Search Results (2,819)

Background: Bayesian model-informed precision dosing (MIPD) is increasingly used to individualize drug therapy; therefore, this review aimed to identify and characterize its implementation in routine clinical practice. Methods: A focused systematic review was conducted. Web of Science Core Collection and PubMed were searched from inception to February 2026. Eligible studies were original research articles evaluating Bayesian MIPD in routine clinical practice using software platforms that supported dosing decisions. Data were synthesized descriptively. No formal risk-of-bias assessment was performed due to heterogeneity in study design. Results: Fifteen studies met the inclusion criteria. Anti-infective therapy predominated, particularly vancomycin (n = 11), with additional studies involving busulfan, mycophenolate mofetil, amikacin, and tobramycin. Commonly reported software platforms included InsightRx (n = 6) and DoseMeRx (n = 4), along with Abbottbase, NextDose, and ISBA. MIPD was mainly applied with therapeutic drug monitoring, reflecting predominant a posteriori use in routine care. Across studies, implementation was associated with improved pharmacokinetic target attainment, while a subset reported clinical benefits, including reduced nephrotoxicity and favorable effectiveness-related outcomes. Pharmacist involvement was commonly described. Conclusions: Published evidence indicates that Bayesian MIPD is being implemented in routine clinical settings, but current published experience is dominated by vancomycin-focused studies. Although the evidence base remains limited, it has grown since 2020 and suggests that software-supported Bayesian dosing can improve pharmacokinetic target attainment and may support better clinical outcomes. Full article

Pollen monitoring is an integral part of aerobiology. The analysis of pollen content in the air, which is its core routine work, requires reliable devices. The continuous evolution of technology prompted us to give an update on current techniques used in pollen monitoring to provide a historical overview and an outlook into the future. Standard works in aerobiology and the most important literature were incorporated to summarize the development of pollen monitoring technology. We span a range from the first description of pollen monitoring in the 1870s, the invention of simple devices by early researchers, onwards to the development of the first volumetric samplers, such as the Rotorod- or Hirst-type traps. While volumetric devices are widely used in the USA and in Europe today, automatic and near-real-time pollen monitoring play an increasing role and offer new possibilities. In contrast to volumetric methods, most of these still require validation and standardization. Other methods, like the analysis of environmental DNA (eDNA) and the modeling of historical pollen data for pollination forecasts, are outlined. Aerobiology and pollen monitoring will continue to benefit from technological advances and be re-shaped in the next decades. Full article

Minimal residual disease (MRD) is the most robust independent prognostic biomarker for pediatric acute lymphoblastic leukemia (ALL). Conventional MRD detection assays suffer from insufficient sensitivity and inherent technical limitations, failing to identify ultra-low-level leukemic blasts and thereby contributing to disease relapse. Next-generation sequencing (NGS)-based MRD detection (NGS-MRD) overcomes these drawbacks by targeting immunoglobulin (Ig)/T-cell receptor (TCR) gene rearrangements and enabling the precise quantification of residual leukemic clones. In recent years, NGS-MRD has undergone extensive technological optimization in target panel design, result interpretation and sample type expansion, and has been validated for its clinical utility in therapeutic threshold definition, prognostic stratification, post-therapy monitoring and treatment adjustments in pediatric ALL. This review synthesizes the latest technological refinements and clinical applications of NGS-MRD in pediatric ALL, critically discusses the current challenges that limit its routine clinical use, and proposes future research directions to address these issues. Full article

This study proposes and tests an analytical framework for interpreting digitally monitored municipal biowaste collection services through comparable diagnostics of operational performance, additional effort, and emissions intensity. The framework was applied to 572 collection services recorded between July and December 2025 in the Municipality of Barreiro, Portugal, covering seven circuits operating under different urban morphologies and collection configurations. Service-level operational records were transformed into physically interpretable performance indicators and an additional operational effort index was derived from robust normalization of serviced container density and service time per kilometer. The results showed marked heterogeneity across service regimes, with the highest effort observed in residential circuits characterized by greater spatial and temporal demand, while the non-domestic and communal circuits remained at or below municipal reference conditions. At the municipal scale, operational effort was moderately associated with mass collected per kilometer (ρ = 0.490, n = 572), weakly and non-significantly associated with mass per hour (ρ = 0.075, p = 0.074), and negatively associated with mass per container (ρ = −0.325). For services operating above municipal reference conditions (Eesf > 0, n = 286), emissions intensity was negatively associated with both effort components and with the aggregate effort index, with the strongest association observed for Eesf (ρ = −0.554). The results indicate that higher operational effort tends to coincide with greater spatial mass recovery, but not with higher container-level yield or proportionate improvements in emissions performance. More broadly, the study shows that the analytical value of digital monitoring depends not only on data availability, but also on the ability to convert routine service records into interpretable diagnostics for municipal decision-making. Full article

Riverine detritus is a key nutritional resource for benthic consumers, yet its biochemical quality fluctuates rapidly and is poorly captured by bulk indicators such as elemental analysis. To improve assessment sensitivity, we compared two analytical approaches targeting organic nitrogen. We refined a fluorimetric assay for primary amines using o-phthalaldehyde (OPA), identifying 2 M KCl as an optimal extraction medium that maximizes recovery while minimizing matrix interference. In parallel, we optimized capillary electrophoresis with contactless conductivity detection (CE-C4D) for free amino acid determination using 0.4 M ammonium carbonate. Applied to detritus from multiple river sites and seasons, both methods showed that primary amines and amino acids vary by an order of magnitude more than total nitrogen and exhibit patterns not detectable by elemental analysis, with consistent temporal trends across catchments. Primary amine-based measurements therefore provide a more sensitive and ecologically relevant assessment of detrital nutritional quality than bulk nitrogen metrics. The OPA assay is well suited for routine monitoring due to its simplicity and robustness, whereas CE-C4D enables detailed compositional profiling where amino acid speciation is required. Overall, detrital quality reflects both intrinsic properties and recent hydrological conditions, underscoring the importance of antecedent discharge and precipitation dynamics in its interpretation. Full article

This study investigated the prevalence and molecular characteristics of canine vector-borne pathogens (CVBPs) circulating in diverse dog populations in Thailand by using molecular diagnostic methods. A total of 400 blood samples were collected from four groups (n = 100 each): stray dogs (Group A), vector-borne disease–suspected companion dogs (Group B), healthy companion dogs presenting for routine examination (Group C), and companion dogs presenting with non-vector-borne illnesses (Group D). The overall infection rate was 46.25%. Ehrlichia spp. were the most frequently detected pathogens (23.5%), followed by Babesia spp. (16.5%), Rickettsia spp. (15.0%), and Anaplasma spp. (11.5%). The prevalence differed markedly among groups, including group A (88.0%), group B (54.0%), group C (27.0%) and group D (16.0%) (p < 0.05). DNA sequence analysis showed 100% identity with GenBank™ reference sequences, confirming the presence of Ehrlichia canis, Rickettsia asembonensis, Babesia vogeli, and Anaplasma platys. The detection of CVBPs across all groups demonstrates free-roaming and owned dogs serve as reservoirs for substantial ongoing infections and pose potential zoonotic implications to humans. Overall, these findings emphasize the importance of sustained molecular surveillance, improved vector control strategies, and proactive monitoring of high-risk dog populations to reduce the burden of CVBPs in Thailand. Full article

Introduction: Magnetic resonance imaging (MRI) is the reference imaging modality for locoregional staging and restaging of rectal cancer (RC). However, its agreement with surgical pathology in real-world practice is limited. We aimed to assess the agreement and diagnostic performance of preoperative MRI for dichotomized T and N staging in RC. Secondarily, we explored the direction of MRI misclassification and potential preoperative factors associated with discordance. Methods: We conducted a retrospective real-world study on 152 consecutive patients with pathologically confirmed RC who underwent surgery between September 2019 and June 2025 in our institution. Two cohorts were analyzed separately: patients treated without neoadjuvant therapy (non-NAT, n = 70) and patients treated with NAT followed by restaging MRI and surgery (NAT, n = 82). The main staging outcomes were dichotomized into T0-T2 vs. ≥T3 and N0 vs. N+, using final pathology as the reference standard. Agreement, Cohen’s kappa, sensitivity, specificity, predictive values, McNemar’s test, and exploratory regression analyses for misclassification were performed. Results: In the overall cohort, agreement was 72.4% for T staging and 73.0% for N staging, with moderate agreement for T (kappa = 0.452) and fair-to-moderate agreement for N (kappa = 0.349). Sensitivity and specificity were 80.3% and 67.0% for T staging and 54.5% and 80.6% for N staging, respectively. T-stage errors were mainly associated with overstaging. In NAT-treated patients, baseline MRI showed markedly poorer agreement with final pathology than restaging MRI, particularly for T stage (45.1% vs. 72.0%). Exploratory analyses did not identify strong or reproducible predictors of misclassification. Conclusions: This real-world study provides a contemporary estimate of MRI-pathology agreement for dichotomized T and N staging in routine RC care. Agreement was moderate, and performance was more consistent for advanced T-category assessment than for nodal staging. These findings support MRI as a practical tool for multidisciplinary risk stratification and highlight the need for continued monitoring of MRI usage and performance in clinical practice. Full article

Severe aplastic anemia (SAA) in pregnancy represents a rare but life-threatening clinical challenge. Standard therapies such as hematopoietic stem cell transplantation (HSCT) and immunosuppressive therapy are limited during pregnancy due to safety concerns, leaving supportive care as the mainstay. Thrombopoietin receptor agonists (TPO-RAs) such as eltrombopag have emerged as promising agents in refractory SAA, though evidence of their safety in pregnancy remains scarce. We present the case of a 27-year-old woman with SAA post-allogeneic bone marrow transplant who relapsed during subsequent pregnancies. Her disease course was characterized by recurrent pancytopenia, mixed chimerism, and repeated need for stem cell boosts. During pregnancy in 2023, discontinuation of cyclosporine led to worsening cytopenias, prompting reintroduction of cyclosporine and the continuation of eltrombopag. This combined approach, alongside G-CSF and stem cell boosts, contributed to favorable hematologic stabilization. She successfully delivered a healthy infant and achieved hematologic recovery following a third stem cell boost postpartum. This report highlights the potential utility of TPO-RAs during pregnancy when conventional therapy is limited, while emphasizing the need for vigilant monitoring of maternal–fetal outcomes. A review of the literature suggests that although routine use of eltrombopag in pregnancy is not recommended, it may be considered in refractory SAA cases with careful risk–benefit assessment. The case underscores the role of multidisciplinary care, individualized therapeutic planning, and the need for further studies on TPO-RAs in pregnancy-associated bone marrow failure syndromes. Full article

Background: Antibiotic-free approaches to boar semen preservation are gaining importance to counter emerging antimicrobial resistance. Hypothermic storage at 5 °C, instead of the conventional 17 °C, is a promising strategy to eliminate antibiotics still commonly used in extenders. For practical adoption, the method must be simple and compatible with on-farm routines. Objective: To assess fertility when cooling was initiated on farm one day after delivery, and to evaluate the robustness of cold-stored semen to temporary warming and subsequent re-cooling, mimicking typical handling on insemination days. Methods: Individual ejaculates (n = 34) from six boars were extended in Androstar^® Premium either without antibiotics (5 °C) or with gentamicin (17 °C control). One day after collection, antibiotic-free doses were cooled on farm to 5 °C and used alongside controls in routine insemination of 270 sows. Sperm quality was evaluated by computer-assisted semen analysis and flow cytometry, and bacterial counts were monitored. In a separate test, cold-stored doses were exposed to 20 °C for 60 min and re-cooled to 5 °C. Results: Farrowing rates and litter sizes did not differ between groups (p > 0.05). In antibiotic-free samples after 120 h, bacterial counts were mostly not detectable or low (<10² CFU/mL). Sperm motility and plasma membrane integrity in cold-stored doses remained >80%, comparable to controls (p > 0.05). Temporary warming did not affect sperm quality or bacterial counts. Conclusions: Antibiotic-free semen storage at 5 °C is easy to implement in practice and maintains fertility under field conditions. Broader validation under routine conditions is encouraged in support of the One Health concept. Full article

Background/Objectives: Evidence-based nutritional recommendations for obesity management require understanding of sex-specific and age-specific body composition patterns and their associations with metabolic biomarkers, habitual dietary intake and chronic low-grade inflammation. This study aimed to characterize body composition phenotypes in a large clinical cohort of adults with obesity, to evaluate associated metabolic and inflammatory biomarker patterns, to contextualise these patterns against habitual nutrient intake assessed in a dietary subcohort, and to derive age- and sex-specific nutritional recommendations based on the identified patterns. Methods: We performed a cross-sectional analysis of 29,544 adults with obesity (BMI ≥ 30; 21,374 women, 8170 men; age 30–69) who underwent multi-frequency bioelectrical impedance analysis (BIA; InBody 770). Biochemical assessments (fasting glucose, lipid profile, uric acid, HbA1c, insulin) were available for 2019 hospitalized patients from the same population. Habitual dietary intake was quantitatively assessed in a dietary subcohort of 423 patients using the validated Russian software-based questionnaire “Scientific Nutrition Analysis Tool”. Inflammatory biomarkers (high-sensitivity CRP, IL-6) and adipokines (leptin, adiponectin) together with serum 25(OH)D were measured in an inflammation/adipokine subcohort of 116 patients. A body composition phenotype with low relative muscle mass and high visceral fat (VFA ≥ 100 cm²) was defined using FNIH criteria (ALM/BMI < 0.789 men, <0.512 women). Benjamini–Hochberg FDR correction (q < 0.05) was applied for multiple comparisons. Results: The body composition phenotype prevalence increased progressively with age: men 24.6% (30–39) to 42.0% (60–69); women 10.3% (30–39) to 31.8% (60–69). Skeletal muscle mass (SMM) was positively associated with uric acid (r = +0.347, p < 0.001, FDR q < 0.05) and inversely associated with HDL-cholesterol (r = −0.321, p < 0.001, FDR q < 0.05)—both associations with direct nutritional implications. BMI was associated with fasting insulin (r = +0.233, p < 0.001, FDR q < 0.05). Women showed significant age-related metabolic differences between the 30–39 and 60–69 age groups: fasting glucose +12.9%, triglycerides +34.8%, uric acid +15.0% (all p < 0.001); in men, significant differences were observed for fasting glucose (+7.0%) and HbA1c (+5.2%) (both p < 0.001), while lipid parameters did not reach significance. In the dietary subcohort, habitual saturated-fat intake exceeded recommended values in 70–72% of patients of both sexes, dietary fibre intake was below recommended levels in 73–85%, and habitual calcium intake decreased significantly with age in women (1022 → 746 mg/day, p = 0.028). Serum CRP was elevated (median 5.59 mg/L, n = 59). In a separate extended laboratory subcohort, serum oestradiol declined markedly with age in women (55.0 → 16.8 pmol/L between 30–39 and 50–59 years, p < 0.001), consistent with the menopausal transition; serum testosterone in men remained stable across age groups; and 25(OH)D insufficiency (<30 ng/mL) was prevalent in 49.7–55.8% of patients. Conclusions: The identified sex-specific and age-specific body composition patterns provide a rationale, supported by observed dietary and inflammatory patterns, for targeted nutritional intervention: increased dietary protein, omega-3 fatty acids supplementation, low-glycemic-index dietary patterns, and purine restriction with hyperuricemia. Routine BIA-based nutritional screening combined with quantitative dietary assessment should begin at age 30, with preventive monitoring at age 40 and intensification of control at age 50, to guide personalized dietary planning in obesity. Full article

Industrial and municipal wastewater may contain substances that inhibit biological processes in wastewater treatment plants (WWTPs), posing risks to operational stability and environmental protection. The aim of this study is to evaluate the practical suitability of the ISO 8192:2007 respiration inhibition test for assessing the toxicity of wastewater. Nitrified activated sludge from a municipal WWTP was used to analyze wastewater from three industrial companies, wastewater from several discharge locations at a hospital, and WWTP influent. Oxygen consumption and inhibition were determined at sample-specific dilution levels and the reference substance 3,5-dichlorophenol. Two samples from the dental department of the hospital showed toxic effects on activated sludge respiration (inhibition > 50%), while no toxic effects were observed in the remaining samples. Several samples exhibited stimulatory effects (inhibition < 0%), indicating the presence of readily biodegradable organic matter. However, inhibitory effects (0–50% inhibition) were detected in individual wastewater samples at higher concentrations. This demonstrates that the method can detect toxicological changes in wastewater and is suitable for routine monitoring and early warning in WWTPs. Full article

Background and Clinical Significance: Autosomal dominant tubulointerstitial kidney disease caused by a mutation in the uromodulin gene (ADTKD-UMOD) is a rare kidney disorder characterized by progressive tubulointerstitial damage and a slowly progressive loss of renal function. ADTKD is often under-recognized in the clinical setting. Diagnosis of ADTKD-UMOD can be challenging due to its nonspecific symptoms and is confirmed by genetic testing alone. Case presentation: We report the case of a 42-year-old male patient referred for evaluation of renal dysfunction, which was accidentally discovered during routine laboratory checks. He had no significant medical history and no known family history of kidney disease or gout. Physical examination was unremarkable. Renal dysfunction was confirmed, with serum creatinine at 1.44 mg/dL and eGFR at 59.5 mL/min/1.73 m². Urinalysis was within physiological limits, proteinuria being 75 mg/day. Uric acid was mildly elevated (7.5 mg/dL) without a history of gout. Other laboratory findings, including autoantibodies, were in the normal range. The patient underwent a kidney biopsy, though it was not diagnostic, showing mild focal tubular atrophy and interstitial fibrosis without glomerular involvement. Immunofluorescence staining was negative for complement and immunoglobulins. Given the above nonspecific findings, the patient was suspected of having possible ADTKD. Genetic investigation using a clinical exome next-generation sequencing approach identified a novel heterozygous missense variant in the UMOD gene (c.409T>C; p.Cysteine137Arginine (p.Cys137Arg)) that is likely pathogenic. The patient is under regular clinical-laboratory monitoring. After one year, his overall health is good, renal function is stable with no proteinuria, and uric acid is mildly increased without gout attacks. Conclusions: Increased clinical awareness is crucial for detecting ADTKD-UMOD. Genetic testing can help to resolve clinical diagnostic challenges in patients with unexplained decreased kidney function. Full article

Cottonseed oil (CSO) is regarded as a nutritionally balanced oil, and is routinely used for food and cosmetics products. Autooxidation degrades oil storage quality and shortens the shelf life of oil products. In this research, crude CSO (c-CSO) from recently developed glandless cotton and commercially available refined CSO (r-CSO) from conventional glanded cotton were subjected to accelerated oxidation under storage at 60 °C in a convection oven for 45 days. Selective parameters (e.g., acid, peroxide, and anisidine values) and spectroscopic features (ultraviolet–visible absorptivity and Fourier transform infrared band intensity) were used to monitor the changes in the storage quality behaviors during the storage. The resulting data indicated that the specific values and the change trends of these parameters were not exactly the same between c-CSO and r-CSO. Generally, the c-CSO sample tended to show lower autooxidation degrees than r-CSO during storage. The content of tocopherol (a specific fat-soluble type of antioxidant compounds with a methylated phenolic ring) was 1016 and 23 mg kg⁻¹, in the two oil samples, respectively. The decreasing trend of tocopherol content in c-CSO samples implied that the tocopherols played roles in slowing down c-CSO’s autoxidation process, thus increasing its shelf life. Information derived from this work would be helpful in the application of the new c-CSO as an effective antioxidant component in addition to conventional CSO’s nutrient values. Full article

Wearable sensors enable continuous recording of electrocardiographic, photoplethysmographic, and inertial signals and have accelerated the development of digital biomarkers in cardiovascular medicine. Transthyretin amyloidosis (ATTR) is a progressive multisystem disease characterized by arrhythmia, conduction disturbances, hemodynamic impairment, autonomic dysfunction, and gait abnormalities, making it theoretically suitable for multimodal wearable monitoring. This review summarizes current knowledge on wearable applications in amyloidosis with ATTR serving as an illustrative case, evaluates the plausibility of extrapolating signal-based biomarkers from related cardiovascular and neurological cohorts, and outlines methodological and implementation challenges. ATTR-specific data remain limited to small observational studies, mainly on long-term rhythm monitoring and supervised functional assessment. More comprehensive findings support the extraction of metrics such as atrial fibrillation burden, activity patterns, gait variability, and heart rate variability. However, ATTR-related structural remodeling and high arrhythmia burden may distort conventional digital biomarkers, necessitating disease-specific preprocessing and prospective validation. Wearable monitoring in ATTR is technically feasible and biologically plausible but remains investigational. Before routine integration into care pathways can be recommended, standardized, phenotype-stratified studies are needed that link wearable-derived characteristics to assessed clinical outcomes. Full article

The foot arch functions as a dynamic biomechanical system, maintained by the integrated actions of bones, ligaments, and muscles. A large body of clinical evidence indicates that, in addition to congenital foot deformities, acquired variations in the foot arch caused by factors such as poor gait, aging, weight, or injury can significantly affect quality of life. Early intervention upon detection of foot arch changes can help mitigate progression and prevent further deterioration. Despite the availability of multimodal sensor-integrated running platforms for gait analysis, such systems are inherently bulky and not conducive to routine walking measurement. To overcome the above limitations, this study employed a flexible plantar pressure insole with an integrated accelerometer and a dedicated acquisition circuit to capture plantar pressure and acceleration data. This smart insole system acquires plantar data, performs feature extraction via time–domain and wavelet analysis, and then employs machine learning to classify the foot arch type as a normal foot, flatfoot, or high-arched. A Random Forest classifier was then established to categorize foot arch types based on the collected data, which integrates numerous decision trees through bootstrap aggregation and random feature selection, with final classification determined by majority voting. A total of 30 volunteers participated, including 11 with normal arches, 11 with flat feet, and 8 with high arches. Compared with support vector machine, K nearest neighbors, and decision tree, the Random Forest achieved the highest recognition accuracy of 92%. This system reveals the patterns of plantar pressure distribution and acceleration fluctuations during walking across three foot arches and demonstrates that wavelet entropy can effectively quantify the changes in signal complexity included in foot arch differences. Compared with laboratory force plates, this system features lower cost and a smaller form factor, making it suitable for real-time monitoring. This system can lay the technical foundation for personalized foot orthopedics and health monitoring. Full article