Search Results (105)

Peptic ulcer disease remains one of the leading causes of non-variceal upper gastrointestinal bleeding. Despite advances in endoscopic therapy and pharmacological management, recurrent bleeding continues to represent a major cause of morbidity and mortality. Risk stratification is traditionally based on endoscopic stigmata according to the Forrest classification; however, ulcers with similar endoscopic findings may exhibit markedly different clinical outcomes. Increasing evidence suggests that ulcer-related anatomical factors, including size, location, and depth of penetration, may influence the risk of severe or recurrent hemorrhage, particularly in cases involving adjacent arterial structures. In this conceptual, hypothesis-generating review, we propose a conceptual bi-dimensional framework integrating endoscopic and anatomical determinants of bleeding risk. This approach aims to improve patient stratification by identifying a subgroup at “very-high-risk” of recurrent bleeding, in whom standard endoscopic therapy alone may be insufficient. Although this framework is hypothesis-generating and not yet validated, it may provide a conceptual basis for future studies aimed at improving individualized management strategies, including early imaging assessment and consideration of transarterial embolization in selected high-risk patients. Full article

The development of large-scale microalgae growth for biofuel production is currently limited by the cost of biomass production. However, new approaches to infrastructure and cultivation practices are bringing the field closer to realization. Macronutrients in the cultivation media contribute significant costs, especially since their concentrations have not been optimized for specific strains and conditions. Environmental photobioreactors (ePBRs) were used to simulate cultivation under outdoor conditions, during which the nitrogen and phosphorus levels in the media were varied. The growth of two potential biofuel production strains, Picochlorum celeri and Tetraselmis striata, with varying nutrient inputs during summer and winter scripts, respectively, was studied. This study demonstrated that nitrogen and phosphorus in f/2 media could be reduced by more than 60% from the standard formulation, while maintaining growth rates in a semi-continuous harvesting approach. Experiments comparing the standard and reduced nutrient input concentrations were also conducted for both species in 820 L outdoor raceway ponds, in Mesa, AZ. P. celeri grown in these ponds in October had a growth rate of 10.6 ± 0.7 g/m²/day and 10.6 ± 0.3 g/m²/day for the standard and low-nutrient P. celeri ponds, respectively. T. striata grown in April–May had a growth rate of 16.6 ± 1.4 g/m²/day for the standard nutrient input ponds and 17.4 ± 1.1 g/m²/day for the low-nutrient input ponds, and in October 14.5 ± 0.6 g/m²/day for standard nutrient ponds and 14.4 ± 0.6 g/m²/day for low-nutrient ponds. These outdoor data therefore confirmed the indoor ePBR data. Techno-economic analysis shows that, if high growth rates can be attained at lower nutrient concentrations, a reduction of at least 60% in nutrient costs can be achieved. Such results highlight the importance of managing macronutrient media inputs, as these have a considerable contribution to biomass production costs in large-scale facilities. The analysis also points to the importance of maintaining high spent medium recycling rates in an industrial deployment, so as to minimize the losses of nitrogen and phosphorus compounds. Full article

Microbeam Radiation Therapy (MRT) is a drastically novel approach of radiosurgery, challenging the understanding of how normal tissues respond to radiation therapy, where X-rays generated by a synchrotron light source are collimated into wafers of high-dose (hundreds of Gray), thin (50 µm) parallel microbeams. Recent work showed that MRT dose prescription must consider a dual approach: separating normal tissue dose constraints tied to the valley dose prescription and anti-tumor effects, depending on the prescribed number of ports. Here, we consolidate this assumption by increasing the number of MRT incidences to irradiate 9L-bearing rats with a cumulated valley dose of 10 Gy. 9L-bearing rats were irradiated by eight ports of conventional Broad Beam (BB) or MRT. Animals were followed up clinically by MR imaging, histopathology and survival analysis. MRI follow-up revealed that MRT significantly amplified antitumor effect and tumor tissue damage while improving the clinical score of animals. Ten Gy, delivered by either BB or MRT, increased median survival time to 15 and 39.5 days after irradiation, respectively. Neither complete ablation of brain tumors nor long-term survival was achieved, but multiport MRT (eight ports) showed an outstanding dose equivalence factor (×2.9), which needs to be tested in a clinical environment. Full article

Background/Objectives: To evaluate the Risk Factor-Weighted Clinical Likelihood (RF-CL) model for the diagnosis of chronic coronary syndrome (CCS) in men and women. Methods: The study included 222 patients (100 men and 122 women; mean age 64.76 ± 10.3 years) with suspected CCS. Diagnostic evaluation was performed in accordance with the 2024 clinical practice guidelines for stable coronary artery disease developed by the Russian Society of Cardiology. The clinical probability of obstructive coronary artery disease (CAD) was calculated for all patients using the RF-CL model. Results: Application of the RF-CL model demonstrated higher probabilities in men than in women (17% [11–27] vs. 6% [4,5,6,7,8,9,10], p < 0.001). Moderate CCS probability (RF-CL > 15–50%) was observed in 64% of men and 9.8% of women (p < 0.001); low probability (RF-CL > 5–15%) in 30% and 60.7% (p < 0.001); very low (RF-CL ≤ 5%) in 6% and 29.5% (p < 0.001). The prevalence of typical angina (21% vs. 17.2%, p = 0.47), atypical angina (31% vs. 26.2%, p = 0.43), and non-anginal chest pain (31% vs. 26.2%, p = 0.43) did not differ. Dyspnea was less frequent in men (44% vs. 59.8%, p = 0.02). Only 35 (15.8%) patients had indications for invasive coronary angiography (ICA), and significant stenosis (≥70%) was found in 17 patients. According to the ROC analysis, the cutoff value of RF-CL for predicting a positive stress test was 19.5% in men (AUC 0.723; p = 0.002), 6.5% in women (AUC 0.479; p = 0.852), and 15% in the overall cohort (AUC 0.737; p < 0.0001). Conclusions: Men with moderate and women with low probability of obstructive CAD are predominantly encountered in clinical practice when the RF-CL model is applied. Our observations have shown that ICA is indicated in relatively few patients and suggest potential overuse of exercise testing regardless of the clinicians’ adherence to the traditional Diamond–Forrester model or the RF-CL algorithm in suspected CCS. Full article

Fungal diseases such as soybean stem canker (SSC), frogeye leaf spot (FLS), and sudden death syndrome (SDS) cause substantial yield losses in soybean worldwide. This study aimed to pyramid major resistance genes and QTLs against these diseases through marker-assisted backcrossing (MABC). Diagnostic SSR markers, linked to Rdm4 (SSC), Rcs3 (FLS), and SDS resistance QTLs, were validated and successfully employed for foreground and background selection in crosses between the elite cultivar A8100RR and the resistant donor ‘Forrest’. Molecular analyses confirmed the effective introgression and fixation of multiple resistance loci in BC₂F₅ lines. Under artificial inoculation, lines R30-11 and R25-13 displayed high resistance levels to Diaporthe aspalathi, Cercospora sojina, Fusarium virguliforme, and F. tucumaniae. Genotype R30-11 exhibited the most consistent resistance across pathogens, while R25-13 combined multi-disease resistance with glyphosate tolerance and stable agronomic performance under field conditions comparable to commercial cultivars. These results represent, to our knowledge, the first report of successful pyramiding genes and QTLs against three distinct fungal diseases (SSC, FLS, and SDS) in soybean through MABC. The developed lines constitute valuable germplasm for breeding programs designed to achieve broad-spectrum, durable and sustainable disease management. Full article

Background: The increasing consumption of ultra-processed foods (UPFs) is concerning, given their negative impacts on environmental sustainability and human health. Evidence suggests a substantial presence of UPFs in health-promoting settings. However, the factors driving these procurement and service delivery decisions remain largely unexplored. Aim: To develop a conceptual model of the known and potential system drivers of UPFs in hospital food services. Methods: Dietitians from purposively sampled Australian hospitals participated. Group model-building workshops followed pre-established scripts from the system dynamics literature. A series of causal loop diagrams identifying drivers of UPF supply in hospitals was developed using model-building software. Primary and secondary drivers were derived inductively from participants and cross-checked against transcripts to produce the consolidated model. Results: The model presents six primary drivers (hospital menu and nutrition standards, food procurement and contracts, cost, standardisation for quality control, shelf life, and convenience) and nineteen secondary drivers that together explain the increased supply of UPFs in hospitals. Feedback loops were apparent, with drivers mutually reinforcing one another. Conclusions: Complex and interconnected drivers explain the increasing supply of UPFs in hospitals. Findings should inform future strategies to build sustainable food systems through improving food provision and reducing UPF supply in hospitals. Full article

Primula beesiana is a perennial herbaceous plant predominantly distributed in the alpine wetland regions of Yunnan Province, China. This species faces dual threats from habitat fragmentation and climate change, but research into its genetic background is severely lacking. Consequently, systematic analysis of the genetic diversity and population structure of Primula beesiana is crucial in formulating scientific conservation strategies. In this study, 86 individuals from six natural populations in Lijiang City, Yunnan Province, were collected and genotyped using double-digest restriction site-associated DNA sequencing (ddRAD-seq). A total of 1537 high-quality SNP loci were identified and used for genetic diversity, principal component (PCA), population structure (STRUCTURE), and gene flow analyses. Analysis of base substitutions revealed twelve mutation types, with transversions accounting for 67.9% and a transition/transversion ratio (Ti/Tv) of 0.47, potentially indicating strong environmental selection pressure. Although high overall genetic diversity was observed, significant genetic differentiation may exist among populations (Fst = 0.0056-0.0407), with heterozygote deficiency detected across all populations. Genetic structure analyses consistently grouped the six populations into four distinct clusters. Populations MDJ, WH, and HS each formed independent clusters, exhibiting clear genetic isolation, whereas XHC2, XHC1, and NX clustered together, showing high genetic similarity and frequent gene flow. Mantel tests demonstrated a significant positive correlation between genetic and geographical distances (r = 0.854, p < 0.01), supporting an isolation-by-distance model. Gene flow estimates varied considerably among populations (5.90-44.69) and decreased with increasing geographical distance. This study provides the first genomic-level evidence of significant genetic differentiation and isolation based on distance in Primula beesiana populations, offering crucial scientific support in identifying evolutionarily significant units and developing zoned conservation management strategies for this species. Full article

Port wine production involves the addition of grape spirit to halt fermentation and retain natural sweetness. This spirit, produced by distilling wine and its by-products, must comply with legal standards, including a mandatory sensory assessment. Because grape spirit influences Port wine’s volatile composition, this study investigated the odour-active compounds present in several grape spirits intended for fortification. Volatile compounds were extracted by liquid–liquid extraction, concentrated, and analysed using gas chromatography–olfactometry (GC-O) and gas chromatography–mass spectrometry (GC-MS). In GC-O, based on frequency detection, a panel of assessors sniffed the extracts to determine the presence of aroma compounds. The results revealed a wide range of odour-active compounds in grape spirits, belonging to several chemical families such as esters, alcohols, terpenic compounds and acids. These compounds exhibited both pleasant aromas, such as fruity, floral and caramel notes as well as undesirable ones like cheese and foot odour. Most of these compounds originate from the fermentation process and are also found in other unaged distilled beverages, including young Cognac, Calvados and fruit spirits. This research highlights the aromatic complexity of grape spirits and, for the first time, determined the aroma thresholds for 25 of 36 the compounds studied at an ethanol content of 20%. Full article

Climate change imposes significant challenges on vitiviniculture, increasing the need to identify more resilient grapevine varieties. While red grape varieties are known for their high anthocyanin content, other phenolic compounds should also be considered when assessing adaptability to biotic and abiotic stresses. For this, the phenolic composition and antioxidant capacity of 27 red Vitis vinifera L. varieties grown in Portugal were studied across two years. Under warmer and drier conditions, most varieties exhibited higher total phenolic content (TPC) and antioxidant activity, with ‘Donzelinho Tinto’ and ‘Zinfandel’ displaying the most pronounced increases. These varieties also had the highest increases in phenolic acids and flavan-3-ols, highlighting how environmental stress modulates secondary metabolites. Varieties such as ‘Aragonez’, ‘Trincadeira’, ‘Touriga Franca’, and ‘Tinta Francisca’, demonstrated stable profiles, indicating a robust response to climatic fluctuation. Correlation analysis revealed strong associations between TPC and antioxidant capacity, highlighting the importance of phenolics in mitigating oxidative stress. By identifying varieties with enhanced phenolic and antioxidant plasticity, the diversity observed in this work offers valuable insights for future varietal selection aimed at mitigating climate change-induced challenges. Overall, this work reinforces the potential of varietal selection to promote sustainable viticulture in regions increasingly impacted by climatic variability. Full article

Background/Objectives: Helicobacter pylori infection is a key etiological factor in upper gastrointestinal bleeding (UGIB) due to its role in mucosal injury and ulcer formation. Despite its clinical relevance, data from the Colombian Caribbean are limited. This study aimed to describe the incidence and clinical–endoscopic features of H. pylori-associated UGIB in a high-complexity hospital in Barranquilla, Colombia. Methods: A retrospective cohort study was conducted including adults (≥18 years) admitted for UGIB between 2021 and 2023. Demographic, clinical, and endoscopic variables were obtained from institutional records. Non-parametric tests (Fisher’s exact, Wilcoxon rank-sum) were applied to compare sex and admission diagnosis. Multiple-correspondence analysis explored associations among clinical and pathological parameters. Significance was set at p < 0.05. Results: Among 329 patients with UGIB, 44 (13%) tested positive for H. pylori. The median age was 60 years, and 57% were male. Melena (48%) and hematemesis (45%) were the main presenting symptoms. Hypertension was significantly more frequent in men (45% vs. 15%, p = 0.04), while chronic gastritis was the most common histopathological finding (75%), followed by gastrointestinal ulcer (23%) and intestinal adenocarcinoma (16%). The majority of ulcers were Forrest IIA (50%), followed by III (40%) and IB (10%), with no sex differences (p > 0.92). Multiple correspondence analysis revealed that male patients tended to present melena and chronic gastritis, whereas females and older adults were more likely to exhibit hematemesis. Conclusions: H. pylori-associated UGIB in this cohort primarily affected older adults with chronic gastritis and hypertension. Recognition of these clinical–pathological profiles may guide early detection, targeted therapy, and prevention strategies in similar regional contexts. Full article

Decoding visual content from neural activity remains a central challenge at the intersections of engineering, neuroscience, and computational modeling. Prior work has primarily leveraged electroencephalography (EEG) with generative models to recover static images. In this study, we advance EEG-based decoding by introducing a temporal encoding framework that approximates dynamic object transformations across time. EEG recordings from healthy participants (n = 20) were used to model neural representations of objects presented in “initial” and “later” states. Individualized classifiers trained on time-specific EEG signatures achieved high discriminability, with Random Forest models reaching a mean accuracy and standard deviation of 92 ± 2% and a mean AUC-ROC and standard deviation of 0.87 ± 0.10, driven largely by gamma- and beta-band activity at the frontal electrodes. These results confirm and extend evidence of strong interindividual variability, showing that subject-specific models outperform intersubject approaches in decoding temporally varying object representations. Beyond classification, we demonstrate that pairwise temporal encodings can be integrated into a generative pipeline to produce approximated reconstructions of short video sequences and 3D object renderings. Our findings establish that temporal EEG features, captured using low-cost open-source hardware, are sufficient to support the decoding of visual content across discrete time points, providing a versatile platform for potential applications in neural decoding, immersive media, and human–computer interaction. Full article

The UNHCR reported that over 123.2 million people were forcibly displaced worldwide by the end of 2024, with the mental health of refugees emerging as a critical issue. In the UK, asylum seekers and refugees make up around 13% of immigrants and the number is increasing year on year. The Immigration and Asylum Act 1999 aimed to ensure that most cases of asylum seekers would be decided fairly, and within six months. However, it has been argued that long wait times and systemic inequalities and inequities within the asylum system have contributed to heightened mental health problems among refugees even once they gain refugee status. The present study aimed to examine the factors that refugees perceive as limiting their ability and willingness to access mental health services in the UK. A systematic review of 15 relevant articles followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results highlight intersecting perceived limitations to accessing mental health services, such as language difficulties, cultural disconnection regarding mental health including stigma and prejudice, mistrust of services as well as structural barriers including general service limitations and the involuntary transient nature of many refugees’ lives. Policy recommendations emphasize integrating ethnic minority organizations into services, developing culturally adapted services that take into consideration the views of refugees, and ensuring holistic approaches to address socio-economic determinants. Full article

The global automotive industry faces significant challenges with respect to its supply chain, particularly component scarcity and the increasing complexity of modern vehicles, which have severely impacted the production of high-tech harnesses. This study addresses the issues faced by a leading automotive harness manufacturing company in Ciudad Obregón, Mexico (an international company that requested confidentiality), which has suffered considerable economic losses (over USD 2870) and production downtime due to component scarcity and delivery delays in component deliveries, affecting “Crew Grande” harness production. This proposal aims to develop a technological solution with a graphical interface to support decision-making in the face of this scarcity. The methodology employed system dynamics to model the supply chain’s complexity, using software such as Stella^® Architect for Forrester diagrams and equations and Vensim^® PLE for causal diagrams. The model was validated with a relative error, confirming its reliability. Multicriteria decision-making (MCDM) was performed using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) and Faire Un Choix Adequate (FUCA) methods to evaluate 15 scenarios (normal, pessimistic, and optimistic), identifying the four most favorable scenarios for optimizing operational performance. The results demonstrate these solutions’ potential to mitigate losses, improve operational efficiency, and strengthen the company’s position against market and demand fluctuations, especially for its main client, Ford Motor Company, using a graphical user interface (GUI) to support analysis and decision-making. Full article

This article utilises Max-Neef’s Human Scale Development (HSD) framework (1991) to answer two research questions: what impact does government and community-based social protection (SP) have on UK asylum-seeker wellbeing; how are interactions with all forms of SP, both as giver and receiver, supporting or harming the satisfaction of asylum-seekers’ fundamental human needs at this time? The research study utilised a mixed-methods, collaborative, case study design situated within a refugee and asylum-seeker (RAS) support charity in Southwest England. Methods included peer-led Qualitative Impact Protocol interviews, Photovoice, surveys, and staff interviews. Data were subjected to an inductive, bottom-up process on Causal Map software (version 2, Causal Map Ltd., 39 Apsley Rd., Bath BA1 3LP, UK) and the analysis used the HSD framework. We found eight over-arching themes. The four main needs-violators/destroyers of asylum-seeker wellbeing were dehumanisation, unfreedoms, enforced ignorance, and (re)traumatisation, and the four main needs-satisfiers were common humanity, autonomy and resistance, exerting agency through knowledge exchange, and healing. Five policy and practice-focused bridging satisfiers are recommended to help move individual and collective experience from a negative to a positive state in the research population. Policy and practice should be transparent and evidence-based, efficient and equitable, supportive of participation and productivity, trauma-informed, and multi-agency. Full article

Chronic diseases are a leading cause of death worldwide and have a significant negative impact on public health, overall well-being, national economies, and the long-term sustainability of already burdened health systems. In addressing some of the current health challenges, the contribution of pharmacists and community pharmacies is of particular significance. Pharmacists play a vital role in the medication use process, enhancing the efficacy of pharmacological interventions and facilitating the delivery of health services. Community pharmacies occupy a key position within the healthcare system, acting as a primary point of contact with the public and frequently representing the most accessible healthcare facility for patients. In recent times, community pharmacies have undergone a process of adaptation, shifting from a narrow focus on the dispensing of medications towards a more comprehensive approach that is patient-centered and incorporates a range of healthcare services, while also prioritizing the quality of the services provided. This work aims to explore the role of pharmacists in the provision of pharmaceutical services in three countries with distinct healthcare systems, examining how these services operate, the requirements for their delivery, the associated remuneration structures, and the extent of out-of-pocket costs for patients—ultimately analyzing their impact on health outcomes. Full article