Search Results (269,165)

The aim of the study was to define radiobiological effects of single and fractionated low doses in normal fibroblasts in 40 patients with squamous cell carcinoma of the head and neck (HNSCC) treated with induction chemotherapy combined with low-dose fractionated radiation (LDFR) and to answer the question regarding the role of low-dose hyper-radiosensitivity (HRS) in these effects. HRS status was determined using flow cytometry-based clonogenic survival assay (cells were irradiated with doses 0.1–4 Gy of 6 MV X-rays). Radiobiological effects (cell kill, kinetics of DSB recognition and repair, chemopotentiation) of LDFR 4x0.5 Gy and a single dose of 2, 0.5 and 0.2 Gy were estimated by clonogenic, pATM and γH2AX foci assays. HRS response was demonstrated for normal fibroblasts in 6 of the 40 HNSCC patients. For all assessed biological parameters, significant interindividual differences were observed. The presence of HRS had no effect on the chemopotentiating effects of LDFR 4x0.5 Gy, which were similar to that after 2 Gy. There was also no association between HRS and the maximum number of pATM and γH2AX foci induced by single (0.2, 0.5, 2 Gy) or fractionated low doses 4x0.5 Gy. Significantly higher percentages of residual pATM and γH2AX foci observed after LDFR 4x0.5 Gy than after 2 Gy were independent of HRS. HRS is a rare finding (15%) in normal fibroblasts from HNSCC patients; therefore, it is of rather little importance in healthy late-reacting connective tissues. Moreover, the fibroblast response to single and fractionated low doses (alone or in combination with carboplatin and paclitaxel) appeared more dependent on individual radiosensitivity than on HRS. Full article

Background: The ISCHEMIA trial demonstrated no overall prognostic benefit of an initial invasive strategy over optimal medical therapy (OMT) in patients with chronic coronary syndrome (CCS) and moderate-to-severe ischemia. However, managing patients with stable angina and low systolic blood pressure (SBP) remains challenging due to limited tolerance to vasodilatory anti-anginal drugs and the uncertain role of revascularization in improving long-term outcomes for this subgroup. Objectives: This study aimed to estimate the treatment effect of an initial invasive strategy (INV) compared with conservative medical therapy (CON) on long-term clinical outcomes and quality of life in patients with stable angina, particularly those with low baseline systolic blood pressure (≤120 mmHg). Methods: We conducted a post hoc analysis of 3544 patients with stable angina from the ISCHEMIA trial, divided into an initial invasive strategy or a conservative approach. The primary endpoint was a 3-year composite of cardiovascular death, myocardial infarction, hospitalization for unstable angina or heart failure, or resuscitated cardiac arrest. Health-related quality of life was assessed using the Seattle Angina Questionnaire (SAQ). In the subgroup, patients were stratified by baseline SBP, diastolic blood pressure (DBP) and heart rate; the Cox model was adjusted for the covariates. Results: Baseline characteristics were generally comparable between the two groups. Over 3 years of follow-up, no significant difference in primary endpoint events was observed between the INV and CON group in the overall cohort (HR = 0.94, 95%CI 0.77–1.14, p = 0.53), and the INV group had the higher SAQ score. Among patients with low baseline SBP (≤120 mmHg), after adjusting for clinical factors using Cox regression, randomized treatment assignment to the INV approach significantly reduced adverse cardiovascular events compared with conservative therapy (HR = 0.58, 95%CI 0.38 to 0.89). Conclusions: In patients with stable angina, an invasive strategy improved long-term quality of life. Among those with low baseline SBP (≤120 mmHg) and limited tolerance to vasodilatory anti-anginal drugs, invasive management reduced 3-year adverse events, supporting tailored revascularization strategies for these patients; a larger cohort is needed for validation. However, this subgroup-specific causal contrast derives from a post hoc exploratory analysis and should be interpreted cautiously; prospective randomized studies are needed to further validate these findings. Full article

Background: Deletion of the MTAP gene at chromosome 9p21.3 defines a therapeutically actionable molecular subset of cancers due to synthetic lethal vulnerability to PRMT5 and MAT2A inhibition. The real-world prevalence and genomic context of MTAP deletion in diverse solid tumors remain incompletely characterized. Methods: We retrospectively analyzed 579 solid tumor specimens subjected to next-generation sequencing-based copy-number profiling. The prevalence of MTAP deletion and its co-occurrence with CDKN2A and CDKN2B were evaluated, and genomic deletion patterns across chromosome 9 were systematically assessed. Results: MTAP deletion was detected in 14 cases (2.4%, 95% confidence interval [CI], 1.45–4.02%), with enrichment in sarcoma, pancreatic cancer, and urothelial carcinoma. Concurrent CDKN2A loss was observed in 92.9% of MTAP-deleted tumors, and 64.3% showed additional CDKN2B loss, indicating a coordinated focal deletion event at 9p21.3. Statistical analyses confirmed strong genomic associations between MTAP and neighboring tumor suppressor genes. Across the full cohort, deletion frequency peaked at the 9p21 locus, and among MTAP-deleted tumors, co-deletion frequency decreased with increasing genomic distance. All MTAP-deleted tumors were microsatellite stable and low tumor mutational burden (TMB-low). Conclusions: Our findings demonstrate that MTAP deletion is an infrequent but genomically coherent event in solid tumors, characterized by a canonical 9p21 co-deletion pattern. This real-world analysis underscores the importance of comprehensive genomic profiling to identify patients who may benefit from emerging MTAP-directed therapies. Full article

Ammoniacal nitrogen (NH₃-N) is a major pollutant in municipal, industrial, and agricultural wastewaters and is a key driver of eutrophication and aquatic ecosystem degradation. This review paper assessed the potential of water hyacinth (Eichhornia crassipes) as a sustainable phytoremediation option for removing ammoniacal nitrogen from wastewater. This paper focused on the plant’s biological characteristics, nutrient uptake pathways, and adaptability to varying environmental conditions. Specific mechanisms examined include direct root uptake of ammonium, internal translocation, and microbial-assisted nitrification and denitrification within the rhizosphere. The influence of pH, temperature, salinity, retention time, and plant density on removal efficiency was also assessed in this study. Across laboratory, pilot, and field-scale studies, water hyacinth achieved ammoniacal nitrogen removal efficiencies ranging from 74% to 97% under favorable conditions, alongside significant reductions in biochemical oxygen demand (BOD), chemical oxygen demand (COD), and total dissolved solids (TDS). Integration with constructed wetlands, microbial systems, and hybrid treatment approaches further enhanced nitrogen removal and process stability. This paper also highlighted opportunities for biomass valorization through biogas, bioethanol, and compost production while identifying challenges related to salinity sensitivity and biomass management. Overall, water hyacinth emerges as a cost-effective, nature-based solution for decentralized wastewater treatment, with strong potential to support sustainable water management and circular bioeconomy initiatives. Full article

Slow lateral wandering and trochoidal-like motion are commonly observed in intense atmospheric vortices, yet most reduced-order vortex models assume a fixed axis or represent centre motion as purely advective. In this work, we propose a minimal reduced-order framework in which slow gyroscopic precession is introduced as an explicit degree of freedom superimposed on a rapidly rotating vortex core. The vortex is represented by a Burgers–Rott-type velocity field with time-dependent stretching rate and circulation, while the vortex centre undergoes a slow precessional motion governed by a time-dependent rate ${\Omega }_p\left(t\right)$. The evolution of the vortex parameters is coupled to environmental variability through simple relaxation laws driven by standard large-scale diagnostics, including convective available potential energy, vertical shear, and background vorticity. A tracker-only analysis of tropical cyclone best-track data is used to constrain the appropriate dynamical regime at the track scale, indicating that observed centre wandering typically occurs in a slow-precession limit P = ${\Omega }_p/{\omega }_c\ll 1$. Numerical demonstrations in cyclone-like configurations show that, despite the smallness of the precession number, cumulative lateral displacement and enhanced Lagrangian dispersion can develop over the vortex lifetime. The proposed framework is intended as a proof-of-concept reduced-order model that isolates the role of weak, environmentally forced precession in modulating vortex wandering and transport, and complements more detailed numerical and observational studies. Full article

Background: Candida albicans is the most clinically significant opportunistic fungal pathogen, and the growing resistance to conventional antifungals, particularly azoles and echinocandins, highlights the urgent need for alternative therapeutic strategies. Although lactic acid bacteria (LAB) have shown inhibitory potential against C. albicans, the relative contributions of live probiotics, heat-inactivated postbiotics, and cell-free supernatants (CFSs) have rarely been compared in parallel under physiologically relevant conditions against a clinical oral isolate. Results: This study systematically evaluated the antifungal activity of Lactiplantibacillus plantarum 299V, Lactobacillus delbrueckii subsp. bulgaricus ATCC 11842, and Lactobacillus acidophilus ATCC 4356 using co-culture assays, minimum inhibitory concentration tests, agar well diffusion assays, and optical microscopy. L. plantarum achieved the strongest inhibitory effect in co-culture, reducing C. albicans viability by 2.39 log₁₀ CFU/mL after 24 h, correlating with the greatest acidification of the culture medium. Methods: CFS from L. acidophilus inhibited fungal growth by 79.01% at native pH, declining to 28.35% upon neutralization to pH 7, confirming that antifungal efficacy is largely pH-dependent and driven by undissociated organic acids. At probiotic concentrations of 1 × 10⁹ CFU/mL, all strains completely suppressed fungal growth. Heat-inactivated postbiotics exhibited up to 95.14% inhibition in MIC assays; however, microscopic analysis revealed coaggregation between postbiotic and fungal cells, which likely interfered with optical density measurements. Conclusions: These findings establish that LAB-mediated antifungal activity is multifactorial and assay-dependent, and highlight the importance of distinguishing between probiotic, postbiotic, and CFS effects when developing LAB-based antifungal strategies. Full article

Background/Objectives: Our goal was to evaluate the effectiveness of tract sealing agents in reducing pneumothorax and chest drainage insertion following CT-guided lung biopsy (CLB), and to assess the certainty of supporting evidence. Methods: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines (PROSPERO: CRD42024608747). Four health science databases (ScienceDirect, PubMed, Scopus, and Cochrane Library) were searched up to 13 October 2025. Randomized controlled trials and cohort studies reporting tract sealing after CLB were included. Outcomes were post-procedural pneumothorax and pleural drainage insertion. Both were analyzed as dichotomous variables using random-effects meta-analysis with the Mantel–Haenszel method. Statistical heterogeneity was assessed using the I² statistic. Results were considered statistically significant for p < 0.05. Study quality was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Risk Of Bias In Non-randomized Studies—of Interventions, Version 2 (ROBINS-I V2) tool for cohort studies. Results: A total of 3328 records were initially retrieved, with 37 studies (13,107 patients, 7161 male and 4526 female) meeting the inclusion criteria. Sealing agents included saline solution, hydrogel plug, gelatin sponge, autologous blood patch, saline + rapid roll-over, hemocoagulase, gelatin sponge + hemocoagulase, and fibrin glue. Meta-analysis demonstrated significant reductions in pneumothorax and drainage insertion with saline solution (pneumothorax: OR = 0.35; 95% CI 0.25–0.48; p < 0.00001; drainage: OR = 0.22, 95% CI 0.11–0.43; p < 0.00001), gelatin sponge (pneumothorax: OR = 0.44, 95% CI 0.37–0.53; p < 0.00001; drainage: OR = 0.40, 95% CI 0.29–0.54; p < 0.00001), autologous blood patch (pneumothorax: OR = 0.50, 95% CI 0.40–0.62; p < 0.00001; drainage: OR = 0.40, 95% CI 0.27–0.59; p < 0.00001), and hydrogel plug (pneumothorax: OR = 0.65, 95% CI 0.50–0.85; p = 0.001; drainage: OR = 0.44, 95% CI 0.25–0.76; p < 0.004). Conclusions: Saline solution, hydrogel plug, gelatin sponge, and autologous blood patch are sealing agents that are effective at lowering the risk of pneumothorax and drainage insertion following CLB. Full article

Background: Post-stroke pain (PSP), particularly shoulder pain, is frequent and often underdiagnosed, limiting rehabilitation adherence and functional recovery. Current pharmacological and physical treatments offer only partial relief. Robotic-assisted therapy (RAT), such as the gravity-supporting Armeo^® Spring exoskeleton, delivers intensive, task-specific training with visual 2D feedback that may also alleviate PSP while enhancing motor outcomes. This study investigates whether RAT performed with the Armeo^® Spring reduces upper-limb PSP in chronic stroke patients versus conventional therapy and evaluates its effects on motor function and functional independence. Methods: In this retrospective parallel group study, 32 chronic post-stroke patients (8 females and 24 males with a mean age of 57 ± 11.74) were allocated to two groups: 16 received upper-limb RAT with the Armeo^® Spring, a gravity-supporting exoskeleton, (RAT group) and 16 underwent conventional rehabilitation (CR). The RAT group completed one-hour sessions 6 days/week for 8 weeks, performing 2D/3D gamified tasks targeting shoulder, elbow and forearm movements. The CR group received an equivalent amount of standard therapy, including passive/active-assisted mobilization, Bobath-based neuromuscular facilitation and reaching exercises. Results: Both the Armeo^® Spring and conventional therapy groups showed significant reductions in post-stroke pain (RAT p < 0.001 and conventional rehabilitation p = 0.004) and improvements in upper-limb motor function and functional independence (both p ≤ 0.002). Spasticity in the impaired limb decreased modestly in the RAT group (p = 0.031), with no significant between-group differences in pain or spasticity change (p = 0.437; p > 0.05, respectively). Conclusions: Gravity-support exoskeleton training reduced upper-limb spasticity, and no statistically significant between-group differences were observed compared with conventional physiotherapy for pain, mobility, and functional independence. Although clinical outcomes improved, health-related quality-of-life domains showed heterogeneous trajectories, underscoring the complexity of perceived health changes during chronic stroke rehabilitation. Larger randomized controlled trials incorporating neurophysiological and kinematic endpoints and longer follow-up are warranted to confirm effectiveness, particularly in chronic stroke and durability. Full article

Background and Clinical Significance: Bladder cancer is common, with urothelial carcinoma (UC) comprising most cases in Western countries. Metastases usually involve pelvic structures, lymph nodes, and organs such as the liver, lungs, bones, and adrenal glands. Identifying unusual metastatic sites is critical for accurate diagnosis and treatment planning. Case Presentation: A 65-year-old man with a history of high-grade (G3) UC and carcinoma in situ, previously treated with TURBT, second-look resection, and SWOG-protocol BCG, presented with a new bladder lesion (pT1). Staging CT revealed extravesical spread and a 1.5 cm pancreatic body nodule. EUS-guided biopsy confirmed metastatic UC with concordant immunohistochemistry (GATA3+), excluding primary pancreatic cancer. The patient was referred for systemic therapy with immune checkpoint inhibitors and Enfortumab Vedotin. Conclusions: This case demonstrates the rare occurrence of pancreatic metastasis from bladder UC. EUS-guided biopsy with immunohistochemistry is essential to distinguish secondary lesions from primary pancreatic tumors. Accurate diagnosis is crucial to guide systemic therapy, particularly with emerging immunotherapy and antibody–drug conjugates. Full article

This study evaluated the effects of dietary perilla seed meal (PSM) inclusion on growth performance, plasma biochemistry, and breast muscle fatty acid composition in Sansui ducks (Sansui Sheldrake ducks) from 4 to 8 wks of age. A total of 320 male ducks, 29 d old, were randomly assigned to 5 dietary treatments (0, 5%, 10%, 15%, or 20% PSM) with 8 replicates each group and 8 ducks per replicate. Results showed that PSM inclusion up to 20% did not significantly (p > 0.05) affect body weight, daily gain, feed intake, feed-to-gain ratio, or carcass traits. Plasma albumin, total cholesterol, and high-density lipoprotein cholesterol were elevated at 10% PSM inclusion (p < 0.05), while liver function markers remained unaffected (p > 0.05). As expected, dietary PSM supplementation dose-dependently enriched breast muscle n-3 polyunsaturated fatty acids, including α-linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid (p < 0.05), and reduced the n-6/n-3 ratio (p < 0.05). These findings indicated that PSM could be incorporated into duck diets at levels up to 20% to enhance the nutritional value of duck meat without adverse effects on growth performance and health, supporting its use as a functional feed ingredient in sustainable duck production. Full article

Background: Exercise enjoyment supports adherence, whereas elevated exercise addiction risk reflects potentially maladaptive persistence marked by rigidity and internal pressure. This study examined the association between enjoyment and exercise addiction risk in Turkish adults and explored variation across sociodemographic, lifestyle, and exercise-related characteristics. Methods: A total of 420 adults (45.0% women, 55.0% men; mean age = 25.68 years) completed an online survey including the Exercise Enjoyment Scale (EES) and the Exercise Addiction Inventory (EAI). Results: Enjoyment was weakly and inversely associated with exercise addiction risk (r = −0.18, p = 0.0002; 95% CI: −0.27 to −0.09). Women reported higher enjoyment and higher EAI scores than men. The proportion screening positive for elevated risk (EAI ≥ 24) was 13.8% (n = 58; 95% CI: 10.8–17.4%); subgroup comparisons were interpreted as exploratory (no multiplicity correction). Conclusions: Enjoyment tended to vary with participation patterns, whereas addiction risk tended to vary with training structure and motives; longitudinal studies are needed to clarify temporal ordering. Full article

Background and Objectives: Despite extensive research into its vascular mechanisms, the relationship between tinnitus and morning blood pressure surge (MBPS) remains unexplored. This study aims to investigate the association between tinnitus and MBPS in hypertensive patients. Materials and Methods: The study included 266 hypertensive patients, 86 with tinnitus and 180 without. Office blood pressure (BP) measurements, 24 h ambulatory BP monitoring (ABPM), echocardiographic findings, and laboratory parameters were analyzed. Tinnitus severity was assessed using the Tinnitus Handicap Inventory (THI). MBPS was calculated as the difference between the average systolic BP (SBP) in the first two hours after waking and the lowest three SBP values measured during sleep. Statistical analyses included regression models, ROC curve analysis, and the Boruta feature selection method. Results: MBPS was significantly higher in the tinnitus group compared to the non-tinnitus group (35 ± 9 vs. 26 ± 11 mm Hg, p < 0.001). Office BP and ABPM were significantly lower in the tinnitus group, while DBP showed no differences. The regression analysis identified MBPS (OR = 1.15, 95% CI: 1.08–1.23, p < 0.001), SBP (OR = 1.09, 95% CI: 1.03–1.15, p = 0.004), age (OR = 0.89, 95% CI: 0.82–0.96, p = 0.003), and smoking status (OR = 3.54, 95% CI: 1.09–11.61, p = 0.037) as independent predictors of tinnitus. The ROC analysis demonstrated that MBPS >28 mm Hg predicted tinnitus with 73.3% sensitivity and 68.3% specificity (AUC = 0.742, 95% CI: 0.685–0.793, p < 0.001). The comparative analysis showed that MBPS had a superior predictive accuracy for tinnitus compared to other BP parameters (p < 0.001). The 5-fold cross-validated ROC analysis further validated the moderate discriminatory power of MBPS, with an average AUC of 0.735 (95% CI: 0.672–0.798). Conclusions: This study demonstrates a significant association between tinnitus and MBPS in hypertensive patients. MBPS may serve as a useful indicator for identifying patients at risk of tinnitus, highlighting the importance of circadian BP monitoring in clinical practice. Full article

Enterocytozoon bieneusi is an important zoonotic intestinal protozoon causing diarrhea in humans and animals, threatening public health and livestock farming. This study aimed to investigate the infection and genotype distribution of E. bieneusi in black goats in Fujian, southeastern China. A total of 539 fecal samples were collected from nine regions. E. bieneusi was detected by nested PCR and sequencing targeting the ITS locus, and genotyped using four microsatellites and one minisatellite. The overall infection rate was 7.79%, with 42 positive samples. Eight genotypes were identified, including seven known genotypes and one novel genotype FJG-1. Ten multilocus genotypes (MLGs) were obtained, and all isolates belonged to Group 2. The infection rate differed significantly among regions (p < 0.01), but not among ages or genders (p > 0.05). This is the first molecular epidemiological survey of E. bieneusi in black goats in Fujian. The results enrich the genotype database and provide data for formulating regional prevention and control strategies against this pathogen. Full article

Background/Objectives: Pressure pain thresholds (PPTs) are commonly used to quantify mechanical hyperalgesia in migraine and tension-type headache (TTH), but the discriminatory performance of PPTs across neural and muscular sites remains unclear. This study compared nerve- and muscle-related PPTs between migraine and frequent episodic TTH and explored site-specific ROC-derived cut-off values as complementary classification markers. Methods: In this cross-sectional case-group discrimination study, participants with migraine (n = 33) and frequent episodic TTH (n = 31) underwent bilateral PPT assessment (electronic algometry) over the temporalis and tibialis anterior muscles, C5/C6 zygapophyseal joints, peripheral nerves (greater occipital, median, ulnar, radial, posterior tibial, common peroneal), and the second metacarpal region. Results: PPTs were generally lower in the migraine group than in the TTH group. After adjustment for sex and age, the most consistent between-group differences remained at the temporalis muscles bilaterally (left: adjusted mean difference 0.49 kg/cm², 95% CI 0.10 to 0.89, p = 0.015; right: 0.53 kg/cm², 95% CI 0.13 to 0.93, p = 0.011) and at the left tibialis anterior muscle (0.90 kg/cm², 95% CI 0.03 to 1.78, p = 0.044). In the main ROC analysis, the temporalis muscles showed the strongest discriminatory performance (left AUC = 0.733; right AUC = 0.707), whereas tibialis anterior and left posterior tibial nerve sites showed modest, below-threshold discrimination (AUCs < 0.70 despite statistical significance in some cases). Women-only ROC analyses showed a broadly similar pattern, with slightly improved metrics at some sites, particularly the temporalis muscles. Across most sites, likelihood ratios indicated only small-to-moderate shifts in post-test probability. Conclusions: Participants with migraine showed lower PPTs than those with frequent episodic TTH across most assessed sites, with the clearest differences at the temporalis muscles. ROC and PR analyses suggest that PPTs (especially at temporalis sites) may provide complementary, hypothesis-generating discriminatory information, but their overall stand-alone discriminative utility is modest. PPT assessment should therefore be interpreted as an adjunct to clinical evaluation rather than a replacement diagnostic test. Full article

Pre-warehouse last-mile delivery is currently constrained by service radiuses and intense delivery pressures. Meanwhile, national policies are increasingly promoting a transition toward green logistics. By undertaking deliveries to remote or dispersed locations, UAVs can streamline truck routes and minimize the fuel consumption and emissions typically exacerbated by urban traffic congestion. Accordingly, this paper establishes a Ground-Vehicle and Drone Parallel Distribution Model with Priorities (PW-PDSVRP-P), quantifying customer priorities via delivery delay functions to align efficiency with social service requirements. A master–slave hybrid Large Neighborhood Search algorithm is developed and validated through a Hema Fresh case study in Xuzhou. Results define a clear “economic advantage zone” for drone adoption and reveal an adaptive assignment strategy: drones serve as mass-delivery tools in low-cost scenarios but act as “surgical tools” to prune inefficient truck segments in high-cost environments. These findings confirm that air–ground collaboration fosters a more resilient urban distribution system by balancing operational costs with environmental and social sustainability goals. Full article