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14 pages, 545 KiB  
Article
Hybrid Galam–Bass Model for Technology Innovation
by Giulia Rotundo, Roy Cerqueti, Gurjeet Dhesi, Claudiu Herteliu, Parmjit Kaur and Marcel Ausloos
Entropy 2025, 27(8), 789; https://doi.org/10.3390/e27080789 - 25 Jul 2025
Abstract
This work proposes a hybrid model that combines the Galam model of opinion dynamics with the Bass diffusion model used in technology adoption on Barabasi–Albert complex networks. The main idea is to advance a version of the Bass model that can suitably describe [...] Read more.
This work proposes a hybrid model that combines the Galam model of opinion dynamics with the Bass diffusion model used in technology adoption on Barabasi–Albert complex networks. The main idea is to advance a version of the Bass model that can suitably describe an opinion formation context while introducing irreversible transitions from group B (opponents) to group A (supporters). Moreover, we extend the model to take into account the presence of a charismatic competitor, which fosters conversion back to the old technology. The approach is different from the introduction of a mean field due to the interactions driven by the network structure. Additionally, we introduce the Kolmogorov–Sinai entropy to quantify the system’s unpredictability and information loss over time. The results show an increase in the regularity of the trajectories as the preferential attachment parameter increases. Full article
(This article belongs to the Special Issue Entropy-Based Applications in Sociophysics II)
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18 pages, 25244 KiB  
Article
The Procaine-Based ProcCluster® Impedes the Second Envelopment Process of Herpes Simplex Virus Type 1
by Johannes Jungwirth, Lisa Siegert, Lena Gauthier, Andreas Henke, Oliver H. Krämer, Beatrice Engert and Christina Ehrhardt
Int. J. Mol. Sci. 2025, 26(15), 7185; https://doi.org/10.3390/ijms26157185 - 25 Jul 2025
Abstract
Herpes simplex virus type 1 (HSV-1) has a global prevalence of 64%. Established antiviral drugs, such as acyclovir (ACV), have been successfully used over the past decades. However, due to growing viral resistance against approved antivirals and the lack of effective vaccines, new [...] Read more.
Herpes simplex virus type 1 (HSV-1) has a global prevalence of 64%. Established antiviral drugs, such as acyclovir (ACV), have been successfully used over the past decades. However, due to growing viral resistance against approved antivirals and the lack of effective vaccines, new concepts are essential to target HSV-1 infections. Here, we present data on the inhibitory effect of the procaine-based substance ProcCluster® (PC) in reducing HSV-1 replication in vitro. Non-toxic PC concentrations significantly decreased HSV-1 replication in infected cells. Immunofluorescence microscopy revealed an accumulation of viral proteins in early and recycling endosomes, resulting in reduced viral release. The combination of PC with ACV resulted in an enhanced antiviral effect. Based on these results, PC alone, as well as in combination with ACV, appears to be a promising substance with antiviral potential against HSV-1 infections. Full article
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7 pages, 168 KiB  
Correction
Correction: Nadelmann et al. Acral Melanoma in Skin of Color: Current Insights and Future Directions: A Narrative Review. Cancers 2025, 17, 468
by Emily R. Nadelmann, Ajay K. Singh, Matteo Abbruzzese, Oluwaseyi O. Adeuyan, Divya B. Kenchappa, Katherine Kovrizhkin, Michelle Lightman, Avishai Samouha, Kevin L. Tao, Jaewon Yun, Tian R. Zhu, Beth N. McLellan and Yvonne M. Saenger
Cancers 2025, 17(15), 2458; https://doi.org/10.3390/cancers17152458 - 25 Jul 2025
Abstract
In the published publication [...] Full article
21 pages, 1292 KiB  
Article
Polymorphism in IFNλ Can Impact the Immune/Inflammatory Response to COVID-19 Vaccination in Older CMV-Seropositive Adults
by Ariane Nardy, Fernanda Rodrigues Monteiro, Brenda Rodrigues Silva, Jônatas Bussador do Amaral, Danielle Bruna Leal Oliveira, Érika Donizetti de Oliveira Cândido, Edison Luiz Durigon, Andressa Simões Aguiar, Guilherme Pereira Scagion, Vanessa Nascimento Chalup, Guilherme Eustáquio Furtado, Marina Tiemi Shio, Carolina Nunes França, Luiz Henrique da Silva Nali and André Luis Lacerda Bachi
Vaccines 2025, 13(8), 785; https://doi.org/10.3390/vaccines13080785 - 24 Jul 2025
Abstract
Background: Chronic cytomegalovirus (CMV) infection may favor the development of immunosenescence and inflammation that impair vaccine responses, including COVID-19. In addition, the polymorphism of the interferon-lambda gene (IFNλ) affects COVID-19 immune responses in older adults. Objective: We aimed to investigate the impact of [...] Read more.
Background: Chronic cytomegalovirus (CMV) infection may favor the development of immunosenescence and inflammation that impair vaccine responses, including COVID-19. In addition, the polymorphism of the interferon-lambda gene (IFNλ) affects COVID-19 immune responses in older adults. Objective: We aimed to investigate the impact of IFNλ polymorphism (IL28B gene-rs12979860) on the immune/inflammatory response to vaccination with CoronaVac for COVID-19 in older adults who were CMV-seropositive. Methods: Blood samples from 42 CMV-seropositive older adults (73.7 ± 4.5 years) were collected before and 30 days after immunization with a second dose of the CoronaVac vaccine to evaluate the immune/inflammatory response. Results: At genotyping, 20 subjects were homozygous for the C/C alleles (Allele-1 group), 5 were homozygous for the T/T Alleles (Allele-2 group), and 17 were heterozygous (C/T, Alleles-1/2 group). The Allele-1 group showed higher IgG levels for COVID-19 (p = 0.0269) and intermediate monocyte percentage (p = 0.017), in contrast to a lower non-classical monocyte percentage (p = 0.0141) post-vaccination than pre-vaccination. Also, this group showed that IgG levels for CMV were positively associated with a systemic pro-inflammatory state and senescent T cells (CD4+ and CD8+). The Allele-2 group presented higher IFN-β levels at pre- (p = 0.0248) and post-vaccination (p = 0.0206) than the values in the Allele-1 and Alleles-1/2 groups, respectively. In addition, the Allele-2 and Alleles-1/2 groups showed that IgG levels for COVID-19 were positively associated with a balanced systemic inflammatory state. Conclusion: CMV-seropositivity in older adults who had Allele-1 could lead to an unbalanced systemic inflammatory state, which may impair their antibody response to COVID-19 vaccination compared to other volunteer groups. Full article
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22 pages, 4683 KiB  
Article
Aerial Image-Based Crop Row Detection and Weed Pressure Mapping Method
by László Moldvai, Péter Ákos Mesterházi, Gergely Teschner and Anikó Nyéki
Agronomy 2025, 15(8), 1762; https://doi.org/10.3390/agronomy15081762 - 23 Jul 2025
Viewed by 70
Abstract
Accurate crop row detection is crucial for determining weed pressure (weeds item per square meter). However, this task is complicated by the similarity between crops and weeds, the presence of missing plants within rows, and the varying growth stages of both. Our hypothesis [...] Read more.
Accurate crop row detection is crucial for determining weed pressure (weeds item per square meter). However, this task is complicated by the similarity between crops and weeds, the presence of missing plants within rows, and the varying growth stages of both. Our hypothesis was that in drone imagery captured at altitudes of 20–30 m—where individual plant details are not discernible—weed presence among crops can be statistically detected, allowing for the generation of a weed distribution map. This study proposes a computer vision detection method using images captured by unmanned aerial vehicles (UAVs) consisting of six main phases. The method was tested on 208 images. The algorithm performs well under normal conditions; however, when the weed density is too high, it fails to detect the row direction properly and begins processing misleading data. To investigate these cases, 120 artificial datasets were created with varying parameters, and the scenarios were analyzed. It was found that a rate variable—in-row concentration ratio (IRCR)—can be used to determine whether the result is valid (usable) or invalid (to be discarded). The F1 score is a metric combining precision and recall using a harmonic mean, where “1” indicates that precision and recall are equally weighted, i.e., β = 1 in the general Fβ formula. In the case of moderate weed infestation, where 678 crop plants and 600 weeds were present, the algorithm achieved an F1 score of 86.32% in plant classification, even with a 4% row disturbance level. Furthermore, IRCR also indicates the level of weed pressure in the area. The correlation between the ground truth weed-to-crop ratio and the weed/crop classification rate produced by the algorithm is 98–99%. As a result, the algorithm is capable of filtering out heavily infested areas that require full weed control and capable of generating weed density maps on other cases to support precision weed management. Full article
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23 pages, 4371 KiB  
Article
Advances in Periodontal Diagnostics: Application of MultiModal Language Models in Visual Interpretation of Panoramic Radiographs
by Albert Camlet, Aida Kusiak, Agata Ossowska and Dariusz Świetlik
Diagnostics 2025, 15(15), 1851; https://doi.org/10.3390/diagnostics15151851 - 23 Jul 2025
Viewed by 126
Abstract
Background: Periodontitis is a multifactorial disease leading to the loss of clinical attachment and alveolar bone. The diagnosis of periodontitis involves a clinical examination and radiographic evaluation, including panoramic images. Panoramic radiographs are cost-effective methods widely used in periodontitis classification. The remaining [...] Read more.
Background: Periodontitis is a multifactorial disease leading to the loss of clinical attachment and alveolar bone. The diagnosis of periodontitis involves a clinical examination and radiographic evaluation, including panoramic images. Panoramic radiographs are cost-effective methods widely used in periodontitis classification. The remaining bone height (RBH) is a parameter used to assess the alveolar bone level. Large language models are widely utilized in the medical sciences. ChatGPT, the leading conversational model, has recently been extended to process visual data. The aim of this study was to assess the effectiveness of the ChatGPT models 4.5, o1, o3 and o4-mini-high in RBH measurement and tooth counts in relation to dental professionals’ evaluations. Methods: The analysis was based on 10 panoramic images, from which 252, 251, 246 and 271 approximal sites were qualified for the RBH measurement (using the models 4.5, o1, o3 and o4-mini-high, respectively). Three examiners were asked to independently evaluate the RBH in approximal sites, while the tooth count was achieved by consensus. Subsequently, the results were compared with the ChatGPT outputs. Results: ChatGPT 4.5, ChatGPT o3 and ChatGPT o4-mini-high achieved substantial agreement with clinicians in the assessment of tooth counts (κ = 0.65, κ = 0.66, κ = 0.69, respectively), while ChatGPT o1 achieved moderate agreement (κ = 0.52). In the context of RBH values, the ChatGPT models consistently exhibited a positive mean bias compared with the clinicians. ChatGPT 4.5 was reported to provide the lowest bias (+12 percentage points (pp) for the distal surfaces, width of the 95% CI for limits of agreement (LoAs) ~60 pp; +11 pp for the mesial surfaces, LoA width ~54 pp). Conclusions: ChatGPT 4.5 and ChatGPT o3 show potential in the assessment of tooth counts on a panoramic radiograph; however, their present level of accuracy is insufficient for clinical use. In the current stage of development, the ChatGPT models substantially overestimated the RBH values; therefore, they are not applicable for classifying periodontal disease. Full article
(This article belongs to the Special Issue Application of Artificial Intelligence to Oral Diseases)
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22 pages, 7569 KiB  
Article
Ancient Ship Structures: Ultimate Strength Analysis of Wooden Joints
by Albert Zamarin, Smiljko Rudan, Davor Bolf, Alice Lucchini and Irena Radić Rossi
J. Mar. Sci. Eng. 2025, 13(8), 1392; https://doi.org/10.3390/jmse13081392 - 22 Jul 2025
Viewed by 56
Abstract
This paper presents an analysis of the ultimate strength of wooden joints of the structures of ancient wooden ships. The aim is to contribute to the discussion about how joining technology and types of joints contributed to the transition from ‘shell-first’ to ‘frame-first’ [...] Read more.
This paper presents an analysis of the ultimate strength of wooden joints of the structures of ancient wooden ships. The aim is to contribute to the discussion about how joining technology and types of joints contributed to the transition from ‘shell-first’ to ‘frame-first’ construction, of which the latter is still traditional Mediterranean wooden shipbuilding technology. Historically, ship construction has consisted of two main structural types of elements: planking and stiffening. Therefore, two characteristic carvel planking joints and two longitudinal keel joints were selected for analysis. For planking, the joint details of the ship Uluburun (14th c. BC) and the ship Kyrenia (4th c. BC) were chosen, while two different types of scarf joints belonging to the ship Jules-Verne 9 (6th c. BC) and the ship Toulon 2 (1st c. AD) were selected. The capacity, i.e., the ultimate strength of the joint, is compared to the strength of the structure as if there was no joint. The analysis simulates the independent joint loading of each of the six numerical models in bending, tension, and compression until collapse. The results are presented as load-end-shortening curves, and the calculation was performed as a nonlinear FE analysis on solid elements using the LSDYNA explicit solver. Since wood is an anisotropic material, a large number of parameters are needed to describe the wood’s behaviour as realistically as possible. To determine all the necessary mechanical properties of two types of wood structural material, pine and oak, a physical experiment was used where results were compared with numerical calculations. This way, the material models were calibrated and used on the presented joints’ ultimate strength analysis. Full article
(This article belongs to the Section Ocean Engineering)
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11 pages, 748 KiB  
Article
Increased Incidence of New-Onset Diabetic Retinopathy in Individuals with COVID-19 in an Underserved Urban Population in the Bronx
by Jai Mehrotra-Varma, Sonya Henry, Diane Chernoff, Andre Galenchik-Chan, Katie S. Duong, Shiv Mehrotra-Varma, Stephen H. Wang and Tim Q. Duong
Diagnostics 2025, 15(15), 1846; https://doi.org/10.3390/diagnostics15151846 - 22 Jul 2025
Viewed by 107
Abstract
Background/Objectives: To investigate the incidence of new-onset diabetic retinopathy (DR) in individuals with pre-existing type 2 diabetes (T2D) up to 3 years post SARS-CoV-2 infection. Methods: This retrospective study consisted of 5151 COVID-19 and 5151 propensity-matched non-COVID-19 patients with T2D in the Montefiore [...] Read more.
Background/Objectives: To investigate the incidence of new-onset diabetic retinopathy (DR) in individuals with pre-existing type 2 diabetes (T2D) up to 3 years post SARS-CoV-2 infection. Methods: This retrospective study consisted of 5151 COVID-19 and 5151 propensity-matched non-COVID-19 patients with T2D in the Montefiore Health System between 1 March 2020 and 17 January 2023. The primary outcome was new-onset DR at least 2 months after the index date up to 17 January 2023. Matching for index date between groups was also used to ensure the same follow-up duration. Hazard ratios (HRs) were computed, adjusted for competing risks. Results: T2D patients with COVID-19 had a higher cumulative incidence of DR than T2D patients. The unadjusted HR for COVID-19 status for developing new DR was 2.44 [1.60, 3.73], p < 0.001. The adjusted HR was 1.70 [1.08, 2.70], p < 0.05, and the adjusted HR for prior insulin use was 3.28 [2.10, 5.12], p < 0.001. Sex, ethnicity, and major comorbidities had no significant association with outcome. Conclusions: T2D patients who contracted COVID-19 exhibited a significantly higher risk of developing DR within three years post infection compared to propensity-matched controls. The increased incidence was primarily driven by greater pre-existing insulin usage and SARS-CoV-2 infection in the COVID-19 positive cohort. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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14 pages, 614 KiB  
Article
“Eyes on the Street” as a Conditioning Factor for Street Safety Comprehension: Quito as a Case Study
by Nuria Vidal-Domper, Susana Herrero-Olarte, Gioconda Ramos and Marta Benages-Albert
Buildings 2025, 15(15), 2590; https://doi.org/10.3390/buildings15152590 - 22 Jul 2025
Viewed by 210
Abstract
The presence of people has a complex relationship with public safety—while it is often associated with increased natural surveillance, it can also attract specific types of crime under certain urban conditions. This exploratory study examines this dual relationship by integrating Jane Jacobs’s urban [...] Read more.
The presence of people has a complex relationship with public safety—while it is often associated with increased natural surveillance, it can also attract specific types of crime under certain urban conditions. This exploratory study examines this dual relationship by integrating Jane Jacobs’s urban theories and the principles derived from them in Quito, Ecuador. Anchored in Jacobs’s concept of “eyes on the street,” this research assesses four morphological dimensions—density, land use mixture, contact opportunity, and accessibility through nine specific indicators. A binary logistic regression model is used to examine how these features relate to the incidence of street robberies against individuals. The findings indicate that urban form characteristics that foster “eyes on the street”—such as higher population density and a mix of commercial and residential uses—show statistically significant associations with lower rates of street robbery. However, other indicators of “eyes on the street”—such as larger block sizes, proximity to public transport stations, greater street lighting, and a higher balance between residential and non-residential land uses—correlate with increased crime rates. Some indicators, such as population density, block size, and distance to public transport stations, show statistically significant relationships, though the practical effect size compared to residential/non-residential balance, commercial and facility mix, and street lighting is modest. These results underscore the importance of contextualizing Jacobs’s frameworks and offer a novel contribution to the literature by empirically testing morphological indicators promoting the presence of people against actual crime data. Full article
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12 pages, 549 KiB  
Article
Disruption of Planetary System Architectures by Stellar Flybys
by Robert Przyłuski, Hans Rickman, Paweł Wajer, Tomasz Wiśniowski, Diego Turrini, Danae Polychroni, Camilla Danielski, J. M. Diederik Kruijssen, Steven Longmore and Mélanie Chevance
Universe 2025, 11(8), 240; https://doi.org/10.3390/universe11080240 - 22 Jul 2025
Viewed by 119
Abstract
We investigate the survivability of solar system-like planetary systems during close encounters in stellar associations using a suite of 1980 N-body simulations. Each system is based on one of the possible five-planet resonant configurations proposed to represent the initial solar system architecture and [...] Read more.
We investigate the survivability of solar system-like planetary systems during close encounters in stellar associations using a suite of 1980 N-body simulations. Each system is based on one of the possible five-planet resonant configurations proposed to represent the initial solar system architecture and is systematically scaled in both planetary mass and orbital compactness to explore the parameter space of observed exoplanetary architectures. Simulations explore a range of stellar encounter scenarios drawn from four distinct cluster environments. Our results show that system survival depends critically on the interplay between planetary mass and orbital scale: compact configurations are more resistant to external perturbations, while increased planetary mass improves resilience only up to a threshold, beyond which internal instabilities dominate. No system whose planets are twice as massive as the ones in the solar system survives stellar encounters. Systems that are at least an order of magnitude more compact than the solar system remain stable under typical encounter conditions. These findings place strong constraints on the initial architectures of planetary systems that can endure stellar-dense birth environments. Full article
(This article belongs to the Section Planetary Sciences)
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9 pages, 550 KiB  
Brief Report
Elevated Urinary Titin in Adult Spinal Muscular Atrophy: A Multicenter, Cross-Sectional Observational Study
by Andrea Sipos, Emese Rebeka Ripszám, Judit Mária Molnár, Zoltán Grosz, Judit Boczán, Melinda Borbála Altorjay, Livia Dézsi, Anett Csáti, Kristóf Babarczy, Norbert Kovács, Nándor Hajdú and Endre Pál
Neurol. Int. 2025, 17(8), 114; https://doi.org/10.3390/neurolint17080114 - 22 Jul 2025
Viewed by 90
Abstract
Background: Spinal muscular atrophy (SMA) is a treatable motor neuron disease. Biomarkers for skeletal muscle atrophy are extremely important for measuring the effects of treatment and monitoring the natural course of the disease. The urinary titin N fragment (UNT) has recently been proven [...] Read more.
Background: Spinal muscular atrophy (SMA) is a treatable motor neuron disease. Biomarkers for skeletal muscle atrophy are extremely important for measuring the effects of treatment and monitoring the natural course of the disease. The urinary titin N fragment (UNT) has recently been proven to be related to muscle damage. Methods: The UNT was measured in 41 patients with SMA and 41 healthy controls. Clinical data, functional tests, and laboratory findings were also recorded. Results: We found significantly higher UNT levels in the patient samples than in the healthy subjects. The UNT was not related to disease type, functional test results, or serum creatine kinase levels. Conclusions: This cross-sectional study highlights the importance of the UNT as a potential noninvasive biomarker for spinal muscular atrophy. Its role can potentially be verified through longitudinal studies. Full article
(This article belongs to the Special Issue Biomarker Research in Neuromuscular Diseases)
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28 pages, 2503 KiB  
Article
The Identification of Transcriptomic and Phytohormonal Biomarkers for Monitoring Drought and Evaluating the Potential of Acibenzolar-S-Methyl Root Application to Prime Two Apple Rootstock Genotypes for Drought Resistance
by Kirstin V. Wurms, Tony Reglinski, Erik H. A. Rikkerink, Nick Gould, Catrin S. Günther, Janine M. Cooney, Poppy Buissink, Annette Ah Chee, Christina B. Fehlmann, Dwayne J. A. Jensen and Duncan Hedderley
Int. J. Mol. Sci. 2025, 26(14), 6986; https://doi.org/10.3390/ijms26146986 - 21 Jul 2025
Viewed by 221
Abstract
Droughts are predicted to intensify with climate change, posing a serious threat to global crop production. Increasing drought tolerance in plants requires an understanding of the underlying mechanisms. This study measured the physiological, phytohormonal and transcriptomic responses to drought in two apple rootstocks [...] Read more.
Droughts are predicted to intensify with climate change, posing a serious threat to global crop production. Increasing drought tolerance in plants requires an understanding of the underlying mechanisms. This study measured the physiological, phytohormonal and transcriptomic responses to drought in two apple rootstocks to identify drought ‘biomarkers’ and investigated whether the application of acibenzolar-S-methyl (ASM) to the roots could enhance drought tolerance. Two potted-plant trials were conducted on dwarfing (M9) and semi-dwarfing (CG202) apple rootstocks. In both trials, the response patterns in the roots and leaves were compared between irrigated and non-irrigated plants over a 14-day period. In trial 2, ASM was applied 14 days before and immediately before withdrawing irrigation. Drought induced significant decreases in transpiration, photosynthesis and stomatal conductance in both trials. This was accompanied by the accumulation of abscisic acid (ABA) metabolites and the upregulation of ABA pathway transcripts (CYP707A1/A2 and NCED3), a decrease in 12-oxophytodienoic acid (cis-OPDA) and the downregulation of ABA receptor genes (PYL4). The responses to drought were greater in the roots than the leaves, broadly similar across both rootstocks, but differed in strength and timing between the rootstocks. The application of ASM to the roots did not significantly affect the responsiveness to drought in either rootstock. The identified phytohormonal and transcriptomic biomarkers require further validation across a broader range of genotypes. Full article
(This article belongs to the Special Issue Phytohormones: From Physiological Response to Application)
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17 pages, 3334 KiB  
Article
Alterations in P-glycoprotein Expression in the Placenta of Obese Rats and Humans
by Péter Szatmári, Kata Kira Kemény, Andrea Surányi, Yakov Rachamim and Eszter Ducza
Int. J. Mol. Sci. 2025, 26(14), 6976; https://doi.org/10.3390/ijms26146976 - 20 Jul 2025
Viewed by 153
Abstract
Obesity affects approximately 30% of pregnancies worldwide and is one of the leading metabolic disorders among pregnant women. Maternal obesity is often associated with placental dysfunction and structural alterations, which increase the risk of developing complications. Efflux transporters, including P-glycoprotein (P-gp), may impact [...] Read more.
Obesity affects approximately 30% of pregnancies worldwide and is one of the leading metabolic disorders among pregnant women. Maternal obesity is often associated with placental dysfunction and structural alterations, which increase the risk of developing complications. Efflux transporters, including P-glycoprotein (P-gp), may impact placental function and fetal development. Consequently, our research examined the effects of obesity on P-glycoprotein expression in both a rat model and human placental tissue. P-gp expression was measured by RT-PCR and Western blot techniques in human and rat placental tissues. Moreover, we further characterized the high-fat and high-sugar diet (HFHSD)-induced gestational obesity rat model by measuring tissue weights. Significant decreases were observed in fetal, placental, and uterus weights in the obese animals near the end of pregnancy. In obese rats, mRNA and protein expression of placental P-gp showed a reduction on gestation days 15, 20, and 22. A similar P-gp reduction was observed in the term placenta in obese women in mRNA and protein levels. We hypothesize that the reduced expression of P-gp may heighten the susceptibility of both the fetus and placenta to P-gp substrates. This alteration could potentially result in an increased risk of pregnancy complications and obesity-related drug contraindications linked to P-gp transport during pregnancy. Full article
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23 pages, 587 KiB  
Review
Immune Checkpoint Inhibitors and Allograft Rejection Risk: Emerging Evidence Regarding Their Use in Kidney Transplant Recipients
by Muhammad Ali Khan, Munir Mehmood, Hind EL Azzazi, Samiullah Shaikh, Bhavna Bhasin-Chhabra, Prakash Gudsoorkar, Sumi Sukumaran Nair, Lavanya Kodali, Girish Mour, Sundararaman Swaminathan and Bassam G. Abu Jawdeh
J. Clin. Med. 2025, 14(14), 5152; https://doi.org/10.3390/jcm14145152 - 20 Jul 2025
Viewed by 353
Abstract
The indications for immune checkpoint inhibitor (ICI) use in cancer treatment continue to expand. This is attributable to their proven anticancer activity in addition to their tolerability and favorable toxicity profile as compared to conventional chemotherapeutic agents. ICIs work by blocking the inhibitory [...] Read more.
The indications for immune checkpoint inhibitor (ICI) use in cancer treatment continue to expand. This is attributable to their proven anticancer activity in addition to their tolerability and favorable toxicity profile as compared to conventional chemotherapeutic agents. ICIs work by blocking the inhibitory signals between tumor cells and T-cells, thereby enhancing the T-cell cytotoxic activity to inhibit tumor growth. Because of their immune-stimulating effect, ICIs are linked to adverse renal outcomes in both native and transplanted kidneys. The risk of kidney allograft rejection in the setting of ICI use has been reported to be around 40%, leading to an increased risk of graft loss. In this report, we review the literature examining outcomes in kidney transplant recipients receiving ICIs for various oncologic indications. Full article
(This article belongs to the Special Issue Clinical Advancements in Kidney Transplantation)
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13 pages, 464 KiB  
Article
Short-Term Outcomes in Planned Versus Unplanned Surgery for Spinal Metastases
by Ali Haider Bangash, Sertac Kirnaz, Rose Fluss, Victoria Cao, Alexander Alexandrov, Liza Belman, Yaroslav Gelfand, Saikiran G. Murthy, Reza Yassari and Rafael De la Garza Ramos
Cancers 2025, 17(14), 2403; https://doi.org/10.3390/cancers17142403 - 20 Jul 2025
Viewed by 256
Abstract
Background/Objectives: Metastatic spine disease (MSD) affects a significant proportion of patients with advanced malignancies and often necessitates surgical intervention to preserve neurological function, alleviate pain, and maintain spinal stability. While oncologic spine surgery is ideally performed in a planned, semi-elective setting, a substantial [...] Read more.
Background/Objectives: Metastatic spine disease (MSD) affects a significant proportion of patients with advanced malignancies and often necessitates surgical intervention to preserve neurological function, alleviate pain, and maintain spinal stability. While oncologic spine surgery is ideally performed in a planned, semi-elective setting, a substantial number of patients require unplanned (urgent or emergent) surgery due to acute deterioration. The impact of surgical planning status on postoperative outcomes following metastatic spine tumor surgery remains underexplored. This study aimed to compare the patient characteristics and short-term outcomes of those undergoing planned versus unplanned surgery for spinal metastases. Methods: We conducted a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2018 to 2023. Patients with disseminated cancer undergoing tumor surgery were identified. Case types were grouped into planned (elective) and unplanned (urgent or emergent). The primary endpoint was failure to rescue (FTR); secondary endpoints included 30-day major complications, 30-day mortality, and length of hospital stay. Univariable and multivariable regression analyses were performed. Results: A total of 2147 patients met our inclusion criteria, out of whom 60% (n = 1284) underwent planned and 40% (n = 863) underwent unplanned surgery. Patients in the unplanned surgery group had a significantly higher prevalence of severe hypoalbuminemia, severe anemia, and ASA class IV status (p ≤ 0.001 for all). For our primary endpoint, a multivariable analysis showed a significant association between unplanned surgery and FTR (OR 2.11 [95% CI 1.24 to 3.56]; p = 0.005). Significant associations were also found with 30-day mortality (OR 1.84 [95% CI 1.25 to 2.72]; p = 0.002) and length of hospital stay (β 2.7 [95% CI 1.97 to 3.43]; p < 0.001). However, unplanned surgery could not independently predict 30-day major complications (OR 1.21 [95% CI 0.97 to 1.51]; p = 0.08). Conclusions: Our study found that unplanned surgery for spinal metastases was associated with significantly higher rates of FTR, 30-day mortality, and extended hospital stay, independent of other covariates. These findings highlight the importance of the timely identification of patients requiring surgery and the potential benefits of semi-elective care. Full article
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