Search Results (658)

We study unconventional multipole moments arising from noncollinear magnetic structures within an augmented framework encompassing electric, magnetic, magnetic toroidal, and electric toroidal multipoles. Employing a tight-binding model for an s-p hybridized orbital system, we analyze two spiral magnetic textures and classify the resulting multipoles according to magnetic point group symmetry. Different spiral wave types, such as cycloidal and proper-screw forms, activate distinct multipole components, with odd-parity multipoles emerging from local s-p parity mixing induced by magnetically driven inversion-symmetry breaking. Calculated multipole structure factors reveal finite-q peaks originating from higher-order magnetic-dipole-scattering processes and their characteristic couplings between Fourier components of the magnetic dipole texture. Our results demonstrate that magnetic ordering can generate parity-mixed states without intrinsic structural inversion asymmetry, offering new pathways to realize cross-correlation phenomena in functional magnetic materials. Full article

Background: Endometrial proliferative lesions are common in the menopausal transition and carry a measurable risk of carcinoma. Early risk stratification may guide evaluation and follow-up. Methods: We performed a single-center retrospective study of 315 women aged 45–55 years (May 2021–May 2024) at a private clinic in Bucharest. Lesions were classified per WHO 2014 as hyperplasia without atypia, atypical hyperplasia/endometrial intraepithelial neoplasia (AH/EIN), or adenocarcinoma; “advanced pathology” was defined as AH/EIN or adenocarcinoma. Clinical comorbidities and transvaginal ultrasound endometrial thickness were recorded. Associations were tested with χ²; odds were estimated with multivariable logistic regression (adjusted ORs), with a modified Poisson sensitivity analysis for adjusted relative risk. Thickness differences were compared by one-way ANOVA, and severity correlations by Spearman’s ρ. Internal validation used 1000-bootstrap resampling. Results: Hyperplasia without atypia comprised 74.6% of cases, AH/EIN 20.0%, and adenocarcinoma 5.4% (advanced pathology 25.4%). Diabetes was independently associated with advanced pathology (aOR 2.75; 95% CI 1.14–6.61; p = 0.0237), while a history of non-atypical hyperplasia was inversely associated (aOR 0.31; 95% CI 0.13–0.72; p = 0.0068). Obesity showed a borderline association (aOR 1.79; 95% CI 0.98–3.26; p = 0.058), and long-term oral contraceptive use also approached significance (aOR 0.42; 95% CI 0.18–1.00; p = 0.051). Endometrial thickness increased stepwise with histopathological severity (ANOVA p < 0.0001; η² = 0.44) and correlated with ordered severity (ρ = 0.634). The multivariable model showed moderate discrimination (AUC 0.68; optimism-corrected 0.66) with acceptable calibration (slope 0.92; Hosmer–Lemeshow p = 0.052) and overall accuracy (Brier 0.18). Conclusions: In perimenopausal abnormal bleeding, metabolic comorbidities—especially diabetes—together with increased endometrial thickness identify women at higher risk of AH/EIN or carcinoma. Histopathology remains the diagnostic reference. The model can aid clinical prioritization but requires external validation and should not be used as the sole basis for decisions. Full article

Background/Objectives: Myelofibrosis (MF) predominantly affects older individuals, and its incidence increases with age. Ruxolitinib (RUX), a JAK1/2 inhibitor, effectively reduces spleen volume and relieves disease-related symptoms in MF patients and can be prescribed regardless of age. Although advanced age is associated with poorer MF prognosis, the influence of patient age on RUX treatment efficacy and safety has not been fully elucidated. Methods: In this single-center, retrospective study, we included 216 adult MF patients who initiated RUX therapy between 2012 and 2024. Patients were stratified by age at the start of RUX as follows: <65 (n = 105), 65–74 (n = 64), and ≥75 years (n = 47). Clinical data were analyzed in order to assess the impact of age on RUX-associated responses, toxicities, and survival. Results: Compared to younger patients, those ≥65 years showed features of more advanced MF and 45% higher odds of not achieving SR [OR = 1.45 (95% CI, 1.10–1.91), p = 0.009]. Patients ≥65 years presented a higher incidence of drug-related anemia at 3 (p = 0.003) and 6 months (p = 0.020). These patients had a two-fold increased risk of RUX discontinuation [HR = 2.07 (95% CI, 1.30–3.31) (p = 0.002) and presented a shorter OS than younger patients [HR = 2.74 (95% CI, 1.67–4.49)] (p < 0.001). In the sub-analysis focused on patients older than 65 years, very elderly patients (≥75 years) exhibited similar baseline characteristics, SR rates, median RUX treatment duration (p = 0.22), and OS (p = 0.86) to the 65–74 years cohort. More patients in the very elderly group presented an infectious event grade ≥ 2 (19.2%) than in the 65–74 years group (3.1%) (p = 0.008). Conclusions: RUX demonstrates overall robust rates of SR and favorable OS across all age groups. However, patients aged ≥65 years experienced higher rates of adverse events and worse outcomes. Our data support RUX usage in all age cohorts while highlighting the need for tailored strategies and close clinical monitoring in older patients. Full article

Background: The worldwide prevalence of obesity in children and adolescents quadrupled in the past decades, becoming a public health priority. Following the recommendation by the Italian Minister of Health, the Emilia-Romagna Region started a community-based program aimed at reducing pediatric overweight through children and family behavioral counseling on nutrition and physical activity. Methods: Children with excess weight, aged 2–17 years, and without severe diseases were visited five times by a multidisciplinary team, who provided dietary advice, exercise plans, and psychosocial support, according to Italian guidelines. The outcomes were the median pre–post change in Δ₃₀BMI (distance between children’s BMI and age- and sex-specific obesity threshold values) and the proportion of children who moved to a lower weight class. Logistic regression was used to identify potential predictors of weight improvement. Results: Up to March 2025, 1331 participants completed the follow-up. In total, 17.5% of the children showed an improvement in weight class, and 32.5% had a reduction of more than one unit of Δ₃₀BMI. The program was significantly and substantially more effective among the children with obesity at baseline (overweight vs. obese children adjusted odds ratio—aOR—of weight class improvement: 0.28; p < 0.001), older than eight years (9–11 years vs. 2–8 years children aOR: 1.41; p < 0.05), who adhered to breakfast recommendations (aOR: 1.60; p < 0.01) and had no obese parents (≥1 vs. 0 obese parents aOR: 0.62; p < 0.05). Conclusions: The multidisciplinary model was associated with an overall positive impact on the weight status of the enrolled children. Given the varying response, however, in order to maximize cost-effectiveness, future programs could be reserved for children with obesity, older than eight years. Further randomized research is needed to investigate the efficacy of this intervention in different settings and on late clinical endpoints. Full article

Background/Objectives: Inhalable Microparticles (IMPs) are part of a currently invading field of medicine. In fact, the anatomical district of Rhinopharynx represents a bed for many different pathologies and infections, where the dimension of drug aerosol Microparticles (MPs) represents a discriminating factor to success therapy. The aims of the present work are to demonstrate the efficacy of a new device and its aerosol reproducibility in the nebulization of suspensions to be deposited in the retropharynx. Materials and Methods: The Low-Angle Laser Light Scattering (LALLS) method was used to evaluate both the dimension and distribution of MPs. Six different APIs, used usually in Rhinopharynx pathology, were compared in order to investigate the dimension of MP emissions using four different devices. The results of a retrospective study including 74 subjects treated with standard therapy (ST) and the inhalation of nebulized Sobrerol (NS) were performed. Data regarding the persistence of clinical symptoms (i.e., cough and nasal constipation) were acquired. Results: No significant statistical differences among all the products tested (p > 0.05) were found. One device, Rinubes, demonstrated efficacy and robustness in the fine nebulization of all the pharmaceutical products analyzed. Rinubes delivered an aerosol cloud with significantly lower MMD (66.3 µm) than Mad Nasal and Spray-sol (142.1 and 116.0 µm, respectively), which would allow a higher fraction of drugs to be deposited in the retropharynx. The retrospective clinical study revealed that NS treatment showed higher odds of cough resolution (OR 9.18; p < 0.001) with respect to control ST and showed higher odds of nasal symptom resolution (OR 6.7; p = 0.043). Conclusions: Improved techniques for the administration of inhalable MPs (INPAD) represent significant progress in overcoming the biological and the anatomical barriers in controlling drug release at a specific site. The challenges of nasopharyngeal pathologies offer promising opportunities for the development of non-invasive drug delivery. Full article

Background: Despite the high prevalence of malignant pericardial effusions (MPEs), the differences in mortality between those undergoing pericardiocentesis for MPE versus non-malignancy pericardial effusions (NMPEs) are not well characterized. To address this knowledge gap, we aim to compare clinical outcomes following pericardiocentesis among patients with MPE and NMPE. Methods: A retrospective analysis was conducted on the US National Inpatient Sample (NIS) to identify all hospitalizations during which pericardiocentesis was performed between 1 January 2016 and 31 December 2020 (total n = 174,776,205). This cohort was further stratified based on the presence or absence of malignancy. The primary outcome of interest was in-hospital mortality. Secondary outcomes included discharge disposition (categorized as non-home discharges), length of stay, and total hospitalization costs. Results: A total of 85,125 patients with pericardial effusions undergoing pericardiocentesis were identified. Patients with an MPE (n = 24,740) were younger and more likely to have a history of malnutrition, prior radiation, palliative care treatments, and do-not-resuscitate (DNR) orders compared to those with an NMPE (n = 60,385). Lung cancer was the most common malignancy (40.3%) in patients with an MPE requiring pericardiocentesis. The in-hospital mortality following pericardiocentesis was 11.8% in patients with malignancy and 8.2% in patients without (odds ratio (OR) for mortality 1.50 (95% confidence interval [CI]: 1.34–1.68, p < 0.001). Lung cancer, non-Hodgkin lymphoma, esophageal cancer, ovarian cancer, and leukemia were associated with a significantly increased risk of death during the same admission. Non-home discharge, length of stay, and total hospitalization cost were marginally greater in those with an MPE. Conclusions: In patients undergoing pericardiocentesis, those with an MPE had significantly higher in-hospital mortality compared to those with an NMPE. Additionally, the MPE group had a marginally longer length of stay and incurred higher total hospital costs. Further research is warranted to explore optimal treatment strategies for MPEs, particularly in patients with a limited life expectancy. Full article

To study the vibration characteristics of viscoelastic slurry pipe structures under fluid–structure interaction (FSI), we constructed a three-dimensional FSI pipe model based on the finite element method to systematically investigate the effects of fluid effects, pipe length, and wall thickness on the vibrational characteristics of viscoelastic slurry pipes. A modal analysis demonstrated that fluid effects not only significantly reduced the natural frequency of the pipe but also disrupted the symmetry of the vibration modes and eliminated the phenomenon of frequency degeneracy. The frequency reduction caused by FSI reached 54%, which was dominant compared with the water-attached effects, and its impact intensified with the increasing vibration order. The water-attached effect exhibited differences between odd and even orders, attributed to the influence of vibration modes on the distribution of fluid inertial forces, with a contribution of 45.07% to 55.24% in the odd orders and of only 37.69% to 38.93% in the even orders. When the FSI and water-attached effects acted together, the frequency reduction was further aggravated, but the reduction ratio did not follow a simple linear superposition. The parametric analysis of the pipe showed that when the pipe length increased from 1 m to 3 m, the growth rate of its natural frequency was only 26.52% that of the shorter pipe, indicating that the longer the pipes, the slower the growth rate of frequency. When the wall thickness increased from 5 mm to 11 mm, the growth rate of the first-order natural frequency decreased from 15.43% to 7.44%, suggesting that the frequency improvement effect caused by the stiffness augmentation diminished with the increase in wall thickness. The research results hold significant guiding significance for the structural design of slurry pipe systems in practical engineering and the safe operation of pipe systems. Full article

This paper presents a wideband D-band frequency sextupler chain implemented in a 100 nm GaAs pHEMT process. The proposed circuit comprises an input-stage frequency tripler, an inter-stage harmonic-rejection power amplifier, and an output-stage frequency doubler. The tripler adopts a balanced topology, which effectively suppresses the fundamental frequency component. The inter-stage power amplifier not only delivers sufficient drive power to the doubler but also enhances suppression of undesired harmonics. The output doubler employs a single-balanced configuration to suppress odd-order harmonics while extracting the second harmonic. The measured peak output power of the sextupler chain is 2.33 dBm, corresponding to an input power of 2 dBm, resulting in a conversion gain of 0.33 dB. The 3 dB output bandwidth spans from 126.3 to 152.7 GHz, corresponding to a relative bandwidth of 18.9%. Owing to the balanced multiplier topology and harmonic-rejection PA, the 5th and 7th harmonics are suppressed by more than 20 dBc. The combination of high output power, wide operating bandwidth, and excellent harmonic suppression makes the design well suited for wideband D-band signal generation in diverse applications. Full article

Background and Objectives: Inflammatory bowel diseases (IBDs) are chronic conditions of the digestive tract, often requiring life-long treatments in order to achieve and maintain remission. However, treatment adherence among patients with IBD can frequently be suboptimal, which can compromise disease control and long-term outcomes. The aim of this study was to analyze the adherence rate and to identify factors that significantly influence treatment adherence in patients with IBD. Materials and Methods: The study employed a cross-sectional design and was conducted at the Fundeni Clinical Institute, a tertiary medical center in Bucharest, Romania. The treatment adherence was assessed using the Medication Adherence Report Scale-5 (MARS-5), with patients scoring greater than 23 considered adherent. Anxiety, depression and perceived stress were assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS), and coping strategies were assessed using the Brief Coping Orientation to Problems Experienced Inventory (Brief COPE Inventory). Results: A total of 188 patients were included in the final analysis. Of these, 99 patients (52.7%) were male and 109 (58.0%) had a diagnosis of Crohn’s disease. The majority of patients (81.9%) were receiving treatment with advanced therapies, including biologics or small molecules. Forty patients were receiving their therapy through more than one route of administration. Optimal adherence was noted in 160 patients (85.1%). Patients treated with advanced therapies (biologics and small molecules) had significantly higher odds of optimal adherence (OR 10.52, 95% CI: 4.3–25.74, p < 0.001), with a rate of adherence of 92.2%. Significantly lower odds of adherence were found for the oral (OR 0.35, 95% CI: 0.14–0.83, p = 0.01) and rectal (OR 0.09, 95% CI: 0.03–0.29, p < 0.001) routes of administration, while the intravenous administration had higher odds of adherence (OR 4.85, 95% CI: 1.02–22.9, p = 0.04) compared to the subcutaneous route. Other factors associated with an improved adherence were being retired (OR 3.5, 95% CI: 1.13–10.8, p = 0.029) and using positive reframing (p = 0.04), planning (p = 0.01) and venting (p = 0.02) as coping strategies; active smoking (OR 0.26, 95% CI: 0.11–0.6, p = 0.002), active disease (OR 0.36, 95% CI: 0.16–0.81, p = 0.014) and behavioral disengagement (p = 0.04) were associated with impaired treatment adherence. No significant differences in adherence were observed between disease phenotypes. Conclusions: The route of administration, smoking status and psychosocial factors, such as perceived stress of social support and coping strategies, may play an important role in influencing treatment adherence in patients with IBD. While the disease phenotype was not associated with differences in adherence, patients with active disease had significantly lower odds of optimal adherence. Full article

The classical Eneström–Kakeya theorem states that an n-degree polynomial ${\displaystyle p\left(z\right)={\displaystyle \sum _{k=0}^n}{a}_k{z}^k}$ with real coefficients satisfying $0\le a_0\le a_1\le \cdots \le a_n$ has all of its zeros in $|z|\le 1$ in the complex plane. Numerous generalizations of this result exist, many of them weakening the condition on the coefficients in order to be applicable to a larger class of polynomials. In this paper, a monotonicity condition on the real and imaginary parts of the even- and odd-indexed coefficients is imposed and bounds on the location of the zeros are established. Full article

Background/Objectives: Diabetic sensorimotor polyneuropathy (DSPN) is a frequent microvascular complication of diabetes mellitus, associated with increased morbidity and reduced quality of life. The existing literature offers a limited understanding of sex-specific cardiovascular risk profiles and their association with DSPN, particularly within Central and Eastern European populations. Methods: A retrospective analysis was conducted using data from 621 individuals with type 1 or type 2 diabetes mellitus who underwent comprehensive neuropathy screening at the University of Debrecen between 2017 and 2021. The diagnosis of DSPN was made in accordance with international criteria, incorporating symptom scores, and electrophysiological measurements. Multivariate logistic regression was applied in order to identify independent predictors. Results: The diagnosis of DSPN was made in 444 individuals (71.5%), of whom 58.2% were female. Despite similar glycemic control (HbA1c: 7.81% in men vs. 7.65% in women, p = 0.297), men had significantly more frequent occurrences of previous myocardial infarction (11.8% vs. 5.0%, p = 0.008), peripheral vascular disease (19.9% vs. 12.7%, p = 0.041) and atherosclerosis (31.7% vs. 22.0%, p = 0.021). Multivariate analysis showed that female gender was independently associated with a lower incidence of DSPN (odds ratio [OR] = 0.592, 95% confidence interval [CI]: 0.369–0.950, p = 0.030), while diabetic retinopathy was a significant predictor (OR = 2.728, 95% CI: 1.300–5.725, p = 0.008). Electrophysiological testing revealed lower nerve conduction amplitudes in females for selected nerves. Conclusions: Our findings highlight sex-specific differences in neuropathy risk and support the implementation of individualized screening strategies in diabetic populations with region-specific risk factors. Full article

The structure of the odd-A silver isotopes ${}^{103–115}\mathrm{Ag}$ is discussed within the frame of the interacting boson–fermion model (IBFM). An overview of their key properties is presented, with a particular attention paid to the “J-1 anomaly”, represented by an abnormal ordering of the lowest ${\mathrm{7/2}}^{+}$ and ${\mathrm{9/2}}^{+}$ states. By examining previously published data and newly performed calculations, it is demonstrated that the experimentally known level schemes and electromagnetic properties of ${}^{103–115}\mathrm{Ag}$ can be reproduced well within IBFM-1 by using a consistent set of model parameters. The contribution of different single-particle orbitals to the structure of the lowest-lying excited nuclear states in ${}^{103–115}\mathrm{Ag}$ is discussed. Given that the J-1 anomaly brings down the ${\mathrm{7/2}}^{+}$ level from the $j^{-3}$ multiplet to energies, which can be thermally populated in hot stellar environments, the importance of low-lying excited states in odd-A silver isotopes for astrophysical processes is outlined. Full article

There has been much interest in the mathematical investigation of critical sets and unavoidable sets in Latin Squares, Sudoku, and their applications to practical problems in areas such as agriculture and cryptology. This paper considers the associated structures of Strictly Concentric Magic Squares (SCMSs) and Prime Strictly Concentric Magic Squares (PSCMSs). A framework of formal definitions is given that leads to the definitions of critical sets and unavoidable sets. Minimal critical sets are of interest in Latin Squares, and in this article, the cardinality of minimal critical sets of SCMS is given for all n, n odd. Two families of unavoidable sets are established for SCMS, leading to a complete classification of unavoidable sets of minimum PSCMS of order 5. Full article

Background/Objectives: Adherence to oral endocrine therapy (OET) is essential to reduce recurrence but is predominantly lower among underserved patients, leading to worse health outcomes. We aimed to depict longitudinal patterns of OET adherence using group-based trajectory modeling (GBTM) and identify predictors associated with each adherence trajectory. Methods: A single-center, retrospective study was conducted to analyze data from women 18 years or older with metastatic breast cancer who initiated with an OET and were treated from January to December 2022. Adherence was measured using a proportion of days covered (PDC > 80%) for 12 months. Binary monthly indicator of PDC was incorporated into GBTM. Four models were generated by changing the number of groups from 2 to 5, using a 2nd-order polynomial function of time. A multinomial logistic regression model was run to evaluate the predictors of non-adherence trajectories, and “adherence” was considered the reference group. Results: A total of 346 women had a (mean age of 60) years; 93% were Hispanic or of Mexican origin; 90% were taking aromatase inhibitors (AIs), with an endocrine therapy of 1.05 years. Three trajectories of adherence to GBTM were identified: a gradual decline in adherence (n = 88, 25.5%), improving suboptimal adherence (n = 106, 30.6%), and adherent (n = 152, 43.9%). Multinomial logistic regression analysis showed that significant predictors are diabetes (odds ratio (OR), 2.96; 95% confidence interval (CI), 1.57–5.57) and fewer years of therapy (OR, 2.96; 95% CI, 1.57–5.57). Suboptimal adherence among RGV patients receiving OET, with approximately 56% following a non-adherent trajectory. Conclusions: Suboptimal adherence among RGV patients receiving OET, with approximately 56% following a non-adherent trajectory. Significant predictors should be considered when designing targeted interventions. Full article

This essay argues for the reciprocal benefits of joining the new theories of matter emerging out of critical posthumanism and the psychedelic drugs currently experiencing a so-called “renaissance” in global north societies. While the former’s twin emphasis on relationality and embodiment is perfectly suited to capture and ground the ontological, epistemological, and ethical implications of psychedelic experiences of interconnectedness and transformation, these substances are in turn powerful companions through which to enact a “posthuman phenomenology” that helps us with the urgent task to “access, amplify, and describe” our deep imbrication with our more-than-human environments. In other words, I argue that while the “new materialism” emerging out of posthumanism can help elaborate a psychedelic rationality, psychedelics can in turn operate as educators in materiality. It is from this materialist perspective that we can best make sense of psychedelics’ often touted potential for social transformation and the enduring suspicion that they are somehow at odds with the “ontoepistemological order” of modernity. From this point of view, I contend that a crucial critical move is to push against the common trope that this opposition is best expressed as a turn from the narrow scientific and “consumerist materialism” of modern Western societies to more expansive “spiritual” worldviews. Pushing against this science-–spirituality binary, which in fact reproduces modern “indivi/dualism” by confining psychedelic experience inside our heads, I argue instead that what is in fact needed to think through and actualize such potentials is an increased attention to our material transcorporeality. In a nutshell, if we want psychedelics to inform social change, we must be more, not less, materialist—albeit by redefining matter in a rather “weird”, non-reductive way and by redefining consciousness as embodied. By the end of the essay, attaching psychedelics to a new materialism will enable us to formulate a “material spirituality” that establishes psychedelics’ political value less in an idealistic or cognitive “politics of consciousness” and more in a “materialization of critique”. Full article