Search Results (417)

Lipopolysaccharide (LPS)-induced inflammation impairs sperm function; however, its impact on ejaculated rabbit sperm remains unexplored. This dose-response study aims to determine the LPS concentration that negatively affects sperm motility in vitro, while also providing the first identification of TLR4 localization on rabbit spermatozoa. Additionally, it evaluates malondialdehyde (MDA) levels in seminal plasma as an indicator of oxidative stress. Sperm motility was analyzed using computer-assisted sperm analysis (CASA) after incubation with increasing LPS concentrations (0, 50, 100, 200, 400, 600, and 800 µg/mL) at multiple time points (0, 1, 2, and 4 h). LPS doses ≥ 400 µg/mL significantly reduced progressive and non-progressive motility, as well as curvilinear velocity (all p < 0.001), while increasing the proportion of static spermatozoa (p < 0.05). Receiver operating characteristic (ROC) analysis identified 300 µg/mL as the threshold dose for motility decline. Immunofluorescence revealed TLR4 localization in the midpiece of sperm tails, with weak labeling in control samples and a marked increase after 4 h of incubation with 400 μg/mL LPS. MDA levels were assessed using the thiobarbituric acid reactive substances (TBARS) assay with a colorimetric kit, showing no significant effect of LPS treatment. No correlation was found between MDA and other semen parameters. ccThese findings identify TLR4 on rabbit sperm for the first time and establish a threshold LPS dose for future in vitro studies. Full article

The increasing presence of persistent pollutants in industrial wastewater underscores the shortcomings of conventional treatment methods, prompting the adoption of advanced oxidation processes (AOPs) for sustainable water remediation. This review examines the development of AOPs, focusing on their ability to produce hydroxyl radicals and reactive oxygen species (ROS) to mineralize complex pollutants. Homogeneous systems such as Fenton’s reagent show high degradation efficiency. However, challenges like pH sensitivity, catalyst recovery issues, sludge generation, and energy-intensive operations limit their scalability. Heterogeneous catalysts, such as TiO₂-based photocatalysts and Fe₃O₄ composites, offer improved pH adaptability, visible-light activation, and recyclability. Emerging innovations like ultraviolet light emitting diode (UV-LED)-driven systems, plasma-assisted oxidation, and artificial intelligence (AI)-enhanced hybrid reactors demonstrate progress in energy efficiency and process optimization. Nevertheless, key challenges remain, including secondary byproduct formation, mass transfer constraints, and economic feasibility for large-scale applications. Integrating AOPs with membrane filtration or biological treatments enhances treatment synergy, while advances in materials science and computational modeling refine catalyst design and reaction mechanisms. Addressing barriers in energy use, catalyst durability, and practical adaptability requires multidisciplinary collaboration. This review highlights AOPs as pivotal solutions for water security amid growing environmental pollution, urging targeted research to bridge gaps between laboratory success and real-world implementation. Full article

Traumatic brain injury (TBI) represents a significant public health issue, causing long-term disabilities and imposing considerable socioeconomic and healthcare challenges. While advancements in acute care have improved survival rates, the demand for effective neurorehabilitation is increasing. This narrative review explores the evidence on neurorehabilitation strategies for TBI, focusing on interventions targeting cognitive, motor, and psychological recovery. A total of 32 studies were included and categorized into six approaches: non-invasive brain stimulation, virtual reality (VR), computer-based training, telerehabilitation, robot-assisted therapy (RAT), and mixed approaches. Non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), showed variable effectiveness in improving cognitive outcomes. VR-based therapies enhanced attention and executive functions, while RAT, such as Lokomat and exoskeletons, improved gait symmetry and functional mobility. Computer-assisted programs demonstrated benefits in rehabilitating social cognition and executive functions. Telerehabilitation and telephone-based treatments provided short-term gains but lacked sustained effects. Overall, cognitive improvements were better described and represented, while several motor improvements lacked consistency. Despite the promising results, significant gaps remain, including heterogeneity in methodologies, small sample sizes, and limited long-term outcome data. Full article

Background: Scaphoid reconstruction after an established non- or malunion is challenging and recent developments have shown the feasibility to reconstruct it with 3D-planned and -printed patient-specific instrumentation. Methods: Our study compared the clinical outcome of computer assisted 3D-reconstructions of the scaphoid using patient-specific guides for primary and revision reconstructions of scaphoid nonunion regarding clinical outcome. Therefore, 39 patients with primary scaphoid nonunion or malunion and 15 patients with nonunion or malunion after a previous operative treatment were treated with patient-specific guides and followed up for a mean of 10.5 months. The consolidation was assessed with a CT-scan, and the time to consolidation was recorded. Pain level, satisfaction, wrist range of motion, and grip strength were measured and compared. Results: The wrist range of motion and grip strength of the two groups were similar, except for the wrist extension, which was significantly reduced in the revision group. Consolidation was observed in 36/39 patients (92%) in the primary group and in 13/15 patients (87%) in the revision group. Our results showed similar clinical results postoperatively between primary reconstructions and revision surgery. Conclusions: The use of 3D-planned and -printed patient-specific instrumentation proves to be similarly effective in revision surgeries for the reconstruction of the scaphoid as it is in primary surgeries. Full article

Image segmentation is one of the key factors in diagnosing glioma patients with brain tumors. It helps doctors identify the types of tumor that a patient is carrying and will lead to a prognosis that will help save the lives of patients. The analysis of medical images is a specialized domain in computer vision and image processing. This process extracts meaningful information from medical images that helps in treatment planning and monitoring the condition of patients. Deep learning models like CNN have shown promising results in image segmentation by identifying complex patterns in the image data. These methods have also shown great results in tumor segmentation and the identification of anomalies, which assist health care professionals in treatment planning. Despite advancements made in the domain of deep learning for medical image segmentation, the precise segmentation of tumors remains challenging because of the complex structures of tumors across patients. Existing models, such as traditional U-Net- and SAM-based architectures, either lack efficiency in handling class-specific segmentation or require extensive computational resources. This study aims to bridge this gap by proposing Segment Anything Model 2-UNetwork, a hybrid model that leverages the strengths of both architectures to improve segmentation accuracy and consumes less computational resources by maintaining efficiency. The proposed model possesses the ability to perform explicitly well on scarce data, and we trained this model on the Brain Tumor Segmentation Challenge 2020 (BraTS) dataset. This architecture is inspired by U-Networks that are based on the encoder and decoder architecture. The Hiera pre-trained model is set as a backbone to this architecture to capture multi-scale features. Adapters are embedded into the encoder to achieve parameter-efficient fine-tuning. The dataset contains four channels of MRI scans of 369 glioma patients as T1, T1ce, T2, and T2-flair and a segmentation mask for each patient consisting of non-tumor (NT), necrotic and non-enhancing tumor (NCR/NET), and peritumoral edema or GD-enhancing tumor (ET) as the ground-truth value. These experiments yielded good segmentation performance and achieved balanced performance based on the metrics discussed next in this paragraph for each tumor region. Our experiments yielded the following results with minimal hardware resources, i.e., 16 GB RAM with 30 epochs: a mean Dice score (mDice) of 0.771, a mean Intersection over Union (mIoU) of 0.569, an $S_{\alpha }$ score of 0.692, a weighted F-beta score ($F_{\beta }^w$) of 0.267, a F-beta score ($F_{\beta }$) of 0.261, an $E_{\varphi }$ score of 0.857, and a Mean Absolute Error (MAE) of 0.04 on the BraTS 2020 dataset. Full article

Background/Objectives: Primary gastric actinomycosis is extremely rare and only a limited number of cases are published in the literature. Actinomycosis is caused by anaerobic Gram-positive bacteria; these microorganisms are members of the normal human microbiome and occasionally lead to infection, especially in immunocompromised patients or patients subjected to abdominal surgery. Advances in personalized medicine, including tailored antimicrobial therapy based on individual patient profiles, may enhance treatment efficacy and reduce unnecessary interventions. Methods: A review was performed through a literature search of the PubMed/MedLine and Scopus databases. Results: A total of 27 patients were included, 15 males (55.56%) and 12 (44.44%) females, with a mean age of 55.11 ± 17.48 years. Among the included patients, 25.93% had a history of abdominal surgery. Abdominal pain (73.08%), weight loss (40.74%), nausea or vomiting (30.77%) and fever (19.23%) constitute the most commonly reported clinical manifestations. Endoscopy (59.26%), computed tomography (48.15%), ultrasonography (22.22%) and magnetic resonance imaging (11.11%) assisted in indicating the primary lesion. Diagnosis was achieved preoperatively in 66.66% of patients, via endoscopy and biopsy (51.85%) or via cultures (14.81%), while nine cases (33.33%) were diagnosed postoperatively. The therapeutic approaches included antimicrobial administration (32%), surgery (24%) or both (44%). The most widely used antimicrobial was penicillin (77.78%) and the mean duration of antimicrobial treatment was 5.85 months. The protocol for this review was registered in Prospero (ID:CRD42025649532). Conclusions: Due to the divergent clinical presentation of primary gastric actinomycosis, clinicians should be aware of this rare entity in order to establish diagnosis in a timely manner and provide prompt and effective treatment. Full article

Objective: This study aimed to investigate the correlation between condylar volume and airway dimensions in skeletal Class I malocclusion patients with different vertical growth patterns. Cone-beam computed tomography (CBCT) files were analyzed using AI-performed segmentation to ensure accurate measurements. Materials and Methods: A total of 93 individuals with skeletal Class I malocclusion (55 females and 38 males; average age 21.3 ± 3.0 years) were classified into three groups (normodivergent, hyperdivergent, and hypodivergent) according to their vertical growth patterns. Upper airway and condylar volumes were calculated following AI-assisted segmentation, and their correlation was evaluated. Results: In the hyperdivergent group, both airway volume (11.2 ± 5.0 cm³) and condylar volume (1.2 ± 0.2 cm³) were significantly lower compared to the normodivergent (airway: 14.4 ± 4.9 cm³; condyle: 1.5 ± 0.3 cm³) and hypodivergent groups (airway: 14.1 ± 6.3 cm³; condyle: 1.5 ± 0.3 cm³) (p < 0.05). Although no statistically significant correlation was detected between airway volume and right condylar volume across the three groups (normodivergent: r = −0.204, p = 0.280; hypodivergent: r = 0.015, p = 0.936; hyperdivergent: r = −0.007, p = 0.971), a strong positive correlation was identified between the right and left condylar volumes in all groups (r > 0.8, p < 0.01). Conclusions: No significant statistical correlation was detected between condylar volume and airway volume across the evaluated groups. However, hyperdivergent individuals were found to have smaller condylar volumes and narrower airway volumes, which may contribute to increased airway resistance and a higher risk of respiratory dysfunctions. These findings highlight the importance of considering vertical growth patterns in orthodontic and orthopedic treatment planning, especially when evaluating airway dimensions. Additionally, a strong and statistically notable positive correlation was detected between the right and left condylar volumes across all groups. Full article

This article provides an overview of various microwave-assisted techniques, such as microwave-assisted extraction (MAE), microwave-assisted organic synthesis (MAOS), microwave-assisted pyrolysis (MAP), microwave-assisted hydrothermal treatment (MAHT), microwave-assisted acid hydrolysis (MAAH), microwave-assisted organosolv (MAO), microwave-assisted alkaline hydrolysis (MAA), microwave-assisted enzymatic hydrolysis (MAEH), and microwave-assisted fermentation (MAF). Microwave-assisted biomass pretreatment has emerged as a promising method to improve the efficiency of biomass conversion processes, in particular microwave-assisted pyrolysis (MAP). The focus is on microwave-assisted pyrolysis, detailing its key components, including microwave sources, applicators, feedstock characteristics, absorbers, collection systems, and reactor designs. Based on different studies reported in the literature and a mathematical model, a mechanical design of a microwave oven adapted for pyrolysis is proposed together with a computer-aided design and a finite element analysis. The semi-continuous system is designed for a 40 L capacity and a power of 800 W. The material with which the vessel was designed is suitable for the proposed process. The challenges, opportunities, and future directions of microwave-assisted technologies for the sustainable use of biomass resources are presented. Full article

According to data from the World Health Organization (WHO), lung cancer is becoming a global epidemic. It is particularly high in the list of the leading causes of death not only in developed countries, but also worldwide; furthermore, it holds the leading place in terms of cancer-related mortality. Nevertheless, many breakthroughs have been made the last two decades regarding its management, with one of the most prominent being the implementation of artificial intelligence (AI) in various aspects of disease management. We included 473 papers in this thorough review, most of which have been published during the last 5–10 years, in order to describe these breakthroughs. In screening programs, AI is capable of not only detecting suspicious lung nodules in different imaging modalities—such as chest X-rays, computed tomography (CT), and positron emission tomography (PET) scans—but also discriminating between benign and malignant nodules as well, with success rates comparable to or even better than those of experienced radiologists. Furthermore, AI seems to be able to recognize biomarkers that appear in patients who may develop lung cancer, even years before this event. Moreover, it can also assist pathologists and cytologists in recognizing the type of lung tumor, as well as specific histologic or genetic markers that play a key role in treating the disease. Finally, in the treatment field, AI can guide in the development of personalized options for lung cancer patients, possibly improving their prognosis. Full article

Background/Objectives: The burden of ulcerative colitis (UC) is increasing in Saudi Arabia (KSA), and patients with UC often suffer from delays in diagnosis and appropriate management. This study investigates the current UC patient journey in KSA from the healthcare professionals’ (HCPs) perspective. It aims to evaluate treatment patterns, identify critical gaps, and provide insights to guide interventions that enhance the quality of life for UC patients in KSA. Methods: Quantitative interviews were conducted with 60 HCPs (45 gastroenterologists and 15 internal medicine specialists) from different regions in Saudi Arabia (KSA) using a Computer-Assisted Personal Interview (CAPI) system. The survey domains included clinical symptoms, diagnostic testing, endoscopic scoring, treatment goals, and medication sequencing. Results: Data were collected from 60 HCPs with an average of 17 ± 12.5 years of experience. Most patients with UC were referred by general practitioners (28%), internal medicine physicians (25%), followed by surgeons (16%). The first-ranked treatment goals were clinical remission (53.3%), endoscopic remission (35%), and improvement of quality of life (33.3%). For outpatient moderate-to-severe UC, the most common first-line treatments are oral systemic steroids (34%), 5-aminosalicylates (5-ASAs) (26%), and TNF-α inhibitors (21%). While second-line treatment rankings were TNF-α inhibitors (23%), followed by Interleukin 12/23 inhibitors (19%), and Janus kinase (JAK) inhibitors (14%). Sphingosine 1-phosphate (S1P) receptor modulators are not well-utilized due to a lack of availability (88%), unfamiliarity with the treatment (24%), and formulary exclusion (12%). Conclusions: In conclusion, most UC patients are referred by general practitioners. Treating gastroenterologists prioritize clinical remission as a treatment goal. Corticosteroids remain overutilized as reflected by treating physicians’ responses. The underutilization of advanced therapies underscores the need for enhanced education and improved access to integrate emerging therapies effectively. Full article

Lung cancer is the leading cause of cancer-related deaths globally and ranks among the most common cancer types. Given its low overall five-year survival rate, early diagnosis and timely treatment are essential to improving patient outcomes. In recent years, advances in computer technology have enabled artificial intelligence to make groundbreaking progress in imaging-based lung cancer diagnosis. The primary aim of this study is to develop a computer-aided diagnosis (CAD) system for lung cancer using endobronchial ultrasonography (EBUS) images and deep learning algorithms to facilitate early detection and improve patient survival rates. We propose ${\mathrm{M}}^3\text{-}\mathrm{Net}$, which is a multi-branch framework that integrates multiple features through an attention-based mechanism, enhancing diagnostic performance by providing more comprehensive information for lung cancer assessment. The framework was validated on a dataset of 95 patient cases, including 13 benign and 82 malignant cases. The dataset comprises 1140 EBUS images, with 540 images used for training, and 300 images each for the validation and test sets. The evaluation yielded the following results: accuracy of 0.76, F1-score of 0.75, AUC of 0.83, PPV of 0.80, NPV of 0.75, sensitivity of 0.72, and specificity of 0.80. These findings indicate that the proposed attention-based multi-feature fusion framework holds significant potential in assisting with lung cancer diagnosis. Full article

Background/Objectives: In recent years, the popularity of non-verbal cognitive training for aphasia has increased. Building on evidence that language abilities engage brain areas involved in executive functions (EFs) processing, this review aims to analyze the utility of EFs training alone or combined with traditional rehabilitation approaches to improve language abilities in aphasia. Methods: Systematic searches were performed in four databases evaluating studies focusing on the effects of EFs training in language rehabilitation, yielding 185 studies. After reading the full text of the selected studies and applying predefined inclusion criteria, nine studies were included based on pertinence and relevance to the topic. This systematic review has been registered in the Prospective Register of Systematic Reviews (PROSPERO 2024) with the number CRD42024519087. Results: The results of the analyzed studies indicate that various EFs training methods, such as computer-assisted executive control training, Cognitive Flexibility in Aphasia Therapy (CFAT), and the Dr. Neuronowski^® program, as well as the combination of transcranial direct current stimulation (tDCS) with EFs training, can lead to improvements in language abilities in people with aphasia. Additionally, EFs training often results in specific effects on treated functions like working memory (near transfer effects) and untreated ones such as spoken sentence comprehension (far transfer effects). Conclusions: Despite the heterogeneity of the treatments and the small simple size of the studies analyzed, preliminary results are promising. Future research should further explore the effectiveness and specific contribution of EFs training to improving language functions in aphasia. Full article

Background: Osteoporosis has become an inevitable health issue with global aging, and the current drug treatments often have adverse side effects, highlighting the need for safer and more effective therapies. Collagen-derived peptides are promising alternatives due to their favorable safety profile and biological activity. This study aimed to investigate the osteogenic and anti-apoptotic properties of collagen peptide UU1 (GASGPMGPR) in addition to its antioxidant activity. Methods: The effects of UU1 were evaluated in MC3T3-E1 cells by assessing osteogenic markers, including alkaline phosphatase (ALP), Cyclin D1, runt-related transcription factor 2 (Runx2), and Akt/β-catenin signaling. Western blot analysis quantified collagen I, osteocalcin, and phosphorylated Akt levels. Anti-apoptotic effects were measured via p-Akt levels and the Bax/Bcl-2 ratio. Computational molecular docking was performed to explore the molecular mechanism of UU1 via its interaction with epidermal growth factor receptor (EGFR) and collagen-binding integrin. Results: UU1 treatment promoted cell differentiation, with elevated ALP, Cyclin D1, Runx2, and Akt/β-catenin signaling. Notably, at 0.025 mg/mL, UU1 upregulated the levels of collagen I, osteocalcin, and phosphorylated Akt by 2.14, 3.37, and 1.95 times, respectively, compared to the control. Additionally, UU1 exhibited anti-apoptotic effects, indicated by increased p-Akt levels and a reduced Bax/Bcl-2 ratio. Molecular docking analysis suggested that UU1 could assist the dimerization of EGFR, facilitating downstream signaling transductions and activating collagen-binding integrin. Conclusions: These findings highlight UU1 as a multifunctional peptide with antioxidant, osteogenic, and anti-apoptotic properties, positioning it as a promising candidate for anti-osteoporosis applications in the food and pharmaceutical industries. Full article

The diagnosis of aneurysmal subarachnoid hemorrhage (aSAH) is most difficult in patients who are in good clinical condition with a small hemorrhage, especially when a ruptured aneurysm might not be considered, or if a computed tomographic (CT) scan is not obtained, or if when a CT is obtained, the findings are subtle and missed by an inexperienced reviewer. All acute onset (thunderclap) headaches should be considered ruptured aneurysms until proven otherwise. Treatment begins with immediate control of pain and blood pressure, placement of an external ventricular drain (EVD) in poor-grade patients and those with acute hydrocephalus on CT scanning, administration of antifibrinolytic tranexamic acid, and then repair of the aneurysm with either surgical clipping or endovascular techniques as soon as the appropriate treatment team can be assembled. After securing the aneurysm, aSAH patient treatment is focused on maintaining euvolemia and a favorable systemic metabolic state for brain repair. A significant and aneurysm-specific threat after aSAH is delayed arterial vasospasm and resulting cerebral ischemia, which is detected by vigilant bedside examinations for new-onset focal deficits or neurological decline, assisted with daily transcranial Doppler examinations and the judicious use of vascular imaging and cerebral perfusion studies with CT. The management of diagnosed symptomatic vasospasm is the prompt induction of hypertension with vasopressors, but if this fails to reverse deficits quickly after reaching a target systolic blood pressure of 200 mmHg, endovascular angioplasty is indicated, providing CT scanning rules out an established cerebral infarction. Balloon angioplasty should be considered early for all patients found to have severe angiographic vasospasm, with or without detectable signs of ischemic neurological deterioration due to either sedation or a pre-existing deficit. Full article

Introduction: Antibiotic resistance is a major public health problem in Europe. Most antibiotics are sold only by prescription in Poland, and it is mainly up to physicians to decide whether to start antibiotic treatment. Therefore, we analyzed the factors influencing the prescribing of antibiotics for upper respiratory tract infections by primary care physicians in Poland, attitudes toward antibiotic resistance, and knowledge of the principles of antibiotic use. Methods: We conducted a CAWI (Computer-Assisted Web Interview) survey, carried out using a proprietary survey distributed online. Results: A total of 528 doctors participated in the study. The result of the physical examination and additional tests, as well as the recommendations of scientific societies are the most important in deciding whether to start antibiotic therapy. Patient pressure (p < 0.011) and workload (p = 0.021) significantly influenced the decision to prescribe an antibiotic among primary care physicians and physicians in the course of specialization, who fear of legal consequences (p < 0.001). The habits of other physicians (p < 0.001) working at the same facility appeared to be additionally important. Conclusions: The decision to implement antibiotic therapy in upper respiratory tract infections is influenced by several factors that depend on the doctor (including place of work and seniority) and the patient (clinical symptoms, expectation of antibiotic prescription). The physician’s level of knowledge contributes to reducing antibiotic prescribing. Considering the factors associated with the level of knowledge and awareness, together with a high prevalence of self-medication with antibiotics in Polish population, there is a strong need to design educational interventions aimed at reducing inappropriate antibiotic prescribing and preventing antibiotic resistance in Poland. Full article