Search Results (1,445)

Background/Objectives: There is a growing need for programs addressing perinatal mental health, particularly for new mothers. Postpartum depression (PPD) may occur during pregnancy or within the first year postpartum, with both short- and long-term negative consequences for both mothers and their infants. This study describes the cultural adaptation, implementation, and one-year follow-up of the Mom-to-Mom (M2M) program for minority Bedouin women in Southern Israel. Methods: We conducted a community-based intervention (M2M) emphasizing cultural adaptation. Outreach efforts were conducted in collaboration with healthcare professionals to encourage referral to the M2M program. A total of 111 mothers completed a self-administered questionnaire that included socio-demographic characteristics and PPD symptoms (PPDs) at two time points: prior to the intervention (Time-1) and one year after participating in the program (Time-2). PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS), using a score cutoff of ≥10. Results: There was a significant decrease in PPDs (EPDS ≥ 13) between Time-1 and Time-2 after one year of follow-up in the M2M program (from 45% to 19.8%). Of the participants, 75% were referred to the program by healthcare professionals. Among those with EPDS ≥ 10, 30% were referred to mental health services. This program provided education, professional support, and led to the establishment of the first M2M center within a Bedouin community, located in the Negev (Naqab). Conclusions: The results emphasize the importance of culturally sensitive approaches to increase awareness, early diagnosis, and professional support in addressing PPD, tailored to a cultural context. Culturally adapted programs can be effective in minority populations and contribute to reducing disparities in maternal mental health care. Full article

We aimed to assess the seroprevalence of anti-Neospora caninum and anti-Toxoplasma gondii antibodies in cattle intended for human consumption in Paraíba, Brazil, and the associated risk factors. A total of 110 serum samples from slaughtered cattle were analyzed using the Indirect Fluorescence Antibody Test (IFAT), with cut-off points of 1:200 for N. caninum and 1:64 for T. gondii. Seroprevalence was 8.2% (9/110) for N. caninum (titers 1:200–1:6400) and 18.2% (20/110) for T. gondii (titers 1:64–1:512). Risk factor analysis revealed that the variable female sex (cows) and the extensive farming system were statistically significantly associated with seroprevalence for N. caninum. Whereas for T. gondii, extensive farming, frequent animal purchase, and the lack of separation between calves and adult cattle were statistically significant. These findings demonstrate the circulation of these parasites in herds, with implications for animal and public health, indicating a potential risk of transmission to definitive hosts and humans through the consumption of raw or undercooked infected meat. Full article

The recent growth of generative artificial intelligence (AI) has brought new possibilities and revolutionary applications in many fields. It has also, however, created important ethical and security issues, especially with the abusive use of deepfakes, which are artificial media that can propagate very realistic but false information. This paper provides an extensive bibliometric, statistical, and trend analysis of deepfake research in the age of generative AI. Utilizing the Web of Science (WoS) database for the years 2014–2024, the research identifies key authors, influential publications, collaboration networks, and leading institutions. Biblioshiny (Bibliometrix R package, University of Naples Federico II, Naples, Italy) and VOSviewer (version 1.6.20, Centre for Science and Technology Studies, Leiden University, Leiden, The Netherlands) are utilized in the research for mapping the science production, theme development, and geographical distribution. The cutoff point of ten keyword frequencies by occurrence was applied to the data for relevance. This study aims to provide a comprehensive snapshot of the research status, identify gaps in the knowledge, and direct upcoming studies in the creation, detection, and mitigation of deepfakes. The study is intended to help researchers, developers, and policymakers understand the trajectory and impact of deepfake technology, supporting innovation and governance strategies. The findings highlight a strong average annual growth rate of 61.94% in publications between 2014 and 2024, with China, the United States, and India as leading contributors, IEEE Access among the most influential sources, and three dominant clusters emerging around disinformation, generative models, and detection methods. Full article

Accurate preoperative staging of bladder cancer on MRI remains challenging because visual reads vary across observers. We investigated a multiparametric MRI (mpMRI) radiomics approach to predict muscle invasion (≥T2) and prospectively tested it on a validation cohort. Eighty-four patients with urothelial carcinoma underwent 1.5-T mpMRI per VI-RADS (T2-weighted imaging and DWI-derived ADC maps). Two blinded radiologists performed 3D tumor segmentation; 37 features per sequence were extracted (LifeX) using absolute resampling. In the training cohort (n = 40), features that differed between non-muscle-invasive and muscle-invasive tumors (Mann–Whitney p < 0.05) underwent ROC analysis with cut-offs defined by the Youden index. A compact descriptor combining GLRLM-LRLGE from T2 and GLRLM-SRLGE from ADC was then fixed and applied without re-selection to a prospective validation cohort (n = 44). Histopathology within 6 weeks—TURBT or cystectomy—served as the reference. Eleven T2-based and fifteen ADC-based features pointed to invasion; DWI texture features were not informative. The descriptor yielded AUCs of 0.934 (training) and 0.871 (validation) with 85.7% sensitivity and 96.2% specificity in validation. Collectively, these findings indicate that combined T2/ADC radiomics can provide high diagnostic accuracy and may serve as a useful decision support tool, after multicenter, multi-vendor validation. Full article

Background: Congenital gastrointestinal anomalies (CGIAs) are the third most common congenital malformation globally, with a mortality rate reaching 39.8% in developing countries. Surgical intervention is often necessary for life-saving or corrective purposes. However, postoperative mortality in resource-limited settings can reach up to 50%. Identifying prognostic factors is essential to improve clinical management and inform family counseling regarding potential outcomes. Objectives: We aimed to develop a prognostic scoring system to predict postoperative mortality in neonates with CGIAs. Methods: This retrospective study analyzed medical records of neonates who underwent surgery for CGIAs between 2020 and 2024. Prognostic factors were identified using logistic regression analysis. Receiver operating characteristic (ROC) curves were used to determine optimal cutoff points for mortality prediction. Results: A total of 282 neonates were included; 121 (42.9%) died and 161 (57.1%) survived. Multivariate logistic regression identified sepsis, mechanical ventilation, prematurity, and upper gastrointestinal anomalies as independent predictors of mortality. A scoring system was developed, with a score > 3 yielding a sensitivity of 83.5% and specificity of 72.0%. The area under the ROC curve (AUC) was 0.840 (p < 0.001). Conclusions: We developed a simple and reliable scoring system to predict postoperative mortality in neonates with CGIAs, which may support clinical decision-making and family counseling. Full article

Patients who present nutritional risk upon hospital admission are more likely to have worse clinical outcomes. Evaluating muscle thickness with ultrasound is a predictor of muscle mass loss in pediatric patients. We reviewed the muscle mass loss detection through ultrasound to assess the body composition of pediatric patients. We found an association between muscle reduction, as detected by ultrasound, and the duration of mechanical ventilation, nutritional deficits in energy and protein intake, and the age-related skeletal muscle atrophy of the limbs. All studies reported a reduction in muscle thickness of more than 10% during hospitalization. There is a lack of standardization in muscle mass assessment protocols and established cut-off points in critically ill hospitalized children. Further studies are needed to establish an accurate and standardized analysis for monitoring muscle changes using ultrasound. Full article

The swift advancement of the digital economy presents new pathways toward achieving common prosperity in China. Based on microdata derived from the China Family Panel Studies (2010–2022), this study employs the “Broadband China” pilot policy as a quasi-natural experiment to explore how digital economy development influences multidimensional relative poverty. We develop a multidimensional relative poverty index encompassing economic, health, education, and living condition aspects utilizing the Alkire–Foster dual cutoff method and employ a staggered Difference-in-Differences design for empirical analysis. Results show that the policy leads to an average decrease of 1.8 percentage points in the probability of multidimensional relative poverty across households. The effect is more pronounced in central and western regions, rural households, and those with a high proportion of non-labor force, particularly in the dimensions of economic, health, and living conditions dimensions. Mechanism analysis via interaction term regression indicates that increased population mobility and improved informal employment are key channels. These findings suggest that enhancing digital infrastructure and tailoring mobility and employment policies to fit regional and urban–rural contexts can effectively alleviate multidimensional relative poverty. This study contributes empirical evidence connecting the advancement of the digital economy to poverty alleviation and aligns with the United Nations Sustainable Development Goal 1 (No Poverty). Full article

Background: Recent hypotheses suggest that mutations associated with alpha1 antitrypsin (AAT) deficiency (AATD) may influence the clinical presentation and progression of cystic fibrosis (CF). This study employs a longitudinal design to determine the prevalence of AATD mutations and assess their impact on CF. Methods: The study Finding AAT Deficiency in Obstructive Lung Diseases: Cystic Fibrosis (FADO-CF) is a retrospective cohort study evaluating people with CF from November 2020 to February 2024. On the date of inclusion, serum levels of AAT were measured and a genotyping of 14 mutations associated with AATD was performed. Historical information, including data on exacerbations, microbiological sputum isolations, and lung function, was obtained from the medical records, aiming at a temporal lag of 10 years. Results: The sample consisted of 369 people with CF (40.9% pediatrics). Of these, 58 (15.7%) cases presented at least one AATD mutation. The AATD allelic combinations identified were PI*MS in 47 (12.7%) cases, PI*MZ in 5 (1.4%) cases, PI*SS in 3 (0.8%) cases, PI*SZ in 2 (0.5%) cases, and PI*M/P_lowell in 1 (0.3%) case. The optimal cutoff value for AAT levels to detect AATD-associated mutation carriers was 129 mg/dL in the overall cohort (sensitivity of 73.0%; specificity 69.2%) and 99.5 mg/dL when excluding PI*MS cases (sensitivity 98.0%; specificity 90.9%), highlighting the need for lower thresholds in clinically severe genotypes to improve case detection. The number of mild exacerbations during the follow-up appeared to be associated with AATD mutations. Conclusions: AATD mutations are prevalent in CF and may impact certain clinical outcomes. If systematic screening was to be planned, we recommend considering the proposed cut-off points to select the population for genetic studies. Full article

Background and Aim: Sarcopenic obesity (SO) is a phenotype characterized by increased body fat combined with reduced muscle mass and strength. SO is prevalent among people living with HIV, especially in men (MLWH); however, the link between this phenotype and diet is still unclear in this population. For this reason, in this study, we aim to examine potential associations between self-reported macronutrient intake and SO in MLWH, and, eventually, to evaluate the diagnostic accuracy of a simple nutritional marker for screening SO. Methods: A total of 216 MLWH were selected from a large cohort who completed a total body composition measurement by dual-energy X-ray absorptiometry (DXA), muscle strength assessment by handgrip test, and nutritional recording by 24 h recall interview. The sample was categorized into SO (n = 45), non-SO (NSO) (n = 33), and non-sarcopenic non-obesity (NSNO) (n = 138). Logistic regression analysis was performed to determine the associations between different macronutrients and SO after adjusting for confounders. Receiver operating characteristic (ROC) curve analysis was used to identify discriminating cut-off points of the determined macronutrient intake to screen for SO. Results: The MLWH with SO while compared to NSO and NSNO, were of an older age and had a higher BMI, but with a lower total caloric and protein intake. However, adjusted logistic regression showed that only protein intake (g/kg/day) (OR = 0.017; 95%CI: 0.003–0.094, p < 0.05) and age (OR = 1.051; 95%CI: 1.011–1.093, p < 0.05) were significantly associated with SO. The age-adjusted ROC analysis identified the 0.98 g/kg/day of protein intake (AUC = 0.8149; p < 0.0001; sensitivity = 71%; specificity = 70%) as a cut-off point to screen for SO in the MLWH. Conclusions: We identified a new cut-off point of daily protein intake able to screen for SO in MLWH, and its use can be implemented in clinical settings. Full article

Background: Rectal cancer is common and frequently treated with neoadjuvant radiotherapy prior to surgery to reduce the risk of tumour recurrence. However, the therapeutic benefits and side effects of radiotherapy can vary between patients, and there are currently no validated biomarkers to predict treatment response. Tumour cell density (TCD) and tumour-infiltrating lymphocyte (TIL) density are proven prognostic biomarkers in colorectal cancer; however, their utility in predicting radiotherapy response remains unclear. We assessed the prognostic and predictive value of TCD and TIL density in rectal cancer patients treated with radiotherapy. Methods: TCD was quantified using a manual point-counting method in 253 pre-treatment biopsies and across the entire tumour area of 569 resection specimens from the MRC CR07 clinical trial, which randomised patients to either neoadjuvant short-course radiotherapy (SCRT) or straight to surgery (control). TIL density was measured in 102 biopsies and matched resection specimens (73 SCRT, 29 control) across different tumour areas using deep learning-based cell detection in MIM (HeteroGenius Ltd., Leeds, UK). Cutoffs for low/high-TCD and TIL density were both pre-defined and derived from survival data using the survminer R package. Survival analyses were performed to evaluate the predictive and prognostic value of TCD/TIL in relation to overall and cancer-specific survival. Results: TCD in the resection specimens was lower in the SCRT group (19.9%, IQR 12.9–26.7%) than the control group (34.3%, IQR 27.7–40.5%, p < 0.001). In control resections, low-TCD was associated with a higher risk of all-cause mortality (HR 2.20, 95% CI 1.41–3.44, p < 0.001) and cancer-related death (HR 2.69, 95% CI 1.41–5.13, p = 0.0026). In contrast, after SCRT, low resection TCD was associated with a reduced risk of death (HR 0.63, 95% CI 0.40–0.98, p = 0.04). In the SCRT group, low biopsy TCD prior to radiotherapy was associated with a reduced risk of cancer-related death (HR 0.34, 95% CI 0.13–0.89, p = 0.028). Across both trial arms, TIL density was higher in pre-treatment biopsies than resections (2492 vs. 1304/mm², p < 0.001). Low biopsy TIL density was associated with an increased risk of all-cause mortality (HR 2.43, 95% CI 1.24–4.76, p = 0.01). The SCRT group had lower TIL density in the resection compared with controls (1210 vs. 1615/mm², p < 0.001), and low resection TIL density across the whole tumour area was associated with a higher risk of death (HR 2.55, 95% CI 1.11–5.87, p = 0.027). Conclusions: Our findings support the role of TCD and TIL density as quantitative biomarkers in rectal cancer patients. TCD can be used to assess the degree of response to radiotherapy, and contrasting survival associations are observed between straight-to-surgery and SCRT-treated patients. This study raises the possibility of using TCD as both a prognostic and predictive biomarker. TIL density failed to show predictive value but demonstrated expected prognostic associations. Full article

Background/Objectives: To establish reference intervals (RIs) and cut-off values for thyroid-related tests on the MAGLUMI X6 immunoassay analyzer (Snibe Diagnostic, Shenzhen, China) in an adult Croatian population. Methods: This study included 305 healthy individuals who underwent regular preventive medical checkup. The following tests were determined in serum: thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin (Tg), reverse triiodothyronine (revT3), total binding capacity of thyroglobulin (T-uptake), thyroglobulin antibodies (anti-Tg), anti-thyroid peroxidase antibodies (anti-TPO) and thyroid receptor antibodies (TRAb). TSH, TT3, TT4, FT3, FT4, Tg, revT3 and T-uptake results were used for calculating double-sided 95% RIs between the 2.5th and 97.5th percentiles. For anti-Tg, anti-TPO and TRAb, right-sided cut-offs that correspond to the 95th percentile were determined. Results: Reference intervals for TSH, TT4, FT3, FT4, Tg, T-uptake and revT3 did not differ by gender (p > 0.05) and were 0.77–5.04 mIU/L, 69.9–127.7 nmol/L, 3.84–6.20 pmol/L, 13.8–19.7 pmol/L, 1.8–51.2 µg/L, 0.9–1.2 TBI and 0.44–0.73 ng/mL, respectively. The RI for TT3 was different for males (1.49–2.53 nmol/L) and females (1.43–2.81 nmol/L), p = 0.021. A single cut-off for anti-TPO was established (<18 kIU/L). Differences in cut-offs for males and females were obtained for anti-Tg (<72 and <104 kIU/L, respectively) and TRAb (0.6 and 0.9 IU/L, respectively). Conclusions: This is the first study to determine RIs for thyroid function tests in Croatian adults on the Snibe analytical platform. The obtained results point out to the use of population- and immunoassay-specific RIs. For TT3, anti-Tg and TRAb gender-specific RIs should be considered. Full article

Sleep in intensive care unit (ICU) patients is frequently disrupted, which may adversely affect their overall health and recovery. Despite the implementation of various strategies to promote sleep, accurately assessing its quality remains complex. This pilot study aimed to evaluate both the quality and quantity of sleep in ICU patients using actigraphy (ACT) and the Richards–Campbell Sleep Questionnaire (RCSQ) and to compare the diagnostic performance of these two tools. We conducted a prospective observational study including 228 ICU patients. Sleep was assessed using both RCSQ and ACT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the discriminative ability of each tool (Area Under the Curve [AUC], sensitivity, specificity), with optimal cut-off points determined using Youden’s Index. The Mann–Whitney U test was used to compare sleep parameters between patients classified as having good or poor sleep based on ACT measurements. The mean RCSQ score was 38.16 ± 17.09, indicating poor perceived sleep quality. Sleep onset latency (based on RCSQ) was 35.71 ± 21.44 min, with a mean of 40.32 ± 20.03 awakenings. According to ACT, sleep latency was 39.23 ± 22.09 min, and total sleep duration was 198.15 ± 128.42 min (approximately 3 h and 18 min), which is significantly below recommended levels. The average number of awakenings recorded was 24.85. In terms of diagnostic performance, the RCSQ demonstrated excellent discriminative ability (AUC = 1.00 for the total score), while ACT showed more variable results: total sleep duration had a good AUC of 0.91, while sleep latency showed a lower performance with an AUC of 0.50. The RCSQ proved to be more reliable than ACT in assessing sleep quality in ICU patients, providing consistent results across multiple parameters, including sleep depth, latency, and number of awakenings. Conversely, ACT yielded less consistent findings, particularly regarding sleep latency and nighttime interruptions. Further studies are warranted to refine objective tools for evaluating sleep in critically ill patients. Full article

Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a significant global challenge affecting health systems, economies, and societies. There is a need to implement case-finding strategies to identify patients at risk of COPD in routine clinical practice in low- and middle-income countries where underdiagnosis is high and access to spirometry is limited. PUMA and CAPTURE questionnaires are available for COPD screening; their comparative effectiveness has not been evaluated in Mexican patients. Methods: Multicenter, cross-sectional, case-finding study. PUMA and CAPTURE with spirometry test were used in COPD screening campaigns. Adults >40 years of age with current and former smoking, exposure to wood or charcoal, with and without chronic respiratory symptoms were eligible. COPD was confirmed by a post-bronchodilator FEV1/FVC  < 0.70. Sensitivity and specificity were calculated for each questionnaire. Correlations between PUMA and CAPTURE scores and FEV1/FVC were evaluated. Propensity score matching (PSM) was performed for patients with/without COPD. Results: In total, 197 subjects were enrolled. COPD was diagnosed in 37.1% of the patients. The cut-off point for PUMA with the best sensitivity (74.0%) and specificity (51.6%) was ≥6. CAPTURE showed cut-off points of ≥3 (sensitivity 76.9%, specificity (40.9%) or ≥4 (sensitivity 61.5%, specificity 72.7%). ROC for PUMA was 0.693 (95% IC 0.618–0.768) and for CAPTURE was 0.714 (95% IC 0.570–0.857). Correlations for PUMA and CAPTURE with FEV1/FVC were −0.390 (p < 0.001) and −0.406 (p = 0.004), respectively. There were no changes in the cut-off points and correlations after the PSM for PUMA or CAPTURE to identify patients with COPD. Conclusions: In Mexican patients, both questionnaires had moderate certainty in the diagnosis of patients at risk for COPD with a spirometric obstructive pattern. Full article

Background/Objectives: Follicular lymphoma (FL) and marginal zone lymphoma (MZL) are low-grade B-cell lymphomas (LGBCLs) with indolent clinical courses but a lifelong risk of histologic transformation (HT) to aggressive lymphomas, particularly diffuse large B-cell lymphoma. Predicting HT can be challenging due to class imbalances and the inherent complexity of time-dependent events. While there are current prognostic indices for survival, they do not specifically address HT risk. This study aimed to develop and validate survival-based and traditional classification machine-learning models to predict HT in cohorts. Methods: Using a multicenter retrospective dataset (n = 1068), survival models (Cox proportional hazards, Lasso-Cox, Random Survival Forest, Gradient-boosted Cox [GBM-Cox], eXtreme Gradient Boosting [XGBoost]-Cox), and classification models (Logistic regression, Lasso logistic, Random Forest, Gradient Boosting, XGBoost) were compared. The best-performing survival models—XGBoost-Cox, Lasso-Cox, and GBM-Cox—were assessed on an independent test set (n = 92). Model sensitivity was maximized using optimal binary risk cutoff points based on Youden’s index. Results: Survival models showed superior predictive performance than classical classifiers, with XGBoost-Cox exhibiting the highest mean accuracy (85.3%), time-dependent area under the curve (0.795), sensitivity (98%), specificity (83.9%), and concordance index (0.836). Incorporating next-generation sequencing (NGS) data improved model accuracy and specificity, indicating that genetic factors improve HT prediction. Principal component analysis revealed distinct gene mutation patterns associated with HT risk, highlighting DNA-repair genes such as TP53, BLM, and RAD50. Conclusions: This study highlights the clinical value of survival-based machine-learning methods integrated with NGS data to personalize HT risk stratification for patients with FL and MZL. Full article

Introduction: In renal transplant recipients (RTRs), kidney graft failure and cardiovascular (CV) disease are prevalent and associated with mortality. Objectives: The objective of the study was to evaluate biomarkers, (cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)), to identify RTRs who are at greater risk of death, CV event, and graft renal survival. Patients and methods: A total of 342 stable RTRs were enrolled in this study, with a median follow-up time of 54 months. The probability of death, CV event, and renal graft survival were calculated using Kaplan–Meier analysis for the group defined by cTnT and NT-proBNP levels above the cutoff values. Results: The probability of death for troponin T level above the cut-off was 23% and for NT-proBNP 29%. For CV events the probability for troponin T was 20% and for NT-proBNP it was 21%. Troponin T concentrations above the cutoff point suggested a 25% probability of death-censored graft survival. For NT-proBNP, it was 26%. The probability of overall graft survival was 38% for patients with higher troponin T levels, and 40% for NT proBNP. Conclusions: These data suggest that cTnT and NT-proBNP could potentially identify patients at high risk for death, CV event, and graft survival. Full article