Search Results (462)

Background/Objectives: Laryngeal cancer remains a global health burden, particularly in regions with high tobacco and alcohol consumption. This study aimed to provide a comprehensive epidemiological overview of laryngeal cancer in Western Greece and to assess overall survival (OS), disease-specific survival (DSS), and key prognostic factors over a 21-year period. Methods: A retrospective cohort study was conducted, including patients diagnosed and treated for laryngeal cancer at the Otorhinolaryngology Department of the University General Hospital of Patras between 1997 and 2017. Demographic, clinical, histopathological, and treatment data were collected. Survival outcomes were estimated using Kaplan–Meier analysis and compared using the log-rank test. Multivariable Cox proportional hazards regression was performed to identify independent prognostic factors. Significance was set at p ≤ 0.05. Results: A total of 211 patients were included (mean age 62.7 years; 95.3% male). Active smoking was reported in 97.6% of cases. Most patients (88.6%) were diagnosed at advanced stages (III–IV), with glottic tumors being the most common (61.1%). The 5-year OS and DSS rates were 47.0% and 55.6%, respectively. Larger tumor size, nodal involvement, and advanced stage were significantly associated with reduced DSS in univariable analysis (p < 0.001). Cox regression confirmed tumor size (HR = 1.665, 95% CI: 1.187–2.336) and nodal status (HR = 1.546, 95% CI: 1.176–2.031) as independent predictors of DSS. Conclusions: The findings highlight the impact of advanced disease at diagnosis and the central prognostic role of tumor burden in laryngeal cancer in Western Greece. Early detection and timely management remain essential to improve patient outcomes. Full article

Climate change presents a challenge for global viticulture due to rising temperatures and water stress, which accelerate grape ripening, increase sugar levels, and reduce acidity. This compromises wine quality and microbial stability, resulting in higher reliance on sulfur dioxide (SO₂). However, SO₂ can inhibit desirable fermentations, including those carried out by non-Saccharomyces yeasts, which are key biotechnological tools for climate adaptation due to their ability to modulate acidity, aroma, and ethanol. Therefore, alternative disinfection methods are needed to control wild microbiota without hindering inoculated yeasts. This review critically analyzes ozone (O₃) as a non-thermal disinfection technology for winemaking. It examines the antimicrobial mechanism of ozone, its efficacy against wine-related microorganisms, its impact on the physicochemical and aromatic parameters of grapes, and its practical viability. Ozone effectively reduces spoilage-causing microbiota, achieving inactivation of approximately 3–4 log CFU/mL for yeasts, while preserving crucial grape compounds and providing a favorable environment for novel fermentation biotechnologies. Compared to other emerging technologies and SO₂, ozone offers a balanced profile: effective disinfection, minimal residues, cost-effectiveness, and compatibility with sustainable winemaking. Ozone is emerging as a promising alternative to facilitate controlled fermentations and improve wine quality among the current climatic and oenological challenges. Full article

Objective: In metastatic colorectal cancer (mCRC), mucinous histology has been associated with poor clinical outcomes, particularly in the presence of peritoneal metastasis. However, it remains unclear whether mucinous histology exerts a context-dependent effect on treatment outcomes by modifying the efficacy of anti-vascular endothelial growth factor (VEGF)-based therapies independently of metastatic dissemination patterns and chemotherapy backbone. Methods: We retrospectively analyzed 250 patients with mCRC treated with bevacizumab-containing systemic therapy. Tumors were classified as mucinous (n = 52) or non-mucinous (n = 198). Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method and compared using the log-rank test. Cox proportional hazards regression models were applied for univariate and multivariate analyses. Predefined subgroup analyses were conducted according to peritoneal metastasis status and chemotherapy backbone (oxaliplatin- or irinotecan-based). A 6-month landmark analysis was performed to reduce early progression bias. Interaction analyses evaluated potential effect modification between histology, peritoneal metastasis, and chemotherapy backbone. Results: Mucinous tumors were more frequently right-sided and strongly associated with peritoneal metastasis. In the overall cohort, mucinous histology was associated with significantly longer median PFS compared with non-mucinous histology (22.9 vs. 11.9 months; p < 0.001). This benefit was driven by patients with peritoneal metastasis, in whom mucinous histology was associated with markedly prolonged PFS (23.9 vs. 8.7 months; p < 0.001). No significant PFS difference according to histology was observed in patients without peritoneal metastasis. On multivariate analysis, mucinous histology remained independently associated with improved PFS (HR 0.44; 95% CI 0.25–0.78; p = 0.005), an effect preserved in the landmark cohort (HR 0.39; 95% CI 0.26–0.59; p < 0.001). A significant interaction between mucinous histology and peritoneal metastasis was observed (p for interaction = 0.040), indicating that the prognostic impact of histology differed according to metastatic pattern. No significant PFS difference or interaction was detected according to chemotherapy backbone within the mucinous subgroup. Conclusions: Among bevacizumab-treated patients with mCRC, mucinous histology—particularly in the presence of peritoneal metastasis—is associated with a pronounced PFS advantage independent of chemotherapy backbone. These findings suggest that mucinous peritoneal mCRC represents a biologically and clinically distinct subgroup that may derive context-specific and disproportionate benefit from anti-VEGF-based strategies, warranting prospective validation. Full article

Time–space fractional diffusion equations are widely used to model anomalous transport in heterogeneous biological tissues, where memory effects, spatial nonlocality, and coefficient variability are intrinsically coupled. However, existing numerical approaches typically treat these aspects in isolation, and a fully discrete framework that simultaneously accounts for heterogeneity, long-memory effects, and computational efficiency remains lacking. In this work, a fully discrete numerical method is developed and analyzed. The method integrates heterogeneous diffusion coefficients and memory-efficient temporal discretization within a unified variational framework. It combines a finite element approximation of a spectral fractional elliptic operator with an implicit $L^1$ discretization of the Caputo derivative enhanced by a sum-of-exponentials approximation of the memory kernel. Unconditional stability, preservation of a discrete energy structure, and a fully discrete error estimate are established, explicitly separating temporal, spatial, and kernel approximation errors. The proposed approach reduces memory complexity from $\mathcal{O}\left(N\right)$ to $\mathcal{O}(logN)$ without compromising accuracy. Numerical experiments confirm the theoretical convergence rates, demonstrate stable behavior across all tested configurations, and illustrate the impact of heterogeneous coefficients on anomalous transport dynamics. Full article

Background/Objectives: Allogeneic hematopoietic stem cell transplantation is associated with increased cardiovascular risk driven by endothelial dysfunction, chronic inflammation, and treatment-related metabolic disturbances, including dyslipidemia. In the contemporary era of post-transplant cyclophosphamide-based prophylaxis, the prognostic significance of dyslipidemia—particularly as assessed by non-HDL cholesterol—remains unclear. In this study, we aimed to compare the engraftment days, graft-versus-host disease (GVHD) development, relapse, overall survival rates, and cardiovascular mortality in patients using myeloablative/reduced intensity conditioning regimens with post-transplant cyclophosphamide (PTCy) 50 mg/kg/day for 2 days in patients with acute leukemias. Methods: A total of 95 adult patients with acute leukemias were included in their first remission who underwent matched sibling donor transplantation with PTCy (50 mg/kg on days +3 and +4). Patients were stratified according to pre-transplant non-HDL-C levels (<160 mg/dL vs. ≥160 mg/dL). Matched related donors were selected for the patients. All patients received either myeloablative or reduced-intensity conditioning based on EBMT criteria, with fludarabine-based combinations including busulfan, treosulfan, or TBI, along with ATLG administered at a total dose of 15 mg/kg. Peripheral blood stem cells were used for all transplants, and GVHD prophylaxis consisted of cyclosporine. Results: Platelet (median 13 vs. 14 days) and neutrophil (median 14 vs. 15 days) engraftment times and veno-occlusive disease (VOD) rates were comparable across groups (all p > 0.05); cumulative incidences of grade II–IV aGVHD at +100 days, grade III–IV aGVHD at +100 days, and moderate-severe cGVHD at 1 year, relapse-free survival, and non-relapse mortality at 1 year were comparable in two cohorts (all p > 0.05). GVHD-free/relapse-free survival (GRFS) at 1 year was also comparable across groups (p = 0.15). Median GRFS was 150 (95% CI: 120–330) days and 270 (95% CI: 154-not reached) days, respectively [HR was 0.68 (0.40–1.15), p = 0.15; GRFS at 1 year was 66.6% vs. 52.0%, respectively]. The groups were also comparable in terms of overall survival (OS). Follow-up ranged from 0.5 to 108 months, and median follow-up was 60 months in two cohorts. Median OS was not reached in non-HDL-C < 160 (95% CI: 70 months–not reached) and 67 months in non-HDL-C ≥ 160 groups (95% CI: 13 months–not reached) (Log rank = 0.21). No cardiovascular death events occurred during the follow-up period. Conclusions: In this homogeneous matched sibling donor transplant cohort with extended follow-up and uniform administration of post-transplant cyclophosphamide, cyclosporine-based GVHD prophylaxis, and anti-thymocyte lymphoglobulin (ATLG), pre-existing dyslipidemia was not associated with an adverse impact on GRFS, NRM, PFS, CMV reactivation, OS or long-term cardiovascular mortality. Full article

Background: High recurrence rates for non-muscle-invasive bladder cancer (NMIBC) remain a clinical challenge. Recommended post-operative treatments are underutilized, highlighting the need for alternative strategies. Given the variability in bladder cancer prognosis, personalized treatment approaches are highly relevant. In this study, we evaluated post-operative two-hour continuous sterile water bladder irrigation (CSWBI) regarding recurrence and safety, as a potential addition to the treatment arsenal for bladder cancer. Method: In 2018, two-hour CSWBI was implemented as routine treatment after all transurethral resection procedures of the bladder (TURB), at the urology department of Sundsvall Hospital. All patients who underwent TURBs four years prior (control group) and four years after the implementation of CSWBI (intervention group) were analyzed. Primary NMIBC were included, MIBC and CIS were excluded. Data were collected retrospectively from patient records, including baseline characteristics, adverse events, and recurrence rates within 12 months follow-up. Statistical analyses included Chi-squared test, Wilcoxon rank-sum test, univariate and multivariate logistic regression analyses, Kaplan–Meier curves and log-rank test. Results: A total of 168 patients were included (control group n = 90, irrigation group n = 78). Median age was 73 years, 23% were female, 77% were male, and 74% were active or previous smokers. The recurrence rate within twelve months for the intervention group vs. the control group was: 27% vs. 21% (p = 0.4) respectively. CSWBI had no statistically significant impact on recurrence (OR 1.25, 95% CI 0.58–2.68, p = 0.6). Adverse effects were limited and equal between groups. Conclusions: Post-operative two-hour CSWBI did not significantly reduce NMIBC recurrence within twelve months in this cohort. Full article

Numerosity can be represented in symbolic formats and non-symbolic dot arrays. How numerosity load unfolds across WM encoding/maintenance and test-stage comparison within a single paradigm remains unclear, especially within the tested 4–6 range. We used a delayed match-to-sample task manipulating numerosity (4–6) and match status, with two test blocks (dot–digit and dot–dot). Behaviorally, a higher numerosity reduced accuracy and increased RTs in both blocks, with larger costs in dot–dot; the mismatch reliably slowed RTs. At sample onset, occipital P1 and N1 amplitudes decreased with increasing numerosity, consistent with greater perceptual/processing demands at higher load, with the strongest differences at the high end of the range. During the delay, numerosity modulation was temporally specific, emerging in the 450–650 ms posterior window and remaining significant after FDR correction across the four consecutive delay windows. At the test, the mismatch elicited a more negative N2 in both blocks (larger in dot–dot), while numerosity also modulated N2 only in dot–dot, showing a monotonic increase in negativity with load. Controlling for condition-mean logRT did not eliminate these N2 effects. P3 showed no reliable modulation, whereas a later positive component was enhanced by mismatch selectively in dot–dot. Together, these results indicate stage-differentiated effects: numerosity load impacts early encoding and a circumscribed maintenance interval, whereas mismatch effects arise primarily during the test-stage comparison, with additional late evaluative activity when formats are aligned. Full article

Background/Objectives: The COVID-19 pandemic substantially disrupted routine childhood vaccination practices across the United States. Oklahoma, a state characterized by lower socioeconomic indicators and higher levels of vaccine hesitancy, may have been particularly vulnerable to these disruptions. This study aimed to assess the impact of the COVID-19 pandemic on routine childhood vaccination in Oklahoma. Methods: Data were obtained from the Oklahoma State Immunization Information System to examine changes in the administration of DTaP and MMR vaccines before and during the COVID-19 pandemic, stratified by pandemic phase. Percentage changes in vaccine doses administered were calculated across time periods. Log-binomial regression models were used to evaluate the association between pandemic timing and receipt of subsequent DTaP doses among children under one year of age. Results: Administration of both DTaP and MMR vaccines declined during the COVID-19 pandemic across all pandemic phases examined. Compared with the pre-pandemic period, fewer children returned for subsequent DTaP doses during the pandemic. Regression analyses indicated a reduced likelihood of completing age-appropriate DTaP dosing among infants during the pandemic. Conclusions: Routine childhood vaccination in Oklahoma declined during the COVID-19 pandemic, with persistent reductions observed across pandemic phases. These findings highlight vulnerabilities in vaccination delivery during public health emergencies and underscore the need for targeted state-level strategies to sustain routine immunization services during future crises. Full article

Background and Objectives: Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers and remains a leading cause of cancer-related mortality worldwide. EGFR-targeted tyrosine kinase inhibitors (TKIs) have substantially improved outcomes in EGFR-mutant NSCLC; however, primary and acquired resistance continues to limit their long-term efficacy. HER3 (receptor tyrosine-protein kinase ErbB3), a member of the ErbB receptor family, has been implicated in TKI resistance through heterodimerization with EGFR and HER2, leading to downstream PI3K/AKT pathway activation. Despite its biological plausibility as a resistance mediator, the clinical significance of HER3 expression as a prognostic and predictive biomarker in EGFR-mutant NSCLC has not been thoroughly characterized in real-world cohorts. Materials and Methods: This retrospective, single-center study included 52 patients diagnosed with EGFR-mutant NSCLC who received TKI therapy at Afyonkarahisar Health Sciences University between January 2011 and September 2023. HER3 protein expression was evaluated by immunohistochemistry (IHC) on formalin-fixed, paraffin-embedded tumor tissue sections using the Huabio anti-HER3 antibody (clone PD00-44, 1:2000 dilution). Staining in more than 30% of tumor cells was considered HER3-positive; membranous staining intensity was scored on a 1–3 scale. Progression-free survival (PFS1, PFS2) and overall survival (OS) were analyzed using the Kaplan–Meier method and log-rank test. Statistical significance was set at p < 0.05. Results: Of 52 patients (55.8% female; mean age 64.5 years), 59.6% received chemotherapy and 40.4% received an EGFR TKI as first-line treatment; erlotinib constituted 71.2% of targeted therapies. In the first-line TKI group, HER3-negative patients had a numerically longer median PFS1 compared with HER3-positive patients (14.0 vs. 7.1 months; p = 0.285); however, this difference did not reach statistical significance and should be interpreted with caution given the small sample size. In contrast, among patients receiving first-line chemotherapy, HER3 staining status did not meaningfully affect PFS1 (4.1 vs. 2.5 months; p = 0.063). In second-line treatment, HER3-positive patients who received TKI after prior chemotherapy demonstrated a PFS2 comparable to or slightly exceeding that of HER3-negative patients (21.8 vs. 19.8 months; p = 0.49), suggesting that the sequencing of chemotherapy before TKI may attenuate the adverse effect of HER3 positivity. Median OS was 15.1 months in HER3-negative patients and 12.7 months in HER3-positive patients (p = 0.824); this numerical difference of approximately 3 months did not reach statistical significance and should therefore be interpreted cautiously. Among patients receiving TKI in the first line, HER3-positive patients had a shorter median OS than HER3-negative patients (9.6 vs. 14.2 months), whereas those receiving TKI in the second line showed a trend toward longer OS in HER3-positive patients (20.5 vs. 17.2 months). Conclusions: HER3 expression was associated with reduced first-line TKI efficacy in EGFR-mutant NSCLC, suggesting a possible role for HER3 in primary TKI resistance; however, these findings are exploratory and did not reach statistical significance. The observation that HER3-positive patients who received chemotherapy before TKI demonstrated outcomes comparable to HER3-negative patients raises the hypothesis that treatment sequencing may potentially influence the impact of HER3 positivity, though this requires prospective validation before any clinical conclusions can be drawn. These results suggest that HER3 expression may warrant further investigation as a candidate biomarker for treatment sequencing decisions and as a potential therapeutic target in EGFR-mutant NSCLC. Prospective studies evaluating chemotherapy–TKI sequencing and HER3-directed agents such as patritumab deruxtecan (HER3-DXd) in HER3-positive patients are needed to confirm these preliminary observations. Full article

Platform-generated default reviews are widespread in e-commerce, yet they are underexamined as a review system design feature. Using 1994 Taobao product snapshots from two windows (January–April 2025, n = 983; December 2025–January 2026, n = 1011) surrounding a gradual interface redesign that folded default reviews from the default view, this study examines how the default review ratio relates to sales and whether reduced visibility moderates the association. Regression results show that higher default review ratios are associated with lower log sales prior to the redesign, while the negative association attenuates once default reviews are de-emphasised; conditional sales levels are also higher post-redesign. Because the rollout was gradual and the data are repeated cross-sectional snapshots, estimates are interpreted as differences in conditional associations across regimes. These patterns are robust to alternative specifications, additional controls, category-specific post shifts, and winsorization. Overall, the market impact of platform-generated review signals depends on interface visibility, highlighting an actionable governance lever for review system design. Full article

Background and Objectives: Visual impairment and reduced stereovision significantly impact the quality of life and increase fall risk in older adults. While standard clinical assessment of visual functions is essential in this population, its use is often limited by the need for specialized equipment and trained personnel. Tablet-based screening tools offer a practical alternative but require clinical validation. This study aimed to assess the agreement, reliability, and diagnostic performance of a tablet-based screening application (index methods) compared to established clinical reference methods for assessing visual acuity (VA) and stereovision (SV) in adults over 60 years. Materials and Methods: This prospective, non-blinded, cross-sectional, feasibility study included two cohorts: a test–retest group of 24 older adults assessed twice within 7 days, and a clinical cross-sectional group of 135 participants recruited from primary care practices. VA was measured using tablet-based Landolt C test and compared with an ETDRS-style chart, while stereovision was assessed using tablet-based static and dynamic random dot stereograms and compared with the TNO stereotest. Agreement and reliability were evaluated using Bland–Altman analysis, intraclass correlation coefficients (ICC), and receiver operating characteristic (ROC) curves. Results: The index VA method demonstrated good test–retest reliability (ICC = 0.79) with no significant difference between repeated measurements. In the clinical cross-sectional group, visual acuity measurements showed a small mean bias (0.022 logMAR) between the index and reference methods, which remained within clinically acceptable limits, particularly in the intermediate acuity range. For stereovision, the index SV tests showed high test–retest agreement. Using a TNO cutoff of 480 arcsec, the index SV method demonstrated good diagnostic accuracy (AUC 0.87 for static and 0.85 for dynamic stimuli) with high sensitivity for detecting impaired stereovision. Conclusions: The tablet-based index method provided reliable and clinically comparable results for VA and SV assessments in older adults, supporting its potential use as a screening tool in primary care and community-based settings. Full article

Central business district (CBD) hospitals must sustain reliable pressure relationships in critical rooms while reducing whole-facility carbon under tight space and disruption constraints. We developed an ontology-grounded semantic digital twin that normalizes building automation system (BAS) and building management system (BMS) telemetry into a unified semantic store consistent with Brick Schema, enabling portable asset discovery via query and thereby supporting forecasting, anomaly detection, and multi-objective optimization without dependence on vendor point naming conventions. Whole-facility impacts were verified using International Performance Measurement and Verification Protocol Option C–style measurement and verification with an S0-calibrated baseline model and residual-based savings attribution. Relative to the baseline (S0), the intervention (S3) produced a step increase in the critical-room pressure-compliance pass rate, tighter room-to-corridor differential-pressure (ΔP) control across airborne infection isolation and open room strata, and intent-aligned ventilation delivery (air changes per hour ratio distribution concentrated near unity; p < 0.05 where letter groups differ). Operational-state discrimination improved (AUC 0.649→0.696) and issue-resolution times shortened (left-shifted cumulative distribution function), indicating reduced service burden. Option C verification showed energy residuals shifting negative under S3, consistent with net savings versus baseline expectations. Across progressive maturity (S0→S3), time-to-value and burden fractions decreased, carbon intensity (tCO₂e m⁻²) decreased, long-tail exposure compressed (log-scale horizon), and composite performance indices increased (p < 0.05). These results demonstrate a verifiable pathway to pressure-reliable, decarbonized hospital operations at the whole-facility boundary while making the semantic layer’s utility explicit through query-driven, ontology-grounded asset discovery. We present an IPMVP Option-C–verifiable semantic digital-twin governance framework that links audited operational evidence (telemetry → actions → verification) to whole-facility energy and carbon outcomes while maintaining critical-room pressure-relationship reliability. Optimization benchmarking (including quantum annealing) is used as supporting decision-support evaluation, rather than as the central contribution. Full article

This article presents an analysis of the impact of atmospheric turbulence on the quality of images obtained during photogrammetric missions in Antarctica using a fixed-wing UAV operating in BVLOS mode. Image quality was evaluated primarily by the degree of blurring, which served as the main assessment criterion. In the Antarctic region, turbulence is a frequent phenomenon and can occur even under very light wind conditions, which formed the basis of this study. Autopilot log data were used to conduct a series of analyses, resulting in maps of areas where turbulence symptoms were recorded. In parallel, the quality of images captured during the mission was examined, producing a map of blurring levels assessed on a five-point scale. The study shows that UAV image blurring is mainly caused by sudden camera movements, mechanical vibrations from the propulsion system, and atmospheric turbulence that disrupts flight stability and overloads image stabilization. Additional factors such as low-light conditions, fog, haze, precipitation, glare, and moving shadows further reduce image clarity. Full article

Postharvest fruit losses significantly impact producers and distributors. Although synthetic preservatives mitigate these losses, consumer safety concerns and regulatory restrictions drive interest in alternative approaches. Propolis, rich in polyphenols, exhibits antioxidant and antimicrobial activities, making it a promising natural strategy to preserve fruit quality. This study aimed to evaluate the effects of the pre- and postharvest applications of Portuguese propolis extracts on the preservation of postharvest quality of ‘Rocha’ pear, an exclusively Portuguese variety of major economic importance. Treatments were applied by spraying the fruits one month before and at harvest. After five months of cold storage, the main quality parameters, phenolic content, antioxidant capacity, physiological disorders, and microbial contamination were assessed. The results showed that the application of propolis extract, either 30 days before or immediately after harvest, reduces the total microbiological load on the fruit’s epidermis (~1-log to 2-log reduction, after treatment). Moreover, the treatment enhanced the preservation of key quality attributes, including a reduction in water loss of up to 44%, a 13–33% decrease in firmness loss relative to the control, and a lower incidence of physiological disorders during postharvest storage. Furthermore, the application of propolis can enhance the production of fruits with higher levels of bioactive compounds, while also adding value to a bee product that is often underappreciated by most beekeepers. Full article

Rotor machining errors strongly influence the air-film pressure distribution of aerostatic spindles and fundamentally limit performance enhancement. However, existing studies rarely provide a comprehensive statistical characterization based on measured manufacturing errors. To address this gap, a multi-scale modeling framework based on harmonic analysis of form errors is developed. Measured surface topography data from a batch of rotors are decomposed to establish a harmonic statistical model, which is then incorporated into a modified Reynolds equation together with macro-scale and micro-scale error components. The static performance of the aerostatic spindle is subsequently analyzed. Results show that low-order harmonics (1st–5th) dominate cylindricity errors, with amplitudes following a log-normal distribution. The statistical bounds are described by 3σ envelopes. When the eccentricity ε exceeds 0.3, barrel-shaped errors reduce the load capacity by more than 15%, whereas waist-drum-shaped errors exhibit a self-stabilizing tendency under small deviations. Performance degradation can be partially mitigated by adjusting the supply pressure and orifice diameter. This study addresses the research gap in understanding the impact of measured manufacturing errors on aerostatic spindle performance and provides a quantitative basis for tolerance allocation and performance optimization. Full article