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12 pages, 234 KB  
Article
Age at Onset Impact on Clinical Profile, Treatment, and Real-Life Perception in Spondyloarthritis Patients, Enhancing a Personalized Approach: A Monocentric Cohort Analysis
by Federico Fattorini, Linda Carli, Cosimo Cigolini, Lorenzo Esti, Marco Di Battista, Marta Mosca and Andrea Delle Sedie
J. Pers. Med. 2026, 16(2), 63; https://doi.org/10.3390/jpm16020063 - 28 Jan 2026
Abstract
Background: Spondyloarthritis (SpA) typically develops before 40 years of age, but increasing life expectancy has led to a growing number of cases in older adults. It is well known that age at onset may influence disease presentation, comorbidities, and patient outcomes. Objectives [...] Read more.
Background: Spondyloarthritis (SpA) typically develops before 40 years of age, but increasing life expectancy has led to a growing number of cases in older adults. It is well known that age at onset may influence disease presentation, comorbidities, and patient outcomes. Objectives: To assess whether age at onset influences SpA clinical presentation. Methods: We analyzed clinical, demographic, clinimetric, and imaging data in 272 SpA patients, grouped by onset age: early (≤40, n = 119), intermediate (41–59, n = 127), and late (≥60, n = 26). All patients had a minimum follow-up duration of 12 months. Their epidemiologic, clinic, and clinimetric data were collected, as well as patient-reported outcome measures (PROs) [Patient Global Assessment (PGA), Health Assessment Questionnaire (HAQ), FACIT-Fatigue (FACIT-F), SHORT-FORM 36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Work Productivity and Activity Impairment Questionnaire (WPAI), CSI (Central Sensitization Inventory), and Psoriatic Arthritis Impact of Disease (PsAID) questionnaire]. In univariate analyses, differences in categorical variables across onset groups were assessed using Fisher’s exact test; for continuous variables, between-group comparisons were performed using the Mann–Whitney U test (two-tailed) or the Kruskal–Wallis test, as appropriate, with Bonferroni correction for post hoc analyses. Multivariable regression models were subsequently fitted, adjusting for sex, diagnosis, and disease duration. For binary outcomes, multivariable logistic regression models were used, while multivariable linear regression models (ANCOVA) were applied for continuous outcomes. The overall association between onset group and each outcome was formally tested using likelihood ratio tests, comparing models including the onset variable with nested models excluding it. A p-value < 0.05 was considered statistically significant. Results: Patients’ mean age was 60.0 ± 13.7 years; 55.9% of them were males; and there were 188 cases (69.1%) of psoriatic arthritis (PsA) and 84 cases (30.9%) of ankylosing spondylitis (AS). In early-onset patients, inflammatory back pain (IBP) was more frequent, whereas late-onset patients more often presented with joint swelling. A family history of SpA and psoriasis was less common in late-onset forms. Comorbidities, including osteoporosis, osteoarthritis, hypertension, hyperuricemia, and diabetes, were more prevalent in older-onset patients, resulting in a higher overall comorbidity burden in Groups 2 and 3. Patient-reported outcomes were largely similar across age groups, although work activity limitation was more pronounced in younger patients. Conclusions: Age at onset seems to influence SpA phenotypes: early-onset could favor axial involvement, while late-onset may associate with peripheral arthritis. Late-onset forms are associated with a more severe comorbidity burden, in particular for cardiovascular risk factors. Lung involvement proved to be more prevalent with respect to the general population, so it should be checked in the routinary assessment of SpA patients. These findings suggest that rheumatologists could tailor their routine assessments based on patients’ age at disease onset. Interestingly, work productivity seems more impacted in early-onset patients. All these points highlight the importance of age at disease onset in SpA, guiding toward personalized medicine in terms of follow-up, therapy, and more holistic patient management. Full article
(This article belongs to the Special Issue Current Trends and Advances in Spondyloarthritis)
29 pages, 14746 KB  
Article
A Novel Strategy for Analyzing Live Load Effects in Cable-Stayed Suspension Hybrid Bridges with Varied Structural Parameters
by Jie Meng, Dongdong Zhao, Zhao Liu, Ding Yang and Jiayong Chen
Buildings 2026, 16(3), 529; https://doi.org/10.3390/buildings16030529 - 28 Jan 2026
Abstract
Cable-stayed suspension hybrid bridges (CSSHBs) integrate the advantages of cable-stayed bridges and suspension bridges into a highly rigid structure. However, due to their hybrid nature, the static performance of CSSHBs is highly sensitive to various factors, presenting significant challenges for parameter analysis and [...] Read more.
Cable-stayed suspension hybrid bridges (CSSHBs) integrate the advantages of cable-stayed bridges and suspension bridges into a highly rigid structure. However, due to their hybrid nature, the static performance of CSSHBs is highly sensitive to various factors, presenting significant challenges for parameter analysis and scheme comparison during design. This study presents a new live load effects analysis strategy for the hybrid bridge with varied structural parameters. The methodology expands the application scenarios of variable parameter influence line (IL) analysis. It solves structural live load responses based on the area of influence lines with the same sign and constructs a “parameter variation-structural response” diagram. Simultaneously, it extracts critical live load cases, enabling designers to adjust parameters during the conceptual design phase based on calculation results from a limited number of load cases. The 690 m Tuwan Bridge is used as the benchmark model for the case study. The study first investigates the characteristics of its influence lines, followed by parametric studies. Results indicate that when the main girder stiffness is increased by a factor of 100, the deflection at the mid-span section and the cable force amplitude of the side hanger are reduced by 53% and 81%, respectively. And increasing the sag-to-span ratio proves effective in mitigating live load effects. Finally, the structural static responses under three critical load cases are analyzed to comprehensively validate the proposed analytical strategy. Full article
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16 pages, 721 KB  
Article
Subclinical Oxidative and Matrix-Regulatory Alterations Associated with Cigarette Smoking and E-Cigarette Use in Periodontally Healthy Adults: A Cross-Sectional Study
by Fatma Soysal, Fatma Oner, Zeliha Guney, M. Sepehr Zarinkamar, Kamyar Shahsavani, Muhittin A. Serdar and Ceren Gokmenoglu
J. Clin. Med. 2026, 15(3), 1026; https://doi.org/10.3390/jcm15031026 - 27 Jan 2026
Abstract
Background/Objectives: Cigarette smoking is a well-established risk factor for periodontal tissue damage caused by oxidative stress and increased proteolytic activity. Electronic cigarettes (e-cigarettes), marketed as less harmful alternatives, deliver nicotine and reactive compounds that may similarly disrupt periodontal health. However, their molecular [...] Read more.
Background/Objectives: Cigarette smoking is a well-established risk factor for periodontal tissue damage caused by oxidative stress and increased proteolytic activity. Electronic cigarettes (e-cigarettes), marketed as less harmful alternatives, deliver nicotine and reactive compounds that may similarly disrupt periodontal health. However, their molecular effects on clinically healthy periodontal tissues remain unclear. This study aimed to compare oxidative stress-related and matrix-degradative biomarkers in the gingival crevicular fluid (GCF) of cigarette smokers (CS), e-cigarette (EC) users, and non-smokers (NS), and to examine the relationships among these markers. Methods: Sixty individuals, who were systemically and periodontally healthy (20 CS, 20 EC, and 20 NS), were examined. Clinical parameters, including probing depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP), were recorded. GCF samples were analyzed for reactive oxygen species (ROS), matrix metalloproteinase-9 (MMP-9), and forkhead box protein O-1 (FOXO-1) using ELISA. Initial group comparisons were descriptive, followed by analysis of covariance (ANCOVA) to adjust for age; PI and PD were included as covariates in separate models. Correlations were assessed using Spearman’s analysis. Results: PD was significantly higher in both EC users and CS compared with NS (p = 0.022). MMP-9 levels were significantly higher in CS than in EC users and NS (p < 0.05), while FOXO-1 concentrations were significantly lower in CS compared with NS (p = 0.0227). ROS levels did not differ significantly among groups (p > 0.05). After adjustment for age, PI, or PD, group differences in MMP-9 and FOXO-1 remained statistically significant, whereas ROS levels remained comparable. FOXO-1 demonstrated positive correlations with ROS and MMP-9 within exposure groups; these associations were considered exploratory. Conclusions: In this cross-sectional study, CS and EC use were associated with altered matrix-regulatory biomarker profiles in clinically healthy periodontal tissues, independent of age and periodontal indices. Causal or temporal inferences cannot be drawn, and longitudinal studies are needed to clarify the long-term periodontal implications of these findings. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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13 pages, 536 KB  
Article
Insulin Resistance and Metabolic Dysfunction in Early-Stage Parkinson’s Disease: Evidence from a Preliminary Case-Control Study
by Elena Contaldi, Lorenzo Ciocca, Francesco Mignone, Michela Barichella, Alessia Siribelli, Giulia Lazzeri, Ioannis Ugo Isaias, Gianni Pezzoli and Federica Invernizzi
J. Clin. Med. 2026, 15(3), 1021; https://doi.org/10.3390/jcm15031021 - 27 Jan 2026
Viewed by 37
Abstract
Background: Parkinson’s disease (PD) is increasingly recognized as a multisystem disorder in which metabolic dysfunction may contribute to disease susceptibility and progression. Peripheral insulin resistance (IR) has been implicated in PD, but data in levodopa-naïve patients are currently limited. Objective: To investigate the [...] Read more.
Background: Parkinson’s disease (PD) is increasingly recognized as a multisystem disorder in which metabolic dysfunction may contribute to disease susceptibility and progression. Peripheral insulin resistance (IR) has been implicated in PD, but data in levodopa-naïve patients are currently limited. Objective: To investigate the prevalence of IR and metabolic dysfunction in early-stage, levodopa-naïve PD patients and their association with clinical features. Methods: We conducted an exploratory case–control study including 20 levodopa-naïve PD patients and 40 age-, sex-, and BMI-matched healthy controls. Participants underwent comprehensive clinical and metabolic assessments, including fasting glucose, insulin, lipid profiles, and HOMA-IR calculation. Peripheral IR was defined using HOMA-IR cut-offs of ≥2.0 (primary analysis) and ≥2.5 (sensitivity analysis). ANCOVA adjusted for age, sex, and BMI was used for between-group comparisons. Results: PD patients exhibited higher fasting insulin (10.7 ± 5.2 vs. 8.0 ± 4.4 µIU/mL; p = 0.020) and HOMA-IR (2.63 ± 1.40 vs. 1.89 ± 1.21; p = 0.014) compared to controls. Using a HOMA-IR ≥ 2.0, IR prevalence was 70% in PD vs. 32.5% in controls (OR = 4.85, 95% CI 1.52–15.50, p = 0.012). ANCOVA analysis confirmed group differences after adjusting for covariates (respectively, p = 0.032 for insulin and p = 0.023 for HOMA-IR). A sensitivity analysis excluding six patients receiving dopaminergic therapy further supported the robustness of the results. No significant correlations were observed between IR and disease severity scores. Conclusions: Early-stage, levodopa-naïve PD patients exhibit a higher prevalence of peripheral insulin resistance compared with matched controls. These findings support the hypothesis that metabolic dysfunction is an intrinsic component of PD pathophysiology and may represent a target for early intervention. Full article
(This article belongs to the Special Issue Parkinson's Disease: Recent Advances in Diagnosis and Treatment)
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14 pages, 1243 KB  
Article
Effects of a 6-Month Minimal-Equipment Exercise Program on the Physical Fitness Profile of Portuguese Firefighter Recruits
by José Augusto Rodrigues dos Santos, Domingos José Lopes da Silva and Andreia Nogueira Pizarro
Fire 2026, 9(2), 57; https://doi.org/10.3390/fire9020057 - 27 Jan 2026
Viewed by 65
Abstract
Firefighting requires high and multidimensional fitness to ensure operational readiness and public safety. In Portugal, there is limited data regarding firefighters’ fitness and exercise programs to improve readiness are lacking. This study evaluated the effects of a 6-month minimal-equipment exercise program on the [...] Read more.
Firefighting requires high and multidimensional fitness to ensure operational readiness and public safety. In Portugal, there is limited data regarding firefighters’ fitness and exercise programs to improve readiness are lacking. This study evaluated the effects of a 6-month minimal-equipment exercise program on the physical fitness of firefighter recruits. Thirty-five male subjects (23.0 ± 2.72 years) were assessed at baseline,3 and 6 months for body composition, handgrip strength, running speed, cardiovascular endurance, anaerobic power, and upper- and lower-body strength. The intervention entailed daily sessions with 15 min of continuous running (50–65% HRmax) and active stretching, followed by alternating routines, including endurance running, free weights, interval sprints, calisthenics, and drills. A repeated-measures ANOVA and Bonferroni adjusted post hoc comparisons identified time-based changes. Significant improvements occurred across all fitness variables. Body fat fell by 8.4% and VO2max increased (p < 0.001), surpassing occupational thresholds required for extended suppression tasks. Bench press and sit-up performance improved by 88% and 81%, respectively, while countermovement jump showed double-digit gains (13%), all of which can translate directly to hose advancement, victim rescue, and forcible entry. These results highlight that resource-constrained departments can implement effective, low-cost exercise programs for enhancing pivotal fitness components, supporting policy initiatives to include structured training throughout firefighters’ careers. Full article
24 pages, 848 KB  
Article
A Cost-Effectiveness Analysis of the Sentio Bone Conduction Hearing Implant System in the Australian Healthcare Setting
by Magnus Värendh, Ida Haggren, Helén Lagerkvist, Maria Åberg Håkansson and Jonas Hjelmgren
J. Mark. Access Health Policy 2026, 14(1), 8; https://doi.org/10.3390/jmahp14010008 - 27 Jan 2026
Viewed by 51
Abstract
Bone conduction hearing implant systems (BCHIs) are established treatments for patients with conductive or mixed hearing loss or single-sided deafness when conventional hearing aids are unsuitable. This study evaluated the cost-effectiveness of the active transcutaneous system Sentio versus a similar system, i.e., Osia [...] Read more.
Bone conduction hearing implant systems (BCHIs) are established treatments for patients with conductive or mixed hearing loss or single-sided deafness when conventional hearing aids are unsuitable. This study evaluated the cost-effectiveness of the active transcutaneous system Sentio versus a similar system, i.e., Osia in an Australian setting. Scenario analyses also compared Sentio to other systems, i.e., Ponto and Baha Attract. A Markov cohort model was adapted from a previously published source to reflect Australian practice, incorporating device acquisition, surgery, maintenance, battery replacement and adverse event management over a 15-year horizon from a healthcare perspective. Effectiveness inputs were derived from published evidence using a naïve indirect comparison. Extensive sensitivity analyses and external validation tested robustness. In the base case, Sentio was associated with lower costs and a small modelled incremental quality-adjusted life years (QALYs) gain versus Osia. Scenario analyses confirmed cost-effectiveness relative to Ponto and Baha Attract, with outcomes below the Australian willingness-to-pay threshold. Health state utility, device price and reimplantation assumptions were the most influential drivers, yet Sentio remained cost-effective in over 95% of simulations. These findings support Sentio as a clinically and economically efficient BCHI in Australia and highlight the need for direct utility and long-term durability data. Full article
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17 pages, 1129 KB  
Article
Kinematic and Kinetic Adaptations to Step Cadence Modulation During Walking in Healthy Adults
by Joan Lluch Fruns, Maria Cristina Manzanares-Céspedes, Laura Pérez-Palma and Carles Vergés Salas
J. Funct. Morphol. Kinesiol. 2026, 11(1), 53; https://doi.org/10.3390/jfmk11010053 - 26 Jan 2026
Viewed by 102
Abstract
Background: Walking cadence is commonly adjusted in sport and rehabilitation, yet its effects on spatiotemporal gait parameters and regional plantar pressure distribution under controlled speed conditions remain incompletely characterized. Therefore, this study aimed to determine whether imposed cadence increases at a constant walking [...] Read more.
Background: Walking cadence is commonly adjusted in sport and rehabilitation, yet its effects on spatiotemporal gait parameters and regional plantar pressure distribution under controlled speed conditions remain incompletely characterized. Therefore, this study aimed to determine whether imposed cadence increases at a constant walking speed would (i) systematically reduce temporal gait parameters while preserving inter-limb symmetry and (ii) be associated with region-specific increases in forefoot plantar loading, representing the primary novel contribution of this work. Methods: Fifty-two adults walked at three imposed cadences (110, 120, 130 steps·min−1) while maintaining a fixed treadmill speed of 1.39 m·s−1 via auditory biofeedback. Spatiotemporal parameters were recorded with an OptoGait system, and plantar pressure distribution was measured using in-shoe pressure insoles. Normally distributed variables were analyzed using repeated-measures ANOVA, whereas plantar pressure metrics were assessed using the Friedman test, followed by Wilcoxon signed-rank post-hoc comparisons with false discovery rate (FDR) correction. Associations between temporal parameters and plantar loading metrics (peak pressure, pressure–time integral) were examined using Spearman’s rank correlation with FDR correction (α = 0.05). Results: Increasing cadence produced progressive reductions in gait cycle duration (~8–10%), contact time (~7–8%), and step time (all p < 0.01), while inter-limb symmetry indices remained below 2% across conditions. Peak plantar pressure increased significantly in several forefoot regions with increasing cadence (all p_FDR < 0.05), whereas changes in the first ray were less consistent across conditions. Regional forefoot pressure–time integral also increased modestly with higher cadence (p_FDR < 0.01). Spearman’s correlations revealed moderate negative associations between temporal gait parameters and global plantar loading metrics (ρ = −0.38 to −0.46, all p_FDR < 0.05). Conclusions: At a constant walking speed, increasing cadence systematically shortens temporal gait components and is associated with small but consistent region-specific increases in forefoot plantar loading. These findings highlight cadence as a key temporal constraint shaping plantar loading patterns during steady-state walking and support the existence of concurrent temporal–mechanical adaptations. Full article
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18 pages, 3896 KB  
Article
Untargeted Serum Proteomics in the Fontan Circulation Reveals Three Distinct Molecular Signatures of Fontan Physiology with CYB5R3 Among Key Proteins
by Alexander Blaha, David Renaud, Fatima Ageed, Bettina Sarg, Klaus Faserl, Alexander Kirchmair, Dietmar Rieder, Isabel Mihajlovic, Nele Ströbel, Kai Thorsten Laser and Miriam Michel
Int. J. Mol. Sci. 2026, 27(3), 1220; https://doi.org/10.3390/ijms27031220 - 26 Jan 2026
Viewed by 93
Abstract
The total cavopulmonary anastomosis (Fontan procedure), a palliative procedure for single-ventricle congenital heart disease, improves survival but is associated with progressive multiorgan complications and high long-term morbidity. Prior blood-based proteomic studies in adults have been limited to targeted antibody-based panels or focused on [...] Read more.
The total cavopulmonary anastomosis (Fontan procedure), a palliative procedure for single-ventricle congenital heart disease, improves survival but is associated with progressive multiorgan complications and high long-term morbidity. Prior blood-based proteomic studies in adults have been limited to targeted antibody-based panels or focused on methodological comparisons. Systemic molecular alterations in younger, clinically heterogeneous patients, particularly in untargeted pathways, remain incompletely characterized. Serum samples from 48 Fontan patients and 48 age- and sex-matched healthy controls were analyzed using mass spectrometry with TMT labeling. 2228 proteins were quantified, of which 124 were significantly differentially abundant (fold change > 1.5 or <0.67, FDR-adjusted p < 0.05). Network analysis identified three major functional clusters: extracellular matrix (ECM) organization (predominantly increased), actin cytoskeleton organization, and platelet-related pathways (both predominantly decreased). Stratified analyses showed reduced ECM protein abundance in high-risk patients, suggesting a shift from active remodeling toward a more established fibrotic state, and uniquely elevated cytochrome b5 reductase 3 (CYB5R3), implicating altered redox homeostasis, nitric oxide metabolism, and cellular aging. Overall, our findings extend prior targeted analyses, reveal potential biomarkers such as CYB5R3 and underscore the complexity of the Fontan circulation, with implications for risk stratification and therapeutic targeting. Full article
(This article belongs to the Special Issue Omics Technologies in Molecular Biology)
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14 pages, 1380 KB  
Article
Lipidemic Profile of Patients with Non-Small Cell Lung Cancer and Its Association with Driver Mutations: A Tertiary Center Retrospective Study
by Maria Lagadinou, Dimitrios Efthymiou, Fotios Sampsonas, Prokopis Karidis, Ioanna Marlafeka, Eirini Adamopoulou, Christos Michailides, Pinelopi Bosgana, Ourania Papaioannou, Emmanouil Psarros, Panagiota Tsiri, Vasilina Sotiropoulou, Matthaios Katsaras, Vasiliki Tzelepi, Argyrios Tzouvelekis and Markos Marangos
Cancers 2026, 18(3), 374; https://doi.org/10.3390/cancers18030374 - 25 Jan 2026
Viewed by 105
Abstract
Background: Altered lipid metabolism has been reported in several malignancies, but its clinical relevance in non-small cell lung cancer (NSCLC) remains uncertain. This study aimed to compare serum lipid parameters between NSCLC patients and healthy controls and to explore their association with histological [...] Read more.
Background: Altered lipid metabolism has been reported in several malignancies, but its clinical relevance in non-small cell lung cancer (NSCLC) remains uncertain. This study aimed to compare serum lipid parameters between NSCLC patients and healthy controls and to explore their association with histological subtype and selected driver mutations. Methods: We retrospectively analyzed serum total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) in patients diagnosed with adenocarcinoma or squamous cell carcinoma from 2021 to 2024, alongside a control group of 100 healthy individuals. Statistical comparisons were performed using appropriate parametric or nonparametric tests after normality assessment (Shapiro–Wilk), and p-values were adjusted using the Benjamini–Hochberg false discovery rate (FDR). Results: A total of 160 NSCLC patients were included. Most were male (75.5%) and current or former smokers (96.1%), with a mean age of 70.4 ± 10.3 years. Squamous cell carcinoma was the predominant subtype (64.4%). Hypocholesterolemia was observed in 59.9% of patients, while hypercholesterolemia was less frequent (40.1%). Compared with controls, patients had significantly lower HDL levels (p = 0.007, FDR-adjusted p = 0.024), while other lipid markers showed no statistically significant differences after correction for multiple testing. Differences between adenocarcinoma and squamous cell carcinoma were not statistically significant. Squamous cell carcinoma patients had higher TG but lower TC, LDL, and HDL levels compared with adenocarcinoma. A negative correlation between TG and ROS1 expression remained significant (r = −0.223, FDR-adjusted p = 0.004). Conclusions: In this retrospective, real-world cohort, only HDL levels demonstrated a robust difference between NSCLC patients and controls. Observed associations should be interpreted cautiously due to potential confounding factors and incomplete clinical data inherent to retrospective analyses. Prospective studies are needed to clarify whether lipid alterations play a biological or prognostic role in NSCLC. Full article
(This article belongs to the Special Issue Advances in Interventional Oncologic Therapies)
17 pages, 2959 KB  
Article
GABES-LSTM-Based Method for Predicting Draft Force in Tractor Rotary Tillage Operations
by Wenbo Wei, Maohua Xiao, Yue Niu, Min He, Zhiyuan Chen, Gang Yuan and Yejun Zhu
Agriculture 2026, 16(3), 297; https://doi.org/10.3390/agriculture16030297 - 23 Jan 2026
Viewed by 143
Abstract
During rotary tillage operations, the draft force is jointly affected by operating parameters and soil conditions, exhibiting pronounced nonlinearity, time-varying behavior, and historical dependence, which all impose higher requirements on tractor operating parameter matching and traction performance analysis. A draft force prediction method [...] Read more.
During rotary tillage operations, the draft force is jointly affected by operating parameters and soil conditions, exhibiting pronounced nonlinearity, time-varying behavior, and historical dependence, which all impose higher requirements on tractor operating parameter matching and traction performance analysis. A draft force prediction method that is based on a long short-term memory (LSTM) neural network jointly optimized by a genetic algorithm (GA) and the bald eagle search (BES) algorithm, termed GABES-LSTM, is proposed to address the limited prediction accuracy and stability of traditional empirical models and single data-driven approaches under complex field conditions. First, on the basis of the mechanical characteristics of rotary tillage operations, a time-series mathematical description of draft force is established, and the prediction problem is formulated as a multi-input single-output nonlinear temporal mapping driven by operating parameters such as travel speed, rotary speed, and tillage depth. Subsequently, an LSTM-based draft force prediction model is constructed, in which GA is employed for global hyperparameter search and BES is integrated for local fine-grained optimization, thereby improving the effectiveness of model parameter optimization. Finally, a dataset is established using measured field rotary tillage data to train and test the proposed model, and comparative analyses are conducted against LSTM, GA-LSTM, and BES-LSTM models. Experimental results indicate that the GABES-LSTM model outperforms the comparison models in terms of mean absolute percentage error, mean relative error, relative analysis error, and coefficient of determination, effectively capturing the dynamic variation characteristics of draft force during rotary tillage operations while maintaining stable prediction performance under repeated experimental conditions. This method provides effective data support for draft force prediction analysis and operating parameter adjustment during rotary tillage operations. Full article
(This article belongs to the Section Agricultural Technology)
22 pages, 11900 KB  
Article
Hydrocarbon Accumulation Controls in the Upper Sinian–Lower Silurian, Laoshan Uplift, South Yellow Sea Basin, China
by Yinguo Zhang, Yong Yuan, Yanqiu Yang, Jianwen Chen, Jie Liang, Jianqiang Wang and Dachao Qi
J. Mar. Sci. Eng. 2026, 14(3), 240; https://doi.org/10.3390/jmse14030240 - 23 Jan 2026
Viewed by 225
Abstract
Despite complex geological conditions and limited exploration activity, the South Yellow Sea Basin has not yet yielded a commercial hydrocarbon discovery. Recent studies indicate substantial hydrocarbon potential within the Upper Sinian–Lower Silurian strata; however, the mechanisms controlling hydrocarbon accumulation in these sequences remain [...] Read more.
Despite complex geological conditions and limited exploration activity, the South Yellow Sea Basin has not yet yielded a commercial hydrocarbon discovery. Recent studies indicate substantial hydrocarbon potential within the Upper Sinian–Lower Silurian strata; however, the mechanisms controlling hydrocarbon accumulation in these sequences remain poorly understood. In this study, outcrop, drilling, organic geochemical, and seismic data from the Yangtze Plate are integrated using a land–sea comparison approach to evaluate petroleum geological conditions, identify key controlling factors, and predict hydrocarbon accumulation in the Upper Sinian–Lower Silurian sequences of the Laoshan Uplift. The results indicate that the Upper Sinian–Lower Silurian strata possess favorable petroleum geological conditions, including two effective source–reservoir–seal assemblages. Key controls on deep hydrocarbon accumulation include high-quality Lower Cambrian source rocks, early development of the Laoshan paleo-uplift, structural stable zones, and Lower Silurian detachment layers. Three hydrocarbon accumulation evolution models are proposed: (1) early stage lateral hydrocarbon supply from adjacent depressions, (2) early stage lower-source–upper-reservoir charging, and (3) late-stage deep-burial cracking with structural adjustment. These findings provide important guidance for deep hydrocarbon exploration the Upper Sinian–Lower Silurian sequences of the Laoshan Uplift in the South Yellow Sea Basin. Full article
(This article belongs to the Section Geological Oceanography)
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16 pages, 1793 KB  
Article
Sedation Strategies for Awake Carotid Endarterectomy: An Exploratory Retrospective Study Comparing Dexmedetomidine and Remifentanil
by Rosanna Carmela De Rosa and Antonio Romanelli
Clin. Pract. 2026, 16(2), 23; https://doi.org/10.3390/clinpract16020023 - 23 Jan 2026
Viewed by 329
Abstract
Background: Awake carotid endarterectomy (CEA) under local anesthesia demands an optimal sedation strategy that ensures patient comfort while preserving the ability for real-time neurological assessment. Dexmedetomidine (DEX) and remifentanil (REMI) are widely used agents, but direct comparisons in this setting remain scarce. Methods: [...] Read more.
Background: Awake carotid endarterectomy (CEA) under local anesthesia demands an optimal sedation strategy that ensures patient comfort while preserving the ability for real-time neurological assessment. Dexmedetomidine (DEX) and remifentanil (REMI) are widely used agents, but direct comparisons in this setting remain scarce. Methods: Exploratory, retrospective, single-center study of awake CEA (March–July 2019). DEX or REMI infusions were titrated to a Richmond Agitation–Sedation Scale (RASS) of −1 to −2. Outcomes were sedation failure (RASS ≥ +2 despite maximum infusion rate), bradycardia, hypotension, and neurologic events. Statistical analyses used χ2 test (categorical variables) and Student’s t-test or Mann–Whitney test (continuous variables). Associations were assessed with Firth’s logistic regression (univariable and bivariate models), reporting odds ratios (OR) with 95% confidence intervals (CI95%). Trends in the Bispectral Index (BIS), hemodynamic, and respiratory parameters were assessed using two-way repeated-measures Analysis of Variance (ANOVA). A p-value < 0.05 was considered significant. Results: Fifty-two patients were included (DEX = 25; REMI = 27). DEX group showed more frequent sedation failure (32.0% vs. 3.7%; p = 0.020), bradycardia (36.0% vs. 3.7%; p = 0.009), and hypotension (28.0% vs. 0%; p = 0.011). DEX was associated with increased risk in sedation failure (OR 8.58, CI95% 1.70–85.81), bradycardia (OR 10.17, CI95% 2.05–101.21), and hypotension (OR 22.30, CI95% 2.46–2959.60); the direction of associations remained consistent in bivariate models adjusted for baseline confounders. ANOVA showed group-by-time interactions for BIS, heart rate, mean arterial pressure, and end-tidal CO2. No intraoperative complications or adverse outcomes were observed. Conclusions: In this retrospective cohort of awake CEA, DEX was associated with higher rates of sedation failure and hemodynamic adverse events compared with REMI, without an apparent impact on procedural success. Given non-random allocation and baseline imbalances, these findings are hypothesis-generating and warrant confirmation in larger, robust, and prospective studies. Full article
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27 pages, 16408 KB  
Article
A SNR-Based Adaptive Goldstein Filter for Ionospheric Faraday Rotation Estimation Using Spaceborne Full-Polarimetric SAR Data
by Zelin Wang, Xun Wang, Dong Li and Yunhua Zhang
Remote Sens. 2026, 18(2), 378; https://doi.org/10.3390/rs18020378 - 22 Jan 2026
Viewed by 88
Abstract
The spaceborne full-polarimetric (FP) synthetic aperture radar (SAR) is an advanced sensor for high-resolution Earth observation. However, FP data acquired by such a system are prone to distortions induced by ionospheric Faraday rotation (FR). From the perspective of exploiting these distortions, this enables [...] Read more.
The spaceborne full-polarimetric (FP) synthetic aperture radar (SAR) is an advanced sensor for high-resolution Earth observation. However, FP data acquired by such a system are prone to distortions induced by ionospheric Faraday rotation (FR). From the perspective of exploiting these distortions, this enables the estimation of the ionospheric FR angle (FRA), and consequently the total electron content, across most global regions (including the extensive ocean areas) using spaceborne FP SAR measurements. The accuracy of FRA estimation, however, is highly sensitive to noise interference. This study addresses denoising in FRA retrieval based on the Bickel–Bates estimator, with a specific focus on noise reduction methods built upon the adaptive Goldstein filter (AGF) that was originally designed for radar interferometric processing. For the first time, three signal-to-noise ratio (SNR)-based AGFs suitable for FRA estimation are investigated. A key feature of these filters is that their SNRs are all defined using the amplitude of the Bickel–Bates estimator signal rather than the FRA estimates themselves. Accordingly, these AGFs are applied to the estimator signal instead of the estimated FRAs. Two of the three AGFs are developed by adopting the mathematical forms of SNRs and filter parameters consistent with the existing SNR-based AGFs for interferogram. The third AGF is newly proposed by utilizing more general mathematical forms of SNR and filter parameter that differ from the first two. Specifically, its SNR definition aligns with that widely used in image processing, and its filter parameter is derived as a function of the defined SNR plus an additionally introduced adjustable factor. The three SNR-based AGFs tailored for FRA estimation are tested and evaluated against existing AGF variants and classical image denoising methods using three sets of FP SAR Datasets acquired by the L-band ALOS PALSAR sensor, encompassing an ocean-only scene, a plain land–ocean combined scene, and a more complex land–ocean combined scene. Experimental results demonstrate that all three filters can effectively mitigate noise, with the newly proposed AGF achieving the best performance among all denoising methods included in the comparison. Full article
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14 pages, 767 KB  
Article
Awareness of Primary Biliary Cholangitis Among Turkish Physicians: A Cross-Sectional, Multicenter, Web-Based Survey
by Hasan Eruzun and Henning Gronbaek
J. Clin. Med. 2026, 15(2), 915; https://doi.org/10.3390/jcm15020915 - 22 Jan 2026
Viewed by 132
Abstract
Background: Primary Biliary Cholangitis (PBC) requires early diagnosis and specialized management to prevent progression to cirrhosis. This study evaluates the awareness levels of Turkish physicians from various specialties regarding the clinical features, diagnostic criteria, and current treatment protocols of PBC. Methods: A multi-regional [...] Read more.
Background: Primary Biliary Cholangitis (PBC) requires early diagnosis and specialized management to prevent progression to cirrhosis. This study evaluates the awareness levels of Turkish physicians from various specialties regarding the clinical features, diagnostic criteria, and current treatment protocols of PBC. Methods: A multi-regional cross-sectional survey was conducted with 269 physicians across Türkiye. Knowledge levels were assessed through a 28-item instrument covering epidemiology, diagnosis and therapy. Data distribution was non-normal (Skewness: −1.296, Kurtosis: 2.857), necessitating the use of the Kruskal–Wallis H test and Dunn–Bonferroni post hoc procedure for inter-group comparisons. Internal consistency was confirmed with a Cronbach’s alpha of 0.80. Results: The overall mean awareness score was 62.6%. Item-level analysis revealed a near-universal understanding of the non-mandatory role of liver biopsy in diagnosis (99.1%) yet identified a critical knowledge gap regarding second-line therapies, particularly the use of steroids (6.8%). Significant disparities were observed among specialties (p < 0.001). Gastroenterologists (Median: 91.07%) and gastroenterology fellows (Median: 85.71%) exhibited significantly higher proficiency compared to general practitioners (64.29%) and family medicine residents (67.86%). Internal medicine specialists outperformed primary care providers, while no significant differences were found among other subgroups after Bonferroni adjustment. Conclusions: Professional specialization is the primary determinant of PBC awareness. While core diagnostic knowledge is stable, significant gaps exist in pharmacological management among non-specialists. Targeted medical education for primary care physicians is essential to ensure timely referral and optimize patient outcomes. Full article
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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12 pages, 669 KB  
Article
Anthropometric Indicators and Early Cardiovascular Prevention in Children and Adolescents: The Role of Education and Lifestyle
by Elisa Lodi, Maria Luisa Poli, Emanuela Paoloni, Giovanni Lodi, Gustavo Savino, Francesca Tampieri and Maria Grazia Modena
J. Cardiovasc. Dev. Dis. 2026, 13(1), 57; https://doi.org/10.3390/jcdd13010057 - 22 Jan 2026
Viewed by 48
Abstract
Background: Childhood obesity represents the most common nutritional and metabolic disorder in industrialized countries and constitutes a major public health concern. In Italy, 20–25% of school-aged children are overweight and 10–14% are obese, with marked regional variability. Excess adiposity in childhood is frequently [...] Read more.
Background: Childhood obesity represents the most common nutritional and metabolic disorder in industrialized countries and constitutes a major public health concern. In Italy, 20–25% of school-aged children are overweight and 10–14% are obese, with marked regional variability. Excess adiposity in childhood is frequently associated with hypertension, dyslipidemia, insulin resistance, and non-alcoholic fatty liver disease (NAFLD), predisposing to future cardiovascular disease (CVD). Objective: To investigate anthropometric indicators of cardiometabolic risk in 810 children and adolescents aged 7–17 years who underwent assessment for competitive sports eligibility at the Sports Medicine Unit of Modena, evaluate baseline knowledge of cardiovascular health aligned with ESC, AAP (2023), and EASO guidelines. Methods: 810 children and adolescents aged 7–17 years undergoing competitive sports eligibility assessment at the Sports Medicine Unit of Modena underwent evaluation of BMI percentile, waist circumference (WC), waist-to-height ratio (WHtR), and blood pressure. Cardiovascular knowledge and lifestyle habits were assessed via a previously used questionnaire. Anthropometric parameters, blood pressure (BP), and lifestyle-related knowledge and behaviors were assessed using standardized procedures. Overweight and obesity were defined according to WHO BMI-for-age percentiles. Elevated BP was classified based on the 2017 American Academy of Pediatrics age-, sex-, and height-specific percentiles. Statistical analyses included descriptive statistics, group comparisons, chi-square tests with effect size estimation, correlation analyses, and multivariable logistic regression models. Results: Overall, 22% of participants were overweight and 14% obese. WHtR > 0.5 was observed in 28% of the sample and was more frequent among overweight/obese children (p < 0.001). Elevated BP was detected in 12% of participants with available measurements (n = 769) and was significantly associated with excess adiposity (χ2 = 7.21, p < 0.01; Cramér’s V = 0.27). In multivariable logistic regression analyses adjusted for age and sex, WHtR > 0.5 (OR 2.14, 95% CI 1.32–3.47, p = 0.002) and higher sedentary time (OR 1.41 per additional daily hour, 95% CI 1.10–1.82, p = 0.006) were independently associated with elevated BP, whereas BMI percentile lost significance when WHtR was included in the model. Lifestyle knowledge scores were significantly lower among overweight and obese participants compared with normal-weight peers (p < 0.01). Conclusions: WHtR is a sensitive early marker of cardiometabolic risk, often identifying at-risk children missed by BMI alone. Baseline cardiovascular knowledge was suboptimal. The observed gaps in cardiovascular knowledge underscore the importance of integrating anthropometric screening with structured educational interventions to promote healthy lifestyles and long-term cardiovascular prevention. Full article
(This article belongs to the Section Epidemiology, Lifestyle, and Cardiovascular Health)
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