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15 pages, 293 KB  
Article
Not All Runners Cross the Same Finish Line: Sociodemographic Inequalities in COVID-19 Recovery After a Mass Sporting Event
by Daniel Martínez-Cevallos, Alejandra Proaño-Grijalva, Frano Giakoni-Ramírez and Daniel Duclos-Bastías
Int. J. Environ. Res. Public Health 2025, 22(9), 1351; https://doi.org/10.3390/ijerph22091351 - 28 Aug 2025
Abstract
Background: The COVID-19 pandemic significantly disrupted patterns of physical activity and participation in mass sporting events, with recreational runners in Latin America among the most affected. In Colombia, pre-existing inequalities in access to sport further exacerbated these impacts. Nevertheless, evidence on post-COVID-19 impact [...] Read more.
Background: The COVID-19 pandemic significantly disrupted patterns of physical activity and participation in mass sporting events, with recreational runners in Latin America among the most affected. In Colombia, pre-existing inequalities in access to sport further exacerbated these impacts. Nevertheless, evidence on post-COVID-19 impact and recovery experiences among regional runners remains limited. Objective: We examined the sociodemographic profiles, athletic experience, and perceptions of COVID-19-related impact and recovery among participants in the 2023 Medellín Marathon, and to assess differences by educational attainment, employment status, age group, and geographic origin. Methods: A cross-sectional descriptive study was undertaken involving 2486 registered marathon runners. An ad hoc questionnaire assessed COVID-19 symptoms and sequelae, perceived respiratory and physical limitations, fears associated with group exercise, and self-reported recovery. Analyses included descriptive statistics, bivariate comparisons and one-way ANOVA tests. Results: Older participants, retirees and those with lower educational levels reported significantly greater COVID-19 impact, longer recovery periods and higher perceived physical and respiratory limitations. In contrast, younger runners and those with a college education showed more complete physical recovery and attributed protective benefits, such as improved cardiorespiratory function and a lower incidence of respiratory symptoms, to their training. Additionally, runners originating from smaller municipalities and other Latin American countries reported higher levels of impact and lower perceptions of recovery. Conclusions: Post-COVID-19 effects among marathon runners are not uniform but vary according to sociodemographic and contextual factors. These findings underscore the importance of tailored support and readaptation strategies—particularly for vulnerable subgroups—to ensure their safe and equitable return to mass endurance events. Full article
14 pages, 767 KB  
Article
Comparison of the Skeletal and Dento-Alveolar Changes Obtained with a Customized Elastodontic Appliance and Twin Block: A Prospective Investigation
by Valentina Lanteri, Andrea Abate, Margherita Donelli, Cinzia Maspero, Enrica Tessore, Maria Elena Grecolini, Francesca Olivi, Matilde Dalmazzini and Alessandro Ugolini
Children 2025, 12(9), 1147; https://doi.org/10.3390/children12091147 - 28 Aug 2025
Abstract
Objectives: This study aimed to compare the skeletal and dentoalveolar effects of a fully customized elastodontic appliance with those of the traditional Twin Block appliance in growing patients with Class II malocclusion during the mixed dentition phase. Methods: A total of 35 patients [...] Read more.
Objectives: This study aimed to compare the skeletal and dentoalveolar effects of a fully customized elastodontic appliance with those of the traditional Twin Block appliance in growing patients with Class II malocclusion during the mixed dentition phase. Methods: A total of 35 patients were included: 18 treated with a customized elastodontic appliance (C-Ela group) and 17 with a Twin Block appliance (TB group). Digital dental models and lateral cephalometric radiographs were obtained at baseline (T1) and after 12 months of treatment (T2). All patients were treated by experienced clinicians according to standardized appliance protocols. Data analysis was performed by a blinded operator using Ortho Analyzer and Dolphin Imaging software. The Shapiro–Wilk test was applied to verify the normal distribution of the data. Paired-sample t-tests were used to assess within-group changes between T1 and T2. For intergroup comparisons two-tail independent-sample t-tests were used, and chi-square tests were used for categorical variables. Statistical significance was set at p < 0.05. Results: Both groups showed significant intragroup improvements in overjet (C-Ela: −2.77 ± 2.07; TB: −2.30 ± 2.72 mm), overbite (C-Ela: −1.79 ± 1.95; TB: −1.40 ± 2.65 mm), and sagittal molar relationship (p < 0.05) after treatment. The C-Ela group exhibited a significantly greater reduction in anterior dental crowding (p < 0.05) and better control of upper (C-Ela: −4.93 ± 7.65°; TB: −1.80 ± 5.72°) and lower incisor inclination (C-Ela: +1.70 ± 4.80°; TB: +4.35 ± 6.22°). In intergroup comparisons, the TB group showed a significantly greater proclination of the lower incisors at T2 (L1/Go-Gn: +4.35°; L1/A-Pog: +1.44 mm), whereas the C-Ela more effectively limited these changes (L1/Go-Gn: +1.70°; L1/A-Pog: +1.18 mm). Skeletal analysis revealed an increase in ANB angle in both groups (C-Ela: −1.49 ± 2.62°; TB: −1.78 ± 2.78°), with no statistically significant intergroup differences, and no other skeletal parameters showed significant between-group changes. Conclusions: Both appliances effectively corrected Class II malocclusions. However, the customized elastodontic device provided better dentoalveolar control, particularly in managing anterior crowding and incisor inclination. Its individualized fit may enhance biomechanical precision and improve overall treatment outcomes in growing patients. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
11 pages, 227 KB  
Article
Hematological Inflammatory Markers Across Neurodevelopmental Disorders: Preliminary Findings of an Observational Retrospective Study
by Raffaele Garotti, Maria Pia Riccio, Chiara Staffa, Mariangela Pezone and Carmela Bravaccio
Brain Sci. 2025, 15(9), 937; https://doi.org/10.3390/brainsci15090937 (registering DOI) - 28 Aug 2025
Abstract
Background/Objectives: Alterations in immunoinflammatory activation may constitute a pathogenetic mechanism in neurodevelopmental disorders (NDDs). Blood cell count (CBC) parameters and hematological inflammatory indices (neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio) are now assuming a greater role as potential biomarkers for NDDs. Methods: In this [...] Read more.
Background/Objectives: Alterations in immunoinflammatory activation may constitute a pathogenetic mechanism in neurodevelopmental disorders (NDDs). Blood cell count (CBC) parameters and hematological inflammatory indices (neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio) are now assuming a greater role as potential biomarkers for NDDs. Methods: In this retrospective observational study, we gathered data on 135 medication-free individuals aged 6 to 17 years: 90 with NDDs (34 with autism spectrum disorder (ASD), 29 with attention-deficit/hyperactivity disorder, 14 with intellectual disability, and 13 with tic disorder) and 45 typically developed controls. The variables analyzed were compared using analysis of variance including Bonferroni posthoc testing for pairwise comparisons Significance was defined as p < 0.05. Results: The analysis of variance revealed statistical significance for all evaluated CBC parameters, as well as for the lymphocyte-to-monocyte ratio. Notably, subjects with ASD exhibited increased values of neutrophils, lymphocytes, monocytes, and eosinophils compared to both typically developing subjects and other NDDs. The lymphocyte-to-monocyte ratio was found to be lower in the tic disorder group compared to typically developing subjects. The elevated lymphocyte and monocyte levels in ASD subjects might reflect chronic low-grade inflammation. Conclusions: Consistent with the evidence in literature, statistically significant differences between the NDD group and typically developed subjects in the CBC parameters were found. The principal limitations of this investigation are the restricted sample size and the exclusion of specific NDD subtypes. Future research is needed to evaluate CBC parameters and inflammatory indices in a broader spectrum of NDDs to better understand the immunoinflammatory response specific to each disorder. Full article
26 pages, 1680 KB  
Article
Uniformity Testing and Estimation of Generalized Exponential Uncertainty in Human Health Analytics
by Mohamed Said Mohamed and Hanan H. Sakr
Symmetry 2025, 17(9), 1403; https://doi.org/10.3390/sym17091403 - 28 Aug 2025
Abstract
The entropy function, as a measure of information and uncertainty, has been widely applied in various scientific disciplines. One notable extension of entropy is exponential entropy, which finds applications in fields such as optimization, image segmentation, and fuzzy set theory. In this paper, [...] Read more.
The entropy function, as a measure of information and uncertainty, has been widely applied in various scientific disciplines. One notable extension of entropy is exponential entropy, which finds applications in fields such as optimization, image segmentation, and fuzzy set theory. In this paper, we explore the continuous case of generalized exponential entropy and analyze its behavior under symmetric and asymmetric probability distributions. Particular emphasis is placed on illustrating the role of symmetry through analytical results and graphical representations, including comparisons of entropy curves for symmetric and skewed distributions. Moreover, we investigate the relationship between the proposed entropy model and other information-theoretic measures such as entropy and extropy. Several non-parametric estimation techniques are studied, and their performance is evaluated using Monte Carlo simulations, highlighting asymptotic properties and the emergence of normality, an aspect closely related to distributional symmetry. Furthermore, the consistency and biases of the estimation methods, which rely on kernel estimation with ρcorr-mixing dependent data, are presented. Additionally, numerical calculations based on simulation and medical real data are applied. Finally, a test of uniformity using different test statistics is given. Full article
(This article belongs to the Special Issue Symmetric or Asymmetric Distributions and Its Applications)
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9 pages, 634 KB  
Brief Report
Biomarker-Associated Remission After Switching to Dupilumab in Severe Asthma Following Failure of Prior Biologics
by Fabio Romano Selvi, David Longhino, Gabriele Lucca, Ilaria Baglivo, Maria Antonietta Zavarella, Chiara Laface, Laura Bruno, Arianna Delfino Spiga, Sara Gamberale, Ludovica Fabbroni, Angela Rizzi, Arianna Aruanno, Marina Curci, Alessandro Buonomo, Stefania Colantuono, Marinella Viola, Gianluca Ianiro, Antonio Gasbarrini and Cristiano Caruso
Biomedicines 2025, 13(9), 2096; https://doi.org/10.3390/biomedicines13092096 - 28 Aug 2025
Abstract
Background/Objectives: Severe asthma remains difficult to treat, even with the range of biologics we now have that target type 2 inflammation. Some patients do not respond well enough to the first biologic they try, which raises the question of whether switching to [...] Read more.
Background/Objectives: Severe asthma remains difficult to treat, even with the range of biologics we now have that target type 2 inflammation. Some patients do not respond well enough to the first biologic they try, which raises the question of whether switching to another option can help. In this study, we looked at how patients who had unsatisfactory therapeutic outcomes on other biologics responded—both clinically and at the biomarker level—after switching to dupilumab. Methods: We reviewed data from the Allergy and Clinical Immunology Unit of Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy, between January and June 2025. The study included fifteen adults with uncontrolled severe asthma who had previously been treated for at least six months with benralizumab, omalizumab, or mepolizumab before switching to dupilumab. We evaluated demographic, clinical and laboratory data. Lung function (Forced Expiratory Volume in 1 s (FEV1)), blood eosinophils, total and specific IgE to staphylococcal enterotoxins, eosinophil cationic protein (ECP), free light chains (FLC), and FeNO were assessed at the time of the switch and again after 12 months. Comparisons were made using paired tests, and a p-value < 0.05 was considered statistically significant. Results: After a year on dupilumab, we saw clear improvements: mean FEV1 went up by about 10.8% predicted (p = 0.002), FeNO dropped by an average of 22 ppb (p = 0.005), blood eosinophils fell by roughly 400 cells/µL (p = 0.003), and ECP levels decreased by 13 µg/L (p = 0.009). Kappa FLCs also showed a significant drop (p = 0.04). Clinically, 40% of patients met criteria for a meaningful response, and 20% achieved complete remission. Dependence on oral corticosteroids was notably reduced. Baseline levels of eosinophils, ECP, IgE, and FLCs correlated with response to treatment. Conclusions: Our study, despite the small sample size, highlights that in patients with severe asthma who do not show a good response to their first biologic, switching to dupilumab can lead to significant improvements. Markers of type 2 inflammation at baseline might help predict who benefits most. Larger, multi-center, prospective studies are needed to confirm these results. Full article
(This article belongs to the Special Issue Recent Advances in Chronic Rhinosinusitis and Asthma: 2nd Edition)
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10 pages, 1406 KB  
Article
Safety and Outcomes of Thyroid Surgery: A High-Volume Center Case Series and the Role of Intraoperative Neuromonitoring in Preventing Complications
by Mariarita Tarallo, Cecilia Carlino, Daniele Crocetti, Giuseppe Cavallaro, Andrea Polistena, Enrico Fiori, Paolo Sapienza and Marco Bononi
J. Clin. Med. 2025, 14(17), 6077; https://doi.org/10.3390/jcm14176077 - 28 Aug 2025
Abstract
Background: Thyroidectomy is one of the most performed endocrine operations worldwide; among the most significant and feared complications are hypoparathyroidism and recurrent laryngeal nerve (RLN) injury. The purpose of this study is to analyze clinical outcomes and complication rates in thyroid surgery performed [...] Read more.
Background: Thyroidectomy is one of the most performed endocrine operations worldwide; among the most significant and feared complications are hypoparathyroidism and recurrent laryngeal nerve (RLN) injury. The purpose of this study is to analyze clinical outcomes and complication rates in thyroid surgery performed at a single high-volume center, with a specific focus on the impact of intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve. Methods: A retrospective observational study was conducted on 1263 patients who underwent thyroid surgery between 2009 and 2024. Data on demographics, surgical procedures, and postoperative complications were collected. Outcomes were compared between the pre-IONM (2009–2017) and post-IONM (2018–2024) periods. Statistical analysis included descriptive measures, chi-square or Fisher’s exact tests, and Kaplan–Meier survival analysis with log-rank comparison. Results: Among the 1263 procedures, 76.7% were total thyroidectomies. The overall incidence of transient and permanent hypoparathyroidism was 2.37% and 0.79%, respectively. RLN injuries included 2 bilateral palsies (0.16%, pre-IONM only), 37 transient unilateral palsies (2.93%), and 10 permanent unilateral palsies (0.79%). After IONM introduction, the incidence of RLN injuries significantly decreased (p = 0.03), and no bilateral injuries were observed (p = 0.04). Kaplan–Meier analysis showed that 92% of transient RLN palsies resolved within 4 months, with significantly faster recovery in the post-IONM group (log-rank p = 0.02). Conclusions: Thyroid surgery in high-volume centers is associated with low complication rates. The implementation of IONM, particularly continuous monitoring, has significantly improved RLN preservation and enhanced recovery from transient injuries. These findings support the routine integration of IONM in thyroid surgery to maximize safety and functional outcomes. Full article
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13 pages, 960 KB  
Article
Integration of Circulating miR-31-3p and miR-196a-5p as Liquid Biopsy Markers in HPV-Negative Primary Laryngeal Squamous Cell Carcinoma
by Gergana Stancheva, Silva Kyurkchiyan, Iglika Stancheva, Julian Rangachev, Venera Dobriyanova, Diana Popova, Radka Kaneva and Todor M Popov
Diseases 2025, 13(9), 279; https://doi.org/10.3390/diseases13090279 - 27 Aug 2025
Abstract
Background and Objectives: Laryngeal cancer is a common head and neck tumor burden, with no significant improvements in long term patient survival. Despite the progress of molecular genetics and oncology strategies, there is still a lack of biomarker use in routine clinical practice [...] Read more.
Background and Objectives: Laryngeal cancer is a common head and neck tumor burden, with no significant improvements in long term patient survival. Despite the progress of molecular genetics and oncology strategies, there is still a lack of biomarker use in routine clinical practice for early laryngeal cancer screening or diagnosis. miRNAs are explored as promising molecules, that could serve as liquid biopsy. Our goal is to explore the screening potential of miR-31-3p and miR-196a-5p in early- and advanced-stage laryngeal HPV-negative plasma samples. Methods: In this study, 50 plasma samples obtained from early and advanced HPV-negative laryngeal cancer patients were included. The expression levels of mir-31-3p and miR-196a-5p were analyzed via TaqMan RT-qPCR. SPSS v27.0 was used for statistical analysis. Results: For the first time, miR-31-3p and miR-196a-5p were analyzed in plasma samples from early HPV-negative primary LSCC patients. Both circulating miRNAs showed significantly elevated expression levels in early and advanced laryngeal cancer samples. miR-31-3p was significantly associated with T stages (p < 0.001) and N stages (p = 0.009). The ROC analysis revealed that miR-31-3p could significantly discriminate early-stage from advanced-stage LSCC with an AUC of 0.850 (95% CI: 0.743–0.956, p < 0.001) at an RQ cutoff of 2.03, achieving a sensitivity of 95.5% and a specificity of 64%. Nevertheless, miR-196a-5p was found to be significantly overexpressed in early-stage LSCC, which could contribute to the development of its screening potential. For the first time, both miRNAs revealed a significant positive correlation, which indicates that miR-31-3p and miR-196a-5p could coregulate cancerogenesis. Conclusions: In conclusion, the data revealed that miR-31-3p has greater potential as an LSCC screening marker in comparison to miR-196a-5p. Still, miR-196a-5p also showed promising results in early-stage laryngeal cancer monitoring. The utilization of circulating miR-31-3p or miR-196a-5p analysis could enable liquid biopsy approaches, with results potentially informing treatment monitoring strategies, personalized oncological protocols, and early diagnosis. These advancements could ultimately benefit patient outcomes by improving laryngeal organ preservation and survival rates. Full article
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23 pages, 4327 KB  
Article
A Global Perspective on Local Sea Level Changes
by Hessel G. Voortman and Rob De Vos
J. Mar. Sci. Eng. 2025, 13(9), 1641; https://doi.org/10.3390/jmse13091641 - 27 Aug 2025
Abstract
In 2021, the IPCC published new sea level projections. For the first time, the projections gave insight into expected relative sea level rise locally. A prudent designer of coastal infrastructure will want to know how the local projections compare to local observations. That [...] Read more.
In 2021, the IPCC published new sea level projections. For the first time, the projections gave insight into expected relative sea level rise locally. A prudent designer of coastal infrastructure will want to know how the local projections compare to local observations. That comparison, to date, has not been made. We compared local projections and observations regarding the rate of rise in 2020. We used two datasets with local sea level information all over the globe. In both datasets, we found approximately 15% of the available sets suitable to establish the rate of rise in 2020. Geographic coverage of the suitable locations is poor, with the majority of suitable locations in the Northern Hemisphere. Latin America and Africa are severely under-represented. Statistical tests were run on all selected datasets, taking acceleration of sea level rise as a hypothesis. In both datasets, approximately 95% of the suitable locations show no statistically significant acceleration of the rate of sea level rise. The investigation suggests that local, non-climatic phenomena are a plausible cause of the accelerated sea level rise observed at the remaining 5% of the suitable locations. On average, the rate of rise projected by the IPCC is biased upward with approximately 2 mm per year in comparison with the observed rate. Full article
(This article belongs to the Special Issue Sea Level Rise and Related Hazards Assessment)
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12 pages, 4072 KB  
Article
A Comparative Analysis of Cardiac Amyloidosis and Cardiac Sarcoidosis: A Single-Center Experience
by Luka Katic, Sanjay Sivalokanathan, James Choi, Darren Kong, Vincent A. Torelli, Alexander Silverman, Alexander Nagourney, Usman Saeedullah, Komail Jafri, Syed Zaidi, Serdar Farhan and Ashish Correa
J. Clin. Med. 2025, 14(17), 6056; https://doi.org/10.3390/jcm14176056 - 27 Aug 2025
Abstract
Background/Objectives: Cardiac amyloidosis (CA) and cardiac sarcoidosis (CS) are two distinct infiltrative cardiomyopathies that can present with overlapping clinical features, including heart failure and arrhythmias. However, they arise from fundamentally different pathophysiological mechanisms: amyloid protein deposition in CA versus granulomatous inflammation in [...] Read more.
Background/Objectives: Cardiac amyloidosis (CA) and cardiac sarcoidosis (CS) are two distinct infiltrative cardiomyopathies that can present with overlapping clinical features, including heart failure and arrhythmias. However, they arise from fundamentally different pathophysiological mechanisms: amyloid protein deposition in CA versus granulomatous inflammation in CS. These differing pathophysiologies result in divergent imaging patterns, clinical trajectories, and treatment strategies. This study aims to compare the clinical presentations, imaging characteristics, and outcomes of patients with CA and CS to identify key differentiating factors that can improve diagnostic precision and guide therapy. Methods: This single-center, retrospective, cross-sectional study analyzed electronic medical records of patients diagnosed with CA (limited to transthyretin CA) or CS at Mount Sinai Morningside system from January 2017 until October 2023. Patients were identified using diagnostic codes and confirmed by histology or disease-specific imaging criteria. Clinical data, transthoracic echocardiography (TTE), cardiac magnetic resonance (CMR) imaging, pyrophosphate scintigraphy (PYP), and fluorodeoxyglucose positron emission tomography (FDG-PET) findings were collected. Statistical comparisons between groups were performed using chi-square tests and independent t-tests, with p < 0.05 considered statistically significant. Results: A total of 16,834 patients were screened and 216 patients were included in the analysis (125 CA, 92 CS). CA patients were older (78.2 vs. 62.0 years, p = 0.01), had greater interventricular septal thickness (1.57 vs. 1.10 cm, p = 0.01), and exhibited diffuse late gadolinium enhancement (LGE) and elevated extracellular volume (ECV) on CMR. CS patients had higher rates of ventricular tachycardia (53.3% vs. 10.7%, p = 0.01), increased myocardial fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) (90%), and more frequent implantable cardioverter-defibrillator (ICD) placement (66.3% vs. 13.0%, p = 0.01). Conclusions: CA and CS demonstrate distinct imaging profiles, arrhythmic risks, and treatment patterns. Early differentiation using advanced imaging is crucial for implementing disease-modifying therapies in CA and for immunosuppression and ICD implantation in CS, thereby improving patient outcomes. Full article
(This article belongs to the Section Cardiovascular Medicine)
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22 pages, 2895 KB  
Article
Dynamic Degradation of Seed Ropes: Influence of Material Type and Adhesion to Different Soils
by Jiaoyang Duan, Xiang Liu and Baolong Wang
Agronomy 2025, 15(9), 2065; https://doi.org/10.3390/agronomy15092065 - 27 Aug 2025
Abstract
Seed rope direct seeding technology is a precision seeding method that can accurately mix and arrange multiple varieties based on specific grain spacing and quantity, making it suitable for precision breeding and variety comparison studies. As seed ropes serve as the crucial seed [...] Read more.
Seed rope direct seeding technology is a precision seeding method that can accurately mix and arrange multiple varieties based on specific grain spacing and quantity, making it suitable for precision breeding and variety comparison studies. As seed ropes serve as the crucial seed encapsulation material in seed rope direct seeding, this study employed a multi-faceted approach to investigate the dynamic degradation of nonwoven fabric and paper material seed ropes under diverse environmental conditions as well as their adhesion properties with Ultisols, Oxisols, and the Substrate in this seeding technique. Firstly, the degradation dynamics were systematically analyzed using image-based surface area detection, breaking force measurement, and organic carbon content analysis. Secondly, the process of seed rope laying was simulated by modeling the sliding friction and adhesion forces during the detachment of soil slurry. The laying motion was simulated considering both sliding friction (during the uniform-speed interaction between the seed rope and soil slurry) and adhesion (during upward detachment), providing crucial reference values for optimizing the rope-breaking mechanism in field applications. The study yielded several significant findings: In natural environments, Wood pulp paper seed rope degrades significantly faster than nonwoven fabric, with a degradation cycle of only 5.68 days in winter (approximately 34% of the degradation cycle of nonwoven fabric) and 4.70 days in summer (approximately 78% of the degradation cycle of nonwoven fabric). The main effect of seed viability on the degradation rate of seed tapes was not statistically significant. The degradation of Wood pulp paper seed rope was relatively predictable in indoor settings but exhibited notable fluctuations outdoors. The peak friction occurred at 35% soil moisture content, with values of 1.22 N for Wood pulp paper seed rope and 2.08 N for nonwoven fabric when interacting with Oxisols; nonwoven ropes demonstrated stronger adhesion than Wood pulp paper seed rope in the Substrate (at moisture contents of 25–30% and 40–45%) and Oxisols (at 35–45% moisture). In Ultisols, nonwoven fabric only showed superior adhesion compared to Wood pulp paper seed rope at 35–45% moisture, while Wood pulp paper seed rope exhibited better adhesion in other moisture ranges. Full article
16 pages, 446 KB  
Article
Malnutrition and Nutrition Impact Symptoms in Kuwaiti Colorectal Cancer Patients: Validation of PG-SGA Short Form
by Raghad Obaid and Dalal Alkazemi
Nutrients 2025, 17(17), 2770; https://doi.org/10.3390/nu17172770 - 27 Aug 2025
Abstract
Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC [...] Read more.
Background/Objectives: Malnutrition is a common but underrecognized complication in colorectal cancer (CRC), contributing to poor treatment outcomes and reduced quality of life. Regional data from the Gulf remains limited. This study assessed the prevalence of malnutrition and nutrition impact symptoms (NISs) among CRC patients in Kuwait. It evaluated the diagnostic performance of the PG-SGA Short Form (PG-SGA SF) in comparison to the full PG-SGA and the Malnutrition Screening Tool (MST). Methods: A cross-sectional study was conducted among 65 CRC outpatients at the Kuwait Cancer Control Center. Nutritional status was assessed using the full PG-SGA, PG-SGA SF, and MST. Dietary intake, anthropometry, biochemical parameters, and NISs were collected. Logistic regression identified independent predictors of malnutrition, and the performance of the tool was evaluated using kappa statistics and diagnostic accuracy metrics. Results: Malnutrition (PG-SGA B/C) was identified in 61.4% of patients. Loss of appetite, dry mouth, and nausea were significantly associated with malnutrition (p < 0.00385); dry mouth independently predicted malnutrition (OR: 17.65, 95% CI: 2.02–154.19, p = 0.009). BMI was not predictive, but reduced mid-arm circumference was significantly associated. PG-SGA SF showed strong agreement with the full PG-SGA (κ = 0.75), with high sensitivity (87.2%) and specificity (88.5%), outperforming MST (κ = 0.38). Only 23.5% of moderately malnourished patients were referred to a dietitian. Conclusions: Malnutrition and NIS are highly prevalent among Kuwaiti CRC patients. PG-SGA SF is a valid and efficient screening tool that should replace MST in oncology settings. Symptom-informed screening and structured referral protocols are crucial for enhancing nutrition care. Full article
(This article belongs to the Section Clinical Nutrition)
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23 pages, 4540 KB  
Brief Report
Injectable Porcine Collagen in Musculoskeletal Disorders: A Delphi Consensus
by Orazio De Lucia, Federico Giarda, Andrea Bernetti, Chiara Ceccarelli, Giulia Letizia Mauro, Fabrizio Gervasoni, Lisa Berti and Antonio Robecchi Majnardi
J. Clin. Med. 2025, 14(17), 6058; https://doi.org/10.3390/jcm14176058 - 27 Aug 2025
Abstract
Background/Objectives: Musculoskeletal disorders causing chronic pain are increasingly prevalent due to factors such as injury, overuse, and aging, leading to interest in porcine collagen injections as a potential therapeutic and conservative option. Despite promising results, evidence-based information on this treatment is scarce. To [...] Read more.
Background/Objectives: Musculoskeletal disorders causing chronic pain are increasingly prevalent due to factors such as injury, overuse, and aging, leading to interest in porcine collagen injections as a potential therapeutic and conservative option. Despite promising results, evidence-based information on this treatment is scarce. To address this gap, the authors conducted an eDelphi consensus among expert Italian physicians in musculoskeletal pain to gather their perspectives on collagen injections. Methods: A Steering Committee and a Panel of 23 physicians developed the statements list (36) including the modalities, safety, and efficacy of intra- and extra-articular collagen injections. Panelists rated their agreement with each statement on a 5-point Likert scale (5 means “Strong Agreement”). Consensus was defined as when at least 75% of the panelists voted with a score of ≥4/5 after two rounds of votes. The weighted average (WA) was calculated for each statement. As control, we elaborated a Hypothetical Parametric Distribution (HPD WA equal to 3.00), where the percent of panelists is equally distributed along each Likert Scale Value (LSV). The maximum WA for 75% of the consensus is established at 3.75. Indeed, the combination of 75% having WA > 3.75 was defined as “Strong Agreement”. While, if the consensus was under 75%, the WA vs. HPD comparison was performed using the Wilcoxon Test. Significant differences among the distribution of LSVs judged the statement as “Low Level of Agreement”. Disagreement was evaluated when the WA was under the PHD. Results: The consensus was reached “Strong Agreement” after twin rounds in 29 out of 36 (8.55%). In 5 out of 36 statements (13.89%), the panelists reached the “Low Level of Agreement” by statistical tests. In the remaining two statements, there was a “Consensus of Disagreement”. All panelists unanimously agreed on crucial points, such as contraindications, non-contraindication based solely on comorbidity, and the importance of monitoring collagen’s effectiveness. Unanimous agreement was reached on recommending ultrasound guidance and associating collagen injections with therapeutic exercise and physical modalities. Substantial consensus (concordance > 90%) supported collagen injections for osteoarthritis, chondropathy, and degenerative tendinopathies, emphasizing intra- and peri-articular treatment, even simultaneously. However, areas with limited evidence, such as the combination of collagen with other injectable drugs, treatment of myofascial syndrome, and injection frequency, showed disagreement. The potential of intra-tendinous porcine collagen injections for tendon regeneration yielded mixed results. Conclusions: Clinicians experts in musculoskeletal pain agree on using collagen injections to treat pain originating from joints (e.g., osteoarthritis) and periarticular (e.g., tendinopathies). Full article
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15 pages, 481 KB  
Article
Effects of Twelve Weeks of Virtual Square Stepping Exercises on Physical Function, Fibromyalgia’s Impact, Pain and Falls in Spanish Women with Fibromyalgia
by Ángel Denche-Zamorano, Damián Pereira-Payo, Raquel Pastor-Cisneros, Juan Manuel Franco-García, Diana Salas-Gómez, Javier De Los Ríos-Calonge, Paulina Fuentes Flores, Jorge Carlos-Vivas, David Mendoza-Muñoz, María Mendoza-Muñoz, Daniel Collado-Mateo and José Carmelo Adsuar
Sci 2025, 7(3), 117; https://doi.org/10.3390/sci7030117 - 27 Aug 2025
Abstract
Severe fatigue, difficulty falling asleep, body stiffness, cognitive impairment, and widespread pain are some of the primary symptoms experienced by individuals with fibromyalgia (FM), leading to reduced physical function, increased frailty, and elevated fall risk. The present study aimed to evaluate the effects [...] Read more.
Severe fatigue, difficulty falling asleep, body stiffness, cognitive impairment, and widespread pain are some of the primary symptoms experienced by individuals with fibromyalgia (FM), leading to reduced physical function, increased frailty, and elevated fall risk. The present study aimed to evaluate the effects of the Virtual Square Step Exercise (V-SSE) program on physical function, frailty, FM impact, pain, fear, and risk of falling, and fall incidence in women with FM. A randomized controlled trial was conducted with 61 sedentary Spanish women with FM. Participants were randomly assigned to two groups: V-SSE and the control group. The V-SSE group completed an exercise program based on the V-SSE for 12 weeks (3 sessions/week), while the control group maintained their usual lifestyle and treatment. Physical function was assessed using the Timed Up and Go (TUG), Four-Step Square (FSST), 6-Minute Walking Test (6MWT), and others. Frailty was assessed with the Short Physical Performance Battery (SPPB). FM impact, pain, falls, and fear of falling were evaluated via questionnaires. Significant intergroup differences were only found in the 30 m Walking Test (p = 0.023; E.S. = 0.539), due to worsening in the control group. Although significant improvements were found in other variables in the V-SSE group, Dual Sit to Stand (p = 0.038), FM impact (p = 0.010), pain (p = 0.003) and falls (p = 0.037), these did not remain statistically significant after adjusting for multiple comparisons, nor were they corroborated in the intergroup comparison. A 12-week program based on the V-SSE was not effective in improving physical function, frailty, FM impact, pain, falls, fear, and risk of falling in Spanish women with FM. Full article
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22 pages, 7015 KB  
Article
Induction Motor Fault Diagnosis Using Low-Cost MEMS Acoustic Sensors and Multilayer Neural Networks
by Seon Min Yoo, Hwi Gyo Lee, Wang Ke Hao and In Soo Lee
Appl. Sci. 2025, 15(17), 9379; https://doi.org/10.3390/app15179379 - 26 Aug 2025
Abstract
Induction motors are the dominant choice in industrial applications due to their robustness, structural simplicity, and high reliability. However, extended operation under extreme conditions, such as high temperatures, overload, and contamination, accelerates the degradation of internal components and increases the likelihood of faults. [...] Read more.
Induction motors are the dominant choice in industrial applications due to their robustness, structural simplicity, and high reliability. However, extended operation under extreme conditions, such as high temperatures, overload, and contamination, accelerates the degradation of internal components and increases the likelihood of faults. These faults are challenging to detect, as they typically develop gradually without clear external indicators. To address this issue, the present study proposes a cost-effective fault diagnosis system utilizing low-cost MEMS acoustic sensors in conjunction with a lightweight multilayer neural network (MNN). The same MNN architecture is employed to systematically compare three types of input feature representations: raw time-domain waveforms, FFT-based statistical features, and PCA-compressed FFT features. A total of 5040 samples were used to train, validate, and test the model for classifying three conditions: normal, rotor fault, and bearing fault. The time-domain approach achieved 90.6% accuracy, misclassifying 102 samples. In comparison, FFT-based statistical features yielded 99.8% accuracy with only two misclassifications. The FFT + PCA method produced similar performance while reducing dimensionality, making it more suitable for resource-constrained environments. These results demonstrate that acoustic-based fault diagnosis provides a practical and economical solution for industrial applications. Full article
(This article belongs to the Special Issue Artificial Intelligence in Machinery Fault Diagnosis)
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15 pages, 884 KB  
Article
Enhancing Sustainability Through Quality Controlled Energy Data: The Horizon 2020 EnerMaps Project
by Simon Pezzutto, Dario Bottino-Leone and Eric John Wilczynski
Sustainability 2025, 17(17), 7684; https://doi.org/10.3390/su17177684 - 26 Aug 2025
Abstract
The Horizon 2020 EnerMaps project addresses the fragmentation and variable reliability of European energy datasets by developing a reproducible quality control (QC) framework aligned with FAIR principles. This research supports sustainability goals by enabling better decision making in energy management, resource optimization, and [...] Read more.
The Horizon 2020 EnerMaps project addresses the fragmentation and variable reliability of European energy datasets by developing a reproducible quality control (QC) framework aligned with FAIR principles. This research supports sustainability goals by enabling better decision making in energy management, resource optimization, and sustainable policy development. This study applies this framework to an initial inventory of 50 spatially referenced energy datasets, classifying them into three assessment levels and subjecting each level to progressively deeper checks: expert consultation, metadata verification against a customized “DataCite/schema.org” schema, documentation review, completeness analysis, consistency testing via simple linear regressions, comparative descriptive statistics, and community feedback preparation. The results show that all datasets are findable and accessible, yet critical FAIR attributes remain weak: 68% lack explicit licenses and 96% omit terms-of-use statements; methodology descriptions are present in 77% of cases, while quantitative accuracy information appears in only 43%. Completeness screening reveals that more than half of the datasets exhibit over 20% missing values in one or more key dimensions. Consistency analyses nevertheless indicate statistically significant correlations (p < 0.05) for the majority of paired comparisons, supporting basic reliability. By improving the FAIRness (Findable, Accessible, Interoperable, Reusable) of energy data, this study directly contributes to more effective sustainability assessments and interventions. The proposed QC workflow therefore provides a scalable route to improve the transparency, comparability, and reusability of heterogeneous energy data, and its adoption could accelerate open energy modelling and policy analysis across Europe. Full article
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