Search Results (8,155)

Reliable anomaly detection is essential for the safe operation of unmanned aerial vehicles (UAVs), particularly in distributed settings where flight telemetry is generated across multiple vehicles or operational sessions and cannot always be centrally collected. This work investigates UAV anomaly detection using models capable of generalizing to unseen flights while keeping raw telemetry within the simulated client partitions during federated training. A self-supervised forecasting framework is evaluated under a simulated federated partitioning of the ALFA corpus and benchmarked using local training, Federated Averaging (FedAvg), FedProx, personalized FedAvg, and centralized learning under a strictly flight-disjoint evaluation protocol. The evaluation comprises 47 complete flights, including 36 failed and 11 nominal flights, grouped into 13 heterogeneous session-based federated clients that serve as statistical partitions rather than physically independent UAVs. The resulting federated setting exhibits non-IID characteristics due to differences in local flight composition and data volume across clients. Federated training is performed for 20 communication rounds with two local epochs per round, and evaluation uses three-fold flight-disjoint cross-validation. Complete flights, including failed flights, are assigned exclusively to either the training or held-out test partition within each fold, ensuring that no samples or overlapping windows from a test flight contribute to model training. An LSTM learns nominal flight dynamics through multivariate next-step forecasting, and the resulting forecasting error is converted into an anomaly score. FedAvg achieves an area under the receiver operating characteristic curve (AUC) of 0.908 and detects 83.3% of failed flights, performing competitively with centralized learning, which obtains an AUC of 0.904 and an 84.4% detection rate. Beyond discrimination performance, calibration, threshold scope, temporal persistence, detection delay, and false-alarm burden are also evaluated. With rolling calibration and a global threshold, the detector maintains an 87.2% flight-level detection rate with a median detection delay of 0.72 s while reducing the false-alarm burden from 202.1 to 66.0 events per hour. However, this alarm frequency remains too high for unattended operational deployment. A more conservative configuration reduces the burden to 8.17 events per hour while retaining 82.8% failed-flight detection and achieving an event precision of 0.851, although the median detection delay increases to 3.38 s. Within this session-partitioned experimental setting, parameter aggregation recovers most of the performance loss associated with local-only training and approaches centralized performance without pooling raw telemetry. These findings should be interpreted as evidence for distributed model aggregation under statistical data partitioning rather than as validation of a fully deployed federated UAV network, while the operational analysis further shows that strong discrimination and flight-level detection do not necessarily translate into practically acceptable alarm behavior. Full article

Background/Objectives: Vitamin A (VA), which is fat-soluble, belongs to the group of carotenoids, a class of highly effective antioxidant and genoprotective compounds (including astaxanthine, zeaxanthine, luteine). It plays a critical role in cellular growth, differentiation, and oxidative stress regulation, but prospective evidence linking childhood VA to subsequent genomic stability is scarce. This study investigated whether baseline VA levels were associated with later measurements of relative telomere length (RTL), four ribosomal DNA copy numbers (rDNA-CN: 5S, 18S, 28S, and 45S), and mitochondrial DNA copy number (mtDNA-CN) in children over a 4-year follow-up. Methods: Baseline VA levels were measured in 2021. In 2025, peripheral blood genomic DNA was extracted, and RTL, rDNA-CNs, and mtDNA-CN were quantified using qPCR. Multivariable linear regression and restricted cubic spline regression (RCS) were employed to examine the associations and dose–response shapes. Sex-stratified analyses with interaction tests were performed to evaluate effect modification by sex. Results: Among 215 children, baseline VA was positively associated with RTL, 5S rDNA-CN, 18S rDNA-CN, and 45S rDNA-CN after covariate adjustment. RCS analyses revealed strictly monotonic positive dose–response curves between VA and RTL, 5S rDNA-CN, and 18S rDNA-CN, with no statistically significant sex interaction (all p for interaction > 0.05). Conclusions: Higher childhood VA levels are positively associated with longer telomeres and higher rDNA-CN in later childhood, suggesting that adequate early-life VA may confer long-term benefits for ribosomal genomic stability and cellular aging. These observations expand our understanding of nutrition-related modulators of child genomic homeostasis and support further investigation into nutritional interventions targeting genomic protection in early life. Full article

Background: Obstructive sleep apnea (OSA) has been associated with adverse cardiometabolic profiles, but its relationship with cholesterol target attainment in patients receiving lipid-lowering therapy remains incompletely characterized. We investigated the association between severe OSA and non-attainment of predefined cholesterol thresholds in patients undergoing elective cardiac surgery. Methods: This secondary analysis included 142 adults from a prospectively assembled observational cohort. Participants underwent in-hospital preoperative Type III cardiorespiratory polygraphy, fasting lipid assessment, and documentation of lipid-lowering therapy. Severe OSA was defined as an apnea–hypopnea index ≥30 events/h. The primary outcome was non-high-density lipoprotein cholesterol (non-HDL-C) ≥ 100 mg/dL. Multivariable models were adjusted for age, sex, body mass index, diabetes mellitus, high-intensity statin therapy, and non-statin lipid-lowering therapy. Results: Severe OSA was associated with higher odds of non-HDL-C ≥ 100 mg/dL (adjusted odds ratio [OR] 3.49, 95% confidence interval [CI] 1.56–7.78; p = 0.002), LDL-C ≥ 55 mg/dL (OR 2.93, 95% CI 1.18–7.29; p = 0.021), and LDL-C ≥ 70 mg/dL (OR 2.30, 95% CI 1.03–5.12; p = 0.041). In contrast, associations with continuous LDL-C (p = 0.113) and non-HDL-C (p = 0.100) concentrations were not statistically significant. No significant associations were observed for triglyceride-related or lipid-derived outcomes. The primary association with non-HDL-C ≥ 100 mg/dL remained significant in the analysis restricted to statin-treated patients. Conclusions: Severe OSA was associated with non-attainment of predefined cholesterol thresholds in this cardiac surgical cohort, with the strongest and most consistent association observed for non-HDL-C ≥ 100 mg/dL. These findings identify an association with categorical cholesterol target non-attainment but do not establish treatment failure, causality, or a generalized increase in cholesterol concentrations. Full article

Introduction: Chikungunya is an emerging mosquito-borne viral disease that has become a growing public health concern worldwide. Despite documented autochthonous outbreaks in Italy and the increasing spread of Aedes albopictus mosquitoes across Europe, little is known about awareness of chikungunya among future healthcare professionals. This study aimed to assess awareness of chikungunya and evaluate related knowledge, attitudes, and practices (KAPs) among nursing students at the University of Palermo, Italy. Methods: A cross-sectional study was conducted in May 2026 among undergraduate nursing students enrolled at the University of Palermo. Data were collected through an anonymous self-administered online questionnaire investigating sociodemographic characteristics, awareness of chikungunya, sources of information, and KAP related to the disease. Associations between awareness and participant characteristics were assessed using chi-square tests and prevalence ratio analyses. Results: A total of 894 students participated (mean age: 22.33 ± 4.53 years; 72.3% female). Overall, only 22 students (2.46%) reported having previously heard of chikungunya. In a multivariable exploratory analysis, third-year students had a higher prevalence of previous awareness compared with first-year students (PR = 3.38; 95% CI: 1.10–10.36), whereas no statistically significant association was observed for age (PR = 1.07; 95% CI: 1.00–1.15). Mass media represented the main source of information (63.6%), followed by university lectures (22.7%). Among participants who reported previous awareness, responses suggested relatively good recognition of major clinical manifestations, although important gaps were observed regarding vector recognition and transmission pathways. Attitudes toward prevention were predominantly positive, and most participants reported adopting recommended mosquito-control practices. Conclusions: Awareness of chikungunya among nursing students was extremely low. Strengthening educational interventions on emerging vector-borne diseases within nursing curricula may improve preparedness, risk communication, and future public health responses. Full article

Background/Objectives: Delirium is a common and serious neuropsychiatric complication in hospitalized and critically ill patients and is associated with prolonged hospitalization and increased mortality. Previous meta-analyses found no clear association between statin use and delirium; however, newly published studies and emerging mortality data warrant re-evaluation. Methods: This updated systematic review and meta-analysis extended a previous meta-analysis and re-evaluated the association between statin use and delirium risk. PubMed, Embase, and the Cochrane Library were searched for eligible studies published from January 2022 through October 2025. Study-level estimates were synthesized using random-effects models. Because ORs, RRs, and HRs are not directly interchangeable, the combined synthesis was considered exploratory. Sensitivity analyses included an OR-only dataset, exclusion of the cross-sectional study, REML models with Hartung–Knapp adjustment, and restriction to observational studies reporting multivariable-adjusted ORs. Results: Nineteen studies (5 randomized controlled trials and 14 observational studies) involving 440,737 participants were included. The exploratory combined analysis yielded an OR of 0.79 (95% confidence interval [CI] 0.66–0.95; p = 0.01; I2 = 90%). Results differed by study design: randomized trials yielded a lower pooled point estimate (OR 0.41, 95% CI 0.20–0.82; I2 = 58%), whereas the pooled association among observational studies was not statistically significant (OR 0.86, 95% CI 0.71–1.03; I2 = 91%; p for subgroup difference = 0.04). However, in the three randomized trials contributing to incident delirium, REML with Hartung–Knapp adjustment substantially widened the confidence interval (OR 0.41, 95% CI 0.09–1.86; p = 0.126). In the overall analysis, REML–Hartung–Knapp inference also increased uncertainty (OR 0.79, 95% CI 0.62–1.00; p = 0.047), as did restriction to multivariable-adjusted observational ORs (OR 0.76, 95% CI 0.57–1.01; p = 0.062). In four studies comprising 21,687 participants, statin use was associated with lower 30-day all-cause mortality under the conventional random-effects model (OR 0.52, 95% CI 0.35–0.79; p = 0.002; I2 = 88%); this estimate remained similar under REML with Hartung–Knapp adjustment (OR 0.52, 95% CI 0.32–0.84; p = 0.022). No significant association was observed for delirium-free days. Conclusions: The available evidence suggests a possible association between statin exposure and lower delirium occurrence, but substantial heterogeneity, differences between randomized and observational evidence, and sensitivity to analytic assumptions limit causal interpretation. The findings do not establish statins as a preventive treatment for delirium or prove a mortality benefit. Further adequately powered randomized trials with clearly defined exposure timing and standardized delirium assessment are warranted. Full article

Floodplain oxbow lakes and natural levees preserve sedimentary archives that can provide information on long-term changes in depositional environments. This study investigates three oxbow lake–natural levee pairs of different ages along the Upper Tisza River using 258 sediment records. Grain size composition, pH, electrical conductivity, CaCO₃-equivalent values, and organic carbon were characterized. Spearman correlation analysis was used to examine relationships among the measured properties, while principal component analysis (PCA) was performed using pH, electrical conductivity, organic carbon, and isometric log-ratio-transformed grain-size data. The profiles showed pronounced vertical and between-site heterogeneity, indicating that geomorphological position alone does not determine sediment properties. PCA identified four major sedimentological and geochemical gradients, whereas cluster analysis distinguished four broad sediment groups with distinct sedimentological and geochemical characteristics. These multivariate statistical analyses revealed relative vertical zonation and sedimentological and geochemical changes associated with oxbow-lake infilling and natural-levee development. Long-term mean sediment accumulation rates were estimated separately from the multivariate analyses using sediment thickness, documented channel-cutoff ages, and, where applicable, stratigraphic correlations. Time-averaged post-cutoff oxbow-lake sediment accumulation rates were approximately 10.2 cm yr⁻¹ for GYM1, 4.56 cm yr⁻¹ for GYM2, and ≤4.62 cm yr⁻¹ for GYM3. For the natural levees, no accumulation rate was estimated for GYF1 because of the absence of an independent chronological marker, whereas tentative correlation of buried paleosol horizons in GYF2 and GYF3 with dated paleosols on the Bereg Plain suggests conditional long-term mean accretion rates of approximately 0.042–0.090 cm yr⁻¹ for GYF2 and 0.032–0.069 cm yr⁻¹ for GYF3, respectively. Integrating vertical sedimentological and geochemical records with multivariate statistical analyses and independent chronological and stratigraphic constraints therefore provides a framework for reconstructing relative depositional succession and estimating long-term sediment accumulation during floodplain evolution. Full article

The genus Populus L. includes ecologically important woody species that occupy diverse floodplain habitats and exhibit considerable morphological and anatomical variation. The aim of this study was to comparatively assess the morphological, anatomical, and dendrometric characteristics of four Populus taxa-P. alba, P. nigra, P. tremula, and P. × canescens-growing in different floodplain habitats of the West Kazakhstan region. Leaf and stem samples were collected during 2025–2026 and examined using conventional anatomical techniques. Quantitative measurements were performed for epidermal, cortical, vascular, and mesophyll tissues, as well as for leaf and tree morphological characteristics. Statistical analyses were conducted in R using descriptive statistics, correlation analysis, and principal component analysis (PCA). The results revealed pronounced interspecific differences in both anatomical and morphological traits. P. alba was characterized by the largest leaf dimensions and the highest dendrometric values, with mean leaf length, width, and petiole length of 9.37 ± 1.63, 7.83 ± 1.29, and 7.41 ± 1.56 cm, respectively, while mean tree height, crown radius, and trunk diameter reached 134.41 ± 57.81, 21.38 ± 9.20, and 42.77 ± 18.41, respectively. P. nigra was distinguished by the largest central cylinder diameter (1085.7 ± 123.2 μm), the thickest xylem (50.7 ± 6.9 μm), and the presence of calcium oxalate crystals in the primary cortex and pith. P. tremula showed the thickest primary cortex (307.8 ± 9.7 μm), whereas P. × canescens had the smallest central cylinder (228.0 ± 45.0 μm) and generally lower dimensions of vascular tissues. Correlation analysis demonstrated strong positive relationships among leaf traits and among dendrometric traits, while leaf and dendrometric characteristics showed predominantly negative relationships at the interspecific level. PCA based on leaf traits explained 93.6% of the total variation in the first two components, whereas the integrated PCA of six leaf and dendrometric traits explained 97.0%. P. alba formed the most distinct morphological group, while P. tremula and P. × canescens showed substantial overlap, reflecting their close morphological similarity and the hybrid origin of P. × canescens. The combined application of anatomical, morphometric, dendrometric, and multivariate approaches provides effective diagnostic criteria for differentiating closely related Populus taxa and contributes to a better understanding of their structural diversity and ecological adaptation in the floodplain ecosystems of Western Kazakhstan. Full article

This study addresses the persistent challenge of low wheat productivity and inefficient water use among smallholder farmers in North Western Nigeria, a region increasingly affected by water scarcity, climate variability, and weak irrigation infrastructure. Despite rising demand for wheat, local production remains inadequate, largely due to limited adoption of sustainable water management practices. The study aims to assess the determinants and conditional effects of adopting such practices on wheat yield and water-use efficiency. Primary data were collected from smallholder wheat farmers using a multi-stage sampling technique across Katsina, Kano, and Kaduna States. The study employed descriptive statistics, principal component analysis (PCA), multivariate probit (MVP) regression, and Bayesian linear regression to analyse adoption behaviour and its effects on productivity outcomes. PCA identified nine key components explaining 68.46% of the variation in water management practices. The MVP results revealed that gender, household size, cooperative membership, farm size, access to credit, and market distance significantly influence adoption decisions, while also highlighting substitutability among practices due to resource constraints. The Bayesian regression results show that adoption of sustainable water management practices were positively associated with wheat yield and water-use efficiency, confirming evidence of a positive association with enhancing productivity under water-limited conditions. The study concludes that improving wheat productivity requires integrated interventions that address both technological and institutional constraints. It recommends strengthening extension systems, promoting targeted agricultural financing, enhancing cooperative-based support, improving rural infrastructure, and adopting climate-smart, location-specific strategies to drive widespread adoption and build resilient agrifood systems. Full article

Background/Objectives: Brucellosis is a systemic zoonotic infection with a heterogeneous clinical presentation, and early identification of patients at risk for focal organ involvement remains challenging. This study aimed to assess whether serum prokineticin-2 (PROK2) and calprotectin levels are associated with focal organ involvement in patients with brucellosis and to examine their variation according to disease stage. Methods: In this prospective case–control study, 150 adults were enrolled, including 90 patients with brucellosis diagnosed based on compatible clinical findings together with a Coombs anti-Brucella titer of ≥1:160 and 60 symptomatic non-brucellosis controls in whom brucellosis was excluded after clinical and laboratory evaluation. The brucellosis group included 30 patients each with acute, subacute, and chronic disease; 50 patients had focal organ involvement and 40 had no focal involvement. Focal organ involvement was defined by organ-specific clinical findings supported by appropriate imaging and/or laboratory methods. Serum PROK2 and calprotectin levels were measured using enzyme-linked immunosorbent assay before antimicrobial treatment, while C-reactive protein (CRP) was evaluated as a routine inflammatory comparator. Comparisons were performed according to disease status, disease stage, and focal organ involvement. Receiver operating characteristic (ROC) curve analysis was used to evaluate discriminative performance for focal organ involvement. A parsimonious multivariable logistic regression model including PROK2, calprotectin, and CRP was used to identify factors independently associated with focal organ involvement. Results: Serum PROK2 and calprotectin levels were significantly higher in patients with brucellosis than in the non-brucellosis control group (both p < 0.01). PROK2 levels showed significant stage-related variation, with significantly higher adjusted levels in the acute than in the subacute stage, whereas the acute–chronic difference was not statistically significant. Patients with focal organ involvement had significantly higher serum PROK2, calprotectin, and C-reactive protein (CRP) levels than those without focal involvement (all p < 0.001). In multivariable analysis, PROK2 (adjusted OR 3.910, 95% CI 1.526–10.018; p = 0.005), calprotectin (per 100 ng/mL; adjusted OR 2.223, 95% CI 1.208–4.091; p = 0.010), and CRP (per 10 mg/L; adjusted OR 1.662, 95% CI 1.202–2.298; p = 0.002) were independently associated with focal organ involvement. For discriminating patients with and without focal organ involvement, the AUCs were 0.877 (95% CI: 0.794–0.959) for calprotectin, 0.864 (95% CI: 0.783–0.946) for CRP, and 0.807 (95% CI: 0.720–0.895) for PROK2. At the exploratory Youden-derived cut-offs, sensitivity/specificity were 92.0%/70.0%, 82.0%/77.5%, and 82.0%/60.0%, respectively. Conclusions: Both PROK2 and calprotectin were independently associated with focal organ involvement; however, PROK2 showed stage-related variation and calprotectin was not independently associated with disease stage. Further studies are required to determine their clinical and prognostic value in the assessment of focal organ involvement. Full article

Background/Objectives: Acute heart failure (AHF) is the leading cause of hospitalization among patients over 65 years and is frequently associated with frailty. Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) currently represent the only drug class recommended across the entire ejection fraction spectrum, although evidence regarding their effectiveness according to frailty status remains limited. Aims: To determine whether functional frailty, measured by the Short Physical Performance Battery (SPPB) test, influences the effectiveness of SGLT2i in reducing hospital readmission and mortality in elderly patients with AHF. Methods: Observational study of 794 polypathological patients admitted to Internal Medicine with AHF. An interaction analysis assessed whether SPPB, as a continuous variable, modified the association between SGLT2i and the composite outcome (hospital readmission or death), using a Cox model. The sample was further divided by SPPB test score (below 4 (N = 477) or ≥4 (N = 317)) for exploratory analyses. Descriptive and comparative analyses were performed according to SGLT2i administration, using the chi-squared test for qualitative variables and Student’s t-test for quantitative ones (Fisher’s and Mann–Whitney U test as appropriate). Survival analysis was done using Kaplan–Meier curves and Cox regression, with multivariable adjustment for confounders. Results: No significant interaction was found between SPPB score and SGLT2i (p = 0.506). When SPPB was dichotomised, SGLT2i treatment was associated with significantly lower all-cause mortality (3.7% vs. 12.0%; p = 0.018) and readmission (30.3% vs. 45.2%; p = 0.021) in SPPB ≥ 4, with mortality and readmission also numerically lower, without reaching statistical significance, in SPPB < 4 (mortality 12.9% vs. 16.9%, p = 0.410; readmission 34.5% vs. 42.0%, p = 0.220). After adjustment, SGLT2i treatment in the SPPB ≥ 4 group remained associated with a numerically lower hazard for the composite outcome (HR 0.652; 95% CI 0.418–1.018; p = 0.060). Conclusions: No evidence was found that functional frailty modifies the effectiveness of SGLT2i in elderly polypathological patients with AHF. An exploratory analysis suggested a possible gradient of greater association with SPPB ≥ 4, although this should be interpreted as hypothesis-generating. Full article

In silico prediction of ADME parameters, Lipinski’s Rule of Five, toxicity, or the reliability level of the predicted biological activity of a given structure against a specific pathogen are an integral part of modern drug discovery to accelerate the identification of promising lead compounds while reducing development costs and toxicity risks. In this context, multivariate statistical methods such as Principal Component Analysis (PCA) play an important role in the evaluation of large chemical and biological datasets, facilitating the identification of structural similarities, physicochemical trends, or predictions of pharmacological behavior. Natural products remain one of the most important sources of structurally diverse bioactive scaffolds, serving as inspiration for the development of novel therapeutics. Buchenavianines are a rare class of piperidine-flavonoid alkaloids isolated from tropical woody species of the genus Buchenavia (Combretaceae). Scientific interest in buchenavianines was initially stimulated by the discovery of potent anti-HIV activity in extracts of Buchenavia capitata, which demonstrated their ability to interfere with viral replication pathways and highlighted their potential as antiviral drug candidates. Studies have suggested that buchenavianines may possess anti-inflammatory, antioxidant, and anticancer potential; therefore they represent important lead compounds for medicinal chemistry in the development of a new generation of drugs. PCA showed that the first two principal components explained 92.7% of the total variance (PC1 = 56%, PC2 = 36.7%), indicating that the selected descriptors adequately captured the variability among the studied buchenavianines. This study underscores the importance of these secondary metabolites as lead compounds in modern medicinal chemistry and drug discovery. Full article

This study investigated associations between perceived school climate and multiple forms of peer bullying involvement (as victims, perpetrators, and bystanders) among early adolescents in China and identified distinct profiles of bullying involvement using a person-centered latent class approach. Participants were 2753 junior high school students recruited from two secondary schools in Susong County, southwestern Anhui Province. Self-report data were collected using the Olweus Bully/Victim Questionnaire (OBVQ), the Student Bystander Behavior Scale (SBBS), and the Chinese version of the Delaware School Climate Survey. Sociodemographic characteristics were included as covariates in all regression models. Statistical analyses comprised multivariate binary logistic regression and latent class analysis (LCA). More positive perceptions of school climate were significantly associated with lower odds of self-reported bullying victimization and perpetration, as well as higher odds of victim-defending bystander behavior. Among the eight school climate dimensions, classmate relationship showed the strongest negative associations with verbal, physical, and social bullying victimization, whereas bullying on campus was the most consistent correlate of lower odds of bullying perpetration and assisting bystander behavior. LCA identified three distinct profiles of bullying involvement: a high bullying involvement class (3.02%), a moderate victimization–low perpetration class (66.47%), and a low bullying involvement class (30.51%). School climate dimensions were significantly associated with latent class membership; more favorable perceptions of bullying on campus were associated with lower odds of membership in the high bullying involvement profile relative to the low involvement profile, whereas positive classmate relationships and respect for diversity were associated with membership in the moderate victimization–low perpetration profile. These findings align with the ecological systems perspective that school microsystem factors are related to adolescent bullying experiences and suggest the potential utility of multi-dimensional school climate improvement strategies for targeted bullying prevention. Full article

Background: Permanent postoperative hypoparathyroidism (p-HypoPT) is a major long-term complication of thyroid surgery; however, its incidence remains uncertain because reported rates are influenced by heterogeneous case mix and variable follow-up. We assessed the burden and determinants of p-HypoPT in patients undergoing surgery for differentiated thyroid cancer (DTC) with long-term endocrine follow-up. Methods: We retrospectively analysed prospectively collected data from 518 consecutive adults with DTC enrolled in a dedicated longitudinal endocrine follow-up programme between 2013 and 2022. p-HypoPT was operationally defined as the persistent requirement for oral calcium and/or active vitamin D supplementation at ≥12 months after surgery. Independent associations were assessed by means of multivariable logistic regression. Rates were also explored across the 2015 and 2025 American Thyroid Association (ATA) risk categories. Results: p-HypoPT occurred in 60/518 patients (11.6%). Median follow-up was 10.8 years (IQR 8.0–12.8), and all patients with p-HypoPT remained on calcium and/or active vitamin D supplementation at their latest available follow-up. Central neck dissection was associated with p-HypoPT in multivariable analysis (adjusted OR 2.94, 95% CI 1.55–5.57; p < 0.001). Under the 2025 ATA classification, p-HypoPT frequencies differed across categories in unadjusted analysis (p = 0.005), with the highest frequency in the high-intermediate-risk group (23.9%). This association was attenuated after adjustment for central and lateral neck dissection and was no longer statistically significant (global p = 0.566). Conclusions: Permanent hypoparathyroidism represents a relevant long-term burden after DTC surgery. Its assessment should account for both the duration of postoperative surveillance and the extent of surgery, moving beyond aggregate rates derived from heterogeneous thyroidectomy cohorts. More granular, procedure-specific and risk-adjusted estimates may ultimately support meaningful quality comparisons and provide a more individualised assessment of long-term functional risk. Full article

Background: Persistent infection with high-risk human papillomavirus (hrHPV) is the principal cause of cervical intraepithelial neoplasia (CIN). Cytokines regulate antiviral immunity and tissue remodeling, and cytokine profiling may provide additional information about the biology of cervical lesions. Objective: To characterize cytokine profiles in cervical mucus and serum across grades of cervical intraepithelial neoplasia. Methods: The study included 90 women aged 18–80 years: 30 HPV-negative women with negative cytology (Control) and 60 HPV-positive women with histologically confirmed low-grade (LSIL, n = 30; Gr-1) or high-grade (HSIL, n = 30; Gr-2) squamous intraepithelial lesions. Participants were also stratified by minor (grade 1) or major (grade 2) colposcopic findings. An exploratory subgroup of 15 women with HPV16/18-positive HSIL received antiviral and immunomodulatory therapy. Concentrations of 27 cytokines (pg/mL)—FGF, eotaxin, G-CSF, GM-CSF, IFN-γ, IL-1ra, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12(p70), IL-13, IL-15, IL-17A, IP-10, MCP-1, MIP-1α, MIP-1β, PDGF-BB, RANTES, TNF-α, and VEGF—were measured in serum and cervical mucus using the Bio-Plex Pro Human Cytokine 27-plex assay (Bio-Rad, USA) on a Luminex 200 platform. Statistical analyses were performed using SPSS version 23.0 and Microsoft Excel 365. Results are reported as medians and interquartile ranges [Q1–Q3]. A two-sided p-value < 0.05 was considered statistically significant. Results: Exploratory multivariate analyses identified IL-1β, IP-10, MCP-1, and FGF as the cytokines most strongly associated with lesion severity and colposcopic findings. In cervical mucus, HSIL was associated with the highest IL-1β concentration (0.83 pg/mL [0.18–4.91] vs. 0.30 pg/mL [0.04–0.69] in controls; p < 0.001) and the lowest IP-10 concentration (3.07 pg/mL [1.02–13.16] vs. 25.12 pg/mL [5.01–42.40]; p < 0.001). The highest mucus FGF concentration was observed in LSIL (1.73 pg/mL [1.33–2.27] vs. 0.32 pg/mL [0.17–0.59] in controls; p < 0.001), whereas MCP-1 was lower in LSIL than in HSIL (2.38 pg/mL [1.57–3.54] vs. 5.38 pg/mL [3.12–10.55]; p < 0.05). Similar patterns were observed in serum, except that IL-1β was lower than in controls. After treatment, HPV was undetectable in 10 women and remained detectable in 5. The overall cytokine profile changed only modestly. Among the five women with persistent HPV infection, cervical mucus MCP-1 was lower after treatment than before treatment (0.09 pg/mL [0.01–0.41] vs. 0.37 pg/mL [0.08–0.73]; p < 0.01). Conclusions: These findings show associations between lesion severity, colposcopic findings, and compartment-specific cytokine patterns. Because the study was cross-sectional and the treatment subgroup was small and uncontrolled, the results should be considered exploratory and require longitudinal validation. Full article

Objective: We aimed to examine the association between adherence to the Mediterranean diet (MD) and sleep quality assessed using both subjective and objective methods in a general adult population. Design: This is a cross-sectional study. Adherence to the MD was evaluated using the Mediterranean Diet Adherence Screener, while sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index and objectively using wrist actigraphy over five consecutive days. Multivariable linear and logistic regression models were applied, adjusting for key sociodemographic and clinical confounders. Settings: We investigated a general adult population from Spain with a total of 500 Spanish adults aged 25–65 years. Results: Higher MEDAS scores were significantly associated with better subjective sleep quality. Each one-point increase in MD adherence was associated with lower PSQI scores, and participants with higher adherence had lower odds of poor sleep quality, although this association did not reach statistical significance. Cluster analysis identified a dietary pattern characterized by higher consumption of fruits, vegetables, fish and olive oil that was associated with better perceived sleep quality. No significant associations were observed between MD adherence and objective sleep parameters, including sleep efficiency, sleep fragmentation or wake after sleep onset. Conclusions: Greater adherence to the MD was associated with better perceived sleep quality but not with objectively measured sleep parameters. These findings suggest that dietary patterns may influence sleep perception rather than objective sleep characteristics and highlight the potential role of the MD as a modifiable factor related to sleep-related well-being. Full article