Search Results (274)

Background/Objectives: Multimodal large language models (LLMs) may directly interpret medical images, including thyroid ultrasounds (USs). Whether these models can reliably assess thyroid nodules—where subtle echogenic and morphological details are critical—remains uncertain. The American College of Radiology (ACR) TI-RADS system provides a structured framework for benchmarking artificial intelligence. This study evaluates GPT-5.0’s ability to interpret thyroid US images according to TI-RADS criteria and contextualizes its performance relative to expert radiologist assessment, using FNA cytology as the reference standard. Methods: This retrospective study included 100 patients (mean age 49.8 ± 12.6 years; 72 women) with cytology-confirmed diagnoses: Bethesda II (benign) or Bethesda V–VI (malignant). Each nodule had longitudinal and transverse US images acquired with high-frequency linear probes. A board-certified radiologist (>10 years’ experience) and GPT-5.0 independently assessed TI-RADS features (composition, echogenicity, shape, margin, echogenic foci) and assigned final categories. Agreement was analyzed using Cohen’s κ, and diagnostic performance was calculated using TR4–TR5 as positive for malignancy. Results: Agreement was substantial for composition (κ = 0.62), shape (κ = 0.70), and margin (κ = 0.68); moderate for echogenicity (κ = 0.48); and poor for echogenic foci (κ = 0.12). GPT-5.0 demonstrated a systematic, risk-averse tendency to up-classify nodules, leading to increased TR4–TR5 assignments. Overall, the TI-RADS agreement was 58% (κ = 0.31). The radiologist showed superior diagnostic performance (sensitivity 89%, specificity 85%) compared with GPT-5.0 (sensitivity 67%, specificity 49%), largely driven by false-positive TR4 classifications among benign nodules. Conclusions: GPT-5.0 recognizes several high-level TI-RADS features but struggles with microcalcifications and tends to overestimate malignancy risk within a risk-stratification framework, limiting its standalone clinical use. Ultrasound-specific training and domain adaptation may enable meaningful adjunctive roles in thyroid nodule assessment. Full article

Background/Objectives: Hepatocellular carcinoma remains a major cause of death from cancer globally. While ¹⁸F-FDG PET/CT is commonly used for tumor imaging, its sensitivity is limited, especially due to high liver background uptake. Recently, ⁶⁸Ga-FAPI PET/CT, which targets fibroblast activation protein in tumor stroma, has emerged as a promising diagnostic tool. In this study, we aimed to assess the diagnostic performance of ⁶⁸Ga-FAPI-04 PET/CT in HCC patients with and without liver cirrhosis and to explore the relationship between PET metrics, tumor size, and PIVKA-II serum marker. Methods: In this prospective single-center study, 59 patients with confirmed HCC (37 with cirrhosis, 22 without) underwent ⁶⁸Ga-FAPI-04 PET/CT. The standard dose (1.5–2.0 MBq/kg) was administered intravenously, and imaging was carried out 60 min post-injection. Semi-quantitative parameters including SUVmax, SUVmean, and tumor-to-background ratio were calculated. Diagnostic performance was assessed using histopathology and multimodal imaging. Statistical analyses included the Mann–Whitney U test and Spearman correlation. Results: The overall sensitivity for HCC detection was 89.8%, with a specificity of 60% and accuracy of 87%. Sensitivity and specificity showed a tendency to be lower in cirrhotic compared with non-cirrhotic patients, with a notably higher background liver uptake in cirrhosis (SUVmax 3.60 vs. 1.3, p < 0.001), resulting in lower TBR values (3.7 vs. 7.0, p < 0.001). A strong correlation between SUVmax and tumor size was seen in non-cirrhotic HCC, while a moderate association between SUVmax and PIVKA-II levels was observed in cirrhotic patients. Conclusions:⁶⁸Ga-FAPI-04 PET/CT demonstrates high sensitivity for HCC detection and may serve as a complementary imaging modality, particularly when interpreted through conventional cross-sectional imaging. Image interpretation in cirrhotic livers may be challenging due to increased background uptake and reduced TBR. Associations between PET-derived parameters, tumor size, and serum PIVKA-II levels should be considered hypothesis-generating and require validation in larger, multicenter studies with clinical outcome data. Full article

Decision-making under uncertainty, especially when dealing with incomplete or linguistically described data, remains a significant challenge in various fields of science and industry. The increasing complexity of real-world problems necessitates the development of mathematical models and data processing techniques that effectively address uncertainty and incompleteness. Aggregators play a key role in solving these problems, particularly in fuzzy systems, where they constitute fundamental tools for decision-making, data analysis, and information fusion. Aggregation functions have been extensively studied and applied in many fields of science and engineering. Recent research has explored their usefulness in fuzzy control systems, highlighting both their advantages and limitations. One promising approach is the use of ordered fuzzy numbers (OFNs), which can represent directional tendencies in data. Previous studies have introduced the property of direction sensitivity and the corresponding determinant parameter, which enables the analysis of correspondence between OFNs and facilitates inference operations. The aim of this paper is to examine existing aggregate functions for fuzzy set numbers and assess their suitability within OFNs. By analyzing the properties, theoretical foundations, and practical applications of these functions, we aim to identify a suitable aggregation operator that complies with the principles of OFN while ensuring consistency and efficiency in decision-making based on fuzzy structures. This paper introduces a novel aggregation approach that preserves the expected mathematical properties while incorporating the directional components inherent to OFN. The proposed method aims to improve the robustness and interpretability of fuzzy reasoning systems under uncertainty. Full article

Documenting baseline elemental distribution patterns in crops under non-contaminated conditions provides a physiological reference for understanding constitutive metal homeostasis. This study compared the internal allocation of elements in sunflower (Helianthus annuus), wheat (Triticum aestivum), and maize (Zea mays) grown in soil with a specific geochemical profile. Soil was characterized using X-ray Fluorescence Spectroscopy (XRF) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Plants were grown under controlled conditions, and elemental concentrations in roots and shoots were quantified to calculate Bioaccumulation (BCF) and Translocation (TF) Factors. Soil analysis confirmed nickel (42.6 mg kg⁻¹) and copper (32.8 mg kg⁻¹) concentrations within typical global ranges for uncontaminated soils. Species exhibited different distribution tendencies: sunflower showed balanced root–shoot allocation for nickel (TF = 1.00); wheat demonstrated pronounced root retention of nickel and copper (TF < 0.5); and maize exhibited preferential translocation of copper (TF = 0.76) alongside root retention of nickel. Concentrations of lead, selenium, and silver were minimal across all species. The study delineates different species-specific tendencies in internal elemental allocation under given growth conditions. These patterns represent baseline physiological behaviors rather than responses to contamination, providing a comparative dataset that contributes to the understanding of crop ionomics and informs the interpretation of tissue metal concentrations in relation to soil conditions. Full article

To solve the problems of large deformation and poor welding quality commonly observed during the double-sided welding of Q355 thin plates, this study systematically investigated the effects of single-sided ultrasonic-assisted welding on the weld formation, microstructure, mechanical properties, and residual stresses of the plates, and compared this welding process with conventional ones. Experimental results indicate that ultrasonic assistance is associated with improved weld shape and quality, contributing to a flatter weld surface and more symmetric cross-sectional profile. In contrast to conventional welds, welds produced by single-sided ultrasonic-assisted gas metal arc welding show no obvious oxide inclusions and a reduced tendency for columnar grain growth. In a single tensile test for each welding condition, the measured tensile strength was 552 MPa for conventional welding and 575 MPa for single-sided ultrasonic-assisted gas metal arc welding. These tensile results should be interpreted as indicative trends and require replication to assess scatter and statistical significance. Furthermore, single-sided ultrasonic-assisted gas metal arc welding is associated with lower welding residual stresses, with peak stress values reduced by up to 36.23% along the longitudinal path. This technique provides an engineering reference for improving weld-quality consistency during the double-sided welding of Q355 thin plates without altering the welding specifications. Full article

This study examines urban–water synergy as the spatial coordination between urban expansion and water systems. Using land-use data from 2000 to 2020, the central urban areas of Jingzhou and Anqing are analyzed as representative small and medium-sized cities. Urban–water synergy is assessed across three dimensions: land-use synergy, pathway synergy, and directional synergy. These dimensions are quantified using four indicators: Urban–Water Interaction Intensity (UWII), Urban–Water Interaction Displacement (UWID), Spatial Path Alignment Distance (SPAD), and Directional Alignment Angle (DAA). The results show that Jingzhou and Anqing exhibit two distinct urban–water synergy modes: a convergent interaction mode characterized by increasing alignment in land-use interactions, spatial pathways, and directional tendencies, and a divergent synergy mode characterized by persistent separation across these dimensions. Differences between these synergy modes are associated with expansion pressure, physical template, and institutional mechanisms. Spearman rank correlation and principal component analysis suggest that institutional mechanisms constitute an independent analytical dimension and may be relevant for interpreting potential non-linear changes in urban–water interaction patterns. Based on these findings, this study discusses governance implications centered on institutional effectiveness, supported by spatial restoration and expansion regulation, for informing urban–water synergy governance in small and medium-sized cities. Full article

Climate change is altering hydrological regimes across the North Aegean and Marmara regions of Türkiye, with increasing relevance for both drought occurrence and flood generation. This study examines long-term variability in temperature, precipitation, and evaporation using meteorological observations over a long time series and relates these changes to urban water management issues. Daily records from 12 meteorological stations, with data availability varying by station and extending back to 1926, were analysed using the non-parametric Mann–Kendall trend test and Sen’s slope estimator. The results indicate statistically significant warming trends across all stations, with several locations recording daily maximum temperatures exceeding 44 °C. Precipitation trends exhibit pronounced spatial heterogeneity: while most stations show decreasing long-term tendencies, others display unchanging or non-significant trends. Nevertheless, extreme daily rainfall events exceeding 200 mm are observed at multiple coastal and island stations, indicating a tendency toward high-intensity precipitation. Evaporation trends also vary across the region, with increasing rates at stations such as Tekirdağ and Çanakkale and decreasing trends at Bandırma and Yalova, reflecting the influence of local atmospheric conditions. Taken together, these findings point to a coupled risk of intensified flooding during short-duration rainfall events and increasing water stress during warm and dry periods. Such conditions challenge the effectiveness of conventional grey infrastructure. The results are therefore interpreted within the framework of the Sponge City approach, which emphasizes permeable surfaces, decentralized storage, infiltration, and the integration of green and blue infrastructure. By linking long-term hydroclimatic trends with urban design considerations, this study provides a quantitative basis for informing adaptive urban water management and planning strategies in Mediterranean-type climate regions. Full article

The link between information and energy introduces the observer and their knowledge into the understanding of a fundamental quantity in physics. Two approaches compete to account for this link—Brillouin’s negentropy law of information and Landauer’s law on data erasure—which are often confused. The first, based on Clausius’ inequality and Shannon’s mathematical results, is very robust, whereas the second, based on the simple idea that information requires a material embodiment (data bits), is now perceived as more physical and therefore prevails. In this paper, we show that Landauer’s idea results from a confusion between information (a global emergent concept) and data (a local material object). This confusion leads to many inconsistencies and is incompatible with thermodynamics and information theory. The reason it prevails is interpreted as being due to a frequent tendency of materialism towards reductionism, neglecting emergence and seeking to eliminate the role of the observer. A paradoxical trend, considering that it is often accompanied by the materialist idea that all scientific knowledge, nevertheless, originates from observation. Information and entropy are actually emergent quantities introduced in the theory by convention. Full article

Increasing levels of chloride in surface water are associated with detrimental effects on water quality, aquatic ecosystems, infrastructure, and human health. Numerous mass-balance studies have inferred watershed transport processes by interpreting chloride inputs and outputs, but few represent internal dynamics explicitly. We constructed a coupled water/chloride mass balance model to gain insights into storage, residence time, and transport processes in a 10-km² urban watershed. The model, which operates over a 10-year period at a daily time scale, represents storage in a dynamic soil-moisture reservoir, quick-flow runoff from storm events, and slow-flow runoff that sustains streamflow in dry weather. The calibrated model accurately represented (a)the observed transition from a streamflow enrichment regime in cold months to a dilution regime in warmer months, (b) the observed tendency for late-summer concentrations to be higher after winters with heavy snowfall, and (c) a period-of-record downward trend in chloride concentration likely associated with a downward trend in annual snowfall. Estimated chloride inputs averaged 195 metric tons per year, while the average output was 270 metric tons per year. In contrast, estimated storage was only 107 metric tons. The estimated mean residence time in groundwater was 1.27 years. This short residence time indicates that efforts to reduce inputs will manifest as decreased concentrations in streamflow on a management-relevant time scale of several years. The coupled mass balance model yielded insights into internal watershed dynamics that would not be possible from simple input/output analysis; such models can be useful tools for gaining insight into small watershed hydrology and pollutant transport. Full article

Background/Objectives: Marker-based motion capture remains widely used for lower limb kinematics due to its high precision, although its application is often constrained by elevated operational costs and the requirement for controlled laboratory environments. Markerless methods, such as MediaPipe offer a promising alternative for extending biomechanical analyses beyond traditional laboratory settings, but evidence supporting their validity in controlled tasks is still limited. This study aimed to validate a pixel-based markerless pipeline for two-dimensional kinematic analysis of hip and knee motion during squatting. Methods: Ten healthy volunteers performed three squats with a maximum depth of 90°. Kinematic data were collected simultaneously using marker-based and markerless systems. For the marker-based method, hip and knee joint angles were calculated from marker trajectories within a fixed coordinate system. For the markerless approach, a custom pixel-based pipeline was developed in MediaPipe 0.10.26 to compute bidimensional joint angles from screen coordinates. A paired t-test was conducted using Statistical Parametric Mapping, and maximum flexion values were compared between systems with Bland–Altman analysis. Total range of motion was also analyzed. Results: The markerless pipeline provided valid estimates of hip and knee motion, despite a systematic tendency to overestimate joint angles compared to the marker-based system, with a mean bias of −17.49° for the right hip (95% LoA: −51.89° to 16.91°). Conclusions: These findings support the use of markerless tools in clinical contexts where cost and accessibility are priorities, provided that systematic biases are taken into account during interpretation. Overall, despite the systematic differences, the 2D MediaPipe-based markerless system demonstrated sufficient consistency to assist clinical decision-making in settings where traditional motion capture is not available. Full article

Credit risk refers to the possibility that a borrower fails to meet contractual repayment obligations, posing potential losses to lenders. This study aims to enhance post-loan default prediction in credit risk management by constructing a time-series modeling framework based on repayment behavior data, enabling the capture of repayment risks that emerge after loan issuance. To achieve this objective, a Residual Enhanced Encoder Bidirectional Long Short-Term Memory (ResE-BiLSTM) model is proposed, in which the attention mechanism is responsible for discovering long-range correlations, while the residual connections ensure the preservation of distant information. This design mitigates the tendency of conventional recurrent architectures to overemphasize recent inputs while underrepresenting distant temporal information in long-term dependency modeling. Using the real-world large-scale Freddie Mac Single-Family Loan-Level Dataset, the model is evaluated on 44 independent cohorts and compared with five baseline models, including Long Short-Term Memory (LSTM), Bidirectional LSTM (BiLSTM), Gated Recurrent Unit (GRU), Convolutional Neural Network (CNN), and Recurrent Neural Network (RNN) across multiple evaluation metrics. The experimental results demonstrate that ResE-BiLSTM achieves superior performance on key indicators such as F1 and AUC, with average values of 0.92 and 0.97, respectively, and demonstrates robust performance across different feature window lengths and resampling settings. Ablation experiments and SHapley Additive exPlanations (SHAP)-based interpretability analyses further reveal that the model captures non-monotonic temporal importance patterns across key financial features. This study advances time-series–based anomaly detection for credit risk prediction by integrating global and local temporal learning. The findings offer practical value for financial institutions and risk management practitioners, while also providing methodological insights and a transferable modeling paradigm for future research on credit risk assessment. Full article

Background: Helsmoortel-Van der Aa syndrome (HVDAS) is a rare multisystemic neurodevelopmental disorder caused by pathogenic variants in the Activity-Dependent Neuroprotective Homeobox Protein (ADNP) gene. Since the extensive clinical description of a cohort of 78 affected individuals in 2019, numerous reports described additional cases affected by the condition. However, no systematic synthesis of the clinical and molecular spectrum of these additional individuals has been conducted to date. Methods: In accordance with the PRISMA 2020 guidelines, we performed a systematic review of all publications describing individuals with genetically confirmed HVDAS. Clinical characteristics, comorbidities, and developmental milestones were systematically extracted to illustrate novel or underrecognized manifestations. Results: A total of 105 individuals reported across 34 publications were included. Of these, 66 were clinically and genetically evaluated, and 39 were analyzed only at the genetic level. Our analysis refines the phenotypic spectrum of HVDAS, including developmental delay, visual anomalies, and congenital heart defects. The additional literature also allows us to characterize in more detail the ophthalmological abnormalities, gait disturbances, and the cognitive profile of HVDAS. Advances in ADNP methylation profiling further enhance diagnostic precision and variant interpretation in this evolving neurodevelopmental syndrome. Conclusions: This systematic review provides a comprehensive synthesis of the clinical, genetic, and epigenetic landscape of HVDAS. It underscores the multisystemic nature of the disorder and the need for multidisciplinary management. The expanding phenotypic heterogeneity likely reflects both improved clinical recognition of the more subtle features and the tendency to prioritize publication of more complex or severely affected cases. Full article

Background/Objectives: Temporomandibular disorders (TMDs) are a heterogeneous subset of orthodontic conditions with persistent diagnostic and reporting variability. This review compared transparency, reporting quality, and spin prevalence in TMD/TMJ (temporomandibular joint)-focused orthodontic randomized controlled trials (RCTs) versus general orthodontic RCTs. Methods: The review followed PRISMA 2020 and was registered in PROSPERO (4201024184). Searches were performed in PubMed/MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from the earliest available records in each database up to 15 October 2025. Eligible studies were peer-reviewed human orthodontic RCTs. Five transparency indicators (funding disclosure, bias discussion, confounder consideration, protocol registration, reporting-guideline adherence) and five spin indicators (selective focus, unsupported efficacy claims, emphasis on benefits, recommendations despite nonsignificance, “trend toward significance” language) were coded dichotomously. Beta–binomial mixed-effects models compared composite scores between groups, adjusting for publication era, impact factor, and journal clustering. Results: Among 874 included trials (840 general, 34 TMD/TMJ-focused), TMD/TMJ-focused studies showed lower adjusted transparency (odds ratio (OR) = 0.58; 95% confidence interval (CI) 0.34–0.99; p = 0.047), mainly due to limited registration and incomplete guideline adherence. Predicted transparency proportions were 0.82 for general and 0.73 for TMD/TMJ-focused studies. Composite spin did not differ (OR = 1.05; 95% CI 0.68–1.62; p = 0.821), though TMD/TMJ-focused abstracts more often emphasized benefits (OR = 4.62) and recommended interventions despite nonsignificant primary outcomes (OR = 2.83). Conclusions: TMD-focused orthodontic trials exhibited lower transparency and a distinct pattern of interpretive spin, particularly a greater tendency to emphasize benefits or recommend interventions despite non-significant results, compared with general orthodontic research. Full article

Background and Objectives: Cement-retained implant restorations are widely used because they offer favorable esthetics and a passive fit. Their long-term performance is strongly influenced by cement selection and surface conditioning. This study compared the clinical performance of a resin-modified glass ionomer cement (Fuji Plus^®) with a provisional acrylic-urethane cement (DentoTemp™) in partial implant restorations. Materials and Methods: A retrospective cohort of 40 patients with three-unit implant-supported fixed dental prostheses was followed for at least three years. Restorations were fabricated from zirconia or metal-ceramic frameworks and cemented with either Fuji Plus^® or DentoTemp™. Clinical outcomes included retention, failure events, marginal adaptation, and peri-implant tissue response. In order to illustrate the impact of cement type and abutment height, mechanical testing was also carried out on standardized in vitro models; however, these tests were not powered for formal hypothesis testing. Although OCT images were included in this study only as illustrative examples from our clinical database and were not obtained from the analyzed cohort, OCT may be a useful tool for non-invasive assessment of marginal fit. Results: Zirconia restorations showed a retention rate of 95 percent, while metal-ceramic restorations reached 85 percent. All four failures occurred in cases cemented with DentoTemp™, giving an overall retention rate of 80 percent for this group. Fuji Plus^® achieved complete retention in all cases. Re-cementation with Fuji Plus^® successfully resolved the failures. Marginal adaptation was evaluated qualitatively because radiographic analysis did not enable accurate measurement of marginal gaps. When cement remnants were found, mild peri-implant inflammation was seen. Conclusions: Within the limitations of this small retrospective, non-randomized cohort, Fuji Plus^® demonstrated a tendency toward better peri-implant tissue response and longer-term retention than DentoTemp™. These findings should be interpreted as preliminary and exploratory rather than conclusive. Fuji Plus^® may be a suitable option for definitive cementation in partial implant restorations, while DentoTemp™ may be considered in selected situations where retrievability is important. Full article

Background: Orthorexia nervosa (OrNe) and healthy orthorexia (HeOr) are two distinct but related dimensions of interest in eating behavior research. Evidence regarding their associations with sociodemographic, dietary, and sport-related variables in physically active young adults remains limited. Methods: A cross-sectional study was conducted in 190 physically active young adults (53.2% women; mean age = 23.16 ± 5.13 years). Participants practiced a variety of sports including fitness (25.3%), soccer (13.7%), handball (10.5%), athletics, martial arts, cycling, and other individual or team sports. Although all participants belonged to organized sports teams or structured training groups, 38.9% were not actively competing at the time of data collection. Participants completed validated instruments assessing OrNe, HeOr, and eating-related cognitions, alongside questionnaires on sociodemographic data, dietary habits, sport discipline, training frequency, and supplement use. Hierarchical and K-means clustering were applied using the standardized scores of HeOr, OrNe, and the EHQ total score. Group differences were assessed using t-tests and ANOVA with effect sizes (η²p) reported. Results: Age correlated positively with OrNe, HeOr, and eating-related cognitions, indicating greater consolidation of rigid eating patterns in young adulthood. BMI was associated with OrNe only among men. Vegetarian participants showed higher nutritional knowledge but lower overall orthorexia scores. Supplement users in fitness-related sports reported higher OrNe, whereas participants in collective sports reported lower scores. Three distinct orthorexia profiles were identified, characterized by lower, slightly above-average, and higher scores on orthorexia-related variables. Participants in the higher-scoring profile showed significantly higher EHQ total, OrNe, and HeOr scores compared with the other groups (η²p range = 0.11–0.19). Correlations among orthorexia dimensions were positive and moderate to large. Differences between clusters in sport modality, training frequency, and supplement use underscored the influence of the sporting context. Conclusions: Orthorexia in young physically active adults reflects heterogeneous patterns shaped by the interplay of individual (age, sex, BMI), dietary, and sport-related factors. The identification of differentiated profiles reinforces the multidimensional nature of orthorexia and underscores the relevance of considering specific sport environments when interpreting orthorexic tendencies. Longitudinal research is warranted to examine the stability or variability of these patterns over time and to enable the use of more robust multivariate approaches that further clarify the characterization of orthorexia. Full article