Search Results (10,876)

Background: This paper investigates the use of the Segment Anything Model (SAM) for chest X-ray (CXR) image segmentation, with a focus on improving its performance using low-rank adaptation (LoRA). Methods: We evaluate three versions of SAM: two zero-shot methods (using coordinate and bounding box prompts) and a fine-tuned SAM using LoRA. To support these approaches, we also trained two standard convolutional neural networks (CNNs), U-Net and DeepLabv3+, to generate draft lung segmentations that serve as input prompts for the SAM methods. Our fine-tuning approach uses LoRA to add lightweight trainable adapters within the Transformer blocks of the SAM, allowing only a small subset of parameters to be updated. The rest of the SAM remains frozen, helping preserve its pre-trained knowledge while reducing memory and computational needs. We tested all models on a dataset of CXR images labeled for COVID-19, viral pneumonia, and normal cases. Results: Results show that fine-tuned SAM with LoRA outperforms zero-shot SAM methods and CNN baselines in terms of segmentation accuracy and efficiency. Conclusions: This demonstrates the potential of combining LoRA with SAM for practical and effective medical image segmentation. Full article

This study presents a two-dimensional hydraulic modelling framework for the simulation of flash and compound flooding in coastal urban areas with non-perennial river systems. The model employs a rain-on-grid approach within HEC-RAS v6.7 beta5 (2D solver) to simulate rainfall-driven runoff and explicitly incorporates coastal water-level forcing to represent storm tides. The framework is applied to an ungauged coastal basin in northern Greece using a 50-year return period design storm. Model results show good agreement with official Flood Risk Management Plan maps while identifying additional inundated areas linked to lower-order streams. Compound flooding simulations indicate a 21% increase in flooded areas, highlighting the importance of integrated modelling for operational flood forecasting. Full article

Rotational cover cropping is a key practice in conservation agriculture. To investigate the effects of maize-crop rotation with cover crops combined with nitrogen management on maize yield, nitrogen use efficiency (NUE), and related traits, a field experiment was conducted from 2023 to 2025. The experiment employed a split-plot design. The main plots consisted of three cropping systems: continuous maize (Fumin 985’) monoculture (CK), maize rotated with rapeseed (CC-Ra), and maize rotated with rye (CC-Ry). The subplots comprised five nitrogen (N) fertilizer application rates (0, 75, 150, 225, and 300 kg ha⁻¹) respectively. Compared to CK, CC-Ra and CC-Ry increased average maize grain yield by 5.93% and 12.89%, and NUE by 8.09% and 2.89%, respectively. At the silking stage, these treatments increased average DM by 6.45% and 16.55%, respectively, and by 5.75% and 15.01% at the maturity stage. The maximum LAI was enhanced by an average of 16.24% and 26.82%, while the net photosynthetic rate (Pn) of the ear leaf increased by 12.29% and 26.32%, respectively. In contrast, the leaf net assimilation rate (NAR) decreased by an average of 19.98% and 18.01%. While higher N application boosted yield, it sharply reduced NUE. Notably, yields under rotations at 225 kg N ha⁻¹ matched the yield of continuous maize at 300 kg N ha⁻¹. This suggests that the inclusion of cover crops can substitute for a portion of nitrogen fertilizer input while maintaining stable maize yield. Principal component analysis fundamentally clarified that maize rotational cover cropping combined with nitrogen fertilizer management significantly promotes yield. While cover crops increase maize yield, they also facilitate nitrogen accumulation and enhance NUE, albeit at the expense of leaf net assimilation rate. Therefore, balancing the source–sink characteristics of the maize population is necessary to avoid the loss of advantages conferred by rotational cover cropping. This study holds significant implications for incorporating cover crops into maize production systems. Full article

There is cumulative evidence that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) can offer cardiovascular protection extending beyond glucose-lowering and weight reduction, but the underlying mechanisms contributing to these effects remain incompletely understood. Modulation of platelet function might contribute to the aforementioned benefits. In the current literature review article, we synthesized available preclinical and clinical data evaluating the effects of GLP-1 RAs on platelet activation and function. Preclinical data indicate that GLP-1 RAs might decrease platelet activation via both GLP-1 receptor-dependent and -independent mechanisms with the involvement of cyclic adenosine monophosphate signaling, increase in nitric oxide bioavailability, and suppression of thromboxane-mediated pathways, particularly under inflammatory or shear-stress conditions. Additionally, clinical studies, despite being limited and heterogeneous, support a reduction in platelet activation markers, even independently of glycemic control or weight loss. However, most of them are characterized by small sample sizes and significant heterogeneity among them. In summary, existing evidence suggests that GLP-1 RAs exhibit potential antiplatelet effects that could contribute to their cardioprotective profile. Larger, well-designed clinical studies are crucial to better understand the clinical importance of platelet modulation by GLP-1 RAs and their potential implications for cardiovascular risk reduction. Full article

While objective street metrics derived from imagery or GIS have become standard in urban analytics, they remain insufficient to capture subjective perceptions essential to inclusive urban design. This study introduces a novel Multimodal Street Evaluation Framework (MSEF) that fuses a vision transformer (VisualGLM-6B) with a large language model (GPT-4), enabling interpretable dual-output assessment of streetscapes. Leveraging over 15,000 annotated street-view images from Harbin, China, we fine-tune the framework using Low-Rank Adaptation(LoRA) and P-Tuning v2 for parameter-efficient adaptation. The model achieves an F1 score of 0.863 on objective features and 89.3% agreement with aggregated resident perceptions, validated across stratified socioeconomic geographies. Beyond classification accuracy, MSEF captures context-dependent contradictions: for instance, informal commerce boosts perceived vibrancy while simultaneously reducing pedestrian comfort. It also identifies nonlinear and semantically contingent patterns—such as the divergent perceptual effects of architectural transparency across residential and commercial zones—revealing the limits of universal spatial heuristics. By generating natural-language rationales grounded in attention mechanisms, the framework bridges sensory data with socio-affective inference, enabling transparent diagnostics aligned with Sustainable Development Goal 11(SDG 11). This work offers both methodological innovation in urban perception modeling and practical utility for planning systems seeking to reconcile infrastructural precision with lived experience. Full article

Background: Despite the widespread implementation of treat-to-target strategies and modern disease-modifying antirheumatic drugs, a substantial proportion of patients with rheumatoid arthritis (RA) continue to report unmet needs (UNs), defined as a mismatch between patient expectations and symptom burden on the one hand and outcomes achieved with current care on the other. Patient–physician discordance in global assessments may reflect multidimensional influences, including pain mechanisms, psychosocial factors, functional impairment, and communication gaps, extending beyond inflammatory disease activity. Methods: In this cross-sectional study, 133 patients with RA and 57 healthy controls were included. UNs were operationalized as the signed difference between patient global assessment and physician global assessment (ΔPGA–PhGA). Clinical variables, patient-reported outcomes, and Short Form-36 (SF-36) domains were incorporated into two regularized partial correlation network models estimated using the extended Bayesian information criterion graphical least absolute shrinkage and selection operator (EBICglasso). Node centrality indices (strength, signed strength, betweenness, and closeness) were calculated. Network stability was evaluated using 2000 bootstrap resamples and correlation stability (CS) coefficients. Results: In the clinical network, pain intensity demonstrated the highest strength centrality and the strongest direct association with UNs. In contrast, Disease Activity Score in 28 joints with C-reactive protein (DAS28-CRP) showed no direct association with UNs after accounting for shared variance. In the SF-36-based quality-of-life network, UNs exhibited inverse associations, particularly with perceived health change and role–emotional functioning. Stability analyses indicated acceptable to good robustness (clinical network: CS = 0.59 for edge weights and 0.44 for strength; SF-36 network: CS = 0.59), supporting the reliability of the estimated network structures. Conclusions: UNs in RA are not solely determined by inflammatory disease activity but are embedded within interconnected clinical and psychosocial domains. Pain occupies a structurally central position in the clinical network, whereas perceived health change and emotional role limitations characterize the quality-of-life context of UNs. These findings underscore the importance of multidimensional and patient-centered assessment strategies in RA management. Full article

Multi-hop networks’ performance strongly depends on relay node placement, which affects delay, throughput, and coverage. This work introduces a dual-layer protocol combining Slotted ALOHA for node-to-relay communication and TDMA for relay-to-gateway transmission. Using a Java-based simulator, we evaluate three relay placement strategies—random, square grid, and hexagonal grid—considering metrics such as delay, throughput, packet collisions, and coverage. Results show that the hexagonal grid offers superior performance, reducing collisions, minimizing delay, and expanding coverage. A fallback mechanism for out-of-range nodes and sensitivity analysis of different backoff values are also included. The study quantifies the benefits of structured relay placement for LoRaWAN and wireless sensor networks, while also identifying challenges for realistic deployments. These findings provide guidelines for designing scalable and reliable IoT networks and highlight directions for future work involving irregular placements and dynamic routing. The simulation results are intended to provide comparative, trend-based insights under conservative modeling assumptions, rather than absolute performance predictions. Full article

Structural damage detection using the finite element method is inherently formulated as an inverse problem, often suffering from ill-posedness and high sensitivity to measurement noise. This study introduces a novel damage detection methodology by applying low-rank adaptation (LoRA), originally developed for fine-tuning large language models, to inverse problems in structural mechanics for the first time. The proposed approach exploits the physically inherent low-rank nature of structural damage: damage is typically localized, and the contribution of each finite element to the stiffness matrix is limited by its degrees of freedom. Accordingly, the stiffness change matrix is factorized into two low-rank matrices, reducing the number of parameters and providing implicit regularization against full-rank measurement noise. Physical consistency is ensured through sparsity and symmetry constraints. Numerical experiments on cantilever beam and L-shaped plate structures across five damage scenarios demonstrated that the proposed method achieved superior noise robustness compared with baseline methods. At a signal-to-noise ratio of 20 dB, representative of practical field conditions, LoRA achieved stiffness errors below 2%, whereas the baseline methods failed to provide reliable results. The proposed framework achieved a 100% success rate in damage zone localization (Precision@n ≥ 80%) with over 60% parameter reduction, presenting a promising solution for practical structural health monitoring. Full article

Aerial remote sensing efficiently surveys large areas, but accurate direct object-level measurement remains difficult in complex natural scenes. Advancements in 3D computer vision, particularly radiance field representations such as NeRF and 3D Gaussian splatting, can improve reconstruction fidelity from posed imagery. Nevertheless, direct aerial measurement of important attributes like tree diameter at breast height (DBH) remains challenging. Trunks in aerial forest scans are distant and sparsely observed in image views; at typical operating altitudes, stems may span only a few pixels. With these constraints, conventional reconstruction methods have inaccurate breast-height trunk geometry. TreeDGS is an aerial image reconstruction method that uses 3D Gaussian splatting as a continuous scene representation for trunk measurement. After SfM–MVS initialization and Gaussian optimization, we extract a dense point set from the Gaussian field using RaDe-GS’s depth-aware cumulative-opacity integration and associate each sample with a multi-view opacity reliability score. Then, we isolate trunk points and estimate DBH using opacity-weighted solid-circle fitting. Evaluated on 10 plots with field-measured DBH, TreeDGS reaches 4.79 cm RMSE (about 2.6 pixels at this GSD) and outperforms a LiDAR baseline (7.66 cm RMSE). This shows that TreeDGS can enable accurate, low-cost aerial DBH measurement. Full article

Candida albicans is the primary agent of acute vulvovaginal candidiasis (VVC) and its recurrent form (RVVC). Local innate immunity contributes to both defense and pathogenesis during vaginal Candida infection, where epithelial β-defensins (BD) constitute key components of the mucosal barrier. We previously reported that epithelial BD-1 expression is dynamically modulated during murine and human vaginitis, revealing strain-dependent and stimulus-specific regulation but leaving the host pathways involved unresolved. This study functionally defines the contribution of key immune pathways to epithelial antimicrobial peptide regulation. Using a murine model of VVC and the virulent C. albicans strain SC5314, we aimed to evaluate the immune signaling pathways governing the temporal regulation of epithelial BD-1 and BD-3 expression during vaginal infection. In wild-type mice, both defensins displayed a biphasic pattern: early induction followed by attenuation as infection progressed. Genetic loss-of-function approaches revealed that NLRP3/IL-1β signaling is required for early BD-1 induction, whereas IL-17RA signaling preferentially supports sustained BD-3 expression. Together, these findings establish a causal and temporal link between host immune signaling and epithelial defensin regulation and reveal a transient subversion of mucosal defenses by C. albicans. This work advances understanding of epithelial innate immunity, defining distinct temporal programs for BD-1 and BD-3 and identifying NLRP3/IL-1β and IL-17RA signaling as key pathways shaping mucosal defensin expression. Full article

Dental resin composites are routinely exposed to chemically aggressive beverages that may compromise long-term functional performance. This study investigated the structure–property–tribology relationships of four restorative composites (Filtek Z250, Filtek Z550, Herculite, and Herculite Ultra) subjected to cyclic immersion in beverages with different pH values. A total of 120 cylindrical specimens (7 mm diameter, 2 mm thickness; n = 5 per material per condition) were fabricated and exposed to mineral water, tea, coffee, Coca-Cola^®, Cola Light^®, and red wine for 28 days under cyclic conditions. Microhardness, surface roughness (Ra), steady-state coefficient of friction (COF), and mass variation were evaluated. All composites exhibited significant microhardness reduction after acidic exposure (p < 0.05), with the greatest decrease observed for Herculite Ultra in red wine (−47.4%) and Coca-Cola^® (−35.3%). Filtek Z250 demonstrated the highest baseline hardness and the lowest degradation susceptibility. Surface roughness changes were formulation-dependent, with Herculite Ultra showing pronounced roughening (ΔRa up to +0.074 µm), whereas Filtek Z550 exhibited erosion-driven smoothing (ΔRa down to −0.068 µm). Tribological behaviour was primarily governed by matrix softening rather than roughness alterations, with softened systems displaying unstable frictional responses (COF range: 0.127–0.697; p < 0.05). The results indicate that polymer matrix stability plays a more critical role in long-term functional performance than surface roughness or mass variation alone. Clinically, frequent exposure to acidic and solvent-containing beverages may accelerate mechanical and tribological degradation of susceptible composite formulations. Full article

Background/Aim: This study aimed to evaluate the changes in hematological indices following methotrexate (MTX) initiation and assess their correlation with and predictive value for treatment responses in rheumatoid arthritis (RA) patients. Methods: A retrospective study was conducted on 299 DMARD-naïve RA patients who received MTX monotherapy for 12 weeks. Univariate and multivariate logistic regression identified predictors of remission and low disease activity. Correlation analyses assessed relationships between hematological and disease activity changes. Receiver operating characteristic (ROC) curve analysis evaluated the discriminatory ability of hematological parameters. Results: After 12 weeks of MTX, significant decreases were observed in white blood cell (p = 0.025), neutrophil (p = 0.026), hemoglobin (p = 0.001), and platelet counts (p < 0.001), alongside an increase in red cell distribution width (RDW) (p < 0.001). Multivariate analysis identified only baseline DAS28-CRP (OR: 9826.7, p < 0.001) and CRP (OR: 0.45, p = 0.005) as independent predictors for remission, and baseline swollen joint count, DAS28-CRP, and CRP for LDA. Hematological parameters were not independent predictors. ROC analysis revealed neither baseline values nor changes in hematological indices had satisfactory discriminatory power for remission or LDA. Conclusions: Hematological parameter changes do not serve as robust independent predictors for early treatment response. Clinical disease activity indices remain superior for prognostication in DMARD-naïve patients starting MTX. Full article

Background/Objectives: The use of GLP-1 RAs has dramatically increased with expanded indications for diabetes mellitus and obesity. Delayed gastric emptying due to these medications can lead to increased residual gastric content (RGC). While previous studies have focused on Esophagogastroduodenoscopy (EGD), few have specifically analyzed the impact of GLP-1 RAs on residual gastric content in patients undergoing concurrent colonoscopy with adequate bowel preparation. Methods: A retrospective, case–control study was conducted at Shanghai East Hospital from January 2023 to June 2025. Adult patients with increased RGC were identified as cases. Controls without increased RGC were randomly selected at a 1:2 ratio, matched for age and sex. Multivariable logistic regression was used to assess the independent association between GLP-1 RAs use and increased RGC. Results: Among 131,255 procedures screened, 3746 patients were included (1257 with increased RGC and 2489 controls). GLP-1 RAs users had higher odds of increased RGC in both unadjusted [OR 15.20 (95% CI 5.98–38.61)] and adjusted analyses [aOR = 13.31 (95% CI 5.07–34.93)]. Other significant risk factors for RGC included diabetes-related complications [aOR = 8.89 (3.15–25.12)]. Interestingly, among the enrolled patients who used GLP-1 RAs and underwent concurrent colonoscopy, 19 of the 22 patients (86.4%) exhibited increased RGC, whereas only 3 (13.6%) did not. Conclusions: Perioperative use of GLP-1 RAs is associated with an increased residual gastric content in patients undergoing EGD alone or with concurrent colonoscopy. There was no aspiration event related to residual gastric content. Our study highlights the need for vigilant preoperative assessment and individualized periprocedural management in patients on GLP-1 RAs undergoing endoscopic procedures, despite having standardized adequate bowel preparation. Full article

This in vitro study assessed the impact of coconut milk, cow milk, and soybean oil on the surface roughness (Ra) of two milled (polymer-infiltrated ceramic network (PICN), Vita Enamic (EN) and resin nanoceramic (RNC), Cerasmart (CS)) and 3D-printed (VarseoSmile Crown plus (VS)) hybrid resin–ceramic materials. Standardized rectangular specimens were prepared and subjected to cyclic immersion in the test media at 37 °C for 30 days to simulate dietary exposure. Surface roughness was measured pre- and post-aging, and statistical analysis was performed using two-way ANOVA and paired t-tests (α = 0.05). All media significantly increased Ra across all materials (p < 0.001). While coconut milk and soybean oil caused comparable roughening (Ra up to 0.155 µm), cow milk exhibited a material-specific impact. It roughened milled materials (EN and CS) (Ra: 0.147–0.154 µm) significantly more than the 3D-printed material (VS) (Ra: 0.126 µm) (p < 0.05). Notably, all post-aging Ra values remained below the clinical bacterial adhesion threshold of 0.2 µm. In conclusion, while all tested dietary media significantly degraded the surface topography of hybrid resin–ceramics, the 3D-printed hybrid resin–ceramic material demonstrated superior resistance to cow milk compared to milled alternatives. Nonetheless, plaque retention risks remain clinically acceptable for all tested materials. Full article

In order to provide clinically significant evidence on the long-term functional performance of CAD/CAM provisional materials, especially 3D-printed and milled resins, accurate tribologically in vitro wear tests that integrate wear parameters and surface topography analysis are necessary. The goal of the study was to assess the wear resistance of several CAM-obtained dental crown materials and the relationship between wear and the manufacturing process, distinctive postprocessing, microhardness, microroughness, and surface topography. A standardized ball-on-flat tribological protocol was applied to (n = 70) CAD/CAM-fabricated PMMA specimens (four 3D-printed groups with distinct post-processing protocols (Optiprint) and three milled materials (TelioCAD, Shaded PMMA, Copra Temp Symphony)) to quantify wear parameters micro- and nanoroughness (Ra, Rz, Sa, Sy), and Vickers microhardness, followed by comprehensive statistical analysis (t-tests, Pearson correlations) to elucidate material- and process-dependent differences in wear behaviour. Nanoroughness was carried using atomic force microscopy evaluation. Wear testing showed that most materials, particularly the 3D-printed groups, developed limited wear, whereas the milled materials evolved toward groove-dominated wear topographies. Wear statistics showed that the printed resins consistently had an advantage, meaning that the degree and rate of wear are significantly influenced by the manufacturing process. Hardness has a central role in governing the wear performance of interim resin materials, while nanoroughness acts as a secondary factor. Optimised post-processing of printed materials, particularly a prolonged post-curing period, yields a beneficial combination of low wear and specific topography, thereby providing a significant clinical advantage. Full article