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12 pages, 613 KB  
Article
Primary Prevention Through Prophylactic Mastectomy and Breast Reconstruction: An Exploratory Study on Patient Satisfaction and Quality of Life
by Delia Nicoara, Ioan Constantin Pop, Maximilian Vlad Muntean, Radu Alexandru Ilies and Patriciu Andrei Achimas-Cadariu
J. Clin. Med. 2025, 14(22), 8093; https://doi.org/10.3390/jcm14228093 (registering DOI) - 15 Nov 2025
Abstract
Background/Objectives: Women who have genetic predisposition to breast cancer often opt for risk-reducing mastectomy with immediate reconstruction. Evaluating their satisfaction and quality of life is essential for guiding shared decision-making. Methods: This exploratory study assessed quality-of-life outcomes in two cohorts of [...] Read more.
Background/Objectives: Women who have genetic predisposition to breast cancer often opt for risk-reducing mastectomy with immediate reconstruction. Evaluating their satisfaction and quality of life is essential for guiding shared decision-making. Methods: This exploratory study assessed quality-of-life outcomes in two cohorts of patients undergoing bilateral prophylactic nipple-sparing mastectomy with immediate prepectoral implant-based reconstruction. Only patients without postoperative complications (necrosis, infection) were included. Each patient completed the BREAST-Q questionnaire both preoperatively (1–2 days before surgery) and postoperatively. Results: Postoperative BREAST-Q scores demonstrated significant improvement, with self-confidence increasing from 40.75 to 44.33, satisfaction with breast size and appearance from 50.42 to 58.50, and general esthetic/functional satisfaction from 26.92 to 33.17 (all p < 0.01). In contrast, physical comfort decreased from 48.00 to 32.42 (p < 0.001). Preoperative responses may have been influenced by anticipatory stress related to the imminent surgery and concern regarding the breast area to be operated. In contrast, postoperative results reflect psychological relief and satisfaction following a successful surgery, with no complications. Conclusions: Nipple-sparing mastectomy with immediate prepectoral reconstruction is associated with high patient-reported satisfaction and perceived improvements in quality of life, particularly regarding body image and emotional well-being. However, functional limitations such as reduced physical comfort should also be acknowledged. These findings further support evidence-based recommendations for prophylactic surgery in high-risk patients. Full article
(This article belongs to the Special Issue New Clinical Advances in Breast Reconstruction)
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24 pages, 874 KB  
Article
A Bioinspired Multimodal CNN-LSTM Network for EEG Analysis of Patients in Coma
by Sérgio Baldo-Júnior, Murillo G. Carneiro, João L. M. Barbosa, Liang Zhao, João Batista Destro-Filho, Marcos Campos and Renato Tinós
Sensors 2025, 25(22), 6981; https://doi.org/10.3390/s25226981 (registering DOI) - 15 Nov 2025
Abstract
Electroencephalography (EEG) is widely used for diagnosis and evaluation of neurological diseases, despite challenges from its high-dimensional and noisy temporal data, which complicate accurate brain signal classification. This study proposes a multimodal deep learning model combining Convolutional Neural Network (CNN) and Long Short-Term [...] Read more.
Electroencephalography (EEG) is widely used for diagnosis and evaluation of neurological diseases, despite challenges from its high-dimensional and noisy temporal data, which complicate accurate brain signal classification. This study proposes a multimodal deep learning model combining Convolutional Neural Network (CNN) and Long Short-Term Memory (LSTM) layers to classify EEG signals, integrating patient information as additional modalities. CNN layers effectively extract spatial features and reduce EEG data dimensionality, while LSTM layers capture long-term temporal dependencies. A Genetic Algorithm (GA) selects relevant multimodal features and optimizes CNN-LSTM hyperparameters. The model was applied to outcome classification in comatose patients, achieving improved classifier performance compared to unimodal approaches. Experimental results demonstrate that multimodal integration and GA optimization significantly enhance accuracy, robustness, and generalization. The architecture shows promise for broader EEG classification tasks, potentially advancing clinical decision support based on EEG signals. Full article
(This article belongs to the Special Issue AI and Neural Networks for Advanced Biomedical Sensor Applications)
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19 pages, 2593 KB  
Article
A Ghost Wave Suppression Method for Towed Cable Data Based on the Hybrid LSMR
by Zhaoqi Wang, Ya Li, Zhixue Sun, Zhonghua Li and Dongsheng Ge
Processes 2025, 13(11), 3689; https://doi.org/10.3390/pr13113689 (registering DOI) - 15 Nov 2025
Abstract
In marine seismic exploration, ghost waves distort reflection waveforms and narrow the frequency band of seismic records. Traditional deghosting methods are susceptible to practical limitations from sea surface fluctuations and velocity variations. This paper proposes a τ-p domain deghosting method based on the [...] Read more.
In marine seismic exploration, ghost waves distort reflection waveforms and narrow the frequency band of seismic records. Traditional deghosting methods are susceptible to practical limitations from sea surface fluctuations and velocity variations. This paper proposes a τ-p domain deghosting method based on the Hybrid Least Squares Residual (HyBR LSMR) algorithm. We first establish a linear forward model in the τ-p domain that describes the relationship between the total wavefield and upgoing wavefield, transforming deghosting into a linear inverse problem. The method then employs the hybrid LSMR algorithm with Tikhonov regularization to address the inherent ill-posedness. A key innovation is the integration of the Generalized Cross Validation (GCV) criterion to adaptively determine regularization parameters and iteration stopping points, effectively avoiding the semi-convergence phenomenon and enhancing solution stability. Applications to both synthetic and field data demonstrate that the proposed method effectively suppresses ghost waves under various acquisition conditions, significantly improves the signal-to-noise ratio and resolution, broadens the effective frequency band, and maintains good computational efficiency, providing a reliable solution for high-precision seismic data processing in complex marine environments. Full article
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10 pages, 1785 KB  
Proceeding Paper
Bridging Theory and Simulation: Parametric Identification and Validation for a Multirotor UAV in PX4—Gazebo
by Erick Loyaga, Estefano Quinatoa, Edgar Haro, William Chamorro, Jackeline Abad, Iván Changoluisa and Esteban Valencia
Eng. Proc. 2025, 115(1), 12; https://doi.org/10.3390/engproc2025115012 (registering DOI) - 15 Nov 2025
Abstract
This paper introduces a structured methodology for bridging the gap between theoretical modeling and high-fidelity simulation of multirotor Unmanned Aerial Systems (UAS) through the construction of digital twins in PX4 v1.12 Software-in-the-Loop (SITL) environments. A key challenge addressed is the absence of standardized [...] Read more.
This paper introduces a structured methodology for bridging the gap between theoretical modeling and high-fidelity simulation of multirotor Unmanned Aerial Systems (UAS) through the construction of digital twins in PX4 v1.12 Software-in-the-Loop (SITL) environments. A key challenge addressed is the absence of standardized procedures for translating physical UAV characteristics into simulation-ready parameters, which often results in inconsistencies between virtual and real-world behavior. To overcome this, we propose a hybrid parametric identification pipeline that combines analytical modeling with experimental characterization. Critical parameters—such as inertial properties, thrust and torque coefficients, drag factors, and motor response profiles—are obtained through a combination of physical measurements and theoretical derivation. The proposed methodology is demonstrated on a custom-built heavy-lift quadrotor, and the resulting digital twin is validated by executing autonomous missions and comparing simulated outputs against flight logs from real-world tests. Full article
(This article belongs to the Proceedings of The XXXIII Conference on Electrical and Electronic Engineering)
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23 pages, 14043 KB  
Article
Unraveling Reservoir Quality: How Mineralogy Shapes Pore Attributes in Sandstone Lithofacies
by Antoine W. Guirguis, Abdelmoktader A. El Sayed, Ashraf R. Baghdady, Abdelaziz L. Khlaifat, Ahmed A. Sharaf-Eldin and Ahmed Gad
Minerals 2025, 15(11), 1203; https://doi.org/10.3390/min15111203 (registering DOI) - 15 Nov 2025
Abstract
The Cenomanian Bahariya Formation exposed at Gebel El Dist in the Western Desert of Egypt provides valuable surface analogues for evaluating the reservoir quality of subsurface Bahariya sandstones. The formation was analyzed using 27 oriented samples and 91 core plugs from quartz arenite [...] Read more.
The Cenomanian Bahariya Formation exposed at Gebel El Dist in the Western Desert of Egypt provides valuable surface analogues for evaluating the reservoir quality of subsurface Bahariya sandstones. The formation was analyzed using 27 oriented samples and 91 core plugs from quartz arenite (QA) and quartz wacke (QW) facies. Analyses included XRD, petrography, SEM, helium porosity–permeability, and capillary tests, as well as measurements of pore-throat radii (R) at 35% and 36% mercury saturation. X-ray diffraction analyses reveal a heterogeneous mineral composition dominated by quartz, feldspars, dolomite, pyrite, siderite, goethite, hematite, clay minerals, glauconite, and gypsum. QA displays higher porosity and permeability than QW, along with larger pore radii, and lower specific surface area per unit pore volume (Spv) and per unit grain volume (Sgv). Multivariate regression equations, specific to each facies, were developed to convert standardized XRD mineral percentages directly into pore-system and flow attributes (ϕ, k, r, Spv, Sgv, R35, R36), quantifying capillary-based recovery contrasts between facies. Across both facies, regressions linking mineralogy to ϕ, k, r, Spv, Sgv, R35, and R36 are strong (R2 = 0.78–1.00). The established predictive equations provide a low-cost method to estimate reservoir quality from mineralogy alone, enabling rapid screening of Cenomanian Bahariya analogues and similar clastic reservoirs where core data are limited. Full article
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16 pages, 9123 KB  
Article
Integrated Multi-Scale Hydrogeophysical Characterisation of a Coastal Phreatic Dune Aquifer: The Belvedere–San Marco Case Study (NE Italy)
by Benedetta Surian, Emanuele Forte and Luca Zini
Hydrology 2025, 12(11), 304; https://doi.org/10.3390/hydrology12110304 (registering DOI) - 15 Nov 2025
Abstract
Low-lying coastal plains are increasingly threatened by saltwater intrusion, yet the extent of the phenomenon and the role of coastal dune systems remain unevenly assessed. In the northern Adriatic Sea (NE Italy), salinisation has been documented, but systematic, spatially resolved studies are lacking. [...] Read more.
Low-lying coastal plains are increasingly threatened by saltwater intrusion, yet the extent of the phenomenon and the role of coastal dune systems remain unevenly assessed. In the northern Adriatic Sea (NE Italy), salinisation has been documented, but systematic, spatially resolved studies are lacking. This work investigates the Belvedere–San Marco relict dune system to assess its hydrogeological function and vulnerability to seawater intrusion. An integrated methodology combining borehole and core stratigraphy, in situ water electrical conductivity (EC) measurements, and multi-method geophysical surveys (FDEM, ERT, GPR, active seismics) was tested. Results reveal a consistent stratigraphy of permeable aeolian sands overlying clay-rich units, with groundwater EC values in the dune sector always remaining well below thresholds for brackish or saline conditions. Geophysical imaging reveals that the dunes are low-conductive bodies contrasting sharply with the conductive surrounding lowlands, thus indicating the persistence of a freshwater lens sustained by local recharge within the dunes. The Belvedere–San Marco dunes therefore act as both freshwater reservoirs and natural hydraulic barriers, buffering shallow aquifers against salinisation. This study demonstrated the applicability of integrated geophysical methods to extensively investigate shallow phreatic aquifers lying a few metres below the surface, and establishes a baseline for monitoring future changes under rising sea levels, subsidence, and increased groundwater exploitation. Full article
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13 pages, 247 KB  
Article
Beyond Experience: How Doctoral and Pedagogical Training Shape Nurse Educators
by Raúl Quintana-Alonso, Lucía Carton Erlandsson and Elena Chamorro-Rebollo
Nurs. Rep. 2025, 15(11), 401; https://doi.org/10.3390/nursrep15110401 (registering DOI) - 15 Nov 2025
Abstract
Background/Objective: Nurse educators are central to consolidating nursing as a discipline and shaping professional identity, yet their preparation is heterogeneous. This study aimed to identify profiles of nurse educators based on the value they assign to teaching competencies and to analyze factors influencing [...] Read more.
Background/Objective: Nurse educators are central to consolidating nursing as a discipline and shaping professional identity, yet their preparation is heterogeneous. This study aimed to identify profiles of nurse educators based on the value they assign to teaching competencies and to analyze factors influencing these profiles. Methods: A cross-sectional, descriptive research design was applied, using convenience sampling to recruit 326 nurse educators from Spanish universities. Data were collected through a self-administered online questionnaire distributed to nursing faculty from public, private, and affiliated (semi-private) universities across Spain. The instrument included sociodemographic and academic variables, along with nine teaching competencies. Descriptive statistics, cluster analysis, ANOVA, chi-square tests, and multinomial logistic regression were conducted using SPSS. Results: Three distinct profiles of nursing faculty were identified. The academic–pedagogical profile assigned the highest importance to all competencies (means 4.78–4.91), the clinical–pragmatic profile assigned the lowest (3.61–4.04), and the intermediate–researcher profile showed moderate values (4.26–4.50). Doctoral degree (χ2 = 65.36, p < 0.001) and pedagogical training (χ2 = 33.89, p < 0.001) were the strongest predictors of membership in the academic–pedagogical group, confirmed in multivariate regression (OR for doctorate = 0.07; OR for pedagogical training = 0.13, both p < 0.001). Conclusion: This study delineates three coherent and statistically robust profiles of nursing faculty based on their appraisal of teaching competencies. Academic qualifications and pedagogical training emerged as key determinants of these profiles. Tailored faculty development strategies that reinforce doctoral-level preparation and pedagogical expertise are critical to advancing the quality and consistency of nursing education. Full article
(This article belongs to the Section Nursing Education and Leadership)
16 pages, 3176 KB  
Commentary
Fostering Cross-Border Trail Tourism Between Windsor, Ontario, Canada and Detroit, Michigan, USA
by John H. Hartig, Lori Newton, Todd Scott, Marlaine Koehler, John E. Gannon, Sam Lovall, Tom Woiwode, Amy Greene, Weston Hillier and Eric Antolak
Green Health 2025, 1(3), 20; https://doi.org/10.3390/greenhealth1030020 (registering DOI) - 15 Nov 2025
Abstract
The 2026 opening of the Gordie Howe International Bridge between Windsor, Ontario, Canada and Detroit, Michigan, USA, with its multi-use trail for cyclists and pedestrians, is projected to catalyze cross-border trail tourism and help further revitalize these two border cities. Both Windsor and [...] Read more.
The 2026 opening of the Gordie Howe International Bridge between Windsor, Ontario, Canada and Detroit, Michigan, USA, with its multi-use trail for cyclists and pedestrians, is projected to catalyze cross-border trail tourism and help further revitalize these two border cities. Both Windsor and Detroit have unique, extensive trail systems with compelling destinations. However, cross-border trail tourism institutionalization needs improvement. Tourism, greenway, and destination partners should explore creating a boundary organization to foster and market cross-border trail tourism. Recommendations from a 2024 cross-border trail tourism conference include: develop strategies for community engagement and storytelling to enhance cultural connections between regions; strengthen ties between trail groups and environmental organizations to provide trail experiences that reconnect people with the river and other natural resources; support the region’s efforts to obtain a UNESCO World Heritage Site designation for the Underground Railroad and support the Canadian federal designation of Windsor’s Ojibway National Urban Park; strengthen collaborations between tourism and cycling partners to promote and market cross-border trail tourism; institutionalize greenway assessments (every 5–10 years) to evaluate trail segment completions, gaps, potential route improvements, safety improvements, equity considerations, etc., and to keep greenways in the public consciousness; and measure and broadly communicate the economic impact of cross-border trail tourism resulting from the bridge. Full article
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16 pages, 2103 KB  
Article
Hydrological and Geochemical Responses to Agricultural Activities in a Karst Catchment: Insights from Spatiotemporal Dynamics and Source Apportionment
by Le Cao, Qianyun Cheng, Shangqing Wang, Shaoqiang Xu, Qirui He, Yanqiu Li, Tao Peng and Shijie Wang
Water 2025, 17(22), 3264; https://doi.org/10.3390/w17223264 (registering DOI) - 15 Nov 2025
Abstract
Karst aquifers, vital freshwater resources, are highly vulnerable to agricultural pollution, yet their hydro-geochemical responses remain poorly understood due to high spatial heterogeneity. This study aimed to unravel these complex responses in a subtropical karst agricultural catchment to provide a basis for its [...] Read more.
Karst aquifers, vital freshwater resources, are highly vulnerable to agricultural pollution, yet their hydro-geochemical responses remain poorly understood due to high spatial heterogeneity. This study aimed to unravel these complex responses in a subtropical karst agricultural catchment to provide a basis for its sustainable management. We employed high-frequency monitoring at a headwater spring (background), a depression well (hotspot), and the catchment outlet (integrated) in Southwest China. Using hydrological and geochemical data from 2017, we applied Principal Component Analysis (PCA) to apportion natural and anthropogenic sources. The main findings revealed significant spatial heterogeneity, with the depression well acting as a contamination hotspot characterized by rapid hydrological responses and elevated SO42− and Cl concentrations. PCA successfully decoupled an “anthropogenic factor” (PC1, 40.5%) from a “natural weathering factor” (PC2, 25.2%). Critically, agricultural SO42− at the hotspot was counter-intuitively higher during the wet season than the dry season, opposing the typical dilution pattern of background ions and revealing that depressions act as contaminant-concentrating pathways, whose risks are severely underestimated by traditional outlet monitoring. The anomalous sulfate dynamics reveal a cross-seasonal “storage-and-release” mechanism (legacy effect) within the karst Critical Zone, demonstrating that these systems can buffer and “remember” contaminants. Full article
(This article belongs to the Section Hydrogeology)
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30 pages, 11720 KB  
Article
Assessment of Groundwater Quality for Irrigation in the Semi-Arid Region of Oum El Bouaghi (Northeastern Algeria) Using Groundwater Quality and Pollution Indices and GIS Techniques
by Norelhouda Messaid, Ramzi Hadjab, Hichem Khammar, Aymen Hadjab, Nadhir Bouchema, Abderrezzeq Chebout, Mourad Aqnouy, Ourania Tzoraki and Lahcen Benaabidate
Water 2025, 17(22), 3266; https://doi.org/10.3390/w17223266 (registering DOI) - 15 Nov 2025
Abstract
Groundwater quality in the semi-arid region of Oum El Bouaghi, Northeastern Algeria, was assessed for irrigation suitability using hydrogeochemical analyses, water quality indices, and GIS techniques. The study analyzed 23 groundwater samples during dry and wet seasons in 2022–2023, several physicochemical parameters were [...] Read more.
Groundwater quality in the semi-arid region of Oum El Bouaghi, Northeastern Algeria, was assessed for irrigation suitability using hydrogeochemical analyses, water quality indices, and GIS techniques. The study analyzed 23 groundwater samples during dry and wet seasons in 2022–2023, several physicochemical parameters were measured. Results revealed neutral to slightly alkaline pH levels, except for one acidic sample, with salinity (EC: 527–5001 µS·cm−1) exceeding WHO guidelines, particularly during the dry season due to evaporation and anthropogenic activities. Hydrogeochemical facies showed dominance of Na+-HCO3 and Ca2+-Cl/SO42− water types, indicating rock–water interactions and evaporation control, as confirmed by Gibbs plots. The IWQI classified water into five categories, with severe restrictions (IWQI < 40) in 13% of samples during the dry season, improving slightly in the wet season. Indices such as SAR, Na%, and RSC indicated low to moderate sodium hazard, while KR and PS highlighted salinity risks in specific areas. Spatial analysis revealed localized pollution hotspots, with the (GPI) identifying minimal to high contamination levels, linked to agricultural and geogenic sources. These findings underscore needs for sustainable groundwater management, including monitoring, optimized irrigation practices, and mitigation of anthropogenic impacts, to ensure long-term agricultural viability in this water-scarce region. Full article
(This article belongs to the Special Issue Research on Hydrogeology and Hydrochemistry: Challenges and Prospects)
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23 pages, 10148 KB  
Article
Improving Fast EMG Classification for Hand Gesture Recognition: A Comprehensive Analysis of Temporal, Spatial, and Algorithm Configurations for Healthy and Post-Stroke Subjects
by Camila Montecinos, Jessica Espinoza, Mónica Zamora Zapata, Viviana Meruane and Ruben Fernandez
Sensors 2025, 25(22), 6980; https://doi.org/10.3390/s25226980 (registering DOI) - 15 Nov 2025
Abstract
Electromyography-based assistive and rehabilitation devices have shown potential for restoring mobility, especially for post-stroke patients. However, the variability of biological signals and the processing delays caused by signal acquisition and feature extraction influence myoelectric control systems’ real-time functionality and robustness. This study evaluates [...] Read more.
Electromyography-based assistive and rehabilitation devices have shown potential for restoring mobility, especially for post-stroke patients. However, the variability of biological signals and the processing delays caused by signal acquisition and feature extraction influence myoelectric control systems’ real-time functionality and robustness. This study evaluates the classification performance of electromyographic (EMG) signals for six distinct hand gestures in healthy individuals and post-stroke patients. Different feature extraction methods and machine learning algorithms are employed to analyze the impact of acquisition time (0.5–4 s) and the number of channels (1–4) on model accuracy, robustness, and generalization. The best results are obtained using power spectral density and dimensionality reduction, reaching a classification accuracy of 94.79% with a 2 s signal and 95.31% for 4 s. Acquisition time has a greater effect on accuracy than the number of channels used with accuracy stabilizing at 2 s. We test for generalization using post-stroke patient data, evaluating two scenarios: intra-patient validation with 90% accuracy and cross-patient validation with 35–40% accuracy. This study contributes to developing effective real-time myoelectric control systems for neurorehabilitation. Full article
(This article belongs to the Special Issue Biosignal Sensing Analysis (EEG, EMG, ECG, PPG) (2nd Edition))
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12 pages, 1677 KB  
Article
MRI Reflects Meningioma Biology and Molecular Risk
by Julian Canisius, Julia Schuler, Maria Goldberg, Olivia Kertels, Marie-Christin Metz, Chiara Negwer, Igor Yakushev, Bernhard Meyer, Stephanie E. Combs, Jan S. Kirschke, Denise Bernhardt, Benedikt Wiestler and Claire Delbridge
Cancers 2025, 17(22), 3665; https://doi.org/10.3390/cancers17223665 (registering DOI) - 15 Nov 2025
Abstract
Background/Objectives: Large-scale (epi)genomic studies have substantially advanced our understanding of the molecular landscape of meningiomas, most recently embedded in the cIMPACT-NOW update 8. As a result, molecular data are increasingly integrated into risk-adapted treatment algorithms. However, it remains uncertain to what extent [...] Read more.
Background/Objectives: Large-scale (epi)genomic studies have substantially advanced our understanding of the molecular landscape of meningiomas, most recently embedded in the cIMPACT-NOW update 8. As a result, molecular data are increasingly integrated into risk-adapted treatment algorithms. However, it remains uncertain to what extent non-invasive MRI can capture underlying molecular variation and risk. Methods: We assembled a large, single-institution cohort of 225 newly diagnosed meningiomas (WHO grades 1–3) with available preoperative MRI, as well as comprehensive epigenome-wide methylation and copy-number profiling. Tumors were segmented into core and edema regions using a state-of-the-art automated pipeline from the BraTS challenge. Radiomic features were extracted and used to train Random Forest classifiers to predict WHO grade, molecular risk, and specific alterations such as 1p loss in a hold-out test set. Results: Our models achieved accuracy above 91% for integrated molecular risk classification, 87.5% for 1p chromosomal status, and 76.8% for WHO grade prediction, with corresponding AUCs of 0.91, 0.90, and 0.89, underscoring the robustness of radiomic features in capturing histopathological and, especially, molecular characteristics. Conclusions: Preoperative MRI effectively captures the underlying molecular biology of meningiomas and may enable rapid molecular assessment to inform decision-making and prioritization of confirmatory testing. However, it is not yet ready for clinical use, showing lower accuracy for current WHO grade classification. Full article
(This article belongs to the Section Methods and Technologies Development)
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11 pages, 651 KB  
Article
Geographic Disparities in Survival After Surgery for Metastatic Bone Disease: A Retrospective Analysis from a German Sarcoma Centre
by Wolfram Weschenfelder, Paula Maria Nickl, Friederike Weschenfelder, Christian Spiegel, Karin Gabriela Schrenk, Thomas Ernst and Mark Lenz
Cancers 2025, 17(22), 3664; https://doi.org/10.3390/cancers17223664 (registering DOI) - 15 Nov 2025
Abstract
Background/Objectives: Metastatic bone disease (MBD) poses an increasing challenge in orthopaedic oncology due to prolonged survival. While clinical prognostic factors are well established, the role of socio-economic determinants remains unclear, particularly within universal healthcare systems. Methods: We retrospectively analysed 243 patients who underwent [...] Read more.
Background/Objectives: Metastatic bone disease (MBD) poses an increasing challenge in orthopaedic oncology due to prolonged survival. While clinical prognostic factors are well established, the role of socio-economic determinants remains unclear, particularly within universal healthcare systems. Methods: We retrospectively analysed 243 patients who underwent surgery for MBD (excluding spine) between 2005 and 2024 at a German sarcoma centre. Socio-economic indicators were derived from national databases and linked to patients’ residential districts. Survival was analysed using Kaplan–Meier estimates and Cox regression, adjusting for clinical confounders. Results: Median postoperative survival was 22 months. Several socio-economic indicators—income, education, and employment—were associated with survival in univariate analysis. In multivariate models, only residential area size remained independently significant (p = 0.047). Patients from villages (<2000 inhabitants) and large cities (>100,000) had poorer survival than those from small or medium-sized towns. This effect persisted after adjustment for tumour type, pathological fractures, and year of surgery. Conclusions: Within a universal healthcare system, residential area size was associated with survival after surgery for MBD, suggesting that regional disparities may persist despite equal formal access to care. Further studies integrating individual-level socioeconomic data are needed to identify mechanisms and guide interventions to reduce geographic inequalities. Full article
(This article belongs to the Special Issue Health Disparities and Outcomes in Cancer Survivors)
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22 pages, 444 KB  
Review
Advancements in Understanding Spasticity: A Neuromusculoskeletal Modeling Perspective
by Mohammad S. Shourijeh, Argyrios Stampas, Shuo-Hsiu Chang, Radha Korupolu and Gerard E. Francisco
J. Clin. Med. 2025, 14(22), 8092; https://doi.org/10.3390/jcm14228092 (registering DOI) - 15 Nov 2025
Abstract
Spasticity, a complex consequence of upper motor neuron lesions, poses challenges for clinical assessment due to its neural and mechanical origins. Traditional scales like the Modified Ashworth and Tardieu Scales provide subjective, context-limited insights, often missing spasticity’s dynamic nature. Neuromusculoskeletal (NMS) modeling offers [...] Read more.
Spasticity, a complex consequence of upper motor neuron lesions, poses challenges for clinical assessment due to its neural and mechanical origins. Traditional scales like the Modified Ashworth and Tardieu Scales provide subjective, context-limited insights, often missing spasticity’s dynamic nature. Neuromusculoskeletal (NMS) modeling offers objective, quantitative insights by integrating patient-specific muscle–tendon properties, reflex dynamics, and multi-joint biomechanics. This scoping review examines advancements in spasticity modeling, comparing mechanical, neurological, and integrated approaches, and their applications in conditions like cerebral palsy and stroke. We highlight barriers to clinical translation, including computational demands and regulatory challenges, and propose future directions, such as real-time simulation and machine learning integration, to enhance personalized assessment and treatment. Full article
(This article belongs to the Section Clinical Rehabilitation)
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23 pages, 7046 KB  
Article
Integrating Kansei Engineering and AI-Generated Image for Commercial Vehicle Body Morphology Design
by Bo Li, Zhen Hu, Yuhang Liu and Zewei Wang
Symmetry 2025, 17(11), 1971; https://doi.org/10.3390/sym17111971 (registering DOI) - 15 Nov 2025
Abstract
Symmetry in vehicle body morphology is a crucial factor for achieving visual sensory balance in users, and it also serves as an important method for enhancing the efficiency of vehicle body research and development. This study proposes an AHP-SD-TOPSIS-AIGC integrated morphological design method [...] Read more.
Symmetry in vehicle body morphology is a crucial factor for achieving visual sensory balance in users, and it also serves as an important method for enhancing the efficiency of vehicle body research and development. This study proposes an AHP-SD-TOPSIS-AIGC integrated morphological design method to address multi-factorial design complexities in new energy commercial vehicle body styling under emotion-driven frameworks. Through literature retrieval and survey analysis, a Kansei evaluation system was constructed, with hierarchical design indicators established via Analytic Hierarchy Process (AHP) and weights determined through consistency matrices. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) identified optimal style forms exhibiting high emotional intention coupling, while edge detection algorithms extracted symmetrical spline features for body contour modeling. Artificial Intelligence Generated Content (AIGC) tools subsequently generated innovative solutions, validated through truck design applications to confirm method rationality and effectiveness. The results of the study show that the styling elements are accurately matched to user preferences and can identify target improvement points, and that the method can effectively achieve the output of the proposal for the design of commercial vehicle body morphology and is also applicable to passenger car-type vehicles to achieve the adaptation of multi-intentional emotional design. Full article
(This article belongs to the Special Issue Symmetry/Asymmetry in Computer-Aided Industrial Design)
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