Search Results (1,844)

Molar pregnancy (MP) is a gestational disorder resulting from abnormal fertilization, leading to atypical trophoblastic proliferation and the formation of a complete or partial hydatidiform mole. This condition represents the most common form of gestational trophoblastic disease (GTD) and carries a significant risk of progression to gestational trophoblastic neoplasia (GTN). Although rare in high-income countries, MP remains up to ten times more prevalent in low-income and developing countries, contributing to preventable maternal morbidity and mortality. This narrative review provides an updated, practical overview of the clinical presentation, diagnosis, treatment, and follow-up of MP. A key focus is the challenge of early diagnosis, particularly given the increasing frequency of first-trimester detection, where classical histopathological criteria may be subtle, leading to diagnostic errors. The review innovates by integrating advanced diagnostic methods—combining histopathology, immunohistochemistry using p57Kip2, Ki-67, and p53 markers, along with cytogenetic analysis—to improve diagnostic accuracy in early gestation. The central role of referral centers is also emphasized, not only in facilitating timely treatment and access to chemotherapy, but also in implementing standardized post-molar follow-up protocols that reduce progression to GTN and maternal mortality. By focusing on both advanced diagnostic strategies and the organization of care through referral centers, this review offers a comprehensive, practice-oriented perspective to optimize patient outcomes in GTD and address persistent care gaps in high-burden regions. Full article

Barium chloride (BaCl₂), a known environmental pollutant, induces organ-specific oxidative stress through disruption of redox homeostasis. This study evaluated the protective effects and safety profile of sodium copper chlorophyllin (SCC) and ascorbic acid (ASC) against BaCl₂-induced oxidative damage in the liver and brain of mice using a two-phase experimental protocol. Animals received either SCC (40 mg/kg), ASC (160 mg/kg), or their combination for 14 days prior to BaCl₂ exposure (150 mg/L in drinking water for 7 days), allowing evaluation of both preventive and therapeutic effects. Toxicological and behavioral assessments confirmed the absence of systemic toxicity or neurobehavioral alterations following supplementation. Body weight, liver and kidney indices, and biochemical markers (Aspartate Aminotransferase (ASAT), Alanine Aminotransferase (ALAT), creatinine) remained within physiological ranges, and no anxiogenic or locomotor effects were observed. In the brain, BaCl₂ exposure significantly increased SOD (+49%), CAT (+66%), GPx (+24%), and GSH (+26%) compared to controls, reflecting a robust compensatory antioxidant response. Although lipid peroxidation (MDA) showed a non-significant increase, SCC, ASC, and their combination reduced MDA levels by 42%, 37%, and 55%, respectively. These treatments normalized antioxidant enzyme activities and GSH, indicating an effective neuroprotective effect. In contrast, the liver exhibited a different oxidative profile. BaCl₂ exposure increased MDA levels by 80% and GSH by 34%, with no activation of SOD, CAT, or GPx. Histological analysis revealed extensive hepatocellular necrosis, vacuolization, and inflammatory infiltration. SCC significantly reduced hepatic MDA by 39% and preserved tissue architecture, while ASC alone or combined with SCC exacerbated inflammation and depleted hepatic GSH by 71% and 78%, respectively, relative to BaCl₂-exposed controls. Collectively, these results highlight a differential, organ-specific response to BaCl₂-induced oxidative stress and the therapeutic potential of SCC and ASC. SCC emerged as a safer and more effective agent, particularly in hepatic protection, while both antioxidants demonstrated neuroprotective effects when used individually or in combination. Full article

Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of clear mucosal changes observed through white-light imaging (WLI) or virtual chromoendoscopy, endocytoscopy can help unveil the presence of GPC by enabling in vivo assessment of nuclear and cellular structures at ultra-high magnification. Endocytoscopy is typically performed using WLI following dye-based staining of the mucosa. In this case, we demonstrate that combining endocytoscopy with the texture and color enhancement imaging (TXI) mode substantially improves the assessment of the gastric mucosa. In a 61-year-old man undergoing esophagogastroduodenoscopy, WLI showed multifocal erythema in the stomach, without clearly visible lesions on either WLI or narrow-band imaging. Conventional endocytoscopy revealed multiple small spots of IM with characteristic changes in glandular structures, which were even more evident when using the TXI mode. Histological analysis of targeted biopsies confirmed small foci of IM in both the antrum and corpus. The patient was enrolled in a surveillance program because of his clinical background. The combination of endocytoscopy with the TXI mode significantly enhances the delineation of mucosal and cellular architecture, supporting a more accurate optical diagnosis. Full article

Background and Objectives: Acute metastatic cord compression (AMSCC) and femoral impending/pathological fracture negatively impact a patient’s quality of life, morbidity and survival, and are considered significant life events. This study aims to compare AMSCC and FMD as distinct yet overlapping metastatic orthopedic emergencies, addressing whether they represent sequential disease stages or distinct patient subpopulations—an analysis critical for prognosis and treatment planning. Materials and Methods: Records of all patients who underwent surgery for a femoral metastatic disease (FMD) over a decade (2004–2015) and patients who were treated for acute metastatic spinal compression (AMSCC) (2007–2017) were retrieved. There were no patients lost to follow-up. Results: The treatment cohorts were similar in terms of age, gender, tumour origin, and the number of spinal metastases. Fifty-four patients were diagnosed with AMSCC. Following treatment, the Frankel muscle grading improved by 0.5 ± 0.8 grades. Two hundred and eighteen patients underwent surgical intervention for FMD. Seventy percent of femoral metastases were located in the femoral neck and trochanteric area. Impending fractures accounted for 52% of the cohort. The FMD cohort, including impending and pathological fractures, was similar to the AMSCC cohort in terms of age and the time interval between cancer diagnosis and surgery (56.7 ± 74.2 vs. 51.6 ± 69.6, respectively, p = 0.646). The Karnofsky functional score was higher for the FMD cohort (63.3 ± 16.2) than for the AMSCC cohort (48.5 ± 19.5; p < 0.001). The mean survival time for the FMD cohort was double that of the AMSCC, at 18.4 ± 23.5 months versus 9.1 ± 13.6 months, respectively (p = 0.006). Conclusions: In conclusion, this study is novel in proposing that FMD and AMSCC are distinct clinical entities, differing in their impact on patient function and, most importantly, on patient survival. Full article

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, projected to affect 55% globally by 2040. Up to one-third of NAFLD patients develop non-alcoholic steatohepatitis (NASH), with 40% progressing to fibrosis. However, there are currently few reliable tools to predict disease progression. Impaired mitochondrial dynamics, characterized by dysregulated fission, fusion, and mitophagy, have emerged as key events in NAFLD pathophysiology, contributing to hepatocyte death and inflammation. This study explored the transition from steatosis to NASH through transcriptomic analyses, including data from patients with steatosis and those with NASH at different fibrosis stages. By identifying a transcriptomic signature associated with disease progression, the study revealed increased expression of genes involved in mitochondrial dynamics in NASH compared to steatosis and during NASH-related fibrosis. Histological analyses highlighted the central role of Dynamin-related protein 1 (Drp1), a dynamin GTPase essential for mitochondrial fission and mitophagy. In human liver biopsies, Drp1 expression progressively increased from NAFLD to NASH and NASH-related fibrosis and cirrhosis, predominantly in Kupffer cells. These finding suggest Drp1 is a potential driver of the transition to more severe liver damage, making it a promising biomarker for NASH development and progression and a potential therapeutic target in metabolic disorders. Full article

Background and Objectives: The association between female breast size and spinal back pain is widely suggested in clinical practice but remains insufficiently quantified in general, non-surgical populations in the scientific literature. Larger breasts may increase biomechanical strain on the spine, contributing to musculoskeletal pain and reduced quality of life. This study aimed to evaluate the association between breast size and back pain in a general orthopedic population of young women. Materials and Methods: A cross-sectional study was conducted among 200 women aged 18–36 who attended orthopedic clinics for non-spinal complaints. Data were collected via structured telephone questionnaires, including demographics, self-reported breast size (cup and band), pain characteristics, and SF-12 quality of life scores. Binary logistic regression, ANOVA, and chi-square analyses assessed associations between breast size, pain presence, severity, and functional outcomes. Results: Back pain prevalence increased with breast size: only 4.9% of B cup participants reported backache, compared to 85% of DD/E cup participants. VAS scores rose from 0.3 ± 1.6 (B cup) to 6.0 ± 2.9 (DD/E cup). Each 1 cm increase in band length raised the odds of back pain by 19.8% (OR = 1.198, p < 0.001), while large cup size was associated with up to 12-fold increased odds of pain. Larger breast size was also significantly associated with work limitations and social impairment. Conclusions: Breast size was strongly associated with the presence and severity of back pain, particularly in the thoracic and cervical regions. Clinicians should consider breast size in the assessment of backache, and reduction mammaplasty may have therapeutic value beyond aesthetics. Full article

Introduction: Limited access to pulmonary rehabilitation (PR) has contributed to the rise of telerehabilitation (TPR) for COPD patients. Positive comparable effects are observed in exercise tolerance, quality of life (QoL), and dyspnoea with TPR. However, patient adherence to TPR is an outcome that has not been sufficiently analysed. Objective: To analyse adherence, satisfaction, and quality-of-life improvements in COPD patients following the TPR program to determine whether telerehabilitation is comparable to conventional therapy or usual care. Methods: A systematic search was conducted using four electronic databases, retrieving 392 articles. Two independent researchers selected and evaluated these articles based on predefined eligibility criteria. A third researcher was consulted in the event of disagreements. Results: Primary outcomes: Adherence to PR and/or usual care showed a minimum reported value of 62% and a maximum reported value of 91%, while TPR adherence had the lowest reported value of 21% and the highest reported value of 93.5%. Five articles compared TPR to PR and/or usual care, showing that TPR adherence is higher or similar to other interventions, whereas only one article found lower TPR adherence compared to PR. Secondary outcomes: A higher number of dropouts were reported for PR and usual care compared to TPR. Three publications analysed satisfaction and demonstrated that patients are satisfied across groups. Tertiary outcomes: Comparable improvements in QoL were found for TPR and PR, both being superior to usual care. Conclusions: This systematic review reveals heterogeneity in classifying adherence for pulmonary rehabilitation and telerehabilitation. Adherence classification may be standardised in future studies for consistent analysis. Full article

Real-time positioning is a technological field with a multitude of applications, which expand across many scopes: from positioning within a large area to localization within smaller spaces; from locating people to locating equipment; from large-scale industrial or military applications to commercially available solutions. There are at least as many implementations of real-time positioning as there are applications and challenges. Within the domain of Radio Frequency (RF) systems, positioning has been approached from multiple angles. Some of the more common solutions involve using Time of Flight (ToF) and time difference of arrival (TDoA) technologies. Within TDoA-based systems, one common limitation stems from the computational power necessary to run the multi-lateration algorithms at a high enough speed to provide high-frequency refresh rates on the tag positions. The system presented in this study implements a complete hardware and software TDoA-based real-time positioning system, using wireless Ultra-Wideband (UWB) technology. This system demonstrates improvements in the state of the art by addressing the above limitations through the use of a hybrid Machine Learning solution combined with algorithmic fine tuning in order to reduce computational power while achieving the desired positioning accuracy. This study presents the design, implementation, verification and validation of the aforementioned system, as well as an overview of similar solutions. Full article

The high resolution of the Synthetic Aperture Radar (SAR) imagery, in addition to its capability to see through clouds and rain, makes it a crucial remote sensing technique. However, SAR images are very sensitive to radar parameters, the observation geometry and the scene’s characteristics. Moreover, for a complex scene of interest with targets located on a rough soil, a composite scattering between the target and the surface occurs and creates distortions on the SAR image. These characteristics can make the SAR images difficult to analyse and process. To better understand the complex EM phenomena and their signature in the SAR image, we propose a methodology to generate raw SAR signals and SAR images for scenes of interest with a target located on a rough surface. With this prospect, the entire radar acquisition chain is considered: the sensor parameters, the atmospheric attenuation, the interactions between the incident EM field and the scene, and the SAR image formation. Simulation results are presented for a rough dielectric soil and a canonical target considered as a Perfect Electric Conductor (PEC). These results highlight the importance of the composite scattering signature between the target and the soil. Its power is 21 dB higher that that of the target for the target–soil configuration considered. Finally, these simulations allow for the retrieval of characteristics present in actual SAR images and show the potential of the presented model in investigating EM phenomena and their signatures in SAR images. Full article

While bulk RNA sequencing provides a comprehensive view of transcriptomes, it lacks cell type specificity. Single-cell RNA sequencing (scRNA-seq) overcomes this limitation by providing detailed insights at the individual cell level, though it involves higher costs. Deconvolution methods can estimate cell type proportions in bulk RNA-seq data, but their results may vary based on the scRNA-seq reference data and software used. This study investigates the estimation of muscle fiber type proportions through deconvolution analysis of Longissimus dorsi muscle bulk RNA-seq data from late-gestation Holstein Friesian multiparous cows. Four software tools (i.e., CIBERSORTx, Cellanneal, DeconvR-NNLS, and DeconvR-RLM) were compared using scRNA-seq reference data from Brahman and Wagyu cattle breeds, which included proportions of types I, IIa, and IIx myofibers. Kruskal–Wallis and Dunn’s tests revealed that the breed of reference data significantly influenced the proportions of type IIa and IIx muscle fibers across different deconvolution methods. To the best of our knowledge, this is the first study to show that the cattle breed used in reference scRNA-seq data can substantially impact deconvolution outcomes, highlighting a critical consideration for accurate cell type proportion estimation in livestock genomics. These findings suggest that future deconvolution studies should carefully consider breed compatibility between reference and target datasets. Full article

The present study aimed to develop biodegradable films formulated with pectin/carboxymethyl cellulose (CMC) and cinnamon essential oil, investigating the effects of CP treatment time on the properties of the films. The developed films were used as packaging to evaluate the shelf life of chicken meat. Biodegradable films were produced from a film-forming solution containing pectin/CMC, glycerol (30%), and cinnamon essential oil (2%). All formulations included the essential oil, and the control group corresponded to the film that was not subjected to CP treatment. The CP treatments were applied at 22.5 L/min, 20 kV, and 80 kHz for 10, 20, and 30 min. The results showed that increasing CP treatment time led to a progressive reduction in apparent viscosity, indicating improved homogeneity of the polymer system. Hydrophobicity increased with treatment time, as shown by a higher contact angle (from 51.15° to 62.38°), resulting in lower water solubility. Mechanical properties were also enhanced, with tensile strength rising from 3.29 MPa to 6.74 MPa after 30 min of CP. Biodegradability improved with treatment time, reaching 99.51% mass loss after 15 days for the longest exposure. Films produced from the solution treated for 30 min (FCP30) were most effective in extending the shelf life of chicken breast fillets, reducing lipid oxidation (TBARS: 61.9%), peroxide content (58.7%), and microbial spoilage (TVB-N: 59.2%) compared to the untreated film. Overall, the results highlight the importance of CP treatment time as a key factor in enhancing film performance, supporting its application in sustainable active packaging. Full article

The application of personalized medicine to lung adenocarcinoma has resulted in new therapies based on specific oncogenic drivers that have improved patient outcomes. However, oncogene-defined subsets of patients exhibit a significant heterogeneity of response to these agents. Defining the factors that mediate the varied depth and duration of response are critical to developing new therapeutic strategies. While the examination of patient samples can provide important correlations, definitive mechanistic studies require the use of relevant preclinical models. Based on a large body of data, interactions between cancer cells and the surrounding tumor microenvironment, comprised of inflammatory, immune, and vascular cells, represent a critical determinant of therapeutic response. In this review, we focus on preclinical models that can be used to explore these interactions, identify new therapeutic targets, and test combination therapies. In particular, we will describe the use of implantable orthotopic immunocompetent models employing a panel of murine lung adenocarcinoma cell lines with oncogenic drivers common to human lung adenocarcinoma as a powerful system to develop new treatment approaches. Full article

Liquefied natural gas (LNG) is increasingly used as a marine fuel due to its capacity to significantly reduce emissions of particulate matter, sulfur oxides (SO_x), and nitrogen oxides (NO_x), compared to conventional fuels. In addition, LNG combustion produces less carbon dioxide (CO₂) than conventional marine fuels, and the use of non-fossil LNG offers further potential for reducing greenhouse gas emissions. However, this benefit can be partially offset by methane slip—the release of unburned methane in engine exhaust—which has a much higher global warming potential than CO₂. This study presents an experimental evaluation of methane emissions from a RoPax vessel powered by low-pressure dual-fuel four-stroke engines with a direct mechanical propulsion system. Methane slip was measured directly during onboard testing and combined with a year-long analysis of engine operation using an Engine Load Monitoring (ELM) method. The yearly average methane slip coefficient (C_slip) obtained was 1.57%, slightly lower than values reported in previous studies on cruise ships (1.7%), and significantly lower than the default values specified by the FuelEU (3.1%) Maritime regulation and IMO (3.5%) LCA guidelines. This result reflects the ship’s operational profile, characterized by long crossings at high and stable engine loads. This study provides results that could support more representative emission assessments and can contribute to ongoing regulatory discussions. Full article

Background: Pulmonary embolism (PE) increases right ventricular (RV) afterload, potentially leading to myocardial stress and electrocardiographic abnormalities. Although QTc prolongation has been suggested as a marker of RV dysfunction, its prevalence, clinical significance, and prognostic value in acute PE remain poorly defined. Objective: The objective of this study is to evaluate the prevalence and clinical implications of QTc prolongation in patients with intermediate–high and high-risk acute PE. Methods: We retrospectively analyzed 95 consecutive patients admitted with intermediate–high or high-risk PE between September 2021 and December 2023. QTc prolongation was defined as ≥470 ms in males and ≥480 ms in females. Clinical, imaging, and laboratory data were compared between patients with normal and prolonged QTc intervals. QTc was assessed at admission, after treatment, and prior to discharge. Results: QTc prolongation was observed in 28.4% of patients at presentation. This group had significantly higher lactate levels (2.3 vs. 1.8 mmol/L, p = 0.03) and a non-significant trend toward elevated troponin and lower oxygen saturation. No differences were observed in echocardiographic or CT-based RV dysfunction parameters. QTc values normalized by discharge irrespective of treatment modality. There was no association between QTc prolongation and in-hospital or long-term mortality. A trend toward more aspiration thrombectomy was noted in the prolonged QTc group (29.6% vs. 11.8%, p = 0.06). Conclusions: QTc prolongation is common in acute intermediate–high and high-risk PE and may reflect transient myocardial stress. While not predictive of clinical outcomes, it should be considered in the differential diagnosis of QTc prolongation in patients presenting with dyspnea and chest pain. Full article

Chemically strengthened glass is widely used for its remarkable fracture strength, mechanical performance, and scratch resistance. Assessing its hardness is crucial to evaluating improvements from chemical tempering. However, conventional methods like Vickers hardness tests are destructive, altering the sample surface. This study presents a novel, rapid, and nondestructive testing (NDT) approach by correlating the nonlinear refractive index (n₂) with surface hardness. Using ultrafast laser pulses, we measured the n₂ cross-section via the nonlinear ellipse rotation (NER) signal in Gorilla^®-type glass subjected to ion exchange (Na⁺ by K⁺). A microscope objective lens provided a penetration resolution of ≈5.5 μm, enabling a localized NER signal analysis. We demonstrate a correlation between the NER signal and hardness, offering a promising pathway for advanced, noninvasive characterization. This approach provides a reliable alternative to traditional destructive techniques, with potential applications in industrial quality control and material science research. Full article