prospective feasibility study was conducted at a single institution involving patients with haematuria who attended an in-person clinic review with access to ChatGPT-4o mini. Using predetermined prompts regarding haematuria, we evaluated the accuracy, consistency, and suitability of the ChatGPT information. Responses were appraised for errors, omission of key information, and suitability for patient education. The functionality, usability, and quality of ChatGPT for patient education were assessed by three urologists using the Patient Education Materials Assessment Tool (PEMAT) and DISCERN tools. Readability was assessed using the Flesch–Kincaid tests. Further clinician questionnaires evaluated ChatGPT’s accuracy, reproducibility, and integration potential. Results: Ten patients were recruited, but one patient was excluded because he refused to use ChatGPT due to language barriers. All patients found ChatGPT to be useful, but most believed it could not entirely replace the doctor, especially for obtaining informed consent. There were no significant errors. The mean PEMAT score for understandability was 77.8%, and actionability was 63.8%. The mean DISCERN score was 57.7, corresponding to a ‘good’ quality score. The Flesch Reading Ease score was 30.2, with the writing level comparable to US grade level 13. Conclusions: ChatGPT offers valuable support for patient education, delivering accurate and comprehensive information. However, challenges with readability, contextual understanding, and actionability highlight the need for development and careful integration. Generative artificial intelligence (AI) should augment, not replace, clinician–patient interactions, emphasising ethical considerations and patient trust. This study provides a basis for further exploration of AI’s role in healthcare. Full article

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23 pages, 59679 KB

Open AccessArticle

Multi-View Omnidirectional Vision and Structured Light for High-Precision Mapping and Reconstruction

by Qihui Guo, Maksim A. Grigorev, Zihan Zhang, Ivan Kholodilin and Bing Li

Sensors 2025, 25(20), 6485; https://doi.org/10.3390/s25206485 (registering DOI) - 20 Oct 2025

Abstract

Omnidirectional vision systems enable panoramic perception for autonomous navigation and large-scale mapping, but physical testbeds are costly, resource-intensive, and carry operational risks. We develop a virtual simulation platform for multi-view omnidirectional vision that supports flexible camera configuration and cross-platform data streaming for efficient [...] Read more.

Omnidirectional vision systems enable panoramic perception for autonomous navigation and large-scale mapping, but physical testbeds are costly, resource-intensive, and carry operational risks. We develop a virtual simulation platform for multi-view omnidirectional vision that supports flexible camera configuration and cross-platform data streaming for efficient processing. Building on this platform, we propose and validate a reconstruction and ranging method that fuses multi-view omnidirectional images with structured-light projection. The method achieves high-precision obstacle contour reconstruction and distance estimation without extensive physical calibration or rigid hardware setups. Experiments in simulation and the real world demonstrate distance errors within 8 mm and robust performance across diverse camera configurations, highlighting the practicality of the platform for omnidirectional vision research. Full article

(This article belongs to the Section Navigation and Positioning)

21 pages, 561 KB

Open AccessReview

Iron in Vascular Calcification: Pro-Calcific Agent or Protective Modulator?

by Enikő Balogh, Andrea Tóth and Viktória Jeney

Int. J. Mol. Sci. 2025, 26(20), 10210; https://doi.org/10.3390/ijms262010210 (registering DOI) - 20 Oct 2025

Abstract

Vascular calcification is a complex, regulated process characterized by the pathological deposition of calcium phosphate minerals in the vascular wall, contributing to cardiovascular morbidity and mortality, particularly in patients with chronic kidney disease (CKD), diabetes, and aging. Once thought to be a passive [...] Read more.

Vascular calcification is a complex, regulated process characterized by the pathological deposition of calcium phosphate minerals in the vascular wall, contributing to cardiovascular morbidity and mortality, particularly in patients with chronic kidney disease (CKD), diabetes, and aging. Once thought to be a passive degenerative process, it is now recognized as an active, cell-mediated phenomenon that shares molecular features with bone formation. Beyond traditional risk factors such as hyperphosphatemia and inflammation, disturbances in iron metabolism have recently emerged as modulators of vascular calcification. Iron, a vital trace element involved in numerous cellular functions, exhibits a dual role as both a potential driver and inhibitor of calcification, depending on its dose, distribution, and cellular context. In this review, we summarize in vitro and in vivo studies investigating the impact of iron on the osteochondrogenic differentiation and calcification of vascular smooth muscle cells and valve interstitial cells. We further highlight mechanistic insights that may explain the divergent findings reported in the literature. Finally, we compile clinical evidence linking disturbances in iron metabolism with coronary artery calcification and cardiovascular mortality in CKD patients. Full article

(This article belongs to the Section Molecular Endocrinology and Metabolism)

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11 pages, 3383 KB

Open AccessArticle

All-Optically Controlled Terahertz Modulation by Silicon-Grown CdSe/CdZnS Colloidal Quantum Wells

by Reyihanguli Tudi, Zhongxin Zhang, Xintian Song, AbulimitiYasen, Bumaliya Abulimiti and Mei Xiang

Nanomaterials 2025, 15(20), 1597; https://doi.org/10.3390/nano15201597 (registering DOI) - 20 Oct 2025

Abstract

The CdSe/CdZnS colloidal quantum wells, with their exceptionally high carrier mobility and ultrafast response characteristics, emerge as highly promising candidate material for high-performance active terahertz modulators—indispensable core components critical for next-generation communication technologies. A high-performance, cost-effective terahertz modulator was fabricated through spin-coating CdSe(4ML)/CdZnS [...] Read more.

The CdSe/CdZnS colloidal quantum wells, with their exceptionally high carrier mobility and ultrafast response characteristics, emerge as highly promising candidate material for high-performance active terahertz modulators—indispensable core components critical for next-generation communication technologies. A high-performance, cost-effective terahertz modulator was fabricated through spin-coating CdSe(4ML)/CdZnS nanosheets onto a silicon substrate. This all-optical device demonstrates broadband modulation capabilities (0.25–1.4 THz), achieving a remarkable modulation depth of 87.6% at a low power density of 2 W/cm^2. Demonstrating pump-power-efficient terahertz modulation characteristics, this core–shell composite shows immediate applicability in terahertz communication systems and non-destructive testing equipment. Full article

(This article belongs to the Collection Nano-Optics and Nano-Optoelectronics: Challenges and Future Trends)

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16 pages, 2085 KB

Open AccessReview

Vaccination Against Herpes Zoster in Adults: Current Strategies in European Union Countries

by Manuela Chiavarini, Angela Bechini, Sara Boccalini, Alisa Barash, Enrica Castellana, Alessandro Senape and Paolo Bonanni

Vaccines 2025, 13(10), 1073; https://doi.org/10.3390/vaccines13101073 (registering DOI) - 20 Oct 2025

Abstract

Background/Objectives: Herpes zoster (HZ), caused by varicella zoster virus (VZV) reactivation, significantly affects the functional status and quality of life of older adults and immunocompromised individuals. Vaccination represents an effective strategy to reduce the incidence of HZ. Methods: This review offers a cross-sectional [...] Read more.

Background/Objectives: Herpes zoster (HZ), caused by varicella zoster virus (VZV) reactivation, significantly affects the functional status and quality of life of older adults and immunocompromised individuals. Vaccination represents an effective strategy to reduce the incidence of HZ. Methods: This review offers a cross-sectional assessment of the current landscape of adult herpes zoster vaccination strategies across the 27 EU member states, drawing on data available up to July 2025 from official sources such as the ECDC, the WHO, and national health authorities. Results: HZ vaccination is recommended in 17 EU countries (63%) according to the National Immunization Programs (NIPs) or by other institutional national health documents; in only 7 countries, vaccination is fully covered by the national healthcare system. HZ vaccination is recommended for healthy adults aged ≥50 years in 23.5% of countries (4/17), ≥60 years in 29.4% (5/17), and ≥65 years in 41.2% (7/17). At-risk groups are targeted in 94.1% of countries (16/17), predominantly from age 18 years (14 countries). Conclusions: An overall tendency toward broader HZ vaccination strategies, targeting both older adults and risk groups, is emerging. However, differences among national policies, together with the European Commission’s withdrawal of the live-attenuated Zostavax vaccine effective 1 June 2025, highlight the urgent need for comprehensive, harmonized immunization strategies to ensure adequate coverage of adult HZ vaccination across Europe. Full article

(This article belongs to the Special Issue From Knowledge to Action: Advances in Herpes Zoster Vaccine and Vaccination)

37 pages, 5043 KB

Open AccessArticle

Appraisal of the Use of Proteomics Methodological Approaches and Technologies on Sheep and Goat Research and Clinical Work

by Maria V. Bourganou, Georgia A. Vaitsi, Dimitra V. Liagka, Charalambia K. Michael, Eleni I. Katsarou, Dimitris C. Chatzopoulos, Natalia G. C. Vasileiou, Elias Papadopoulos, George Th. Tsangaris, Daphne T. Lianou, Vasia S. Mavrogianni, George C. Fthenakis and Angeliki I. Katsafadou

Animals 2025, 15(20), 3050; https://doi.org/10.3390/ani15203050 (registering DOI) - 20 Oct 2025

Abstract

This paper describes a detailed evaluation of published works, in which proteomics methodological approaches and technologies were used to advance knowledge about small ruminants. The specific objective of this assessment was the presentation of quantitative characteristics on the content and the bibliometric details [...] Read more.

This paper describes a detailed evaluation of published works, in which proteomics methodological approaches and technologies were used to advance knowledge about small ruminants. The specific objective of this assessment was the presentation of quantitative characteristics on the content and the bibliometric details of publications on the use of proteomics methodological approaches and technologies in small ruminant work. For the search of published papers, the following topical search string was used: [sheep OR ovine OR Ovis aries OR goat* OR caprine OR Capra hircus] AND [proteom*], in the Web of Science database. In total, 481 published papers (448 original articles and 33 reviews) were evaluated individually. These originated from 56 countries, mostly from China and the United States of America, and increased gradually with time. Most (85.7%) original articles presented experimental work with animals, most often in sheep/goat production (37.4%) and reproduction (21.8%), and less often in physiology (19.0%) or diseases (17.9%). Tissues analyzed more often were milk (17.9%), blood (10.3%), and muscle (9.2%). The proteomics methodological approach and technology employed most frequently was the liquid chromatography-tandem mass spectrometry (52.9% of articles). The journal, in which papers were published most frequently, was the Journal of Proteomics (8.3%). There were 3689 authors in total in the published papers, with a median number of 7 per paper Median number of references was 50 per published paper. Median number of citations was eight per published paper, and median number of annual citations was 2.0 per published paper. Significant predictors for the number of annual citations were (a) for reviews, the number of references, and (b) for original articles, the number of references, the topic of study, and the animal species referred to in the articles. The Epimetre briefly reviews the contribution of proteomics in the health management of sheep and goats. Overall, the results have indicated that the use of proteomics methodological approaches and technologies in sheep and goat work has advanced our knowledge and understanding of the biology of these two animal species in a multitude of fields and topics internationally, with an increasing dissemination and applicability. Full article

(This article belongs to the Special Issue Livestock Omics)

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17 pages, 750 KB

Open AccessArticle

Challenges and Recommendations for Oral Healthcare of Older Adults in a Long-Term Care Facility

by Haslina Rani, Amalina Alya Azizan, Nurul Izzah Abdul Walad, Siti Aisya Athirah Hassan, Tuti Ningseh Mohd Dom, Daphne Shu Huey Yeoh, Joyce Wuen Cheer Tay, Muhammad Syafiq Asyraf Rosli, Nur Saadah Mohamad Aun, Aznida Firzah Abdul Aziz, Kaung Myat Thwin and In Meei Tew

Healthcare 2025, 13(20), 2642; https://doi.org/10.3390/healthcare13202642 (registering DOI) - 20 Oct 2025

Abstract

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing [...] Read more.

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing oral care. Methods: A convergent mixed-methods design was applied, involving 115 residents aged ≥60 years and 16 caregivers in a public facility. The residents’ oral health was assessed using interviewer-assisted questionnaires (demography, dependency level, Oral Frailty Five-item Checklist), clinical examinations (dental caries status, number of remaining teeth, oral and denture hygiene), and the Decayed, Missing, and Filled Teeth (DMFT) index. Focus group discussions with caregivers were conducted, transcribed, and thematically analyzed. Quantitative data were descriptively analyzed using SPSS version 29.0. Results: Over one-third of the residents (39%) were moderately to highly dependent on caregivers. All had experienced dental caries, with most having fewer than 20 teeth (92.9%) and requiring dentures (81.7%). Overall, both oral and denture hygiene were poor. Assessment of oral frailty indicated that the majority of residents (94.8%) were at risk of impaired oral function. A thematic analysis identified four key themes influencing oral health: (1) health and oral health conditions of residents; (2) variety in oral care practices; (3) older adults’ attitudes and behaviors; and (4) system factors. These themes were mapped in a conceptual framework demonstrating multilevel influences on oral care. Conclusions: Despite the single-center design, these findings provide actionable insights for improving geriatric oral health policies in Malaysia. Practical recommendations include integrating oral health into aged-care standards, expanding mobile dental services, and establishing oral care champions within facilities. Addressing these challenges is critical to improving quality of life and aligning long-term care practices with the WHO’s healthy aging priorities. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Third Edition)

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38 pages, 2564 KB

Open AccessArticle

Characterization of Essential Oils and Ethanolic Extracts from Nine Pepper Species: Antioxidant and Antimicrobial Activity and Spectroscopic Analysis

by Aleksandra Sander, Maja Bival Štefan, Tea Sander, Dajana Kučić Grgić, Jelena Parlov Vuković, Iva Blažević and Jasna Jablan

Molecules 2025, 30(20), 4140; https://doi.org/10.3390/molecules30204140 (registering DOI) - 20 Oct 2025

Abstract

This study examined the characteristics of essential oils and ethanolic extracts from nine pepper species’ fruits to determine their chemical compositions and assess their biological activity. Ethanolic extracts and essential oils were analyzed using HPLC, GC-MS, FTIR, and ¹H NMR spectroscopy. The [...] Read more.

This study examined the characteristics of essential oils and ethanolic extracts from nine pepper species’ fruits to determine their chemical compositions and assess their biological activity. Ethanolic extracts and essential oils were analyzed using HPLC, GC-MS, FTIR, and ¹H NMR spectroscopy. The total phenolic content, total flavonoid content, antioxidant activity (DPPH assay), and antibacterial efficacy against five bacterial strains were assessed. Additionally, multielement analysis was performed using the TXRF method. The results demonstrated that the yields and chemical compositions differed markedly according to the pepper origin and extraction method. Ethanolic extracts consistently demonstrated greater total phenolic content and total flavonoid content and enhanced antioxidant and antibacterial properties relative to their respective essential oils. The increased bioactivity is due to the presence of non-volatile, polar compounds, which are not effectively transferred via hydrodistillation. Piperine was solely detected in extracts from black, green, white, Bengali, and Voatsiperifery peppers. This study emphasizes the necessity of optimizing extraction techniques to enhance the bioactivity of pepper extracts, highlighting their potential as sources of natural antioxidants and antibacterial agents. Full article

(This article belongs to the Special Issue Chemical Composition and Biological Activity of Essential Oils and Other Extracts: From Extraction to Application Second Edition)

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22 pages, 5517 KB

Open AccessArticle

Medical vs. Organizational Complaints: A Machine Learning Analysis Reveals Divergent Patterns in Patient Reviews Across Russian Cities

by Irina Evgenievna Kalabikhina, Anton Vasilyevich Kolotusha and Vadim Sergeevich Moshkin

Healthcare 2025, 13(20), 2641; https://doi.org/10.3390/healthcare13202641 (registering DOI) - 20 Oct 2025

Abstract

Background: The growth of digital patient feedback presents a new opportunity for healthcare quality monitoring. This study addresses the need to automatically classify the content of patient reviews to identify primary sources of dissatisfaction. Objective: The purpose of this study is to develop [...] Read more.

Background: The growth of digital patient feedback presents a new opportunity for healthcare quality monitoring. This study addresses the need to automatically classify the content of patient reviews to identify primary sources of dissatisfaction. Objective: The purpose of this study is to develop a machine learning algorithm for classifying negative patient reviews into two core categories: medical content (M—pertaining to diagnosis, treatment, and outcomes) and organizational support (O—pertaining to logistics, cost, and communication). We aim to identify which type of concern prevails and to analyze variations across cities, patient gender, and medical specialties. Methods: A database of 18,680 negative patient reviews (rated 1 star) was compiled from the Russian aggregator infodoctor.ru for the period from July 2012 to August 2023. A training set was created using an independent annotation procedure with three experts. A logistic regression model was trained to classify reviews into M and O categories, demonstrating an accuracy of 88.5%. Results: The analysis revealed a significant structural shift in Moscow, where since 2021, medical (M) complaints began to prevail over organizational (O) ones. This trend was not observed in St. Petersburg or other major Russian cities. Notably, in St. Petersburg, M-type reviews were more common within the most represented medical specialties, whereas O-type reviews consistently dominated in other cities. Gender differences were most pronounced in St. Petersburg, where women were more frequently authors of M reviews and men of O reviews. Conclusions: The developed algorithm provides a valuable tool for the automated monitoring of patient feedback. It enables healthcare managers to distinguish between clinical and service-related issues, facilitating targeted improvements in medical service quality and patient satisfaction. Full article

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15 pages, 706 KB

Open AccessArticle

A New Assessment Tool for Risk of Falling and Telerehabilitation in Neurological Diseases: A Randomized Controlled Ancillary Study

by Letizia Castelli, Chiara Iacovelli, Anna Maria Malizia, Claudia Loreti, Lorenzo Biscotti, Anna Rita Bentivoglio, Paolo Calabresi and Silvia Giovannini

Appl. Sci. 2025, 15(20), 11247; https://doi.org/10.3390/app152011247 (registering DOI) - 20 Oct 2025

Abstract

Recently, telerehabilitation has taken on a significant role in rehabilitation programs, with benefits in improving balance. Many neurological diseases are associated with an increased fall risk and, considering the impact of falls on quality of life, the aim of this study is to [...] Read more.

Recently, telerehabilitation has taken on a significant role in rehabilitation programs, with benefits in improving balance. Many neurological diseases are associated with an increased fall risk and, considering the impact of falls on quality of life, the aim of this study is to evaluate the ability of the Silver Index (via the hunova^® robotic platform) to identify the fall risk and the effect of a telerehabilitation intervention (by ARC Intellicare) on fall risk in patients with neurological disorders. This is an ancillary study of a single-center, randomized controlled trial. Ninety patients with stroke, Multiple Sclerosis (MS), and Parkinson’s Disease (PD) participated, and were randomized into an ARC Intellicare group (experimental group) and a paper-based group (control group). Each group performed home treatment for 60 min a day, 3 days a week, for 8 weeks. Fall risk was assessed with clinical scales and hunova^®. Data analysis showed a correlation between clinical scales and the Silver Index. Furthermore, only the MS patients in the experimental group showed a significant decrease in fall risk (p = 0.015). This study suggested that the Silver Index is a valid tool for assessing fall risk in neurological disorders. It also confirmed that ARC Intellicare is a useful tool for remote rehabilitation at home. Full article

(This article belongs to the Special Issue Current Advances in Rehabilitation Technology)

29 pages, 2864 KB

Open AccessArticle

TiO₂ and CaCO₃ Microparticles Produced in Aqueous Extracts from Satureja montana: Synthesis, Characterization, and Preliminary Antimicrobial Test

by Federica Valentini, Irene Angela Colasanti, Camilla Zaratti, Dumitrita Filimon, Andrea Macchia, Anna Neri, Michela Relucenti, Massimo Reverberi, Ivo Allegrini, Ettore Guerriero, Marina Cerasa, Marta De Luca, Francesca Santangeli, Roberto Braglia, Francesco Scuderi, Lorenza Rugnini, Roberta Ranaldi, Roberto De Meis and Antonella Canini

Molecules 2025, 30(20), 4138; https://doi.org/10.3390/molecules30204138 (registering DOI) - 20 Oct 2025

Abstract

The possibility of modifying the surface chemistry of materials and synthetizing inorganic particles in natural aqueous extracts of plants (avoiding calcination), opens the doors to undoubtedly interesting scenarios for innovative functionalization strategies that are increasingly eco-sustainable and rich in interesting chemical–physical and biochemical [...] Read more.

The possibility of modifying the surface chemistry of materials and synthetizing inorganic particles in natural aqueous extracts of plants (avoiding calcination), opens the doors to undoubtedly interesting scenarios for innovative functionalization strategies that are increasingly eco-sustainable and rich in interesting chemical–physical and biochemical properties. Among the aerial plants, Satureja montana exhibits interesting antibacterial, antifungal, antimicrobial, and antioxidant activities due to the rich volatile and non-volatile compounds (characterized by gas chromatography–mass spectrometry), contained in the aqueous extracts. For the first time, the latter was applied for the green synthesis of TiO₂ and CaCO₃ particles, characterized by X-ray diffraction, Raman, infrared spectroscopies, and scanning electron microscopy, coupled with microanalysis. Screening through antimicrobial assays under indoor passive sedimentation conditions showed opposite trends for two kinds of particles. TiO₂ anatase spherical particles (400 < φ < 600 nm) increase microbial growth, proportionally to increasing particle concentration. Instead, S. montana-functionalized CaCO₃ prismatic microparticles (1 µm × 1 µm × 1 µm) exhibit strong and dose-dependent antimicrobial activities, achieving near-complete inhibition at 50 mg/mL. Full article

(This article belongs to the Special Issue Synthesized and Functionalized Nanoparticles in Natural Compounds)

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14 pages, 1937 KB

Open AccessArticle

Water-Developable PFAS-Free Glycan-Derived Positive Photoresist Materials for Environmentally Friendly Lithography

by Yuna Hachikubo, Hiryu Hayashi, Mano Ando, Mayu Morita, Misaki Oshima, Abdul Manaf Hashim, Nurul Hanis Azhan, Takayuki Ota and Satoshi Takei

Coatings 2025, 15(10), 1228; https://doi.org/10.3390/coatings15101228 (registering DOI) - 20 Oct 2025

Abstract

Traditional lithography processes use resist materials that require organic solvents during the development step but also often contain components derived from PFASs (per- and polyfluoroalkyl substances), raising concerns about environmental pollution and sustainability. PFASs are difficult to degrade, and their long-term effects on [...] Read more.

Traditional lithography processes use resist materials that require organic solvents during the development step but also often contain components derived from PFASs (per- and polyfluoroalkyl substances), raising concerns about environmental pollution and sustainability. PFASs are difficult to degrade, and their long-term effects on ecosystems and human health are the subject of international concern, making the development of alternative technologies an urgent priority. Lithography is a fundamental technology with applications beyond semiconductor manufacturing, electronics, biomedicine, and microfluidic devices. Addressing its environmental impact remains critical in both academic and industrial contexts. This study introduces a water-developable positive photoresist derived from a polymeric material incorporating plant-derived sugar chains as the resist backbone. The reactivity of the material to ultraviolet irradiation, enabled by a photoacid generator, allows microfabrication through water development. Moreover, successful micrometer-scale patterning demonstrated a superior resolution compared to previous sugar-derived water-developable resists. The dextrin-based resist exhibited the highest performance, achieving a sensitivity of 150 mJ/cm² and a resolution of 3.6 µm under an environmentally benign, PFAS-free process that enabled development with water. These findings propose a sustainable alternative to conventional petrochemical-derived photoresists, positioning it as a promising candidate for environmentally friendly photolithography processes. Full article

(This article belongs to the Section Surface Engineering for Energy Harvesting, Conversion, and Storage)

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15 pages, 3774 KB

Open AccessArticle

MSFDnet: A Multi-Scale Feature Dual-Layer Fusion Model for Sound Event Localization and Detection

by Yi Chen, Zhenyu Huang, Liang Lei and Yu Yuan

Sensors 2025, 25(20), 6479; https://doi.org/10.3390/s25206479 (registering DOI) - 20 Oct 2025

Abstract

The task of Sound Event Localization and Detection (SELD) aims to simultaneously address sound event recognition and spatial localization. However, existing SELD methods face limitations in long-duration dynamic audio scenarios, as they do not fully leverage the complementarity between multi-task features and lack [...] Read more.

The task of Sound Event Localization and Detection (SELD) aims to simultaneously address sound event recognition and spatial localization. However, existing SELD methods face limitations in long-duration dynamic audio scenarios, as they do not fully leverage the complementarity between multi-task features and lack depth in feature extraction, leading to restricted system performance. To address these issues, we propose a novel SELD model—MSDFnet. By introducing a Multi-Scale Feature Aggregation (MSFA) module and a Dual-Layer Feature Fusion strategy (DLFF), MSDFnet captures rich spatial features at multiple scales and establishes a stronger complementary relationship between SED and DOA features, thereby enhancing detection and localization accuracy. On the DCASE2020 Task 3 dataset, our model achieved scores of 0.319, 76%, 10.2°, 82.4%, and 0.198 in

{ER}_{20}

,

F_{20}

,

{LE}_{c d}

,

{LR}_{c d}

, and

{SELD}_{s c o r e}

metrics, respectively. Experimental results demonstrate that MSDFnet performs excellently in complex audio scenarios. Additionally, ablation studies further confirm the effectiveness of the MSFA and DLFF modules in enhancing SELD task performance. Full article

(This article belongs to the Special Issue Sensors and Machine-Learning Based Signal Processing)

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18 pages, 2407 KB

Open AccessArticle

Opoka as a Natural Material for Phosphorus Removal: Properties and Applications

by Evelina Svedaite, Kestutis Baltakys and Tadas Dambrauskas

Water 2025, 17(20), 3017; https://doi.org/10.3390/w17203017 (registering DOI) - 20 Oct 2025

Abstract

This study investigates the adsorption efficiency of thermally activated natural opoka, a siliceous–calcareous sedimentary rock, as a low-cost adsorbent for removing phosphorus from aqueous solutions. Comprehensive characterization using XRF, XRD, and STA revealed that raw opoka is primarily composed of quartz, tridymite, and [...] Read more.

This study investigates the adsorption efficiency of thermally activated natural opoka, a siliceous–calcareous sedimentary rock, as a low-cost adsorbent for removing phosphorus from aqueous solutions. Comprehensive characterization using XRF, XRD, and STA revealed that raw opoka is primarily composed of quartz, tridymite, and calcite, with a CaO/SiO₂ molar ratio of approximately 0.45. After calcination at 850 °C, calcite decomposes and reacts with silica to form wollastonite, enhancing surface reactivity. Adsorption experiments conducted at phosphorus concentrations of 0.2, 2.6, and 5.0 g of P/L demonstrated that the material’s removal efficiency for phosphorus was highest at low concentrations (25.7% at 0.2 g/L) and decreased with an increase in concentration (20.8% at 2.6 g/L and 18.6% at 5.0 g/L). The adsorption process followed pseudo-second-order kinetics (R² > 0.999), indicating that chemisorption is the dominant mechanism. It is assumed that amorphous calcium phosphate forms at low phosphorus concentrations and an alkaline pH, whereas brushite is more prevalent at higher concentrations under acidic conditions. Potassium adsorption was negligible and reversible in all cases. The findings demonstrate that calcined opoka has promising applications as a reactive calcium silicate material for sustainable phosphorus management in decentralized water treatment systems. Full article

(This article belongs to the Section Wastewater Treatment and Reuse)

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19 pages, 4481 KB

Open AccessArticle

Multi-Parameter Synchronous Identification Method for Dual Metal Rubber Clamps Considering Directional Differences in Mechanical Properties

by Kunpeng Xu, Ruize Wang and Bo Wang

Appl. Sci. 2025, 15(20), 11239; https://doi.org/10.3390/app152011239 (registering DOI) - 20 Oct 2025

Abstract

Due to structural characteristics and connection dimensions, the dynamic characteristics of dual metal rubber clamps (DMRCs) show significant differences in bolt connection direction and opening direction. Accurately identifying the dynamic parameters of DMRC in different directions is of great significance for analyzing the [...] Read more.

Due to structural characteristics and connection dimensions, the dynamic characteristics of dual metal rubber clamps (DMRCs) show significant differences in bolt connection direction and opening direction. Accurately identifying the dynamic parameters of DMRC in different directions is of great significance for analyzing the dynamic characteristics and vibration control of aero-engine piping systems. This paper takes a DMRC-double straight pipe structure as the research object and establishes a dynamic model of this structure based on the finite element method as the mechanical parameter identification model of DMRCs. A refined simulation mechanism is adopted in the model to reflect the dynamic characteristics of the DMRC. The DMRC is simplified into four concentrated mass blocks and four spring-damping groups to simulate its mass, stiffness, and damping effects. Each spring-damping group consists of a linear spring, a rotational spring, and a damper. The four groups of springs are further divided into two directional groups to simulate the stiffness and damping effects in the opening direction and bolt connection direction, respectively. Four concentrated mass blocks are applied to the four nodes of the pipe to simulate the mass effect of DMRCs. Based on the dynamic model of the pipeline structure mentioned above, the synchronous identification algorithms and procedures for multiple mechanical parameters of DMRCs are proposed, aiming to minimize the deviation of natural characteristic indicators (natural frequency and peak of frequency response function) obtained through testing and model simulation. This method can synchronously identify linear stiffness, rotational stiffness, and damping in different directions. Finally, the effectiveness of the identification method is verified through experiments. Full article

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19 pages, 2530 KB

Open AccessArticle

Investigation of N-(2-oxo-2H-chromen-3-carbonyl)cytisine’s Molecular Structure in Solution

by Kymbat Kopbalina, Aigerim Adekenova, Zhanar Shaimerdenova, Zhanargul Kairatova, Kuanysh Shakarimova, Dmitrii Pankin, Mikhail Smirnov, Anarkul Kishkentayeva, Makpal Artykbayeva and Roza Jalmakhanbetova

Molecules 2025, 30(20), 4139; https://doi.org/10.3390/molecules30204139 (registering DOI) - 20 Oct 2025

Abstract

Cytisine and coumarin derivatives are promising for the creation of new drugs with antiarrhythmic, antiepileptic, antidiabetic, anti-inflammatory, and antimicrobial effects. In this study, the molecular structure of the cytisine and coumarin derivative in solution, a recently synthesized substance N-(2-oxo-2H-chromen-3-carbonyl)cytisine, was studied by NMR [...] Read more.

Cytisine and coumarin derivatives are promising for the creation of new drugs with antiarrhythmic, antiepileptic, antidiabetic, anti-inflammatory, and antimicrobial effects. In this study, the molecular structure of the cytisine and coumarin derivative in solution, a recently synthesized substance N-(2-oxo-2H-chromen-3-carbonyl)cytisine, was studied by NMR and UV-Vis absorption spectroscopies accompanied by a theoretical study based on density functional theory. The existence of four stable conformers associated with the rotation of the cytisine part relative to the coumarin part due to a sufficiently flexible intermediate part has been demonstrated. Their energy and concentrations were estimated. In the 1H and 13C NMR spectra, peaks were found that correspond to individual conformers and groups of conformers. The UV-visible absorption spectrum also revealed spectral features associated with different conformers. It was shown that the obtained results are consistent with earlier studies about conformational state identification in cytisine derivatives functionalized with flexible parts. The obtained theoretical and experimental results provide useful spectroscopic information for such conformer identification in this and structurally similar substances. Full article

(This article belongs to the Section Molecular Structure)

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10 pages, 1165 KB

Open AccessArticle

Estimation of Ionosphere Electron Density Structure Related to the Solar Terminator

by Alexey Andreyev, Vyacheslav Somsikov, Vitaliy Kapytin, Yekaterina Chsherbulova and Stanislav Utebayev

Atmosphere 2025, 16(10), 1217; https://doi.org/10.3390/atmos16101217 (registering DOI) - 20 Oct 2025

Abstract

The solar terminator, due to its unique characteristics, is a remarkable source of atmospheric disturbances. Due to its regularity and constancy, dependent solely on geometric factors, it can serve as a test source of disturbances, which can be used to test the response [...] Read more.

The solar terminator, due to its unique characteristics, is a remarkable source of atmospheric disturbances. Due to its regularity and constancy, dependent solely on geometric factors, it can serve as a test source of disturbances, which can be used to test the response of the medium through which it passes and determine its state. However, our knowledge of the atmospheric phenomena generated by the terminator is far from complete. One clear indication of the terminator’s influence is geomagnetic disturbances manifested in the vertical and eastward components of the magnetic field measured at magnetic observatories. To determine the sources of geomagnetic disturbances from the solar terminator, which can be identified by the strict phase correlation of these disturbances with the moments of terminator passage, ionospheric irregularities arising during terminator passage were studied. Ionospheric irregularities extending along the boundary of the morning solar terminator were detected in total electron content data, based on measurements by GNSS receivers. Assumptions are made about the possible parameters of the ionospheric current structure that creates variations in the magnetic field associated with the passage of the solar terminator. Full article

(This article belongs to the Special Issue Advanced GNSS for Ionospheric Sounding and Disturbances Monitoring)

29 pages, 4817 KB

Open AccessArticle

Bulk Electrical Resistivity as an Indicator of the Durability of Sustainable Concrete: Influence of Pozzolanic Admixtures

by Lorena del Carmen Santos Cortés, Sergio Aurelio Zamora Castro, María Elena Tejeda del Cueto, Liliana Azotla-Cruz, Joaquín Sangabriel Lomeli and Óscar Velázquez Camilo

Appl. Sci. 2025, 15(20), 11232; https://doi.org/10.3390/app152011232 (registering DOI) - 20 Oct 2025

Abstract

Premature deterioration of concrete structures in coastal areas requires a careful evaluation based on durability criteria. Electrical Resistivity (ER) serves as a valuable indicator of concrete durability, as it reflects how easily aggressive agents can penetrate its pores. This testing method offers several [...] Read more.

Premature deterioration of concrete structures in coastal areas requires a careful evaluation based on durability criteria. Electrical Resistivity (ER) serves as a valuable indicator of concrete durability, as it reflects how easily aggressive agents can penetrate its pores. This testing method offers several advantages; it is non-destructive, rapid, and more cost-effective than the chloride permeability test (RCPT). Furthermore, durable concrete typically necessitates larger quantities of cement, which contradicts the goals of sustainable concrete development. Thus, a significant challenge is to create concrete that is both durable and sustainable. This research explores the effects of pozzolanic additives, specifically Volcanic Ash (VA) and Sugarcane Bagasse Ash (SCBA), on the electrical resistivity of eco-friendly concretes exposed to the coastal conditions of the Gulf of Mexico. The electrical resistivity (ER) was measured at intervals of 3, 7, 14, 21, 28, 45, 56, 90, and 180 days across 180 cylinders, each with dimensions of 10 cm × 20 cm. The sustainability of the concrete was evaluated based on its energy efficiency. Three types of mixtures were developed using the ACI 211.1 method, maintaining a water-to-cement (w/c) ratio of 0.57 with CPC 30 R RS cement and incorporating various additions: (1) varying percentages of VA (2.5%, 5%, and 7.5%), (2) SCBA at rates of 5%, 10%, and 15%, and (3) ternary mixtures featuring VA-SCBA ratios of 1:1, 1:2, and 1:3. The findings indicated an increase in ER of up to 37% and a reduction in CO₂ emissions ranging from 4.2% to 16.8% when compared to the control mixture, highlighting its potential for application in structures situated in aggressive environments. Full article

(This article belongs to the Special Issue Advanced Concrete Technology and Applications in Construction Engineering, 2nd Edition)

18 pages, 250 KB

Open AccessArticle

HIV Treatment Services Among Men Who Have Sex with Men During COVID-19 in Limpopo Province, South Africa

by Betty Sebati, Edith Phalane, Amukelani Bilankulu and Refilwe Nancy Phaswana-Mafuya

COVID 2025, 5(10), 180; https://doi.org/10.3390/covid5100180 (registering DOI) - 20 Oct 2025

Abstract

Men who have sex with men (MSM) are part of the key populations (KPs) that are susceptible to Human Immunodeficiency Virus (HIV) acquisition, transmission, and disruptions to access HIV services. This study aimed to explore and describe the HIV interventions implemented among MSM [...] Read more.

Men who have sex with men (MSM) are part of the key populations (KPs) that are susceptible to Human Immunodeficiency Virus (HIV) acquisition, transmission, and disruptions to access HIV services. This study aimed to explore and describe the HIV interventions implemented among MSM during the COVID-19 lockdown in the Capricorn District of Limpopo Province in South Africa. This study followed an exploratory qualitative study design with a purposive sample of 16 men who identified as MSM. Data were collected through in-depth interviews which were tape-recorded, transcribed verbatim, and captured on Atlas.ti. Patterns from the created codes were formulated into themes/sub-themes guided by the Consolidated Framework for Implementation Research (CFIR). The MSM had a mean age of 27.9 years. Various constructs and domains of the CFIR showed that during the COVID-19 lockdown, MSM encountered a disruption of HIV services. The response time was elongated, thus increasing the complexity of interventions. Interventions were implemented to ensure continuity of services. These included tailoring the programme through a door-to-door strategy and offering resources to healthcare facilities to enable MSM to access antiretroviral therapy (ART) and related services. The relative advantage of the programme is that it prioritises MSM. Future research should look into COVID-19’s impact on a bigger scale. Full article

(This article belongs to the Section COVID Public Health and Epidemiology)

11 pages, 2202 KB

Open AccessArticle

The Effect of Implant Thread’s Pitch on Primary Stability: An In Vitro Polyurethane Study with Under-Preparation and Low-Speed Drilling

by Margherita Tumedei, Natalia Di Pietro, Tea Romasco, Adriano Piattelli and Luca Comuzzi

Appl. Sci. 2025, 15(20), 11245; https://doi.org/10.3390/app152011245 (registering DOI) - 20 Oct 2025

Abstract

Background: The morphology of implant threads plays a crucial role in achieving primary stability, which is essential for successful osseointegration and immediate loading of dental implants. This study aimed to evaluate how different implant thread pitches and an under-preparation drilling technique impact primary [...] Read more.

Background: The morphology of implant threads plays a crucial role in achieving primary stability, which is essential for successful osseointegration and immediate loading of dental implants. This study aimed to evaluate how different implant thread pitches and an under-preparation drilling technique impact primary stability using an in vitro model. Methods: The study was conducted on low-density polyurethane bone models with and without cortical layers. The following three different implant thread profiles were tested: CYROTH 0.40 (0.40 mm), CYROTH 0.45 (0.45 mm), and CYROTH T (0.35 mm). Two different drilling procedures were utilized, with diameters of 3.4 mm and 3.7 mm, at a low rotational speed of 30 rpm. Primary stability was assessed by measuring insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA). Results: The low rotational speed of 30 rpm was found to be effective for achieving favorable fixation parameters in all scenarios. The 0.45 mm thread consistently exhibited higher implant stability quotient (ISQ) values (from two to six points higher) compared to the 0.40 mm and standard 0.35 mm threads, while also requiring lower IT. The highest ISQ values were recorded in the 20 pounds per cubic foot (PCF) block with a cortical layer using the 0.45 mm thread and a 3.4 mm drill. The under-preparation using the 3.4 mm drill resulted in higher IT and RT values than the 3.7 mm drill. Conclusions: This study demonstrated that implant thread pitch and drilling technique are critical factors influencing primary stability. Utilizing a wider thread pitch (0.45 mm) along with an under-preparation drilling protocol can significantly improve implant stability, even in low-density bone, without the need for excessive IT. These findings suggest that selecting the appropriate implant macrogeometry and surgical technique can optimize the primary stability of dental implants. Full article

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23 pages, 7592 KB

Open AccessArticle

Numerical Modelling of Gas Mixing in Salt Caverns During Cyclic Hydrogen Storage

by Krzysztof Miłek and Wiesław Szott

Energies 2025, 18(20), 5528; https://doi.org/10.3390/en18205528 (registering DOI) - 20 Oct 2025

Abstract

This study presents the development of a robust numerical model for simulating underground hydrogen storage (UHS) in salt caverns, with a particular focus on the interactions between original gas-methane (CH₄) and injected gas represented by hydrogen (H₂). Using the [...] Read more.

This study presents the development of a robust numerical model for simulating underground hydrogen storage (UHS) in salt caverns, with a particular focus on the interactions between original gas-methane (CH₄) and injected gas represented by hydrogen (H₂). Using the Schlumberger Eclipse 300 compositional reservoir simulator, the cavern was modelled as a highly permeable porous medium to accurately represent gas flow dynamics. Two principal mixing mechanisms were investigated: physical dispersion, modelled by numerical dispersion, and molecular diffusion. Multiple cavern configurations and a range of dispersion–diffusion coefficients were assessed. The results indicate that physical dispersion is the primary factor affecting hydrogen purity during storage cycles, while molecular diffusion becomes more significant during long-term gas storage. Gas mixing was shown to directly impact the calorific value and quality of withdrawn hydrogen. This work demonstrates the effectiveness of commercial reservoir simulators for UHS analysis and proposes a methodological framework for evaluating hydrogen purity in salt cavern storage operations. Full article

(This article belongs to the Special Issue Hydrogen Storage and Transportation: Materials, Technologies, and Infrastructure Development)

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20 pages, 4112 KB

Open AccessArticle

Electrophysiological Regulation of Nutrient Transport in Mangrove Species Under Salinity Stress: A Comparative Physiological Analysis of Aegiceras corniculatum (L.) Blanco and Kandelia obovata Sheue, H.Y. Liu & J.W.H. Yong

by Kashif Ali Solangi, Yun Wang, Yanyou Wu, Mazhar Hussain Tunio, Farheen Solangi, Irfan Abbas, Jinling Zhang and Xiqiang Song

Plants 2025, 14(20), 3228; https://doi.org/10.3390/plants14203228 (registering DOI) - 20 Oct 2025

Abstract

Salinity is a major environmental constraint that influences nutrient acquisition and internal transport in coastal plant species. However, the electrophysiological mechanisms underlying nutrient flow regulation in mangroves remain poorly understood. This study investigates the active transport flow of nutrients (NAF) and nutrient plunder [...] Read more.

Salinity is a major environmental constraint that influences nutrient acquisition and internal transport in coastal plant species. However, the electrophysiological mechanisms underlying nutrient flow regulation in mangroves remain poorly understood. This study investigates the active transport flow of nutrients (NAF) and nutrient plunder capacity (NPC) in two ecologically significant mangrove species, Aegiceras corniculatum (L.) Blanco (A. corniculatum) and Kandelia obovata Sheue, H.Y. Liu & J.W.H. Yong (K. obovata), using intrinsic electrophysiological leaf traits including inherent impedance (IZ), inherent capacitive reactance (IXC), inherent inductive reactance (IXL), and inherent capacitance (IC). A randomized block design was employed using three different saline treatments with control, such as control (0 mM), low (T1,100 mM), medium (T2, 250 mM), and high (T3, 450 mM). The results of the fitting equations show a positive correlation between resistance (Re), capacitive reactance (XC), and inductive reactance (XL) with clamping force (CF); all values of R² are ≥0.98, and p-values are <0.0001. Nutrient transport capacity (NTC) was non-significant in control and low-salt treatment for both mangrove species, indicating resistance to low levels of salt stress. NAF results of A. corniculatum showed a slight reduction of 7.9% under low salinity, while K. obovata displayed strong positive responses NAF increasing by 63.7% compared to the control. Additionally, the NPC of A. corniculatum species was not significantly affected at low and medium salt levels but declined at high salt levels. In contrast, K. obovata exhibited a higher growth rate and better photosynthetic performance than A. corniculatum. Our findings provide novel mechanistic insights into how electrophysiological regulation governs nutrient transport under salinity stress and highlight interspecies differences in adaptive strategies, with implications for understanding mangrove resilience in saline environments. Full article

(This article belongs to the Special Issue Systems-Level Understanding of Plant Adaptation to Abiotic Stress: Physiological and Biochemical Perspectives)

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13 pages, 684 KB

Open AccessArticle

From Prompts to Practice: Evaluating ChatGPT, Gemini, and Grok Against Plastic Surgeons in Local Flap Decision-Making

by Gianluca Marcaccini, Luca Corradini, Omar Shadid, Ishith Seth, Warren M. Rozen, Luca Grimaldi and Roberto Cuomo

Diagnostics 2025, 15(20), 2646; https://doi.org/10.3390/diagnostics15202646 (registering DOI) - 20 Oct 2025

Abstract

Background: Local flaps are a cornerstone of reconstructive plastic surgery for oncological skin defects, ensuring functional recovery and aesthetic integration. Their selection, however, varies with surgeon experience. Generative artificial intelligence has emerged as a potential decision-support tool, although its clinical role remains [...] Read more.

Background: Local flaps are a cornerstone of reconstructive plastic surgery for oncological skin defects, ensuring functional recovery and aesthetic integration. Their selection, however, varies with surgeon experience. Generative artificial intelligence has emerged as a potential decision-support tool, although its clinical role remains uncertain. Methods: We evaluated three generative AI platforms (ChatGPT-5 by OpenAI, Grok by xAI, and Gemini by Google DeepMind) in their free-access versions available in September 2025. Ten preoperative photographs of suspected cutaneous neoplastic lesions from diverse facial and limb sites were submitted to each platform in a two-step task: concise description of site, size, and tissue involvement, followed by the single most suitable local flap for reconstruction. Outputs were compared with the unanimous consensus of experienced plastic surgeons. Results: Performance differed across models. ChatGPT-5 consistently described lesion size accurately and achieved complete concordance with surgeons in flap selection. Grok showed intermediate performance, tending to recognise tissue planes better than lesion size and proposing flaps that were often acceptable but not always the preferred choice. Gemini estimated size well, yet was inconsistent for anatomical site, tissue involvement, and flap recommendation. When partially correct answers were considered acceptable, differences narrowed but the overall ranking remained unchanged. Conclusion: Generative AI can support reconstructive reasoning from clinical images with variable reliability. In this series, ChatGPT-5 was the most dependable for local flap planning, suggesting a potential role in education and preliminary decision-making. Larger studies using standardised image acquisition and explicit uncertainty reporting are needed to confirm clinical applicability and safety. Full article

(This article belongs to the Special Issue Large Language Models in Medical Diagnostics: Advancing Clinical Practice, Research, and Patient Care)

20 pages, 2387 KB

Open AccessArticle

Prognostic Value of Dynamic Changes in Immune-Inflammatory and Tumor Biomarkers Following Chemoradiotherapy in Locally Advanced Rectal Cancer

by Mahmoud Al-Masri, Yasmin Safi, Mohammad Almasri, Ramiz Kardan, Daliana Mustafa, Osama Alayyan, Bilal Kahalah and Rama AlMasri

Cancers 2025, 17(20), 3383; https://doi.org/10.3390/cancers17203383 (registering DOI) - 20 Oct 2025

Abstract

Background: The prognostic utility of inflammatory and tumor biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA), in rectal cancer has been increasingly studied, but results remain inconsistent. This study evaluates the prognostic significance of pre- and post-chemoradiotherapy (CRT) levels [...] Read more.

Background: The prognostic utility of inflammatory and tumor biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA), in rectal cancer has been increasingly studied, but results remain inconsistent. This study evaluates the prognostic significance of pre- and post-chemoradiotherapy (CRT) levels and dynamic changes in NLR, PLR, and CEA for predicting overall survival (OS) and disease-free survival (DFS) in locally advanced rectal cancer (LARC). Methods: This retrospective study included 261 LARC patients treated with neoadjuvant CRT followed by curative surgery. Pre- and post-CRT NLR, PLR, and CEA were collected. Survival analyses were performed using Kaplan–Meier curves and Cox proportional hazards models. ROC curves assessed predictive performance, and patients were stratified by cut-offs and biomarker changes (delta values). Results: The cohort had a mean age of 55.5 years; 55.9% were male, and 93.5% had clinical stage III disease. Post-CRT NLR (HR: 1.05, p = 0.007) and CEA (HR: 1.00, p < 0.001) were independently associated with OS, while post-CRT CEA and AJCC stage III were predictors of DFS (HR: 4.12, p = 0.009). ROC analysis showed improved accuracy when combining NLR (AUC = 0.66) and CEA (AUC = 0.70), yielding a combined AUC of 0.84 for OS. Patients with decreases in both NLR and CEA had the most favorable outcomes, whereas increases in both markers indicated poor prognosis (OS p < 0.0001; DFS p = 0.00019). Conclusions: Post-CRT levels and dynamic changes in NLR and CEA are independent prognostic markers in rectal cancer. Their combined assessment enhances survival prediction and may guide personalized postoperative surveillance and treatment strategies. Full article

(This article belongs to the Special Issue Biomarkers for Therapy Response in Gastrointestinal Malignancies: Predicting Outcomes and Personalizing Care)

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14 pages, 1480 KB

Open AccessArticle

Evaluation of MRI-Based Measurements for Patellar Dislocation: Reliability and Reproducibility

by Ivan Brumini, Tamara Pranjkovic and Danijela Veljkovic Vujaklija

Diagnostics 2025, 15(20), 2647; https://doi.org/10.3390/diagnostics15202647 (registering DOI) - 20 Oct 2025

Abstract

Background/Objectives: The aim of our study was to identify the most reliable MRI measurements associated with patellar dislocation. Methods: MRI scans from 86 knees (48 controls and 38 with a history of patellar dislocation) were retrospectively analyzed. The following parameters were measured: lateral [...] Read more.

Background/Objectives: The aim of our study was to identify the most reliable MRI measurements associated with patellar dislocation. Methods: MRI scans from 86 knees (48 controls and 38 with a history of patellar dislocation) were retrospectively analyzed. The following parameters were measured: lateral trochlear inclination (LTI) and its modified version, sulcus angle (SA), trochlear depth (TD), tibial tubercle–trochlear groove distance (TT–TG), patellar tendon–lateral trochlear ridge distance (PT–LTR), and PT–LTR horizontal, a novel modification. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs), and diagnostic accuracy was evaluated using ROC analysis. Results: All measurements significantly differed between the groups (p < 0.05). SA and TD were highly discriminative (AUC > 0.8) but demonstrated lower inter-rater agreement. PT-LTR horizontal strongly correlated with PT-LTR and was equally sensitive and specific for patellar dislocation as PT-LTR (81.6% and 87.5%, respectively) when in line or extending more laterally than the lateral trochlear ridge (AUC = 0.896, p < 0.001). LTI demonstrated the highest diagnostic performance with a sensitivity of 89.5% and a specificity of 97.9% for a cut-off ≤12.85° (AUC = 0.981), with excellent inter-rater agreement. LTI modified also performed well (AUC = 0.937), with a sensitivity and specificity of 81.6% and 93.7%, respectively. Conclusions: LTI, PT–LTR, and their modified versions demonstrated the highest reliability and diagnostic performance among the MRI measurements evaluated. Given their reproducibility and ease of application, these parameters may be useful in the imaging assessment of patellar dislocation. Further prospective studies are recommended to confirm their clinical utility in broader populations. Full article

(This article belongs to the Special Issue Orthopedics and the Musculoskeletal System: Diagnosis, Prognosis, and Mechanisms)

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