Search Results (19,384)

One of the sometimes-neglected fields is the landscape design of hospital premises. This study focuses on the perception and preferences of responders regarding hospital site design. The objective was to determine if people are aware of the benefits of restorative contact with nature and if there were preferences for any specific landscape type. The online questionnaire with color figures was distributed using emails and social media from 4th May to 2nd August 2024. Some 110 respondents returned the questionnaire. Most of the respondents were women under 25. Most respondents declared that the surroundings of the healthcare building influence the health and well-being of patients (96%) and health personnel (86%). The results confirmed the awareness of the importance of contact with nature (89%). Moreover, this study demonstrated a preference for calm garden compositions, stimulating physical and mental recovery with trees, flowers, and water features, as well as stabilized paths and sheltered sitting places. The results confirm previous studies and demonstrate the importance of landscape architecture design of hospital premises for the well-being of patients. The findings may influence urban landscape planning and the design of hospital sites. Full article

Alpha-synuclein (αsyn) misfolding and aggregation underlie several neurodegenerative disorders, including Parkinson’s disease. Early oligomeric intermediates are particularly toxic yet remain challenging to detect and characterize within cellular systems. Here, we employed the luminescent conjugated oligothiophene h-FTAA to investigate early aggregation events of human wildtype (huWT) and A53T-mutated αsyn (huA53T) both in vitro and in HEK293 cells stably expressing native human-αsyn. Comparative fibrillation assays revealed that h-FTAA detected αsyn aggregation with higher sensitivity and earlier onset than Thioflavin T, with the A53T variant displaying accelerated fibrillation. HEK293 cells stably expressing huWT- or huA53T-αsyn were exposed to respective pre-formed fibrils (PFFs), assessed via immunocytochemistry, h-FTAA staining, spectral emission profiling, and fluorescence lifetime imaging microscopy (FLIM). Notably, huA53T PFFs promoted earlier aggregation patterns and yielded narrower fluorescence lifetime distributions compared with huWT PFFs. Spectral imaging showed h-FTAA emission maxima (~550–580 nm) red-shifted and broadened in cells along with variable lifetimes (0.68–0.87 ns), indicating heterogeneous aggregate conformations influenced by cellular milieu. These findings demonstrate that h-FTAA is useful for distinguishing early αsyn conformers in living systems and, together with stable αsyn-expressing HEK293 cells, offers a platform for probing early αsyn morphotypes. Taken together, this opens for further discovery of biomarkers and drugs that can interfere with αsyn aggregation. Full article

Background/Objectives: Germ Cell Neoplasia In Situ (GCNIS) is considered the precursor lesion for the majority of testicular germ cell tumors (TGCTs). The aim of this study was to evaluate whether first-order radiomics features derived from volumetric diffusion tensor imaging (DTI) metrics—specifically apparent diffusion coefficient (ADC) and fractional anisotropy (FA) histogram parameters—can detect GCNIS. Methods: This study included 15 men with TGCTs and 10 controls. All participants underwent scrotal MRI, including DTI. Volumetric ADC and FA histogram metrics were calculated for the following tissues: group 1, TGCT; group 2: testicular parenchyma adjacent to tumor, histologically positive for GCNIS; and group 3, normal testis. Non-parametric statistics were used to assess differences in ADC and FA histogram parameters among the three groups. Pearson’s correlation analysis was followed by ordinal regression analysis to identify key predictive histogram parameters. Results: Widespread distributional differences (p < 0.05) were observed for many ADC and FA variables, with both TGCTs and GCNIS showing significant divergence from normal testes. Among the ADC statistics, the 10th percentile and skewness (p = 0.042), range (p = 0.023), interquartile range (p = 0.021), total energy (p = 0.033), entropy and kurtosis (p = 0.027) proved the most significant predictors for tissue classification. FA_energy (p = 0.039) was the most significant fingerprint of the carcinogenesis among the FA metrics. These parameters correctly characterized 88.8% of TGCTs, 87.5% of GCNIS tissues and 100% of normal testes. Conclusion: Radiomics features derived from volumetric ADC and FA histograms have promising potential to differentiate TGCTs, GCNIS, and normal testicular tissue, aiding early detection and characterization of pre-cancerous lesions. Full article

High-rise building facades offer an alternative site for installing photovoltaic panels, which are traditionally placed on rooftops. The unique spatial configuration of high-rise buildings, characterized by a small footprint area relative to their height, supports the application of vertical facades for this purpose. Photovoltaic panels installed in these areas not only generate electricity but also enhance the aesthetic dimension of the urban landscape. The proposed methodology uses the EnergyPlus software to simulate the electricity generation of photovoltaic panels mounted on the walls of high-rise buildings in the city of Kragujevac, Serbia. A technical, economic, and environmental analysis was conducted for two scenarios: (1) photovoltaic panels installed on two facade areas with the highest solar potential, and (2) photovoltaic panels installed on all four available facade areas. In Scenario 1, the annual reduction in electricity consumption, annual cost savings in electricity consumption, and investment payback period range from 13 to 38%, 11 to 31%, and 8.4 to 10.6 years, respectively. In Scenario 2, these values range from 23 to 58%, 18 to 47%, and 10.9 to 12.9 years, respectively. The results indicate that southeast and southwest facades consistently achieve higher levels of electricity generation, underscoring the importance of prioritizing high-performing orientations rather than maximizing overall surface coverage. The methodology is particularly efficient for analyzing the solar potential of numerous buildings with comparable shapes, which is a characteristic commonly found in Eastern European architecture from the late 20th century. The study demonstrates the applicability of the proposed methodology as a practical and adaptable tool for assessing early-stage solar potential and providing decision support in urban energy planning. The approach addresses the identified methodological gap by offering a low-cost, flexible framework for assessing solar potential across diverse urban contexts and building typologies, while significantly simplifying the modeling process. Full article

Background/Objectives: Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and total triiodothyronine (TT3) are biomarkers for evaluating thyroid function. Although hormone levels are affected by many biological and environmental factors, most laboratories use manufacturer-provided reference intervals (RIs) without considering these factors. Thus, in this study we assessed RIs for TSH, FT4, and TT3 in a Korean population, using a direct selection technique. Methods: Serum samples from patients without a history of thyroid disease, medication, family history, or antibody-positive test results were collected after a review of medical records. TSH, FT4, and TT3 levels were measured using the Cobas e801 analyzer (Roche Diagnostics GmbH, Mannheim, Germany) with dedicated reagents. RIs were then established using a non-parametric method, using values at the 2.5th and 97.5th percentiles as reference limits, which were then verified in a validation cohort. Results: A total of 618 subjects were enrolled in this study. Because the distribution of reference values for the four subgroups divided by sex and age (65 years) showed insignificant differences, combined RIs were determined, with the established RIs being 0.38–5.46 mIU/L for TSH, 12.28–22.40 pmol/L for FT4, and 0.94–2.32 nmol/L for TT3. When compared to manufacturer-claimed RIs, the Korean RI for TSH showed higher upper limits, while that for TT3 showed lower upper limits. Additionally, when newly established RIs were applied to the validation cohort, the rate of test-positive results decreased significantly. Conclusions: Significant differences in RIs for TSH and TT3 in the Korean population, compared to manufacturer-claimed values, highlight the need for population-specific RIs. Thus, interpreting the results for the Korean population requires caution, and Korean population-based RIs are necessary. Full article

Heritage Building Information Modelling (HBIM) requires the accurate classification of diverse building elements from 3D point clouds. This study presents a novel classification approach integrating a bespoke Uniclass-derived taxonomy with a hierarchical Random Forest model. It was applied to the 17th-century Queen’s House in Greenwich, a building rich in classical architectural elements whose geometric properties are often defined by principles of symmetry. The bespoke classification was implemented across three levels (50 mm, 20 mm, 5 mm point cloud resolutions) and evaluated against the prior experiment that used Uniclass classification. Results showed a substantial improvement in classification precision and overall accuracy at all levels. The Level 1 classifier’s accuracy increased by 15% of points (relative ~50% improvement) with the bespoke classification taxonomy, reducing the misclassifications and error propagation in subsequent levels. This research demonstrates that tailoring the Uniclass building classification for heritage-specific geometry significantly enhances machine learning performance, which, to date, has not been published in the academic domain. The findings underscore the importance of adaptive taxonomies and suggest pathways for integrating multi-scale features and advanced learning methods to support automated HBIM workflows. Full article

The growing threat of multidrug-resistant fungal pathogens, especially Candida auris, has underscored the need for effective antifungal vaccines. This commentary highlights recent advances in peptide-based vaccination using the SNAP (Spontaneous Nanoliposome Antigen Presentation) platform, focusing on the FM-SNAP vaccine, a bivalent liposomal formulation targeting the surface-expressed peptides fructose bisphosphate aldolase (Fba) and methionine synthase (Met6). Compared to earlier constructs such as MP12, FM-SNAP achieves superior immunogenicity and long-lasting protection at lower antigen doses. It elicits balanced Th1/Th2 cytokine responses and demonstrates durable efficacy in both immunocompetent and complement-deficient mouse models. The platform’s compatibility with clinically approved adjuvants (MPLA and QS-21), modular peptide design, and potential for multi-pathogen applications underscores its translational promise. FM-SNAP exemplifies a next-generation vaccine strategy that is both scalable and adaptable for high-risk immunocompromised populations. Full article

Background: The aim of this study is to investigate the effect of topical ice slush on cardiac protection in patients undergoing cardiac surgery and to analyze its potential side effects. Methods: Between 2023 and 2024, 890 patients who underwent cardiac surgery were evaluated. The patients were divided into two groups: Group A (n = 549), assigned ice slush(+), and Group B (n = 341), assigned ice slush(−). Echocardiographic findings, laboratory parameters, arterial blood gas findings, inotrope requirements, and postoperative outcomes were compared. Patients with a left internal thoracic artery were excluded from this study, and new subgroups were created as follows: Group C (n = 235), assigned ice slush(+), and Group D (n = 111), assigned ice slush(−). Chest radiography and diaphragm elevations (DEs) were compared at the 12-month follow-up. Results: No significant differences were found between the groups in terms of demographic characteristics, comorbidities, and operative data. The postoperative echocardiographic findings and ABG findings were similar. The inotrope requirement was higher in Group A. Postoperative day 1 Troponin T was higher in Group A than in Group B (median: 561–473 ng/mL, p = 0.01). The postoperative outcomes were similar between the groups, except that the intubation duration was longer in Group A. In the 1st postoperative week, 199 (36.2%) patients in Group A and 127 (37.2%) patients in Group B had DE. In the 12th month postoperation, 20 (3.6%) patients in Group A and 12 (3.5) patients in Group B had DE. Although not statistically significant, the incidence of DE was higher in Group C than in Group D in the early postoperative period only. Conclusions: We found no additional cardioprotective benefit from the use of topical ice slush in cardiac surgery. The intubation time was longer in patients with topical ice slush than in patients without it. Our results suggest that the routine use of topical ice slush in cardiac surgery is not necessary and that it has potential adverse effects. Full article

Introduction: Women with gestational diabetes mellitus (GDM) can present with hypoglycaemia during the oral glucose tolerance test (OGTT), which has been associated with adverse perinatal outcomes. Objectives: We studied whether the presence of hypoglycaemia during the OGGT (HdOGTT) was associated with adverse perinatal outcomes. Methods: Retrospective study of a national database of women diagnosed with GDM in the 24–28th week OGTT. Excluded: women with missing OGTT or the primary outcomes data. HdOGGT: any glucose value < 70 mg/dL. Primary outcomes: hypertensive disease of pregnancy, preterm delivery, caesarean section (CSA), small-for-gestational-age, large-for-gestational-age, neonatal hypoglycaemia, respiratory distress syndrome, and intensive care unit admission. Women with and without hypoglycaemia were compared. Predictors of HdOGTT and the association between HdOGTT and the primary outcomes were studied using a multivariate logistic regression analysis. Results: We analysed 7704 women, 10.7% with HdOGTT. Most of them (94.8%) presented fasting hypoglycaemia, and 3.2% had blood glucose values < 54 mg/dL. There were no differences between groups regarding the primary outcomes, except for women with HdOGTT, who had a lower rate of CSA (34.1% vs. 29.0%, p = 0.001), large-for-gestational-age newborns (9.7% vs. 13.8%, p < 0.001), and a higher rate of small-for-gestational-age newborns (11.0% vs. 6.9%, p < 0.001) than those without HdOGTT. Age, BMI, previous miscarriage, and chronic hypertension were associated with lower risk of HdOGTT. HdOGTT was only associated with increased risk of SGA [OR (95% CI): 1.25 (1.00–1.56), p = 0.047] after adjustment for confounders. Conclusions: The prevalence of HdOGTT was 10.7%. Age, BMI, previous miscarriage, and chronic hypertension were associated with lower risk of HdOGTT. HdOGTT was associated with 25% higher risk of SGA newborns. Full article

Background/Objectives: While oral nutritional supplements (ONSs) are known to support general growth in undernourished children, their specific effects on body composition and bone health remain underexplored. This manuscript evaluates the impact of ONS combined with dietary counselling (DC) on these outcomes in Indian children aged 3 to 6.9 years at nutritional risk, within the framework of a larger randomized controlled trial assessing multiple growth parameters. Methods: This prospective, randomized controlled trial was conducted among Indian children, both male and female participants with picky eating habits and at risk of undernutrition, aged 3 to 6.9 years (height-for-age and weight-for-height below the 25th percentile per WHO Growth Standards and Growth Reference). Participants were randomized in a 1:1 ratio to receive either ONS + DC or DC alone for 6 months. Body composition, bone mineral density (BMD), and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry (DXA) at baseline and after 6 months. Group differences were analyzed to evaluate intervention effects. Results: A total of 223 children were enrolled and randomized. At 6 months, the test group showed significantly greater improvements in BMD (0.023 g/cm²) compared to the control (0.017 g/cm²; p = 0.004), and a greater gain in BMC (36.60 g vs. 28.48 g; p =0.0007). Lean mass increased significantly more in the test group (926.33 g) versus the control (801.48 g; p = 0.0401). Fat mass showed a numerical reduction in the test group (−171.42 g) compared with the control group (−114.60 g), although this difference was not statistically significant. Conclusions: These findings highlight the potential of targeted nutritional interventions to favorably improve body composition and bone health during critical growth periods in undernourished children, offering a promising approach to address early-life nutritional deficits with lasting health benefits. Full article

Pertussis is an infectious disease that contributes to hundreds of thousands of deaths worldwide each year. Despite the prevalence of preventive vaccination programs, there has been an increasing number of new cases of the disease over the past few decades. This poses a particular problem for the pediatric population among whom the highest mortality from the disease is recorded. Several reasons for this phenomenon can be mentioned, but what is particularly important from the microbiological point of view is the correlation of the increased number of pertussis cases with the introduction of a new form of vaccine—the acellular vaccine in place of the whole-cell vaccine. In this review, we summarized the current state of knowledge on potential factors that may contribute to the decline in immunization efficacy against the pathogen. The post-vaccination response profile, symptomatic of vaccination with vaccination-acellular, is characterized by recruitment of Th₂ and Th₁₇ lymphocytes; it has been reported that in the long term, this results in insufficient activation of B cells and low titers of antibodies to key bacterial antigens (hemagglutinin, pertactin). Moreover, the immune response proceeds by bypassing the recruitment of tissue-resident memory T cells, resulting in a lack of protection against colonization of the nasal cavity by the bacterium despite vaccination. The decline in vaccination efficacy should also be attributed to the phenotypic variability of Bordetella. The popularization of the PtxP3 strain, characterized by its ability to incompletely activate immune mechanisms, poses a real threat to public health. The growing resistance of B. pertussis to standardly used antibiotics including macrolides also remains a problem. This makes it difficult to eradicate pathogens from the nasal cavity area and increases the pool of bacterial carriers in the population area. The increasing prevalence of the disease prompts reflection on more effective methods of prevention. Particularly promising in this field seem to be new vaccines, especially mucosally implemented, e.g., intranasal, or developed on the basis of B. pertussis antigens other than those used so far. Full article

Although methotrexate (MTX) is a magnificent cure for cancerous neoplasms and inflammatory disorders, its usage is bound due to associated hazards, especially nephrotoxicity. The present study investigated the possible therapeutic impact of alogliptin (ALO), prescribed for managing type 2 diabetes, on renal injury caused by MTX and explored the mechanisms that could illustrate this suggested protective effect. Four rat groups were involved: control, ALO (20 mg/kg/d, intragastrically (I.G.)) for ten days, MTX, and MTX + ALO groups. The latter two groups were given MTX (20 mg/kg, I.P.) on the 7th day, while the MTX + ALO group was administered ten days of 20 mg/kg of ALO. A significant impairment in renal function, catalase activity, reduced glutathione content, nuclear factor erythroid 2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) expressions, coupled with an increase in kidney injury molecule-1 (KIM-1), malondialdehyde, tumor necrosis factor-alpha (TNF-α), and cleaved caspase-3 (c-caspase-3) expressions, was observed in MTX-intoxicated rats, evidenced by remarkable deterioration in renal construction. Conversely, ALO improved renal function and architecture. Moreover, ALO retrieved the oxidative balance, the attenuated Nrf2/HO-1 expression, and the elevated KIM-1, TNF-α, and c-caspase-3 expression. In conclusion, ALO might abrogate MTX-elicited kidney damage by rectifying the deviation in oxidative status, apoptotic and inflammatory pathways, paving the way for managing MTX-induced nephrotoxicity. Full article

Sex and gender play a critical role in allergic diseases, influencing immune response, clinical phenotypes, treatment strategies, outcomes, and health-related quality of life. Despite mounting evidence across multiple studies examining sex/gender differences in a multitude of allergic diseases, most address isolated conditions, not taking into consideration the vast interplay of hormonal, genetic, immunological, and sociocultural factors and their unique consequences for clinicians and researchers. With this position paper, we aim to assess currently available evidence on the sex- and gender-specific characteristics of the most common allergic diseases, providing an overview of present knowledge and future areas of improvement for clinicians and researchers. This position paper was developed by the Società Italiana di Allergologia, Asma ed Immunologia Clinica (SIAAIC): a panel of experts who conducted a literature review focusing on sex and gender differences across major allergic diseases. A consensus-based approach was employed to assess the immunological, clinical, and therapeutic implications of available evidence, offering a recommendation for researchers and clinicians alike. Data highlights marked differences driven by sex and gender in disease prevalence, immune pathways, clinical phenotype and severity, as well as therapeutic outcomes. Female patients appear to show a higher prevalence of Th2-driven ailments, autoimmune overlap, and allergic drug reactions, whereas males are more likely to experience fatal anaphylaxis and severe mastocytosis. Sex hormones can modulate multiple immune pathways leading to mast cell activation, antibody production, and cytokine expression, thus contributing to divergent disease trajectories. In conclusion, sex and gender are a key determinant in allergic diseases, and their integration in future research is essential to develop a tailored approach to treatment. Efforts should prioritise the identification of sex- and gender-specific biomarkers, therapeutic strategies, and equitable access to healthcare services. A sex- and gender-aware approach could potentially improve outcomes, optimise treatment strategies, and address current gaps in allergy practice. Full article

Background/Objectives: Patient education materials (PEMs) in ophthalmology often exceed recommended readability levels, limiting accessibility for many patients. While organizations like the AAO provide relatively easy-to-read resources, topics remain limited, and other associations’ PEMs are too complex. AI chatbots could help clinicians create more comprehensive, accessible PEMs to improve patient understanding. This study aims to compare the readability of patient education materials (PEMs) written by the American Academy of Ophthalmology (AAO) with those generated by large language models (LLMs), including ChatGPT-4o, Microsoft Copilot, and Meta-Llama-3.1-70B-Instruct. Methods: LLMs were prompted to generate PEMs for 15 common diagnoses relating to cornea and anterior chamber, which was followed by a follow-up readability-optimized (FRO) prompt to reword the content at a 6th-grade reading level. The readability of these materials was evaluated using nine different readability analysis python libraries and compared to existing PEMs found on the AAO website. Results: For all 15 topics, ChatGPT, Copilot, and Llama successfully generated PEMs, though all exceeded the recommended 6th-grade reading level. While initially prompted ChatGPT, Copilot, and Llama outputs were 10.8, 12.2, and 13.2, respectively, FRO prompting significantly improved readability to 8.3 for ChatGPT, 11.2 for Copilot, and 9.3 for Llama (p < 0.001). While readability improved, AI-generated PEMs were on average, not statistically easier to read than AAO PEMs, which averaged an 8.0 Flesch–Kincaid Grade Level. Conclusions: Properly prompted AI chatbots can generate PEMs with improved readability, nearing the level of AAO materials. However, most outputs remain above the recommended 6th-grade reading level. A subjective analysis of a representative subtopic showed that compared to AAO, there was less nuance, especially in areas of clinical uncertainty. By creating a blueprint that can be utilized in human–AI hybrid workflows, AI chatbots show promise as tools for ophthalmologists to increase the availability of accessible PEMs in ophthalmology. Future work should include a detailed qualitative review by ophthalmologists using a validated tool (like DISCERN or PEMAT) to score accuracy, bias, and completeness alongside readability. Full article

The increasing share of renewable energy sources in power grids demands greater load flexibility from thermal power plants. Circulating Fluidized Bed (CFB) combustion systems, while offering fuel flexibility and high thermal inertia, face challenges in maintaining hydrodynamic and thermal stability during load transitions. This study investigates partial flue gas recirculation (FGR) as a strategy to enhance short-term load flexibility in a 1 MW_th CFB pilot plant fired exclusively with solid recovered fuel. Two experimental test series were conducted. Under conventional operation, where fuel and fluidization air are reduced proportionally, load reductions to 86% and 80% led to operating regime shift. Particle entrainment from the riser to the freeboard and loop seal decreased, circulation weakened, and the temperature difference between bed and freeboard zone increased by 71 K. Grace diagram analysis confirmed that the system approached the boundary of the circulating regime. In contrast, the partial FGR strategy maintained total fluidization rates by replacing part of the combustion air with recirculated flue gas. This stabilized pressure conditions, sustained particle circulation, and limited the increase in the temperature difference to just 7 K. Heat extraction in the freeboard remained constant or improved, despite slightly lower flue gas temperatures. While partial FGR introduces a minor efficiency loss due to the reheating of recirculated gases, it significantly enhances combustion stability and enables low-load operation without compromising fluidization quality. These findings demonstrate the potential of partial FGR as a control strategy for flexible, waste-fueled CFB systems and supports its application in future low-carbon energy systems. Full article