Search Results (4,956)

As direct detection methods of Borrelia burgdorferi are limited, serology plays an important role in diagnosing Lyme disease (LD). There are various types of Lyme serological tests with varying diagnostic accuracy, so it is necessary to compare and rank them. The aim of this study is to compare the accuracy of various serological diagnostic methods for LD using network meta-analysis (NMA). We searched the Cochrane Library and PubMed databases for all serological diagnostic accuracy studies published from the discovery of LD until June 2024. After screening, we assessed the quality of the included studies with QUADAS-C and extracted relevant data. We calculated the Q* index of the receiver operating characteristic curve for each diagnostic test. Meta-disc 2.0 and Stata 15.0 were used to perform traditional meta-analysis and NMA with the gold standard (the comprehensive evaluation) as a reference. We then compared the Q* index values between different methods using two-by-two comparisons and ranked them accordingly. A total of 52 studies with 181,032 participants, including 5318 patients with LD, were included. These studies covered 14 diagnostic methods. The results of the NMA suggest that modified two-tiered testing (MTTT), C6 enzyme immunoassay (EIA), and standard two-tiered testing (STTT) rank in the top three among the 14 methods in terms of Q* index, with MTTT being the highest, followed by C6 EIA and STTT. MTTT and C6 EIA have higher overall diagnostic performance, and their accuracy is not inferior to that of the widely used STTT (PROSPERO CRD42022378326). Full article

Background/Objectives: While elevated Lp(a) levels are associated with incident heart failure development, the role of Lp(a) in established heart failure with reduced ejection fraction (HFrEF) versus heart failure with preserved ejection fraction (HFpEF) remains unexplored. Methods: We conducted a retrospective analysis of 387 heart failure patients from our institutional database (January 2018–June 2024). Patients were categorized as HFrEF (n = 201) or HFpEF (n = 186) using ICD-10 codes. Categorical variables were compared between heart failure types using the Chi-square test or Fisher’s Exact test, and continuous variables were compared using the two-sample t-test or Wilcoxon rank-sum test, as appropriate. Logistic regression was utilized to assess heart failure type as a function of Lp(a) levels, adjusting for covariates. Spearman correlation assessed relationships between Lp(a) and pro-BNP levels. Results: Despite significant demographic and clinical differences between HFrEF and HFpEF patients, Lp(a) concentrations showed no significant variation between groups. Median Lp(a) levels were 60.9 nmol/dL (IQR: 21.9–136.7) in HFrEF versus 45.0 nmol/dL (IQR: 20.1–109.9) in HFpEF (p = 0.19). After adjusting for demographic and clinical covariates, Lp(a) showed no association with heart failure subtype (OR: 1.001, 95% CI: 0.99–1.004; p = 0.59). Conclusions: Lp(a) levels do not differ significantly between HFrEF and HFpEF phenotypes, suggesting possible shared pathophysiological mechanisms rather than phenotype-specific biomarker properties. These preliminary findings may support unified screening and treatment strategies for elevated Lp(a) across heart failure, pending confirmation in larger studies. Full article

Background/Objectives: The quality of surgical margins has been shown to be a prognostic factor in many sarcoma entities, yet its role in osteosarcoma remains controversial. While previous studies have shown that the outcome was not related to the margin width in bone, the impact of the extraosseous margin width (margin at the soft tissue invasion)—which needs to be close sometimes due to neurovascular structures—needs to be assessed. This study aims to evaluate the influence of soft tissue surgical margins on local recurrence and overall survival in patients with high-grade osteosarcoma. Methods: We conducted a retrospective, single-center study including 75 patients treated for high-grade osteosarcoma. All patients underwent standardized neoadjuvant chemotherapy followed by complete surgical resection. Patients were stratified into three groups based on the histological margin width of the extraosseous parts: group 1 (<1 mm), group 2 (1–5 mm), and group 3 (≥5 mm). Primary endpoints were local recurrence and overall survival (OS), analyzed using Kaplan–Meier estimates, log-rank tests, and Cox regression. Results: Local recurrence occurred in seven patients (9%). Although the overall comparison between the three groups was not statistically significant (p = 0.074), a subgroup analysis revealed a significantly higher recurrence rate in patients with margins < 1 mm compared to those with wider margins (p = 0.024). No significant differences in overall survival (OS) were observed between the groups (p = 0.896). Tumor location, metastatic status, and UICC stage were significant predictors for both endpoints in univariate analysis. However, none of these association were confirmed in multivariate analyses. Conclusions: Very close surgical margins (<1 mm) may increase the risk of local recurrence in high-grade osteosarcoma; however, they do not appear to affect overall survival. Full article

The berth allocation and crane assignment problem (BACAP) is a key challenge in port logistics, particularly under dynamic and uncertain vessel arrival conditions. To address the limitations of existing methods in handling large-scale and high-disturbance scenarios, this paper proposes a novel optimization framework: Ternary Historical Memory-based Robust Clustered Particle Swarm Optimization (THM-RCPSO). In this method, the initial particle swarm is divided into multiple clusters, each conducting local searches to identify regional optima. These clusters then exchange information to iteratively refine the global best solution. A ternary historical memory mechanism further enhances the optimization by recording and comparing the best solutions from three different strategies, ensuring guidance from historical performance during exploration. Experimental evaluations on 25 dynamic BACAP benchmark instances show that THM-RCPSO achieves the lowest average vessel dwell time in 22 out of 25 cases, with the lowest overall average rank among five tested algorithms. Specifically, it demonstrates significant advantages on large-scale instances with 150 vessels, where it consistently outperforms competing methods such as HRBA, ACO, and GAMCS in both solution quality and robustness. These results confirm THM-RCPSO’s strong capability in solving dynamic and large-scale DBACAP scenarios with high disturbance levels. Full article

Background/Objectives: Inflammation-based markers have emerged as potential prognostic tools in hepatocellular carcinoma (HCC), but comparative data with classical prognostic factors in untreated HCC are limited. This study aimed to evaluate and compare the prognostic performance of inflammatory and conventional markers using Harrell’s concordance index (C-index). Methods: This retrospective study included 250 patients with untreated HCC. Prognostic variables included age, BCLC stage, Child–Pugh classification, Milan criteria, MELD score, AFP, albumin, Charlson comorbidity index, and the inflammation-based markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), Systemic Inflammation Response Index (SIRI), and Systemic Immune-inflammation Index (SIII). Survival was analyzed using Cox regression. Predictive performance was assessed using the C-index, Akaike Information Criterion (AIC), and likelihood ratio tests. Results: Among the classical markers, BCLC showed the highest predictive performance (C-index: 0.717), while NLR ranked highest among the inflammatory markers (C-index: 0.640), above the MELD score and Milan criteria. In multivariate analysis, NLR ≥ 2.3 remained an independent predictor of overall survival (HR: 1.787; 95% CI: 1.264–2.527; p < 0.001), along with BCLC stage, albumin, Charlson index, and Milan criteria. Including NLR in the model modestly improved the C-index (from 0.781 to 0.794) but significantly improved model fit (Δ–2LL = 10.75; p = 0.001; lower AIC). Conclusions: NLR is an accessible, cost-effective, and independent prognostic marker for overall survival in untreated HCC. It shows discriminative power comparable to or greater than most conventional predictors and may complement classical stratification tools for HCC. Full article

We report an investigation on the cobalt(II) chelation mechanism by a modified α-maltoside ligand 9 decorated with two iminodiacetate (IDA) residues on C6,C6′ positions. Herein we uncovered the capacity of this biodegradable ligand to chelate cobalt(II), an ionic metal contaminant in the environment that is used, in particular, in lithium-ion batteries. The interactions between cobalt(II) and synthesized ligand 9 were systematically studied using different analytical methods such as ¹H and ¹³C NMR, potentiometry, spectrophotometry, ITC, and ICP-AES. We observed a high affinity for the 1:1 complex, one cobalt(II) associated with two iminodiacetate groups, which is 10-fold higher than the 2:1 complex, where each of the two IDA groups interacts alone with a cobalt(II). Taking into account the log β_CoL value obtained (≈12.3) with the stoichiometry 1:1, the strength of this complexation with cobalt(II) can be ranked as follows for the most common ligands: IDA < MIDA < NTA < 9 < EDTA < TTHA < DTPA. We further completed a preliminary remediation test with water contaminated with cobalt(II) and recovered cobalt(II) metal using Chelex^® resin, which allowed a recycling of the synthetic ligand for future recovering experiments. The results shed light on the great potential of using this synthetic ligand as an effective and green remediation tool. Full article

Background: The purpose of this study was to evaluate Achilles tendon ruptures (ATR) in NHL players and the effects on return to play and player performance metrics. The incidence, mechanism of injury, management strategy, return to play (RTP), and post-injury were assessed from official online sports databases. Methods: A retrospective review of NHL players who sustained a partial or complete tear of the Achilles tendon from 2008 to 2024 was performed. Data were collected from NHL injury databases and media reports, and included player demographics, injury mechanism, treatment, and post-injury performance metrics. A Wilcoxon signed rank test was used to compare pre-injury and post-injury performance metrics, with significance set at p < 0.05. Results: Here, 15 NHL players with a mean age of 27.8 years were identified, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. Overall, 73.3% of ATRs were non-contact in nature, with 60.0% of ATRs occurring during off-season training. Fourteen players were managed with non-operative treatment, with no re-ruptures reported. The RTP rate was 93.3%, with players missing a mean number of 45.7 games. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury. Conclusions: This study found that Achilles tendon ruptures are an uncommon injury in NHL players, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. A high RTP rate of 93.3% was observed in this cohort. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury, highlighting the potential devastating sequelae of ATRs in elite NHL athletes. Full article

As large language models (LLMs) increasingly enter specialized domains, inference without external resources often leads to knowledge gaps, opaque reasoning, and hallucinations. To address these challenges in power equipment defect grading, we propose a zero-shot question-answering framework that requires no task-specific examples. Our system performs two-stage retrieval—first using a Sentence-BERT model fine-tuned on power equipment maintenance texts for coarse filtering, then combining TF-IDF and semantic re-ranking for fine-grained selection of the most relevant knowledge snippets. We embed both the user query and the retrieved evidence into a Chain-of-Thought (CoT) prompt, guiding the pre-trained LLM through multi-step reasoning with self-validation and without any model fine-tuning. Experimental results show that on a held-out test set of 218 inspection records, our method achieves a grading accuracy of 54.2%, which is 6.0 percentage points higher than the fine-tuned BERT baseline at 48.2%; an Explanation Coherence Score (ECS) of 4.2 compared to 3.1 for the baseline; a mean retrieval latency of 28.3 ms; and an average LLM inference time of 5.46 s. Ablation and sensitivity analyses demonstrate that a fine-stage retrieval pool size of k = 30 offers the optimal trade-off between accuracy and latency; human expert evaluation by six senior engineers yields average Usefulness and Trustworthiness scores of 4.1 and 4.3, respectively. Case studies across representative defect scenarios further highlight the system’s robust zero-shot performance. Full article

This study proposes a novel metaheuristic algorithm, Cosmic Evolution Optimization (CEO), for numerical optimization and engineering design. Inspired by the cosmic evolution process, CEO simulates physical phenomena including cosmic expansion, universal gravitation, stellar system interactions, and celestial orbital resonance.The algorithm introduces a multi-stellar framework system, which incorporates search agents into distinct subsystems to perform simultaneous exploration or exploitation behaviors, thereby enhancing diversity and parallel exploration capabilities. Specifically, the CEO algorithm was compared against ten state-of-the-art metaheuristic algorithms on 29 typical unconstrained benchmark problems from CEC2017 across different dimensions and 13 constrained real-world optimization problems from CEC2020. Statistical validations through the Friedman test, the Wilcoxon rank-sum test, and other statistical methods have confirmed the competitiveness and effectiveness of the CEO algorithm. Notably, it achieved a comprehensive Friedman rank of 1.28/11, and the winning rate in the Wilcoxon rank-sum tests exceeded 80% in CEC2017. Furthermore, CEO demonstrated outstanding performance in practical engineering applications such as robot path planning and photovoltaic system parameter extraction, further verifying its efficiency and broad application potential in solving real-world engineering challenges. Full article

Background/Objectives: Aging is associated with a gradual decline in physical capabilities, often leading to impaired balance and reduced functional status, which are major contributors to falls in older adults. Although many studies have assessed these variables independently, a limited amount of research has explored the direct relationship between balance and functional status in a healthy geriatric population. The aim of this study was to investigate the relationship between balance and functional capacity and to assess the influence of demographic factors such as age, comorbidities, smoking status, and history of falls. Methods: A sample of community-dwelling older adults (19 women, 16 men) (n = 35), aged 60 years and above (M = 78 years; SD = 9.23) from Sparta, Greece, took part in the present study. Participants were assessed using three validated tools: (a) the Five Times Sit-to-Stand test, (b) the Timed Up-and-Go test, and (c) the Berg Balance Scale. Spearman’s rank correlation coefficient was used for statistical analysis (α = 0.05). Results: Age was positively correlated with poorer performance in the Five Times Sit-to-Stand (r = 0.40; p < 0.01) and the Timed Up-and-Go test (r = 0.47; p < 0.01) and negatively correlated with Berg Balance Scale scores (r = −0.51; p < 0.01). Comorbidities and smoking were also associated with the Berg Balance Scale. A strong negative correlation was observed between balance and the other two functional tests (Five Times Sit-to-Stand: r = −0.51; Timed Up-and-Go: r = −0.66; both p < 0.01). Conclusions: The findings highlight the importance of evaluating both balance and functional capacity in older adults as interrelated factors that can significantly influence quality of life and fall risk. Future research with larger and more diverse populations is recommended to confirm the present findings and to use exercise programs to prevent falls in the geriatric population. Full article

The ongoing secular changes in human movement development means that an assessment of primitive reflexes is now required not only in disabled but also in neurotypical children. This study had three aims: (1) presenting the TASHUN test battery as suitable for the assessment of primitive reflex activity in normal children and child athletes; (2) analyzing reflex characteristics of neurotypical children; (3) verifying validity and reliability of tests. Spearman’s rank correlation and ROC analysis were used for validation. Intraclass Correlation Coefficient and RM ANOVA analyzed reliability. The test on 242 schoolgirls has demonstrated that retained primitive reflexes are present in almost every individual (84.7–95.7%). Correlations showed strong positive association, with all values exceeding 0.8, and ROC analysis demonstrated excellent predictive strength (AUC values over 0.9). Interobserver reliability showed excellent agreement (ICC values above 0.9). No significant offset was present among the scoring by evaluators. Therefore, testing for primitive reflexes is necessary in neurotypical children in order to obtain a realistic image about the physiology of reflexes and their role in motor development. Our screening could be useful for practicing sport professionals, researchers and academics, to identify deficiencies, to further explore reflexes and to train future PE teachers and trainers. Full article

Background: Patient survival after liver transplantation is lower in donor–recipient race mismatched patients for indications other than primary sclerosing cholangitis. Objectives: To determine if survival is lower after liver transplantation in donor–recipient race mismatched recipients with primary sclerosing cholangitis. Methods: The Organ Procurement and Transplantation Network database was analyzed for deceased donor adult liver transplant recipients with primary sclerosing cholangitis. Graft and patient survival by donor–recipient race were estimated using Kaplan–Meier survival method and compared using the log-rank test. Multivariable analysis was performed using Cox regression. Results: From 2002 to 2018, 5-year patient survival in White (n = 2223) and Black recipients (n = 491), was 89.8% and 87.1%, respectively. Five-year patient survival for the donor–recipient pairs, White–White (n = 1622), Black–Black (n = 110), Black–White (n = 335), and White–Black (n = 314) was 90.8%, 91.1%, 87.1%, and 86.0%, respectively, p = 0.026. In multivariable analysis, 5-year patient mortality was higher in Black recipients of White donors [HR 1.69, 95% CI 1.16, 2.45], compared to White recipients of White donors. Conclusions: Five-year patient mortality after deceased donor liver transplantation for primary sclerosing cholangitis is higher in Black recipients who received livers from White donors compared to matched White donors and recipients. Full article

Efficient and accurate panel assignment is critical in expert and peer review processes. Traditional methods—based on manual preferences or Heuristic rules—often introduce bias, inconsistency, and scalability challenges. We present an automated framework that combines transformer-based document similarity modeling with optimization-based reviewer assignment. Using the all-mpnet-base-v2 from model (version 3.4.1), our system computes semantic similarity between proposal texts and reviewer documents, including CVs and Google Scholar profiles, without requiring manual input from reviewers. These similarity scores are then converted into rankings and integrated into an Integer Linear Programming (ILP) formulation that accounts for workload balance, conflicts of interest, and role-specific reviewer assignments (lead, scribe, reviewer). The method was tested across 40 researchers in two distinct disciplines (Chemical Engineering and Philosophy), each with 10 proposal documents. Results showed high self-similarity scores (0.65–0.89), strong differentiation between unrelated fields (−0.21 to 0.08), and comparable performance between reviewer document types. The optimization consistently prioritized top matches while maintaining feasibility under assignment constraints. By eliminating the need for subjective preferences and leveraging deep semantic analysis, our framework offers a scalable, fair, and efficient alternative to manual or Heuristic assignment processes. This approach can support large-scale review workflows while enhancing transparency and alignment with reviewer expertise. Full article

Background: Angiosarcomas (ASs) represent a heterogeneous and highly aggressive subset of tumors that respond poorly to systemic treatments and are associated with short progression-free survival (PFS) and overall survival (OS). The aim of this study was to develop and validate an immune-related prognostic model—termed the AS score—using data from two independent sarcoma cohorts. Methods: A prognostic model was developed using a previously characterized cohort of 25 angiosarcoma samples. Candidate genes were identified via the Maxstat algorithm (Maxstat v0.7-25 for R), combined with log-rank testing. The AS score was then computed by weighing normalized gene expression levels according to Cox regression coefficients. For external validation, transcriptomic data from TCGA Sarcoma cohort (n = 253) were analyzed. The Immunoscore—which reflects the tumor immune microenvironment—was inferred using the ESTIMATE package (v1.0.13) in R. All statistical analyses were performed in RStudio (v 4.0.3). Results: Four genes—IGF1R, MAP2K1, SERPINE1, and TCF12—were ultimately selected to construct the prognostic model. The resulting AS score enabled the classification of angiosarcoma cases into two prognostically distinct groups (p = 0.00012). Cases with high AS score values, which included both cutaneous and non-cutaneous forms, exhibited significantly poorer outcomes, whereas cases with low AS scores were predominantly cutaneous. A significant association was observed between the AS score and the Immunoscore (p = 0.025), with higher Immunoscore values found in high-AS score tumors. Validation using TCGA sarcoma cohort confirmed the prognostic value of both the AS score (p = 0.0066) and the Immunoscore (p = 0.0029), with a strong correlation between their continuous values (p = 2.9 × 10⁻⁸). Further survival analysis, integrating categorized scores into four groups, demonstrated robust prognostic significance (p = 0.00021). Notably, in tumors with a low Immunoscore, AS score stratification was not prognostic. In contrast, among cases with a high Immunoscore, the AS score effectively distinguished outcomes (p < 0.0001), identifying a subgroup with poor prognosis but potential sensitivity to immunotherapy. Conclusions: This combined classification using the AS score and Immunoscore has prognostic relevance in sarcoma, suggesting that angiosarcomas with an immunologically active microenvironment (high Immunoscore) and poor prognosis (high AS score) may be prime candidates for immunotherapy and this approach warrants prospective validation. Full article

Polysaccharides and phenols are commonly co-localized in various plant-derived foods, including highland barley (Hordeum vulgare L. var. nudum Hook. f.). The interactions between these compounds can influence multiple characteristics of food products, including their physicochemical properties and functional performance, such as bioavailability, stability, and digestibility, which may support promising application of the phenol and polysaccharide complex in health food industry. In this study, two complexes with potential existence in highland barley, such as β-glucan-ferulic acid (GF) and β-glucan-quercetin (GQ), were prepared using the equilibrium dialysis method in vitro. FTIR and SEM results showed that ferulic acid and quercetin formed complexes with β-glucan separately, with covalent and non-covalent bonds and a dense morphological structure. The pH value, reaction temperature, and concentration of phosphate buffer solution (PBS) were confirmed to have an impact on the formation and yield of the complex. Through the test of the response surface, it was found that the optimum conditions for GF and (GQ) preparations were a pH of 6.5 (6), a PBS buffer concentration of 0.08 mol/L (0.3 mol/L), and a temperature of 8 °C (20 °C). Through in vitro assays, GF and GQ were found to possess good antioxidant activity, with a greater scavenging effect of DPPH, ABTS, and hydroxyl radical than the individual phenolic acids and glucans, as well as their physical mixtures. Taking GF as an example, the DPPH radical scavenging capacity ranked as GF (71.74%) > ferulic acid (49.50%) > PGF (44.43%) > β-glucan (43.84%). Similar trends were observed for ABTS radical scavenging (GF: 54.56%; ferulic acid: 44.37%; PGF: 44.95%; β-glucan: 36.42%) and hydroxyl radical elimination (GF: 39.16%; ferulic acid: 33.06%; PGF: 35.51%; β-glucan: 35.47%). In conclusion, the convenient preparation method and excellent antioxidant effect of the phenol–polysaccharide complexes from highland barley provide new opportunities for industrial-scale production, development, and design of healthy food based on these complexes. Full article