Search Results (59,592)

Background and objectives: Early recurrence (ER) following curative-intent surgery for pancreatic ductal adenocarcinoma (PDAC) is associated with poor prognosis. Identifying preoperative risk factors for ER is essential for optimizing perioperative strategies. This study aimed to investigate perioperative predictors of ER, with a specific focus on tumor localization. Methods: We retrospectively analyzed 163 patients who underwent R0 or R1 resection for PDAC. ER was defined as recurrence within 6 months postoperatively. Two separate multivariate logistic regression analyses were conducted: one including only preoperative variables, and one including both pre- and postoperative factors. Results: ER occurred in 35.6% of patients and was associated with significantly worse overall survival (median 9 vs. 21 months, p < 0.001) and post-recurrence survival (5 vs. 8 months, p = 0.008). Preoperative ECOG performance status > 0 (OR 3.31, p = 0.013) and CA 19-9 > 208 U/mL (OR 3.18, p = 0.022) were identified as independent predictors of ER. In the postoperative model, tumor localization in the body/tail (OR 3.23, p = 0.035), tumor size > 3.25 cm, lymph node ratio > 0.13, and absence of adjuvant therapy were also significant. Notably, tumor location did not influence overall survival. Conclusions: Tumor localization in the body/tail of the pancreas is independently associated with early recurrence but not overall survival. These findings highlight the importance of incorporating tumor site into preoperative risk stratification and support the consideration of neoadjuvant therapy in select anatomically resectable patients, particularly those with left-sided tumors. Full article

Background and Objectives: To analyze changes in risk factors for refractive errors among Korean adolescents before and after the COVID-19 pandemic and examine the impact of lifestyle modifications on myopia development, Methods: this cross-sectional study utilized nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016) and VIII (2021). We analyzed 691 adolescents aged 10–18 years from 2016 (pre-COVID-19) and 490 from 2021 (post-COVID-19). Refractive errors were categorized as hyperopia (≥+0.50 D), emmetropia (−0.50 to +0.50 D), myopia (−6.00 to −0.50 D), and high myopia (≤−6.00 D). Complex sample linear regression analyses identified factors associated with spherical equivalent (SE) refractive errors. Results: At the population level, overall myopia prevalence declined from 84.2% in 2016 to 77.4% in 2021, whereas the prevalence of high myopia increased from 10.0% to 11.5% (p = 0.047). This indicates that although the absolute proportion of adolescents with myopia decreased, the relative contribution of high myopia to the overall myopia burden within this population increased. Mean SE was −2.77 ± 0.11 D in (−10.63~+3.00 D/median: −2.00 D) 2016 and −2.63 ± 0.13 D (−14.00~+1.63/median: −1.75 D) in 2021 (p = 0.443). Age-related myopia progression accelerated post-pandemic (−0.193 D to −0.324 D per year in univariate regression and −0.185 D to −0.312 D, in multivariate regression analysis, p < 0.001). In both the 3 h and ≥4 h near work groups, statistically significant associations were observed at both time points, but a greater myopic shift was evident after COVID-19 (B = –0.853 and –0.757 in 2016; B = –1.311 and –1.167 in 2021, p < 0.05). Conclusions: The COVID-19 pandemic altered myopia risk factors among Korean adolescents. High myopia prevalence increased despite overall myopia with underweight status and environmental factors such as digital device time and urban living identified as important considerations for post-pandemic myopia prevention. Full article

Background: The high-intensity demands of CrossFit induce respiratory muscle fatigue, potentially impairing performance via the metaboreflex. Respiratory muscle training (RMT) may mitigate this effect, but evidence in female athletes remains limited. Objective: We aimed to investigate the effects of RMT on sport-specific performance and maximal inspiratory pressure (PIMAX) in recreational female CrossFit practitioners. Design: We conducted a parallel-group randomized controlled trial. Setting: The study was conducted in a CrossFit-affiliated gym. Participants: We recruited twenty-nine recreational female practitioners (age: 30.3 ± 7.9 years) with ≥1 year of uninterrupted training who were free from respiratory diseases. Interventions: Participants were randomized to a CrossFit-only group (n = 14) or CrossFit + RMT group (n = 15). Both trained 5 days/week for 6 weeks; the RMT group additionally performed 30 inspiratory efforts at 50% of PIMAX, 5 days/week, with weekly load adjustment. Main Outcome Measures: Primary: Sport-specific performance (total repetitions in a 10-min AMRAP [As Many Rounds As Possible] test). Secondary: PIMAX (cmH₂O). Measurements were taken pre- and post-intervention. Results: Baseline performance and PIMAX were similar between groups. After 6 weeks, the CrossFit + RMT group improved in performance more (Δ = +10.5 ± 10.7 reps, p = 0.03, ηp² = 0.168) than the CrossFit-only group (Δ = +2.3 ± 8.1). PIMAX gains were also greater with RMT (Δ = +19.6 ± 8.4 cmH₂O, p = 0.043, ηp² = 0.148) vs. control (Δ = +10.1 ± 9.7). No adverse events occurred. Conclusions: Adding RMT to CrossFit training enhanced sport-specific performance and inspiratory strength in recreational female practitioners more than CrossFit alone. RMT appears to be a safe and effective complementary strategy for high-intensity functional training. Full article

This article presents the ADAImpact tool, a QGIS plugin designed to assess the potential impacts of geohazards—such as landslides, subsidence, and sinkholes—using open-access surface displacement data from the European Ground Motion Service (EGMS), which is based on Sentinel-1 satellite observations. Created as part of the European RASTOOL project, ADAImpact integrates InSAR-derived ground movement data with exposure datasets (including population, infrastructure, and buildings) to support civil protection agencies in conducting risk assessments and planning emergency responses. The tool combines “Process Magnitude”, with “Exposure” metrics, quantifying the population and critical infrastructure affected, to generate potential impact maps for ground motion hazards. When applied to case studies along the Portugal–Spain border and the coastal region of Granada, Spain, ADAImpact successfully identified areas of high potential impact. These results underscore the tool’s utility in pre- and post-disaster assessment, highlighting its potential for scalability across Europe. Full article

Background: Breast cancer-related lymphedema (BCRL) is a common and debilitating treatment-related adverse event that can profoundly impact quality of life and financial well-being. Although prospective surveillance and early intervention for BCRL have been shown to reduce the incidence and severity of this chronic condition, diagnostic accuracy of screening, programmatic utilization and efficacy vary widely. We describe the protocol for the BCRL Prospective Surveillance Model (PSM) and Early Intervention Program at the Dana-Farber Brigham Cancer Center that aims to address these issues by augmenting arm measurements (standard of care) with use of patient-reported outcome metrics (PROMs). Methods: Women with newly diagnosed stage I-III breast cancer at high risk for developing BCRL based on tumor and treatment characteristics are eligible for inclusion in our PSM care pathway, which uses both the Breast Cancer and Lymphedema Symptom Experience Index PROMs and arm measurements for screening. Screening begins prior to the initiation of neoadjuvant therapy and continues at regular intervals postoperatively. A positive screen, defined as new patient-reported arm swelling/heaviness and/or relative volume change (RVC) ≥ 5% in the affected limb, triggers consideration for multidisciplinary early intervention. Analysis: The BCRL detection rate will be compared to years previous to protocol development. PSM feasibility will be determined according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Efficacy of the PSM will be gauged by comparing change in patient-reported outcomes of interest and arm volume measurement pre and post early intervention. Feasibility will be determined by calculating the percentage of PSM-eligible individuals who complete all PSM activities in a 1-year span. Characteristics of participants versus non-participants in the target population will be compared. Furthermore, 1:1 semi-structured interviews with enrolled patients will be performed to understand facilitators and barriers to implementation. Conclusions: The findings from this study will be used to develop a standardized approach to PSM and early intervention that can be adapted to both resource-modest and resource-abundant healthcare infrastructures. Full article

Pancreatic ductal adenocarcinoma (PDAC) represents a malignancy characterized by one of the lowest survival rates; furthermore, at the time of diagnosis, the majority of tumors are deemed unresectable. Consequently, there exists a pressing need to investigate early signs and symptoms, as well as to implement screening protocols for patients at risk of developing PDAC. By doing so, we may enhance the potential for improved treatment outcomes in light of the typically poor prognosis associated with PDAC. A review of recent literature focused on symptoms that manifest prior to the diagnosis of PDAC has been conducted, emphasizing the underlying biological mechanisms and potential screening applications, alongside data pertaining to the influence of these symptoms on prognosis and treatment. Additionally, the roles of pre-existing pain, depression, diabetes mellitus, and paraneoplastic syndromes in treatment and outcomes were scrutinized to ascertain the feasibility of integrating these factors into clinical practice. Full article

The Yangtze River Delta (YRD) region has experienced rapid development in its tourism industry, establishing itself as a leading force within China’s tourism sector. However, significant regional disparities continue to hinder its sustainable development. This study adopts a mixed-methods approach to analyze the spatiotemporal evolution of domestic tourist flows and tourism industry agglomeration patterns in the region. Using city-level data from 2016 to 2022, the analysis employs a comprehensive methodology including standard deviation, coefficient of variation, standard deviation ellipse, and locational entropy. The main findings are as follows: (1) In the pre-pandemic period (2016–2019), absolute disparities in tourist flows widened, whereas relative disparities narrowed. During the pandemic (2020–2022), absolute disparities decreased, while relative disparities initially increased before contracting. (2) Tourist flows displayed a southeast–northwest gradient, with high-value areas clustered along the southeastern coast. Standard deviation ellipse analysis reveals that tourist flows were primarily distributed along the eastern coastal corridor, parallel to the coastline. Prior to the pandemic, tourism growth showed a tendency toward spatial equilibrium; however, this trend was disrupted during the pandemic, resulting in a more decentralized spatial pattern. (3) Throughout the pandemic, tourism industry concentration increased significantly in most cities. Cities with renowned scenic attractions and diversified economic structures demonstrated stronger resilience, while those heavily reliant on tourism were more vulnerable to the pandemic’s effects. Full article

Background: Globally, uncorrected refractive errors are recognized as the primary cause of visual impairment and blindness. According to a report by the World Health Organization (WHO), providing spectacle lenses at an affordable cost remains a significant challenge, particularly for underprivileged populations in developing countries. This challenge contributes to the low compliance with spectacle wear worldwide. However, the benefits of wearing spectacles are influenced by the perceptions of the population regarding spectacle use. Methods: A quantitative, cross-sectional survey-based study was conducted at a superior educative center in Oman, the University of Buraimi. Participants were recruited from the four major colleges, namely, the College of Health Sciences (COHS), College of Business (COB), College of Engineering (COE), and College of Law (COL), and the Center for Foundation Studies (CFS). This study was conducted over the period from 18 December 2022 to 18 December 2023. Essential data were collected using an electronic questionnaire facilitated by the Google platform. The initial section of the questionnaire outlines this study’s objectives and its benefits to the community. The digital survey comprises three sections: the first section addresses the sociodemographic profile of the participants; the second section explores perceptions related to spectacles; and the third section examines visual symptoms associated with spectacle wear. In this study, a pre-tested survey was administered following consultation with a panel of three subject matter experts who reviewed the clarity and content validity of the test items. Data analyses were performed using descriptive statistics, and linear regression was applied to assess the effect of socioeconomic profile on perceptions of spectacles. Additionally, data entry, processing, and analysis were conducted using SPSS 25 software. The overall mean score for spectacle-related visual symptoms was 2.51 ± 0.75, indicating a moderate level of symptom occurrence. Results: A total of 415 participants (N = 415) were included in this study, comprising 133 males (32.0%) and 282 females (68.0%). The most prominent symptoms related to spectacle perception were “light sensitivity” and “eye pain”, with mean values of 3.03 ± 1.30 and 3.04 ± 1.25, respectively. Additionally, 249 participants (60%) reported moderate concern regarding spectacle-related visual symptoms. Among female participants, 118 (41.8%) exhibited little concern about visual symptoms associated with spectacle wear, whereas this was observed in 25.6% of male participants. Descriptive statistics indicated the mean perceived spectacle-related disadvantages score measured on a scale of 0 to 4 was 2.88 ± 1.16 (57.69% ± 23.15% in percentages), reflecting a moderate perception of such disadvantages. The linear regression model demonstrated statistical significance, as indicated by the likelihood ratio chi-square = 199.194 (df = 15, p < 0.001). The most significant predictor was study major (χ² = 72.922, p < 0.001). Conclusions: The present study indicates that undergraduate students generally exhibit a low perception of the disadvantages associated with wearing spectacles. Randomized sampling should be preferred in future studies to the convenience sampling technique. The most frequently reported visual symptoms include “light sensitivity and eye pain” among spectacle wearers. Therefore, it is imperative to implement health education programs and foundational studies across colleges to address these issues among undergraduate university students. Full article

High non-esterified fatty acids (NEFAs) during negative energy balance in dairy cattle can impair reproduction. While their effects on oocyte maturation and preimplantation embryo development are known, their impact during fertilisation is largely unexplored. This study examined the effects of high NEFA exposure exclusively during in vitro fertilisation (IVF). Bovine oocytes were matured in vitro and fertilised under physiological or high NEFA concentrations. High NEFA concentrations decreased fertilisation, cleavage, and blastocyst rates. Reactive oxygen species production in zygotes was not affected, but blastocysts derived from the High-NEFA group had fewer cells. Spermatozoa exposed to high NEFA concentrations exhibited increased plasma membrane and acrosome damage, higher DNA fragmentation, and reduced mitochondrial membrane potential. The expression of H3K27me3, a repressive histone mark normally erased from fertilisation to embryonic genome activation, was higher in 2-cell than in 4-cell embryos on day 2 after IVF, but only in the High-NEFA group. This delayed H3K27me3 loss, along with increased DNA damage, could partially explain the reduced blastocyst formation observed. In conclusion, high NEFA concentrations can impair pre-implantation embryo development during zygote formation, potentially via effects on both the oocyte and spermatozoon. The latter warrants further investigation using an intracytoplasmic sperm injection model. Full article

This study explores an innovative delivery strategy for the management of skin conditions: lipid nanosystems incorporated into a gel matrix. Echinacea purpurea extract, known for its antibacterial, antioxidant, and wound-healing properties, was encapsulated into lipid-based nanosystems and subsequently incorporated into Carbopol-based gel. The extract, rich in chicoric and caftaric acids, exhibited strong antioxidant activity (IC₅₀ = 56.9 µg/mL). The resulting nanosystems showed nanometric size (about 200 nm), high entrapment efficiency (63.10–75.15%), and excellent short-term stability. Superior biocompatibility of the nanosystems, compared to the free extract, was demonstrated using an MTS assay on L-929 fibroblasts. Moreover, the cytoprotective potential of the lipid carriers was evident, as pre-treatment significantly increased cell viability under H₂O₂-induced oxidative stress. These findings suggest that lipid-based encapsulation enhances the therapeutic profile of E. purpurea. The optimal lipid formulation was incorporated into a Carbopol-based gel, which demonstrated an appropriate pH (5.15 ± 0.75), favorable textural properties, sustained polyphenol release, and overall good stability. This research highlights the potential of plant-derived bioactives in the development of dermatocosmetic products, aligning with current trends in eco-conscious and sustainable skincare. Full article

The use of molybdenum-based alloys as materials for components operating under high temperatures and significant mechanical loads is widely recognized due to their excellent mechanical properties. However, their low high-temperature resistance remains a critical limitation, which can be effectively mitigated by applying protective coatings. In this study, we investigate the influence of a two-step coating process on the properties and performance of the TZM molybdenum alloy. In the first step, pack cementation was performed. Simultaneous surface saturation with aluminum and silicon, a process known as aluminosiliconizing, was conducted at 1000 °C for 6 h. The saturating mixture comprised powders of aluminum, silicon, aluminum oxide, and ammonium chloride. The second step involved the application of a pre-ceramic coating based on polyhydrosiloxane modified with silicon and boron. This treatment effectively eliminated pores and cracks within the coating. Thermodynamic calculations were carried out to evaluate the likelihood of aluminizing and siliconizing reactions under the applied conditions. Aluminosiliconizing of the TZM alloy resulted in the formation of a protective layer 20–30 µm thick. The multiphase structure of this layer included intermetallics (Al₆₃Mo₃₇, MoAl₃), nitrides (Mo₂N, AlN, Si₃N₄), oxide (Al₂O₃), and a solid solution α-Mo(Al). Subsequent treatment with silicon- and boron-modified polyhydrosiloxane led to the development of a thicker surface layer, 130–160 µm in thickness, composed of crystalline Si, amorphous SiO₂, and likely amorphous boron. A transitional oxide layer ((Al,Si)₂O₃) 5–7 µm thick was also observed. The resulting coating demonstrated excellent structural integrity and chemical inertness in an argon atmosphere at temperatures up to 1100 °C. High-temperature stability at 800 °C was observed for both coating types: aluminosiliconizing, and aluminosiliconizing followed by the pre-ceramic coating. Moreover, additional oxide layers of SiO₂ and B₂O₃ formed on the two-step coated TZM alloy during heating at 800 °C for 24 h. These layers acted as an effective barrier, preventing the evaporation of the substrate material. Full article

The development of single-crystal Ni-rich layered cathode materials (SC-NCMs) is regarded as an effective strategy to address the mechanical failure issues commonly associated with polycrystalline counterparts. However, the industrial production of SC-NCM faces challenges such as lengthy processing steps, high manufacturing costs, and inconsistent product quality. In this study, we innovatively propose a metal/organic framework (MOF)-mediated one-step synthesis strategy to achieve controllable structural preparation and in situ Nb⁵⁺ doping in SC-NCM. Using a Ni–Co–Mn-based MOF as both precursor and self-template, we precisely regulated the thermal treatment pathway to guide the nucleation and oriented growth of high-density SC-NCM particles. Simultaneously, Nb⁵⁺ was pre-anchored within the MOF framework, enabling atomic-level homogeneous doping into the transition metal layers during crystal growth. Exceptional electrochemical performance is revealed in the in situ Nb-doped SC-NCM, with an initial discharge capacity reaching 176 mAh/g at a 1C rate and a remarkable capacity retention of 86.36% maintained after 200 cycles. This study paves a versatile and innovative pathway for the design of high-stability, high-energy-density cathode materials via a MOF-mediated synthesis strategy, enabling precise manipulation of both morphology and chemical composition. Full article

Optimizing the neuromechanical determinants of explosive performance remains a key objective in sports science. This study compared the effects of an eight-week movement-pattern-based training program (MPT) with an isometric strength training protocol (ITG) on countermovement jump (CMJ) mechanics in competitive track and field athletes. Thirty-four athletes (19 men, 15 women) with ≥7 years of training experience were randomly allocated to the MPT or ITG. Pre- and post-intervention assessments were conducted using dual force plates to evaluate jump height, musculotendinous stiffness, concentric and eccentric impulses, contraction time, eccentric-to-concentric force ratio, and rate of force development (RFD). The MPT elicited significant gains in stiffness (Δ = +840.94 ± 1302.21 N/m; p = 0.002), maintained concentric peak force, and reduced contraction time (Δ = –64.53 ± 190.32 ms; p = 0.01), suggesting improved elastic efficiency and neuromuscular timing. Conversely, ITG was associated with reductions in concentric peak force (Δ = –66.18 ± 77.45 N; p = 0.003) and stiffness (Δ = –691.94 ± 1414.41 N/m) and an increase in the eccentric-to-concentric force ratio (Δ = +1.99%; p = 0.006). The RFD changes were inconsistent across both groups. These findings indicate that dynamic multi-joint training confers superior neuromechanical adaptations compared to isolated isometric loading. From a performance perspective, programming strategies should prioritize movement-specific dynamic tasks to enhance the explosive qualities critical for sprinting, jumping, and multidirectional field sports. Full article

Weeds are a primary factor affecting sugarcane production and productivity in Thailand. During the late-rainy season, when cultivation is carried out under rainfed conditions, weed competition becomes increasingly severe, prompting farmers to perform secondary weed control using post-emergence herbicides. Therefore, to guide farmers on the appropriate use of herbicides for effective weed management and long-term control during the critical period of sugarcane growth, this study evaluates the effectiveness of pre- and post-emergence herbicides. Conducted in Northeast Thailand using a randomized complete block design (RCBD) with four replications, the experiment revealed that several pre-emergence herbicides, namely pendimethalin + imazapic (825 + 75 g a.i. ha⁻¹), indaziflam (62.5 g a.i. ha⁻¹), and sulfentrazone (875 g a.i. ha⁻¹), and a combination of indaziflam + sulfentrazone (46.88 + 750 g a.i. ha⁻¹) were applied one day after sugarcane planting, demonstrating high weed control efficacy. These treatments significantly reduced the summed dominance ratio (SDR) of both total weed (41.65–78.54%) and dominant weeds (70.13–86.04%), including Digitaria ciliaris (Retz.) Koel., Dactyloctenium aegyptium (L.), Brachiaria distachya (L.) Stapf, and Cyperus rotundus, compared with the no-weeding treatment. In summary, effective weed management in sugarcane fields under late-rainy season can be achieved through the application of pendimethalin + imazapic at 825 + 75 g a.i. ha⁻¹, which produced the highest sugarcane yield (a 139.00% increasing compared with no weeding) and net profit (a 79.75% increasing compared with hand weeding) in loamy sand soil conditions, where D. ciliaris, D. aegyptium, and C. rotundus were dominant weeds. Similarly, indaziflam at 62.5 g a.i. ha⁻¹ yielded the best results (a 71.68% increasing compared with no weeding) and net profit (a 121.04% increasing compared with no weeding) in sandy loam soil, where B. distachya was the only dominant weed. This weed management strategy is potentially transferable to sugarcane production systems in other regions that share comparable soil properties, climatic conditions, and dominant weed species. Full article

This study presents the modeling and analysis of a composite structure incorporating an embedded macro fiber composite (MFC) patch. MFC actuators are available in several variants, with types P1 and P2 being the most commonly used. In this paper, an electromechanical model of the hybrid structure is developed, and experimental procedures are outlined for identifying selected system parameters. In the first phase of the study, two separate cantilever beam specimens are investigated—one with an embedded P1 patch and the other with a P2 patch. Their behaviors are tested and compared to identify and critically assess the advantages and limitations associated with each MFC type. In the second phase, a more complex system—a bistable cantilever shell—is examined. The choice of the appropriate MFC type (P1 or P2) for this structure is based on the findings obtained in the first phase. For the system incorporating the selected MFC patch, the dynamic response is analyzed in the vicinity of both stable equilibrium states, which are characterized by significantly different levels of pre-strain and pre-stress. The study concludes with highlights for the design of smart composite structures with integrated MFC patches. Full article