Search Results (3,369)

Background: Comprehensive Geriatric Assessment (CGA) is essential for evaluating older cancer patients, but significant gaps persist in both research and clinical practice. This study aimed (I) to identify the CGA elements that most influence anti-cancer treatment decisions in older patients and (II) to explore the predictive value of CGA components for mortality. Methods: This observational study included older patients with newly diagnosed, histologically confirmed solid or hematological cancers, recruited consecutively from 2003 to 2023. Participants were followed for four years. The data collected included CGA measures of functional (Activities of Daily Living-ADL), cognitive (Mini-Mental State Examination-MMSE), and emotional (Geriatric Depression Scale-GDS) domains. Patients were categorized into frail, vulnerable, or fit groups based on Balducci’s criteria. Statistical analyses included decision tree modeling and Cox regression to identify predictors of mortality. Results: A total of 7022 patients (3222 females) were included, with a mean age of 78.3 ± 12.9 years. The key CGA factors influencing treatment decisions were ADL (first step), cohabitation status (second step), and age (last step). After four years, 21.9% patients had died. Higher GDS scores (OR 1.04, 95% CI 1.01–1.07, p = 0.04) were independently associated with survival in men and living with family members (OR 1.67, 95% CI 1.35–2.07, p < 0.001) in women. Younger patients (<77 years) showed both MMSE and GDS as significant risk factors for mortality. Conclusions: Functional capacity, cohabitation status, and GDS scores are crucial for guiding treatment decisions and predicting mortality in older cancer patients, emphasizing the need for a multidimensional geriatric assessment. Full article

The exponential increase in electronic waste (e-waste) from end-of-life electrical and electronic equipment presents a growing environmental challenge. E-waste contains high concentrations of rare earth elements (REEs), which are classified as critical raw materials (CRMs). Their removal and recovery from contaminated systems not only mitigate pollution but also support resource sustainability within a circular economy framework. The present study proposed the use of hazelnut shells as a biosorbent to reduce water contamination and recover REEs. The sorption capabilities of this lignocellulosic material were assessed and optimized using the response surface methodology (RSM) combined with a Box–Behnken Design (three factors, three levels). Factors such as pH (4 to 8), salinity (0 to 30), and biosorbent dose (0.25 to 0.75 g/L) were evaluated in a complex mixture containing 9 REEs (Y, La, Ce, Pr, Nd, Eu, Gd, Tb and Dy; equimolar concentration of 1 µmol/L). Salinity was found to be the factor with greater significance for REEs sorption efficiency, followed by water pH and biosorbent dose. At a pH of 7, salinity of 0, biosorbent dose of 0.75 g/L, and a contact time of 48 h, optimal conditions were observed, achieving removals of 100% for Gd and Eu and between 81 and 99% for other REEs. Optimized conditions were also predicted to maximize the REEs concentration in the biosorbent, which allowed us to obtain values (total REEs content of 2.69 mg/g) higher than those in some ores. These results underscore the high potential of this agricultural waste with no relevant commercial value to improve water quality while providing an alternative source of elements of interest for reuse (circular economy). Full article

The process of designing reinforced concrete (RC) buildings has traditionally relied on manually evaluating a limited number of layout alternatives—a time-intensive process that may not always yield the most functionally efficient solution. This research introduces a parametric algorithmic model for the automated optimization of RC buildings with solid slab systems. The model automates and optimizes the layout process, yielding measurable improvements in spatial efficiency while maintaining compliance with structural performance criteria. Unlike prior models that address structural or architectural parameters separately, the proposed framework integrates both domains through a unified generative design approach within a BIM environment, enabling automated evaluation of structurally viable and architecturally coherent slab layouts. Developed within the parametric visual programming environment in Dynamo for Revit, the model employs a generative design (GD) engine to explore and refine various design alternatives while adhering to structural constraints. By leveraging a BIM-based framework, this method enhances efficiency, optimizes resource utilization, and systematically balances structural and architectural requirements. The model was validated through three case studies, demonstrating cost reductions between 2.7% and 17%, with material savings of up to 13.38% in concrete and 20.87% in reinforcement, achieved within computational times ranging from 120 to 930 s. Despite the current development being limited to vertical load scenarios and being most suitable for regular slab-based configurations, the results demonstrated the model’s effectiveness in optimizing grid dimensions and reducing material quantities and costs, and highlighted its ability to streamline early-stage design processes. Full article

Co_0.95R_0.05Fe₂O₄ nanoparticles were synthesized using a sol-gel approach incorporating bio-based agents and were found to be single phases adopting a cubic Fd-3m structure. XPS shows the presence of Gd³⁺ and Ho³⁺ ions. The spin–orbit splitting of about 15.4 eV observed in Co 2p core-level spectra is an indication that Co is predominantly present as Co³⁺ state, while the satellite structures located at about 6 eV higher energies than the main lines confirm the existence of divalent Co in Co_0.95R_0.05Fe₂O₄. The positions of the Co 3s and Fe 3s main peaks obtained by curve fitting and the exchange splitting obtained values for Co 3s and Fe 3s levels point to the high Co³⁺/Co²⁺ and Fe³⁺/Fe²⁺ ratios in both samples. The saturation magnetizations are smaller for the doped samples compared to the pristine ones. For theoretical magnetization calculation, we have considered that the heavy rare earths are in octahedral sites and their magnetic moments are aligned antiparallelly with 3d transition magnetic moments. ZFC-FC curves shows that some nanoparticles remain superparamagnetic, while the rest are ferrimagnetic, ordered at room temperature, and showing interparticle interactions. The M_S/Ms ratio at room temperature is below 0.5, indicating the predominance of magnetostatic interactions. Full article

A novel type of multifunctional hybrid membranes combining modified chitosan, functionalized multi-walled carbon nanotubes (MWCNTs), and rare earth element ion-imprinted polymers (REEIIPs) were designed and characterized. The synthesized materials were characterized by thermogravimetric analysis (TGA), scanning electron microscopy (SEM), vibrating sample magnetometry (VSM), X-ray diffraction (XRD), X-ray micro-tomography, and Fourier transform infrared spectroscopy (FTIR). The hybrid membranes were also studied in terms of their mechanical and rheological properties. The key element of the proper preparation of hybrid membranes using the casting method in an external magnetic field was to synthesize membrane components with appropriate magnetic properties. It was found that they showed tunable weak ferromagnetic properties, and the increase in modified nanotube addition caused the rise in the membrane’s saturation magnetization, which for Nd-selective hybrid membranes reached 0.44 emu/g. Also, the increase in thermooxidative stability was noted after introducing functionalized nanotubes into polymer matrices, which, in the case of Gd-selective membranes, were stable even up to 730 °C. The rise in the modified MWCNT addition and selection of appropriate REE ion-imprinted polymers improved mechanical (Rm and E values increase even twice) and rheological parameters (almost double growth of E′ and E″ values) of the tested membranes. Synthesized hybrid membranes showed a high rejection of matrix components and an increase in retention ratio with rising MWCNT-REEIIP addition, ultimately reaching 94.35%, 92.12%, and 90.11% for Nd, Pr, and Gd, respectively. The performed analysis confirmed homogeneous dispersion, phase compatibility, network integration, formation of a complex 3D microstructure, and improved operational stability of created hybrid membranes, which is significant for their future applications in Nd, Pr, and Gd recovery from coal fly ash extracts. Full article

Objectives: To identify clinical, functional, laboratory, and patient-reported parameters associated with medium-term risk of hospitalization or death among older adults attending a multidisciplinary outpatient clinic, and to assess the predictive performance of these measures for individual risk stratification. Methods: In this cohort study, 350 adults aged ≥65 years were assessed at baseline and followed for an average of 8 months. The primary outcome was a composite of hospitalization or all-cause mortality. Parameters assessed included frailty and comorbidity measures, functional parameters, such as gait speed and grip strength, laboratory biomarkers, and patient-reported measures, such as quality of life (QoL, assessed on a Likert scale) and the presence of depressive symptoms. Predictive performance was evaluated using univariable logistic regression and multivariable modeling. Discriminative ability was assessed via area under the ROC curve (AUC), and selected models were internally validated using repeated k-fold cross-validation. Results: Overall, 40 participants (11.4%) experienced hospitalization or death. Traditional clinical risk indicators, including frailty and comorbidity scores, were significantly associated with the outcome. Patient-reported QoL (AUC = 0.74) and Geriatric Depression Scale (GDS) scores (AUC = 0.67) demonstrated useful overall discriminatory ability, with high specificities at optimal cut-offs, suggesting they could act as “red flags” for adverse outcomes. However, the limited sensitivities of individual predictors underscore the need for more comprehensive screening instruments with improved ability to identify at-risk individuals earlier. A multivariable model that incorporated several predictors did not outperform QoL alone (AUC = 0.79), with cross-validation confirming comparable discriminative performance. Conclusions: Patient-reported measures—particularly quality of life and depressive symptoms—are valuable predictors of hospitalization or death and may enhance traditional frailty and comorbidity assessments in outpatient geriatric care. Future work should focus on developing or integrating screening tools with greater sensitivity to optimize early risk detection and guide preventive interventions. Full article

Gaucher disease (GD) is an autosomal recessive disorder caused by the deficient activity of the lysosomal enzyme glucocerebrosidase (GCase). Although enzyme replacement therapy (ERT) remains the standard of care for non-neuropathic GD patients, its high cost significantly limits accessibility. To enhance production efficiency, we developed a lentiviral system encoding a codon-optimized GCase gene driven by the human elongation factor 1a (hEF1α) promoter for stable production in human cell lines. A functional lentiviral vector, LV_EF1α_GBA_Opt, was generated at a titer of 7.88 × 10⁸ LV particles/mL as determined by qPCR. Six transduction cycles were performed at a multiplicity of infection of 30–50. The transduced heterogeneous human cell population showed GCase-specific activity of 307.5 ± 53.49 nmol/mg protein/h, which represents a 3.21-fold increase compared to wild-type 293FT cells (95.58 ± 16.5 nmol/mg protein/h). Following single-cell cloning, two clones showed specific activity of 763.8 ± 135.1 and 752.0 ± 152.1 nmol/mg/h (clones 15 and 16, respectively). These results show that codon optimization, a lentiviral delivery system, and clonal selection together enable the establishment of stable human cell lines capable of producing high levels of biologically active, synthetic recombinant GCase in vitro. Further studies are warranted for the functional validation in GD patient-derived fibroblasts and animal models. Full article

Background: Fatty acid status during the perinatal period is important for optimal offspring growth and development. Objectives: We aimed to test the association between maternal fatty acid (FA) intake during the third trimester of pregnancy and the FA composition of placental phospholipids, a marker of maternal fatty acid status. Methods: This cohort study was performed on 54 mothers participating in the PREOBE study. Maternal dietary intake was assessed with prospective 7-day food diaries at 34 weeks of gestation. Placenta samples were collected immediately after delivery and phospholipid FA was quantified with established methods. Data were analyzed with Pearson correlations and linear regression models, with adjustment for confounding factors. Results: Total energy intake was 2019 ± 527 kcal/d (mean ± SD) and total fat intake of the mothers was 87 ± 35 g/day. Myristic, stearic, oleic, and α-linolenic acid intakes were modestly correlated with placental percentages, with r-values ≤ 0.33. Only docosahexaenoic (DHA) acid intake (%-energy, %-fat, and g/d) showed r-values > 0.4 for the correlation with placenta phospholipids. Intake of other fatty acids, including arachidonic acid, was not associated with the placenta percentage. Linear regression models considering confounders showed only dietary DHA intake significant associations. Total fat intake did not interfere with the association of DHA intake with placental incorporation. Conclusions: DHA and arachidonic acid are enriched in the placenta, but only placental DHA content seems modifiable by maternal dietary DHA intake. Full article

Complex oxides with the general formula Gd₂(Ti_1−xZr_x)₂O₇ are promising candidates for radioactive waste immobilization due to their capacity to withstand radiation by dissipating part of the free energy driving defect creation and phase transitions. In this study, samples with varying zirconium content (xZr = 0.00, 0.15, 0.25, 0.375, 0.56, 0.75, 0.85, 1.00) were synthesized via the sol–gel method and thermally treated at 500 °C to obtain nanosized powders mimicking the defective structure of irradiated materials. Synchrotron-based techniques were employed to investigate their structural properties: High-Resolution X-ray Powder Diffraction (HR-XRPD) was used to assess long-range structure, while Pair Distribution Function (PDF) analysis and Extended X-ray Absorption Fine Structure (EXAFS) spectroscopy provided insights into the local structure. HR-XRPD data revealed that samples with low Zr content (xZr ≤ 0.25) are amorphous. Increasing Zr concentration led to the emergence of a crystalline phase identified as defective fluorite (xZr = 0.375, 0.56). Samples with the highest Zr content (xZr ≥ 0.75) were fully crystalline and exhibited only the fluorite phase. The experimental G(r) functions of the fully crystalline samples in the low r range are suitably fitted by the Weberite structure, mapping the relaxations induced by structural disorder in defective fluorite. These structural insights informed the subsequent EXAFS analysis at the Zr-K and Gd-L₃ edges, confirming the splitting of the cation–cation distances associated with different metal species. Moreover, EXAFS provided a local structural description of the amorphous phases, identifying a consistent Gd-O distance across all compositions. Full article

Background/Objectives: Gestational diabetes (GD), which affects approximately 15% of pregnancies worldwide, poses significant risks to both maternal and fetal health, underscoring the need for effective prevention and management strategies. This umbrella review aims to evaluate the role of probiotics in the prevention of GD. Methods: The review was conducted in accordance with the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. A comprehensive literature search was performed in November 2024 across four databases: PubMed/Medline, Cochrane Library, Embase, and CINAHL. A total of 307 articles were identified, of which 6 met the inclusion criteria and were included in the final synthesis. Results: Probiotic supplementation was associated with a significant reduction in the incidence of GD in selected populations, particularly in women with a body mass index (BMI) < 26, age < 30 years [Relative Risk (RR): 0.58], and p < 0.05 in the other studies included, alongside improvements in several metabolic parameters. However, consistent benefits on maternal or neonatal complications were not observed but a 33% reduction in GD was confirmed (RR 0.67). The combination of probiotics with healthy lifestyle behaviors appeared to exert a stronger protective effect against GD and its potential complications. Conclusions: This umbrella review suggests that probiotics—particularly multi-strain formulations—may have a potential role in reducing the risk of GD in certain populations. However, the findings across the included studies are inconsistent and sometimes conflicting. While probiotics are generally considered safe and have recognized benefits for metabolic health, their efficacy as an adjunct intervention for GD prevention remains not fully clear. Further well-designed research is needed to clarify which specific probiotic interventions may be effective and to better guide clinical practice. Full article

This study investigated the isoforms of porcine-origin Ral guanine nucleotide dissociation stimulator (RalGDS) in LLC-PK1 cells using reverse transcription-polymerase chain reaction (RT-PCR) and sequencing. Through segmented amplification, sequence assembly, and comparative genomics analysis, seven RalGDS isoforms were identified, characterized by insertions, deletions, and frameshift mutations. These genetic variations may significantly alter RalGDS’s protein structure and function, potentially impacting its role in Ral GTPase-mediated signaling pathways. This work provides foundational insights into the genetic diversity of porcine RalGDS and its implications for porcine physiology and economically significant traits. Full article

Various data such as power grid sensors and manual observed icing, CMA (China Meteorological Administration) Land Surface Data Assimilation System (CLDAS) products, and the Fifth Generation Atmospheric Reanalysis of the Global Climate from Europe Center of Middle Range Weather Forecast (ERA5) are adopted to diagnose an icing process under a cold surge during 16–23 December 2023 in northeastern Yunnan Province. The results show that: (1) in the early stage of the process, mainly the freezing types, such as GG (temperature > 0 °C, relative humidity ≥ 75%) and DG (temperature < 0 °C, relative humidity ≥ 75%), occur. At the end of the process, an increase in icing type as GD (temperature > 0 °C, relative humidity < 75%) appears. (2) Significant differences exist in the elements during different stages of icing, and the atmospheric thermal, dynamic, and water vapor conditions are conducive to the occurrence of freezing rain during ice accretion. The main impact weather systems of this process include a strong high ridge in the mid to high latitudes of East Asia, transverse troughs in front of the high ridge south to Lake Baikal, low altitude troughs, and ground fronts. The transverse trough in front of the high ridge can cause cold air to accumulate and then move eastward and southward. The southerly flows, surface fronts, and other low-pressure systems can provide powerful thermodynamic and moisture conditions for ice accumulation. Full article

A reliable estimation of protein requirements in lactating dairy cows is necessary for formulating nutritionally adequate diets, improving feed efficiency, and minimizing nitrogen excretion. This study aimed to develop machine learning-based models to predict net protein requirements for maintenance (NPm) and lactation (NPl) using random forest regression (RFR) and support vector regression (SVR). A total of 1779 observations were assembled from 436 peer-reviewed publications and open-access databases. Predictor variables included farm-ready variables such as milk yield, dry matter intake, days in milk, body weight, and dietary crude protein content. NPm was estimated based on the National Academies of Sciences, Engineering, and Medicine (NASEM, 2021) equations, while NPl was derived from milk true protein yield. The model adequacy was evaluated using 10-fold cross-validation. The RFR model demonstrated higher predictive performance than SVR for both NPm (R² = 0.82, RMSEP = 22.38 g/d, CCC = 0.89) and NPl (R² = 0.82, RMSEP = 95.17 g/d, CCC = 0.89), reflecting its capacity to model the rule-based nature of the NASEM equations. These findings suggest that RFR may provide a valuable approach for estimating protein requirements with fewer input variables. Further research should focus on validating these models under field conditions and exploring hybrid modeling frameworks that integrate mechanistic and machine learning approaches. Full article

Background: Apathy predicts functional and cognitive decline in community-dwelling older adults. However, the behavioral correlates of apathy, which could promote cognitive decline have not been described. Our objective was to investigate the associations of apathy with leisure and social engagement. Methods: N = 538 older adults enrolled in the Central Control of Mobility in Aging study. We used the GDS3A, a 3-item subscale of the Geriatric Depression Scale, to define apathy and the frequency of participation in cognitive, physical, and social leisure activities. Linear regression models were conducted to assess the association between apathy and its behavioral correlates: social engagement and leisure activity participation. Covariates included age, gender, education level, multimorbidity, and dysphoria. Results: Apathy was present in 29.7% of participants and was significantly associated with less frequent participation in physical activity days per week (−1.688. p = 0.003) but not cognitive (−1.094, p = 0.252) or social (−0.654, p = 0.103) leisure activities. Apathy was also associated with a decreased social behavior composite score (−0.055, p < 0.001), Social Network Index (−0.478, p = 0.003), and Medical Outcomes Study Social Support scores (−0.26, p = 0.001). Conclusions: Our findings suggest that apathy presents with reduced participation in physical leisure activities and reduced social engagement, which may provide a way for clinicians and caregivers to identify apathy in the future. Full article

This study reports the use of single-cell RNA sequencing to evaluate B cells in the peripheral blood mononuclear cells (PBMCs) and intrathyroidal blood mononuclear cells of patients with Graves’ disease (GD) undergoing thyroidectomy. These cells were stimulated with overlapping peptides of thyroid autoantigens, including thyroid-stimulating hormone receptor (TSHR), thyroglobulin (Tg), and thyroid peroxidase (TPO). In PBMCs, naive B cells are characterized by IL6 and CXCR5, whereas memory B cells express IGHG1, IGHG2, and CD74. HLA-DMA, HLA-DRB1, IGHG, IGHM, CD74, CD79A, and MS4A1 expression increased in peptide-stimulated naive and memory B cells compared to those in the controls. Thyroid naive B cells are characterized by CD40 and TNFRSF13C, whereas memory B cells express IGHM, CD79A, and MS4A1. Thyroid B cells showed higher DUSP1, DUSP2, CD69, FOSB, RGS1, and immunoglobulin gene expression than control PBMCs and thyroid cells. B-cell receptor analysis revealed frequent IGHV3-23 and IGHV4-34 usage in controls, whereas IGHV4-34/IGHJ4 expression was increased in TSHR-stimulated groups. We concluded that B-cell responses to TSHR, Tg, and TPO differed and that changes in B-cell reactivity also occurred in PBMCs and the thyroid. Additionally, IGHV3-23 and IGHV4-34 may be associated with autoantibody production in GD. Full article