Search Results (5,531)

Background: Hypoxic–ischemic encephalopathy (HIE) is a leading cause of severe neurological impairments in childhood. Therapeutic hypothermia (TH) is both safe and effective in neonates born at ≥36 weeks gestation with moderate to severe HIE. We aimed to evaluate short-term outcomes—including brain injury detected on magnetic resonance imaging (MRI)—in infants born at 34–35 weeks of gestation drawing on our clinical experience with neonates under 36 weeks of gestational age (GA). Methods: In this retrospective cohort study, 20 preterm infants with a GA of 34 to 35 weeks and a matched cohort of 80 infants with a GA of ≥36 weeks who were diagnosed with moderate to severe HIE and underwent TH were included. Infants were matched in a 1:4 ratio based on the worst base deficit in blood gas and sex. Maternal and neonatal characteristics, brain MRI findings and short term outcomes were compared. Results: Infants with a GA of 34–35 weeks had a lower birth weight and a higher rate of caesarean delivery (both p < 0.001). Apgar scores, sex, intubation rate in delivery room, blood gas pH, base deficit and lactate were comparable between the groups. Compared to infants born at ≥36 weeks of GA, preterm neonates were more likely to receive inotropes, had a longer time to achieve full enteral feeding, and experienced a longer hospital stay. The mortality rate was 10% in the 34–35 weeks GA group. Neuroimaging revealed injury in 66.7% of infants born at 34–35 weeks of gestation and in 58.8% of those born at ≥36 weeks (p = 0.56). Injury was observed across multiple brain regions, with white matter being the most frequently affected in the 34–35 weeks GA group. Thalamic and cerebellar abnormal signal intensity or diffusion restriction, punctate white matter lesions, and diffusion restriction in the corpus callosum and optic radiations were more frequently detected in infants born at 34–35 weeks of gestation. Conclusions: Our study contributes to the growing body of literature suggesting that TH may be feasible and tolerated in late preterm infants. Larger randomized controlled trials focused on this vulnerable population are necessary to establish clear guidelines regarding the safety and efficacy of TH in late preterm infants. Full article

Introduction: Given the impact of aneurysmal subarachnoid hemorrhage (aSAH) on patients’ health, preclinical research is substantial to understand its pathophysiology and improve treatment strategies, which necessitates reliable and comprehensive animal models. Traditionally, aSAH models utilize iliac or subclavian access for angiography, requiring invasive procedures that are associated with significant risks and animal burden. This pilot study explores a less invasive method of digital subtraction angiography (DSA) by using the auricular artery (AA) as an alternative access point. Our aim was to demonstrate the feasibility of this refined technique, with the intention of reducing procedural risks, providing shorter operation times with enhanced neurological recovery, and simplifying the process for both researchers and animals. Materials and Methods: In this study, six female New Zealand white rabbits (3.2–4.1 kg body weight) underwent experimental induction of aSAH via a subclavian-cisternal shunt. The initial steps of this procedure followed traditional techniques, consisting of subclavian access through microsurgical preparation, followed by DSA to analyze retrograde filling of the basilar artery (BA). To evaluate the alternative method, on day 3 after induction of aSAH, DSA was performed via the AA instead of the traditional subclavian or femoral access. A catheter was placed in the AA to allow retrograde filling of the BA. This approach aimed to simplify the procedure while maintaining comparable imaging quality. Results: All rabbits survived until the study endpoint. Postoperatively, two rabbits showed signs of hemisyndrome, which significantly improved by the time of follow-up. No additional morbidities were observed. Upon euthanasia and necropsy, all animals showed clear subarachnoid bleeding patterns. DSA via the AA produced strong contrasting of the BA comparable to the traditional method. Conclusions: This technical note presents an initial evaluation of AA access as a feasible and potentially advantageous method for DSA in a rabbit model of blood shunt subarachnoid hemorrhage. The method shows promise in reducing invasiveness and procedural complexity, but further studies are required to fully establish its efficacy and safety. Future research should focus on expanding the sample size, refining the anatomical understanding of the AA, and continuing to align with ethical considerations regarding animal welfare. Full article

Limb–girdle muscular dystrophy (LGMD) encompasses a heterogeneous group disease, genetic and phenotypically. There are more than 30 subtypes divided into two groups: autosomal dominant and recessive. LGMDs are characterised by muscle weakness; however, psychosocial factors seem to be affected too, such as HRQoL. Given the lack of literature in this respect, the present cross-sectional study aimed to create a patient profile comparing both dominant and recessive forms by analysing HRQoL through the INQoL, and sociodemographic data. The LGMD-recessive group had a worse HRQoL compared to the dominant group, specifically in the dimensions of muscle weakness (p = 0.007), emotion (p = 0.046), independence (p = 0.029), and body image (p = 0.022). In addition, in the LGMD-dominant group, 77.9% of the relational indicator was explained by age (B = 0.907, p = 0.012), which can be understood as a limitation in their social role due to the disease progression. In contrast, no sociodemographic variables were found to be predictive of the HRQoL of patients with recessive forms of LGMD. These results are relevant for clinical practice, as they reflect the most affected areas of HRQoL in LGMD patients, differentiating between recessive and dominant forms. Full article

Background/Objectives: The global population of individuals aged ≥ 80 years is rapidly growing, leading to an increasing incidence of cancer diagnoses in this age group. While stereotactic body radiotherapy (SBRT) has proven effective in treating pulmonary oligometastases, patients over 80 remain underrepresented in clinical analyses. This study aimed to evaluate clinical outcomes and toxicity of SBRT for pulmonary oligometastases in octogenarians. Methods: This retrospective, single-centre analysis included 34 patients aged ≥ 80 years treated with SBRT for histologically confirmed pulmonary oligometastases between 2010 and 2024. Results: A total of 46 pulmonary metastases were treated with curative intent using fractionation schemes of 3 × 15 Gy, 6 × 8 Gy, or 10 × 6 Gy. Median biologically effective dose (BED10) was 112.5 Gy. Follow-up included regular CT imaging and toxicity assessment according to CTCAE. With a median follow-up of 22.6 months, 1-, 2-, and 3-year local control (LC) rates were 95.2%, 95.2%, and 90.2%, respectively. Median overall survival (OS) was 46.6 months, with 1-, 2-, and 3-year OS rates of 78.4%, 71.4%, and 59.5%. Progression-free survival (PFS) at 1, 2, and 3 years was 63.4%, 51.6%, and 47.3%, respectively. No grade ≥ 3 toxicities were observed. Grade 2 pneumonitis and dermatitis occurred in 2.9% each and were well managed. Asymptomatic rib fractures were detected in 5.9% of patients. No significant predictors for LC, PFS, or OS were identified in univariate analysis. Conclusions: SBRT for pulmonary oligometastases in patients ≥ 80 years is feasible, safe, and effective. High local control, favourable cancer-specific survival, and minimal toxicity support its use as a curative-intent treatment in this growing patient population. These findings contribute important site- and age-specific evidence and support the inclusion of very elderly patients in future prospective SBRT trials. Full article

One of the persistent challenges in multispectral image analysis is the interference caused by dense cloud cover and its resulting shadows, which can significantly obscure surface features. This becomes especially problematic when attempting to monitor surface changes over time using satellite imagery, such as from Landsat-8. In this study, rather than simply masking visual obstructions, we aimed to investigate the role and influence of clouds within the spectral data itself. To achieve this, we employed Independent Component Analysis (ICA), a statistical method capable of decomposing mixed signals into independent source components. By applying ICA to selected Landsat-8 bands and analyzing each component individually, we assessed the extent to which cloud signatures are entangled with surface data. This process revealed that clouds contribute to multiple ICA components simultaneously, indicating their broad spectral influence. With this influence on multiple wavebands, we managed to configure a set of components that could perfectly delineate the extent and location of clouds. Moreover, because Landsat-8 lacks cloud-penetrating wavebands, such as those in the microwave range (e.g., SAR), the surface information beneath dense cloud cover is not captured at all, making it physically impossible for ICA to recover what is not sensed in the first place. Despite these limitations, ICA proved effective in isolating and delineating cloud structures, allowing us to selectively suppress them in reconstructed images. Additionally, the technique successfully highlighted features such as water bodies, vegetation, and color-based land cover differences. These findings suggest that while ICA is a powerful tool for signal separation and cloud-related artifact suppression, its performance is ultimately constrained by the spectral and spatial properties of the input data. Future improvements could be realized by integrating data from complementary sensors—especially those operating in cloud-penetrating wavelengths—or by using higher spectral resolution imagery with narrower bands. Full article

Background/Objectives: Thyroid nodules are commonly found through sensitive imaging methods like ultrasonography. While most nodules are benign and asymptomatic, certain characteristics may indicate malignancy, prompting fine needle aspiration biopsy. Factors like age and gender affect cancer risk, complicating ultrasound-based risk systems. We aimed to determine whether the cytological malignancy rate of thyroid nodules could be adjusted for several clinical parameters. Methods: Data from patients aged 18 and above with thyroid nodules assessed via fine needle aspiration (FNA) were retrospectively reviewed. Malignancy classification was based on cytopathology and histopathology results. The study examined how various clinical parameters, adjusted for the ACR TI-RADS category, affected thyroid nodule malignancy rates, including age, sex, Body Mass Index (BMI), nodule size, presence of autoimmunity, and thyroxine therapy. Additionally, we analyzed the performance of ACR TI-RADS in predicting malignant cytology across different age subgroups of thyroid nodules. Results: The study included 1128 thyroid nodules from 1001 adult patients, with a median age of 48 years and predominantly female (76.68%). Malignancy rates varied across ACR TI-RADS categories, with higher rates associated with larger nodules and younger age groups. Age emerged as a significant predictor of malignancy, with a consistent decrease in the odds ratio for malignant cytology with advancing age across all ACR TI-RADS categories, indicating its potential utility in risk assessment alongside nodule size and sex. Conclusions: Raising the size threshold for recommending FNA of TR3-3 nodules and incorporating patients’ age and gender into the evaluation process could enhance the system’s accuracy in assessing thyroid nodules and guiding clinical management decisions. Full article

In recent years, the concept of the myofascial network has transformed biomechanical understanding by emphasizing the body as an integrated, multidirectional system. This study advances that paradigm by applying graph theory to model the osteo-myofascial system as an anatomical network, enabling the identification of topologically central nodes involved in force transmission, stability, and coordination. Using the aNETomy model and the BIOMECH 3.4 database, we constructed an undirected network of 2208 anatomical nodes and 7377 biomechanical relationships. Centrality analysis (degree, betweenness, and closeness) revealed that structures such as the sacrum and thoracolumbar fascia exhibit high connectivity and strategic importance within the network. These findings, while derived from a theoretical modeling approach, suggest that such key nodes may inform targeted treatment strategies, particularly in complex or compensatory musculoskeletal conditions. The proposed concept of a polyconnective skeleton (PCS) synthesizes the most influential anatomical hubs into a functional core of the system. This framework may support future clinical and technological applications, including integration with imaging modalities, real-time monitoring, and predictive modeling for personalized and preventive medicine. Full article

Currently, most studies evaluating storm surges are conducted at the provincial level, and there is a lack of detailed research focusing on cities. This paper focuses on the urban scale, using some fine-scale data of coastal areas obtained through remote sensing images. This research is based on the Hazard–Exposure–Vulnerability (H-E-V) framework and PPRR (Prevention, Preparedness, Response, and Recovery) crisis management theory. It focuses on 52 Chinese coastal cities as the research subject. The evaluation system for the disaster response capabilities of Chinese coastal cities was constructed based on three aspects: the stability of the disaster-incubating environment (S), the risk of disaster-causing factors (R), and the vulnerability of disaster-bearing bodies (V). The significance of this study is that the storm surge capability of China’s coastal cities can be analyzed based on the results of the evaluation, and the evaluation model can be used to identify its deficiencies. In this paper, these storm surge disaster response capabilities of coastal cities were scored using the entropy weighted TOPSIS method and the weight rank sum ratio (WRSR), and the results were also analyzed. The results indicate that Wenzhou has the best comprehensive disaster response capability, while Yancheng has the worst. Moreover, Tianjin, Ningde, and Shenzhen performed well in the three aspects of vulnerability of disaster-bearing bodies, risk of disaster-causing factors, and stability of disaster-incubating environment separately. On the contrary, Dandong (tied with Qinzhou), Jiaxing, and Chaozhou performed poorly in the above three areas. Full article

Fluid resuscitation after thermal injury is paramount to avoid burn shock and restore organ perfusion. Both over- and under-resuscitation can lead to unintended consequences affecting patient outcomes. While many studies have examined systemic effects, limited data exist on how fluid resuscitation impacts burn wound progression in the acute period. Furthermore, the mechanisms underlying burn wound progression remain not fully understood. This study used a swine model to investigate how varying resuscitation levels affect peri-burn wound dynamics. Twenty-seven female Yorkshire pigs were anesthetized, subjected to 40% total body surface area burn and 15% hemorrhage, then randomized (n = 9) to receive decision-support-driven (adequate, 2–4 mL/kg/%TBSA), fluid-withholding (under, <1 mL/kg/%TBSA), or high-constant-rate (over, >>4 mL/kg/%TBSA) resuscitation. Pigs were monitored for 24 h in an intensive care setting prior to necropsy. Laser Doppler Imaging (LDI) was conducted pre-burn and at 2, 6, 12, and 24 h post burn to assess perfusion. Biopsies were taken from burn, peri-burn (within 2 cm), and normal skin. RNA was isolated at 24 h for the qRT-PCR analysis of IL-6, CXCL8, and IFN-γ. At hour 2, LDI revealed increased peri-burn perfusion in over-resuscitated animals vs. under-resuscitated animals (p = 0.0499). At hour 24, IL-6 (p = 0.0220) and IFN-γ (p = 0.0253) were elevated in over-resuscitated peri-burn skin. CXCL8 showed no significant change. TUNEL staining revealed increased apoptosis in over- and under-resuscitated peri-burn skin. Differences in perfusion and cytokine expression based on resuscitation strategy suggest that fluid levels may influence burn wound progression. Full article

Infants discriminate faces early in the first year, but research on infants’ discrimination of bodies is plagued by mixed findings. Using a familiarisation novelty preference method, we investigated 7- and 9-month-old infants’ discrimination of body postures presented in upright and inverted orientations, and with and without heads, along with relationships with gross and fine motor development. In our initial studies, 7-month-old infants discriminated upright headless postures with forward-facing and about-facing images. Eye tracking revealed that infants looked at the bodies of the upright headless postures the longest and at the heads of upright whole figures for 60–70% of the time regardless of the presence of faces, suggesting that heads detract attention from bodies. In a more stringent test, with similarly complex limb positions between test items, infants could not discriminate postures. With longer trials, the 7-month-olds demonstrated a familiarity preference for the upright whole figures, and the 9-month-olds demonstrated a novelty preference, albeit with a less robust effect. Unlike previous studies, we found that better gross motor skills were related to the 7-month-olds’ better discrimination of upright headless postures compared to inverted postures. The 9-month-old infants’ lower gross and fine motor skills were associated with a stronger preference for inverted compared to upright whole figures. This is further evidence of a configural representation of bodies in infancy, but it is constrained by an upper bias (heads in upright figures, feet in inverted), the test item similarity, and the trial duration. The measure and type of motor development reveals differential relationships with infants’ representations of bodies. Full article

Background: A precise radiographic evaluation of adolescent idiopathic scoliosis (AIS) is essential for effective treatment planning and follow-up. The pelvic axial rotation (PAR) and horizontal balance of the pelvis are critical factors to consider throughout the treatment and monitoring of AIS. While some previous studies have examined spinal curvature in relation to PAR direction and the direction of the major curve (DMC) in AIS patients, this study aims to explore the relationship between scoliosis morphology, pelvic axial rotation (PAR), and the direction of the major curve in patients with adolescent idiopathic scoliosis. Methods: Radiographic images of 397 patients diagnosed with AIS between 2023 and 2024 at a Tertiary Referral Hospital were retrospectively evaluated. Morphological and morphometric measurements, including sex, Lenke and Risser classifications, lower leg discrepancy, Cobb angle, PAR direction, and major curvature direction, were performed. Results: The mean age of the 397 patients (246 female, 151 male) was 14.47 ± 2.29. There is no significant correlation between PAR and DMC (p = 0.919). No significant differences were found in terms of sex (p = 0.603). Regardless of the PAR direction, major curvature was more common on the left side (57.7%). Furthermore, a positive correlation was noted between the Cobb angle and LLD. Conclusions: Our study contributes to a growing body of literature questioning the deterministic role of PAR in AIS. While previous reports have emphasized the directional correlation between the pelvis and spinal curvature, our findings suggest that pelvic rotation may not be a reliable indicator of curve direction in all patients. This highlights the complexity of AIS biomechanics and underscores the need for individualized radiographic and clinical evaluation rather than a reliance on generalized compensatory models. Full article

Background/Objectives: Digital food-related videos significantly influence cravings, appetite, and weight outcomes; however, the dynamic neural mechanisms underlying appetite fluctuations during naturalistic viewing remain unclear. This study aimed to identify neural activity patterns associated with moment-to-moment appetite changes during naturalistic food-cue video viewing and to examine their relationships with cravings and weight-related outcomes. Methods: Functional magnetic resonance imaging (fMRI) data were collected from 58 healthy female participants as they viewed naturalistic food-cue videos. Participants concurrently provided continuous ratings of their appetite levels throughout video viewing. Hidden Markov Modeling (HMM), combined with machine learning regression techniques, was employed to identify distinct neural states reflecting dynamic appetite fluctuations. Findings were independently validated using a shorter-duration food-cue video viewing task. Results: Distinct neural states characterized by heightened activation in default mode and frontoparietal networks consistently corresponded with increases in appetite ratings. Importantly, the higher expression of these appetite-related neural states correlated positively with participants’ Body Mass Index (BMI) and post-viewing food cravings. Furthermore, these neural states mediated the relationship between BMI and food craving levels. Longitudinal analyses revealed that the expression levels of appetite-related neural states predicted participants’ BMI trajectories over a subsequent six-month period. Participants experiencing BMI increases exhibited a significantly greater expression of these neural states compared to those whose BMI remained stable. Conclusions: Our findings elucidate how digital food cues dynamically modulate neural processes associated with appetite. These neural markers may serve as early indicators of obesity risk, offering valuable insights into the psychological and neurobiological mechanisms linking everyday media exposure to food cravings and weight management. Full article

The effect of periodical heatwaves and related thermal stratification in freshwater aquatic ecosystems has been a hot research issue. A large dataset of samples was generated from samples exposed to temporary thermal stratification in mesocosms mimicking shallow eutrophic freshwater lakes. Temperature regimes were based on IPCC climate warming scenarios, enabling simulation of future warming conditions. Surface oxygen levels reached 19.37 mg/L, while bottom layers dropped to 0.07 mg/L during stratification. Analysis by FlowCAM revealed dominance of Cyanobacteria under ambient conditions (up to 99.2%), while Cryptophyta (up to 98.9%) and Chlorophyta (up to 99.9%) were predominant in the A2 and A2+50% climate scenarios, respectively. We identified temperature changes and shifts in nutrient concentrations, particularly phosphate, as critical factors in microbial community composition. Furthermore, five distinct Microcystis morphospecies identified by FlowCAM-based analysis were associated with different microbial clusters. The combined use of imaging flow cytometry, which differentiates phytoplankton based on morphological parameters, and nanopore long-read sequencing analysis has shed light into the dynamics of microbial communities associated with different Microcystis morphospecies. In our observations, a peak of algicidal bacteria abundance often coincides with or is followed by a decline in the Cyanobacteria. These findings highlight the importance of species-level classification in the analysis of complex ecosystem interactions and the dynamics of algal blooms in freshwater bodies in response to anthropogenic effects and climate change. Full article

A novel brain positron emission tomography (PET) radioligand, [¹¹C]HY-2-15, has potential for imaging alpha-synuclein aggregations in multiple system atrophy and misfolded tau proteins in tauopathies, based on its high binding affinity in disease brain tissue homogenates. Here, we demonstrate that [³H]HY-2-15 has the capability to bind to aggregated alpha-synuclein in multiple system atrophy brain and tau aggregations in progressive supranuclear palsy and corticobasal degeneration brain tissues via in vitro autoradiography study. A first-in-human pilot multicenter clinical study recruited a total of 10 subjects including healthy controls and patients with Parkinson’s disease, multiple system atrophy, or progressive supranuclear palsy. The study revealed that [¹¹C]HY-2-15 has a relatively higher specific uptake in the pallidum and midbrain of patients with progressive supranuclear palsy. Total-body scans performed on the PennPET Explorer showed the radiotracer was cleared by renal excretion. However, the rapid metabolism and low brain uptake resulted in a limited signal of [¹¹C]HY-2-15 in brain. Full article

Burn injuries result in complex physiological and psychological sequelae, including hypermetabolism, muscle wasting, mobility impairment, scarring, and disrupted body image. While advances in acute care have improved survival, comprehensive rehabilitation strategies are critical for restoring function, appearance, and psychosocial well-being. Structured physical activity, including resistance and aerobic training, plays a central role in counteracting muscle atrophy, improving cardiovascular function, enhancing scar quality, and promoting psychological resilience and body image restoration. This narrative review synthesizes the current evidence on the effects of exercise-based interventions on post-burn recovery, highlighting their therapeutic mechanisms, clinical applications, and implementation challenges. In addition to physical training, emerging technologies such as virtual reality, aquatic therapy, and compression garments offer promising adjunctive benefits. Notably, artificial intelligence (AI) is gaining traction in burn rehabilitation through its integration into wearable biosensors and telehealth platforms that enable real-time monitoring, individualized feedback, and predictive modeling of recovery outcomes. These AI-driven tools have the potential to personalize exercise regimens, support remote care, and enhance scar assessment and wound tracking. Overall, the integration of exercise-based interventions with digital technologies represents a promising, multimodal approach to burn recovery. Future research should focus on optimizing exercise prescriptions, improving access to personalized rehabilitation tools, and advancing AI-enabled systems to support long-term recovery, functional independence, and positive self-perception among burn survivors. Full article