Search Results (14,921)

Background and Objective: Patients with stage III clear cell renal cell carcinoma (ccRCC) have a high risk for disease recurrence post-nephrectomy. To mitigate overtreatment, there is a pressing need to determine who benefits from immune checkpoint inhibition (ICI) around the time of surgical resection. We performed digital spatial analysis of both gene and protein expression in stage III ccRCC tumors, some of which had preoperative ICI exposure. Methods: Nephrectomy specimens from stage III ccRCC patients were analyzed using the Nanostring GeoMx Digital Spatial Profiler. Differential expression analysis was performed and validated using NCT02210117 trial data to identify genes associated with both ICI and clinical response. A gene score was then generated to predict overall survival in patients from The Cancer Genome Atlas (TCGA). Key Findings and Limitations: In a small cohort of 19 patients, RNA expression significantly differed based on preoperative ICI exposure and recurrence status—CD8+ effector and central-memory T-cell signatures were less prevalent in the treatment-naïve with recurrence group. Three out of four patients with preoperative immune checkpoint inhibition recurred. External validation yielded a four-gene set (GZMK, GZMA, ITGAL, and IL7R), where higher expression levels predicted better overall survival in the TCGA cohort (p = 0.005). Conclusions and Clinical Implications: Preoperative ICI favorably altered the tumor microenvironment to resemble that of treatment-naïve patients without recurrence but did not translate to improved survival. Upon external validation, the genes GZMK, GZMA, ITGAL, and IL7R were modifiable with ICI and associated with improved overall survival. Further investigation is needed to assess if patients with low baseline expression of these genes may benefit from ICI around the time of surgery. Full article

Introduction: The health care burden of chronic hepatis B virus (CHB) infection can be reduced by appropriate workup, treatment, and monitoring. Methods: As a primary objective, we determined whether adequate initial hepatitis B virus (HBV) laboratory workup in CHB patients is associated with improved CHB complications risk. Secondary outcomes assessed included: mortality, hospitalization, emergency department, and liver specialist visits. We conducted a retrospective cohort study from 1 January 2012 to 31 December 2018. Participants were followed from 12 months post index event until outcome occurrence, death, loss of eligibility, or 31 March 2023. Health administrative data from Ontario, Canada was utilized. The study cohort included individuals with at least one positive result of either hepatitis B surface antigen, hepatitis B e antigen, or HBV DNA viral load documented during the study window. The exposure of interest was defined as adequate laboratory workup, defined as having subsequent quantitative HBV DNA, and alanine aminotransferase testing completed within 12 months of the index event. CHB-related complications were assessed using previously validated diagnostic codes. Modified Poisson regression modelling was used to estimate relative risks. Results: The study cohort consisted of 30,794 CHB patients, with a mean age 45.7 years. The majority were male (53.5%) and within the lowest two income quintiles (50.2%). In total, 68.0% underwent adequate workup. Individuals with adequate workup were more likely to be older, male, urban based, and of the highest racialized and newcomer populations quintile. The risk for CHB complications was 1.50 (95% CI 1.36–1.65) times greater among those with adequate workup. By multivariable analysis, adequate workup was associated with a lower risk of mortality (RR 0.78; 95% CI 0.69–0.87), all-cause hospitalizations (RR 0.77; 95% CI 0.74–0.80), all-cause (RR 0.77; 95% CI 0.75–0.78), and liver-related (RR 0.67; 95% CI 0.60–0.75) ED visits. Conclusions: Adequate CHB clinical workup is associated with improved patient outcomes. Our findings advocate for the comprehensive evaluation of CHB patients using key laboratory tests to optimize clinical management and improve long-term health outcomes. We identified gaps in the workup of young adults, females, and those residing in rural settings, which should be addressed to ensure equity of HBV care. Full article

This observation-based and explainable approach demonstrates the applicability of multi-source remote sensing for flood assessment in data-scarce regions, offering a robust scientific basis for flood management and spatial planning in monsoon-affected areas. Floods are among the most frequent and devastating natural hazards, particularly in developing countries such as Myanmar, where monsoon-driven rainfall and inadequate flood-control infrastructure exacerbate disaster impacts. This study presents a satellite-driven and interpretable framework for high-resolution flood susceptibility and risk assessment by integrating multi-source remote sensing and geospatial data with ensemble machine-learning models—Extreme Gradient Boosting (XGBoost) and Light Gradient Boosting Machine (LightGBM)—implemented on the Google Earth Engine (GEE) platform. Eleven satellite- and GIS-derived predictors were used, including the Digital Elevation Model (DEM), slope, curvature, precipitation frequency, the Normalized Difference Vegetation Index (NDVI), land-use type, and distance to rivers, to develop flood susceptibility models. The Jenks natural breaks method was applied to classify flood susceptibility into five categories across Myanmar. Both models achieved excellent predictive performance, with area under the receiver operating characteristic curve (AUC) values of 0.943 for XGBoost and 0.936 for LightGBM, effectively distinguishing flood-prone from non-prone areas. XGBoost estimated that 26.1% of Myanmar’s territory falls within medium- to high-susceptibility zones, while LightGBM yielded a similar estimate of 25.3%. High-susceptibility regions were concentrated in the Ayeyarwady Delta, Rakhine coastal plains, and the Yangon region. SHapley Additive exPlanations (SHAP) analysis identified precipitation frequency, NDVI, and DEM as dominant factors, highlighting the ability of satellite-observed environmental indicators to capture flood-relevant surface processes. To incorporate exposure, population density and nighttime-light intensity were integrated with the susceptibility results to construct a natural–social flood risk framework. This observation-based and explainable approach demonstrates the applicability of multi-source remote sensing for flood assessment in data-scarce regions, offering a robust scientific basis for flood management and spatial planning in monsoon-affected areas. Full article

This study presents a validated framework to quantify regional sea-level risk on U.S. coasts by (i) extracting trends and seasonality from satellite altimetry (ADT, GMSL), (ii) learning regional dynamical regimes via PCA-embedded KMeans on gridded ADT time series, and (iii) coupling these regimes with socioeconomic exposure (population, income, ocean-sector employment/GDP) and wetland submersion scoring. Relative to linear and ARIMA/SARIMA baselines, a sinusoid+trend fit and an LSTM forecaster reduce out-of-sample error (MAE/RMSE) across the North Atlantic, North Pacific, and Gulf of Mexico. The clustering separates high-variability coastal segments, and an interpretable submersion score integrates elevation quantiles and land cover to produce ranked adaptation priorities. Overall, the framework converts heterogeneous physical signals into decision-ready coastal risk tiers to support targeted defenses, zoning, and conservation planning. Full article

The principal global sources of platinum-group elements (Os, Ir, Ru, Rh, Pt, Pd), collectively referred to as PGEs, are magmatic Ni-Cu sulfide deposits associated with large, layered intrusions, such as the Bushveld Complex. Recent exploration efforts have identified rock types with elevated PGE concentrations, although their potential remains uncertain. This comprehensive review synthesizes the current knowledge regarding potential sources from both natural magmatic and anthropogenic activities, as well as the environmental risks associated with the Pt, Pd, and Rh sub-group, or PPGEs. The order of Pd > Pt > Rh content in emitted particulates has been documented in dust and soil along roadsides, whereas in Fe-Ni laterite, Pt tends to accumulate residually at the top of profiles due to the higher mobility of Pd compared to Pt and Rh. The greater mobility and transfer of Pd are evidenced by higher bioaccumulation factors for Pd in plants and crops, with a higher Pd content observed in roots than in shoots. The effects of chronic occupational exposure to Pt compounds, such as allergic reactions affecting the skin and respiratory system of workers, are well-documented. Although no established permissible limits for Pt, Pd, and Rh in soil, water, or plants exist within major regulatory frameworks, the increasing applications of PPGEs and the use of Pd in catalytic converters (due to its lower cost) underscore the need for further studies on the recycling of spent catalytic converters, health impacts, ecotoxicological assessments, and the application of current technological advances to mitigate exhaust emissions. Full article

In today’s volatile digital environments, conventional data governance practices fail to adequately address the dynamic, context-sensitive, and risk-hazardous nature of data use. This paper introduces DRADG (Dynamic Risk-Adaptive Data Governance), a new paradigm that unites risk-aware decision-making with adaptive data governance mechanisms to enhance resilience, compliance, and trust in complex data environments. Drawing on the convergence of existing data governance models, best practice risk management (DAMA-DMBOK, NIST, and ISO 31000), and real-world enterprise experience, this framework provides a modular, expandable approach to dynamically aligning governance strategy with evolving contextual factors and threats in data management. The contribution is in the form of a multi-layered paradigm combining static policy with dynamic risk indicator through application of data sensitivity categorization, contextual risk scoring, and use of feedback loops to continuously adapt. The technical contribution is in the governance-risk matrix formulated, mapping data lifecycle stages (acquisition, storage, use, sharing, and archival) to corresponding risk mitigation mechanisms. This is embedded through a semi-automated rules-based engine capable of modifying governance controls based on predetermined thresholds and evolving data contexts. Validation was obtained through simulation-based training in cross-border data sharing, regulatory adherence, and cloud-based data management. Findings indicate that DRADG enhances governance responsiveness, reduces exposure to compliance risks, and provides a basis for sustainable data accountability. The research concludes by providing guidelines for implementation and avenues for future research in AI-driven governance automation and policy learning. DRADG sets a precedent for imbuing intelligence and responsiveness at the heart of data governance operations of modern-day digital enterprises. Full article

Traditional chemical analysis of plant tissue is time-consuming, costly, and poses risks due to exposure to toxic gases, highlighting the need for faster, low-cost, and safer alternatives. Vis-NIR spectroscopy, combined with machine learning, offers a promising method for estimating leaf nutrient levels without chemical reagents. This study evaluated the potential of Vis-NIR spectroscopy for nutrient estimation in leaf samples of banana (n = 363), mango (n = 239), and grapevine (n = 336) by applying spectral pre-processing techniques—smoothing (SMO) and first derivative Savitzky–Golay (SGD1d) alongside two machine learning methods: Partial Least Squares Regression (PLSR) and Random Forest (RF). Plant tissue samples were analyzed using sulfuric and nitroperchloric wet digestion and hyperspectral sensors. The prediction models were assessed using concordance correlation coefficient (CCC) and mean squared error (MSE). The highest accuracy (CCC > 0.80 and MSE < 2 g kg⁻¹) was achieved for Ca in banana, P in mango, and N and Ca in grapevine across both machine learning methods and pre-processing techniques. The predictive models calibrated for ‘Grapevine’ exhibited the highest accuracy—characterized by higher CCC values and lower MSE values—when compared with the models developed for ‘Mango’ and ‘Banana’. Models using SMO and SGD1d showed better performance than those using raw spectra (RAW). The high amplitudes and variations in nutrient levels, combined with large standard deviations, negatively affected the predictive performance of the models. Full article

Background: Microvascular osseous free flaps play a central role in head and neck reconstruction; surgeons often rely on fragmented and inconsistently reported data when counselling patients and planning reconstructive strategies. This systematic review and meta-analysis aimed to quantify postoperative complication rates and to evaluate complication patterns according to flap type. Methods: The study protocol was registered in PROSPERO (CRD420251237516). Studies published between January 2000 and November 2025 reporting postoperative complications following mandibular or maxillary reconstruction with osseous free flaps were identified. Eligible studies included adult cohorts with a minimum sample size of twenty patients. Random-effects meta-analyses of proportions were conducted. Risk of bias was assessed using the ROBINS-I tool. Results: Fourteen retrospective studies encompassing 1198 flaps were included. The pooled incidence of total flap loss was 6% (95% CI 3–9%), and partial flap loss was 6% (95% CI 3–10%). The pooled rates for postoperative infection, fistula formation, and wound dehiscence were 7% (95% CI 2–22%), 12% (95% CI 7–20%), and 16% (95% CI 8–31%), respectively, with substantial heterogeneity. Fibular free flaps demonstrated pooled rates of 6.1% for total flap loss, 6.6% for partial flap loss, 9.0% for infection, 10.4% for fistula formation, and 17.1% for wound dehiscence. For scapular free flaps, pooled total flap loss was 5% (95% CI 1–29%). DCIA flaps demonstrated hardware-related complications (8.1%), fistulas (16.7%), bone exposure (4.2%), and wound dehiscence (29.7%). Donor site morbidity was inconsistently reported and could not be quantitatively synthesized. Conclusions: Osseous free flap reconstruction shows relevant complication rates, highlighting the need for standardized reporting to support evidence-based decision-making. Full article

(1) Background: Listeria monocytogenes (Lm) is recognized by the World Health Organization (WHO) as one of the four principal foodborne pathogens. This study aimed to investigate the molecular characteristics of Lm isolates from Jiaxing, China, using whole-genome sequencing (WGS) to enhance our understanding of their molecular epidemiology. (2) Methods: A total of 39 foodborne Lm isolates and 7 clinical Lm isolates were analyzed via WGS to identify resistance genes, virulence factors, lineage, sequence type (ST), and clonal complex (CC). Antibiotic susceptibility was assessed using Minimum Inhibitory Concentration (MIC) testing, and serotypes were confirmed via multiplex PCR. (3) Results: We found that 39 food isolates were mainly lineage II (66.67%), with 13 STs; ST8 was the dominant ST, and 2 new types, ST3210 and ST3405, were found. Among the seven clinical isolates, lineage I was dominant (57.14%), and ST87 was the dominant ST. Serotype 1/2a was dominant, accounting for 54.35%, followed by 1/2b, which accounted for 36.96%. The overall antimicrobial resistance rate was 13.04%, with a multidrug resistance rate of 2.17%. All strains harbored LIPI-1 and LIPI-2, and five strains carried LIPI-3 genes: one strain belonged to ST619 of lineage I, two strains belonged to ST224 of lineage I, and two strains belonged to ST11 of lineage II. (4) Conclusions: This study clarified the genotype and serotype characteristics of Listeria monocytogenes in Jiaxing, as well as their molecular characteristics relating to drug resistance and virulence, thus providing a technical basis for improving exposure risk assessment of Listeria monocytogenes. Continuous monitoring, prevention, and control are recommended to further improve regional public health and safety. Full article

Titanium dioxide (TiO₂) nano- and submicrometric particles’ widespread use in different sectors raised concerns about human and environmental exposure. The validation of analytical methods is essential to ensure reliability in risk assessment studies. In this study, a single-particle inductively coupled plasma mass spectrometry (spICP-MS) method was validated for the detection, quantification, and dimensional characterization of TiO₂ particles in biological tissues. Tissue samples collected after exposure to TiO₂ particles underwent mild acidic digestion using a HNO₃/H₂O₂ mixture to achieve complete matrix decomposition while preserving particle integrity. The resulting digests were analyzed by ICP-MS operated in single-particle mode to quantify and size TiO₂ particles. Method validation was conducted according to ISO/IEC 17025:2017 and included linearity, repeatability, recovery, and detection limit assessments. The limit of detection for TiO₂ particles was 0.04 µg/g, and 55.7 nm was the size the detection limit. Repeatability was within 0.5–11.5% for both TiO₂ mass concentrations and particle size determination. The validated method was applied to tissues from inhalation-exposed subjects, showing TiO₂ levels of 80 ± 20 µg TiO₂/g and particle number concentrations of 5.0 × 10⁵ ± 1.2 × 10⁵ part. TiO₂/mg. Detected TiO₂ particles’ mean diameter ranged from 230 to 330 nm. The developed and validated spICP-MS method provides robust and sensitive quantification of TiO₂ particles in biological matrices, supporting its use in human biomonitoring and exposure assessment studies. Full article

Background: Presence of milk, fruits, eggs, fish, nuts and wheat antigens in the amniotic fluid is described in the literature. Studies show a contradictory relationship between maternal exposure to allergens and early sensitization of the fetus to allergens. Hemochorionic type of the human placenta allows for easier transfer of nutrients and antibodies from the mother’s blood to the fetal circulation through the direct contact of maternal blood with the fetal chorion. During the third trimester of pregnancy, immunoglobulin G (IgG) is actively transferred through the placenta into the fetal via neonatal FcRN receptor (FcRN). In addition, monomeric immunoglobulin E (IgE) cannot cross the placenta Aim: The objective of our study is to track intrauterine sensitization to essential food proteins at birth in umbilical cord blood in mothers with established peripheral blood eosinophilia and in their infants using allergen-specific IgE and IgG. Methods: An observational study was carried out in a cohort of 22 mothers with eosinophilia and their babies. Differences in expression between groups were assessed. Blood samples were collected to determine serum IgE and IgG specific to a set of inhalant and food allergens. Results: We did not find a significant correlation between specific IgE to cow’s milk (p = 0.857), egg white (p = 0.926) and egg yolk (p = 0.096) in umbilical cord blood and maternal blood samples taken immediately before birth. Spearman’s correlation of the specific IgE and IgG in umbilical cord blood showed no dependence between the two variables. In contrast, statistical analysis showed that maternal eosinophilia in peripheral blood could be a risk factor for the development of allergy in the offspring (χ², p = 0.0347). However, given the small number of patients, this claim needs to be confirmed with further studies. Conclusions: Due to the functional immaturity of the developing immune system of the fetus, the generation and maintenance of an independent immune response to allergens are incomplete. Maternal IgG (specific) passes to the baby and high maternal IG to a specific allergen reduces babies IgE production. In addition, low maternal specific IgG may promote IgE production in the baby under the influence of microenvironmental factors (cytokine background). The main limitation of our study is the small number of patients. Further research is needed in this direction to clarify the mechanisms and risk factors for early sensitization in newborns. Full article

Background: Fungal infection of pancreatic fluid collections (PFCs) in severe acute pancreatitis (SAP) is under-recognized and associated with poor outcomes. Overlap with bacterial infections and the need for invasive sampling often delay diagnosis, leading to prolonged antibiotic use without the use of antifungal agents. Methods: We report three cases of SAP complicated by fungal infection of PFCs. Two patients, one with alcohol-related pancreatitis and the other with biliary pancreatitis, developed symptomatic encapsulated necrosis. Both were successfully managed with endoscopic drainage and targeted antifungal therapy against Candida albicans, achieving full resolution. The third patient, with necrotizing biliary pancreatitis, underwent multiple surgical and endoscopic interventions and developed an infection with a non-albicans Candida species. Reduced susceptibility requires individualized antifungal adjustment guided by susceptibility testing. Despite aggressive multimodal therapy, the patient progressed to multiorgan failure and died subsequently. Results: These cases emphasize the clinical impact of fungal infections in patients with SAP, particularly their association with severe disease, prolonged hospitalization, and prior antibiotic exposure. These findings highlight the prognostic value of early microbiological sampling, species-level identification, and prompt initiation of antifungal therapy. Infections caused by non-albicans species pose additional challenges due to their reduced sensitivity to standard antifungal agents. Conclusions: Fungal infection of PFCs is a clinically significant and frequently underestimated complication of SAP. Early recognition and species-directed antifungal therapy are critical for improving outcomes in high-risk patients. Full article

Gammaretroviruses are ubiquitous pathogens, often associated with the induction of neoplasia, especially leukemia, lymphoma, and sarcoma, and with a propensity to target the germline. The latter trait has left extensive evidence of their infectious competence in vertebrate genomes, the human genome being no exception. Despite the continuing activity of gammaretroviruses in mammals, including Old World monkeys, apes, and gibbons, humans have apparently evaded novel infections by the virus class for the past 30 million years or so. Nevertheless, from the 1970s onward, cell culture studies repeatedly discovered gammaretroviral components and/or virus replication in human samples. The last novel ‘human’ gammaretrovirus, identified in prostate cancer tissue, culminated in the XMRV frenzy of the 2000s. In the end, that discovery was shown to be due to lab contamination with a murine gammaretrovirus. Contamination is also the likely source of the earlier findings. Complementation between genes of partially defective endogenous proviruses could have been another source of the virions observed. However, the capacity of many gammaretroviruses to replicate in human cell lines, as well as the presence of diverse infectious gammaretroviral species in our animal companions, for instance in mice, cats, pigs, monkeys, chickens, and bats, does not make a transmission to humans an improbable scenario. This review will summarize evidence for, or the lack of, gammaretrovirus infections in humans in the past, present, and near future. Aspects linked to the probabilities of novel gammaretrovirus infections in humans, regarding exposure risk in connection to modern lifestyle, geography, diet, and habitat, together with genetic and immune factors, will also be part of the review, as will be the estimated consequences of such novel infections. Full article

Selenium (Se) is an antioxidant essential trace element influencing inflammatory and immune pathways. This systematic review aimed to evaluate the role of maternal Se status during pregnancy in miscarriage risk. A systematic search of PubMed and Embase up to July 2024 was conducted to identify relevant original research studies in English. Available evidence was qualitatively synthesized and predefined sources of bias were assessed. Of 2345 studies identified, 421 full texts were assessed and 14 were included, encompassing 2309 pregnancies. Despite notable methodological limitations across several studies, current evidence indicates that maternal blood Se concentrations are lower among women who experience miscarriage compared to those with uncomplicated pregnancies. Findings regarding placental Se levels were inconsistent, but important methodological issues were noted. Environmental Se exposure was investigated in a single low-powered study, which did not demonstrate a statistically significant association. Potential interactions between Se status, co-exposure to other environmental or lifestyle factors, and effect modification remain insufficiently explored. Adequate maternal Se status during early gestation may reduce miscarriage risk by mitigating oxidative stress and ferroptosis, supporting immune regulation, and modulating thyroid autoimmunity and function. However, causal inference cannot be established due to the absence of randomized interventional evidence. Full article

Metabolic bariatric surgery (MBS) induces substantial metabolic, inflammatory, and nutritional changes that can alter hemostatic balance through redox-dependent mechanisms. This systematic review evaluated coagulation disturbances after MBS with emphasis on oxidative stress and micronutrient deficiencies. A structured search of PubMed, Scopus, and Web of Science (2000–2025) identified 1707 records; 21 studies met inclusion criteria. Available evidence suggests that although MBS reduces obesity-related inflammation and oxidative burden in many patients, a proportion of individuals may present with persistent redox imbalance, elevated D-dimer or vWF (von Willebrand Factor), and delayed normalization of fibrinolysis. Micronutrient deficiencies—particularly vitamins K, B12, folate, selenium, zinc, and copper—are common after malabsorptive procedures and contribute to both thrombotic and hemorrhagic complications by impairing antioxidant defenses, endothelial function, and vitamin K-dependent coagulation pathways. Postoperative venous thromboembolism (VTE) incidence ranges from 0.3 to 0.5%, with higher risk after Roux-en-Y gastric bypass than sleeve gastrectomy, while bleeding is primarily associated with vitamin K deficiency, marginal ulcers, and anticoagulant exposure. The findings underscore the interdependence of oxidative stress, nutritional status, and hemostasis after MBS. Individualized thromboprophylaxis, routine detection of micronutrient deficiencies, and long-term biochemical monitoring are essential to maintain hemostatic stability. Standardized redox–hemostasis biomarker panels are needed to clarify mechanistic pathways and improve postoperative preventive strategies. Full article