Search Results (1,202)

Arrhythmogenic cardiomyopathies (ACMs) are a phenotypically and etiologically heterogeneous group of myocardial disorders characterized by fibrotic or fibro-fatty replacement of ventricular myocardium, electrical instability, and an elevated risk of sudden cardiac death. Initially identified as a right ventricular disease, ACMs are now recognized to include biventricular and left-dominant forms. Genetic causes account for a substantial proportion of cases and include desmosomal variants, non-desmosomal variants, and familial gene-elusive forms with no identifiable pathogenic mutation. Nongenetic etiologies, including post-inflammatory, autoimmune, and infiltrative mechanisms, may mimic the phenotype. In many patients, the disease remains idiopathic despite comprehensive evaluation. Cardiac magnetic resonance imaging has emerged as a key tool for identifying non-ischemic scar patterns and for distinguishing arrhythmogenic phenotypes from other cardiomyopathies. Emerging classifications propose the unifying concept of scarring cardiomyopathies based on shared structural substrates, although global consensus is evolving. Risk stratification remains challenging, particularly in patients without overt systolic dysfunction or identifiable genetic markers. Advances in tissue phenotyping, multi-omics, and artificial intelligence hold promise for improved prognostic assessment and individualized therapy. Full article

Photovoltaic (PV) micro-installations producing renewable electricity and automatic pellet boilers producing renewable heat energy are promising solutions for single-family houses. A single-family house equipped with a prosumer 7.56 kWp PV micro-installation and a 26 kW pellet boiler was analyzed. This study aimed to analyze the production and use of electricity and heat over three successive years (from 1 January 2021 to 31 December 2023) and to identify opportunities for securing renewable energy supply for the house. Electricity production by the PV was, on average, 6481 kWh year⁻¹; the amount of energy fed into the grid was 4907 kWh year⁻¹; and the electricity consumption by the house was 4606 kWh year⁻¹. The electricity supply for the house was secured by drawing an average of 34.2% of energy directly from the PV and 85.2% from the grid. Based on mathematical modeling, it was determined that if the PV installation had been located to the south (azimuth 180°) in the analyzed period, the maximum average production would have been 6897 kWh. Total annual heat and electricity consumption by the house over three years amounted, on average, to 39,059 kWh year⁻¹. Heat energy accounted for a dominant proportion of 88.2%. From a year-round perspective, a properly selected small multi-energy installation can ensure energy self-sufficiency and provide renewable energy to a single-family house. Full article

Background: Hemiplegic migraine (HM) is a rare and severe subtype of migraine with a complex genetic basis. Although pathogenic variants in CACNA1A, ATP1A2, and SCN1A explain some familial cases, a significant proportion of patients remain genetically undiagnosed. Increasing evidence points to an overlap between migraine and cerebral small vessel disease (SVD), implicating vascular dysfunction in HM pathophysiology. Objective: This study aimed to identify rare or novel variants in genes associated with SVD in a cohort of patients clinically diagnosed with HM who tested negative for known familial hemiplegic migraine (FHM) pathogenic variants. Methods: We conducted a case-control association analysis of whole exome sequencing (WES) data from 184 unrelated HM patients. A targeted panel of 34 SVD-related genes was assessed. Variants were prioritised based on rarity (MAF ≤ 0.05), location (exonic/splice site), and predicted pathogenicity using in silico tools. Statistical comparisons to gnomAD’s Non-Finnish European population were made using chi-square tests. Results: Significant variants were identified in several SVD-related genes, including LRP1 (p.Thr4077Arg), COL4A1 (p.Pro54Leu), COL4A2 (p.Glu1123Gly), and TGFBR2 (p.Met148Leu and p.Ala51Pro). The LRP1 variant showed the strongest association (p < 0.001). All key variants demonstrated pathogenicity predictions in multiple computational models, implicating them in vascular dysfunction relevant to migraine mechanisms. Conclusions: This study provides new insights into the genetic architecture of hemiplegic migraine, identifying rare and potentially deleterious variants in SVD-related genes. These findings support the hypothesis that vascular and cellular maintenance pathways contribute to migraine susceptibility and may offer new targets for diagnosis and therapy. Full article

Weeds represent increasingly troublesome threats to modern wheat production. Jiangsu Province, China, is one of the largest wheat-planting areas, characterized by a high level of agricultural mechanization, in the country. In 2024, we surveyed weed communities of 924 wheat lands from 308 sites in Jiangsu and compared them with historical data surveyed in 1999–2000 in this province. A total of 156 weed species belonging to 103 genera and 39 families were recorded. Compositae and Poaceae showed the highest species richness, with 26 and 23 species, respectively. Poaceae weeds accounted for 54.3% of the overall weeds in dominance values. Beckmannia syzigachne showed the highest proportion of the overall weeds in dominance values (19.2%). Compared with the historical data, weed diversity increased by 33.3% in species, and by 62.5% in families; grassy weeds such as Beckmannia syzigachne, Alopecurus japonicus, and Alopecurus myosuroides became more dominant, while several low-growing grassy weeds became less dominant. The dominance of broadleaf weeds, such as Galium spp., Vicia spp., and Veronica spp., decreased greatly, and a clear trend of weed homogenization among different areas and types of wheat lands was observed. This is the first investigation of weed community succession against the background of agricultural modernization in China. Full article

Background/Objectives: Breastmilk offers numerous benefits for the health and development of preterm infants, while prolonged hospitalization may impair neurodevelopment. At our institution, the implementation of enhanced family-centered care (FCC) has enabled earlier discharge of preterm infants. This study aimed to assess the impact of early discharge on breastfeeding and breastmilk provision. Methods: This analysis is based on data from a prospective single-center longitudinal cohort study conducted from October 2020 to November 2023, involving six consecutive cohorts (one baseline and five intervention cohorts; n = 184). FCC was progressively enhanced across cohorts. The primary outcome of the main study was postmenstrual age (PMA) at discharge. In this secondary analysis, breastfeeding and breastmilk provision were assessed at four time points: 4 weeks postnatal age, at discharge, 4 weeks post-discharge, and at 3 months PMA. Results: From baseline to intervention cohort 5, the PMA at discharge declined significantly from 37.8 ± 2.1 to 35.7 ± 0.91 weeks (p = 0.03), while the percentage of infants necessitating home nasogastric tube feeding increased from 6.3% to 66.7% (p < 0.01). The proportion of breastmilk of daily feeding volume remained unchanged at 4 weeks postnatal age (0.66 ± 0.42 vs. 0.9 ± 0.28) and at discharge (0.6 ± 0.45 vs. 0.79 ± 0.36). At 4 weeks post-discharge, 65.8% vs. 62.5% of the infants were on partial or exclusive breastmilk (p = 0.91) feeding. Similarly, the percentage of exclusively breastfed infants at 4 weeks post-discharge (23.7% vs. 19.8%) and at 3 months PMA (20% vs. 28.6%) did not differ significantly between baseline and intervention cohort 5. Conclusions: Early discharge did not reduce breastmilk supply or exclusive breastfeeding. However, the persistently low rate of exclusive breastfeeding post-discharge highlights the need for additional support strategies during and after hospitalization. Full article

Background and Objectives: General-purpose multimodal large language models (LLMs) are increasingly used for medical image interpretation despite lacking clinical validation. This study evaluates the diagnostic reliability of ChatGPT-4o and Claude 2 in photographic assessment of adolescent idiopathic scoliosis (AIS) against radiological standards. This study examines two critical questions: whether families can derive reliable preliminary assessments from LLMs through analysis of clinical photographs and whether LLMs exhibit cognitive fidelity in their visuospatial reasoning capabilities for AIS assessment. Materials and Methods: A prospective diagnostic accuracy study (STARD-compliant) analyzed 97 adolescents (74 with AIS and 23 with postural asymmetry). Standardized clinical photographs (nine views/patient) were assessed by two LLMs and two orthopedic residents against reference radiological measurements. Primary outcomes included diagnostic accuracy (sensitivity/specificity), Cobb angle concordance (Lin’s CCC), inter-rater reliability (Cohen’s κ), and measurement agreement (Bland–Altman LoA). Results: The LLMs exhibited hazardous diagnostic inaccuracy: ChatGPT misclassified all non-AIS cases (specificity 0% [95% CI: 0.0–14.8]), while Claude 2 generated 78.3% false positives. Systematic measurement errors exceeded clinical tolerance: ChatGPT overestimated thoracic curves by +10.74° (LoA: −21.45° to +42.92°), exceeding tolerance by >800%. Both LLMs showed inverse biomechanical concordance in thoracolumbar curves (CCC ≤ −0.106). Inter-rater reliability fell below random chance (ChatGPT κ = −0.039). Universal proportional bias (slopes ≈ −1.0) caused severe curve underestimation (e.g., 10–15° error for 50° deformities). Human evaluators demonstrated superior bias control (0.3–2.8° vs. 2.6–10.7°) but suboptimal specificity (21.7–26.1%) and hazardous lumbar concordance (CCC: −0.123). Conclusions: General-purpose LLMs demonstrate clinically unacceptable inaccuracy in photographic AIS assessment, contraindicating clinical deployment. Catastrophic false positives, systematic measurement errors exceeding tolerance by 480–1074%, and inverse diagnostic concordance necessitate urgent regulatory safeguards under frameworks like the EU AI Act. Neither LLMs nor photographic human assessment achieve reliability thresholds for standalone screening, mandating domain-specific algorithm development and integration of 3D modalities. Full article

Background/Objectives: Healthcare workers (HCW) have increased the risk of occupational stress injuries and adverse mental health outcomes, which were exacerbated during the COVID-19 pandemic. Understanding HCW psychological distress patterns and help-seeking behaviors can inform responsive resource development that may mitigate negative outcomes in future crises. This paper provides insights on monthly trends in HCW distress and support utilization at a large Canadian hospital over a 14-month period. Methods: As part of a hospital-wide wellness initiative during COVID-19, the STEADY program emailed monthly confidential wellness assessments to hospital staff from April 2020 to May 2021. The assessments included screens for burnout, anxiety, depression and posttraumatic stress, types of support accessed, and demographic information. Repeated cross-sectional data were summarized as monthly proportions and examined alongside longitudinal COVID-19 data. Results: A total of 2498 wellness assessments were submitted (M = ~168 monthly, range: 17–945). Overall, 67% of assessments had at least one positive screen for distress. Average positive screens were 44% for anxiety, 29% for depression, 31% for posttraumatic stress, and 53% for burnout. Despite high distress, most respondents used informal supports (e.g., family/friends), highlighting limited formal support use. Conclusions: HCWs experienced sustained high levels of psychological distress during the COVID-19 pandemic, with burnout remaining a predominant and persistent concern. The limited use of formal support services may indicate barriers to accessing these types of supports. Our findings underscore the need for accessible and acceptable mental health supports for HCW during prolonged crises. Full article

The rubber plantations in Sankuru province, located in the Democratic Republic of Congo (DRC), have historically been pivotal to the regional economy. However, the absence of suitable silvicultural practices has promoted self-regeneration, resulting in the proliferation of diverse species. This study aims to characterize species richness and plant structure of these plantations. To this end, 80 subplots measuring 0.25 hectares were meticulously established, with a proportionate division between state-owned and farmer plantations. The results obtained from this study indicate that these plantations are home to approximately 105 species, classified into 33 distinct botanical families, with dominant families such as Fabaceae, Meliaceae, Euphorbiaceae, Olacaceae, Clusiaceae, and Moraceae. Despite the similarity between the two types of plantations (Cs = 58%), significant disparities were observed in terms of individuals, 635 ± 84.06 and 828 ± 144.62 (p < 10⁻³); species, 41 ± 7.49 and 28 ± 4.59 (p < 10⁻³); families, 19 ± 3.06 and 16 ± 1.62 (p < 10⁻²); and basal area, 29.88 ± 5.8 and 41.37 ± 7.57 (p < 10⁻²) for state and peasant plantations, respectively. State plantations exhibited greater diversity (H′ = 1.87) and enhanced equity (J’ = 0.43) than peasant plantations. The diametric structure exhibited an inverted J-shaped distribution, indicating constant and regular regeneration of these plantations. The upper canopy dominates the vertical structure in both types of plantations, with a significantly higher proportion in peasant plantations (83.60%) than in state plantations (73.8%), ANOVA (F (2.24 = 21.78), df = 24; p = 4.03 × 10⁻⁶). The findings indicate that the sustainable management of these plantations could incorporate agroecological principles to promote the coexistence of rubber production and biodiversity conservation while contributing to the restoration of degraded ecosystems and the well-being of local communities. Full article

Background/Objectives: Congenital microcephaly is a clinical manifestation with a heterogeneous etiology, and its epidemiological surveillance relies on the systematic identification of cases and investigation of their underlying causes to inform preventive strategies and improve prognostic assessments. In Latin America, despite the existence of congenital anomaly reporting programs since 1967, the surveillance of microcephaly only gained substantial attention following the Zika virus (ZIKV) epidemic in 2015. Since then, efforts have predominantly concentrated on cases of infectious origin, often at the expense of recognizing endogenous etiologies, particularly those of genetic nature. This review aims to examine the role of genetic alterations in microcephaly pathogenesis and evaluates the limitations of current surveillance systems. Methods: A literature review centered on syndromic and non-syndromic genetic etiologies, alongside an analysis of Latin American surveillance frameworks (ECLAMC, RyVEMCE, ICBDSR, ReLAMC) was performed. Results: The findings reveal improved case detection and increased reported prevalence; however, the proportion of genetically attributed cases has remained stable. No systematic studies were found identifying the most common genetic causes; instead, genetic investigations were limited to isolated cases with a family history. Conclusions: While epidemiological surveillance systems in Latin America have advanced in the reporting of congenital microcephaly cases, substantial gaps remain in case ascertainment and etiological investigation, particularly concerning genetic contributions Full article

The performance of solar thermal systems for space heating and domestic hot water (DHW) production depends on the tilt angle of solar collectors, which governs the amount and seasonal distribution of captured solar radiation. This study evaluates the impact of fixed collector tilt angles on the annual solar fraction (SF) of a solar heating system designed for a typical single-family house located in Kraków, Poland (50° N latitude). A numerical model based on the f-Chart method was employed to simulate system performance under varying collector areas, storage tank volumes, heat exchanger characteristics, and DHW proportions. The analysis revealed that although total annual irradiation decreases with increasing tilt angle, the SF reaches a maximum at a tilt angle of approximately 60°, which is about 10° higher than the local geographic latitude. This configuration offers a favorable balance between winter energy gain and summer overheating mitigation. The results align with empirical recommendations in the literature and offer practical guidance for optimizing fixed-tilt solar heating systems in temperate climates. Full article

One of the methods for mitigating the duck curve phenomenon in photovoltaic (PV) energy systems is storing surplus energy in the form of hydrogen. However, there is a lack of studies focused on residential PV systems that assess the impact of hydrogen storage on the reduction of energy flow imbalance to and from the national grid. This study presents an analysis of hydrogen energy storage based on real-world data from a household PV installation. Using simulation methods grounded in actual electricity consumption and hourly PV production data, the research identified the storage requirements, including the required operating hours and the capacity of the hydrogen tank. The analysis was based on a 1 kW electrolyzer and a fuel cell, representing the smallest and most basic commercially available units, and included a sensitivity analysis. At the household level—represented by a single-family home with an annual energy consumption and PV production of approximately 4–5 MWh over a two-year period—hydrogen storage enabled the production of 49.8 kg and 44.6 kg of hydrogen in the first and second years, respectively. This corresponded to the use of 3303 kWh of PV-generated electricity and an increase in self-consumption from 30% to 64%. Hydrogen storage helped to smooth out peak energy flows from the PV system, decreasing the imbalance from 5.73 kWh to 4.42 kWh. However, while it greatly improves self-consumption, its capacity to mitigate power flow imbalance further is constrained; substantial improvements would necessitate a much larger electrolyzer proportional in size to the PV system’s output. Full article

(1) Background: Urban parks play a critical role in conserving biodiversity within city landscapes, yet the effects of fine-scale microhabitat heterogeneity remain poorly understood. This study examines how land cover and vegetation unit type within parks influence butterfly diversity. (2) Methods: From July to September 2019 and June to September 2020, adult butterflies were surveyed in 27 urban parks across Beijing. We classified vegetation into units based on vertical structure and management intensity, and then applied the patch–matrix framework and landscape metrics to quantify fine-scale heterogeneity in vegetation unit composition and configuration. Generalized linear models (GLM), generalized additive models (GAM), and random forest (RF) models were applied to identify factors influencing butterfly richness (Chao1 index) and abundance. (3) Results: In total, 10,462 individuals representing 37 species, 28 genera, and five families were recorded. Model results revealed that the proportion of park area covered by spontaneous herbaceous areas (SHA), wooded spontaneous meadows (WSM), and the Shannon diversity index (SHDI) of vegetation units were positively associated with butterfly species richness. In contrast, butterfly abundance was primarily influenced by the proportion of park area covered by cultivated meadows (CM) and overall green-space coverage. (4) Conclusions: Fine-scale vegetation patch composition within urban parks significantly influences butterfly diversity. Our findings support applying the patch–matrix framework at intra-park scales and suggest that integrating spontaneous herbaceous zones—especially wooded spontaneous meadows—with managed flower-rich meadows will enhance butterfly diversity in urban parks. Full article

Gray snapper (Lutjanus griseus; Family: Lutjanidae) local habitat preferences have been assessed, but the biotic and abiotic factors influencing age and growth rates in Mosquito Lagoon, Florida, have not been quantified. To address this knowledge gap, the goal of this study was to estimate mean age and growth rate of gray snapper, and use generalized linear mixed models to investigate if prey and/or other environmental factors (e.g., abiotic/biotic conditions, time, location, or habitat restoration status) impact size at both the lagoon- and habitat-specific scales. Age data were extracted via otolith microstructural analyses, and incorporated with size into a lagoon-scale linear growth model. Based on microstructural analyses, mean age of gray snapper at the lagoon scale was 175 ± 66 days (range = 56–350 days). The results indicate the most common life stage of gray snapper in Mosquito Lagoon is juveniles, with living shoreline habitats having a greater proportion of relatively young juveniles (111 ± 36 days) and oyster reef habitats having a greater proportion of relatively older juveniles (198 ± 58 days). The estimated growth rate was 0.43 mm/day. Body mass and body length were correlated positively with habitat quality and lagged salinity levels. Hence future studies should strive to characterize benthic habitat characteristics, and investigate biotic and abiotic factors that potentially influence gray snapper growth. Collectively, this study increases our understanding of environmental drivers affecting juvenile gray snapper development and shows that the restoration of benthic habitats can produce conditions conducive to gray snapper growth. The age-, size-, and habitat-specific growth rates of juveniles from this study can be incorporated into stock assessments, and thereby be used to refine and develop more effective ecosystem-based management strategies for gray snapper fisheries. Full article

Background/Objectives: Ultra-processed foods (UPFs) constitute a large proportion of the daily energy intake of Europeans, particularly among children and adolescents. High UPFs consumption is associated with poor dietary quality and adverse health outcomes. This study aimed to examine whether high UPFs consumption is associated with metabolic health in children, adolescents, and adults, using data from the I.Family study. Methods: This cross-sectional analysis (2013/2014) included 2285 participants: 147 children (6–9 years), 645 adolescents (10–19 years), and 1493 adults (≥20 years). For the children and adolescents, a metabolic syndrome (MetS) z-score was calculated, consisting of age- and sex-standardized z-scores of WC, HOMA index, HDL-C, TRG, systolic blood pressure (SBP), and diastolic blood pressure (DBP). For the adults, MetS was defined according to the criteria of the International Diabetes Federation Task Force and other societies. The participants completed at least one 24 h recall, from which their UPFs consumption was estimated using the NOVA classification. The consumption levels were divided into age- and sex-specific quintiles based on the relative energy contribution of these foods. Multivariable regression analyses were conducted to evaluate the associations between UPFs consumption and MetS or its components. Results: No statistically significant associations were found between UPFs consumption and MetS or its components in any age group. The effect sizes were negligible across the quintiles (η² = 0.0065 in children, 0.015 in adolescents, and 0.0009 in adults). While the mean MetS score showed little variation, the prevalence of MetS scores above the 90th percentile increased in the highest UPFs quintile among the children. The diet quality decreased with increasing UPFs consumption. Conclusions: UPFs consumption was not associated with MetS or its components across the age groups. However, a decline in diet quality was observed with increasing UPFs intake, highlighting the importance of public health strategies to reduce UPFs consumption and improve dietary patterns, particularly among younger populations. Full article

Urban gardens, including family allotment gardens (FAGs) and community gardens (CGs), play an increasingly important role in urban resilience to climate change—particularly through the delivery of regulatory ecosystem services. They occupy as much as 2.6% of Warsaw’s land area and thus have a tangible impact on the entire metropolitan system. These gardens are used in different ways, and each use affects the magnitude of the provided ecosystem services. This preliminary study explores how different types of allotment garden uses affect biodiversity and ecosystem services, addressing a critical knowledge gap in the classification and ecological functioning of urban gardens. We surveyed 44 plots in Warsaw, categorizing them into five vegetation use types: turf, flower, vegetable, orchard, and abandoned. For each plot, we assessed the floristic diversity, vegetation structure (leaf area index, LAI), and six regulatory services: air and soil cooling, water retention, humidity regulation, PM 2.5 retention, and nectar provision. Flower gardens had the highest species diversity (Shannon index = 1.93), while turf gardens had the lowest (1.43) but the highest proportion of native species (92%). Abandoned plots stood out due to the densest vegetation (LAI = 4.93) and ecological distinctiveness. Principal component analysis showed that the selected ecosystem services explained 25% of the variation in vegetation types. We propose a use-based classification of urban gardens and highlight abandoned plots as a functionally unique and overlooked ecological category. Full article