Search Results (7,160)

Background and Objectives: Patients with type 2 diabetes mellitus (T2DM) are at a heightened risk of adverse outcomes from Coronavirus Disease 2019 (COVID-19). However, the influence of glycemic control on systemic inflammation and clinical severity remains incompletely understood. This study aimed to compare inflammatory markers, composite severity scores, and clinical outcomes between T2DM patients with COVID-19 who had well-controlled diabetes (hemoglobin A1c < 7%) versus those with poorly controlled diabetes (hemoglobin A1c ≥ 7%). Methods: We retrospectively reviewed 181 adult patients with T2DM and severe COVID-19 admitted to a tertiary hospital between January 2022 and December 2023. Patients were divided into two groups: well-controlled (n = 117) and poorly controlled (n = 64) T2DM. Baseline demographics, comorbidities, and laboratory parameters (C-reactive protein, interleukin-6, ferritin, neutrophil and lymphocyte counts, platelets, and calculated indices such as the neutrophil-to-lymphocyte ratio [NLR] and systemic immune-inflammation index [SII]) were collected. Composite severity scores (APACHE II, CURB-65, and NEWS) and clinical outcomes (ICU admission, mechanical ventilation, mortality, and length of stay) were compared. Statistical tests used included Student’s t-test or the Mann–Whitney U for continuous variables and chi-square for categorical variables, with p < 0.05 deemed significant. Results: The two groups did not differ significantly in age or duration of diabetes (p = 0.40 and p = 0.75, respectively). Patients with poorly controlled T2DM exhibited higher inflammatory markers (mean CRP of 93.4 mg/L vs. 78.6 mg/L, p = 0.002; IL-6 of 64.2 pg/mL vs. 52.8 pg/mL, p = 0.004) and elevated severity scores (APACHE II of 16.8 vs. 14.1, p = 0.001). Poor glycemic control was associated with higher ICU admissions (39.1% vs. 22.2%, p = 0.02) and mortality (14.1% vs. 6.0%, p = 0.05). Conclusions: In T2DM patients hospitalized with COVID-19, poor glycemic control correlates with heightened inflammatory responses, worse composite severity scores, and increased rates of unfavorable outcomes. These findings underscore the necessity of stringent glucose management to mitigate inflammation and improve prognoses in this vulnerable patient population. Full article

Kidney injury molecule-1 (KIM-1) is a transmembrane protein that is significantly upregulated in renal cells following injury. It has considerable potential as a biomarker for diagnosing and monitoring renal cell carcinoma (RCC). This review examines KIM-1 expression across multiple biological sources—including tissue, blood, and urine—and highlights its strong association with RCC risk. Clinical studies have shown that KIM-1 levels decline within weeks after nephrectomy, underscoring its utility in assessing therapeutic response. Additionally, urinary KIM-1 levels correlate with histopathological outcomes following cisplatin treatment, supporting its role as a non-invasive marker for treatment effectiveness. Despite these promising findings, several challenges remain. These include variability in assay performance and the modulatory effects of the tumour microenvironment on KIM-1 expression. Overcoming these technical limitations is crucial for integrating KIM-1 into clinical workflows. Furthermore, its potential role in guiding combination therapies—such as tyrosine kinase inhibitors (TKIs), immune checkpoint inhibitors (ICIs), and mTOR inhibitors—could enhance therapeutic precision while minimizing toxicity. Continued research is essential to validate these applications and facilitate the routine clinical use of KIM-1 in RCC management. Full article

Background/Objectives: Vitiligo is an autoimmune condition causing melanocyte destruction and skin depigmentation. First-line treatments for vitiligo include topical medications and phototherapy; however, access and utilization of these treatments vary, particularly in pediatric patients. This study evaluates nbUVB use in pediatric versus adult vitiligo patients to better understand utilization in the pediatric population. Methods: A retrospective chart review study was conducted, collecting demographics and treatment characteristics for 102 adults and 19 children with vitiligo treated with nbUVB phototherapy at one institution. Statistical analysis included comparisons for categorical variables made using Chi-squared test or Fisher’s exact test, as appropriate, and using a non-parametric Mann–Whitney U test for continuous variables. Results: On average, adults underwent nbUVB for 23.8 months (range 0.5–418, median 9), while children had an average duration of 14.8 months (range 2–60, median 8). The average number of nbUVB sessions for adults was 83.8, whereas children had an average of 33.5 sessions. Overall, 59.6% of adults and 60.0% of children experienced repigmentation with nbUVB. Conclusions: Retrospective analysis indicated that the duration and frequency of nbUVB sessions varied widely among both adults and children. While the average duration of treatment was comparable between the groups, children underwent fewer sessions on average. This may reflect differences in physician recommendation, scheduling constraints, or treatment adherence. Despite this variability, most pediatric patients exhibited repigmentation, supporting nbUVB efficacy. Our results suggest nbUVB is underutilized in pediatric vitiligo. Addressing obstacles to access is crucial for improving treatment outcomes and quality of life. Full article

The accurate estimation of forest aboveground biomass (AGB) is essential for effective forest resource management and carbon stock assessment. However, the estimation accuracy of forest AGB is often constrained by scarce in situ measurements and the limitations of using a single data source or retrieval model. This study proposes a multi-source data integration framework using Sentinel-1 (S-1) and Sentinel-2 (S-2) data along with eight predictive models (i.e., multiple linear regression—MLR; Elastic-Net; support vector regression (with a linear kernel and polynomial kernel); k-nearest neighbor; back-propagation neural network—BPNN; random forest—RF; and gradient-boosting tree—GBT). With airborne light detection and ranging (LiDAR)-derived AGB as a reference, a three-stage optimization strategy was developed, including stepwise feature selection (SFS), hyperparameter optimization, and multi-decision vector fusion (MDVF) model construction. Initially, the optimal feature subsets for each model were identified using SFS, followed by hyperparameter optimization through a grid search strategy. Finally, eight models were evaluated, and MDVF was implemented to integrate outputs from the top-performing models. The results revealed that LiDAR-derived AGB demonstrated a strong performance (R² = 0.89, RMSE = 20.27 Mg/ha, RMSE_r = 15.90%), validating its effectiveness as a supplement to field measurements, particularly in subtropical forests where traditional inventories are challenging. SFS could adaptively select optimal variable subsets for different models, effectively alleviating multicollinearity. Satellite-based AGB estimation using the MDVF model yielded robust results (R² = 0.652, RMSE = 31.063 Mg/ha, RMSE_r = 20.4%) through the synergy of S-1 and S-2, with R² increasing by 4.18–7.41% and the RMSE decreasing by 3.55–5.89% compared to the four top-performing models (BPNN, GBT, RF, MLR) in the second optimization stage. This study aims to provide a cost-effective and precise strategy for large-scale and spatially continuous forest AGB mapping, demonstrating the potential of integrating active and passive satellite imagery with airborne LiDAR to enhance AGB mapping accuracy and support further ecological monitoring and forest carbon accounting. Full article

Asymmetric deformation has been observed along the Altyn Tagh Fault (ATF), the northern boundary of the Tibetan Plateau. Several mechanisms have been proposed to explain this asymmetry, including contrasts in crustal strength, lower crust/upper mantle rheology, deep fault dislocation shifts, and dipping fault geometry; however, the real scenario remains debated. This study utilizes a time series Interferometric Synthetic Aperture Radar (InSAR) technique to investigate spatially variable asymmetries across the western section of the ATF (83–89°E). We generated a high-resolution three-dimensional (3D) crustal velocity field from Sentinel-1 data for the northwestern Tibetan Plateau (~82–92°E; 33–40°N). Our results confirm that pronounced greater deformations within the Tibetan Plateau occur only along the westernmost section of the ATF (83–85.5°E). We propose this asymmetry is primarily driven by a splay fault system within a transition zone, bounded by the ATF in the north and the Margai Caka Fault (MCF)–Kunlun Fault (KLF) in the south, which accommodates an east–west extension in the central Tibetan Plateau while transferring sinistral shear to the KLF. The concentrated strain observed along the ATF and MCF–KLF lends more support to a block-style eastward extrusion model, rather than a continuously deforming model, for Tibetan crustal kinematics. Full article

Objectives: Ovarian cancer continues to be one of the most prevalent gynecological cancers diagnosed. Early detection is highly critical for increasing survival chances. This research aims to assess the feature extraction process from various machine learning techniques for better modelling of ovarian cancer and the selection process in ovarian cancer analysis. By eliminating irrelevant features, this approach could guide clinicians towards more accurate results and optimize diagnostic precision. Methods: This study included both patients with and without ovarian cancer, creating a dataset containing 50 independent variables/features. Eight machine learning algorithms: Random Forest, XGBoost, CatBoost, Decision Tree, K-Nearest Neighbors, Naive Bayes, Gradient Boosting, and Support Vector Machine, were evaluated alongside four feature selection techniques: Boruta, PCA, RFE, and MI. Metrics performance has been evaluated to obtain the best possible combination for diagnosis. Results: These results were obtained using these methods with a significantly reduced number of features. Random Forest and CatBoost’s performances demonstrated significant differences in contrast to other algorithms (respectively, AUC 0.94% and 0.95%). On the other hand, feature selection methods such as Boruta and RFE consistently reflected higher AUC and accuracy scores than the others. Conclusions: This study highlights the importance of choosing appropriate machine learning algorithms and feature selection techniques for ovarian cancer diagnosis. Boruta and RFE showed high accuracy. By reducing the number of features from 50 to the most relevant ones, clinicians can make more precise diagnoses, enhance patient outcomes, and reduce unnecessary tests. Full article

Osteosarcoma is recognized as the most prevalent primary bone malignancy, primarily affecting children and adolescents. It is characterized by its aggressive behavior and high metastatic potential, which often leads to poor patient outcomes. Despite advancements in surgical techniques and chemotherapy regimens, the prognosis for patients with osteosarcoma remains unsatisfactory, with survival rates plateauing over the past few decades. A significant barrier to effective treatment is the development of chemotherapy resistance, which complicates the management of the disease and contributes to high rates of recurrence. This review article aims to provide a comprehensive overview of recent advancements in osteosarcoma therapy, particularly in overcoming chemotherapy resistance. We begin by discussing the current standard treatment modalities, including surgical resection and conventional chemotherapy agents such as methotrexate, doxorubicin, and cisplatin. While these approaches have been foundational in managing osteosarcoma, they are often limited by adverse effects and variability in efficacy among patients. To address these challenges, we explore novel pharmacological strategies that aim to enhance treatment outcomes. This includes targeted therapies focusing on specific molecular alterations in osteosarcoma cells and immunotherapeutic approaches designed to harness the body’s immune system against tumors. Additionally, we review innovative drug delivery systems that aim to improve the bioavailability and efficacy of existing treatments while minimizing toxicity. The review also assesses the mechanisms underlying chemotherapy resistance, such as drug efflux mechanisms, altered metabolism, and enhanced DNA repair pathways. By synthesizing current research findings, we aim to highlight the potential of new therapeutic agents and strategies for overcoming these resistance mechanisms. Ultimately, this article seeks to inform future research directions and clinical practices, underscoring the need for continued innovation in treating osteosarcoma to improve patient outcomes and survival rates. Full article

Human mesenchymal stem cells (hMSCs) are widely used in regenerative medicine, but large-scale in vitro expansion alters their function, impacting proliferation and differentiation potential. Currently, a predictive marker to assess these changes is lacking. Here, we used dielectrophoresis (DEP) to characterize the electrical phenotype of hMSCs derived from bone marrow (BM), adipose tissue (AT), and umbilical cord (UC) as they aged in vitro from passage 4 (P4) to passage 9 (P9). The electrical phenotype was defined by the DEP spectra, membrane capacitance, and cytoplasm conductivity. Cell morphology and size, growth characteristics, adipogenic differentiation potential, and osteogenic differentiation potential were assessed alongside label-free biomarker membrane capacitance and cytoplasm conductivity. Differentiation was confirmed by histological staining and RT-qPCR. All hMSCs exhibited typical morphology, though cell size varied, with UC-hMSCs displaying the largest variability across all size metrics. Growth analysis revealed that UC-hMSCs proliferated the fastest. The electrical phenotype varied with cell source and in vitro age, with high passage hMSCs showing noticeable shifts in DEP spectra, membrane capacitance, and cytoplasm conductivity. Correlation analysis revealed that population doubling level (PDL) correlated with membrane capacitance and cytoplasm conductivity, indicating PDL as a more precise marker of in vitro aging than passage number. Additionally, we demonstrate that membrane capacitance correlates with the osteogenic marker COL1A1 and that cytoplasm conductivity correlates with the adipogenic markers ADIPOQ and FABP4, suggesting that DEP-derived electrical properties serve as label-free biomarkers of differentiation potential. While DEP has previously been applied to BM-hMSCs and AT-hMSCs, and more recently to UC-hMSCs, few studies have provided a direct comparison across all three sources or tracked changes across continuous expansion. These findings underscore the utility of DEP as a label-free approach for assessing hMSC aging and function, offering practical applications for optimizing stem cell expansion and stem cell banking in clinical settings. Full article

In the context of global warming, there is an increasing risk of the emergence and re-emergence of vector-borne diseases (VBDs). As one of the most important vectors, Culex tritaeniorhynchus can carry and transmit numerous human and animal infectious pathogens. To better understand the current distribution and possible future dynamics of Cx. tritaeniorhynchus in China, an ecological niche modeling approach (MaxEnt) was adopted to model its current and future habitat suitability. The most comprehensive dataset (1100 occurrence records) in China to date was established for model training. Multiple global climate models (GCMs) and climate change scenarios were introduced into the model to counter the uncertainties of future climate change. Based on the model prediction, Cx. tritaeniorhynchus currently exhibits high habitat suitability in southern, central, and coastal regions of China. It is projected that its suitable niche will experience continuous expansion, and the core distribution is anticipated to shift northward in the future 21st century (by the 2050s, 2070s and 2090s). Several environmental variables that reflect temperature, precipitation, and land-use conditions were considered to have a significant influence on the distribution of Cx. tritaeniorhynchus, among which annual mean temperature and urban land contribute the most to the model. Our study conducted a quantitative analysis of the shift and expansion of the future habitats of Cx. tritaeniorhynchus, providing references for vector monitoring and the prevention and control of VBDs. Full article

Background/Objectives: Hypoparathyroidism (HPT) is a common complication following thyroid surgery with an incidence reaching up to 29%, potentially resulting in significant long-term morbidity. To improve its early identification and patient outcomes, we investigated the prevalence and predictors of postoperative HPT. Methods: This retrospective, multicenter observational study included patients who underwent thyroid surgery from 2016 to 2022 in four centers located in Saudi Arabia’s Eastern Province. We analyzed demographic data, underlying thyroid or parathyroid conditions, surgical indications, types of procedures, pathology results, and preoperative corrected calcium and vitamin D levels, along with postoperative corrected calcium and parathyroid hormone (PTH) levels. For data analysis, IBM Statistical Package for the Social Sciences (SPSS) Statistics 22 was used, with categorical variables presented as frequencies/percentages and non-normal continuous variables as the median/first quartile (Q1) and third quartile (Q3). Associations were tested with chi-square/Fisher exact tests, medians with Mann–Whitney U-tests, and odds ratios (ORs) with 95% confidence intervals (CIs) via multivariate analysis with statistical significance set at p < 0.05. Results: A total of 679 cases were included. The median age of patients was 43 years (with 48.9% of them aged 41–60 years), and 82% were female. HPT occurred in 228 cases (35.3%), with 115 (81.0%) experiencing transient HPT and 27 (19.0%) permanent HPT. Multivariate analysis identified total thyroidectomy (OR 2.7, p = 0.005), completion thyroidectomy (OR 8.4, p = 0.004), and low immediate postoperative PTH level (OR 3.1, p < 0.001) as independent predictors of HPT. Central lymph node dissection (CLND; OR 4.03, p = 0.004) and low postoperative PTH level (OR 2.56, p = 0.049) were significant predictors of permanent HPT. Conclusions: Key predictors of HPT include surgical extent and low postoperative PTH level, while CLND and low postoperative PTH level are the strongest predictors of permanent HPT. Careful assessment of these risks when determining the extent of surgery and avoiding unnecessary aggressive procedures can help to minimize the occurrence of HPT. Measuring the PTH level immediately after surgery may aid in identifying high-risk patients for early intervention and appropriate follow-up. Full article

The beneficial effects of cannabinoids in the treatment of respiratory diseases have been drawing researchers’ attention for several decades. Asthma is a complex disease entity characterized by a variable course, the treatment of which requires the continuous search for alternative, adjuvant treatment strategies designed for patients refractory to available pharmacotherapies. Cannabinoids exert certain physiological responses in the respiratory system due to their immunomodulatory properties and the strong presence of the endocannabinoid system in the lungs. In animal model studies, THC and CBD seem to counteract bronchoconstriction and inhibit pro-inflammatory mediation, respectively, which highlights their possible future contribution to the treatment of respiratory and allergic diseases, such as asthma. However, there are controversies regarding the health consequences of cannabis usage, the extracts’ proportions, or equally safe and effective routes of administration, especially considering the alarming reports indicating an increased risk of asthma development among recreational cannabis smokers. The purpose of this review is to analyze the available literature on the influence of the endocannabinoid system, phytocannabinoids, and their modes of action on asthma pathogenesis in an attempt to assess their potential clinical relevance and determine future research directions. Full article

Background/Objectives: Glycemic variability (GV) is a novel concept in the assessment of the quality of glycemic control in patients with diabetes, with its importance emphasized in patients with type 1 diabetes. Its adoption in clinical practice emerged with the increased availability of continuous glycemic monitoring systems. The aim of this study is to evaluate the GV in patients with type 1 diabetes mellitus (T1DM) and to assess its associations with other parameters used to evaluate the glycemic control. Methods: GV indexes and classical glycemic control markers were analyzed for 147 adult patients with T1DM in a multicentric cross-sectional study. Results: Stable glycemia was associated with a higher time in range (TIR) (78% vs. 63%; p < 0.001) and a lower HbA1c (6.8% vs. 7.1%; p = 0.006). The coefficient of variation (CV) was reversely correlated with TIR (Spearman’s r = −0.513; p < 0.001) and positively correlated with hemoglobin A1c (HbA1c) (Spearman’s r = 0.349; p < 0.001), while TIR was reversely correlated with HbA1c (Spearman’s r = −0.637; p < 0.001). The composite GV and metabolic outcome was achieved by 28.6% of the patients. Conclusions: Stable glycemia was associated with a lower HbA1c, average and SD of blood glucose, and a higher TIR. A TIR higher than 70% was associated with a lower HbA1c, and SD and average blood glucose. Only 28.6% of the patients with T1DM achieved the composite GV and metabolic outcome, despite 53.7% of them achieving the HbA1c target, emphasizing thus the role of GV in the assessment of the glycemic control. Full article

Long-term intensive agricultural management practices have led to a continuous decline in farmland soil quality, posing a serious threat to food security and agricultural sustainability. Green manure, as a natural, cost-effective, and environmentally friendly cover crop, plays a significant role in enhancing soil quality, ensuring food security, and promoting sustainable agricultural development. The improvement of soil quality by green manure is primarily manifested in the enhancement of soil physical, chemical, and biological properties. Specifically, it increases soil organic matter content, optimizes soil structure, enhances nutrient cycling, and improves microbial community composition and metabolic activity. The integration of green manure with agronomic practices such as intercropping, crop rotation, conservation tillage, reduced fertilizer application, and organic material incorporation demonstrates its potential in addressing agricultural development challenges, particularly through its contributions to soil quality improvement, crop yield stabilization, water and nutrient use efficiency enhancement, fertilizer input reduction, and agricultural greenhouse gas emission mitigation. However, despite substantial evidence from both research and practical applications confirming the benefits of green manure, its large-scale adoption faces numerous challenges, including regional variability in application effectiveness, low farmer acceptance, and insufficient extension technologies. Future research should further clarify the synergistic mechanism between green manure and agronomic measures such as intercropping, crop rotation, conservation tillage, reduced fertilization and organic material return to field. This will help explore the role of green manure in addressing the challenges of soil degradation, climate change and food security, develop green manure varieties adapted to different ecological conditions, and optimize green manure planting and management technologies. Governments should comprehensively promote the implementation of green manure technologies through economic incentives, technology extension, and educational training programs. The integration of scientific research, policy support, and technological innovation is expected to establish green manure as a crucial driving force for facilitating the global transition towards sustainable agriculture. Full article

Background and Objectives: In the present systematic review and meta-analysis, we aimed to discover the overall efficacy of azithromycin in children with cystic fibrosis (CF) and with or without Pseudomonas aeruginosa infection, specifically regarding its effect on respiratory parameters such as forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in addition to its effect on exacerbations and the need to use additional antibiotics. Materials and Method: We conducted this systematic review and meta-analysis by searching for all eligible articles on PubMed, Web of Science, and Scopus published between inception and September 2024. We used the following search strategy for our searching process: “Cystic fibrosis” AND “Azithromycin” and “Children” OR “Pediatric” OR “Infant”. We conducted the meta-analysis by pooling the mean difference (MD) and comparing the continuous variables and odds ratio (OR) for dichotomous variables at 95% confidence intervals (CI), at a p-value of 0.05. Results: Azithromycin was observed to be associated with increased FEV1 compared with the control, showing an MD of 1.91 (95% CI: 1.09, 2.74, p < 0.00001) and non-significant heterogeneity. However, no significant difference was observed between azithromycin and control groups regarding FVC with MD = 0.62 (95% CI: −0.01, 1.25, p = 0.06). Compared with the control group, azithromycin was significantly associated with lower risk and a lower number of exacerbations, with OR = 0.48 (95% CI: 0.34, 0.67, p < 0.0001) and MD = −0.82 (95% CI: −1.32, −0.33, p = 0.001), respectively, with non-significant heterogeneity. Regarding the need for new antibiotic usage, azithromycin showed a significantly lower need, with OR = 0.35 (95% CI: 0.13, 0.94, p = 0.04), I² = 75%, p = 0.02. No significant difference was observed between both groups regarding hospitalization rate, with OR = 0.88 (95% CI: 0.55, 1.4, p = 0.59). Conclusions: This systematic review and meta-analysis showed the efficacy of azithromycin in pediatric patients with CF, as it improved lung function by increasing FEV1, reduced exacerbations of CF, which is the most common symptom of CF that leads to mortality, and reduced the number of antibiotics that needed to be administered to patients with CF, which reduces the risk of antibiotic resistance. Therefore, the long-term use of azithromycin is recommended for pediatric patients with CF as part of their treatment regimen. Full article

Objective: We aimed at assessing our experience at the European Institute of Oncology in order to evaluate the peri- and immediately post-operative impact of neoadjuvant chemotherapy in patients who underwent pneumonectomy for NSCLC. Materials and methods: We retrospectively reviewed the outcomes and medical records of patients undergoing pneumonectomy (2010–2024). We compared pre-, peri- and post-operative outcomes of patients treated with induction chemotherapy and subsequent pneumonectomy with patients who underwent surgery directly. Differences in their distribution between study arms were assessed using the chi-square test for categorical variables or the Mantel–Haenszel test for trend for ordinal variables. We tested normality of the distribution of continuous variables using the Shapiro–Wilk test. We used logistic regression to quantify the risk of various outcomes (complications, 30-day and 12-day mortality) in patients who received neoadjuvant chemotherapy. Risks were expressed as odds ratios (ORs) with 95% confidence intervals (CIs adjusted for age (<60, 60–64, 65–69, ≥70 years), sex and comorbidities (cardiovascular, pulmonary or previous cancer). Results: We observed a higher frequency of post-operative respiratory complications in patients who underwent neoadjuvant therapy and pneumonectomy compared to those who only underwent surgery (11.4% vs. 18.5%; p = 0.05). After adjustment for age, sex and comorbidities we observed a significantly higher rate of pulmonary complications (OR 1.95; 95% CI 1.09–3.47; p = 0.02), ARDS (OR 2.88; 95% CI 1.26–6.59; p = 0.02) and 30-day mortality rate (OR 8.19; 95% CI 1.33–50.3; p = 0.02) in pre-treated patients. Conclusions: It is therefore strongly recommended to study and select potentially eligible patients in an extremely meticulous way before starting the neoadjuvant treatment, and to thoroughly re-evaluate the cardiorespiratory status after inductive therapy, before surgery. Full article