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Machine learning models based on magnetic resonance imaging for predicting Lymphovascular Invasion in Invasive Breast Cancer
Objectives Treatment strategies for invasive breast cancer require accurate lymphovascular invasion (LVI) predictions. This study aimed to investigate the feasibility and effectiveness of delta radiomics signature based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and radiomics signature based on T2-weighted fat suppressed imaging(T2FS) for assessing LVI in invasive breast cancer. Materials and methods A total of 166 patients with resectable invasive breast cancer who underwent preoperative DCE-MRI and T2FS from July 10, 2020 to December 31, 2023 were enrolled. Radiomics features were extracted from pre-contrast phase (RF pre ), second post-contrast phase (RF post ), and Delta radiomics features (RF Delta ) calculated as RF post minus RF pre . Then four radiomics signatures (RS T2 , RS pre , RS post , RS Delta ) were further developed based on the Random Forest model for RF T2 , RF pre , RF post and RF Delta , respectively. The predictive performance of all signatures was evaluated by receiver operating characteristic (ROC) analysis, with accuracy and area under the curve (AUC) as the main quantitative metrics. Results In the test set, RS Delta (10 features) achieved the highest accuracy of 0.717 and an AUC of 0.764; RS post (8 features) had an accuracy of 0.565 and an AUC of 0.610; RS pre (7 features) and RS T2 (6 features) both showed an accuracy of 0.565 with AUCs of 0.535 and 0.662, respectively. Statistical differences were observed in predictive performance between RS Delta and RS pre , RS post (both p < 0.05), while no significant difference was found between RS Delta and RS T2 ( p = 0.239). Conclusion RS T2 , RS pre , RS post and RS Delta are all feasible for predicting LVI in invasive breast cancer, and RS Delta outperforms the other three radiomics signatures, which can serve as a potential non-invasive imaging biomarker for LVI prediction in clinical practice.
Knowledge, attitudes, and practices regarding mycoplasma pneumoniae pneumonia among family members of affected children
Abstract This study aimed to assess the knowledge, attitudes, and practices (KAP) among family members of children with Mycoplasma pneumoniae pneumonia (MPP) and explore the relationships between these dimensions. A cross-sectional survey was conducted at Xuzhou First People’s Hospital (June-July 2025). A structured questionnaire collected demographic information and KAP data from 449 family caregivers. Adequate KAP levels were defined as scores ≥ 70% of the maximum. Structural equation modeling (SEM) analyzed the direct and indirect associations between knowledge, attitude, and practice. Most respondents were female (74.16%), with a mean age of 35.60 ± 6.62 years. The mean scores were 12.61 ± 5.00 (knowledge, range 0–20), 56.00 ± 5.74 (attitude, range 13–65), and 39.92 ± 4.63 (practice, range 9–45). Using the ≥ 70% cutoff, 170/449 (37.86%) had adequate knowledge, 442/449 (98.44%) had a positive attitude, and 430/449 (95.77%) reported proactive practices, though the latter two figures likely reflect the engagement of caregivers already active in hospital follow-up systems. In the latent-variable SEM, higher knowledge scores were positively associated with more favorable attitudes (standardized β = 0.404, P < 0.001), and more favorable attitudes were associated with better reported practices (standardized β = 0.570, P < 0.001). Knowledge showed a significant indirect association with practice through attitude (standardized β = 0.230, P < 0.01). In this hospital-linked sample of family caregivers (recruited from inpatient/outpatient services and WeChat follow-up groups), knowledge was limited and attitudes were generally positive, while reported practices were overall high, which may reflect selection effects. These findings and the observed associations among knowledge, attitude, and practice should be interpreted in the context of caregivers already engaged in clinical follow-up, and may not generalize to all family caregivers of children with MPP in the community.
The utility of innominate dry bone weight in age estimation: A new pelvic aging method
This research investigated the relationships between bone weight, chronological age, and biological sex. This study examined 383 innominates from individuals aged 16–93 years to investigate how bone weight (here a proxy for bone mineral density) was patterned throughout the lifespan. Standard osteology laboratory equipment as well as a scale were used to measure innominate height and dry bone weight. Dry bone weight is an imperfect proxy for bone mineral density; however, the phenomenon of decreases in bone weight with age was observed and quantified in this dry bone sample. While both males and females are affected by a slow reduction in bone mineral density over the course of their lifespans, this effect is exaggerated in females and was reflected in the study results. To quantify these changes, the authors created predictive Bayesian linear models to estimate age at death from dry bone weight, height, and biological sex. The best performing model R 2 was 0.33, with an average inaccuracy of 9.37 years. Estimated age was within ±10 years of known age for 57.3% of the training sample, and 87.2% of estimated ages at death were within ±20 years of known age. When these models were tested on a smaller modern subsample, the results were both less accurate and less precise, demonstrating a need for validation on expanded modern samples. Overall, these results demonstrate that significant decreases in dry bone weight are associated with increased chronological age in the training sample, particularly in females. This study demonstrates that dry bone weights may be used to support estimates of chronological age; however, they should be applied cautiously, further tested, and only used in concert with well-validated age-at-death estimation methods.
Short-term intraocular pressure changes following intravitreal aflibercept 8 mg versus 2 mg in diabetic macular edema: a prospective observational study
A student-led pilot lecture in nutrition as a catalyst for curriculum change: A case study from one medical school
Background Poor diet is the leading cause of global disability and premature death, contributing to 11 million deaths annually. Despite this, nutrition remains underemphasized in medical education, with over 70% of United States (U.S.) medical schools failing to meet the National Research Council’s 1985 recommendation of 25 hours of nutrition training. In 2022, the U.S. House of Representatives passed a bipartisan resolution calling for meaningful nutrition education for health professionals. Amid this gap, unreliable media sources frequently shape patient nutrition knowledge rather than professional sources such as registered dietitians or licensed physicians. Strengthening interprofessional collaboration with nutrition professionals could enhance dietary counseling and patient care. Methods In response, one student implemented and evaluated the usefulness of a clinical nutrition lecture at the University of Miami Miller School of Medicine (UMMSM). Resulting student enthusiasm catalyzed the formation of a 50-member taskforce formed to expand and integrate nutrition longitudinally. A pre- and post-lecture survey around the session (Npre = 98, Npost = 77) assessed knowledge, perceptions of nutrition training, and comfort with dietary counseling. Results Knowledge of evidence-based nutrition improved significantly (p < .001). Post-lecture, students reported greater confidence applying nutrition in clinical practice and increased interest in lifestyle medicine training (p < .001). Conclusions After the session, there was increased self-reported confidence and understanding of nutrition’s role in health amongst students. Resulting student enthusiasm catalyzed the formation of a 50-member taskforce formed to expand nutrition education longitudinally with additional lectures to be integrated into the curriculum. This trajectory illustrates how even a small pilot can stimulate institutional dialogue and student-led momentum. We discuss key elements of an effective, multifaceted nutrition curriculum and propose a roadmap adaptable to other institutions.
Comparison of transcutaneous electrical nerve stimulation and interferential therapy for salivary stimulation in postmenopausal women: a pilot study
Experimental investigation of four-port MIMO-Dual-Band (MDB) antenna for n260/n263 mmWave bands with analysis including conformal & specific-absorption-rate
The single-input-single-output (SISO) system or the single-port antenna faces the problem of path-loss and fading of the signals, which results in loss of data. However, the fast-data transmission is needed in an hour, and the multiple-input-multiple-output millimeter-Wave (MIMO mmWave ) technology satisfies the high-speed of communication without a low loss of data, irrespective of the design of the antenna. The millimeter-Wave bands need to be explored since the lower 5 G-sub 6 GHz is already overloaded with huge traffic and is unable to cater to the needs. Hence, to utilize millimeter-Wave bands for n260 and partial-n263 in FR2, a four-port MIMO mmWave antenna is designed. The proposed MIMO mmWave work is characterized for S-parameters, far-field results, bending analysis, and SAR calculation for on-body applications. This research article discusses ultra-compact dual-band MIMO mmWave antenna radiating EM Energy is designed for n260 and partial-n263 band with etched circular-patch printed on top-surface of 0.254 mm thickness Rogers-flexible substrate and ground on opposite surface. The single-port version occupies PCB space of 6 × 8 mm2 (0.93λ 0 ×1.23λ 0 ), and the four-port proposed version utilizes 12 × 16 mm 2 (1.85λ 0 ×2.47λ 0 ) space. The fabricated four-port mmWave antenna achieves impedance bandwidth of 36.60GHz-39.12GHz and 58.48GHz-61.48GHz. The MIMO antenna also offers an averaged gain in n260 and partial-n263 band corresponding to 6.532dBi & 6.978dBi. The conformal capability at 45° in the x-axis and y-axis maintains both the mmWave bands without much deviation in comparison with planar no-bending of the MIMO mmWave antenna. The diversity parameter for n260/ partial-n263 bands corresponds to Envelope Correlation Coefficient<2.78 × 10 -4 (38.0GHz)/2.93 × 10 -4 (60.0GHz), Diversity Gain mmWave ≈ 10.0dB (38.0GHz/60.0GHz), Total Active Reflection CoefficientmmWave < −7.358dB (38.0GHz)/-9.12dB (60.0GHz), Channel Capacity LossmmWave<1.58 × 10 -2 (38.0GHz)/1.83 × 10 -2 (60.0GHz) and Mean Effective Gain mmWave (all ports) ≈ -30.0dB (38.0GHz/60.0GHz) and is deployable in 5G infrastructure. The SAR analysis with respect to single port corresponds to 0.0174W/Kg at 38.0GHz and 0.0384W/Kg at 60.0W/Kg and the MIMOmmWave values are 0.00895W/Kg at 38.0GHz & 0.0301W/Kg at 60.0GHz.
Early sleep after action observation and motor imagery improved manual dexterity in patients after surgery for metacarpal and phalangeal fractures
Effects of bilateral and unilateral mental practice on actual motor performance and event-related desynchronization
Bilateral hand movement has been reported to enhance actual motor performance and increase motor cortex activation more than unilateral hand movement. This study investigated the interaction effects of bilateral and unilateral mental practice on event-related desynchronization (ERD) amplitude and unilateral motor performance, to explore better clinical rehabilitation for stroke patients with hemiparesis. The task was a ball rotation, where participants circulated two balls on their palm by using their fingers. Seventy-six healthy young adults were randomly assigned to one of three mental practice groups or a control group without mental practice. In the mental practice groups, three subgroups of participants engaged in ball-rotation motor imagery for two blocks in different orders: bilateral hand imagery followed by left hand imagery (BL group), left hand imagery followed by bilateral hand imagery (LB group), and consecutive left hand imagery (LL group). The results showed greater improvement in actual motor performance in the BL group than in the control group, while the performance of the LB and LL groups did not significantly differ from that of the control group. Greater ERD was observed in the BL group than in the LL group in the early sets of the first block. However, ERD amplitude decreased with continued mental practice, and significant correlations between ERD and motor performance were limited. These results suggest that engaging in bilateral mental practice before unilateral mental practice is beneficial in improving unilateral motor performance. Bilateral mental practice following unilateral mental practice may provide neither notable improvements nor detrimental effects on unilateral motor action. Our findings also reveal a mismatch between ERD and motor performance, implying that these two measures are not straightforwardly linked.
Interpretation of serum magnesium concentrations in the presence of the systemic inflammatory response: a large patient cohort study
Abstract The present study aimed to quantify the relationship between the systemic inflammatory response (SIR), measured by C-reactive protein (CRP) and albumin, and serum magnesium concentrations. Retrospective interrogation of laboratory computer databases at 4 centres between 1st October 2018 to 31st March 2019 provided results from patients in whom serum CRP and albumin had been measured together with serum magnesium concentrations. Analyte results were categorized into groups according to CRP and albumin. Patients (n = 9,624) were grouped according to serum magnesium concentrations: within normal range (0.75–1.10 mmol/L) (n = 6,313) (65%), low (< 0.75 mmol/L) (n = 3,152) (33%), or high (> 1.10) (n = 159) (2%). In those patients with a serum magnesium concentration below the normal range and a normal CRP, median serum magnesium concentrations were 0.70 (0.65–0.72) mmol/L, 0.68 (0.60–0.71) mmol/L, and 0.67 (0.59–0.72) mmol/L in patients with serum albumin concentrations ≥ 35 g/L, 25- <35, and < 25 g/L respectively. This represents a 4.2% change in serum magnesium concentrations among patients within the low serum magnesium group between mild inflammation and severe inflammation categories (p = 0.086). In those patients with a normal serum albumin concentration who were within the low serum magnesium category, serum magnesium concentrations were 0.70 (0.65–0.72) mmol/L, 0.69 (0.63–0.72) mmol/L, and 0.68 (0.63–0.71) mmol/L for CRP concentrations < 10 mg/dL, 11–79 mg/dL and > 80 mg/dL respectively. This represents a 2.9% change in serum magnesium concentrations for patients with normal serum albumin concentration between mild – severe inflammation (p = 0.109). Across a large, real-world clinical population, serum magnesium concentrations demonstrated limited variation in relation to the magnitude of the systemic inflammatory response and serum albumin concentration. Routine albumin adjustment of serum magnesium measurements may offer limited additional value as any observed differences in the present study were small and unlikely to be meaningful in clinical practice.
Postpartum depression as the main predictor of impaired mother- infant bonding: A prospective study in a low-risk obstetric and neonatal cohort
Introduction The postpartum period imposes complex demands on women, making it essential to examine the mother-infant bond and its predictors to promote maternal and child health and inform public policy. Objectives To identify the primary predictors of the mother-infant bond within the first six months postpartum, considering sociodemographic, obstetric, and neonatal factors, as well as symptoms of postpartum depression (PPD). Methods A prospective cohort study was conducted with postpartum women in a northeastern Brazilian capital city, assessed at three and six months postpartum. The affective bond was measured using the Postpartum Bonding Questionnaire (PBQ), and PPD symptoms were evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Associations were analyzed using multiple linear regression models and reported as β coefficients (95% confidence intervals). Results PPD was the strongest predictor of impaired mother-infant bonding. At the third month postpartum, PPD was significantly associated with total PBQ scores (β = 1.15, 95% CI: 0.93–1.37), impaired bonding (ABF1: β = 0.59, 95% CI: 0.46–0.72), and anxiety about the infant (ABF3: β = 0.28, 95% CI: 0.23–0.33). These associations remained significant at the sixth month postpartum across the same measures: total PBQ (β = 0.84, 95% CI: 0.61–1.08), ABF1 (β = 0.40, 95% CI: 0.26–0.54), and ABF3 (β = 0.24, 95% CI: 0.19–0.30). In contrast, social support emerged as a protective factor, negatively correlating with total PBQ scores (β = −8.53, 95% CI: −13.03 to −4.04) and impaired bonding (ABF1: β = −3.59, 95% CI: −6.26 to −0.93). Conclusion These findings identify PPD as a primary risk factor and social support as a crucial protective factor for mother-infant bonding. The results underscore the importance of routine PPD screening and the development of targeted interventions to enhance social support networks for women during the postpartum period.
A temporal adaptive dictionary-constrained LDA and Bi-calibrated dual granularity DTM framework for dynamic topic evolution analysis in academic papers
Multi-omics profiling reveals epidermal growth factor as a potential biomarker and therapeutic target in lupus nephritis and ANCA-associated vasculitis with rapidly progressive glomerulonephritis
The kidney is a primary target organ in systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (AAV), which frequently manifest as lupus nephritis (LN) and renal AAV, respectively. A severe acute presentation of both diseases is rapidly progressive glomerulonephritis (RPGN), leading to rapid loss of renal function. However, the shared molecular mechanisms underlying this aggressive phenotype remain poorly defined. This study aimed to identify key biomarkers and pathological processes in acute autoimmune-related glomerulonephritis, with a focus on LN and AAV presenting as RPGN. Through comparative transcriptomic analysis of glomerular samples from patients with LN, AAV, and RPGN against healthy controls, we identified a total of 180 common differentially expressed genes, comprising 33 upregulated and 147 downregulated genes. Pathway analysis revealed enhanced immune and inflammatory responses, including neutrophil extracellular trap (NET) formation, accompanied by significant impairments in amino acid and fatty acid metabolism. A core set of 12 hub genes was identified, and network analysis suggested specific transcriptional and post-transcriptional regulatory axes. Immune infiltration analysis demonstrated a common pattern characterized by decreased resting immune cells and increased activated cells—including memory CD4 ⁺ T cells, NK cells, and mast cells—along with elevated monocyte levels, particularly in LN. Notably, epidermal growth factor (EGF) was significantly downregulated and strongly correlated with impaired renal function, demonstrating good diagnostic performance. These findings suggest that EGF may serve as a potential biomarker for LN and RPGN. This study provides the first systematic transcriptomic analysis of LN and AAV presenting as RPGN, highlighting enhanced inflammation (including NETosis) and dysregulated amino acid/fatty acid metabolism as key glomerular pathological features. Targeting EGF signaling and monocyte differentiation may offer novel therapeutic strategy for LN and AAV presenting as RPGN.
Investigation of microstructure, mechanical properties and fracture behaviour of AA8011/TiB₂ composites for sustainable engineering applications
A landscape analysis of psychedelic facilitation training in the US
Skilled interpersonal support and safety monitoring can enhance the therapeutic potential of psychedelic compounds and reduce the potential for harm. In the anticipation of legalized psychedelic care, and the recognition of ongoing psychedelic use across a variety of contexts, numerous training programs have been established to educate psychedelic facilitators in supporting individuals who take psychedelics. However, psychedelic facilitation training in the US has not been well characterized, making it difficult to appraise the strengths, needs, and gaps in this emerging discipline, especially with regard to the development of competencies in spiritually responsive care. This project used a quality improvement approach to identify common priorities, practices, needs, and gaps in the emerging field of psychedelic facilitation training from the standpoint of 13 established and emerging training organizations from the US. Interviews were conducted with one or more representatives from each participating organization. Notes from these interviews, once confirmed by the interviewees, were synthesized to identify common practices, procedures, priorities, and gaps. Areas of focus among the programs included: careful selection of trainees and faculty; content emphases in instruction; addressing spiritual, existential, religious, and theological topics; and teaching strategies used in programs. Several gaps were also identified, pointing to the need for continuing education among program graduates, parity with other disciplines, and development of field standards in training facilitators. Psychedelic facilitation training is an evolving discipline. Training programs and trainees may benefit from greater collaboration, including ongoing exchange about best practices and adjustments to scientific, social, economic, and regulatory developments.
MSML-DenseXmer: harnessing vision transformers through integration with novel dense networks for medical image fusion
Abstract The integration of multiple modalities in medical imaging allows a thorough representation of structural and functional details, resulting in improved diagnosis and treatment. Deep learning methods outperform conventional methods by automating the extraction of pertinent features and fusing them while preserving both structural and textural integrity. Existing methods lack the ability to capture complex global structures, small-scale textural features, and long-range dependencies, which causes incomplete feature representation. This study presents a novel deep-learning framework that combines an improved DenseNet for capturing local fine- grained features with a Swin Transformer for extracting global structural details and long- range relationships, thereby facilitating a more comprehensive fused output. A modified hybrid approach utilizing L1, L2 and infinity norm is used to generate attention weights in the feature fusion-oriented row-column vector dimension technique. The model is trained on different modalities in the Whole Brain Atlas dataset and the Lung-PET-CT-Dx dataset using a novel loss function. This function improves fusion by integrating pixel loss, structural similarity, and textural preservation. The evaluation of the fused image’s quality involves multiple metrics that assess image clarity, structural integrity, feature retention, contrast improvement, and overall visual accuracy, providing a thorough analysis. The MSML-DenseXmer framework demonstrates improved performance compared to existing approaches across multiple medical imaging modalities. Specifically, it achieves over 9.94% rise in MRI-SPECT fusion, above 6.82% gain in MRI-PET fusion, a minimum of 18.37% increase in MRI-CT fusion, and at least 2.83% gain on the Lungs PET-CT dataset, indicating its potential in improving fusion quality.
Predictive value of neutrophil-to-lymphocyte ratio on hospital outcomes of patients with community-acquired pneumonia
Background Community-acquired pneumonia (CAP) remains a leading cause of hospitalization and mortality worldwide, particularly in low- and middle-income countries. Risk stratification is essential for guiding treatment decisions, yet commonly used biomarkers such as C-reactive protein and procalcitonin are costly and not always readily available. The neutrophil-to-lymphocyte ratio (NLR), a simple index derived from routine blood counts, has been proposed as a cost-effective prognostic marker. This study aimed to evaluate the predictive value of NLR on hospital outcomes in patients with CAP. Methods A prospective observational study was conducted in the Department of Medicine at Dhaka Medical College Hospital, Bangladesh, between July 2023 and June 2024. One hundred adult patients with CAP were enrolled using purposive sampling. Demographic, clinical, and laboratory data were recorded at admission, including complete blood counts and CURB-65 scores. NLR was calculated, with ≥7.12 defined as elevated. Patients were followed for outcomes including mortality, oxygen requirement, ICU admission, and length of hospital stay. Statistical analyses included chi-square tests, logistic regression, and ROC curve analysis. Results The mean age of participants was 53.7 ± 10.9 years, and 62% were male. An elevated NLR (≥7.12) was present in 67% of patients and was significantly associated with mortality (p = 0.027), oxygen requirement (p < 0.001), ICU admission (p < 0.005), and prolonged hospital stay (p < 0.001). Regression analysis confirmed NLR ≥ 7.12 is associated with prolonged stay (OR: 15.235; 95% CI: 4.613–50.316; p < 0.001), oxygen requirement (OR: 1.846; 95% CI: 1.415–2.408; p < 0.001), ICU transfer (OR: 5.172; 95% CI: 1.289–20.747; p < 0.001), and mortality (OR: 7.704; 95% CI: 1.962–61.690). ROC analysis showed moderate discriminatory ability for prolonged stay (AUC: 0.762) and modest predictive performance for oxygen need, ICU admission, and mortality. Conclusion Elevated NLR is strongly associated with adverse outcomes in CAP, including mortality, ICU admission, oxygen requirement, and prolonged hospitalization. Given its simplicity and accessibility, NLR may serve as a valuable tool for early risk stratification in resource-limited settings.