Search Results (1,119)

Simultaneous values of glucose rate of change (RoC) and glucose can be presented in a dynamic glucose region plot, and risk spaces can be specified for (RoC, glucose) values expected to remain in the target range (glucose 3.9–10.0 mmol/L) or leave or return to the target range within the next 30 min. We downloaded continuous glucose monitoring (CGM) data for 60 days from persons with type 1 diabetes using two different systems for automated insulin delivery (AID), A (n = 65) or B (n = 85). The relative distribution of (RoC, glucose) values in risk spaces was compared. The fraction of all (RoC, glucose) values anticipated to remain in the target range in the next 30 min was higher with system A (62.5%) than with system B (56.8%) (difference 5.7, 95% CI (2.2–9.2%), p = 0.002). The fraction of (RoC, glucose) values in the target range with a risk of progressing to the above range (glucose > 10.0 mmol/L) was slightly lower in system A than in B (difference −1.1 (95% CI: −1.8–−0.5%, p < 0.001). Dynamic glucose region plots and the concept of risk spaces are novel strategies to obtain insight into glucose homeostasis and to demonstrate clinically relevant differences comparing two AID systems. Full article

Via a One Health approach, this study concomitantly assessed the susceptibility of humans and dogs to Trypanosoma cruzi infections on three islands and in two mainland seashore areas of southern Brazil. Human serum samples were tested using an enzyme-linked immunosorbent assay (ELISA) to detect anti-T. cruzi antibodies, while dog serum samples were tested using indirect fluorescent antibodies in an immunofluorescence assay (IFA). Seropositive human and dog individuals were also tested using quantitative polymerase chain reaction (qPCR) in corresponding blood samples. Overall, 2/304 (0.6%) human and 1/292 dog samples tested seropositive for T. cruzi by ELISA and IFA, respectively, and these cases were also molecularly positive for T. cruzi by qPCR. Although a relatively low positivity rate was observed herein, these cases were likely autochthonous, and the individuals may have been infected as a consequence of isolated events of disturbance in the natural peridomicile areas nearby. Such a disturbance could come in the form of a fire or deforestation event, which can cause stress and parasitemia in wild reservoirs and, consequently, lead to positive triatomines. In conclusion, T. cruzi monitoring should always be conducted in suspicious areas to ensure a Chagas disease-free status over time. Further studies should also consider entomological and wildlife surveillance to fully capture the transmission and spread of T. cruzi on islands and in seashore mainland areas of Brazil and other endemic countries. Full article

Catalytic and bioelectrocatalytic properties of four white rot fungal laccases (Trametes hirsuta, ThL; Coriolopsis caperata, CcL; Steccherinum murashkinskyi, SmL; and Antrodiella faginea, AfL) from different orthologous groups were comparatively studied in homogeneous reactions of electron donor substrate oxidation and in a heterogeneous reaction of dioxygen electroreduction. The ThL and CcL laccases belong to high-redox-potential enzymes (E⁰_T1 = 780 mV), while the AfL and SmL laccases are medium-redox-potential enzymes (E⁰_T1 = 620 and 650 mV). We evaluated the efficiency of laccases in mediatorless bioelectrocatalytic dioxygen reduction by the steady-state potential (E_ss), onset potential (E_onset), half-wave potential (E_1/2), and the slope of the linear segment of the polarization curve. A good correlation was observed between the T1 center potential of the laccases and their electrocatalytic characteristics; however, no correlation with the homogeneous reactions of electron donor substrates’ oxidation was detected. The results obtained are discussed in the light of the known data on the three-dimensional structures of the laccases studied. Full article

Procoagulant platelets are a specialized subset of activated platelets that externalize phosphatidylserine (PS) on their surface, facilitating the assembly of tenase and prothrombinase complexes and enhancing thrombin generation and clot formation. Although procoagulant platelet formation shares certain features with nucleated cell death pathways, such as mitochondrial dysfunction, calcium (Ca²⁺) overload, membrane blebbing, and microvesiculation, it differs in key molecular mechanisms, notably lacking nuclei and caspase-dependent deoxyribonucleic acid (DNA) fragmentation. Interestingly, molecular components of nucleated cell death pathways in platelets can promote thrombus formation without impacting platelet lifespan. Under pathological conditions, excessive platelet activation may result in platelet lysis, resembling the complete activation of nucleated cell death pathways and contribute to thrombocytopenia. This review compares procoagulant platelet formation with various nucleated cell death pathways, including necrosis, necroptosis, pyroptosis, and ferroptosis, and explores their role in pathological thrombosis and blood clotting. A deeper understanding of mechanisms may help in developing targeted therapies to prevent aberrant blood clotting, platelet death and thrombocytopenia. Full article

BACH1 has been identified as a functional regulator of cancer metastasis and metabolic signaling in breast cancer cells. However, the clinical relevance of BACH1 expression in breast tumors remains poorly understood. Using a tissue microarray from a cohort of 130 patients, we assessed the expression of BACH1 and its known target gene, MCT1 (encoded by SLC16A1), through immunohistochemistry (IHC). The expression data were then analyzed in relation to clinical variables, including breast cancer subtypes, tissue types, tumor size and grade, patient racial background, and age group. We found positive associations between BACH1 expression and tumor size, tumor grade, and the basal-like subtype. Importantly, BACH1 expression was significantly higher in tumors from Black women compared to those from White women, as well as in the basal-like subtype of breast tumors from Black women. Additionally, a positive correlation was observed between BACH1 and MCT1 IHC scores in tumors from Black women, while a weak association was noted in tumors from White women. Our study provides compelling evidence that BACH1 expression is evident based on the race and subtypes of breast cancer patients. Full article

Sexual dysfunction is a prevalent and often under-addressed concern among prostate cancer survivors, significantly affecting quality of life for patients and their partners. The True North Sexual Health and Rehabilitation eClinic (SHAReClinic) is a virtual, biopsychosocial intervention developed to improve access to sexual health support for prostate cancer survivors and their partners. This study used a qualitative descriptive design to examine barriers and facilitators influencing the integration of SHAReClinic into oncology care across nine Canadian health care centres. Semi-structured interviews were conducted with 17 knowledge users, including health care providers and institutional leaders. Data were analyzed using a hybrid deductive–inductive thematic approach guided by the Consolidated Framework for Implementation Research (CFIR) 2.0. Participants described SHAReClinic as a much-needed resource, particularly in the absence of standardized sexual health pathways in oncology care. The virtual format was seen as accessible and well suited to addressing sensitive topics. However, limited funding, lack of institutional support, and workflow integration challenges emerged as primary barriers to implementation. Findings offer practical, theory-informed guidance for integrating SHAReClinic into oncology care and highlight key considerations for developing sustainable and scalable survivorship care models. Full article

Background/Objectives: Partial maxillectomy frequently results in severe impairments of oral functions, such as difficulties in chewing, speech, swallowing, and facial appearance. Immediate prosthetic rehabilitation is challenging because soft tissue healing is typically required before impression taking. This study aimed to (1) develop a comprehensive digital workflow for fabricating immediate obturator prostheses using preoperative data and (2) assess their early clinical effectiveness in restoring oral functions after surgery. Methods: In this prospective clinical study, 20 patients undergoing partial maxillectomy from January 2023 to January 2025 were enrolled. A digital workflow combining cone-beam computed tomography (CBCT), intraoral scanning, CAD/CAM design, and 3D metal printing was implemented. Obturator prostheses were digitally designed preoperatively and inserted immediately post-resection. Functional outcomes were postoperatively evaluated after one month using the Obturator Functioning Scale (OFS), which measures functional, speech, esthetic, and psychosocial aspects. Results: The digitally fabricated immediate obturator prostheses were successfully placed intraoperatively in all patients. Most participants reported mild to moderate difficulties, with speech-related issues being the most common, while esthetic concerns were minimal. Masticatory function was satisfactorily restored in 75% of cases, and 60% of patients experienced minimal fluid leakage during swallowing. No significant differences were found between genders. Patients with larger defects tended to report greater functional challenges. Conclusions: The digitally planned immediate obturator prosthesis provides a practical and effective solution for early rehabilitation following partial maxillectomy. This digital workflow reduces patient discomfort, restores key oral functions, and facilitates psychosocial recovery. Full article

The intricate and complex tumor cell morphology in breast pathology images is a key factor for tumor classification. This paper proposes a lightweight breast tumor classification model with multi-frequency feature fusion (LMFM) to tackle the problem of inadequate feature extraction and poor classification performance. The LMFM utilizes wavelet transform (WT) for multi-frequency feature fusion, integrating high-frequency (HF) tumor details with high-level semantic features to enhance feature representation. The network’s ability to extract irregular tumor characteristics is further reinforced by dynamic adaptive deformable convolution (DADC). The introduction of the token-based Region Focus Module (TRFM) reduces interference from irrelevant background information. At the same time, the incorporation of a linear attention (LA) mechanism lowers the model’s computational complexity and further enhances its global feature extraction capability. The experimental results demonstrate that the proposed model achieves classification accuracies of 98.23% and 97.81% on the BreaKHis and BACH datasets, with only 9.66 M parameters. Full article

This study assessed the viable and culturable microbial diversity that remained on equipment surfaces after hygiene procedures in Brazilian poultry and fish slaughterhouses. Food-contact surface samples were collected using sterile swabs in poultry (n = 50) and fish (Oreochromis niloticus, n = 50) slaughterhouses. The swab samples were used to prepare culture plates to recover viable and culturable cells. The grown plates were washed, and the total DNA of the cell suspension was extracted with a commercial kit. Sequencing of the total DNA extracted from cultures was targeted at the V3 and V4 regions of the 16S rRNA. DNA reads were analyzed by QIIME2 software, with results expressed in relative frequency (%RF). Alpha and beta diversity indexes were analyzed considering the spots of sample collection, type of industry, surfaces (smooth or modular), and materials (polypropylene, stainless steel, or polyurethane). The results showed that in the poultry slaughterhouse, the most abundant genera were Acinetobacter (27.4%), Staphylococcus (7.7%), and Pseudomonas (5.3%), while for the fish slaughterhouse, there was a higher abundance of Staphylococcus (27.7%), Acinetobacter (17.2%), and Bacillus (12.5%). Surface characteristics influenced the microbial diversity, with Acinetobacter spp. dominating modular surfaces and Staphylococcus spp. prevailing on smooth surfaces. The results obtained indicate there is an important resident microbiota that persists even after hygiene processes, and surface-specific cleaning strategies should be developed. Full article

Background: Pregnancies in patients with systemic lupus erythematosus (SLE) have always been considered high-risk. D-dimer is known for its role in excluding the diagnosis of thrombosis and has been associated with lupus reactivation; however, its physiological elevation during pregnancy limits its utility in this population. Fibrin monomer (FM) has been shown in multiple studies to remain stable in pregnant women. The objectives of this study were to evaluate D-dimer and FM levels, as well as to assess the role of FM in SLE activity during pregnancy. Methods: The subjects included 76 pregnant women with SLE diagnosed according to the Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria. The assessment of disease activity was in accordance with the Systemic Lupus Erythematosus Pregnancy Disease Activity Index (SLEPDAI). Results: The log₁₀-transformed D-dimer (LtDD) and FM (LtFM) concentrations in the pregnant women with lupus were 1.229 (0.722–1.953) and 4.17 (3.01–5.34) µg/mL, respectively. A multivariate regression indicated that 59.1% of the variation in LtDD was influenced by the gestational age and SLEPDAI, while only 18.3% of the fluctuation in LtFM was affected by these factors. The concentration of LtFM was an independent factor in predicting SLE flare and disease activity level according to the SLEPDAI in pregnant women. Conclusions: In conclusion, this study’s findings suggest that elevated levels of both D-dimer and FM were observed in pregnant patients with SLE. However, only FM levels can be used as a prognostic factor in assessing the risk of SLE reactivation during pregnancy. Full article

Electric vehicles (EVs) have introduced new operational challenges for distribution network service providers (DNSPs), particularly for voltage regulation due to unpredictable charging behaviour and the intermittent nature of distributed energy resources (DERs). This study focuses on formulating an empirical EV load model that characterises charging behaviour over a broad spectrum of supply voltage magnitudes to enable more accurate representation of EV demand under varying grid conditions. The empirical model is informed by laboratory evaluation of one Level 1 and two Level 2 chargers, along with five EV models. The testing revealed that all the chargers operated in a constant current (CC) mode across the applied voltage range, except for certain Level 2 chargers, which transitioned to constant power (CP) operation at voltages above 230 V. A model of a typical low voltage network has been developed using the OpenDSS software package (version 10.2.0.1) to evaluate the performance of the proposed empirical load model against traditional CP load modelling. In addition, a 24 h case study is presented to provide insights into the practical implications of increasing EV charging load. The results demonstrate that the CP model consistently overestimated network demand and voltage drops and failed to capture the voltage-dependent behaviour of EV charging in response to source voltage change. In contrast, the empirical model provided a more realistic reflection of network response, offering DNSPs improved accuracy for system planning. Full article

Background and Objectives: Acute lymphoblastic leukemia (ALL) is a hematologic malignancy characterized by the aberrant proliferation of immature lymphoid cells. Lymphoblasts derived from the B-cell lymphoid lineage are identified as B-ALL. A20, CYLD and Cezanne are deubiquitinase genes that inhibit inflammatory response and tumor progression. Age-related increases in tumor necrosis factor (TNF)-α are associated with poor outcomes in ALL. Little is known about the associations of A20, CYLD and Cezanne with leukocyte accumulation in B-ALL. Materials and Methods: Blood samples of 147 patients with B-ALL and 144 healthy subjects were examined. Gene expression profiles were determined by quantitative PCR, gene polymorphisms by direct DNA sequencing, immunophenotype by flow cytometry and secretion of inflammatory cytokines by an ELISA. Results: Genetic analysis of the A20 gene identified six nucleotide changes in exon 7. Sequencing of the Cezanne gene identified three variants in intron 10. The results indicated that B-ALL patients carrying the A20 p.P348L and Cezanne rs1230581026 variants had higher variant frequencies and lower expression levels than healthy controls. Importantly, carriers of the A20 p.P348L variant had a higher numbers of CD20⁺ and HLA DR⁺ cells than those with a normal genotype, and carriers of the Cezanne rs1230581026 variant had increases in neutrophil, basophil, monocyte, lymphocyte, and CD38⁺ cell counts as well as age-related increases in the levels of TNF-α. Conclusions: The results indicate that the A20 p.P348L and Cezanne rs1230581026 variants are associated with low expression levels of A20/Cezanne, leukocyte expansion and poor outcomes in B-ALL patients. Full article

Grounded in the existing literature on administrative burden and using a qualitative and community-engaged research approach, the research examined the administrative burden experienced in accessing disability, retirement, and survivor benefits from the Social Security Administration (SSA). The research team held in person and virtual focus groups and interviews with 40 adults with disabilities, older adults, and family members of people with disabilities who resided in rural areas of the U.S. State of New Hampshire in 2024. The qualitative analysis revealed that rural residents, regardless of type of SSA benefit receipt, were experiencing high levels of administrative burden in their interactions with the SSA and preferred to turn to in-person assistance at local SSA field offices (rather than phone, mail, or web-based service options) to address these concerns. Overall, people living in rural counties that do not have local SSA field offices voiced a distinct disadvantage in terms of knowing where to turn with questions about their benefits. A lack of ready and reliable access to information and advice led to endangering their own economic stability and to increased calls and visits to the SSA. Persons with stronger social networks were better able to overcome these barriers to services. Full article

Chemical exchange saturation transfer (CEST) MRI is a novel technique that allows for the specific imaging of certain molecules that contain exchangeable protons. Neuroimaging is a major contributor to diagnosing and monitoring infections of the central nervous system (CNS). This review focuses on summarizing the current literature surrounding the use of CEST MRI imaging in diagnosing, monitoring, and treating CNS infections. BacCEST is a new technique to detect bacterial infection in organs at profound levels. This technique allows for the specific pathogen causing the infection to be understood, allowing for tailored antibiotic therapies. The bacCEST signal is also directly proportional to the number of bacterial cells; this means it can be used over periods to track response to treatment via cell numbers. The results show that most of the research in this area has focused on infections of the brain parenchyma (e.g., encephalitis) and that most studies investigate the use of CEST in animal models, with a minority exploring the application of CEST to human participants. The common neuroinfectious disease presentations relevant to clinical medicine are also briefly described, as well as the traditional and modern imaging techniques used to visualize them. Full article

Pathological images are crucial for tumor diagnosis; however, due to their extremely high resolution, pathologists often spend considerable time and effort analyzing them. Moreover, diagnostic outcomes can be significantly influenced by subjective judgment. With the rapid advancement of artificial intelligence technologies, deep learning models offer new possibilities for pathological image diagnostics, enabling pathologists to diagnose more quickly, accurately, and reliably, thereby improving work efficiency. This paper proposes a novel Global Channel Spatial Attention (GCSA) module aimed at enhancing the representational capability of input feature maps. The module combines channel attention, channel shuffling, and spatial attention to capture global dependencies within feature maps. By integrating the GCSA module into the SegFormer architecture, the network, named GCSA-SegFormer, can more accurately capture global information and detailed features in complex scenarios. The proposed network was evaluated on a liver dataset and the publicly available ICIAR 2018 BACH dataset. On the liver dataset, the GCSA-SegFormer achieved a 1.12% increase in MIoU and a 1.15% increase in MPA compared to baseline models. On the BACH dataset, it improved MIoU by 1.26% and MPA by 0.39% compared to baseline models. Additionally, the performance metrics of this network were compared with seven different types of semantic segmentation, showing good results in all comparisons. Full article