Search Results (19,081)

Dynamic Spectrum Sharing (DSS) enables spectrum sharing between Long-Term Evolution (LTE) and New Radio (NR) systems, addressing spectrum scarcity in NR. To avoid interference when supporting NR traffic within LTE spectrum, key factors must be compatible. Effective DSS techniques are essential for coexistence. This paper discusses these issues in two parts. Part I covers LTE and NR coexistence using DSS, introducing resource grids, control signals, and channels, and explores DSS approaches for NR data traffic, including NR Synchronization Signal/Physical Broadcast Channels (SSB) transmission via LTE Multicast-Broadcast Single-Frequency Network (MBSFN) and non-MBSFN subframes with associated challenges and standardization efforts for DSS improvement. Part II presents a DSS technique using MBSFN subframes in a heterogeneous network with a macrocell and picocells running on LTE, and in-building small cells running on NR, sharing LTE spectrum via DSS. An optimization problem is formulated to manage traffic through MBSFN allocation, determining the optimal number of MBSFN subframes per LTE frame. System simulations indicate DSS improves Spectral and Energy Efficiency in small cells. The paper concludes with key lessons for LTE and NR coexistence. Full article

Background/Objectives: The most prevalent prolonged cardiac arrhythmia and a significant global health burden is atrial fibrillation (AF). Although its connection to AF is still unknown, lipoprotein(a) (Lp(a)), a genetically determined lipoprotein with pro-inflammatory and pro-atherogenic characteristics, has been linked to cardiovascular disease. The purpose of this study was to measure and assess the relationship between circulating Lp(a) levels and AF. Methods: In compliance with the PRISMA 2020 guidelines, a systematic review and meta-analysis were carried out using a protocol that was preregistered in PROSPERO (CRD420251153244). Comprehensive searches of PubMed/MEDLINE, Embase, Web of Science, Scopus, the Cochrane Library, and Google Scholar up until September 2025 were used to find observational studies comparing circulating Lp(a) levels in adults with and without AF. Results: Circulating Lp(a) concentrations were significantly higher in AF patients than in controls across 10 studies (pooled MD = 2.81; 95%CI: 1.58–4.05; p < 0.0001). In the subgroup analysis by geographical setting, studies conducted in Asia and studies from Europe/USA exhibited a statistically significant effect. Despite the extreme heterogeneity (I² = 99%), sensitivity analyses verified that the overall effect was stable. Conclusions: Our pooled analysis revealed a statistically significant association between Lp(a) and AF; however, the certainty of the evidence was rated as very low according to the GRADE methodology. To elucidate causality, enhance risk stratification, and investigate whether Lp(a)-lowering tactics could alter AF risk, large, prospective, multi-ethnic studies with standardized biomarker assessment are needed. Full article

Glioblastoma (GBM) is the most malignant primary brain tumor, characterized by extensive heterogeneity, invasiveness, infiltrating behavior, and resistance to standard therapies, including radiation and temozolomide (TMZ). Despite considerable efforts in investigating its pathophysiology, GBM represents one of the most challenging cancers to treat, with a median survival rate under 15 months and a 5-year survival rate below 5%. A major barrier to progress in GBM therapy development is the lack of reliable preclinical models that faithfully recapitulate the tumor’s molecular heterogeneity, invasive behavior, and complex microenvironment. Traditional cell lines and xenograft models often fail to reflect the key pathological features of human GBM, including immune suppression, vascular abnormalities, and treatment resistance. In recent years, attention has focused on the development of numerous clinically relevant GBM models based on brain organoids as a powerful “disease-in-a-dish” model. They strongly mimic GBM key histopathological and molecular features, such as the tumor’s cellular heterogeneity, genetic landscape, and microenvironment, enabling more accurate studies of tumor biology, invasion, and therapeutic response in a controlled in vitro setting. Notably, research in microgravity offers a unique and promising platform to study cancer biology under conditions that enhance tissue self-organization, mimic aspects of tumor growth, and potentially unveil novel therapeutic vulnerabilities. This review compares organoids to conventional preclinical models, tracing their historical development and salient features, focusing on the preparation and use of organoids in GBM research. We also introduce a novel and promising field of organoid application: space-based organoid brain research. Full article

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, often diagnosed at late stages due to the limited sensitivity of current screening tools. This study explores whether blood-based lipidomic profiling, combined with explainable artificial intelligence (XAI), can improve early and interpretable detection of HCC. Methods: We analyzed lipidomic data from 219 HCC patients and 219 matched healthy controls using liquid chromatography-mass spectrometry. An Explainable Boosting Machine (EBM) was employed to identify discriminatory lipid biomarkers and was compared against several standard machine learning algorithms. Results: The EBM model achieved superior performance with 87.0% accuracy, 87.7% sensitivity, 86.3% specificity, and an AUC of 91.8%, outperforming other models. Key lipid biomarkers identified included specific phosphatidylcholines (PC 38:2, PC 40:4), sphingomyelins (SM d40:2 B), and lysophosphatidylcholines (LPC 18:2), which exhibited significant alterations in HCC patients and highlighted disruptions in sphingolipid metabolism. Conclusions: Integration of lipidomics with explainable machine learning offers a powerful, transparent approach for HCC biomarker discovery, achieving high diagnostic accuracy while providing biological insights. This strategy holds promise for developing non-invasive, clinically interpretable screening tools to improve early detection of liver cancer. Full article

Background: Diabetic foot ulcers (DFUs) carry high risks of infection, amputation, and mortality. We systematically reviewed randomized controlled trials (RCTs) of negative-pressure wound therapy (NPWT), including single-use systems, for clinically uninfected DFUs (with sensitivity analyses for mixed/infected cohorts). Methods: We searched PubMed and Scopus (1 January 2004–30 June 2024). Dual reviewers performed screening and extraction; risk of bias was assessed with Cochrane Risk of Bias 2 (RoB 2) and certainty of evidence with GRADE. When ≥2 trials reported comparable outcomes, we used random-effects meta-analysis. The DiaFu cohort reported in two publications was counted once across analyses. Results: Eleven RCT publications (n = 1699; 10 unique cohorts) met criteria; eight trials (n = 1456) informed the primary endpoint. Trials largely excluded severe ischemia; findings therefore apply mainly to neuropathic or mixed-etiology DFUs with adequate perfusion. NPWT increased complete healing at 12–16 weeks (risk ratio [RR] 1.46, 95% CI 1.21–1.76; I² = 48%) and shortened time to healing (mean difference –18 days, 95% CI −28 to −8). Effects were similar for conventional and single-use NPWT. Outcomes did not vary systematically within commonly used pressure ranges (approximately −80 to −125 mmHg). Only two RCTs reported direct cost data (exploratory). Moderate heterogeneity (Higgins’ I² 48–68%) reflected variation in ulcer severity, device type/settings, dressing-change frequency, and off-loading protocols. Conclusions: NPWT probably improves short-term healing of clinically uninfected DFUs compared with standard care and may reduce minor amputations, without increasing adverse events. Certainty is moderate for healing and low for most secondary outcomes. Benefits appear consistent across device classes and may support earlier discharge and community-based care. Evidence gaps include ischemia-dominated ulcers, long-term outcomes (recurrence and limb preservation), adherence mechanisms, and contemporary cost-effectiveness. Full article

By 2045, approximately 783.2 million people are projected to be diagnosed with type 2 diabetes mellitus (T2DM). In addition, obesity is expected to affect up to 22% of the world’s population or one in four people. The diabesity epidemic, a worrying trend in which T2DM and obesity co-occur, is becoming increasingly evident and could be the most significant epidemic of non-communicable chronic diseases in human history. The salutogenic pattern of health, which emphasises well-being and resistance resources, could be a promising solution to address this alarming worldwide problem. The salutogenic pattern of health has numerous positive effects on the health of persons with T2DM. These include reducing the risk of it, lowering some biomarkers and laboratory parameters related to its control, and promoting a better lifestyle, ultimately improving the overall quality of life. The salutogenic pattern of health offers an effective and evidence-based approach to address the growing global problem of chronic non-communicable diseases such as T2DM. Integrating this theory into standard modern medical practice has the potential to significantly improve health outcomes and overall patient well-being, making it an important direction for modern medicine. Accordingly, the aim is to explore and analyse the salutogenic pattern of health associated with T2DM in order to prevent it, but also the better management of it. Full article

Protein-based APIs represent a big group of modern therapeutics. Their characterization involves complex analytical protocols which require special methods, especially in the case when the protein drug is included into tablet dosage forms. Although the fluorescence polarization assay (FPA) is not currently regulated by many national Pharmacopeias, it represents a promising approach for protein drug standardization, considering their rapid, sensitive, and automatable detection suitable for high-throughput analysis and real-time quality control. To evaluate the applicability of FPA for the analysis of protein drugs in tablets, the quantifying of lysozyme in tablet dosage forms was studied by this method with the use of a fluorescently labeled synthetic chitooligosaccharide tracer. It was shown that this approach overcomes the limitations of the conventional turbidimetric assay of lysozyme determination, which is labor-intensive and relies on unstable reagents. Measurements were performed with both portable and stationary fluorescence polarization readers. Commercial tablets from five manufacturers containing lysozyme (20 mg) and pyridoxine hydrochloride (10 mg) together with other excipients were analyzed. The FPIA method showed a linear range of 5.0–70 µg/mL, with specificity confirmed by the absence of interference from excipients. Accuracy, evaluated by standard addition (10–20 mg), yielded recoveries of 100.2–106.0%. Placebo spiked with lysozyme at 80–120% of nominal content demonstrated recoveries of 98.0–100.1%, with RSD (n = 6) not exceeding 13.7%, indicating good precision. The developed method enables reliable lysozyme quantification in tablets, offering speed, simplicity, and robustness, and shows its suitability for the routine quality control of protein-containing dosage forms including the enzyme ones. Full article

Pediatric torticollis, predominantly resulting from congenital muscular torticollis, is characterized by unilateral shortening of the sternocleidomastoid muscle, leading to head tilt and limited cervical mobility. Conventional management primarily involves physical therapy and repositioning strategies, with most infants achieving full recovery. However, a subset of patients exhibits persistent symptoms despite conservative treatment. Botulinum toxin type A (BoNT-A) has emerged as a minimally invasive adjunct intervention that targets muscular hypertonicity by inhibiting acetylcholine release at neuromuscular junctions. This scoping review synthesizes clinical evidence from six studies, including randomized controlled trials and case reports, assessing the efficacy and safety of BoNT-A in pediatric torticollis. Results indicate consistent improvements in range of motion, head posture correction, and patient satisfaction, with rare and mild adverse events such as local bruising and transient muscle weakness. Despite promising outcomes, variability in dosing, injection protocols, and follow-up durations underscores the need for standardized treatment guidelines and further high-quality research. These findings support BoNT-A as a valuable therapeutic option for refractory pediatric torticollis, warranting integration into multidisciplinary care frameworks. Full article

Background: Radiation necrosis (RN) is a delayed and potentially debilitating complication of radiotherapy for central nervous system (CNS) tumors. It presents significant diagnostic and therapeutic challenges due to the variable clinical manifestations and overlap with tumor recurrence. Although advances in radiotherapy have improved tumor control, RN remains incompletely understood and inadequately addressed. This narrative review synthesizes current evidence on RN pathophysiology, risk factors, diagnostic strategies, and management approaches. Methods: A literature search was conducted for English-language literature published between January 1990 and December 2024. Studies were included if they addressed RN incidence, diagnosis, treatment, or novel preventive strategies in CNS tumor populations. Relevant findings were synthesized to produce a narrative review summarizing pathophysiology, diagnostic challenges, and treatment strategies. Results: RN results from radiation-induced neurovascular injury, inflammation, and vessel permeability, with incidence ranging from 3 to 26% depending on tumor type, location, and treatment parameters. Risk is influenced by dose, fractionation, cumulative exposure, re-irradiation, and adjuvant therapies. Advanced modalities such as SRS, HFSRT, brachytherapy, proton therapy, and IORT reduce but do not eliminate RN risk. Diagnosis remains challenging despite advanced MRI and PET techniques, with histopathology as the gold standard. Management includes corticosteroids, bevacizumab, surgery, LITT, and experimental therapies. Connectomics-based planning shows promise in minimizing RN by sparing critical brain networks. Conclusions: RN is a clinically significant and multifactorial complication of CNS radiotherapy. Precision treatment modalities and advanced imaging have improved prevention and detection, but diagnostic uncertainty and recurrence risk persist. Integration of connectomics into treatment planning may offer future promise of a reduction in RN-related morbidity by preserving structural and functional network integrity. Full article

Background: The morphology of the acromion has long been implicated in shoulder pathology, particularly in relation to subacromial impingement and rotator cuff disease. More recently, interest has shifted toward the posterior acromion, with studies examining its potential role in posterior instability, eccentric glenohumeral osteoarthritis, and massive rotator cuff tears. Methods: A critical literature review of nine studies assessing sagittal acromial tilt, posterior coverage, and acromial height was conducted, emphasizing reproducibility and clinical significance across different shoulder disorders. Results: In posterior instability and eccentric osteoarthritis, the acromion is generally described as more horizontally oriented, less covering posteriorly, and positioned higher. Conversely, in massive cuff tears, it tends to appear more posteriorly covering without consistent change in tilt. Although these trends suggest a possible biomechanical role for the acromion, reported values vary widely between studies, and significant overlap exists between pathological and control groups. Such variability is compounded by differences in imaging modality, definitions of anatomical landmarks, and the frequent reduction of three-dimensional structures into two-dimensional projections. These methodological inconsistencies undermine reproducibility and limit the clinical applicability of posterior acromial parameters. Conclusions: Posterior acromial morphology appears to influence shoulder biomechanics, but existing measurements should be considered population-level markers rather than diagnostic thresholds. Future research should adopt standardized, three-dimensional, pathology-independent reference models anchored to stable scapular landmarks and validated across imaging modalities to improve reproducibility and clinical utility. Full article

The existence of residual ammonium in weathered crust elution-deposited rare earth ore (WREO) tailings will cause serious environmental pollution, and it is necessary to remove it from the ore body. In this work, ferric chloride was applied as the eluent, and the effects of the ferric salt concentration, liquid/solid ratio, and the eluting temperature on the ammonium removal process were investigated. The results indicated that ferric chloride demonstrated a significant capability to eliminate residual ammonium (RA) from rare earth (RE) tailings. The optimal conditions identified for this process included a ferric salt concentration of 0.06 mol/L, a liquid/solid ratio of 2:1, and a temperature of 25 °C. Under optimal conditions, the removal efficiency of RA by ferric chloride was measured at 97.47%. The NH₄⁺ concentration in the final stage leachate was determined to be 1.85 mg/L, which satisfies the environmental standards. Kinetic analysis revealed an internal diffusion-controlled elution mechanism for RA in the RE ore tailings, with a reaction order of 0.28 and an activation energy of 13.36 kJ/mol. FT-IR characterization results showed that most of the RA salts were effectively removed. This study establishes a feasible approach to remove RA from RE ore tailings, thereby laying a theoretical foundation for this process. Full article

Background/Objectives: Artificial Intelligence (AI) is rapidly advancing in medicine, facilitating personalized care by leveraging complex clinical data, imaging, and patient monitoring. This study characterizes current practices in AI use within oncology clinical trials by analyzing completed U.S. trials within the Cancer Control Continuum (CCC), a framework that spans the stages of cancer etiology, prevention, detection, diagnosis, treatment, and survivorship. Methods: This cross-sectional study analyzed U.S.-based oncology trials registered on ClinicalTrials.gov between January 2015 and April 2025. Using AI-related MeSH terms, we identified trials addressing stages of the CCC. Results: Fifty completed oncology trials involving AI were identified; 66% were interventional and 34% observational. Machine Learning was the most common AI application, though specific algorithm details were often lacking. Other AI domains included Natural Language Processing, Computer Vision, and Integrated Systems. Most trials were single-center with limited participant enrollment. Few published results or reported outcomes, indicating notable reporting gaps. Conclusions: This analysis of ClinicalTrials.gov reveals a dynamic and innovative landscape of AI applications transforming oncology care, from cutting-edge Machine Learning models enhancing early cancer detection to intelligent chatbots supporting treatment adherence and personalized survivorship interventions. These trials highlight AI’s growing role in improving outcomes across the CCC in advancing personalized cancer care. Standardized reporting and enhanced data sharing will be important for facilitating the broader application of trial findings, accelerating the development and clinical integration of reliable AI tools to advance cancer care. Full article

Background: Plyometric training (PT) and resistance training (RT) can improve jumping and sprinting performance, although their comparative effectiveness in elite female basketball players remain unknown. Objectives: To compare the effects of PT and RT on jumping and sprinting performance in elite female basketball players. Methods: Thirty elite female basketball players were randomly assigned to PT (n = 10), RT (n = 10) or control groups (n = 10, standard basketball training). Performance assessments before and after the interventions (8 weeks, 16 training sessions) included countermovement jump (CMJ) height and peak power, drop jump (DJ) height and reactive strength index (RSI), standing long jump distance (LJ), CMJ with arm swing (CMJA) height, running CMJA height, and 22.2 m linear sprint time. Performance changes were analyzed using linear and Bayesian mixed-effects models. Results: Compared to controls, RT and PT improved the RSI. Additionally, PT improved (p < 0.05; posterior probability >0: 99.4–99.9%) CMJ height, CMJ peak power, DJ height and RSI, LJ, CMJA, Running CMJA and sprint time when compared to both controls and RT. Conclusions: Compared to RT, PT induced greater jumping and sprinting performance improvements in elite female basketball players. Full article

Background: A combination of docetaxel and ramucirumab represents a standard of care in second-line treatment for patients with advanced NSCLC. Evidence of the regimen’s efficacy is based on the results of the REVEL trial conducted in the pre-immunotherapy (immune checkpoint inhibitors–ICIs) era. Given the lack of randomized trials after the use of ICIs in front-line therapy, a question remains regarding the impact of the combination when disease progresses after ICI-based therapy. Methods: From 1 January 2018 to 31 December 2024, 55 patients from three oncology centers who had documented progression on ICI-based therapy subsequently received docetaxel/ramucirumab, and we reviewed their outcomes. Results: The studied group’s median progression-free survival (PFS) was 5.8 months, while the median overall survival (OS) was 11.1 months. The objective response rate (ORR) and disease control rate (DCR) were 42% and 76%, respectively. Patients who had received ICI-based therapy for ≥6 months had a numerically better median PFS and statistically significant OS compared to those who had experienced progression on ICI-based therapy in <6 months. Regarding adverse events (AEs), 92.7% of patients experienced Grade 1–2 AEs, whereas 54.5% experienced Grade ≥ 3 AEs. One death due to GI bleeding was also recorded. Conclusion: Docetaxel/ramucirumab is an acceptable regimen for patients progressing on first-line ICI-based therapies. Our results are in concordance with the REVEL study and other retrospective studies of this combination after ICIs. Full article

In recent years, several randomized controlled trials have been published regarding cervical cancer therapy and significantly changed the treatment landscape. Recent advances have improved the treatment options and allow personalized treatment concepts with escalation of treatment in high-risk disease and de-escalation with reduction in morbidity in selected low-risk patients. This review aims to provide a comprehensive analysis of the latest landmark studies that are poised to significantly influence clinical practice. Personalized treatment concepts with careful patient selection allow de-escalation in the surgical treatment of cervical cancer. In low-risk cervical cancer patients (lesions of ≤2 cm with limited stromal invasion), simple hysterectomy (SH) was non-inferior to radical hysterectomy in terms of 3-year incidence of pelvic recurrence and was associated with a lower risk of urinary incontinence or retention and improved sexual health and quality of life. Furthermore, sentinel lymphadenectomy is constantly replacing systematic pelvic lymphadenectomy in patients with low-risk cervical cancer. In addition, further studies are necessary to clarify the role of postoperative therapy for patients with intermediate-risk cervical cancer. Starting in 2008, the EMBRACE studies assess the role of Image guided adaptive brachytherapy (IGABT) in LACC in addition to modern external beam radiotherapy concurrent to chemotherapy. The publication of the results of the EMBRACE I prospective study established MRI guided IGABT as state-of-the-art brachytherapy for LACC. EMBRACE II and additional prospective studies emerging from this consortium will address important questions in modern radiotherapy for LACC. Immune checkpoint inhibitors (CPIs) have been evaluated across various clinical settings and are expected to be utilized in numerous scenarios due to several positive randomized trials. Particularly, the combination of platinum-based chemotherapy and pembrolizumab, with or without bevacizumab, has been established as the new standard treatment for primary metastatic or recurrent PD-L1 positive high-risk cervical cancer. In locally advanced cervical cancer, two new treatment escalation regimens—neoadjuvant chemotherapy and adjuvant CPI therapy—have been evaluated in addition to chemoradiation. Furthermore, antibody-drug conjugates, such as tisotumab-vedotin, represent a promising future therapeutic option for recurrent cervical cancer. Full article