Search Results (105,414)

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease in which identifying simple biomarkers reflecting disease severity remains challenging. This study aimed to evaluate the relationship between systemic inflammatory indices and radiological disease severity assessed by the Lund–Mackay (LM) score. This retrospective study included 90 adult patients with CRSwNP who underwent endoscopic sinus surgery. Preoperative computed tomography findings were scored using the LM system, and systemic inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-monocyte ratio (NMR), systemic immune-inflammatory index (SII), systemic inflammation response index (SIRI), and eosinophil/leukocyte ratio, were calculated from complete blood count parameters. Spearman correlation and univariate logistic regression analyses were performed. ELR (r = 0.49, p < 0.001) and eosinophil/leukocyte ratio (r = 0.46, p < 0.001) showed moderate positive correlations with LM score, whereas other indices were not significantly associated. In logistic regression analysis, both ELR (OR = 5.44 × 10⁴, p < 0.001) and eosinophil/leukocyte ratio (OR = 4.99 × 10¹², p = 0.001) were significantly associated with high disease burden (LM ≥ 15). These findings suggest that eosinophil-based inflammatory indices may better reflect radiological disease severity in CRSwNP compared to traditional systemic inflammatory markers. Full article

Background/Objectives: Preoperative characterization of salivary gland tumors remains challenging because conventional MRI and diffusion-weighted imaging may show overlapping features, particularly between Warthin tumors and malignant lesions. This study evaluated the diagnostic value of quantitative permeability MRI based on dynamic contrast-enhanced pharmacokinetic analysis for differentiating salivary gland tumors. Methods: This retrospective single-center study included 51 patients with 59 histologically confirmed salivary gland lesions examined between January 2022 and November 2024. MRI included diffusion-weighted imaging and dynamic contrast-enhanced MRI (DCE-MRI). Quantitative pharmacokinetic analysis based on the Extended Tofts model provided Ktrans, Kep, Ve, and Vp. Interobserver reproducibility was assessed using the intraclass correlation coefficient, and diagnostic performance was evaluated by receiver operating characteristic analysis. Results: Of 59 lesions, 44 were benign, and 15 were malignant. Warthin tumors showed significantly higher Kep values than malignant lesions (median, 998 vs. 480 × 10⁻³/min; p = 0.002) and lower Ve values (median, 121 vs. 245 × 10⁻³; p = 0.004). ADC values partially overlapped between Warthin tumors and malignant lesions. Interobserver agreement was good, with ICC values ranging from 0.78 to 0.86. Kep showed the highest diagnostic performance in this cohort, with an AUC of 0.96. A Kep threshold of 723 × 10⁻³/min yielded 92.3% sensitivity and 93.3% specificity. Conclusions: Quantitative DCE-MRI, particularly Kep, may provide additional information for differentiating Warthin tumors from malignant salivary gland lesions within a multiparametric MRI assessment. The threshold identified in this cohort is exploratory and requires external validation before routine clinical use. Full article

Water scarcity and increasing energy demand are critical challenges that often characterize Mediterranean regions, especially islands such as Crete. A sustainable solution for a combined water and energy supply lies in the domain of hybrid renewable energy systems. This research study evaluates a large-scale wind-driven desalination system with pumped-hydro energy storage for the Regional Unit of Rethymno, Crete, focusing on climate-driven demand and air temperature variation. The proposed system integrates wind energy production, seawater desalination, pumped-hydro storage, and water supply both for domestic and for irrigation purposes. Four scenarios, each with increasing air temperature, are examined in order to assess their effect on water demand and system performance. The analysis evaluates electricity allocation, the production of desalinated water, domestic and irrigation coverage, as well as the economic performance of the system. The results indicate that domestic water demand is almost fully covered in all four scenarios, reaching nearly 99.9%, while irrigation water coverage decreases from 82% under present conditions to 67% under higher-temperature scenarios. Wind-generated electricity is mainly used for water-related processes, with a constant share supplied to the grid. The economic assessment indicates that the system can operate under break-even conditions using realistic water and electricity prices. Full article

Background/Objectives: This study aimed to assess nerve conduction studies (NCS) parameters of the median nerve and abductor pollicis brevis (APB) muscle activity in patients with cervical spondylosis. Additionally, we evaluated longitudinal changes in these parameters at six months following a multimodal rehabilitation treatment. Methods: This quasiexperimental, nonrandomized study included 41 patients with cervical spondylosis and 25 healthy controls. Median nerve conduction studies and semiquantitative surface electromyography (sEMG) of the APB muscle were assessed using a two-channel Neuro-MEP-Micro system (version 2009, Neurosoft Ltd.). The evaluations were performed at baseline in both groups and repeated after six months in the patient group. Pain intensity was assessed using the Visual Analog Scale (VAS). Results: Compared with controls, patients showed reduced compound muscle action potential (CMAP) amplitude (Cohen’s d = 1.53–1.83), slower motor conduction velocity (r = 0.91–0.95), and impaired sEMG amplitude and recruitment pattern of the APB muscle (all adjusted p < 0.001). After application of multimodal rehabilitation treatment, VAS scores decreased significantly (adjusted p < 0.001), and favorable changes in NCS and sEMG parameters were observed, with moderate to large effect sizes (Cohen’s d = 0.56–0.82; r = 0.52–0.86; all adjusted p ≤ 0.006). CMAP amplitude correlated positively with sEMG amplitude and recruitment pattern (ρ = 0.483–0.632, all adjusted p ≤ 0.001). Conclusions: Multimodal rehabilitation treatment may be associated with clinical and electrophysiological improvements, suggesting the complementary value of NCS and sEMG for the evaluation and follow-up of patients with cervical spondylosis. However, because of the nonrandomized uncontrolled design and the absence of longitudinal follow-up in controls, causal treatment effects cannot be inferred. Full article

The modern multi-domain battlespace increasingly demands cost-effective, persistent platforms for Forward Air Control (Airborne) (FAC(A)) and Close Air Support (CAS) missions. While utilizing Commercial Derivative Aircraft (CDA) presents a viable alternative to high-maintenance military assets, the specific aerodynamic, ergonomic, and cognitive workload limitations encountered during the transition across the civil–military “airworthiness seam” remain a significantly underexplored gap in contemporary aerospace literature. To address this gap, a comprehensive empirical flight test campaign was executed on the LX7-135 turboprop to evaluate its tactical mission suitability. Employing the Cooper–Harper Handling Qualities Rating and Bedford Workload scales, and guided by military specifications (MIL-HDBK-516C, MIL-F-8785C), the study systematically assessed the aircraft’s pure performance, unaugmented flight dynamics, and human–machine interface during simulated combat scenarios, including dynamic 9-Line briefings and kinetic “Box Pattern” delivery profiles. Flight test data indicated 12 “SATISFACTORY” parameters, highlighting climb rates, extended endurance, and heavily damped short-period and Dutch roll modes optimal for target tracking. Conversely, the evaluation identified 4 “UNSATISFACTORY” and 10 “TOLERABLE” deficiencies—chiefly a single-door egress bottleneck, restricted stick clearance, degraded longitudinal static stability, and the absence of secure tactical communications. Although these constraints elevated pilot cognitive workload during multi-axis tasks, the LX7-135 demonstrates potential suitability for further development for the FAC(A) role, subject to the successful implementation and subsequent flight-test verification of the identified critical engineering modifications and specialized training syllabi. Full article

Non-coding single nucleotide polymorphisms (SNPs) are key modulators of gene regulation and have been implicated in diverse complex traits and diseases. With the growing demand for accurate functional interpretation of non-coding variants, the choice of encoding strategies becomes critical in downstream predictive modeling. Despite recent advances, a systematic evaluation of encoding approaches tailored for non-coding SNPs remains lacking. To address this gap, we present a comprehensive benchmark that evaluates six representative encoding strategies, including categorical, semantic, and functional embeddings, across three quantitative trait loci (QTL)-related prediction tasks. The study encompasses nine machine learning and deep learning models and incorporates experimental controls and repeated trials to ensure robustness and reproducibility. We assess each strategy along multiple dimensions, such as interpretability, representation abundance, and computational efficiency. Rather than ranking individual methods, our analysis emphasizes the interaction between encoding strategies, model types, and preprocessing protocols, and highlights their collective influence on predictive performance. This work establishes a standardized framework for evaluating non-coding SNP representations and offers guidance for selecting and optimizing prediction pipelines in regulatory genomics. Full article

Background: Patients with stage I rectal cancer generally have favorable outcomes after curative surgery, but prognosis is not completely homogeneous. This study explored the prognostic association of preoperative inflammation–nutrition indices with overall survival and developed an interpretable internally validated machine learning survival model. Methods: We retrospectively included 475 patients with primary pathological stage I rectal adenocarcinoma who underwent curative-intent radical surgery at Sichuan University West China Hospital between 2018 and 2021. Patients downstaged to ypStage I after neoadjuvant therapy or treated by local transanal excision without lymph node dissection were excluded. Candidate predictors included age, sex, carcinoembryonic antigen, and routinely available preoperative inflammation–nutrition indices. LASSO-Cox regression was used for feature selection. Six survival models were developed and evaluated using 1000 bootstrap resamples with out-of-bag internal validation. Model performance was assessed at 60 months using time-dependent AUC, C-index, Brier score, calibration, and decision curve analysis. SHAP analysis was used for model interpretation. Results: During a median follow-up of 68 months, 30 deaths occurred. LASSO-Cox regression identified five predictors: age, lymphocyte-to-white blood cell ratio, fibrinogen-to-lymphocyte ratio, albumin-to-alkaline phosphatase ratio, and neutrophil-to-HDL cholesterol ratio. In bootstrap out-of-bag internal validation, XGBoost-Cox achieved the highest, although only marginally higher, discriminative performance among the evaluated models, with a 60-month time-dependent AUC of 0.783, a C-index of 0.774, and a Brier score of 0.0507. The calibration intercept and slope of XGBoost-Cox were 0.519 and 1.070, respectively. SHAP analysis identified age as the most influential predictor, followed by the selected inflammation–nutrition indices. Decision curve analysis suggested potential clinical utility within threshold probabilities from 1% to 20%, although this finding remains exploratory. Conclusions: Preoperative inflammation–nutrition indices may contribute to overall survival prognostic stratification in primary pathological stage I rectal cancer. External validation in larger multicenter cohorts is required before clinical application. Full article

Background and Objectives: Sarcopenia is highly prevalent among older adults with chronic kidney disease (CKD) and is associated with adverse clinical outcomes. The finger-ring (Yubi-wakka) test is a simple anthropometric screening tool based on calf circumference; however, its performance in older adults with CKD remains unclear. This study aimed to investigate the association of the finger-ring test with low muscle mass, sarcopenia, and comprehensive geriatric assessment parameters and to evaluate its diagnostic performance for identifying low muscle mass in older adults with CKD. Materials and Methods: This cross-sectional study included 115 patients aged ≥65 years with CKD who were evaluated in geriatric and nephrology inpatient services. After excluding two participants with missing finger-ring measurements, 113 individuals were analyzed. Muscle mass was assessed using bioelectrical impedance analysis and low muscle mass was defined according to EWGSOP2-based Turkish cut-off values. Demographic characteristics, anthropometric measurements, laboratory findings, and comprehensive geriatric assessment parameters were recorded. Correlation analyses, logistic regression models, receiver operating characteristic (ROC) analyses, and likelihood-ratio tests were performed. Results: Among 113 participants, 62 were classified as finger-ring positive (FR = 0) and 51 as finger-ring negative (FR = 1). Low muscle mass was significantly more frequent in the FR = 0 group than in the FR = 1 group (51.6% vs. 24.0%, p = 0.005). Finger-ring test results showed strong correlations with calf circumference (rho = 0.689, p < 0.001) and body mass index (BMI) (rho = 0.631, p < 0.001), whereas the correlation with muscle mass was modest (rho = 0.250, p = 0.008). For detecting low muscle mass, the finger-ring test demonstrated an area under the curve (AUC) of 0.643 (95% CI 0.554–0.732), sensitivity of 72.7%, specificity of 55.9%, positive predictive value of 51.6%, and negative predictive value of 76.0%. In multivariable analyses, BMI remained the strongest independent determinant of finger-ring test results, whereas the association with muscle mass lost statistical significance after BMI adjustment. Adding age and sex significantly improved discrimination, while the contribution of nutritional status was limited. Conclusions: The finger-ring test is associated with low muscle mass in older adults with CKD; however, its diagnostic performance is modest and appears to be substantially influenced by body size and calf circumference. Therefore, the finger-ring test should be considered a simple adjunctive screening tool rather than a stand-alone method for identifying low muscle mass in this population. Full article

Background/Objectives: Wheat root and crown rot, caused by Fusarium pseudograminearum, Fusarium graminearum, and Bipolaris sorokiniana, are devastating soil-borne diseases that cause substantial yield losses worldwide. Endophytic fungi are promising sources of bioactive metabolites for agricultural applications. This study aimed to isolate and characterize an endophytic fungus with antifungal activity against major wheat pathogens, identify its active compound, and investigate the underlying transcriptional response. Methods: An endophytic strain Y2 was isolated from Hedyotis diffusa leaves and identified through morphological and phylogenetic analysis based on TEF-1α and RPB2 sequences. Pathogenicity of strain Y2 was evaluated on wheat stem bases. The bioactive compound was purified by HPLC and identified by HR-ESI-MS and NMR. Antifungal activity was assessed using dual-culture and microbroth dilution assays. Transcriptomic analysis (RNA-seq) was performed on F. pseudograminearum treated with equisetin, with qRT-PCR validation of seven representative differentially expressed genes. Results: Strain Y2 was identified as Fusarium incarnatum or a closely related member of the F. incarnatum–equiseti species complex (FIESC) and confirmed to be non-pathogenic to wheat. The purified bioactive compound was characterized as equisetin, which exhibited significant antifungal activity with MIC values of 16, 32, and 64 μg/mL against F. pseudograminearum, B. sorokiniana, and F. graminearum, respectively. Transcriptomic analysis revealed that equisetin treatment induced a polarized transcriptional response in F. pseudograminearum, characterized by strong upregulation of ribosome and translation-related genes and widespread downregulation of other metabolic pathways, particularly nitrogen metabolism. qRT-PCR validation of seven representative genes confirmed the reliability of the RNA-seq data. Conclusions: Our findings demonstrate that equisetin is the active antifungal metabolite produced by F. incarnatum Y2, with potent in vitro activity against major wheat root and crown rot pathogens. The transcriptomic data provide insights into the potential mechanism of action, while the non-pathogenic nature of strain Y2 supports its biosafety. Although these results highlight equisetin as a promising lead compound for antifungal development, further in planta efficacy and safety studies are required before it can be considered for practical biocontrol. Full article

Dwarf apple trees are increasingly cultivated in China, whereas their environmental and economic performance remain insufficiently quantified. Here, life cycle assessment (LCA) and grouping methods are jointly conducted to quantify the environmental risks and mitigation potentials of dwarf apple production systems based on survey data from 110 growers on China’s Loess Plateau. Based on apple yield and the partial factor productivity of nitrogen fertilizer (PFP-N), the growers’ orchards were grouped into LL (low yield + low PFP-N), LH (low yield + high PFP-N), HL (high yield + low PFP-N), and HH (high yield + high PFP-N). Results showed that farm-averaged total energy depletion (ED), global warming potential (GWP), eutrophication potential (EP), and acidification potential (AP) were 3444 MJ t⁻¹, 498 kg CO₂-eq t⁻¹, 0.992 kg PO₄³-eq t⁻¹, and 3.494 kg SO₂-eq t⁻¹, respectively. Over 85.0% of ED and GWP occurred at the agricultural material stage, while AP and EP were mainly generated at the orchard management stage. The ED, GWP, EP, and AP differed significantly among the four groups. Considering apple yield, environmental pollution index, and economic analysis, the HH group increased apple yield by 11.4–188%, reduced environment risks by 52.0–84.8%, and increased economic returns by 39.0–425%, compared with LL, LH and HL. This study highlights the importance of farm best management practices to efficiently achieve yield–environmental–economic benefits in dwarf apple production systems. Full article

Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive infiltrative cardiomyopathy associated with substantial morbidity and mortality. This systematic review evaluates the effects of tafamidis on echocardiographic parameters, cardiac biomarkers, functional outcomes, mortality, and safety in patients with ATTR-CM. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420261391553). PubMed, Embase, and Web of Science were searched through 20 March 2026. Eligible studies included adults with ATTR-CM treated with tafamidis and reporting, echocardiographic, biomarker, functional, mortality, or safety outcomes. Randomized controlled trials and observational studies were included. Risk of bias was assessed using the Cochrane RoB 2 tool and Newcastle–Ottawa Scale. Due to substantial heterogeneity, a narrative synthesis was performed. Results: Seventeen studies were included with a total of 1890 patients. Tafamidis treatment was potentially associated with stabilization of global longitudinal strain, preservation of functional status, and lower all-cause mortality compared with untreated or control cohorts. Biomarker findings, including N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT), were heterogeneous and did not demonstrate a consistent pattern of improvement. Functional outcomes, including New York Heart Association (NYHA) class, 6-minute walk distance (6MWT), National Amyloidosis Center (NAC) staging, and quality-of-life measures, suggested slower clinical deterioration among treated patients. Limited available safety data indicated that tafamidis was generally well tolerated, with no major safety concerns identified. Conclusions: Current evidence may suggest that tafamidis slows disease progression and may potentially be associated with improved survival in ATTR-CM. Further prospective studies with standardized outcome reporting are needed. Evidence was limited by heterogeneity in study design, outcome reporting, and follow-up duration, with most included studies being observational. Full article

Background: Precise quantification of JAK2 V617F variant allele frequency (VAF) is clinically important in Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs). This study evaluated the analytical performance and clinical utility of a laboratory-developed chip-based real-time digital PCR (dPCR) assay for JAK2 V617F and compared it with a commercial quantitative real-time PCR (qPCR) assay. Methods: Residual DNA extracts from 76 JAK2 V617F-positive clinical specimens collected from patients with suspected MPNs were analyzed using both qPCR and dPCR. Analytical performance was assessed according to CLSI-based approaches, including limit of blank (LoB), limit of detection (LoD), precision, linearity, and method comparison. Associations between VAF and hematologic parameters, as well as diagnostic groups, were also examined. Results: Both methods showed a LoB of 0. The LoD was 0.1167% for qPCR and 0.0846% for dPCR, and dPCR demonstrated lower variability than qPCR across high-, intermediate-, and low-concentration samples, with the largest difference observed at low VAF levels. Linearity was excellent for both assays (R² = 0.988 for qPCR and 0.999 for dPCR), although dPCR showed less low-concentration bias. The two methods were highly correlated (Pearson r = 0.9789, R² = 0.958), but dPCR yielded slightly higher VAF values overall. VAF was significantly higher in polycythemia vera than in essential thrombocythemia, and both qPCR- and dPCR-based VAFs were positively correlated with white blood cell count. Conclusions: The chip-based laboratory-developed dPCR assay showed high concordance with qPCR while providing lower LoD and better precision at low allele burden. These findings support its potential utility as a sensitive alternative for JAK2 V617F quantification in clinical laboratories, particularly in settings requiring accurate low-level detection and follow-up monitoring. Full article

Effective evaluation of building fabric is essential to understanding building performance. Traditional methods, such as ISO 9869-1, provide point U-values but do not always capture the complete picture, and new measurement-led approaches are needed to support building retrofit. Heat3D is a novel iOS application that performs rapid U-value measurements of building elements by mapping thermographic images from a mobile infrared camera onto an augmented reality (AR) model of a room, from which heat flux across the element is calculated. A field trial of 22 UK properties during the 2019–2020 winter heating season assessed Heat3D’s heat flux measurements against traditional heat flux plates, with 90% of 295 Heat3D surveys falling within the combined uncertainty of the reference method. A second field trial, conducted over the 2020–2021 winter heating period, evaluated a new timelapse iteration of the method capable of measuring wall U-value within approximately 60 min; 90% of 42 Heat3D surveys fell within the combined confidence interval of the ISO 9869-1-measured U-value. These results indicate that Heat3D offers a viable, rapid alternative to traditional methods for both heat flux and U-value measurement. Full article

Background/Objectives: Bariatric surgery is the most effective treatment for sustained weight loss; however, early postoperative complications remain a significant concern. Routine biochemical markers obtained in the immediate postoperative period may enable early risk stratification, yet their prognostic value remains incompletely defined. This study aimed to evaluate the association between early postoperative biochemical alterations and composite adverse outcomes after bariatric surgery. Methods: In this retrospective observational study, 260 adult patients undergoing elective bariatric surgery were included. Preoperative and postoperative day 1 (POD1) laboratory parameters were retrieved from electronic medical records. The primary endpoint was a composite adverse outcome comprising postoperative intensive care unit admission, infection, anastomotic leak, or 30-day readmission. Univariable and multivariable logistic regression analyses were performed to evaluate independent associations, and receiver operating characteristic (ROC) curve analysis was used to assess discriminative performance. Results: Composite adverse outcomes occurred in 51 patients (19.6%). In multivariable analysis, longer operative duration (OR 1.17 per 10 min, 95% CI 1.04–1.31; p = 0.009), POD1 AST (OR 1.15 per 10 U/L, 95% CI 1.07–1.24; p < 0.001), and POD1 lactate-to-albumin ratio (LAR ×100) (OR 1.20, 95% CI 1.04–1.38; p = 0.014) were independently associated with adverse outcomes. POD1 AST demonstrated the highest discriminative ability (AUC 0.733), followed by glucose (AUC 0.688) and ALT (AUC 0.680), whereas LAR showed limited stand-alone performance (AUC 0.594). Conclusions: Longer operative duration and higher POD1 AST and LAR levels were independently associated with the composite adverse perioperative outcome. AST showed the highest, although moderate, individual discrimination, whereas LAR demonstrated limited stand-alone performance. Because immediate postoperative ICU transfer preceded POD1 biomarker sampling and dominated the composite outcome, these findings should be interpreted as associations rather than prospective prediction. Full article

Preterm infants are at high risk of neurodevelopmental disorders (NDDs), yet current brain assessments using 2D cranial ultrasound (cUS) remain subjective and limited. 3D cUS offers richer anatomical details but is underutilized due to its complexity and lack of automated tools. We developed and evaluated Deep Learning (DL) methods for total brain (TB) segmentation from 3D cUS of preterm neonates, emphasizing accuracy, reproducibility, and clinical deployability. We compared 2D UNet models, a contextual UNet, and self-configuring 2D/3D nnUNet variants, evaluating accuracy, efficiency, and GPU/CPU feasibility. Clinical relevance was examined through longitudinal total brain volume (TBV) trajectories and their association with 2-year neurodevelopmental outcomes. The nnUNet ensemble achieved the best performance (Dice: 0.97, Volumetric Difference Error: 2.32%), while contextual UNet offered a favorable accuracy-efficiency trade-off on low-resource hardware. Longitudinal analysis showed significantly slower TBV growth in infants with adverse outcomes (p = 0.007), supporting the prognostic value of automated volumetric measurements. We developed a clinician-facing web application to illustrate clinical integration. This work demonstrates the feasibility of DL-based TB segmentation from 3D cUS and provides a scalable reproducible framework supporting early quantitative assessment of brain development, laying the groundwork for future lightweight, privacy-aware AI solutions for Neonatal Intensive Care Unit integration. Full article