Search Results (3,677)

Ship association in satellite imagery is important for maritime surveillance, but existing methods are generally limited to images with similar resolutions. This paper proposes a multi-resolution ship association framework that combines high-resolution object detection with low-resolution template matching. In the high-resolution stage, ship targets are detected and their positions and patches are recorded. In the low-resolution stage, the detected positions are used to define candidate search regions, within which template matching is performed to locate the corresponding ships. Experiments on three satellite scenes with different spatial resolutions show that the proposed method consistently outperforms the baseline methods. The association accuracy, defined as the proportion of correctly associated ship pairs, reaches 0.933, 0.870 and 0.862. These results demonstrate the effectiveness of the proposed framework for multi-resolution ship association in the tested GF-1 scenes and its potential for practical maritime monitoring. Full article

Microplastic pollution in tropical urban rivers has become an increasing environmental concern due to rapid urbanization, inadequate waste management, and hydrological transport processes. This study investigated the occurrence, characteristics, and spatiotemporal distribution of microplastics in the Can Tho River, Vietnam, along an urban–peri-urban–rural gradient during dry and wet seasons. Surface-water samples were collected at 15 sites and analyzed for microplastic abundance, density, shape, color, and size composition using stereomicroscopic identification and statistical analyses. Microplastics were detected at all sampling sites in both seasons, indicating widespread contamination throughout the river system. Although seasonal differences in overall abundance and density were not statistically significant at the basin scale, clear spatial variability was observed, particularly in urban and peri-urban regions. Fibers and fragments were the dominant shapes, while blue, purple, and green particles were the most common color categories. Particles larger than 1000 µm accounted for the largest proportion of detected microplastics, and continuous size-distribution analysis revealed broadly similar overall distributions, although a greater proportion of smaller particles was observed during the dry season. The results suggest that hydrological conditions, urbanization, and land-use characteristics may contribute to the observed spatial and seasonal patterns of microplastic distribution in the Can Tho River. Peri-urban zones exhibited the greatest seasonal variability, highlighting their role as transitional areas that may influence microplastic redistribution in tropical river systems. This study provides baseline information for understanding microplastic pollution in the Mekong Delta and supports future river management strategies. Full article

Background/Objectives: Acute ischemic stroke (AIS) care depends on rapid, coordinated workflows. This study compared two real-world in-hospital stroke models—a neurohospitalist-led model and a stroke practitioner-led multidisciplinary model—in terms of time metrics, radiological outcomes, and 3-month clinical outcomes in patients undergoing reperfusion therapy. Methods: This retrospective, single-center cohort study evaluated patients across two sequential workflow periods. In the practitioner-led model, trained non-neurologist clinicians coordinated care with a stroke nurse under neurologist supervision. Time metrics included door-to-needle time (DNT) and door-to-puncture time (DPT). Clinical outcomes included intensive care unit (ICU) transfer and 3-month functional outcomes assessed by the modified Rankin Scale (mRS). Multivariable logistic regression analyses were performed to explore variables associated with achievement of DNT < 60 min and ICU transfer. Results: A total of 573 patients were included (284 neurohospitalist-led, 289 practitioner-led). Baseline NIHSS scores were similar between groups. Among patients receiving intravenous thrombolysis, the proportion achieving DNT < 60 min did not differ significantly between periods (77.9% vs. 72.5%, p = 0.124), while mean DNT and DPT were comparable. Early radiological outcomes at 24 h were similar between groups. ICU transfer rates were significantly lower in the practitioner-led period (17.6% vs. 28.2%, p = 0.002). In multivariable analyses, the stroke practitioner-led period was not independently associated with achieving DNT < 60 min among thrombolysed patients, but remained independently associated with a lower likelihood of ICU transfer. Three-month mRS outcomes did not differ significantly. Conclusions: A structured, practitioner-led multidisciplinary workflow was associated with lower ICU transfer rates, while no statistically significant differences were detected in DNT target achievement among thrombolysed patients, safety outcomes, or functional outcomes compared with the neurohospitalist-led period. The observed associations between workflow organization and ICU utilization highlight the potential importance of system-level factors in AIS care delivery. Full article

Glycosaminoglycans (GAGs) are the carbohydrate portion of proteoglycans (PGS), a family of complex biomacromolecules ubiquitously found in the extracellular matrix and on cell surfaces that play critical roles in a plethora of physiological and pathological processes. In the present work, chondroitin sulfate (CS) and dermatan sulfate (DS) were extracted and purified from the head (GCB) and skin (GDB) of blue runner fish (Caranx crysos) to explore their structural features and biological properties. GCB and GDB were purified by ion-exchange chromatography with yields of 0.82% and 0.61%, respectively. Chemical and structural analysis showed that GCB and GDD demonstrated quite similar sulfation degrees (4.45% and 4.24%, respectively). The molecular weight values obtained for GCB and GDB as estimated by high-performance size exclusion chromatography coupled with a triple detector array (HP-SEC-TDA) were 48.9 and 28.54 KDa, respectively. Structural features were elucidated using FT-IR and 2D NMR spectroscopy. GCB was mainly identified as chondroitin sulfate, containing 82% GlcA and minor proportions of IdoA and IdoA2S (scoring 18% dermatan-like structures). In contrast, GDB was predominantly dermatan sulfate, with a higher unsulfated IdoA content (54%) and a lower GlcA percentage (17%). In vitro anticoagulant activity, evaluated using APTT and PT assays, demonstrated that both GAGs exhibit significant anticoagulant potential. In addition, both fractions exhibited no antiplatelet activity, suggesting that the isolated glycosaminoglycans selectively target the coagulation cascade without affecting platelet aggregation. Furthermore, hemolytic assays confirmed that neither GCB nor GDB showed any hemolytic activity at the tested concentrations. Cytotoxicity assessment in HEK293 and HUVEK cell lines further confirmed the absence of detectable toxicity even at high concentration. Overall, these marine-derived GAGs present promising therapeutic potential as a source of anticoagulant drugs. Full article

Building energy consumption accounts for a significant proportion of total societal energy consumption, and reducing building energy consumption is critical to the global mission of reducing emissions. Windows are regarded as the least energy-efficient component of a building’s envelope. This study examines service-area buildings fitted with high-performance glass in Chinese cities across various climates and employs the non-dominated sorting genetic algorithm II (NSGA-II) genetic algorithm for multi-objective optimization. In considering design variables such as building orientation and wall insulation, advanced passive design strategies, including electrochromic and aerogel glass, are incorporated into the optimization process to minimize construction costs and operational carbon emissions. Sensitivity analyses were conducted to evaluate the impact of each design variable on building operational carbon emissions. The optimal solution within the Pareto optimal set was further evaluated using the technique for order preference by similarity to ideal solution (TOPSIS) decision-making method, and the preferred energy-saving solution was quantitatively analyzed. The results indicate that optimization leads to a reduction of approximately 7.70–10.50% in annual operational carbon emissions for service-area buildings across different regions, compared to the base case, with a payback period ranging from 4.90 to 13.56 years. The proposed method contributes to sustainable building design by jointly quantifying carbon-emission reduction, construction cost, and payback period, thereby supporting climate-responsive and economically feasible low-carbon envelope decisions for service-area buildings. Full article

Andean crops can be efficiently incorporated into food industrialization after the characterization of their components. This study evaluated tarwi (Lupinus mutabilis Sweet) flours from three ecotypes: PNTF (punto negro), WTF (white), and MTF (moro), with a particle size of 125 µm, analyzing their color, proximate composition, amino acid profile, bioactive compounds, and spectroscopic, thermal, and microstructural properties. Significant differences among ecotypes were determined at p < 0.05. The white ecotype showed greater accumulation in Dx (50), while black point exhibited the highest Dx (90), indicating a higher proportion of large particles. Regarding color, WTF presented the highest lightness and whiteness index, PNTF intermediate values, and MTF the darkest coloration, with greenish tones in black point and reddish tones in moro. The MTF ecotype showed the highest protein content (56.28%) and higher levels of essential amino acids, with methionine being the limiting amino acid. It also contained phenolic compounds ranging from 29.97 to 35.49 mg GAE/100 g, flavonoids from 9.36 to 10.8 mg quercetin/100 g, and antioxidant capacity measured by DPPH ranging from 25.79 to 55.30 mg TE/100 g, particularly notable in MTF. PNTF stood out for its dietary fiber (5.93%) and carbohydrate (17.22%) content. Infrared spectroscopy analysis revealed a similar macromolecular fingerprint among the samples. Differential Scanning Calorimetry (DSC) and Thermogravimetric Analysis (TGA) indicated greater thermal stability in MTF. Scanning Electron Microscopy (SEM) revealed greater compaction of irregular particles in MTF and greater dispersion in PNTF. These results support the differentiated valorization of tarwi ecotypes as complementary raw materials for the development of high-value-added foods in the current food industry. Full article

Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis and hospitalization in infants worldwide. In 2024, the Piedmont region introduced universal immunoprophylaxis with Nirsevimab for all infants experiencing their first RSV season. We carried out a multicenter retrospective observational study across the three pediatric units of ASL TO4 (Ivrea, Ciriè, Chivasso), comparing bronchiolitis-related hospitalizations during the 2023–2024 season (pre-Nirsevimab) with those from the 2024–2025 season (post-Nirsevimab). The primary outcome was the proportion of RSV-positive hospitalizations. Secondary outcomes included age at admission, need for respiratory support, PICU/NICU transfer, and length of stay. Immunization coverage was assessed using the regional electronic registry. Immunization coverage exceeded 88% across all centers (overall 90.4%). A total of 179 bronchiolitis hospitalizations were recorded (134 pre- vs. 45 post-Nirsevimab). RSV-positive admissions showed a reduction from 70.9% to 55.6% after implementation (OR 0.52; 95% CI 0.24–1.09). Center-specific analyses suggested reductions in Ciriè (OR 2.48; 95% CI 1.41–4.39) and Chivasso (OR 2.28; 95% CI 1.09–4.77), with a similar trend observed in Ivrea. In a supplementary denominator-based analysis restricted to infants younger than 12 months, RSV-related hospitalization incidence decreased from 42.0 to 10.3 per 1000 infants between seasons (OR 4.23; 95% CI 2.64–6.78; p < 0.0001). Disease severity remained unchanged between seasons in terms of respiratory support, length of stay, and PICU/NICU transfers. Age at admission increased significantly during the post-intervention season (mean 118.3 vs. 160.9 days; Welch’s two-sample t-test, p = 0.026). Among 15 immunized infants hospitalized in 2024–2025, 6 were RSV-positive, none required intensive care, and only two needed high-flow nasal cannula (HFNC). Universal Nirsevimab prophylaxis was associated with a trend toward reduction in RSV-related hospitalizations at the aggregate level, although the overall comparison did not reach statistical significance. Center-specific analyses suggested reductions in RSV-positive admissions in some participating units. A supplementary denominator-based analysis among infants younger than 12 months showed a lower incidence of RSV-related hospitalizations during the post-implementation season. No evidence of increased severity among breakthrough cases was observed. High coverage demonstrated the feasibility of implementation and its potential public health value. Continued longitudinal surveillance over additional RSV seasons is essential to better define the durability of protection and long-term epidemiological impact. Full article

Background/Objectives: Conjunctival hyperemia is a common clinical finding in clinical practice; however there are significant differences between graders. Vessel detection using deep-learning approaches could enable more objective measures. We aimed to evaluate vascular metrics derived from automated vessel detection and compare these metrics with manual severity gradings. Methods: Slit lamp images from 139 glaucoma patients were included. Images from 103 participants were used as the primary development dataset and the remaining as a validation subset. The images were independently graded by two graders for conjunctival hyperemia using the Efron Grading Scheme. Conjunctival vessels were detected using an automated vessel detection pipeline based on semi-supervised learning. Vessel density, fractal dimension and tortuosity were calculated and compared with the manual Efron grades. Results: Grading of conjunctival hyperemia between the two graders were consistent (Spearman’s rho: 0.79; ICC: 0.79 [95%CI: 0.72–0.84]) but showed significant differences with a higher proportion of differences in the moderate grades. Of the vascular metrics, vessel density showed significant associations with the individual Efron grading and against the mean Efron grading (0.78, p < 0.001). Fractal dimension was significantly associated with the mean Efron grading (0.55, p < 0.001). Agreements were similar in the subset (vessel density, 0.80, p < 0.001; fractal dimension 0.62, p < 0.001). Vessel tortuosity showed lower agreements (<0.23). Conclusions: Vessel density and fractal dimension showed significant associations with manual Efron gradings. These metrics could be potentially used to enable more objective and interpretable measures of conjunctival hyperemia severity. Full article

Background/Objectives: Oocytes retrieved from the pouch of Douglas during transvaginal oocyte pick-up (OPU) have historically been described mainly in isolated case reports and small series. Their developmental competence and clinical relevance remain incompletely characterized. This study aimed to evaluate the embryological and clinical outcomes of oocytes recovered from pouch of Douglas fluid and to compare developmental outcomes between ovarian-derived and pouch of Douglas-derived oocytes. Methods: This retrospective observational study was conducted at a tertiary referral university hospital IVF center. Clinical and embryological data collected between February 2023 and June 2025 were retrospectively analyzed. A total of 2423 OPU cycles were screened, and 49 cycles with ≥2 cm of free fluid in the pouch of Douglas before OPU met the inclusion criteria. Following completion of ovarian follicular aspiration, free peritoneal fluid from the pouch of Douglas was aspirated separately and assessed for the presence of oocytes. Cycles were categorized according to whether oocytes were identified in the pouch of Douglas. Baseline cycle characteristics, ovarian response parameters, embryological outcomes, and clinical outcomes were evaluated. Developmental outcomes of ovarian-derived and pouch of Douglas-derived oocytes were compared within the same cycles. Results: Oocytes were recovered from pouch of Douglas fluid in 30 of 49 cycles (61.2%). Baseline characteristics, trigger-day hormonal parameters, follicle numbers, and ovarian embryological outcomes were similar between cycles with and without pouch of Douglas oocytes. A total of 44 oocytes were retrieved from pouch of Douglas fluid, of which 36 (81.8%) were metaphase II (MII) oocytes. Twenty-six oocytes demonstrated normal fertilization (2PN), with subsequent cleavage-stage and blastocyst-stage embryo development observed. No significant differences were observed between ovarian-derived and pouch of Douglas-derived oocytes in fertilization or embryo development rates. The proportion of MII oocytes was significantly higher among pouch of Douglas-derived oocytes (81.8% vs. 66.2%, p = 0.021). Five embryo transfers involving embryos derived from pouch of Douglas oocytes resulted in clinical pregnancy and live birth, including three transfers exclusively involving pouch of Douglas-derived embryos. No procedure-related complications were observed. Conclusions: Oocytes recovered from pouch of Douglas fluid demonstrated fertilization capacity, embryo developmental potential, and the ability to contribute to clinical pregnancy and live birth. These findings suggest that free peritoneal fluid identified before OPU may contain developmentally competent oocytes that would otherwise remain unrecovered. Given the retrospective design, limited number of embryo transfers, and uncertainty regarding the precise origin of these oocytes, the findings should be considered exploratory and require confirmation in larger prospective studies. Full article

Identification keys are important aspects of taxonomic research, but their quality varies substantially. I surveyed all the keys associated with the description of new non-insect animal genera that were available to me (through online and library resources or emailed pdfs received upon request from authors) published in 2021 and 2022. I found 50 keys in 45 papers that permitted the identification of 441 genera, of which 82 were newly described. I assessed the same variables as treated in an earlier paper that dealt only with insects over the same time period. Of the 17 variables evaluated as to whether the key was as useful as possible or whether it was suboptimal, an average of 5.6 were found wanting, very similar to the average for insects (5.7). Important differences between insect and non-insect datasets are: (i) the relatively lower frequency of identification keys associated with the description of new genera in non-insect, (ii) the relatively higher level in the taxonomic hierarchy to which the keys applied in non-insects and (iii) the higher proportion of keys that were to the global fauna in non-insect papers. The frequencies of occurrence of suboptimality among the 17 variables were also similar between the two datasets. Evaluation of non-insect papers suggested several additional recommendations for authors to bear in mind when constructing a key above those resulting from a similar survey of insects. Full article

Background/Objectives: The ANALI and DiStrict scores are novel quantitative magnetic resonance cholangio-pancreatography (MRCP)-derived scoring systems designed to predict outcomes in primary sclerosing cholangitis (PSC). However, as their prognostic utility and inter-reader reproducibility are not widely validated, their utility in clinical practice is currently limited. This study aimed to assess the reproducibility and prognostic performance of the ANALI without gadolinium (ANALI_NG) and DiStrict scores in predicting liver-related outcomes in patients with PSC. Methods: We conducted a multicentre retrospective cohort study enrolling adult patients with large-duct PSC and at least one MRCP from the time of diagnosis. MRCPs were scored by five blinded senior abdominal radiologists with inter- and intra-reader agreement assessed via intraclass correlation coefficients. Multivariate Cox proportional models were used to evaluate the prognostic value of the ANALI_NG and DiStrict scores, with a composite endpoint of liver transplantation, hepatic decompensation, or liver-related death. Results: Eighty-nine patients with a median of 5.5 years (IQR 3.4–9.2) of follow-up were included. The ANALI_NG score showed higher intra-reader agreement (ICC 0.87, 95% CI 0.82–0.92 vs. ICC 0.64, 95% CI 0.36–0.79) and similar inter-reader agreement (ICC 0.71, 95% CI 0.63–0.78 vs. ICC 0.67, 95% CI 0.59–0.75) compared to the DiStrict score. Only the ANALI_NG score was associated with liver-related events, which remained significant when adjusted for age and sex (aHR 1.28, 95% CI 1.01–1.63) and MELD (aHR 1.69, 95% CI 1.22–2.34). Conclusions: The ANALI_NG score is a reproducible, MRI-derived scoring system that is independently associated with liver outcomes and has higher intra-reader agreement compared to the DiStrict score. Full article

Background/Objectives: An effective dental workforce is essential to ensure timely, high-quality oral healthcare across health systems worldwide. Many countries are currently facing challenges related to workforce supply, professional mobility, and the alignment between training capacity and population needs. Using Israel as an empirical case, this study examines long-term trends in the national dental workforce and explores their relevance for international workforce planning. Methods: A retrospective longitudinal analysis was conducted using Israel’s National Health Professions Database (“Oskim”), supplemented by data on dental education and specialty training. Descriptive longitudinal analyses were performed to evaluate workforce trends over time, and inferential statistical analyses were used to assess differences in demographic and geographic workforce distributions. Workforce indicators were analyzed using internationally standardized metrics to enable comparison with OECD healthcare systems. Results: The number of licensed dentists increased substantially, while the number of actively practicing dentists grew more moderately, reflecting a widening gap between licensure and workforce participation. Between 2008 and 2023, the number of licensed dentists increased by 49.9%, compared with a 40.4% increase in the actively practicing workforce. Accordingly, the practicing dentist-to-population ratio increased only slightly, from 0.80 to 0.84 per 1000 population. Israel reported 0.84 practicing dentists per 1000 population in 2023, exceeding the OECD average of 0.70. However, despite exceeding the OECD average, the relatively modest increase in the practicing workforce suggests that higher dentist-to-population ratios may overestimate actual workforce capacity when workforce participation patterns are not taken into account. Internationally trained dentists accounted for approximately 75% of new licensees, highlighting the role of professional mobility in shaping workforce supply. The proportion of dental specialists remained relatively stable at approximately 10%. In addition, the number of licensed dental hygienists increased by 96.1% (from 1468 to 2879), while the number of newly licensed hygienists declined by approximately 43% (from 174 to 100 annually). Conclusions: Despite substantial growth in the number of licensed dentists, the practicing workforce and specialist capacity expanded only modestly, and geographic disparities persisted. The difference between growth in licensed dentists and the actively practicing workforce highlights the importance of incorporating participation measures into national monitoring and oral health planning policies. The Israeli experience illustrates how workforce expansion driven by internationally trained dentists may coexist with structural challenges in participation, specialization, and distribution. These findings highlight broader considerations for oral health workforce planning and may provide insights for other health systems facing similar demographic and staffing dynamics. Because indicators of oral health need, service utilization, disease burden, and workforce productivity were unavailable, the study could not determine whether the observed workforce supply was adequate to meet population oral health needs. Full article

Background: Evidence of the relationship between frailty and depression trajectories and digestive disease in real-world populations remains insufficient. Investigating the long-term dynamic effects of frailty and depression may provide valuable insights for clinical intervention and the precise classification of risk factors for gastrointestinal or liver disease. In the study, we aimed to elucidate the aforementioned association among two representative cohorts. Methods: The CHARLS dataset represents a cohort of 10,303 participants over 40 years of age in China, with a follow-up period from 2011 to 2018. First, a group-based trajectory modeling method was used to identify combined trajectories of frailty and depression over a 7-year follow-up period. Frailty was assessed using the frailty index, while depression was measured using CESD10 scores. Binary logistic models and discrete survival models were applied to explore the associations between combined frailty–depression trajectories and the outcomes of gastrointestinal or liver diseases. Second, after excluding participants with baseline gastrointestinal or liver diseases, a binary logistic regression model was used to analyze the association between baseline frailty and depression and disease outcomes, with the results presented as odds ratios (ORs) and 95% confidence intervals (CIs). Third, Cox proportional hazards models with restricted cubic splines were applied to estimate the association between the baseline frailty index or CESD 10 scores and disease risk, with the results expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). Comprehensive sensitivity analyses and subgroup stratifications supported the findings. The SHARE dataset was used as validation to prove the reliability of the conclusions. The SHARE cohort comprises 5834 participants 40 years of age and older in Europe, with a follow-up period from 2011 to 2017, and uses the frailty index to assess frailty and the EURO-D scale to assess depression. A binary logistic regression model was used to analyze the association between the trajectory groups and disease outcomes after excluding participants with baseline gastrointestinal diseases, with the results presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results: Three distinct combined trajectories were identified in the CHARLS cohort: G1 (59.7%), stable and robust with no depression; G2 (31.5%), moderate persistent frailty and depression; and G3 (8.8%), escalating frailty and high depression. In the fully adjusted binary model, compared with G1, the risk of gastrointestinal disease was elevated in G2 (OR = 1.94, 95% CI: 1.67–2.24) and G3 (OR = 2.73, 95% CI: 2.12–3.53). Similarly, the risk of liver disease was evidently elevated in G2 (OR = 1.72, 95% CI: 1.38–2.13) and G3 (OR = 3.44, 95% CI: 2.50–4.75). The SHARE findings were consistent with those from CHARLS, with three similar trajectory groups identified in the SHARE cohort. Compared with G1, the risk of gastrointestinal disease was evidently elevated in G2 (OR = 2.035, 95% CI: 1.359, 3.048) and G3 (OR = 4.588, 95% CI: 2.561, 8.218) in the fully adjusted model. Conclusions: Trajectories of frailty and depression were significantly correlated with increased occurrence of gastrointestinal and liver disease, with the results remaining robust across various sensitivity analyses and external cohort validations. A limitation of this study is that the outcome measures are based on self-reported data, which may be subject to measurement bias. These findings highlight the importance of sustained integrated physical–mental approaches and precise psychological screening and classification for the prevention and treatment of gastrointestinal and liver disease. Full article

Background: This study assessed the 5-year clinical outcomes of phacoemulsification combined with implantation of either the first-generation iStent Trabecular Micro-Bypass or the Hydrus Microstent in eyes with open-angle glaucoma. Methods: In this prospective, non-randomized comparative study, 65 eyes of 65 patients underwent combined cataract and micro-invasive glaucoma surgery with either iStent or Hydrus implantation. Intraocular pressure (IOP), number of glaucoma medications, best-corrected visual acuity (BCVA), surgical success, postoperative complications, and subsequent glaucoma procedures were analyzed over a 60-month follow-up. Results: At 60 months, outcome data were available for 47 eyes (72.3%), including 25 eyes in the iStent group and 22 eyes in the Hydrus group. Baseline characteristics did not differ significantly between groups. Mean IOP at 60 months was similar after iStent and Hydrus implantation (16.7 ± 1.8 mmHg vs. 16.5 ± 1.9 mmHg, respectively). The mean number of glaucoma medications decreased from 1.86 ± 0.94 to 1.36 ± 1.08 in the iStent group and from 1.60 ± 0.72 to 0.36 ± 0.49 in the Hydrus group, with significantly fewer medications required after Hydrus implantation at 60 months. Medication-free complete surgical success using the IOP ≤ 18 mmHg criterion was achieved in 20.0% of iStent-treated eyes and 63.6% of Hydrus-treated eyes. No eye underwent additional glaucoma surgery or selective laser trabeculoplasty during follow-up. Conclusions: In this prospective non-randomized comparative cohort, both procedures provided comparable long-term treated IOP control when combined with phacoemulsification. Hydrus implantation was associated with a greater medication-sparing effect and a higher proportion of medication-free complete surgical success at 5 years; however, these findings should be interpreted in the context of the non-randomized design and available-case follow-up. Full article

Background: Fixed-ratio combinations of basal insulin and glucagon-like peptide-1 receptor agonists have emerged as an effective strategy for treatment intensification in type 2 diabetes mellitus (T2DM). However, long-term real-world data on their metabolic, β-cell, and renal effects remain limited. This study aimed to evaluate the 12-month real-world outcomes of insulin glargine/lixisenatide (iGlarLixi) therapy. Methods: This retrospective observational study included 78 patients with T2DM who were initiated on iGlarLixi and followed for 12 months. Clinical and laboratory parameters were assessed at baseline, 3 months, and 12 months. Changes in anthropometric, glycemic, biochemical, and renal parameters were analyzed. Early (3-month) changes were evaluated as predictors of long-term outcomes using correlation and receiver operating characteristic (ROC) analyses. Results: Median HbA1c decreased from 9.0% to 8.2% at 12 months (p = 0.015), with clinically meaningful improvement (≥1% reduction) observed in 21 (26.9%) patients. Body weight decreased significantly from 93.0 kg to 89.5 kg (p < 0.001). C-peptide levels increased from 2.46 to 3.00 ng/mL (p = 0.016). Median albumin-to-creatinine ratio (ACR) showed statistically significant paired changes; however, group-level median values remained similar over time. A reduction in albuminuria was observed in 34 (54.8%) of patients with available paired data. Exploratory ROC analyses suggested that early changes in body weight (AUC: 0.82), HbA1c (AUC: 0.74), and C-peptide (AUC: 0.76) may be associated with long-term outcomes. A combined model incorporating early weight and C-peptide changes showed improved exploratory predictive performance (AUC: 0.88). Conclusions: In a real-world setting, iGlarLixi therapy was associated with significant improvements in glycemic control and body weight, along with increased C-peptide levels that may reflect improved endogenous insulin secretion. While group-level renal changes were modest, individual-level improvements in albuminuria were observed in a substantial proportion of patients. Early treatment responses may serve as practical predictors of long-term outcomes, supporting a personalized approach to diabetes management. These findings should be interpreted in the context of concomitant therapies and comorbidities that may have influenced metabolic and renal outcomes in routine clinical practice. Full article