Search Results (2,801)

Background and Objectives: Atrial fibrillation (AF) is a common arrhythmia in patients with mitral valve prolapse (MVP) after mitral valve repair surgery and is associated with adverse cardiac outcomes. Early identification of patients at high risk for AF development after repair surgery is crucial for early treatment and follow-up of these patients. This study aimed to identify ECG predictors of AF in patients with MVP following mitral valve repair surgery. Materials and Methods: This retrospective, non-randomized study included 62 patients who underwent mitral valve repair for MVP. The patients’ ECGs were analyzed preoperatively and at 1, 3, and 6 months post-surgery to identify patients who developed AF. AF was diagnosed based on ECG findings or Holter monitoring. The P wave dispersion, P wave peak time (PWPT), P wave duration, PR interval, P wave terminal force in lead V1 (PWTF), interatrial block, P wave axis, biphasic P waves in inferior leads, QRS duration, corrected QT interval (QTc), fragmented QRS (fQRS), and ST segment-T wave abnormalities were analyzed on baseline ECG as AF predictors. Results: The PWPT, P wave dispersion, and maximum P wave duration were significantly longer on preoperative ECG in patients who developed AF postoperatively compared to those who did not. Biphasic P waves were more frequently observed in patients who developed AF postoperatively. Univariate analysis identified biphasic P waves, P wave dispersion, maximum P wave duration, PWPT, and left ventricular ejection fraction (LVEF) as potential predictors of postoperative AF. However, multivariate analysis revealed that P wave dispersion, PWPT, and left atrial volume index (LAVI) were independent predictors of AF in six months after mitral valve repair. No significant changes were observed in QRS duration, QT interval, or the fQRS. Conclusions: The P wave dispersion, PWPT, and LAVI are significant ECG predictors of AF following mitral valve repair surgery in MVP patients. These ECG markers may help identify individuals at higher risk for postoperative AF, allowing for targeted monitoring and management strategies. Full article

A pressing scientific task is the development of modern extractants that meet the increased requirements for efficiency and safety. In this work, a new three-component eutectic solvent based on bis(2,4,4-trimethylpentyl)phosphinic acid (BTMPPA), tributyl phosphate (TBP) and phenol was proposed. The formation of the eutectic solvent was confirmed by IR and ³¹P NMR spectroscopy. The temperature dependences of the main physical properties of the proposed eutectic solvent—the refractive index, density and viscosity—were determined. For the first time, the extraction properties of the eutectic solvent BTMPPA/TBP/phenol (1:1:2) were studied using the example of the extraction of metal ions from aqueous nitrate solutions. The extraction efficiencies of Pr, Nd and Dy in a single stage were 34, 38 and 81%, respectively. The extraction behaviour of Pr, Nd and Dy with the eutectic solvent BTMPPA/TBP/phenol was studied as a function of pH, salting-out agent concentration, component ratio in the eutectic mixture, phase volume ratio, etc. Nitric acid with a concentration of 0.5 mol/L was chosen as a stripping agent, and the chemical stability of the eutectic solvent BTMPPA/TBP/phenol during extraction–stripping cycles was evaluated. In summary, the proposed hydrophobic eutectic solvent has good physical characteristics and enables a more efficient recovery of rare-earth elements from nitrate solutions. Full article

Study Aim: Patients with high-risk Ewing sarcoma (ES) have dismal outcomes despite aggressive multimodal therapy. This phase II, single-institution study evaluated the response rate to two up-front cycles of irinotecan, temozolomide, and temsirolimus (ITT) and assessed the tolerability of maintenance therapy following standard treatment in high-risk ES. Methods: Eligible patients had newly diagnosed high-risk ES (age ≥14 years old, metastatic disease, or primary pelvic tumor). The therapy included two cycles of window therapy (ITT) followed by interval-compressed chemotherapy (vincristine, doxorubicin, and cyclophosphamide alternating with ifosfamide and etoposide) and maintenance therapy (cyclophosphamide, sorafenib, and bevacizumab). A two-stage sequential design was employed to assess a >50% WHO response (CR or PR) with 80% power. Patients who required emergent radiation were excluded from receiving window therapy. Results: Sixteen patients (median age 12.2 years; range 4.8–23.6 years) were enrolled (12 evaluable for overall response, 10 for primary tumor response). Only three achieved a PR to window therapy, leading to study closure. All evaluable patients demonstrated a decline in their primary tumor volume (mean decline: 32.5%, standard deviation: 17.6%, p-value: 0.0005) and SUV peak (mean decline: 49.9%, standard deviation: 21.1%, p-value: 0.002). Maintenance therapy was well tolerated, with only 2/13 patients discontinuing due to toxicity. Conclusions: ITT did not achieve the prespecified response rate of 50%, according to WHO criteria; however, all patients exhibited decreased volume and metabolic activity, highlighting the limitations of conventional response assessments. Maintenance therapy was feasible and well tolerated. Although limited by small sample size, heterogeneous disease presentations, and the absence of a control arm, this study supports further evaluation of ITT and a maintenance approach in larger, randomized trials for high-risk ES. Full article

Background/Objectives: [18F]FDG PET/CT radiomics could improve risk stratification in untreated breast carcinoma. Methods: PubMed Central was accessed for full-text English articles (2015–2025) evaluating radiomic features from pretreatment [18F]FDG PET/CT. The Newcastle-Ottawa Scale (NOS) was used to evaluate the risk of bias. Results: Seven studies (1394 patients with a median cohort of about 150 patients) met the inclusion criteria. Radiomics outperformed conventional metabolic measures at predicting pCR to NAC (with the best AUC 0.83 when combining intra- and peritumoral features); differentiating molecular subtypes (AUC 0.856 luminal vs. non-luminal; 0.818 HER2+ vs. HER2−, and 0.888 triple negative vs. others); and assessing androgen receptor (AR) expression. No additional value was found for ER/PR status. Age influenced SUV and texture metrics, especially in triple-negative lesions. Methodological variation was notable: all studies were retrospective, the majority were single-center, only two provided external validation with different protocols of acquisition and segmentation, and at least four distinct software platforms were used for feature extraction and statistical analysis. Conclusions: [18F]FDG PET/CT radiomics shows good potential for predicting neoadjuvant response and molecular profile in breast cancer. However, small, diverse cohorts and non-standardized methodologies limit the evidence. Prospective multicenter studies with standardized acquisition, segmentation and feature extraction are required before clinical use. Full article

As the fields of plastic surgery and dermatology advance, regenerative medicine is positioned to play a transformative role in both aesthetic and reconstructive procedures. This narrative review examines current and emerging applications of biologic therapies, including exosomes, platelet-rich plasma (PRP), and adipose-derived stem cells (ASCs) with an emphasis on their mechanisms of action, clinical efficacy, and regulatory considerations. We also explore synergistic strategies, such as the combined use of biologics with laser-based technologies, which may enhance therapeutic outcomes. Looking forward, we highlight promising developments in mitochondrial-based therapies, microRNA-based therapies, synthetic exosome mimetics, and AI-assisted biologic design, offering a framework for personalized, precision-driven interventions. By synthesizing existing clinical data alongside scientific and ethical challenges, this narrative review provides a comprehensive perspective on how regenerative therapies are transforming the landscape of aesthetics. Ultimately, successful integration of these innovations will require rigorous validation, ethical responsibility, and a patient-centered approach by plastic surgeons and dermatologists to ensure both safety and accessibility in mainstream practice. Full article

Somatic mutations in KRAS and TP53 are among the most common genetic alterations in pancreatic ductal adenocarcinoma (PDAC). Advances in PCR-based technologies now enable the detection of these mutations in tumor tissue and cell-free DNA (cfDNA), providing a minimally invasive approach to assess tumor burden. However, in resectable PDAC, circulating tumor DNA (ctDNA) may represent less than 0.1% of total cfDNA, requiring highly sensitive detection methods. The aim of our study was to assess two PCR-based assays—competitive allele-specific PCR (castPCR) and digital PCR (dPCR)—for detecting selected somatic mutations in tumor tissue, cfDNA, and extracellular vesicle-associated DNA (EV-DNA) from plasma. Matched primary tumor and preoperative plasma samples were collected from 50 patients undergoing upfront resection for PDAC. CastPCR was used for detecting selected KRAS, TP53, SMAD4, and CDKN2A mutations in tumor DNA. Additionally, dPCR was used to analyze KRAS and TP53 mutations in tumor DNA as well as cfDNA and EV-DNA. The concordance between both platforms was 71.4% for KRAS p.G12D and 58.3% for the analysis of TP53 p.R273H mutations in tumor tissue. However, dPCR detected these mutations in an additional 28.6% and 39.6% of samples, respectively. In cfDNA, dPCR identified KRAS p.G12D in 10.2% and TP53 p.R273H in 2.0% of samples. Mutation detection in EV-DNA was limited by low DNA yield. Both platforms proved effective for tumor DNA analysis, with dPCR offering greater sensitivity. Somatic mutation detection from liquid biopsy using dPCR further supports its potential utility in the preoperative setting. Full article

Bioactive resin cements are gaining popularity for their clinical benefits, but concerns remain regarding their color stability. This study evaluated the color change (ΔE₀₀) and whiteness change (ΔWI_D) in bioactive resin cements and how their potential discoloration affects the shade of bonded CAD/CAM glass–ceramics at different ceramic thicknesses. VITA Mark II blocks were prepared in three thicknesses (0.5, 0.8, and 1.0 mm) and divided by resin cement: Panavia SA Universal (Pn), Predicta Bioactive Cement (Pr), and ACTIVA BioACTIVE Cement (Ac) (n = 10). Additionally, 10 specimens (10 × 2 mm) of each cement alone were prepared. Color was measured before and after 24 days of coffee immersion. Cement type significantly affected ΔE₀₀ (p < 0.001). Pn had the highest color stability, followed by Pr and Ac, with significant differences between each. ΔWI_D also varied by cement (p = 0.004), with Pn and Pr differing significantly from Ac. Ceramic thickness alone had no significant effect on ΔE₀₀ or ΔWI_D, but its interaction with cement type was significant (p < 0.001). While ceramic thickness does not directly affect the final shade, its combination with resin cement does. Choosing the right resin cement is key for long-term esthetic outcomes. Full article

In regenerative medicine, orthobiologics, particularly platelet-rich plasma (PRP), are widely used due to their ability to enhance natural tissue repair mechanisms. PRP contains a concentrated pool of growth factors and cytokines that enhance regeneration while also acting as a biomimetic scaffold, thereby optimizing the microenvironment for tissue healing. In bone tissue engineering, PRP is commonly combined with synthetic or natural biomaterials, as its fibrin matrix alone lacks sufficient mechanical stability. However, even such composite systems frequently exhibit limited osteoinductive capacity, necessitating further supplementation with bioactive components. This review evaluates the regenerative potential of PRP in bone defect healing when combined with osteoinductive agents in preclinical in vivo models. We present compelling experimental evidence supporting the efficacy of this combined therapeutic approach. Full article

Two proline-rich antimicrobial peptides (PrAMPs), named P1 and P2, purified from hemolymph of the greater wax moth Galleria mellonella, were studied for their effects on Gram-negative (Escherichia coli) and Gram-positive (Micrococcus luteus) bacteria. Both peptides decreased the M. luteus bacterial survival rate and caused E. coli bacterial membrane permeabilization. However, in both cases, the P2 peptide was approximately three times more effective than the P1 peptide. Fluorescence microscopy imaging demonstrated binding of both FITC-labeled peptides to E. coli and M. luteus cells. Atomic force microscopy (AFM) and scanning electron microscopy (SEM) imaging of peptide-treated bacteria revealed considerable changes in cell morphology, cell surface topography, and nanomechanical properties. The interactions of the PrAMPs with bacterial cells were also analyzed by FTIR spectroscopy. The P1 peptide action toward E. coli led to partial aggregation of proteins, whereas treatment with P2 resulted in reduced protein aggregation, reflecting differences between both G. mellonella PrAMPs antibacterial action. Moreover, both PrAMPs caused a decrease and an increase in the protein content in relation to lipids on the E. coli and M. luteus cell surface, respectively. The obtained results reflect not only differences between the G. mellonella P1 and P2 peptides but also differences in the cell surface between Gram-negative and Gram-positive bacteria. Both characterized G. mellonella PrAMPs are further representatives of proline-rich peptides with a membrane-permeabilizing antimicrobial mode of action. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing public health concern influenced by both genetic and metabolic factors. Polygenic risk scores (PRSs), which combine the effects of known single-nucleotide polymorphisms (SNPs), may improve early risk stratification. We conducted an observational study on 298 MASLD patients: 148 from a Hepatology Unit and 150 from a Bariatric Surgery Unit. Genotyping was performed for the PNPLA3, TM6SF2, MBOAT7, and GCKR variants. A PRS was calculated and used to stratify patients by genetic risk. Liver fibrosis was assessed using the FIB-4 index, and a subset also underwent transient elastography. Clinical, biochemical, and anthropometric data were analyzed across genetic strata. PRSs showed positive correlations with AST, ALT, and FIB-4, indicating increased liver injury and fibrosis risk with higher genetic burden. Transaminases increased significantly across PRS quartiles (p < 0.05), and individuals with PRS > 0.532 exhibited elevated AST, ALT, and borderline FIB-4. Variant-specific associations included PNPLA3 with increased AST and MBOAT7 with higher hepatic steatosis (CAP). Subgroup analyses revealed distinct genetic and phenotypic patterns between the two clinical cohorts. These findings support the additive role of genetic risk in MASLD progression and underscore the value of polygenic profiling for the early identification and personalized management of high-risk patients. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE—session template set to 50% of the day’s maximal sustained effort; 6 levels × 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT—spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within ≤30 min. Sham—valve set to minimal resistance (9 cmH₂O); 36 inspirations within ≤30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 ± 12.9 years), Threshold n = 12 (67.4 ± 6.9 years), Sham n = 12 (67.3 ± 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 ± 7.5 kg/m². The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p < 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted. Full article

Background/Objectives: Pothos chinensis is commonly used as traditional medicine in China and India. Codon usage analysis is a good way to understand plants’ evolution. However, there is no report about the codon usage bias of chloroplast genomes in P. chinensis. Methods: In this study, the chloroplast genome of the medicinal plant P. chinensis was newly obtained. Comparative analyses, DNA barcoding investigation, codon usage bias, and phylogenetic reconstruction were conducted to reveal the chloroplast genome characteristics of P. chinensis. Results: The length of the chloroplast genome of P. chinensis was 165,165 bp. A total of 134 genes were annotated, i.e., 90 protein-coding genes, 36 transfer RNA genes, and eight ribosomal RNA genes. Compared to its sister group Anthurium andraeanum, the length of the large single-copy region (LSC) had been expanded, while the small single-copy region (SSC) had been contracted. Within P. chinensis and P. scandens there were no obvious differences in the length of LSC, SSC, and two inverted repeat regions. Based on Pi values, seven hypervariable regions of whole plastomes were identified. The analysis of codons showed that an average frequency of the 50 candidate genes was 35.30%, and these genes preferred A/U-ending codons. The average effective number of codon (ENC) value was 45.49, which indicated weak codon usage bias. ENCs had a highly significant positive correlation with GC3. Fourteen optimal codons had been identified, 11 of which ended with A/U. The results of the neutrality plot, ENC-plot, and PR2-plot analysis indicated that natural selection might have a significant impact on codon usage patterns. Conclusions: Taken together, our study unraveled the codon usage patterns in P. chinensis and provided valuable genetic information for the genus Pothos. Full article

Biological control serves as a crucial strategy for crop disease management. The biocontrol potential and plant growth-promoting effects of the strain YTBTa14 were investigated. Genetic sequencing confirmed YTBTa14 as Pseudomonas chlororaphis, which exhibited broad-spectrum antifungal activity against multiple pathogens affecting grapevine, apple, cherry, and wheat. YTBTa14 significantly enhanced the growth of wheat and grapevine, specifically increasing wheat seed germination rates and improving root and coleoptile development. In grapevine plant, significant increases in root length, stem length, and fresh weight were observed. The strain demonstrated robust adaptability and stable antagonism under varying sodium chloride (NaCl) concentrations, pH levels, and temperatures. YTBTa14 modulated plant hormone levels, elevating the content of indole-3-acetic acid (IAA), gibberellins (GA), and cytokinins (CTK). Furthermore, it effectively stimulated the production of key plant defense enzymes, including superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT). Pretreatment of grape leaves with YTBTa14 triggered plant cell defense response and upregulated the expression of defense-related genes PR1 (pathogenesis-related protein 1) and PAL1 (phenylalanine ammonia-lyase 1), thereby mitigating the severity of downy mildew disease and inducing systemic resistance. These findings demonstrate that YTBTa14 is a highly promising candidate for development as a multifunctional agricultural biocontrol agent. Full article

Background/Objectives: Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes, often leading to infection, amputation, and reduced quality of life. Platelet-rich plasma (PRP) therapy has emerged as a promising treatment due to its potential to accelerate wound healing through growth factors and cytokines. Despite growing interest, evidence on PRP’s efficacy and safety in DFU management remains variable. This article critically reviews recent studies to evaluate the effectiveness of PRP in promoting ulcer healing, while examining methodological rigor, ethical considerations, and research parameters to provide a comprehensive, evidence-based assessment for clinical application. Materials and Methods: This review explores the biological mechanisms underlying platelet-rich plasma (PRP) as an adjunctive therapy for DFUs, focusing on its regenerative capabilities. PRP is an autologous concentration of platelets containing growth factors and bioactive molecules that promote angiogenesis, cellular proliferation, and extracellular matrix remodeling. Various application methods—topical, injectable, gel-based, and PRP-enhanced dressings—are examined. The review also evaluates the efficacy of PRP as monotherapy and in combination with other interventions such as debridement and split-thickness skin grafting. Results: Clinical studies suggest that PRP, particularly when used alongside surgical debridement or skin grafting, significantly enhances healing outcomes in patients with non-healing DFUs. It provides a biologically favorable environment for tissue regeneration while reducing inflammation and potentially exhibiting antimicrobial properties. However, variability in PRP preparation techniques, application protocols, and patient selection criteria presents challenges to standardization and broader clinical adoption. Conclusions: While PRP therapy demonstrates significant potential in the management of diabetic foot ulcers, further randomized controlled trials with standardized methodologies are essential to establish optimal treatment protocols and confirm long-term benefits. PRP offers a minimally invasive, autologous, and biologically active treatment modality that may serve as a vital component in the multidisciplinary approach to DFU management. Full article

A novel five-degrees-of-freedom (DOF) P(2PRPU)/PRPS double-driven parallel mechanism (PM) is proposed in this study, and its kinematics and stiffness are studied systematically. First, the structural configuration is described, and the degrees of freedom of the parallel mechanism are analyzed based on constraint conditions. Next, the position model, velocity model, and Jacobian matrix are derived, and the workspace and kinematic performance of the mechanism are studied. Third, based on the principle of virtual work, a static model and a deformation decomposition method are employed to construct the stiffness model, resulting in the corresponding stiffness and compliance matrices. Finally, the stiffness performance of the mechanism is analyzed using the derived compliance matrix. This study is expected to provide new insights for the design of machining tools. Full article