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16 pages, 471 KB  
Article
Profiling the Kidney Before the Incision: CT-Derived Signatures Steering Reconstructive Strategy After Off-Clamp Minimally Invasive Partial Nephrectomy
by Umberto Anceschi, Antonio Tufano, Davide Vitale, Francesco Prata, Rocco Simone Flammia, Federico Cappelli, Leonardo Teodoli, Claudio Trobiani, Giulio Eugenio Vallati, Antonio Minore, Salvatore Basile, Riccardo Mastroianni, Aldo Brassetti, Gabriele Tuderti, Maddalena Iori, Giuseppe Spadaro, Mariaconsiglia Ferriero, Alfredo Maria Bove, Elva Vergantino, Eliodoro Faiella, Aldo Di Blasi, Rocco Papalia and Giuseppe Simoneadd Show full author list remove Hide full author list
Cancers 2025, 17(19), 3236; https://doi.org/10.3390/cancers17193236 - 5 Oct 2025
Viewed by 172
Abstract
Introduction: In minimally invasive, off-clamp partial nephrectomy (ocMIPN), the reconstructive strategy profoundly influences functional outcomes. Traditional nephrometry scores aid preoperative planning but do not directly inform the choice of closure technique. This dual-institutional study aimed primarily to identify preoperative CT-derived parameters predictive of [...] Read more.
Introduction: In minimally invasive, off-clamp partial nephrectomy (ocMIPN), the reconstructive strategy profoundly influences functional outcomes. Traditional nephrometry scores aid preoperative planning but do not directly inform the choice of closure technique. This dual-institutional study aimed primarily to identify preoperative CT-derived parameters predictive of renorrhaphy versus a sutureless approach, and secondarily to compare perioperative and functional outcomes between these techniques. Methods: We retrospectively analyzed 201 consecutive ocMIPN cases performed using a standardized off-clamp technique by two experienced surgical teams across robotic platforms and conventional laparoscopy. Preoperative CT scans were centrally reviewed to quantify morphometric features, including contact surface area (CSA), tumor radius, and Gerota’s fascia thickness. Univariable and multivariable logistic regression models—one restricted to radiologic variables and one expanded with RENAL score terms—were generated to identify independent predictors. Perioperative outcomes, renal functional metrics, and Trifecta rates were compared between cohorts. Results: Among the 201 patients, 101 (50.2%) underwent sutureless reconstruction and 100 (49.8%) renorrhaphy. Cohorts were comparable at baseline except for tumor size (3.1 vs. 3.6 cm; p = 0.04). In multivariable analysis, CSA > 15 cm2 (OR 3.93; 95% CI 1.26–12.26; p = 0.02) and tumor radius (OR 1.14 per mm; 95% CI 1.01–1.29; p = 0.04) consistently predicted renorrhaphy, while Gerota’s fascia < 10 mm emerged as significant only in the expanded specification (OR 0.08; 95% CI 0.01–0.70; p = 0.02). Integration with RENAL improved predictive performance (ΔAUC 0.06; NRI 0.14; IDI 0.07), and the final model demonstrated strong discrimination (AUC 0.81) with satisfactory calibration. Perioperative outcomes, postoperative renal function, and Trifecta achievement were similar between groups (all p ≥ 0.21). Conclusions: A concise set of CT-derived morphologic markers—CSA, tumor radius, and perinephric fascia thickness—anticipated reconstructive strategy in ocMIPN and augmented the discriminatory power of RENAL nephrometry. When anatomy was favorable, sutureless repair was not associated with statistically significant differences in perioperative safety or renal function, although the study was not powered for formal equivalence testing. These findings support the integration of radiologic markers into preoperative planning frameworks for nephron-sparing surgery. Full article
(This article belongs to the Section Methods and Technologies Development)
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16 pages, 3259 KB  
Article
Spinal Epidural Fat as an Imaging Biomarker of Visceral Obesity: An MRI-Based Quantitative Analysis
by Nicola Marrone, Gabriele Bilancia, Domenico Romeo, Valerio D’Agostino, Federico Ponti, Francesca Salamanna, Amandine Crombé and Paolo Spinnato
Diagnostics 2025, 15(19), 2490; https://doi.org/10.3390/diagnostics15192490 - 29 Sep 2025
Viewed by 492
Abstract
Background/Objectives: Spinal epidural lipomatosis (SEL) is increasingly recognized as a possible radiological indicator of Metabolic Syndrome (MS) and visceral adiposity. However, the precise relationship between visceral adiposity and the accumulation of epidural fat (EF) remains unclear. This study aimed to investigate the [...] Read more.
Background/Objectives: Spinal epidural lipomatosis (SEL) is increasingly recognized as a possible radiological indicator of Metabolic Syndrome (MS) and visceral adiposity. However, the precise relationship between visceral adiposity and the accumulation of epidural fat (EF) remains unclear. This study aimed to investigate the association between visceral adipose tissue (VAT) and EF thickness using quantitative MRI analyses. Methods: We retrospectively reviewed all MRI scans performed at our institution over a 7-month period, from May to November 2024. Two radiologists measured and recorded the VAT maximum antero-posterior diameter at the L3 level, EF maximum diameter at the L5-S1 level, spinal canal antero-posterior diameter at the L5-S1 level, and subcutaneous fat (SF) when included in the MRI images (at the L3 level) in all the MRI scans. Results: A cohort of 516 patients was collected (320 women and 196 men; mean age 57.31 ± 18.45 years old). In 508 patients (98.4%) SF and VAT were both measurable, while in 8 patients VAT only was assessable on MRI scans. Pearson correlation identified significant associations between EF and VAT thickness (correlation coefficient > 20%; p < 0.05). A linear regression model confirmed a significant, albeit modest, positive relationship between VAT and EF (R2 = 5.4%). A multivariate regression model incorporating age, sex, spinal canal size, VAT, and SF improved the explanatory power (adjusted R2 = 16.7%), with VAT, spinal canal diameter, and age emerging as significant predictors of EF (p < 0.001). Conclusions: Our study revealed in a large cohort of patients that EF and VAT are directly associated. On the other hand, SF resulted in not being associated with EF. These findings support the emerging concept that SEL can be a radiological phenotype of visceral obesity and, by extension, of MS. Integrating EF measurement into standard MRI interpretation may facilitate the early detection of SEL and offer additional insights into patients’ underlying metabolic profile. Full article
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18 pages, 708 KB  
Review
Hot Topics in the Surgical Treatment of Intrahepatic Cholangiocarcinoma: A Narrative Review of Current Managements
by Silvio Caringi, Antonella Delvecchio, Annachiara Casella, Valentina Ferraro, Michele Dezio, Stefania Marini, Roberto Calbi, Francesco Cortese, Rosalinda Filippo, Matteo Stasi, Tommaso Maria Manzia, Michele Tedeschi, Riccardo Inchingolo and Riccardo Memeo
Cancers 2025, 17(19), 3127; https://doi.org/10.3390/cancers17193127 - 26 Sep 2025
Viewed by 476
Abstract
Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer with a poor prognosis. Negative-margin resection is presently the only potentially curative treatment option. Emerging trends with direct applicability to surgical strategy include margin thickness, lymphadenectomy, optimization of future liver remnant (FLR), [...] Read more.
Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer with a poor prognosis. Negative-margin resection is presently the only potentially curative treatment option. Emerging trends with direct applicability to surgical strategy include margin thickness, lymphadenectomy, optimization of future liver remnant (FLR), minimally invasive techniques, incorporation of systemic therapy, and reconsideration of liver transplantation. This review emphasizes areas of consensus and ongoing debate. Margins ≥5–10 mm are associated with improved results, but biology generally takes precedence over prognosis. Regional lymphadenectomy enhances staging accuracy, although its therapeutic benefit remains unsettled. PVE is standard for FLR enlargement, LVD provides faster hypertrophy, and ALPPS remains reserved for highly selective cases. Minimally invasive and robotic hepatectomy share oncologic results in skilled institutions. Systemic therapies, including immunotherapy and biomarker-directed targeted therapy, are increasingly being incorporated perioperatively. Liver transplant may be of potential value in early-stage disease or on strict indications after neoadjuvant treatment. The modern surgical management of iCCA encompasses a blend of oncologic considerations, FLR optimization, minimally invasive surgery, and systemic therapy according to tumor biology. Multidisciplinary planning and participation in clinical trials are necessary to align surgical innovation with advancements in molecular and systemic treatments, ultimately leading to improved long-term outcomes. Full article
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11 pages, 758 KB  
Article
Measurement of the 33S(n,α)30Si Thermal Cross-Section with Slow Neutrons at ILL
by Javier Praena, Begoña Fernández, Miguel Macías, Ignacio Porras, María Pedrosa-Rivera, Hanna Koivunoro, Marta Sabaté-Gilarte and Fernando Arias de Saavedra
Quantum Beam Sci. 2025, 9(3), 27; https://doi.org/10.3390/qubs9030027 - 22 Sep 2025
Viewed by 330
Abstract
This work is focused on an accurate experimental determination of the thermal 33S(n,α)30Si cross-section. This cross-section is a critical parameter for the potential use of 33S as a cooperative target in boron neutron capture therapy [...] Read more.
This work is focused on an accurate experimental determination of the thermal 33S(n,α)30Si cross-section. This cross-section is a critical parameter for the potential use of 33S as a cooperative target in boron neutron capture therapy or to understand its role in the stellar nucleosynthesis of 36S. At present, there are large discrepancies in this experimental value; therefore, in this work we measured it relative to the 10B(n,α)7Li standard cross-section at the high flux reactor of the Institut Laue-Langevin. The experimental setup was based on a double-sided silicon strip detector. Two 33S samples were used. One 10B sample was used as reference. Particular attention was taken to the characterization of the mass thickness of the samples before and after the experiment because of the high volatility of 33S. Such work was already published in a dedicated paper. A cross-check of the 10B sample was carried out with the neutron flux monitor at the n_TOF-CERN facility. The obtained cross-section of (280 ± 33) mb is significantly higher than the existing data. Full article
(This article belongs to the Special Issue Quantum Beam Science: Feature Papers 2025)
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11 pages, 4595 KB  
Article
Histopathologic Evaluation of Corneal Tissue After Adjunctive Rose Bengal Photodynamic Antimicrobial Therapy and Keratoplasty in Advanced Acanthamoeba Keratitis
by Jordan J. Huang, Juan Carlos Navia, Joshua M. Huang, Matthew Camacho, Charissa H. Tan, Paula A. Sepulveda-Beltran, Sara Mustafa, Heather Durkee, Alejandro Arboleda, Mariela C. Aguilar, Darlene Miller, Jean-Marie Parel, Guillermo Amescua, Sander R. Dubovy and Jaime D. Martinez
J. Clin. Med. 2025, 14(17), 6104; https://doi.org/10.3390/jcm14176104 - 29 Aug 2025
Viewed by 694
Abstract
Background/Purpose: To compare the microbiologic and histopathologic features of Acanthamoeba isolates recovered from patients with Acanthamoeba keratitis (AK) who underwent a therapeutic penetrating keratoplasty (TPK), optical penetrating keratoplasty (OPK), or deep anterior lamellar keratoplasty (DALK) after Rose Bengal Photodynamic Antimicrobial Therapy (RB-PDAT). [...] Read more.
Background/Purpose: To compare the microbiologic and histopathologic features of Acanthamoeba isolates recovered from patients with Acanthamoeba keratitis (AK) who underwent a therapeutic penetrating keratoplasty (TPK), optical penetrating keratoplasty (OPK), or deep anterior lamellar keratoplasty (DALK) after Rose Bengal Photodynamic Antimicrobial Therapy (RB-PDAT). Methods: Surgical specimens were stained with hematoxylin, eosin, and Periodic Acid-Schiff stains as per institutional protocol at the University of Miami, Bascom Palmer Eye Institute. Analysis of Acanthamoeba cyst depth, number of cysts, and average corneal thickness was established by light microscopy. Results: Seventeen patients with AK underwent surgical intervention and RB-PDAT. Eight patients underwent a TPK and nine patients underwent an OPK/DALK. In the TPK group, average cyst depth was 42.0 ± 52.5 μm from Descemet’s layer and mean corneal button thickness was 661.7 ± 106.5 μm. Comparatively, in the OPK/DALK group, average cyst depth from Descemet’s layer was 261.7 ± 222.7 μm with a mean corneal button thickness of 474.2 ± 126.6 μm. Conclusions: Acanthamoeba cysts were found to penetrate deeper within the cornea amongst patients that underwent an emergent TPK compared to patients that underwent an elective OPK/DALK. This may suggest an association between Acanthamoeba cyst depth and infection severity and provides valuable clinical insights towards understanding factors such as infection recurrence and resistance to treatment. Full article
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23 pages, 6848 KB  
Review
The Expanding Frontier: The Role of Artificial Intelligence in Pediatric Neuroradiology
by Alessia Guarnera, Antonio Napolitano, Flavia Liporace, Fabio Marconi, Maria Camilla Rossi-Espagnet, Carlo Gandolfo, Andrea Romano, Alessandro Bozzao and Daniela Longo
Children 2025, 12(9), 1127; https://doi.org/10.3390/children12091127 - 27 Aug 2025
Viewed by 926
Abstract
Artificial intelligence (AI) is revolutionarily shaping the entire landscape of medicine and particularly the privileged field of radiology, since it produces a significant amount of data, namely, images. Currently, AI implementation in radiology is continuously increasing, from automating image analysis to enhancing workflow [...] Read more.
Artificial intelligence (AI) is revolutionarily shaping the entire landscape of medicine and particularly the privileged field of radiology, since it produces a significant amount of data, namely, images. Currently, AI implementation in radiology is continuously increasing, from automating image analysis to enhancing workflow management, and specifically, pediatric neuroradiology is emerging as an expanding frontier. Pediatric neuroradiology presents unique opportunities and challenges since neonates’ and small children’s brains are continuously developing, with age-specific changes in terms of anatomy, physiology, and disease presentation. By enhancing diagnostic accuracy, reducing reporting times, and enabling earlier intervention, AI has the potential to significantly impact clinical practice and patients’ quality of life and outcomes. For instance, AI reduces MRI and CT scanner time by employing advanced deep learning (DL) algorithms to accelerate image acquisition through compressed sensing and undersampling, and to enhance image reconstruction by denoising and super-resolving low-quality datasets, thereby producing diagnostic-quality images with significantly fewer data points and in a shorter timeframe. Furthermore, as healthcare systems become increasingly burdened by rising demands and limited radiology workforce capacity, AI offers a practical solution to support clinical decision-making, particularly in institutions where pediatric neuroradiology is limited. For example, the MELD (Multicenter Epilepsy Lesion Detection) algorithm is specifically designed to help radiologists find focal cortical dysplasias (FCDs), which are a common cause of drug-resistant epilepsy. It works by analyzing a patient’s MRI scan and comparing a wide range of features—such as cortical thickness and folding patterns—to a large database of scans from both healthy individuals and epilepsy patients. By identifying subtle deviations from normal brain anatomy, the MELD graph algorithm can highlight potential lesions that are often missed by the human eye, which is a critical step in identifying patients who could benefit from life-changing epilepsy surgery. On the other hand, the integration of AI into pediatric neuroradiology faces technical and ethical challenges, such as data scarcity and ethical and legal restrictions on pediatric data sharing, that complicate the development of robust and generalizable AI models. Moreover, many radiologists remain sceptical of AI’s interpretability and reliability, and there are also important medico-legal questions around responsibility and liability when AI systems are involved in clinical decision-making. Future promising perspectives to overcome these concerns are represented by federated learning and collaborative research and AI development, which require technological innovation and multidisciplinary collaboration between neuroradiologists, data scientists, ethicists, and pediatricians. The paper aims to address: (1) current applications of AI in pediatric neuroradiology; (2) current challenges and ethical considerations related to AI implementation in pediatric neuroradiology; and (3) future opportunities in the clinical and educational pediatric neuroradiology field. AI in pediatric neuroradiology is not meant to replace neuroradiologists, but to amplify human intellect and extend our capacity to diagnose, prognosticate, and treat with unprecedented precision and speed. Full article
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24 pages, 1603 KB  
Article
Long-Term Variability of Ice Phenomena in Selected Rivers of the Central Vistula River Catchment
by Agnieszka Hejduk and Michał Szalkowski
Water 2025, 17(17), 2523; https://doi.org/10.3390/w17172523 - 24 Aug 2025
Viewed by 774
Abstract
The phenomenon of surface freezing in lakes, rivers, and reservoirs, has been an essential part of Poland’s winter landscape for centuries. It plays critical ecological roles, such as regulating heat balance and influencing the state of biocenoses. Due to progressive climate warming, we [...] Read more.
The phenomenon of surface freezing in lakes, rivers, and reservoirs, has been an essential part of Poland’s winter landscape for centuries. It plays critical ecological roles, such as regulating heat balance and influencing the state of biocenoses. Due to progressive climate warming, we have observed significant changes in ice cover duration, thickness, and timing in recent decades. Ice phenomena on rivers are temporary. They strongly depend on air temperature, which has recently been increasing worldwide. This paper analyzes the variability of ice phenomena formation in selected river profiles of the central Vistula River catchment, central Poland. The research period covers the years 1968–2016. The data come from the Institute of Meteorology and Water Management-State Research Institute (IMGW-PIB). The duration (including the dates of occurrence and disappearance of the phenomenon) and the frequency of occurrence of ice phenomena over the long-term were determined with particular attention to ice cover. The long-term occurrence of ice phenomena shows a decreasing trend (shorter duration, later onset dates) with a simultaneous increase in the average air temperature during the winter half of the hydrological year. Full article
(This article belongs to the Section Hydrology)
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9 pages, 211 KB  
Communication
Prevention Works Best in Pairs: An Observational Study on Connubial Melanoma
by Alessandra Iorio, Maria Concetta Fargnoli, Francesca Sperati, Pasquale Frascione and Paola De Simone
Diagnostics 2025, 15(15), 1869; https://doi.org/10.3390/diagnostics15151869 - 25 Jul 2025
Viewed by 361
Abstract
Background: Connubial melanoma, the occurrence of melanoma in non-consanguineous spouses, is rarely described in the literature. This study aimed to evaluate the prevalence of shared risk factors, preventive behaviors, and the influence of couple dynamics on the early diagnosis of cutaneous melanoma (CM). [...] Read more.
Background: Connubial melanoma, the occurrence of melanoma in non-consanguineous spouses, is rarely described in the literature. This study aimed to evaluate the prevalence of shared risk factors, preventive behaviors, and the influence of couple dynamics on the early diagnosis of cutaneous melanoma (CM). Methods: We conducted a retrospective observational study at the San Gallicano Dermatological Institute IRCCS, Rome, enrolling 52 heterosexual couples diagnosed with CM between 2010 and 2023. Clinical and anamnestic data, including phototype, history of sun exposure, use of tanning devices, and reason for dermatological evaluation, were collected. Dermatological assessments included dermoscopy, total body photography, and histological examination of excised lesions. Statistical analyses were performed using chi-square and Student’s t-tests. Results: Women reported significantly higher use of artificial ultraviolet sources (51.9% vs. 19.2%, p < 0.001) and more frequent histories of sunburn. Phototype II was associated with higher use of tanning devices and a greater prevalence of sunburns. Although the CM stage did not significantly differ between sexes, husbands exhibited a greater Breslow thickness. Melanoma localization differed by sex, with lower limbs more often affected in women and the trunk in men (p < 0.001). In 86.5% of cases, wives initiated their husband’s dermatological evaluation, leading to earlier diagnosis. Conclusions: Despite shared environmental exposures, men and women differ in preventive behaviors and risk profiles. Women play a crucial role in promoting early detection among couples. Couple-based preventive strategies may be instrumental in improving early melanoma diagnosis and outcomes. Full article
(This article belongs to the Special Issue New Developments in the Diagnosis of Skin Tumors)
12 pages, 1462 KB  
Article
Characterization of Melanoma in Hungary Based on a Retrospective Single-Center Study Between 2001 and 2018
by Renáta Gubán, Petra Parrag, Mihály Tamás Kispál, Kata Czirbesz, Tímea Danyi, István Kenessey and Gabriella Liszkay
Cancers 2025, 17(13), 2171; https://doi.org/10.3390/cancers17132171 - 27 Jun 2025
Viewed by 494
Abstract
Background/Objectives: Over the past few decades, the incidence of melanoma has been steadily rising. In Hungary, the National Institute of Oncology serves as the national center for the diagnosis and treatment of malignancies, including melanoma. This study aims to analyze our patients’ data, [...] Read more.
Background/Objectives: Over the past few decades, the incidence of melanoma has been steadily rising. In Hungary, the National Institute of Oncology serves as the national center for the diagnosis and treatment of malignancies, including melanoma. This study aims to analyze our patients’ data, providing a comprehensive characterization of melanoma across the country. Methods: We systematically analyzed the clinico-pathological data of melanoma patients treated in the Department of Oncodermatology between 2001 and 2018. Prognostic parameters were collected from the Hospital Information System of the Institute, including gender, age, tumor location, exulceration of primary lesion, Clark level, and Breslow thickness. In addition, survival analysis was also performed. Results: A total of 6267 melanoma patients were included in the study, with a slight predominance of female cases. The most common tumor location was the trunk. Female patients and younger age groups were more likely to present with lower Breslow thickness, while tumors in the head region were associated with increased thickness. Over the study period, the annual median Breslow thickness showed a significant decline. Female gender, younger age, and lower Breslow thickness was correlated with improved overall survival. Over time, the studied patient population exhibited better outcomes. Conclusions: Despite the rising incidence of melanoma in Hungary, the annual median Breslow thickness in our studied patient group showed a decreasing trend, accompanied by improved mortality outcomes. This highlights the critical role of secondary prevention measures and their effectiveness, as well as the impact of novel therapeutic advancements. Full article
(This article belongs to the Special Issue Prognosis and Treatment of Cutaneous Melanoma (2nd Edition))
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24 pages, 6055 KB  
Article
Assessment of Remote Sensing Reflectance Glint Correction Methods from Fixed Automated Above-Water Hyperspectral Radiometric Measurement in Highly Turbid Coastal Waters
by Behnaz Arabi, Masoud Moradi, Annelies Hommersom, Johan van der Molen and Leon Serre-Fredj
Remote Sens. 2025, 17(13), 2209; https://doi.org/10.3390/rs17132209 - 26 Jun 2025
Cited by 1 | Viewed by 751
Abstract
Fixed automated (unmanned) above-water radiometric measurements are subject to unavoidable sky conditions and surface perturbations, leading to significant uncertainties in retrieved water surface remote sensing reflectances (Rrs(λ), sr−1). This study evaluates various above-water Rrs(λ) glint correction [...] Read more.
Fixed automated (unmanned) above-water radiometric measurements are subject to unavoidable sky conditions and surface perturbations, leading to significant uncertainties in retrieved water surface remote sensing reflectances (Rrs(λ), sr−1). This study evaluates various above-water Rrs(λ) glint correction methods using a comprehensive dataset collected at the Royal Netherlands Institute for Sea Research (NIOZ) Jetty Station located in the Marsdiep tidal inlet of the Dutch Wadden Sea, the Netherlands. The dataset includes in-situ water constituent concentrations (2006–2020), inherent optical properties (IOPs) (2006–2007), and above-water hyperspectral (ir)radiance observations collected every 10 min (2006–2023). The bio-optical models were validated using in-situ IOPs and utilized to generate glint-free remote sensing reflectances, Rrs,ref(λ), using a robust IOP-to-Rrs forward model. The Rrs,ref(λ) spectra were used as a benchmark to assess the accuracy of glint correction methods under various environmental conditions, including different sun positions, wind speeds, cloudiness, and aerosol loads. The results indicate that the three-component reflectance model (3C) outperforms other methods across all conditions, producing the highest percentage of high-quality Rrs(λ) spectra with minimal errors. Methods relying on fixed or lookup-table-based glint correction factors exhibited significant errors under overcast skies, high wind speeds, and varying aerosol optical thickness. The study highlights the critical importance of surface-reflected skylight corrections and wavelength-dependent glint estimations for accurate above-water Rrs(λ) retrievals. Two showcases on chlorophyll-a and total suspended matter retrieval further demonstrate the superiority of the 3C model in minimizing uncertainties. The findings highlight the importance of adaptable correction models that account for environmental variability to ensure accurate Rrs(λ) retrieval and reliable long-term water quality monitoring from hyperspectral radiometric measurements. Full article
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11 pages, 943 KB  
Article
Impact of Microkeratome Dissection Parameters on Textural Interface Opacities in DSAEK Grafts
by Marina S. Chatzea, George D. Kymionis, Dionysios G. Vakalopoulos, Robert C. O’Brien, Daniella Mora, Katrina Llanes, Elizabeth Fout, William Buras, Concetta Triglia, Rahul S. Tonk and Sonia H. Yoo
Diagnostics 2025, 15(13), 1608; https://doi.org/10.3390/diagnostics15131608 - 25 Jun 2025
Viewed by 440
Abstract
Background: Textural interface opacities (TIOs) following Descemet’s stripping automated endothelial keratoplasty (DSAEK) have become a significant postoperative concern. Studies have explored possible links such as stromal irregularities and viscoelastic usage, but the exact cause of TIOs remains unclear. PURPOSE: To evaluate the [...] Read more.
Background: Textural interface opacities (TIOs) following Descemet’s stripping automated endothelial keratoplasty (DSAEK) have become a significant postoperative concern. Studies have explored possible links such as stromal irregularities and viscoelastic usage, but the exact cause of TIOs remains unclear. PURPOSE: To evaluate the relationship between microkeratome dissection parameters and the development of textural interface opacities in DSAEK grafts utilizing the “M-TIO” grading scale for standardized assessment. Methods: Optical coherence tomography (OCT) images of DSAEK-processed corneal grafts, prepared with the same microkeratome and technique for transplantation at Bascom Palmer Eye Institute, underwent blinded analysis using a newly developed grading scale termed “M-TIO”. This analysis aimed to evaluate and categorize the occurrence of TIO, explore its potential correlation with graft characteristics prior to DSAEK preparation, and assess specific stages of the DSAEK dissection process. Data collected included the size of the microkeratome head used, the difference between the head and the actual stromal cut, and the difference between the pre-cut graft thickness and post-cut DSAEK lenticule thickness. Results: The study retrospectively included 422 donor corneas transplanted from 2019 to 2023. Variables associated with TIO in the final multivariable ordinal logistic model included the difference between the pre-cut graft thickness and the post-cut DSAEK lenticule thickness (OR: 1.57 [99% CI: 1.22 to 2.06] per 50 µm) and microkeratome head (OR: 6.95 [99% CI: 1.04 to 36.60] 300 µm, OR: 4.39 [99% CI: 0.76 to 19.00] 350 µm, and OR: 18.86 [99% CI: 2.35 to 175.91] 400 µm vs 450 or 500 µm, respectively). Conclusions: This study identified a statistically significant association between TIOs and the microkeratome DSAEK preparation, proposing several factors that could help prevent its occurrence. Specifically, creating an ultra-thin DSAEK lenticule from an initially thick graft using a smaller microkeratome head with the slow single-pass technique may increase the risk of TIOs. In contrast, utilizing a larger microkeratome head can improve stromal thickness consistency, reduce technical challenges during graft preparation, and lower the risk of TIOs. Full article
(This article belongs to the Special Issue Optical Coherence Tomography in Diagnosis of Ophthalmology Disease)
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23 pages, 8102 KB  
Article
Ensemble Learning for Spatial Modeling of Icing Fields from Multi-Source Remote Sensing Data
by Shaohui Zhou, Zhiqiu Gao, Bo Gong, Hourong Zhang, Haipeng Zhang, Jinqiang He and Xingya Xi
Remote Sens. 2025, 17(13), 2155; https://doi.org/10.3390/rs17132155 - 23 Jun 2025
Viewed by 500
Abstract
Accurate real-time icing grid fields are critical for preventing ice-related disasters during winter and protecting property. These fields are essential for both mapping ice distribution and predicting icing using physical models combined with numerical weather prediction systems. However, developing precise real-time icing grids [...] Read more.
Accurate real-time icing grid fields are critical for preventing ice-related disasters during winter and protecting property. These fields are essential for both mapping ice distribution and predicting icing using physical models combined with numerical weather prediction systems. However, developing precise real-time icing grids is challenging due to the uneven distribution of monitoring stations, data confidentiality restrictions, and the limitations of existing interpolation methods. In this study, we propose a new approach for constructing real-time icing grid fields using 1339 online terminal monitoring datasets provided by the China Southern Power Grid Research Institute Co., Ltd. (CSPGRI) during the winter of 2023. Our method integrates static geographic information, dynamic meteorological factors, and ice_kriging values derived from parameter-optimized Empirical Bayesian Kriging Interpolation (EBKI) to create a spatiotemporally matched, multi-source fused icing thickness grid dataset. We applied five machine learning algorithms—Random Forest, XGBoost, LightGBM, Stacking, and Convolutional Neural Network Transformers (CNNT)—and evaluated their performance using six metrics: R, RMSE, CSI, MAR, FAR, and fbias, on both validation and testing sets. The stacking model performed best, achieving an R-value of 0.634 (0.893), RMSE of 3.424 mm (2.834 mm), CSI of 0.514 (0.774), MAR of 0.309 (0.091), FAR of 0.332 (0.161), and fbias of 1.034 (1.084), respectively, when comparing predicted icing values with actual measurements on pylons. Additionally, we employed the SHAP model to provide a physical interpretation of the stacking model, confirming the independence of selected features. Meteorological factors such as relative humidity (RH), 10 m wind speed (WS10), 2 m temperature (T2), and precipitation (PRE) demonstrated a range of positive and negative contributions consistent with the observed growth of icing. Thus, our multi-source remote-sensing data-fusion approach, combined with the stacking model, offers a highly accurate and interpretable solution for generating real-time icing grid fields. Full article
(This article belongs to the Special Issue Remote Sensing for High Impact Weather and Extremes (2nd Edition))
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13 pages, 226 KB  
Article
Comparing Amniotic Membranes to Other Bioengineered Skin Substitutes in Wound Healing: A Propensity Score-Matched Analysis
by Micaela J. Tobin, Audrey K. Mustoe, Sasha Nickman, Tricia Mae Raquepo, Mohammed Yamin, Agustin N. Posso, Sarah J. Karinja, Bernard T. Lee and Ryan P. Cauley
J. Clin. Med. 2025, 14(12), 4272; https://doi.org/10.3390/jcm14124272 - 16 Jun 2025
Viewed by 781
Abstract
Background/Objectives: The amniotic membrane, which is widely available and inexpensive, has received recent attention for its potential applications in wound healing. This is the first study to use a large database to examine the efficacy of amniotic membrane grafting compared to other [...] Read more.
Background/Objectives: The amniotic membrane, which is widely available and inexpensive, has received recent attention for its potential applications in wound healing. This is the first study to use a large database to examine the efficacy of amniotic membrane grafting compared to other skin substitutes. Methods: The TriNetX electronic health database was queried in October 2024 for patients with burns or chronic skin ulcers. Patients were stratified by treatment with amniotic membrane grafts or another skin substitute. These patients were then 1:1 propensity score-matched based on age, demographics, and comorbidities. Group differences were assessed with risk ratios and p-values. Results: A total of 557 patients remained in each group after propensity score matching. Patients who were treated with amniotic membrane grafts had significantly decreased hypertrophic scarring (1.7% vs. 6.2%, p < 0.0001), local skin infections (17.4% vs. 29.9%, p < 0.0001), and acute postoperative pain (3.7% vs. 7.8%, p = 0.003). Additionally, subsequent split-thickness skin grafting was utilized significantly less after amniotic membrane grafts. When compared to skin substitutes for large wounds (>100 cm2), the advantages of amniotic membrane were even more pronounced. Conclusions: This multi-institutional study supports amniotic membranes as a viable alternative to conventional bioengineered skin substitutes. Further research should evaluate amniotic membranes in wound beds of different sizes to better characterize their use in preparation for or as an alternative to skin grafting itself. Full article
11 pages, 641 KB  
Article
Development of a Digital Application Program Based on an Institutional Algorithm Sustaining the Decisional Process for Breast Reconstruction in Patients with Large and Ptotic Breasts: A Pilot Study
by Federico Ziani, Andrea Pasteris, Chiara Capruzzi, Emilio Trignano, Silvia Rampazzo, Martin Iurilli and Corrado Rubino
Cancers 2025, 17(11), 1807; https://doi.org/10.3390/cancers17111807 - 28 May 2025
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Abstract
Background/Objectives: Immediate implant-based breast reconstruction is an established option for selected patients undergoing mastectomy. However, patients with large and ptotic breasts present specific reconstructive challenges, often requiring tailored approaches to minimize complications and optimize aesthetics. This pilot study aimed to evaluate the clinical [...] Read more.
Background/Objectives: Immediate implant-based breast reconstruction is an established option for selected patients undergoing mastectomy. However, patients with large and ptotic breasts present specific reconstructive challenges, often requiring tailored approaches to minimize complications and optimize aesthetics. This pilot study aimed to evaluate the clinical feasibility and effectiveness of a mobile application developed to support intraoperative decision-making based on an institutional algorithm for breast reconstruction. It is also important to underline that this pilot study was exploratory in nature and primarily aimed at assessing feasibility and adherence to an app-based decision pathway, rather than comparative efficacy. Methods: We conducted a prospective observational study from October 2023 to December 2024 at the University Hospital of Sassari. Female patients with large and ptotic breasts undergoing immediate implant-based reconstruction were included. A mobile app, developed using MIT App Inventor 2, implemented our institution’s algorithm and guided surgeons through both preoperative and intraoperative decision-making. Surgical options included subpectoral, prepectoral with autologous fascial flaps, or prepectoral with acellular dermal matrix (ADM) reconstruction, depending on flap thickness and fascia integrity. Results: Sixteen patients (21 reconstructed breasts) were included. Surgical planning and execution followed app-generated recommendations in all cases, with no intraoperative deviations. Subpectoral reconstruction was performed in six patients, prepectoral with ADM in eight, and prepectoral with fascial flaps in two. The app was rated positively by all surgeons and facilitated consistent decision-making. Conclusions: The proposed mobile application, described in this pilot study, proved to be a feasible and effective decision-support tool for implant-based breast reconstruction in patients with challenging anatomy. It standardized surgical choices, supported training, and has the potential to enhance reproducibility and safety in complex reconstructive procedures. Full article
(This article belongs to the Special Issue Oncoplastic Techniques and Mastectomy in Breast Cancer)
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15 pages, 1210 KB  
Article
Two-Year Outcome of Selective Laser Trabeculoplasty for Normal-Tension Glaucoma in Japan: First-Line or Second-Line Selective Laser Trabeculoplasty (FSS) Study
by Tomoko Naito, Koji Nitta, Takako Miki, Akiko Narita, Tairo Kimura, Yasushi Ikuno, Shiro Mizoue, Maki Katai, Yoshiaki Saito, Mami Nanno, Naoki Tojo, Naoto Tokuda, Shigeki Yamabayashi, Katsuyoshi Suzuki, Kimihito Konno, Hiroaki Ozaki, Toru Nakazawa, Tadashi Nakano, Kenji Nakamoto, Naoya Nezu, Shigeru Mori, Kazuyuki Hirooka, Itaru Kimura, Takeshi Sagara, Toyoaki Tsumura, Aika Tsutsui, Kae Sugihara, Takuji Matsuda, Yoshitaka Tasaka, Satoru Tsuda, Tomoyuki Watanabe, Naka Shiratori, Yutaro Tobita, Kaori Komatsu, Akiko Harano, Kazuhisa Sugiyama, Keiji Yoshikawa and Masaki Tanitoadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(10), 3459; https://doi.org/10.3390/jcm14103459 - 15 May 2025
Viewed by 1811
Abstract
Objectives: The objective of this study is to investigate the two-year continuous efficacy, risk factors, and safety profile of selective laser trabeculoplasty (SLT) in Japanese individuals diagnosed with normal-tension glaucoma (NTG) who underwent SLT as either a first-line or second-line treatment. Methods [...] Read more.
Objectives: The objective of this study is to investigate the two-year continuous efficacy, risk factors, and safety profile of selective laser trabeculoplasty (SLT) in Japanese individuals diagnosed with normal-tension glaucoma (NTG) who underwent SLT as either a first-line or second-line treatment. Methods: A retrospective chart review was conducted of patients with NTG who underwent SLT as either an initial or secondary therapy at 26 medical institutions in Japan between January 2020 and December 2021 with a 2-year follow-up. The primary endpoint was a reduction in the rate of intraocular pressure (IOP) over 2 years after SLT. To estimate the time-varying effect of IOP reduction, a linear mixed-effects model was employed. The secondary endpoints were numerical IOP reduction, treatment success rates shown by a Kaplan–Meier analysis, and complications. Success was defined as an outflow pressure improvement rate (ΔOP) ≥ 20% (definition A) or an IOP reduction rate ≥ 20% (definition B) without further treatment. A Cox proportional hazards regression analysis was used to identify the risk factors to successful SLT treatment. The study was registered with UMIN-CTR (ID: UMIN R000064045). Results: A total of 230 eyes from 230 individuals participated in this study, with 148 eyes receiving SLT as an initial (first-line) therapy and 82 eyes undergoing SLT as a secondary (second-line) intervention. In the first-line group, the mean IOP dropped from 16.7 ± 2.3 mmHg to 13.7 ± 2.4 mmHg at two years post-treatment, reflecting a 16.8% reduction. In the second-line group, the average IOP declined from 15.9 ± 2.5 mmHg to 13.2 ± 2.0 mmHg, marking a 14.4% decrease over the same period. The treatment success rate according to definition A (ΔOP ≥ 20%) was 73.7% at 2 years. Analysis using a linear mixed-effects model identified time (p < 0.001), age (p = 0.044), baseline IOP (p < 0.001), and central corneal thickness (CCT) (p < 0.001) as statistically significant contributors to IOP reduction following SLT. However, neither the Group (first-line vs. second-line) variable (p = 0.386) nor the Time × Group interaction (p = 0.298) reached statistical significance. A lower baseline IOP and a thicker CCT were confirmed as significant predictors of SLT treatment failure. Conclusions: Both initial and secondary SLT treatments for NTG proved to be effective and safe over a two-year period, although the extent of IOP reduction was smaller in cases with a lower baseline IOP. Our findings indicate that the IOP-lowering effect of SLT in NTG is influenced by pretreatment IOP levels, aligning with previous studies on primary open-angle glaucoma and ocular hypertension. However, in contrast to those earlier findings, our research identified pretreatment central corneal thickness as a statistically significant factor influencing SLT efficacy in NTG. These results support the role of SLT as a reliable and safe therapeutic option for managing NTG. Full article
(This article belongs to the Special Issue Clinical Advances in Glaucoma: Current Status and Prospects)
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