Search Results (8,143)

Background: We aimed to investigate the prognostic significance of hematological inflammatory indices and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) in the diagnosis and prognosis of Bell’s palsy. Method: The study included 156 cases diagnosed with Bell’s palsy in the neurology clinic and 156 healthy controls. The patients diagnosed with Bell’s palsy were staged according to the House–Brackmann Scoring system. Hematological inflammatory parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) levels, and MHR were calculated from the parameters in the patient files. Result: Hematological inflammatory parameters such as NLR, PLR, SII, SIRI, and MHR were found to be higher in Bell’s palsy patients. In addition, these parameters were found to be higher in patients with grade V and above Bell’s palsy and in patients who did not respond to treatment, compared to the grade IV group and patients who responded to treatment, respectively. SIRI was an independent predictor of both the diagnosis of the disease and the lack of response to treatment, and this was confirmed by LASSO analysis. Conclusions: This study is among the few that demonstrated predictive models based on hematological inflammatory indices that can aid in both the diagnosis and treatment response assessment of newly diagnosed Bell’s palsy patients, validated using the LOOCV method. The findings highlight the potential clinical utility of simple, inexpensive, and practical biomarkers such as NLR, PLR, SII, SIRI, and MHR. These easily accessible parameters may support early diagnosis and prognostic evaluation in routine clinical settings. Full article

When unmanned aerial vehicles (UAVs) perform transmission line ice cover detection, it is often due to the variable shooting angle and complex background environment, which leads to difficulties such as poor ice-covering recognition accuracy and difficulty in accurately identifying the target. To address these issues, this study proposes an improved icing detection model based on HCDFI–You Only Look Once version 8 (HCDFI-YOLOv8). First, a cross-dense hybrid (CDH) parallel heterogeneous convolutional module is proposed, which can not only improve the detection accuracy of the model, but also effectively alleviate the problem of the surge in the number of floating-point operations during the improvement of the model. Second, deep and shallow feature weighted fusion using improved CSPDarknet53 to 2-Stage FPN_Dynamic Feature Fusion (C2f_DFF) module is proposed to reduce feature loss in neck networks. Third, optimization of the detection head using the feature adaptive spatial feature fusion (FASFF) detection head module is performed to enhance the model’s ability to extract features at different scales. Finally, a new inner-complete intersection over union (Inner_CIoU) loss function is introduced to solve the contradiction of the CIOU loss function used in the original YOLOv8. Experimental results demonstrate that the proposed HCDFI-YOLOv8 model achieves a 2.7% improvement in mAP@0.5 and a 2.5% improvement in mAP@0.5:0.95 compared to standard YOLOv8. Among twelve models for icing detection, the proposed model delivers the highest overall detection accuracy. The accuracy of the HCDFI-YOLOv8 model in detecting complex transmission line environments is verified and effective technical support is provided for transmission line ice cover detection. Full article

Background: miRNA profiling across different stages of laryngeal carcinogenesis explores dysregulated molecules relevant to engaged gene pathways and identifies markers for differential diagnosis and prognosis in early mucosal lesions of the larynx. Methods: Tissue samples were prospectively collected from 28 patients with hypertrophic vocal fold lesions: no dysplasia (ND), low-grade dysplasia (LGD), high-grade dysplasia (HGD), and invasive cancer (IC), as well as from 3 patients with vocal fold polyps. miRNA profiling of the samples was performed using microfluidic cards—TaqMan^® Human MicroRNA Array A. A comparative analysis of ΔCt (dCt) miRNA expression levels was conducted between groups. Results: hsa-miR-216a-5p and hsa-miR-488-3p were selectively expressed in control tissues, while hsa-miR-105-5p and hsa-miR-516a-5p were exclusively detected in HGD and IC samples. Significant differences in miRNA expression were identified across 4, 16, 17, and 38 miRNA types between control and ND, LGD, HGD, and IC groups, respectively. hsa-miR-185-5p and hsa-miR-21-5p showed significantly altered expression between ND and LGD, HGD, and IC (p = 0.026, 0.001, 0.002; and p = 0.021, 0.002, 0.001, respectively). Twenty-five miRNAs were differentially expressed between LGD and both HGD and IC, while eleven miRNAs distinguished HGD from IC. Notably, hsa-miR-503-5p expression decreased progressively with increasing histological severity. Conclusions: Distinct miRNA expression profiles are associated with progressive stages of laryngeal mucosal lesions. Specific miRNAs may serve as valuable biomarkers for early detection, risk stratification, and prognosis in vocal fold carcinogenesis. Full article

Background: Meniere’s disease (MD) is a chronic inner ear disorder affecting approximately 0.2% of the population, with 30% of patients remaining refractory to conventional treatments. The pathophysiology involves endolymphatic hydrops, suggesting that agents affecting fluid homeostasis might provide therapeutic benefit. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors, originally developed for diabetes, offer unique mechanisms including natriuresis and osmotic diuresis that may address the underlying fluid imbalance in MD. Methods: We conducted a retrospective observational study at the Korea University Anam Hospital, analyzing the medical records of patients with definite MD (Bárány Society criteria) who received off-label empagliflozin 10 mg daily between January 2023 and December 2023. Six patients (3 men, 3 women; mean age 55.8 years) with treatment-resistant MD were identified who had failed conventional therapy for at least 3 months. Primary outcomes included changes in pure tone threshold average (PTA), low-frequency threshold average (LFA), vertigo episode frequency, and vertigo severity using visual analog scale (VAS) scores, assessed at baseline and after 3 months of treatment. Results: All patients demonstrated clinically significant improvements in both auditory and vestibular symptoms. Mean PTA improved from 31.4 dB to 20.8 dB (improvement of 10.6 dB, p < 0.05). Low-frequency hearing showed more substantial recovery, with LFA improving from 37.2 dB to 15.6 dB (improvement of 21.6 dB, p < 0.01). Vertigo frequency decreased dramatically from 1.6 episodes per month to 0.1 episodes per month, with four patients experiencing a complete resolution of vertigo episodes. VAS scores for vertigo severity decreased from 5.2 to 0.5. Treatment was well-tolerated, with only minor adverse effects reported in two patients: transient polyuria in one patient and 5 kg weight loss in another, both consistent with the known pharmacological profile of SGLT-2 inhibitors. Conclusions: This preliminary study suggests a potential clinical benefit of repurposing SGLT-2 inhibitors for treatment-resistant MD. However, the retrospective design and inherent limitations prevent definitive conclusions about causality. The significant improvements observed in both hearing thresholds and vestibular symptoms warrant further investigation through randomized controlled trials with objective outcome measures to establish the true efficacy of this therapeutic approach. Full article

Background and Clinical Significance: Granulomatosis with polyangiitis (GPA), an immune-mediated systemic small-vessel vasculitis affecting the upper/lower respiratory tracts and kidneys, frequently presents with non-specific nasal symptoms that lead to misdiagnosis. Case Presentation: We report a case of a 55-year-old female with GPA complicated by Bartter syndrome. She presented with one month of left nasal congestion, rhinorrhea, epistaxis, and headache. Initial diagnosis was acute sinusitis. Computed tomography (CT) revealed left maxillary and ethmoid sinus inflammation with bone destruction, while metagenomic next-generation sequencing (mNGS) suggested conventional bacterial infection. Postoperative pathology demonstrated chronic mucosal inflammation with lymphoid tissue hyperplasia. GPA was ultimately diagnosed based on PR3-ANCA seropositivity and chest CT findings of cavitary pulmonary nodules. Postoperatively, severe hypokalemia and hypomagnesemia secondary to Bartter syndrome emerged. Following electrolyte correction, induction therapy with glucocorticoids and cyclophosphamide was initiated. Conclusions: This case underscores that GPA’s head and neck manifestations are frequently misdiagnosed as infections or malignancies. Early diagnosis requires vigilance for GPA ‘red flags’, such as refractory nasal symptoms to conventional therapy (e.g., bloody rhinorrhea), characteristic CT findings (e.g., sinus opacification without ostiomeatal complex obstruction), and nasal endoscopy findings (e.g., ulcers/crusting). Otolaryngologists play a pivotal role in recognizing early disease onset and initiating timely treatment. Full article

With the rapid expansion of global maritime transportation, infrared ship detection has become increasingly critical for ensuring navigational safety, enhancing maritime monitoring, and supporting environmental protection. To address the limitations of conventional methods in handling small-scale targets and complex background interference, in this paper, we propose an improved approach by embedding the convolutional block attention module (CBAM) into different components of the YOLOv5 architecture. Specifically, three enhanced models are constructed: the YOLOv5n-H (CBAM embedded in the head), the YOLOv5n-N (CBAM embedded in the neck), and the YOLOv5n-HN (CBAM embedded in both the neck and head). The comprehensive experiments are conducted on a publicly available infrared ship dataset to evaluate the impact of attention placement on detection performance. The results demonstrate that the YOLOv5n-HN achieves the best overall performance, attaining the mAP@0.5 of $86.83\%$, significantly improving the detection of medium- and large-scale maritime targets. The YOLOv5n-N exhibits superior performance for small-scale target detection. Furthermore, the incorporation of the attention mechanism substantially enhances the model’s robustness against background clutter and its discriminative capacity. This work offers practical guidance for the development of lightweight and robust infrared ship detection models. Full article

Surface defect detection in aluminum profiles is critical for maintaining product quality and ensuring efficient industrial production. However, existing detection algorithms often struggle to address the challenges of imbalanced defect categories, low detection accuracy for small-scale defects, and irregular flaw geometries. These limitations compromise both detection accuracy and algorithmic robustness. Accordingly, we proposed MCH-YOLOv12—an improved YOLOv12-based algorithm for precise defect detection. Firstly, we enhanced the original Ghost convolution by incorporating multi-scale feature extraction and named the improved version MultiScaleGhost, which replaced the standard convolutions in the Backbone of YOLOv12. This improvement mitigated the limitations of single-scale convolution, enhancing feature representation and the detection of irregularly shaped defects. Secondly, we addressed the directional and edge-specific nature of defects by enhancing the traditional Channel-wise Gated Linear Unit (CGLU). We proposed the Spatial-Channel Collaborative Gated Linear Unit (SCCGLU), which was embedded after the C3k2 module in the Neck of YOLOv12 to better capture fine-grained features. Finally, we designed a Hybrid Head combining anchor-based and anchor-free detection to improve adaptability to defects of various sizes and shapes. Experimental results on an aluminum profile defect dataset demonstrated improved accuracy, reduced category imbalance, and lower parameters and Floating Point Operations (FLOPs), making the algorithm suitable for real-time industrial inspection. Full article

Objectives: The application of fasciocutaneous free flaps for reconstruction of head and neck defects following oncological surgery has increased since the 1970s, coinciding with developments in microvascular techniques. Although reported success rates are between 90% and 99%, flap failure continues to occur, most frequently due to venous congestion. This study examines the rates of re-exploration and flap failure according to the number of venous anastomoses in patients receiving free flap reconstruction after head and neck cancer surgery. Materials and Methods: This retrospective analysis included 163 patients who underwent head and neck reconstruction with free flaps (radial forearm free flap [RFFF] and anterolateral thigh flap [ALTF]) at the University Hospital of Verona between January 2019 and June 2024. Variables examined comprised the type of flap performed, donor and recipient vessels utilized, and number of venous anastomoses, as well as the type (end-to-end [ETE] versus end-to-side [ETS]) and site (internal jugular vein versus external jugular vein) of venous anastomosis. Results: The overall success rate was 93.3%, with no significant difference between single and dual venous anastomosis groups. Prompt re-exploration upon detecting signs of flap failure is critical, as approximately one-third of such failures may be prevented through timely intervention. Conclusions: Single venous end-to-end anastomosis utilizing the internal jugular vein system is typically effective. Further research is warranted to clarify the indications for dual anastomosis involving the external jugular vein system. Full article

Accurate detection of student behavior in the classroom helps analyze students’ learning states and contributes to improving teaching effectiveness. We propose the PLA-YOLO11n classroom behavior detection model. We design a novel C3K2_PConv module that integrates partial convolution with modules from the YOLO11 network and apply it to the backbone and neck feature fusion layers. To enhance small-target feature representation, we incorporate a large-kernel self-attention (LSKA) mechanism and replace the SPPF at the end of the backbone with the attention feature integration module (AIFI). We also add a high-resolution detection head. Experimental results on the SCB2 dataset demonstrate that the improved model outperforms the original YOLO11, achieving an increase of 3.8% in mean average precision (mAP@0.5). Full article

Objective: Sinonasal squamous cell carcinoma (SNSCC) is a rare and aggressive malignancy, with limited treatment strategies in the recurrent or metastatic cases. Although immune checkpoint inhibitors (ICIs) have shown efficacy in head and neck cancers (HNCs), clinical data specific to SNSCC are scarce. This study aimed to evaluate the therapeutic efficacy and prognosis of ICIs in patients with SNSCC. Methods: We conducted a retrospective review of 18 patients with pathologically confirmed SNSCC treated with nivolumab or pembrolizumab at Gifu University Hospital between May 2017 and December 2024. Treatment response was assessed using RECIST v1.1 criteria. Overall response rate (ORR) and disease control rate (DCR) were evaluated as treatment effects, and overall survival (OS) and progression-free survival (PFS) were evaluated as prognoses. Subgroup analyses were performed according to treatment regimen. Results: The ORR and DCR for all patients were 43.8% and 56.3%, respectively. Pembrolizumab-treated patients showed higher response rates (ORR: 66.7%; DCR: 83.3%) compared to those treated with nivolumab (ORR: 30%; DCR: 40%). Median OS and PFS were 21.5 and 7.9 months, respectively. Long-term durable responses exceeding two years were observed in several cases. Although pembrolizumab tended to result in better outcomes, no statistically significant difference was found between groups. Immune-related adverse events were infrequent and manageable. Conclusions: This study suggests that a subset of patients with SNSCC may benefit from ICI therapy, particularly in combination with chemotherapy. Despite the rarity of SNSCC, accumulating clinical evidence—including prospective studies—is essential to establish standardized treatment strategies for this disease. Full article

Background/Objectives: To prevent flap failure, adequate tissue perfusion and effective regenerative processes, undisturbed wound healing are essential, among others. To improve wound healing, various locally and systematically administered pharmacons can be used. This study investigated the effect of PACAP 1-38 (pituitary adenylate cyclase activating polypeptide) and BGP-15 (a nicotinic amidoxime derivative) on the healing of epigastric fasciocutaneous flaps exposed to ischemia–reperfusion (I/R). Methods: Wistar rats were randomly divided into control (no substance), PACAP 1-38, and BGP-15 groups. Groin flaps were prepared bilaterally. The left flap was exposed to 120 min of ischemia prior to suturing it back. We applied wound gels containing substances. Laboratory tests (hematology, erythrocyte deformability, and aggregation) were performed before surgery on the 1st, 3rd, and 7th postoperative days. Lastly, flap skin samples were taken for histological and tensile strength measurements. Results: Impaired erythrocyte deformability and enhanced aggregation were found because of flap I/R. The pharmacons were able to reduce the systemic micro-rheological impairment to varying degrees. The tensile strength increased in the areas of better perfusion. Conclusions: The anti-inflammatory effects of PACAP 1-38 and BPG-15, as well as the impact of PACAP 1-38 on collagen and elastic fiber composition, have been demonstrated. Full article

Objective: The aim of this study is to develop and evaluate the antibacterial and anti-biofilm efficacy of ciprofloxacin-coated tympanostomy tubes (TTs) using a sustained-release varnish (SRV-CIPRO) and introduce a novel tympanic membrane model for preclinical evaluation. Study Design: This was an in vitro experimental study. Setting: This study was conducted in a biofilm research laboratory in an academic medical center. Methods: Sterile fluoroplastic TTs were coated with SRV-CIPRO or placebo varnish. A novel tympanic membrane (TM) model was developed using a layered agar–plastic system. Antibacterial activity, biofilm inhibition, and bacterial viability were assessed through agar diffusion, MTT, ATP quantification, HR-SEM, and SD-CLSM. Results: SRV-CIPRO-coated TTs exhibited sustained antibacterial activity for up to 10 days. Compared to the placebo, SRV-CIPRO significantly inhibited biofilm formation, reduced metabolic activity, and decreased bacterial viability (p < 0.05). Imaging confirmed fewer bacterial colonies on SRV-CIPRO TTs. The TM model allowed realistic testing of tube insertion and infection simulation. Conclusion: SRV-CIPRO-coated TTs offer sustained antibiotic delivery, potentially reducing postoperative otorrhea and biofilm-related complications. The TM model provides a platform for preclinical evaluation of middle ear devices. Full article

The effectiveness of breathing interventions on postural alignment, pain reduction, and functional improvement in patients with forward head posture (FHP) and chronic neck pain remains uncertain. Previously conducted randomized controlled trials (RCTs) that involved breathing interventions were identified through searches of the PubMed, Cochrane Library, Web of Science, and Scopus databases. Studies were included if they applied diaphragmatic breathing, breathing muscle training, or feedback breathing exercises for at least 2 weeks to chronic neck pain (duration ≥ 3 months) and/or forward head posture. The craniovertebral angle (CVA), the visual analog scale (VAS), and the neck disability index (NDI) were the primary outcome measures. The results showed that breathing interventions had a moderate effect size in terms of improving the CVA. Limited effects were observed for pain reduction, and improvements in neck disability approached statistical significance. However, despite these positive findings, the overall evidence was rated as ‘very low certainty’ in the GRADE assessment, primarily due to high heterogeneity among studies, limited sample sizes, and the potential for unit-of-analysis errors in diagnosis-based subgroup analyses. Consequently, their overall effectiveness in chronic neck pain was limited. Future research is needed to explore a multidisciplinary approach to neck pain using standardized protocols and larger samples. Full article

Background/Objectives: HNSCC is a highly aggressive malignancy marked by the dysregulation of the cell cycle. In HPV⁻ HNSCC, mutations in the CDKN2A gene frequently result in the loss of the p16 protein, a key inhibitor of the cyclin D1/CDK4/6 complex. This loss results in unchecked G1/S phase progression. The CDK4/6 inhibitor palbociclib has shown therapeutic potential in HPV⁻ HNSCC by inducing G1 phase arrest and reducing cell viability. In this study, we investigated the molecular mechanisms by which palbociclib affects cell viability in HPV⁻ HNSCC. Methods: Four HPV⁻ HNSCC cell lines were treated with palbociclib, and RNA sequencing was performed to assess changes in gene expression. Cell viability was measured using the MTT assay. To further investigate protein localization, interactions, and function, we used immunofluorescence staining, co-immunoprecipitation, small molecule inhibitors, and siRNA-mediated knockdown. Results: We demonstrate that palbociclib downregulates survivin, a protein that plays dual roles in mitosis and apoptosis, thereby inhibiting cell proliferation. We also found that survivin is overexpressed in HPV⁻ HNSCC. Inhibiting survivin dimerization using the compound LQZ-7i significantly reduces cell viability and promotes its export from the nucleus to the cytoplasm. Additionally, we identified USP1, a deubiquitinase, as both a downstream target of CDK4/6 and a key regulator of survivin stability. Inhibiting USP1 activity or silencing its expression significantly reduces survivin levels. Conclusions: Our findings highlight survivin as a critical mediator of cell proliferation in HPV⁻ HNSCC and suggest that targeting the CDK4/6-USP1-survivin axis may offer a promising therapeutic strategy. Full article

Background: Oral cancer remains a significant global health concern due to its high incidence and mortality, as highlighted by GLOBOCAN 2022, and is characterized by poor survival rates despite available therapies. Therefore, there is an imperative need for developing novel therapeutic targets for this disease. Methods: This study investigates the oncogenic role of mortalin in oral cancer. We have used The Cancer Genome Atlas (TCGA) dataset, samples from North Eastern Region of India and tissue microarray to examine the expression of this gene/protein in patient samples. siRNA related knock down studies were carried out to determine the role of mortalin on oral cancer cell proliferation, survival, metastases, EMT, autophagy etc. Results: Analysis of TCGA dataset revealed increased mortalin expression in head and neck squamous cell carcinoma (HNSCC), which correlated with tumor grade and stage, and was associated with diminished overall survival. These findings were validated in oral cancer patient tissue samples obtained from the North East Region of India and oral cancer cell lines. Functional assays showed that mortalin knockdown via siRNA reduced cancer cell proliferation, migration, invasion, and angiogenesis while inducing apoptosis, disrupting mitochondrial membrane potential, and modulating autophagy. These effects were linked to altered expression of regulatory molecules, including p53, p21WAF1, cyclins, caspases, MMPs, Survivin, and components of the Akt/mTOR pathway, thereby alleviating key hallmarks of oral cancer. Conclusion: Collectively, these data support mortalin as a potential therapeutic target for oral cancer and warrant further studies for the development of mortalin-targeting drugs in both laboratory and clinical settings. Full article