Search Results (4,904)

Immunohistochemistry (IHC) is a widely used method for detecting specific proteins in tissue samples, helping diagnose diseases such as cancer. Traditional analysis methods rely heavily on human interpretation, which can lead to inconsistencies. In this study, we propose DeepFlare, a weakly supervised deep learning framework for cross-modality translation and segmentation of immunofluorescence and immunohistochemistry images. The proposed method utilizes multiplex immunofluorescence (mpIF) and co-registered IHC images, combined with preprocessing techniques such as affine transformation, stain normalization, noise reduction, and artifact removal. Multiple imaging channels, including hematoxylin, DAPI, Lap2, and nuclear envelope signals, are leveraged to generate segmentation masks using a U-Net++ architecture. The final segmentation mask is obtained through weighted fusion of modality-specific outputs. A generative adversarial network (GAN) is employed to measure translation fidelity between generated and real images. Weakly supervised learning techniques, including image-level supervision and consistency constraints, are applied to enhance performance under limited annotation scenarios. Pretrained pathology foundation encoders such as UNI and Virchow are integrated to extract multi-scale morphological and contextual features. Explainable AI techniques are incorporated to highlight critical regions and refine model attention. Experimental results demonstrate strong performance, achieving an SSIM of 0.7077 for image translation and a Dice score of 0.7424 for segmentation. The integration of the UNI encoder provides marginal improvement over the baseline (0.72 Dice score), indicating limited domain adaptation without fine-tuning on the dataset of 1264 training samples. Full article

Background/Objectives: Anemia and iron dysregulation are common in chronic heart failure (CHF), but additional metabolic mechanisms may contribute to these alterations. This study aimed to evaluate purine metabolism and oxidative stress markers in patients with CHF and to explore their potential relationship with anemia. Methods: In this cross-sectional study, 176 patients with CHF and 29 control individuals were included. CHF phenotypes were classified according to left ventricular ejection fraction (HFpEF, HFmrEF, HFrEF). Purine metabolites (guanine, hypoxanthine, adenine, xanthine, and uric acid) were measured using high-performance liquid chromatography, while lipid peroxidation (LPO) and advanced oxidation protein products (AOPPs) were assessed spectrophotometrically. Non-parametric statistical tests with correction for multiple comparisons were applied. Results: Anemia was present in 40.3% of patients with CHF. Serum iron and platelet counts were significantly lower in CHF compared with controls (p = 0.001). Among purine metabolites, adenine levels were higher in CHF (nominal p = 0.009), whereas other metabolites did not differ significantly between groups. LPO levels were lower and AOPP levels were higher in CHF (p = 0.021 and p = 0.008, respectively). No statistically significant associations were observed between hemoglobin levels and purine metabolites. Conclusions: CHF is associated with alterations in iron status and oxidative stress markers, as well as changes in purine metabolism. However, no significant associations between purine metabolites and anemia were identified in this cohort, and these findings should be interpreted cautiously given the exploratory design and sample size limitations. Full article

Life satisfaction (LS) is an important indicator of subjective well-being among college students. However, relatively few studies have integrated variable-centered and person-centered approaches to examine the associations among physical activity (PA), social support (SS), and LS in female college students. This cross-sectional study surveyed 2097 female college students from 11 universities in Jiangxi Province, China. PA, SS, and LS were assessed using self-report questionnaires. A mediation model was used to examine whether SS statistically mediated the association between PA and LS after controlling for education level and place of origin. Latent profile analysis was then conducted using six LS items, and the BCH method was used to compare PA and SS across profiles. The results showed that PA was positively associated with SS and LS, and SS was positively associated with LS. The indirect association between PA and LS through SS was statistically significant, suggesting a partial statistical mediation pattern. Latent profile analysis identified three level-based LS profiles: low-, medium-, and high-LS profiles. PA and SS increased progressively across these profiles, with the highest levels in the high-LS profile and the lowest levels in the low-LS profile. These findings suggest that PA, SS, and LS are closely interrelated and that meaningful quantitative heterogeneity exists in LS among female college students. Given the cross-sectional design and convenience sampling, the findings should be interpreted as statistical associations rather than causal effects. Full article

Background and Objectives: Cigarette smoking remains a leading modifiable cardiovascular risk factor. This study aimed to analyze decade trends in daily smoking prevalence and its association with education level and physical activity by gender and age groups in Latvia. Materials and Methods: We analyzed data from two distinct waves of a population-based cross-sectional study conducted in Latvia. The study included a stratified random sample of adults aged 25–74 (N = 3807 in 2009; N = 4070 in 2019). Smoking status and education level were self-reported in both years; physical activity data were collected only in 2019. Multivariable logistic regression identified independent factors associated with smoking. Results: From 2009 to 2019, smoking prevalence decreased among men (from 43.6% to 36.0%, p < 0.01) and increased among women (from 15.0% to 18.1%, p < 0.01). Men and women with higher education were significantly less likely to be daily smokers (2019, Men: odds ratio (OR): 0.48, 95% confidence interval (CI) 0.38–0.59; Women: OR: 0.39, 95% CI 0.29–0.50). Among men, the proportion of daily smokers was higher in physically inactive (39.8%) and active (39.0%) groups compared to the moderately active group (31.4%, p < 0.01). However, physical activity level was not a significant predictor of smoking in the multivariable analysis. Conclusions: Over the decade, daily smoking prevalence decreased in men but increased in women in Latvia, with education level being a strong independent predictor. Although the proportion of smokers among men differed across physical activity groups, this factor was not an independent predictor of smoking. These findings underscore the need for targeted public health interventions in Latvia, specifically focusing on individuals with lower education levels to reduce the long-term cardiovascular burden. Full article

Background/Objectives: Pain is a common symptom in patients undergoing hemodialysis (HD) and may influence their quality of life. Pain self-efficacy may play an important role in self-management and adherence behaviors. This study aimed to examine the association between pain self-efficacy and adherence to the HD regimen in patients undergoing HD. Methods: In this descriptive and cross-sectional study, 199 patients undergoing HD from a single private hospital (convenience sample) in Athens, Greece, completed the Greek-Simplified Adherence Questionnaire-HD (GR-SMAQ-HD) to assess adherence and the Pain Self-efficacy Questionnaire (PSEQ) to assess pain self-efficacy. Sociodemographic and clinical data were also recorded. Bivariate analyses and multiple linear regression were performed to identify factors associated with adherence. Statistical significance was set at p < 0.05. Results: Patients demonstrated moderate levels of pain self-efficacy (mean PSEQ = 33.96 ± 9.74) and moderate adherence to the HD regimen (mean GR-SMAQ-HD = 4.78 ± 2.54). No significant correlation was found between pain self-efficacy and adherence in bivariate analysis (rho = 0.125, p = 0.221). However, in multivariate analysis, pain self-efficacy was a significant independent predictor of adherence (β = 0.056, p = 0.032). Longer duration of End-Stage Renal Disease (ESRD) (β = −0.158, p < 0.001), higher pill burden (rho = −0.237, p = 0.030) were associated with lower adherence. Marital status was also a significant predictor of adherence (β = 1.631, p = 0.016). The model explained 24% of the variance in adherence (Adjusted R² = 0.24). Conclusions: Pain self-efficacy may indirectly affect adherence to the HD regimen, although its direct effect is modest. Adherence appears to be negatively influenced by pill burden and ESRD duration, while social support may play an important role. Full article

Introduction: Compassion is defined as the emotional response that arises when an individual perceives another’s suffering and is motivated to alleviate it. Purpose: To explore levels of self-compassion among nurses working in pediatric hospitals and examine their associations with nurses’ characteristics. Materials and Methods: This cross-sectional study included a convenience sample of 208 nurses from a public pediatric hospital. Data were collected through interviews using the Neff Self-Compassion Scale (SCS) which includes the following subscales: Self-Kindness, Common Humanity, Mindfulness, Self-Judgment, Isolation, and Over-Identification. The Greek-validated version of the instrument was used with acceptable internal consistency in the present sample (Cronbach’s alpha = 0.849). Data analysis included descriptive statistics and inferential tests (non-parametric comparisons and multiple linear regression), with statistical significance defined as p < 0.05. Results: The mean total Self-Compassion score was 83.24 ± 12.6 (range: 26–130). Regarding family-related factors, total Self-Compassion (p = 0.029), Common Humanity (p = 0.033), and Over-Identification (p = 0.041) were associated with the number of children. In relation to age, Self-Kindness (p = 0.033), Isolation (p = 0.005), and Over-Identification (p = 0.005) showed significant associations. Professional factors were also relevant, as Isolation was associated with total years of nursing experience (p = 0.032) and choice of nursing as a profession (p = 0.004), while Over-Identification was associated with years of experience in pediatric settings (p = 0.004) and choice of nursing as a profession (p = 0.049). Additionally, marital status was associated with Over-Identification (p = 0.045). Conclusions: Demographic and professional characteristics appear to influence the expression of Self-compassion. Healthcare organizations should implement targeted training programs to individualize professional development. Future research should explore work-related and personal factors influencing self-compassion to improve care quality and outcomes. Full article

Background/Objectives: Type 2 diabetes may impair anterior segment immune regulation. Because transforming growth factor-β2 maintains ocular immune privilege, while nuclear factor-κB is linked to inflammatory activation, we compared their aqueous humor levels in cataract patients with and without diabetes. Methods: In this prospective cross-sectional study, aqueous humor samples were collected from 90 patients (30 diabetic, 60 non-diabetic) via anterior chamber needle aspiration at the commencement of routine phacoemulsification, prior to viscoelastic injection, without additional intervention. Transforming growth factor-β2 and nuclear factor-κB levels were then measured using enzyme-linked immunosorbent assay (ELISA). Between-group comparisons and ROC curve analyses were performed to evaluate differences in biomarker levels and their discriminative ability in distinguishing diabetic status. Covariate-adjusted analysis (ANCOVA) was additionally performed. Results: Transforming growth factor-β2 levels were significantly lower in the diabetic group (p < 0.001), while nuclear factor-κB levels showed no significant difference (p = 0.285). The between-group difference in transforming growth factor-β2 remained significant after adjustment for cataract grade and hypertension duration (F(1,86) = 17.901, p < 0.001, partial η² = 0.172; Cohen’s d = 0.94). Transforming growth factor-β2 demonstrated high specificity (100%) but limited sensitivity (45%) for identifying diabetic status at a cut-off of <449.25 ng/L; however, given the small sample size and exploratory nature of the study, this specificity value should be interpreted with caution and requires validation in larger cohorts. Conclusions: Lower aqueous humor TGF-β2 levels in diabetic cataract patients, independent of cataract severity and hypertension duration, suggest that TGF-β2 suppression may represent an earlier molecular event in anterior segment immune dysregulation preceding overt inflammatory activation. While TGF-β2 shows exploratory biomarker potential, validation in larger, prospective, mechanistic studies is required before clinical application. Full article

Background/Objectives: Promoting postural health in children requires not only adequate knowledge but also the implementation of health-promoting behaviors in the school environment. Teachers play a key role in this process; however, the extent to which their knowledge is reflected in everyday practice remains unclear. The study aimed to analyze and compare the levels of knowledge among preschool, early school, and physical education teachers regarding postural health in children and adolescents, including postural abnormalities, ergonomics, the selection of corrective exercises, and behaviors that promote correct body posture. Methods: A cross-sectional study was conducted on a sample of 153 teachers in Poland: 24 preschool (P), 53 early school education (EE), and 76 physical education (PE) teachers. The self-report Teachers’ Body Posture Literacy Questionnaire (TBPLQ) was used to assess knowledge regarding postural abnormalities. Results: PE achieved the highest TBPLQ scores, with significant differences observed mainly in comparison with EE (r = 0.30–0.50, p < 0.001). Across all groups, teachers performed best in recognizing postural abnormalities and worst in selecting appropriate corrective exercises. Although knowledge levels were relatively high, only weak correlations were found between knowledge and postural hygiene-promoting behaviors. The largest behavioral differences concerned the use of appropriate sportswear during physical education classes (η² > 0.14). Conclusions: Teachers demonstrated relatively high levels of knowledge regarding posture health. However, a clear knowledge–behavior gap was identified. Knowledge was only partially translated into proactive health-promoting actions, particularly regarding corrective interventions and communication with parents. The results suggest the need for educational initiatives for teachers focusing on proactive health-promoting and postural hygiene behaviors. Full article

Wheat is a major staple crop, and storage mold growth poses a severe threat to grain safety and quality stability. Natural mold development in stored wheat exhibits subtle, localized, and highly heterogeneous characteristics. Existing unimodal methods and global fusion approaches generally suffer from insufficient local feature sensitivity, hindering fine-grained mold severity grading. To address this limitation, we propose a Mask-Guided Fine-Grained Fusion Network, a weakly supervised framework based on local RGB–HSI fusion. This framework employs a dynamic parallel A/B experimental design to construct time-matched proxy labels via weakly supervised learning. A standardized preprocessing pipeline including single-kernel extraction, foreground segmentation, and cross-modal registration is established to resolve RGB–HSI spatial misalignment, ensuring physical-level spatial consistency of multimodal features. The model incorporates a Foreground-Aware Spectral Recalibration (FASR) module to suppress background noise, a Mask-Guided Dilated Cross-modal Local Attention (MDCLA) mechanism to establish fine-grained local mappings between RGB visual phenotypes and hyperspectral responses, and a sample-level adaptive fusion strategy to dynamically weight features by modal reliability, enhancing representation of complex samples across all mold stages. Experiments show that the Mask-Guided Fine-Grained Fusion Network achieves 0.9689 classification accuracy, 0.9698 Macro-F1 score, and 0.0593 Mean Absolute Error (MAE), significantly outperforming state-of-the-art unimodal deep models and global attention fusion baselines. This work provides a proof-of-principle framework for fine-grained non-destructive mold risk assessment in stored wheat. Full article

H9N2 avian influenza viruses inherently carry cross-species transmission potential, making continuous surveillance critical for pandemic prevention. This study focused on monitoring the 2024 H9N2 epidemic in Jiangsu Province’s external environment, analyzing its molecular evolution and receptor binding properties, assessing cross-species transmission and pandemic risks, and investigating serological antibody levels across different human populations. Environmental samples were collected from live poultry markets, farms, slaughterhouses, and bird habitats across Jiangsu, screened via quantitative PCR (qPCR), with positive samples used for virus isolation and whole-genome sequencing. Receptor binding properties were tested by hemagglutination assay, and H9N2 antibody levels were measured in 370 occupationally exposed individuals and 240 non-exposed individuals using hemagglutination inhibition (HI) assays. Among the 5779 collected samples, 6.89% tested H9N2-positive, and 12 strains belonging to the Eurasian lineage Y280-like clade G57 genotype were successfully isolated. All strains carried the HA-Q226L mutation, with 11 showing preferential binding to human α-2,6 receptors and one strain possessing dual receptor binding capability. Internal genes harbored mammalian adaptation mutations, and M2 proteins contained mutations conferring complete resistance to amantadine-class antiviral drugs. Serological tests revealed antibody positive rates of 4.05% in exposed populations and 2.5% in non-exposed populations, with no statistically significant difference between groups. These findings confirm that Jiangsu’s circulating H9N2 viruses have acquired human receptor preference and mammalian adaptation, posing silent infection and pandemic risks. Enhanced surveillance and the development of candidate vaccine stockpiles are strongly recommended. Full article

This study examines complex thinking as a higher-order cognitive competence in international graduate education. Drawing on Edgar Morin’s theoretical perspective, it analyzes how master’s students perceive this competence through four interrelated dimensions: systemic, scientific, critical, and innovative thinking. A total of 491 international students from a graduate university in Japan participated in the study. Using a quantitative, cross-sectional design, data were collected with the validated eComplexity instrument and analyzed through PERMANOVA with 999 permutations. The analysis examined differences in self-perceived complex thinking by sex, academic field, nationality, and academic semester. Results showed moderately high levels of self-perceived complex thinking across the sample, with systemic and critical thinking emerging as the strongest dimensions. Significant differences were found by nationality and academic semester, while no significant differences were observed by sex or academic field. These findings suggest that students’ perceptions of complex thinking are associated with cultural and academic trajectories, although the cross-sectional and self-report design requires cautious interpretation. The study contributes to competence-based graduate education by showing that complex thinking can be examined as a multidimensional and context-sensitive form of perceived cognitive development. Educational implications are discussed in relation to curriculum design, intercultural learning, global citizenship, and inclusion in international master’s programs. Full article

Accurate and efficient detection of cyanobacteria in microscopic images is important for automated water-quality monitoring, but remains challenging because of complex aquatic backgrounds, large scale variation, and uneven sample quality. This study proposes an adaptive multi-scale fusion enhanced RT-DETR framework for cyanobacteria detection. The baseline RT-DETR-R18 is improved by incorporating the SeFaster module for efficient feature extraction, the high-level screening-feature fusion pyramid network for semantic-guided multi-scale fusion, and the Wise-IoU loss for more stable localization learning under mixed-quality samples. Experiments on the reorganized EMDS-7 dataset show that the proposed method achieved 79.05% mAP@0.5, 66.03% mAP@0.5:0.95, 16.31 M parameters, 54.6 G FLOPs, and 70.85 FPS. The proposed model also obtained the highest mAP@0.5 across the seven cyanobacteria categories. Moreover, cross-dataset evaluations further suggest the stability and transferability of the model. These results indicate that the proposed framework demonstrates potential for effective cyanobacteria detection in microscopic images with a good balance between detection accuracy and computational efficiency. Full article

Background/Objectives: Informed consent (IC) is an essential component of medical practice; however, patients’ understanding of medical information remains challenging. This study aimed to assess both objective and self-perceived comprehension of information presented in an IC scenario and to identify factors associated with understanding. Methods: A cross-sectional study was conducted using an anonymous online questionnaire with 275 adult participants in Romania. The questionnaire included a standardized IC scenario followed by comprehension assessment questions. Each correct answer was assigned one point, generating a total comprehension score ranging from 0 to 8. Self-perceived comprehension was evaluated using a Likert scale. Statistical analyses included descriptive statistics to summarize participant characteristics and questionnaire responses, Spearman’s correlations to examine associations between self-perceived comprehension and objective comprehension scores, independent samples t-tests and ANOVA to compare comprehension scores across participant groups, and multiple linear regression to identify independent predictors of comprehension. Results: The mean comprehension score was 6.81 ± 1.48, indicating a generally high level of understanding. A moderate positive correlation was observed between objective and self-perceived comprehension (ρ = 0.35, p < 0.001). Non-healthcare participants achieved slightly higher scores than healthcare field participants (p = 0.046), while educational level was not significantly associated with comprehension score (p = 0.566). Multiple linear regression analysis identified self-perceived comprehension as a significant independent predictor of the comprehension score (β = 0.381, p < 0.001). Conclusions: Although the overall level of comprehension was high, discrepancies between self-perceived comprehension and objective comprehension were identified. These findings highlight the importance of patient-centered communication strategies and the need to actively verify patient understanding during the informed consent process to support truly informed decision-making. Full article

Small ruminant production in Kosovo is predominantly extensive, and biosecurity practices remain poorly characterized. The emergence of Peste des Petits Ruminants (PPR) in Europe (beginning in 2024) and the first confirmed case in Kosovo (July 2025) highlight the urgent need for baseline biosecurity data to inform disease control. A cross-sectional pilot study was conducted on 63 small ruminant farms (53 meat-producing, 10 dairy-producing) across seven municipalities in Kosovo between September 2025 and February 2026. Biosecurity practices were assessed using the Biocheck.UGent™ questionnaire during direct on-farm visits. External (Ext) biosecurity scores (preventing pathogen introduction) were higher (p < 0.0001) than internal (Int) scores (limiting spread within farms). For external biosecurity, the highest scores were observed for purchase and reproduction (Ext A), intermediate scores existed for feed and water (Ext C) and visitors and farm workers (Ext D), and the lowest scores were found for transport and carcass removal (Ext B) and infrastructure (Ext E). For internal biosecurity, the highest scores were observed for lamb/kid management (Int H) and dairy management (Int I), followed by the management of adult animals (Int J); work organization (Int K) and reproduction management (Int G) formed an intermediate-low cluster, whereas disease management (Int F) scored the lowest. Benchmarking against the Biocheck.UGent™ worldwide database (predominantly intensive systems, thus not directly comparable) indicated that internal biosecurity and overall biosecurity levels were lower than the benchmark, while external biosecurity was comparable for some components. Given the convenience sample (36.4% response rate), findings are exploratory and are not directly generalizable. Larger herd size was positively correlated with external (ρ = 0.54, p < 0.0001), internal (ρ = 0.35, p = 0.005), and overall (ρ = 0.57, p < 0.0001) biosecurity scores. This first empirical biosecurity assessment of small ruminant farms in Kosovo reveals critical gaps in transport hygiene, disease management, and reproductive management pathways that enable PPR spread and perpetuate endemic zoonoses. The positive association between herd size and biosecurity may indicate structural barriers and/or knowledge gaps for small farms. Current biosecurity tools, designed for intensive systems, require adaptation for extensive production systems. These findings provide a baseline for targeted interventions, policy development, and validation of context-appropriate biosecurity instruments in Kosovo and similar extensive systems globally. Full article

Urban Park vegetation plays a crucial role in mitigating air pollution by serving as a natural sink for gaseous and particulate pollutants, thereby enhancing the ecological sustainability of cities. Identifying tree species with high tolerance to air pollution is therefore essential for effective urban park planning and management in highly polluted urban environments. This study evaluated the air pollution tolerance of selected tree species commonly found in urban parks of Kandy City, Sri Lanka, using the Air Pollution Tolerance Index (APTI). Five tree species—Terminalia catappa (Indian almond), Cassia fistula (golden shower tree), Pongamia pinnata (Indian beech), Madhuca longifolia (butter tree), and Tabebuia rosea (pink poui)—were assessed at two urban park locations representing contrasting pollution levels, identified based on ambient SO₂, NO₂, and PM_2.5 concentrations. APTI was calculated using four leaf biochemical parameters: pH, ascorbic acid content, relative water content, and total chlorophyll content. Leaf samples were collected from ten replicates of each species at both sites. Madhuca longifolia exhibited the highest APTI values (17.06 at the HP site and 25.17 at the LP site), followed by Cassia fistula, Terminalia catappa, Tabebuia rosea, and Pongamia pinnata. These findings suggest that the identified species, particularly Madhuca longifolia and Cassia fistula, are well-suited for urban greening and can contribute to mitigating air pollution impacts. However, these findings are constrained by a single cross-sectional sampling term, limited species screening, sequential data collection variances, and fixed mathematical equations. Consequently, future research should implement continuous multi-station monitoring arrays, expand species diversity, establish localized biochemical weightings, and initiate long-term multi-seasonal tracking to resolve temporal dynamics in tropical urban ecosystems. Full article