Search Results (40,179)

Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) exhibits pronounced racial disparities in incidence and outcomes, yet the molecular basis remains poorly understood. Here, we examined racial differences in gene rearrangements (MYC, BCL2, BCL6), fusions (IGH::MYC, IGH::BCL2), and their interactions among White, Black, Asian, and Other-race groups in patients with DLBCL to uncover genetic drivers of disparities. Methods: We analyzed 919 DLBCL cases (2006–2023) from Johns Hopkins Hospital using fluorescence in situ hybridization to detect gene abnormalities. We used logistic regression and proportional odds models, adjusted for age and sex, to evaluate racial differences in five gene abnormalities and 10 gene–gene interaction pairs. Pearson’s Chi-squared and Goodman–Kruskal’s gamma tests assessed prevalence and interaction severity across racial groups. Results: MYC rearrangements and the MYC*IGH::MYC interaction were marginally more frequent in the White group than in Black and Other groups (p = 0.092, p = 0.098, respectively). IGH::BCL2 fusions were more prevalent in the Asian group than in the White group (p = 0.095), and the BCL2*IGH::BCL2 interaction was significantly higher in the Asian group (p = 0.049) than in the White group. Although high-grade B-cell lymphoma (HGBCL) prevalence showed no significant racial differences (p = 0.16), the Asian group exhibited a higher proportion of aggressive HGBCL with concurrent IGH::MYC and IGH::BCL2 fusions compared with the White group (p = 0.076). Age significantly influenced all gene abnormalities and interactions (p < 0.001–0.052), except for MYC rearrangements and specific pairs. Sex and sex–race interactions showed no significant effects. Conclusions: This study highlights molecular contributions to the racial differences in DLBCL disease. Further research collecting ancestry-specific biomarkers, treatment regimens, and clinical variables and outcomes is needed to advance personalized treatment strategies. Full article

Background/Objectives: Falls are a leading cause of hospitalization, injury, and healthcare spending among older adults. Surveillance data on local falls, especially for those associated with Alzheimer’s disease and related dementias (ADRD), are limited. We conducted a surveillance analysis to describe fall-related hospitalizations and their associations with ADRD in Los Angeles County (LAC). Methods: We analyzed countywide hospital discharge data for LAC residents aged 50+ from 2016–2022 (n = 3,520,927) to assess differences in fall-related hospitalizations by ADRD status and demographic characteristics. We used multivariable logistic regression to identify predictors of fall status and multinomial regression to examine associations between ADRD status and discharge disposition. Results: Of all hospitalizations, 6.8% were fall-related. Individuals hospitalized for falls had longer stays, higher charges, and were more frequently female, older, and White. Fall frequency peaks consistently occurred during winter months, with higher seasonal variation among those without ADRD. After adjustment, ADRD diagnosis was associated with increased odds of fall-related hospitalization (AOR = 1.14) and non-routine discharge, including transfer to a short-term hospital (AOR = 1.35), skilled nursing or other care facilities (AOR = 1.88), and home health care (AOR = 1.23). Conclusions: This study provides one of the most comprehensive local assessments of fall-related hospitalization among older adults in the United States. The findings highlight the increased risk and care complexity among patients with ADRD. As results are descriptive and reflect cross-sectional surveillance, temporality and causality cannot be inferred. Nevertheless, the findings underscore the need for better surveillance and integrated fall prevention, discharge planning, and post-hospital support strategies tailored to individuals with ADRD. Full article

Diurnal enuresis can significantly affect a child’s biopsychosocial well-being; however, there is a lack of diagnostic and management algorithms on the diagnosis. The purpose of this literature review is to dissect the development of the evaluation and management of diurnal enuresis. A total of 44 articles published from January 1900 to December 2024 were chosen through literature searches in PubMed, Science Direct, Embase, and Google scholar. Search terms were “Diurnal Enuresis” or “Daytime Incontinence” as Mesh terms, and subsequent terms included “pediatrics”, “urinary bladder, overactive”, and “therapeutics”. Inclusion criteria included studies involving pediatric study subjects aged 5–18 years old with a specific diagnosis of diurnal enuresis, exclusion criteria were studies before 1900 and involving night-time wetting diagnoses. A consensus among the literature and the American Academy of Family Physicians recommends a stepwise diagnostic evaluation, including history taking followed by a focused physical exam, for diurnal enuresis has proven to be the most effective. Regarding treatment, biofeedback was shown to improve symptoms in 74% of cases in one study by Wiener, while pharmacological treatment via Mirabegron (beta 3 agonist) showed a 70% improvement in one study by Fryer, but older drugs such as oxybutynin (anticholinergics) are still preferred. A multidisciplinary approach with TENS therapy, behavioral modification, biofeedback, and pharmacology can enhance effectiveness, improve reliability, and provide more successful results while minimizing the impact of diurnal enuresis on a child’s well-being. Further research is needed to optimize pharmacologic management strategies and improve adherence to increase the likelihood of reaching treatment goals. Full article

Background/Objectives: Socio-cognitive disorders constitute the early-stage disabling dimension of non-motor symptoms of Parkinson’s disease (PD) and affect social functioning and interpersonal adjustment. However, current assessment tools do not adequately reveal the nature of these disorders. The Edinburgh Social Cognition Test (ESCoT) has recently been validated as a multifaceted, sensitive instrument for detecting this dysfunction in various neurological disorders. This study aimed to systematically examine socio-cognitive changes in early-stage PD using the ESCoT and their relationship with executive functions. Methods: This prospective case–control study included 27 early-stage idiopathic PD patients without cognitive impairment and 46 healthy controls. Social cognitive abilities were assessed using the ESCoT, and executive functions via the Frontal Assessment Battery (FAB). Group differences and inter-variable linear associations were evaluated using parametric inferential statistics. The independent predictive contribution of FAB to ESCoT performance was modeled through multiple linear regression. Results: Groups did not differ in age, sex, or education (p > 0.05). PD patients had significantly lower ESCoT total scores (45.67 ± 0.85 vs. 55.52 ± 0.63) and reduced performance across all subscales: Cognitive Theory of Mind (ToM), affective ToM, interpersonal, and intrapersonal norms (p < 0.001). In the PD cohort, FAB correlated strongly with ESCoT (r > 0.40, p < 0.05) and significantly predicted ESCoT total (R² = 0.247, p = 0.008), affective ToM (β = 0.221, p = 0.034), and interpersonal norms (β = 0.447, p = 0.019). Conclusions: This study demonstrates, for the first time, that ESCoT can sensitively capture multidimensional social cognitive deficits in PD, even in preserved global cognitive function. The observed link with executive dysfunction underlines the need for a more integrative approach to cognitive symptoms in PD. Full article

Early and reliable detection of skin cancer is critical for improving patient outcomes and minimizing diagnostic uncertainty in dermatological practice. This study proposes an interpretable hybrid framework that integrates ConvMixer-based deep feature extraction with gradient boosting classifiers to perform multi-class skin lesion classification on the publicly available PAD-UFES-20 dataset. The dataset contains 2298 dermoscopic and clinical images with associated patient metadata (age, gender, and anatomical site), enabling a joint evaluation of demographic and anatomical factors influencing model performance. After data augmentation, normalization, and class balancing using Borderline-SMOTE, Image embeddings extracted via ConvMixer were integrated with patient metadata and subsequently classified using CatBoost, XGBoost, and LightGBM. Among these, CatBoost achieved the highest macro-AUC of 0.94 and macro-F1 of 0.88, with a melanoma sensitivity of 0.91, while maintaining good calibration (Brier score = 0.06). Grad-CAM and SHAP analyses confirmed that the model’s attention and feature importance correspond to clinically relevant lesion regions and attributes. The results highlight that age and body-region imbalances in the PAD-UFES-20 dataset modestly influence predictive behavior, emphasizing the importance of balanced sampling and stratified validation. Overall, the proposed ConvMixer–CatBoost framework provides a compact, explainable, and generalizable solution for AI-assisted skin cancer classification. Full article

Background and Objectives: Age-related macular degeneration (AMD) is an age-associated retinal disorder characterized by blood–retinal barrier (BRB) breakdown and pathological angiogenesis, leading to vascular leakage. The intravitreal administration of anti-VEGF agents remains the most effective treatment for neovascular AMD. However, repetitive intravitreal injections have risks, causing side effects such as cataracts, bleeding, retina damage, and, in severe cases, post-injection endophthalmitis. Hence, the development of innovative drug delivery systems is essential to minimize the risks and discomfort associated with intravitreal injections. Materials and Methods: We developed a microemulsion (ME)-based topical drug delivery system incorporating α-linolenic acid (ALA). In brief, pseudo-ternary phase diagrams were constructed by the water titration method using different combinations of surfactants and cosurfactants (S_mix-Cremophor RH 40: Span 80: Transcutol P in ratios of 1:1.05, 1:1:1, 1:1:1.5) containing ALA as the oil phase. Three blank microemulsions (ME1, ME2, and ME3) were prepared and characterized based on the optimized pseudo-ternary phase equilibrium with a S_mix ratio of 1:1:1. Results: ME3, with an average particle size of 38.59 nm, was selected as the optimized formulation for developing drug-loaded ME containing Fenofibrate, Axitinib, and Sirolimus. The drug-loaded ME showed particle size (46.94–56.39 nm) and in vitro release displayed sustained and longer time drug release for 240 h. The irritation and antiangiogenic activities were evaluated using the hen’s egg chorioallantoic membrane (HET-CAM) assay employing the optimized ME loaded with each drug. Among the three drug-loaded ME, the Sirolimus ME showed a reduction in blood vessel sprouting in the HET-CAM assay, indicating strong antiangiogenic activity. Treatment with the optimized blank ME and Sirolimus ME significantly (p < 0.05) reduced COX-2 protein expression in LPS-stimulated RAW 264.7 cells, suggesting their potential anti-inflammatory effects. Conclusions: Overall, we suggest that the α-linolenic acid-based Sirolimus microemulsion may serve as a promising topical therapeutic approach for managing AMD and offering a potential alternative to invasive intravitreal injections. Full article

Breeding value estimations of Warmblood horses in Poland are based on field performance, but the amount of stallions’ data is still insufficient (334 horses). The first study’s aim is to compare stallions’ results in different stages and evaluate the overall ability using both stages. The effects on preselection (first stage free movement) and performance tests (second stage under rider) were analyzed separately and together as the overall ability. Spearman correlations were evaluated. The second aim was to evaluate the training period on the results. Due to the pandemic and lack of tests, horses had different training periods during the six years studied. The combined year-place effect, horse specialization group, and birth country had effects on four of twelve traits. The regression on age influenced only the preselection jumping trait (p = 0.04), while the training period influenced canter (p = 0.04) and “success” (passed/or not) in the performance test (p = 0.04). It seems that the training period and horse age are more significant for young horses’ performance. The correlations between stages for the same traits are moderate for gaits (<0.53) and low for jumping (<0.3). Thus, at least on a basic phenotypical level, results do not correspond strongly with each other. Full article

Background: Young adults, particularly university students, are at increased risk for psychological distress and burnout. Regular physical activity is widely recognized as a protective factor for mental health. This study aimed to compare physically active and inactive college students in terms of perceived stress, well-being, burnout, and resilience. Methods: A cross-sectional online survey was conducted among Hungarian university students (N = 264; 24.6% male; mean age = 24.21 years). Participants completed validated questionnaires assessing physical activity habits, perceived stress, resilience, and academic burnout. Results: Results showed that students engaging in regular physical activity reported significantly lower levels of perceived stress (Cohen’s d = 0.288) and burnout (Cohen’s d = 0.277), and higher resilience (Cohen’s d = 0.258) and well-being (Cohen’s d = 0.322) compared to their inactive peers. Correlation analyses confirmed strong associations between lower stress, reduced burnout, and greater resilience and well-being. Cluster analysis revealed two distinct psychological profiles: one characterized by higher mental hazards (stress and burnout) and the other by higher mental assets (resilience and well-being). Physical activity was strongly associated with membership in the mentally resilient cluster. Conclusions: These findings underscore the mental benefits of remaining physically active and highlight the importance of physical activity within university settings as a key strategy to enhance resilience, reduce academic burnout, and support the maintenance of mental health among young adults. However, the cross-sectional design, reliance on self-report measures, and convenience sampling limit causal interpretation and generalizability. Full article

Background/Objectives: The clinical presentation of homozygous familial hypercholesterolemia (HoFH) and severe heterozygous familial hypercholesterolemia (sHeFH) often demonstrates substantial overlap, as low-density lipoprotein cholesterol (LDL-C) levels may fall within similar ranges in both conditions. Methods: In this single-center 10-year retrospective study at the University of Debrecen, Hungary, we present the clinical characteristics of patients with 6 HoFH and 6 sHeFH diagnosed by genetic testing, discuss the diagnostic limitations encountered in clinical practice, and outline the key components of therapeutic management. Results: The mean age at diagnosis was lower in the HoFH group (31.83 ± 19.5 vs. 41.83 ± 15.9 years). The differences in total cholesterol (13.48 ± 7.4 vs. 11.02 ± 3.5 mmol/L) and LDL-C levels (10.89 ± 6.6 vs. 8.58 ± 3.26 mmol/L) between the groups were not statistically significant. Interestingly, vascular complications were more frequent in sHeFH group as well (4 vs. 1 patients). In neither the HoFH nor the sHeFH group were we able to achieve the target LDL-C levels, due in part to the specific features of the reimbursement system, patient and parental preferences, the extremely high baseline LDL-C levels, and certain genetic characteristics. Conclusions: Our findings highlight the importance of genetic testing-based personalized therapy in these specific patient subpopulations. We emphasize that serum LDL-C alone is insufficient to distinguish between HoFH and sHeFH patients, and that therapeutic challenges should be anticipated in both groups arising partly from limited patient adherence as well as from financial constraints. Full article

Alzheimer’s disease (AD) is the leading cause of dementia and is often prefaced by mild cognitive impairment (MCI). Detection of AD-related changes via blood-based biomarkers would enable critical therapeutic interventions early in disease progression. Neuronal enriched extracellular vesicle (NEEV) miRNAs regulate peripheral genes as a response to early AD brain changes and hence may have biomarker potential. Plasma NEEVs were captured from plasma samples of Mexican Americans (MAs) and Non-Hispanic Whites (NHWs) using an antibody against the neuronal surface marker CD171. miRNAs isolated from NEEVs were sequenced and analyzed using miRDeep2/DEseq2 and QIAGEN RNA-seq portal for differential expression between cognitively impaired (CI) and cognitively unimpaired controls. hsa-miR-122-5p was significantly underrepresented in the CI group in both MAs and NHWs compared to the healthy control. Other population-specific miRNAs (MAs: hsa-miR-26a-5p, hsa-let-7f-5p, and hsa-miR-139-5p, NHWs: hsa-miR-133a-3p, hsa-miR-125b-5p, and hsa-miR-100-5p) identified may have biomarker potential in AD precision medicine. Some of these differentially expressed miRNAs were associated with key AD-related comorbidities such as APOE genotype, age, and metabolic burden and were predicted to target genes within NF-κB -regulated inflammatory pathways. Together, these findings suggest that dysregulated miRNA networks may serve as a mechanistic link between comorbidity burden and AD-related neuroinflammation and neurodegeneration. Full article

Molybdenum oxide (MoO_X) has been widely utilized as a hole transport layer (HTL) in crystalline silicon (c-Si) solar cells, owing to characteristics such as a wide bandgap and high work function. However, the relatively low conductivity of MoO_X films and their poor contact performance at the MoO_X-based hole-selective contact severely degrade device performance, particularly because they limit the fill factor (FF). Oxygen vacancies are of paramount importance in governing the conductivity of MoO_X films. In this work, MoO_X films were modified through ultraviolet irradiation (UV-MoO_X), resulting in MoO_X films with tunable oxygen vacancies. Compared to untreated MoO_X films, UV-MoO_X films contain a higher density of oxygen vacancies, leading to an enhancement in conductivity (2.124 × 10⁻³ S/m). In addition, the UV-MoO_X rear contact exhibits excellent contact performance, with a contact resistance of 20.61 mΩ·cm², which is significantly lower than that of the untreated device. Consequently, the application of UV-MoO_X enables outstanding hole selectivity. The power conversion efficiency (PCE) of the solar cell with an n-Si/i-a-Si:H/UV-MoO_X/Ag rear contact reaches 24.15%, with an excellent FF of 84.82%. Full article

Background: Population ageing is a global challenge, prompting ageing-in-place policies in Hong Kong to support community-dwelling older adults while reducing healthcare costs. Yet, their impact on health-related quality of life (HRQoL) remains underexplored amid Hong Kong’s long life expectancy and growing older population. Traditional surveys are costly and time-consuming, while routinely collected registration data offers a large, efficient source for health insights. This study uses enhanced administrative data to track HRQoL trajectories and inform policy. Methods: This is a prospective, open-ended longitudinal study, enrolling adults aged 50 or older from a collaborating non-governmental organization in Hong Kong’s Southern District. Data collection, started in February 2021, occurs annually via phone and face-to-face interviews by trained social workers and volunteers using a standardized questionnaire to assess individual (e.g., socio-demographics), environmental (e.g., social support via Lubben Social Network Scale-6), biological (e.g., chronic illnesses), functional (e.g., cognition via Montreal Cognitive Assessment), and HRQoL (e.g., EQ-5D-5L) factors. A secure online system links health and service use data (e.g., service utilization like community care visits). Analysis employs descriptive statistics, group comparisons, correlations, growth modelling to identify health trajectories, and structural equation modelling to test a revised quality-of-life framework. Sample size (projected 470–580 after two follow-ups from a 2321 baseline) is based on power calculations: 300–500 for latent class growth analysis (LCGA) class detection and 200–400 for structural equation modelling (SEM) fit (e.g., RMSEA < 0.06) at 80% power/α = 0.05, simulated via Monte Carlo with a 50–55% attrition. Discussion: This is the first longitudinal HRQoL study in Hong Kong using enhanced non-governmental organization (NGO) administrative data, integrating social–ecological and HRQoL models to predict trajectories (e.g., stable vs. declining mobility) and project care demands (e.g., increase in in-home care for frailty). Unlike prior cross-sectional or inpatient studies, it offers a scalable model for NGOs, informing ageing-in-place policy effectiveness and equitable geriatric care. Full article

Background: skull base chordoma (Ch) and chondrosarcoma (ChSa) are rare neoplasms prone to local relapse. Alongside surgery, proton therapy (PT) is a well-established treatment for them. Given the relatively long patient survival expectancy, post-treatment quality of life (QoL) is crucial. This study prospectively assessed long-term QoL in this collective. Methods: seventy-seven adult patients (median age, 50 years; male n = 31; 40.3%) with skull base Ch/ChSa completed at least two EORTC-QLQ-C30 and BN20 questionnaires during and after PT. Oncological outcomes and therapy-related toxicities were recorded during follow-up. QoL was analyzed, with post-treatment scores compared to each patient’s baseline and correlated to oncological outcomes. Results: median follow-up was 51 months (range, 1–94), with 5-year overall survival (5yOS) and local control (5yLC) rates of 88.8% and 82.8%, respectively. The time to local or distant failure ranged from 8 to 58 (median, 22) months. QoL deteriorated directly at completion of PT and two to three years thereafter, especially in patients with local or distant failure. From the fifth year onward, QoL improved again. Complete resection before PT correlated to better QoL at all time points. Disease progression was associated with overall worse QoL, higher neurological symptoms already before PT, and higher symptom burden one year thereafter. Males reported better QoL before and one year after PT than females. Conclusions: PT achieves excellent OS and LC in patients with skull base Ch/ChSa. QoL declines directly after PT but remains close to reference population values. From the fifth year onward, QoL improves again. Gender, resection status, and disease progression significantly affect QoL in these patients. Full article

Early detection of pancreatic ductal adenocarcinoma (PDAC) could extend patient survival, and biomarkers to facilitate this are urgently needed. Here, we performed a second independent validation of PancreaSure, a 5-plex serum biomarker signature to detect early-stage PDAC in high-risk individuals. In contrast to the first validation, this study’s cohort was preemptively balanced for age and sex and only included samples stored for fewer than 5 years. The primary endpoint was to measure test sensitivity against the performance target of 65%. Measuring specificity against the performance target of 90% and comparing test performance to that of carbohydrate antigen 19-9 (CA 19-9) alone were secondary endpoints. Signature analytes were retrospectively measured in serum from a blinded independent cohort of Stage I and II PDAC cases and high-risk controls. A predictive signal for PDAC was generated from a predefined cutoff established in a previous model development study. PancreaSure distinguished early-stage PDAC from controls with 76.5% sensitivity (95% CI, 67.7–83.9), significantly higher than the performance target (p = 0.005). PancreaSure achieved 87.8% specificity (95% CI, 83.9–91.4), similar to the performance goal, and significantly outperformed sensitivity of CA 19-9 alone (p = 0.02). These results confirm that PancreaSure performs well at detecting early-stage PDAC in high-risk individuals. Full article

Gait impairment in post-stroke patients increases the risk of falls, but the role of ground reaction force variability (GRF variability) in controlling gait stability remains unclear. The objectives of this study were (1) to clarify the differences in GRF variability during walking between post-stroke patients and age-matched controls and (2) to identify the differences in GRF variability between post-stroke patient fallers and non-fallers. Sixteen post-stroke patients (age: 72.19 ± 8.54, six female, four fallers: age: 71.75 ± 11.32, twelve non-fallers: age: 72.33 ± 8.03) and nineteen age-matched controls (age: 68.63 ± 5.73, nine female) participated. GRF variability was measured using shoe sensors during walking. After adjusting for walking speed, the anterior–posterior (AP) GRF variability on the paretic side in the 91–100% stance phase was significantly lower in the post-stroke patients (F = 3.721, p = 0.038). This phase’s AP GRF variability was not correlated with Berg Balance Scale scores. Furthermore, the faller group in stroke patients showed the AP GRF variability on the paretic side was lower in the 41–50% (W = 17, p = 0.045), 51–60% (W = 16, p = 0.045), 61–70% (W = 16, p = 0.045), and 91–100% (W = 23, p = 0.045) sub-stance phases. After adjusting for sex and orthosis, the sensitivity analysis showed no significant intergroup difference. This suggested an adaptive control mechanism for maintaining gait and avoiding falls in post-stroke patients. Full article