Search Results (3,898)

Background: Acute kidney injury (AKI) frequently occurs following major liver resection, adversely affecting both short- and long-term outcomes. This study aimed to determine the incidence of AKI post-hepatectomy and identify relevant pre- and intraoperative risk factors. Our secondary objectives were to develop a predictive score for postoperative AKI and assess the associations between AKI, chronic kidney disease (CKD), and 1-year mortality. Methods: This was a retrospective study in a cancer referral center in Marseille, France, from 2018 to 2022. Results: Among 169 patients, 55 (32.5%) experienced AKI. Multivariate analysis revealed several independent risk factors for postoperative AKI, including age, body mass index, the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, time to liver resection, intraoperative shock, and bile duct reconstruction. Neoadjuvant chemotherapy was protective. The AKIMEBO score was developed, with a threshold of ≥15.6, demonstrating a sensitivity of 89.5%, specificity of 76.4%, positive predictive value of 61.8%, and negative predictive value of 94.4%. AKI was associated with increased postoperative morbidity and one-year mortality following major hepatectomy. Conclusion: AKI is a common complication post-hepatectomy. Factors such as time to liver resection and intraoperative shock management present potential clinical intervention points. The AKIMEBO score can provide a valuable tool for postoperative risk stratification. Full article

This paper reports a statistical analysis of a database archiving information on the strengths of the materials in existing Italian bridges having pre- and post-tensioned concrete beams. Data were collected in anonymous form by analyzing a stock of about 170 bridges built between 1960 and 2000 and located in several Italian regions. To date, the database refers to steel reinforcing bars, concrete, and prestressing steel, whose strengths were gathered from design nominal values, acceptance certificates, and in situ test results, all derived by consulting the available documents for each examined bridge. At first, this paper describes how the available data were collected. Then, the results of a statistical analysis are presented and commented on. Moreover, goodness-of-fit tests are carried out to verify the assumption validity of a normal distribution for steel reinforcing bars and prestressing steel, and a log-normal distribution for concrete. The database represents a valuable resource for researchers and practitioners for the assessment of existing bridges. It may be applied for the use of prior knowledge within a framework where Bayesian methods are included for reducing uncertainties. The database provides essential information on the strengths of the materials to be used for a simulated design and/or for verification in the case of limited knowledge. Goodness-of-fit tests make the collected information very useful, even if probabilistic methods are applied. Full article

Objectives: To investigate the reliability and validity of the Singer Reflux Symptom Score (sRSS), a new patient-reported outcome questionnaire documenting the severity of reflux symptoms in singing voice is proposed. Methods: Amateur and professional singers consulting the European Reflux Clinic for laryngopharyngeal reflux disease (LPRD) symptoms and findings were prospectively recruited from January 2022 to February 2023. The diagnosis was based on a Reflux Symptom Score (RSS) > 13 and Reflux Sign Assessment (RSA) > 14. A control group of asymptomatic singer subjects was recruited from the University of Mons. The sRSS was rated within a 7-day period to assess test–retest reliability. Internal consistency was measured using Cronbach’s α in patients and controls. A correlation analysis was performed between sRSS and Singing Voice Handicap Index (sVHI) to evaluate convergent validity. Responsiveness to change was evaluated through pre- to post-treatment sRSS changes. The sRSS threshold for suggesting a significant impact of LPRD on singing voice was determined by receiver operating characteristic (ROC) analysis. Results: Thirty-three singers with suspected LPRD (51.5% female; mean age: 51.8 ± 17.2 years) were consecutively recruited. Difficulty reaching high notes and vocal fatigue were the most prevalent LPRD-related singing complaints. The sRSS demonstrated high internal consistency (Cronbach-α = 0.832), test–retest reliability, and external validity (correlation with sVHI: r = 0.654; p = 0.015). Singers with suspected LPRD reported a significant higher sRSS compared to 68 controls. sRSS item and total scores significantly reduced from pre-treatment to 3 months post-treatment except for the abnormal voice breathiness item. ROC analysis revealed superior diagnostic accuracy for sRSS (AUC = 0.971) compared to sRSS-quality of life (AUC = 0.926), with an optimal cutoff at sRSS > 38.5 (sensitivity: 90.3%; specificity: 85.0%). Conclusions: The sRSS is a reliable and valid singer-reported outcome questionnaire for documenting singing symptoms associated with LPRD leading to personalized management of Singers. Future large-cohort studies are needed to evaluate its specificity for LPRD compared to other vocal fold disorders in singers. Full article

Water scarcity and spatial variability in soil fertility are key constraints to stable grain production in the Huang-Huai-Hai Plain. However, the interaction mechanisms between regulated deficit irrigation and soil fertility influencing yield formation and water-nitrogen use efficiency in winter wheat remain unclear. In this study, a two-year field experiment (2022–2024) was conducted to investigate the effects of two irrigation regimes—regulated deficit irrigation during the heading to grain filling stage (D) and full irrigation (W)—under four soil fertility levels: F1 (N: P: K = 201.84: 97.65: 199.05 kg ha⁻¹), F2 (278.52: 135: 275.4 kg ha⁻¹), F3 (348.15: 168.75: 344.25 kg ha⁻¹), and CK (no fertilization). The results show that aboveground dry matter accumulation, total nitrogen content, pre-anthesis dry matter and nitrogen translocation, and post-anthesis accumulation significantly increased with fertility level (p < 0.05). Regulated deficit irrigation promoted the contribution of post-anthesis dry matter to grain yield under the CK and F1 treatments, but suppressed it under the F2 and F3 treatments. However, it consistently enhanced the contribution of post-anthesis nitrogen to grain yield (p < 0.05) across all fertility levels. Higher fertility levels prolonged the grain filling duration by 18.04% but reduced the mean grain filling rate by 15.05%, whereas regulated deficit irrigation shortened the grain filling duration by 3.28% and increased the mean grain filling rate by 12.83% (p < 0.05). Grain yield significantly increased with improved fertility level (p < 0.05), reaching a maximum of 9361.98 kg·ha⁻¹ under the F3 treatment. Regulated deficit irrigation increased yield under the CK and F1 treatments but reduced it under the F2 and F3 treatments. Additionally, water use efficiency exhibited a parabolic response to fertility level and was significantly enhanced by regulated deficit irrigation. Nitrogen partial factor productivity (NPFP) declined with increasing fertility level (p < 0.05); Regulated deficit irrigation improved NPFP under the F1 treatment but reduced it under the F2 and F3 treatments. The highest NPFP (41.63 kg·kg⁻¹) was achieved under the DF1 treatment, which was 54.81% higher than that under the F3 treatment. TOPSIS analysis showed that regulated deficit irrigation combined with the F1 fertility level provided the optimal balance among yield, WUE, and NPFP. Therefore, implementing regulated deficit irrigation during the heading–grain filling stage under moderate fertility (F1) is recommended as the most effective strategy for achieving high yield and efficient resource utilization in winter wheat production in this region. Full article

Water treadmill (WT) exercise is used for horses’ rehabilitation and training. Given that each training needs to be individualized for each horse, the goal is to assess whether infrared thermography (IRT) can serve as a non-invasive tool for daily monitoring of individual training and rehabilitation progress in horses undergoing WT exercise. Fifteen Polish Warmblood school horses were subjected to five WT sessions: dry treadmill, fetlock-depth water, fetlock-depth water with artificial river (AR), carpal-depth water, and carpal-depth water with AR. IRT images, collected pre- and post-exercise, were analyzed for the mean temperature (Tmean) and maximal temperature (Tmax) across 14 regions of interest (ROIs) representing the body surface overlying specific superficial muscles. While on a dry treadmill, Tmean and Tmax increased post-exercise in all ROIs; wetting of the hair coat limited surface temperature analysis in ROIs annotated on limbs. Tmax over the m. brachiocephalicus, m. trapezius pars cervicalis, m. triceps brachii, and m. semitendinosus increased during walking in carpal-depth water, which therefore may be suggested as an indirect indicator of increased activity related to forelimb protraction and flexion–extension of the limb joints. Tmax over the m. latissimus dorsi and m. longissimus increased during carpal-depth WT exercise with active AR mode, which may be suggested as an indicator of increased workload including vertical displacement of the trunk. Full article

Background: Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of severe aortic valve stenosis (AS). Balloon post-dilatation (PD) remains an important procedural step to optimize valve function by resolving incomplete valve expansion, which may lead to paravalvular regurgitation and other potentially adverse effects. There are only limited data on the predictors, incidence, and clinical impact of PD during TAVI. Methods: This retrospective, single-center study analyzed 585 patients who underwent TAVI (2016–2022). Pre-procedural evaluations included transthoracic echocardiography and CT angiography to assess key parameters, including the aortic valve calcium score (AVCS); aortic valve calcium density (AVCd); aortic valve maximal systolic transvalvular flow velocity (AV Vmax); and aortic valve mean systolic pressure gradient (AV MPG). We identified imaging predictors of PD and evaluated associated clinical outcomes by analyzing procedural endpoints (according to VARC-3 criteria) and long-term survival. Results: PD was performed on 67 out of 585 patients, with elevated AV Vmax (OR: 1.424, 95% CI: 1.039–1.950; p = 0.028) and AVCd (OR: 1.618, 95% CI: 1.227–2.132; p = 0.001) emerging as a significant independent predictor for PD in TAVI. Kaplan–Meier survival analysis revealed no significant differences in short- and mid-term survival between patients who underwent PD and those who did not. Interestingly, patients requiring PD exhibited a lower incidence of adverse events regarding major vascular complications, permanent pacemaker implantations and stroke. Conclusions: The study highlights AV Vmax and AVCd as key predictors of PD. Importantly, PD was not associated with increased procedural adverse events and did not predict adverse events in this contemporary cohort. Full article

Academic English support is crucial for English as an Additional Language (EAL) nursing students in English-medium nursing education programmes. However, empirical research on content and language integrated learning (CLIL) within this specific context remains limited. This study, informed by recent advancements in translanguaging and trans-semiotising (TL-TS) theory, investigates the patterns of teacher collaboration in nursing CLIL and its impact when employing a TL-TS pedagogical approach. Analysis of students’ pre- and post-tests and multimodal classroom interactions reveals that effective collaboration between nursing specialists and language experts in CLIL can be fostered by (1) aligning with language education principles through the incorporation of internally persuasive discourse (IPD) about language learning and TL-TS practices; (2) simulating potential professional contingencies and co-developing coping strategies using TL-TS; and (3) elucidating nursing language norms through TL-TS and IPD. We advocate for re-imagination of CLIL in English-medium nursing education through an organistic–procedural TL perspective and highlight its potential to enhance EAL nursing students’ development of language proficiency and professional competencies. Full article

This study examined data from participants who completed the SLeep Education for Everyone Program (SLEEP) to explore how various demographic variables affected sleep outcomes and to determine which participant characteristics predicted success. A total of 104 individuals participated. The Sleep Hygiene Index (SHI) measured undesirable sleep behaviors; the Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality and self-reported sleep duration. Participant demographic information was collected at baseline. A mixed ANOVA evaluated group differences, and a multiple linear regression model identified predictors of sleep improvements. Change in SHI scores from pre- to post-intervention demonstrated a significant time × group interaction between Black and white participants (p = 0.024); further analysis indicated Black participants improved more. Better baseline scores predicted more favorable post-intervention outcomes for SHI, PSQI, and sleep duration. Fewer chronic conditions predicted better post-intervention SHI and PSQI scores. Older age also predicted better SHI scores. More favorable initial scores, fewer chronic conditions, and older age were the strongest predictors of positive outcomes following SLEEP. Improved sleep hygiene, sleep quality, and sleep duration were observed over time within subjects across all groups. In summary, SLEEP appears to be effective. Further work exploring challenges experienced by younger participants or those with multiple co-morbidities is warranted. Full article

Recent archaeological discoveries across the Aegean, Cyprus, and western Anatolia have renewed interest in pre-Neolithic seafaring and early island colonization. However, the environmental contexts that support such early coastal occupations remain poorly understood, largely due to the submergence of Pleistocene shorelines following post-glacial sea-level rise. This study addresses this gap through an integrated geoarchaeological investigation of the pre-Neolithic site of Ouriakos on Lemnos Island, northeastern Aegean (Greece), dated to the mid-11th millennium BCE. By reconstructing both the terrestrial and submerged paleolandscapes of the site, we examine ecological conditions, resource availability, and sedimentary processes that shaped human activity and site preservation. Employing a multiscale methodological approach—combining bathymetric survey, geomorphological mapping, soil micromorphology, geochemical analysis, and Optically Stimulated Luminescence (OSL) dating—we present a comprehensive framework for identifying and interpreting early coastal settlements. Stratigraphic evidence reveals phases of fluvial, aeolian, and colluvial deposition associated with an alternating coastline. The core findings reveal that Ouriakos was established during a phase of environmental stability marked by paleosol development, indicating sustained human presence. By bridging terrestrial and marine data, this research contributes significantly to the understanding of human coastal mobility during the Pleistocene–Holocene transition. Full article

Background: Thailand is rapidly transitioning into an aging society, creating an intergenerational caregiving gap that strains existing support systems. Objective: This study evaluated the effectiveness of “Young Care,” a community-based intervention designed to enhance youth knowledge, attitudes, and caregiving practices (KAP) toward older adults. Methods: A two-day structured training was conducted in Maha Sarakham Province in 2023 using a pre-post mixed-methods design. Middle and high school students participated in lectures, multimedia sessions, and experiential learning activities related to caregiving. Quantitative data were collected using validated KAP questionnaires, while qualitative insights were obtained from focus group discussions involving students, older persons, caregivers, and local leaders. Results: Post-intervention analysis revealed significant improvements in knowledge and attitudes (p < 0.001), accompanied by increased empathy, caregiving initiative, and a sense of moral responsibility among participants. Conclusions: The initiative fostered formal partnerships among schools, local governments, healthcare providers, and universities through memoranda of understanding. These collaborations enabled budgetary support and outreach to out-of-school youth, positioning “Young Care” as a scalable, youth-centered strategy to address Thailand’s long-term care challenges. Full article

This paper explores emotional analysis in Hebrew texts, focusing on improving machine learning techniques for depression detection by integrating psychological feature lexicons. Hebrew’s complex morphology makes emotional analysis challenging, and this study seeks to address that by combining traditional machine learning methods with sentiment lexicons. The dataset consists of over 350,000 posts from 25,000 users on the health-focused social network “Camoni” from 2010 to 2021. Various machine learning models—SVM, Random Forest, Logistic Regression, and Multi-Layer Perceptron—were used, alongside ensemble techniques like Bagging, Boosting, and Stacking. TF-IDF was applied for feature selection, with word and character n-grams, and pre-processing steps like punctuation removal, stop word elimination, and lemmatization were performed to handle Hebrew’s linguistic complexity. The models were enriched with sentiment lexicons curated by professional psychologists. The study demonstrates that integrating sentiment lexicons significantly improves classification accuracy. Specific lexicons—such as those for negative and positive emojis, hostile words, anxiety words, and no-trust words—were particularly effective in enhancing model performance. Our best model classified depression with an accuracy of 84.1%. These findings offer insights into depression detection, suggesting that practitioners in mental health and social work can improve their machine learning models for detecting depression in online discourse by incorporating emotion-based lexicons. The societal impact of this work lies in its potential to improve the detection of depression in online Hebrew discourse, offering more accurate and efficient methods for mental health interventions in online communities. Full article

Cryotherapy could stimulate immune responses and induce abscopal effects. A novel technique was developed for treating spinal bone tumors involving the use of frozen tumor-containing autologous bone grafts for anterior spinal reconstruction following total en-bloc spondylectomy, with the aim of activating cryoimmunity. This study focused on analyzing changes in the T-cell receptor (TCR) repertoire after surgery to evaluate T-cell diversity. Blood samples were collected pre- and post-operatively, with subsequent RNA extraction and immunosequencing. Compared to pre-surgery samples, the diversity and abundance of the Complementarity-Determining Region 3, regions of the TCR α and β chains decreased, suggesting that more selective clones may have emerged and influenced immune responses. Through TCR repertoire analysis, this study demonstrated that transplantation of frozen tumor-containing autologous bone impacted the immune system. This study is expected to provide a foundation for developing treatments that may enhance immune activation. Full article

High-Intensity Focused Ultrasound (HIFU) is a non-invasive technology widely used in aesthetic dermatology for skin tightening and facial rejuvenation. This study aimed to evaluate the safety and efficacy of a modified HIFU device, More Young, compared to the standard 7D HIFU system through a randomized, single-blinded clinical trial. The More Young device features enhanced focal depth precision and energy delivery algorithms, including nine pre-programmed stabilization checkpoints to minimize treatment risks. A total of 100 participants with facial wrinkles and skin laxity were randomly assigned to receive either More Young or 7D HIFU treatment. Skin improvements were assessed at baseline and one to six months post-treatment using the VISIA^® Skin Analysis System (7th Generation), focusing on eight key parameters. Patient satisfaction was evaluated through the Global Aesthetic Improvement Scale (GAIS). Data were analyzed using paired and independent t-tests, with effect sizes measured via Cohen’s d. Both groups showed significant post-treatment improvements; however, the More Young group demonstrated superior outcomes in wrinkle reduction, skin tightening, and texture enhancement, along with higher satisfaction and fewer adverse effects. No significant differences were observed in five of the eight skin parameters. Limitations include the absence of a placebo group, limited sample diversity, and short follow-up duration. Further studies are needed to validate long-term outcomes and assess performance across varied demographics and skin types. Full article

Acetate may act as a signaling molecule, regulating Paracin 1.7 production via quorum sensing (QS) in Lacticaseibacillus paracasei HD1.7. The “acetate switch” phenomenon requires mechanistic exploration to optimize Paracin 1.7 production. The “acetate switch” phenomenon delays with higher glucose levels (30 h, 36 h, and 96 h). Before the occurrence of the “acetate switch”, the ATP content increases and peaks at the “acetate switch” point and the NAD⁺/NADH ratio decreases, indicating energy changes. Moreover, the QS genes used for the pre-regulation of bacteriocin, such as prcKR, comCDE, were highly expressed. After the “acetate switch”, the ATP content decreased and the QS genes for the post-regulation of bacteriocin were highly expressed, such as rggs234 and sigma70-1/70-2. The “acetate switch” could act as an energy switch, regulating bacterial growth and QS genes. Before and after the “acetate switch”, some metabolic pathways were significantly altered according to the transcriptomic analysis by HD1.7 and HD1.7-Δpta. In this study, acetate was used as an input signal to regulate the two-component system, significantly influencing the bacteriocin expression system. And this study clarifies the roles of acetate, energy, and quorum sensing in promoting Paracin 1.7 production, providing a theoretical basis for optimizing the bacteriocin fermentation process of HD1.7. Full article

Overfishing represents one of the most alarming threats to marine conservation in the Mediterranean Sea. In particular, deep-sea trawl fishing can severely damage marine habitats that may take decades to recover due to their slow growth rates. Hence, monitoring the health and subsistence of deep-sea ecosystems in fishing hotspots is vital to understand the impacts of deep-sea fishing. This paper presents a methodological study to prepare an expedition in Sardinian (Italy) deep waters. The methodology is composed of three sections: first, it offers a comparative analysis of the proper technological mix to identify fishing hotspots pre-expedition; second, it simulates an in situ expedition to monitor the state of deep-sea ecosystems in proximity of the fishing hotspots identified; and third, it offers recommendations for data analysis and management post-expedition. This study offers a replicable methodology for advancing knowledge on the state of deep-sea ecosystems affected by trawl fishing. Full article