Search Results (9,012)

Background/Objectives: Crohn’s disease (CD) requires precise, noninvasive monitoring to guide therapy and support treat-to-target management. Magnetic resonance enterography (MRE), particularly diffusion-weighted imaging (DWI), is the preferred cross-sectional technique for assessing small-bowel inflammation. Indices such as the Magnetic Resonance Index of Activity (MaRIA) and its diffusion-weighted variant (DWI MaRIA) are widely used for grading disease activity. This study evaluated whether unsupervised clustering of MRI-derived features can complement these indices by providing more coherent and biologically grounded stratification of disease activity. Materials and Methods: Fifty patients with histologically confirmed CD underwent 1.5 T MRE. Of 349 bowel segments, 84 were pathological and classified using literature-based thresholds (MaRIA, DWI MaRIA) and unsupervised clustering. Differences between inactive, active, and severe disease were analyzed using multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), and t-tests. Mahalanobis distances were calculated to quantify and compare separation between categories. Results: Using MaRIA thresholds, 5, 16, and 63 segments were classified as inactive, active, and severe (Mahalanobis distances 2.60, 4.95, 4.12). Clustering redistributed them into 22, 37, and 25 (9.26, 24.22, 15.27). For DWI MaRIA, 21, 14, and 49 segments were identified under thresholds (3.59, 5.72, 2.85) versus 21, 37, and 26 with clustering (7.40, 16.35, 9.41). Wall thickness dominated cluster-derived separation, supported by diffusion metrics and the apparent diffusion coefficient (ADC). Conclusions: Cluster-derived classification yielded clearer and more biologically consistent separation of disease-activity groups than fixed thresholds, emphasizing its potential to refine boundary definition, enhance MRI-based assessment, and inform future AI-driven diagnostic modeling. Full article

Objective: This study aimed to assess whether oocyte donation in triplet pregnancies is associated with increased risk of placental abnormalities and pregnancy complications compared to triplet pregnancies conceived through assisted reproductive technology (ART) without oocyte donation. Methods: This single-center, retrospective, case–control study analyzed triplet pregnancies conceived via ART. The case group included pregnancies resulting from oocyte donation, while the control group comprised triplet pregnancies conceived by ART without oocyte donation. Maternal, obstetric, fetal, and neonatal outcomes were assessed. Gross and histopathological placental findings were evaluated using standardized criteria. Univariate and multivariate statistical analyses were performed. Results: A total of 77 triplet pregnancies (231 fetuses) were included: 29 in the oocyte donation group (87 fetuses) and 48 in the non-oocyte donation group (144 fetuses). Multivariate analysis revealed significantly higher rates of pregnancy-induced hypertension (p = 0.03), preeclampsia (p = 0.03), fetal growth restriction (p = 0.04), and fetal death (p = 0.01) in the oocyte donation group. Placental evaluation showed a higher frequency of infarcts (p = 0.04) and chronic inflammatory lesions—chronic villitis (p = 0.02) and chronic deciduitis (p = 0.03)—as well as signs of fetal vascular malperfusion, including avascular villi (p = 0.02) and stromal–vascular karyorrhexis (p = 0.01). Intervillous fibrin deposition was also more common in this group (p = 0.02). Conclusions: Oocyte donation in triplet pregnancies is associated with increased rates of placental abnormalities and adverse maternal and fetal outcomes when compared with ART without oocyte donation. Placental examination may provide valuable insights into the mechanisms involved. Further research is warranted to clarify the underlying immunological and vascular pathways. Synopsis: In our cohort of 77 triplet pregnancies, those conceived via oocyte donation showed significantly higher rates of preeclampsia, fetal growth restriction, and fetal death. Placental examination revealed more chronic villitis, deciduitis, intervillous fibrin, avascular villi, and stromal–vascular karyorrhexis, suggesting immune and vascular dysfunction in oocyte donation pregnancies. Full article

Background: Glioblastoma (GBM) prognosis has been reported to be influenced by age and comorbidity in several investigations. Identifying factors that contribute to poor survival is crucial to optimizing and personalizing therapeutic strategies. In the present retrospective analysis, we investigated the impact of GBM patient stratification using the age adjusted Charlson Comorbidity Index (ACCI). Methods: A total of 165 patients diagnosed with IDH wild-type GBM, treated with post-operative radio or radio-chemotherapy, were evaluated. To assess the impact of comorbidities, patients were stratified into two groups according to their ACCI scores: Group A (ACCI 0–2) and Group B (ACCI >2). The Cox proportional hazards model test was used to compare overall survival (OS) between the two groups of patients and determine whether the presence of comorbidities significantly affected outcomes. Primary and secondary endpoints were OS and progression free survival (PFS), respectively. Results: The median follow-up period was 36 months, and the median OS was 14 months (95% CI 12.4–15.5). The univariate analysis evidenced that patients in Group A had a significantly longer OS compared to those in Group B, with median OS times of 18 months (95% CI 16–20) and 12 months (95% CI 10.5–13.5), respectively (p = 0.015). The OS remained statistically significant in the multivariate analysis (p = 0.015). Conclusions: The results of this study indicate that ACCI may serve as an independent prognostic factor in patients with newly diagnosed GBM. Full article

Background: The increase in obesity rates and related liver diseases has risen in recent years in Mexico. Dietary factors, such as the imbalance between n-6 and n-3 polyunsaturated fatty acids, have been associated with a higher risk of developing conditions such as fatty liver. The objective of this study was to analyse the influence of the dietary n-6/n-3 ratio on fatty liver in Mexican adults. Methods: This analytical cross-sectional study included 213 Mexican adults aged 18 to 65 years, of both genders. The dietary n-6/n-3 ratio was calculated using the Nutritionist Pro software. Participants were divided into two groups according to the median of their dietary n-6/n-3 intake ratio: “low” (<10.2:1) and “high” (≥10.2:1). Anthropometric and biochemical markers were evaluated using standardised methods. The hepatic steatosis index (HSI) was used as a surrogate marker of fatty liver. Multivariate logistic regression analyses were conducted to predict fatty liver based on HSI. Results: Overall, the mean dietary n-6/n-3 ratio was 12.75 in the general population. Higher HSI values were found in participants with a high n-6/n-3 ratio (p = 0.038). In the multivariate model, the n-6/n-3 ratio was positively associated with high HSI (OR = 1.48, 95% CI, 1.02, 1.99). Conclusions: This study concludes that a high n-6/n-3 ratio may contribute to the development of fatty liver in Mexican adults. These results highlight the importance of a balanced intake of fatty acids to prevent metabolic complications and improve public health. Full article

Background/Objectives: Exercise capacity and patient prognosis are heavily influenced by comorbidities. However, the specific impact of individual comorbid conditions on objective measures of exercise performance remains insufficiently characterized. The study aimed to identify predictors of reduced physical capacity in patients qualified for cardiac rehabilitation. Methods: A single-center retrospective analysis was conducted on 518 patients qualified for cardiac rehabilitation. After excluding 51 post-cardiac surgery patients, cardiopulmonary exercise testing data from 425 patients (316 men, median age 63 years) were analyzed. Comorbidities data, peak oxygen uptake (peak VO₂), and the ventilation-to-carbon dioxide output slope (VE/VCO₂ slope) were evaluated. Results: A significantly reduced exercise capacity (peak VO₂ < 70% of the predicted value) was observed in 29.4% of patients, while an increased VE/VCO₂ slope (≥36) was noted in 20.8% of patients. Univariate logistic regression identified sex, heart failure, valvular disease, peripheral artery disease, diabetes mellitus (T2DM), chronic kidney disease (CKD), Charlson Comorbidity Index (CCI), left ventricular ejection fraction <50%, diastolic dysfunction, and anemia as predictors of both reduced peak VO₂ and a steeper VE/VCO₂ slope. Multivariate regression analysis further identified T2DM and CKD as independent predictors of reduced peak VO₂, while sex, CKD, and CCI were independent predictors of a steeper VE/VCO₂ slope. Conclusions: Among patients qualified for cardiac rehabilitation, patient’s sex, T2DM, CKD, and the CCI emerged as key predictors of reduced exercise capacity. Reduced peak VO₂ was more commonly observed in men, while women more frequently exhibited a steeper VE/VCO₂ slope, indicating potential sex-related physiological mechanisms influencing exercise performance. Full article

In saline soil, legumes are restricted in their growth potential by osmotic stress, ion toxicity, and oxidative damage. We evaluated five halotolerant plant growth-promoting bacteria and selected Pseudomonas putida RT12 for its exceptional EPS production, tolerance to 600 mM NaCl, strong biofilm development, and plant growth-promoting traits (ACC-deaminase 2.86 µM·mg⁻¹; IAA 144 µM·mL⁻¹). RT12 was evaluated on two varieties of peas (peas2009 and 9800-10) with and without inoculation at 0, 75, and 150 mM NaCl concentrations. RT12 markedly protected growth under severe salinity: at 150 mM, shoot length rose to 23.13 cm (peas2009) and 17.44 cm (9800-10), in contrast to 11.18 cm and 12.32 cm in uninoculated specimens; root length and dry weight demonstrated comparable recovery (root length increased from 11.00 to 22.25 cm; dry weight of peas2009 from 0.15 to 0.17 and 0.41 to 0.71 g). RT12 sustained photosynthesis (total chlorophyll increased from 43.5 to 54.5), enhanced relative water content (to 94.1% and 97.2%), elevated osmolytes (total soluble proteins rose from 7.34 to 18.12 µg·g⁻¹ FW; total soluble sugars increased from 19.1 to 41.3 mg·g⁻¹ FW), and augmented antioxidant activities (catalase increased from 2.11 to 4.70; superoxide dismutase rose from 1.20 to 4.83; peroxidase increased from 0.08 to 0.18), while reducing malondialdehyde/hydrogen peroxide levels. RT12 was significant as it inhibited the accumulation of Na⁺ (from 23.95 to 16.32 mg·g⁻¹ DW), elevated K⁺ levels (from 17.76 to 29.12 mg·g⁻¹ DW), and restored the K⁺/Na⁺ ratio to normal (from 0.74 to 1.59) in inoculated plants compared to non-inoculated ones. A multivariate analysis linked growth protection to ionic homeostasis, osmotic control, and the detoxification of reactive oxygen species (ROS). RT12 is a promising bioinoculant for cultivating peas in saline-affected soils. Full article

Background: In patients aged 65 years and older who experience severe trauma, their underlying health status significantly influences overall mortality. This study aimed to determine whether computed tomography (CT) evaluation of skeletal muscle quality could serve as an effective risk stratification tool in the emergency department (ED) for this population. Methods: Retrospective observational study conducted between January 2018 and September 2021, including consecutive patients ≥65 years admitted to the ED for a major trauma (defined as having an Injury Severity Score > 15). Muscle quality analysis was made by specific software (Slice-O-Matic v5.0, Tomovision^®, Montreal, QC, Canada) on a CT-scan slice at the level of the third lumbar vertebra (L3). Results: A total of 263 patients were included (72.2% males, median age 76 (71–82)), of whom 88 (33.5%) died during hospitalization. The deceased patients had a significantly lower skeletal muscle area density (SMAd) compared with survivors. The multivariate Cox regression analysis confirmed that SMAd <38 at the ED admission was an independent risk for death (adjusted HR 1.68 [1.1–2.7]). The analysis also revealed that, among the survivors after the first week of hospitalization, the patients with low SMAd had an increased risk of death (adjusted HR 3.12 [1.2–7.9]). Conclusions: Skeletal muscle density assessed by a CT scan at ED admission may represent a valuable prognostic marker for risk stratification patients ≥65 years with major trauma. In patients with SMAd <38 HU the in-hospital mortality risk could be particularly increased after the first week of hospitalization. Full article

Background: In patients with permanent atrial fibrillation, hypertension and diabetes frequently coexist and contribute to adverse cardiovascular outcomes. Beyond traditional clinical outcomes, health-related quality of life has become an essential measure of disease burden. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a validated patient-reported outcome instrument widely used in cardiovascular populations, but its role in hypertensive diabetics has not been systematically explored. This study aimed to evaluate the impact of diabetes on patient-reported quality of life in hypertensive individuals with permanent atrial fibrillation and identify clinical determinants of impaired health status. Methods: We conducted a retrospective study on hypertensive patients with permanent atrial fibrillation hospitalized between January 2021 and December 2023 at the County Emergency Clinical Hospital of Timișoara. Patients completed the KCCQ during admission and were stratified into hypertension without diabetes (HTN-only, n = 89) and hypertension with type 2 diabetes (HTN + DM, n = 109). Demographic, laboratory, and echocardiographic data were analyzed. The primary outcome was the difference in KCCQ scores between groups. Multivariable regression identified independent predictors of quality of life, and logistic regression with ROC analysis evaluated predictors of low KCCQ (<50). Results: Among 198 patients (109 with diabetes, 89 without), mean KCCQ was lower in HTN + DM versus HTN-only patients (50.9 ± 11.3 vs. 54.9 ± 14.4, p = 0.034). Diabetic patients had worse renal function, higher uric acid, and greater inflammatory burden. KCCQ correlated positively with eGFR (r = 0.43, p < 0.001) and negatively with creatinine, urea, neutrophil percentage, left atrial volume, and age. In multivariable analysis, diabetes was not an independent predictor, whereas reduced eGFR, higher neutrophils, larger atrial volume, and HFrEF were significant determinants. Logistic regression for low KCCQ showed good discrimination (AUC 0.78, 95% CI: 0.72–0.84). Conclusions: Diabetes worsens health-related quality of life in hypertensive patients with permanent atrial fibrillation primarily through renal dysfunction, inflammation, and cardiac remodeling. Targeting these pathways may improve both outcomes and patient-perceived health. Full article

Somatic embryogenesis (SE) in Narcissus offers significant potential for both horticultural propagation and pharmaceutical applications. In this study, embryogenic callus lines derived via primary and secondary SE were evaluated under different in vitro conditions to assess the effects of medium type (liquid vs. solid) and composition (proliferation vs. regeneration) on biomass growth and somatic embryo formation. Lines derived from primary SE (LC1–LC4) were less efficient compared to those obtained through secondary SE (LC5–LC7). Cultures cultivated in liquid proliferation medium for eight weeks showed a greater biomass accumulation than those grown on solid medium. Multivariate analyses revealed distinct growth patterns and responses to medium type among the callus lines. The LC5 and LC7 lines formed a separate cluster characterized by superior biomass proliferation and embryogenic competence. An eight-week culture in a liquid proliferation medium followed by a transfer to a solid medium of the same composition resulted in the highest somatic embryo yield in the LC5 line (54.4 embryos per 0.5 g of callus). Under the same conditions, the LC7 line showed the highest biomass growth (a 23.4-fold increase), but its embryogenic response was more effectively stimulated when the callus was initially proliferated on a solid medium and then transferred to a regeneration medium. Full article

Various types of anomalies can arise in cyber–physical production systems, caused by either faulty devices or incorrect processes. Anomalies within individual devices can often be detected by applying machine learning techniques to the respective produced multivariate time series. While this data typically shows temporal and spatial changes and can therefore be efficiently utilized by models, detecting anomalies within the process is often more challenging, as process data usually only consists of events, binary signals, or changes in unique process states. Due to the low variance of data, existing anomaly detection methods struggle to detect anomalies effectively and accurately. To address this challenge, in this paper, we propose a novel concept for process anomaly detection based on conditional discrete-time dynamic graphs. Through the conditional connections of the graph, essential characteristics can be generated and utilized to effectively train machine learning models to detect anomalies in the process data. Identified anomalies can be related to the current graph, facilitating transparent and explainable detections. By evaluating the concept against process data from an industrial unit and achieving an F1-Score of 0.96 and 1 for the realized repetitive processes, the accuracy and effectiveness of the concept can be demonstrated. Full article

Secondary peritonitis (SP) remains a major clinical challenge due to its high complication rates and it often results in sepsis and multi-organ dysfunction. This study investigated the association between four nitric oxide synthase (NOS) single-nucleotide polymorphisms (SNPs)—NOS3 c.-786T>C (rs2070744), NOS3 c.894G>T (rs1799983), NOS3 27 bp variable number tandem repeat (VNTR) (rs61722009), and NOS2 (rs2297518)—and sepsis-related complications in 202 patients with SP. Demographic and baseline clinical characteristics, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, Mannheim Peritonitis Index, and complications (multiple organ dysfunction syndrome (MODS), multiple organ failure (MOF), acute respiratory distress syndrome (ARDS), and sepsis) were analyzed for associations with the NOS gene variants. Haplotype analysis was also performed. No SNP showed an association with in-hospital mortality. However, the NOS3 c.-786T>C TT genotype was significantly associated with an increased risk of MOF (p = 0.008), and remained independently associated after multivariate adjustment (p_MOF = 0.006). The T4bG haplotype was significantly more frequent among patients with MODS (p = 0.026), MOF (p = 0.048), and sepsis (p = 0.018). These findings suggest that NOS gene variants, particularly NOS3 c.-786T>C and the T4bG haplotype, may potentially serve as biomarkers for risk stratification in critically ill patients. Full article

Hydrocodone, a commonly prescribed opioid, was rescheduled from Schedule III to Schedule II in October 2014, imposing stricter prescribing regulations. While prior studies have examined its effects in general populations, its impact on breast cancer patients remains unclear. We evaluated changes in pain management among older women with early-stage breast cancer following this policy change. Using SEER-Medicare data from 2011–2019, we identified a retrospective cohort of 52,792 women aged ≥66 years. We assessed trends in the use of hydrocodone, non-hydrocodone opioids, NSAIDs, and antidepressants before and after rescheduling. Hydrocodone use declined from 55% to 40%, while non-hydrocodone opioid use increased from 43% to 50%. Multivariable logistic regression adjusted for demographic and clinical factors confirmed a significant decrease in hydrocodone use (AOR: 0.81, 95% CI: 0.75–0.86) and an increase in non-hydrocodone opioid use (AOR: 1.25, 95% CI: 1.21–1.30). Hydrocodone dosage also declined, while non-hydrocodone opioid dosages remained stable. No significant changes were observed in NSAID or antidepressant use. These findings suggest that hydrocodone rescheduling significantly altered opioid prescribing patterns, reducing hydrocodone use and prompting a shift toward alternative opioids. Further research is warranted to evaluate the appropriateness and outcomes of such shifts in cancer pain management. Full article

Objectives: This study aimed to assess the significance of a novel subclassification for partial thickness tears of the subscapularis tendon (SSC) by Yoo and Rhee and to identify key MRI findings predictive of the newly adopted surgical indicator (Yoo type IIB). Methods: Between June 2021 and January 2024, 190 patients undergoing preoperative MRI and arthroscopic rotator cuff repair were enrolled. Patients with arthroscopically confirmed Lafosse type 1 tears (n = 148) who underwent debridement were included. Preoperative MRIs were retrospectively evaluated for SSC tear according to Yoo and Rhee classification, muscle atrophy, fatty infiltration, lesser tuberosity cyst, and long head of the biceps (LHBT) pathologies. Patients were divided into the control (Yoo type I + IIA) and study (Yoo type IIB) groups, and significant associations of MRI findings between the groups were investigated. Results: Among Lafosse type 1 patients, the control group (Yoo type I [n = 70] and Yoo type IIA [n = 41]; n = 111; mean age, 61.8 years ± 9.6, 48 men), and the study group (Yoo type IIB, n = 32; mean age, 66.2 years ± 7.8, 16 men) showed significant differences in age (p = 0.017), but not in gender (p = 0.634). Preoperative MRI findings, including muscle atrophy (p < 0.001), fatty infiltration (p < 0.001), lesser tuberosity cyst (p = 0.033), and LHBT pathologies (full thickness tear, p = 0.040; partial thickness tear, p < 0.001; tendinosis, p = 0.003; subluxation, p < 0.001), differed significantly between the groups. Multivariate analysis identified muscle atrophy (odds ratio [OR] = 33.83, p = 0.008) and LHBT subluxation (OR = 22.83, p < 0.001) as independent predictors for Yoo type IIB. Conclusions: In partial thickness tears of SSC, significant MRI differences were found between the Yoo and Rhee classifications. Notably, muscle atrophy and LHBT subluxation were valuable indicators for predicting Yoo type IIB as a surgical indication. Full article

In this study, six club raspberry varieties were examined for their aromatic profiles and sensory qualities, and statistical approaches were used to determine how aroma components affect consumer impressions. Analysis of the aroma’s chemical composition was performed utilizing headspace SPME and GC-MS. MS-DIAL -v5.5.250627 software was used to identify components from commercial libraries, after 10 repetitions for each variety, followed by manual verification. A sensory evaluation of fresh fruits, with 55 volunteers, was statistically analyzed and linked to chemical composition using multivariate analysis and the OPLS-HDA classification method, which was employed for the first time. Tula Magic was scored the highest in the sensory evaluation compared to Adelita, Himbo Top, Glen Dee, San Rafael, and Cascade Harvest. 2-Heptanol (fresh, lemongrass-like, herbal, floral, fruity, green), heptanal (fresh, aldehydic, fatty, green, herbal), and 2-methyl-6-hepten-1-ol (oily-green, herbaceous-citrusy) separated Tula Magic from the other varieties assessed. The same components were recognized in OPLS as positive contributors to the flavor score, while terpenoids like trans-β-ionone, α-ionone, and α,β-dihydro-β-ionone, as well as 2-heptanone, scored slightly lower. This suggests that a fine balance between the individual components is key to the overall aroma sensation. Full article

Background/Objectives: Nutritional disorders are common conditions in older people. This study aimed to determine nutritional disorders in a Mediterranean cohort of nursing home residents without cognitive or functional impairment. Methods: A multicentre cross-sectional observational study was conducted in 10 Spanish geriatric centres. Socio-health, clinical, and laboratory data were recorded from the participants’ medical records. The Mini-Nutritional Assessment (MNA) and Global Leadership Initiative in Nutrition (GLIM) diagnostic criteria [weight loss and serum C-reactive protein (CRP)] were used. Frailty risk was assessed using the FRAIL questionnaire. Anthropometric parameters [body mass index, weight loss, triceps skinfold thickness (TSF), muscle mass circumference (MAMC), and calf-circumference] were evaluated. Body composition [hydration pattern, fat-free mass, muscle mass (MM), fat mass, and phase angle (PhA)] was measured by bioelectrical impedance analysis. Laboratory parameters, such as haemoglobin, total lymphocyte count, serum albumin, transferrin, and CRP, were recorded. Participants were classified into two groups: the disease-related malnutrition (DRM) group and the no-DRM group. Using multivariate regression analysis, predictive factors for nutritional status were tested. Results: Among 340 participants, 63.2% were over 85 years old, 28.2% were men, and the median length of stay was 24 months (range: 6–119). Nutritional risk or malnutrition, as assessed by the MNA, was present in 60.8% of the residents. DRM was diagnosed in 39.4%, and frailty risk was diagnosed in 57.6%. Older adults with DRM had significantly lower MAMC, calfcircumference, MM, and serum albumin, as well as higher CRP concentrations compared with their No-DRM counterparts (all, at least, p < 0.05). The frailty risk (OR = 3.317), MM (OR = 0.732), PhA (OR = 0.033), serum albumin (OR = 0.070), and EuroQol visual analogue scale (OR = 0.961) were risk predictors of DRM in nursing home residents. Conclusions: This study supports the importance of conducting comprehensive nutritional assessments to ensure the earliest recognition of nutrition disorders in nursing homes. Older adults with DRM had greater unintentional weight loss, inflammation, and a high risk of frailty, as well as reduced MM, compared to those without DRM. Subclinical low-grade systemic inflammation is a risk factor for DRE and functional decline in older adults living in nursing homes. The generalisation of the study results is limited to institutionalised older adults without cognitive impairment who are clinically stable and functionally independent. Full article