Search Results (3,596)

High-frequency surface wave radar (HFSWR) often suffers from highly non-uniform, striped ionospheric clutter, which significantly degrades sea-surface target detection performance. To address this challenge, this paper proposes a reduced-dimension space-time adaptive processing (STAP) algorithm based on sparse representation. In this method, a dictionary is first constructed using the Doppler resolution and an appropriate angle interval as the frequency and angle grids, aiming to obtain fully orthogonal clutter atoms. Both the training sample and the cell under test are then sparsely represented over this dictionary to extract consistent clutter atoms. Due to discrepancies between the dictionary atoms and the actual clutter, low-power atoms are deemed unreliable and are discarded via a thresholding procedure. The remaining reliable atoms are used to construct a dimensionality-reduction matrix, thereby obtaining an accurate local clutter-plus-noise covariance matrix. Experimental results on measured data demonstrate that the proposed method effectively suppresses striped ionospheric clutter and enhances target detection performance. Full article

The aim of this study is to conduct a comprehensive assessment of the water quality of the Sidi Mohammed Ben Taiba (SMBT), one of the largest drinking water reservoirs in northwestern Algeria, by integrating chemical and biological indicators. The assessment combines the Drinking Water Quality Index (DWQI), the Irrigation Water Quality Index (IWQI), the Organic Pollution Index (OPI) and zooplankton-based biological indicators (Zoo-IQ). A total of 23 physicochemical parameters were analyzed and interpreted using multivariate statistical approaches. This study fills an important knowledge gap by evaluating long-term temporal variability (January 2018–May 2025) and recent spatial heterogeneity (June 2023–May 2025), aiming to support sustainable water management. The results indicate that the reservoir water quality is generally suitable for drinking purposes (22.3 < DWQI < 54.0), is deemed excellent for agricultural irrigation (65 < IWQI < 69) and that the reservoir surface waters are slightly polluted to unpolluted (0.3 < OPI < 1.1). However, a deterioration in water quality has been detected in recent years, linked to increasing nutrient concentrations, as confirmed by the TSI–SD index. Despite the early signs of nutrient enrichment, the Zoo-IQ index remained within the moderate to good range, suggesting a certain degree of resilience in the zooplankton community. However, pronounced seasonal fluctuations observed in the Zoo-IQ and species diversity (H′) during periods of environmental stress serve as an early warning signal of emerging problems that may negatively affect water quality indices (WQI, IWQI, OPI). Station S4, located at the confluence of Wadi Belhassen and Wadi Farhat, descending from the Dahra mountain range in Algeria, has been identified as the most sensitive area and a potential hotspot for future pollution. The study provides robust data on the quality of reservoir water, offering a valuable decision-making tool for artificial reservoir managers and contributing to sustainable water management by identifying risk areas and supporting the implementation of preventive measures. Full article

Measurable residual disease (MRD) is the most powerful predictor of relapse and long-term survival in adult acute lymphoblastic leukemia (ALL), consistently outperforming traditional clinical and cytogenetic risk factors. The advent of high-sensitivity next-generation sequencing (NGS) capable of detecting MRD at 10⁻⁶ has transformed monitoring, reclassifying a substantial proportion of patients previously deemed negative by multiparameter flow cytometry (MFC) or quantitative PCR (qPCR), and revealing clinically relevant disease persistence at ultra-low levels. This review synthesizes current MRD detection platforms and their clinical applications across frontline therapy, allogeneic hematopoietic cell transplantation, and relapsed/refractory disease with specific focus on B-ALL. We integrate the 2024 European LeukemiaNet (ELN) and the 2025 US expert panel recommendations, highlighting important differences in preferred methodologies and decision thresholds. Particular attention is given to the emerging role of early deep NGS negativity in guiding transplant deferral among selected standard-risk patients, including some with Ph+ ALL treated with chemotherapy-free regimens, and to the challenges of interpreting persistent low-level positivity (10⁻⁴–10⁻⁶). Despite technological advances, key questions remain: when should deeper detection trigger therapeutic escalation, and how should discordance between modalities, peripheral blood monitoring, and subtype-specific variability be interpreted? Addressing these issues through prospective validation, platform harmonization, and broader global access will be essential to ensure that increasing sensitivity translates into evidence-based, equitable clinical benefit. Full article

(1) Background: Hypofractionated radiotherapy and immunotherapy (IT) are possible treatment options for HNSCC patients unsuitable for standard curative treatment, yet no high-level evidence supports their combined use. We aim to report on the clinical outcome of a single-center cohort of HNSCC patients treated with a hypofractionated radiotherapy (hypoRT) regimen in combination with IT alone or chemo-immunotherapy (CT-IT). (2) Methods: We enrolled a cohort of elderly and frail HNSCC patients unsuitable for standard curative treatment, deemed candidates to undergo hypoRT in a sequential strategy (time interval < 6 months), followed or preceded by IT alone (hypoRT_IT) or CT-IT. We selected our sample using the Geriatric 8 (G8) score and the Charlson Comorbidity Index (CCI). (3) Results: At a median follow-up of 11 months (IQR 5–20), the median locoregional control (LRC) was 12 months (95% CI 7.0–17.1) with a 1-year progression-free survival rate of 63%. For the hypoRT-IT group, the median overall survival was 12 months (95% CI 0–24). No grade (G) 4–5 in-field acute side effects were observed, while one case of G3 oral mucositis and two cases of G3 radiation dermatitis were reported. (4) Conclusions: A sequential combination of checkpoint inhibitors and hypoRT may provide clinical benefit with acceptable toxicity in frail and elderly patients with advanced HNSCC unfit for standard therapy. Full article

Three–dimensional excitation–emission matrix (3D–EEM) fluorescence spectroscopy is widely applied for the rapid characterization of dissolved organic matter (DOM) in aquatic environments. However, conventional decomposition based on parallel factor analysis (PARAFAC) requires multiple spectra and manual intervention, limiting its applicability for rapid analysis and future online implementation. The purpose of this study is to develop an efficient data–driven method capable of decomposing fluorescence components from a single 3D–EEM spectrum. We propose a conditional single–spectrum decomposition network (CSSD–Net) based on the encoder–decoder model. The encoder extracts fluorescence features from the input spectrum, while the decoder combines these features with conditional information on component count to generate up to five component maps. The component count can be automatically predicted by CSSD–Net or manually specified to support flexible application scenarios. CSSD–Net was trained using publicly available component spectra from the OpenFluor database without PARAFAC preprocessing. Validation on natural water samples demonstrates that the results obtained from CSSD–Net using a single sample are highly consistent with those from PARAFAC using multiple parallel samples, with a mean Tucker’s congruence coefficient (TCC) of 0.9615. These results show that CSSD–Net provides a fast and practical solution for decomposing single 3D–EEM spectra under constrained aquatic scenarios, and it has potential for future near–real–time and in situ applications. Full article

Background/Objectives: Total neoadjuvant therapy (TnT) has emerged as a treatment option for locally advanced rectal cancer. Few studies have evaluated specifically the use of chemotherapy and short-course radiation therapy (SCRT) in obtaining a complete clinical response (cCR) or near-complete clinical response (nCR) and offering non-operative management (NOM). This phase II study sequences FOLFOX followed by SCRT with the primary aim of evaluating the rate of cCR or nCR. Methods: Treatment-naïve adults with non-metastatic clinical T2-3N0 or T1-3 with N1-2a rectal adenocarcinoma deemed candidates for total mesorectal excision (TME) were eligible for this open-label, single-arm clinical trial. This trial evaluated TnT with 5-fluorouracil, leucovorin and oxaliplatin (mFOLFOX6) followed by SCRT. The primary endpoint was the rate of cCR or nCR. Those with cCR or nCR after TnT were offered NOM and close surveillance; all others underwent TME. Secondary endpoints included 1-year disease-free survival (DFS), overall survival (OS), and R0 surgical resection rate. Results: Twelve patients of a planned 40 were enrolled with a median follow-up duration of 4.1 years. The study was closed early after results of the OPRA trial suggested a benefit of sequencing radiation prior to chemotherapy when seeking organ preservation. Four of the twelve patients (33%, 95% CI = (9.9%, 65.1%)) achieved cCR or nCR after TnT and underwent NOM; one patient had local regrowth 5.5 months after the completion of TnT and underwent TME. All four were free of disease at time of analysis. The 1-year DFS was 100%. The median OS was not reached. All surgical resections were R0 with no local recurrence after TME. Conclusions: This paper suggests that TnT with FOLFOX followed by SCRT is a safe and effective approach for treating locally advanced rectal cancer. This approach can be considered in select patients. The 33% of patients offered NOM is lower than the published 74% in OPRA, however, suggesting that chemotherapy followed by SCRT may not be the most optimal approach if organ preservation is the primary treatment aim. Full article

Background and Objectives: Cardiovascular disorders contribute substantially to medical ineligibility for compulsory military service in Lithuania. This study aimed to describe cardiovascular disease patterns and assess their association with military service eligibility among conscription-age individuals treated at a tertiary care center, considering gender, place of residence, age, and the most common cardiovascular causes of medical ineligibility. Materials and Methods: This retrospective hospital-based study included men and women aged 18–26 years with cardiovascular disease diagnoses defined according to ICD-10 codes specified by the Order of the Minister of National Defense of the Republic of Lithuania. Anonymized medical records from the Hospital of the Lithuanian University of Health Sciences Kaunas Clinics were reviewed. Participants were categorized into four military service eligibility classes based on medical history data and were stratified by gender, age, and place of residence. Results: The study included 521 participants (56.6% male, 43.4% female). Gender and residence showed no significant impact on military service eligibility. Younger individuals, particularly those aged 18–19, were more often deemed eligible, while eligibility declined with age. Males more commonly had essential hypertension and hypertensive heart disease, whereas females more frequently presented with paroxysmal tachycardia and other arrhythmias. Hypertension and other severe cardiovascular conditions most strongly reduced eligibility for compulsory military service, whereas rhythm disorders were more often compatible with service. Conclusions: In this hospital-based cohort of conscription-age individuals with cardiovascular disease, gender and place of residence did not significantly influence eligibility for military service. Eligibility declined with increasing age, and hypertension-related cardiovascular disorders were the leading cause of ineligibility among conscripts. Full article

In rural South Africa, many households lack access to clean and reliable water sources and are therefore forced to rely on contaminated sources for their daily needs. This study presents the design of a manually operated hand water pump with an integrated filtration system. The design makes use of a double-acting cylinder and is optimized for a 50 m static lift, as this depth provides an optimal balance between structural integrity and ergonomic limits. SolidWorks Flow Simulations 2020 and numerical analysis show that the system overcomes a dynamic head of 51.44 m and a pump pressure of 503,063.62 Pa while maintaining a mechanical advantage of 4.8. Through the use of anthropometric data, a crank radius of 0.396 m was deemed optimal, resulting in a peak hand force of 158.38 N. This design proves that deep well water extraction can be achieved without any compromise to user ergonomics. By integrating filtration, unlike existing designs, this pump offers a practical solution for the water challenges faced in rural communities. Full article

It is well established that an anti-intrusion beam is a passive safety system that serves an essential role for passengers during collisions. In this study, the influence of internal reinforcements on the bending failure of a cylindrical aluminum tube was systematically investigated through a series of composite beam tests. Polymeric materials, including cast polyamide (PA6) and polypropylene (PP), with varying wall thicknesses, were deemed suitable for use as the inner reinforcement of the Al 6063-T6 tube. The test setup, which simulates impact conditions experienced by structural components in full-scale crash tests, is a powerful tool for the bending impacts in the study. To describe the connection between bending impact and quasi-static loading of composite beams, each method is compared to clarify the composite’s failure behavior. An explicit Finite Element Analysis (FEA) of impact scenarios has been performed to understand the deformation behavior of polymer-reinforced composites and to determine the absorbed impact energy, thereby clarifying which specimen is better able to absorb bending impact energy. Primarily, three polymer-reinforced specimens were accepted with a hollow Al tube. After initial tests and simulations, the expected parametric study could not be achieved except for one. Then, three more combinations were offered. For one of the three specimens, the thickness of the central reinforcement PP was increased until a fully developed shaft was produced, resulting in better-than-expected bending impact-absorbing performance. The results indicate that the energy level of the inner reinforcements with polymeric materials increased 8.8 times, to about 750 J, compared to the plain Al tube (85 J) under bending impact loads. The numerical simulations are relevant and reliable for the details of the specimens’ impact process and show good agreement with the experimental results. Finally, depending on the content, this research, rather than focusing on the fundamental concept of polymer-reinforced aluminum crash tubes, focuses on the specific dynamic bending impact evaluation of the Al, PA6, and PP configuration and the design insight that hollow PP reinforcement can accelerate fracture. In contrast, a fully filled PP core inside a PA6 sleeve can suppress splitting and substantially improve impact energy absorption. Full article

Background/Objectives: Recently the European Association of Urology (EAU) guidelines presented the EAU Guidelines bot to assist urologists in the reading of the guidelines; however, there is a lack of up-to-date external validation. The aim of our study is to assess the accuracy, completeness, and clarity of the guidelines bot in urethral strictures. Methods: A total of 117 questions based on the EAU urethral strictures guidelines recommendations were developed. Each question was input to the EAU guidelines bot and the response was assessed by two expert urologists to assess the accuracy, completeness, and clarity. Moreover, 10 simple clinical cases were input. A 5-point Likert scale was used as a score and, in case of discrepancies, a third urologist was queried. Accuracy, completeness and clarity were assessed per chapter and per grade of recommendation. All questions and answers were recorded in an Excel file. Results: Overall 117 questions were developed. In terms of accuracy, 111/117 (95%) were defined as accurate (scores 4–5), 4/117 (3%) presented a fair accuracy (score 3), and 2/117 (2%) were deemed not accurate. In terms of completeness, 93/117 (80%) were defined as complete (scores 4–5), 22/117 (19%) presented a fair completeness (score 3), and 2/117 (2%) were deemed not complete. Finally, in terms of clarity, 104/117 (89%) were defined as clear (scores 4–5), 13/117 (11%) presented a fair clarity (score 3), and 0/109 (0%) were deemed not clear. When comparing strong and weak recommendations, no differences were recorded. Overall the answers to simple clinical cases were in line with the guidelines with good accuracy, completeness and clarity scores. Conclusions: The EAU guidelines bot represents an accurate tool for urethral stenosis guidelines. Some fine-tuning is needed to improve readability and clarity. Full article

Objective: To report a rare case of pulp space tissue growth in a mature mandibular molar with severe endo-periodontal involvement after conservative endodontic treatment and to discuss the possible biological explanations, including regeneration and granulation tissue healing. Severe endo-periodontal lesions are challenging, particularly as endodontic regeneration is usually observed in immature teeth, while revascularization in mature teeth, especially in cases of advanced periodontal disease, is rare, as demonstrated in this case. Methods: This study reports a rare case of tissue regeneration versus granulation tissue healing in the pulp space, occurring alongside periodontal healing, in a mature mandibular molar with necrotic pulp and severe periodontal involvement. A 52-year-old patient presented with a mature mandibular molar (tooth #19) exhibiting necrotic pulp with severe endo-periodontal involvement, including grade-3 mobility, tenderness to percussion, a 12 mm probing depth, and extensive periradicular radiolucency. The tooth was diagnosed with necrotic pulp and symptomatic apical periodontitis and was deemed hopeless, with extraction planned. Results: Following patient refusal, endodontic treatment was initiated, including cleaning, shaping, and placement of the intracanal medicament, Ledermix. The patient canceled the extraction due to symptom resolution and disappeared for 12 months. On return, the patient presented with spontaneous pain exacerbated by thermal stimuli, consistent with symptoms of irreversible pulpitis. Clinical examination revealed significant clinical and radiographic improvements, including reduced probing depth (3 mm), no mobility, resolution of apical translucency, radiographic findings suggestive of canal narrowing, and a positive pulp sensibility response. Re-entry elicited profuse bleeding with newly formed vital tissue beneath the medicament. Sodium hypochlorite irrigation failed to achieve hemostasis; inflamed tissue was removed; root canals were cleaned, shaped and obturated; and treatment was completed with placement of a permanent coronal resin composite restoration. A forty-month follow-up showed an asymptomatic tooth with clinical and radiographic healing. Conclusions: This case demonstrates that conservative endodontic management may result in favorable clinical and radiographic outcomes in mature teeth with severe endo-peroidontal involvement, influencing extraction decisions. It provides clinical evidence suggestive of tissue regeneration and periodontal healing in a mature tooth with necrotic pulp and severe periodontal compromise, challenging conventional prognosis. The observed pulp space tissue growth may be suggestive of regeneration; however, alternative explanations, including granulation tissue healing or repair processes, cannot be excluded. Healing by granulation tissue in the pulp space remains possible. Root canal treatment in advanced endo-perio lesions can yield favorable outcomes and may influence extraction decisions. Further clinical and histological studies are needed to clarify underlying mechanisms and optimize treatment strategies. Full article

Reproductive genetic carrier screening (RGCS) is recommended preconceptionally or early pregnancy to identify the risk of autosomal recessive (AR) disorders in healthy couples. Data on shared carrier status at the couple’s level remains limited in Eastern Europe. This study presents the first couple-based RGCS analysis in Western Romania. We retrospectively analyzed RGCS results from 247 couples with no known consanguinity at the time of evaluation (494 apparently unrelated individuals, aged 22–52 years), assessed at a single genetic center between 2020–2024. Next-generation sequencing was performed using an expanded panel targeting 302 genes, including 300 genes associated with AR onset disorders. This analysis was accompanied by both pre- and post-test genetic counseling. The prevalence of individual and shared carrier status and reproductive risk was assessed. Pathogenic or likely pathogenic (PLP) variants were identified in the study cohort, with an overall couple carrier frequency of 64.37%. Shared carrier status for PLP variants in the same gene was identified in 17.4%, including three couples carrying pathogenic variants in two shared genes. Additionally, 46.96% of couples carried pathogenic variants in different genes without overlapping. The most frequently shared genes with PLP variants were HFE, CFTR, SMN1, BTD, and COL7A1; 14 additional shared genes with PLP variants were associated with severe, early-onset disorders. Forty-three couples were deemed high risk for AR conditions. Their reproductive choices varied, including in vitro fertilization or proceeding with pregnancy with or without prenatal testing. Couple-based RGCS revealed a substantial burden of shared AR carrier status in Western Romania, supporting the implementation of population-level screening programs to improve reproductive risk assessment and informed decision-making. Full article

Ambient heat exposure reduces male fertility in mammals with scrotal testes. Our previous work has demonstrated that some stallions are more susceptible to ambient heat-related subfertility than others, yet the mechanism for heat-induced subfertility remains uncertain, limiting both diagnosis and preventative measures. This study sought to define how the phenotype of stallions susceptible to heat-induced subfertility differs from that of more resilient animals, by measuring the systemic (blood plasma) and localized (reproductive tract) inflammatory and oxidative stress markers of sperm concentration, sperm motility assessments, total antioxidant capacity (TAC; in blood and seminal plasma), malondialdehyde (MDA; in blood and seminal plasma), oxidized guanine species (8-OH-2dG; in blood plasma and spermatozoa DNA), sperm DNA damage (assessed via Halo, SCSA (Sperm Chromatin Structure Assay) and CMA3 (Chromomycin A3)), and c-reactive protein (CRP; in blood plasma). Post-breeding dismount semen samples (n = 357) and blood plasma samples (n = 97) were collected from 31 stallions at commercial thoroughbred studs throughout one breeding season (NSW, Australia). A subset of stallions (16%) was deemed heat-induced subfertility-susceptible (HISS) stallions. These animals showed reduced seminal plasma antioxidant capacity, increased systemic and localized lipid peroxidation, and distinct systemic inflammatory response. Seminal antioxidant capacity was found to be strongly associated with impaired sperm motility (r = 0.739 * vs. r = −0.059). The plasma c-reactive protein of heat-susceptible stallions correlated to heat exposure (r = 0.597 *) and affected sperm motilities (r = −0.527 **, r = −0.434 *). Systemic oxidative DNA damage (8-OH-2dG) also increased following heat events (r = 0.862 ***) and correlated with fertility losses (FCP: r = −0.740 **, PCP: r = −0.603 *). Non-HISS stallions displayed greater variability in systemic antioxidant status and robust response following heat exposure (r = 0.307 *) and localized antioxidant capacity was more strongly correlated to systemic antioxidant capacity than in the heat-susceptible group (r = 0.897 *** vs. r = 0.482 **). We demonstrate that impaired antioxidant responses, altered redox balance and suppressed acute-phase inflammatory signalling are key features associated with heat-induced subfertility in stallions and highlight biomarkers that could be used to identify animals with heat-susceptible fertility. Full article

As a higher-layer protocol over a controller area network (CAN) or CAN with a flexible data-rate bus, Society of Automotive Engineers (SAE) J1939 has been widely adopted in commercial vehicles. Although it supports advanced diagnostics, complex data transmission, and network management in harsh environments, SAE J1939 lacks native authentication mechanisms. Consequently, in-vehicle communication remains vulnerable to replay, spoofing, and injection attacks. In practice, deploying a Security-designated Electronic Control Unit (SeCU) is often deemed necessary to provide robust authentication, as generating and distributing session keys is essential. However, this introduces a single point of failure and renders the SeCU a high-value target for attackers. To address these issues, we propose J1939-ADBE, an authentication and key-distribution scheme that operates without a centralized SeCU. The scheme is built on Authenticated Distributed Broadcast Encryption (ADBE), a tightly integrated construction that augments distributed broadcast encryption with publicly verifiable sender authentication in a shared bilinear setting. By leveraging ADBE, we eliminate the requirement for a SeCU while achieving the desired security goals. Using the Tamarin Prover, we formally verify in the Dolev–Yao model that J1939-ADBE satisfies injective agreement, session secrecy, known-key security, and forward secrecy. Furthermore, the broadcast nature of ADBE reduces the communication cost of key distribution from $\mathcal{O}\left(n\right)$ to $\mathcal{O}\left(\right|\mathcal{G}\left|\right)$, where n denotes the number of Electronic Control Units (ECUs) and $\left|\mathcal{G}\right|$ denotes the number of ECU logical groups. Experimental results show that our proposal is practical for authentication within SAE J1939 networks. Full article

Background: The plantaris muscle (PM) shows substantial variability in its proximal belly attachments. Although often deemed vestigial, specific variants may narrow or reshape the popliteal corridor and contribute to vascular (popliteal artery entrapment syndromes, PAES) and neural conflict (TN, CPN, sural nerves). Despite abundant anatomical descriptions of the plantaris, its contribution to neurovascular compression has not been organised into a classification-linked, imaging-integrated framework. Objective: To synthesise adult and foetal anatomical data with clinical–radiological evidence into a classification-linked framework that stratifies vascular and neural compression risk by proximal PM variants, and to propose an integrated risk matrix and variant-directed diagnostic/operative pathway. Methods: Narrative, classification-centred review centred on the Olewnik schema (Types I–VI) and multi-headed/accessory variants. We mapped variant geometry to (1) physiological compromise on provoked Doppler US and (2) anatomical correlates on MRI/MR angiography (MRA) (axial “band sign”), deriving graded risk for vascular and neural axes and an integrated, action-oriented grade per limb. Results: Baseline risk is low for canonical/compact footprints (Type I–IA, Type V), moderate for capsular-junction patterns (Types II/III), and potentially higher-risk for lateral linkage (Type IV; iliotibial band (ITB)/Kaplan fibres continuity) and multi-headed configurations (duplication, bifurcation, ≥3–4 heads; accessory proximal slips). The integrated matrix upgrades risk for a clear band sign, reproducible compromise on provoked Doppler US, or multi-headed/Type IV anatomy and downgrades when rigorous provocation is negative and muscle volume is small. We provide a variant-indexed imaging checklist, common pitfalls (e.g., Type IV misread as ITB thickening; multi-headed variants misread as cyst/tumour), and operative checkpoints to target capsular clefts, lateral bands, tunnels, and accessory slips. Conclusions: A classification-linked, imaging-integrated approach clarifies which proximal PM variants are plausibly associated with neurovascular entrapment (based on case-level evidence) and aligns work-up with targeted decompression and may improve diagnostic precision and inform surgical planning. Clinical relevance: The framework operationalises variant naming in reports, standardises dynamic provocation and axial mapping, and prioritises variants considered higher risk (Type IV; multi-headed) for early multidisciplinary review. Given that most clinical signals derive from case reports/series (Level IV), these recommendations are inferential and should be applied with clinical judgement. Full article