Search Results (1,707)

Deep learning systems for radiographic fracture detection routinely achieve high internal accuracy, yet they rarely undergo external validation across demographically distinct populations, leaving critical generalization gaps unexamined. Pediatric and adult populations represent fundamentally different imaging domains due to developmental anatomy (particularly growth plates (physes) in children), making cross-age validation critical for understanding true model robustness. We trained two ResNet-50 classifiers on publicly available datasets: GRAZPEDWRI-DX (pediatric wrist radiographs, n = 20,327) and FracAtlas (mixed-age multi-region radiographs, n = 4083). Models were evaluated internally and cross-tested bidirectionally on the opposing population. Both models achieved acceptable internal test accuracy (82.2% and 83.7%), yet cross-testing revealed complete discrimination failure: specificity collapsed to 0% in both directions while sensitivity artificially inflated to 100% due to all-positive prediction bias. Grad-CAM analysis identified distinct failure mechanisms: the FracAtlas-trained model misinterpreted normal pediatric physes as fractures, while the pediatric-trained model exhibited texture bias on heterogeneous adult imaging. These results demonstrate that high internal performance provides no assurance of cross-population generalizability and that pediatric–adult domain shifts can trigger catastrophic rather than graduated failure. Mandatory external validation across age-defined populations should be required before clinical deployment of fracture detection AI. Full article

Browning and microbial spoilage are major constraints on the shelf-life of fresh-cut potatoes, yet the concentration-dependent effects of sodium metabisulfite (SM) on product quality and bacterial dynamics are poorly understood. In this study, the impact of SM on the quality and bacterial dynamics of fresh-cut potatoes during storage was investigated. This study evaluated the concentration-dependent effects of SM on the quality of fresh-cut potatoes. The results showed that 0.3% SM treatment effectively delayed browning. Subsequently, the quality and bacterial community of fresh-cut potatoes of CK and 0.3% SM-treated groups were further investigated. The results indicated that a 0.3% SM treatment could inhibit the activities of polyphenol oxidase (PPO), peroxidase (POD) and phenylalanine ammonia-lyase (PAL) as well as the growth of Duganella. On day 7 of storage, the L* values of the control group (CK) and 0.3% SM groups decreased by 17.02% and 7.68%, respectively, while their total plate counts were 4.33 and 4.21 log CFU/g, showing a significant difference between the two groups (p < 0.05). Furthermore, SM treatment extended the shelf-life of fresh-cut potatoes to approximately 7 days, decreased the loss of soluble solids and weight, and maintained textural characteristics (firmness and elasticity). These findings demonstrate that SM treatment is an effective strategy for preserving the quality of fresh-cut potatoes and provide new insights into its role in inhibiting enzymatic browning during storage. Full article

To investigate the influence of porosity defects and the strengthening effect of bonded iron-based shape memory alloy (Fe-SMA) plates, fatigue tests were conducted on defect-free, porosity-containing, and Fe-SMA-strengthened U-rib butt-welded specimens. A numerical model considering porosity defects and the bonded Fe-SMA plate was also established and validated against the experimental results. The results show that porosity defects significantly increased the local stress level near the crack. Under a load of 60 kN, the stress at the section 2 mm from the crack edge increased from 98 MPa to 139.5 MPa. Meanwhile, the fatigue life decreased from 260 × 10⁴ cycles to 127 × 10⁴ cycles. After Fe-SMA strengthening, the stress decreased to 75.59 MPa, and the fatigue life increased to 326 × 10⁴ cycles, which was 2.57 times that of the unreinforced defective specimen. The Fe-SMA plate did not change the fatigue crack propagation path but effectively slowed crack growth through local stiffness enhancement and activation-induced pre-compressive stress. Parametric analysis further showed that, among the investigated numerical cases, an activation temperature of 200 °C produced the largest predicted strengthening effect. Increasing the pore diameter from 0.5 mm to 2.0 mm reduced the reinforcement effect from 69.45% to 52.98%, and increasing the crack length from 10 mm to 50 mm reduced it from 65.41% to 35.53%. These results indicate that bonded Fe-SMA plates can effectively improve the fatigue performance of U-rib butt-welded joints with porosity defects, especially when applied before excessive crack growth occurs. Full article

Sodium (Na) metal anodes suffer from poor processability, severe volume fluctuation, unstable interfacial chemistry, and uncontrolled dendrite growth during cycling, which significantly hinder their practical application. Herein, a Na/Na₂In composite foil is fabricated through an in situ spontaneous alloying reaction enabled by a simple rolling–folding process using Na and indium (In) foils as precursors. Structural characterizations confirm the complete conversion of metallic In into the Na₂In alloy phase, forming a continuous architecture with uniformly distributed Na₂In networks embedded within the Na matrix. Owing to the sodiophilic and mechanically robust Na₂In framework, the Na/Na₂In composite anode effectively regulates Na plating/stripping behavior and suppresses dendritic growth, thereby maintaining a dense and stable electrode morphology during repeated charge/discharge processes. As a result, the Na/Na₂In symmetric cell exhibits stable cycling for over 900 h at 0.5 mA cm⁻² and 1 mAh cm⁻² with low polarization hysteresis, whereas the pure Na counterpart fails after only 143 h. Moreover, full cells paired with NaFe_1/3Ni_1/3Mn_1/3O₂ cathodes deliver enhanced cycling stability, retaining 87% of the initial capacity after 100 cycles at 0.5 C, together with improved rate capability. This work demonstrates a scalable mechanical fabrication strategy for high-stability Na metal composite anodes and provides new insights into the practical development of high-energy-density Na metal batteries. Full article

Lithium metal batteries (LMBs) incorporating solid-state electrolytes (SSEs) promise high energy density and safety, yet their practical deployment is hindered by poor interfacial stability between SSEs and lithium metal anodes. Here we show that a simple incorporation of LiBF₄ into the sulfohalide (Li₃SCl) framework forms a mixture Li₃SCl@LiBF₄ (LSC@BF) SSE via a two-step solid-state synthesis, preserving a high room-temperature ionic conductivity of 4.32 × 10⁻⁴ S cm⁻¹ with a low activation energy of 0.22 eV while fundamentally altering the interface. X-ray photoelectron spectroscopy and electron microscopy reveal that LiBF₄ promotes the in situ formation of a mechanically robust, LiF-rich solid-electrolyte interphase at the SSE|Li interface. This LiF-rich layer effectively suppresses lithium dendrite growth and stabilizes the interface, enabling symmetric Li|LSC@BF|Li cells to achieve stable lithium plating/stripping for over 800 h at 0.2 mA cm⁻². Cross-sectional post-mortem imaging confirms a dense, void-free interface without dendrite penetration. Our work demonstrates that LiBF₄ incorporation offers a simple, scalable strategy to simultaneously maintain high ionic conductivity and resolve interfacial instability in sulfohalide SSEs for high-performance LMBs. Full article

As a traditional element of Chinese medicine, Hippocampus erectus is well known for promoting adolescent growth, yet its active fractions and underlying molecular mechanisms remain unclear. In this study, the aqueous extract of H. erectus was subjected to in vitro simulated gastrointestinal digestion and ultrafiltration to separate three molecular weight fractions (<10 kDa, 10–30 kDa, >30 kDa). Their chemical profiles were characterized, and osteogenic activities were systematically evaluated using cell assays, a juvenile rat model, and integrated transcriptomics and data-independent acquisition (DIA) proteomics. Results revealed that chemical profiling showed the >30 kDa fraction was mainly composed of hemocyanin subunits, and the 10–30 kDa fraction was enriched in growth-related amino acids and steroid derivatives; functionally, the 10–30 kDa fraction promoted preosteoblast proliferation and early differentiation via enhanced alkaline phosphatase (ALP) activity, while the >30 kDa fraction dominated late osteoblast maturation and mineralization. Both fractions significantly increased rat body and bone length by expanding growth plate proliferative zones and elevating serum insulin-like growth factor-1 (IGF-1)/bone morphogenetic protein-2 (BMP-2) levels. Transcriptomic and proteomic analyses identified vascular endothelial growth factor (VEGF), Wingless-related integration site (Wnt), phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt), and extracellular matrix (ECM)–receptor interaction as potential core regulatory pathways. Integrated multi-omics analysis further confirmed Frizzled-related protein B (Frzb) and AKT1 substrate 1 (Akt1s1) as candidate key regulatory targets enriched in the Wnt and adenosine monophosphate-activated protein kinase (AMPK) signaling pathways. These findings elucidate the multi-fraction, multi-pathway mechanism of H. erectus in promoting skeletal development, providing scientific evidence for its traditional use and a theoretical basis for growth-promoting functional food development. Full article

Background: Medical device-associated infections represent a major component of healthcare-associated infections. Biofilm formation promotes microbial persistence on device surfaces, reduces antimicrobial susceptibility, and contributes to multidrug resistance (MDR), complicating diagnosis and treatment. Materials and Method: This study investigated biofilm production and antimicrobial resistance in microorganisms recovered from 100 indwelling and implantable medical devices, including urinary and venous catheters, urethral stents, catheter tips, and orthopedic or prosthetic materials, collected at a tertiary-care hospital (AOU “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy). Microbiological cultures were performed using direct and enrichment methods. Microbial identification was carried out by MALDI-TOF MS, antimicrobial susceptibility testing by VITEK^® (bioMérieux, Marcy-l'Étoile, France) 2 according to EUCAST criteria, and biofilm production was assessed using the crystal violet tissue culture plate assay. MDR status was defined according to international guidelines. Results: Microbial growth was detected in the majority of analized devices, frequently with polymicrobial contamination. Within the study cohort, coagulase-negative staphylococci (CoNS) were the most frequently recovered microorganisms (20%), followed by Klebsiella pneumoniae (10%), Candida albicans (9%), Staphylococcus aureus (9%), Enterococcus faecalis (8%), and Escherichia coli (8%). A significant association was observed between multidrug resistance and biofilm production, with MDR isolates showing a markedly higher likelihood of being biofilm producers compared with non-MDR isolates (OR 9.50; 95% CI 2.72–42.96; p < 0.005). Biofilm formation also differed significantly among device types (p = 0.028). Conclusions: These findings indicate a high prevalence of biofilm-producing MDR microorganisms among isolated recovered from medical devices in our cohort and highlight a significant association between MDR phenotype and biofilm production. These results provide a microbiological characterization of device-associated isolates that may support future studies on infection dynamics and control strategies. Full article

Stainless-steel bipolar plates (BPPs) are attractive for proton exchange membrane water electrolysis (PEMWE) due to their low cost and manufacturability, yet their use is limited by severe corrosion. Despite the advantages of plasma-enhanced atomic layer deposition (PEALD) in producing dense films, ion bombardment may induce surface damage and increase roughness. This paper describes a cross-flow PEALD strategy with a remote plasma source to deposit metallic tantalum (Ta) coatings on stainless steel. In a cross-flow reactor, plasma species reach the substrate primarily through diffusion across the boundary layer of the gas flow, providing a gentler plasma–surface interaction and enabling the formation of dense, smooth Ta coatings. The roughness of the Ta films is markedly reduced from 1.45 nm to 0.24 nm, which is favorable for interfacial electrical contact. The process exhibits self-limiting growth with a linear growth rate of ~0.49 Å cycle⁻¹. In a simulated PEMWE environment, Ta-coated stainless steel shows improved corrosion resistance, with the corrosion potential increasing from −0.27 to 0.07 V vs. Ag/AgCl (pH 0.3) and the corrosion current density decreasing to 2.05 × 10⁻⁷ A cm⁻². Overall, cross-flow PEALD enables high-quality metallic Ta coatings that enhance corrosion protection and interfacial electrical performance for BPPs. Full article

Non-invasive drug delivery for ocular diseases remains a significant challenge in ophthalmology, as conventional eye drops offer less than 5% bioavailability due to pre-corneal barriers and the corneal epithelium. This review explores the intranasal (IN) route as a promising strategy for targeting both the anterior and posterior segments of the eye. The IN route leverages several distinct pathways: the nasolacrimal reflex for remote physiological stimulation; the “neural bridge” through the cribriform plate, allowing direct perineural and vascular transport via the olfactory and trigeminal nerves to bypass the blood–retinal barrier; and systemic absorption that avoids hepatic first-pass metabolism. Pre-clinical evidence indicates that IN administration of agents such as erythropoietin, nerve growth factor, and insulin achieves superior retinal concentrations compared to topical or systemic dosing, offering neuroprotection in models of retinal degeneration and glaucoma. Clinically, varenicline nasal spray is already FDA-approved for dry eye disease, while intranasal steroids demonstrate a favorable ocular safety profile without significantly increasing intraocular pressure. Although limited by mucociliary clearance and small delivery volumes, the IN route offers a painless, non-invasive alternative to intraocular injections, potentially enhancing patient compliance. Future advancements in mucoadhesive nanocarriers are essential to optimize drug residence time and realize the full potential of nose-to-eye delivery in chronic ophthalmic care. Full article

Staphylococcus epidermidis is a major cause of periprosthetic and other implant-associated orthopedic infections because of its ability to adhere to biomaterial surfaces and form biofilm. Tranexamic acid (TXA) is routinely used in arthroplasty to reduce perioperative blood loss; however, emerging evidence suggests that it may also modulate bacterial behavior and antibiotic activity. This study investigated the in vitro effects of TXA in combination with teicoplanin on planktonic growth and biofilm biomass formation in clinical Staphylococcal isolates. Clinical Staphylococcal isolates were evaluated using disk diffusion assays, microtiter plate-based planktonic growth assays, and crystal violet biofilm biomass assays. Microplate-based growth and biofilm assays were performed using five clinical isolates, whereas disk diffusion assays were performed using a separate set of seven clinical staphylococcal isolates. Teicoplanin was tested at literature-based low concentrations of 0.1 and 0.4 µg/mL, either alone or in combination with TXA at 10 and 50 mg/mL. In disk diffusion assays, inhibition zone diameters were quantified using ImageJ. Planktonic growth was assessed by optical density at 600 nm, and biofilm biomass accumulation was quantified by crystal violet staining at 570 nm. Disk diffusion data were analyzed using paired t-tests, while microplate-based growth and biofilm data were analyzed using two-way analysis of variance (ANOVA) followed by Tukey’s multiple-comparisons test. In disk diffusion assays, TXA co-application was associated with larger teicoplanin inhibition zones on both blood agar and Mueller–Hinton agar, suggesting an increased apparent inhibitory zone under agar-based conditions. In microplate-based planktonic growth assays, responses were isolate-dependent. However, co-exposure to TXA, particularly at 50 mg/mL, was associated with reduced OD600-based bacterial growth in several isolates compared with teicoplanin alone. A similar isolate-dependent pattern was observed for crystal violet-based biofilm biomass accumulation. In most tested isolates, teicoplanin combined with 50 mg/mL TXA was associated with lower biofilm biomass than teicoplanin alone, whereas one isolate showed minimal responsiveness. Under the tested in vitro conditions, TXA–teicoplanin co-exposure was associated with reduced planktonic growth and crystal violet-based biofilm biomass accumulation in several clinical staphylococcal isolates. However, because TXA-only controls were not available across the full experimental framework and formal synergy assays were not included, these findings do not establish synergistic activity or distinguish combination-specific effects from TXA-associated effects alone. Further studies are needed to clarify the biological and translational relevance of these observations. Full article

Postharvest diseases caused by fungal pathogens lead to significant economic losses in citrus production. The intensive use of synthetic fungicides has triggered the emergence of resistant strains and environmental contamination, emphasizing the need to search for sustainable alternatives. This study evaluated the antifungal efficacy of a strawberry leaf aqueous extract (SLE) against local isolates of citrus phytopathogens such as Penicillium digitatum and P. italicum (both fungicide−sensitive and fungicide−resistant) and Geotrichum citri-aurantii. In vitro assays showed complete inhibition of mycelial growth for all pathogens on potato dextrose agar plates supplemented with 0.05 g·mL⁻¹ SLE after 5 days at 24 °C. Furthermore, total inhibition of conidial germination and loss of viability were achieved at 0.1 g·mL⁻¹ following an 8 or 24 h exposure period respectively. To elucidate the underlying mode of action, membrane integrity and cellular ultrastructure were examined. SYTOX™ Green staining revealed increased membrane permeability, and transmission electron microscopy showed marked intracellular disorganization in SLE-treated conidia from all phytopathogens. These findings were further validated through in vivo assays using artificially inoculated lemons where a significant reduction in green mold incidence was demonstrated. Overall, SLE exhibited broad-spectrum efficacy against major citrus postharvest pathogens, effectively overcoming established fungicide resistance. Our results could position SLE as a promising biocontrol agent for sustainable fruit preservation. Full article

Alpine permafrost and seasonally frozen ground threaten the long-term safe operation of highway infrastructures. Aiming at the structural performance optimization of prefabricated corrugated steel plate retaining walls in alpine permafrost regions, this study adopted finite element numerical simulation combined with field test validation to systematically explore the influences of wall height, plate thickness, corrugation geometry, and tie reinforcement layout on structural deformation and internal force, and carried out targeted parameter optimization. The core innovations include the following: (1) Structural lateral displacement and internal force rise nonlinearly with the increase in wall height, and high retaining walls exhibit an accelerated growth trend of deformation and stress. (2) Increasing plate thickness can effectively reduce structural displacement and stress, while the improvement effect gradually weakens after exceeding a critical thickness. Specifically, when the thickness increases from 4 mm to 5 mm, the displacement decreases by 33.13%. (3) Appropriately increasing corrugation pitch and height improves structural equivalent stiffness and optimizes stress distribution. Increasing the corrugation pitch from 75 mm to 400 mm and corrugation height from 25 mm to 150 mm reduces the maximum horizontal displacement by 52.6%. This demonstrates that larger corrugation profiles significantly improve structural stiffness. For walls higher than 6 m, the spacing should be reduced to 0.8 m × 1.0 m to provide additional lateral restraint. (4) Furthermore, seasonal freeze–thaw cycles and a non-uniform temperature field significantly amplify structural displacement and stress. After 12 months of freeze–thaw cycles, the maximum horizontal displacement increases by 49.7% and the maximum equivalent stress increases by 56.9% compared to the initial state. This study clarifies the parameter control mechanism and temperature coupling effect and provides a reliable theoretical basis and design reference for the engineering application of prefabricated corrugated steel plate retaining walls in alpine permafrost areas. Full article

Introduction: Ado-trastuzumab emtansine (T-DM1) is a targeted agent for human epidermal growth factor receptor 2 (HER2)-positive breast cancer, which combines the anti-tumor activity of trastuzumab with the cytotoxic effect of DM1, a microtubule inhibitor. Although T-DM1 has improved outcomes in patients with HER2-positive breast cancer, portal hypertension may occur during treatment in the absence of overt cirrhosis on liver biopsy. These clinical and pathological features are consistent with porto-sinusoidal vascular disorder (PSVD). This study aimed to summarize the reported clinical, biochemical, imaging, histological, therapeutic, and prognostic features of T-DM1-associated PSVD. Methods: PubMed and Web of Science were searched for published cases of T-DM1-associated PSVD. Given the evolving terminology of PSVD, related terms, including non-cirrhotic portal hypertension and nodular regenerative hyperplasia, were also included in the search strategy. If the patient has a recorded history of T-DM1 exposure and the liver biopsy results meet PSVD criteria, the case is included regardless of whether there is clinical, endoscopic, or imaging evidence of portal hypertension. Cases without liver biopsy or with features suggestive of overt cirrhosis were excluded. Patient-level data were extracted and descriptively summarized, including demographic characteristics, clinical manifestations, biochemical indicators, imaging examination results, liver biopsy results, treatment methods, and prognosis. Unreported data were considered missing values and were not imputed. Results: Seven eligible articles comprising eight patients were identified. All patients were female, with a mean age of 60.38 years and a median age of 62.50 years. The interval from T-DM1 initiation to PSVD diagnosis ranged from 6 to 30 months. When reported, the mean interval from treatment initiation to symptom onset was 18.3 months. Thrombocytopenia and splenomegaly were observed in 7 of 8 patients. Mild elevations in alanine aminotransferase and aspartate aminotransferase were observed in all patients. Liver biopsy showed thinned and disorganized hepatic plates accompanied by nodular regeneration of hepatocytes in six patients. Clinical improvement was observed after discontinuation or modification of T-DM1 in most cases. Conclusions: T-DM1-associated PSVD is a rare but clinically significant complication that may develop months after treatment initiation. It commonly presents with thrombocytopenia, splenomegaly, gastrointestinal bleeding, or mild liver biochemical abnormalities in the absence of overt cirrhosis. Early recognition of unexplained platelet decline, splenic enlargement, or portal hypertension-related findings during T-DM1 therapy may facilitate timely diagnosis and individualized management. Withdrawal or modification of the suspected drug may contribute to clinical improvement, although further studies are needed to clarify the mechanism and optimal management strategy. Full article

Foxtail millet is one of the important minor cereal crops and is highly valued for its nutritional quality and drought tolerance. With the continuous expansion of the foxtail millet industry, the harm caused by foxtail millet blast has become increasingly severe. In this study, 53 samples of foxtail millet leaves symptomatic of foxtail millet blast were collected from a foxtail millet base in Dingxiang County, Shanxi Province, from June to October 2023. Isolation, culture and identification of the pathogen were carried out, yielding a total of 16 pure isolates, and preliminary studies on the growth inhibition and control effects of the fungus were conducted by determining the plate inhibition rate, scanning electron microscope observations and indoor potted plant experiments. The results showed that based on the morphological characteristics of the isolated strains and the combined analysis of ITS-RPB1-ACT sequences, all 16 pure isolates obtained were identified as Pyricularia oryzae. The results of the antifungal test showed that Bacillus velezensis YQH had the highest inhibition rate of 57.93% against the pathogen of foxtail millet blast; among chemical fungicides, 9% Pyraclostrobin Suspension Concentrate, 45% Prochloraz Emulsifiable Concentrate and 32.5% Difenoconazole–Azoxystrobin Suspension Concentrate had strong inhibitory effects on the fungus, with EC₅₀ values (95% confidence intervals) of 0.328 (0.262–0.400) μg·mL⁻¹, 0.848 (0.578–1.219) μg·mL⁻¹ and 0.310 (0.197–0.484) μg·mL⁻¹, respectively. The results of the potted plant experiment were in accordance with the in vitro antifungal results, and scanning electron microscopy showed that the mycelia in the treatment groups of these three chemical fungicides showed developmental deformities, breakage or surface shrinkage. In conclusion, B. velezensis YQH and the three chemical fungicides (especially 9% Pyraclostrobin Suspension Concentrate and 32.5% Difenoconazole–Azoxystrobin Suspension Concentrate) are effective candidates for controlling foxtail millet blast. Full article

Healthcare-associated infections (HAIs) remain a major public health concern, contributing to increased morbidity, mortality, and antimicrobial resistance. Healthcare workers (HCWs) are recognized as key vehicles in the transmission of nosocomial pathogens, primarily via contaminated hands and medical devices. This study assessed the effectiveness of hand hygiene protocols among HCWs, their correlation with bloodstream infections, and the potential of natural antimicrobial agents as complementary preventive measures. Between January and June 2025, 128 hand samples were collected from HCWs in surgical, intensive care, and internal medicine units of hospitals managed by ASL Caserta (Marcianise, n = 65; Piedimonte Matese, n = 30; Sessa Aurunca, n = 18; Maddaloni, n = 15). Sampling was performed upon entry to clinical areas and after antiseptic handwashing, using Rodac TSA plates to quantify microbial load (CFU/cm²). Isolates were identified via MALDI-TOF, and multidrug resistance was confirmed using the Phoenix BD system. Microbial growth was detected in 54.7% of samples. Coagulase-negative staphylococci, mainly Staphylococcus epidermidis and S. hominis, accounted for 67.1% of positive cultures, followed by Enterobacteriaceae (28.6%). Comparison with concurrently collected blood cultures revealed potential overlapping pathogens, with Staphylococcus spp. prevalence ranging from 35 to 56% and Gram-negatives from 18 to 39. Selected isolates were further tested for susceptibility to natural antimicrobial agents, derived from hop, red vine leaf, green tea, and pomegranate fruit, as well as thyme essential oil. Thyme essential oil (Thymus vulgaris) demonstrated notable antimicrobial activity, in several cases surpassing that of standard hygiene agents. These findings highlight not only that maintaining high standards of hand hygiene, proper care of invasive devices, and continuous microbiological surveillance is critical for preventing HAIs, but also that incorporating natural antimicrobial compounds into hygiene protocols may provide an effective and sustainable adjunct to reduce microbial contamination and combat infections caused by multidrug-resistant organisms. Full article