Search Results (117)

Background: Pericarotid adipose tissue (PCAT) characteristics and systemic inflammation may play an important role in carotid endarterectomy (CEA) outcomes. This study explores the association between PCAT Hounsfield Unit (HU) ranges, radiomic features, and systemic inflammatory markers in patients undergoing carotid endarterectomy (CEA). Methods: Twenty patients undergoing CEA were included in this cross-sectional study. PCAT was analyzed using preoperative computed tomography angiography (CTA) images, with regions of interest defined around the carotid arteries. PCAT was categorized into three HU ranges: −190 to −120, −119 to −70, and −69 to −30. Radiomics features were extracted using PyRadiomics. The primary outcome was the correlation of PCAT imaging with preoperative neutrophil-to-lymphocyte ratios (NLRs). The secondary outcome was the association of PCAT imaging with the red cell distribution width (RDW-CV). Linear regression was used to evaluate associations between PCAT characteristics and inflammatory markers. Results: Distinct HU ranges in PCAT imaging showed strong correlations with the preoperative NLR. The −190 to −120 HU range demonstrated a negative association (β = −3.809, p < 0.001), whereas the −119 to −70 HU range showed a positive correlation (β = 3.814, p < 0.001). PCAT uniformity was positively associated with RDW-CV (β = 0.494, p = 0.027). Other radiomics features, such as contrast, showed trends but did not reach statistical significance. A larger outer area of PCAT was inversely associated with the NLR (β = −0.677, p < 0.001). Conclusions: Specific PCAT HU ranges and radiomics features are significantly associated with systemic inflammatory markers in CEA patients. These findings suggest that HU-based segmentation and radiomics analysis of PCAT may offer valuable insights into the relationship between local adipose tissue characteristics and systemic inflammation. Full article

One of the most widely used rocket propulsion systems that uses liquid propellants is the liquid rocket engine. Due to their high density and specific impulse, liquid fuels and oxidizers are preferred. This project’s goal was to evaluate the performance of a small-scale liquid rocket engine’s pressure feed system, which generates 250 N of thrust. A thrust bed was used for testing to obtain the experimental values, since rocket engine testing was required. A bipropellant chemical propulsion system that uses kerosene II as fuel and gaseous oxygen as an oxidant was created. Using NASA CEA, a theoretical performance evaluation was also performed in addition to this experimentation. For different propellant mixture ratios, the performance metrics under equilibrium flow, including specific impulse, characteristic velocity, thrust, and nozzle exit temperature, were examined. The performance parameters, characteristic velocity, and thrust were highest for all considered chamber pressure values and were maximum at a mixture ratio of 2.25. Full article

Background and Aims: Decreased cerebrovascular reactivity (CVR) in patients with significant internal carotid artery stenosis (ICAS ≥ 70%) is an independent risk factor for cerebral infarction. To evaluate CVR, changes in cerebral perfusion pressure and blood flow velocity (BFV) of the middle cerebral artery (MCA) can be estimated by CO₂- (hyperventilation—HV and breath-holding—BH) and pressure–flow-based (Common Carotid Artery Compression—CCC and Valsalva Maneuver—VM) stimuli. We used a multimodal approach to characterize CVR in patients before carotid endarterectomy (CEA). Methods: HV, BH, CCC, and VM tests were performed on 31, 26, and 34 patients. BFV of MCAs was monitored by transcranial Doppler, and continuous arterial blood pressure was registered non-invasively. CVR was compared between the operated significantly stenotic and the contralateral sides. Results: The extent of HV- and BH-induced CVR was similar, but the time to the lowest HV-induced BFV was shorter on the side with significant ICAS. The response to CCC was sensitive to hemodynamic asymmetry in the transient hyperemic response ratio and in the cumulative change in the (mean arterial blood pressure)/(mean BFV) ratio. In VM, the slope of BFV increased in the ascending (2b) phase, and the time to overshoot correlated with the side of the stenosis. Conclusions: These results suggest that in patients with significant ICAS, in addition to CO₂ reactivity measurements, a more complex estimation of CVR, by using hemodynamic tests (CCC and VM), should also be used to better quantify cerebral ischemic risk. Full article

Background: The prognostic utility of inflammatory and tumor biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA), in rectal cancer has been increasingly studied, but results remain inconsistent. This study evaluates the prognostic significance of pre- and post-chemoradiotherapy (CRT) levels and dynamic changes in NLR, PLR, and CEA for predicting overall survival (OS) and disease-free survival (DFS) in locally advanced rectal cancer (LARC). Methods: This retrospective study included 261 LARC patients treated with neoadjuvant CRT followed by curative surgery. Pre- and post-CRT NLR, PLR, and CEA were collected. Survival analyses were performed using Kaplan–Meier curves and Cox proportional hazards models. ROC curves assessed predictive performance, and patients were stratified by cut-offs and biomarker changes (delta values). Results: The cohort had a mean age of 55.5 years; 55.9% were male, and 93.5% had clinical stage III disease. Post-CRT NLR (HR: 1.05, p = 0.007) and CEA (HR: 1.00, p < 0.001) were independently associated with OS, while post-CRT CEA and AJCC stage III were predictors of DFS (HR: 4.12, p = 0.009). ROC analysis showed improved accuracy when combining NLR (AUC = 0.66) and CEA (AUC = 0.70), yielding a combined AUC of 0.84 for OS. Patients with decreases in both NLR and CEA had the most favorable outcomes, whereas increases in both markers indicated poor prognosis (OS p < 0.0001; DFS p = 0.00019). Conclusions: Post-CRT levels and dynamic changes in NLR and CEA are independent prognostic markers in rectal cancer. Their combined assessment enhances survival prediction and may guide personalized postoperative surveillance and treatment strategies. Full article

Cryptocurrencies such as Bitcoin can be classified as commodities under the Commodity Exchange Act (CEA), giving the Commodity Futures Trading Commission (CFTC) jurisdiction over those cryptocurrencies deemed commodities, particularly in the context of futures trading. This paper presents a method for predicting both long- and short-term trends in selected cryptocurrencies based on the Fractal Market Hypothesis (FMH). The FMH applies the self-affine properties of fractal stochastic fields to model financial time series. After introducing the underlying theory and mathematical framework, a fundamental analysis of Bitcoin and Ethereum exchange rates against the U.S. dollar is conducted. The analysis focuses on changes in the polarity of the ‘Beta-to-Volatility’ and ‘Lyapunov-to-Volatility’ ratios as indicators of impending shifts in Bitcoin/Ethereum price trends. These signals are used to recommend long, short, or hold trading positions, with corresponding algorithms (implemented in Matlab R2023b) developed and back-tested. An optimisation of these algorithms identifies ideal parameter ranges that maximise both accuracy and profitability, thereby ensuring high confidence in the predictions. The resulting trading strategy provides actionable guidance for cryptocurrency investment and quantifies the likelihood of bull or bear market dominance. Under stable market conditions, machine learning (using the ‘TuringBot’ platform) is shown to produce reliable short-horizon estimates of future price movements and fluctuations. This reduces trading delays caused by data filtering and increases returns by identifying optimal positions within rapid ‘micro-trends’ that would otherwise remain undetected—yielding gains of up to approximately 10%. Empirical results confirm that Bitcoin and Ethereum exchanges behave as self-affine (fractal) stochastic fields with Lévy distributions, exhibiting a Hurst exponent of roughly 0.32, a fractal dimension of about 1.68, and a Lévy index near 1.22. These findings demonstrate that the Fractal Market Hypothesis and its associated indices provide a robust market model capable of generating investment returns that consistently outperform standard Buy-and-Hold strategies. Full article

Background: Adnexal masses are common in women across different age and hormonal states: pregnancy, premenopause, and postmenopause. Ovarian carcinoma, a malignancy arising in the adnexa, poses significant health risks. While malignancy risk increases with age and postmenopausal status, current methods for stratifying borderline cases remain inadequate, potentially leading to over- or undertreatment that may affect fertility or survival. Methods: This retrospective study was conducted with 318 adult women who were diagnosed with adnexal masses and underwent surgery at a university hospital between 2020 and November 2023. Patient data were retrieved from the hospital’s electronic medical record system. Routinely measured preoperative serologic parameters—carbohydrate antigen (CA)125, CA19-9, CA15-3, carcinoembryonic antigen (CEA), Alpha-fetoprotein (AFP), Lactate dehydrogenase (LDH), and fibrinogen-to-albumin ratio (FAR) levels—were analyzed alongside final histopathological results. No procedures outside routine clinical practice were performed. Diagnostic performance of each marker was evaluated using receiver operating curve (ROC) analysis. Results: A total of 318 patients with adnexal masses were analyzed. The FAR levels were significantly elevated in malignant compared to borderline and benign groups (p < 0.001), and FAR alone showed 47% sensitivity and 91% specificity for borderline tumors, whereas CA125 showed 70% sensitivity and 85% specificity. Multivariate models combining FAR, CA125, and CA15-3 achieved the highest diagnostic accuracy, with superior AUCs compared to single biomarkers. Conclusions: FAR is a simple, accessible inflammatory marker that complements CA125 by enhancing specificity. Combination of multiple markers with the highest sensitivity and specificity, together with FAR, may reduce the risk of both false negatives, offering a more balanced and accurate diagnostic tool for preoperative stratification of borderline tumor cases. Full article

Optimizing spectral quality is a key strategy in controlled environment agriculture (CEA) to enhance both productivity and nutritional quality in horticultural crops. In this study, we investigated the organ-specific physiological and metabolic responses of celery (Apium graveolens L. cv. Dayehuang) to supplemental blue light at three intensities (10, 20, and 30 μmol·m⁻²·s⁻¹ with red/blue light ratios of 0.76, 0.68, and 0.60, respectively) in a plant factory with artificial lighting. Results showed that a moderate red/blue light ratio of 0.68 significantly enhanced chlorophyll accumulation, PSII quantum efficiency, and net photosynthetic rate, resulting in the highest shoot biomass without inducing photoinhibition. Leaf tissues showed marked increases in flavonoids and total phenolics, while petioles exhibited elevated soluble sugar levels and favorable modulation of volatile compound profiles. Antioxidant enzyme activities, particularly superoxide dismutase and peroxidase, were also enhanced with a moderate red/blue light ratio of 0.68, contributing to improved oxidative stress defense. Composite indices, including functional yield index and antioxidant performance index, confirmed that a moderate red/blue light ratio of 0.68 achieved the optimal trade-off between biomass production and nutritional enhancement. These findings reveal distinct organ-specific responses to supplemental blue light and underscore the value of spectral fine-tuning to simultaneously promote both source (leaf) and sink (petiole) performance in celery grown under CEA systems. Full article

Background and Objectives: Diagnosing the underlying cause of ascites remains complex, especially when cytology results are inconclusive. Measuring biomarkers directly in ascitic fluid may offer better diagnostic insight than serum testing alone. This review evaluated the clinical utility of tumor and inflammatory markers in ascitic fluid. Materials and Methods: A systematic search was conducted in PubMed and Scopus for studies published from January 2014 to December 2024, with the final search carried out in May 2025. The included studies were observational, comparative or biomarker validation studies evaluating ascitic fluid markers for diagnosing malignant and inflammatory ascites. The extracted outcomes included diagnostic accuracy metrics such as area under the curve (AUC), sensitivity and specificity. Risk of bias was evaluated using the ROBINS-I tool. Studies were excluded if they were case reports, animal studies, cytology-only analyses, or if they lacked biomarker data in ascitic or peritoneal fluid. Results: Forty-two studies met the inclusion criteria. CEA showed high diagnostic performance when measured in ascitic fluid. Combining markers or using ascitic-to-serum ratios improved diagnostic reliability. Inflammatory markers in ascitic fluid, such as CRP, IL-6 and VEGF added diagnostic value when cytology was inconclusive. Discussion and Conclusions: Evaluating biomarkers in ascitic fluid improved diagnostic accuracy. However, the included studies showed considerable methodological heterogeneity and moderate risk of bias. Full article

In solid rocket propulsion systems, overload effects induced by aircraft maneuvers can lead to gas accumulation in the afterburning chamber, resulting in severe localized ablation of thermal insulation layers and significantly compromising overall operational stability. Traditional ablation experimental methods (e.g., oxyacetylene and plasma ablation) exhibit poor correlation with the actual thermal environments in solid rocket ramjets, thereby posing substantial challenges for simulating real operational conditions. To address this issue, an oxygen-kerosene engine-based ablation device was developed. Methodologically, the CEA-optimized oxygen-to-fuel ratio (3.5) enabled authentic combustion simulation, while 3D compressible flow modeling (Ansys Fluent 2020 R2) quantified critical parameters such as chamber pressure and achieved precise control of surface temperature. Ablation experiments were conducted on diverse ablative materials using this device, yielding a maximum error in mass ablation rate of only 5.67%. This demonstrates the high accuracy of the device, which meets the requirements for ablation experiments. This reliable simulator (with an error <6%) provides a validated platform for high-fidelity evaluation of ablation performance in maneuverable solid rocket ramjets. Full article

Background/Objectives: The TOPAZ-1 phase III trial reported a survival benefit of using durvalumab, an anti-programmed death ligand 1 (anti-PD-L1) antibody, in combination with gemcitabine and cisplatin (GCD) treatment in patients with advanced biliary tract cancer. This retrospective study investigated the efficacy and safety of GCD treatment for advanced biliary tract cancer in real-world conditions. Methods: The study subjects were 52 patients with biliary tract cancer who received GCD therapy between January 2023 and May 2024. The observation parameters included the modified Glasgow Prognostic Score (mGPS), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), tumor markers (CEA, CA19-9), overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events. Results: The cohort included 36 men and 16 women, with a median age of 73.0 years. There were 36 cases of cholangiocarcinoma (distal: 10, perihilar: 19, intrahepatic: 7), 13 cases of gallbladder cancer, and 3 cases of ampullary carcinoma. The stages were locally advanced in 30 cases and metastatic in 22 cases. Biliary drainage was performed in 30 cases. There were 38 cases receiving first-line therapy and 14 cases receiving second-line or later treatments. The median values at the start of GCD therapy were ALB 3.7 g/dL, CRP 0.39 mg/dL, NLR 2.4, PLR 162.5, CEA 4.8 ng/mL, and CA19-9 255.9 U/mL. The mGPS distribution was 0:23 cases, 1:18 cases, and 2:11 cases. The treatment outcomes were ORR 25.0% (CR 2 cases, PR 11 cases), DCR 78.8% (SD 28 cases, PD 10 cases, NE 1 case), median PFS 8.6 months, and median OS 13.9 months. The PLR was suggested to be useful for predicting PFS. A decrease in CEA at six weeks after the start of treatment was a significant predictor of PFS and OS. Gallbladder cancer had a significantly poorer prognosis compared to other cancers. The immune-related adverse events included hypothyroidism in two cases, cholangitis in one case, and colitis in one case. Conclusions: The ORR, DCR, and PFS were comparable to those in the TOPAZ-1 trial. Although limited by its retrospective design and small sample size, this study suggests that GCD therapy is an effective treatment regimen for unresectable biliary tract cancer in real-world clinical practice. Full article

Objective: Tumor progression is regulated by systemic immune status, nutritional metabolism, and the inflammatory microenvironment. This study aims to investigate inflammatory–nutritional biomarkers associated with metachronous liver metastasis (MLM) in colorectal cancer (CRC) and develop a machine learning model for accurate prediction. Methods: This study enrolled 680 patients with CRC who underwent curative resection, randomly allocated into a training set (n = 477) and a validation set (n = 203) in a 7:3 ratio. Feature selection was performed using Boruta and Lasso algorithms, identifying nine core prognostic factors through variable intersection. Seven machine learning (ML) models were constructed using the training set, with the optimal predictive model selected based on comprehensive evaluation metrics. An interactive visualization tool was developed to interpret the dynamic impact of key features on individual predictions. The partial dependence plots (PDPs) revealed a potential dose–response relationship between inflammatory–nutritional markers and MLM risk. Results: Among 680 patients with CRC, the cumulative incidence of MLM at 6 months postoperatively was 39.1%. Multimodal feature selection identified nine key predictors, including the N stage, vascular invasion, carcinoembryonic antigen (CEA), systemic immune–inflammation index (SII), albumin–bilirubin index (ALBI), differentiation grade, prognostic nutritional index (PNI), fatty liver, and T stage. The gradient boosting machine (GBM) demonstrated the best overall performance (AUROC: 0.916, sensitivity: 0.772, specificity: 0.871). The generalized additive model (GAM)-fitted SHAP analysis established, for the first time, risk thresholds for four continuous variables (CEA > 8.14 μg/L, PNI < 44.46, SII > 856.36, ALBI > −2.67), confirming their significant association with MLM development. Conclusions: This study developed a GBM model incorporating inflammatory-nutritional biomarkers and clinical features to accurately predict MLM in colorectal cancer. Integrated with dynamic visualization tools, the model enables real-time risk stratification via a freely accessible web calculator, guiding individualized surveillance planning and optimizing clinical decision-making for precision postoperative care. Full article

In controlled environment agriculture (CEA), supplementary lighting, particularly light-emitting diode (LED) technology, is essential for optimizing plant growth and development. Among the spectral components, blue light (400–500 nm) plays an important role in affecting plant morphogenesis, photosynthesis, and key physiological processes. However, species-specific guidelines for optimizing blue light parameters such as intensity, duration, and spectral ratios remain insufficiently developed. Furthermore, plant spectral requirements shift across developmental stages, highlighting distinct blue light management strategies for each phase. This review synthesizes existing knowledge on the impacts of blue light on morphological adaptation, photosynthetic efficiency, flowering, and secondary metabolism, with an emphasis on differential responses across diverse plant species. We emphasize the need for growth-stage-specific lighting protocols and scalable strategies applicable to commercial CEA systems. Interdisciplinary collaboration, integrating molecular biology, genomics, and horticultural engineering, is necessary to enhance understanding of blue light-driven regulatory networks, optimize photoreceptor responses, and facilitate systematic validation of adaptive lighting approaches, ultimately advancing sustainable horticulture and next-generation CEA innovations. Full article

Background: Rectal cancer (RC) patients with a clinical complete response (cCR) after neoadjuvant chemoradiotherapy (nCRT) may qualify for a watch-and-wait (W&W) approach. However, a 20–30% local tumor regrowth rate highlights challenges in identifying true responders. This study explores markers for future near-infrared fluorescence tumor imaging by endoscopy to differentiate responders and the effect of nCRT on their expression. Methods: RC samples (n = 51) were collected from both pre-treatment biopsies and corresponding post-treatment surgical specimens. Samples were categorized by treatment response and determined using tumor regression grade (TRG) scoring. Immunohistochemistry assessed the expression of CEA, EpCAM, EGFR, and c-MET in tumors and adjacent normal tissues. Expression levels were quantified using H-scores (0–3), combining the percentage and intensity of stained cells. Pre- and post-treatment H-scores were compared to evaluate the impact of nCRT. Results: CEA, EpCAM, and c-MET were overexpressed in tumor tissue as compared to adjacent healthy mucosa in 100% (51/51), 98.4% (50/51), and 92% (47/51) of tumor biopsies, respectively, while EGFR showed no overexpression. A tumor-to-normal (T/N) ratio ≥ 2 was considered sufficient for differentiation in molecular fluorescence imaging. In pre-treatment biopsy samples, c-MET showed the highest T/N expression ratio (53% of the samples ≥ 2), followed by CEA (26.3%) and EpCAM (16%). Following nCRT treatment, CEA and c-MET maintained a ≥ 2 differential expression in 45% of all samples, whereas EpCAM exhibited this difference in only 9.2% of cases. Neoadjuvant therapy even significantly improved the T/N expression ratio for CEA and c-MET (p < 0.01) and EpCAM (p < 0.05), while EGFR expression remained lower than adjacent normal tissue. Significant increases in all marker expressions were observed in minimal responders (TRG4/5, p < 0.01–0.001), while near-complete responders (TRG2) exhibited non-significant changes in CEA, c-MET, and EGFR expression. Conclusions: c-MET and CEA emerged as optimal tumor imaging targets, showing sustained differential expression after nCRT. In vivo fluorescence-guided endoscopy using probes against these markers could play a role in future clinical decision-making. Full article

Sex steroid hormones and systemic iron metabolism are emerging as modulators of colorectal cancer (CRC) development and progression. However, information linking systemic factors to tumor characteristics and epithelial–mesenchymal transition (EMT) is limited, particularly in a sex-specific context. We measured serum levels of sex hormones [testosterone, estradiol, progesterone, Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), Carcinoembryonic antigen (CEA)] and iron-related biomarkers (iron, transferrin, ferritin, % transferrin saturation, ceruloplasmin, and the ceruloplasmin/transferrin ratio) in 82 CRC patients and 31 healthy controls. EMT-related proteins [mediator of ErbB2-driven cell motility 1 (MEMO1), E-cadherin, fibronectin, vimentin, and vinculin] were quantified by Western blotting in tumor and adjacent normal mucosa. Non-parametric tests and Spearman correlations were applied, stratified by sex and corrected for age and anemia where appropriate. Progesterone levels were significantly lower in male CRC patients (median 0.17 ng/mL vs. 0.20 ng/mL, p = 0.04) and higher in female patients (0.17 ng/mL vs. 0.10 ng/mL, p = 0.0077) compared with controls. The iron-related biomarkers indicated a pattern of iron deficiency, including in non-anemic patients, with reduced % transferrin saturation (p < 0.01) and an elevated ceruloplasmin/transferrin ratio (p = 0.02). Correlations were found between iron status, tumor stage, and hormonal levels. Progesterone correlated with EMT protein expression in healthy mucosa (e.g., fibronectin in females: ρ = 0.567, p = 0.014; vimentin in males: ρ = −0.446, p = 0.007), but not in tumor tissue. In the healthy mucosa of male patients, ceruloplasmin/transferrin correlated with MEMO1 (ρ = 0.419, p = 0.04), vinculin (ρ = 0.299, p = 0.041), and vimentin (ρ = 0.394, p = 0.07); transferrin levels inversely correlated with MEMO1 expression (ρ = −0.392, p = 0.032), and vimentin showed a positive correlation with serum iron (ρ = 0.350, p = 0.043). Furthermore, fibronectin expression inversely correlated with iron in the sole tumor tissue of female patients (ρ = −0.366, p = 0.040). These findings support the role of sex hormones and iron metabolism in CRC biology, suggesting that EMT might be accompanied by altered iron uptake and redox remodeling, which can enhance cellular motility and the metastatic potential. Full article

Light is crucial in controlled-environment agriculture (CEA), affecting germination, growth, and overall plant quality. Here, we explored the optimization of various LED light spectra on the germination traits such as germination percentage, mean germination time, germination index, vigor index, and early seedling growth of ‘Lollo Bionda’ lettuce seedlings in a plant factory. A completely randomized design was implemented, involving three replications. LED lamps with different spectral compositions—red (R, peak at 656 nm), red/blue (3:1 ratio, R:B, peak at 656 nm), blue (B, peak at 450 nm), and white (400–700 nm)—were utilized in this study. The combination of red and blue LED lights, along with monochromatic red and blue treatments, significantly enhanced germination traits and early seedling growth compared to white and ambient lighting. The combined spectrum resulted in the highest seedling emergence, the longest shoot and root lengths, and the highest fresh weight. These findings underscore the potential of the LED technology to improve germination efficiency and enhance seedling quality in CEA. Future studies should refine multispectral LED strategies by examining factors such as light intensity and photoperiod, while also elucidating the molecular pathways involved in light-driven germination and early development in lettuce. Full article