Search Results (35,406)

Coronavirus disease-2019 COVID-19 exhibits marked inter-individual variability in susceptibility and clinical outcomes, suggesting a role for host genetic factors. Vitamin D exerts immunomodulatory effects through the vitamin D receptor (VDR), and genetic variation in the VDR gene may influence host responses to SARS-CoV-2 infection. This study aimed to investigate the association between VDR-gene polymorphisms—FokI (rs2228570), TaqI (rs731236), ApaI (rs7975232), and BsmI (rs1544410)—and COVID-19 susceptibility in the Kurdish population. The FokI polymorphism was significantly associated with COVID-19 susceptibility. Interestingly, the GG-genotype was more frequent among Patients than controls and was associated with increased odds of infection (OR = 9.00; 95% CI: 3.22–25.15; p < 0.0001), whereas the AG-genotype was associated with reduced susceptibility (OR = 0.33; 95% CI: 0.14–0.76; p = 0.001). Additionally, the G-allele was also more prevalent in Patients than controls (OR = 1.87; 95% CI: 1.21–2.89; p = 0.004). Similarly, the TaqI TT-genotype was more frequent among Patients and was associated with increased susceptibility (OR = 36.0; 95% CI: 11.2–115.8; p < 0.0001). In contrast, the ApaI AA-genotype was less frequent among Patients and was associated with reduced odds of COVID-19 susceptibility under a recessive model (OR = 0.15; 95% CI: 0.03–0.68; p = 0.003). Moreover, the BsmI polymorphism was monomorphic in both groups and therefore not informative. Genetic variation in the VDR gene, particularly at the FokI, TaqI, and ApaI loci, was associated with COVID-19 susceptibility in the case–control study, while BsmI showed no variations. These findings suggest that genetic variation in the VDR gene may contribute to inter-individual differences in susceptibility to SARS-CoV-2 infection in the Kurdish population. Larger studies incorporating functional validation and detailed clinical data are required to confirm these associations. Full article

Background/Objectives: Aging is associated with declines in cognitive function and neurotrophic support. Brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) are peripheral biomarkers discussed in relation to brain health and aging. This study investigated changes in serum BDNF, IGF-1, and cognitive screening scores after a 16-week Hatha Yoga program performed twice or four times per week in older women. Methods: Fifty-one community-dwelling women aged 70–79 years were allocated to a twice-per-week yoga group (2YG; n = 17), a four-times-per-week yoga group (4YG; n = 17), or a non-exercise control group (CON; n = 17) based on availability and participant preference; forty-three participants completed the study. Serum BDNF and IGF-1 were analyzed using enzyme-linked immunosorbent assay and chemiluminescent immunoassay, and cognitive status was evaluated using the Cognitive Impairment Screening Test (CIST). Outcomes were analyzed using two-way repeated-measures ANOVA and additional ANCOVA models adjusting for corresponding baseline values. Exploratory correlations were examined between biomarker changes and CIST changes. Effect sizes and 95% confidence intervals were reported. Results: BDNF showed a significant main effect of time (p < 0.05) without a significant group × time interaction; ANCOVA adjusting for baseline BDNF showed no significant group effect (p = 0.270). IGF-1 showed a significant group × time interaction (p < 0.01) with increases in both yoga groups; ANCOVA adjusting for baseline IGF-1 showed a significant group effect (p = 0.001). CIST showed a significant main effect of time (p < 0.01), but changes were small and the group × time interaction was not significant; ANCOVA adjusting for baseline CIST showed no significant group effect (p = 0.114). Biomarker changes were not clearly correlated with CIST changes (ΔBDNF–ΔCIST: r = −0.244, p = 0.115; ΔIGF-1–ΔCIST: r = −0.050, p = 0.750). Conclusions: In this quasi-experimental study with non-random allocation and limited covariate information, changes in peripheral neurotrophic factors and only small changes in cognitive screening scores were observed after participation in a 16-week Hatha Yoga program. However, frequency-dependent conclusions are limited, and findings should be interpreted cautiously as screening-level, hypothesis-generating reference data. Nevertheless, the program is considered a feasible, low-risk health promotion activity for older women and may inform future randomized or well-controlled studies. Full article

Background: The role of systemic fibrinolysis in patients with intermediate-risk pulmonary embolism (PE) remains controversial because of the uncertain balance between potential benefits and bleeding risk. This study evaluated the association between systemic fibrinolysis and clinical outcomes in a real-world cohort of patients with symptomatic intermediate-risk PE. Methods: This prospective observational study included consecutive patients with symptomatic intermediate-risk PE from 2009 to 2019 at a tertiary hospital. Patients receiving systemic fibrinolysis were compared with those treated with anticoagulation alone. The primary outcome was 30-day all-cause mortality. Secondary outcomes included major bleeding, and recurrent venous thromboembolism. Multivariable Cox proportional hazards regression models were used to adjust for potential confounders. Results: A total of 560 patients with symptomatic intermediate-risk PE were included, of whom 54 (9.6%) received systemic fibrinolysis. Patients receiving fibrinolysis were younger than those treated with anticoagulation alone (median age 58 vs. 73 years; p < 0.001). Thirty-day mortality occurred in 1.8% and 3.3% of patients, respectively (p = 1). After adjustment, fibrinolysis was not associated with reduced 30-day mortality (aHR 1.5; 95% CI 0.1–17.9), nor with a significant increase in 30-day major bleeding (aHR 2.6; 95% CI 0.8–8.3). Intracranial hemorrhage and VTE recurrences were rare. Conclusions: In this real-world cohort, systemic fibrinolysis was not associated with improved survival compared with anticoagulation alone, consistent with current guideline recommendations against routine fibrinolysis in intermediate-risk PE. Full article

This article compares the analytical results from two models, based on the theory of hereditary creep strain, with experimental results on the rheological properties of lightweight sintered aggregate concrete under cyclically varying loads. In a previous article, the authors analyzed the adequacy of standard models for the same test results. Because the use of standard models is very complex and does not improve the approximation of test results without additional calibration, the authors suggest reconsidering the use of hereditary models for LWAC. The application of four such long-term models was analyzed. Among these models, the Arutiunian theory of hereditary creep with aging and the modified hereditary theory with Bažant aging function yielded quantitatively and qualitatively correct results. The application of hereditary creep theory allowed for the formulation of the total strain as a superposition of strain increments, obtained by an integral equation. This equation was applied to a series of constant stress increments and decrements, as in the case of cyclic loading, and it was mathematically described in segmented form. Knowledge of the properties of LWAC and useful long-term models is essential for the design of prestressed structures made of lightweight aggregate concrete subjected to time-varying loads. Full article

Electrochemical energy storage serves as a foundational technology in contemporary electrical energy storage systems, with its operational safety and stability being crucial to socio-economic development. The estimation of the state of health (SOH) of energy storage batteries is an essential component for ensuring system safety warnings and lifecycle management. To address the challenges of redundant health feature dimensions, insufficient correlation of influencing factors, and limited prediction accuracy in existing SOH estimation methods, in this paper, a novel state of health estimation framework is introduced, leveraging an Improved Gray Wolf Optimization (IGWO) algorithm to optimize the parameters of a Support Vector Machine (SVM). This model achieves precise prediction of battery health states by extracting multidimensional health features, including the differential temperature, incremental capacity, time interval of equal charge voltage difference (DT-IC-TIECVD) and implementing the improved gray wolf optimization algorithm with support vector machine algorithm (IGWO-SVM). Validated on the Oxford battery aging dataset, the proposed model achieves mean absolute error (MAE), root mean squared error (RMSE), and coefficient of determination (R²) values of 0.43%, 0.55%, and 0.99, respectively. These results confirm the high accuracy and feasibility of the proposed method, while also providing a novel technical pathway for the health management of energy storage batteries. Full article

Background/Objectives: Longer lifetime exposure to endogenous estradiol (L_EE2) has been associated with lower risk of age-related cognitive decline and dementia. Complementary to cognitive decline, behavioral and functional decline are also predictive of dementia risk; however, the association between L_EE2 and these domains is underexplored. We investigated whether L_EE2 is correlated with later-life changes in behavior and function. Methods: Baseline data from 1156 females enrolled in the CAN-PROTECT study were analyzed. L_EE2 was estimated based on the length of the reproductive period (menopause age–menarche age) plus years pregnant and scaled in 5-year increments. Objective cognition was measured using the CAN-PROTECT neuropsychological battery, while subjective cognition, behavior, and function were measured using the Revised Everyday Cognition (ECog-II) scale, Mild Behavioral Impairment Checklist (MBI-C), and Standard Assessment of Global Everyday Activities (SAGEA) scale, respectively. Linear regressions modeled the association between L_EE2 and neuropsychological performance. Three separate negative binomial regression models examined the association between L_EE2 and ECog-II, MBI-C, and SAGEA total scores. All models adjusted for menopause hormone therapy, menopause type, age at first childbirth, body mass index, age, education, and ethnocultural background. Results: Each five-year increase in L_EE2 was associated with a lower MBI-C score (count ratio [CR] = 0.89, 95% CI [0.82, 0.97]) and lower SAGEA score (CR = 0.91, 95% CI [0.84, 0.98]). L_EE2 was not significantly associated with any objective or subjective cognitive measures. Conclusions: Longer L_EE2 may associate with lower severity of later-life behavioral and functional symptoms in older women. Full article

Voluntary turnover represents a critical challenge in essential public services, where workforce attrition affects both employee well-being and service quality. The primary objective of this study was to identify the psychosocial predictors of well-being profiles and turnover intention among public transport workers, using the Job Demands–Resources model as a theoretical framework. A cross-sectional study design was employed, with 131 employees of an Italian public transport company completing a questionnaire assessing turnover intention and key psychosocial factors (job satisfaction, perceived work-related stress, work engagement, meaning of work, and perceived workplace safety). The analytical strategy integrated Latent Profile Analysis (LPA), logistic regression, and path analysis. LPA identified two distinct well-being profiles: a “low well-being profile,” with high perceived stress and low engagement and meaning of work; and a “high well-being profile,” with low stress and high engagement and work meaning. Logistic regression analyses showed that satisfaction with pay and the intrinsic nature of work tasks predicted membership in the high well-being profile. Path analysis indicated that profile membership significantly predicted turnover intention, with employees in the high well-being profile reporting lower turnover intention. Additionally, satisfaction with supervision, perceived workplace safety, and age showed direct effects on turnover intention. These findings highlight the organizational and psychological resources that can increase employee well-being and retention in the public transport sector, offering insights for preventive interventions and for promoting safer and more sustainable public transport systems. Full article

Background and Objectives: This study aimed to evaluate postoperative outcomes following transaxillary first rib resection with concomitant anterior scalenotomy (Roos procedure) for Thoracic Outlet Syndrome, using an ambispective design with a standardized two-year multimodal follow-up in a prospectively observed subgroup. Materials and Methods: This ambispective observational cohort study included 32 patients (87.5% women; mean age, 33.8 years) who underwent transaxillary first rib resection with anterior scalenotomy for Thoracic Outlet Syndrome. Of these, seven patients comprised the retrospective cohort, having undergone surgery between 2017 and 2019, while the remaining 25 patients were enrolled prospectively and underwent surgery from 2020 onwards. Patients were classified as having neurogenic, vascular (arterial or venous), or mixed Thoracic Outlet Syndrome. Retrospective data were obtained from medical records, while prospectively treated patients were followed according to a predefined postoperative protocol. Longitudinal changes in clinical outcomes were analyzed using mixed linear and logistic regression models. Results: All analyzed symptoms improved after surgery (p < 0.05), with a significant reduction in upper limb edema over time (OR = 0.44, p = 0.002). The prevalence of positive provocative tests decreased notably across all maneuvers postoperatively. Pathological color duplex ultrasound findings of the upper limb vessels resolved almost completely during follow-up. Patient-reported outcome measures (CBSQ, DASH, and BPI) demonstrated meaningful postoperative improvement with sustained benefits over time. Electrophysiological evaluation revealed notable improvement in median sensory and motor nerve conduction parameters. Conclusions: Transaxillary first rib resection with anterior scalenotomy appears to improve clinical, functional, and objective outcomes in patients with Thoracic Outlet Syndrome; however, findings should be interpreted with caution due to the ambispective design, small sample size, and cohort heterogeneity, and require confirmation in larger prospective studies. Full article

Chronic low-grade inflammation, altered microvascular support, and progressive stress-related cellular dysfunction are major contributors to tissue aging and impaired repair. Dermal fibroblasts are central regulators of these processes because they integrate cytokine-related signaling, redox balance, and extracellular matrix homeostasis. Increasing evidence indicates that endogenous bioelectrical activity may influence these cellular functions by shaping upstream regulatory conditions linked to downstream molecular responses. In the present study, we investigated the molecular effects of the Radio Electric Asymmetric Conveyer Anti-Inflammatory Cellular Treatment delivered under Inside Blue Zone conditions (REAC ACT-IBZ) in human dermal fibroblasts (HFF1). Cells were exposed to nine standardized treatment sessions, and molecular changes were assessed by RT-qPCR, ELISA, and immunofluorescence analysis complemented by supportive semi-quantitative fluorescence intensity assessment. REAC ACT-IBZ exposure was associated with increased SIRT1 and VEGF expression and with transcriptional modulation of selected cytokine-related genes, including IL-1α, IL-1β, IL-2, and IL-8. Immunofluorescence analysis, complemented by supportive semi-quantitative fluorescence intensity assessment, showed a pattern consistent with increased FOXO1 and SIRT1 staining and reduced mTOR staining in treated cells. Overall, these findings identify a molecular profile associated with REAC ACT-IBZ exposure in human dermal fibroblasts, involving stress-response regulators, angiogenesis-related signaling, and selective cytokine-related transcriptional changes. Within the limits of the present in vitro model, the data support the view that endogenous bioelectrical modulation may interact with molecular networks relevant to tissue homeostasis and inflammaging. Full article

Background/Objectives: To evaluate the Risk Factor-Weighted Clinical Likelihood (RF-CL) model for the diagnosis of chronic coronary syndrome (CCS) in men and women. Methods: The study included 222 patients (100 men and 122 women; mean age 64.76 ± 10.3 years) with suspected CCS. Diagnostic evaluation was performed in accordance with the 2024 clinical practice guidelines for stable coronary artery disease developed by the Russian Society of Cardiology. The clinical probability of obstructive coronary artery disease (CAD) was calculated for all patients using the RF-CL model. Results: Application of the RF-CL model demonstrated higher probabilities in men than in women (17% [11–27] vs. 6% [4,5,6,7,8,9,10], p < 0.001). Moderate CCS probability (RF-CL > 15–50%) was observed in 64% of men and 9.8% of women (p < 0.001); low probability (RF-CL > 5–15%) in 30% and 60.7% (p < 0.001); very low (RF-CL ≤ 5%) in 6% and 29.5% (p < 0.001). The prevalence of typical angina (21% vs. 17.2%, p = 0.47), atypical angina (31% vs. 26.2%, p = 0.43), and non-anginal chest pain (31% vs. 26.2%, p = 0.43) did not differ. Dyspnea was less frequent in men (44% vs. 59.8%, p = 0.02). Only 35 (15.8%) patients had indications for invasive coronary angiography (ICA), and significant stenosis (≥70%) was found in 17 patients. According to the ROC analysis, the cutoff value of RF-CL for predicting a positive stress test was 19.5% in men (AUC 0.723; p = 0.002), 6.5% in women (AUC 0.479; p = 0.852), and 15% in the overall cohort (AUC 0.737; p < 0.0001). Conclusions: Men with moderate and women with low probability of obstructive CAD are predominantly encountered in clinical practice when the RF-CL model is applied. Our observations have shown that ICA is indicated in relatively few patients and suggest potential overuse of exercise testing regardless of the clinicians’ adherence to the traditional Diamond–Forrester model or the RF-CL algorithm in suspected CCS. Full article

Background and Objectives: Outcomes after trauma are traditionally attributed to injury severity and acute physiologic derangement. However, host vulnerability at presentation—reflecting underlying physiologic and nutritional status—may also be associated with bleeding severity and transfusion requirements following acute injury. Whether such vulnerability contributes additional risk information beyond established factors remains incompletely understood. Materials and Methods: We conducted a retrospective cohort study of adult trauma patients using a single-center trauma registry. Host vulnerability was assessed using a composite score (CE; range 0–3) based on admission hypoalbuminemia (<3.5 g/dL), anemia (hemoglobin < 11 g/dL), and reduced renal function (estimated glomerular filtration rate < 60 mL/min/1.73 m²). Primary outcomes were any blood transfusion and massive transfusion, defined as transfusion of ≥10 units of packed red blood cells within 24 h of admission. Associations between CE score and transfusion outcomes were evaluated using univariable and multivariable logistic regression models adjusted for age, Injury Severity Score (ISS), admission lactate level, and systolic blood pressure (SBP). Results: Among 4105 trauma patients, transfusion requirements increased progressively with higher CE scores. Rates of any transfusion rose from 21.7% in patients with CE 0 to 78.6% in those with CE 3, while massive transfusion increased from 1.9% to 23.1% across the same categories. In multivariable analyses, each 1-point increase in CE score was independently associated with higher odds of any transfusion (adjusted odds ratio [aOR] 3.21, 95% confidence interval [CI] 2.80–3.68) and massive transfusion (aOR 1.73, 95% CI 1.45–2.07). Conclusions: A composite score reflecting host vulnerability at presentation was associated with bleeding severity and transfusion requirements after trauma, beyond injury severity and acute physiologic factors. These findings suggest that simple laboratory-based markers may provide additional information for early risk stratification of hemorrhagic outcomes after trauma. Full article

Accurate, scalable estimation of rice planting dates is essential for climate-adaptive management in multi-cropping regions, yet most models rely on static calendars, which fail to capture climate-driven shifts and bias simulated yield responses. This study aims to develop a climate-driven, spatially explicit framework to simulate dynamic transplanting dates across diverse multi-cropping systems in monsoon Asia. Utilizing daily AgERA5 reanalysis and Monsoon Asia Rice Calendar (MARC) data from 2019 to 2020, we present Geo-ROCKET. The framework integrates an automated K-means clustering workflow to delineate bimodal planting windows and employs random convolutional kernel transforms with adaptive geographic neighborhoods to capture local climate heterogeneity. Evaluated by area-weighted mean absolute error (MAE), the model achieves high accuracy across six seasons (MAE 6.53–12.50 days), outperforming six traditional ROCKET and ensemble baselines while preserving smooth spatial error fields. Sensitivity experiments reveal that a 15-day bias in the previous harvest date can increase transplanting error to 10.8–17.8 days, emphasizing the importance of sequential consistency. By providing dynamic, climate-sensitive inputs, Geo-ROCKET improves the accuracy of crop modeling for climate impact projections. This framework offers a flexible tool for characterizing human management decisions and evaluating adaptation strategies in intensive agricultural systems. Full article

Mathematical modeling plays a key role in understanding and optimizing transport system operations under uncertain and dynamic conditions. This study proposes a data-driven predictive framework for estimating passenger-accepted vehicle occupancy, addressing a critical gap in transport system planning under public health-related constraints. Using data from a structured survey conducted across seven Southeast European countries (N = 476), the study integrates statistical analysis and machine learning approaches to model acceptable occupancy levels across multiple transport modes, including passenger cars, taxis, tourist buses, and public buses. The problem is formulated as a predictive mapping between multidimensional input variables and occupancy acceptance levels, modeled using both probabilistic and nonlinear function approximation methods. The results highlight that age, gender, and area of residence are the most significant determinants of occupancy acceptance, while education level has limited predictive relevance. Furthermore, a multi-layer feedforward artificial neural network is developed to capture nonlinear relationships between variables, achieving strong predictive performance (minimum MSE = 0.0089). The main contribution of this research lies in linking behavioral data with predictive modeling to quantify acceptable occupancy thresholds and support realistic simulation of passenger responses in crisis conditions. The proposed modeling framework contributes to transport system planning, enabling data-driven capacity management, enhanced safety strategies, and improved resilience of passenger transport operations. Full article

Purpose: To compare the efficacy of Superb Microvascular Imaging (SMI) with grayscale ultrasound (US) and dynamic contrast-enhanced MRI in predicting pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in invasive breast cancer. Methods: A total of 115 patients included in the study were evaluated based on their pre-treatment imaging findings (US, mammography, and MRI). Following completion of NAC, all patients underwent grayscale US and SMI examinations. In patients with available post-NAC MRI, treatment response was additionally assessed by comparing MRI findings. Imaging results were correlated with postoperative pathological outcomes, which served as the reference standard. pCR was defined as the absence of residual invasive carcinoma, regardless of ductal carcinoma in situ. Molecular subtype, Ki-67, and axillary status were recorded. Statistical analyses included chi-square tests and stepwise multiple logistic regression. Significance was set at p < 0.05 (95% CI). Results: The median age was 51 years (range: 30–75). Most tumors were high-grade (55%) and invasive ductal carcinoma (95%). Breast-pCR was achieved in 43% of patients. Significant predictors of pCR included hormone receptor negativity, HER-2 positivity, high Ki-67 expression (≥40%), non-luminal subtype, and complete radiologic response on US and MRI (p < 0.05). Lower SMI index values were strongly associated with pCR (p < 0.001), with an optimal cut-off of 1.8 demonstrating good diagnostic performance (AUC = 0.804, 95% CI: 0.721–0.887). In multivariate analysis, the combined model including US, SMI, HER-2 status, and MRI showed the highest predictive performance (AUC = 0.890, 95% CI: 0.829–0.950), explaining 55.1% of the variance in pCR. Conclusions: An SMI index < 1.8, HER-2 positivity, and complete response on US and MRI are independent predictors of pCR after NAC. Combining SMI with multimodal imaging significantly improves predictive accuracy. Full article

Background/Objectives: People with HIV (PWH) remain at high risk for cardiovascular and metabolic complications despite effective antiretroviral therapy (ART). Diet quality is an important modifiable factor that may influence these complications. Diets high in ultra-processed foods (UPF) have been linked to adverse metabolic and inflammatory profiles in the general population, but their impact on PWH remains poorly understood. The NOVA 4 classification categorizes foods by degree of processing, from unprocessed/minimally processed (NOVA 1) to UPF (NOVA 4). Methods: We conducted a cross-sectional study of adults with virologically suppressed HIV on stable ART. Assessments included dietary intake consisting of 24 h recalls analyzed with Nutrition Data System for Research software (NDSR) and classified into NOVA categories by a registered dietitian and the following characteristics: body composition (total and regional fat by DEXA and CT scan abdomen), cardiometabolic variables (glucose, HbA1C, HOMA-IR, lipids, blood pressure), and biomarkers of inflammation, immune activation, and gut integrity quantified by ELISA. Patients were stratified into NOVA 4 groups based on the median and quartile proportions of total energy intake from NOVA 4 foods. Associations between dietary NOVA and outcomes were analyzed using generalized additive models (GAMs) adjusted for age, sex, race, and CD4 count. Results: Among 222 PWH (mean age 45.4 ± 14.2 years; 31% female; 66% non-white; BMI 30.61 ± 7.91 kg/m²), median NOVA 4 intake was 45.6% of total energy intake. Participants with higher vs. lower NOVA 4 intake showed differences in diet quality, but in GAMs, higher NOVA 4 intake was not associated with higher levels of inflammatory, cardiometabolic, gut integrity, and body composition variables. Conclusions: In PWH, UPF consumption was high but not associated with markers of cardiometabolic health, systemic inflammation, or gut integrity. This may reflect the multifactorial nature of the heightened inflammation in PWH, potentially obscuring the effect of diet. Full article