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11 pages, 327 KiB  
Article
Metabolic Mediation of the Association Between Hyperandrogenism and Paratubal Cysts in Polycystic Ovary Syndrome: A Structural Equation Modeling Approach
by Jin Kyung Baek, Chae Eun Hong, Hee Yon Kim and Bo Hyon Yun
J. Clin. Med. 2025, 14(15), 5545; https://doi.org/10.3390/jcm14155545 (registering DOI) - 6 Aug 2025
Abstract
Objectives: Paratubal cysts (PTCs) are embryological remnants and are potentially hormonally responsive. Since hyperandrogenism (HA) is representative of polycystic ovary syndrome (PCOS), we examined whether biochemical hyperandrogenism is associated with PTCs in women with PCOS and if body mass index (BMI) and [...] Read more.
Objectives: Paratubal cysts (PTCs) are embryological remnants and are potentially hormonally responsive. Since hyperandrogenism (HA) is representative of polycystic ovary syndrome (PCOS), we examined whether biochemical hyperandrogenism is associated with PTCs in women with PCOS and if body mass index (BMI) and insulin resistance (IR) mediate this association. Methods: This retrospective study included 577 women diagnosed with PCOS at a tertiary academic center from 2010 to 2018. Clinical data included age at diagnosis, BMI, and diagnoses of hypertension, non-alcoholic fatty liver disease, and metabolic syndrome. Laboratory measures included total testosterone, sex hormone-binding globulin, anti-Müllerian hormone, luteinizing hormone, fasting glucose, insulin, and triglycerides (TG). Derived indices included a free androgen index (FAI), homeostasis model assessment of insulin resistance (HOMA-IR), and fasting glucose-to-insulin ratio. PTCs were identified through imaging or surgical findings. Structural equation modeling (SEM) assessed direct and indirect relationships between FAI, BMI, HOMA-IR, and PTCs, while adjusting for diagnostic age. Results: PTCs were identified in 2.77% of participants. BMI, FAI, TG, and IR indices were significantly higher for women with PTCs than those without PTCs. SEM revealed significant indirect effects of FAI on PTCs via BMI and HOMA-IR. The direct effect was negative, resulting in a non-significant total effect. A sensitivity model using HOMA-IR as the predictor showed a significant direct effect on PTCs without mediation via FAI. Conclusions: Biochemical HA may influence PTC development in PCOS through metabolic pathways, establishing the need to consider metabolic context when evaluating adnexal cysts in hyperandrogenic women. Full article
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12 pages, 2764 KiB  
Article
AlxCoCrFeNi High-Entropy Alloys Enable Simultaneous Electrical and Mechanical Robustness at Thermoelectric Interfaces
by Xiaoxia Zou, Wangjie Zhou, Xinxin Li, Yuzeng Gao, Jingyi Yu, Linglu Zeng, Guangteng Yang, Li Liu, Wei Ren and Yan Sun
Materials 2025, 18(15), 3688; https://doi.org/10.3390/ma18153688 (registering DOI) - 6 Aug 2025
Abstract
The interface between high-performance thermoelectric materials and electrodes critically governs the conversion efficiency and long-term reliability of thermoelectric generators under high-temperature operation. Here, we propose AlxCoCrFeNi high-entropy alloys (HEA) as barrier layers to bond Cu-W electrodes with p-type skutterudite (p-SKD) thermoelectric [...] Read more.
The interface between high-performance thermoelectric materials and electrodes critically governs the conversion efficiency and long-term reliability of thermoelectric generators under high-temperature operation. Here, we propose AlxCoCrFeNi high-entropy alloys (HEA) as barrier layers to bond Cu-W electrodes with p-type skutterudite (p-SKD) thermoelectric materials. The HEA/p-SKD interface exhibited excellent chemical bonding with a stable and controllable reaction layer, forming a dense, defect-free (Fe,Ni,Co,Cr)Sb phase (thickness of ~2.5 μm) at the skutterudites side. The interfacial resistivity achieved a low value of 0.26 μΩ·cm2 and remained at 7.15 μΩ·cm2 after aging at 773 K for 16 days. Moreover, the interface demonstrated remarkable mechanical stability, with an initial shear strength of 88 MPa. After long-term aging for 16 days at 773 K, the shear strength retained 74 MPa (only 16% degradation), ranking among the highest reported for thermoelectric materials/metal joints. Remarkably, the joint maintained a shear strength of 29 MPa even after 100 continuous thermal cycles (623–773 K), highlighting its outstanding thermo-mechanical stability. These results validate the AlxCoCrFeNi high-entropy alloys as an ideal interfacial material for thermoelectric generators, enabling simultaneous optimization of electrical and mechanical performance in harsh environments. Full article
(This article belongs to the Section Metals and Alloys)
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17 pages, 2624 KiB  
Article
Cerebral Hemodynamics as a Diagnostic Bridge Between Mild Cognitive Impairment and Late-Life Depression: A Multimodal Approach Using Transcranial Doppler and MRI
by Sergiu-Florin Arnautu, Diana-Aurora Arnautu, Minodora Andor, Cristina Vacarescu, Dragos Cozma, Brenda-Cristina Bernad, Catalin Juratu, Adrian Tutelca and Catalin-Dragos Jianu
Life 2025, 15(8), 1246; https://doi.org/10.3390/life15081246 - 6 Aug 2025
Abstract
Background: Vascular dysfunction is increasingly recognized as a shared contributor to both cognitive impairment and late-life depression (LLD). However, the combined diagnostic value of cerebral hemodynamics, neuroimaging markers, and neuropsychological outcomes remains underexplored. This study aimed to investigate the associations be-tween transcranial Doppler [...] Read more.
Background: Vascular dysfunction is increasingly recognized as a shared contributor to both cognitive impairment and late-life depression (LLD). However, the combined diagnostic value of cerebral hemodynamics, neuroimaging markers, and neuropsychological outcomes remains underexplored. This study aimed to investigate the associations be-tween transcranial Doppler (TCD) ultrasound parameters, cognitive performance, and depressive symptoms in older adults with mild cognitive impairment (MCI) and LLD. Importantly, we evaluated the integrative value of TCD-derived indices alongside MRI-confirmed white matter lesions (WMLs) and standardized neurocognitive and affective assessments. Methods: In this cross-sectional study, 96 older adults were enrolled including 78 cognitively unimpaired individuals and 18 with MCI. All participants underwent structured clinical, neuropsychological, and imaging evaluations including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15), MRI-based Fazekas scoring of WMLs, and TCD ultrasonography of the middle cerebral artery. Hemodynamic variables included mean blood flow velocity (MBFV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI). Logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of MCI. Results: Participants with MCI showed significantly lower MBFV and EDV, and higher PI and RI (p < 0.05 for all) compared with cognitively unimpaired participants. In multivariate analysis, lower MBFV (OR = 0.64, p = 0.02) and EDV (OR = 0.70, p = 0.03), and higher PI (OR = 3.2, p < 0.01) and RI (OR = 1.9, p < 0.01) remained independently associated with MCI. ROC analysis revealed excellent discriminative performance for RI (AUC = 0.919) and MBFV (AUC = 0.879). Furthermore, PI correlated positively with depressive symptom severity, while RI was inversely related to the GDS-15 scores. Conclusions: Our findings underscore the diagnostic utility of TCD-derived hemodynamic parameters—particularly RI and MBFV—in identifying early vascular contributions to cognitive and affective dysfunction in older adults. The integration of TCD with MRI-confirmed WML assessment and standardized cognitive/mood measures represents a novel and clinically practical multi-modal approach for neurovascular profiling in aging populations. Full article
(This article belongs to the Special Issue Intracerebral Hemorrhage: Advances and Perspectives)
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12 pages, 754 KiB  
Article
High Efficacy of Triclabendazole/Ivermectin Combination Compared to Triclabendazole Monotherapy for Treating Human Fascioliasis in Upper Egypt: A Prospective Study
by Waleed Attia Hassan, Haidi Karam-Allah Ramadan, Mona Gaber, Samia S. Alkhalil and Alzahraa Abdelraouf Ahmad
Trop. Med. Infect. Dis. 2025, 10(8), 221; https://doi.org/10.3390/tropicalmed10080221 - 6 Aug 2025
Abstract
Triclabendazole (TCBZ) is the gold standard treatment for fascioliasis. However, reports on resistance are increasing, emphasizing the need for alternative therapy. Combining TCBZ with ivermectin (IVM) was found to be effective for treating animal fascioliasis. Building on this, we aimed to evaluate the [...] Read more.
Triclabendazole (TCBZ) is the gold standard treatment for fascioliasis. However, reports on resistance are increasing, emphasizing the need for alternative therapy. Combining TCBZ with ivermectin (IVM) was found to be effective for treating animal fascioliasis. Building on this, we aimed to evaluate the efficacy of the TCBZ/IVM combination therapy for human fascioliasis. This study enrolled 136 patients with Fasciola from Upper Egypt, and they were divided into the first group (n = 65), who received TCBZ monotherapy, and the second group (n = 71), who received the TCBZ/IVM combination. Assessments were to evaluate treatment response based on clinical, eosinophilic, and radiological parameters. Chronic fasciolosis was diagnosed in 17 patients (12.5%). No differences were observed in age and sex. Significant improvements were noted in all parameters in both groups, with more pronounced effects observed in the second group. A significantly higher complete response, including clinical, eosinophilic, and radiological improvements, was reported in the combined therapy group, with 53.3% compared to 26.2% in the monotherapy group (p < 0.001). A high baseline eosinophilic count was significantly associated with response. The efficacy of the TCBZ/IVM combination for treating human fascioliasis suggested a possible boosting effect, which can benefit regions of TCBZ failure. Further large-scale randomized studies are warranted to confirm these findings. Full article
(This article belongs to the Section Neglected and Emerging Tropical Diseases)
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11 pages, 624 KiB  
Article
The Role of Asprosin in Females in the Context of Fertility—An Exploratory Study
by Magdalena Skowrońska, Michał Pawłowski, Aleksandra Dyszkiewicz, Angelika Buczyńska and Robert Milewski
J. Clin. Med. 2025, 14(15), 5527; https://doi.org/10.3390/jcm14155527 - 6 Aug 2025
Abstract
Background: Asprosin is a relatively recently discovered glucogenic adipokine secreted during fasting that plays an important role in various biochemical processes in the body, including those connected with obesity and insulin resistance. The aim of this exploratory study was to investigate the associations [...] Read more.
Background: Asprosin is a relatively recently discovered glucogenic adipokine secreted during fasting that plays an important role in various biochemical processes in the body, including those connected with obesity and insulin resistance. The aim of this exploratory study was to investigate the associations between selected hormonal, anthropometric, and lifestyle-related parameters and serum asprosin concentration. As studies concerning fertility and asprosin have so far been limited to men or women with PCOS, its role in the general female population remains largely unexplored. The direction of this exploration was thus pointed toward possible connections with female fertility. Methods: The case-control study group included 56 women of reproductive age (25–42 years), who were patients of the Reproductive Health Clinic and the Clinic of Endocrinology, Diabetology, and Internal Medicine of the Medical University of Białystok, Poland. The levels of selected hormones, including anti-Müllerian hormone (AMH), estradiol, sex hormone-binding globulin (SHBG), and testosterone, body composition parameters, and a lifestyle parameter—night fasting duration—were assessed to test their associations with serum asprosin concentration. Results: A weak negative correlation was found between AMH level and serum asprosin concentration, suggesting a potential link between asprosin and ovarian reserve. Furthermore, a moderate positive correlation was found between the percentage of total body water (TBW) and serum asprosin concentration. No significant associations were observed between the levels of the other tested hormones and serum asprosin concentration, or between body composition parameters or night fasting duration and serum asprosin concentration. The multivariate model designed in the study shows that AMH, TBW, and night fasting duration explain 23.4% of asprosin variability. Conclusions: Although the nature of the study is exploratory, the findings indicate that the role of asprosin in the female population—particularly its role in fertility—requires further research. Not only is the number of available studies on asprosin insufficient, but the results of this study partly contradict what is known about the hormone from previous studies, which were largely performed with male cohorts. In addition, the results of this study suggest that asprosin may indeed be involved in mechanisms related to female fertility, particularly those connected with ovarian reserve. Nevertheless, studies performed in larger, more homogeneous populations are necessary to confirm the role of asprosin in women, including its association with female fertility. Full article
(This article belongs to the Section Reproductive Medicine & Andrology)
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21 pages, 546 KiB  
Review
The Inflammatory Bridge Between Type 2 Diabetes and Neurodegeneration: A Molecular Perspective
by Housem Kacem, Michele d’Angelo, Elvira Qosja, Skender Topi, Vanessa Castelli and Annamaria Cimini
Int. J. Mol. Sci. 2025, 26(15), 7566; https://doi.org/10.3390/ijms26157566 - 5 Aug 2025
Abstract
Chronic low-grade inflammation is a hallmark of both metabolic and neurodegenerative diseases. In recent years, several studies have highlighted the pivotal role of systemic metabolic dysfunction, particularly insulin resistance, in shaping neuroinflammatory processes and contributing to impaired cognitive performance. Among metabolic disorders, type [...] Read more.
Chronic low-grade inflammation is a hallmark of both metabolic and neurodegenerative diseases. In recent years, several studies have highlighted the pivotal role of systemic metabolic dysfunction, particularly insulin resistance, in shaping neuroinflammatory processes and contributing to impaired cognitive performance. Among metabolic disorders, type 2 diabetes mellitus has emerged as a major risk factor for the development of age-related neurodegenerative conditions, suggesting a complex and bidirectional crosstalk between peripheral metabolic imbalance and central nervous system function. This review aims to explore the cellular and molecular mechanisms underlying the interaction between metabolic dysregulation and brain inflammation. By integrating current findings from endocrinology, immunology, and neuroscience, this work provides a comprehensive overview of how chronic metabolic inflammation may contribute to the onset and progression of neurodegenerative conditions. This interdisciplinary approach could offer novel insights into potential therapeutic strategies targeting both metabolic and neuroinflammatory pathways. Full article
(This article belongs to the Collection Latest Review Papers in Endocrinology and Metabolism)
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27 pages, 2005 KiB  
Article
Glyoxalase 1 Inducer, trans-Resveratrol and Hesperetin–Dietary Supplement with Multi-Modal Health Benefits
by Mingzhan Xue, Naila Rabbani and Paul J. Thornalley
Antioxidants 2025, 14(8), 956; https://doi.org/10.3390/antiox14080956 (registering DOI) - 4 Aug 2025
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Abstract
A dietary supplement, trans-resveratrol and hesperetin (tRES+HESP)—also known as GlucoRegulate—induces increased expression of glyoxalase 1 (Glo1) by activation of transcription factor Nrf2, countering accumulation of the reactive dicarbonyl glycating agent, methylglyoxal. tRES+HESP corrected insulin resistance and decreased fasting and postprandial plasma glucose [...] Read more.
A dietary supplement, trans-resveratrol and hesperetin (tRES+HESP)—also known as GlucoRegulate—induces increased expression of glyoxalase 1 (Glo1) by activation of transcription factor Nrf2, countering accumulation of the reactive dicarbonyl glycating agent, methylglyoxal. tRES+HESP corrected insulin resistance and decreased fasting and postprandial plasma glucose and low-grade inflammation in overweight and obese subjects in a clinical trial. The aim of this study was to explore, for the first time, health-beneficial gene expression other than Glo1 induced by tRES+HESP in human endothelial cells and fibroblasts in primary culture and HepG2 hepatoma cell line and activity of cis-resveratrol (cRES) as a Glo1 inducer. We measured antioxidant response element-linked gene expression in these cells in response to 5 µM tRES+HESP by the NanoString method. tRES+HESP increases gene expression linked to the prevention of dicarbonyl stress, lipid peroxidation, oxidative stress, proteotoxicity and hyperglycemia-linked glycolytic overload. Downstream benefits were improved regulation of glucose and lipid metabolism and decreased inflammation, extracellular matrix remodeling and senescence markers. The median effective concentration of tRES was ninefold lower than cRES in the Glo1 inducer luciferase reporter assay. The GlucoRegulate supplement provides a new treatment option for the prevention of type 2 diabetes and metabolic dysfunction–associated steatotic liver disease and supports healthy aging. Full article
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18 pages, 914 KiB  
Article
Microvascular, Biochemical, and Clinical Impact of Hyperbaric Oxygen Therapy in Recalcitrant Diabetic Foot Ulcers
by Daniela Martins-Mendes, Raquel Costa, Ilda Rodrigues, Óscar Camacho, Pedro Barata Coelho, Vítor Paixão-Dias, Carla Luís, Ana Cláudia Pereira, Rúben Fernandes, Jorge Lima and Raquel Soares
Cells 2025, 14(15), 1196; https://doi.org/10.3390/cells14151196 - 4 Aug 2025
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Abstract
Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes and are often difficult to treat. Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment to promote healing, but its long-term clinical and biological effects remain insufficiently characterized. This study [...] Read more.
Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes and are often difficult to treat. Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment to promote healing, but its long-term clinical and biological effects remain insufficiently characterized. This study aimed to evaluate the impact of HBOT on systemic biomarkers, local microvasculature, and clinical outcomes in patients with DFUs. Methods: In this non-randomized prospective study, 20 patients with ischemic DFUs were followed over a 36-month period. Fourteen received HBOT in addition to standard care, while six received standard care alone. Clinical outcomes—including DFU resolution, recurrence, lower extremity amputation (LEA), and mortality—were assessed alongside systemic inflammatory and angiogenic biomarkers and wound characteristics at baseline and at 3, 6, 12, and 36 months. CD31 immunostaining was performed on available tissue samples. Results: The two groups were comparable at baseline (mean age 62 ± 12 years; diabetes duration 18 ± 9 years). At 3 months, the HBOT group showed significant reductions in erythrocyte sedimentation rate and DFU size (p < 0.05), with downward trends observed in C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and placental growth factor (PlGF), and an increase in stromal-derived factor-1 alpha (SDF1-α). No significant changes were observed in the control group. CD31+ microvessel density appeared to increase in HBOT-treated DFU tissue after one month, although the sample size was limited. Patients receiving HBOT had lower rates of LEA and mortality, improved wound healing, and sustained outcomes over three years. DFU recurrence rates were similar between groups. Conclusions: HBOT was associated with improved wound healing and favorable biomarker profiles in patients with treatment-resistant ischemic DFUs. While these findings are encouraging, the small sample size and non-randomized design limit their generalizability, highlighting the need for larger, controlled studies. Full article
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13 pages, 1636 KiB  
Article
Mechanical Performance of Sustainable Asphalt Mixtures Incorporating RAP and Panasqueira Mine Waste
by Hernan Patricio Moyano-Ayala and Marisa Sofia Fernandes Dinis-Almeida
Constr. Mater. 2025, 5(3), 52; https://doi.org/10.3390/constrmater5030052 - 4 Aug 2025
Viewed by 19
Abstract
The increasing demand for sustainable practices in road construction has prompted the search for environmentally friendly and cost-effective materials. This study explores the incorporation of reclaimed asphalt pavement (RAP) and Panasqueira mine waste (greywacke aggregates) as full replacements for virgin aggregates in hot [...] Read more.
The increasing demand for sustainable practices in road construction has prompted the search for environmentally friendly and cost-effective materials. This study explores the incorporation of reclaimed asphalt pavement (RAP) and Panasqueira mine waste (greywacke aggregates) as full replacements for virgin aggregates in hot mix asphalt (HMA), aligning with the objectives of UN Sustainable Development Goal 9. Three asphalt mixtures were prepared: a reference mixture (MR) with granite aggregates, and two modified mixtures (M15 and M20) with 15% and 20% RAP, respectively. All mixtures were evaluated through Marshall stability, stiffness modulus, water sensitivity, and wheel tracking tests. The results demonstrated that mixtures containing RAP and mine waste met Portuguese specifications for surface courses. Specifically, the M20 mixture showed the highest stiffness modulus, improved moisture resistance, and the best performance against permanent deformation. These improvements are attributed to the presence of stiff aged binder in RAP and the mechanical characteristics of the greywacke aggregates. Overall, the findings confirm that the combined use of RAP and mining waste provides a technically viable and sustainable alternative for asphalt pavement construction, contributing to resource efficiency and circular economy goals. Full article
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13 pages, 269 KiB  
Review
From Genotype to Guidelines: Rethinking Neutropenia Risk in Clozapine Use
by Amir Agustin Estil-las, William C. Sultan, Carla Sultan, Martena Grace, Mark Elias and Kristal Arraut
Psychiatry Int. 2025, 6(3), 93; https://doi.org/10.3390/psychiatryint6030093 (registering DOI) - 4 Aug 2025
Viewed by 24
Abstract
Clozapine, a second-generation antipsychotic known for its effectiveness in treating resistant schizophrenia, is often linked with serious hematological side effects, particularly neutropenia and agranulocytosis. This review investigates the underlying pathophysiological mechanisms of clozapine-induced neutropenia (CIN) and agranulocytosis (CIA), outlines associated risk factors, and [...] Read more.
Clozapine, a second-generation antipsychotic known for its effectiveness in treating resistant schizophrenia, is often linked with serious hematological side effects, particularly neutropenia and agranulocytosis. This review investigates the underlying pathophysiological mechanisms of clozapine-induced neutropenia (CIN) and agranulocytosis (CIA), outlines associated risk factors, and evaluates current clinical management strategies. Clozapine’s pharmacological profile, marked by its antagonism of dopamine D4 and serotonin receptors, contributes to both its therapeutic advantages and hematological toxicity. Epidemiological data show a prevalence of CIN and CIA at approximately 3.8% and 0.9%, respectively, with onset typically occurring within the first six months of treatment. Key risk factors include older age, Asian and African American ethnicity, female sex, and certain genetic predispositions. The development of CIN and CIA may involve bone marrow suppression and autoimmune mechanisms, although the exact processes remain partially understood. Clinical presentation often includes nonspecific symptoms such as fever and signs of infection, necessitating regular hematological monitoring in accordance with established guidelines. Management strategies include dosage adjustments, cessation of clozapine, and the administration of granulocyte colony-stimulating factors (G-CSF). Advances in pharmacogenomics show promise for predicting susceptibility to CIN and CIA, potentially improving patient safety. This review emphasizes the importance of vigilant monitoring and personalized treatment approaches to reduce the risks associated with clozapine therapy. Full article
20 pages, 7843 KiB  
Article
Effect of Ageing on a Novel Cobalt-Free Precipitation-Hardenable Martensitic Alloy Produced by SLM: Mechanical, Tribological and Corrosion Behaviour
by Inés Pérez-Gonzalo, Florentino Alvarez-Antolin, Alejandro González-Pociño and Luis Borja Peral-Martinez
J. Manuf. Mater. Process. 2025, 9(8), 261; https://doi.org/10.3390/jmmp9080261 - 4 Aug 2025
Viewed by 33
Abstract
This study investigates the mechanical, tribological, and electrochemical behaviour of a novel precipitation-hardenable martensitic alloy produced by selective laser melting (SLM). The alloy was specifically engineered with an optimised composition, free from cobalt and molybdenum, and featuring reduced nickel content (7 wt.%) and [...] Read more.
This study investigates the mechanical, tribological, and electrochemical behaviour of a novel precipitation-hardenable martensitic alloy produced by selective laser melting (SLM). The alloy was specifically engineered with an optimised composition, free from cobalt and molybdenum, and featuring reduced nickel content (7 wt.%) and 8 wt.% chromium. It has been developed as a cost-effective and sustainable alternative to conventional maraging steels, while maintaining high mechanical strength and a refined microstructure tailored to the steep thermal gradients inherent to the SLM process. Several ageing heat treatments were assessed to evaluate their influence on microstructure, hardness, tensile strength, retained austenite content, dislocation density, as well as wear behaviour (pin-on-disc test) and corrosion resistance (polarisation curves in 3.5%NaCl). The results indicate that ageing at 540 °C for 2 h offers an optimal combination of hardness (550–560 HV), tensile strength (~1700 MPa), microstructural stability, and wear resistance, with a 90% improvement compared to the as-built condition. In contrast, ageing at 600 °C for 1 h enhances ductility and corrosion resistance (Rp = 462.2 kΩ; Ecorr = –111.8 mV), at the expense of a higher fraction of reverted austenite (~34%) and reduced hardness (450 HV). This study demonstrates that the mechanical, surface, and electrochemical performance of this novel SLM-produced alloy can be effectively tailored through controlled thermal treatments, offering promising opportunities for demanding applications requiring a customised balance of strength, durability, and corrosion behaviour. Full article
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12 pages, 244 KiB  
Article
Predisposing Factors Associated with Third-Generation Cephalosporin-Resistant Escherichia coli in a Rural Community Hospital in Thailand
by Ratchadaporn Ungcharoen, Jindanoot Ponyon, Rapeepan Yongyod and Anusak Kerdsin
Antibiotics 2025, 14(8), 790; https://doi.org/10.3390/antibiotics14080790 - 4 Aug 2025
Viewed by 112
Abstract
Background: Various predisposing factors contribute to the emergence and dissemination of the multidrug-resistant (MDR) phenotype in Escherichia coli and Klebsiella pneumoniae. Understanding these factors is crucial for guiding appropriate antimicrobial therapy and infection control strategies. This study investigated the predisposing factors contributing [...] Read more.
Background: Various predisposing factors contribute to the emergence and dissemination of the multidrug-resistant (MDR) phenotype in Escherichia coli and Klebsiella pneumoniae. Understanding these factors is crucial for guiding appropriate antimicrobial therapy and infection control strategies. This study investigated the predisposing factors contributing to the MDR characteristics of E. coli and K. pneumoniae isolated in a community hospital in northeastern Thailand. Methods: This case–control study utilized retrospective data from bacterial culture, as well as demographic, clinical, and antibiotic susceptibility records collected during 5 years (January 2016–December 2020). E. coli and K. pneumoniae isolates were analyzed from various clinical samples, including blood, urine, pus, sputum, and other body fluids. Data were analyzed using descriptive statistics and univariate logistic regression. Results: In total, 660 clinical isolates were analyzed (421 E. coli and 239 K. pneumoniae). Blood was the most common source of the detection of E. coli (63.0%) and sputum was the most common source of K. pneumoniae (51.0%). The median ages of patients were 67 and 63 years for E. coli and K. pneumoniae, respectively. E. coli cases were significantly associated with prior antibiotic use (OR = 1.79, 95% CI: 1.17–2.74 p = 0.008). MDR was observed in 50.1% of E. coli and 29.7% of K. pneumoniae (p < 0.001). E. coli compared to K. pneumoniae had lower resistance to third-gen cephalosporins (64.9% versus 95.8%) and carbapenems (8.0% versus 6.9%). ICU admission was the only factor significantly associated with MDR E. coli (OR = 2.40, 95% CI: 1.11–5.20 p = 0.026). No significant differences were observed in gender, age, or comorbidities between MDR cases. Antibiotic usage patterns also differed, with E. coli more likely to receive third-gen cephalosporins compared to carbapenems (OR = 3.02, 95% CI:1.18–7.74 p = 0.021). Conclusions: The use of third-generation cephalosporin may drive MDR E. coli more than K. pneumoniae. Prior antibiotic exposure was linked to E. coli bloodstream infections, while MDR E. coli showed greater clinical severity. These findings highlighted the need for improved antibiotic stewardship in rural hospitals. Full article
44 pages, 6212 KiB  
Article
A Hybrid Deep Reinforcement Learning Architecture for Optimizing Concrete Mix Design Through Precision Strength Prediction
by Ali Mirzaei and Amir Aghsami
Math. Comput. Appl. 2025, 30(4), 83; https://doi.org/10.3390/mca30040083 (registering DOI) - 3 Aug 2025
Viewed by 182
Abstract
Concrete mix design plays a pivotal role in ensuring the mechanical performance, durability, and sustainability of construction projects. However, the nonlinear interactions among the mix components challenge traditional approaches in predicting compressive strength and optimizing proportions. This study presents a two-stage hybrid framework [...] Read more.
Concrete mix design plays a pivotal role in ensuring the mechanical performance, durability, and sustainability of construction projects. However, the nonlinear interactions among the mix components challenge traditional approaches in predicting compressive strength and optimizing proportions. This study presents a two-stage hybrid framework that integrates deep learning with reinforcement learning to overcome these limitations. First, a Convolutional Neural Network–Long Short-Term Memory (CNN–LSTM) model was developed to capture spatial–temporal patterns from a dataset of 1030 historical concrete samples. The extracted features were enhanced using an eXtreme Gradient Boosting (XGBoost) meta-model to improve generalizability and noise resistance. Then, a Dueling Double Deep Q-Network (Dueling DDQN) agent was used to iteratively identify optimal mix ratios that maximize the predicted compressive strength. The proposed framework outperformed ten benchmark models, achieving an MAE of 2.97, RMSE of 4.08, and R2 of 0.94. Feature attribution methods—including SHapley Additive exPlanations (SHAP), Elasticity-Based Feature Importance (EFI), and Permutation Feature Importance (PFI)—highlighted the dominant influence of cement content and curing age, as well as revealing non-intuitive effects such as the compensatory role of superplasticizers in low-water mixtures. These findings demonstrate the potential of the proposed approach to support intelligent concrete mix design and real-time optimization in smart construction environments. Full article
(This article belongs to the Section Engineering)
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13 pages, 1283 KiB  
Communication
Clinical Performance of Analog and Digital 18F-FDG PET/CT in Pediatric Epileptogenic Zone Localization: Preliminary Results
by Oreste Bagni, Roberta Danieli, Francesco Bianconi, Barbara Palumbo and Luca Filippi
Biomedicines 2025, 13(8), 1887; https://doi.org/10.3390/biomedicines13081887 - 3 Aug 2025
Viewed by 195
Abstract
Background: Despite its central role in pediatric pre-surgical evaluation of drug-resistant focal epilepsy, conventional analog 18F-fluorodeoxyglucose (18F-FDG) PET/CT (aPET) systems often yield modest epileptogenic zone (EZ) detection rates (~50–60%). Silicon photomultiplier–based digital PET/CT (dPET) promises enhanced image quality, but [...] Read more.
Background: Despite its central role in pediatric pre-surgical evaluation of drug-resistant focal epilepsy, conventional analog 18F-fluorodeoxyglucose (18F-FDG) PET/CT (aPET) systems often yield modest epileptogenic zone (EZ) detection rates (~50–60%). Silicon photomultiplier–based digital PET/CT (dPET) promises enhanced image quality, but its performance in pediatric epilepsy remains untested. Methods: We retrospectively analyzed 22 children (mean age 11.5 ± 2.6 years) who underwent interictal brain 18F-FDG PET/CT: 11 on an analog system (Discovery ST, 2018–2019) and 11 on a digital system (Biograph Vision 450, 2020–2021). Three blinded nuclear medicine physicians independently scored EZ localization and image quality (4-point scale); post-surgical histology and ≥1-year clinical follow-up served as reference. Results: The EZ was correctly identified in 8/11 analog scans (72.7%) versus 10/11 digital scans (90.9%). Average image quality was significantly higher with dPET (3.0 ± 0.9 vs. 2.1 ± 0.9; p < 0.05), and inter-reader agreement improved from good (ICC = 0.63) to excellent (ICC = 0.91). Conclusions: Our preliminary findings suggest that dPET enhances image clarity and reader consistency, potentially improving localization accuracy in pediatric epilepsy presurgical workups. Full article
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15 pages, 1706 KiB  
Article
Study on a High-Temperature-Resistant Foam Drilling Fluid System
by Yunliang Zhao, Dongxue Li, Fusen Zhao, Yanchao Song, Chengyun Ma, Weijun Ji and Wenjun Shan
Processes 2025, 13(8), 2456; https://doi.org/10.3390/pr13082456 - 3 Aug 2025
Viewed by 158
Abstract
Developing ultra-high-temperature geothermal resources is challenging, as traditional drilling fluids, including foam systems, lack thermal stability above 160 °C. To address this key technical bottleneck, this study delves into the screening principles for high-temperature-resistant foaming agents and foam stabilizers. Through high-temperature aging experiments [...] Read more.
Developing ultra-high-temperature geothermal resources is challenging, as traditional drilling fluids, including foam systems, lack thermal stability above 160 °C. To address this key technical bottleneck, this study delves into the screening principles for high-temperature-resistant foaming agents and foam stabilizers. Through high-temperature aging experiments (foaming performance evaluated up to 240 °C and rheological/filtration properties evaluated after aging at 200 °C), specific additives were selected that still exhibit good foaming and foam-stabilizing performance under high-temperature and high-salinity conditions. Building on this, the foam drilling fluid system formulation was optimized using an orthogonal experimental design. The optimized formulations were systematically evaluated for their density, volume, rheological properties (apparent viscosity and plastic viscosity), and filtration properties (API fluid loss and HTHP fluid loss) before and after high-temperature aging (at 200 °C). The research results indicate that specific formulation systems exhibit excellent high-temperature stability and particularly outstanding performance in filtration control, with the selected foaming agent FP-1 maintaining good performance up to 240 °C and optimized formulations demonstrating excellent HTHP fluid loss control at 200 °C. This provides an important theoretical basis and technical support for further research and field application of foam drilling fluid systems for deep high-temperature geothermal energy development. Full article
(This article belongs to the Section Energy Systems)
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