Search Results (105)

Hybrid polysaccharide-based aerogels offer significant potential as advanced drug delivery platforms due to their tunable structure, high porosity, and biocompatibility. In this study, aerogel microparticles were synthesized using alginate, pectin, carrageenan, and their hybrid formulations via an emulsion–gelation technique followed by supercritical fluid CO₂ extraction. The resulting aerogels exhibit mesoporous structures with specific surface areas ranging from 324 to 521 m²/g and pore volumes between 1.99 and 3.75 cm³/g. Comprehensive characterization (SEM, gas sorption, XRD, TGA, DSC, and FTIR) confirmed that hybridization improved morphological uniformity and thermal stability compared to single polymer aerogels. Ibuprofen was used as a model drug to evaluate loading efficiency and release kinetics. Among all formulations, the alginate/carrageenan (2:1) hybrid showed the highest drug loading efficiency (93.5%) and a rapid release profile (>90% within 15 min), closely matching the performance of commercial ibuprofen tablets. Drug release followed Fickian diffusion, as confirmed by the Korsmeyer–Peppas model (R² > 0.99). These results highlight the potential of hybrid polysaccharide aerogels as vehicles for drug delivery and other fast-acting therapeutic applications. Full article

Background and Objectives: Multiple primary malignancies involving endometrial carcinoma (EC) present complex diagnostic and management challenges. This study aimed to identify clinical, pathological, and demographic patterns among patients with EC and a second primary tumor and assess the role of comorbidities in tumor behavior. Materials and Methods: We retrospectively analyzed 35 women diagnosed with EC and a second malignancy between 2017 and 2024. We evaluated clinical variables, tumor characteristics, and comorbidities. Statistical analysis included chi-square tests, Mann–Whitney U tests, Kruskal–Wallis tests, Spearman correlations, and logistic regression. Multiple testing correction was applied using the Benjamini–Hochberg method. Results: Endometrioid EC was the most prevalent subtype (80%), most frequently associated with breast (28.5%) and colorectal cancers (11.4%). Obesity (45.7%), hypertension (62.9%), and diabetes (22.9%) were common. While univariate analysis suggested associations between comorbidities and tumor features (e.g., obesity and tumor type, ρ = 0.30, p = 0.08), no correlation remained significant after adjustment. Logistic regression identified age (OR = 0.88, CI: 0.79–0.98, p = 0.022) and obesity (OR = 0.11, CI: 0.01–0.83, p = 0.033) as independent predictors of non-endometrioid histology. Conclusions: These findings suggest that age and obesity may influence histological differentiation in EC with multiple primaries. This study suggest that age and obesity may play a role in the histological differentiation of EC in patients with multiple primary tumors. The small cohort size (n = 35) limits the statistical power and generalizability of the results; therefore, they should be regarded as exploratory and hypothesis-generating, warranting validation in larger prospective studies. Full article

This study investigates the use of untreated coconut coir fibers as a sustainable reinforcement in cement mortars, with emphasis on the combined effects of fiber content (0.5–2.0% by volume) and length (10–25 mm) on mechanical performance and water absorption. Sixteen mortar mixes were tested for water absorption, flexural and compressive strength, and microstructural characteristics. Results showed that moderate fiber addition significantly improved both strength and durability. The optimal mix (1.0% fiber, 15 mm length) achieved 8.36 MPa in flexural and 29.28 MPa in compressive strength, representing 61% and 131% improvements over the control, respectively. It also recorded the lowest water absorption (8.38%), attributed to improved fiber–matrix bonding and densification of the interfacial transition zone, as confirmed by Scanning Electron Microscopy. In contrast, excessive fiber dosages led to agglomeration, reduced workability, and diminished performance. A third-degree polynomial regression model was developed to predict mechanical properties based on fiber parameters. The findings demonstrate the feasibility of using untreated coconut waste fibers to enhance mortar performance while contributing to sustainable construction practices aligned with circular economy principles and SDGs. This work provides practical insights into fiber optimization and supports broader adoption of bio-based materials in cementitious systems. Full article

Background and Clinical Significance: Cardiac myxomas, though typically benign and asymptomatic, can rarely present with acute cardiovascular compromise. We report a case of a left atrial myxoma presenting as acute pulmonary edema in a patient with prior normal cardiac imaging. Case Presentation: A 55-year-old male, with a history of thrombolyzed myocardial infarction and normal coronary angiography and echocardiography five years earlier, was admitted with acute dyspnea and pulmonary edema. Bedside transthoracic echocardiography (TTE) revealed a left atrial mass causing severe mitral inflow obstruction. Emergency surgical excision was performed, and the mass was submitted for histopathological analysis. Discussion: Histology confirmed cardiac myxoma. The procedure and recovery were uneventful, and follow-up at one month confirmed no recurrence. Conclusions: This case illustrates the potential for cardiac myxoma to manifest suddenly with life-threatening symptoms, even after previously normal investigations. Echocardiography remains pivotal in diagnosing intracardiac masses and guiding timely intervention. Full article

Natural polymers, such as gelatin, offer a sustainable, green, and versatile alternative for developing proton exchange membranes in low-temperature fuel cell applications. They provide a balance of biocompatibility, flexibility, and ionic conductivity. In this work, gelatin-based composite membranes are reported. The membranes were fabricated and modified with various additives, including ionic liquids (ILs), polyethylene glycol (PEG), and glycerol, to enhance their electrochemical and mechanical properties. The proton conductivity of the pure gelatin membrane was relatively low at 1.0368 × 10⁻⁴ Scm⁻¹; however, the incorporation of IL ([DEMA][OMs]) significantly improved it, with the gelatin/0.2 g IL membrane achieving the highest conductivity of 4.181 × 10⁻⁴ Scm⁻¹. The introduction of PEG and glycerol also contributed to enhanced conductivity and flexibility. The water uptake analysis revealed that IL-containing membranes exhibited superior hydration properties, with the highest water uptake recorded for the gelatin/0.2 g glycerol/0.2 g IL membrane, which was found to be very high (906.55%). The results showed that the combination of IL and PEG provided enhanced proton transport and mechanical stability (as examined visually), making these membranes promising candidates for fuel cell applications. Therefore, this study underscores the importance of bio-based materials by utilizing gelatin as a sustainable, biodegradable polymer, supporting the transition toward greener energy materials. The findings demonstrate that modifying gelatin with conductivity-enhancing and plasticizing agents can significantly improve its performance, paving the way for bio-based proton exchange membranes with improved efficiency and durability. Full article

The sustainability of bridge infrastructure is becoming increasingly important due to rising environmental, economic, and social demands. However, most current assessment models remain fragmented, often overlooking the social pillar, underutilizing risk integration across the lifecycle, and failing to fully leverage digital tools such as Building Information Modeling (BIM) and Life Cycle Sustainability Assessment (LCSA), resulting in incomplete sustainability evaluations. This study addresses these limitations by introducing a practical and adaptable model that integrates BIM, LCSA, and expert-driven risk prioritization. Five Hungarian bridge projects were modeled using Tekla Structures and analyzed in OpenLCA to quantify environmental, economic, and social performance. A custom Sustainability Level Change (SLC) algorithm was developed to compare baseline scenarios (equal weighting) with risk-informed alternatives, simulating the impact of targeted improvements. The results demonstrated that prioritizing high-risk sustainability indicators leads to measurable lifecycle gains, typically achieving SLC improvements between +2% and +6%. In critical cases, targeted enhancement scenarios, applying 5% and 10% improvements to top-ranked, high-risk indicators, pushed gains up to +12%. Even underperforming bridges exhibited performance enhancements when targeted actions were applied. The proposed framework is robust, standards-aligned, and methodologically adaptable to various bridge types and lifecycle phases through its data-driven architecture. It empowers infrastructure stakeholders to make more informed, risk-aware, and data-driven sustainability decisions, advancing best practices in bridge planning and evaluation. Compared to earlier tools that overlook risk dynamics and offer limited lifecycle coverage, this framework provides a more comprehensive, actionable, and multi-dimensional approach. Full article

Background/Objectives: ISUP grade group discordance between prostate biopsy and radical prostatectomy (RP) impacts treatment decisions in over a third (~25–40%) of prostate cancer (PCa) patients. We aimed to identify ISUP grade migration predictors and assess the impact of preoperative imaging (MRI) in a contemporary Romanian PCa cohort. Methods: We retrospectively analyzed 142 PCa patients undergoing RP following biopsy between January 2021 and December 2024 at Pius Brinzeu County Hospital, Timișoara: 90 without and 52 with preoperative MRI. Clinical parameters, MRI findings (PI-RADS), and biopsy characteristics were evaluated. Machine learning models (gradient boosting, random forest) were developed with SHAP analysis for interpretability. Results: Grade migration occurred in 69/142 patients (48.6%): upstaging in 55 (38.7%) and downstaging in 14 (9.9%). In the non-MRI cohort, 37/90 (41.1%) were upstaged and 9/90 (10.0%) were downstaged, versus 18/52 (34.6%) upstaged and 5/52 (9.6%) downstaged in the MRI cohort. The MRI group showed a 6.5% absolute reduction in upstaging (34.6% vs. 41.1%), a promising non-significant trend (p = 0.469) that requires further investigation. Grade 1 patients showed the highest upstaging (69.4%), while Grades 3–4 showed the highest downstaging (11/43, 25.6%). PI-RADS 4 lesions had the highest upstaging (43.5%). PSA density > 0.20 ng/mL² emerged as the strongest predictor. Gradient boosting achieved superior performance (AUC = 0.812) versus logistic regression (AUC = 0.721), representing a 13% improvement in discrimination. SHAP analysis revealed PSA density as the most influential (importance: 0.287). Grade migration associated with adverse pathology: extracapsular extension (52.7% vs. 28.7%, p = 0.008) and positive margins (38.2% vs. 21.8%, p = 0.045). Conclusions: ISUP grade migration affects 48.6% of Romanian patients, with 38.7% upstaged and 9.9% downstaged. The 69.4% upstaging in Grade 1 patients emphasizes the need for enhanced risk stratification tools, while 10% downstaging suggests potential overtreatment. Machine learning with SHAP analysis provides superior predictive performance (13% AUC improvement) while offering clinically interpretable risk assessments. PSA density dominates risk assessment, while PI-RADS 4 lesions warrant closer scrutiny than previously recognized. Full article

Background/Objectives: Colorectal cancer is a leading cause of cancer-related death worldwide, with rising incidence in younger adults. Unhealthy diets high in red and processed meat and low in fiber are key modifiable risk factors, highlighting the need for preventive nutritional strategies targeting CRC through dietary interventions. Methods: A one-day sample diet for colorectal cancer prevention, consisting of fiber-rich meals excluding red meat and incorporating whole grains, legumes, vegetables, fruits, nuts, and lean protein alternatives (such as fish and poultry), was developed. Its acceptability was assessed in a cross-sectional study using an online questionnaire among healthy Romanian adults aged 18–50, with a total of 395 included participants. Results: Of the 395 respondents meeting the inclusion criteria (aged 18–50, no cancer or chronic gastrointestinal disorders), 63.5% were females, predominantly urban (90.1%), and highly educated. Mean age was 32.4 years; mean BMI was 25.07 kg/m². The proposed colorectal cancer-preventive diet was rated as “quite attractive” and “very attractive” by 74.9% of participants. All meals received high ratings, with dinner and the first snack being most favored. Most respondents (77.2%) found the diet satisfying and the satiety level and energy adequate, and 90.4% were willing to adopt it at least a few times per week. Financial accessibility was affirmed by 77.2% of the respondents. However, 61.8% reported difficulty eliminating red meat consumption. Female participants rated the diet significantly more attractive than males did (p = 0.041). Willingness to adopt the diet strongly correlated with higher acceptability (p < 0.0001), while BMI and education level showed no significant effect. Conclusions: The proposed colorectal cancer-preventive diet was well accepted by Romanian adults aged 18–50, with higher receptivity among women and those with higher education; willingness to adopt the diet at least a few days per week was high, especially among those psychologically ready for dietary change, while key barriers included red meat reduction and perceived cost, underscoring the need for gender-sensitive, culturally adapted interventions and further research on long-term adherence and clinical impact. Full article

Chemically strengthened glass is widely used for its remarkable fracture strength, mechanical performance, and scratch resistance. Assessing its hardness is crucial to evaluating improvements from chemical tempering. However, conventional methods like Vickers hardness tests are destructive, altering the sample surface. This study presents a novel, rapid, and nondestructive testing (NDT) approach by correlating the nonlinear refractive index (n₂) with surface hardness. Using ultrafast laser pulses, we measured the n₂ cross-section via the nonlinear ellipse rotation (NER) signal in Gorilla^®-type glass subjected to ion exchange (Na⁺ by K⁺). A microscope objective lens provided a penetration resolution of ≈5.5 μm, enabling a localized NER signal analysis. We demonstrate a correlation between the NER signal and hardness, offering a promising pathway for advanced, noninvasive characterization. This approach provides a reliable alternative to traditional destructive techniques, with potential applications in industrial quality control and material science research. Full article

Background: Gastric neoplasms remain pathologies of the malignant spectrum with high incidence and prevalence, with their management requiring a precise histopathological characterization for optimal treatment planning. Methods: The present study is a retrospective analysis that included 67 histopathologically confirmed gastric neoplasia subjects and was performed at a single surgical center from January 2020 to December 2021. Demographics, tumor characteristics, surgical procedures, and oncologic outcomes were included, filtered, and subsequently analyzed using SPSS Statistics 29.0. Results: This study involved 67 patients (mean age 65.7 years, 56.7% men), with adenocarcinoma being the most common histologic type (91.0%) and most tumors being diagnosed directly as Stage III (40.3%). Lauren classification revealed the intestinal type as the most common (49.2%), followed by diffuse (36.1%) and mixed (14.8%). Poorly differentiated tumors (G3) accounted for 53.7% of cases. The surgical team performed curative resection in 75% (n = 50) of patients, achieving R0 margins in 88% of these cases. Subtotal gastrectomy with D2 lymphadenectomy yielded the highest curative success rate with 96.6% R0 resection. Statistically, we identified two significant correlations between age and tumor grade (rho = 0.28; p = 0.021) and between the number of lymph nodes examined and the number of lymph nodes invaded (rho = 0.65, p < 0.001). This study again revealed that adenocarcinomas showed higher rates of lymph node invasion than other tumor types (p = 0.017). Conclusions: The analysis of patients with gastric neoplasms is vital for appropriate therapeutic management. Even though the study period included a pandemic, the analysis remained a complex one with high-quality surgical outcomes, confirming the importance of maintaining oncologic standards during medical crises. Full article

Background/Objectives: Operating rooms represent valuable and pivotal units of any hospital. Therefore, their management affects healthcare service delivery through rescheduling, staff shortage/overtime, cost inefficiency, and patient dissatisfaction, among others. To optimize scheduling, we aim to assess preoperative evaluation criteria that influence the prediction of surgery duration for gastric cancer (GC) patients. In GC, radical surgery with curative intent is the ideal treatment. Nevertheless, the intervention sometimes must be palliative if the patient’s status and tumor staging prove too advanced. Methods: A 6-year retrospective cohort study was performed in a tertiary care hospital, including all cases diagnosed with GC (ICD-10 code C16), confirmed through histopathology, and undergoing surgical treatment (N = 108). Results: The results of our study confirm male predominance (63.89%) among GC surgery candidates while bringing new perspectives on patient evaluation criteria and choice of surgical intervention (curative—Group 1, palliative—Group 2). Surgery duration, including anesthesiology (175.19 [95% CI (157.60–192.77)] min), shows a direct correlation with the number of lymph nodes dissected (Surgical duration [min] = 10.67 × No. of lymph nodes removed − 32.25). Interestingly, the aggressiveness of the tumor based on histological grade (highly differentiated being generally less aggressive than poorly differentiated) shows differential correlation with surgery duration among curative and palliative surgery candidates. Similarly, TNM staging indicates the need for a longer surgical duration (pTNM stage IIA, IIB, and IIIA) for curative interventions in patients with less advanced stages, as opposed to shorter surgery duration for palliative interventions (pTNM stage IIIC and IV). Conclusions: The study quantitatively presents the resources needed for the optimal surgical treatment of different groups of GC patients, as the disease coding systems in use regard the treatment of each pathology as “standard” in terms of patient management. The results obtained are anchored in the global perspectives of surgical outcomes and aim to improve the management of operating room scheduling, staff, and resources. Full article

The Brazilian Amazon, a global biodiversity hotspot, faces escalating anthropogenic pressures and climate change, underscoring the urgent need to identify priority areas for ecological restoration and sustainable forest use. This study applied a topoclimatic zoning methodological framework in the Legal Amazon to evaluate the environmental suitability of 12 native tree species across anthropogenically altered landscapes. Species occurrence data were compiled from the RADAMBRASIL Project, GBIF, Herbaria, and forest inventory literature. Climatic, topographic, and geographic variables (1961–2022) informed the zoning model. Our findings reveal that species such as Dinizia excelsa Ducke (81%) and Handroanthus albus (Cham.) Mattos (78%) exhibit exceptionally high topoclimatic suitability. Conversely, Simarouba amara Aubl. (37%) and Schizolobium parahyba (Vell.) S.F.Blake var. amazonicum (Huber ex Ducke) Barneby (46%) showed the lowest proportions in high-potential areas, suggesting their greater ecological breadth or specific niche requirements in altered zones. Principal Component Analysis (PCA) indicated strong correlations between high-potential areas and Af3, Am3, and Aw4 climatic subtypes. This study offers a replicable, evidence-based model for prioritizing species and locations, significantly supporting sustainable silviculture and enhancing the long-term resilience of Amazonian forests in the face of climate change. Full article

Inefficient material tracking continues to be a major challenge in sustainable construction, often leading to unnecessary waste, budget overruns, and project delays. While many digital tools have been introduced in recent years, there is still a lack of practical, field-tested frameworks that combine these technologies with clear, structured procedures, especially in resource-constrained environments. This study introduces a Standard Operating Procedure (SOP) framework designed to improve materials tracking systems (MTSs) by integrating QR codes, GPS tracking, and cloud-based dashboards. Together, these tools support more accurate planning, smoother coordination, and real-time monitoring from the early design stages to on-site implementation. A mixed-methods approach was used, combining surveys with construction professionals and focus group discussions with engineers, IT specialists, and logistics staff. The findings highlight procurement and implementation as the phases most prone to inefficiencies, particularly around material receiving, quality checks, and on-site placement. The validated SOP framework shows strong potential to improve tracking accuracy, reduce material waste, and streamline construction workflows. It offers a flexible, easy-to-use system for integrating sustainability into everyday project practices. Looking ahead, this study also points to future opportunities for applying AI-based tools—such as predictive tracking and automated quality checks—to further improve decision-making and resource efficiency in construction projects. Full article

Background: Palbociclib, when combined with endocrine therapy, represents a valuable treatment option for patients diagnosed with hormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) negative advanced breast cancer (BC) or metastatic breast cancer (MBC). Approved in Europe following phase II/III trials, it became the first CDK4/6 inhibitor used alongside hormone therapy. Available real-world data demonstrate the strong performance of Palbociclib in unselected, heavily pretreated patient groups. Our retrospective, observational, multicenter study, conducted in six Romanian institutions during a follow-up period of 2.5 years, aimed to assess Palbociclib’s safety and effectiveness in clinical practice. Objectives: The primary endpoints included response rate such as overall response rate (ORR), duration of response (DOR), disease control rate (DCR) and best clinical response (BCR), progression free survival (PFS) and overall survival (OS). The secondary objectives focused on treatment duration with aromatase inhibitors (AI) or fulvestrant and subsequent therapies after disease progression. Grade 3/4 adverse events were individually recorded. Exploratory analysis evaluated the potential predictive biomarkers such as Ki67, lower levels of HER2 expression (HER2-low), and histological or luminal subtype. Methods: Approximately 650 patients were planned for inclusion. PFS and OS were analyzed via the Kaplan–Meier method, with median times, 1- and 2-year estimates, and 95% confidence intervals reported. Conclusions: This study supports the integration of clinical trial evidence into real-world settings, enhancing patient selection and treatment personalization. Full article

Active magnetic bearings (AMBs) are a class of electromechanical equipment that effectively integrate Magnetic Bearing technology with PMSM technology, particularly for applications involving high-power and high-speed permanent magnet motors. However, as the rotor operates in a suspended state, the motor’s trajectory changes continuously. The installation of a speed sensor poses a risk of collisions with the shaft, which inevitably leads to rotor damage due to imbalance, shaft wear, or other mechanical effects. Consequently, for the rotor control system of PMSM, it is crucial to adopt a sensorless speed estimation method to achieve high-performance speed and position closed-loop control. This study uses the rotor system of a 75 kW AMB high-speed motor as a case study to provide a detailed analysis of the principles of high-frequency square wave signal injection (HFSWSII) and current signal injection for speed estimation. The high-frequency current response signal is derived, and a speed observer is designed based on signal extraction and processing methods. Subsequently, a speed estimation model for PMSM is constructed based on HFSWSII, and the issue of “filter bandwidth limitations and lagging effects in signal processing” within the observer is analyzed. A scheme based on the high-frequency pulse array current injection method is then proposed to enhance the observer’s performance. Finally, to assess the system’s anti-interference capability as well as the motor’s static and dynamic tracking performance, its dynamic behavior is tested under conditions of increasing and decreasing speed and load. Simulation and experimental results demonstrate that the PMSM control system based on HFSWSII achieves accurate speed estimation and shows excellent static and dynamic performance. Full article