Search Results (16,099)

Background/Objectives: Preclinical chest computed tomography (CT) imaging in small animals is often limited by low resolution due to scan time and dose constraints, which hinders accurate detection of subtle lesions. Traditional super-resolution (SR) metrics, such as peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM), may not adequately reflect clinical interpretability. We aimed to evaluate whether deep learning-based SR models could enhance image quality and lesion detectability in rat chest CT, balancing quantitative metrics with radiologist assessment. Methods: We retrospectively analyzed 222 chest CT scans acquired from polyhexamethylene guanidine phosphate (PHMG-p) exposure studies in Sprague Dawley rats. Three SR models were implemented and compared: single-image SR (SinSR), segmentation-guided SinSR with lung cropping (SinSR3), and omni-super-resolution (OmniSR). Models were trained on rat CT data and evaluated using PSNR and SSIM. Two board-certified thoracic radiologists independently performed blinded evaluations of lesion margin clarity, nodule detectability, image noise, artifacts, and overall image quality. Results: SinSR1 achieved the highest PSNR (33.64 ± 1.30 dB), while SinSR3 showed the highest SSIM (0.72 ± 0.08). Despite lower PSNR (29.21 ± 1.46 dB), OmniSR received the highest radiologist ratings for lesion margin clarity, nodule detectability, and overall image quality (mean score 4.32 ± 0.41, κ = 0.74). Reader assessments diverged from PSNR and SSIM, highlighting the limited correlation between conventional metrics and clinical interpretability. Conclusions: Deep learning-based SR improved visualization of rat chest CT images, with OmniSR providing the most clinically interpretable results despite modest numerical scores. These findings underscore the need for reader-centered evaluation when applying SR techniques to preclinical imaging. Full article

Objectives: Histopathological growth patterns (HGPs) of liver metastases have been shown to possess prognostic significance. To date, only 2 studies have evaluated the reproducibility of HGP assessment. The aim of our study was to assess the interobserver reproducibility of HGP classification in liver metastases. Methods: A retrospective, consecutive, single-center cohort study was conducted, including patients who underwent surgical resection for liver metastases at the University of Szeged between 2011 and 2023. A comprehensive database was established, incorporating basic histopathological data for each case. Histological slides were independently reviewed by 2 pathologists, 3 pathology specialist trainees, and 2 medical students with varying levels of experience in gastrointestinal pathology. Interobserver agreement was evaluated using intraclass correlation coefficients (ICC) and Fleiss’ kappa. Results: The study included resection specimens from 205 patients, comprising 336 metastatic lesions, predominantly of gastrointestinal origin (n = 188). Excellent interobserver agreement was observed among specialist trainees (ICC = 0.911) and board-certified pathologists (ICC = 0.984). Overall agreement among all 7 evaluators was good (ICC = 0.822). Conclusions: Our findings demonstrate that HGPs can be reliably assessed by individuals with at least 2 years of experience in general pathology. To our knowledge, this is the first study to include the largest number of board-certified pathologists and pathology specialist trainees in a HGP reproducibility analysis. Additionally, no comprehensive literature review on this topic has been previously conducted. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications of pregnancy and is linked to long-term metabolic and cardiovascular risks for both mother and child. Its pathophysiology includes increased generation of reactive oxygen species (ROS) and/or decreased antioxidant defenses; nonetheless, the redox dynamics between mother and fetus are still poorly understood. Our goal was to assess oxidative stress (via derivatives of reactive oxygen metabolites, d-ROMs) and antioxidant capacity (via biological antioxidant potential, BAP) in maternal, umbilical cord, and neonatal blood from women with GDM compared to normoglycemic controls, and to investigate potential associations with clinical and neonatal outcomes. Methods: In this single-center cross-sectional study, 56 women with GDM and 52 matched controls provided maternal venous, umbilical cord, and neonatal blood samples at delivery. Plasma d-ROMs and BAP were measured using colorimetric assays. Clinical and neonatal outcome data were collected. Results: Women with GDM had considerably higher maternal d-ROM levels compared to both the umbilical cord and neonatal compartments. BAP measurements revealed that maternal blood had the lowest antioxidant capacity, while cord and newborn samples had higher levels. GDM mothers had significantly greater maternal d-ROMs and lower BAP compared to controls (both p < 0.05). There were no differences in cord blood d-ROMs or BAP between the GDM and the control group. The maternal BAP/d-ROM ratio decreased significantly in the GDM group (p < 0.01), but the cord ratio remained constant. Notably, neither maternal nor neonatal redox indicators were related to perinatal outcomes, indicating a limited prognostic potential for unfavorable neonatal occurrences. Conclusions: GDM is associated with increased maternal oxidative stress and decreased antioxidant capacity, with no substantial changes in newborn redox status. Redox indicators did not predict perinatal issues across this group. These findings demonstrate the need for larger prospective research to determine whether early changes in redox balance can predict the development of GDM or unfavorable outcomes. Full article

Background: Policymakers in Korea are calling for Local Medical Centers (LMCs) to address regional healthcare disparities by expanding their roles beyond safety-net functions yet often overlook local community perspectives. Methods: Face-to-face survey data collected in 2022 from 2057 adults residing in Chungcheongnam-do were analyzed in this study, using Importance–Performance Analysis to assess how residents of large cities, non-large cities, and rural areas prioritize nine LMC functions. Results: While all valued public health policy and infectious disease control amid COVID-19, notable regional variations appeared: non-large city residents prioritized unmet healthcare needs and operational efficiency, rural respondents emphasized post-discharge care coordination due to aging and chronic disease, and large city residents focused on safety-net roles. Staff training and medical innovation ranked lowest across regions. Conclusions: The results highlight the inadequacy of one-size-fits-all policies and the importance of regionally tailored, resident-informed strategies for equitable public health in Korea. Full article

Background: This study investigated sex differences in foot arch structure and function, and their impact on postural control and energy flow during dynamic tasks. Findings aim to inform sex-specific training, movement assessment, and injury prevention strategies. Methods: A total of 108 participants (53 males and 55 females) underwent foot arch morphological assessments and performed a sit-to-stand (STS). Motion data were collected using an infrared motion capture system, three-dimensional force plates, and wireless surface electromyography. A rigid body model was constructed in Visual3D, and joint forces, segmental angular and linear velocities, center of pressure (COP), and center of mass (COM) were calculated using MATLAB. Segmental net energy was integrated to determine energy flow across different phases of the STS. Results: Arch stiffness was significantly higher in males. In terms of postural control, males exhibited significantly lower mediolateral COP frequency and anteroposterior COM peak velocity during the pre-seat-off phase, and lower COM displacement, peak velocity, and sample entropy during the post-seat-off phase compared to females. Conversely, males showed higher anteroposterior COM velocity before seat-off, and greater anteroposterior and vertical momentum after seat-off (p < 0.05). Regarding energy flow, males exhibited higher thigh muscle power, segmental net power during both phases, and greater shank joint power before seat-off. In contrast, females showed higher thigh joint power before seat-off and greater shank joint power after seat-off (p < 0.05). Conclusions: Significant sex differences in foot arch function influence postural control and energy transfer during STS. Compared to males, females rely on more frequent postural adjustments to compensate for lower arch stiffness, which may increase mechanical loading on the knee and ankle and elevate injury risk. Full article

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide exerting, among others, strong trophic and protective effects. It plays a role in several physiological functions, including glucose homeostasis. The protective effects of PACAP are mainly mediated via its specific PAC1 receptor by stimulating anti-inflammatory, anti-apoptotic and antioxidant pathways. The aim of the present review is to summarize data on the protective effects of PACAP in the three major complications of diabetes, retinopathy, nephropathy and neuropathy, as well as some other complications. In type 1 and type 2 diabetic retinopathy models and in glucose-exposed cells of the eye, PACAP counteracted the degeneration of retinal layers and inhibited apoptosis and factors leading to abnormal vessel growth. In models of nephropathy, kidney morphology was better retained after PACAP administration, with decreased apoptosis and fibrosis. In diabetic neuropathy, PACAP protected against axonal–myelin lesions and less activation in pain processing centers. This neuropeptide has several other beneficial effects in diabetes-induced complications like altered vascular response, cognitive deficits and atherosclerosis. The promising therapeutic effects of PACAP in several pathological conditions have encouraged researchers to design PACAP-related drugs and to develop ways to enhance tissue delivery. These intentions are expected to result in overcoming the hurdles preventing PACAP from being introduced into therapeutic treatments, including diabetes-related conditions. Full article

Despite the well-established link between animal abuse and interpersonal violence, animal mistreatment remains a global issue. Challenges such as inconsistent legislation, limited training of specialized pathologists, and lack of regional data persist and must be addressed. In Spain, the real incidence of animal abuse is unknown, and the literature on the topic remains scarce. This study aims to assess the evolution of feline abuse cases in the Community of Madrid, Spain, since the publication of a previous study in the same region. Over a five-year period (2020–2024), 53 cats with suspected abuse were diagnosed at the Pathology and Forensic Veterinary Unit of the VISAVET Health Surveillance Center. Thirty-one cats (58.49%) died from non-natural causes: 17 (32.07%) due to blunt force trauma, eight (15.09%) due to poisoning, and six (11.32%) due to projectile injuries. Natural causes accounted for 21 cases (39.62%). Compared to the previous study, data suggest a possible upward trend in the number of cats referred with suspected animal abuse, including eight new cases of ethylene glycol poisoning. The correlation between the type of suspected abuse and final diagnosis was very low. This article examines current challenges related to animal violence, with particular emphasis on feline colonies, and promotes awareness among both veterinary and non-veterinary professionals. Full article

Magnetocardiography (MCG) offers a noninvasive method for early screening and precise localization of cardiovascular diseases by measuring picotesla-level weak magnetic fields induced by cardiac electrical activity. However, in unshielded magnetic environments, geomagnetic disturbances, power-frequency electromagnetic interference, and physiological/motion artifacts can significantly overwhelm effective magnetocardiographic components. To address this challenge, this paper systematically constructs an integrated denoising framework, termed “AOA-VMD-WT”. In this approach, the Arithmetic Optimization Algorithm (AOA) adaptively optimizes the key parameters (decomposition level K and penalty factor α) of Variational Mode Decomposition (VMD). The decomposed components are then regularized based on their modal center frequencies: components with frequencies ≥50 Hz are directly suppressed; those with frequencies <50 Hz undergo wavelet threshold (WT) denoising; and those with frequencies <0.5 Hz undergo baseline correction. The purified signal is subsequently reconstructed. For quantitative evaluation, we designed performance indicators including QRS amplitude retention rate, high/low frequency suppression amount, and spectral entropy. Further comparisons are made with baseline methods such as FIR and wavelet soft/hard thresholds. Experimental results on multiple sets of measured MCG data demonstrate that the proposed method achieves an average improvement of approximately 8–15 dB in high-frequency suppression, 2–8 dB in low-frequency suppression, and a decrease in spectral entropy ranging from 0.1 to 0.6 without compromising QRS amplitude. Additionally, the parameter optimization exhibits high stability. These findings suggest that the proposed framework provides engineerable algorithmic support for stable MCG measurement in ordinary clinic scenarios. Full article

Background: Intensive Care Unit (ICU) readmission and in-hospital mortality are critical indicators of patient outcomes following ICU discharge. Patients readmitted to the ICU often face worse prognosis, higher healthcare costs, and prolonged hospital stays. Identifying high-risk patients is essential for optimizing post-ICU care and resource allocation. Methods: This two-phase study included the following: (1) a retrospective analysis of ICU survivors in a mixed medical–surgical ICU to identify risk factors associated with ICU readmission and in-hospital mortality, and (2) a prospective validation of a newly developed predictive model: the Worse Outcome Score (WOScore). Data collected included demographics, ICU admission characteristics, severity scores (SAPS II, SAPS III, APACHE II, SOFA), interventions, complications and discharge parameters. Results: Among 1.190 ICU survivors, 126 (10.6%) were readmitted to the ICU, and 192 (16.1%) died in hospital after ICU discharge. Key risk factors for ICU readmission included Diabetes Mellitus, SAPS III on admission, and ICU-acquired infections (Ventilator-Associated Pneumonia (VAP) and Catheter-Related Bloodstream Infection, (CRBSI)). Predictors of in-hospital mortality were identified: medical admission, high SAPS III score, high lactate level on ICU admission, tracheostomy, reduced GCS at discharge, blood transfusion, CRBSI, and Acute Kidney Injury (AKI) during ICU stay. The WOScore, developed based on the results above, demonstrated strong predictive ability (AUC: 0.845 derivation, 0.886 validation). A cut-off of 20 distinguished high-risk patients (sensitivity: 88.1%, specificity: 73.0%). Conclusions: ICU readmission and in-hospital mortality are influenced by patient severity, underlying comorbidities, and ICU-related complications. The WOScore provides an effective, easy-to-use risk stratification tool that can guide clinicians in identifying high-risk patients at ICU discharge and guide post-ICU interventions, potentially improving patients’ outcomes and optimizing resource allocation. Further multi-center studies are necessary to validate the model in diverse healthcare settings. Full article

Background/Objectives: Cardiometabolic risk remains a major challenge in patients with type 2 diabetes mellitus (DMT2). This study aimed to evaluate cardiovascular (CV) risk stratification using advanced glycation end-products (AGEs) measured via skin autofluorescence (SAF) and to assess the achievement of evidence-based ABC targets (HbA1c, blood pressure, low-density lipoprotein (LDL) cholesterol) in adults with DMT2 in Dalmatia. Methods: In this single-center cross-sectional study, 251 adults with DMT2 were stratified by CV risk based on SAF measured AGE levels. Clinical, biochemical, and anthropometric data were collected, including ABC goal attainment and medication use. Statistical analyses compared groups and explored predictors of ABC target achievement using regression models adjusted for clinical factors. Results: Only 17.5% of participants achieved all three ABC goals, indicating suboptimal cardiometabolic control. Those with elevated CV risk had higher hip circumference and lower diastolic blood pressure. Use of sodium-glucose cotransporter 2 (SGLT2) inhibitors was positively associated with ABC goal achievement in patients with prior CV or cerebrovascular events, while higher body mass index was negatively associated. SAF measured AGE levels correlated with cardiometabolic risk but showed no significant differences across LDL cholesterol or other traditional markers. Conclusions: SAF AGE measurement shows potential for CV risk stratification in DMT2 beyond traditional factors. The low rate of ABC goal attainment highlights the need for intensified individualized management incorporating novel biomarkers and therapeutics like SGLT2 inhibitors. Further prospective studies are needed to validate these findings and improve prevention of cardiovascular complications in DMT2. Full article

Children’s neighborhood mobility has been widely examined through either independent movement or psychological autonomy, yet few studies consider how these dimensions intersect in the lived realities of low-income, high-density environments. This study explores how neighborhood conditions simultaneously constrain and enable children’s experiences of mobility and autonomy, focusing on People’s Housing Project (PPR) estates in Kuala Lumpur, Malaysia. Using a qualitative, child-centered approach, data were collected through child-led walks and mental mapping with 23 children aged 7–12. The child-led walks revealed everyday hazards that restricted children’s freedom of movement and heightened concerns for safety. Conversely, the mental maps highlighted intangible but significant attachments that fostered a sense of belonging, pride, and autonomy despite material deprivation. Together, these findings illustrate that children’s well-being depends not only on opportunities for independent mobility but also on affective and symbolic dimensions of autonomy embedded in their neighborhood environments. The study concludes that planning and housing policies must move beyond efficiency and density to address children’s rights to safe, supportive, and meaningful spaces that nurture both freedom of movement and autonomy in everyday life. Full article

Background/Objectives: This study involved an analysis of clinical data, histological types, genetic predisposition, treatment and outcomes in PPB in children. Patients and methods: We conducted a retrospective review of children treated for PPB at Polish pediatric oncology centers between 2011 and 2024. Results: A total of fifteen children (seven boys, eight girls; median age of 39 months; range: 27–64 months) were included. Type II solid/cystic PPB and type III solid PPB were diagnosed in six and eight children, respectively (one not known). Overall, 93% of patients were diagnosed at up to 4 years of age. Metastatic disease at diagnosis was confirmed in three (20%) patients, localized in bones, bone marrow and lymph nodes. Diagnosis was confirmed via central pathology review in 11 patients (73%). DICER1 pathogenic variants were identified in eight patients. All children presented with respiratory symptoms. The tumor dimensions were >10 cm (n = 7), 5–10 cm (n = 5) and <5 cm (n = 2). No bilateral lung involvement was observed. Tumor biopsy was performed in six children (40%), with subsequent resection (R0) in five patients. Primary resection (R0) was achieved in three patients (20%) with type II (n = 1) or type III (n = 2). In the other six patients, non-radical resection was performed: R1 in four (27%) children (with a tumor rupture in one patient) and R2 (subtotal resection) in two children (13%). All patients received postoperative chemotherapy. Maintenance chemotherapy was given to two patients. No patient received radiotherapy as first-line treatment. Progressive disease occurred in two patients in the CNS and lungs. Relapsed disease appeared in three patients, all with CNS involvement. Conclusions: PPB is a rare, malignant tumor of early childhood with an uncertain prognosis. Despite multimodal treatment, patients remain at risk of progression or CNS relapse. Complete surgical resection remains a key prognostic factor. Full article

A critical factor contributing to the burden of childhood asthma is the lack of effective self-management in homecare settings. Artificial intelligence (AI) and lung sound monitoring could help address this gap. Yet, existing AI-driven auscultation tools focus on wheeze detection and often rely on subjective human labels. To improve the early detection of asthma worsening in children in homecare setting, we trained and evaluated a Deep Learning model based on spirometry-labelled lung sounds recordings to detect asthma exacerbation. A single-center prospective observational study was conducted between November 2020 and September 2022 at a tertiary pediatric pulmonology department. Electronic stethoscopes were used to record lung sounds before and after bronchodilator administration in outpatients. In the same session, children also underwent spirometry, which served as the reference standard for labelling the lung sound data. Model performance was assessed on an internal validation set using receiver operating characteristic (ROC) curves. A total of 16.8 h of lung sound recordings from 151 asthmatic pediatric outpatients were collected. The model showed promising discrimination performance, achieving an AUROC of 0.763 in the training set, but performance in the validation set was limited (AUROC = 0.398). This negative result demonstrates that acoustic features alone may not provide sufficient diagnostic information for the early detection of asthma attacks, especially in mostly asymptomatic outpatients typical of homecare settings. It also underlines the challenges introduced by differences in how digital stethoscopes process sounds and highlights the need to define the severity threshold at which acoustic monitoring becomes informative, and clinically relevant for home management. Full article

Background: Clinical pharmacy services (CPSs) play a key role in ensuring medication safety, optimizing pharmacotherapy, and improving patient outcomes. While their benefits are well-documented globally, their specific impact within the Saudi healthcare system remains underexplored. Objective: This study aimed to evaluate the impact of pharmacist-led interventions in a tertiary medical center in Saudi Arabia. Methods: A retrospective chart review was conducted at a 1200-bed academic hospital in western Saudi Arabia. Pharmacist interventions documented between 1 January 2023 and 31 December 2023 were analyzed. Interventions were categorized into 13 types, including dosage errors, unavailable medications, and drug–drug interactions. Descriptive statistics were used to summarize the data. Results: A total of 38,143 pharmacist interventions were recorded. Dosage errors accounted for 77.2% (n = 29,584) of interventions, followed by issues with medication availability (6.57%, n = 2519) and incorrect medication orders (4.59%, n = 1761). The most frequently implicated medications were acetylsalicylic acid, enoxaparin, and paracetamol, collectively representing 43.55% of interventions. The highest intervention rates were in the Emergency Department (25.3%, n = 11,050), Oncology Clinics (9.81%, n = 4285), and Male Medical Units (9.43%, n = 4119). Conclusions: Clinical pharmacists play a significant role in reducing medication errors and improving patient safety across various specialties. Their targeted interventions optimize therapeutic outcomes, highlighting the need for integrating advanced tools and expanding CPSs to meet evolving healthcare demands in Saudi Arabia. Full article

The rapid growth of AI-enabled medical wearables and home-based diagnostic devices has opened new pathways for preventive care, chronic disease management and user-driven health insights. Despite significant technological progress, many solutions face adoption hurdles, often due to usability challenges, episodic measurements and poor alignment with daily life. This review surveys the current landscape of at-home healthcare technologies, including wearable vital sign monitors, digital diagnostics and body composition assessment tools. We synthesize insights from the existing literature for this narrative review, highlighting strengths and limitations in sensing accuracy, user experience and integration into daily health routines. Special attention is given to the role of AI in enabling real-time insights, adaptive feedback and predictive monitoring across these devices. To examine persistent adoption challenges from a user-centered perspective, we reflect on the Pi-CON methodology, a conceptual framework previously introduced to stimulate discussion around passive, non-contact, and continuous data acquisition. While Pi-CON is highlighted as a representative methodology, recent external studies in multimodal sensing, RFID-based monitoring, and wearable–ambient integration confirm the broader feasibility of unobtrusive, passive, and continuous health monitoring in real-world environments. We conclude with strategic recommendations to guide the development of more accessible, intelligent and user-aligned smart healthcare solutions. Full article