Search Results (83,160)

Background and Objectives: Ongoing efforts to develop early diagnostic tools for Acute Ischemic Stroke (AIS) point out the advantages of accessible biomarkers such as Immature Platelet Fraction (IPF). This is particularly important for emergency department (EDs), especially those that are overcrowded and have limited resources. The present study aimed to evaluate the diagnostic, prognostic, and therapeutic significance of IPF in patients with AIS presenting to the ED. Materials and Methods: This prospective case–control study was conducted in an ED. Participants aged 18-years and older who presented with complaints of numbness, weakness, diplopia or visual disturbances, speech or comprehension impairment, confusion, imbalance, impaired coordination and gait, or dizziness were included in the study. The diagnostic value of IPF in AIS and its relationship with short-term prognosis (STP) were investigated. Additional variables potentially associated with parameters such as infarct localization, number of lesions, affected hemisphere, main artery status, carotid status and treatment method were also analyzed. Results: The median age of the study participants was 67 years (Q1 = 54, Q3 = 76), with 48.9% (n = 88) being female and 51.1% (n = 92) male. Receiver operating characteristic curve analysis demonstrated that IPF was statistically significantly superior to other complete blood count parameters in the diagnostic evaluation of AIS. The diagnostic cutoff value of IPF for AIS was calculated as 2.45. An increase of 1 unit in IPF was found to raise the likelihood of AIS by 2.599 times. The Ratio of Red Cell Distribution Width (RDW) to IPF and NEU to IPF, mean corpuscular volume, and infarct volume were found to be significant predictors in STP assessment. Conclusions: Although not definitive alone, IPF may aid early stroke recognition, support treatment monitoring, and inform targeted therapies. The use of IPF, a biomarker that can be rapidly obtained, in the diagnosis of AIS is expected to yield beneficial outcomes in patient management, particularly in emergency departments and other clinical settings. Full article

Background: The number of publications related to rivaroxaban is growing, making it difficult for scientists to review relevant materials. Objectives: This bibliometric analysis is focused on highlighting hot spots and new trends associated with rivaroxaban studies and provides references and guidance for further research. Methods: A comparison between countries, journals, authors, and organizations was performed. Microsoft Excel 2021 and VOSviewer were used to process and visualize data extracted from Web of Science. The time range was set from 1991 to late 2024. A total of 6979 articles were analyzed and bibliometric maps of co-citations of references and co-occurrences of the keywords were built. Results: Relative research interest increased until 2021, when it started to drop. The new trends in publications related to rivaroxaban are associated with a comparison of NOAC therapy outcomes with previously used vitamin K antagonists (warfarin). The research was focused also on new NOAC representatives, medical conditions treated with NOAC, and safety of the therapy. New trending topics are related to ABCB1, peripheral artery disease, direct-acting oral anticoagulants, PCI, and SARS-CoV-2. Conclusions: This bibliometric analysis showed that increasing attention is being paid to the medical conditions treated with NOACs and issues related to the safety of this therapy. Full article

Salmonella Enteritidis is a serious foodborne threat, being the most reported Salmonella serovar in the past several years. Biofilm formation contributes significantly to its persistence and resistance in food processing environments, making it harder to eliminate using conventional disinfectants. Recently, essential oils have emerged as promising natural alternatives due to their antimicrobial and anti-biofilm properties. In this study, the biofilm-forming ability of Salmonella Enteritidis, isolated from chicken meat, was evaluated under various nutrient conditions and temperatures. Furthermore, the anti-biofilm activity of essential oils derived from oregano, cinnamon, rosemary, clove, and thyme was assessed against strong and moderate biofilms formed by Salmonella Enteritidis. The isolates demonstrated the capacity to form biofilms in tryptic soy broth, meat broth, and Luria–Bertani broth at 37 °C, 15 °C, and 5 °C. All selected essential oils, at their minimum bactericidal concentrations, effectively reduced preformed biofilms by between 36.98% to 74.83%. The destructive effect of essential oils on Salmonella Enteritidis bacterial cells was further confirmed through scanning electron microscopy analysis. In conclusion, the selected essential oils exhibited promising anti-biofilm potential and may serve as effective natural agents for controlling biofilm-associated contamination by Salmonella Enteritidis. Full article

Background: Telomere attrition has been implicated in immune function and vulnerability to infectious diseases. However, the relation between telomere length and COVID-19 severity remains unclear. Methods: In this cross-sectional study, patients aged 30–75 years, with confirmed SARS-CoV-2 infection, as well as age- and BMI-matched controls without COVID-19, were recruited over a period of 1 year (2021–2022) from the outpatient clinics and wards of the General Hospitals “Laiko” and “Elpis” in Athens, Greece. Telomere length, expressed as a telomere to single-copy gene (T/S) ratio, was measured in all participants using a quantitative PCR-based method. Participants’ clinical, biochemical, demographic, and respiratory parameters were assessed in relation to their telomere length. Results: Study participants included a total of 139 individuals divided into three groups: controls (n = 34), patients with non-severe COVID-19 (n = 50), and patients with severe COVID-19 (n = 55). Patients with severe COVID-19 had significantly shorter telomeres when compared to both the non-severe COVID-19 group and controls (p < 0.001). Logistic regression analysis confirmed that telomere length was independently associated with disease severity (p < 0.001). Females demonstrated longer telomeres than males (p = 0.039), but no significant correlation was found between telomere length and age. When patients with non-severe and severe COVID-19 were analyzed together, no significant difference in telomere length was observed compared to controls (p = 0.727). Conclusions: Shortened telomeres may be linked to more severe forms of COVID-19, suggesting a potential role for telomere biology in disease progression. Results highlight the need for further research into telomere dynamics as a biomarker for disease susceptibility and outcome in viral infections. Full article

Cost is a key performance indicator for evaluating the success of architectural construction projects. While previous studies have relied on quantitative data and statistical models to evaluate cost performance, recent advancements in methods have enabled analysis using unstructured data. Unstructured data, particularly in construction supervision reports, can be considered the significant variables for performance evaluation, as they represent independent third-party monitoring of the construction project’s execution. This study aims to present a framework that supports cost performance evaluation using unstructured data and random forests (RFs), a representative method of machine learning. Specifically, association rule analysis and social network analysis were used to identify the main keywords, and an RF model was applied to these data to evaluate cost performance. The tuning of hyper-parameters in the RF was implemented by the Bayesian optimization technique with the augmentation of the original dataset. The accuracy of cost performance evaluation was 59% for the traditional logistic regression (LR), 74% for the regularization-based logistic regression (BLR) designed to prevent overfitting, and 76% for the RF model utilizing augmented data. The complementary utility of the models consisting of the proposed framework can be useful for deriving various evaluation explanations about cost performance. The applicability is expected to increase as more data become available in the future. Full article

Background: Maternal obesity affects 20–25% of pregnancies globally and has been associated with adverse offspring neurodevelopmental outcomes. This umbrella review synthesized evidence on neurodevelopmental pathways linking maternal obesity to offspring cognitive, executive, and behavioral outcomes. Methods: Following PRISMA 2020 guidelines, we systematically searched six databases (PubMed/MEDLINE, Scopus, Web of Science, PsycINFO, EMBASE, CINAHL) for studies published 2008–2024. We included original peer-reviewed studies examining maternal pre-pregnancy obesity (BMI ≥ 30 kg/m2) and offspring neurodevelopmental outcomes using prospective cohort, experimental, neuroimaging, or systematic review designs with validated assessments. Risk of bias was assessed using Newcastle–Ottawa Scale, Cochrane RoB 2.0, and SYRCLE guidelines. Results: Analysis of 78 studies encompassing 650,000+ mother–child pairs from 17 countries revealed significant associations. Study designs included prospective cohorts (59%), animal experiments (22%), systematic reviews/meta-analyses (13%), neuroimaging studies (4%), and randomized trials (3%). Maternal obesity (BMI ≥ 30 kg/m2) was associated with reduced cognitive abilities (IQ differences: −2.5 to −5.8 points), impaired executive function (OR 1.4–2.3), and increased ADHD symptoms (OR 1.4–2.8) and emotional dysregulation (OR 1.5–2.2). Dose–response relationships revealed threshold effects at BMI ≥ 30 kg/m2, accelerating at BMI ≥ 35 kg/m2. Four primary mechanistic pathways were identified: inflammatory, metabolic, epigenetic, and neurotransmitter alterations. Only 57.7% of studies used prospectively measured pre-pregnancy BMI. Conclusions: Observational and experimental evidence indicates maternal obesity represents a modifiable risk factor for offspring neurodevelopmental impairment. The primarily observational human evidence, supported by mechanistic animal studies, suggests multimodal interventions targeting identified pathways during critical windows (pre-conception through early postnatal period) warrant investigation. Full article

Background: Balance problems are one of the major risk factors for falls. Despite the availability of effective fall prevention interventions, falls and related injuries are rising. This study explored the factors associated with healthcare utilization for balance problems in community-dwelling adults in the United States. Methods: Study involved secondary analysis of nationally representative National Health and Nutrition Examination Survey 2001–2004 data (latest data with variables of interest at the time of study). All adults (≥40 years) who reported balance problems in the past 12 months were included. Dependent variable was whether the individual ever saw a healthcare professional for balance problems. All analyses were adjusted for probability sampling weights. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated using multivariable logistic regression. Results: Study included 1834 adults with self-reported balance problems (mean age 60.1 years (0.5 SE), 62.3% females). Of these, only 32.13% ever saw a healthcare professional for their balance problems. Having encounter(s) with a healthcare provider for any reason in the past year (AOR 2.45; 95% CI,1.19–5.06; p = 0.017), lack of health insurance (AOR 0.52; 95% CI,0.32–0.84; p = 0.009), falls in the past year (AOR, 1.29; 95% CI,1.03–1.61; p = 0.028) and age (AOR, 0.98; 95% CI,0.97–0.996; p = 0.011) had significant association with healthcare utilization for balance problems. The predicted probability of healthcare use for balance problems decreased from 0.39 for 40-year-olds to 0.26 for 80-year-olds. Conclusions: This study reports the association between factors such as age, health insurance, encounter with a healthcare provider, and falls in the past year with healthcare utilization for balance problems among community-dwelling adults with self-reported balance problems and identifies populations at increased risk of underutilization. Despite the use of older data, it provides useful information for guiding future research in this novel domain of healthcare research. Full article

The construction industry is a major contributor to global resource consumption and waste. This sector extracts over two billion tons of raw materials each year and contributes over 30% of all solid waste generated annually through construction and demolition debris. The movement toward circularity in the built environment aims to replace linear processes of extraction and disposal by promoting policies favoring building preservation and adaptive reuse, as well as the salvage and reuse of building materials. Few North American cities have implemented explicit policies that incentivize circularity to decouple urban growth from resource consumption, and there remain substantial hurdles to adoption. Nonetheless, existing regulatory and planning tools, such as zoning codes and historic preservation policies, may already influence redevelopment in ways that could align with circularity. This article examines spatial patterns in these indirect pathways through a case study of a college town in New York State, assessing how commonly used local planning tools shape urban redevelopment trajectories. Using a three-stage spatial analysis protocol, including exploratory analysis, Geographically Weighted Regressions (GWRs), and Geographic Random Forest (GRF) modeling, the study evaluates the impact of zoning regulations and historic preservation designations on patterns of demolition, reinvestment, and incremental change in the building stock. National historic districts were strongly associated with more building adaptation permits indicating reinvestment in existing buildings. Mixed-use zoning was positively correlated with new construction, while special overlay districts and low-density zoning were mostly negatively correlated with concentrations of building adaptation permits. A key contribution of this paper is a replicable protocol for urban building stock analysis and insights into how land use policies can support or hinder incremental urban change in moves toward the circular city. Further, we provide recommendations for data management strategies in small cities that could help strengthen analysis-driven policies. Full article

Epigenetic modifications are emerging as key regulators of plant stress responses. However, their role in eggplant (Solanum melongena)–western flower thrips (WFTs; Frankliniella occidentalis) interactions remains elusive. WFTs cause substantial economic losses in eggplant cultivation worldwide. Understanding the molecular mechanisms underlying eggplants’ defense is critical for developing resistant varieties. We investigated the function of histone H3 lysine 27 trimethylation (H3K27me3) in modulating the early transcriptional reprogramming of eggplants during WFT infestation. We performed ChIP-seq and RNA-seq on eggplant leaves at an early stage of WFT infestation to elucidate the epigenetic landscape and associated gene expression alterations. ChIP-seq analysis showed that genome-wide enrichment of H3K27me3 was mainly at the transcription start sites, with a notable decrease in WFT-infested plants. Concurrently, RNA-seq analysis identified 2822 genes that were upregulated following WFT infestation. Many of these genes associated with abscisic acid, jasmonic acid, and salicylic acid pathways were upregulated, underscoring their central role in early plant defense. Integrated analysis revealed six genes with decreased H3K27me3 levels and concurrent upregulation, potentially involved in ABA and JA signaling. Thus, removal of the repressive H3K27me3 mark may facilitate the transcriptional activation of early defense genes in eggplants that are crucial in their response to insect herbivory. Full article

Background: Despite advances in temporary mechanical circulatory support (tMCS), patients with cardiogenic shock (CS) who are treated with a microaxial flow pump (mAFP; Impella^®, Abiomed) still have a high mortality rate. A dysregulated systemic inflammatory response significantly contributes to multiorgan failure in this population. CytoSorb^® hemadsorption has emerged as a potential adjunctive therapy for modulating inflammation, but data on its use in CS are limited. Methods: This retrospective, single-center study used propensity score matching analysis (1:1 matching; n = 15 per group) to compare the outcomes of patients receiving mAFP support with and without concomitant CytoSorb therapy. Baseline data (T0), including comorbidities and clinical status at ICU admission, were collected for all patients. In the CytoSorb group, data were collected at two additional time points: 24 h before the start of CytoSorb therapy (T1), and 24 h after its completion (T2). At these time points, laboratory values and parameters on respiratory, hemodynamic, and organ function were assessed. Corresponding data were also collected for matched patients in the non-CytoSorb group at equivalent time points relative to their matched counterparts. Results: In the propensity score-matched cohort, patients treated with CytoSorb exhibited significant improvements between T1 and T2. Specifically, reductions were observed in the vasoactive-inotropic score (p = 0.035), procalcitonin levels (p = 0.041), peak inspiratory pressure (p = 0.036), and positive end-expiratory pressure (p = 0.016). Flow rates through the mAFP declined significantly (p = 0.014), suggesting stabilization of hemodynamics. These changes were not observed in the non-CytoSorb group, where most parameters remained unchanged or exhibited less pronounced trends. We observed a lower in-hospital mortality rate in the CytoSorb group (33.3% versus 46.7%), though the difference was not significant, potentially due to limited statistical power. Conclusions: CytoSorb hemadsorption in mAFP-supported CS was associated with improved hemodynamic stability and reduced inflammatory burden. These findings suggest a potential therapeutic benefit of adjunctive hemadsorption in this high-risk population. Full article

Adolescence is a developmental stage characterized by increased vulnerability to technology use. Several models have been proposed to explain the psychological processes involved in addictive use. In response to this evidence, therapeutic and preventive intervention programs aim to reduce key symptoms in order to promote health and protect adolescents. This study presents a systematic review and meta-analysis on the effectiveness of psychological therapeutic and preventive interventions for problematic use of Information and Communication Technologies (ICTs) in adolescents (aged 10–21). A total of nine studies (five RCTs and four non-RCTs) with 744 participants were analyzed. The search was conducted following PRISMA guidelines and using the PICO framework. Included studies involved face-to-face or online psychological therapeutic and preventive interventions targeting adolescents, with a particular focus on cognitive behavioral therapy (CBT). Results indicate significant effects in favor of the experimental group in reducing symptoms associated with Internet, video game, social media, and instant messaging addiction, with pooled effect sizes of SMD = −1.53 (RCTs) and SMD = −1.13 (non-RCTs). Despite heterogeneity and potential publication bias, the evidence supports the effectiveness of these interventions, particularly CBT, family therapy, and executive function training. A multidisciplinary approach, early detection, and treatment personalization are recommended. Methodological limitations were identified, highlighting the need for more rigorous future research with attention to gender differences and cultural adaptation. Full article

Background/Objectives: Major spine surgery often leads to significant blood loss and coagulopathy, necessitating blood product transfusion. Cryoprecipitate and plasma are two blood products commonly used to manage coagulopathy, but outcomes associated with their use in spine surgery remain unclear. Methods: This retrospective cohort study included adult patients undergoing major spine surgery from 2015 to 2022 within a single health system. Included patients received at least one unit of packed red blood cells (PRBCs) followed by either cryoprecipitate or plasma to investigate the treatment of coagulopathy after blood loss. Study endpoints included hospital length of stay (H-LOS), ICU length of stay (ICU-LOS), discharge disposition, one-year mortality, and total blood products transfused up to postoperative day (POD) 2. Multivariable linear and logistic regression was used to estimate associations between the use of cryoprecipitate or plasma and outcomes. Results: Of 189 patients meeting inclusion criteria, 120 received cryoprecipitate, and 69 received plasma as the first product after PRBCs. In the univariable analysis, the cryoprecipitate group had lower 1-year mortality (5.0% vs. 14.5%; [95% CI]: 0.31 [0.10, 0.88], p = 0.0031) and a shorter ICU-LOS (46 vs. 74 h; [95% CI]: 0.73 [0.53, 1.00], p = 0.048). However, despite a trend favoring the cryoprecipitate group, there were no differences between the cryoprecipitate and plasma groups in the multivariable model for H-LOS (adjusted geometric mean ratio [95%CI]: 0.84 [0.68,1.04], p = 0.109), ICU-LOS (adjusted geometric mean ratio [95%CI]: 0.72 [0.50,1.04], p = 0.078), one-year mortality (adjusted OR [95%CI]: 0.49 [0.13,1.88], p = 0.288), or total blood products transfused up to POD2 (adjusted mean difference [95% CI]: –1 unit [–2, 1], p = 0.253). Compared with plasma, patients in the cryoprecipitate group were more likely to be discharged to home independently versus disposition to other facility or needing assistance (adjusted OR 0.41 (95%CI: 0.16,0.97, p = 0.049). Conclusions: Use of cryoprecipitate was associated with higher odds of home discharge, while other outcomes were similar between the two groups once adjusting for potential confounders. Further research is needed to better appreciate the clinical impact of the choice of blood products to treat coagulopathy in the setting of bleeding in major spine surgery. Full article

Background: Sarcopenia assessed by skeletal muscle area (SMA) at the third lumbar vertebra (L3) is an established prognostic marker in many malignancies, including head and neck cancer (HNC). However, in HNC, L3 is rarely assessed. The prognostic value of myosteatosis, measured by skeletal muscle radiation attenuation (SMRA) remains largely unexplored. This study evaluated both muscle metrics at the third cervical vertebra (C3) for locoregional control (LRC) and overall survival (OS) in HNC. Methods: SMA and SMRA at C3 were quantified in CT scans of 904 HNC cases by a deep learning-based segmentation pipeline with manual verification. Cox proportional hazards models assessed associations with LRC and OS. Results: Median SMA was 36.64 cm² (IQR: 30.12–42.44). Median SMRA was 50.77 HU (IQR: 43.04–57.39). In multivariable analysis, lower SMA (HR 1.85, 95% CI: 1.19–2.88, p ≤  0.001) and lower SMRA (HR 1.76, 95% CI: 1.22–2.54, p < 0.001) were associated with lower LRC. For OS, lower SMA (HR 1.53, 95% CI:1.06–2.20, p = 0.02) and lower SMRA (HR 2.13, 95% CI: 1.58–2.88, p <  0.001) were associated with a worse outcome in multivariable analysis. Conclusions: Both SMRA and SMA assessed at C3 correlate with worse LRC and OS in HNC. Full article

Background: The use of neoadjuvant therapies in patients with hepatocellular carcinoma prior to liver transplantation has gained increasing popularity in recent years. To date, there are only limited data investigating the impact of neoadjuvant therapy on post-transplant survival. Methods: In this retrospective study, we evaluated patients with hepatocellular carcinoma who underwent deceased donor or living donor liver transplantation at Jena University Hospital between 2019 and 2023. Comprehensive clinical and pathological variables were systematically analyzed, including correlations between neoadjuvant therapy use, tumor burden and overall survival. Survival outcomes were estimated using the Kaplan–Meier method. Results: A total of 107 patients were included in the analysis, of whom 90 received neoadjuvant therapy prior to transplantation. Treatment modalities comprised SIRT, TACE, liver resection and combined SIRT and TACE. The 1-, 3-, and 5-year OS rates following transplantation were 93.5%, 82.2%, and 79.4%, respectively. Recurrence-free survival at 1, 3, and 5 years was 91.6%, 85.0%, and 83.2%, respectively. Among the various neoadjuvant strategies, SIRT and TACE yielded the highest OS rates. Patients listed outside the transplantation criteria (Milan, UCSF, up-to-seven) at the time of initial diagnosis who underwent SIRT had significantly better OS than those outside the criteria who underwent TACE. In contrast, among patients within the Milan, UCSF and up-to-seven criteria, TACE was associated with superior OS compared with SIRT. Conclusion: The use of neoadjuvant therapies confers a significant survival benefit following liver transplantation in patients with HCC. TACE appears to be most suitable for patients listed within established transplantation criteria, who consequently have a lower tumor burden. In contrast, SIRT is more beneficial for patients with a higher tumor burden and those beyond standard transplantation criteria. A limitation of our study, however, is that the included SIRT cohort comprised only 24 patients, and TACE was preferentially performed in patients with a lower tumor burden, which means that a selection bias cannot be fully excluded. Overall, further studies are required to define the optimal bridging strategies. Full article

Background/Objectives: Oocyte maturation is a process involving both nuclear and cytoplasmic development regulated by epigenetic changes in gene expression. Cyclin-B3 (CCNB3) and cyclin-A2 (CCNA2) genes are thought to be involved in oocyte maturation; however, the expression profiles and key function in Metaphase-I (MI) and Metaphase-II (MII) phases have yet to be fully elucidated. Small non-coding RNA sequences are involved in epigenetic regulation of specific transcriptional targets, whereas microRNAs (miRNAs) participate in the post-transcriptional and translational repression of target genes. This study examined the expression levels of CCNB3, CCNA2, and their associated miRNAs (miR-17, miR-106b, miR-190a, miR-1275) in cumulus oophorous complex (COC) cells derived from MI and MII oocytes of NOR and DOR IVF cases, with particular emphasis on elucidating their functions during the transition from MI to MII stage. Methods: Follicular fluid containing cumulus–oocyte complex (COC) cells obtained from oocytes of 120 cases in each group NOR MI (n = 30), NOR MII (n = 30), DOR MI (n = 30), and DOR MII (n = 30) who were admitted to the Istanbul Bahçeci Health Group Assisted Reproductive Treatment Center. Following total RNA isolation from COC cells, the gene and protein expression levels of CCNB3 and CCNA2, along with the expression of miR-17, miR-106b, miR-190a, and miR-1275, were assessed using (qPCR-based assay) and immunohistochemistry (IHC). To investigate the functional roles of COC cell populations, morphological analysis was performed using H&E staining. Additionally, metadata of the cases, including age, number of oocytes, fertilization, and embryonic development rates, were evaluated. Results: The expressions of miR-17 and miR-1275 were significantly elevated in both NOR MI and DOR MI groups compared to their respective NOR MII and DOR MII groups (p < 0.05). Additionally, miR-106b levels were higher in the NOR MII group relative to NOR MI (p < 0.05), while an increase was also observed in DOR MI compared to DOR MII (p < 0.05). No difference was observed in miR-190a expression between the NOR and DOR (p > 0.05). Based on the results of H and E staining, the NOR MI, NOR MII, DOR MI, and DOR MII groups exhibited distinct variations in cellular morphology, nuclear characteristics, cytoplasmic volume, and cell density. Conclusions: CCNB3 is predicted to be a potential candidate for determining MI between the NOR and DOR cases. On the other hand, only for the NOR MII cases could CCNA2 provide evidence of oocyte maturation. Moreover, we determined the relationship between related genes and miRNAs which target CCNA2 and CCNB3. Genetic and protein expression analysis across diverse molecular pathways and miRNAs yielded comprehensive preliminary data regarding the developmental stages of oocytes at the MI and MII phases, and their fertilization potential following maturation shows potential and warrants prospective validation with clinical performance evaluation. Full article