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14 pages, 1588 KiB  
Case Report
Fatal Cytokine Collision: HLH–AIHA in Advanced AIDS—Case Report and Literature Review
by Xiaoyi Zhang, Maria Felix Torres Nolasco, Wing Fai Li, Toru Yoshino and Manasa Anipindi
Reports 2025, 8(3), 137; https://doi.org/10.3390/reports8030137 - 4 Aug 2025
Abstract
Background and Clinical Significance: Hemophagocytic lymphohistiocytosis (HLH) and autoimmune hemolytic anemia (AIHA) are both life-threatening hematologic syndromes that rarely present together outside of malignancy. Advanced acquired immunodeficiency syndrome (AIDS) creates a milieu of profound immune dysregulation and hyperinflammation, predisposing patients to atypical [...] Read more.
Background and Clinical Significance: Hemophagocytic lymphohistiocytosis (HLH) and autoimmune hemolytic anemia (AIHA) are both life-threatening hematologic syndromes that rarely present together outside of malignancy. Advanced acquired immunodeficiency syndrome (AIDS) creates a milieu of profound immune dysregulation and hyperinflammation, predisposing patients to atypical overlaps of these disorders. Case Presentation: A 30-year-old woman with poorly controlled AIDS presented with three weeks of jaundice, fever, and fatigue. Initial labs revealed pancytopenia, hyperbilirubinemia, and elevated ferritin level. Direct anti-globulin testing confirmed warm AIHA (IgG+/C3d+) with transient cold agglutinins. Despite intravenous immunoglobulin (IVIG), rituximab, and transfusions, she developed hepatosplenomegaly, extreme hyperferritinemia, and sIL-2R > 10,000 pg/mL, meeting HLH-2004 criteria. Bone marrow biopsy excluded malignancy; further work-up revealed Epstein–Barr virus (EBV) viremia and cytomegalovirus (CMV) reactivation. Dexamethasone plus reduced-dose etoposide transiently reduced soluble interleukin-2 receptor (sIL-2R) but precipitated profound pancytopenia, Acute respiratory distress syndrome (ARDS) from CMV/parainfluenza pneumonia, bilateral deep vein thrombosis (DVT), and an ST-elevation myocardial infarction (STEMI). She ultimately died of hemorrhagic shock after anticoagulation despite maximal supportive measures. Conclusions: This case underscores the diagnostic challenges of HLH-AIHA overlap in AIDS, where cytopenias and hyperferritinemia mask the underlying cytokine storm. Pathogenesis likely involved IL-6/IFN-γ overproduction, impaired cytotoxic T-cell function, and molecular mimicry. While etoposide remains a cornerstone of HLH therapy, its myelotoxicity proved catastrophic in this immunocompromised host, highlighting the urgent need for cytokine-targeted agents to mitigate treatment-related mortality. Full article
(This article belongs to the Section Allergy/Immunology)
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12 pages, 362 KiB  
Article
Predictors and Outcomes of Right Ventricular Dysfunction in Patients Admitted to the Medical Intensive Care Unit for Sepsis—A Retrospective Cohort Study
by Raksheeth Agarwal, Shreyas Yakkali, Priyansh Shah, Rhea Vyas, Ankit Kushwaha, Ankita Krishnan, Anika Sasidharan Nair, Balaram Krishna Jagannayakulu Hanumanthu, Robert T. Faillace, Eleonora Gashi and Perminder Gulani
J. Clin. Med. 2025, 14(15), 5423; https://doi.org/10.3390/jcm14155423 (registering DOI) - 1 Aug 2025
Viewed by 127
Abstract
Background: Right ventricular (RV) dysfunction is associated with poor clinical outcomes in critically ill sepsis patients, but its pathophysiology and predictors are incompletely characterized. We aimed to investigate the predictors of RV dysfunction and its outcomes in sepsis patients admitted to the [...] Read more.
Background: Right ventricular (RV) dysfunction is associated with poor clinical outcomes in critically ill sepsis patients, but its pathophysiology and predictors are incompletely characterized. We aimed to investigate the predictors of RV dysfunction and its outcomes in sepsis patients admitted to the intensive care unit (ICU). Methods: This is a single-center retrospective cohort study of adult patients admitted to the ICU for sepsis who had echocardiography within 72 h of diagnosis. Patients with acute coronary syndrome, acute decompensated heart failure, or significant valvular dysfunction were excluded. RV dysfunction was defined as the presence of RV dilation, hypokinesis, or both. Demographics and clinical outcomes were obtained from electronic medical records. Results: A total of 361 patients were included in our study—47 with and 314 without RV dysfunction. The mean age of the population was 66.8 years and 54.6% were females. Compared to those without RV dysfunction, patients with RV dysfunction were more likely to require mechanical ventilation (63.8% vs. 43.9%, p = 0.01) and vasopressor support (61.7% vs. 36.6%, p < 0.01). On multivariate logistic regression analysis, increasing age (OR 1.03, 95% C.I. 1.00–1.06), a history of HIV infection (OR 5.88, 95% C.I. 1.57–22.11) and atrial fibrillation (OR 4.34, 95% C.I. 1.83–10.29), and presence of LV systolic dysfunction (OR 14.40, 95% C.I. 5.63–36.84) were independently associated with RV dysfunction. Patients with RV dysfunction had significantly worse 30-day survival (Log-Rank p = 0.023). On multivariate Cox regression analysis, older age (HR 1.02, 95% C.I. 1.00–1.04) and peak lactate (HR 1.16, 95% C.I. 1.11–1.21) were independent predictors of 30-day mortality. Conclusions: Among other findings, our data suggests a possible association between a history of HIV infection and RV dysfunction in critically ill sepsis patients, and this should be investigated further in future studies. Patients with evidence of RV dysfunction had poorer survival in this population; however this was not an independent predictor of mortality in the multivariate analysis. A larger cohort with a longer follow-up period may provide further insights. Full article
(This article belongs to the Section Intensive Care)
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23 pages, 811 KiB  
Article
Backstepping-Based Finite-Horizon Optimization for Pitching Attitude Control of Aircraft
by Ang Li, Yaohua Shen and Bin Du
Aerospace 2025, 12(8), 653; https://doi.org/10.3390/aerospace12080653 - 23 Jul 2025
Viewed by 119
Abstract
In this paper, the problem of pitching attitude finite-horizon optimization for aircraft is posed with system uncertainties, external disturbances, and input constraints. First, a neural network (NN) and a nonlinear disturbance observer (NDO) are employed to estimate the value of system uncertainties and [...] Read more.
In this paper, the problem of pitching attitude finite-horizon optimization for aircraft is posed with system uncertainties, external disturbances, and input constraints. First, a neural network (NN) and a nonlinear disturbance observer (NDO) are employed to estimate the value of system uncertainties and external disturbances. Taking input constraints into account, an auxiliary system is designed to compensate for the constrained input. Subsequently, the backstepping control containing NN and NDO is used to ensure the stability of systems and suppress the adverse effects caused by the system uncertainties and external disturbances. In order to avoid the derivation operation in the process of backstepping, a dynamic surface control (DSC) technique is utilized. Simultaneously, the estimations of the NN and NDO are applied to derive the backstepping control law. For the purpose of achieving finite-horizon optimization for pitching attitude control, an adaptive method termed adaptive dynamic programming (ADP) with a single NN-termed critic is applied to obtain the optimal control. Time-varying feature functions are applied to construct the critic NN in order to approximate the value function in the Hamilton–Jacobi–Bellman (HJB) equation. Furthermore, a supplementary term is added to the weight update law to minimize the terminal constraint. Lyapunov stability theory is used to prove that the signals in the control system are uniformly ultimately bounded (UUB). Finally, simulation results illustrate the effectiveness of the proposed finite-horizon optimal attitude control method. Full article
(This article belongs to the Section Aeronautics)
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23 pages, 8766 KiB  
Article
Robust Tracking Control of Underactuated UAVs Based on Zero-Sum Differential Games
by Yaning Guo, Qi Sun and Quan Pan
Drones 2025, 9(7), 477; https://doi.org/10.3390/drones9070477 - 5 Jul 2025
Viewed by 293
Abstract
This paper investigates the robust tracking control of unmanned aerial vehicles (UAVs) against external time-varying disturbances. First, by introducing a virtual position controller, we innovatively decouple the UAV dynamics into independent position and attitude error subsystems, transforming the robust tracking problem into two [...] Read more.
This paper investigates the robust tracking control of unmanned aerial vehicles (UAVs) against external time-varying disturbances. First, by introducing a virtual position controller, we innovatively decouple the UAV dynamics into independent position and attitude error subsystems, transforming the robust tracking problem into two zero-sum differential games. This approach contrasts with conventional methods by treating disturbances as strategic “players”, enabling a systematic framework to address both external disturbances and model uncertainties. Second, we develop an integral reinforcement learning (IRL) framework that approximates the optimal solution to the Hamilton–Jacobi–Isaacs (HJI) equations without relying on precise system models. This model-free strategy overcomes the limitation of traditional robust control methods that require known disturbance bounds or accurate dynamics, offering superior adaptability to complex environments. Third, the proposed recursive Ridge regression with a forgetting factor (R3F2 ) algorithm updates actor-critic-disturbance neural network (NN) weights in real time, ensuring both computational efficiency and convergence stability. Theoretical analyses rigorously prove the closed-loop system stability and algorithm convergence, which fills a gap in existing data-driven control studies lacking rigorous stability guarantees. Finally, numerical results validate that the method outperforms state-of-the-art model-based and model-free approaches in tracking accuracy and disturbance rejection, demonstrating its practical utility for engineering applications. Full article
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27 pages, 15418 KiB  
Article
Revision of Macrima Baly, 1878 (Coleoptera: Chrysomelidae: Galerucinae)
by Chuan Feng, Xingke Yang, Jan Bezděk and Siqin Ge
Insects 2025, 16(7), 685; https://doi.org/10.3390/insects16070685 - 30 Jun 2025
Viewed by 381
Abstract
This study presents a taxonomic revision of the genus Macrima Baly, 1878 to advance the understanding of suprageneric, non-monophyletic “Monoleptites”. Through comprehensive morphological examinations of all type specimens, including detailed analyses of male and female genitalia and the structure of the cavitous anterior [...] Read more.
This study presents a taxonomic revision of the genus Macrima Baly, 1878 to advance the understanding of suprageneric, non-monophyletic “Monoleptites”. Through comprehensive morphological examinations of all type specimens, including detailed analyses of male and female genitalia and the structure of the cavitous anterior part of the head, we propose M. roseofulva Medvedev, 2011 and M. ferrugina Jiang, 1990 as new synonyms of M. aurantiaca (Laboissière, 1936), M. bifida Yang, 1992 a new synonym of M. cornuta (Laboissière, 1936), and M. yunnanensis (Laboissière, 1936) as a new synonym of M. pallida (Laboissière, 1936). In addition, M. costatipennis Jacoby, 1896 is transferred to Hoplosaenidea Laboissière, 1933 (comb. nov.). Color photos of habitus, body details, and genitalia are presented for all species. Full article
(This article belongs to the Special Issue Revival of a Prominent Taxonomy of Insects)
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14 pages, 1778 KiB  
Systematic Review
Safety and Efficacy of Achieving Very Low LDL Cholesterol Concentrations with PCSK9 Inhibitors
by Akshay Machanahalli Balakrishna, Sharanya Kaushik, Sangeetha Tandalam Palanivelu, Noorhan Monther, Shiva P. Ponamgi, Venkata Mahesh Alla and Shantanu M. Patil
J. Clin. Med. 2025, 14(13), 4562; https://doi.org/10.3390/jcm14134562 - 27 Jun 2025
Viewed by 691
Abstract
Background: The advent of newer pharmacological agents, particularly proprotein convertase subtilisin/kexin type 9 (PCSK-9) inhibitors, in combination with conventional lipid-lowering treatments, has allowed for the significant lowering of low-density lipoprotein cholesterol (LDL-C). However, it is unclear if very low LDL-C levels achieved with [...] Read more.
Background: The advent of newer pharmacological agents, particularly proprotein convertase subtilisin/kexin type 9 (PCSK-9) inhibitors, in combination with conventional lipid-lowering treatments, has allowed for the significant lowering of low-density lipoprotein cholesterol (LDL-C). However, it is unclear if very low LDL-C levels achieved with the use of PCSK-9 inhibitors are associated with increased adverse events that may outweigh potential benefits. Methods: A systematic search of PubMed, Medline, and Cochrane databases was conducted from their inception to 21 February 2025, for randomized controlled trials (RCTs) reporting clinical outcomes with intensive lipid-lowering treatment with PCSK-9 inhibitors leading to very low (<40 mg/dL) LDL-C levels vs. a control group with higher LDL-C levels. The outcomes of interest included the incidence of major adverse cardiovascular events (MACEs), neurocognitive disorders, diabetes mellitus, muscle disorders, any adverse events, events leading to drug discontinuation, cataract, hepatobiliary disorders, and cancer. Random effects meta-analysis models were used to calculate the pooled incidence and odds ratio (OR) with 95% confidence intervals (Cis). Results: A total of six RCTs with 52,951 patients (11,209 very low LDL-C, and 41,742 control) met the inclusion criteria. Compared with patients in the control arm, very low LDL-C was associated with a reduction in MACEs (OR = 0.76, 95% CI: 0.64, 0.89; p < 0.01; I2 = 44.8%). The incidence of most safety outcomes including neurocognitive disorders, diabetes mellitus, muscle disorders, any adverse events, events leading to drug discontinuation, cataract, hepatobiliary disorders, and cancer were comparable between the very low LDL-C and control groups. Conclusions: Very low LDL-C values following intensive lipid-lowering with PCSK-9 inhibitors are associated with a major reduction in cardiovascular events without any significant increase in serious side effects. Full article
(This article belongs to the Section Cardiovascular Medicine)
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18 pages, 2168 KiB  
Article
A New Approach to Topology Optimization with Genetic Algorithm and Parameterization Level Set Function
by Igor Pehnec, Damir Sedlar, Ivo Marinic-Kragic and Damir Vučina
Computation 2025, 13(7), 153; https://doi.org/10.3390/computation13070153 - 26 Jun 2025
Viewed by 469
Abstract
In this paper, a new approach to topology optimization using the parameterized level set function and genetic algorithm optimization methods is presented. The impact of a number of parameters describing the level set function in the representation of the model was examined. Using [...] Read more.
In this paper, a new approach to topology optimization using the parameterized level set function and genetic algorithm optimization methods is presented. The impact of a number of parameters describing the level set function in the representation of the model was examined. Using the B-spline interpolation function, the number of variables describing the level set function was decreased, enabling the application of evolutionary methods (genetic algorithms) in the topology optimization process. The traditional level set method is performed by using the Hamilton–Jacobi transport equation, which implies the use of gradient optimization methods that are prone to becoming stuck in local minima. Furthermore, the resulting optimal shapes are strongly dependent on the initial solution. The proposed topology optimization procedure, written in MATLAB R2013b, utilizes a genetic algorithm for global optimization, enabling it to locate the global optimum efficiently. To assess the acceleration and convergence capabilities of the proposed topology optimization method, a new genetic algorithm penalty operator was tested. This operator addresses the slow convergence issue typically encountered when the genetic algorithm optimization procedure nears a solution. By penalizing similar individuals within a population, the method aims to enhance convergence speed and overall performance. In complex examples (3D), the method can also function as a generator of good initial solutions for faster topology optimization methods (e.g., level set) that rely on such initial solutions. Both the proposed method and the traditional methods have their own advantages and limitations. The main advantage is that the proposed method is a global search method. This makes it robust against entrapment in local minima and independent of the initial solution. It is important to note that this evolutionary approach does not necessarily perform better in terms of convergence speed compared to gradient-based or other local optimization methods. However, once the global optimum has been found using the genetic algorithm, convergence can be accelerated using a faster local method such as gradient-based optimization. The application and usefulness of the method were tested on typical 2D cantilever beams and Michell beams. Full article
(This article belongs to the Special Issue Advanced Topology Optimization: Methods and Applications)
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20 pages, 311 KiB  
Article
Finite Orthogonal M Matrix Polynomials
by Esra Güldoğan Lekesiz
Symmetry 2025, 17(7), 996; https://doi.org/10.3390/sym17070996 - 24 Jun 2025
Cited by 1 | Viewed by 319
Abstract
In this study, we aim to construct a finite set of orthogonal matrix polynomials for the first time, along with their finite orthogonality, matrix differential equation, Rodrigues’ formula, several recurrence relations including three-term relation, forward and backward shift operators, generating functions, integral representation [...] Read more.
In this study, we aim to construct a finite set of orthogonal matrix polynomials for the first time, along with their finite orthogonality, matrix differential equation, Rodrigues’ formula, several recurrence relations including three-term relation, forward and backward shift operators, generating functions, integral representation and their relation with Jacobi matrix polynomials. Thus, the concept of “finite”, which is used to impose parametric constraints for orthogonal polynomials, is transferred to the theory of matrix polynomials for the first time in the literature. Moreover, this family reduces to the finite orthogonal M polynomials in the scalar case when the degree is 1, thereby providing a matrix generalization of finite orthogonal M polynomials in one variable. Full article
(This article belongs to the Section Mathematics)
9 pages, 1072 KiB  
Article
Elevated Immunoglobulin G as a Predictor of Progression to Severe Lung Disease in Cystic Fibrosis: A Longitudinal Cohort Study
by Ori Goldberg, Siwar Shekh-Yusuf, Miri Dotan, Moshe Heching, Eyal Jacobi, Meir Mei-Zahav, Hannah Blau, Huda Mussaffi and Dario Prais
J. Clin. Med. 2025, 14(12), 4331; https://doi.org/10.3390/jcm14124331 - 18 Jun 2025
Viewed by 335
Abstract
Background: Elevated immunoglobulin G (IgG) levels are associated with worse lung function and disease severity in people with cystic fibrosis (PwCF). This study evaluated whether elevated IgG levels—defined as values above the 97.5th percentile (Z-score ≥ 1.96 standard deviations above the mean)—can predict [...] Read more.
Background: Elevated immunoglobulin G (IgG) levels are associated with worse lung function and disease severity in people with cystic fibrosis (PwCF). This study evaluated whether elevated IgG levels—defined as values above the 97.5th percentile (Z-score ≥ 1.96 standard deviations above the mean)—can predict progression to severe lung disease. Methods: A retrospective cohort study of children and adults with CF at a single-center clinic was performed. Patients with elevated baseline IgG Z-scores were compared to those with normal or low IgG levels. Progression to severe lung disease was defined as % predicted FEV1 < 40%, referral for lung transplantation, or death. Kaplan–Meier survival curves and Cox models were used to analyze clinical outcomes. A sensitivity analysis was conducted for patients aged 18 years or older. Results: Of 97 patients, 31 (31.9%) had elevated IgG levels. Progression to severe lung disease occurred in 14 (14.4%) patients, 12 (85.7%) of whom had elevated IgG. These patients were significantly older and had a higher prevalence of Pseudomonas aeruginosa colonization. Among adults, those with elevated IgG had lower baseline % predicted FEV1 and greater annual lung function decline. Elevated IgG was independently associated with progression to severe lung disease (adjusted hazard ratio [aHR]: 9.8; 95% CI: 1.9–48.6), even after adjusting for Pseudomonas colonization and annual % predicted FEV1 decline. Conclusions: Elevated IgG was associated with progression to severe lung disease in PwCF and correlated with older age, Pseudomonas colonization, and—in adults—lower baseline lung function and faster decline. These findings highlight elevated serum IgG as a meaningful prognostic biomarker for identifying high-risk PwCF who may benefit from closer monitoring and earlier intervention. Full article
(This article belongs to the Special Issue Cystic Fibrosis: Novel Strategies of Diagnosis and Treatments)
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13 pages, 1071 KiB  
Article
The Influence of the Mass Ratio and the Jacobi Constant on the Probability of Escape in the 3D (4+2)-Body Ring Problem
by Zahra Boureghda, Mari Carmen Martínez-Belda and Juan F. Navarro
Mathematics 2025, 13(12), 1992; https://doi.org/10.3390/math13121992 - 17 Jun 2025
Viewed by 260
Abstract
The dynamics of escape in the (N+2)-body ring problem exhibits a limited supply of research that involves the investigation in the three-dimensional scenario. In this paper, we introduce a new method based on the use of a spherical [...] Read more.
The dynamics of escape in the (N+2)-body ring problem exhibits a limited supply of research that involves the investigation in the three-dimensional scenario. In this paper, we introduce a new method based on the use of a spherical surface of section to analyze the probability of escape in the (4+2)-body ring problem in three dimensions. Our analysis reveals perplexing results regarding the impact of the mass ratio, β, and the Jacobi constant, C, parameters on this escape probability. In order to delineate the different effects exerted by these parameters, we incorporate into the system three increasing values of β and four values of C for each value of β, that show different behaviors in the distribution of the escaping orbits. Full article
(This article belongs to the Special Issue Mathematical Methods and N-Body Problem in Celestial Mechanics)
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21 pages, 330 KiB  
Review
Schrödinger Potentials with Polynomial Solutions of Heun-Type Equations
by Géza Lévai and Tibor Soltész
Mathematics 2025, 13(12), 1963; https://doi.org/10.3390/math13121963 - 14 Jun 2025
Viewed by 293
Abstract
The present review discusses the solution of the Heun, confluent, biconfluent, double confluent, and triconfluent equations in terms of polynomial expansions, and applies the results to generate exactly solvable Schrödinger potentials. Although there are more general approaches to solve these differential equations in [...] Read more.
The present review discusses the solution of the Heun, confluent, biconfluent, double confluent, and triconfluent equations in terms of polynomial expansions, and applies the results to generate exactly solvable Schrödinger potentials. Although there are more general approaches to solve these differential equations in terms of the expansions of certain special functions, the importance of polynomial solutions is unquestionable, as most of the known potentials are solvable in terms of the hypergeometric and confluent hypergeometric functions; i.e., Natanzon-class potentials possess bound-state solutions in terms of classical orthogonal polynomials, to which the (confluent) hypergeometric functions can be reduced. Since some of the Heun-type equations contain the hypergeometric and/or confluent hypergeometric differential equations as special limits, the potentials generated from them may also contain Natanzon-class potentials as special cases. A power series expansion is assumed around one of the singular points of each differential equation, and recurrence relations are obtained for the expansion coefficients. With the exception of the triconfluent Heun equations, these are three-term recurrence relations, the termination of which is achieved by prescribing certain conditions. In the case of the biconfluent and double confluent Heun equations, the expansion coefficients can be obtained in the standard way, i.e., after finding the roots of an (N + 1)th-order polynomial in one of the parameters, which, in turn, follows from requiring the vanishing of an (N + 1) × (N + 1) determinant. However, in the case of the Heun and confluent Heun equations, the recurrence relation can be solved directly, and the solutions are obtained in terms of rationally extended X1-type Jacobi and Laguerre polynomials, respectively. Examples for solvable potentials are presented for the Heun, confluent, biconfluent, and double confluent Heun equations, and alternative methods for obtaining the same potentials are also discussed. These are the schemes based on the rational extension of Bochner-type differential equations (for the Heun and confluent Heun equation) and solutions based on quasi-exact solvability (QES) and on continued fractions (for the biconfluent and double confluent equation). Possible further lines of investigations are also outlined concerning physical problems that require the solution of second-order differential equations, i.e., the Schrödinger equation with position-dependent mass and relativistic wave equations. Full article
(This article belongs to the Section E4: Mathematical Physics)
18 pages, 861 KiB  
Article
Fast Quaternion Algorithm for Face Recognition
by Anita Carević and Ivan Slapničar
Mathematics 2025, 13(12), 1958; https://doi.org/10.3390/math13121958 - 13 Jun 2025
Viewed by 211
Abstract
Quaternions extend the concept of complex numbers and have significant applications in image processing, as they provide an efficient way to represent RGB images. One interesting application is face recognition, which aims to identify a person in a given image. In this paper, [...] Read more.
Quaternions extend the concept of complex numbers and have significant applications in image processing, as they provide an efficient way to represent RGB images. One interesting application is face recognition, which aims to identify a person in a given image. In this paper, we propose an algorithm for face recognition that models images using quaternion matrices. To manage the large size of these matrices, our method projects them onto a carefully chosen subspace, reducing their dimensionality while preserving relevant information. An essential part of our algorithm is the novel Jacobi method we developed to solve the quaternion Hermitian eigenproblem. The algorithm’s effectiveness is demonstrated through numerical tests on a widely used database for face recognition. The results demonstrate that our approach, utilizing only a few eigenfaces, achieves comparable recognition accuracy. This not only enhances execution speed but also enables the processing of larger images. All algorithms are implemented in the Julia programming language, which allows for low execution times and the capability to handle larger image dimensions. Full article
(This article belongs to the Section E: Applied Mathematics)
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17 pages, 3650 KiB  
Systematic Review
Catheter-Based Therapies in Acute Pulmonary Embolism—Mortality and Safety Outcomes: A Systematic Review and Meta-Analysis
by Panagiotis Zoumpourlis, Shaunak Mangeshkar, Kuan-Yu Chi, Dimitrios Varrias, Michail Spanos, Muhammad Fahimuddin, Matthew D. Langston, Usman A. Khan, Michael J. Grushko, Prabhjot Singh and Seth I. Sokol
J. Clin. Med. 2025, 14(12), 4167; https://doi.org/10.3390/jcm14124167 - 12 Jun 2025
Viewed by 595
Abstract
Background/Objectives: Right ventricular (RV) dysfunction and circulatory collapse are considered to play a major role in mortality in patients suffering from pulmonary embolism (PE). Catheter-based therapies (CBTs) have been shown to improve RV hemodynamics. The aim of this study was to present available [...] Read more.
Background/Objectives: Right ventricular (RV) dysfunction and circulatory collapse are considered to play a major role in mortality in patients suffering from pulmonary embolism (PE). Catheter-based therapies (CBTs) have been shown to improve RV hemodynamics. The aim of this study was to present available data for CBTs in acute PE and investigate whether CBTs offer mortality benefit and better safety outcomes over anticoagulation (AC) in patients with intermediate-risk PE. Methods: PubMed was searched from inception until February 2024 for studies that investigated treatment strategies in patients with confirmed PE. We initially investigated the crude incidence of mortality and major bleeding for individual interventions in patients with either intermediate or high-risk PE. We then directly compared CBT to AC for intermediate-risk PE, for which the effectiveness endpoint was comparative short-term (30-day or in-hospital) and midterm (90-day or 1-year) all-cause mortality and the safety outcomes included minor bleeding, major bleeding, and intracranial hemorrhage (ICH). Results: In all, 59 studies (4457 patients) were eventually included in our study. For the prevalence study, we described the crude incidence for mortality and major bleeding for interventions like catheter-directed thrombolysis (CDT), mechanical thrombectomy (MT), AC, and systemic thrombolysis (ST) in patients with either intermediate or high-risk PE. Our data synthesis comparing CBT to AC included 1657 patients (11 studies) with intermediate-risk PE. Our results indicate that CBT is associated with a lower risk of both short-term (RR 0.43; 95% CI [0.24–0.79], I2 = 0%) and midterm all-cause mortality (RR 0.38; 95% CI [0.23–0.62], I2 = 0%) compared to AC. Major bleeding and ICH did not differ between the two groups. Conclusions: In patients with intermediate-risk PE, our meta-analysis of the current literature suggests that CBT offers better outcomes in terms of short-term and midterm mortality compared to AC alone, with no difference in safety outcomes. Further RCTs are needed to explore and validate these findings. Full article
(This article belongs to the Section Cardiovascular Medicine)
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23 pages, 765 KiB  
Review
Molecular Diagnosis, Clinical Trial Representation, and Precision Medicine in Minority Patients with Oncogene-Driven Lung Cancer
by Ahan Bhatt, Nang Yone, Mumtu Lalla, Hyein Jeon and Haiying Cheng
Cancers 2025, 17(12), 1950; https://doi.org/10.3390/cancers17121950 - 11 Jun 2025
Viewed by 1070
Abstract
Lung cancer remains the leading cause of cancer-related death in the US and worldwide. Recent advances in molecular profiling and targeted therapies have revolutionized the management of non-small cell lung cancer (NSCLC), particularly in oncogene-driven subtypes. These therapies selectively target key molecular alterations [...] Read more.
Lung cancer remains the leading cause of cancer-related death in the US and worldwide. Recent advances in molecular profiling and targeted therapies have revolutionized the management of non-small cell lung cancer (NSCLC), particularly in oncogene-driven subtypes. These therapies selectively target key molecular alterations in EGFR, ALK, KRAS, ROS1, MET, RET, ERBB2 (HER2), BRAF V600E, and NTRK, resulting in substantial improvements in survival rates and quality of life for lung cancer patients. However, disparities in molecular diagnostics and precision treatments persist, disproportionately affecting minority patients. These inequities include underrepresentation in clinical trials, disparities in molecular testing, and barriers to treatment access. The limited participation of racial and ethnic minorities in landmark clinical trials raises concerns about the generalizability of findings and their applicability to diverse populations. In this review, we examine the current landscape of molecular diagnosis and precision medicine in minority patients with oncogene-driven lung cancer, highlighting challenges, opportunities, and future directions for achieving equity in precision oncology. Additionally, we discuss differences in the prevalence of oncologic driver mutations across populations and emphasize the urgent need for greater diversity in clinical research. Addressing these gaps is critical to improving survival outcomes and ensuring equitable access to personalized lung cancer care for all patients. Full article
(This article belongs to the Special Issue Screening, Diagnosis and Staging of Lung Cancer)
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24 pages, 19628 KiB  
Article
On Exact Non-Traveling Wave Solutions to the Generalized Nonlinear Kadomtsev–Petviashvili Equation in Plasma Physics and Fluid Mechanics
by Shami A. M. Alsallami
Mathematics 2025, 13(12), 1914; https://doi.org/10.3390/math13121914 - 8 Jun 2025
Viewed by 307
Abstract
The Kadomtsev–Petviashvili (KP) equation serves as a powerful model for investigating various nonlinear wave phenomena in fluid dynamics, plasma physics, optics, and engineering. In this paper, by combining the method of separation of variables with the modified generalized exponential rational function method (mGERFM), [...] Read more.
The Kadomtsev–Petviashvili (KP) equation serves as a powerful model for investigating various nonlinear wave phenomena in fluid dynamics, plasma physics, optics, and engineering. In this paper, by combining the method of separation of variables with the modified generalized exponential rational function method (mGERFM), abundant explicit exact non-traveling wave solutions for a (3+1)-dimensional generalized form of the equation are constructed. The proposed method utilizes a transformation approach to reduce the original equation to a simpler form. The derived solutions include several arbitrary functions, which enable the construction of a wide variety of exact solutions to the model. These solutions are expressed through diverse functional forms, such as exponential, trigonometric, and Jacobi elliptic functions. To the best of the author’s knowledge, these results are novel and have not been documented in prior studies. This study enhances understanding of wave dynamics in the equation and provides a practical method applicable to other related equations. Full article
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