Search Results (5,213)

All-solid-state anode-free sodium batteries present a special and especially important kind of energy storage device. Unfortunately, the industrial production of such batteries has been absent up to now, although the prospects of their development seem to be rather optimistic. The present mini review considers the fundamental advantages of all-solid-state anode-free sodium batteries as well as challenges in their creation. The advantages of all-solid-state anode-free sodium batteries reveal themselves when comparing them with ordinary sodium-ion batteries, sodium metal batteries, sodium batteries with liquid electrolyte, and their lithium counterparts. Full article

Background: The efficient control of hygiene and Campylobacter’s contamination status at various steps of poultry meat production is essential for the prevention of Campylobacter transmission to humans. Microbiological methods are laborious and time-consuming, and molecular methods of detection are often too skill- and infrastructure-demanding. Methods: We have developed CampyTube, a simple and user-friendly format for the integration of isothermal DNA amplification with embedded instrument-free detection on a miniaturized lateral flow test in a single vial. All test components, from the dry amplification reagents to the mini lateral flow tests, are incorporated into a standard single vial, which is closed after the addition of the liquid sample and never has to be opened again. This ensures the absolute prevention of carry-over contamination and makes the system very safe and simple to use in point-of-need settings. Results: As few as 60 Campylobacter genome copies per reaction could be successfully detected with CampyTube. We have primarily developed and evaluated CampyTube for the detection of Campylobacter in chicken neck skin samples and could reach 100% sensitivity and 100% specificity in the samples exceeding the regulatory limit of 1000 CFU/g confirmed microbiologically, while the sensitivity in all samples that tested positive using qPCR (1.4 × 10²–2.5 × 10⁶ genome copies/g) was 71.1%. We discuss the impact of sample preparation on CampyTube performance and suggest further options for test optimization. Conclusions: CampyTube is a highly versatile and efficient, yet simple, affordable, and material-saving system that can be adapted for other targets and sample types. Full article

Background: Statins exhibit pleiotropic anti-inflammatory, antioxidant, and immunomodulatory effects, suggesting their potential in non-cardiovascular conditions. However, evidence supporting their repurposing remains limited, and off-label prescribing policies vary globally. Objective: To systematically review evidence on statin repurposing in oncology and infectious diseases, and to assess Hungarian regulatory practices regarding off-label statin use. Methods: A systematic literature search (PubMed, Web of Science, Scopus, ScienceDirect; 2010–May 2025) was conducted using the terms “drug repositioning” OR “off-label prescription” AND “statin” NOT “cardiovascular,” following PRISMA guidelines. Hungarian off-label usage data from the NNGYK (2008–2025) were also analyzed. Results: Out of 205 publications, 12 met the inclusion criteria—75% were oncology-focused, and 25% focused on infectious diseases. Most were preclinical (58%); only 25% offered strong clinical evidence. Applications included hematologic malignancies, solid tumors, Cryptococcus neoformans, SARS-CoV-2, and dengue virus. Mechanisms involved mevalonate pathway inhibition and modulation of host immune responses. Hungarian data revealed five approved off-label statin uses—three dermatologic and two pediatric metabolic—supported by the literature and requiring post-treatment reporting. Conclusions: While preclinical findings are promising, clinical validation of off-label statin use remains limited. Statins should be continued in cancer patients with cardiovascular indications, but initiation for other purposes should be trial-based. Future directions include biomarker-based personalization, regulatory harmonization, and cost-effectiveness studies. Full article

Background and Clinical significance: Single-shot spinal anesthesia for intrapartum Cesarean section has recently been incriminated in carrying a high risk of high neuraxial block (HNB) occurrence in parturients receiving labor epidural analgesia. The so-called volume effect of the epidurally injected solution causes a contraction of the dural sack and unexpected HNB. Case presentation: We present two cases of HNB in parturients receiving epidural analgesia. The first case describes the 36-year-old patient G3P2, who was administered a repeated rescue analgesia single-shot spinal injection with low-dose local anesthetic (levobupivacaine, 3 mg) following non-functional combined spinal–epidural analgesia. The second case describes the 28-year-old parturient G1P0, who experienced HNB after single-shot spinal anesthesia with hyperbaric bupivacaine (7.5 mg) following labor epidural analgesia. Conclusions: Intrathecal administration of local anesthetic for the purpose of spinal analgesia or anesthesia in a parturient with epidural analgesia can cause unexpected HNB and could occur even at low doses of intrathecally administered medications. The interplay of numerous variables and circumstances in the specific case can result in the occurrence of HNB. We assume that in our first case, the volume effect and repeated dural puncture, and in the second case, the low height of the parturient coupled with the volume effect, played significant role in the occurrence of HNB. Full article

Background/Objectives: Cardiovascular diseases (CVDs) are frequently associated with psychiatric and cognitive comorbidities. These conditions have been shown to significantly impact quality of life and clinical outcomes. This study aims to evaluate the prevalence of anxiety, depression, and cognitive deficits in patients with CVD and to compare the results with existing evidence in the literature. Methods: A total of 74 patients were assessed using the following standardized screening tools: Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI). A systematic review was then conducted to compare the findings with those reported in the literature. Results: Most previous studies using the MoCA reported an over 70% absence of cognitive impairment, whereas this study shows a balanced distribution between the absence of (32.4%) and mild (35%) or moderate (32%) impairment. Studies with the MMSE indicated high rates of absence of cognitive deficits (74–79%), but here, the rate of absence was lower (58%), with an increase in mild impairment (42%). Regarding depression, compared with studies showing only absence or moderate/severe forms, this study reveals a more balanced profile, with 57% without depression and with varying severity levels (22% mild, 19% moderate, and 3% severe). Finally, for anxiety, unlike previous asymmetric distributions, greater variability was observed, with 58% without anxiety and significant percentages of mild (26%), moderate (12%), and severe (4%) anxiety. Conclusions: The results highlight a significant and varied prevalence of anxiety, depression, and cognitive deficits, emphasizing the importance of a multidimensional assessment to improve clinical management and therapeutic outcomes. Full article

Background/Objectives: Neuromodulation is under investigation as a possibly effective add-on therapy in Alzheimer’s disease (AD). While transcranial pulse stimulation (TPS) has shown positive short-term effects, long-term effects have not yet been fully explored. This study aims to evaluate the long-term feasibility, safety, and potential cognitive benefits of TPS over one year in patients with Alzheimer’s disease, focusing on domains such as memory, speech, orientation, visuo-construction, and depressive symptoms. Methods: We analyzed preliminary data from the first ten out of thirty-five patients enrolled in a prospective TPS study who completed one year of follow-up and were included in a dedicated long-term database. The protocol consisted of six initial TPS sessions over two weeks, followed by monthly booster sessions delivering 6000 pulses each for twelve months. Patients underwent regular neuropsychological assessments using the Alzheimer Disease Assessment Scale (ADAS), Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Beck Depression Inventory (BDI-II). All adverse events (AEs) were documented and monitored throughout the study. Results: Adverse events occurred in less than 1% of stimulation sessions and mainly included mild focal pain or transient unpleasant sensations, as well as some systemic behavioral or vigilance changes, particularly in patients with underlying medical conditions, with some potentially related to the device’s stimulation as adverse device reactions (ADRs). Cognitive test results showed significant improvement after the initial stimulation cycle (ADAS total improved significantly after the first stimulation cycle (M_pre = 28.44, M_post = 18.56; p = 0.001, d = 0.80, 95% CI (0.36, 1.25)), with stable scores across all domains over one year. Improvements were most notable in memory, speech, and mood. Conclusions: TPS appears to be a generally safe and feasible add-on treatment for AD, although careful patient selection and monitoring are advised. While a considerable number of participants were lost to follow-up for various reasons, adverse events and lack of treatment effect were unlikely primary causes. A multifocal stimulation approach (F-TOP2) is proposed to enhance effects across more cognitive domains. Full article

Per- and polyfluoroalkyl substances (PFASs) have gained significant attention due to their widespread distribution in the environment and potential adverse health effects. While ingestion, especially through contaminated drinking water, is considered the primary route of human exposure, recent research suggests that other pathways, such as inhalation and dermal absorption, also play a significant role. This review provides a concise overview of the toxicological impacts of both legacy and emerging PFASs, such as GenX and perfluorobutane sulfonic acid (PFBS), with a particular focus on their effects on the liver, kidneys, and immune and nervous systems, based on findings from recent in vivo, in vitro, and epidemiological studies. Despite the transition to PFAS alternatives, much of the existing toxicity data focus on a few legacy compounds, such as perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), which have been linked to adverse immune outcomes, particularly in children. However, evidence for carcinogenic risk remains limited to populations with extremely high exposure levels, and data on neurodevelopmental effects remain underexplored. While epidemiological and experimental animal studies supported these findings, significant knowledge gaps persist, especially regarding emerging PFASs. Therefore, this review examines the visceral, neural, and immunotoxicity data for emerging PFASs and mixtures from recent studies. Given the known risks from well-studied PFASs, a precautionary principle should be adopted to mitigate human health risks posed by this large and diverse group of chemicals. Full article

Background/Objectives: There is significant interest in using texture features to extract hidden image-based information. In medical imaging applications using radiomics, AI, or personalized medicine, the quest is to extract patient or disease specific information while being insensitive to other system or processing variables. While we use digital breast tomosynthesis (DBT) to show these effects, our results would be generally applicable to a wider range of other imaging modalities and applications. Methods: We examine factors in texture estimation methods, such as quantization, pixel distance offset, and region of interest (ROI) size, that influence the magnitudes of these readily computable and widely used image texture features (specifically Haralick’s gray level co-occurrence matrix (GLCM) textural features). Results: Our results indicate that quantization is the most influential of these parameters, as it controls the size of the GLCM and range of values. We propose a new multi-resolution normalization (by either fixing ROI size or pixel offset) that can significantly reduce quantization magnitude disparities. We show reduction in mean differences in feature values by orders of magnitude; for example, reducing it to 7.34% between quantizations of 8–128, while preserving trends. Conclusions: When combining images from multiple vendors in a common analysis, large variations in texture magnitudes can arise due to differences in post-processing methods like filters. We show that significant changes in GLCM magnitude variations may arise simply due to the filter type or strength. These trends can also vary based on estimation variables (like offset distance or ROI) that can further complicate analysis and robustness. We show pathways to reduce sensitivity to such variations due to estimation methods while increasing the desired sensitivity to patient-specific information such as breast density. Finally, we show that our results obtained from simulated DBT images are consistent with what we see when applied to clinical DBT images. Full article

Medical education often emphasizes theoretical knowledge, limiting students’ opportunities to practice history taking, a structured interview that elicits relevant patient information before clinical decision making. Large language models (LLMs) offer novel solutions by generating simulated patient interviews. This study evaluated the educational potential of LLM-generated history-taking dialogues, focusing on clinical validity and diagnostic diversity. Chest pain was chosen as a representative case given its frequent presentation and importance for differential diagnosis. A fine-tuned Gemma-3-27B, specialized for medical interviews, was compared with GPT-4o-mini, a freely accessible LLM, in generating multi-branching history-taking dialogues, with Claude-3.5 Sonnet inferring diagnoses from these dialogues. The dialogues were assessed using a Chest Pain Checklist (CPC) and entropy-based metrics. Gemma-3-27B outperformed GPT-4o-mini, generating significantly more high-quality dialogues (90.7% vs. 76.5%). Gemma-3-27B produced diverse and focused diagnoses, whereas GPT-4o-mini generated broader but less specific patterns. For demographic information, such as age and sex, Gemma-3-27B showed significant shifts in dialogue patterns and diagnoses aligned with real-world epidemiological trends. These findings suggest that LLMs, particularly those fine-tuned for medical tasks, are promising educational tools for generating diverse, clinically valid interview scenarios that enhance clinical reasoning in history taking. Full article

Background/Objectives: Malnutrition in older adults is both preventable and treatable, yet its detection and etiology remain complex. Therefore, the aim of this study was to evaluate the prevalence of malnutrition and various factors involved in the etiology of malnutrition in community-dwelling individuals aged 65 years and older. Methods: This cross-sectional study was conducted with community-dwelling individuals aged 65 years and older in a health center in Ağrı, Türkiye. The nutritional status of older adults was measured using the Mini Nutritional Assessment (MNA). Data were collected through face-to-face interviews and a series of validated instruments, including the Standardized Mini Mental Examination (MMSE), body composition measurements (BIA), dietary intake records, and physical performance tests such as hand grip strength, chair stand, and Timed ‘Up & Go’ (TUG) Test. Statistical analyses included chi-square and Mann-Whitney U tests for group comparisons and logistic regression to investigate independent factors associated with risk of malnutrition. Results: A total of 182 participants were included in the study. The mean age of the participants was 72.1 ± 6.0 years. Of the participants, 59.3% were male. 1.6% of the participants were malnourished, and 25.3% were at risk of malnutrition. Perceived health status compared to peers (OR: 1.734, 95% CI: 1.256–2.392, p = 0.001), lower appetite status (OR: 1.942, 95% CI: 1.459–2.585, p < 0.001) and lower waist circumference (OR: 1.089, 95% CI: 1.040–1.140, p < 0.001) were independent predictors of malnutrition risk. Conclusions: The risk of malnutrition was higher among individuals with lower appetite, poorer self-perceived health status compared to peers, and smaller waist circumference. Reduced physical function and strength were also associated with an increased risk of malnutrition. Full article

Coastal erosion, exacerbated by climate change, poses a critical global threat to both the environment and human livelihoods. Acquiring accurate, high-resolution topo-bathymetric data is vital for understanding these dynamic environments, without underestimating the hydrodynamic and meteo-oceanographic conditions. However, traditional methods often present significant challenges in achieving comprehensive, high-resolution topo-bathymetric coverage efficiently in shallow coastal zones, leading to a notable ”white ribbon” data gap. This study introduces a novel, integrated methodology combining unmanned aerial vehicles (UAVs) for terrestrial surveys, unmanned surface vehicles (USVs) for bathymetry, and the Global Navigation Satellite System (GNSS) for ground control and intertidal gap-filling. Through this technologically rigorous approach, a seamless Bathymetry-Topography Digital Surface Model for the Guardamar del Segura dune system (Spain) was successfully elaborated using a DJI Mini 2 UAV, Leica Zeno FLX100 GNSS, and Apache 3 USV. The method demonstrated a substantial time reduction of at least 50–75% for comparable high-resolution coverage, efficiently completing the 86.4 ha field campaign in approximately 4 h. This integrated approach offers an accessible and highly efficient solution for generating detailed coastal elevation models crucial for coastal management and research. Full article

Accurate classification of breast cancer histopathology images is critical for early diagnosis and treatment planning. Yet, conventional deep learning models face significant challenges under limited annotation scenarios due to their reliance on large-scale labeled datasets. To address this, we propose Dynamic Cross-Scale Swin Transformer (DCS-ST), a robust and efficient framework tailored for histopathology image classification with scarce annotations. Specifically, DCS-ST integrates a dynamic window predictor and a cross-scale attention module to enhance multi-scale feature representation and interaction while employing a semi-supervised learning strategy based on pseudo-labeling and denoising to exploit unlabeled data effectively. This design enables the model to adaptively attend to diverse tissue structures and pathological patterns while maintaining classification stability. Extensive experiments on three public datasets—BreakHis, Mini-DDSM, and ICIAR2018—demonstrate that DCS-ST consistently outperforms existing state-of-the-art methods across various magnifications and classification tasks, achieving superior quantitative results and reliable visual classification. Furthermore, empirical evaluations validate its strong generalization capability and practical potential for real-world weakly-supervised medical image analysis. Full article

This review critically examines the recent advancements in the development and application of electrospun molecularly imprinted polymer (MIP) nanofiber membranes for environmental remediation. Emphasizing the significance of these materials, the discussion highlights the mechanisms by which electrospun MIPs achieve high selectivity and efficiency in removing various pollutants, including dyes, heavy metals, and pharmaceutical residues such as NSAIDs and antiretroviral drugs. The synthesis methodologies are explored in detail, focusing on the choice of monomers, templates, and polymerization conditions that influence the structural and functional properties of the membranes. Characterization techniques used to assess morphology, surface area, porosity, and imprinting efficacy are also examined, providing insights into how these parameters affect adsorption performance. Furthermore, the review evaluates the performance metrics of electrospun MIPs, including adsorption capacities, selectivity, reusability, and stability in complex environmental matrices. Practical considerations, such as scalability, regeneration, and long-term operational stability, are discussed to assess their potential for real-world applications. The article concludes with an outline of future research directions, emphasizing the need for multi-template imprinting, integration with existing treatment technologies, and field-scale validation to address current limitations. Full article

Atrial fibrillation remains the most frequent sustained arrhythmia, particularly in the elderly population, and is associated with increased risks of stroke, heart failure, and reduced quality of life. While catheter ablation is widely used for rhythm control, its efficacy is limited in persistent and long-standing atrial fibrillation. Over the past two decades, minimally invasive surgical strategies have emerged as effective alternatives, aiming to replicate the success of the Cox-Maze procedure while reducing surgical trauma. This overview critically summarizes the current minimally invasive techniques available for atrial fibrillation treatment, including mini-thoracotomy ablation, thoracoscopic ablation, and hybrid procedures such as the convergent approach. These methods offer the potential for durable sinus rhythm restoration by enabling direct visualization, transmural lesion creation, and left atrial appendage exclusion, with lower perioperative morbidity compared to traditional open surgery. The choice of energy source plays a key role in lesion efficacy and safety. Particular attention is given to the technical steps of each procedure, patient selection criteria, and the role of left atrial appendage closure in stroke prevention. Hybrid strategies, which combine epicardial surgical ablation with endocardial catheter-based procedures, have shown encouraging outcomes in patients with refractory or long-standing atrial fibrillation. Despite the steep learning curve, minimally invasive techniques provide significant benefits in terms of recovery time, reduced hospital stay, and fewer complications. As evidence continues to evolve, these approaches represent a key advancement in the surgical management of atrial fibrillation, deserving integration into contemporary treatment algorithms and multidisciplinary heart team planning. Full article

The results of experimental data on the heat transfer coefficient during the boiling of pro-ecological refrigerants in a compact tube-shell heat exchanger are presented. The boiling process occurred in the micro-space of the exchanger shell on the surface of horizontal tubes, which were heated from the inside with warm water. The flow of the refrigerant was gravity-based. The heat exchanger was practically flooded with liquid refrigerant at a saturation temperature (ts), which flowed out after evaporation in a gaseous form. The tests were conducted for four refrigerants: R1234ze, R1234yf, R134a (a high-pressure refrigerant), and HFE7100 (a low-pressure refrigerant). Thermal characteristics describing the heat transfer process throughout the entire compact heat exchanger, specifically for the boiling process itself, were developed. It was found that in the case of micro-space boiling, there is an exponential dependence of the heat transfer coefficient on the heat flux density on the heated surface. Experimental data were compared to experimental and empirical data presented in other studies. Our own empirical models were proposed to determine the heat transfer coefficient for boiling in a mini-space for individual refrigerants. The proposed calculation models were also generalized for various refrigerants by introducing the value of reduced pressure into the calculation relationship. The developed relationship enables the determination of heat transfer coefficient values during boiling in a micro-space on the surface of horizontal tubes for various refrigerants with an accuracy of ±25%. Full article