Search Results (113)

Secure autonomous secret key distillation (SKD) systems traditionally depend on external common randomness (CR) sources, which often suffer from instability and limited reliability over long-term operation. In this work, we propose a novel SKD architecture that synthesizes CR by combining a keystream of a shared-key keystream generator $KSG\left(K_G\right)$ with locally generated binary Bernoulli noise. This construction emulates the statistical properties of the classical Maurer satellite scenario while enabling deterministic control over key parameters such as bit error rate, entropy, and leakage rate (LR). We derive a closed-form lower bound on the equivocation of the shared-secret key $K_G$ from the viewpoint of an adversary with access to public reconciliation data. This allows us to define an admissible operational region in which the system guarantees long-term secrecy through periodic key refreshes, without relying on advantage distillation. We integrate the Winnow protocol as the information reconciliation mechanism, optimized for short block lengths ($N=8$), and analyze its performance in terms of efficiency, LR, and final key disagreement rate (KDR). The proposed system operates in two modes: ideal secrecy, achieving secret key rates up to 22% under stringent constraints (KDR < 10⁻⁵, LR < 10⁻¹⁰), and perfect secrecy mode, which approximately halves the key rate. Notably, these security guarantees are achieved autonomously, without reliance on advantage distillation or external CR sources. Theoretical findings are further supported by experimental verification demonstrating the practical viability of the proposed system under realistic conditions. This study introduces, for the first time, an autonomous CR-based SKD system with provable security performance independent of communication channels or external randomness, thus enhancing the practical viability of secure key distribution schemes. Full article

Background/Objectives: Hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) is an emerging imaging modality that combines metabolic and anatomical data in a single session, offering promising diagnostic performance in various cardiac conditions. However, its role in inflammatory cardiac diseases (ICDs), such as myopericarditis and endocarditis, remains underexplored. This study aims to evaluate the diagnostic value of PET/MRI in ICDs through a systematic review of the literature, complemented by our institutional experience. Methods: We conducted a systematic review of PubMed, Scopus, and Embase up to April 2025, using keywords including “PET/MRI,” “PET/MR”, “myocarditis”, “endocarditis”, “pericarditis”, “inflammatory heart disease”, and “inflammatory cardiac disease”. Studies reporting the use of hybrid PET/MRI in ICDs were included and analyzed. Additionally, we retrospectively reviewed clinical and imaging data from 33 consecutive patients who underwent PET/MRI in our center for suspected myopericarditis or endocarditis between September 2022 and March 2025. Results: The systematic review identified 12 eligible studies evaluating PET/MRI in ICDs, highlighting its added value in cases with inconclusive findings on standalone MRI or PET. Common advantages reported included improved localization of active inflammation, better characterization of tissue damage, and enhanced diagnostic confidence. In our cohort, hybrid PET/MRI was considered diagnostically useful in 16/21 (76%) of myopericarditis cases and 9/12 (75%) of endocarditis cases, particularly for reclassifying uncertain findings and guiding clinical management. Conclusions: The combined analysis of the current literature and real-world clinical experience supports the diagnostic utility of hybrid PET/MRI in the evaluation of ICDs. This multimodal approach improves the interpretation of equivocal cases, facilitates accurate diagnosis, and may influence therapeutic decisions. However, larger prospective studies are needed to confirm these findings and establish standardized protocols. Full article

Cardiovascular magnetic resonance imaging (MRI) is an advanced cardiac imaging modality that is often required when evaluating athletic individuals. Unrestricted imaging planes, excellent spatial resolution, and a lack of ionising radiation are some of the benefits of this modality. Cardiac MRI has been established as the gold standard imaging modality for morphological assessment, volumetric analysis, and tissue characterisation. Cardiac MRI without any doubt is an excellent diagnostic tool when evaluating athletes with symptoms or those individuals exhibiting equivocal findings at screening. It is also useful for athletes who fall within the grey zone and is especially important among athletes with a suspected or confirmed diagnosis. Cardiac MRI plays a strategic role when adopting a shared decision-making model in athletes with heart disease, tailoring and personalising medical care to the condition and the athlete’s wishes. The aim of this review is to provide a comprehensive yet practical overview of the role of cardiac MRI when evaluating athletes in clinic. Full article

MRI plays an increasingly important role in the diagnosis of status epilepticus (SE). Approximately half of patients with SE do not have pre-existing epilepsy, and the cause of de novo SE is frequently unknown. The role of MRI in the identification of causes of SE is invaluable. MRI is often helpful as a diagnostic tool in cases of non-convulsive status epilepticus (NCSE) with ambiguous EEG findings. Thus, MRI is recommended for all patients presenting with de novo SE, patients with known epilepsy with the first episode of SE and NCSE with equivocal EEG. Different peri-ictal MRI (PMA) alterations may be seen during ongoing SE or briefly after its cessation. They commonly present as peri-ictal hyper-perfusion, diffusion restriction and/or FLAIR-hyperintensity affecting specific brain areas such as the cortex, hippocampus, pulvinar of the thalamus, splenium of the corpus callosum, claustrum or cerebellum, frequently in combination, suggesting the existence of a “status epilepticus network”. MRI sequences, which are necessary for detecting PMA, include diffusion-weighted imaging, fluid attenuated inversion recovery, T1-weighted imaging with and without contrast application, as well as perfusion sequences such as arterial spin labeling. Recent research suggests that they may serve as biomarkers for predicting an outcome in SE. Patients with PMA seem to have a higher mortality rate compared to those without PMA. However, there is still a substantial knowledge gap and there are many open questions related to imaging in SE. Further prospective quantitative MRI studies with uniform protocols, timing and follow-up periods are needed to answer these important and clinically relevant questions. Full article

Background: Sublobar resection (SLR), including segmentectomy and wedge resection (WR), is an alternative to lobectomy for early-stage lung cancer due to its potential benefits in preserving lung function. However, the comparative outcomes between segmentectomy and WR for stage IA lung adenocarcinoma are equivocal. This population-based study aimed to compare overall survival between segmentectomy and WR. Methods: Data on patients with clinical stage IA lung adenocarcinoma were collected from the Taiwan Cancer Registry between 2011 and 2018. The primary endpoint was overall survival. Further subgroup survival analyses were conducted based on tumor size. Propensity score matching (PSM) was used to balance baseline differences such as age and tumor stage between the two groups. Predictors of survival other than the surgical procedure were analyzed using a Cox regression model. Results: In total, 6598 patients with stage IA lung adenocarcinoma undergoing SLR between 2011 and 2018 were enrolled, including 2061 and 4537 receiving segmentectomy and WR, respectively. The mean age was 60.3 ± 11.7 years, 66.2% were female, and 81.5% never smoked. After PSM, segmentectomy was associated with significantly better overall survival than WR (p = 0.019), especially for tumors larger than 2 cm (p < 0.001). Aside from segmentectomy, age ≤ 75 years, well-differentiated tumors, small tumor size, and the absence of nodal metastasis were associated with better overall survival. Conclusions: Segmentectomy offered superior overall survival for patients with tumors larger than 2 cm. For tumors smaller than 2 cm, the outcomes of segmentectomy and WR were comparable, offering flexibility in surgical decision-making. These findings highlight the need for individualized surgical approaches based on tumor characteristics. Full article

Background/Objectives: Research considering objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary behaviors (SB) and health outcomes among urban children has produced equivocal findings. Therefore, this study was designed (i) to compare MVPA and SB of urban and non-urban children and (ii) to analyze associations between the risk of overweight and MVPA of children by their degree of urbanization. Methods: The sample comprised 389 children (195 girls) aged 6 to 10 years. Measurements for height and weight were taken, followed by the calculation of body mass index (BMI). A motion sensor was employed to gather data on MVPA and SB for 7 days. Urban regions were characterized as areas with a population density exceeding 500 inhabitants per square kilometer or having a total population greater than 50,000. ANOVAs, partial correlations, and logistic regression analysis were used, controlling for potential confounders. Results: After controlling for wearing time and sex, urban children were significantly less active (lower MVPA) than non-urban peers [i.e., urban: 48 min/day vs. 51 min/day (non-urban)]. On the other hand, urban children spent significantly more time on SB than their non-urban counterparts on the weekend and during all assessed days. MVPA was significantly associated with the risk of being overweight at the weekend for both urban and non-urban children. Inspection of the final regression model indicated that urban children who engaged in sedentary behavior for extended periods were at a higher risk of being categorized as overweight. Conclusions: Findings revealed the association between MVPA and the risk of overweight on weekdays was just significant for urban children. The location where a child lives significantly influences their weight status, and therefore, community-based programs [at schools (PE and recess) and after-school (organized sports)] should be developed that encourage active lifestyles tailored to urban environments. Full article

Alkenylbenzenes occur as natural constituents in a variety of edible plants, in particular those herbs and spices used to give a distinctive flavor to a range of food and feed items. Some alkenylbenzenes with relevance for food, such as estragole and methyleugenol, are known to be genotoxic and carcinogenic in rodents. However, the genotoxic and carcinogenic potential of other structurally related alkenylbenzenes, such as myristicin and elemicin, is still under scientific discussion. Here, we investigated the potential of myristicin and elemicin to induce micronuclei (MN) in V79 cells in comparison to that of estragole and methyleugenol. In addition, we determined the impact of these alkenylbenzenes on cell viability and on the induction of apoptosis and necrosis. All tested alkenylbenzenes affected cell viability in a concentration-dependent manner, albeit to varying degrees. Regarding MN formation, elemicin induced a weak but statistically significant response at 100 µM and 500 µM in the absence of an exogenous metabolizing system (S9 mix). Negative results were obtained for estragole and myristicin at the highest tested non-cytotoxic concentration of 10 µM and 100 µM, respectively. For methyleugenol, the MN assay results were considered equivocal, since the observed change in MN induction was rather small and not supported by a concentration-related trend. These findings indicate that traditional in vitro test systems utilizing exogenous metabolizing systems have limited explanatory power with regard to the genotoxic potential of alkenylbenzenes. Full article

Background/Objectives: Current literature has demonstrated the benefits of transversus abdominis plane (TAP) blocks for reducing postoperative pain and opioid consumption for an array of surgical procedures. Some randomized controlled trials and retrospective studies have compared ultrasound guidance TAP blocks completed by anesthesiologists (US-TAP) to laparoscopic guidance TAP blocks completed by surgeons (LAP-TAP). However, the findings of these studies have not been consolidated to improve recommendations and patient outcomes. Our objective is to consolidate and summarize current literature regarding the efficacy of TAP blocks for postoperative pain control and opioid consumption when performed with ultrasound guidance (US-TAP, compared to laparoscopic guidance (LAP-TAP). Methods: We performed a systematic review and meta-analysis of RCTs and retrospective studies to evaluate US-TAP versus LAP-TAP blocks for postoperative pain control and opioid consumption. We searched PubMed/MEDLINE, CINAHL, Cochrane, and Web of Science databases for all articles meeting the search criteria until the time of article extraction in February 2024. The primary outcome variables were postoperative pain scores and opioid consumption. The secondary outcome variables were complications, time taken to perform the block, length of stay (LOS) in the hospital, and cost of performing the block. Results: Of the 1673 articles initially identified, 18 studies met the inclusion criteria for evaluation. Of the included studies, 88.9% and 77.8% found no significant difference in postoperative pain scores or opioid consumption, respectively, between US-TAP and LAP-TAP groups. Six studies (33.3%) found that LAP-TAP was faster to perform than US-TAP. Meta-analysis demonstrated no statistically significant differences in postoperative pain scores or opioid consumption between groups but showed that block times were significantly longer in the US-TAP group. Conclusions: US-TAP and LAP-TAP blocks may be equivocal in terms of reducing postoperative pain and opioid consumption. LAP-TAPs may be less time-consuming and more cost-effective and viable alternatives to US-TAP blocks in the perioperative setting. Full article

The genetic link between Weideshan-type rocks and gold mineralization in the Jiaodong Peninsula remains unclear. In this study, we examined the geochemical characteristics, water content, and oxidation states of Weideshan-type rocks and associated felsic dykes to assess the potential of a Weideshan-type batholith in directly contributing the fluids responsible for extensive gold mineralization. The findings reveal that the emplacement timing of Weideshan-type magmatic rocks in the Jiaodong Peninsula is slightly different from the timing of gold mineralization. Additionally, high zircon Eu/Eu* values indicate a relatively high water content within the Weideshan batholith. However, due to limited data on crystallization pressures, it remains equivocal whether water was saturated during the emplacement of the Weideshan batholith. Even if fluid saturation did occur, the magmatic oxidation states of Weideshan-type rocks are notably high (>FMQ + 1.5), which is incompatible with the reduced mineral assemblages typical of Jiaodong gold deposits. Therefore, our study suggests that the genetic link between gold mineralization and Weideshan-period granitic magmatism may be weak. Full article

Spatial navigation allows animals to understand their environment position and is crucial to survival. An animal’s primary mode of spatial navigation (horizontal or vertical) is dependent on how they naturally move in space. Observations of the domestic dog (Canis familiaris) have shown that they, like other terrestrial animals, navigate poorly in vertical space. This deficit is visible in their use of multi-story buildings. To date, no research has been conducted to determine if dogs can learn how to navigate in an anthropogenic vertical environment with the help of a landmark. As such, we herein investigate the effect of the addition of a visual or olfactory landmark on dogs’ ability to identify when they are on their home floor. Subject behaviors toward their home door and a contrasting floor door were compared before and after exposure to a landmark outside of their home door. While subjects initially showed no difference in latency to approach an apartment door on their home or a wrong floor, we found a significant difference in latency to approach the doors in the test trials for subjects who approached the doors in every trial. Other findings are equivocal, but this result is consistent with the hypothesis that dogs can learn to navigate in vertical space. Full article

Municipal solid waste (MSW) is a growing problem worldwide posing a variety of environmental and human health impacts. Despite recycling being one major strategy to alleviate MSW production, the effectiveness of recycling has been equivocally dependent on local policy implementation and citizen environmental behavior. To enhance recycling effectiveness in Hong Kong, the government has established Green@Community, a unified community-based network for recycling and public environmental education. Since its establishment, the number of visitors to and the amount of recyclable materials collected at the network increased steadily over time. Our study is the very first to investigate the effectiveness of this territory-wide recycling network. Through a questionnaire survey, we found that respondents’ recycling traits were stronger if they have accrued gift tokens through participating in recycling activities. Visiting a Green@Community facility could also enhance knowledge of the types of acceptable recyclables, and respondents who had visited a Green@Community facility agreed that education and publicity could increase the recycling rate in Hong Kong. These findings highlighted the effectiveness and uniqueness of this community-based recycling network, its role in raising recycling knowledge, and its implications for policymakers and urban planners of densely populated cities to leverage society’s recycling participation, but also called for more efforts on developing, promoting, and incentivizing the usage of such a network to further enhance recycling and alleviate MSW production in Hong Kong. Full article

Global warming is attributed to an increased frequency of high ambient temperatures and humidity, elevating the prevalence of high-temperature-related illness and death. Evidence over recent decades highlights that tailored nutritional strategies are essential to improve performance and optimise health during acute and chronic exertional-heat exposure. Therefore, the purpose of this review is to discuss the efficacy of various nutritional strategies and ergogenic aids on responses during and following acute and chronic exertional-heat exposure. An outline is provided surrounding the application of various nutritional practices (e.g., carbohydrate loading, fluid replacement strategies) and ergogenic aids (e.g., caffeine, creatine, nitrate, tyrosine) to improve physiological, cognitive, and recovery responses to acute exertional-heat exposure. Additionally, this review will evaluate if the magnitude and time course of chronic heat adaptations can be modified with tailored supplementation practices. This review highlights that there is robust evidence for the use of certain ergogenic aids and nutritional strategies to improve performance and health outcomes during exertional-heat exposure. However, equivocal findings across studies appear dependent on factors such as exercise testing modality, duration, and intensity; outcome measures in relation to the ergogenic aid’s proposed mechanism of action; and sex-specific responses. Collectively, this review provides evidence-based recommendations and highlights areas for future research that have the potential to assist with prescribing specific nutritional strategies and ergogenic aids in populations frequently exercising in the heat. Future research is required to establish dose-, sex-, and exercise-modality-specific responses to various nutritional practices and ergogenic aid use for acute and chronic exertional-heat exposure. Full article

People living with HIV (PLWH) and people who use drugs are vulnerable populations who may face barriers to accessing health services and may have irregularities in immune function. People with undiagnosed HIV infection may be particularly likely to have compromised immune function. However, research about whether/how HIV status is related to COVID-19-related health outcomes has been equivocal, and research on the predictors of COVID-19-related health service access/uptake has been limited in Sub-Saharan African settings. Among 470 participants of a peer-recruitment-based HIV-testing intervention in KwaZulu-Natal, we examined whether HIV status and/or hard drug use were associated with uptake of COVID-19 testing and vaccination, and whether they moderated the relationship between COVID-19 vaccination status and COVID-19 IgG antibody status. Women were significantly more likely than men to report testing for COVID-19 (OR = 1.84; p = 0.002) and being vaccinated (OR = 1.79; p = 0.002). Neither HIV status nor drug use was associated with likelihood of getting tested or vaccinated. Vaccinated participants (90% of whom obtained vaccines more than 6 months before the study) were significantly more likely to test positive for COVID-19 IgG antibodies (OR = 6.86; p < 0.0005). This relationship held true for subgroups of PLWH and participants with previously undiagnosed/uncontrolled HIV infection, and was not moderated by HIV status or hard drug use. These findings may suggest that both people who use drugs and PLWH were served as well as other people by KwaZulu-Natal’s COVID-19 response. However, gender-based disparities in COVID-19 service uptake suggest that special care should be taken during future COVID-19 outbreaks or other new epidemics to improve access to related healthcare services among men in this region. Full article

Background: Varicella infections follow a benign course in around 90% of cases, with more severe forms occurring in adults. To identify potential pockets of susceptibility and to improve targeted immunization strategies, this study aims to critically assess immunological status by evaluating varicella seroprevalence among adults (18–99 years) in the province of Florence (Italy), nearly a decade after Tuscany introduced the vaccination program. Methods: A convenience sample of 430 subjects aged 18 to 94 years (mean age 51.8 ± 18.8 years), stratified by age and sex (53.7% of subjects were female; N = 231), was collected between 2018 and 2019. Sero-analytical analyses were conducted utilizing EUROIMMUN Anti-VZV ELISA (IgG) kits. Results: Most of them were of Italian nationality (87.4%; N = 376). Among the 430 tested samples, 385 (89.5%) were positive and 39 (9.1%) were negative. The remaining six sera (1.4%), confirmed as equivocal, were excluded from further analysis. No significant differences were found based on sex (p-value = 0.706) or nationality (p-value = 0.112). The application of trend tests (Mantel–Haenszel; Kendall Tau-b) showed a significant trend (p < 0.024 and p < 0.032, respectively), with an increasing probability of finding a positive anti-varicella serological status passing from a lower age group (84.2%) to a higher one (93.0%). By considering the female population aged 18–49 years, the seroprevalence of anti-varicella antibodies was found to be 88.4%, with a susceptibility of 11.6%, highlighting the risk of acquiring infection during pregnancy. Conclusions: The introduction of varicella vaccination has had a significant impact on public health in Tuscany and in Italy more generally. However, further efforts should be made to reduce the number of individuals still susceptible in adulthood, with particular attention given to women of childbearing age and the promotion of vaccination through mass and social media and institutional websites. Full article

Introducing a hybrid imaging approach, such as single-photon emission computerized tomography with X-ray computed tomography (SPECT)/CT, improves diagnostic accuracy and patient management. The ongoing advancement of SPECT hardware and software has resulted in the clinical application of novel approaches. For example, whole-body SPECT/CT (WB-SPECT/CT) studies cover multiple consecutive bed positions, similar to positron emission tomography-computed tomography (PET/CT). WB-SPECT/CT proves to be a helpful tool for evaluating bone metastases (BM), reducing equivocal findings, and enhancing user confidence, displaying effective performance in contrast to planar bone scintigraphy (PBS). Consequently, it is increasingly utilized and might substitute PBS, which leads to new questions and issues concerning the acquisition protocol, patient imaging time, and workflow process. Therefore, this review highlights various aspects of WB-SPECT/CT acquisition protocols that need to be considered to help understand WB-SPECT/CT workflow processes and optimize imaging protocols. Full article