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31 pages, 5203 KiB  
Article
Projecting Extinction Risk and Assessing Conservation Effectiveness for Three Threatened Relict Ferns in the Western Mediterranean Basin
by Ángel Enrique Salvo-Tierra, Jaime Francisco Pereña-Ortiz and Ángel Ruiz-Valero
Plants 2025, 14(15), 2380; https://doi.org/10.3390/plants14152380 (registering DOI) - 1 Aug 2025
Abstract
Relict fern species, confined to microhabitats with stable historical conditions, are especially vulnerable to climate change. The Alboran Arc hosts a unique relict fern flora, including Culcita macrocarpa, Diplazium caudatum, and Pteris incompleta, and functions as a major Pleistocene refuge. [...] Read more.
Relict fern species, confined to microhabitats with stable historical conditions, are especially vulnerable to climate change. The Alboran Arc hosts a unique relict fern flora, including Culcita macrocarpa, Diplazium caudatum, and Pteris incompleta, and functions as a major Pleistocene refuge. This study assesses the population trends and climate sensitivity of these species in Los Alcornocales Natural Park using annual abundance time series for a decade, empirical survival projections, and principal component analysis to identify key climatic drivers. Results reveal distinct climate response clusters among populations, though intra-specific variation highlights the importance of local conditions. Climate change is already impacting population viability, especially for P. incompleta, which shows high sensitivity to rising maximum temperatures and prolonged heatwaves. Climate-driven models forecast more severe declines than empirical ones, particularly for C. macrocarpa and P. incompleta, with the latter showing a projected collapse by the mid-century. In contrast, D. caudatum exhibits moderate vulnerability. Crucially, the divergence between models underscores the impact of conservation efforts: without reinforcement and reintroduction actions, projected declines would likely be more severe. These results project a decline in the populations of the studied ferns, highlighting the urgent need to continue implementing both in situ and ex situ conservation measures. Full article
(This article belongs to the Special Issue Plant Conservation Science and Practice)
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19 pages, 1107 KiB  
Article
A Novel Harmonic Clocking Scheme for Concurrent N-Path Reception in Wireless and GNSS Applications
by Dina Ibrahim, Mohamed Helaoui, Naser El-Sheimy and Fadhel Ghannouchi
Electronics 2025, 14(15), 3091; https://doi.org/10.3390/electronics14153091 (registering DOI) - 1 Aug 2025
Abstract
This paper presents a novel harmonic-selective clocking scheme that facilitates concurrent downconversion of spectrally distant radio frequency (RF) signals using a single low-frequency local oscillator (LO) in an N-path receiver architecture. The proposed scheme selectively generates LO harmonics aligned with multiple RF bands, [...] Read more.
This paper presents a novel harmonic-selective clocking scheme that facilitates concurrent downconversion of spectrally distant radio frequency (RF) signals using a single low-frequency local oscillator (LO) in an N-path receiver architecture. The proposed scheme selectively generates LO harmonics aligned with multiple RF bands, enabling simultaneous downconversion without modification of the passive mixer topology. The receiver employs a 4-path passive mixer configuration to enhance harmonic selectivity and provide flexible frequency planning.The architecture is implemented on a printed circuit board (PCB) and validated through comprehensive simulation and experimental measurements under continuous wave and modulated signal conditions. Measured results demonstrate a sensitivity of 55dBm and a conversion gain varying from 2.5dB to 9dB depending on the selected harmonic pair. The receiver’s performance is further corroborated by concurrent (dual band) reception of real-world signals, including a GPS signal centered at 1575 MHz and an LTE signal at 1179 MHz, both downconverted using a single 393 MHz LO. Signal fidelity is assessed via Normalized Mean Square Error (NMSE) and Error Vector Magnitude (EVM), confirming the proposed architecture’s effectiveness in maintaining high-quality signal reception under concurrent multiband operation. The results highlight the potential of harmonic-selective clocking to simplify multiband receiver design for wireless communication and global navigation satellite system (GNSS) applications. Full article
(This article belongs to the Section Microwave and Wireless Communications)
19 pages, 1721 KiB  
Article
Demography and Biomass Productivity in Colombian Sub-Andean Forests in Cueva de los Guácharos National Park (Huila): A Comparison Between Primary and Secondary Forests
by Laura I. Ramos, Cecilia M. Prada and Pablo R. Stevenson
Forests 2025, 16(8), 1256; https://doi.org/10.3390/f16081256 (registering DOI) - 1 Aug 2025
Abstract
Understanding species composition and forest dynamics is essential for predicting biomass productivity and informing conservation in tropical montane ecosystems. We evaluated floristic, demographic, and biomass changes in eighteen 0.1 ha permanent plots in the Colombian Sub-Andean forest, including both primary (ca. 60 y [...] Read more.
Understanding species composition and forest dynamics is essential for predicting biomass productivity and informing conservation in tropical montane ecosystems. We evaluated floristic, demographic, and biomass changes in eighteen 0.1 ha permanent plots in the Colombian Sub-Andean forest, including both primary (ca. 60 y old) and secondary forests (ca. 30 years old). Two censuses of individuals (DBH ≥ 2.5 cm) were conducted over 7–13 years. We recorded 516 species across 202 genera and 89 families. Floristic composition differed significantly between forest types (PERMANOVA, p = 0.001), and black oak (Trigonobalanus excelsa Lozano, Hern. Cam. & Henao) forests formed distinct assemblages. Demographic rates were higher in secondary forests, with mortality (4.17% yr), recruitment (4.51% yr), and relative growth rate (0.02% yr) exceeding those of primary forests. The mean aboveground biomass accumulation and the rate of annual change were higher in primary forests (447.5 Mg ha−1 and 466.8 Mg ha−1 yr−1, respectively) than in secondary forests (217.2 Mg ha−1 and 217.2 Mg ha−1 yr−1, respectively). Notably, black oak forests showed the greatest biomass accumulation and rate of change in biomass. Annual net biomass production was higher in secondary forests (8.72 Mg ha−1 yr−1) than in primary forests (5.66 Mg ha−1 yr−1). These findings highlight the ecological distinctiveness and recovery potential of secondary Sub-Andean forests and underscore the value of multitemporal monitoring to understand forest resilience and assess vulnerability to environmental change. Full article
(This article belongs to the Special Issue Forest Inventory: The Monitoring of Biomass and Carbon Stocks)
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24 pages, 6260 KiB  
Article
Transforming Product Discovery and Interpretation Using Vision–Language Models
by Simona-Vasilica Oprea and Adela Bâra
J. Theor. Appl. Electron. Commer. Res. 2025, 20(3), 191; https://doi.org/10.3390/jtaer20030191 (registering DOI) - 1 Aug 2025
Abstract
In this work, the utility of multimodal vision–language models (VLMs) for visual product understanding in e-commerce is investigated, focusing on two complementary models: ColQwen2 (vidore/colqwen2-v1.0) and ColPali (vidore/colpali-v1.2-hf). These models are integrated into two architectures and evaluated across various [...] Read more.
In this work, the utility of multimodal vision–language models (VLMs) for visual product understanding in e-commerce is investigated, focusing on two complementary models: ColQwen2 (vidore/colqwen2-v1.0) and ColPali (vidore/colpali-v1.2-hf). These models are integrated into two architectures and evaluated across various product interpretation tasks, including image-grounded question answering, brand recognition and visual retrieval based on natural language prompts. ColQwen2, built on the Qwen2-VL backbone with LoRA-based adapter hot-swapping, demonstrates strong performance, allowing end-to-end image querying and text response synthesis. It excels at identifying attributes such as brand, color or usage based solely on product images and responds fluently to user questions. In contrast, ColPali, which utilizes the PaliGemma backbone, is optimized for explainability. It delivers detailed visual-token alignment maps that reveal how specific regions of an image contribute to retrieval decisions, offering transparency ideal for diagnostics or educational applications. Through comparative experiments using footwear imagery, it is demonstrated that ColQwen2 is highly effective in generating accurate responses to product-related questions, while ColPali provides fine-grained visual explanations that reinforce trust and model accountability. Full article
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19 pages, 1408 KiB  
Article
Self-Supervised Learning of End-to-End 3D LiDAR Odometry for Urban Scene Modeling
by Shuting Chen, Zhiyong Wang, Chengxi Hong, Yanwen Sun, Hong Jia and Weiquan Liu
Remote Sens. 2025, 17(15), 2661; https://doi.org/10.3390/rs17152661 (registering DOI) - 1 Aug 2025
Abstract
Accurate and robust spatial perception is fundamental for dynamic 3D city modeling and urban environmental sensing. High-resolution remote sensing data, particularly LiDAR point clouds, are pivotal for these tasks due to their lighting invariance and precise geometric information. However, processing and aligning sequential [...] Read more.
Accurate and robust spatial perception is fundamental for dynamic 3D city modeling and urban environmental sensing. High-resolution remote sensing data, particularly LiDAR point clouds, are pivotal for these tasks due to their lighting invariance and precise geometric information. However, processing and aligning sequential LiDAR point clouds in complex urban environments presents significant challenges: traditional point-based or feature-matching methods are often sensitive to urban dynamics (e.g., moving vehicles and pedestrians) and struggle to establish reliable correspondences. While deep learning offers solutions, current approaches for point cloud alignment exhibit key limitations: self-supervised losses often neglect inherent alignment uncertainties, and supervised methods require costly pixel-level correspondence annotations. To address these challenges, we propose UnMinkLO-Net, an end-to-end self-supervised LiDAR odometry framework. Our method is as follows: (1) we efficiently encode 3D point cloud structures using voxel-based sparse convolution, and (2) we model inherent alignment uncertainty via covariance matrices, enabling novel self-supervised loss based on uncertainty modeling. Extensive evaluations on the KITTI urban dataset demonstrate UnMinkLO-Net’s effectiveness in achieving highly accurate point cloud registration. Our self-supervised approach, eliminating the need for manual annotations, provides a powerful foundation for processing and analyzing LiDAR data within multi-sensor urban sensing frameworks. Full article
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12 pages, 5079 KiB  
Article
Enhancing QoS in Opportunistic Networks Through Direct Communication for Dynamic Routing Challenges
by Ambreen Memon, Aqsa Iftikhar, Muhammad Nadeem Ali and Byung-Seo Kim
Telecom 2025, 6(3), 55; https://doi.org/10.3390/telecom6030055 (registering DOI) - 1 Aug 2025
Abstract
Opportunistic Networks (OppNets) lack the capability to maintain consistent end-to-end paths between source and destination nodes, unlike Mobile Ad Hoc Networks (MANETs). This absence of stable routing presents substantial challenges for data transmission in OppNets. Due to node mobility, routing paths are inherently [...] Read more.
Opportunistic Networks (OppNets) lack the capability to maintain consistent end-to-end paths between source and destination nodes, unlike Mobile Ad Hoc Networks (MANETs). This absence of stable routing presents substantial challenges for data transmission in OppNets. Due to node mobility, routing paths are inherently dynamic, requiring the selection of neighboring nodes as intermediate hops to forward data toward the destination. However, frequent node movement can cause considerable delays for senders attempting to identify appropriate next hops, consequently degrading the quality of service (QoS) in OppNets. To mitigate this challenge, this paper proposes an alternative approach for scenarios where senders cannot locate suitable next hops. Specifically, we propose utilizing direct communication via line of sight (LoS) between sender and receiver nodes to satisfy QoS requirements. The proposed scheme is experimented with using the ONE simulator, which is widely used for OppNet experiments and study, and compared against existing schemes such as the history-based routing protocol (HBRP) and AEProphet routing protocol. Full article
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9 pages, 911 KiB  
Brief Report
Evaluation of a Febrile Neutropenia Protocol Implemented at Triage in an Emergency Department
by Stefanie Stramel-Stafford, Heather Townsend, Brian Trimmer, James Cohen and Jessica Thompson
Medicines 2025, 12(3), 20; https://doi.org/10.3390/medicines12030020 - 1 Aug 2025
Abstract
Objective: The impact of a febrile neutropenia (FN) emergency department (ED) triage screening tool and protocol on time to antibiotic administration (TTA) and patient outcomes was evaluated. Methods: This was a retrospective, quasi-experimental study of adult FN patients admitted through the ED from [...] Read more.
Objective: The impact of a febrile neutropenia (FN) emergency department (ED) triage screening tool and protocol on time to antibiotic administration (TTA) and patient outcomes was evaluated. Methods: This was a retrospective, quasi-experimental study of adult FN patients admitted through the ED from April 2014 to April 2017. In March 2016 a triage screening tool and protocol were implemented. In patients who screened positive, nursing initiated a protocol that included laboratory diagnostics and a pharmacy consult for empiric antibiotics prior to evaluation by a provider. Patients were evaluated pre- and post-protocol for TTA, 30-day mortality, ED length of stay (LOS), and hospital LOS. Results: A total of 130 patients were included in the study, 77 pre-protocol and 53 post-protocol. Median TTA was longer in the pre-protocol group at 174 min (interquartile range [IQR] 105–224) vs. 109 min (IQR 71–214) post-protocol, p = 0.04. Thirty-day mortality was greater at 18.8% pre-protocol vs. 7.5% post-protocol, p = 0.12. There was no difference in hospital LOS. Pre-protocol patients compared to post-protocol patients who had a pharmacy consult demonstrated a further reduction in TTA (174 min [IQR 105–224] vs. 87.5 min [IQR 61.5–135], p < 0.01) and a reduced mortality (18% vs. 0%, p = 0.04). Conclusions: To our knowledge, this is the first report of a protocol for febrile neutropenia that allows pharmacists to order antibiotics based on a nurse triage assessment. Evaluation of the protocol demonstrated a significant reduction in TTA and trend toward improved mortality. Full article
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30 pages, 4409 KiB  
Article
Accident Impact Prediction Based on a Deep Convolutional and Recurrent Neural Network Model
by Pouyan Sajadi, Mahya Qorbani, Sobhan Moosavi and Erfan Hassannayebi
Urban Sci. 2025, 9(8), 299; https://doi.org/10.3390/urbansci9080299 (registering DOI) - 1 Aug 2025
Abstract
Traffic accidents pose a significant threat to public safety, resulting in numerous fatalities, injuries, and a substantial economic burden each year. The development of predictive models capable of the real-time forecasting of post-accident impact using readily available data can play a crucial role [...] Read more.
Traffic accidents pose a significant threat to public safety, resulting in numerous fatalities, injuries, and a substantial economic burden each year. The development of predictive models capable of the real-time forecasting of post-accident impact using readily available data can play a crucial role in preventing adverse outcomes and enhancing overall safety. However, existing accident predictive models encounter two main challenges: first, a reliance on either costly or non-real-time data, and second, the absence of a comprehensive metric to measure post-accident impact accurately. To address these limitations, this study proposes a deep neural network model known as the cascade model. It leverages readily available real-world data from Los Angeles County to predict post-accident impacts. The model consists of two components: Long Short-Term Memory (LSTM) and a Convolutional Neural Network (CNN). The LSTM model captures temporal patterns, while the CNN extracts patterns from the sparse accident dataset. Furthermore, an external traffic congestion dataset is incorporated to derive a new feature called the “accident impact” factor, which quantifies the influence of an accident on surrounding traffic flow. Extensive experiments were conducted to demonstrate the effectiveness of the proposed hybrid machine learning method in predicting the post-accident impact compared to state-of-the-art baselines. The results reveal a higher precision in predicting minimal impacts (i.e., cases with no reported accidents) and a higher recall in predicting more significant impacts (i.e., cases with reported accidents). Full article
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13 pages, 1809 KiB  
Perspective
Specific Low/Endogenous Replication Stress Response Protects Genomic Stability via Controlled ROS Production in an Adaptive Way and Is Dysregulated in Transformed Cells
by Bernard S. Lopez
Cells 2025, 14(15), 1183; https://doi.org/10.3390/cells14151183 - 31 Jul 2025
Abstract
Cells are assaulted daily by stresses that jeopardize genome integrity. Primary human cells adapt their response to the intensity of replication stress (RS) in a diphasic manner: below a stress threshold, the canonical DNA damage response (cDDR) is not activated, but a noncanonical [...] Read more.
Cells are assaulted daily by stresses that jeopardize genome integrity. Primary human cells adapt their response to the intensity of replication stress (RS) in a diphasic manner: below a stress threshold, the canonical DNA damage response (cDDR) is not activated, but a noncanonical cellular response, low-level stress-DDR (LoL-DDR), has recently been described. LoL-DDR prevents the accumulation of premutagenic oxidized bases (8-oxoguanine) through the production of ROS in an adaptive way. The production of RS-induced ROS (RIR) is tightly controlled: RIR are excluded from the nucleus and are produced by the NADPH oxidases DUOX1/DUOX2, which are controlled by NF-κB and PARP1; then, RIR activate the FOXO1-detoxifying pathway. Increasing the intensity of RS suppresses RIR via p53 and ATM. Notably, LoL-DDR is dysregulated in cancer cell lines, in which RIR are not produced by NADPH oxidases, are not detoxified under high-level stress, and favor the accumulation of 8-oxoguanine. LoL-DDR dysregulation occurred at an early stage of cancer progression in an in vitro model. Since, conversely, ROS trigger RS, this establishes a vicious cycle that continuously jeopardizes genome integrity, fueling tumorigenesis. These data reveal a novel type of ROS-controlled DNA damage response and demonstrate the fine-tuning of the cellular response to stress. The effects on genomic stability and carcinogenesis are discussed here. Full article
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29 pages, 3400 KiB  
Article
Synthetic Data Generation for Machine Learning-Based Hazard Prediction in Area-Based Speed Control Systems
by Mariusz Rychlicki and Zbigniew Kasprzyk
Appl. Sci. 2025, 15(15), 8531; https://doi.org/10.3390/app15158531 (registering DOI) - 31 Jul 2025
Abstract
This work focuses on the possibilities of generating synthetic data for machine learning in hazard prediction in area-based speed monitoring systems. The purpose of the research conducted was to develop a methodology for generating realistic synthetic data to support the design of a [...] Read more.
This work focuses on the possibilities of generating synthetic data for machine learning in hazard prediction in area-based speed monitoring systems. The purpose of the research conducted was to develop a methodology for generating realistic synthetic data to support the design of a continuous vehicle speed monitoring system to minimize the risk of traffic accidents caused by speeding. The SUMO traffic simulator was used to model driver behavior in the analyzed area and within a given road network. Data from OpenStreetMap and field measurements from over a dozen speed detectors were integrated. Preliminary tests were carried out to record vehicle speeds. Based on these data, several simulation scenarios were run and compared to real-world observations using average speed, the percentage of speed limit violations, root mean square error (RMSE), and percentage compliance. A new metric, the Combined Speed Accuracy Score (CSAS), has been introduced to assess the consistency of simulation results with real-world data. For this study, a basic hazard prediction model was developed using LoRaWAN sensor network data and environmental contextual variables, including time, weather, location, and accident history. The research results in a method for evaluating and selecting the simulation scenario that best represents reality and drivers’ propensities to exceed speed limits. The results and findings demonstrate that it is possible to produce synthetic data with a level of agreement exceeding 90% with real data. Thus, it was shown that it is possible to generate synthetic data for machine learning in hazard prediction for area-based speed control systems using traffic simulators. Full article
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26 pages, 3012 KiB  
Perspective
The Palisades Fire of Los Angeles: Lessons to Be Learned
by Vytenis Babrauskas
Fire 2025, 8(8), 303; https://doi.org/10.3390/fire8080303 (registering DOI) - 31 Jul 2025
Abstract
In 1961, Los Angeles experienced the disastrous Bel Air fire, which swept through an affluent neighborhood situated in a hilly, WUI (wildland–urban interface) location. In January 2025, the city was devastated again by a nearly-simultaneous series of wildfires, the most severe of which [...] Read more.
In 1961, Los Angeles experienced the disastrous Bel Air fire, which swept through an affluent neighborhood situated in a hilly, WUI (wildland–urban interface) location. In January 2025, the city was devastated again by a nearly-simultaneous series of wildfires, the most severe of which took place close to the 1961 fire location. Disastrous WUI fires are, unfortunately, an anticipatable occurrence in many U.S. cities. A number of issues identified earlier remained the same. Some were largely solved, while other new ones have emerged. The paper examines the Palisades Fire of January, 2025 in this context. In the intervening decades, the population of the city grew substantially. But firefighting resources did not keep pace. Very likely, the single-most-important factor in causing the 2025 disasters is that the Los Angeles Fire Department operational vehicle count shrank to 1/5 of what it was in 1961 (per capita). This is likely why critical delays were experienced in the initial attack on the Palisades Fire, leading to a runaway conflagration. Two other crucial issues were the management of vegetation and the adequacy of water supplies. On both these issues, the Palisades Fire revealed serious problems. A problem which arose after 1961 involves the unintended consequences of environmental legislation. Communities will continue to be devastated by wildfires unless adequate vegetation management is accomplished. Yet, environmental regulations are focused on maintaining the status quo, often making vegetation management difficult or ineffective. House survival during a wildfire is strongly affected by whether good vegetation management practices and good building practices (“ignition-resistant” construction features) have been implemented. The latter have not been mandatory for housing built prior to 2008, and the vast majority of houses in the area predated such building code requirements. California has also suffered from a highly counterproductive stance on insurance regulation. This has resulted in some residents not having property insurance, due to the inhospitable operating conditions for insurance firms in the state. Because of the historical precedent, the details in this paper focus on the Palisades Fire; however, many of the lessons learned apply to managing fires in all WUI areas. Policy recommendations are offered, which could help to reduce the potential for future conflagrations. Full article
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19 pages, 3297 KiB  
Article
Secrecy Rate Maximization via Joint Robust Beamforming and Trajectory Optimization for Mobile User in ISAC-UAV System
by Lvxin Xu, Zhi Zhang and Liuguo Yin
Drones 2025, 9(8), 536; https://doi.org/10.3390/drones9080536 - 30 Jul 2025
Viewed by 96
Abstract
Unmanned aerial vehicles (UAVs) have emerged as a promising platform for integrated sensing and communication (ISAC) due to their mobility and deployment flexibility. By adaptively adjusting their flight trajectories, UAVs can maintain favorable line-of-sight (LoS) communication links and sensing angles, thus enhancing overall [...] Read more.
Unmanned aerial vehicles (UAVs) have emerged as a promising platform for integrated sensing and communication (ISAC) due to their mobility and deployment flexibility. By adaptively adjusting their flight trajectories, UAVs can maintain favorable line-of-sight (LoS) communication links and sensing angles, thus enhancing overall system performance in dynamic and complex environments. However, ensuring physical layer security (PLS) in such UAV-assisted ISAC systems remains a significant challenge, particularly in the presence of mobile users and potential eavesdroppers. This manuscript proposes a joint optimization framework that simultaneously designs robust transmit beamforming and UAV trajectories to secure downlink communication for multiple ground users. At each time slot, the UAV predicts user positions and maximizes the secrecy sum-rate, subject to constraints on total transmit power, multi-target sensing quality, and UAV mobility. To tackle this non-convex problem, we develop an efficient optimization algorithm based on successive convex approximation (SCA) and constrained optimization by linear approximations (COBYLA). Numerical simulations validate that the proposed framework effectively enhances the secrecy performance while maintaining high-quality sensing, achieving near-optimal performance under realistic system constraints. Full article
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19 pages, 6032 KiB  
Article
Recombinant Human Annexin A5 Ameliorates Localized Scleroderma by Inhibiting the Activation of Fibroblasts and Macrophages
by Bijun Kang, Zhuoxuan Jia, Wei Li and Wenjie Zhang
Pharmaceutics 2025, 17(8), 986; https://doi.org/10.3390/pharmaceutics17080986 (registering DOI) - 30 Jul 2025
Viewed by 116
Abstract
Background: Localized scleroderma (LoS) is a chronic autoimmune condition marked by cutaneous fibrosis and persistent inflammation. Modulating the activation of inflammatory cells and fibroblasts remains a central strategy in LoS treatment. We investigate the anti-fibrotic effects of Annexin A5 (AnxA5), identified as [...] Read more.
Background: Localized scleroderma (LoS) is a chronic autoimmune condition marked by cutaneous fibrosis and persistent inflammation. Modulating the activation of inflammatory cells and fibroblasts remains a central strategy in LoS treatment. We investigate the anti-fibrotic effects of Annexin A5 (AnxA5), identified as a key inflammatory component in fat extract, and assess its therapeutic efficacy. Methods: In vitro experiments were performed using TGF-β-stimulated primary human dermal fibroblasts treated with recombinant AnxA5. The anti-fibrotic effects and underlying mechanisms were assessed using CCK-8 assays, quantitative real-time PCR, Western blotting, and immunocytochemistry. In vivo, AnxA5 was administered via both preventative and therapeutic protocols in bleomycin-induced LoS mouse models. Treatment outcomes were evaluated by histological staining, collagen quantification, immunostaining, and measurement of pro-inflammatory cytokines. Results: TGF-β stimulation induced myofibroblast differentiation and extracellular matrix (ECM) production in dermal fibroblasts, both of which were significantly attenuated by AnxA5 treatment through the inhibition of phosphorylation of Smad2. In vivo, both preventative and therapeutic administration of AnxA5 effectively reduced dermal thickness, collagen deposition, ECM accumulation, M1 macrophage infiltration, and levels of pro-inflammatory cytokines. Conclusions: Through both preventative and therapeutic administration, AnxA5 ameliorates LoS by exerting dual anti-fibrotic and anti-inflammatory effects, underscoring its potential for treating fibrotic diseases. Full article
(This article belongs to the Section Biopharmaceutics)
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15 pages, 826 KiB  
Article
Composite RAI, Malnutrition, and Anemia Model Superiorly Predicts 30-Day Morbidity and Mortality After Surgery for Adult Spinal Deformity
by Aladine A. Elsamadicy, Paul Serrato, Shaila D. Ghanekar, Justice Hansen, Ethan D. L. Brown, Syed I. Khalid, Daniel Schneider, Sheng-fu Larry Lo and Daniel M. Sciubba
J. Clin. Med. 2025, 14(15), 5379; https://doi.org/10.3390/jcm14155379 - 30 Jul 2025
Viewed by 163
Abstract
Background/Objective: This study examines the composite influence of frailty, malnutrition, and anemia on postoperative outcomes for patients with adult spinal deformity (ASD). Methods: In this retrospective cohort study using the 2011–2022 NSQIP database, we utilized CPT and ICD codes to identify ASD patients [...] Read more.
Background/Objective: This study examines the composite influence of frailty, malnutrition, and anemia on postoperative outcomes for patients with adult spinal deformity (ASD). Methods: In this retrospective cohort study using the 2011–2022 NSQIP database, we utilized CPT and ICD codes to identify ASD patients who underwent PSF. Subjects were stratified based on frailty status. Frail patients were then classified according to malnutrition and anemia status. Frailty was determined using the revised risk analysis index (RAI-rev). Our primary outcomes were extended length of stay (LOS), non-routine discharge (NRD), 30-day adverse events (AE), and 30-day mortality. For each outcome, we fitted four nested multivariable logistic regression models (RAI-rev + anemia + malnutrition, RAI-rev + anemia, RAI-rev + malnutrition, and RAI-rev alone) and compared the incremental discrimination of each model using receiver operating characteristic (ROC) analysis. Results: Of 3639 patients, 460 were frail alone, 266 were frail + anemic, 37 were frail + malnourished, 121 were frail + anemic + malnourished, and 2755 were not frail. RAI-rev (aOR: 1.84, 95% CI: 1.45–2.35), anemia (aOR: 1.84, 95% CI: 1.45–2.35), and malnourishment (aOR: 2.34, 95% CI: 1.69–3.24) were independent predictors of extended LOS. RAI-rev (aOR: 1.07, 95% CI: 1.04–1.11) and anemia (aOR: 2.09, 95% CI: 1.66–2.61) were associated with an increased risk of 30-day AEs. RAI-rev and malnutrition were independent predictors of NRD (RAI-rev: aOR: 1.11, 95% CI: 1.06–1.16; Malnutrition: aOR: 1.57, 95% CI: 1.08–2.29) and 30-day mortality (RAI-rev: aOR: 1.10, 95% CI: 1.04–1.17; Malnutrition: aOR: 3.79, 95% CI: 1.24–11.60). Based on ROC analysis, RAI-rev + anemic + malnourished was a superior predictor of LOS and 30-day AEs (both p < 0.001). Compared to RAI-rev, RAI-rev + anemic superiorly predicted LOS and 30-day AEs, and RAI-rev + malnutrition superiorly predicted LOS (all p < 0.001). Conclusions: Our results reveal RAI-rev combined with malnutrition and anemia superiorly predicts 30-day AEs and LOS in postoperative ASD patients. Future studies should investigate the feasibility and efficacy of these models for perioperative risk stratification and optimized recovery planning to improve outcomes for ASD patients. Full article
(This article belongs to the Section Orthopedics)
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11 pages, 996 KiB  
Article
The Prognostic Value of Non-Invasive Ventilation in Patients with Acute Heart Failure
by Pietro Scicchitano, Assunta Cinelli, Gaetano Citarelli, Anna Livrieri, Cosimo Campanella, Micaela De Palo, Pasquale Caldarola, Marco Matteo Ciccone and Francesco Massari
Biomedicines 2025, 13(8), 1844; https://doi.org/10.3390/biomedicines13081844 - 29 Jul 2025
Viewed by 214
Abstract
Objectives: Patients with acute heart failure (AHF) often receive initial non-invasive ventilation (NIV). This study aimed to evaluate the prognostic role of NIV in patients hospitalized for AHF. Methods: This was a retrospective cohort study. We enrolled patients admitted to our cardiac intensive [...] Read more.
Objectives: Patients with acute heart failure (AHF) often receive initial non-invasive ventilation (NIV). This study aimed to evaluate the prognostic role of NIV in patients hospitalized for AHF. Methods: This was a retrospective cohort study. We enrolled patients admitted to our cardiac intensive care unit with a diagnosis of AHF. Anthropometric, clinical, pharmacological, and instrumental assessments were collected. Both in-hospital and 180-day post-discharge mortality were evaluated. Results: Among 200 patients (mean age 81 ± 9 years; 52% male), NIV was applied in 80 cases (40%). These patients had more severe NYHA functional class, a higher prevalence of de novo AHF, required higher diuretic doses, and had longer hospital stays. In multivariate analysis, NIV remained significantly associated with length of stay (LOS) (r = 0.26; p = 0.0004). In-hospital mortality was 5% overall and significantly higher in the NIV group compared to non-NIV patients (10% vs. 1.6%, p < 0.001). At 180 days, mortality was also significantly higher in the NIV group [hazard ratio (HR) 1.84; 95% confidence interval (CI): 1.18–2.85; p = 0.006]. After adjusting for age, BNP, CRP, arterial blood gas parameters, renal function, and LVEF, NIV remained an independent predictor of 180-day mortality (HR 1.61; 95% CI: 1.01–2.54; p = 0.04). Conclusions: Patients with AHF who required NIV exhibited more severe disease and longer hospital stays. NIV use was independently associated with both in-hospital and post-discharge mortality, suggesting its potential role as a prognostic marker in AHF. Full article
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