Search Results (1,051)

The role of insulin-like growth factor-binding proteins (IGFBPs) in the regulation of carbohydrate metabolism and the development of complications is well established; however, the impact of the glucagon-like peptide-1 receptor agonist semaglutide on IGFBPs has not been previously investigated. We aimed to examine the effects of semaglutide and dipeptidyl peptidase-4 inhibitor sitagliptin therapy on serum levels of IGFBP-1, IGFBP-3, and IGFBP-rp1, and to analyze their associations with anthropometric variables and markers of carbohydrate and lipid metabolism. In this prospective study, we enrolled 34 patients with type 2 diabetes mellitus (T2DM) on metformin monotherapy and 31 age-, sex- and BMI-matched controls. Among the patients, 18 received semaglutide, and 16 were treated with sitagliptin. Anthropometric and laboratory assessments were performed at baseline, 26 and 52 weeks. IGFBP levels were measured using ELISA. Both semaglutide and sitagliptin treatment significantly increased IGFBP-1 levels. IGFBP-3 levels were significantly decreased following sitagliptin therapy. No significant change in IGFBP-rp1 levels was observed with either treatment. Based on multiple regression analysis, the best predictors of IGFBP-1 were insulin and hsCRP, while the best predictor of IGFBP-3 was LDL-C level. Our findings suggest that semaglutide and sitagliptin may exert favorable effects on the GH/IGF-1 axis, potentially contributing to their beneficial metabolic outcomes in patients with T2DM. Full article

Background/Objectives: This study aimed to evaluate the one-year real-world effectiveness of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in controlling myopia progression in a Turkish pediatric cohort and to identify predictors of treatment response using age-specific physiological growth curves. Methods: This retrospective single-center study included 54 patients (108 eyes) aged 6–16 years with myopia who wore DIMS spectacle lenses full time for 12 months. The primary outcomes were spherical equivalent refraction (SER) success and axial length (AL)-based treatment response. Treatment success was defined as an SER progression of ≤0.50 dioptres per year and AL elongation within age-specific physiological limits. Subgroup analyses were performed according to age, gender, and the baseline AL group. Results: After 12 months, the mean AL elongation was 0.14 ± 0.31 mm, and the mean SER change was −0.28 ± 0.42 D. SER-based success was achieved in 85.2% of eyes. For AL-based response, 61.1% of eyes showed a good response, 16.7% showed a low–moderate response, and 22.2% had no response. Eyes with moderate baseline AL exhibited significantly less axial elongation than those with high baseline AL (p = 0.001). Children aged ≥ 10 years demonstrated better AL-based responses (p = 0.016). The baseline AL group significantly predicted the AL treatment response, while both the baseline AL group and gender predicted SER success. Gender was associated with SER outcomes but not with AL-based response. Conclusions: DIMS spectacle lenses effectively reduced myopia progression and axial elongation in this real-world Turkish pediatric cohort. Baseline AL and gender were significant predictors of treatment outcomes. Incorporating age-specific physiological growth curves provided an individualized framework for interpreting treatment success. Further prospective studies with larger samples and longer follow-up are warranted to confirm these findings. Full article

The platelet-to-lymphocyte ratio (PLR) has been used as a marker of inflammation, endothelial damage, and a predictor of mortality. Expanded hemodialysis (HDx) using medium cut-off dialyzer (MCO) can effectively clear medium-sized uremic toxins. This study evaluated the effect of the Theranova dialyzer, a type of MCO dialyzer, on PLR and uremia-related inflammatory markers. A total of 44 patients with maintenance hemodialysis (HD) using high-flux dialyzer were randomly allocated to the Theranova or high-flux group. PLR and inflammatory markers including fibroblast growth factor 23, tumor necrosis factor-α (TNF-α), and interleukin 6 were evaluated every 4 weeks. The changes in PLR and the reduction ratio of inflammatory markers were compared between two groups during the 12-week study period. The baseline characteristics and PLR were not different between groups. After 12 weeks, the levels of PLR, and TNF-α were significantly lower in the Theranova group compared to the high-flux group (all p < 0.05). The generalized estimating equation model also revealed a significant decrease in PLR over time in the Theranova group than in the high-flux group (p = 0.04). The fold change in 12-week PLR to baseline PLR was lower in the Theranova group than in the high-flux group (p = 0.03). In the multivariable linear regression analysis, the Theranova dialyzer showed a negative correlation with the PLR fold change (β = −0.32, p = 0.04). Our results showed that HDx using the Theranova dialyzer improves PLR over time compared to the high-flux HD. The superior removal of the inflammatory uremic toxins by the Theranova dialyzer may have reduced inflammation and inflammation-related complications in HD patients. Full article

Background/Objectives: Since the first successful birth following assisted reproductive technologies (ART) several decades ago, the global population of ART-conceived children has surpassed 13 million, with over 40,000 born in Kazakhstan. Despite this growth, questions remain about their long-term neurological outcomes, with existing studies reporting inconsistent findings. This study aimed to assess psychomotor development and the prevalence of nervous system pathologies among ART-conceived children in Kazakhstan and to develop a prognostic model for identifying pathological neurodevelopmental conditions. Methods: We studied 252 children (120 conceived via ART and 132 controls) using clinical examination and medical history data. Brain immaturity predictors were identified by univariate and multivariate logistic regression. Results: ART-conceived children exhibited a higher incidence of neurosonographic signs of brain structure immaturity. However, multivariate analysis indicated that ART itself was not an independent risk factor. Instead, perinatal complications—including prematurity, multiple pregnancy, low birth weight, asphyxia, and intrauterine infections—explained the observed differences. The prognostic model highlighted prematurity and preconceptional progesterone therapy as significant predictors. Overall neurological development did not differ significantly between the groups. Conclusions: These findings underscore the importance of early identification of perinatal risk factors and targeted preventive interventions to mitigate adverse neurodevelopmental outcomes in ART-conceived children. Full article

Background: Angiogenesis, the physiological process by which new blood vessels originate from pre-existing ones, can be triggered by tumor cells to promote the growth, survival, and progression of cancer. Malignant tumors require a constant blood supply to meet their needs for oxygen and nutrients, making angiogenesis a key process in tumor development. Its pathologic role is caused by the dysregulation of signaling pathways, particularly those involving VEGFR-2, a key mediator of angiogenesis, and the K-RAS G12C mutant, a promoter of VEGF expression. Given their critical involvement in tumor progression, these targets represent promising candidates for new cancer therapies. Methods and Results: In this study, we applied an in silico hybrid and hierarchical virtual screening approach to identify potential dual VEGFR-2/K-RAS G12C inhibitors with anticancer and antiangiogenic properties. To this end, we screened the National Cancer Institute (NCI) database through ADME filtering tools. The refined dataset was then submitted to the ligand-based Biotarget Predictor Tool (BPT) in a multitarget mode. Subsequently, structure-based analysis, including molecular docking studies on VEGFR and K-RAS G12C, was performed to investigate the interactions of the most promising small molecules with both targets. Conclusions: Finally, the molecular dynamics simulations suggested compound 737734 as a promising small molecule with high stability in complex with both VEGFR-2 and K-RAS G12C, highlighting its potential as a dual-target inhibitor for cancer therapy. Full article

Background: Human milk (HM) is the optimal nutrition for preterm infants, but supplementation is often required to meet their unique nutritional needs. Donor human milk (DHM) and preterm formula are commonly used alternatives, yet their impacts on bone metabolism and clinical outcomes remain incompletely defined. Objective: To compare the effects of exclusive mother’s own milk (MOM), MOM supplemented with DHM, and MOM supplemented with preterm formula on bone metabolism markers, growth milestones, and clinical outcomes in very preterm and very low birth weight (VLBW) infants. Methods: We conducted a retrospective review of medical records for infants born at <32 weeks’ gestation or <1500 g birth weight between January 2018 and June 2023. Feeding groups included exclusive MOM (N = 135), MOM + DHM (N = 74), and MOM + Formula (N = 54). Biochemical markers were assessed at baseline and on days 7, 14, and 28. Multivariate regression analyses evaluated predictors of growth and clinical outcomes. Results: Infants in the MOM group had significantly lower gestational age and birth weight, with higher rates of respiratory morbidity. Time to full enteral feeding and duration of parenteral nutrition were longer in the MOM group, but feeding regimen was not an independent predictor of these outcomes. By day 14, the MOM group had higher alkaline phosphatase levels and lower phosphorus levels compared to mix feeding groups, but these differences resolved by day 28. Calcium levels varied between groups but remained within normal ranges. Necrotizing Enterocolitis (NEC) incidence did not differ significantly across feeding regimens and was primarily associated with longer parenteral nutrition duration. Conclusions: Supplementation of MOM with either DHM or preterm formula supported adequate growth and bone metabolism without increasing NEC risk. Feeding regimen did not independently influence time to full enteral feeding or length of hospitalization, which were driven primarily by infant maturity and clinical status. Both DHM and preterm formula are viable supplements to MOM, ensuring nutritional adequacy without adverse bone health effects. Prospective studies are needed to evaluate long-term outcomes of these feeding strategies. Full article

Purpose: This study examines the association between tumor volume doubling time (TVDT) and clinical outcomes for patients with hepatocellular carcinoma (HCC) treated with transarterial embolization (TAE) and evaluates the impact of tumor genotype on TVDT. Methods: This was a retrospective cohort study at a single tertiary care cancer center, including treatment-naïve patients with biopsy-proven HCC treated with TAE from 1/2014 to 6/2022. The patients underwent initial baseline contrast-enhanced cross-sectional imaging more than 30 days prior to embolization. Index tumors were defined as the largest HCC present on baseline imaging treated with TAE, and TVDT was calculated using Schwartz’s equation with perpendicular trans-axial measurements. Genetic mutation analysis was performed on HCC tissue specimens using next-generation sequencing. Survival analysis was performed using the Kaplan–Meier method, and Cox regression was used to assess prognostic factors for survival. Results: Patients with a TVDT ≤ 2.5 months had a worse overall survival (OS) after TAE (p = 0.011). On multivariate regression analysis, predictors of worse OS following TAE included TVDT ≤ 2.5 months (p = 0.036), Eastern Cooperative Oncology Group (ECOG) performance score of 1 or 2 (p = 0.006), and alpha fetoprotein > 200 ng/mL (p = 0.013). The presence of ≥5 HCC tumors on initial imaging was associated with a worse local tumor progression-free survival (LTPFS) on multivariate analysis (p = 0.002). No single genetic mutation was associated with shorter TVDT. Conclusion: Patients with HCC exhibiting rapid growth, defined as shorter TVDT, may be associated with worse overall survival following TAE. Rapid tumor growth does not seem to be correlated with a single genetic mutation. Full article

The macro-economic growth rate of Peru is analyzed for sensitivity to climatic conditions. Year-on-year fluctuations in the inflation-adjusted gross domestic product (GDP) per capita over the period 1970–2024 are subjected to correlation and composite statistical methods. Upturns relate to cool east Pacific La Niña, downturns with warm El Niño. Composites are analyzed by subtracting upper and lower terciles, representing a difference of ~USD 40 B at current value. These reveal how the regional climate exerts a partial influence among external factors. During the austral summer with southeasterly winds over the east Pacific, sea temperatures undergo a 2.5 °C cooling. Consequently, atmospheric subsidence draws humid air from the Amazon toward the Peruvian highlands, improving crop production. Dry weather along the coast sustains transportation networks and urban infrastructure, ensuring good economic performance over the year. The opposing influence of El Niño is built into the statistics. A multi-variate algorithm is developed to predict changes in the Peru growth rate. Austral summer winds and subsurface temperatures over the tropical east Pacific account for a modest 23% of year-on-year variance. Although external factors and the varied landscape weaken macro-economic links with climate, our predictors significantly improve on traditional indices: SOI and Nino3. Adaptive measures are suggested to take advantage of Southern Oscillation’s influence on Peru’s economy. Full article

This study analyses the factors influencing renewable energy infrastructure public–private partnership (PPP) financing, using data from 28 countries covering the period from 1996 to 2024. A composite institutional quality index was constructed using Principal Component Analysis (PCA). The analysis employs a panel econometric framework: the autoregressive distributed lag (ARDL) model to capture short- and long-term dynamics. The results highlight the significance of the time dimension on renewable energy PPP financing. In the short term, none of the predictor variables are significant, reflecting the inherently long-term character of renewable energy PPP investments. However, in the long term, gross domestic product per capita, inflation dynamics, efficiency in energy transmission, and institutional quality are identified as key determinants of renewable energy investment. The findings suggest that strengthening sector-specific regulatory frameworks and improving various aspects of institutional quality as defined by the World Governance Indicators can be important to attract private capital in energy PPPs. These institutional reforms, complemented by growth-oriented macroeconomic policies, would contribute to making renewable energy markets more attractive while reducing exposure to macroeconomic and institutional risks. Full article

Soil lead (Pb) contamination poses a severe threat to agricultural sustainability and food security. Phytoremediation offers a green alternative for remediation, yet its efficiency is limited by poor plant tolerance and restricted metal uptake. In this study we investigated the functional roles of the microbial inoculants Trichoderma guizhouense NJAU4742 and Bacillus velezensis SQR9 in enhancing the performance of Salix suchowensis P1024 grown in Pb-contaminated soil. NJAU4742 significantly increased plant biomass by 34% (p < 0.05), accompanied by increased soil microbial biomass and higher activities of urease, acid phosphatase, and sucrase. In contrast, SQR9 strongly enhanced Pb accumulation by 19% (p < 0.05), which was accompanied by upregulated antioxidant enzymes, reduced lipid peroxidation, and elevated cysteine levels. Random forest and correlation analyses demonstrated that soil nutrient cycling indices (urease, MBC, sucrase) were key predictors of biomass, whereas antioxidant defenses (POD, CAT) primarily explained Pb accumulation. These findings provide new insights into the distinct contributions of NJAU4742 and SQR9 to willow growth and Pb remediation, and provide a basis for developing more effective microbe-assisted phytoremediation strategies. Full article

Objective: Multifetal gestations are linked to an increased risk of pregnancy-related hypertensive disorders and other adverse outcomes. The probability positively correlates with the number of fetuses. Therefore, the objective of the study was to assess the use of various maternal and pregnancy-related characteristics for the prediction of adverse pregnancy outcomes in triplet pregnancies, dependent on different possible predictive factors such as maternal age, BMI, assisted reproductive technology (ART), parity, uterine artery Doppler (UtA-PI) measured and chorionicity. Methods: This was a screening study in 99 triplet pregnancies to evaluate the risk for adverse pregnancy outcomes for PE, hypertension, fetal growth restriction (FGR), intrauterine fetal death (IUFD), small for gestational age (SGA) and preterm birth below 32 + 0 gestational weeks, dependent on different possible predictive factors. Logistic regression analysis was performed. Results: 99 triplet pregnancies were included. Additionally, 58 women (58.6%) developed adverse pregnancy outcomes: FGR 16.2%, SGA (3.0%). Gestational hypertension was observed in 16 pregnancies (16.2%), and preeclampsia was diagnosed in 11 cases (11.1%). Furthermore, 6 pregnancies (6.2%) were complicated by IUFD, and 36 pregnancies (36.4%) resulted in preterm birth before 32 + 0 weeks of gestation. Conclusions: Hypertension and PE are common maternal complications in triplet pregnancies. While higher maternal age is a clear predictor of hypertension and PE, a model based on maternal and pregnancy characteristics did not provide sufficient predictive accuracy. Full article

Background: Early hematoma expansion is a major determinant of poor outcomes after spontaneous intracerebral hemorrhage (ICH). Identifying reliable predictors of hematoma expansion may facilitate risk stratification and timely interventions. This study aimed to evaluate clinical, laboratory, and radiological factors associated with early hematoma expansion within 24 h. Methods: We retrospectively analyzed consecutive patients with spontaneous ICH admitted to a tertiary hospital in Korea between 2009 and 2021. Inclusion criteria were aged ≥ 18 years, primary spontaneous ICH, baseline non-contrast CT (NCCT), and follow-up CT within 24 h. Clinical, laboratory, and medication histories were collected, and NCCT/CT angiography (CTA) imaging markers (spot sign, blend sign, hypodensity, swirl sign, black hole sign, island sign, mean hematoma density) were evaluated. Early hematoma expansion was defined as an absolute volume increase ≥6 cm³ or a relative increase ≥33% on follow-up CT. Multivariate logistic regression identified independent predictors. Results: Among 899 screened patients, 581 met inclusion criteria (mean age 61.6 years; 59.7% male). Seventy-eight patients (13.4%) experienced early hematoma expansion. Independent predictors included CTA spot sign (adjusted OR 9.001, 95% CI 4.414–18.354), blend sign (OR 3.054, 95% CI 1.349–6.910), mean hematoma density <60 HU (OR 2.432, 95% CI 1.271–4.655), male sex (OR 2.902, 95% CI 1.419–5.935), and statin use (OR 2.990, 95% CI 1.149–7.782). Prior antiplatelet therapy was associated with a reduced risk of hematoma expansion (OR 0.118, 95% CI 0.014–0.981). Conclusions: Early hematoma expansion occurred in 13.4% of patients and was predicted by a combination of CTA and NCCT markers, as well as clinical and pharmacological factors. Spot sign remained the strongest predictor, while NCCT features such as blend sign and low hematoma density also provided practical prognostic value. These findings underscore the multifactorial pathophysiology of ICH expansion and highlight the importance of integrating imaging, clinical, and therapeutic variables into prediction models to improve early risk stratification and guide targeted interventions. Full article

This study investigated the effects of elevated temperature on the phenology and morphology of the early-maturing peach cultivar ‘Mihong’. The experiment was conducted from 2019 to 2024 in a temperature-gradient chamber at the National Institute of Horticultural and Herbal Science, Wanju, Korea, with four warming treatments (+2.2 °C to +5.0 °C above ambient). Higher temperatures delayed the onset of endodormancy and markedly shortened the period from endodormancy release to full bloom. Elevated temperatures also increased the LD ratio, with the proportion of fruits exceeding an LD ratio of 1.0 rising significantly with temperature. The LD ratio showed strong correlations with November mean temperature (MT11) and March maximum temperature (HT3) (r = 0.81) and was also associated with the average temperature (Temp3, r = 0.51) and duration (P3, r = −0.54) of the endodormancy release to full bloom phase. Stepwise and PLS regression identified temperatures in May, November, and March as key predictors of the LD ratio, while PCA revealed that temperature variables (Temp3, Temp5) and stage durations (P3, P4) were major contributors. These results confirm that climate warming alters the phenology and morphology of ‘Mihong’, reducing fruit quality and marketability, while providing a basis for predictive modeling and highlighting the importance of adaptive strategies such as shading or growth regulator application. Full article

Fast and precise monitoring of soil organic matter (SOM) during maize growth periods is crucial for real-time assessment of soil quality. However, the big challenge we usually face is that many agricultural soils are covered by crops or snow, and the bare soil period is short, which makes reliable SOM prediction complex and difficult. In this study, an unmanned aerial vehicle (UAV) was utilized to acquire multi-temporal hyperspectral images of maize across the key growth stages at the field scale. The auxiliary predictors, such as spectral indices (I), field management (F), plant characteristics (V), and soil properties (S), were also introduced. We used stepwise multiple linear regression, partial least squares regression (PLSR), random forest (RF) regression, and XGBoost regression models for SOM prediction, and the results show the following: (1) Multi-temporal remote sensing information combined with multi-source predictors and their combinations can accurately estimate SOM content across the key growth periods. The best-fitting model depended on the types of models and predictors selected. With the I + F + V + S predictor combination, the best SOM prediction was achieved by using the XGBoost model (R² = 0.72, RMSE = 0.27%, nRMSE = 0.16%) in the R3 stage. (2) The relative importance of soil properties, spectral indices, plant characteristics, and field management was 55.36%, 26.09%, 9.69%, and 8.86%, respectively, for the multiple periods combination. Here, this approach can overcome the impact of the crop cover condition by using multi-temporal UAV hyperspectral images combined with valuable auxiliary variables. This study can also improve the field-scale farmland soil properties assessment and mapping accuracy, which will aid in soil carbon sequestration and soil management. Full article

This study investigates the complex interplay between internal communication, psychological well-being, and job satisfaction, as well as their influence on employee retention and job performance in Romania’s post-pandemic hospitality sector. In this study, data were collected from 350 employees across hotels, restaurants, and resorts. A Covariance-Based Structural Equation Modeling (CB-SEM) approach was employed for the analysis. Findings suggest that both internal communication and psychological well-being are significant positive predictors of job satisfaction. In turn, job satisfaction is a powerful driver of both employee retention and job performance. A key finding is that job satisfaction fully mediates the relationship between psychological well-being and job performance, with no direct effect observed between the latter two constructs. These results underscore that fostering an employee-centric environment is crucial for achieving social sustainability, directly supporting global Sustainable Development Goals (SDG 8: Decent Work and Economic Growth and SDG 3: Good Health and Well-being). Theoretical and practical implications, as well as limitations and future research directions, are discussed. Full article