Search Results (531)

Blood pressure prediction in adolescents continues to remain a major challenge for health practitioners. In classical regression, many factors are found to be statistically significant based on p-values due to large sample sizes, but they may not be equally important predictors for an outcome variable. Machine learning methods provide non-linear and non-parametric approaches with superior predictive performance and a lower chance of model misspecification. Therefore, we employed a leave-one-covariate-out (LOCO) method, a novel variable importance measure, in addition to linear mixed-effects models integrated within random forest for prediction of longitudinal blood pressure. We used health markers such as BMI and dietary habits of 2379 Black and White adolescent girls, tracked yearly from ages 9 and 10 until 19 in the National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study (NGHS, USA). Age, BMI, waist circumference, and dietary cholesterol were consistently the most quantitatively important variables for prediction of systolic blood pressure (SBP). However, age, BMI and waist circumference were consistently the most quantitatively important covariates for prediction of diastolic blood pressure (DBP). The study findings demonstrate the importance of understanding how dietary habits and health markers influence blood pressure. Full article

Pesticides have been extensively used in agriculture, forestry, and veterinary medicine under intensive production systems. Unfortunately, pesticide pollution resulted in a significant decline in non-target organisms, for instance, in detritivores such as necrophagous insects. Even formulations proposed as less harmful alternatives, such as neonicotinoids like imidacloprid (IMI), have been demonstrated to permeate the trophic chain and trigger severe consequences on non-target species. Here, the intra- and inter-generational effects of a sublethal dose of IMI were explored in the necrophagous greenbottle fly, Lucilia sericata (Meigen, 1826) (Diptera: Calliphoridae). This is because it has been demonstrated that the carcasses of domestic and wild animals can be contaminated with levels of these neonicotinoids. Transgenerational effects, extending up to three generations after a focal application of the pesticide on laboratory-cultivated F₁ flies, were investigated in this study. Morphological, demographic, and phenological features were evaluated through various analyses, including general linear mixed models (GLMM) and Haldane units analyses. Although GLMM showed no significant differences between treatments for the multiple traits observed, a significant directional microevolutionary trend of increased average imago and pupal size was identified for the IMI treatment through Haldane unit analysis. This microevolutionary change falls within the threshold of transgenerational phenotypic plasticity, a crucial mechanism for adaptive responses to environmental stressors. Among the possible explanations for this pattern, it is proposed that this is a likely consequence of the triggering of an epigenetic hormetic transgenerational change. This may contribute to explaining the development of adaptation and resistance towards pesticide formulations in a few generations after focal exposure. In addition to this idea, other possible mechanisms and consequences that explain the observed pattern are discussed. Overall, this experiment highlights the concerns of pesticide spillover consequences, even from sublethal doses of these formulations. Full article

The present study assesses the effectiveness of the indole-type alkaloid Yohimbine (YHB) as a green corrosion inhibitor for OLC52 carbon steel and Al in 0.25/0.25 mol L⁻¹ acetic acid/potassium acetate solutions relevant for de-icing applications. Electrochemical techniques, including cyclic and linear sweep voltammetry, chronoamperometry, and electrochemical impedance spectroscopy have been combined with the evaluation of adsorption isotherms and molecular modeling calculations. YHB significantly decreases the corrosion rate for both metals, attaining inhibitory efficiencies of up to 95% for OLC52 and 91% for Al at 298 K, while maintaining high protection efficiency even at higher temperatures. The Langmuir adsorption model and the values of $∆G_{ads}^o$ between −31 and −41 kJ mol⁻¹ indicate a spontaneous adsorption process defined by a mixed physicochemical mechanism, resulting in the formation of a compact protective film. Quantum molecular descriptors support the ability of YHB molecules to interact with metal surfaces via donor–acceptor interactions and electrostatic interactions. The findings demonstrate the potential of YHB as an environmentally friendly inhibitor for the protection of ferrous and non-ferrous alloys in mildly acidic acetic/acetate media used in de-icing solutions. Full article

Neonicotinoid insecticides (NNIs) are globally pervasive, and toxicological evidence indicates potential adverse effects from low-dose exposure in non-targeted organisms. Humans may be exposed to NNIs through multiple pathways, such as ingestion and inhalation, with dietary intake recognized as the dominant exposure route. However, longitudinal evidence characterizing evolving exposure patterns in rural children remains scarce. We evaluated temporal trends and dietary determinants of NNI exposure among 643 children at ages 7, 10, and 14 years in the Sheyang Mini Birth Cohort Study. Twelve NNIs and six metabolites in urine samples were measured using UPLC-HRMS; estimated daily exposure doses and hazard index (HI) were calculated, and linear mixed models were used to evaluate dietary determinants of NNI exposure. Widespread exposure was observed (ΣNNIs detection: 98.8–100%), and although cumulative risks remained below safety thresholds, both medians and upper bounds of HI increased with age (0.0007 to 0.0074; 0.2045 to 0.4054). Notably, exposure composition shifted, with declining imidacloprid and emerging dominance of clothianidin (CLO) and thiamethoxam (THM). Fruit and vegetable intakes were positively associated with ΣNNIs, whereas cereals, poultry, and eggs showed inverse associations, with more pronounced effects observed in boys. These findings indicated persistent yet evolving exposure risks in school-aged children, highlighting fruits and vegetables as major contributors. Although current toxicological risk appears low, the transition toward CLO and THM—compounds with limited chronic toxicity data—underscores the need for continued biomonitoring and targeted exposure mitigation. Full article

This paper proposes a scheduling approach for multi-type spacecraft operational tasks that can be interleaved, considering constrained space–ground telemetry, tracking, and command (TT&C) resources, as well as task splitting. A mixed-integer linear programming model is formulated to maximize the total task completion reward under service time-window constraints for splittable and unsplittable routine tasks, continuous tracking requirements, coupling relationships between routine and continuous tracking tasks, temporal logic dependencies, visibility constraints, and non-overlapping scheduling conditions. To improve solution efficiency and scheduling performance, a heuristic algorithm that combines priority rules with partial backtracking is developed. Task priorities are determined based on completion rewards, due times, execution durations, and temporal relationships, and scheduling is refined to avoid conflicts with predefined constraints. A partial backtracking mechanism guided by task release times enables effective adjustment when TT&C requirements cannot be satisfied. Comparative experiments with CPLEX and four heuristic algorithms validate the effectiveness of the proposed method. Full article

Background: Given the rapid global increase in asthma cases, understanding the impact of climate change on respiratory health is necessary for evidence-based policymaking, particularly in low- and middle-income countries (LMICs). Objectives: To estimate the short-term associations between temperature (mean and diurnal range), particulate matter (PM_2.5 and PM₁₀), nitrogen dioxide (NO₂), ozone (O₃), and childhood asthma exacerbations in Cape Town, South Africa. Methods: We analysed daily hospital records (n = 7753; 2009, 2014, 2019) alongside citywide air quality and meteorological data using negative binomial mixed-effects models and distributed lag non-linear models to capture delayed effects. Results: NO₂ and PM₁₀ were consistently associated with a higher exacerbation risk, with additional delayed effects observed for PM_2.5, PM₁₀, and NO₂. Mean temperature and diurnal temperature range were also linked to an increased risk at short (lag 0–1) and medium (lag 4–5) delays. Conclusions: Temperature variability and traffic-related air pollution contribute to childhood asthma exacerbations in urban LMIC settings. The findings support child-centred early warning systems and stricter air quality controls aligned with WHO guidance. Full article

In Israel, irregular migrants (IMs) living with human immunodeficiency virus (HIV-1) that have no access to regular health insurance are provided with HIV-1-related health coverage under a public–private partnership (PPP) program initiated by the Ministry of Health in 2014. Here we characterized IMs referred to the PPP in 2019–2024 and used a linear mixed-effects model to follow up their CD4 and HIV-1 viral load (VL) counts for a median period of 16 months. Subtypes, resistance mutations and phylogenetic relationships were determined in all cases with viral failure and in selected cases with available blood remains. A total of 231 of 238 referred to the PPP initiated antiretroviral treatment (ART) with nucleoside reverse transcriptase inhibitors (NRTIs) and either non-nucleoside reverse transcriptase inhibitors (NNRTIs, 61.5%, 142/231) or protease inhibitors (PIs, 38.5%, 89/231). Irrespective of the treatment regimen, all these individuals increased their CD4 and decreased their VL trajectories over time (p < 0.001). However, mixed model analysis revealed two classes of CD4 trajectory patterns. Comparison between these two patterns revealed that Class-1 individuals started with lower initial CD4 counts compared to Class-2 individuals (median of 115 cells/mm³, IQR 70–171 compared to median of 312 cells/mm³, IQR 104–510, p < 0.001) and experienced slower recovery compared to Class-2. Most Class-1 individuals originated from Africa (78% vs. 52%, p = 0.016). Treatment failure was observed in 5.6% of all individuals receiving treatment under the program. Sequencing analysis, enabled in 23% of the treated cohort, revealed that the reverse transcriptases (RT) M184V (13%) and K103N (7.4%) were the most prevalent mutations. Conclusively, while treatment was not consistent with current recommendations for first-line therapy, the virological and immunological response of most patients was favorable and the prevalence of cases with resistance mutations was not higher than that identified in people living with HIV-1 who are covered by the national health insurance. Despite the limitations of the PPP, this program may provide a unique therapeutic opportunity for IMs with HIV-1. Full article

Comprehensive weekly load data appears relatively absent in the literature for the professional female soccer population. This exploratory observational study quantified the weekly training, match, and total loads experienced in a professional soccer team and compared these loads according to player role. Data were collected over a full season from 22 players competing in the Australian national A-League Women’s soccer competition. Internal (session-rating of perceived exertion load [session-RPE load]) and external load (total and relative values for total and high-speed running [HSR] distance) data were acquired during on-field training sessions and matches. Players were categorized as starters (started the match) or non-starters (used as a substitute in the match) within each week. Linear mixed models and effect size analyses were used to compare weekly loads between player roles. Weekly match and total load analyses revealed higher (p < 0.001, moderate-to-very large effects) duration, total distance, total HSR distance, and session-RPE load in starters than non-starters. In contrast, relative total and HSR distance in matches were higher (p < 0.001, moderate-to-large effects) in non-starters than in starters. These data provide an initial reference for the weekly loads in this competition, highlighting disparities between player roles that should be considered when developing training and preparation plans. Given the recruitment of a single team and small sample size, future research should extend upon this study to further strengthen the evidence base in this population. Full article

Background/Objectives: Telogen effluvium (TE) is a common, non-scarring hair loss condition characterized by excessive shedding due to disruptions in the hair growth cycle. It is often triggered by stress, hormonal changes, or nutritional deficiencies and is often associated with impaired quality of life. The objective of this study was to evaluate the efficacy and safety of a novel once-a-day drinkable food supplement in women experiencing TE. Methods: A monocentric, open-label, single-arm pilot study was conducted, enrolling 37 female subjects aged 20 to 45 years with self-perceived hair shedding and diagnosed with TE. Subjects refrained from using products with similar effects throughout the study. Evaluations included hair density, hair shedding, anagen to catagen/telogen (A:C/T) ratio, and self-perception after 1, 3, and 6 months. Statistical analyses were performed using Linear Mixed-effects Models (LMMs) and Wilcoxon signed-rank tests. Results: At 1, 3, and 6 months, a statistically significant increase in hair density compared to baseline was observed under the regimen of the tested product. After 6 months, this translated into a 12% increase vs. baseline (p < 0.001). Hair shedding decreased significantly from baseline to each subsequent visit, with a 28% reduction in shedding after 6 months (p < 0.05). The A:C/T ratio significantly increased after both 3 and 6 months, from 3.39:1 to 6.96:1 (p < 0.001). Self-perception questionnaires indicated high satisfaction with hair improvements. Conclusions: This single-arm pilot study suggests that the novel, drinkable food supplement improves hair density and hair shedding in women experiencing TE and underscores the potential of supplement intervention for managing female hair thinning, mainly by reducing TE through increased density of growing hairs. Whilst these preliminary results are encouraging, we recognize that a larger, placebo-controlled, blinded, randomized trial using the product is necessary to corroborate these findings and further explore the underlying hair cycle effects. Full article

This study aimed to establish the optimal mix proportions for eco-friendly lightweight boards based on Ground Granulated Blast-furnace Slag (GGBFS) and waste rock wool using Response Surface Methodology (RSM). The investigation focused on optimizing three key properties: flexural failure load (Y₁), moisture content (Y₂), and specific gravity (Y₃). ANOVA results identified Binder and Perlite as the most dominant and statistically significant factors, exhibiting critical conflicting effects necessary for balancing strength and lightweight goals. Wollastonite showed a non-linear effect on flexural strength, peaking at an intermediate level. A Response Optimization simulation, targeting a minimum flexural load of 400 N, moisture content of 2.0%, and specific gravity of 0.80, yielded an optimal mix proportion: Binder 52.12%, Perlite 48.45%, and Wollastonite 7.37%. This blend achieved a high Composite Desirability (D) of 0.8725. Experimental verification confirmed the model’s reliability. The measured flexural load (408.54 N) successfully exceeded the 400 N target, and all measured values exhibited a low error margin (under 7%) compared to the predicted values. This optimized mix proportion provides a reliable foundation for developing high-performance, sustainable lightweight construction materials. Full article

Face masks are widely recognized as a key intervention to limit SARS-CoV-2 transmission, yet the distribution and persistence of viral RNA across different mask regions and layers remain poorly understood. To address this, we analyzed 185 masks collected from 60 SARS-CoV-2-positive individuals in Rio de Janeiro between December 2020 and September 2022. Masks were sectioned into anatomical regions (nose, mouth, sides) and structural layers (inner, middle, outer), and viral RNA was quantified using RT-qPCR. Samples with the highest viral loads were selected for partial sequencing of the spike gene, and paired analyses with swab samples were performed. Statistical comparisons included non-parametric tests and a linear mixed-effects model. Our results showed that the inner layer and nose region consistently harbored the highest viral RNA levels, with no significant differences between surgical and fabric masks. Viral load decreased by an estimated 39% per day, consistent with exponential decay. Sequencing confirmed identical viral genomes in masks and swabs and allowed identification of circulating variants, including Gamma and Omicron. These findings indicate that masks serve not only as effective physical barriers but also as non-invasive sources for genomic surveillance, providing insights into viral shedding patterns and informing strategies for monitoring and controlling SARS-CoV-2 transmission. Full article

Background: Diabetic neuropathy affects almost half of diabetic patients, yet the relative contributions of metabolic, vascular and clinical factors remain controversial. We aimed to investigate which risk factors are more associated with reduced corneal nerve fiber length (CNFL). Methods: This is a cross-sectional study of 30 patients with type 2 diabetes. We assessed metabolic parameters (HbA1c, lipids), vascular measurements (Doppler ultrasonography of carotid and ophthalmic arteries, central vessel density measured by optical coherence tomography angiography), and corneal epithelial thickness. We explored the data using network analysis, then applied penalized mixed-effect regression (in which $\beta$ represents the standardized coefficients with mean 0 and unit standard deviation), followed by generalized additive models and polynomial transformations. Results: Penalized regression identified vascular parameters as dominant predictors: carotid plaques ($\beta$ = −0.609) and intima-media thickness ($\beta$ = −0.574) showed the strongest associations with CNFL. Traditional metabolic markers including HbA1c failed to meet selection thresholds. Bifurcation velocity ($\beta$ = −0.313) and corneal sensitivity measures ($\beta$ = 0.278–0.135) were also significant. The non-linear modeling showed complex vascular–structural interactions. Conclusions: Vascular compromise, particularly carotid disease, had the highest association with CNFL in our cohort. Thus, our study reports a higher effect of vascular parameters than HbA1c in patients with a longer history of diabetes. This may reflect the progression of diabetic complications, where initial metabolic insults are followed by vascular pathology as the primary driver of end-organ damage. Our findings highlight the need for carotid artery screening in diabetic patients for a better estimation of the neuropathy risk. Full article

Objective: This in vitro study aimed to evaluate and compare the trueness and precision of four extraoral 3D facial scanning systems using a standardized 3D-printed human head model. Methods: A 3D-printed head model with 16 anatomical landmarks and 17 inter-landmark linear distances was fabricated using a high-resolution 3D printer. Caliper measurements were used as reference standards. The model was scanned 15 times by four systems: a handheld scanner (MetiSmile, Shining 3D, Hangzhou, China), a desktop scanner (RAYFace v2.0, Ray Co., Seongnam, Gyeonggi-do, Republic of Korea), and two mobile applications (Heges and Polycam, iPhone 15, Apple Inc., Cupertino, CA, USA). All digital distances were measured in Blender software. To assess intra-observer reliability, all measurements were repeated twice by the same examiner with a 3-week interval between sessions, and intra-class correlation coefficients were calculated using a two-way mixed-effects, single-measurement, absolute-agreement model (ICC 3,1). Trueness, defined as the absolute deviation from the reference caliper values, was compared across scanners using the Kruskal–Wallis test due to its non-normal distribution. Precision, regional trueness and precision values across the four scanners defined as the standard deviation of repeated scans, was analyzed using One-way ANOVA with Tukey post-hoc comparisons for normally distributed datasets (α = 0.05). Distances were measured digitally in Blender software, and trueness (absolute deviation from reference) and precision (standard deviation of repeated scans) were analyzed using the Kruskal–Wallis test and One-way ANOVA with Tukey post hoc comparisons (α = 0.05). Results: The Polycam application demonstrated the highest trueness (0.49 ± 0.32 mm), followed by MetiSmile (0.51 ± 0.36 mm), RAYFace (0.58 ± 0.39 mm), and Heges (0.73 ± 0.42 mm). The MetiSmile scanner showed the highest precision (0.12 ± 0.07 mm), while RAYFace and Polycam exhibited moderate precision (0.28 ± 0.19 mm and 0.15 ± 0.06 mm, respectively). Vertical measurements tended to be more accurate than horizontal ones, and the lower facial region showed smaller deviations; however, these differences were not statistically significant (p > 0.05). Conclusions: MetiSmile achieved the highest precision and Polycam the highest trueness. Although all systems showed mean deviations < 1 mm, only three demonstrated <0.6 mm accuracy (except for Heges scanner). These results suggest that professional and mobile-based scanners can provide clinically acceptable facial data for educational and preliminary digital workflow applications, though further validation under clinical conditions is required. This study provides quantitative evidence on the accuracy and repeatability of commonly available extraoral 3D facial scanning systems under controlled laboratory conditions. The results indicate that both professional-grade and mobile-based scanners can reproduce facial morphology with clinically acceptable deviations, particularly in flat and stable regions such as the forehead and chin. Although only three systems achieved mean trueness below 0.6 mm, all demonstrated errors within 1 mm, sufficient for diagnostic visualization, digital smile design, and preliminary virtual patient modeling. These findings support the safe and cost-effective adoption of extraoral facial scanning in dental education and treatment planning, while emphasizing the need for further validation in real clinical environments where motion, lighting, and soft-tissue variability may affect accuracy. Full article

Background: Quantitative urine culture (CFU/mL) remains the reference standard for diagnosing urinary tract infections (UTIs) but is limited by delayed turnaround times and sensitivity to pre-analytic factors. Multiplex PCR panels offer rapid detection; however, standardized mappings between molecular signals and viable bacterial burdens are insufficiently defined. We used the multicenter NCT06996301 paired dataset to evaluate the analytical validity (AV), clinical validity (CV), and pre-analytic robustness of ΔCt (Ct_target − IC_Ct) as a semi-quantitative indicator of bacterial load. Methods: We analyzed 1027 paired PCR and quantitative urine culture specimens from six sites. The primary molecular predictor was ΔCt (Ct_target − IC_Ct). Species-level Spearman and Pearson correlations, species-specific linear mixed-effects calibration models (log₁₀CFU ~ ΔCt + (1|site)), and ROC analyses were performed for the taxa meeting pre-specified sample thresholds. A pooled multilevel model assessed the collection method and time-to-processing (hours) effects (log₁₀CFU ~ ΔCt × collection_method + ΔCt × time_to_processing_h + (1|site) + (1|run)). AV was assessed via reproducibility, internal control normalization, and site run variance. CV was assessed by ΔCt calibration and discrimination. Clinical utility (CU) was contextualized using outcomes from the parent randomized trial. Results: PCR positivity exceeded culture positivity across all sites (PCR ~82–88% vs. culture ~66–70%); this excess likely reflects a combination of molecular detection of non-viable DNA, detection of fastidious taxa less readily recovered by culture, and pre-analytic effects. For six common uropathogens (n = 90 pairs/species), ΔCt correlated strongly with log₁₀CFU (Spearman ρ = −0.64 to −0.75; Pearson r = −0.75 to −0.83). Species-specific mixed models yielded slopes of −0.746 to −0.922 log₁₀CFU per ΔCt unit (all p < 0.001), indicating that each 1 unit ΔCt change corresponds to a ~5.6–8.4-fold CFU difference. ROC AUCs for ΔCt discrimination were 0.78–0.84 (interpreted as good discrimination, i.e., ΔCt meaningfully improves the clinician’s probability estimate of a high CFU but does not perfectly classify every specimen). The collection method (catheter vs. clean-catch) did not materially modify the ΔCt→CFU relationship, whereas the processing delay was associated with reduced recovered CFU (~0.048 log₁₀CFU lost per hour) and a significant ΔCt × time interaction, consistent with time-dependent viability loss driving the PCR⁺/culture⁻ discordance. Conclusions: ΔCt from the DOC Lab UTM 2.0 panel shows a reproducible, analytically valid semi-quantitative measure of urinary bacterial load. Laboratories can derive assay- and workflow-specific ΔCt cut points for semi-quantitative reporting, but thresholds must be validated prospectively and paired with operational controls for specimen handling. Full article

Background and Objectives: Hamstring strength deficits are common after ACL reconstruction and may impair stability and increase reinjury risk. Despite structured rehabilitation, early postoperative asymmetries frequently persist. Platelet-rich plasma (PRP) has emerged as a potential biologic adjunct that may enhance tissue healing and facilitate muscle strength recovery. This study aimed to evaluate the efficacy of intra-articular PRP injections on hamstring strength restoration in non-professional athletes undergoing ACLR. Materials and Methods: This retrospective cohort study analyzed 68 non-professional athletes who underwent primary ACLR between 2020 and 2024. Participants followed a standardized, phase-appropriate rehabilitation program and were allocated to either a PRP group (n = 34; five intra-articular PRP injections every 4 weeks starting at week 4 postoperatively) or a control group (n = 34; rehabilitation alone). Data were analyzed with linear mixed-effects models to examine group, time, and group-by-time interactions. Results: Both groups improved over time, but PRP influenced faster hamstring strength recovery and greater symmetry. At 20 weeks, the PRP group achieved higher concentric strength (15.6 ± 4.3 vs. 13.6 ± 3.5; p = 0.040) and markedly reduced asymmetry (isometric: –1.1 vs. 0.6; p < 0.001; concentric: –0.6 vs. 1.9; p < 0.001). Conclusions: The addition of serial PRP injections to a structured rehabilitation protocol after ACLR influenced faster hamstring strength recovery and improved interlimb symmetry compared to rehabilitation alone. These findings suggest that PRP may serve as a potential biologic adjunct to optimize postoperative outcomes and facilitate a safer return to sport in non-professional athletes. Full article