Search Results (1,041)

Background and Objectives: Lower limb defects often present significant reconstructive challenges due to limited soft tissue availability and exposure of critical structures. Perforator-based flaps offer reliable solutions, with minimal donor site morbidity. This study aimed to evaluate the efficacy of infrared thermography (IRT) in preoperative planning and postoperative monitoring of perforator-based flaps, assessing its accuracy in identifying perforators, predicting complications, and optimizing outcomes. Materials and Methods: A prospective observational study was conducted on 76 patients undergoing lower limb reconstruction with fascio-cutaneous perforator flaps between 2022 and 2024. Perforator mapping was performed concurrently with IRT and Doppler ultrasonography (D-US), with intraoperative confirmation. Flap design variables and systemic parameters were recorded. Postoperative monitoring employed thermal imaging on days 1 and 7. Outcomes were correlated with thermal, anatomical, and systemic factors using statistical analyses, including t-tests and Pearson correlation. Results: IRT showed high sensitivity (97.4%) and positive predictive value (96.8%) for perforator detection. A total of nine minor complications occurred, predominantly in patients with diabetes mellitus and/or elevated glycemia (p = 0.05). Larger flap-to-defect ratios (A/C and B/C) correlated with increased complications in propeller flaps, while smaller ratios posed risks for V-Y and Keystone flaps. Thermal analysis indicated significantly lower flap temperatures and greater temperature gradients in flaps with complications by postoperative day 7 (p < 0.05). CRP levels correlated with glycemia and white blood cell counts, highlighting systemic inflammation’s impact on outcomes. Conclusions: IRT proves to be a reliable, non-invasive method for perforator localization and flap monitoring, enhancing surgical planning and early complication detection. Combined with D-US, it improves perforator selection and perfusion assessment. Thermographic parameters, systemic factors, and flap design metrics collectively predict flap viability. Integration of IRT into surgical workflows offers a cost-effective tool for optimizing reconstructive outcomes in lower limb surgery. Full article

FMC63-CAR T cell therapy targeting CD19 protein on malignant B-cells is effective in patients with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL), with complete response rates of 43–54%. Common germline variants of the immune-checkpoint regulator CTLA-4 may elicit different responses to CAR-T cell therapy. The CTLA4 gene single-nucleotide polymorphism rs231775 coding threonine or alanine at amino acid position 17 of the CTLA-4 protein was prevalent in 55% of the studied DLBCL patients. In a retrospective comparative analysis of clinical outcome, there were significant differences in CTLA4 A17hom vs. T17Ahet and T17hom carriers with four-year progression-free survival at 77%, 59%, and 30% (p = 0.019), four-year overall survival was 79%, 41%, and 33% (p = 0.049), the relapse rates were 20%, 37%, and 56% (p = 0.025), and the death rates 20%, 54%, and 52% (p = 0.049). Conclusions: CTLA4 rs231775 polymorphism may impact the treatment outcome in FMC63-anti-CD19 CAR-T cell therapy, with an association of the CTLA4 minor allele A17 to favorable treatment outcome. Full article

On 10 May 2024, a super geomagnetic storm with a minimum Dst index of less than −400 nT occurred. It has attracted a significant amount of attention in the literature. Using total electron content (TEC) observations from a global navigation satellite system (GNSS), in situ electron density data from the Swarm satellite, and corresponding simulations from the thermosphere–ionosphere–electrodynamics general circulation model (TIEGCM), the dynamic poleward shift of the equatorial ionization anomaly (EIA) during the main phase of the super geomagnetic storm has been explored. The results show that the EIA crests moved poleward from ±15° magnetic latitude (MLat) to ±20° MLat at around 19.6 UT, to ±25° MLat at 21.2 UT, and to ±31° MLat at 22.7 UT. This poleward shift was primarily driven by the enhanced eastward electric field, neutral winds, and ambipolar diffusion. Storm-induced meridional winds can move ionospheric plasma upward/downward along geomagnetic field lines, causing the poleward movement of EIA crests, with minor contributions from zonal winds. Ambipolar diffusion contributes/prevents the formation of EIA crests at most EIA latitudes/the equatorward edge. Full article

Despite targeting mainly the respiratory tract, SARS-CoV-2 disrupts T cell homeostasis in ways that may explain both acute lethality and long-term immunological consequences. In this study, we aimed to evaluate the T-cell-mediated chain of immunity and formation of TCR via TREC assessment in COVID-19 and long COVID (LC). For this study, we collected 231 blood samples taken from patients with acute COVID-19 (n = 71), convalescents (n = 51), people diagnosed with LC (n = 63), and healthy volunteers (n = 46). With flow cytometry, we assessed levels of CD4+ and CD8+ minor T cell subpopulations (i.e., naïve, central and effector memory cells (CM and EM), Th1, Th2, Th17, Tfh, Tc1, Tc2, Tc17, Tc17.1, and subpopulations of effector cells (pE1, pE2, effector cells)). Additionally, we measured TREC levels. We found distinct changes in immune cell distribution—whilst distribution of major subpopulations of T cells was similar between cohorts, we noted that COVID-19 was associated with a decrease in naïve Th and CTLs, an increase in Th2/Tc2 lymphocyte polarization, an increase in CM cells, and a decrease in effector memory cells 1,3, and TEMRA cells. LC was associated with naïve CTL increase, polarization towards Th2 population, and a decrease in Tc1, Tc2, Em2, 3, 4 cells. We also noted TREC correlating with naïve cells subpopulations. Our findings suggest ongoing immune dysregulation, possibly driven by persistent antigen exposure or tissue migration of effector cells. The positive correlation between TREC levels and naïve T cells in LC patients points to residual thymic activity. The observed Th2/Th17 bias supports the hypothesis that LC involves autoimmune mechanisms, potentially driven by molecular mimicry or loss of immune tolerance. Full article

Background: Pancreas and pancreas–kidney transplantation are well-established therapeutic options for patients with type 1 diabetes mellitus (T1DM) and end-stage kidney disease (ESKD), offering the potential to restore endogenous insulin production and kidney function. It improves metabolic control, quality of life, and long-term survival. While surgical techniques and immunosuppressive strategies have advanced considerably, graft rejection and limited long-term graft survival remain significant clinical challenges. Method: To better understand these risks, the genetic and immunological factors that influence transplant outcomes are examined. Beyond traditional human leukocyte antigen (HLA) matching, non-HLA genetic variants such as gene deletions and single-nucleotide polymorphisms (SNPs) have emerged as contributors to alloimmune activation and graft failure. Result: Polymorphisms in cytokine genes, minor histocompatibility antigens, and immune-regulatory pathways have been implicated in transplant outcomes. However, the integration of such genomic data into clinical practice remains limited due to underexplored gene targets, variability in study results, and the lack of large, diverse, and well-characterized patient cohorts. Initiatives like the International Genetics & Translational Research in Transplantation Network (iGeneTRAiN) are addressing these limitations by aggregating genome-wide data from thousands of transplant donors and recipients across multiple centers. These large-scale collaborative efforts aim to identify clinically actionable genetic markers and support the development of personalized immunosuppressive strategies. Conclusions: Overall, genetic testing and genomics hold great promise in advancing precision medicine in pancreas and pancreas–kidney transplantation. Full article

Background/Objectives: Cardiovascular diseases are a global health issue with an increasing burden and are exacerbated by hypertension. High blood pressure is partly attributed to genetic variants that are generally not well understood or extensively studied in sub-Saharan African populations. Variants linked to blood pressure have been found through genome-wide association studies (GWASs), which were mostly conducted among European ancestry populations; however, limited research has been undertaken in Africa. The current study evaluated single-nucleotide polymorphisms (SNPs) of PCSK9, ABCA1, LPL, and PON1 in relation to blood pressure measurements of 1839 Ghanaian adults. Methods: Genotypes were extracted from data generated by the H3Africa SNP array. After adjusting for sex, age, smoking, and body mass index (BMI), inferential statistics were used to investigate the relationships between SNPs and blood pressure (BP) indices. Additionally, Bonferroni correction was used to adjust for multiple testing. Results: Diastolic blood pressure (DBP) and the minor allele T of the PCSK9 variant (rs17111557) were positively associated at p = 0.006 after covariate adjustments. Although this novel DBP-associated variant is located in the 3′ untranslated region (3′ UTR) of the PCSK9 gene, in silico functional prediction suggests it is an expression quantitative trait locus (eQTL) that may change the binding site of transcription factors, potentially altering the rate of transcription and impacting DBP in this Ghanaian population. Conclusions: Our findings highlight the role of genetics in hypertension risk and the potential of discovering new therapies targeting isolated diastolic blood pressure in this rural African population. Full article

The rapid growth of Internet of Things (IoT) environments has increased security challenges due to heightened exposure to cyber threats and attacks. A key problem is the class imbalance in attack traffic, where critical yet underrepresented attacks are often overlooked by intrusion-detection systems (IDS), thereby compromising reliability. We propose Feature-Importance GAN SMOTE (FIGS), an innovative, realistic intrusion-detection framework designed for IoT environments to address this challenge. Unlike other works that rely only on traditional oversampling methods, FIGS integrates sensitivity-based feature-importance analysis, Generative Adversarial Network (GAN)-based augmentation, a novel imbalance ratio (GIR), and Synthetic Minority Oversampling Technique (SMOTE) for generating high-quality synthetic data for minority classes. FIGS enhanced minority class detection by focusing on the most important features identified by the sensitivity analysis, while minimizing computational overhead and reducing noise during data generation. Evaluations on the CICIoMT2024 and CICIDS2017 datasets demonstrate that FIGS improves detection accuracy and significantly lowers the false negative rate. FIGS achieved a 17% improvement over the baseline model on the CICIoMT2024 dataset while maintaining performance for the majority groups. The results show that FIGS represents a highly effective solution for real-world IoT networks with high detection accuracy across all classes without introducing unnecessary computational overhead. Full article

The broad-spectrum insect growth regulator (IGR) and insecticide 2-((1-(4-Phenoxyphenoxy)propan-2-yl)oxy)pyridine (MPEP; also known as pyriproxyfen) is increasingly being used to address public health programs for vector control, initiated by the spread of Zika virus in 2015–2016. While considered relatively safe for humans under normal conditions, limited toxicology data are available. Current studies were undertaken to address the data gap regarding potential immunotoxicity of MPEP, with particular emphasis on host resistance to viral infection. Hsd:Harlan Sprague Dawley SD^® rats were treated for 28 days by oral gavage with doses of 0, 62.5, 125, 250 or 500 mg/kg/day of MPEP in corn oil. There was a dose-dependent increase in liver weights which is consistent with the liver playing a dominant role in MPEP metabolism. However, no histological correlates were observed. Following treatment, rats were subjected to a battery of immune tests as well as an established rat model of influenza virus infection to provide a comprehensive assessment of immune function and host resistance. While several of the immune tests showed minor exposure-related changes, evidenced by negative dose–response trends, most did not show significant differences in any of the MPEP treatment groups relative to vehicle control. Most notable was a negative trend in pulmonary mononuclear cell phagocytosis with increases in dose of MPEP. There was also a positive trend in early humoral immune response (5 days after immunization) to keyhole limpet hemocyanin (KLH) as evidenced by increased serum anti-KLH IgM antibodies which was followed later (14 days following immunization) by decreasing trends in anti-KLH IgM and IgG antibody levels. However, MPEP treatment had no effect on the ability of rats to clear the influenza virus nor the T-dependent IgM and IgG antibody response to the virus. The lack of effects of MPEP on host resistance to influenza suggests the immune effects were minimal and unlikely to present a hazard with respect to susceptibility to respiratory viral infection. Full article

The Citrus tristeza virus (CTV), a member of the Closterovirus genus, is considered a serious threat to citrus trees grafted onto sour orange (SO) rootstock. In the Mediterranean area, the most prevalent CTV strains are VT and T30. The VT strain includes both mild and severe isolates, some of them associated with seedling yellows (SY) syndrome. Mild CTV-VT isolates that do not induce SY symptoms (no-SY) show minor variations in their Orf1a, p23, and p33 genes, with a single nucleotide polymorphism at position 161 of the p23 gene. These isolates can repress superinfection with homologous severe isolates. The aim of this study was to investigate the mechanism of cross-protection by means of biological indexing, real-time RT-PCR high-resolution melting (HRM), and p23 gene amplicon sequencing. Four no-SY CTV-VT isolates were inoculated onto SO seedlings and Hamlin sweet orange trees grafted on SO. These plants were later challenged with two homologous CTV-VT SY isolates and remained asymptomatic. The biological evaluation of the infection process in superinfected plants was investigated via inoculation of the bark on SO seedlings that were also asymptomatic. A parallel HRM analysis of midvein RNA extracts revealed that the melting temperature (Tm) of the no-SY isolates was statistically lower than that of the SY isolates. The Tm values of RNAs extracts from superinfected plants were not statistically different from those of the no-SY isolates. This suggests that the SY isolates failed to establish infection or replicate in plants pre-inoculated with no-SY isolates. This blockage of replication resembles superinfection exclusion, with attractive perspectives to prevent SY damage in field applications. Full article

Yellow mealworm (Tenebrio molitor) meal is a promising sustainable protein for pet food, yet its effect on nutrient balance and granule texture is incompletely defined. Five dry dog food formulas containing 25%, 30%, 35%, 40%, and 45% of T. molitor meal were extruded and analyzed for proximate composition, fatty-acid and amino-acid profiles, and compressive mechanical properties. Crude-protein concentration remained stable, whereas fat and ash increased (p < 0.01) and carbohydrates decreased as the inclusion level rose. Tenebrio molitor meal enriches granules in oleic, linoleic, and α-linolenic acids, improving the ω-6:ω-3 ratio from 8.0 to 5.4. Essential amino acid levels were conserved, although lysine and methionine fell modestly (≤11%). Mechanical testing showed a linear decline in hardness (331 → 300 N) and stiffness (46 → 41 N mm⁻¹), indicating softer, more deformable granules at higher inclusion levels. The inclusion of up to 45% T. molitor meal can be incorporated without compromising protein quality while enhancing unsaturated fat content. Minor lysine/methionine dilution can be offset by targeted supplementation. These data support wider adoption of insect protein in hypoallergenic and eco-friendly canine diets. Full article

Soilborne diseases cause losses of 45–70% in faba bean in Ethiopia. Studies were undertaken to define soilborne pathogens and their complexes in Ethiopia. First, the severity of root rot was assessed in 150 field sites across seven Ethiopian regions. Soil samples were collected, and the DNA of 29 pests and pathogens was quantified using a commercial quantitative PCR (qPCR) soil testing service. There was a very high incidence rate of Macrophomina phaseolina, as well as Pythium clades F and I. The other detected species in order of incidence included Fusarium redolens, Rhizoctonia solani, Aphanomyces euteiches, Phytophthora megasperma, Sclerotinia sclerotiorum and S. minor, and Verticillium dahliae, as well as low levels of Thielaviopsis basicola. Five anastomosis groups (AG) of R. solani, namely AG2.1, AG2.2, AG3, AG4, and AG5, were detected, of which AG2.2 and AG4 were most prevalent. We believe this is the first report of occurrence for Ethiopia of A. euteiches, Ph. megasperma, T. basicola, and the five AGs for R. solani. There were very high incidence rates of the foliar pathogens Botrytis cinerea, B. fabae, Didymella pinodes, and Phoma pinodella and of the nematode Pratylenchus thornei, followed by P. neglectus and P. penetrans. The root rot severity and distribution varied significantly across regions, as well as with soil types, soil pH, and soil drainage. Subsequently, metabarcoding of the soil DNA was undertaken using three primer pairs targeting fungi (ITS2), Fusarium species (TEF1 α), and Oomycetes (ITS1Oo). The ITS2 and TEF1α primers emphasized F. oxysporum as the most abundant soilborne fungal pathogen and highlighted F. ananatum, F. brachygibbosum, F. brevicaudatum, F. clavum, F. flagelliforme, F. keratoplasticum, F. napiforme, F. nelsonii, F. neocosmosporiellum, F. torulosum, and F. vanettenii as first reports of occurrence for Ethiopia. The ITS1Oo primer confirmed Pythium spp. as the most prevalent of all Oomycetes. Full article

Diabetes is the world’s leading cause of renal and premature cardiovascular disease. There are marked differences between groups of patients with different ethnicities in their susceptibility to diabetes and its renal and cardiovascular complications. Novel markers of developing diabetes complications are related to disturbances in oxidative metabolism. In this cross-sectional study, we measured the arterial stiffness in patients of differing ethnicities with type 2 diabetes mellitus and assessed the relationship of their ethnicity with systemic markers of oxidative stress. Patients from black, African and Caribbean, and Asian minor ethnic groups were studied, with white patients with T2DM (n = 170) without evidence of cardiovascular disease (CVD). The vascular stiffness was measured by infrared finger-photoplethysmography. The oxidative stress burden was assessed by measuring the urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), activities of plasma glutathione peroxidase (GPx-3), superoxide dismutase (SOD) activities, and concentration of selenium. The vascular stiffness and 8-OHdG were higher in the white than in the Black patients (9.68 m/s vs. 9.26 m/s, p = 0.021 and 292.8 ng/mL vs. 200.9 ng/mL, p = 0.0027, respectively). Meanwhile, the GPx-3 and SOD activities and selenium were lower in the white than in the Black patients (283.3 U/L vs. 440.4 U/L, p < 0.0001; 37.5 U/L vs. 75.6 U/L, p = 0.0007; and 1.14 vs. 1.28 µmol/L, p = 0.0001, respectively). In regression modelling, the 8-OHdG/creatinine ratio was an independent predictor of vascular stiffness in the white patient group (β = 0.23 m/s per unit increase in ln(8-OHdG/creatinine) [95% CI, 0.03 to 0.42]; p = 0.021) but not in the Black patient group (p = 0.29). Increased vascular stiffness, lower endogenous antioxidant defense, and greater levels of oxidative damage were found in patients of white ethnicity, which could contribute to the higher incidence of CVD compared with patients from Black minor ethnic groups with diabetic renal disease. Full article

Background/Objectives: Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy with poor prognosis, particularly in metastatic cases. The Ki-67 proliferation index is a recognized marker of tumor aggressiveness, yet its role in guiding diagnostic imaging and surgical decision-making remains underexplored. This study evaluates Ki-67’s predictive value for metastasis at diagnosis, leveraging artificial intelligence (AI) to inform personalized, minimally invasive strategies for ACC management. Methods: We retrospectively analyzed 53 patients with histologically confirmed ACC from the Adrenal-ACC-Ki67-Seg dataset in The Cancer Imaging Archive. All patients had Ki-67 indices from surgical specimens and preoperative contrast-enhanced CT scans. Descriptive statistics, t-tests, ANOVA, and multivariable logistic regression evaluated associations between Ki-67, tumor size, age, and metastasis. Random Forest classifiers—with and without the Synthetic Minority Oversampling Technique (SMOTE)—were developed to predict metastasis. A Ki-67-only model served as a baseline comparator. Model performance was assessed using the area under the curve (AUC) and DeLong’s test. Results: Patients with metastatic disease had significantly higher Ki-67 indices (mean 39.4% vs. 21.6%, p < 0.05). Logistic regression identified Ki-67 as the sole significant predictor (OR = 1.06, 95% CI: 1.01–1.12). The Ki-67-only model achieved an AUC of 0.637, while the SMOTE-enhanced Random Forest achieved an AUC of 0.994, significantly outperforming all others (p < 0.001). Conclusions: Ki-67 is significantly associated with metastasis at ACC diagnosis and demonstrates independent predictive value in regression analysis. However, integration with machine learning models incorporating tumor size and age significantly improves overall predictive accuracy, supporting AI-assisted risk stratification and precision imaging strategies in adrenal cancer care. Full article

Background/Objectives: Non-enhanced computed tomography of the kidneys, ureters and bladder (NECT KUB) is the initial imaging modality for suspected nephroureterolithiasis. However, for alternative diagnoses, NECT may not be the ideal technique. Our institution changed the protocol for this cohort from NECT to intravenous contrast-enhanced CT (CECT) KUB. We aimed to retrospectively compare the rate of alternative diagnosis seen and the rates of calculus detection in CECT versus NECT KUB as a means of assessing performance. Our secondary aim was to compare the radiation dose between CECT and NECT KUB. Methods: Patients referred from the emergency department with suspected nephroureterolithiasis who underwent NECT and CECT KUB over two years were included. Key performance metrics included calculus detection rate, alternative findings, and negative studies. The metrics were compared between genders and age groups. Categorical variables were analysed using Chi-squared or Fisher’s Exact Test and continuous with T-testing. Results: A total of 423 patients had CT KUB imaging (209 NECT, 214 CECT). The incidence of alternative findings in the NECT group was 23% and 40% in CECT (p < 0.001). There were 48 findings (13 major, 11 moderate and 24 minor) in NECT studies and 85 findings (23 major, 43 moderate and 19 minor) in CECT (p < 0.001). Major diagnoses ranged from acute emergencies to more indolent findings, including suspicious nodules/masses. The calculus detection rate (NECT 56%, CECT 54%, p = 0.643) and negative studies (NECT 28%, CECT 22%, p = 0.168) did not significantly differ between protocols. CECT had a mean effective dose of 8.71 ± 2.58 mSv representing 2.4 times the exposure of NECT (p < 0.001). Conclusions: CECT is associated with a greater alternative diagnosis rate with similar calculus detection rates compared to NECT KUB, suggesting superior performance. However, CECT exposes patients to significantly greater levels of ionizing radiation. Full article

Non-Native Tree Species (NNTs) play crucial roles in global and European forests. However, in the Czech Republic, NNTs represent a tiny fraction of the forested areas due to limited research on their potential use. The country is actively afforesting abandoned agricultural lands; NNTs which are already tested and certified could enhance the country’s forestry system. This study aimed to evaluate the initial growth of Castanea sativa, Platanus acerifolia, and Corylus colurna under three soil treatments on abandoned agricultural soil, evaluate the survival and mortality of the tree species, and further compare the soil dynamics among the three ecosystems to describe the initial state and short-term changes in the soil environment. The research plot was set in the Doubek area, 20 km East of Prague. Moreover, soil-improving materials, Humac (1.0 t·ha⁻¹) and Alginite (1.5 t·ha⁻¹), were established on the side of the control plot at the afforested part. The heights of plantations of tree species were measured from 2020 to 2024. Furthermore, 47 soil samples were collected at varying depths from three ecosystems (afforested soil, arable land, and old forest) in 2022. A single-factor ANOVA was run, followed by a post hoc test. The result shows that the Control-C plot (Castanea Sativa + Platanus acerifolia + Corylus colurna + agricultural soil without amendment) had the highest total growth (mean annual increment in the year 2024) for Castanea sativa (KS = 40.90 ± a21.61) and Corylus colurna (LS = 55.62 ± 59.68); Alginite-A (Castanea Sativa + Platanus acerifolia + Corylus colurna + Alginite) did best for Platanus acerifolia (PT = 39.85 ± 31.52); and Humac-B (Castanea Sativa + Platanus acerifolia + Corylus colurna + Humac) had the lowest growth. Soil dynamics among the three ecosystems showed that the old forest (plot two) significantly differs from arable soil (plot one), Humac and Platanus on afforested land (plot three), Platanus and Alginite on afforested land (plot four), and Platanus without amendment (plot five) in horizon three (the subsoil or horizon B) and in horizon four (the parent material horizon or horizon C). Results document the minor response of plantations to soil-improving matters at relatively rich sites, good growth of plantations, and initial changes in the soil characteristics in the control C plot. We recommend both sparing old forests and the afforestation of abandoned agricultural soils using a control treatment for improved tree growth and sustained soil quality. Further studies on the species’ invasiveness are needed to understand them better. Full article