Search Results (24,682)

Background/Objectives: To evaluate the influence of different DIXON contrasts on the quality of subtraction images in dynamic breast MRI using maximum intensity projections (MIPs). Methods: This retrospective study included n = 40 women (median age: 53.5 years, range 23–83) undergoing clinically indicated breast MRI (3T). For each MRI examination, two independent readers individually evaluated GBCA-enhanced subtraction MIPS for different timepoints (n = 5) and DIXON contrasts (n = 4) per breast, resulting in a total of 800 individual evaluations. Evaluations comprised (a) qualitative measures, using Likert-scores for artefact strength, breast parenchyma visibility, lesion visibility and reading confidence; and (b) signal intensity, measured in three regions of interest with the apparent signal-to-noise ratio (aSNR) and apparent contrast-to-noise ratio (aCNR) calculated. The evaluation results were analysed to identify differences between DIXON contrasts. Results: The “only water” DIXON contrast at ~120s after GBCA injection achieved the highest lesion conspicuity and reading confidence scores and lowest artefact scores; however, its performance was not statistically significant (p > 0.05) compared to the “in-phase” and “opposed-phase” subtractions. The aCNR at the second timepoint was slightly, but not significantly (p > 0.05), lower than the first timepoint, whilst aSNR increased significantly from the first to second timepoint in all contrasts. Conclusions: Subtraction MIPs derived from the “only water” DIXON contrast achieved the highest qualitative scoring for lesion conspicuity and confidence, with the aSNR increasing and aCNR decreasing between the first and second timepoints. Full article

Background: Normal-weight obesity (NWO) is a nutritional status in which individuals have a normal body mass index (BMI) with a high percentage of body fat (%BF). However, the impact of elevated %BF on cardiometabolic risk remains unclear. This study aimed to evaluate whether NWO is associated with worse cardiometabolic risk markers and scores. Methods: We conducted a cross-sectional study using a convenience sample of employees from a public hospital. Participants aged ≥18 years with a BMI between 18.5–24.9 kg/m² were included in the study. %BF was categorized according to sex and age (InBody720). Normal weight and normal %BF (NWNB) and NWO were defined using cutoff points. Body composition, serum biochemical and inflammatory markers, hemodynamics, and autonomic function were considered cardiometabolic risk markers. The visceral fat area (VFA), atherogenic coefficient (AC), atherogenic index of plasma (AIP), body shape index (ABSI), and Framingham Risk (FR) score were considered cardiometabolic risk scores. Statistical significance was set at p < 0.05. Results: Of the 228 eligible participants, 52 met the inclusion criteria (NWNB, N = 29 and NWO, N = 23). Participants with NWO presented worse values of lipid profiles, anthropometric measurements, hemodynamic parameters, and autonomic function indices. After adjustment for age and sex, NWO remained associated with selected cardiometabolic markers, particularly LDL-c, triglycerides, and autonomic indices, whereas body composition findings should be interpreted as confirmatory of the phenotype. Conclusions: In this cross-sectional secondary analysis, NWO was associated with worse cardiometabolic markers and selected risk scores compared with NWNB. These findings support an unfavorable cardiometabolic profile in individuals with NWO, but do not allow inferences about future cardiometabolic events or causal relationships. Longitudinal studies are needed to clarify its prognostic significance. Full article

Background/Objectives: The purpose of this study was to (i) determine the levels of interleukins in patients with COVID-19 admitted to the Intensive Care Unit (ICU) and (ii) evaluate their early dynamics, as well as (iii) assess their relationships with morbidity and mortality. Methods: This was a prospective analytical study of critically ill patients with COVID-19 who were monitored from admission to three days of stay in the ICU. Circulating levels of IL-1β, IL-2, IL-6, IL-7, IL-8, IL-10, and tumour necrosis factor-alpha (TNF-α) were measured. Cytokine levels were analysed in relation to clinical severity parameters and 28-day mortality. Results: A dynamic cytokine response was observed during the first 72 h, with a significant increase in TNF-α levels and a decrease in IL-10 and IL-1β. Non-survivors showed higher TNF-α levels than survivors. In the multivariable analysis adjusted for clinical severity, TNF-α remained independently associated with 28-day mortality, whereas other cytokines did not retain statistical significance. The overall predictive performance of cytokines was moderate. Conclusions: Early cytokine dynamics reflect the evolving inflammatory response in critically ill COVID-19 patients. TNF-α emerges as an independent predictor of mortality, supporting its role as a relevant biomarker of adverse outcomes. Although its predictive capacity is moderate, TNF-α may provide clinically meaningful information for risk stratification when integrated with established clinical and laboratory parameters. Full article

The influence of growing site conditions on the chromatic properties of heartwood in black locust (Robinia pseudoacacia L.) cultivar ‘Nyírségi’ sampled from five regions of Hungary was investigated in this study. A total of 23 boards (average age of trees: 34.5 years) representing four site types were analyzed by instrumental colorimetry using the CIE Lab system. The overall average color coordinates were L* = 69.9 ± 4.0, a* = 4.0 ± 0.8, and b* = 27.4 ± 2.3. Significant chromatic differences were observed among site types proven by statistical analysis; however, no single site type consistently increased within-site color variability. Average total color differences (ΔE*) ranged from 3.94 to 6.31 across site types, corresponding to “noticeable” to “large” visual differences. Regionally, 89.1% of 55 specimen pairs exhibited clearly perceptible color variation (ΔE* > 2), with 61.8% classified as “large” (ΔE* > 5). Within-tree comparisons revealed ΔE* values of 3.72–3.75 under poor site conditions but <2.0 on good growing sites. The a* and b* components appear with measurable variations across all sites, while the characteristic yellow hue remains distinct and stable independent of site origin due to the high b* value. Full article

Background: Fascicular turnover flap (FTF) is a donor-sparing option for segmental facial nerve repair. This study compared autologous nerve grafting with proximally based and distally based FTF in a rat facial nerve model. Methods: Adult male Wistar rats were randomized to autograft, proximal FTF, or distal FTF (n = 8 per group). A single additional animal with an untreated defect served as a qualitative histological reference. The prespecified primary endpoint was whisker motion amplitude at week 8; the secondary endpoints were central section histomorphometry (nerve tissue area, µm²) and variability metrics (IQR, SD, and coefficient of variation) as measures of reproducibility. Non-parametric tests (Kruskal–Wallis; Mann–Whitney U) were used; pairwise functional comparisons were Holm-corrected; and effect sizes were expressed as Cliff’s δ. Results: At week 8, the overall functional comparison was significant (Kruskal–Wallis p = 0.047), but no pairwise contrast remained significant after Holm correction. Functional recovery was highest in the autograft group, followed by proximal FTF and distal FTF. Both FTF groups showed lower inter-animal variability than autograft for the week-8 functional endpoint, with the distal FTF showing the lowest dispersion. Central section nerve area comparisons did not reach global significance; effect sizes and descriptive statistics favored autograft, and a single unadjusted pairwise contrast (autograft > proximal FTF) should be interpreted cautiously. Conclusions: Both FTF configurations achieved measurable functional and structural regeneration while avoiding an additional free donor nerve graft. Within an 8-week window, autograft remained the benchmark. Between FTF variants, distal FTF produced more stable functional outcomes, but this did not translate into superior functional recovery. Confirmation in larger, balanced cohorts with longer follow-up and vascular/neural labeling is warranted. Full article

Computational thinking (CT) is increasingly recognized as a foundational skill in primary education, yet its developmental progression in the early school years remains underexplored. This study examined CT as a competence comprising three core concepts—sequences, loops, and conditionals—through a cognitive developmental lens. A total of 517 students in Grades 1 to 3 in Greece were assessed using the Greek adaptation of the Beginners Computational Thinking Test (BCTt), a validated tool for young learners. To examine performance trends, conceptual interrelations, and learner profiles, we employed repeated-measures ANOVAs, correlation analysis, and cluster analysis. The results showed that students performed highest in sequences, followed by loops and conditionals, with statistically significant differences across concepts. This pattern was also reflected in the cluster analysis, which identified three distinct student profiles differing in both overall performance and conceptual emphasis. Overall, the findings underscore the progressive nature of CT development and highlight the need for instruction aligned with students’ cognitive readiness and conceptual growth. Full article

Bisphenol A (BPA) is a widely used endocrine-disrupting chemical that has been linked to oxidative stress and inflammation. This study investigated whether carvacrol (CAR), a natural monoterpene with antioxidant potential, mitigates BPA-induced hepatorenal toxicity in rats. Forty-two male Wistar albino rats were allocated into six groups (n = 7/group): control, vehicle (corn oil), BPA (25 mg/kg/day), and BPA co-administered with CAR (12.5, 25, or 50 mg/kg/day) by oral gavage for 30 days. Oxidative status was assessed in liver and kidney homogenates by measuring malondialdehyde (MDA), reduced glutathione (GSH), and the activities of superoxide dismutase (SOD) and catalase (CAT). In addition, histopathological evaluations were performed, and pro-inflammatory gene expression (NF-κB, TNF-α, and IFN-γ) was quantified by RT-qPCR. BPA induced a consistent pro-oxidant pattern, including increased hepatic MDA with depleted antioxidant defenses, and upregulated inflammatory transcripts. Carvacrol attenuated these alterations in a dose-dependent manner, and the CAR50 group was associated with statistically supported improvements across the oxidative stress panel, pro-inflammatory transcript expression, and histopathology scores. Overall, these findings identify carvacrol as a candidate for further preclinical evaluation against BPA-triggered oxidative and inflammatory disturbances in vivo; however, human-relevant extrapolation will require careful attention to dose scaling, bioavailability, and metabolism. Full article

Optical density (OD)-based cell growth measurement is commonly used in high-throughput screening (HTS) during drug discovery or when deciphering the pharmaceutical mechanism of action. While resuspending the cells via a mixing step is often assumed to be necessary prior to OD measurement, its essentiality in HTS workflows has not been systematically verified. Here, through the measurement of the growth of several strains of the microbial yeast Schizosaccharomyces pombe cells, we compared the overall growth dynamics between samples that have been mixed and not mixed. Using statistical quantification by a two-tailed paired t-test followed by multiple comparison corrections, we concluded from the comparison of the doubling time of cells growing in the exponential phase that mixing did not significantly affect the biological interpretation compared to unmixed samples. Doubling time quantification between mixed and unmixed samples showed a difference of approximately 10% on average based on the assessment of the growth of eight strains. As such, if the experimental outcome can accommodate this level of variability, incorporating a mixing step before OD determination would not be necessary. These observations support the simplification of HTS processes, improving the cost efficacy and process efficiency of readouts, yet maintaining the accuracy of data acquisition. Full article

Robust vehicle detection in real-world traffic surveillance remains challenging due to degraded imagery caused by motion blur, adverse weather, and low illumination, which significantly increases detector sensitivity to hyperparameter configurations. This study proposes a “Frugal AI” distributed multi-GPU framework that optimizes hyperparameters via a stochastic simplex-based search coupled with five-fold cross-validation. Utilizing three low-cost NVIDIA GTX 1050 Ti GPUs, the framework performs parallel candidate exploration with an asynchronous model-level exchange mechanism to escape local optima without the overhead of gradient synchronization. Seven CNN backbones—VGG16, VGG19, GoogLeNet, MobileNetV2, ResNet18, ResNet50, and ResNet101—were evaluated within YOLOv2 and Faster R-CNN detectors. To address memory constraints (4 GB VRAM), YOLOv2 was selected for extensive benchmarking. Performance was measured using a harmonic precision–recall-based cost metric to strictly penalize imbalanced outcomes. Experimental results demonstrate that under identical wall-clock time budgets, the proposed framework achieves an average 1.38% reduction in aggregated cost across all models, with the highly sensitive VGG19 backbone showing a 4.00% improvement. Benchmarking against Bayesian optimization, genetic algorithms, and random search confirms that our method achieves superior optimization quality with statistical significance ($p < 0.05$). Under a rigorous IoU = 0.75 threshold, the optimized models consistently yielded F1-scores 0.8444 $\pm$ 0.0346. Ablation studies further validate that the collaborative model exchange is essential for accelerating convergence in rugged loss landscapes. This research offers a practical, scalable, and cost-efficient solution for deploying robust AI surveillance in resource-constrained smart city infrastructure. Full article

Objective: This in vitro study aimed to compare the layer-matched color compatibility of three 3Y/4Y/5Y multilayer zirconia grades marketed in shade A2. Materials and Methods: Disc specimens (18 mm × 1.5 mm) were milled from pre-shaded multilayer zirconia blanks (Katana™ Multi-Layered Zirconia; Kuraray Noritake Dental Inc., Tokyo, Japan) in three grades: UTML (5Y), STML (4Y), and HTML (3Y). Twelve discs per grade were polished and measured on a neutral-gray background (Munsell N7) using a dental spectrophotometer (VITA Easyshade Advance 4.0; VITA Zahnfabrik, Bad Säckingen, Germany) at the incisal, middle, and cervical thirds. Color differences were calculated using CIEDE2000 (ΔE₀₀). Yttria content (wt%) was determined using EDS (JSM-7800F; JEOL Ltd., Tokyo, Japan), and phases were assessed using XRD (X’Pert PRO; Malvern Panalytical, Almelo, The Netherlands); microstructure and grain size were examined using FE-SEM after thermal etching. Statistics: A two-way mixed-design ANOVA with Bonferroni adjustment (α = 0.05) was conducted. Results: A significant incisal-to-cervical gradient was observed within each grade (p < 0.001), whereas layer-matched inter-material differences were small (all ΔE00 < 1.0), i.e., below the commonly accepted perceptibility threshold. EDS confirmed the expected stepwise decrease in Y₂O₃ from UTML to HTML, accompanied by corresponding changes in phase constitution and grain size. Conclusions: Despite compositional and microstructural differences, the three multilayer zirconia grades showed no clinically perceptible layer-matched color differences, supporting their combined use in extended rehabilitations while maintaining the natural-like color gradient across the multilayer blank. Full article

Background and Objectives: This study examined the effects of a novel phytochemical supplement blend on markers of exercise-induced muscle damage. Methods: In a randomised, parallel group design, 24 healthy participants (14 males) consumed 300 mg of a phytochemical blend (calcium fructoborate, turmeric and pomegranate; PB) or inert placebo for 9 days (n = 12 per condition). On day 7, participants performed 150 drop jumps to induce muscle damage. Markers of neuromuscular function, muscle soreness/pain, perceived exhaustion and sleep quality, were measured pre-exercise and 24, 48, and 72 h post-exercise; systemic markers of inflammation, muscle damage, and oxidative stress were measured on these days as well post-exercise and 2.5 h post-exercise. Results: There was an interaction effect for pressure pain threshold in the vastus lateralis (p = 0.041), which was ~21% higher in PB 72 h post-exercise (p = 0.074; d_s = 0.767). Perceived sleep quality was greater 72 h post-exercise in PB (p = 0.049; r_rb = 0.423) and those in the PB condition reported feeling more recovered and less mentally drained post-exercise (p ≤ 0.043). There were no statistically significant between-condition differences for any markers of neuromuscular function, inflammation, oxidative stress or muscle damage (p > 0.05). Conclusion: In conclusion, a novel PB showed promise for attenuating muscle pain and perceived exhaustion, and improving sleep quality, in the days after muscle damaging exercise. The study protocol was pre-registered on the Open Science Framework Registry (registration number: qgw3a). Full article

Knowledge sharing (KS) among healthcare professionals is essential for sustaining organisational learning and facilitating the transfer of expertise between experienced and less experienced professionals, thereby supporting workforce stability and retention in healthcare organisations (HCOs). However, despite its importance, high turnover among healthcare professionals remains a significant and persistent challenge in public HCOs, indicating a potential gap in understanding the mechanisms that support workforce stability. To address this gap, this study examines the interplay between work performance (WP), satisfaction with co-workers (CW), KS and turnover intention (TI) among healthcare professionals. Data from 220 respondents were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) within the Input–Process–Output (IPO) framework. The results indicate that CW positively influences KS, while KS has a negative effect on TI, thereby reducing TI. In contrast, WP does not have a statistically significant effect on KS, nor does it indirectly influence TI through KS. Furthermore, although both WP and CW were hypothesised to be predictors of KS, only CW demonstrates a significant indirect effect on TI through KS. Grounded in Social Exchange Theory (SET) and the Knowledge-Based View (KBV), the results highlight the role of KS and interpersonal relationships in supporting sustainable human resource management (SHRM). Although sustainability-related dimensions were not directly measured, the results suggest potential implications for the Sustainable Development Goals (SDGs), particularly SDG 3, SDG 8, and SDG 9. Full article

Background: Magnesium sulfate (MgSO₄) has been investigated as an adjuvant in perioperative analgesia because of its antagonistic effects on the N-methyl-D-aspartate receptor (NMDA receptor) and its potential to attenuate central sensitization. However, clinical findings regarding its analgesic efficacy remain inconsistent across surgical procedures. Lumbar microdiscectomy is a common spinal procedure in which effective early postoperative pain control is important for patient comfort and early mobilization. This study aimed to evaluate the effect of intraoperative MgSO₄ administration on early postoperative analgesia and perioperative outcomes in patients undergoing lumbar microdiscectomy. Methods: This retrospective single-center cohort study included thirty-eight patients with American Society of Anesthesiologists (ASA) physical status I–II who underwent elective single-level lumbar microdiscectomy under general anesthesia. Patients were divided into two groups according to intraoperative magnesium administration: a control group receiving standard anesthesia without MgSO₄ (n = 19) and an MgSO₄ group receiving an intravenous MgSO₄ bolus of 30 mg/kg followed by a continuous infusion of 10 mg/kg/h until skin closure (n = 19). Postoperative pain intensity was assessed using the Numeric Rating Scale (NRS) at 0, 5, 10, 15, and 30 min after admission to the post-anesthesia care unit. Secondary outcomes included intraoperative remifentanil consumption, extubation time, and time to first mobilization. Complementary in silico analyses included molecular docking and protein–protein interaction (PPI) network analysis. Results: Postoperative NRS scores were numerically lower in the MgSO₄ group; however, between-group differences were not statistically significant. Mean intraoperative remifentanil consumption was numerically lower in the MgSO₄ group (236 ± 166 µg) compared with the control group (319 ± 298 µg), without statistical significance (p = 0.27). Repeated-measures analysis demonstrated the significant effect of time on postoperative NRS scores, whereas the overall group effect was not significant. Molecular analyses indicated stable morphine binding to opioid receptors and highlighted glutamatergic signaling components as central nodes within the interaction network. Conclusions: Intraoperative MgSO₄ administration was not associated with significant improvements in early postoperative pain scores or perioperative recovery parameters following lumbar microdiscectomy. Molecular analyses provide exploratory in silico insights and should be interpreted cautiously given the retrospective design and the in silico nature of these findings. Full article

Effective incident management is a cornerstone of transportation system performance, influencing roadway clearance times (RCTs) and the risk of secondary crashes. This study investigated how towing regulations involving large commercial vehicle crashes and jurisdictional variations affect the management of large-vehicle crashes, focusing on the relationship between regulatory frameworks, incident duration, and secondary crash occurrence with the state of Tennessee as a case study. The objective was to determine whether differences in towing policies, operational mandates, and rural/urban contexts lead to measurable changes in clearance efficiency. A multi-year dataset of more than 770,000 traffic incidents and 4400 towing-involved large-vehicle crashes from 2017 to 2022 was analyzed. Statistical methods, including two-sample testing and hazard-based survival modeling, were applied to evaluate the impact of towing regulations and operational protocols on roadway clearance and secondary crash patterns. The results consistently showed that strong performance-based towing regulations, such as mandated maximum response times and standardized training and equipment requirements, were associated with significantly lower average RCTs. Jurisdictions with enforced rapid-response mandates achieved average clearance durations of approximately 120–130 min, even under high incident volumes, compared to over 150 min in areas without performance benchmarks or with more complex procedural requirements. A pronounced rural–urban divide was observed, with incidents outside urbanized areas averaging 30–40% longer clearance times, largely due to limited towing resources, longer dispatch distances, and less stringent regulatory enforcement. Secondary crash analysis identified that more than 90% of secondary collisions were linked to crashes requiring towing, with the majority occurring within 20 min and 0.5 miles of the primary incident, underscoring the direct connection between delayed clearance and safety risk. These results carry direct implications for transportation policy and incident management practice by providing empirical evidence that standardized, performance-based towing regulations can meaningfully reduce RCTs and secondary crash risk, particularly when paired with investments in rural towing infrastructure Full article

This paper presents a comprehensive life-cycle analysis of distribution transformers, based on realized measurements of the increased power losses as a result of their long-term service under real-world conditions. The study is based on aggregated measured data from extensive fleets of oil-immersed distribution transformers characterized by diverse designs, manufacturing vintages, and service lives. The evolution of no-load losses and short-circuit losses is analyzed as a function of operational duration, structural characteristics, and the specific technologies employed for windings and magnetic core construction. Statistical models describing the variation in these losses are presented, highlighting the limitations of the static assumptions commonly utilized in power distribution network planning. On this basis, an approximation of the time evolution of the transformer’s total power and energy losses is proposed as appropriate for implementation in a life-cycle analysis model. Furthermore, the impacts of thermal loading and abnormal operating conditions—such as unbalanced loads, frequent short circuits, and repeated overheating of the transformer oil—are analyzed as drivers of accelerated transformer aging. These effects are integrated into a unified life-cycle framework, enabling the quantitative assessment of loss variations and their associated operational expenditures (OPEX). A numerical example is provided to evaluate the cost-effectiveness of “repair vs. replacement” scenarios, utilizing a discounted cash flow analysis that incorporates a carbon component. The findings establish a methodological foundation for a broader assessment of technical condition and energy performance, identifying the optimal intervention point for repair or replacement to support decision-making for Distribution System Operators (DSOs) amidst increasing requirements for efficiency and decarbonization. Full article