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Search Results (3,167)

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20 pages, 1309 KiB  
Systematic Review
Computational Thinking in Primary and Pre-School Children: A Systematic Review of the Literature
by Efrosyni-Alkisti Paraskevopoulou-Kollia, Christos-Apostolos Michalakopoulos, Nikolaos C. Zygouris and Pantelis G. Bagos
Educ. Sci. 2025, 15(8), 985; https://doi.org/10.3390/educsci15080985 (registering DOI) - 2 Aug 2025
Abstract
Computational Thinking (CT) has been an important concept for the computer science education community in the last 20 years. In this work we performed a systematic review of the literature regarding the computational thinking of children from kindergarten to primary school. We compiled [...] Read more.
Computational Thinking (CT) has been an important concept for the computer science education community in the last 20 years. In this work we performed a systematic review of the literature regarding the computational thinking of children from kindergarten to primary school. We compiled a large dataset of one hundred and twenty (120) studies from the literature. Through analysis of these studies, we tried to reveal important insights and draw interesting and valid conclusions. We analyzed various qualitative and quantitative aspects of the studies, including the sample size, the year of publication, the country of origin, the studies’ design and duration, the computational tools used, and so on. An important aspect of the work is to highlight differences between different study designs. We identified a total of 120 studies, with more than half of them (>50%) originating from Asian countries. Most studies (82.5%) conducted some form of intervention, aiming to improve their computational thinking in students. A smaller proportion (17.5%) were assessment studies in which the authors conducted assessments regarding the children’s computational thinking. On average, intervention studies had a smaller number of participants, but differences in duration could not be identified. There was also a lack of large-scale longitudinal studies. Block-based coding (i.e., Scratch) and Plugged and Unplugged activities were observed in high numbers in both categories of studies. CT assessment tools showed great variability. Efforts for standardization and reaching a consensus are needed in this regard. Finally, robotic systems have been found to play a major role in interventions over the last years. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to STEM Education)
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27 pages, 1326 KiB  
Systematic Review
Application of Artificial Intelligence in Pancreatic Cyst Management: A Systematic Review
by Donghyun Lee, Fadel Jesry, John J. Maliekkal, Lewis Goulder, Benjamin Huntly, Andrew M. Smith and Yazan S. Khaled
Cancers 2025, 17(15), 2558; https://doi.org/10.3390/cancers17152558 (registering DOI) - 2 Aug 2025
Abstract
Background: Pancreatic cystic lesions (PCLs), including intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs), pose a diagnostic challenge due to their variable malignant potential. Current guidelines, such as Fukuoka and American Gastroenterological Association (AGA), have moderate predictive accuracy and may lead [...] Read more.
Background: Pancreatic cystic lesions (PCLs), including intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs), pose a diagnostic challenge due to their variable malignant potential. Current guidelines, such as Fukuoka and American Gastroenterological Association (AGA), have moderate predictive accuracy and may lead to overtreatment or missed malignancies. Artificial intelligence (AI), incorporating machine learning (ML) and deep learning (DL), offers the potential to improve risk stratification, diagnosis, and management of PCLs by integrating clinical, radiological, and molecular data. This is the first systematic review to evaluate the application, performance, and clinical utility of AI models in the diagnosis, classification, prognosis, and management of pancreatic cysts. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD420251008593). Databases searched included PubMed, EMBASE, Scopus, and Cochrane Library up to March 2025. The inclusion criteria encompassed original studies employing AI, ML, or DL in human subjects with pancreatic cysts, evaluating diagnostic, classification, or prognostic outcomes. Data were extracted on the study design, imaging modality, model type, sample size, performance metrics (accuracy, sensitivity, specificity, and area under the curve (AUC)), and validation methods. Study quality and bias were assessed using the PROBAST and adherence to TRIPOD reporting guidelines. Results: From 847 records, 31 studies met the inclusion criteria. Most were retrospective observational (n = 27, 87%) and focused on preoperative diagnostic applications (n = 30, 97%), with only one addressing prognosis. Imaging modalities included Computed Tomography (CT) (48%), endoscopic ultrasound (EUS) (26%), and Magnetic Resonance Imaging (MRI) (9.7%). Neural networks, particularly convolutional neural networks (CNNs), were the most common AI models (n = 16), followed by logistic regression (n = 4) and support vector machines (n = 3). The median reported AUC across studies was 0.912, with 55% of models achieving AUC ≥ 0.80. The models outperformed clinicians or existing guidelines in 11 studies. IPMN stratification and subtype classification were common focuses, with CNN-based EUS models achieving accuracies of up to 99.6%. Only 10 studies (32%) performed external validation. The risk of bias was high in 93.5% of studies, and TRIPOD adherence averaged 48%. Conclusions: AI demonstrates strong potential in improving the diagnosis and risk stratification of pancreatic cysts, with several models outperforming current clinical guidelines and human readers. However, widespread clinical adoption is hindered by high risk of bias, lack of external validation, and limited interpretability of complex models. Future work should prioritise multicentre prospective studies, standardised model reporting, and development of interpretable, externally validated tools to support clinical integration. Full article
(This article belongs to the Section Methods and Technologies Development)
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14 pages, 2889 KiB  
Article
Ensuring Reproducibility and Deploying Models with the Image2Radiomics Framework: An Evaluation of Image Processing on PanNET Model Performance
by Florent Tixier, Felipe Lopez-Ramirez, Emir A. Syailendra, Alejandra Blanco, Ammar A. Javed, Linda C. Chu, Satomi Kawamoto and Elliot K. Fishman
Cancers 2025, 17(15), 2552; https://doi.org/10.3390/cancers17152552 (registering DOI) - 1 Aug 2025
Abstract
Background/Objectives: To evaluate the importance of image processing in a previously validated model for detecting pancreatic neuroendocrine tumors (PanNETs) and to introduce Image2Radiomics, a new framework that ensures reproducibility of the image processing pipeline and facilitates the deployment of radiomics models. Methods: A [...] Read more.
Background/Objectives: To evaluate the importance of image processing in a previously validated model for detecting pancreatic neuroendocrine tumors (PanNETs) and to introduce Image2Radiomics, a new framework that ensures reproducibility of the image processing pipeline and facilitates the deployment of radiomics models. Methods: A previously validated model for identifying PanNETs from CT images served as the reference. Radiomics features were re-extracted using Image2Radiomics and compared to those from the original model using performance metrics. The impact of nine alterations to the image processing pipeline was evaluated. Prediction discrepancies were quantified using the mean ± SD of absolute differences in PanNET probability and the percentage of classification disagreement. Results: The reference model was successfully replicated with Image2Radiomics, achieving a Cohen’s kappa coefficient of 1. Alterations to the image processing pipeline led to reductions in model performance, with AUC dropping from 0.87 to 0.71 when image windowing was removed. Prediction disagreements were observed in up to 45% of patients. Even minor changes, such as switching the library used for spatial resampling, resulted in up to 21% disagreement. Conclusions: Reproducing image processing pipelines remains challenging and limits the clinical deployment of radiomics models. While this study is limited to one model and imaging modality, the findings underscore a common risk in radiomics reproducibility. The Image2Radiomics framework addresses this issue by allowing researchers to define and share complete processing pipelines in a standardized way, improving reproducibility and facilitating model deployment in clinical and multicenter settings. Full article
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14 pages, 454 KiB  
Article
The Evaluation of Blood Prooxidant–Antioxidant Balance Indicators and Cortisol Pre- and Post-Surgery in Patients with Benign Parotid Gland Tumors: A Preliminary Study
by Sebastian Bańkowski, Jan Pilch, Bartosz Witek, Jarosław Markowski, Wirginia Likus, Michał Rozpara and Ewa Sadowska-Krępa
J. Clin. Med. 2025, 14(15), 5425; https://doi.org/10.3390/jcm14155425 (registering DOI) - 1 Aug 2025
Abstract
Background: The majority of parotid gland tumors are benign, e.g., pleomorphic adenoma (PA) and Warthin’s tumor (WT). From a biomedical point of view, oxidative stress is of significant importance due to its established association with the initiation and progression of various types of [...] Read more.
Background: The majority of parotid gland tumors are benign, e.g., pleomorphic adenoma (PA) and Warthin’s tumor (WT). From a biomedical point of view, oxidative stress is of significant importance due to its established association with the initiation and progression of various types of cancer, including parotid gland cancers. This study aimed to assess whether blood prooxidant–antioxidant markers could aid in diagnosing and guiding surgery for recurrent malignancies after parotid tumor treatment. Methods: We examined patients (n = 20) diagnosed with WT (n = 14) and PA (n = 6) using histopathological verification and computed tomography (CT) who qualified for surgical treatment. Blood samples were taken before the surgery and again 10 days later for biochemical analysis. The activities of the antioxidant enzymes (SOD, CAT and GPx), the non-enzymatic antioxidants (GSH and UA) and oxidative stress markers (MDA and TOS) were determined in the blood. The activities of CK and LDH and the concentrations of Cor and TAS were measured in the serum. Hb and Ht were determined in whole blood. Results: The patients’ SOD, CAT, and GPx activities after surgery did not differ significantly from their preoperative levels. However, following surgery, their serum TOS levels were significantly elevated in all the patients compared to baseline. In contrast, the plasma MDA concentrations were markedly reduced after surgery. Similarly, the GSH concentrations showed a significant decrease postoperatively. No significant changes were observed in the CK and LDH activities, TAS concentrations, or levels of Hb, Ht and Cor following surgery. Conclusions: The surgical removal of salivary gland tumors did not result in a reduction in oxidative stress at 10 days after surgery. Therefore, further studies are needed to determine the effectiveness of endogenous defense mechanisms in counteracting the oxidative stress induced by salivary gland tumors. Full article
(This article belongs to the Section Oncology)
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11 pages, 1707 KiB  
Article
Genetic Variant of the Canine FGF5 Gene for the Hair Length Trait in the Akita: Utility for Hair Coat Variations and Welfare in Conservation Breeding
by Shinichiro Maki, Md Shafiqul Islam, Norio Kansaku, Nanami Arakawa, Akira Yabuki, Tofazzal Md Rakib, Abdullah Al Faruq and Osamu Yamato
Genes 2025, 16(8), 927; https://doi.org/10.3390/genes16080927 (registering DOI) - 1 Aug 2025
Abstract
Background/Objectives: Variations in hair length are observed in many dog breeds, as determined by the canine FGF5 gene. Long-haired Akitas, which are disqualified under breeding standards of Akitas, are sometimes born to short-haired parents and may have been subjected to treatments compromising [...] Read more.
Background/Objectives: Variations in hair length are observed in many dog breeds, as determined by the canine FGF5 gene. Long-haired Akitas, which are disqualified under breeding standards of Akitas, are sometimes born to short-haired parents and may have been subjected to treatments compromising animal welfare. Here, we aimed to identify an FGF5 variant associated with hair coat variations in Akitas in Japan, and to assess how welfare of this breed can be improved by carefully planned breeding. Methods: DNA samples were obtained from 60 Akitas in 2021 (modern Akitas) and 73 Akitas in the 1970s and the 1980s (classic Akitas). Sanger sequencing was performed on all exons and exon–intron junctions of the FGF5 gene to determine the causative variant of long hair in Akitas. A real-time PCR assay was developed to genotype FGF5:c.578C>T in modern and classic Akitas. Using 54 dogs from modern Akitas, scores (1 to 10) of hair length were compared among the three genotypes (C/C, C/T, and T/T). Results: Sanger sequencing revealed that the canine FGF5:c.578C>T variant was associated with long hair in Akitas in Japan. Genotyping revealed that the frequency of the mutant T allele was 0.350 in modern Akitas, which was significantly higher (p < 0.001) than in classic Akitas (0.212). The three genotypes were not in Hardy–Weinberg equilibrium (HWE) in modern Akitas but were in HWE in classic Akitas. There were significant differences in hair length scores among the three genotypes (p < 0.001) and between the C/C and C/T genotypes (p < 0.005). There was no significant difference in the scores between male and female dogs. Conclusions: This study revealed that a causative variant that determines the long hair trait of Akitas in Japan was the FGF5:c.578C>T variant, which was inherited in an incompletely dominant manner. Akita dog breeders were more likely to select heterozygous C/T dogs based on the appearance of the hair coat for breeding dogs with an ideal fluffy hair coat. This might result in a high mutant T allele frequency and the production of undesired long-haired Akitas with T/T, which may create welfare problems. Genetic testing for this variant is necessary to improve welfare and conserve the Akita breed. Full article
(This article belongs to the Special Issue Genetics in Canines: From Evolution to Conservation)
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12 pages, 955 KiB  
Article
Single-Center Preliminary Experience Treating Endometrial Cancer Patients with Fiducial Markers
by Francesca Titone, Eugenia Moretti, Alice Poli, Marika Guernieri, Sarah Bassi, Claudio Foti, Martina Arcieri, Gianluca Vullo, Giuseppe Facondo, Marco Trovò, Pantaleo Greco, Gabriella Macchia, Giuseppe Vizzielli and Stefano Restaino
Life 2025, 15(8), 1218; https://doi.org/10.3390/life15081218 - 1 Aug 2025
Abstract
Purpose: To present the findings of our preliminary experience using daily image-guided radiotherapy (IGRT) supported by implanted fiducial markers (FMs) in the radiotherapy of the vaginal cuff, in a cohort of post-surgery endometrial cancer patients. Methods: Patients with vaginal cuff cancer [...] Read more.
Purpose: To present the findings of our preliminary experience using daily image-guided radiotherapy (IGRT) supported by implanted fiducial markers (FMs) in the radiotherapy of the vaginal cuff, in a cohort of post-surgery endometrial cancer patients. Methods: Patients with vaginal cuff cancer requiring adjuvant radiation with external beams were enrolled. Five patients underwent radiation therapy targeting the pelvic disease and positive lymph nodes, with doses of 50.4 Gy in twenty-eight fractions and a subsequent stereotactic boost on the vaginal vault at a dose of 5 Gy in a single fraction. One patient was administered 30 Gy in five fractions to the vaginal vault. These patients underwent external beam RT following the implantation of three 0.40 × 10 mm gold fiducial markers (FMs). Our IGRT strategy involved real-time 2D kV image-based monitoring of the fiducial markers during the treatment delivery as a surrogate of the vaginal cuff. To explore the potential role of FMs throughout the treatment process, we analyzed cine movies of the 2D kV-triggered images during delivery, as well as the image registration between pre- and post-treatment CBCT scans and the planning CT (pCT). Each CBCT used to trigger fraction delivery was segmented to define the rectum, bladder, and vaginal cuff. We calculated a standard metric to assess the similarity among the images (Dice index). Results: All the patients completed radiotherapy and experienced good tolerance without any reported acute or long-term toxicity. We did not observe any loss of FMs during or before treatment. A total of twenty CBCTs were analyzed across ten fractions. The observed trend showed a relatively emptier bladder compared to the simulation phase, with the bladder filling during the delivery. This resulted in a final median Dice similarity coefficient (DSC) of 0.90, indicating strong performance. The rectum reproducibility revealed greater variability, negatively affecting the quality of the delivery. Only in two patients, FMs showed intrafractional shift > 5 mm, probably associated with considerable rectal volume changes. Target coverage was preserved due to a safe CTV-to-PTV margin (10 mm). Conclusions: In our preliminary study, CBCT in combination with the use of fiducial markers to guide the delivery proved to be a feasible method for IGRT both before and during the treatment of post-operative gynecological cancer. In particular, this approach seems to be promising in selected patients to facilitate the use of SBRT instead of BRT (brachytherapy), thanks to margin reduction and adaptive strategies to optimize dose delivery while minimizing toxicity. A larger sample of patients is needed to confirm our results. Full article
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17 pages, 3686 KiB  
Article
Beauty or the Beast? A Puzzling Modification of the Clypeus and Mandibles on the Eocene Ant
by Dmitry Zharkov, Dmitry Dubovikoff and Evgeny Abakumov
Insects 2025, 16(8), 794; https://doi.org/10.3390/insects16080794 (registering DOI) - 31 Jul 2025
Abstract
Some Cretaceous ants belonging to the stem group of Formicidae exhibit bizarre morphology. This wide range of unusual adaptive features is primarily related to the mouthparts and clypeus. The researchers were perplexed by their specific ecology, as modern ant lineages do not exhibit [...] Read more.
Some Cretaceous ants belonging to the stem group of Formicidae exhibit bizarre morphology. This wide range of unusual adaptive features is primarily related to the mouthparts and clypeus. The researchers were perplexed by their specific ecology, as modern ant lineages do not exhibit anything similar. Here, we report and describe a new genus based on an extraordinary and mysterious alate ant from Late Eocene Baltic amber. Undoubtedly, the new ant is classified within the subfamily Formicinae (one of the crown groups), yet it displays a highly specialised morphology and an unusual array of features that are not observed in any extant ant lineages. Neither recent nor extinct ants have such a combination of features. While the exact phylogenetic placement of the new ant remains uncertain, we offer a discussion of its potential affinities based on our constrained phylogenetic analyses. We propose that †Eridanomyrma gen. n. should be considered in the new tribe †Eridanomyrmini trib. n. This new taxon highlights the adaptive diversity of a highly specialised, extinct lineage of Eocene crown-group ants. We also present a 3D model based on X-ray computed microtomography (µCT). Full article
(This article belongs to the Special Issue Fossil Insects: Diversity and Evolutionary History)
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14 pages, 871 KiB  
Article
Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery
by Álvaro Pérez-Sala, Pablo Montes Fernández-Micheltorena, Miriam Bobadilla, Ricardo Fernández-Valadés Gámez, Javier Martínez Goñi, Ángela Villanueva, Iñigo Calvo Archanco, José Luis Del Castillo Pardo de Vera, José Luis Cebrián Carretero, Carlos Navarro Cuéllar, Ignacio Navarro Cuellar, Gema Arenas, Ana López López, Ignacio M. Larrayoz and Rafael Peláez
Appl. Sci. 2025, 15(15), 8478; https://doi.org/10.3390/app15158478 (registering DOI) - 30 Jul 2025
Viewed by 169
Abstract
Orthognathic surgery (OS) is a complex procedure commonly used to treat dentofacial deformities (DFDs). These conditions, related to jaw position or size and often involving malocclusion, affect approximately 15% of the population. Due to the complexity of OS, accurate planning is essential. Digital [...] Read more.
Orthognathic surgery (OS) is a complex procedure commonly used to treat dentofacial deformities (DFDs). These conditions, related to jaw position or size and often involving malocclusion, affect approximately 15% of the population. Due to the complexity of OS, accurate planning is essential. Digital assessment using computer-aided design (CAD) and computer-aided manufacturing (CAM) tools enhances surgical predictability. However, limitations in soft tissue simulation often require surgeon input to optimize aesthetic results and minimize surgical impact. This study aimed to evaluate the accuracy of virtual surgery planning (VSP) by analyzing the relationship between planning deviations and surgical satisfaction. A single-center, retrospective study was conducted on 16 patients who underwent OS at San Pedro University Hospital of La Rioja. VSP was based on CT scans using Dolphin Imaging software (v12.0, Patterson Dental, St. Paul, MN, USA) and surgeries were guided by VSP-designed occlusal splints. Outcomes were assessed using the Orthognathic Quality of Life (OQOL) questionnaire and deviations were measured through pre- and postoperative imaging. The results showed high satisfaction scores and good overall outcomes, despite moderate deviations from the virtual plan in many cases, particularly among Class II patients. A total of 63% of patients required VSP modifications due to poor soft tissue fitting, with 72% of these being Class II DFDs. Most deviations involved less maxillary advancement than planned, while maintaining optimal occlusion. This suggests that VSP may overestimate advancement needs, especially in Class II cases. No significant differences in satisfaction were observed between patients with low (<2 mm) and high (>2 mm) deviations. These findings support the use of VSP as a valuable planning tool for OS. However, surgeon experience remains essential, especially in managing soft tissue behavior. Improvements in soft tissue prediction are needed to enhance accuracy, particularly for Class II DFDs. Full article
(This article belongs to the Special Issue Intelligent Medicine and Health Care, 2nd Edition)
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12 pages, 537 KiB  
Article
Surgical Versus Conservative Management of Supratentorial ICH: A Single-Center Retrospective Analysis (2017–2023)
by Cosmin Cindea, Samuel Bogdan Todor, Vicentiu Saceleanu, Tamas Kerekes, Victor Tudor, Corina Roman-Filip and Romeo Gabriel Mihaila
J. Clin. Med. 2025, 14(15), 5372; https://doi.org/10.3390/jcm14155372 - 30 Jul 2025
Viewed by 182
Abstract
Background: Intracerebral hemorrhage (ICH) is a severe form of stroke associated with high morbidity and mortality. While neurosurgical evacuation may offer theoretical benefits, its impact on survival and hospital course remains debated. We aimed to compare the outcomes of surgical versus conservative [...] Read more.
Background: Intracerebral hemorrhage (ICH) is a severe form of stroke associated with high morbidity and mortality. While neurosurgical evacuation may offer theoretical benefits, its impact on survival and hospital course remains debated. We aimed to compare the outcomes of surgical versus conservative management in patients with lobar, capsulo-lenticular, and thalamic ICH and to identify factors influencing mortality and the surgical decision. Methods: This single-center, retrospective cohort study included adult patients admitted to the County Clinical Emergency Hospital of Sibiu (2017–2023) with spontaneous supratentorial ICH confirmed via CT (deepest affected structure determining lobar, capsulo-lenticular, or thalamic location). We collected data on demographics, clinical presentation (Glasgow Coma Scale [GCS], anticoagulant use), hematoma characteristics (volume, extension), treatment modality (surgical vs. conservative), and in-hospital outcomes (mortality, length of stay). Statistical analyses included t-tests, χ2, correlation tests, and logistic regression to identify independent predictors of mortality and surgery. Results: A total of 445 patients were analyzed: 144 lobar, 150 capsulo-lenticular, and 151 thalamic. Surgical intervention was more common in patients with larger volumes and lower GCS. Overall, in-hospital mortality varied by location, reaching 13% in the lobar group, 20.7% in the capsulo-lenticular group, and 35.1% in the thalamic group. Within each location, surgical intervention did not significantly reduce overall in-hospital mortality despite the more severe baseline presentation in surgical patients. In lobar ICH specifically, no clear survival advantage emerged, although surgery may still benefit those most severely compromised. For capsulo-lenticular hematomas > 30 mL, surgery was associated with lower mortality (39.4% vs. 61.5%). In patients with large lobar ICH, surgical intervention was associated with mortality rates similar to those seen in less severe, conservatively managed cohorts. Multivariable adjustment confirmed GCS and hematoma volume as independent mortality predictors; age and volume predicted the likelihood of surgical intervention. Conclusions: Despite targeting more severe cases, neurosurgical evacuation did not uniformly lower in-hospital mortality. In lobar ICH, surgical patients with larger hematomas (~48 mL) and lower GCS (~11.6) had mortality rates (~13%) comparable to less severe, conservative cohorts, indicating that surgical intervention was associated with similar mortality rates despite higher baseline risk. However, these findings do not establish a causal survival benefit and should be interpreted in the context of non-randomized patient selection. For capsulo-lenticular hematomas > 30 mL, surgery was associated with lower observed mortality (39.4% vs. 61.5%). Thalamic ICH remained most lethal, highlighting the difficulty of deep-brain bleeds and frequent ventricular extension. Across locations, hematoma volume and GCS were the primary outcome predictors, indicating the need for timely intervention, better patient selection, and possibly minimally invasive approaches. Future prospective multicenter research is necessary to refine surgical indications and validate these findings. To our knowledge, this investigation represents the largest and most contemporary single-center cohort study of supratentorial intracerebral hemorrhage conducted in Romania. Full article
(This article belongs to the Section Brain Injury)
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12 pages, 402 KiB  
Article
SBRT in the Very Elderly: A Viable Option for Pulmonary Oligometastases?
by Samuel M. Vorbach, Meinhard Nevinny-Stickel, Ute Ganswindt and Thomas Seppi
Cancers 2025, 17(15), 2512; https://doi.org/10.3390/cancers17152512 - 30 Jul 2025
Viewed by 227
Abstract
Background/Objectives: The global population of individuals aged ≥ 80 years is rapidly growing, leading to an increasing incidence of cancer diagnoses in this age group. While stereotactic body radiotherapy (SBRT) has proven effective in treating pulmonary oligometastases, patients over 80 remain underrepresented in [...] Read more.
Background/Objectives: The global population of individuals aged ≥ 80 years is rapidly growing, leading to an increasing incidence of cancer diagnoses in this age group. While stereotactic body radiotherapy (SBRT) has proven effective in treating pulmonary oligometastases, patients over 80 remain underrepresented in clinical analyses. This study aimed to evaluate clinical outcomes and toxicity of SBRT for pulmonary oligometastases in octogenarians. Methods: This retrospective, single-centre analysis included 34 patients aged ≥ 80 years treated with SBRT for histologically confirmed pulmonary oligometastases between 2010 and 2024. Results: A total of 46 pulmonary metastases were treated with curative intent using fractionation schemes of 3 × 15 Gy, 6 × 8 Gy, or 10 × 6 Gy. Median biologically effective dose (BED10) was 112.5 Gy. Follow-up included regular CT imaging and toxicity assessment according to CTCAE. With a median follow-up of 22.6 months, 1-, 2-, and 3-year local control (LC) rates were 95.2%, 95.2%, and 90.2%, respectively. Median overall survival (OS) was 46.6 months, with 1-, 2-, and 3-year OS rates of 78.4%, 71.4%, and 59.5%. Progression-free survival (PFS) at 1, 2, and 3 years was 63.4%, 51.6%, and 47.3%, respectively. No grade ≥ 3 toxicities were observed. Grade 2 pneumonitis and dermatitis occurred in 2.9% each and were well managed. Asymptomatic rib fractures were detected in 5.9% of patients. No significant predictors for LC, PFS, or OS were identified in univariate analysis. Conclusions: SBRT for pulmonary oligometastases in patients ≥ 80 years is feasible, safe, and effective. High local control, favourable cancer-specific survival, and minimal toxicity support its use as a curative-intent treatment in this growing patient population. These findings contribute important site- and age-specific evidence and support the inclusion of very elderly patients in future prospective SBRT trials. Full article
(This article belongs to the Special Issue Treatment Outcomes in Older Adults with Cancer)
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14 pages, 909 KiB  
Article
The -124C>T Mutation of the TERT Promoter Indicates Favorable Prognosis in Ovarian Clear Cell Carcinoma: A Single Institutional Study in China
by Xiaonan Zhou, Yifei Liu, Jue Hu, Jing Zhang, Min Ren, Gang Ji, Xu Cai and Rui Bi
Curr. Oncol. 2025, 32(8), 422; https://doi.org/10.3390/curroncol32080422 - 27 Jul 2025
Viewed by 340
Abstract
Background: Ovarian clear cell carcinoma (OCCC) is characterized by chemoresistance and poor prognosis in advanced or recurrent cases. This study aimed to find specific prognostic markers for OCCC. Methods: We analyzed 169 OCCC patients for clinicopathological features. TERT promoter and PIK3CA mutations were [...] Read more.
Background: Ovarian clear cell carcinoma (OCCC) is characterized by chemoresistance and poor prognosis in advanced or recurrent cases. This study aimed to find specific prognostic markers for OCCC. Methods: We analyzed 169 OCCC patients for clinicopathological features. TERT promoter and PIK3CA mutations were assessed by Sanger sequencing, and immunohistochemistry for ARID1A, HDAC6, Cyclin E1, and p53 was performed on tissue microarrays. Survival analysis was conducted using Kaplan–Meier and Cox regression models. Results: The -124C>T TERT promoter mutation was associated with longer OS and PFS and was an independent predictor of favorable OS. This mutation correlated with lower CA125 levels and higher SNP frequency. p53 mutations indicated advanced disease, bilateral tumors, reduced Cyclin E1, and poor prognosis. Low HDAC6 expression was linked to worse PFS. Mutual exclusivity was observed between PIK3CA exon 20 mutations and SNPs. Conclusions: The -124C>T TERT promoter mutation may serve as a favorable prognostic marker in OCCC, while p53 mutations and reduced HDAC6 expression are associated with poor outcomes. Full article
(This article belongs to the Section Gynecologic Oncology)
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10 pages, 226 KiB  
Article
Association of SIRT1 Promoter Polymorphisms with Type 2 Diabetes Mellitus and Pregnancy-Related Complications in the Greek Population
by Sophia Letsiou, Eirini Prountzou, Despina Vougiouklaki, Maria Trapali, Michail Papapanou, Zoe Siateli, Konstantinos Ladias, Dimitra Houhoula and Panagiotis Halvatsiotis
Genes 2025, 16(8), 886; https://doi.org/10.3390/genes16080886 - 27 Jul 2025
Viewed by 239
Abstract
Background/Objectives: SIRT1 is a NAD+-dependent protein deacetylase regulating metabolic and stress response pathways. Genetic variations in the SIRT1 gene may contribute to the pathogenesis of type 2 diabetes mellitus (T2DM). This case–control study investigates the associations of two SIRT1 promoter polymorphisms, [...] Read more.
Background/Objectives: SIRT1 is a NAD+-dependent protein deacetylase regulating metabolic and stress response pathways. Genetic variations in the SIRT1 gene may contribute to the pathogenesis of type 2 diabetes mellitus (T2DM). This case–control study investigates the associations of two SIRT1 promoter polymorphisms, rs12778366 and rs3758391, in patients with type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM), preeclampsia, and healthy controls. Methods: This case–control study compared the genotypes between T2DM and pregnant and non-pregnant controls. We also compared genotypes between pregnant women with T2DM, GDM, preeclampsia, and healthy pregnant controls. Genomic DNA was extracted and analyzed using PCR-RFLP for the detection of rs12778366 and rs3758391 polymorphisms. Genotype frequencies were compared using chi-square tests, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: The study included 66 patients with T2DM, 36 with GDM, 12 with preeclampsia, and 81 pregnant and non-pregnant controls (33 pregnant controls). Although rs3758391 was more frequent in T2DM, the difference was not statistically significant between SIRT1 polymorphisms and T2DM. The CT genotype was more prevalent in T2DM (54.5%) compared to controls (33.4%); however, this difference was not significant. We finally found no significant association of the investigated SIRT1 polymorphisms with any of the conditions studied. In addition, the small sample size, especially for preeclampsia cases, limits the statistical power to detect significant associations. Conclusions: Although no significant association was observed between SIRT1 polymorphisms and diabetes, the findings of our study underscore the need for further studies examining SIRT1 polymorphisms in various ethnic groups, with a focus on leveraging these genetic variations in diabetes pathophysiology. Larger studies in the Greek population could also provide additional meaningful findings. Full article
(This article belongs to the Section Human Genomics and Genetic Diseases)
13 pages, 617 KiB  
Article
Management and Outcomes of Blunt Renal Trauma: A Retrospective Analysis from a High-Volume Urban Emergency Department
by Bruno Cirillo, Giulia Duranti, Roberto Cirocchi, Francesca Comotti, Martina Zambon, Paolo Sapienza, Matteo Matteucci, Andrea Mingoli, Sara Giovampietro and Gioia Brachini
J. Clin. Med. 2025, 14(15), 5288; https://doi.org/10.3390/jcm14155288 - 26 Jul 2025
Viewed by 276
Abstract
Background: Renal trauma accounts for approximately 3–5% of all trauma cases, predominantly affecting young males. The most common etiology is blunt trauma, particularly due to road traffic accidents, and it frequently occurs as part of polytrauma involving multiple organ systems. Management strategies are [...] Read more.
Background: Renal trauma accounts for approximately 3–5% of all trauma cases, predominantly affecting young males. The most common etiology is blunt trauma, particularly due to road traffic accidents, and it frequently occurs as part of polytrauma involving multiple organ systems. Management strategies are primarily dictated by hemodynamic stability, overall clinical condition, comorbidities, and injury severity graded according to the AAST classification. This study aimed to evaluate the effectiveness of non-operative management (NOM) in high-grade renal trauma (AAST grades III–V), beyond its established role in low-grade injuries (grades I–II). Secondary endpoints included the identification of independent prognostic factors for NOM failure and in-hospital mortality. Methods: We conducted a retrospective observational study including patients diagnosed with blunt renal trauma who presented to the Emergency Department of Policlinico Umberto I in Rome between 1 January 2013 and 30 April 2024. Collected data comprised demographics, trauma mechanism, vital signs, hemodynamic status (shock index), laboratory tests, blood gas analysis, hematuria, number of transfused RBC units in the first 24 h, AAST renal injury grade, ISS, associated injuries, treatment approach, hospital length of stay, and mortality. Statistical analyses, including multivariable logistic regression, were performed using SPSS v28.0. Results: A total of 244 patients were included. Low-grade injuries (AAST I–II) accounted for 43% (n = 105), while high-grade injuries (AAST III–V) represented 57% (n = 139). All patients with low-grade injuries were managed non-operatively. Among high-grade injuries, 124 patients (89%) were treated with NOM, including observation, angiography ± angioembolization, stenting, or nephrostomy. Only 15 patients (11%) required nephrectomy, primarily due to persistent hemodynamic instability. The overall mortality rate was 13.5% (33 patients) and was more closely associated with the overall injury burden than with renal injury severity. Multivariable analysis identified shock index and active bleeding on CT as independent predictors of NOM failure, whereas ISS and age were significant predictors of in-hospital mortality. Notably, AAST grade did not independently predict either outcome. Conclusions: In line with the current international literature, our study confirms that NOM is the treatment of choice not only for low-grade renal injuries but also for carefully selected hemodynamically stable patients with high-grade trauma. Our findings highlight the critical role of physiological parameters and overall ISS in guiding management decisions and underscore the need for individualized assessment to minimize unnecessary nephrectomies and optimize patient outcomes. Full article
(This article belongs to the Special Issue Emergency Surgery: Clinical Updates and New Perspectives)
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12 pages, 1720 KiB  
Article
Synergistic Imaging: Combined Lung Ultrasound and Low-Dose Chest CT for Quantitative Assessment of COVID-19 Severity—A Prospective Observational Study
by Andrzej Górecki, Piotr Piech, Karolina Kołodziejczyk, Ada Jankowska, Zuzanna Szostak, Anna Bronikowska, Bartosz Borowski and Grzegorz Staśkiewicz
Diagnostics 2025, 15(15), 1875; https://doi.org/10.3390/diagnostics15151875 - 26 Jul 2025
Viewed by 276
Abstract
Background/Objectives: To assess quantitatively the correlation between the lung ultrasound severity scores (LUSSs) and chest CT severity scores (CTSSs) derived from low-dose computed tomography (LDCT) for evaluating pulmonary inflammation in COVID-19 patients. Methods: In this prospective observational study, from an initial cohort of [...] Read more.
Background/Objectives: To assess quantitatively the correlation between the lung ultrasound severity scores (LUSSs) and chest CT severity scores (CTSSs) derived from low-dose computed tomography (LDCT) for evaluating pulmonary inflammation in COVID-19 patients. Methods: In this prospective observational study, from an initial cohort of 1000 patients, 555 adults (≥18 years) with confirmed COVID-19 were enrolled based on inclusion criteria. All underwent LDCT imaging, scored by the CTSS (0–25 points), quantifying involvement across five lung lobes. Lung ultrasound examinations using standardized semi-quantitative scales for the B-line (LUSS B) and consolidation (LUSS C) were performed in a subgroup of 170 patients; 110 had follow-up imaging after one week. Correlation analyses included Spearman’s and Pearson’s coefficients. Results: Significant positive correlations were found between the CTSS and both the LUSS B (r = 0.32; p < 0.001) and LUSS C (r = 0.24; p = 0.006), with the LUSS B showing a slightly stronger relationship. Each incremental increase in the LUSS B corresponded to an average increase of 0.18 CTSS points, whereas a one-point increase in the LUSS C corresponded to a 0.27-point CTSS increase. The mean influence of the LUSS on CTSS was 8.0%. Neither ultrasound score significantly predicted ICU admission or mortality (p > 0.05). Conclusion: Standardized lung ultrasound severity scores show a significant correlation with low-dose CT in assessing pulmonary involvement in COVID-19, particularly for the B-line artifacts. Lung ultrasound represents a valuable bedside tool, complementing—but not substituting—CT in predicting clinical severity. Integrating both imaging modalities may enable the acquisition of complementary bedside information and facilitate dynamic monitoring of disease progression. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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37 pages, 11546 KiB  
Review
Advances in Interferometric Synthetic Aperture Radar Technology and Systems and Recent Advances in Chinese SAR Missions
by Qingjun Zhang, Huangjiang Fan, Yuxiao Qin and Yashi Zhou
Sensors 2025, 25(15), 4616; https://doi.org/10.3390/s25154616 - 25 Jul 2025
Viewed by 372
Abstract
With advancements in radar sensors, communications, and computer technologies, alongside an increasing number of ground observation tasks, Synthetic Aperture Radar (SAR) remote sensing is transitioning from being theory and technology-driven to being application-demand-driven. Since the late 1960s, Interferometric Synthetic Aperture Radar (InSAR) theories [...] Read more.
With advancements in radar sensors, communications, and computer technologies, alongside an increasing number of ground observation tasks, Synthetic Aperture Radar (SAR) remote sensing is transitioning from being theory and technology-driven to being application-demand-driven. Since the late 1960s, Interferometric Synthetic Aperture Radar (InSAR) theories and techniques have continued to develop. They have been applied significantly in various fields, such as in the generation of global topography maps, monitoring of ground deformation, marine observations, and disaster reduction efforts. This article classifies InSAR into repeated-pass interference and single-pass interference. Repeated-pass interference mainly includes D-InSAR, PS-InSAR and SBAS-InSAR. Single-pass interference mainly includes CT-InSAR and AT-InSAR. Recently, China has made significant progress in the field of SAR satellite development, successfully launching several satellites equipped with interferometric measurement capabilities. These advancements have driven the evolution of spaceborne InSAR systems from single-frequency to multi-frequency, from low Earth orbit to higher orbits, and from single-platform to multi-platform configurations. These advancements have supported high precision and high-temporal-resolution land observation, and promoted the broader application of InSAR technology in disaster early warning, ecological monitoring, and infrastructure safety. Full article
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