Browse Articles

Predictors of reverse cardiac remodeling after sacubitril/valsartan in heart failure with reduced ejection fraction

Abstract Sacubitril/valsartan (Sac/Val) is associated with reverse cardiac remodeling in heart failure with reduced ejection fraction (HFrEF). However, the predictors of reverse cardiac remodeling after Sac/Val have not yet been fully established. We aimed to evaluate the predictors of reverse cardiac remodeling in patients with HFrEF, with a focus on HF duration and the dose of Sac/Val. In this retrospective, multicenter cohort study, 600 patients with HFrEF who received a Sac/Val prescription were enrolled at six tertiary hospitals in Korea between February 2017 and April 2019. After excluding patients without baseline or 12-month follow-up echocardiographic data, 294 patients were enrolled. Reverse cardiac remodeling was defined by comparing the baseline and follow-up echocardiographic data: an absolute increase in left ventricular ejection fraction (LVEF) ≥ 10% and a relative decrease in left ventricular end-diastolic volume index ≥ 10%. The average daily Sac/Val dose was calculated during the first 6 and 12 months after initiation. Among the 294 patients, 107 presented with reverse cardiac remodeling at 12 months. Patients with HF duration < 12 months at the time of Sac/Val initiation showed a higher proportion of reverse cardiac remodeling than patients with HF duration ≥ 12 months (46.1% vs. 25.7%; P  < 0.001). Patients with an average daily Sac/Val dose ≥ 200 mg/day over 6 months also had a higher proportion of reverse cardiac remodeling than patients with Sac/Val < 200 mg/day (44.0% vs. 31.9%; P  < 0.001). Multivariable logistic regression revealed low baseline LVEF, HF duration < 12 months, and higher Sac/Val dose as independent predictors of reverse cardiac remodeling. In conclusion, early initiation of Sac/Val following HF diagnosis and higher Sac/Val doses were associated with a higher likelihood of reverse cardiac remodeling in HFrEF.

Sarcopenia as an independent prognostic marker in liposarcoma: A longitudinal analysis of body composition and survival

Background Sarcopenia is increasingly recognized as an important prognostic factor in oncology; however, its clinical relevance in liposarcoma remains insufficiently defined. This study aimed to evaluate longitudinal changes in CT-derived body composition parameters in liposarcoma patients, to assess the influence of tumor grade, recurrence, and treatment modalities on these parameters and to determine the association of baseline sarcopenia and progressive muscle loss with overall survival and functional status. Methods In a retrospective, single center study between 2010 and 2024, 64 patients were analyzed. All patients underwent surgical tumor resection of a histologically confirmed liposarcoma. Included were patients with two consecutive CT scans. The following morphometric parameters were measured on CT axial images at the height of lumbar vertebral 3: Skeletal muscle index (SMI), paraspinal muscle index (PSMI), psoas muscle index (PMI), skeletal muscle density (SMD), and visceral adipose tissue (VAT). Standardized Hounsfield unit thresholds were used for the assessment. Additionally, the influence of tumor grade, recurrence, and treatment modalities on body composition was assessed. A Kaplan Meier survival analysis was performed using data from the residents´ registration office. Survival was further analyzed by Cox regression using uni- and multivariate models. Metric data was compared using student´s t-test. Results Significant reductions in SMI, PSMI, PMI, and VAT were observed over the disease course, particularly among patients with high-grade tumors, chemotherapy, or local tumor recurrence. Baseline sarcopenia and a progressive SMI loss were independently associated with reduced overall survival. In multivariate analysis, baseline sarcopenia (HR: 2.331, p  = 0.007) and a ≥ 15% SMI decline (HR: 2.601, p  = 0.006) remained significant predictors of mortality. Both markers did not correlate with changes in Eastern Cooperative Oncology Group (ECOG) performance status. Conclusion CT-morphometric parameters deteriorate substantially during the disease course of liposarcoma patients and serve as independent predictors of survival. These findings support the integration of CT-based body composition analysis into routine oncologic assessment and highlight its potential role in identifying high-risk patients for early supportive intervention.

Adversarial robust EEG-based brain–computer interfaces using a hierarchical convolutional neural network

Estimation of enteric methane emissions in dairy cows under grazing a silvopastoral system and a grass monoculture in the Colombian Amazonian foothills

Mitigating enteric methane in the humid tropics, particularly in the Colombian Amazonian foothills, remains challenging due to limited field-based data under real grazing conditions. This study evaluated the performance of a laser methane detector (LMD) as a non-invasive alternative to traditional techniques, providing the first field-based validation of this approach in Amazonian grazing systems. Two contrasting production systems were compared: a silvopastoral system (SPS) with trees and shrubs, and a grass monoculture (traditional pasture, TP). A crossover design (two groups of five cows) was implemented across four periods. The LMD enabled repeated, activity measurements without disrupting natural behavior, capturing emissions during grazing, ruminating, resting, and milking. Daily CH₄ emissions were significantly lower in SPS than TP (233 ± 6.95 vs. 277 ± 8.87 g CH₄ animal ⁻ ¹ day ⁻ ¹; p < 0.0001). Methane intensity also decreased in SPS when expressed per kg milk (15.5 vs. 20.7 g CH₄ kg ⁻ ¹), energy-corrected milk (16.0 vs. 21.2 g CH₄ kg ⁻ ¹), and dry matter intake (18.9 vs. 26.7 g CH₄ kg DMI ⁻ ¹; all p < 0.0001). Classification was based on animal activity rather than diet, allowing detailed behavioral associations with CH₄ release dynamics. While the LMD requires strict environmental protocols and does not capture continuous 24-h data, its portability and non-invasive nature make it a practical, scalable tool for tropical field conditions. These results provide novel evidence supporting SPS as a mitigation strategy, strengthen GHG inventories in tropical livestock systems, and offer guidance for policymakers promoting sustainable production systems.

Feature extraction in sensor plant disease datasets using reformed membership functions independent of class variables

Water use and conservation in the operating room and perioperative setting: A scoping review

Public health and food security in the United States depend on a reliable supply of fresh water. Freshwater availability is worsening, and prolonged drought conditions have affected large portions of the country. Hospitals are major consumers of water, and processes related to the operating room may present an opportunity to improve water conservation. A scoping review of the MEDLINE, Science Citation Index-Expanded, Emerging Sources Citation Index, and Embase databases was conducted for articles addressing water use and interventions for water conservation from January 1, 1948, to March 26, 2025. The review identified twenty-six studies meeting inclusion criteria, addressing four subsets of operating room and perioperative processes. The preponderance of published studies addressed water use during surgical hand scrubbing, with the remainder evaluating water use related to textiles, equipment, or sterilization processes. Interventions supported by high-quality evidence for reducing water use included turning off idling sterilizer equipment when not in use. Moderate to low quality evidence favored converting to waterless scrub techniques and/or on-demand scrub sinks, reusable alternatives for equipment, and non-cotton reusable textiles. Our findings identify several focused areas with potential for improving water conservation in the operative and perioperative setting. Further research is needed to comprehensively evaluate operating room, perioperative and overall hospital processes for water use, and to describe effective interventions for conservation.

Mechanical and durability performance prediction of geopolymer incorporating ferrosilicon slag and aluminum powder using machine learning techniques

Design and optimization of a butterfly-shaped grafting clip and cutting mechanism based on finite element simulation

To improve the reliability and cost-efficiency of the grafting mechanism, this study proposes a novel butterfly-shaped polyethylene (PE) grafting clip and integrated cutting-type clip-feeding mechanism. The proposed system replaces traditional steel coil clips and vibration screen feeders with a lightweight, low-damage, and low-cost design capable of continuous clip feeding. The mechanical behavior of the PE clip material was characterized through tensile testing and modeled using the Johnson-Cook constitutive equation. A finite element model of the cutting process was established in Abaqus to investigate the effects of cutting force, speed, and angle on blade stress and clip deformation. Using the Box-Behnken response surface methodology, the cutting parameters were optimized to minimize stress concentration and material distortion. Simulation results showed that optimal performance was achieved at a cutting force of 110 N, a speed of 25.618 cm/s, and a cutting angle of 32.414 ° , yielding a maximum blade stress of 1.31 MPa and clip strain of 5.304%. Validation tests demonstrated that a 30 ° cutting angle produced the highest cutting quality, consistent with simulation predictions. Comparative performance evaluations with a commercial vibrating screen clip feeder confirmed the superiority of the proposed system in terms of reliability, energy efficiency, operational noise, and cost. The developed mechanism offers a compact and practical solution for automated grafting, particularly suitable for small and medium-sized seedling nurseries seeking affordable mechanization technologies.

Four novel Planctomicrobium species isolated from sewage sludge or leakage water of a compost heap in Northern Germany

Abstract Four non-pigmented, off-white to ivory strains, SH527 T , SH661 T , SH664 T and SH668 T , have been isolated from sewage sludge or leakage water of a compost heap in Northern Germany as part of an isolation campaign conducted by Heinz Schlesner, Kiel University in the 1980s-early 2000s. Analyses based on five phylogenetic markers place the novel strains in the genus Planctomicrobium in the family Planctomycetaceae within the phylum Planctomycetota . All four strains are aerobic heterotrophs with a neutrophilic and mesophilic growth profile. Genome sequencing revealed relatively small genomes compared to the relatives in the same family, with strain SH668 T having the currently smallest genome (4.81 Mbp) of any described member of the family Planctomycetaceae . The analysis of genome-encoded features suggests a metabolism better adapted to the degradation of polysaccharides rather than of lignocellulose-derived aromatic compounds. The collected data justifies the delineation of the novel isolates from the sole species in the genus, Planctomicrobium piriforme. The four isolates belong to four separate novel species, for which we introduce the names Planctomicrobium limosum sp. nov., Planctomicrobium stercoris sp. nov., Planctomicrobium aquicomposti sp. nov. and Planctomicrobium mucosum sp. nov. The novel taxa are represented by the following isolates as respective type strains: SH527 T (= CECT 30937 T  = KCTC 102136 T ), SH661 T (= DSM 116760 T  = KCTC 102128 T ), SH664 T (= DSM 116388 T  = KCTC 102081 T ) and SH668 T (= DSM 116585 T  = KCTC 102080 T ).

Virulent MDR Edwardsiella tarda from stinging catfish (Heteropneustes fossilis)

Edwardsiellosis, caused by Edwardsiella tarda , is a highly pathogenic disease affecting both freshwater and marine fish, leading to mass mortality. This study encompassed the molecular detection, virulence and antibiogram profiling of E. tarda from Heteropneustes fossilis (stinging catfish). A total of 40 fish samples were collected from different fish farms in the Mymensingh district. Isolation of E. tarda was performed using selective media, followed by identification through morphological, cultural, and biochemical testing, and confirmed through polymerase chain reaction (PCR). Antibiogram was performed following the disc diffusion method, and virulence and antibiotic resistance genes were detected through PCR. 19 out of 40 fishes were positive for Edwardsiella infection and 32 E. tarda were isolated. PCR assays consistently amplified gro EL (623 bp), gyr B (415 bp), etf A (415 bp), and etf D (445 bp) genes, respectively. The prevalence of virulence genes was: gad B (17%), muk F (35%), fim A (10%), and cit C (12.5%). The antibiogram revealed that the highest resistance (90.63%) was found against cotrimoxazole and amoxicillin, whereas sensitive (100%) to gentamicin and meropenem. Among 32 isolates, 90.75% were found to be multi-drug resistant (MDR). Again, multiple antibiotic resistance (MAR) index analysis revealed the highest value of 0.61, and 93.75% of isolates have an MAR index above 0.2. Resistance gene distribution was observed as the highest (62.5%) isolates harbored the tet A gene and the lowest (21.88%) isolates harbored qnr B. It could be concluded that MDR and pathogenic potential E. tarda was present in stinging catfish, posing a potential threat to animals, humans, and the environment.

Position prediction from performance and anthropometric indicators in young footballers: a machine learning approach

A compact uniform circular array antenna for circularly polarized higher-order OAM beam generation through modes superposition

This paper presents the design and validation of a compact uniform circular array (UCA) antenna for the generation of a higher-order orbital angular momentum (OAM) beam. The array combines the fifth-order OAM generated by individual ring patch antenna elements with the first-order OAM mode of the array to radiate the resultant sixth-order OAM beam through mode superposition. A dual-feed configuration is employed to achieve a 90-degree phase difference using differential feed lengths. Sequential rotation of elements ensures circular polarization without the need for complex feeding networks. Characteristic Mode Analysis (CMA) confirms the excitation of TM 61 degenerate modes from ring patch antenna responsible for the fifth-order OAM radiation. The antenna operates at 3.55 GHz and achieves significant mode purity with an axial ratio below 3 dB. The proposed design is a single-layer, low-profile antenna that is suitable for narrowband OAM-based wireless sensor and communication systems, enabling high-order mode generation with a reduced number of array elements.

Insights into the seismogenesis and tectonic implications of an isolated intraplate earthquake (M4.0) on February 17, 2025, in Delhi

Designing a Territorial Composite Vulnerability Index to guide public health action in Cali, Colombia

Background Social determinants of health are central to explaining health inequalities. In fragmented urban contexts such as Cali, Colombia, territorially focused public health action requires analytical tools to identify priority areas for intervention. Objective To design and apply a Territorial Composite Vulnerability Index for the city of Santiago de Cali to support the micro-planning of public health interventions. Methods We conducted an ecological, citywide study with a geospatial, multivariate approach. Seven indicators representing social determinants were selected: multidimensional poverty, critical overcrowding, youth unemployment, adult illiteracy, limited access to basic services, food insecurity, and population officially registered as victims of violence and displacement. Indicators were standardized and combined using principal component analysis to derive a single composite score. Spatial patterns were depicted with choropleth maps, and local indicators of spatial association were used to identify statistically significant clusters of high vulnerability. Construct validity was assessed by examining correlations between the index and health outcomes, including infant mortality, adolescent pregnancy, and suicide attempts. Results The composite index explained 74.3% of the joint variance of the underlying indicators. High-vulnerability areas concentrated in the eastern and hillside zones of the city, with significant high–high clusters in communes 13, 14, 15, 18, and 20. The index showed positive correlations with infant mortality, adolescent pregnancy, and suicide attempts, supporting its criterion validity. Conclusions This Territorial Composite Vulnerability Index is a valid and operational tool for guiding territorial public health management. It enables targeting of interventions to areas at greater risk and supports intersectoral and community action. Incorporating the index into local planning may help reduce social gaps in health within fragmented urban settings.

High prevalence of iron deficiency and predictive value of nutritional risk scores in critically ill geriatric emergency patients: a prospective cross-sectional study

Antecedents of loneliness among cancer survivors: An exploratory analysis of the Health Information National Trends Survey (HINTS) data

Social isolation is a growing public health concern, particularly among cancer survivors who face persistent challenges in maintaining social connections following treatment. While its impact on mental health is increasingly recognized, the underlying pathways and contextual differences across rural and urban settings remain underexplored. This study aimed to identify the psychosocial and personal factors that contribute to perceived social isolation among U.S. cancer survivors and to assess how isolation mediates the relationship between these factors and mental health. We also examined whether these associations differ between rural and urban populations. Data were drawn from the 2022 Health Information National Trends Survey (HINTS 6), with a subsample of cancer survivors (n = 926). A conceptual framework was developed using constructs from the Biopsychosocial Model, the Stress Process Model, the Transactional Model of Stress and Coping, and the Andersen Behavioral Model of Health Services Use. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to evaluate the relationships among personal factors (age, BMI, time since diagnosis, inability of self-care), psychosocial perceptions (perceived care quality, cancer information comprehension, negative life perception), social isolation, and mental health (PHQ-4). Multigroup analysis compared rural and urban survivors. Social isolation was a strong predictor of mental health, with key antecedents including cancer information access, inability of self-care, time since diagnosis, negative life perception, and perception of care quality. Several pathways varied by geography; for instance, the effects of self-care difficulty and care perception on isolation and mental health were significant only in urban settings. This study highlights the central role of social isolation in shaping mental health outcomes among cancer survivors and underscores the importance of targeted, context-sensitive interventions to reduce isolation and promote psychosocial well-being, particularly in underserved rural communities.

Early prediction of colonization by carbapenemase-producing enterobacterales at ICU admission using machine learning

Praxis function in the ADL Observation Scale: Spanish cross-cultural adaptation and psychometric properties

Objective To cross-cultural adapt the ADL Observation Scale and evaluate its psychometric properties in a sample of Spanish-speaking patients with stroke. Methods A validation study that included cross-cultural adaptation, structural validity assessment, reliability, and diagnostic accuracy analysis. The study followed COSMIN and STARD criteria. Translation and cross-cultural adaptation of the ADL Observation Scale followed a backward translation process. Structural validity was assessed with confirmatory factor analysis, and internal consistency was analyzed using Cronbach’s alpha and McDonald’s omega coefficient. Cut-off points were estimated using ROC analysis, and diagnostic accuracy was evaluated using sensitivity, specificity, and positive and negative predictive values. Internal consistency, cut-off points, and diagnostic accuracy were calculated for two different age groups (≥65 years; > 65 years). Results The Spanish version of the ADL Observation Scale was obtained after cross-cultural adaptation. The psychometric properties were tested in a sample of 180 patients with stroke. Structural validity showed a four-factor structure of the scale (RMSEA = 0.078; CFI = 0.952; TLI = 0.934). Internal consistency for each factor indicated Omega values between 0.641, 95% CI [0.495, 0.753], and 0.915, 95% CI [0.882, 0.936]. Cut-off points, also calculated for each factor, ranged from ≥1 to ≥4 points. Sensitivity, specificity, and positive and negative predictive values showed high values, indicating the scale’s discriminatory capacity for correctly classifying patients with praxis deficits. Conclusion The ADL Observation Scale has a four-factor structure, and it is a reliable instrument for evaluating the levels of praxis function in daily living among Spanish-speaking patients with stroke. The scale also has adequate diagnostic accuracy in detecting patients with praxis deficits.

SMAD2 ubiquitination through PY motif regulates skeletal muscle mass and fibrotic degeneration

Diversity of soil bacterial communities in response to fonio (Digitaria exilis Stapf) genotypes and pedoclimatic conditions in Benin

In sub-Saharan regions, soil fertility is a major concern for plant productivity, influenced by physical, chemical, and biological components. Among biological properties, the recruitment of soil microbial communities by plant roots is influenced by both physico-chemical soil properties and plant characteristics, dependent on species or genotypes. Here, rhizosphere bacterial communities associated with five fonio genotypes cultivated under three pedoclimatic conditions were investigated. Rhizosphere soils were collected for high-throughput 16S rRNA gene sequencing to characterize soil bacterial diversity. Additional parameters were assessed to classify soil fertility of the three pedoclimatic conditions and to evaluate relationships between the bacterial community’s composition and soil fertility variables. Principal Component Analysis revealed a clear effect of pedoclimatic condition, whereas genotype had no significant impact on soil chemical properties or enzyme activities. Overall, soils were low in fertility, with Boukoumbe soil standing out for its higher chemical values and enzyme activities. For example, Boukoumbe reached 1.48% organic carbon, compared to 0.61% in Gogounou and 0.36% in Ina. Similarly, total nitrogen and available phosphorus were also higher in Boukoumbe. Regarding bacterial community, there is no impact of pedoclimatic condition and genotype on their richness and diversity. However, Bray-Curtis index revealed a significant difference in bacterial community structure among pedoclimatic conditions, but not among fonio genotypes. This suggests, in rhizosphere, bacterial community structure is more modulated by soil properties than crop genotypes. Proteobacteria and Bacteroidota were most abundant phyla, varying significantly across pedoclimatic conditions. Moraxellaceae and Oxalobacteraceae bacteria were most abundant families within Proteobacteria, while Chitinophagaceae and Weeksellaceae dominated in Bacteroidota. Our study highlighted the significant roles of soil pH, as well as sulfate and nitrate content, in shaping bacterial communities. These findings offer valuable insights into the bacterial communities associated with fonio and their key drivers.