Search Results (1,384)

Objective: Appetitive traits influence obesity risk, yet no validated Danish tool exists to assess these traits in adults. We translated the Adult Eating Behavior Questionnaire (AEBQ) into Danish and evaluated reliability and validity. Methods: Adults (n = 1257) from the South Danish Obesity Initiative completed the Danish AEBQ; a subsample took part in test–retest analysis (n = 256). Content validity was assessed via Three-Step Test Interviews (n = 5). Test–retest reliability was examined by intraclass correlation (ICC). Confirmatory factor analysis (CFA) tested structural validity (with an ancillary eight- vs. seven-factor comparison). Internal consistency was evaluated by Cronbach’s α and McDonald’s ω. Pearson correlations and regression models (adjusted for age, sex, and education) related subscales to BMI, waist-to-hip ratio (WHR), and body fat percentage (fat%). Results: Three-Step Test Interviews supported content validity. Test–retest reliability was good for most subscales (ICCs ≈ 0.80–0.88) and moderate for Emotional Undereating (ICC = 0.640). Both CFA models showed acceptable fit; information criteria favored the seven-factor solution, with small differences on other indices. Internal consistency was acceptable for most subscales (α and ω ≥ 0.70), borderline for Hunger (α = 0.70; ω = 0.71), and below threshold for Satiety Responsiveness (α = 0.69; ω = 0.69). Food Responsiveness and Emotional Overeating were positively associated with BMI/WHR/fat%, while Emotional Undereating showed inverse associations; other subscales showed no associations. Conclusions: The Danish AEBQ shows adequate psychometric performance, and both seven- and eight-factor structures appear applicable in a Danish setting, with the caveat that internal consistency for Hunger and Satiety Responsiveness fell just below conventional cut-offs. Full article

Imbalanced learning occurs when rare but critical events are missed because classifiers are trained primarily on majority-class samples. This paper introduces WISEST, a locality-aware weighted-interpolation algorithm that generates synthetic minority samples within a controlled threshold near class boundaries. Benchmarked on more than a hundred real-world imbalanced datasets, such as KEEL, with different imbalance ratios, noise levels, geometries, and other security and IoT sets (IoT-23 and BoT–IoT), WISEST consistently improved minority detection in at least one of the metrics on about half of those datasets, achieving up to a 25% relative recall increase and up to an 18% increase in F1 compared to the original training and other approaches. However, in most cases, WISEST’s trade-off gains are in accuracy and precision depending on the dataset and classifier. These results indicate that WISEST is a practical and robust option when minority support and borderline structure permit safe synthesis, although no single sampler uniformly outperforms others across all datasets. Full article

Large Language Models (LLMs) are increasingly used for rubric-based assessment, yet reliability is limited by instability, bias, and weak diagnostics. We present EvalCouncil, a committee-and-chief framework for rubric-guided grading with auditable traces and a human adjudication baseline. Our objectives are to (i) characterize domain structure in Human–LLM alignment, (ii) assess robustness to concordance tolerance and panel composition, and (iii) derive a domain-adaptive audit policy grounded in dispersion and chief–panel differences. Authentic student responses from two domains–Computer Networks (CNs) and Machine Learning (ML)–are graded by multiple heterogeneous LLM evaluators using identical rubric prompts. A designated chief arbitrator operates within a tolerance band and issues the final grade. We quantify within-panel dispersion via MPAD (mean pairwise absolute deviation), measure chief–panel concordance (e.g., absolute error and bias), and compute Human–LLM deviation. Robustness is examined by sweeping the tolerance and performing leave-one-out perturbations of panel composition. All outputs and reasoning traces are stored in a graph database for full provenance. Human–LLM alignment exhibits systematic domain dependence: ML shows tighter central tendency and shorter upper tails, whereas CN displays broader dispersion with heavier upper tails and larger extreme spreads. Disagreement increases with item difficulty as captured by MPAD, concentrating misalignment on a relatively small subset of items. These patterns are stable to tolerance variation and single-grader removals. The signals support a practical triage policy: accept low-dispersion, small-gap items; apply a brief check to borderline cases; and adjudicate high-dispersion or large-gap items with targeted rubric clarification. EvalCouncil instantiates a committee-and-chief, rubric-guided grading workflow with committee arbitration, a human adjudication baseline, and graph-based auditability in a real classroom deployment. By linking domain-aware dispersion (MPAD), a policy tolerance dial, and chief–panel discrepancy, the study shows how these elements can be combined into a replicable, auditable, and capacity-aware approach for organizing LLM-assisted grading and identifying instability and systematic misalignment, while maintaining pedagogical interpretability. Full article

The efficient pre-incubation selection of duck eggs is essential to ensuring stable hatchability, but most existing optoelectronic and machine vision systems have been calibrated for chicken eggs and cannot be directly used for duck eggs because of their larger size, stronger reflectivity and wider morphological variability. This study proposes an optoelectronic method specifically adapted to Adigel duck eggs that combines load cell weighing, infrared distance sensing and dual-projection image processing in a single stationary setup. A total of 300 eggs were measured manually and automatically, and the results were statistically compared. The developed algorithm uses adaptive Gaussian thresholding (51 × 51, C = 2) and a median 5 × 5 filter to stabilize contour extraction on glossy and spotted shells, followed by ellipsoid-based volume estimation with a breed-specific correction factor (K_v = 0.637). The automatic system showed high agreement with manual measurements (r > 0.95 for mass and linear dimensions) and a mean relative error below 2%. Density, the shape index (If) and the shape coefficient (K₁) were computed to classify eggs into “suitable”, “borderline” and “unsuitable” categories. A preliminary incubation trial (n = 60) of eggs classified as “suitable” resulted in 92% hatchability, thus confirming the predictive value of the proposed criteria. Unlike chicken-oriented systems, the presented solution provides breed-specific calibration and can be implemented in small and medium hatcheries for the reproducible, non-destructive sorting of hatching duck eggs. Full article

Background: Hepatitis C (HC) remains a major public health concern, affecting approximately 50 million people globally. In addition to hepatic damage, HC induces extrahepatic manifestations (EHMs), including oral conditions such as oral lichen planus (OLP), xerostomia, and Sjögren syndrome-like (SS-like), which impair quality of life. The aim of this study was to investigate the possible association between certain extrahepatic manifestations of HC and the presence of risk factors. Methods: A cross-sectional study was conducted on 38 adults (22 males and 16 females; mean age 56.5 ± 8.6 years) with inactive HC. For each patient, demographic and clinical data were collected, including the following: frequency of dental brushing, frequency of professional dental hygiene visits, smoking, alcohol consumption, the presence of xerostomia, OLP, and SS-like. Logistic regression analyses and ROC curves were performed using R software to identify independent predictors for each condition. Results: OLP was present in 39.5%, xerostomia in 47.4%, and SS-like in 15.8% of patients. Female gender significantly predicted OLP and showed a borderline association with xerostomia. Smoking was weakly associated with xerostomia. No predictors were significant for SS-like. Conclusions: Oral hygiene and smoking are risk factors for oral EHM, their good control being important for the quality of life of these patients. Gender has also been shown to be a risk factor for these manifestations. Full article

Introduction: Hyperuricemia is increasingly recognized as a metabolic disorder linked to dyslipidemia, insulin resistance, and vascular complications. In Saudi Arabia, the prevalence of hyperuricemia is rising with obesity and diabetes, yet its relationship with lipid-derived cardiometabolic indices remained understudied. This study aimed to examine the associations between uricemia status and lipid-derived cardiometabolic indices in a large adult cohort. Methods: This retrospective cross-sectional study analyzed data from 7652 adults, including 5385 normouricemic (NU) and 2267 hyperuricemic (HU). Key cardiometabolic indices, including the triglyceride-glucose index (TyG), non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), atherogenic index of plasma (AIP), and Castelli risk indices I and II (CRI-I, CRI-II), were calculated. Associations were evaluated treating HU as the exposure and the lipid-derived cardiometabolic indices as the outcomes. Multivariable regression analyses, receiver operating characteristic (ROC) curves, and prevalence-based association estimates were used to assess these relationships. Results: HU individuals exhibited significantly higher TG along with lowered HDL-C. Median TyG (4.61), AIP (0.38), non-HDL-C (147 mg/dL), RC (18 mg/dL), CRI-I (4.30), and CRI-II (2.85) were higher in the HU group compared to NU group, with non-HDL-C and CRI-I falling within the abnormal range, AIP in the high-risk range, and TyG and CRI-II at borderline levels. Across the separately adjusted models, hyperuricemia showed consistent positive associations with RC, AIP, CRI-I, and CRI-II, whereas associations with TyG and non-HDL-C diminished after adjustment for renal or liver markers. ROC analysis demonstrated modest discriminatory ability of uric acid for elevated indices, with AIP (AUC = 0.641) and CRI-I (AUC = 0.640) exhibiting the highest performance. The prevalence of elevated indices was substantially higher in HU, particularly for CRI-II (44.0% vs. 25.9%) and CRI-I (28.2% vs. 13.7%). Conclusions: These findings highlight associations between HU and lipid-derived cardiometabolic indices, but further longitudinal research is required to determine whether HU has a clinical predictive value in cardiovascular risk assessment. Full article

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers, with poor survival even after surgical resection. Clinical stages include resectable (R-PDAC), borderline resectable (BR-PDAC), locally advanced, and metastatic disease. Neoadjuvant therapy (NAT)—chemotherapy or chemoradiotherapy before surgery—has emerged as a promising strategy to improve outcomes by increasing margin-negative resection rates and enhancing overall survival. For R-PDAC, surgery followed by adjuvant chemotherapy remains the standard, but NAT may be considered in high-risk patients, such as those with severe pain, elevated CA 19-9, or large tumors. For BR-PDAC, NAT is the primary approach, significantly increasing R0 resection rates and prolonging survival. Common regimens include mFOLFIRINOX and gemcitabine-based combinations. NAT also carries risks, including disease progression during therapy, loss of resectability, and uncertainty in evaluating response. Current tools, such as imaging and CA 19-9, offer limited predictive value. The role of NAT in R-PDAC remains under debate, while its benefits in BR-PDAC are more established. This review summarizes current evidence and guidelines on NAT in PDAC, with a focus on treatment strategies, patient selection, and emerging approaches. Full article

Background: Kawasaki Disease (KD) is an acute vasculitis affecting children under five years of age, with atypical presentations posing diagnostic challenges and a higher risk of coronary complications when untreated. Methods: We report on a 2-year-old girl with persistent fever, limb edema, erythema, and non-purulent conjunctivitis, without cervical lymphadenopathy or the typical rash. Inflammatory markers were assessed, and a cytokine expression profile was obtained using qRT-PCR. Results: Laboratory analysis showed elevated C-reactive protein (11.1 mg/dL), high fibrinogen (468 mg/dL), borderline D-dimer (484 ng/mL), and a normal platelet count. The cytokine profile revealed marked upregulation of IFN-α, IFN-β, IFN-γ, IL-1α, IL-1β, IL-5, IL-8, and IL-12, with downregulation of IL-2 and IL-4, as well as low TNF-α levels. These findings, although not pathognomonic, were consistent with an inflammatory profile compatible with atypical KD, in which a preceding viral infection may have played a role, although causality cannot be established. Conclusions: This case highlights the diagnostic utility of cytokine profiling in suspected atypical KD, particularly when clinical criteria are incomplete. The integration of immunological data may aid in earlier recognition and therapeutic intervention, thereby helping to prevent cardiovascular sequelae. Cytokine analysis may serve as a promising adjunct for atypical KD diagnosis, although confirmation in larger cohorts is needed. Full article

Background: Anal squamous cell carcinoma (ASCC) is a rare malignancy primarily treated with chemoradiotherapy (CRT). This study evaluated outcomes and the prognostic value of simple hematologic indices in patients receiving modern image-guided CRT. Methods: Fifty-five patients with non-metastatic ASCC treated between 2017 and 2025 were retrospectively analyzed. Survival was estimated by Kaplan–Meier methods, and prognostic factors were assessed by log-rank testing and Cox regression. Baseline neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios were analyzed individually and in combination with nodal status. Results: At a median follow-up of 53.1 months, overall survival reached 90% at 5 years, whereas disease-free survival declined to 51%. Nodal positivity showed a non-significant trend toward poorer DFS. Baseline PLR ≥ 150 was significantly associated with inferior DFS in univariable analysis (HR 5.28, 95% CI 1.12–24.97, p = 0.036), while NLR ≥ 3 showed a borderline effect (p = 0.108). In multivariable models, PLR retained borderline prognostic relevance (p = 0.083), whereas Kaplan–Meier curves indicated non-significant trends (p = 0.129 and 0.055). Integrated models combining nodal status with PLR ± NLR improved risk discrimination: Model A (N + PLR ≥ 150 ± NLR ≥ 3) showed a trend (p = 0.059), and Model B (N + PLR ≥ 150) reached significance (p = 0.021; C-index ≈ 0.68–0.69). Conclusions: Modern CRT achieved excellent OS with acceptable toxicity, though early recurrences limited DFS. Integrating hematologic indices with nodal status provides a pragmatic, cost-effective approach for individualized risk assessment and follow-up in ASCC. Full article

The construction industry has persistently high accident rates, and major events continue despite strengthened safety management systems. This study analyzes 19,456 accident records from the national Construction Safety Management Integrated Information (CSI) system and applies a Light Gradient Boosting Machine (LightGBM) model to predict fatal versus injury outcomes. SHAP was used to identify influential factors and quantify each variable’s contribution. Fatal events represented about 5% of cases, reflecting substantial class imbalance. To address this, three oversampling methods—SMOTE, Borderline-SMOTE, and ADASYN—were tested. The ADASYN model showed the best performance (F1-score = 0.905, AUC = 0.879) and was selected as the final model. Oversampling was applied exclusively to the training folds during stratified 10-fold cross-validation on the training set. After identifying the optimal number of iterations, the model was retrained on the full training data and its final performance was evaluated on the independent test set. SHAP results indicated that Type of Accident, Accident Object, and Work Process were primary drivers of fatal outcomes, whereas Safety Management Plan and Public/Private Ownership helped lessen severity. Project Cost, Progress Rate, and Number of Workers moderated prediction strength through interactions with key variables. This study clarifies structural relationships among factors affecting accident outcomes using a LightGBM–SHAP framework that captures nonlinear interactions, supporting explainable artificial intelligence (AI)–based safety management and risk monitoring. Full article

Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer-related mortality in Europe, with a 5-year survival rate of approximately 10%. Surgical intervention is the only curative method of treatment in PDAC. However, especially in the case of patients with borderline or locally advanced cancer, neoadjuvant treatment is often administered in an attempt to downstage the tumor. Uncommonly, after neoadjuvant treatment, no viable tumor in the specimen after surgical resection is found- this is defined as a complete pathological response (pCR). Our paper presents a narrative review of this rare phenomenon and its possible association with patient’s survival. Conclusions: Achieving pCR may be associated with a significant improvement in the prognosis of patients with PDAC. However, it remains unknown why pCR is achievable in only a few patients. Further studies on large groups of patients are needed to identify the factors that increase the chance of pCR. Full article

Background/Objectives: To determine whether long-term oncological follow-up is required following fertility-sparing surgery (FSS) for mucinous borderline ovarian tumours (MBOTs). Methods: A retrospective cohort study set in the tertiary gynaecology oncology centre at Imperial College Healthcare NHS Trust. Patients included were those under follow-up post-surgery for an MBOT in the ovarian clinic from 2007 to 2025. Rate of recurrence was compared amongst patients who underwent ovarian cystectomy, unilateral salpingo-oophorectomy (USO) or bilateral salpingo-oophorectomy (BSO) +/− hysterectomy. Results: From 74 patients diagnosed with MBOT, 36.5% (27/74) underwent BSO +/− hysterectomy and 63.5% (47/74) had FSS. Of the patients who underwent FSS, 59.6% (28/47) had an initial USO and 40.4% (19/47) underwent ovarian cystectomy. Subsequently, 63.2% (12/19) of patients who initially had ovarian cystectomy proceeded with completion USO, leading to a total of 40 USOs performed. There were no recurrences following BSO +/− hysterectomy, primary USO or completion USO after a median follow-up of 49.0, 65.5 and 48.0 months, respectively. Of the patients who underwent ovarian cystectomy, 15.8% (3/19) were found to have residual MBOT (n = 1) two months post-cystectomy or MBOT recurrence (n = 2) at 10- and 66-months post-cystectomy, all diagnosed at USO. There is a significant association between ovarian cystectomy and disease recurrence (Fisher’s exact test p = 0.015). Conclusions: Patients of reproductive age who undergo USO for a MBOT can be offered a reduced follow-up schedule as the risk of recurrence is very low. In contrast, patients who are managed by ovarian cystectomy have a higher risk of recurrence and require long-term surveillance monitoring. Full article

The detection of exoplanets in space-based photometry relies on identifying periodic transit signatures in stellar light curves. The Kepler Threshold Crossing Events (TCE) catalog collects all periodic dimming signals detected by the pipeline, while the Kepler Objects of Interest (KOI) catalog provides vetted dispositions (CONFIRMED, CANDIDATE, FALSE POSITIVE). However, the pathway from raw TCE detections to KOI classifications remains ambiguous in many borderline cases. We introduce FAS-XAI, a framework that integrates Fuzzy C-Means (FCM) clustering, supervised learning, and explainable AI (XAI) to improve transparency in exoplanet candidate classification. FCM applied to TCE parameters (period, duration, depth, and SNR) reveals three meaningful regimes in the transit-signal space and quantifies ambiguity through fuzzy memberships. Linking these clusters to KOI dispositions highlights a progressive consolidation of confirmed planets within the high-SNR, medium-duration regime. A supervised XGBoost classifier trained on KOI labels and augmented with fuzzy memberships achieves strong performance (Accuracy = 0.73, Macro F1 = 0.69, ROC–AUC = 0.855), clearly separating CONFIRMED and FALSE POSITIVE objects while appropriately reflecting the transitional nature of CANDIDATES. SHAP, LIME, and ELI5 provide consistent global and local attributions, identifying period, duration, depth, SNR, and fuzzy ambiguity as the key explanatory features. Finally, stellar parameters from Kepler DR25 validate the physical plausibility of the detected regimes, demonstrating that FAS-XAI captures astrophysically meaningful patterns rather than purely statistical structures. Overall, the framework illustrates how fuzzy logic and explainable AI can jointly enhance the interpretability and scientific rigor of exoplanet vetting pipelines. Full article

Background/Objectives: This study aims to investigate the association between health literacy (HL) and stress among family caregivers of older adults with dementia. Methods: Older adults and their caregivers were recruited from the geriatric outpatient memory clinic of an Italian hospital. Caregiver stress was assessed using the General Health Questionnaire-12 items (GHQ-12). HL was measured using the Newest Vital Sign (NVS) and the Short Form of the Test of Functional Health Literacy in Adults (S-TOFHLA). Results: A total of 170 (71% females) caregivers, including spouses and offspring, were included in the analysis. According to the NVS, 53% demonstrated adequate HL, while 83% achieved adequate scores on the S-TOFHLA. The median GHQ-12 score was 15, with 48% presenting a score above 14, indicating higher stress levels; women reported significantly higher GHQ-12 scores than men. In a multivariate linear regression analysis adjusted for sex, education, and number of care tasks provided, the S-TOFHLA score showed a borderline association with the GHQ-12 score (B = −1.45; p = 0.064). When characteristics of the care-recipient were added to the model, the S-TOFHLA score emerged as an independent predictor of the GHQ-12 score (B = −1.41; p = 0.048), along with female caregiver sex and behavioral and psychological symptoms in the care-recipients. Exploratory analysis suggested that the association between HL and stress was present among male but not female caregivers. Conclusions: HL was associated with psychological stress in caregivers of older adults with dementia, with the relationship appearing more pronounced among male caregivers. Full article

Fatigue is a common and disabling symptom in Sjögren’s disease (SjD), yet its links with hematologic parameters and salivary gland histopathology are not well established. This study aimed to investigate associations between complete blood count (CBC) indices, fatigue severity, and minor salivary gland biopsy findings in SjD using a multidimensional, disease-specific fatigue instrument. Ninety-seven patients meeting the 2012 ACR criteria for SjD underwent CBC, immunologic testing, and detailed clinical evaluation. Fatigue was assessed with the Profile of Fatigue and Discomfort–Sicca Symptoms Inventory (PROFAD-SSI-SF). Histopathology data, including focus score, were available for a subset of patients. Correlation analyses, subgroup comparisons, and multivariable regressions explored associations among hematologic, immunologic, and fatigue variables. No strong correlations were found between fatigue and hematologic indices. The strongest were between total PROFAD and leukocyte (r = 0.18) or platelet counts (r = 0.16). ANA and anti-Ro52 positivity were associated with higher total SSI scores, while anti-SSB positivity correlated with lower somatic fatigue. Joint pain showed a borderline association with increased somatic fatigue. Focus score and other histopathologic features did not correlate with fatigue domains. In conclusion, fatigue in SjD is multifactorial and only weakly related to hematologic indices, emphasizing the need for longitudinal biomarker studies integrating clinical and histopathologic data. Full article