Search Results (309,695)

Background: Adverse pregnancy outcomes such as preeclampsia (PE), preterm birth, low birth weight (LBW), small for gestational age (SGA), and stillbirth are major contributors to maternal and neonatal morbidity and mortality. Elevated maternal homocysteine (Hcy) levels, influenced by genetic, dietary, and lifestyle factors, have been increasingly associated with placental dysfunction and adverse pregnancy outcomes. This review aims to evaluate the link between hyperhomocysteinemia and pregnancy complications to inform clinical practice. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Central Library was conducted up to December 2024. Observational studies assessing maternal Hcy levels in relation to pregnancy complications were included. Heterogeneity was measured using the I² statistic, and a random-effects model using the DerSimonian–Laird method was applied to account for study variability. Effect sizes were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Thirteen studies were included in this meta-analysis. Elevated maternal Hcy was significantly associated with: PE (OR: 2.49; 95% CI: 1.41–4.40; I² = 96.03%; n = 9), preterm birth (OR: 4.01; 95% CI: 1.84–8.72; I² = 91.08%; n = 6), fetal loss (OR: 1.76; 95% CI: 1.22–2.52; I² = 41.47%; n = 6), SGA (OR: 1.69; 95% CI: 1.35–2.11; I² = 0.00%; n = 3), and LBW (OR: 2.46; 95% CI: 1.37–4.43; I² = 77.71%; n = 3). Conclusions: This review highlights a significant association between elevated maternal Hcy levels and various pregnancy complications. However, given the substantial heterogeneity and reliance on observational evidence, these findings should be interpreted with caution. Future well-designed prospective cohort studies with standardized definitions of hyperhomocysteinemia, consistent timing of exposure assessment across pregnancy trimesters, and adjustment for key confounders are needed to better clarify these associations and underlying mechanisms. Full article

Phosphorus (P) limitation is prevalent in terrestrial ecosystems. Plants can improve soil P availability through the exudation of organic acids and symbiotic interactions with microorganisms. However, associations between different plant functional groups and phosphorus cycling in P limited karst ecosystems remain poorly understood. To investigate this, the exudation rates of oxalic, citric and acetic acids from fine roots, the contents of carbon, nitrogen, and P in leaves and fine roots, and the contents of oxalic, citric and acetic acids, total P, available P (AP), and microbial biomass P in rhizosphere soils were measured across different plant functional groups in a karst ecosystem in southwestern China. Additionally, the activities of acid and alkaline phosphatases were also analyzed, as well as the relative abundance, community structure, diversity, and co-occurrence network patterns of arbuscular mycorrhizal fungi (AMF) and alkaline phosphatase-encoding (phoD) gene-harboring bacteria. The results showed that both the exudation rates and the contents of organic acids and AP were highest in the tree group, followed by the shrub and grass groups. The AP content of the legume group was significantly higher than that of the non-legume group. The exudation rates of oxalic acid were significantly greater than those of citric and acetic acids. AMF diversities were highest in the shrub and legume groups. The diversities of phoD-harboring bacteria decreased from the tree group to the shrub group and then to the grass group, yet there were no significant differences between the legume and non-legume groups. The communities of both AMF and phoD-harboring bacteria exhibited significant differences among these plant functional groups. The prevalent genera of phoD-harboring bacteria across all groups were Pseudomonas and Halomonas, with Halomonas being particularly prevalent in the legume group. The AMF community was dominated by Glomus, which attained its highest relative abundance in the tree and legume groups. Furthermore, the increased exudation rate and content of oxalic acid were associated with higher relative abundances of Glomus in AMF and Pseudomonas and Bacillus among phoD-harboring bacteria. Structural Equation Model (SEM) analysis demonstrated that plant-exuded organic acids, especially oxalic acid, were positively associated with P availability indirectly through their linkages with the diversity and abundance of AMF and phoD-harboring bacteria. The crucial role of oxalic acid was particularly prominent in the tree and legume groups. Our findings suggest that screening AMF and phoD-harboring bacteria with highly efficient P transformation activity and inoculating them into the rhizosphere of plants with high oxalic acid exudation could help improve plant resilience to P limitation and support sustainable restoration in karst ecosystems. Full article

Visually rich document understanding (VrDU) models rely on tightly coupled textual, layout, and visual representations. In real-world deployments, these models must continuously adapt to new document domains over time. However, naïve sequential fine-tuning leads to severe catastrophic forgetting due to shared parameters and strong cross-task interference. Existing continual learning approaches either constrain parameter updates, preserve output distributions, or uniformly suppress gradient directions associated with previous tasks. While effective in limited settings, these strategies fail to balance stability and plasticity in large multimodal transformers. We propose AMD-Proj, an adaptive memory-driven selective gradient projection framework for continual learning in document understanding. It models task knowledge using specific gradient subspaces and adaptively modulates incoming gradients based on their alignment with this memory, selectively blocking interfering directions while reinforcing reusable ones. An efficient truncated SVD mechanism with online subspace merging ensures bounded memory usage and scalability to large transformer-based architectures. We evaluate AMD-Proj on four VrDU benchmarks (FUNSD, SROIE, CORD, and BuDDIE) under a task-incremental learning setting using LayoutLMv2 and LayoutLMv3 backbones. Results show that AMD-Proj reduces catastrophic forgetting and improves F1-based stability over EWC, GPM, LwF, OWM, CUBER, TRGP and parameter-efficient fine-tuning methods. Extensive mechanistic analyses, including gradient spectrum decomposition and layer-wise reuse versus block dynamics, provide insight into how selective gradient projection controls optimization geometry during continual adaptation. These findings establish selective gradient projection as a principled and interpretable approach for continual learning in visually rich document understanding. Full article

Coal gasification slag (CGS) is rich in Si-Al-Ca components and thus has potential for ceramic utilization, but associated heavy metals may pose environmental risks. In this study, CGS from Yili (Xinjiang, China) was used as the major raw material (80 wt%), with clay and waste glass as additives, to prepare ceramsite by firing green pellets (8–12 mm) at 1000–1200 °C. The phase evolution, microstructure, and heavy-metal migration were characterized, and the leaching safety was evaluated. Increasing temperature leads to progressive quartz consumption, enrichment of feldspar-type crystalline phases, and liquid-phase sintering, which together enhance densification. The apparent density and single-particle compressive strength exhibit an “increase-then-decrease” trend with temperature and reach maxima at 1150 °C, where the compressive strength is 15.38 MPa. Heavy-metal behavior is element-specific: As and Zn show stronger volatilization, whereas Mn, Ba, Ni, and Cu are largely retained in the solid phase; Cr shows intermediate, temperature-dependent volatilization. After firing at ≥1150 °C, the leached concentrations of Cr, Mn, Ni, Cu, Zn, As, and Ba under the sulfuric acid–nitric acid test (HJ/T 299-2007) are below the Class III limits of the Chinese Groundwater Quality Standard (GB/T 14848-2017). Considering phase/structure evolution, mechanical performance, and short-term heavy-metal leaching, 1150 °C is identified as the preferred firing temperature in this work. Full article

Ototoxicity represents a clinically significant complication of anticancer therapy in pediatric patients. Cytotoxic agents used in oncology, particularly platinum-based chemotherapy, may induce damage to the auditory and vestibular systems, resulting in hearing loss, tinnitus, and balance disturbances. Even mild hearing impairment during childhood may negatively affect speech perception, language development, communication abilities, and subsequent educational and psychosocial functioning. This narrative review aims to synthesize current evidence on treatment-related ototoxicity in children, with particular focus on commonly implicated therapies, clinical consequences, diagnostic approaches, and potential preventive strategies. A focused literature search was conducted in PubMed for publications from 2019 to 2025 addressing ototoxicity associated with pediatric anticancer treatment and audiological monitoring methods. The analysis indicates that platinum-based compounds, especially cisplatin and carboplatin, remain the primary agents associated with ototoxicity, with reported incidence ranging from approximately 20–70% for cisplatin and 10–30% for carboplatin. Additional risk factors include young age, baseline hearing status, renal function, and exposure to other ototoxic agents such as aminoglycoside antibiotics. Early detection relies on comprehensive audiological monitoring combining behavioral and objective methods, including pure-tone audiometry, extended high-frequency audiometry, otoacoustic emissions, and auditory brainstem response testing. Standardized grading systems such as ASHA, Brock, Chang, and SIOP Boston criteria play a key role in identifying and classifying ototoxic changes. Emerging research focuses on improved monitoring protocols, biomarker identification, and the development of otoprotective strategies, including sodium thiosulfate and experimental molecular therapies. Implementing systematic hearing monitoring and preventive strategies is essential to reduce long-term auditory complications and improve quality of life in pediatric cancer survivors. Full article

Background: Kounis syndrome is an allergic acute coronary syndrome precipitated by coronary vasospasm, plaque destabilization, stent thrombosis, or bypass occlusion. Cardiac surgery represents a uniquely high-risk setting due to cardiopulmonary bypass–associated inflammation and exposure to multiple pharmaceutical agents. Importantly, Kounis syndrome remains underrecognized in this context, as classical signs of anaphylaxis may be masked under general anesthesia and cardiopulmonary bypass, while ischemic manifestations may be misattributed to other perioperative conditions. Methods: A narrative review of PubMed-indexed literature was conducted to synthesize current evidence on the pathophysiology, perioperative triggers, clinical presentation, diagnostic strategies, and management of Kounis syndrome in cardiac surgery, with emphasis on intraoperative recognition and surgical decision-making. Published cases were retrieved involving perioperative cardiac surgery patients with a definite diagnosis of Kounis syndrome. Additionally, cases presenting with severe perioperative anaphylaxis and life-threatening cardiovascular involvement (grade III with cardiovascular collapse and grade IV with cardiac arrest) were included as possible Kounis syndrome, reflecting real-world diagnostic uncertainty in the intraoperative setting. Results: The literature review identified five cases of definite Kounis syndrome and ten cases of possible Kounis syndrome, including three cases with cardiovascular collapse and seven cases with cardiac arrest. Recurrent episodes were reported in several patients, particularly due to re-exposure to the triggering agent. In the context of cardiac surgery, Kounis syndrome is most frequently triggered by chlorhexidine, protamine, antibiotic prophylaxis, and anesthetic agents. The clinical presentation is often subtle during cardiopulmonary bypass. Vasoplegia, pulmonary hypertension, ventricular dysfunction, new regional wall-motion abnormalities, and hyperdynamic ventricles on transesophageal echocardiography commonly precede overt electrocardiographic changes. Diagnosis is primarily clinical and relies on intraoperative ultrasound, hemodynamic monitoring, serum tryptase, serum troponin, and, when indicated, coronary angiography. A dual-pathway approach addressing both anaphylaxis and myocardial ischemia is essential; however, one component may predominate, particularly in perioperative patients with limited clinical information, potentially leading to misdiagnosis. A multidisciplinary approach is therefore required for rapid diagnosis and individualized management. In refractory cases, cardiopulmonary bypass or ventricular assist devices may provide lifesaving support. Conclusions: Kounis syndrome remains underrecognized in cardiac surgery but carries significant morbidity. Increased clinical awareness, multidisciplinary collaboration, structured diagnostic approaches, and preventive strategies are essential to improve outcomes and reduce the risk of recurrence during future procedures. Full article

Plant-based diets are generally associated with a reduced risk of chronic diseases; however, the relationship between a vegan diet and genome integrity remains insufficiently characterized. In this cross-sectional study, we assessed primary DNA damage in peripheral blood cells of vegans and omnivores. A total of 62 apparently healthy adults were included: 31 vegans (median vegan diet duration 4.5 years) and 31 omnivores matched for sex and smoking status. DNA damage was assessed using the alkaline comet assay under standardized conditions and expressed as tail intensity (% tail DNA), tail length, tail moment, and total comet area. Tail intensity was significantly higher in vegans than in omnivores (B = 1.98; 95% CI 0.19 to 3.76; p = 0.031) after adjustment for age, physical activity, body mass index (BMI), and alcohol consumption. Within the vegan group, longer duration of adherence to a vegan diet was positively associated with tail intensity, independent of age (B = 0.23; 95% CI 0.03 to 0.43; p = 0.026). These findings suggest that adherence to a vegan diet and its duration may be associated with higher levels of primary DNA damage; however, these results should be interpreted with caution given the observational design and modest sample size. Full article

The increasing use of antibiotics around the globe has contributed to an increase in antimicrobial resistance and become a major risk to both public health and sustainable development. Reliable and fast detection of antibiotic residues in clinical, agricultural, and environmental matrices is required to monitor antimicrobial resistance effectively. The conventional analytical techniques are sensitive, but they are also expensive, complex and lacking in portability. Voltammetry is a recently emerging electrochemical detection technique that is low-cost and rapid. To the best of our knowledge, for the first time, a meta-analysis was conducted on graphene-based electrochemical sensors and biosensors for antibiotic detection over the last decade. This systematic review critically examines the analytical properties of sensors and biosensors, the physicochemical properties of antibiotics, adsorption characteristics, and the use of nanoparticles to improve the selectivity and sensitivity of devices. This review critically examines the cost-effectiveness, scalability, and practicality of point-of-use devices using graphene-based sensors and biosensors. This systematic review also discusses the potential risks to human health from antibiotic contamination and the role of monitoring in contributing to achieving the UN’s Sustainable Development Goals. This systematic review identifies a gap between developing sensors in laboratories versus their deployment as field-deployable devices; it highlights challenges associated with stability, matrix effects and the complexity of manufacturing devices. Finally, it provides recommendations for future research that may help to address this gap to promote the transition of innovative devices from academic to practical applications. Full article

This systematic review synthesized the existing evidence on neurofeedback interventions applied to football players, aiming to clarify their effects on cognitive, technical–tactical, physical and psychological performance. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four databases (PubMed, Web of Science, SCOPUS and SportsDiscus) were searched up to November 2025. Seven studies met the inclusion criteria, involving 133 players across youth, amateur, national and elite levels. Neurofeedback protocols primarily targeted alpha or sensorimotor rhythm (SMR) activity, and some were combined with heart rate variability (HRV) biofeedback. Across studies, neurofeedback may be associated with improvements in several cognitive outcomes, including improvements in working memory, visuospatial memory, task switching, mental rotation and decision-making. Limited evidence suggests potential improvements in technical skills (particularly shooting accuracy) and tactical decision-making. Some studies reported changes in physiological markers and stress-recovery capacity, although their interpretation remains uncertain. However, the evidence base remains constrained by small samples, heterogeneous protocols and limited use of randomized controlled designs. Overall, neurofeedback appears to be a potentially promising but still experimental tool to support cognitive and psychophysiological readiness in football, warranting more rigorous and standardized research to establish efficacy and optimal training parameters. Full article

Background: The early detection of prostate and testicular tumors remains challenging as standard diagnostic tools often lack sensitivity and produce ambiguous results. Seminal fluid is a biologically rich medium that closely reflects the state of male reproductive tissues and has therefore emerged as a promising source of non-invasive molecular biomarkers. Objective: This study aimed to critically evaluate the evidence regarding cell-free DNA, RNA, proteins and metabolites in seminal fluid, and to assess their potential for improving the early detection of male reproductive cancers. Methods: A systematic review was performed according to PRISMA guidelines. Comprehensive searches of the PubMed and Scopus databases were conducted to identify original clinical studies analyzing molecular biomarkers in seminal fluid from patients with prostate or testicular tumors. For each study, data were extracted on biomarker types, cohort characteristics, analytical methods and diagnostic performance. Results: Forty-two eligible studies were included, covering multiple biomarker classes. Most were observational, single-center investigations classified as level 3b evidence. Across the different types of biomarkers, seminal fluid was associated with tumor-associated molecular changes. Alterations in the concentration, fragmentation and methylation patterns of cell-free DNA (e.g., GSTP1, RARβ2, LGALS3 and OCT3/4) distinguished malignant from benign conditions with sensitivities of up to 80–100%. RNA-based markers, including microRNAs, small non-coding RNAs, and tRNA fragments, showed improved performance in several studies, with multimarker models achieving areas under the curve (AUCs) of 0.85–0.93. Proteomic analyses identified high-specificity candidates such as TGM4, AMACR, PROS1 and DKK3. Metabolomic profiling further strengthened the diagnostic potential; reduced seminal citrate outperformed prostate-specific antigen (AUC 0.748 vs. 0.548), and reproducible shifts in amino acid and lipid profiles were observed in testicular tumors. However, substantial heterogeneity in study design, patient selection, and analytical platforms was observed. Risk of bias varied, and large prospective validation cohorts were lacking. Conclusions: Current evidence suggests that seminal fluid contains molecular signals associated with tumors that could be used for diagnosis. However, the available data are predominantly exploratory and methodologically heterogeneous. Before seminal fluid-based biomarkers can be considered for routine clinical implementation, robust prospective studies with standardized protocols are required. Full article

Purpose: Black soils in Northeast China are declining in fertility under intensive fertilization, motivating strategies that integrate crop residue return with microbial inoculation. We conducted a field experiment to test whether maize straw return combined with compound microbial inoculants improves soil properties, bacterial communities, and soybean performance. Methods: A field experiment compared four treatments: fertilization alone (F), fertilization + inoculants (CF), fertilization and straw (SF), and fertilization and straw with inoculants (CSF). Soil physicochemical properties, enzyme activities, 16S rDNA-based bacterial communities, and soybean agronomic yield were measured across growth stages. Results: CSF produced the highest soybean performance, and increased yield by 3.91–5.46% compared with F. CSF increased soil pH, moisture, and nutrient availability (notably available P and K) and enhanced sucrase, urease, catalase, and acid phosphatase activities compared with other treatments. Bacterial communities were dominated by Acidobacteriota and Proteobacteria. CSF increased bacterial abundance and shifted community composition, and pH and available P were key factors associated with community variation. Conclusions: Co-applying maize straw and compound microbial inoculants enhances soybean yield while improving soil biochemical functioning and reshaping bacterial communities in black soil. Full article

Infectious agents shape fish populations by inducing lethal and sublethal changes that alter nutrient metabolism and metal bioaccumulation. These shifts can manifest as changes in the ionome—the specific combination of essential and non-essential chemical elements defining the whole-body composition of an individual. Understanding how pathogens shape the fish ionome is critical for developing advanced monitoring tools and clarifying the ecological roles of hosts and their pathogens. This study reports the first documented outbreak of Citrobacter freundii, Pseudomonas aeruginosa, Pseudomonas mosselii, and Shewanella xiamenensis bacterial infections in wild-caught eastern mosquitofish (Gambusia holbrooki) from three populations in Extremadura, southwestern Spain. Under laboratory-controlled conditions, we established associations between these bacterial outbreaks and the whole-fish body ionome of G. holbrooki. We compared 19 chemical elements and seven elemental ratios among diseased fish, healthy fish at the outbreak, and individuals fully recovered 100 days post-infection following antibiotic treatment. The fish ionome clearly discriminated between diseased and healthy states, and the response was consistent across all three populations. Our findings support the utility of whole-fish body elemental composition in G. holbrooki as a biomarker for environmental monitoring. Furthermore, as the bacterial infections were associated with the capture and transport-induced stress of wild individuals, this study provides critical data on the opportunistic pathogens that may be co-introduced into recipient ecosystems through the release of this widely distributed invasive fish species. Full article

Aflatoxin B1 (AFB1) and patulin (PAT) are prevalent foodborne mycotoxins with hepatotoxic potential, but the hepatic effects of combined exposure remain largely unclear. This study investigated the hepatotoxic consequences of co-exposure to AFB1 and PAT using no-observed adverse effect levels (NOAELs) in C57BL/6 mice and low-cytotoxic concentrations in HepG2 cells selected by viability screening. Mice and cells were assigned to four groups: control, AFB1, PAT and AFB1 + PAT. Exposure to either toxin individually did not cause evident liver injury, whereas co-exposure significantly elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, reduced liver index, and induced clear histopathological alterations. Co-exposure markedly aggravated oxidative stress, characterized by increased reactive oxygen species (ROS) and malondialdehyde (MDA) and decreased superoxide dismutase (SOD). In parallel, the levels of interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α) were elevated, together with the early fibrosis-related markers alpha-smooth muscle actin (α-SMA) and vimentin. The apoptotic response was characterized by increased Bcl-2-associated X protein (Bax) and reduced B-cell lymphoma-2 (Bcl-2), together with cysteine-dependent aspartate-specific protease-3 (caspase-3) activation. These findings indicate that co-exposure to AFB1 and PAT elicits hepatotoxicity through amplified oxidative stress, inflammation, and caspase-dependent apoptosis, supporting the need to further consider mycotoxin co-exposure in toxicological evaluation. Full article

In this study, we developed a chatbot-based system for detecting early signs of depression and verified its effectiveness through experimental evaluations and user surveys. Emphasizing that it does not rely on medical checklists, the system is designed to automatically extract three linguistic features associated with depression—frequent use of first-person pronouns, pessimistic expressions, and obsessive-compulsive writing styles—from natural user conversations. Multiple models were constructed for these features, and an ensemble layer integrates their outputs for a comprehensive judgment. The implemented system analyzes input sentences obtained through chat, extracts the three categories of features, calculates a final score through an ensemble layer, and visualizes potential signs of depression based on the total score. We performed an evaluation experiment with 20 participants. In the test data evaluation, the system demonstrated over 76% accuracy in each of the three classification categories: first-person usage, pessimistic tendency, and obsessive-compulsive tendency. Full article

As mining operations progressively advance to greater depths to meet increasing mineral demand, there is a growing need to develop new or improved rockbolts capable of effectively dissipating energy under dynamic loading conditions. Impact laboratory tests provide valuable insights into the dynamic performance of rockbolts; however, such tests require considerable time and cost associated with specimen preparation and experimental validation. Numerical modeling represents a robust alternative which, when properly calibrated with laboratory results, can accurately simulate the deformation process and energy dissipation mechanisms of support elements. This paper presents the implementation and results of a numerical model developed to simulate the dynamic behavior of a threadbar subjected to impact loading. The model explicitly represents all components of a full-scale impact test configuration, including the impact mass, reaction frame, threadbar geometry, grout, and steel tube. The numerical model enables real-time analysis of the dynamic response and interaction among the test components (steel tube, grout, and bolt). The implemented numerical codes were calibrated and validated against published laboratory results of threadbar dynamic behavior. Subsequently, a comprehensive parametric analysis was conducted to evaluate the response of each component in terms of load, displacement, and dissipated energy. The results allowed identification of the primary factors governing the dynamic response of the rockbolt system. The proposed methodology can be extended to other reinforcement systems and provides relevant insights into the design of bolts under dynamic loading conditions. Full article