Search Results (947)

Background/Objectives: The reciprocal relationship between Systemic Lupus Erythematosus (SLE) and pregnancy continues to elude the scientific community’s approaches for a clear understanding. Multiple studies have reached dissimilar results regarding the impact that SLE exerts on pregnancy, whilst the potential risks of lupus pregnancies continue to encumber women of childbearing age. Whether SLE predisposes to a complicated pregnancy and conversely whether pregnancy impacts the progression of the disease is aimed to be assessed by this systematic review. Methods: A thorough search of original research articles was conducted using online databases (PubMed, Google Scholar), initially identifying 877 potential studies. Results: Upon further assessment for relevance and eligibility, 65 articles were selected for detailed analysis. Conclusions: We concluded that, even though advanced approaches have optimized SLE prognosis and treatment, the complexity of the disease requires further extensive study in order to grasp the mechanism behind the susceptibility to adverse complications. SLE pregnancy cannot be considered without risk. Comprehensive, multidisciplinary, and continuous monitoring of the disease course prior to, during, and after pregnancy is necessary to ensure optimal recovery and minimal maternal and fetal complications. Tailored treatments and novel biomarkers would move us towards precise patient-centered care that addresses each patient’s unique disease profile and pregnancy needs, ultimately improving both maternal and fetal outcomes in women with systemic lupus erythematosus. Full article

The real nature of little red dots (LRDs), a class of very compact galaxies in the early Universe recently discovered by the James Webb Space Telescope, is still poorly understood. The most popular theories competing to interpret the phenomena include active galactic nuclei and enhanced star formation in dusty galaxies. To date, however, neither model gives a completely satisfactory explanation to the population as a whole; thus, alternative theories have arisen, including tidal disruption events (TDEs). By considering observational constraints on the radio emission of LRDs, we discuss whether TDEs are adequate alternatives solving these high-redshift enigmas. We utilise radio flux density upper limits from LRD stacking analyses, TDE peak radio luminosities, and volumetric density estimates. We find that the characteristic values of flux densities and luminosities allow radio-quiet TDEs as the underlying process of LRDs in any case, while the less common radio-loud TDEs are compatible with the model under special constraints only. Considering other factors, such as volumetric density estimates, delayed and long-term radio flares of TDEs, and cosmological time dilation, TDEs appear to be a plausible explanation for LRDs from the radio point of view. Full article

Gout is a chronic inflammatory disease characterized by the deposition of monosodium urate (MSU) crystals within joints, leading to recurrent acute flares and long-term tissue damage. While various hypotheses have been proposed to explain the self-limiting nature of acute gout attacks, we posit that aggregated neutrophil extracellular traps (aggNETs) play a central role in this process. This review focuses on the mechanisms underlying MSU crystal-induced formation of neutrophil extracellular traps (NETs) and explores their dual role in the clinical progression of gout. During the initial phase of acute flares, massive NET formation is accompanied by the release of preformed inflammatory mediators, which is a condition that amplifies inflammatory cascades. As neutrophil recruitment reaches a critical threshold, the NETs tend to form high-order aggregates (aggNETs). The latter encapsulate MSU crystals and further pro-inflammatory mediators within their three-dimensional scaffold. High concentrations of neutrophil serine proteases (NSPs) within the aggNETs facilitate the degradation of soluble inflammatory mediators and eventually promote the resolution of inflammation in a kind of negative inflammatory feedback loop. In advanced stages of gout, MSU crystal deposits are often visible via dual-energy computed tomography (DECT), and the formation of palpable tophi is frequently observed. Based on the mechanisms of resolution of inflammation and the clinical course of the disease, building on the traditional static model of “central crystal–peripheral fibrous encapsulation,” we have expanded the NETs component and refined the overall concept, proposing a more dynamic, multilayered, multicentric, and heterogeneous model of tophus maturation. Notably, in patients with late-stage gout, tophi exist in a stable state, referred to as “silent” tophi. However, during clinical tophus removal, the disruption of the structural or functional stability of “silent” tophi often leads to the explosive reactivation of inflammation. Considering these findings, we propose that future therapeutic strategies should focus on the precise modulation of NET dynamics, aiming to maintain immune equilibrium and prevent the recurrence of gout flares. Full article

Regulatory changes related to the policy of reducing CO₂ emissions from natural gas are leading to an increase in the share of hydrogen in gas transmission and utilization systems. In this context, the impact of the change in composition on thermal radiation zones should be assessed for flaring during startups, scheduled shutdowns, maintenance, and emergency operations. Most existing models are calibrated for hydrocarbon flare gases. This study assesses how the CH₄–H₂ blends affect thermal radiation zones using a developed solver based on the Brzustowski–Sommer methodology with composition-dependent fraction of heat radiated (F) and range-dependent atmospheric transmissivity. Five blends, 0–50% (v/v) H₂, were analyzed for a 90 m stack at wind speeds of 3 and 5 m·s⁻¹. Comparisons were performed at constant molar (standard volumetric) throughput to isolate composition effects. Adding H2 contracted the radiation zones and reduced peak ground loads. Superposition analysis for a multi-flare layout indicated that replacing one 100% (v/v) CH₄ flare with a 10% (v/v) H₂ blend reduced peak ground radiation. Emission-factor analysis (energy basis) showed reductions of 3.24/3.45% at 10% (v/v) H₂ and 7.01/7.44% at 20% (v/v) H₂ (LHV/HHV); at 50% (v/v) H₂, the decrease reached 22.18/24.32%. Hydrogen blending provides coupled safety and emissions co-benefits, and the developed framework supports screening of flare designs and operating strategies as blends become more prevalent. Full article

Global policy actions to reduce the environmental and social impacts of natural gas flaring are primarily derived from voluntary arrangements. This paper evaluates stakeholder preferences amongst competing policies and regulatory options, optimizing environmental governance to eliminate routine gas flaring by 2030 and achieve net-zero greenhouse emissions by 2050, whilst addressing questions of justice and fair implementation. Using a mixed-methods social scientific approach, incorporating literature and document review, interviews, expert surveys, Analytical Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal Solution (G-TOPSIS), we derive two competing perspectives on gas flaring policy strategy, with differences revealed through the AHP ranking process of individual criteria. All identified criteria and sub-criteria were integral to achieving the flaring and emissions targets, with “policy and targets” and “enabling framework” being the most important individual criteria. The “background and the role of reductions in meeting environmental and economic objectives” and ‘’nonmonetary penalties” were the key emergent sub-criteria. G-TOPSIS showed that fully implementing gas flaring policies and regulatory framework criteria to limit warming to 1.5 °C is the most effective policy alternative. Globally coordinated, uniform, and reciprocal legally binding agreements between countries to supplement national initiatives are imperative for improving the effectiveness of country-specific gas flaring policy strategies. Full article

Background/Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory disease frequently associated with acute uveitis (AU). Adalimumab, a monoclonal tumor necrosis factor (TNF) inhibitor, is widely used to manage AS and AU. While biologic tapering is recommended in stable AS, its impact on uveitis recurrence remains unclear. Methods: This real-world retrospective cohort study analyzed 65 AS patients with a history of AU who received adalimumab for ≥6 months. Time-dependent covariates, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and adalimumab dosing interval, were incorporated into a logistic regression model using generalized estimating equations to identify risk factors for uveitis recurrence. Uveitis recurrence rates were compared among different dosing intervals: every 2 weeks (q2w), every 3 weeks (q3w), and every 4 weeks or longer (q4w+). Results: Among the 65 patients, 27 (41.5%) experienced a total of 50 AU flares during adalimumab treatment. Recurrence rates increased with dosing interval extension (1.5% for q2w, 3.6% for q3w, and 4.0% for q4w+; p = 0.036). In adjusted logistic analysis, the odds ratio (OR) for AU recurrence was significantly higher for q3w (OR = 3.766) and q4w+ (OR = 4.916) compared to q2w. Other factors, including age, sex, ESR, and BASDAI, were not significantly associated with uveitis recurrence. Conclusions: Extended dosing intervals of adalimumab in AS patients with prior AU may be associated with a higher prevalence of uveitis recurrence, even when axial symptoms remain controlled. Therefore, adalimumab spacing strategies should be implemented with caution in these patients to minimize the risk of uveitis recurrence. Full article

Background: Children with inflammatory bowel disease (IBD) are at heightened risk for vaccine-preventable infections because of underlying immune dysregulation and long-term immunosuppressive therapy. Despite published guidelines affirming vaccine safety, real-world coverage remains suboptimal. It is a pilot, single-country survey designed to explore baseline knowledge and practices regarding vaccination in paediatric IBD within a specific local healthcare context. Objective: The objective of this study is to evaluate the knowledge, attitudes, and practices of paediatric gastroenterologists (PGs) regarding the immunisation of children with IBD. Methods: We conducted an exploratory pilot, cross-sectional survey of paediatric gastroenterologists in Russia, focusing on immunisation knowledge and practical barriers in routine care. A cross-sectional, anonymous online survey was distributed to PGs nationwide between January 2022 and April 2022. The online questionnaire explored demographic characteristics, awareness of international recommendations, perceptions of vaccine safety at various disease and treatment stages, and routine vaccination practices. Responses were analysed with non-parametric statistics (α = 0.05). In a parallel prospective cohort, the vaccination certificates of 98 paediatric IBD patients (January 2022–April 2023) were audited to quantify real-world coverage. Results: Fifty-one PGs completed the survey. Forty-one per cent agreed that vaccines do not provoke IBD flares, while 17.6% considered live vaccines acceptable during immunosuppressive remission. Nearly one-third (32%) did not personally oversee immunisation, and 18% occasionally discouraged vaccination during therapy. Only 35.3% deemed baseline serology essential before starting immunosuppression; 46.5% supported antibody checks immediately prior to vaccination. The certificate audit revealed a full schedule completion rate of 66.3% for measles–mumps–rubella and 74.2% for hepatitis B, contrasting with parental reports of 82.3% complete coverage. Conclusions: Knowledge gaps, limited guideline awareness, and parental concerns contribute to suboptimal vaccination of paediatric IBD patients. Targeted educational initiatives, clearer shared-care pathways, and routine certificate audits are needed to close the coverage gap and reduce infection-related morbidity. Findings are hypothesis-generating and reflect local practice; as a pilot study, results should be interpreted with caution and may not generalise beyond similar settings. Full article

The precise monitoring of solar flares holds significant scientific value for space mission safety, communication security, and space environment forecasting. The H$\alpha$ line has long been utilized as a tool to extract information about the structure and dynamics of the solar chromosphere and is crucial for observing solar activities such as prominences and flares. However, ground-based H$\alpha$ observations are susceptible to cloud interference, which significantly reduces data reliability and complicates the effective separation of genuine flare signals from cloud modulation effects. To address this challenge, our study proposes a dual-band brightness ratio method tailored to the SMAT configuration, leveraging synchronous observation data from the Huairou SMAT at two wavelengths (photospheric 5324 Å and chromospheric 6562.8 Å). Observational data validation demonstrates that this method can effectively characterize true chromospheric brightness variations. In real observational data, the reconstructed brightness curve successfully recovered the brightness peak of an M1.5 class flare, with the peak position aligning well with the X-ray flux peak. This method enhances the accuracy of flare monitoring under cloudy conditions for SMAT, providing a promising pathway for high-reliability ground-based solar activity observations with this telescope. Full article

Ulcerative colitis (UC) is a chronic, relapsing inflammatory disease of the colon, often associated with gut microbial dysbiosis. Although anti-TNF-α agents, such as Adalimumab (Cinnora^®), are used to treat moderate-to-severe UC, the treatment response is highly variable. Identifying early microbial biomarkers of response could help support personalized therapeutic strategies and prevent unnecessary exposure to ineffective treatments. However, the long-term effects of anti-TNF therapy on both stool and mucosal microbiota remain poorly understood. This prospective longitudinal study included 23 corticosteroid-refractory or -dependent UC patients who started Adalimumab after endoscopy-confirmed flare-ups. Stool samples and inflamed colonic biopsies were collected at baseline, and 3 and 6 months. Microbiota profiling was performed using 16S rRNA sequencing. Microbial changes were analyzed over time and compared between responders (Mayo score 0–1) and non-responders (Mayo score ≥ 2). Sixty percent of patients achieved clinical remission. In responders, stool microbiota showed increased Bacteroidetes and decreased Proteobacteria abundances, along with an enrichment of beneficial taxa including Faecalibacterium prausnitzii, Bifidobacterium, and Akkermansia muciniphila. Mucosal microbiota exhibited persistent dysbiosis, characterized by an increase in Proteobacteria and a reduced Firmicutes/Proteobacteria ratio. Notably, responders showed distinct compartment-specific microbial changes, with a decrease in Gammaproteobacteria in stool and an increase in Corynebacterium in tissue. Adalimumab induces divergent microbial changes in stool and mucosa. While stool microbiota trends toward eubiosis in responders, persistent mucosal dysbiosis may reflect asymptomatic inflammation. These findings underscore the importance of niche-specific microbiome profiling in UC and support its integration into personalized treatment monitoring. Full article

This review provides an overview of the most significant developments in gout pathophysiology research published in 2024. Thirteen studies were selected based on originality, scientific rigor, and potential clinical impact and grouped into four major categories: inflammation and pain mechanisms (LRRC8 anion channels, CXCL5-CXCR2 axis, CD38 and NAD⁺ metabolism, PLK1 and NLRP3 inflammasome localization, and IFN1 suppression), biomarkers and proteomics (scRNA-seq reveals monocyte and T-cell flare signatures, and Olink serum profiling reveals a proinflammatory signature in hyperuricemia and also identifies TNFSF14 as a novel flare biomarker, while a multi-omics integrative study implicates TRIM46 as a key causal gene), gut virome, and novel therapies (vagus nerve stimulation, biomimetic nanosystem, and restoration of Urate Oxidase (Uox) function). The studies selected focused primarily on work on subjects other than on hyperuricemia. The findings collectively expand our understanding of gout’s complex pathophysiology and highlight potential strategies for diagnosis, management, and innovative treatments. Full article

In this paper, the effect of nozzle height on the combustion dynamics of jet fires in rotating flow fields (JFRFFs) is systematically investigated through experimental and numerical simulations. As the nozzle height increases, the JFRFF flame state transitions from stable rotation (SR) to unstable rotation (USR), and eventually to non-rotation (NR), indicating a weakening interaction between the vortex flow and the jet flame. The radial distribution of tangential velocity gradually deviates from the Burgers vortex model as the nozzle height increases, providing a criterion for distinguishing different flame states. Both vortex intensity and flame length are found to decrease with increasing nozzle height, whereas the maximum flame diameter increases. The relative position of the maximum flame diameter to the whole flame length firstly increases and then decreases to match that of the free jet fires, as the flame evolves from SR to USR and NR. In addition, the air entrainment near the nozzle exit decreases with increasing nozzle height, as evidenced by the gradual rise in lift-off height. These findings establish a theoretical basis for the fire performance design of flares in pipeline retrofitting and process industries. Full article

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by widespread immune dysregulation and the production of autoantibodies targeting nuclear, cytoplasmic, and cell surface antigens. These autoantibodies are central to disease pathogenesis, contribute to immune complex formation and organ damage, and serve as essential diagnostic and prognostic markers. Their detection supports disease classification, guides clinical decision-making, and offers insight into disease activity and therapeutic response. Traditional markers such as anti-nuclear antibodies (ANA), anti-dsDNA, and anti-Sm antibodies remain diagnostic cornerstones, but growing attention is given to anti-C1q, anti-nucleosome antibodies (ANuA), anti-ribosomal P, antiphospholipid, and anti-cytokine antibodies due to their associations with specific disease phenotypes and activity. These markers may reflect disease activity, specific organ involvement, or predict flares. The mechanisms underlying their persistence include B cell tolerance failure and long-lived plasma cell activity. The aim of this review is to summarize current knowledge on the major autoantibodies in SLE, appraise available detection methods, highlight their clinical utility and limitations and present evidence on the association between antibodies and disease phenotypes. Full article

Objective: This study aims to evaluate obstetric and neonatal outcomes in pregnancies complicated by RDs and to identify hemogram-derived biomarkers associated with adverse perinatal events. Methods: This retrospective cohort study analyzed 360 pregnancies in individuals diagnosed with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), ankylosing spondylitis (AS), Sjögren’s disease, sarcoidosis, undifferentiated connective tissue disease (UCTD), and other autoimmune conditions, followed up at the Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, between 2013 and 2018. Data on disease activity, maternal complications, neonatal outcomes, and inflammatory markers were extracted from electronic medical records. Results: Patients with SSc had the highest rates of preterm birth (57.1%) and fetal growth restriction (FGR) (42.9%), whereas those with SLE (50%) and AS (25%) exhibited the highest disease flare rates. Neonates born to mothers with SSc, SLE, and Sjögren’s disease had significantly lower Apgar scores, suggesting increased neonatal distress. NICU admission was associated with elevated neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR), with higher NLR and ELR also predicting spontaneous abortion. Monocyte-to-lymphocyte ratio (MLR) and ELR demonstrated the highest predictive value for composite adverse perinatal outcomes. Additionally, RA patients experiencing disease flares had an 87.5% cesarean section (CS) rate, significantly exceeding the general population rate. Conclusions: This study underscores the increased risk of preterm birth, FGR, and neonatal complications in RD pregnancies, particularly in SSc and SLE patients. The findings suggest that early risk assessment using hemogram-based inflammatory markers may improve perinatal management and patient stratification. Full article

Background: Crohn’s disease (CD) is a chronic inflammatory bowel disease that significantly affects patients’ quality of life. Nutrition is increasingly recognized as a modifiable factor influencing disease activity and symptom management. Despite growing interest, structured dietary guidelines for CD are lacking, and patients often rely on personal experience or fragmented advice. This study aimed to investigate patients’ perceptions of diet, the support they receive, and the psychosocial burden of dietary management in CD. Methods: A nationwide online survey was conducted in Italy from April to May 2025 among individuals diagnosed with CD. The questionnaire, developed in line with the CROSS reporting guidelines, comprised 30 multiple-choice questions across five sections: demographics, disease characteristics, dietary habits during remission, dietary habits during flare-ups, and psychological impact. Invitations were distributed through patient associations, webinars, and gastroenterology professionals. Responses were anonymized. Results: A total of 222 participants completed the survey (59.5% female, most aged 30–39 years). Fatigue was the most common symptom (71.6%), frequently persisting even during remission. Nearly half of respondents reported diet as “very important” in disease management, yet only 32% had received a formal referral to a nutritionist. The most commonly adopted dietary approach was a low-fiber diet, while awareness of evidence-based protocols like the Crohn’s disease exclusion diet (CDED) was limited (11.7%). Social and psychological burdens were significant, with 79.2% reporting anxiety when outside their home. Conclusions: Dietary education and psychological support are unmet needs for CD patients. Improved access to tailored nutritional counseling and greater awareness of validated dietary approaches may enhance disease management and quality of life. Full article

Existing nighttime visibility enhancement methods primarily focus on improving overall brightness under low-light conditions. However, nighttime road images are also affected by glare, glow, and flare from complex light sources such as streetlights and headlights, making it challenging to suppress locally overexposed regions and recover fine details. To address these challenges, we propose a Nighttime Road Glare Suppression Network (NRGS-Net) for glare removal and detail restoration. Specifically, to handle diverse glare disturbances caused by the uncertainty in light source positions and shapes, we designed a gated positional attention (GPA) module that integrates positional encoding with local contextual information to guide the network in accurately locating and suppressing glare regions, thereby enhancing the visibility of affected areas. Furthermore, we introduced an improved Uformer backbone named LCAtransformer, in which the downsampling layers adopt efficient depthwise separable convolutions to reduce computational cost while preserving critical spatial information. The upsampling layers incorporate a residual PixelShuffle module to achieve effective restoration in glare-affected regions. Additionally, channel attention is introduced within the Local Context-Aware Feed-Forward Network (LCA-FFN) to enable adaptive adjustment of feature weights, effectively suppressing irrelevant and interfering features. To advance the research in nighttime glare suppression, we constructed and publicly released the Night Road Glare Dataset (NRGD) captured in real nighttime road scenarios, enriching the evaluation system for this task. Experiments conducted on the Flare7K++ and NRGD, using five evaluation metrics and comparing six state-of-the-art methods, demonstrate that our method achieves superior performance in both subjective and objective metrics compared to existing advanced methods. Full article