Search Results (8,592)

Background and Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked with type 2 diabetes mellitus (T2D) and obesity. Despite its growing prevalence, effective pharmacological interventions remain limited, with antidiabetic agents such as glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) showing emerging promise. This study aimed to evaluate the impact of different antidiabetic therapies on hepatic steatosis, fibrosis, and cardiometabolic risk factors in patients with T2D and MASLD from Romania. Materials and Methods: We conducted a prospective observational study involving 256 patients with T2D and MASLD followed up for 6 months. Assessed parameters included anthropometry, glycemic indices, lipid profile, renal function, liver enzymes, and non-invasive evaluation of hepatic steatosis and fibrosis. Patients were 53% women, had a median age of 63 years, a median BMI of 32.2 kg/m², a median baseline CAP of 281 dB/m, a FibroScan of 8.9 kPa, and an HbA1c of 8.0%. Results: CAP decreased significantly from 281 to 245 dB/m, p < 0.0001; FibroScan from 8.9 to 8.0 kPa, p < 0.0001. The largest changes were observed in the GLP-1 RA subgroup (CAP −50 dB/m, FibroScan −1.0 kPa, weight −8.0 kg, HbA1c −0.7%), and in the SGLT2i subgroup (CAP −30.5 dB/m, FibroScan −0.7 kPa, weight −4.0 kg, HbA1c −0.5%). In regression analysis, independent factors associated with CAP improvement included GLP-1 RA therapy (β = 44.5, 95% CI 38.3–50.6, p < 0.0001), SGLT2i therapy (β = 23.4, 95% CI 15.7–31.1, p < 0.0001), and ≥10% weight loss (β = 23.2, 95% CI 12–34.4, p < 0.0001). For FibroScan improvement, GLP-1 RA (β = 1.0, 95% CI 0.8–1.2, p < 0.0001) and SGLT2i (β = 0.5, 95% CI 0.3–0.7, p < 0.0001) therapies were both significant. Conclusions: Antidiabetic therapy, particularly GLP-1 RA, was significantly associated with improvement in hepatic steatosis, fibrosis, and cardiometabolic risk in T2D patients with MASLD beyond the weight reduction effect. However, weight loss and lipid modulation enhance these benefits, supporting the development of integrated therapeutic strategies for this high-risk population. Full article

In this study, we explored the evolution of mechanical properties in hydroxyl-terminated polybutadiene (HTPB) propellants under fatigue loading by performing fatigue tests with varying maximum stresses and cycle numbers, followed by uniaxial tensile tests on post-fatigue specimens. Residual elongation was used as a key parameter to characterize mechanical behavior, while scanning electron microscopy (SEM) provided insights into the mesostructural morphological changes that occur under different loading conditions, revealing the mechanisms responsible for variations in mechanical properties. The results show that, as the number of loading cycles increases, residual elongation decreases, with three distinct phases of decline—slow change, gradual decline, and rapid deterioration—depending on the stress levels. SEM analysis identified damage mechanisms such as “dewetting” and particle fragmentation at the mesostructural level, which compromise the material’s structural integrity, leading to reduced residual elongation. A novel aspect of this study is the application of Williams–Landel–Ferry (WLF) theory to construct a master curve describing residual elongation decay. This approach enabled the development of a generalized model to predict the material’s degradation under fatigue loading, with experimental validation of the fitted evolution model, offering a new and effective method for assessing the long-term performance of HTPB propellants. Full article

This work aims to leverage generative modeling-based anomaly detection to enhance interpretability in AI failure detection systems and to aid data curation for large repositories. For failure detection interpretability, this retrospective study utilized 3339 CT scans (525 patients), divided patient-wise into training, baseline test, and anomaly (having failure-causing attributes—e.g., needles, ascites) test datasets. For data curation, 112,120 ChestX-ray14 radiographs were used for training and 2036 radiographs from the Medical Imaging and Data Resource Center for testing, categorized as baseline or anomalous based on attribute alignment with ChestX-ray14. StyleGAN2 networks modeled the training distributions. Test images were reconstructed with backpropagation and scored using mean squared error (MSE) and Wasserstein distance (WD). Scores should be high for anomalous images, as StyleGAN2 cannot model unseen attributes. Area under the receiver operating characteristic curve (AUROC) evaluated anomaly detection, i.e., baseline and anomaly dataset differentiation. The proportion of highest-scoring patches containing needles or ascites assessed anomaly localization. Permutation tests determined statistical significance. StyleGAN2 did not reconstruct anomalous attributes (e.g., needles, ascites), enabling the unsupervised detection of these attributes: mean (±standard deviation) AUROCs were 0.86 (±0.13) for failure detection and 0.82 (±0.11) for data curation. 81% (±13%) of the needles and ascites were localized. WD outperformed MSE on CT (p < 0.001), while MSE outperformed WD on radiography (p < 0.001). Generative models detected anomalous image attributes, demonstrating promise for model failure detection interpretability and large-scale data curation. Full article

Background/Objectives: Tumor growth delay is frequently used in preclinical experiments evaluating oncologic interventions. While treatment response in humans is based on imaging criteria for obvious reasons, manual caliper measurement of subcutaneous tumors is standard in animal studies. In a murine tumor model treated with immunotherapy (ImT) and radiotherapy (RT), the reliability of caliper measurements was tested by comparing normalized tumor growth delay (NTGD) rates derived from caliper- and image-based volumetrics. Methods: A 4T1 breast syngeneic murine model was used, in which thirty animals were inoculated in the right inguinal mammary fat pad and the right axilla. One RT fraction of 8 Gy was delivered to the right inguinal tumor on day 11 post-implant, and intraperitoneal ImT (PD-1 checkpoint inhibitor) injections were administered on days 11, 12, and 14. Each animal underwent three MRI scans (days 10, 17, and 20). Caliper measurements were also performed by two independent observers on the same days. The measurements were averaged and used to estimate ellipsoid tumor volumes. The acquired MRIs were used for image segmentation and volume estimation. Tumor volumes (days 17 and 20) were normalized against the baseline pre-treatment tumor volume (day 10). NTGD rates derived from hand- and image-based volumetrics were compared to assess the reliability of caliper vs. MRI estimation. Results: Caliper volumes between the two observers correlated at 0.799 (Pearson, p < 0.001). The averaged caliper volumes correlated with MRI volumes at 0.897 (Pearson, p < 0.001). Absolute volume differences between caliper and MRI increased with tumor growth. NTGD-derived rates showed no correlation, with only 15% of NTGD caliper rates falling within 10% of the MRI rates. Conclusions: NTGD rate based on caliper volumes is a suitable measure of treatment response in preclinical studies. In the experiment described herein, caliper-derived NTGD rates did not correlate with MRI ground truth. These findings suggest that more accurate tumor volumetrics, derived from stored and verifiable medical imaging sources, should be used in preclinical assessment of oncologic interventions instead of standard caliper estimates. Full article

Objectives: Employing 18F-FDG PET/CT radiomic properties both within and surrounding tumors, in conjunction with clinical attributes, to precisely differentiate among several pathological subtypes of non-small-cell lung cancer (NSCLC). Approaches: The study comprised 222 patients who received 18F-FDG PET/CT scans from January 2015 to December 2020 and were later diagnosed with NSCLC, encompassing 169 cases of lung adenocarcinoma (LUAD) and 53 cases of lung squamous cell carcinoma (LUSC). They were arbitrarily allocated into a training group and a validation group in a 7:3 ratio. Radiomics feature extraction was conducted on 18F-FDG PET/CT images of primary tumors and adjacent tumor regions with LIFE-x (5.2.0). A multivariate logistic regression analysis was employed to develop a nomogram for differentiating lung adenocarcinoma (LUAD) from lung squamous cell carcinoma (LUSC). The clinical efficacy of each model was assessed and contrasted utilizing accuracy (Acc), sensitivity (Sen), specificity (Spe), receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). Outcomes: The nomogram model that integrates 18F-FDG PET/CT radiomics features with clinical characteristics showed superior efficacy in differentiating adenocarcinoma from squamous cell carcinoma in NSCLC patients, surpassing models based only on PET or CT radiomics. The validation set exhibited an Area under curve (AUC) of 0.880, an Acc of 0.929, a Sen of 0.808, and a Spe of 0.962. This model exhibits the most superior overall performance in DCA. Conclusions: A nomogram model integrating radiomic features derived from 18F-FDG PET/CT images of tumors and adjacent tissues with clinical characteristics can effectively differentiate between LUAD and LUSC. Full article

The use of copper and its alloys in architecture, especially in arid regions, is growing, driven by visual appeal, functional advantages, and sustainability. Changes in visual and colorimetric appearances and patina formation were evaluated for architectural Cu metal, brass (CuZn15), bronze (CuSn4), and a golden alloy (CuZn5Al5). Coupons were exposed over 4 years in Dubai, United Arab Emirates, at a test site located 2 km from the seashore under unsheltered conditions, and at various surface inclinations. Comparative exposures were conducted in Brest, France, at sites of increasing distance from the seashore. Visual appearance was assessed by colorimetry and optical imaging; patina cross-sections were characterized by means of scanning electron microscopy and elemental analysis (SEM/EDS), and crystalline phase identification was conducted by means of x-ray diffraction (XRD). All Dubai surfaces developed red-yellowish, heterogeneous patinas with embedded sand and dust, reducing lightness and visual appeal. Inclination had minor effect, although some extent of spallation occurred on downward-facing CuSn4. Even the corrosion-resistant CuZn5Al5 alloy lost its golden hue due to the incorporation of sand and dust into the patina. In Brest, appearance depended on the distance from the seashore, with green-blue patinas near the sea and red-yellowish farther inland, similar to Dubai. Cleaning may restore some luster, but the desert exposure generally reduced the long-term aesthetic performance of all materials. Full article

Femoroacetabular impingement (FAI) and hip dysplasia have been shown to increase the risk of hip osteoarthritis in affected individuals. MRI with T2 mapping provides an objective measure of femoral and acetabular articular cartilage tissue quality. This study aims to evaluate the relationship between hip morphology measurements collected from three-dimensional (3D) reconstructed computed tomography (CT) scans and the T2 mapping values of hip articular cartilage assessed by three independent, blinded reviewers on the optimal sagittal cut. Hip morphology measures including lateral center edge angle (LCEA), acetabular version, Tönnis angle, acetabular coverage, alpha angle, femoral torsion, neck-shaft angle (FNSA), and combined version were recorded from preoperative CT scans. The relationship between T2 values and hip morphology was assessed using univariate linear mixed models with random effects for individual patients. Significant associations were observed between femoral and acetabular articular cartilage T2 values and all hip morphology measures except femoral torsion. Hip morphology measurements consistent with dysplastic anatomy including decreased LCEA, increased Tönnis angle, and decreased acetabular coverage were associated with increased cartilage damage (p < 0.001 for all). Articular cartilage T2 values were strongly associated with the radiographic markers of hip dysplasia, suggesting hip microinstability significantly contributes to cartilage damage. The relationships between hip morphology measurements and T2 values were similar for the femoral and acetabular sides, indicating that damage to both surfaces is comparable rather than preferentially affecting one side. Full article

Rhinogenic contact point headache (RCPH) represents a diagnostic challenge due to different anatomical presentations and unstandardized imaging markers. This prospective multicenter study involving 120 patients aimed to develop and validate a CT-based imaging framework for RCPH diagnosis. High-resolution CT scans were systematically assessed for seven parameters: contact point (CP) type, contact intensity (CI), septal deviation, concha bullosa (CB) morphology, mucosal edema (ME), turbinate hypertrophy (TH), and associated anatomical variants. Results revealed CP-I (37.5%) and CP-II (22.5%) as predominant patterns, with moderate CI (45.8%) and septal deviation > 15° (71.7%) commonly observed. CB was found in 54.2% of patients, primarily bulbous type (26.7%). Interestingly, focal ME at CP was independently associated with greater pain severity in the multivariate model (p = 0.003). The framework demonstrated substantial to excellent interobserver reliability (κ = 0.76–0.91), with multivariate analysis identifying moderate–severe CI, focal ME, and specific septal deviation patterns as independent predictors of higher pain scores. Our imaging classification system highlights key radiological biomarkers associated with symptom severity and may facilitate future applications in quantitative imaging, automated phenotyping, and personalized treatment approaches. Full article

Background: To report a deep learning-based algorithm for automated segmentation of geographic atrophy (GA) among patients with age-related macular degeneration (AMD). Methods: Validation of a deep learning algorithm was performed using optical coherence tomography (OCT) images from patients in routine clinical care diagnosed with GA, with and without concurrent nAMD. For model construction, a 3D U-Net architecture was used with the output modified to generate a 2D mask. Accuracy of the model was assessed relative to the manual labeling of GA with the Dice similarity coefficient (DSC) and correlation r² scores. Results: The OCT data set included 367 scans from the Spectralis (Heidelberg, Germany) from 55 eyes in 33 subjects; 267 (73%) scans had concurrent nAMD. In parallel, 348 scans were collected using the Cirrus (Zeiss), from 348 eyes in 326 subjects; 101 (29%) scans had concurrent nAMD. For Spectralis data, the mean DSC score was 0.83 and r² was 0.91. For Cirrus data, the mean DSC score was 0.82 and r² was 0.88. Conclusions: The reported deep learning algorithm demonstrated strong agreement with manual grading of GA secondary to AMD on the OCT data set from routine clinical practice. The model performed well across two OCT devices as well as amongst patients with GA with concurrent nAMD, suggesting applicability in the clinical space. Full article

Background and Objectives: Femoroacetabular impingement (FAI) morphology refers to structural abnormalities that can alter normal joint mechanics and potentially lead to early onset osteoarthritis. Although commonly diagnosed in symptomatic individuals, such morphological features are also found in asymptomatic adults, underlining their relevance for early detection and preventive management. This study aimed to evaluate the three-dimensional congruence of hip joint surfaces in relation to FAI and the morphology of asymptomatic hips with potential FAI features. Materials and Methods: Retrospective three-dimensional reconstructions of 86 hip joints were created using Mimics software from computed tomography (CT) scans of the lower abdomen and pelvis retrieved from the radiology archive. CT scans belonged to individuals with preserved anatomical integrity (20 females, 23 males, bilateral hips), aged 24–76 years. Lateral center-edge angle (LCEA) and alpha angle measurements were obtained from reconstructions to assess the risk of asymptomatic FAI. Results: Significant gender differences were found in alpha angles. The mean right alpha angle was 46.57 ± 3.12° in females and 49.28 ± 6.66° in males p = 0.046, while the mean left alpha angle was 43.75 ± 5.53° in females and 47.37 ± 5.77° in males p = 0.021. An alpha angle >50°, suggestive of cam type FAI, was present in 25.6% of right hips and 13.9% of left hips. LCEA values showed no significant gender or side differences, with a mean of 30.21 ± 8.96° across the cohort. Conclusions: Three-dimensional evaluation of asymptomatic hips revealed FAI-consistent morphology in a notable proportion of individuals, particularly males. Cam-type deformities tended to occur bilaterally, whereas pincer-type morphologies were more sporadic and often unilateral. Increased alpha and LCEA measurements in asymptomatic individuals suggest that FAI morphology may exist subclinically without always indicating disease. Future studies incorporating longitudinal imaging and clinical follow-up are needed to clarify the prognostic significance of these findings. Full article

Among the main man-made water pollutants that pose a danger to the environment are oil products, heavy metals, and radionuclides, as well as micro- and nanoplastics. To purify such waters, it is necessary to use advanced methods, with sorption being one of them. The aim of this work is to develop a nano-functionalized composite, comprising magnetically responsive, thermally expanded graphite (TEG) and the natural clay bentonite, and to assess its ability to purify man-made contaminated waters. Throughout the course of the research, the methods of scanning electron microscopy, optical microscopy, dynamic light scattering, radiometry, and atomic absorption spectrophotometry were used. The use of the TEG–bentonite composite for the purification of the model water, simulating radioactively contaminated nuclear power plant (NPP) effluent, reduced the content of organic substances by 10–15 times, and the degree of extraction of cesium, strontium, cobalt, and manganese was between 81.4% and 98.8%. The use of the TEG–bentonite composite for the purification of real radioactively contaminated water obtained from the object “Shelter” (“Ukryttya” in Ukrainian), in the Chernobyl Exclusion Zone, Ukraine, with high activity, containing organic substances, including micro- and nanoplastics, reduced the radioactivity by three orders of magnitude. The use of cesium-selective sorbents for additional purification of the filtrate allowed for further decontamination of radioactively contaminated water with an efficiency of 99.99%. Full article

Background and Objectives: Acute pulmonary thromboembolism (PTE) is one of the leading causes of cardiovascular mortality. Recent insights into PTE pathophysiology emphasize the complex interplay of multiple mechanisms, particularly the roles of thrombosis and inflammation. Methods: This retrospective, single-center observational study included 138 participants: 69 adult patients diagnosed with PTE via computed tomography pulmonary angiography (CTPA) and 69 matched healthy controls. Upon admission, a standard 12-lead electrocardiogram (ECG) was performed, and Daniel’s score was calculated. Peripheral blood samples were collected to assess inflammatory biomarkers and hemogram-derived ratios (SII, NLR, dNLR, NPR, PLR, LMR). CTPA scans were analyzed not only for diagnostic purposes and PTE localization but also for inflammatory changes. PTE severity was classified according to the 2019 ESC guidelines. Results: Patients with PTE had significantly higher Daniel’s ECG scores, initial values of inflammatory biomarkers (WBC, neutrophils, IL-6, CRP) and hemogram-derived ratios (SII, NLR, dNLR, NPR) compared to controls. In multivariate analysis, older age (OR = 1.05; p = 0.038), higher Daniel’s ECG score (OR = 1.24; p < 0.001), and higher dNLR (OR = 1.40; p = 0.001) were found as an independent predictors of PTE severity. Ground-glass opacity (GGO) was the most common parenchymal and pleural inflammatory finding relating to CTPA (48.4%), but these findings did not show significant predictive value for PTE severity. Conclusions: Daniel’s ECG score and dNLR, both readily available and cost-effective biomarkers demonstrated independent predictive value for assessing PTE severity. Full article

Objectives: This study evaluated the utility of complex morphometric analyses for predicting radiation pneumonitis (RP) and proposed a quantitative prognostic framework for patients with non-small cell lung cancer (NSCLC) undergoing curative-intent radiotherapy (RT). Imaging biomarkers, including box-counting fractal dimension (BoxFD), lacunarity, and minimum spanning tree fractal dimension (MSTFD), were assessed for their prognostic significance. Materials and Methods: We retrospectively analyzed 166 NSCLC patients who received curative-intent RT and had both pre-treatment and follow-up chest CT scans. Among them, 85 received RT alone and 81 underwent concurrent chemoradiotherapy (CCRT). Fractal features were measured to build a Random Forest model (RFM) predicting RP of grade ≥ 2, and the most important features were used to construct a decision tree model. Results: RP of grade ≥ 2 occurred in 19 patients (22.3%) in the RT alone group and 44 patients (54.3%) in the CCRT group. Lacunarity increased significantly post-RT in both groups, while BoxFD and MSTFD showed no significant changes. In the RFM, pre-RT MSTFD and lung dose parameters (V10 in RT alone; V5–V20 in CCRT) were identified as key predictors. Decision tree models based on these features achieved high predictive performance, with AUROC of 0.83 and 0.85, and F1 scores of 0.92 and 0.76 for RT alone and CCRT groups, respectively. Conclusions: Fractal imaging biomarkers demonstrated promising prognostic value for predicting grade ≥ 2 RP in NSCLC patients. The proposed decision tree model may serve as a practical tool for early identification of high-risk patients, facilitating personalized treatment strategies and informing future research. Full article

Achieving a best-fit prosthetic socket is essential to comfort, functional performance, and long-term residual limb health in lower-limb amputees. To our knowledge, no previous study has quantitatively compared in vivo residual limb geometry under vacuum versus non-vacuum conditions using high-resolution computed tomography (CT). In this patient-specific case study of a bilateral knee-disarticulation (KD) amputee, both residual limbs were scanned under standardized conditions: one enclosed in a vacuum-compressed sleeve and the contralateral limb untreated as a natural control, thereby minimizing inter-subject variability. CT-based 3D reconstructions enabled volumetric and cross-sectional quantification, including symmetry/asymmetry analysis of paired limbs, while finite element analysis (FEA) assessed the biomechanical consequences for socket performance. Vacuum application resulted in a 4.1% reduction in total limb volume and a 5.3% reduction in mid-thigh cross-sectional area, with regionally asymmetric displacement of soft tissues. FEA demonstrated that vacuum-induced geometry reduced peak Von Mises stresses (27.43 MPa to 15.83 MPa), minimized maximum displacement (1.72 mm to 0.88 mm), and improved minimum factor of safety (~2.0 to ~3.0), while homogenizing contact pressure distribution (peak fell from 2.42 to 1.28 N/mm²). These findings provide preliminary CT-based evidence that vacuum application induces measurable morphological adaptations with implications for socket conformity, comfort, and load transfer. While limited to a single patient, this study highlights the potential of vacuum-induced modeling to inform personalized prosthetic socket design. Full article

Rice (Oryza sativa L.) is a salt-sensitive crop, where even moderate soil salinity (electrical conductivity ≥ 3.5 dS/m) can cause significant yield reduction. During the seedling stage, the underdeveloped root system has limited capacity for salt uptake and translocation, making root system architecture (RSA) a crucial trait for enhancing salinity tolerance. In this study, we used 165 individuals from the 3K Rice Genome Project to comprehensively measure multidimensional root morphological traits at the early seedling stage under salt stress, thereby overcoming the limitations of conventional methods that mainly rely on root length and biomass. We identified 78 quantitative trait nucleotides (QTNs) associated with eight root morphological traits through genome-wide association studies (GWAS) of 3VmrMLM. Among these, 12 QTNs co-localized within genomic regions of previously cloned salt tolerance-related genes. Additionally, six salt-tolerant lines were selected based on significantly increased root volume (RV) and surface area (SA), suggesting that their adaptive mechanism under salinity involves optimized spatial root distribution rather than radial thickening. Our findings show that high-resolution root scanning-based phenotyping provides a reliable platform for screening and breeding salt-tolerant rice varieties, offering valuable indicators for assessing seedling-stage salt tolerance. Full article