Search Results (1,005)

Upper tract urothelial carcinoma (UTUC) is a relatively rare malignancy, far less frequent than its counterpart in the bladder, but with a more aggressive course, worse prognosis and unique diagnostic challenges. Despite the histological and molecular similarities between upper and lower tract urothelial tumours, UTUC has many key distinct traits, both clinical and genomic, and must be viewed as a separate entity from bladder urothelial carcinoma (BUC). Ureteroscopy with biopsy is the only means to obtain tissue for histo-logical confirmation of diagnosis and more accurate tumour grading, but is not always feasible or preferable because it carries the risk of potentially severe complications. Aside from the widely available but poorly sensitive urine cytology, a large variety of urine-based diagnostics are increasingly investigated as non-invasive alternatives to ureteroscopy. Fluorescence in situ hybridization (FISH) is the most widely used molecular assay for the diagnosis and monitoring of UTUC, but has failed, as of yet, to display a comparable diagnostic accuracy to the existing gold standards of computed tomography urography (CTU) and ureteroscopy. We herein aimed to comprehensively review all published data on the performance of FISH for the detection of UTUC, in comparison to urine cytology and other assays, while further commenting on the existing challenges and future perspectives in the field of urine-based diagnostics. Across all studies (n = 29) which were included in this review, the sensitivity and specificity of FISH ranged from 36.8% to 100.0% (mean: 75.5%; median: 78.9%) and 34.4% to 100.0% (mean: 84.9%; median: 89.9%), respectively, in the overall patient population, while in the low- versus high-grade subgroups, the sensitivity of FISH ranged from 30.0% to 90.0% (mean: 55.6%; median: 60%) versus 50.0% to 100.0% (mean: 77.9%; median: 78.8%). Furthermore, FISH showed superi-or sensitivity and similar or lower specificity in comparison to cytology, in the over-whelming majority of studies, while Xpert^®BC Detection showed the highest sensitivity values among all evaluated assays, reaching 100% even in the low-grade subgroup, albeit at the cost of a significantly reduced specificity. Despite the adequate overall sensitivity and specificity of FISH, its suboptimal performance in the detection of low-grade UTUC seems to preclude its use as a stand-alone screening test. Full article

Transportation agencies receive large volumes of free-form public comments describing infrastructure conditions, safety concerns, and service issues. These comments are often processed manually for downstream operational actions, which is time-consuming, inconsistent across reviewers, and difficult to scale, thereby limiting their value for operational decision-making. This study presents a machine learning and Large Language Model (LLM) framework for automated triage of free-form public comments, assigning each report to a three-level hierarchical taxonomy consisting of Category, Subcategory, and Final Decision. The proposed framework uses agency historical data together with retrieval-based evidence, where semantically similar past comments are provided to the LLM as contextual support to better align predictions with agency-specific labeling practices. The framework was evaluated using TF-IDF with Logistic Regression, TF-IDF with Linear SVM, embedding-based kNN with cosine similarity, few-shot LLM prompting, and retrieval-based LLM prompting. Results show that retrieval-based prompting achieved the best overall performance, with the highest accuracy at both the Category and Subcategory levels. At the Final Decision level, retrieval-based prompting slightly outperformed kNN, while few-shot prompting performed worse. Error analysis showed that many misclassifications were semantically plausible alternatives, reflecting the overlap across infrastructure-related complaint categories. When a second candidate label was allowed, further improving performance. Latency analysis also indicated that the framework can process more than 2000 comments in under 30 min, supporting faster and more consistent agency workflows. Full article

We would like to express our sincere gratitude to the authors of the comment for their careful reading and insightful observations regarding our recently published review, “The Involvement of Resolvins in Pathological Mechanisms of Periodontal Disease Associated with Type 2 Diabetes: A Narrative Review” [...] Full article

Objective: Nutrition is a key determinant of women’s health across all life stages. Clinical practice remains heterogeneous because of lack of evidence and non-homogeneous guidelines. Despite growing research on micronutrient supplementation, skeptical opinions persist around universal versus individualized approaches, optimal dosages, and life-stage-specific recommendations. Material and methods: This is a modified Delphi process conducted under the supervision of the Italian Association of University Gynecologists and Obstetricians (AGUI). Thirteen Italian experts in gynecology and obstetrics completed two rounds of anonymous online surveys (September–November 2025). The questionnaire, developed through a scoping review, covered six domains: pre-/periconception, pregnancy, postpartum, routine supplementation in non-pregnant women, nutrition in gynecological conditions, and menopause. Consensus was defined as ≥75% agreement on a 10-point Likert scale. Quantitative data were summarized descriptively, and qualitative comments contextualized findings. Results: Experts strongly supported personalized nutritional strategies across all life stages. Consensus was reached on individualized micronutrient supplementation in the preconception period and on the prescription of active folates for women undergoing assisted reproduction. In pregnancy, agreement emerged for universal DHA supplementation (200–300 mg/day); however, universal vitamin D supplementation lacked consensus except in gestational diabetes. In the postpartum period, iron supplementation for non-breastfeeding women reached consensus, while micronutrient recommendations for breastfeeding women remained uncertain. Strong agreement supported personalized dietary approaches for PCOS, endometriosis, and gestational diabetes, including inositol use, while evidence for interventions in severe premenstrual syndrome remained insufficiently supported. In menopause, consensus was reached for macronutrient adjustments and universal calcium and vitamin D supplementation. Conclusions: This Delphi consensus highlights shared expert perspectives on nutritional care in women and identifies key evidence gaps, particularly regarding vitamin D in physiological pregnancy, postpartum micronutrient needs during breastfeeding, and nutritional strategies for premenstrual disorders. Unified life-course guidelines and future research on standardized nutritional assessments are necessary for nutritional approach management. Full article

Background/Objectives: The multifaceted concept of body image (BI) refers to an individual’s attitudes and impressions of their body. Negative BI is associated with a number of harmful health consequences, including obesity, eating disorders, and symptoms of sadness. The contemporary digital era, marked by the dominance of platforms, has brought about a considerable transformation in the landscape of BI issues. This study’s goal is to compile and assess the connections between social media (SM) use, body weight, and BI in adult populations. Methods: This is a narrative review that comprehensively searches across multiple academic databases, such as PubMed, Medline, Scopus, Web of Science, and Google Scholar. Studies that used SM (online blogs, microblogs, content communities, or social networking sites) for engagement (e.g., sharing, commenting, liking) or image-related activities (e.g., viewing, posting, or engaging with images) with healthy adults (aged 18–70 years) of any body mass index (BMI kg/m²) met the inclusion criteria. Included were observational and experimental studies that examined habitual SM use. Only peer-reviewed works published in English between 2015 and 2025 met the search criteria. Results: The currently available findings suggest that obese people are more dissatisfied with their bodies than people of normal weight, and obese women are more dissatisfied with their bodies than their peers of normal weight. Furthermore, experimental studies have demonstrated that immediate BI is adversely affected by acute exposure to idealized social media photographs. Conclusions: Policies should support specialized training that emphasizes a holistic approach to health and puts functionality and health above attractiveness. This training is crucial for dispelling weight-related stigmas and enabling healthcare providers to offer compassionate treatment that supports mental and physical health. Future research must concentrate on internalization and social pressure or reinforcement because these subjects have not gotten as much emphasis in prior studies. Such mechanism research could help better contextualize the role of recently introduced SM items. Full article

Arif and colleagues commented on our paper Fleifil et al. “DNAJB1-PKAc is expressed in Young Patients with Pediatric Liver Cancers and Enhances Carcinogenic Pathways” published in Cancers in 2024. In our paper, we examined expression of DNAJB1::PRKACA (DNAJB1-PKAc or J-PKAc) in the Bio Bank of HBL (Hepatoblastoma) and HCN-NOS (Hepatocellular Malignant Neoplasm, Not Otherwise Specified) tissue samples collected at CCHMC during the last five years. Our data demonstrated that DNAJB1::PRKACA was detected in approximately 70% of HBL/HCN-NOS patients, with varying expression levels. In the commentary, the authors reviewed their earlier data and found no evidence of the fusion DNAJB1-PKAc expression within their cohorts of HBL specimens. Based on these data, the authors stated that “…DNAJB1::PRKACA remains specific to fibrolamellar carcinoma among liver tumors and caution against its use as a diagnostic marker for hepatoblastoma without rigorous validation in external cohorts.” After reviewing the commentary, we are offering a response outlined below. Full article

While sustainability is set as a goal by a broad range of international organizations, its definition varies, and there is still a lack of practical criteria for product designers to evaluate the degree of (un)sustainability in the design phase. Life cycle assessment (LCA) can allow quantification of the environmental impacts of a product but is often carried out post-design, when the manufacturing process is already settled. Finally, while significant advances have been made towards standardizing LCA calculations by providing product category rules, large uncertainties remain in the calculation results due to a lack of transparency regarding the choices of databases, system boundaries, allocation, cut-off rules, and level of data granularity. A practical way to improve in those areas is to share with the semiconductor community a parametrizable life cycle inventory (LCI) model based on a target device to (1) identify knowledge gaps in LCA methods for such products, (2) identify the main process variables, and (3) provide a starting point for LCA calculations by the designers themselves. With this aim, a parametrizable cradle-to-gate manufacturing LCI model was developed based on the peer-reviewed process flow of a trench field-stop silicon insulated gate bipolar transistor (IGBT) semiconductor power device. The model allows computation of the environmental impacts of the IGBT manufacturing process based on different tunable parameters such as die size, wafer diameter, manufacturing yield, abatement efficiency, wafer fab throughput, wafer fab location, and associated electricity mix. Embedding a high level of data granularity, it helps identify, at elementary process levels, key environmental hotspots and associated technical levers for their reduction. Analysis of the IGBT manufacturing process tends to demonstrate the importance of an impact assessment approach considering multiple environmental categories, going beyond the sole focus on greenhouse gas emissions and accounting for potential transfers of impact. With an open-source mindset and in a continuous improvement prospective, the manufacturing inventory model and its associated tools are freely available from a public GitHub repository and open for comments and consolidation from users. Full article

Over the past 20 years, trends in the construction or renovation of football stadiums have undergone rapid transformation. Simple sports venues are constantly evolving into multifunctional facilities and play a decisive role in shaping cities’ image. To date, significant emphasis has been placed on developing stadiums as venues for sporting events, with a focus on supply-side perspectives, particularly in relation to design, marketing, and sustainability. However, we know relatively little about how the direct consumers of this product, the visitors to these facilities, experience and perceive these infrastructures, especially outside of match days. This paper follows a framework for researching this perspective, focusing on the services provided as key points of interest in stadium tourism, and on the written reactions on social networks. This framework is implemented by employing a set of well-known single-word themes, matching each review to these themes, and finally measuring the sentiment of the collected short texts as an implicit indicator of sentiment on the studied themes. Its realization is based on natural language processing, semantic similarity analysis, and sentiment evaluation to identify dominant themes, recurring lexical patterns, and emotional tones in visitor comments. The study concerns thirteen major European stadiums and reviews posted on Google and TripAdvisor. The research findings highlight the themes that shape a unique tourist experience, capturing tourist interests in stadium tourism in the post-COVID-19 era. Finally, the individual evaluation of the themes provides practical and clear tools for stadium managers, tourism operators, destination managers and legislators who seek to maximize visitor engagement and multiply the overall socio-economic value of these iconic infrastructures for the benefit of the wider urban environment that hosts them. Full article

In the context of rapid urban tourism expansion and the growing emphasis on equitable and sustainable transport development, understanding how transport systems support different types of attractions has become increasingly important. This study investigates how attraction hierarchy and functional type interact with public transport accessibility to shape urban tourism patterns and equity. Whereas prior work emphasizes objective metrics, the alignment between perceived accessibility and actual transport conditions remains understudied. Using Wuhan’s A-rated and popular unrated attractions as a case, we have developed an innovative “ objective–perceived coupling framework that integrates GIS network analysis, travel cost matrix, non-parametric testing, and online comment text mining methods to examine how scenic spot levels (A-level and unrated popular scenic spots) and functional types interact with the public transportation system from both objective and perceptual dimensions. Results show: (1) A-rated attractions cluster in suburbs with low accessibility, while unrated sites concentrate centrally with high rail-bus connectivity, revealing a “high-grade–low-accessibility” mismatch. (2) Accessibility varies by type: natural sites are lowest, cultural/leisure venues intermediate, and comprehensive sites highest due to multimodal hub proximity. (3) Sentiment and topic analyses based on transport-related review content suggest that some A-rated attractions receive less favorable evaluations of access conditions (e.g., transfers, waiting, last-mile walking, wayfinding, and parking), whereas many popular unrated sites are evaluated more positively in these transport-specific aspects. (4) Quadrant analysis shows many highly rated attractions fall into a “low objective–low perceived” disadvantage, while most unrated ones exhibit strong objective–perceived coupling. These findings underscore structural imbalances among administrative grading, attraction function, and transit provision, offering evidence for optimizing public transport service to tourist attractions. They help optimize the spatial structure of urban tourism, improve resource allocation efficiency, guide differentiated scenic spot development strategies, and promote sustainable and experience-oriented urban tourism governance. Full article