Search Results (46,669)

Background: The COVID-19 pandemic prompted investigation into the interaction between SARS-CoV-2 infection and immune checkpoint inhibitor (ICI) therapy in lung cancer patients. Understanding this interplay is crucial for optimizing cancer immunotherapy. Methods: A retrospective analysis was conducted on lung cancer patients, characterizing changes in peripheral immune cells and plasma cytokines (including IL-10 and IL-12p70) before, during, and after SARS-CoV-2 infection. Progression-free survival (PFS) was compared between ICI-treated patients with and without COVID-19. Cytokine dynamics were further analyzed in a non-infected cohort. Results: SARS-CoV-2 infection induced a prolonged systemic cytokine storm, with elevated IL-10 and IL-12p70 levels and reduced monocyte proportions lasting up to 10 weeks post-recovery. Despite this immune perturbation, COVID-19 did not impair long-term PFS; instead, a transient improvement in disease control was observed in infected patients. In non-infected patients, sustained or increased IL-10 and IL-12p70 levels during ICI therapy were associated with longer PFS (p < 0.05). Conclusions: SARS-CoV-2 infection transiently alters the immune landscape in lung cancer patients without compromising ICI efficacy. The sustained elevation of IL-10 and IL-12p70 may contribute to short-term clinical benefits. Monitoring cytokine dynamics could serve as a prognostic tool for predicting ICI response. Full article

Background/Objectives: This study evaluated the psychometric properties and correlates of the Screen for Disordered Eating (SDE) in the Chinese context. Eating and body image in Asian cultures differed from those in the Western context, elevating its importance in testing the validity of SDE in the Chinese context. Methods: The reliability, validity and correlates of the SDE were examined in a sample of 766 university students in Taiwan. Results: Convergent validity of the Chinese version of the SDE was demonstrated with high correlation (r = 0.664, p < 0.001) and satisfactory consistency (κ = 0.413, p < 0.001) with the Sick, Control, One Fat, and Food (SCOFF) questionnaire. Substantial factor loadings were suggested, with 52% of the variance in item responses, especially for SDE4 and SDE5. Significant correlates of disordered eating were found with sex, depressive symptoms, anxiety symptoms, and experiences of childhood trauma. Conclusions: The SDE is a reliable and valid screening instrument for disordered eating. Health and social care practitioners can utilise the SDE to screen for disordered eating behaviours in the Chinese context, so that timely interventions can be provided. Full article

Background/Objectives: The combination of anti-programmed death-1 (PD-1) inhibitors and chemotherapy is the standard first-line treatment for unresectable or metastatic esophageal squamous cell carcinoma (ESCC). However, real-world data remain limited, particularly regarding prognostic biomarkers. Methods: This multi-institutional retrospective study analyzed patients with metastatic or unresectable ESCC who received first-line pembrolizumab or nivolumab plus fluoropyrimidine and platinum-based chemotherapy. Treatment regimens mirrored those in KEYNOTE-590 and CheckMate 648. Efficacy, safety, and prognostic factors were assessed. Prognostic factors were identified using multivariable Cox regression, and a point-based risk scoring system was developed. Results: Among 87 patients, the objective response rate was 48.3%, and the disease control rate was 77.0%. Median progression-free survival (PFS) was 5.6 months (95% CI, 4.5–8.7), and the median overall survival (OS) was 13.1 months (95% CI, 10.6–not reached). Grade 3–4 treatment-related adverse events occurred in 51.7% of patients. Eastern Cooperative Oncology Group (ECOG) performance status ≥ 2, elevated C-reactive protein, and lower programmed death-ligand 1 (PD-L1) combined positive score (CPS) were independently associated with worse PFS and OS. A prognostic risk score ranging from 0 to 5 based on these factors stratified patients into four prognostic groups with distinct survival outcomes. Median PFS ranged from not reached in the low-risk group to 2.1 months in the high-risk group. Stratifying PD-L1 CPS into three levels (<10, 10–49, ≥50) revealed a graded association between CPS and treatment outcomes, supporting the need for more nuanced PD-L1 evaluation beyond binary classification. Conclusions: First-line anti-PD-1 therapy combined with chemotherapy demonstrated favorable real-world outcomes in ESCC. The proposed prognostic scoring system may help personalize treatment strategies. Full article

This article investigates the zonotope-based state estimation for boost converter system with Markov jump process. DC-DC boost converters are pivotal in modern power electronics, enabling renewable energy integration, electric vehicle charging, and microgrid operations by elevating low input voltages from sources like photovoltaics to stable high outputs. However, their nonlinear dynamics and sensitivity to uncertainties/disturbances degrade control precision, driving research into robust state estimation. To address these challenges, the boost converter is modeled as a Markov jump system to characterize stochastic switching, with time delays, disturbances, and noises integrated for a generalized discrete-time model. An adaptive event-triggered mechanism is adopted to administrate the data transmission to conserve communication resources. A zonotopic set-membership estimation design is proposed, which involves designing an observer for the augmented system to ensure $H_{\infty }$ performance and developing an algorithm to construct zonotopes that enclose all system states. Finally, numerical simulations are performed to verify the effectiveness of the proposed approach. Full article

Semantic segmentation of LiDAR point clouds in powerline corridor environments is crucial for the intelligent inspection and maintenance of power infrastructure. However, existing deep learning methods often underperform in such scenarios due to severe class imbalance, sparse and long-range structures, and complex elevation variations. We propose EMPower-Net, an Elevation-Aware Multi-Resolution Network, which integrates an Elevation Distribution (ED) module to enhance vertical geometric awareness and a Multi-Resolution (MR) module to enhance segmentation accuracy for corridor structures with varying object scales. Experiments on real-world datasets from Yunnan and Guangdong show that EMPower-Net outperforms state-of-the-art baselines, especially in recognizing power lines and towers with high structural fidelity under occlusion and dense vegetation. Ablation studies confirm the complementary effects of the MR and ED modules, while transfer learning results reveal strong generalization with minimal performance degradation across different powerline regions. Additional tests on urban datasets indicate that the proposed elevation features are also effective for vertical structure recognition beyond powerline scenarios. Full article

Acute myocardial infarction (AMI) remains the leading cause of death worldwide, with myocardial ischemia/reperfusion injury (MIRI) emerging as a significant factor influencing patient outcomes despite timely reperfusion therapy. MIRI refers to paradoxical myocardial damage that occurs upon restoration of coronary blood flow and is driven by complex inflammatory, oxidative, and metabolic mechanisms, which can exacerbate infarct size (IS), contributing to adverse outcomes. This review explores the molecular and cellular pathophysiology of MIRI, emphasizing both its clinical and forensic relevance. The principal mechanisms discussed include oxidative stress and mitochondrial dysfunction, calcium overload and ion homeostasis imbalance, inflammatory responses, with particular focus on the NLRP3 inflammasome and cytokine pathways, and multiple forms of cell death (apoptosis, necroptosis, pyroptosis, and autophagy). Additionally, the authors present original immunohistochemical findings from autopsy cases of patients who suffered ST-segment elevation myocardial infarction (STEMI) and underwent percutaneous coronary intervention (PCI), but subsequently died. These findings underscore that successful reperfusion does not completely prevent delayed complications, like arrhythmias, ventricular fibrillation (VF), and sudden cardiac death (SCD), often caused by secondary MIRI-related mechanisms. Moreover, the case series highlight the diagnostic value of inflammatory markers for pathologists in identifying MIRI as a contributing factor in such fatalities. Finally, immunotherapeutic strategies—including IL-1 and IL-6 inhibitors such as Canakinumab and Tocilizumab—are reviewed for their potential to reduce cardiovascular events and mitigate the effects of MIRI. The review advocates for continued multidisciplinary research aimed at improving our understanding of MIRI, developing effective treatments, and informing forensic investigations of reperfusion-related deaths. Full article

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies for which there are few effective biomarkers for diagnosis, prognosis, and treatment monitoring. Given the paucity of data in the literature, this study aimed to evaluate the biomarker potential of selected miRNAs (miR-222-3p, miR-3154, miR-3945, miR-4534, and miR-4742) and their protein targets in the context of PDAC. Methods: The expression levels of miRNA candidates were quantified by real-time quantitative PCR in lymphocyte samples from 46 PDAC patients and 50 healthy controls. In silico analyses were performed to identify potential target genes and proteins. ELISA was used to measure protein expression in both groups. Statistical analyses included ROC curve analysis, linear regression, and correlation analyses. In addition, correlations between miRNA/protein expression and clinicopathologic characteristics, including survival, were investigated. Results: miR-222-3p and miR-3154 were significantly downregulated in PDAC patients compared to controls (p < 0.001). Among the dual miRNA combinations, miR-222-3p and miR-4534 showed the highest discriminatory power (AUC = 0.629, p = 0.022). The miR-222-3p expression was significantly increased in patients with a history of alcohol consumption (p = 0.02). Significant correlations were observed between miR-3154 expression and T-stage (p = 0.01) and between perineural invasion and miR-222-3p levels (p = 0.02). Survival analysis showed that high miR-3945 expression was significantly associated with shorter overall survival (p = 0.001). Elevated levels of ESR1, HCFC1, and EPC1 were significantly associated with lymphatic invasion (p < 0.05), while high KCNA1 expression correlated with shorter survival (p = 0.006), indicating its potential as a negative prognostic biomarker. Linear regression analysis revealed a significant positive correlation between miR-3945 and KCNA1 expression (β = 0.259, p = 0.038), indicating a possible regulatory interaction. A borderline correlation was also found between miR-4742 and EPC1 expression (p = 0.055). Conclusions: This study identifies several miRNAs and associated proteins with diagnostic and prognostic significance in PDAC. The results emphasize the clinical relevance of integrating multi-layered analyses of miRNA–protein interactions. The observed associations highlight the role of these molecular markers in tumor progression and patient survival and offer promising opportunities for future research and clinical application in precision oncology. Full article

Lakes account for approximately 87% of the Earth’s surface water resources and serve as sensitive indicators of climate and environmental change. Understanding how lake areas respond to climate change across different elevation gradients is crucial for guiding sustainable water resource management in Xinjiang. We utilized Landsat series remote sensing imagery (1990–2023) on the Google Earth Engine (GEE) platform to extract the temporal dynamics of natural lakes larger than 10 km² in Xinjiang, China (excluding reservoirs). We analyzed the relationships between lake area dynamics, climatic factors, and human activities to assess the sensitivity of lakes at different altitudinal zones to environmental change. The results showed that (1) the total area of Xinjiang lakes increased by 1188.36 km² over the past 34 years, with an average annual area of 5998.54 km²; (2) plain lakes experienced fluctuations, reaching their maximum in 2000 and their minimum in 2015, alpine lakes peaked in 2016, and plateau lakes continued to expand, with the maximum recorded in 2020 and the minimum in 1995; and (3) human activities such as urban and agricultural water use were the primary causes of shrinking plain lakes, while an increased PET accelerates evaporation, alpine lakes were influenced by both climate variability and human disturbance, and plateau lakes were highly sensitive to climate change, with rising temperatures increasing snowmelt and glacial runoff into lakes, which were the main drivers of their expansion. These findings highlight the importance of incorporating elevation-specific lake responses into climate adaptation strategies and sustainable water management policies in arid regions. Full article

Background: There are limited data on the association between B12 levels, objective sleep quality, and cardiovascular disease in patients with obstructive sleep apnoea (OSA). Therefore, the aim of our study was to assess vitamin B12 levels in a sleep clinic population in Crete, Greece, and investigate possible correlations with polysomnographic parameters and prevalent cardiovascular disease (CVD). Methods: In this cross-sectional study, data from 1468 recruited patients with OSA from the clinical database of the Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, were analyzed. OSA was defined as an apnoea–hypopnoea index ≥ 5 events per hour of sleep after type-1 Polysomnography (PSG). Data regarding anthropometrics, socio-demographics, and medical history was obtained. Logistic regression analysis was applied to examine the effect of vitamin B12 levels on PSG parameters and prevalent CVD after controlling for potential explanatory variables, including age, gender, obesity, smoking status, and co-morbidities. Results: The median vitamin B12 was 380.5 (301, 490) pg/mL. After adjustments, Vitamin B12 levels < 380.5 were associated with 24% higher odds of prolonged sleep latency (≥40 min) prevalence (OR = 1.240, 95% CI = 1.005–1.531, p = 0.045) and alterations in the proportion of NREM and REM sleep stages with 2.3 times higher likelihood of elevated NREM sleep > 80% of total sleep time (OR = 2.312, 95% CI = 1.049–5.096, p = 0.038) and 2.9 times higher likelihood of low REM sleep < 20% of total sleep time (OR = 2.858, 95% CI = 1.197–6.827, p = 0.018). Moreover, Vitamin levels < 380.5 were significantly associated with a 59.9% increase in the odds of prevalent CVD (OR = 1.599, 95% CI = 1.035–2.471, p = 0.034). Conclusions: In conclusion, our results suggest that vitamin B12 status may be associated with impaired objective sleep quality in OSA patients, potentially influencing prevalent CVD. However, further prospective research is needed to establish causality and elucidate the potential underlying mechanisms that could link vitamin B12 levels to various sleep parameters and cardiovascular disease in patients with OSA. Full article

The Source Region of the Yangtze and Yellow Rivers (SRYY), situated on the Qinghai-Tibet Plateau, serves as a vital ecological barrier and a critical component of the global carbon cycle. However, this region faces severe ecosystem degradation driven by climate change and human activities. This study establishes an integrated ecological security assessment framework that couples ecological risk, ecosystem health, and ecosystem services to evaluate ecological dynamics in the SRYY from 2000 to 2020. Leveraging multi-source data (vegetation, hydrological, meteorological) and advanced modeling techniques (spatial statistics, geographically weighted regression), we demonstrate that: (1) The Ecological Security Index (ESI) exhibited an initial increase followed by a significant decline after 2010, falling below its 2000 level by 2020. (2) The rising Ecological Risk Index (ERI) directly weakened both the ESI and Ecosystem Service Index (ESsI), with this negative effect intensifying markedly post-2010. (3) A distinct spatial gradient pattern emerged, shifting from high-security core areas in the east to low-security zones in the west, closely aligned with terrain and elevation; conversely, areas exhibiting abrupt ESI changes showed little correlation with permafrost degradation zones. (4) Vegetation coverage emerged as the key driver of ESI spatial heterogeneity, acting as the central hub in the synergistic regulation of ecological security by climate and topographic factors. Full article

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a major global public health challenge with a significant impact on human life. The current study aims to provide a comprehensive analysis of the magnitude of dyslipidemia and the factors associated with elevated LDL-C levels among Black South Africans with T2DM. Methods: This was a cross-sectional study conducted in a tertiary hospital. Blood samples for glycated hemoglobin (HbA1c) and lipid profile were collected from the study participants and analyzed using Siemens Atellica™ analyzer. The data was entered into Microsoft excel and analyzed using SPSS version 24. Bivariate and multivariate logistic regression was employed to identify variables significantly associated with the outcomes, with a p-value  ≤  0.05 and a 95% confidence interval. Results: A total of 194 study participants with T2DM were recruited in the study. The overall prevalence of dyslipidemia was 90.72%. Of those with dyslipidemia, 40.9% had an isolated dyslipidemia, 39.7% had a combined dyslipidemia and 19.3% had atherogenic dyslipidemia. Significant factors associated with elevated levels of LDL-C included age, non-adherence to treatment (NAT) and duration. However, after multivariate analysis, NAT was found to be an independent associated factor with elevated levels of LDL-C (AOR: 4.596; 95% CI: 0.177–2.874; p = 0.027). Conclusions: Our study found that dyslipidemia is highly prevalent among Black South African patients with T2DM at a tertiary hospital, despite the use of lipid-lowering therapy. NAT was significantly associated with elevated levels of LDL-C. However, it is important to note that the study employed a cross-sectional design, conducted at a single hospital, which may impair the generalizability of the findings. Full article

Soft-furred tree mice (genus Typhlomys), which are native to southern China and northern Vietnam, are unique rodents capable of echolocation. Little is known about their taxonomy, ecology, and natural history. In this study, we generated the complete mitochondrial genomes of seven species/putative species of Typhlomys. We conducted a comprehensive comparative analysis of these mitochondrial genomes focusing on sequence length, A+T content, A/T bias, A+T-rich regions, overlapping and intergenic spacer regions, nucleotide composition, relative synonymous codon usage, ancestral distributions, and the non-synonymous/synonymous substitution ratio (Ka/Ks). Additionally, we analyzed the phylogeny and adaptive evolution of these species/putative species. The mitogenomes of Typhlomys ranged from 16,487 to 17,380 bp in length, encoding the complete set of 37 genes typically found in mammalian mitogenomes. The base composition exhibited an A+T bias. The most frequently used codons were CUA (Leu), AGC (Ser), GGA (Gly) and UUA (Leu), UUG, CUG, CGU and GCG were the less frequently used codons. Ancestral distribution reconstruction suggests that Typhlomys originated in Central or Southwestern China. Notably, we found that the Ka/Ks ratio of the ND5 gene in T. huangshanensis was greater than 1, indicating that this gene has undergone positive selection for efficient respiration in higher elevations and colder climates. Full article

In women in post-menopause, the presence of severe vasomotor symptoms is associated with sleep disorders and a depressive mood. Vasomotor symptoms, sleep disorders, and a depressive mood are all related to an increased risk of cardiovascular events and bone fractures. The association is still elusive, but some mechanisms may sustain a hypothetical causal relation. During flush, the heart rate increases, augmenting blood turbulence and possibly posing a risk for endothelial damage. Altered sleep is associated with a reduced nocturnal blood pressure decline, which represents a risk factor for cardiovascular disease. Cortisol levels rise during each flush but also following sleep deprivation or in individuals with depression. Increased cortisol was found in women with menopausal symptoms and can induce insulin resistance, metabolic syndrome, cardiovascular disease, and bone demineralization. An elevated oxidative state is associated with vasomotor symptoms, sleep disturbances, and depression and increases the risk of cardiovascular events and osteoporosis. The use of non-hormonal remedies for symptom management leads to a decrease in blood pressure and a reduction of 24 h urinary cortisol, contingent upon the extent of symptom alleviation. Recent evidence indicates that fezolinetant, a neurokinin-3 receptor antagonist and elinzanetant, a neurokinin-1-3 receptor antagonist, diminish the frequency and severity of vasomotor symptoms. As the secondary endpoint of these studies, some amelioration of patients reported that sleep disturbance was observed during fezolinetant and more consistently during elinzanetant. Some improvement in the quality of life and depressive mood were also observed during elinzanetant. The causal relation of symptoms with cortisol levels and oxidative stress, and the reduction in cortisol and blood pressure by symptom improvements, support the possibility that neurokinin antagonists may decrease those factors linking menopausal symptoms with cardiovascular disease and osteoporosis. Dedicated studies are needed to test the hypothetical possibility that neurokinin receptor antagonists contribute to reduce the long-term burden of cardiovascular disease and osteoporosis of symptomatic women in post-menopause unwilling or with contraindication to the use of menopause hormone therapy. Full article

Low-level wind shear (LLWS) is a critical issue in aviation meteorology, posing serious risks to flight safety—especially at plateau airports with high elevation and complex terrain. This study investigates a convective wind shear event at Xining Airport on 29 May 2021. Multi-source observations—including the Doppler Wind Lidar (DWL), the Doppler weather radar (DWR), reanalysis datasets, and automated weather observation systems (AWOS)—were integrated to examine the event’s fine-scale structure and temporal evolution. High-resolution simulations were conducted using the Large Eddy Simulation (LES) framework within the Weather Research and Forecasting (WRF) model. Results indicate that the formation of this wind shear was jointly triggered by convective downdrafts and the gust front. A northwesterly flow with peak wind speeds of 18 m/s intruded eastward across the runway, generating multiple radial velocity couplets on the eastern side, closely associated with mesoscale convergence and divergence. A vertical shear layer developed around 700 m above ground level, and the critical wind shear during aircraft go-around was linked to two convergence zones east of the runway. The event lasted about 30 min, producing abrupt changes in wind direction and vertical velocity, potentially causing flight path deviation and landing offset. Analysis of horizontal, vertical, and glide-path wind fields reveals the spatiotemporal evolution of the wind shear and its impact on aviation safety. The WRF-LES accurately captured key features such as wind shifts, speed surges, and vertical disturbances, with strong agreement to observations. The integration of multi-source observations with WRF-LES improves the accuracy and timeliness of wind shear detection and warning, providing valuable scientific support for enhancing safety at plateau airports. Full article

The research interest in the oral microbiome’s role in esophageal cancer is growing, yet a comprehensive synthesis of available evidence is still lacking. This study aimed to explore the effects of oral microbiome on the development of esophageal cancer through a systematic review of existing literature retrieved from the Embase, PubMed, and Web of Science databases. Eighteen studies published between 2015 and 2024 were obtained, involving 1191 cases and 1403 controls, mostly using oral saliva samples and 16S rRNA gene sequencing. Findings on alpha-diversity were inconsistent, while most studies reported significant beta-diversity differences between cases and controls. Notably, several investigations on esophageal squamous cell carcinoma showed higher levels of Prevotella, Porphyromonas, and Fusobacterium, while two studies on esophageal adenocarcinoma reported elevated levels of Actinomyces species. A fixed-effect meta-analysis of two studies showed that individuals with specific oral microbial signatures had significantly higher odds of developing esophageal squamous cell carcinoma (OR = 9.50; 95% CI: 5.89–15.29). Quality assessments highlighted methodological strengths but noted variability in group comparability and local applicability. These results reveal the potential of oral microbiome shift as an early detection biomarker and for developing personalized strategies in treating esophageal cancer, meriting further clinical investigation. Full article