Search Results (18,642)

Background: The number of patients with rheumatoid arthritis (RA) undergoing forefoot arthroplasty has increased to better control the disease. Despite patients frequently expressing concerns regarding postoperative foot appearance and footwear-related expectations, no study has investigated postoperative changes in foot length and width in patients with RA. The aim of this study was to evaluate the effect of surgical procedures for rheumatoid forefoot deformities on variations in radiologically determined foot length and width. Methods: In total, 72 feet of 50 women and 3 men (average age: 66.7 years) underwent joint-preserving arthroplasty (n = 33) and arthrodesis of the first metatarsophalangeal joint with shortening osteotomy of the lesser metatarsals or resection arthroplasty of the lesser metatarsal heads (n = 39); procedures were carried out in our institute from August 2013 to February 2020. The mean disease duration was 23.5 years, and the average follow-up period was 17.5 months. Pre- and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA) of the first and second metatarsals (M1M2A), and IMA of the first and fifth metatarsals (M1M5A) were measured on weightbearing radiographs as well as foot length and width. We also evaluated the correlation between changes in radiographic parameters and variations in radiologically determined foot length and width. Results: Radiologically determined foot width changed significantly from 10.1 cm to 9.7 cm (p < 0.01), while no significant difference was found between pre- and postoperative radiologically determined foot length. HVA, M1M2A, and M1M5A were significantly improved after the surgery (p < 0.01, p < 0.01, and p < 0.01, respectively). A significant negative correlation was found between the variation in radiologically determined foot length and changes in HVA (r = −0.29, p = 0.02) and M1M5A (r = −0.23, p < 0.05), while a significant positive correlation was found between the variation in the foot width and changes in HVA (r = 0.34, p < 0.01), M1M2A (r = 0.55, p < 0.01), and M1M5A (r = 0.45, p < 0.01). There were no significant differences between operative procedures regarding variation in radiologically determined foot length and width. Conclusions: Surgical procedure for rheumatoid forefoot deformity improved radiographic parameters and reduced radiographic foot width while maintaining foot length. Full article

Background/Objectives: The aim of this study was to identify predictors of temporal window failure (TWF) in transcranial color-coded duplex sonography (TCCS) based on demographical and computed tomography (CT)-based parameters such as temporal bone thickness (TBT), and to define sex-specific thresholds for predicting TWF. Methods: We retrospectively analyzed a series of adult patients who underwent cranial CT and TCCS. Bitemporal TBT was measured in nine standardized regions on CT, and mean TBT per side was calculated. Temporal bone window (TBW) quality was graded with two semiquantitative TCCS scores assessing the visibility of the middle cerebral artery (MCA), contralateral temporal bone, mesencephalon, and ipsilateral sphenoid bone. Associations between TBT, sex, age, and TBW visibility were analyzed by correlation, chi-square tests, and logistic regression. Results: 200 patients (102 men, 98 women; mean age 68 ± 16 years) were enrolled. Mean TBT was 3.1 ± 0.7 mm (right) and 3.2 ± 0.7 mm (left). TBT correlated weakly with age (r = 0.15–0.18, p < 0.05) and was higher in women (p < 0.05). Age and sex influenced TBW visibility (p < 0.05) with small effect sizes. Increased TBT strongly predicted poor TBW (β ≈ –1.7, p < 0.001). Optimal TBT cut-offs predicting adequate TBW were 3.8 mm (men) and 3.3 mm (women), maximizing specificity (men: 0.95, women: 0.85) and negative predictive value (men: 0.87, women: 0.66). Conclusions: Advanced age and female sex were both associated with TWF. CT-assessed TBT represents a robust predictor of TCCS feasibility. Implementation of sex-specific TBT threshold values may facilitate patient pre-selection and improve procedural efficiency in neurosonographic diagnostics. Full article

Background and Objectives: Assessing the national burden of chronic wounds is a complex data analytics challenge. Robust estimates in Eastern Europe are scarce, highlighting the need for computational methods to validate cases in large-scale health databases. Materials and Methods: We applied a large-scale data analytics approach to Romania’s National Inpatient Database (public hospitals, 2017–2022). A computational case-ascertainment algorithm (validated “≥2 admissions” rule) was used to identify recurrently hospitalized patients, establishing a cohort of 18,856 patients (65,771 hospitalizations). We computed annual prevalence, incidence, and mortality per 100,000 adults, stratified by ulcer categories, age, and sex. Results: Hospital-treated prevalence and incidence showed a clear pre-pandemic peak followed by a marked decline in 2020–2021 and only partial rebound by 2022, consistent with pandemic-related disruption of inpatient care. Population-level mortality remained low, but pressure ulcers, although least frequent, accounted for the highest mortality burden. Venous ulcers were the most common category, and the hospital-treated burden was concentrated in adults aged ≥ 65 years and in men. Conclusions: This nationwide data-analytics framework provides the first validated inpatient indicators of chronic ulcer burden in Romania and demonstrates substantial hospital-treated disease burden with pronounced sensitivity to healthcare access constraints. Clinical Implications: The findings can support health-policy and prevention strategies by prioritizing early detection and integrated hospital–community wound care pathways for high-risk groups (men and older adults) and by strengthening outpatient services to reduce avoidable admissions. Full article

Background: Early and adequate empiric antibiotic therapy is essential in the treatment of pneumonia and sepsis and may influence the clinical outcome. Aims and Objectives: This retrospective before–after study aimed to appraise the impact of a local Antibiotic Stewardship Program (ASP—written guidelines and antibiotic restriction) on antibiotic (AB) use and clinical outcomes in patients requiring intensive care due to pneumonia and sepsis. Methods: This study was conducted as a single-center, retrospective observational study in the intensive care unit (ICU) of a pulmonology department of a tertiary care center. Data were collected for the pre-intervention period between January 2018 and May 2022 and for the ASP period between June 2022 and March 2024. In addition to descriptive statistics and univariable methods, interrupted time series (ITS) analysis was used to assess AB use and length of stay in the ICU before and after ASP implementation, using a segmented linear regression with a fixed breakpoint and continuous (hinge) specification. Results: The patients admitted to the ICU with pneumonia and sepsis were mainly men (58/101, 57.4% and 84/128, 65.6%), the need for intensive care increased with age, and most of the patients belonged to 65+ age group in both study phases (69/101, 68.3% and 75/128, 58.6%). The majority of the patients had four or more comorbidities (58/101, 57.4% and 52/128, 40.6%). In-hospital mortality was relatively high (42.6% and 41.4%), with most of the patients losing their lives in the ICU (33/43, 76.7% and 37/53, 69.8%). Significant increase in guideline-adherent agent selection (34.5%) and use of combination therapy (35.0%) was observed, while the use of fluoroquinolones decreased significantly (−31.1%). In the after period, a significant decrease in the number of patients using restricted ABs (−53.3%) was observed. In one-third of these cases (10/34, 29.4% and 16/40, 40%), two to four multidrug-resistant pathogens (MDRs) were detected simultaneously, resulting in a significant increase in direct costs (10.5%) in the ICU. The inappropriate use of AB therapy was relatively low in the presence of MDRs in both phases (2/34, 5.9% and 6/40, 15%). In the ASP period, guideline adherence was associated with slightly better clinical outcomes (30-day mortality: −0.8%; length of stay: −22.6%) in pneumonia and sepsis. The ITS analyses after the ASP implementation showed a weak downward trend and before it a slight increasing trend. Conclusions: ASP implementation in the ICU resulted in a significant improvement in the appropriate use of ABs, and guideline adherence led to slightly better clinical outcomes. Our results suggest that ASP may offer improved antimicrobial resistance with a sustained long-term effect. Full article

Background: To describe an aortic arch incision and closure technique (AICT) for proximal fixation of a frozen elephant trunk (FET) and to report early outcomes. Methods: We retrospectively reviewed 15 consecutive patients who underwent distal arch repair with an FET using AICT (mean age 77 ± 7 years; 14 men). Indications were distal arch aneurysm (n = 12), acute Stanford type B dissection (n = 2), and distal arch enlargement after thoracic endovascular aortic repair (n = 1). Under circulatory arrest, an oblique arch aortotomy was created, the FET was deployed antegrade, trimmed, and sutured to the native aortic wall during simultaneous closure, allowing extended posterior fixation. Clinical outcomes and postoperative computed tomography were assessed. Results: No ischemic complications related to graft kinking or thrombosis, reoperation for bleeding, stroke, spinal cord ischemia, or organ failure occurred. One patient died of pneumonia on postoperative day 47 (6.7%). Cervical branch reconstruction was required in 12 patients (80%), whereas two patients with type III arch morphology and acute angulation were treated without debranching via a Zone 3 aortotomy. At a median follow-up of 29 months, no proximal endoleak was observed; one distal endoleak occurred without reintervention. Coronary bypass grafts remained patent in all patients with concomitant or prior CABG. Conclusions: AICT provided secure proximal FET fixation and arch closure while preserving the ascending aorta, offering an alternative to total arch replacement in selected distal arch pathologies. Full article

Objectives: To determine whether caffeine supplementation and its expectancy influence muscle strength (ST) and muscle endurance (ME) using a balanced-placebo design. Methods: Using a randomized, double-blind, balanced-placebo design, resistance-trained men (18–30 years; n = 16) participated in two assessment/familiarization visits (demographics; one repetition maximum (1RM) followed by four counterbalanced sessions: C/C (informed caffeine/used caffeine), P/C (informed placebo/used caffeine), C/P (informed caffeine/used placebo), P/P (informed placebo/used placebo). Caffeine dose was 5 mg/kg. Peak torque (PT) and maximum work (MW) were measured in the knee extensors at 0, 60, 180, and 300°/s, which was followed by ME testing (three sets of maximal repetitions using 60%1RM). Capillary blood lactate was measured after ME testing. Results: Caffeine increased PT only during static and 60°/s contractions (4%; p ≤ 0.003; d = 0.3 for both speeds), while MW increased across all speeds (4%; p < 0.001; d = 0.2). Caffeine did not increase ME (3%; p = 0.184; d = 0.1), but it did increase blood lactate levels (1.2 mmol/L; p < 0.001; d = 0.7). Caffeine expectation did not improve ST or ME, but increased blood lactate levels (0.7 mmol/L; p = 0.003; d = 0.4). Across ST and ME, responses to caffeine were markedly heterogeneous, with 50–88% of individuals considered responders (∆ > 0), and improvements in responders ranged from 1–16%. Conclusions: Caffeine significantly increased ST, despite ME increasing in 50% of participants, this was not significant. No placebo effect was observed in ST or ME, but it significantly increased lactate. Further research is necessary to elucidate the mechanisms behind this variability in the ME response, especially the role of fiber-type predominance. Full article

Objective: This study aimed to (i) examine the test–retest reliability of a holistic motor competence test (HOLMOT) in adults aged 30–60 years, and (ii) evaluate its ability to discriminate performance according to sex and age group. Methods: A total of 435 adults (206 women and 229 men; Mean age: 43.49 ± 7.55 years; Weight: 69.10 ± 9.88 kg; BMI: 23.81 ± 2.42 kg/m²) participated in this cross-sectional study. Motor Competence was assessed using the HOLMOT, a time-based protocol integrating motor-cognitive, locomotor, and manipulative domains. Test–retest reliability was examined in a subsample of 217 participants over a one-week interval using relative (ICC, Pearson’s r) and absolute (SEM, MDC) reliability indices. Sex and age-group differences were analyzed using independent t-tests and analysis of variance. Results: The HOLMOT demonstrated good to excellent reliability for the motor-cognitive (ICC = 0.89), locomotor (ICC = 0.94), and total time (ICC = 0.84) outcomes, with low SEM and MDC values. Reliability was lower for the manipulative section (ICC = 0.44). Men exhibited shorter completion times than women across all sections (p < 0.001), and adults over 50 years showed significantly longer times in the motor-cognitive and locomotor domains (p < 0.05). Conclusions: The HOLMOT is a feasible and reliable tool for assessing motor competence in mid-adulthood, demonstrating sensitivity to sex- and age-related differences and supporting holistic, lifespan-oriented models of motor competence. Full article

Background/Objectives: This study examined the acute effects of different doses of melatonin on performance, physiological, and psychophysiological responses during individualized exhaustive cycling exercise. Methods: Fifteen physically active but cycling-inexperienced men (18–35 years) completed a double-blind, randomized, placebo-controlled, crossover protocol. Following an incremental test to determine the anaerobic threshold (AnT), participants performed four exhaustive exercise sessions at 80% of AnT after ingesting placebo or melatonin (5, 12.5, or 20 mg), administered approximately 30 min before exercise. Time to exhaustion (TLim) was considered the primary performance outcome. Heart rate, peripheral oxygen saturation, blood lactate concentration, blood glucose, and ratings of perceived exertion were assessed before, during, and after exercise. Results: No significant differences were observed between experimental conditions for TLim or for any physiological or psychophysiological variable. Only main effects of time were detected, reflecting expected exercise-induced responses, with small effect sizes and no evidence of a dose–response relationship across melatonin conditions. Baseline values were comparable among sessions. These findings indicate that acute melatonin administration at doses ranging from 5 to 20 mg does not elicit ergogenic effects nor modulate physiological or psychophysiological responses during prolonged individualized cycling exercise in healthy individuals. Conclusions: In male, healthy, physically active individuals inexperienced in cycling, acute melatonin administration at the doses tested did not produce ergogenic effects or alter physiological and psychophysiological responses during prolonged, individualized cycling exercise. Full article

Introduction: Currently, REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) is an emerging technique for resuscitation in patients presenting severe pathology in hemodynamic shock refractory to conventional treatments. The REBOA technique consists of inserting a balloon through the femoral artery to temporarily occlude the aorta and thus control massive bleeding and improve perfusion of vital organs in critical situations such as hemorrhagic shock. Although it is not a definitive technique, its use buys time before the implementation of a definitive treatment when possible. This makes REBOA an ideal technique for the philosophy of out-of-hospital emergency services and more particularly in the HEMS (Helicopter Emergency Medical Service) environment. On the other hand, REBOA has been postulated as one of the basic pillars in the resuscitation of severe trauma patients with hemorrhagic shock and of the doctrine of damage-control resuscitation in non-compressible torso and lower limb hemorrhage. Objective: To evaluate the potential feasibility of REBOA implementation in patients attended by HEMS teams in Castilla-La Mancha, Spain. Method: A retrospective observational study was conducted analyzing medical and nursing reports from HEMS units between 1 January and 31 December 2023. A statistical study of the variables collected was carried out using statistical techniques appropriate to the pre-specified study variables. A descriptive analysis of the population was performed. Frequency results are expressed in absolute terms, as percentages and confidence intervals. Continuous variables are expressed as mean (SD) and median (range) according to normality test (Kolmogorov–Smirnov test). For the study of the relationship between the different variables, Chi-square or Analysis of Variance is used if they are parametric. Descriptive and inferential statistics were performed using SPSS v24. Results: A total of 103 patients (72.81% men, mean age 57.7 years) were identified as potential REBOA candidates. On arrival of the emergency services the mean SI (shock index) of the patients was 1.36 (SD +/− 0.380). On arrival at the hospital, the mean SI was 1.25 (SD +/− 0.601). Of the series, 57 (55.33%) patients suffered cardiorespiratory arrest (CRA) at some point during pre-hospital care. Of the total number of patients, 38 were patients presenting severe trauma criteria (characterized by life-threatening injuries, with RTS score ≤ 11, shock index > 0.9, or ISS ≥ 16, indicating severe physiological or anatomical alterations), of which 26 (68.4%) did not go into CRA, while 12 (31.6%) did. Of the total number of patients, 65 (63.1%) did not meet severe trauma criteria, but did present medical criteria for REBOA placement, of which 55 (53.4%) were patients who at some point during attendance presented CRA. Although the shock index showed a slight decrease after healthcare without statistical significance or relevant correlation, a highly significant association was observed between severe trauma and cardiorespiratory arrest (p < 0.001). Conclusions: It could be affirmed that it may have been feasible to implement REBOA in 4.47% (103) of the patients attended by the HEMS healthcare team of Castilla-La Mancha. This could help to reduce the morbimortality and mortality of critical patients in medical helicopters. More studies are needed to corroborate this assertion. Full article

Prostatitis includes infectious and noninfectious inflammatory phenotypes that can impair male reproductive potential and may influence couple-level reproduction via seminal inflammatory and microbial exposure. This review summarizes mechanisms linking prostatic inflammation and dysbiosis to semen dysfunction and sperm DNA damage and proposes an infertility-oriented diagnostic and management framework. This is a narrative review of clinical and translational evidence addressing semen inflammation, oxidative stress, sperm DNA fragmentation (SDF), microbiome signatures, and reproductive outcomes in prostatitis (National Institutes of Health (NIH) categories I-IV). Across prostatitis phenotypes, leukocytospermia and elevated seminal cytokines (especially interleukin-8) are associated with impaired motility, altered viscosity and liquefaction, oxidative stress, and higher SDF. Persistent infection or dysbiosis may sustain immune activation and redox injury, while ductal remodeling and pain-related sexual dysfunction can further reduce natural conception. Seminal cytokines and microbes may affect female reproductive tract biology, although clinical outcome data remain limited. Prostatitis-related infertility requires evaluation beyond routine semen analysis. A biomarker-guided workup integrating inflammatory markers, oxidative stress testing, targeted microbiology (culture plus nucleic acid amplification tests when indicated), SDF testing in selected men, and imaging when obstruction is suspected can identify treatable drivers and guide timing and selection of assisted reproduction strategies. Future studies should standardize fertility endpoints and validate biomarker-guided and microbiome-directed interventions. Full article

Background: Obstructive sleep apnea (OSA) is a major modifiable risk factor for atrial fibrillation (AF), promoting arrhythmogenesis through intermittent hypoxia, autonomic activation, and atrial remodeling. Although continuous positive airway pressure (CPAP) effectively treats OSA, real-world evidence linking objectively measured CPAP exposure to clinically relevant AF recurrence remains limited. Aims: We aimed to evaluate the association between CPAP adherence and risk of recurrent paroxysmal AF, and to compare time to first recurrence between patients with mean nightly CPAP use ≥4 h/night versus <4 h/night. Materials and Methods: In this prospective observational cohort (2017–2024), consecutive hospitalized and outpatient adults with severe obstructive sleep apnea (OSA; apnea–hypopnea index > 30 events/h) and documented paroxysmal atrial fibrillation (AF) were enrolled. Persistent and long-standing persistent AF were excluded to ensure a homogeneous population with respect to atrial substrate. OSA was assessed using home sleep apnea testing (ResMed ApneaLink), and all patients initiated continuous positive airway pressure (CPAP) therapy (ResMed AirSense 10). Objective adherence data were obtained via the ResMed AirView telemonitoring platform. Exclusion criteria included permanent AF, prior pulmonary vein isolation, central sleep apnea, left ventricular ejection fraction < 50%, end-stage chronic kidney disease (eGFR < 15 mL/min/1.73 m² or dialysis), or inability to initiate or maintain CPAP therapy. Patients were followed for 12 months. The primary endpoint was time to first documented recurrence of paroxysmal AF (≥30 s on 12-lead electrocardiography or 24-h Holter monitoring). Progression to permanent AF, defined after unsuccessful rhythm control attempts and subsequent transition to a rate control strategy, was assessed as a secondary endpoint. Time-to-event analyses used Kaplan–Meier estimates with log-rank testing, and Cox proportional hazards regression adjusted for age, body mass index, apnea–hypopnea index, heart failure, left atrial volume index, and antiarrhythmic drug therapy. Results: The final analysis included 91 patients (mean age 62.15 ± 8.29 years; 68.13% men). Mean nightly CPAP use was ≥4 h/night in 49 patients and <4 h/night in 42 patients. During follow-up, paroxysmal AF recurrence occurred in 12/49 (24.5%) patients in the ≥4 h/night group and 16/42 (38.1%) in the <4 h/night group. Mean arrhythmia-free survival at 12 months was numerically higher in the ≥4 h/night group (11.25 vs. 10.51 months), without a statistically significant difference in Kaplan–Meier curves (log-rank p = 0.11). In multivariable Cox regression, binary adherence (≥4 h/night) was not independently associated with recurrence (HR 0.52, p = 0.13), whereas mean nightly CPAP use analyzed as a continuous variable remained independently associated with delayed recurrence (per 1-h increase: HR 0.66, 95% CI 0.48–0.91, p = 0.01). Progression to permanent AF occurred in 4/49 (10.0%) versus 9/42 (17.6%) patients, respectively (p = 0.29). Conclusions: In this real-world cohort of patients with severe OSA and paroxysmal AF, higher objectively measured CPAP exposure was independently associated with delayed AF recurrence when analyzed as a continuous variable, suggesting a graded association between objectively measured CPAP exposure and AF recurrence. Larger studies with extended follow-up and continuous rhythm monitoring are warranted to confirm long-term rhythm benefits and effects on AF progression. Full article

Despite several policies and legislation enactments to address gender inequality in the post-apartheid South African employment landscape, a significant proportion of female academics still face marginalization and underrepresentation in senior executive positions. This paper aims to investigate the glass ceiling effect and gender discrimination in higher education institutions. This qualitative research, built on the assumption of the phenomenology design, interviewed 12 academics (men and women) selected across disciplines to understand their perceptions and experiences of gender discrimination and barriers in women’s career progression and women academics. The thematic analysis employed to analyze the qualitative data shows societal, cultural, and organizational dynamics as constraints to women’s career advancements. Findings show that patriarchal ideology is associated with leadership and masculine traits, with women being disadvantaged. There is evidence of stereotypical behaviours and biassed evaluation in the career progression of women, hinged on cultural perception. Managing barriers in women’s career growth requires training that focuses on women’s leadership skill development for addressing gender discrimination. Higher education must ensure that managing gender discrimination and barriers associated with the glass ceiling are channelled through dialogues and measures that promote opportunities for women’s development, including institutional mechanisms like mentorship programmes and family-friendly policies for women academics. Full article

Background: MRI-based radiomics has shown promise in men with prostate cancer (PCa); however, successful clinical implementation is contingent upon on reproducible measurements. Purpose: We assessed the reproducibility of radiomics features extracted from bi-parametric prostate MRI (bpMRI) in prostate lesions and non-tumoral prostate tissue in men with PCa undergoing active surveillance (AS). Methods: This retrospective study included 47 men with biopsy-proven PCa undergoing AS (mean 68.9 ± 8.2 years, mean PSA density [PSAD] 0.08 ± 0.03 ng/mL/mL) who underwent two bpMRI approximately 12 months apart (range, 10–14 months; December 2018 to April 2020). The reproducibility of radiomics measurements was assessed using the same MRI platform (3T Skyra, Siemens Healthineers; inter-platform) (n = 37), different MRI vendors (Skyra, Siemens Healthineers; 3T Discovery MR750, GE Healthcare; inter-platform) (n = 10), and between observers (n = 10). Shape/1st-/2nd-order radiomics features were extracted from regions of interest on axial T2-weighted (T2-WI), diffusion-weighted imaging (DWI, b1600), and apparent diffusion coefficient (ADC) maps on prostate lesions, non-tumoral peripheral zones (PZs), and transition zones (TZs) using software. Reproducibility was evaluated by calculating the intraclass correlation coefficient (ICC) and coefficient of variation (CV). Associations of clinical variables and prostate volume were assessed. Results: PCa diagnoses included Gleason grade groups 1 (n = 46) and 2 (n = 1)]. Thirty-seven lesions (mean size 0.9 ± 0.4 cm) in 31 patients had PI-RADS v2.1 scores of 2 (n = 3)/3 (n = 12)/4 (n = 21)/5 (n = 1); 16 patients demonstrated diffuse PI-RADS 2 changes. Lesion radiomics features from T2-WI yielded a high proportion of good/moderate ICCs (intra-platform, 77.8%; inter-platform, 56.5%), whereas most DWI/ADC features yielded poor reproducibility. Similar results were observed for non-tumoral PZ/TZ. Intra-platform CVs were lowest for T2-WI lesion features (13.6%) and background PZ/TZ (<13.3%), while DWI/ADC exceeded 20%. Inter-platform CVs were lowest for lesions on T2-WI and were <18% for DWI/ADC; all background PZ/TZ CVs were < 16.4%. Inter-observer analyses showed good/moderate ICCs across all sequences and regions (57.4–92.6%). The distribution of ICC and CV values did not differ between intra- and inter-platform analyses (p > 0.05). Higher reproducibility (ICC > 0.5) was associated with larger prostate volume (intra-platform diagnostic odds ratio [DOR] = 2.58, 95% confidence interval [95%CI], 1.35–3.80, p = 0.01; inter-platform DOR = 3.48, 95%CI 1.79–5.17, p = 0.01) and older age (inter-platform DOR = 5.30, 95%CI 3.75–6.85, p < 0.01). Conclusions: Radiomics measurements from T2-WI demonstrated better intra-/inter-platform reproducibility than DWI/ADC for prostate lesions and non-tumoral tissue. Patient factors (larger prostate volumes and older age) influence radiomics stability. The optimization of diffusion-based radiomics features is needed to improve reproducibility given the essential role of DWI in prostate MRI. Full article

Over the past two decades, Olympic swimming performance has improved. However, less attention has been given to the evolution of Olympic Qualification Time (OQT) standards. This retrospective observational study analyzed event-specific qualification standards for all male pool swimming events. Data were extracted from publicly available documents and competition reports. Descriptive statistics, percentage change calculations, Pearson correlation analysis, and paired-sample t-tests between Olympic cycles from 2008 to 2028 were performed. For 2028, the OQTs were defined as the 14th fastest entry time from the 2024 Olympic Games. Across all events, the mean cumulative reduction in OQTs between Beijing 2008 and Los Angeles 2028 was 2.86 ± 0.54%, corresponding to an average proportional decrease of 0.6% per Olympic cycle, with trend analysis confirming statistical significance (p < 0.001). Event-level analysis revealed the greatest tightening in the 100 m breaststroke (−3.74%) and 100 m butterfly (−3.25%). When grouped by distance, sprint events (50–100 m) showed the strongest overall tightening (−3.57%), followed by middle-distance (200–400 m, −2.08%) and long-distance (800–1500 m, −2.45%). When grouped by stroke, butterfly (−3.28%) and freestyle (−3.20%) showed the largest decrease, whereas individual medley (−2.29%) demonstrated the smallest decrease. A strong positive correlation was observed between OQT tightening and Olympic performance improvement across events (r = 0.74). These findings indicate that OQTs have become demanding and broadly aligned with elite performance progression, providing applied benchmarks for coaches and performance staff. Full article

Background: Resting energy expenditure (REE) represents 60–75% of total daily energy expenditure and is mainly determined by fat-free mass (FFM). Indeed, the predictive equations vary according to FFM techniques and population characteristics. Therefore, this study aimed to explore the influence of dual-energy X-ray absorptiometry (DXA)-derived FFM on REE prediction by different predictive equations in a large and diverse cohort. Methods: A total of 1987 active and sedentary participants of both sexes (43.8 ± 19.4 years) underwent body composition assessment by DXA. REE was predicted using the Harris–Benedict, Schofield, Mifflin–St Jeor (weight- and height-based), and Mifflin (FFM-based) equations. Statistical analyses included Kruskal–Wallis, Spearman correlations, and linear regression. Results: Men presented higher absolute FFM, whereas women exhibited higher relative fat mass (FM) (p < 0.01). Across age groups, FFM declined progressively, while FM increased (p < 0.01). The REE differed significantly (p < 0.001) between equations, with the lowest values predicted from the FFM-based model, while the Harris–Benedict and Schofield equations showed the highest REE, especially in women. Strong correlations were observed between FFM and REE (r = 0.77–0.98; p < 0.01) for all age groups and equations, whereas FM showed strong correlations (r = 0.77–0.85; p < 0.01) only for the ≥60 years group. REE tended to be higher in active than sedentary participants, with the correlations to FFM and FM exhibiting a similar profile to that observed for the whole group. Conclusions: FFM showed a strong association with the estimate of REE in active and sedentary participants from both sexes and different age groups, but FM showed a similar trend in older participants only. Therefore, the increase or the maintenance of FFM with an active lifestyle is important to keep REE at high and efficient levels regardless of sex and age. Full article