Search Results (189,011)

Two structurally tunable (propyl-3-ol)triphenyltin(IV) (Ph₃SnL₁) and (butyl-4-ol)triphenyltin(IV) (Ph₃SnL₂) compounds were investigated at the human serum transferrin (Tf) molecular interface to resolve how ligand architecture and protein metallation modulate organotin(IV) biocompound stability and lobe-selective binding. Steady-state fluorescence spectroscopy revealed efficient quenching of native Tf emission (λ_ex = 280 nm, 296–310 K, pH 7.4) without significant spectral displacement, indicating the predominant formation of non-fluorescent ground-state complexes. Calculated bimolecular quenching constants (K_q ~10¹² M⁻¹ s⁻¹) exceeded the diffusion-controlled aqueous limit, ruling out a collisional dynamic quenching mechanism and confirming static complexation as the principal origin of fluorescence suppression. Double-log binding analysis revealed moderate affinity (K_a ~10²–10³ M⁻¹) and an approximately single dominant binding event per protein (n ≈ 0.65–0.90). Temperature-dependent van’t Hoff evaluation yielded positive ΔH° and ΔS° values, supporting a spontaneous, entropy-favored association process largely governed by hydrophobic and dispersion-type contributions, consistent with lipophilic organotin(IV) scaffold accommodation. Iron (Fe³⁺) loading of Tf markedly enhanced ligand engagement, especially for Ph₃SnL₁, evidencing that metallation-induced lobe closure reshapes pocket accessibility and local polarity relevant for organotin(IV) binding presentation rather than simply strengthening empirical docking scores. Molecular docking localized the most stable Ph₃SnL₂ poses in the sterically confined, rigid C-lobe, while Ph₃SnL₁ preferentially penetrated the more adaptive N-lobe. ONIOM QM/MM refinement of docking poses confirmed strong interfacial stabilization (ΔE_int ≈ –38 to –62 kcal mol⁻¹) and clarified charge–packing interplay without invoking frontier orbital analysis. The results map multiscale structure–interaction relationships defining lobe preference and complex stability at the transferrin interface. Full article

Background/Objectives: The growing number of older adults with complex healthcare needs increases demand for homecare services, while a shrinking workforce often lacks skills for advanced tasks. Digital health is seen as a promising tool to address these challenges. This study explored Swedish homecare professionals’ perceptions of the potential use of digital twins in daily work. Methods: Four focus group discussions were conducted with 31 homecare professionals; two groups each in one urban/rural and one rural municipality. Data were analyzed using inductive content analysis. Results: Three main themes emerged: (i) Perceptions of digital twins as support for older adults, including needs-based, individualized care and proactive support enabling preventive measures; (ii) Perceptions of digital twins as support for professionals, including a better work environment through streamlined tasks and flows and enhanced planning and assessment; and (iii) Concerns about digital twins, focusing on ethical and social issues and limited understanding, which were related to monitoring aspects, the importance of physical visits, and how the technology works. Conclusions: Digital twins are perceived by professionals to have the potential to improve homecare services by supporting both older adults and professionals; however, further research is needed to address concerns and practical implications. Full article

Background: Among many deleterious effects on the well-being of children and youth, the COVID-19 pandemic contributed to a surge in youth mental health distress. This, coupled with pre-existing prolonged wait times for mental health care, highlighted the need for accessible community-based mental health supports. The Healthy Living Project (HELP) is a virtual lifestyle change support program aimed at promoting positive lifestyle changes and improved mental well-being among youth with mental distress. A pilot feasibility study explored youth engagement with HELP e-resources, and preliminary mental health and lifestyle measures over a 3-month period. Methods: Youth were enrolled in a 3-month pilot of the HELP e-resource. Feasibility metrics (recruitment, retention, and platform engagement) were documented, while exploratory self-reported data on emotional and behavioral difficulties, youth quality of life, sedentary behavior (screen time), sleep hygiene, and physical activity were assessed at baseline and 3 months. Results: Twenty-three youth (mean age 15.7 years, SD 1.7) completed baseline assessments and started the intervention, with ten participants retained by the end of the study. Compared with non-completers (n = 13), study completers (n = 10) tended to report higher quality of life and healthier habits (lower screen time, improved sleep hygiene, and higher activity). Ongoing access to HELP over 3 months was associated with suggestive trends toward improvement in emotional and behavioral difficulties and sleep hygiene. Engaged participants who received screen time education tended to report lower screen times as compared to unengaged counterparts. Conclusions: This study provides early insights into the implementation and acceptability of HELP e-resources among youth experiencing mental distress, with suggestive trends toward potential benefit. Low recruitment and high attrition preclude definitive conclusions, and the findings should be interpreted as exploratory. Lessons from this pilot will inform the design of a subsequent trial to more rigorously evaluate feasibility and the potential impact of HELP on youth with mental distress. Full article

Computer-aided modeling and mathematical optimization of energy systems are essential for improving operational efficiency and achieving emission reductions, particularly for steam turbine systems with part-load-dependent efficiency characteristics. Mixed-Integer Linear Programming (MILP) is the state of the art, due to its short computational times and reliable convergence. However, its simplifications often reduce model accuracy. Mixed-Integer Nonlinear Programming (MINLP) offers high accuracy but faces long computational times and potential convergence issues. Recent advancements in Mixed-Integer Quadratically Constrained Programming (MIQCP) offer a promising approach for more accurate energy system modeling by enabling quadratic and bilinear representations while avoiding the full complexity of nonlinear programs. This study compares the optimization methods MILP, MINLP and MIQCP for the operational optimization of a steam turbine system. The parameterization of the models is based on hourly measurement data of two real-world steam turbines. Key evaluation criteria include accuracy, computational time, implementation complexity and the deviation in the calculated optimum. The results show that MIQCP improves accuracy compared with MILP while requiring lower computational time than MINLP. Overall, the results demonstrate that MIQCP provides a suitable compromise between model accuracy and computational efficiency for the operational optimization of steam turbine systems. Full article

Aquaculture has grown rapidly worldwide and has become a key source of food and employment opportunities. However, its expansion faces environmental, health, reproductive, and technological challenges that threaten its long-term sustainability. In this context, biologists play a crucial role in promoting sustainable practices and integrated management of aquaculture systems. This article reviews their main contributions to animal health, genetic improvement, assisted reproduction, and resource conservation. They also highlight their leadership in applying advanced technologies, including biotechnology, nanotechnology, and genetic engineering. Moreover, this study explores emerging research trends and emphasizes the importance of interdisciplinary training to address the evolving demands of the sector. This underscores the need to strengthen collaboration between science, technology, and public policy to ensure sustainable aquaculture. Enhancing the role of biologists is essential for overcoming current challenges and advancing efficient, ethical, and environmentally responsible aquaculture systems that meet global demand. Full article

Accurately assessing the glomerular filtration rate (GFR) is critical in patients with cancer for acute kidney injury diagnosis, chemotherapy selection, drug dosing, and clinical trial eligibility. Yet, traditional equations such as Cockcroft–Gault and MDRD fail due to multiple physiological changes specific to this vulnerable population. Cancer-related sarcopenia, creatinine secretion blockade, and total body volume fluctuations may lead to inaccurate GFR estimations. This ultimately leads to undertreatment of underlying malignancy, overdosing of nephrotoxic therapies with adverse effects, and excluding patients from clinical trials unnecessarily. The 2024 KDIGO guidelines as well as the American Society of Onconephrology position statement recommend the use of combined GFR equation such as CKD-EPI 2021 that utilizes both cystatin C and creatinine to improve GFR estimation accuracy. Direct GFR measurement via exogenous filtration markers should be pursued in high-risk patients when precise values are warranted. This review highlights current challenges associated with GFR evaluation in patients with cancer and outlines clinical implications as well as recent recommendations for optimal clinical practice. Full article

Background: People with Parkinson’s disease suffer from gait impairments. Clinical scales provide a limited and rater-dependent assessment of gait. Wearable sensors allow an objective characterization by capturing rhythm, pace, and signature patterns. This study investigated if sensor-derived gait parameters have prognostic value for short-term progression of gait impairments. Methods: A total of 111 longitudinal visit pairs were analyzed, where participants underwent clinical evaluation and a 4 × 10 m walking test instrumented with wearable sensors. Changes in the UPDRSIII gait score between baseline and follow-up were used to classify participants as Improvers, Stables, or Deteriorators. Baseline group differences were assessed statistically. Machine-learning classifiers were trained to predict group membership using clinical variables alone, sensor-derived gait features alone, or a combination of both. Results: Significant between-group differences emerged. In participants with UPDRSIII gait score = 1, Improvers showed higher median gait velocity ($0.81 \mathrm{m}/\mathrm{s}$) and stride length ($0.80 \mathrm{m}$) than Stables ($0.68 \mathrm{m}/\mathrm{s}$; $0.70 \mathrm{m}$) and Deteriorators ($0.59 \mathrm{m}/\mathrm{s}$; $0.68 \mathrm{m}$), along with lower stance time variability (3.10% vs. 4.49% and 3.75%; all $p<0.05$). The combined sensor-based and clinical model showed the best performance (AUC $0.82$). Conclusions: Integrating sensor-derived gait parameters with clinical score can support the identification of patients at risk of gait deterioration in the near future. Full article

Wetlands in dryland regions are rapidly degrading under the combined effects of climate change and human regulation, yet long-term, seasonally resolved assessments of surface water extent (SWE) and its dynamics remain scarce. Here, we map and analyze seasonal surface water extent (SWE) over the period 2000–2024 in the Ile River Delta (IRD), south-eastern Kazakhstan, using Landsat TM/ETM+/OLI data within the Google Earth Engine (GEE) framework. We integrate multiple indices using the modified Normalized Difference Water Index (mNDWI), Automated Water Extraction Index (AWEI) variants, Water Index 2015 (WI2015), and Multi-Band Water Index (MBWI) with dynamic Otsu thresholding. The resulting index-wise binary water maps are merged via ensemble agreement (intersection, majority, union) to delineate three SWE regimes: stable (persists most of the time), periodic (appears regularly but not in every season), and ephemeral (appears only occasionally). Validation against Sentinel-2 imagery showed high accuracy F1-Score/Overall accuracy (F1/OA ≈ 0.85/85%), confirming our workflow to be robust. Hydroclimatic drivers were evaluated through modified Mann–Kendall (MMK) and Spearman’s (r) correlations between SWE, discharge (D), water level (WL), precipitation (P), and air temperature (AT), while a hybrid ensemble–occurrence framework was applied to identify degradation and transition patterns. Trend analysis revealed significant long–term declines, most pronounced during summer and fall. Discharge is predominantly controlled by stable spring SWE, while discharge and temperature jointly influence periodic SWE in summer–fall, with warming reducing the delta surface water. Ephemeral SWE responds episodically to flow pulses, whereas precipitation played a limited role in this semi–arid region. Spatially, area(s) of interest (AOI)-II/III (the main distributary system) support the most extensive yet dynamic wetlands. In contrast, AOI-I and AOI-IV host smaller, more constrained wetland mosaics. AOI-I shows persistence under steady low flows, while AOI-IV reflects a stressed system with sporadic high-water levels. Overall, the results highlight the dominant influence of flow regulation and distributary allocation on IRD hydrology and the need for ecologically timed releases, targeted restoration, and transboundary cooperation to sustain delta resilience. Full article

Background and Clinical Significance: Chronic non-bacterial osteomyelitis (CNO) is a rare autoinflammatory bone disorder that primarily affects children and adolescents, with females more frequently impacted. The condition remains poorly understood, though cytokine dysregulation and inflammasome activation are believed to contribute to its pathogenesis. Clinically, CNO is often difficult to distinguish from infectious osteomyelitis, as presenting symptoms such as bone pain, swelling, and functional limitation are nonspecific, while cultures are frequently negative. As a diagnosis of exclusion, delays in recognition can lead to prolonged or unnecessary antibiotic exposure and uncertainty in management. Case Presentation: A 14-year-old male with a history of left second toe osteomyelitis initially diagnosed in 2021. Despite negative cultures and limited histopathologic findings, he received multiple antibiotic courses with little improvement, and the digit remained chronically swollen. Three years later, a repeat evaluation revealed osseous resorption of the middle and distal phalanges, and a biopsy confirmed acute and mild chronic fibrosing osteomyelitis, consistent with CNO. Given the risk of progression and possible amputation, surgical reconstruction was pursued. The patient underwent autologous calcaneal bone grafting with digital fusion using a K-wire. At three months and one year postoperatively, radiographs demonstrated solid fusion of the digit with maintained activity and resolution of pain. Conclusions: This case emphasizes the diagnostic complexity of CNO and the importance of considering it in children with culture-negative or recurrent osteomyelitis. It further illustrates how timely surgical intervention can preserve function and quality of life while avoiding unnecessary amputation. Full article

Background: Nicotine use among the youth has been on the rise, especially with the introduction of E-cigarettes. This has sparked concerns regarding E-cigarettes and traditional cigarettes in terms of patterns, dependence, and perceptions within the youth population, which are issues this study aimed to investigate. Methods: A cross-sectional survey was conducted among university students at Ajman University, which is in the Middle East and North Africa (MENA) region. Using the Cigarette Dependence Scale (CDS-12) and Penn State Electronic Cigarette Dependence Index (PS-ECDI), dependence on both cigarettes and E-cigarettes was quantified. Results: Out of 1713 respondents, 18.9% were currently using nicotine products, including E-cigarettes (12.7%) and traditional cigarettes (5.1%). Nicotine use was significantly associated more with males than females with an odds ratio of 4.14. However, there was no difference between genders in the dependence scores. In addition, dual nicotine use and an earlier onset of nicotine consumption were associated with significantly higher dependence scores than single users and a late onset of smoking. Participants overall attributed cigarettes and E-cigarettes as equally harmful. Conclusions: Both cigarette and e-cigarette use were prevalent and associated with notable dependence. Although E-cigarettes are often promoted as cessation aids, their use in our sample did not appear to facilitate quitting and may instead sustain nicotine dependence. Targeted youth-focused cessation programs and stricter marketing and sales regulations are essential to prevent further normalization. Longitudinal studies are needed to track evolving patterns and health impacts in the MENA region. Full article

Adult obesity rates have risen steadily across the United States over the past decade, with more than 40% of adults affected. Persistent geographic and demographic disparities exist in obesity prevalence across the nation. While prior research has examined individual or environmental associated factors of obesity, limited studies have addressed both physical activity and food environments across the nation using multilevel approaches. This cross-sectional ecological study (2014–2024) used a two-level random intercept model to assess the association between county- and state-level factors and adult obesity prevalence across over 3000 U.S. counties nested within 51 states. County-level associated factors included food insecurity, poverty, unemployment, median household income, limited access to stores, and the density of various food outlets (grocery stores, convenience stores, supercenters, fast-food restaurants, Supplemental Nutrition Assistance Program (SNAP)-authorized retailers, and farmers’ markets), along with access to recreational facilities. State-level factors included SNAP benefits per capita and the presence of soda and chip taxes. Variables were group-mean- or grand-mean-centered to distinguish within- and between-state effects. Results showed that food insecurity, poverty, unemployment, limited access to stores, and a higher density of fast-food and convenience stores were positively associated with adult obesity prevalence. While higher recreational facility access, supercenter availability, median household income, SNAP benefits per capita were associated with lower adult obesity prevalence, these associations varied in strength across counties and states. These results emphasize the need for place-based strategies that address both the physical activity and food environment in shaping obesity disparities Full article

Gadolinium-doped hydroxyapatite nanoparticles (HapGd NPs) have emerged as promising multifunctional platforms for biomedical applications due to their unique combination of biocompatibility, structural tunability, and magnetic responsiveness. In this work, HapGd nanoparticles were synthesized using a microwave-assisted method and subsequently functionalized with curcumin and folic acid to enhance therapeutic efficiency and selective targeting. The synthesized nanostructures were characterized using various techniques, including X-ray diffraction (XRD), transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), vibrating sample magnetometry (VSM), and relaxometry. Structural analyses revealed successful incorporation of Gd³⁺ ions into the Hap lattice, resulting in reduced unit cell volume and slight lattice distortion, while preserving the apatite crystalline framework. Surface functionalization with curcumin and folic acid was confirmed through spectroscopic characterization, demonstrating effective molecular attachment. Nuclear Magnetic Resonance (NMR) relaxation measurements indicated that Gd doping endowed paramagnetic behavior suitable for contrast enhancement in magnetic resonance imaging (MRI). Relaxometry studies revealed a strong linear correlation between 1/T₁ and the Gd³⁺ concentration, especially in the functionalized samples, with performance comparable to the commercial contrast agent Omniscan™. The developed HapGd-based nanoplatform exhibits integrated diagnostic and therapeutic potential, providing a foundation for future research in biomedical applications. Full article

Metastatic lesions are the most common malignant tumor of the adrenal gland. While surgery can have a favorable surgical outcome for isolated adrenal metastatic lesions, most adrenal metastases occur in the context of disseminated disease, and the overall prognosis remains poor. Although data are limited, metastatic lesions from diverse solid tumors to the adrenal gland have typically demonstrated poor response to immunotherapy, particularly immune checkpoint inhibitors with programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) blockade. This apparent resistance to immunotherapy suggests that the adrenal gland microenvironment may be influenced by local microenvironmental factors, resulting in an organ microenvironment that is immune tolerant and permissive to tumor growth. However, the current literature on the adrenal gland immune microenvironment is limited, underscoring the need for better understanding of the immunobiology of this critical endocrine organ. Thus, the current scarcity of scientific studies on this topic is a novel opportunity to investigate and develop innovative treatment strategies for adrenal solid cancer metastases. In this literature review, we summarize the available data published on the immunobiology of the adrenal gland and the potential local immune mechanisms that may be contributing to the adrenal gland’s role in promoting resistance to otherwise breakthrough immunotherapy treatments. Full article

Objectives: The diagnosis of infective endocarditis (IE) is clinically challenging. This study aimed to examine an endocarditis network and the effects of delayed diagnosis. Methods: We reviewed the patients who were admitted for infective endocarditis at our institution between January 2012 and December 2021. Infective endocarditis was diagnosed according to ESC/EACTS guidelines for the management of endocarditis. Details of admitting hospitals were obtained from the German Hospital Directory. Data are presented as medians (25th–75th quartiles) or absolute values (percentages) unless otherwise specified. Results: A total of 812 consecutive patients were admitted to our centre for IE. Exact records on the time to diagnosis were available for 707 patients (87.1%). The patients were divided into two groups based on the time to diagnosis, i.e., up to 7 days (n = 509; 72.0% group ED) and more than 7 days (n = 198; 28.0% group LD). The EuroSCORE II (p = 0.001) and the EndoSCORE (p = 0.019) were significantly higher in the LD group. The median time to diagnosis was shorter in university hospitals as compared to non-teaching hospitals (p = 0.008) and among patients admitted to cardiology and cardiac surgery departments (p < 0.001). Patients diagnosed later had higher rates of tracheostomy (p < 0.001), longer ICU (p = 0.004) and hospital stays (p < 0.001) and higher in-hospital mortality (p = 0.027). We found that a delayed diagnosis (p = 0.040), stroke (p = 0.004), age > 75 years (p = 0.044) and atrial fibrillation (p < 0.001) were independently associated with in-hospital mortality. Furthermore, survival at 1 and 5 years was significantly higher in the ED group (p < 0.001). Conclusions: The diagnosis of IE may be influenced by a multitude of factors. Our results indicate that a delayed diagnosis is independently associated with an increased rate of in-hospital mortality. According to our results, an early diagnosis of IE may be associated with improved outcomes. Full article