Search Results (109,827)

Objective: To compare respiratory outcomes between infants undergoing retinopathy of prematurity (ROP) laser treatment with or without elective intubation. Study Design: This retrospective cohort study analyzed preterm infants treated by the same pediatric ophthalmologist at two tertiary hospitals between January 2010 and March 2023, Hospital 1 (No-endotracheal tube or ETT intubation) and Hospital 2 (ETT intubation). Infants intubated for unrelated reasons or treated with only anti-vascular endothelial growth factor (VEGF) injections were excluded. Data collected included demographics, comorbidities, ROP stage, and respiratory outcomes. Results: Among 91 infants (61 No-ETT, 30 ETT), the No-ETT group had significantly lower birth weight and had more Black infants. The mean duration of mechanical ventilation post-surgery was significantly shorter in the No-ETT than in the ETT cohort (0 vs. 1 days, p = 0.005), and the total respiratory support (both invasive and non-invasive) after surgery was significantly longer in the No-ETT than in the ETT cohort (108 vs. 4.5 days, p < 0.001). No statistically significant differences were observed between groups in terms of length of hospital stay after surgery. The two cohorts demonstrated similar clinical trajectories with respect to overall length of hospital stay, day of life at which laser surgery was performed, and multiple comorbidities. Over 90% of No-ETT infants tolerated the procedure without requiring elective intubation, with emergent intubation only occurring 9.8% of the time. Conclusions: Elective intubation during ROP surgery was associated with a longer length of post-surgery mechanical ventilation without clear improvements in short-term outcomes. Similar rates of multiple comorbidities, hospital length of stay, and timing of laser surgery suggest there is no associated clinical advantage to routine elective intubation. Routine elective intubation may be unnecessary for most infants during ROP laser surgery. Full article

Background: Patients undergoing hemodialysis commonly exhibit deficiencies in water-soluble vitamins, primarily as a result of inadequate dietary intake and loss into the dialysate. Given the essential role of vitamin C in numerous metabolic pathways, routine supplementation has been proposed as a potentially beneficial intervention in this population. Aim: We aimed to evaluate the current evidence on vitamin C supplementation in patients undergoing hemodialysis, with particular attention to clinical conditions associated with renal replacement therapy, including anemia, chronic inflammation, restless legs syndrome (RLS), and secondary hyperparathyroidism. Methods: This systematic review was conducted in accordance with PRISMA guidelines. The MEDLINE (via PubMed) and EMBASE databases were searched. The initial search yielded 844 articles, of which 37 studies met the inclusion criteria for this review. Results: Evidence indicates that hemodialysis patients exhibit vitamin C deficiency, both in dietary intake and in plasma or serum concentrations. Despite its intrinsic antioxidant properties and proposed anti-inflammatory effects, vitamin C supplementation has demonstrated inconsistent effects on inflammatory markers. Most clinical studies support a beneficial role of vitamin C supplementation in functional iron deficiency and in alleviating symptoms of RLS within this population. Conclusions: Evidence on vitamin C supplementation for functional iron deficiency and RLS suggests that it might be an effective therapeutic approach. However, despite low serum vitamin C level in hemodialysis patients, current data does not justify the routine use of vitamin C in the hemodialyzed population for other comorbidities, including chronic inflammation and secondary hyperparathyroidism. Further high-quality studies are required to establish the broader clinical utility of targeted vitamin C supplementation. Full article

Phase unwrapping in interferometric synthetic aperture radar (InSAR) aims to recover a continuous phase field from wrapped observations, which enable accurate topographic reconstruction and surface deformation measurements. With the recent advances in deep learning (DL), several DL-based unwrapping approaches have shown promising performance. However, deep learning networks suffer from inconsistent feature representations between encoder and decoder stages. This leads to incompatible skip connections that provide limited benefits and even degrade reconstruction quality. To overcome this limitation, we propose ResUCTransNet that integrates residual learning with transformer-based feature modeling. The network employs a multi-scale residual backbone derived from Res_UNet to extract stable deep features. Then, to replace conventional skip connections, a channel transformer (CTrans) module is introduced that composed of channel-wise cross fusion transformer (CCT) and channel-wise cross attention (CCA). This design effectively reduces the semantic gap in different network stages, which allows adaptive integration of local CNN features and global transformer representations. Experiments on the public InSAR-DLPU dataset demonstrate that ResUCTransNet effectively reduces model complexity and achieves substantial improvements over existing deep learning models and classical unwrapping algorithms. Specifically, the proposed method attains the best performance in terms of RMSE and SSIM (RMSE = 1.6247, SSIM = 0.7741). Compared with the second-best model, Res_Unet (RMSE = 2.8409, SSIM = 0.7733), ResUCTransNet achieves an approximately 42.8% reduction in RMSE while maintaining nearly identical structural similarity. The proposed method provides higher reconstruction accuracy and better structural fidelity, while maintaining strong robustness and generalization in complex terrain or severe noise conditions. Full article

Natural disasters pose major challenges to economic development, yet empirical evidence on their growth effects remains mixed. This study examines whether the macroeconomic impact of disasters depends on infrastructure development, using electricity access as a conditioning variable. Employing a balanced panel of 108 countries from 1996 to 2022, we estimate a panel threshold regression to capture nonlinear disaster–growth relationships. The results indicate that disaster impacts vary systematically across infrastructure regimes. In very low electricity-access contexts, disaster intensity is associated with short-run growth responses consistent with reconstruction-driven dynamics in a very limited subset of observations. Once basic electricity access is achieved, this association weakens and becomes statistically indistinguishable from zero. Beyond this lower regime, the analysis also reveals a broader structural transition in which disaster impacts gradually decouple from economic growth as infrastructure coverage expands. These findings suggest that disaster effects are nonlinear and contingent on development stage. By distinguishing between statistical thresholds and economically meaningful transition zones, the study reconciles mixed evidence in the disaster–growth literature and highlights electricity access as a key determinant of economic resilience. Full article

This study presents a two-stage, mechanics-based method for optimizing vibratory sorting machine of adult crickets for post-harvest size grading. In the first stage, the static coefficient of friction (COF) was measured for three cricket size classes across seven tray surface conditions to quantify cricket–substrate interactions relevant to vibratory transport. COF varied significantly with both morphology and surface microtexture (p < 0.0001), with intermediate roughness levels generating higher friction than smooth or highly rough surfaces. In the second stage, a factorial experiment evaluated the effects of oscillating speed (300–350 rpm), tray inclination (2°–3°), and surface roughness (G0–G5) on sorting efficiency, throughput, batch sorting time, and specific energy consumption (SEC). All main factors and most interactions significantly influenced sorting performance (p < 0.0001). The optimal operating condition—350 rpm, 2° inclination, and G2 roughness—achieved 95% sorting accuracy, 39 crickets·min⁻¹ throughput, and the lowest SEC (0.37 Wh·cricket⁻¹). The results demonstrate that friction–vibration coupling governs cricket transport on vibrating surfaces and provide an engineering framework for designing scalable, energy-efficient sorting systems for insect rearing and processing. Full article

Background: The management of rectal cancer has evolved toward response-adapted strategies, including organ preservation in selected patients achieving a clinical complete response (cCR) after neoadjuvant treatment. However, most available evidence derives from clinical trials, and data from real-world clinical practice remain limited. Methods: We conducted a retrospective observational cohort study including consecutive patients with rectal adenocarcinoma treated at a tertiary referral center between January 2021 and December 2025. Baseline clinical, tumor-related, and treatment characteristics were collected. Tumor response was assessed using clinical, endoscopic, and radiological criteria. The primary endpoint was the rate of clinical complete response and the implementation of watch-and-wait strategies. Secondary endpoints included recurrence patterns and exploratory oncologic outcomes according to baseline tumor characteristics. Results: A total of 229 patients were identified, of whom 148 were evaluable for treatment response. Clinical complete response was documented in 56 patients (37.8%), and a watch-and-wait strategy was implemented in 42 patients (28.4%). Higher cCR rates were observed in patients with stage I–II disease and in tumors measuring < 4 cm on baseline magnetic resonance imaging, with cCR rates exceeding 55% in this subgroup. Tumors ≥ 4 cm showed substantially lower response rates. Clinical complete responses were observed across both short-course radiotherapy plus chemotherapy and long-course chemoradiotherapy regimens in patients with small tumors and early-stage disease. Tumor distance from the anal verge was not consistently associated with response. With a median follow-up of 26 months in the watch-and-wait group, five recurrences were observed, including three local recurrences. Conclusions: In this real-world cohort, baseline tumor size and clinical stage were the main determinants of clinical complete response and eligibility for organ-preservation strategies in rectal cancer. Small tumors (<4 cm) showed high response rates regardless of neoadjuvant regimen. These findings support response-adapted, individualized treatment strategies and highlight the importance of tumor burden in selecting candidates for non-operative management in routine clinical practice. Full article

Background/Objectives: Alzheimer’s disease (AD) is a neurodegenerative disease for which there are no highly effective treatments, which highlights the need for novel therapeutics. Cannabidiol (CBD) has demonstrated antioxidant, anti-inflammatory and neuroprotective properties. Chronic CBD treatment (20 mg/kg and 50 mg/kg) reverses social recognition memory deficits of APP_Swe/PS1∆E9 (APP/PS1) transgenic mice; however, it does not produce effects on AD-relevant brain pathology. Methods: Here, we investigated whether chronic high-dose CBD treatment (i.e., 100 mg/kg intraperitoneally) in early symptomatic 7.5-month-old APP/PS1 males would reverse cognitive deficits while also influencing neuropathological markers relevant to AD. Mice were assessed for anxiety, recognition memory, and social and aggressive behaviours before carrying out neuropathological analyses of collected brain tissue. Results: Vehicle-treated APP/PS1 transgenic males demonstrated reduced aggressive behaviour and increased socio-positive behaviour. A moderate deficit in social recognition memory was restored by CBD. APP/PS1 mice also exhibited elevated cortical proBDNF levels under vehicle treatment, and hippocampal levels of TNF-α and IL-1β were reduced in all APP/PS1 mice. AD transgenic mice exhibited no changes in soluble or insoluble Aβ₄₂ levels or PPARγ isoforms. Conclusions: This study found that high-dose CBD restored a moderate social recognition memory deficit. However, CBD did not have marked effects on AD-relevant neuropathological markers assessed, most likely because the AD transgenic mice were evaluated at a disease stage too early to detect significant pathological changes. Thus, the underlying mechanisms for CBD’s effect on social recognition memory require further investigation. Full article

Aptamers are synthetic nucleic acid ligands that have been proposed as alternatives to antibodies for targeting molecules and cells. In hematology, most reviews have organized aptamer literature around diseases or technological platforms. This framing has obscured how unevenly different blood cell types have been covered. In this review, we present developed aptamers organized by blood cell lineages. Specifically, we examine aptamers for B cells, T cells, natural killer cells, and red blood cells. This organization revealed a strong concentration on a small set of canonical surface markers and on malignant cell models. A parallel gap appeared in aptamers that distinguish differentiation stages or functional cell states. Within this framework, we evaluated reported applications, design strategies, and experimental use cases alongside persistent limitations in target selection and biological resolution. Our analysis highlighted both practical constraints and conceptual blind spots in current blood-cell-targeting aptamer research. Together, these observations defined a set of clear opportunities for expanding aptamer development toward more state-resolved, biologically informative, and clinically relevant targeting strategies. Full article

Patagonia in the far south of Chile is used as a breeding ground for cattle, which are then transported north for their final stages of growth before being killed for meat. The objective of this study was to compare mortality in beef cattle exposed to two different types of long-distance transport: by ship, using a roll-on/roll-off system, or by truck. Data from a major transport company were used to compare the mortality risks for calves and older cattle when conveyed by sea or road from southern to central Chile journeys of four and two days, respectively. Mortality was higher for both calves and older cattle traveling by sea than those traveling by road, but when the data was corrected for journey duration, mortality/day was greater for those traveling by road. Mortality was increased at high stocking densities and, for older cattle, winter was a high-risk season, compared with summer. Mortality was also higher for calves than older cattle. The results identify the greatest risks of mortality over the two routes to facilitate reform of the transport processes so that cattle welfare is improved. Full article

The effective transfer of research-based instructional innovations into classroom practice requires assessment tools that allow teachers to critically examine the quality and applicability of STEM learning designs. This study employs the RubeSTEM rubric to analyze a STEM teaching–learning sequence on fire ecology, focusing on how preservice and in-service teachers evaluate disciplinary integration, structural coherence, and classroom feasibility. By involving teachers at different stages of professional experience, the study examines patterns in teachers’ evaluative judgments and explores differences according to teaching experience and specialization. The findings indicate a high level of perceived disciplinary integration, particularly in the dimensions of argumentation and authenticity, highlighting strengths in the design of the sequence. At the same time, limitations were identified in relation to engineering design and the evaluation of the learning process, pointing to areas for improvement in STEM instructional planning. Statistically significant differences in evaluations were found according to teaching experience, especially in the assessment of the theoretical dimension, with higher ratings from teachers with intermediate experience. Overall, the results illustrate how a structured evaluation rubric can be used to examine the quality of integrated STEM teaching–learning sequences from a teacher perspective, providing empirical evidence on design coherence, disciplinary integration, and classroom applicability. Full article

Background: Physical exercise is a potential non-pharmacological therapy for patients with end-stage renal disease (ESRD). Perception of benefits and barriers of exercise among hemodialysis (HD) patients is linked with their exercise behavior. This study aimed to investigate perceptions of exercise benefits and barriers among patients on HD in Saudi Arabia and their associated predictors. Methods: This is a cross-sectional survey study that was conducted in two dialysis centers in Saudi Arabia between May and September 2025. In this research, the Dialysis Patient-perceived Exercise Benefits and Barriers Scale (DPEBBS) was used to examine patients’ perceived benefits and barriers to exercise. Patients’ physical activity status was evaluated using the General Practice Physical Activity Questionnaire (GPPAQ). Multivariate logistic regression analysis was used to define factors influencing positive perception towards physical activities and perceived barriers. Results: This study included 104 patients with ESRD. Most patients expressed positive perceptions regarding the benefits of exercise. The majority agreed or strongly agreed that exercise improves mood (87.5%), prevents muscular atrophy (81.8%), postpones decline in body function (81.7%), and enhances quality of life (83.7%). Regarding barriers to exercise, several concerns were frequently reported by patients. The most prominent barrier was worry about affecting the arteriovenous fistula. Tiredness (70.2%) and muscle fatigue (63.5%) were also commonly cited obstacles. Age was significantly associated with lower odds of perceiving exercise as beneficial (aOR = 0.94; 95%CI:0.91–0.98; p = 0.008). This indicates that older patients were slightly less likely to report a positive perception towards exercise. Having a bachelor’s degree is associated with higher odds of reporting exercise barriers compared with no education (aOR = 16.22, 95%CI:1.29–204.42; p = 0.03). The majority of the patients (78.8%) are classified as physically inactive. Conclusions: This study revealed that most patients on HD in Saudi Arabia have positive perceptions regarding the benefits of exercise. Nevertheless, several barriers were also reported by these patients, with tiredness, worry about affecting the arteriovenous fistula, body pain, and muscle fatigue being the most reported barriers. Further studies are necessary to investigate the relationship between a positive perception of exercise benefits and exercise engagement. Full article

Sensorineural hearing loss (SNHL), the predominant form of global hearing impairment, stems from the irreversible loss of inner ear sensory cells and neurons. Since mammalian cochlea lacks regenerative capacity, cell death represents a final common pathway for diverse insults. Current therapies are merely compensatory, underscoring an urgent need for mechanistic, targeted interventions. Autophagy, a critical homeostatic process, plays complex and dynamic roles in the cochleae. This review synthesizes current evidence on its regulation, highlighting its stage-specific and dual roles in SNHL. We emphasize mitophagy and its context-dependent effects on cell survival. Critically, we discuss an emerging therapeutic paradigm: a dual-phase autophagy modulation strategy. This approach proposes enhancing cytoprotective autophagy in early stages to maintain homeostasis, while inhibiting excessive autophagic flux later to prevent catastrophic cell death. This precision-targeting framework holds significant promise for guiding novel drug development and future clinical translation, moving beyond symptomatic management towards transformative treatment. Full article

Nitrogen (N) is a key macronutrient that influences the uptake and partitioning of other essential elements in plants. In this research, we evaluated the effect of different N concentrations in the nutrient solution (0, 4.2, 8.4, and 12.6 mg L⁻¹) during the flowering stage on the concentration and accumulation of macronutrients in organs of Mexican marigold (Tagetes erecta L.) ‘Inca’. After 40 days of treatment, plants were separated into leaves, flowers, stems, and roots to determine the concentrations of N, P, K, Ca, Mg, and S, as well as their accumulation based on dry biomass. Nitrogen supply significantly affected dry biomass production and its partitioning among organs, promoting biomass allocation to leaves and flowers while reducing relative root biomass at higher N concentrations. Nitrogen concentrations and accumulation increased in leaves, stems, and flowers as N supply increased, whereas an inverse relationship was observed in roots. When applying 8.4 and 12.6 mg N L⁻¹, phosphorus displayed enhanced concentrations in leaves and stems, although root tissues did not change the concentration of this nutrient. When N was supplied at up to 8.4 mg L⁻¹, the concentration of potassium rose in aboveground organs but decreased at the highest dose, while its accumulation in roots was reduced under high N concentrations tested. Calcium exhibited greater accumulation in the aboveground organs, particularly at 12.6 mg N L⁻¹. Magnesium concentration and accumulation increased in aboveground organs with increasing N supply, whereas its accumulation in roots decreased. The highest concentrations of sulfur in leaves and stems were observed at 8.4 mg N L⁻¹, and its accumulation in the aboveground organs tended to stabilize at the highest dose. Effect size analysis (partial ηp²) revealed that N supply explained a large proportion of the variance in macronutrient concentration and accumulation in aerial organs, whereas responses in roots were generally weaker and nutrient specific. Overall, our data indicate that intermediate N levels (8.4 mg L⁻¹) boost a more efficient nutritional balance in the aboveground organs, while the highest dose predominantly enhances Ca and Mg accumulation. Understanding how these plants respond to nitrogen can help improve the quality of Mexican marigold crops and make better use of fertilizers. Full article

Social cohesion is a core dimension of social sustainability and a prerequisite for inclusive, resilient cities. Rapid rural-to-urban migration often exceeds the capacity of cities to accommodate newcomers, leading many immigrants to settle in informal neighborhoods. These areas, typically composed of diverse ethnic groups with distinct cultural, linguistic, and social backgrounds, frequently face challenges in building social cohesion. This study examines how physical elements of public spaces influence social cohesion in multiethnic informal settlements, using the Hesar Imam Khomeini neighborhood in Hamadan, Iran, as a case study. Hesar, with its rural origins and recent influx of Lor, Kurdish, Turkish, and Fars migrants, provides a unique setting to explore the relationship between the built environment and interethnic relations. A conceptual model was developed based on existing literature, and data were collected through a questionnaire survey using a Likert scale. Partial least squares structural equation modeling (PLS-SEM) was applied to test the hypothesized relationships. The findings demonstrate that physical factors shape social cohesion through a three-stage mechanism: they first foster social interactions among residents, which then contribute to the development of social capital, and ultimately lead to greater social cohesion and integration. These results highlight how inclusive public-space design can support community-based informal-settlement upgrading and sustainable urban development, by strengthening social sustainability outcomes such as cohesion, integration, and resilience. Full article

Skin cancer is one of the most common and dangerous cancers, with global mortality rates continuing to increase each year. Alongside rapid advancements in Artificial Intelligence (AI) within the medical field, significant challenges have emerged, particularly related to patient data privacy and security. In response to these challenges, this research aims to develop a skin cancer classification system that not only ensures the security of patient data but also maintains model efficiency on devices with limited computing power by Federated Learning and real-time inference on edge computing platforms. The proposed approach combines deep learning through an Xception-based Convolutional Neural Network (CNN) architecture with Federated Learning. Federated Learning enables decentralized model training by utilizing a global server and multiple local servers, where sensitive data remain on local nodes and only model updates are shared for aggregation. The experiments were conducted using two benchmark datasets, HAM10000 (10,000 images) and ISIC 2019 (25,331 images). The resulting global federated model achieved an accuracy of 98.8%. In addition to training evaluation, the proposed model was further assessed during the inference stage on edge devices to evaluate its real-world performance under limited computational resources. Performance benchmarking was conducted on NVIDIA Jetson Orin and Raspberry Pi platforms, where Raspberry Pi 5 demonstrated the fastest inference time of 0.16 s. Full article