Browse Articles

Histopathological changes of the Eustachian tube mucosa following balloon Eustachian tuboplasty in children: insights from standard endovascular balloon application

Abstract Balloon Eustachian tuboplasty (BET) has emerged as an established intervention for obstructive Eustachian tube dysfunction; however, the high cost of proprietary balloon systems limits widespread accessibility. Standard endovascular balloons represent a low-cost alternative, yet their tissue-level effects remain insufficiently characterized, particularly in pediatric populations. This study aimed to evaluate histopathological changes of the Eustachian tube (ET) mucosa before and after BET using a standard endovascular balloon. Twenty-two Eustachian tubes (ETs) from eleven children with bilateral obstructive dysfunction refractory to medical and prior surgical management underwent BET. Mucosal biopsies were obtained immediately before and after dilation in all cases. In addition, follow-up biopsies at 16 weeks were obtained from two ETs in a single patient to explore short-term histopathological changes. Specimens were independently analyzed by two blinded pathologists using light microscopy, focusing on epithelial integrity, inflammatory infiltration, lymphoid tissue architecture, and fibrosis. Pre-dilation specimens demonstrated epithelial inflammation with dense submucosal lymphocytic infiltration. Immediately following dilation, mucosal thinning, partial epithelial disruption, and compression of lymphoid tissue were observed, while the basal epithelial layer remained largely preserved. At 16 weeks, limited follow-up specimens demonstrated partial re-epithelialization with restoration toward pseudostratified ciliated columnar epithelium and reduction in inflammatory infiltrates, without histological evidence of tissue necrosis or marked fibrosis in the sampled specimens. BET using a standard endovascular balloon was associated with immediate epithelial and submucosal injury-related histopathological alterations while preserving the basal epithelial layer. Limited follow-up histological observations from a single case demonstrated partial re-epithelialization with reduced inflammatory infiltrates. However, these findings should be considered preliminary and do not permit definitive conclusions regarding reparative response, clinical tolerability, safety, feasibility, or long-term tissue remodeling, which require validation in larger prospective longitudinal studies.

Validation of the Arab Mental Health Continuum Short Form (AMHC-SF) in Oman: Psychometric properties and factorial structure

Background The Mental Health Continuum–Short Form (MHC–SF) is a widely used instrument designed to assess three dimensions of positive mental health: emotional, social, and psychological well-being. However, there is limited evidence regarding its validity within Arab populations. Method This study aimed to validate the Arabic version of the MHC–SF (AMHC–SF) among a community-based sample in Oman. A total of 1,101 participants aged 18–65 years (M = 31.49, SD = 9.69) completed the questionnaire through an online survey. Confirmatory factor analyses (CFA) were performed to examine factorial validity, while internal consistency reliability was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Discriminant validity was examined through correlations with anxiety scales. Results Confirmatory factor analysis supported the superiority of the bifactor model over the original three-factor structure, demonstrating excellent model fit (CFI = 0.99, TLI = 0.98, RMSEA = 0.032) and substantial general factor loadings (0.64–0.76). Reliability estimates for the total scale and subscales were excellent, with Cronbach’s alpha and McDonald’s omega coefficients ranging from 0.86 to 0.95. The AMHC-SF also showed apparent discriminant validity, as higher well-being scores were associated with lower anxiety levels. Conclusion The findings support the factorial validity, reliability, and discriminant validity of the AMHC–SF, confirming its cross-cultural applicability within the Arab context. The scale represents a brief, psychometrically sound instrument for assessing positive mental health among adults in Oman and other Arabic-speaking populations.

Epicardial adipose tissue thickness is associated with circulating biomarkers in individuals without known cardiac disease across a broad adiposity spectrum

Feature integration of [18F]FDG PET brain imaging using deep learning for sensitive cognitive decline detection

Background Distinguishing individuals with cognitive decline (CD), including early Alzheimer’s disease, from cognitively normal (CN) individuals is essential for improving diagnostic accuracy and enabling timely intervention. Positron emission tomography (PET) captures metabolic brain alterations associated with CD, but its broader application is often limited by cost and radiation exposure. To enhance the clinical utility of PET while addressing data limitations, we propose a data-efficient framework that integrates complementary multi-scale PET representations at voxel-level and region-level. Methods Voxel-level features were extracted using convolutional neural networks (CNN) or principal component analysis networks (PCANet) from [¹⁸F]FDG PET imaging. Region-level features were derived from standardized uptake value ratio measurements across predefined brain regions and processed using a deep neural network (DNN). These voxel- and region-level information are integrated through direct concatenation. For the final prediction, different machine learning models and ensemble technique were applied. The models were trained and validated using 5-fold cross-validation on PET scans from 252 participants in the Alzheimer’s Disease Neuroimaging Initiative, comprising 118 CN and 134 CD subjects. Additional correlation analysis and disease classification comparison with the Mini-Mental State Examination (MMSE) were also performed. Results In 5-fold cross-validation, CNN, PCANet, and DNN models achieved classification accuracies of 0.69 ± 0.04, 0.69 ± 0.06, and 0.82 ± 0.06, respectively. The integrated DNN-CNN model using direct concatenation yielded the highest accuracy (0.87 ± 0.05), with a 6.33% improvement in accuracy and reduced standard deviation relative to the DNN-only model. Overall, there were an increase of 14.22% in Recall (0.77 to 0.88) and an increase of 7.92% in F1-Score (0.82 to 0.88). Moreover, the predicted probability of CD showed a significant correlation with MMSE scores, and the model achieved higher accuracy, recall, and F1-score than MMSE-based classification. Conclusion Combining complementary voxel-level and region-level PET representations with deep learning improved classification performance over single-representation models, particularly by enhancing sensitivity to cognitive decline. These findings support the potential utility of multi-scale FDG-PET representations for machine learning-based cognitive decline detection.

Mechanistic investigation of Chai Gui Zexie Decoction in treating non-small cell lung cancer: an integrated metabolomics and network pharmacology approach

Correction for Stöhr et al., Distinct synthetic Aβ prion strains producing different amyloid deposits in bigenic mice

MSPFormer: An enhanced multi-scale and semantic-preserving transformer for sheep ownership identification in precision livestock farming

Overgrazing is a major driver of grassland degradation on the Qinghai–Tibet Plateau, posing significant challenges for sustainable livestock management. To mitigate this issue, intelligent technologies that can effectively recognize and manage different herders’ sheep flocks are essential for achieving balanced grass–livestock management and reducing overgrazing. This study aims to develop a robust and efficient model for intelligent sheep ownership recognition by leveraging sheep back color features, facilitating scientific grazing management, and supporting herder conflict resolution. A dedicated dataset was constructed, capturing diverse color distributions under variable lighting and complex backgrounds. We propose MSPFormer, a multi-scale and semantic-preserving Transformer model, which builds upon Mask2Former by integrating three key modules: (1) an Atrous Spatial Pyramid Pooling (ASPP) module between the Pixel Decoder and Transformer Decoder to enhance multi-scale feature extraction; (2) a Dynamic Prompt Attention (DPA) module to improve semantic consistency; and (3) a Content-Aware ReAssembly of Features (CARAFE) upsampling module after the Transformer Decoder to optimize spatial detail recovery. Experimental results show that MSPFormer achieves superior segmentation performance, increasing the mIoU from 82.46% to 83.81% (a relative improvement of approximately 1.35%), the mF1-score from 90.08% to 90.92% (an improvement of approximately 0.84%), the mPrecision from 89.50% to 91.52% (an improvement of approximately 2.02%), and the mRecall from 90.74% to 90.92% (an improvement of approximately 0.18%). Validation on the public VOC2012 dataset and several small-sample subsets further demonstrates the model’s strong generalization capability and stability. This study provides an effective and intelligent solution for sheep ownership recognition, contributing to sustainable grazing management and conflict resolution among herders on the Qinghai–Tibet Plateau. Future work will focus on lightweighting the model through pruning and knowledge distillation to facilitate practical deployment.

Novel nano-reinforced chitosan derivatives for adsorption of heavy metal ions from aqueous media

Abstract A novel NH 2 -MIL-53(Al)@CS-EDTA hybrid nanocomposite was synthesized by functionalizing chitosan with EDTA and integrating it with an Al-based MOF for heavy metal removal. Structural and morphological characterizations were performed using FT-IR, XRD, SEM-EDX, N2 adsorption-desorption isotherms, point of zero charge (PZC), and thermogravimetric analysis (TGA). Batch experiments showed maximum adsorption capacities of 31.8, 28.1, and 21 mg·g − 1 for Cu 2+ , Fe 2+ , and Ni 2+ at pH 6. The adsorption data were best fitted by the Langmuir isotherm and the pseudo-second-order kinetic model under the investigated experimental conditions. The observed adsorption behavior is proposed to involve coordination and electrostatic interactions between the metal ions and the abundant functional groups (–OH, –NH₂, and –COOH) of the composite. The biopolymer MOF composite’s reusability was also evaluated, and even after five consecutive adsorption-desorption cycles, > 90% efficiency was found, indicating acceptable stability over repeated cycles. The novelty of this study lies in the synergistic integration of biopolymer, chelating agent, and MOF into a single, reusable adsorbent with improved properties.

Investigation on dynamic characteristics of herringbone planetary gear transmission system with staggered tooth phase

Vibration and noise are critical indicators that directly affect the transmission characteristics of planetary gearboxes. Consequently, the suppression of vibration and noise has emerged as a major research focus in this field. This paper investigates the meshing mechanism of herringbone planetary gear systems with staggered tooth phase (STP), and derives the analytical formulation for calculating the time-varying mesh stiffness (TVMS) of such gear configurations. In addition, it examines the correlation between the staggered tooth phase angle (STPA) and the system vibration response, as well as the dynamic effects induced by variations in rotational speed and different types of tooth profile errors. The results demonstrate that the implementation of STP could substantially enhance the vibration characteristics of herringbone planetary gear systems. Furthermore, among various tooth profile errors, the single tooth tangential error (STTE) is identified as the dominant factor governing vibration.

Multivariate analysis of Quercus castaneifolia C.A. Mey based on morphological characterizations

Response duration tracks confidence

The timing of behavioral responses is among the most robust signatures of cognitive processing—with easier, more accurate, and more confident judgments typically made more quickly. But which aspects of response timing carry these signals? Whereas the time taken to initiate a response (e.g., the interval between stimulus onset and keypress) is one of the most popular and informative measures in experimental psychology, another aspect of response timing is its duration (e.g., how long the key is held down before being released). Here, across three preregistered experiments spanning perceptual and higher-cognitive tasks, we demonstrate that response duration reliably predicts subjective confidence, over and above response initiation time. When detecting faces (Experiment 1), judging motion coherence (Experiment 2), and answering trivia questions (Experiment 3), subjects held down a response key longer during trials in which they subsequently reported lower confidence in their judgments, as if making these judgments in a tentative fashion. In all cases, response duration accounted for variance in confidence that was not predicted by response initiation time. Our results suggest that response duration itself carries independent information about cognitive processing, advancing a useful and ubiquitously available tool to complement traditional response time measures in the study of cognition.

Cholesteatoma disease recidivism after canal wall up tympanomastoidectomy with or without obliteration (CLEAR-EAR): A protocol for a randomized controlled trial

Background and rationale Cholesteatoma treatment relies on surgery with disease removal as the primary goal. While canal wall down (CWD) and canal wall up (CWU) tympanomastoidectomy remain standard approaches, mastoid obliteration has gained popularity. Canal wall up preserves ear canal anatomy and adding the obliteration technique suggests lower recurrence and residual rates. However, controversy persists and surgical consensus is lacking. Current decision-making relies on personal experience and patient-related factors rather than high-quality evidence. This study therefore investigates whether CWU with obliteration reduces cholesteatoma recurrence and residual disease compared to CWU without obliteration, by comparing recidivism rates for both interventions. Additionally, complications, hearing outcomes, quality of life and economic evaluation will be assessed. This study will assess long-term outcomes with a follow up of 5 years. Methods This multicentre single-blind randomized controlled trial (RCT) will include 178 adults undergoing CWU tympanomastoidectomy for cholesteatoma removal, randomized in a 1:1 ratio to CWU with obliteration or without obliteration. Recurrent or residual disease is assessed by micro-otoscopy at 6–18 weeks and by micro-otoscopy and DW-MRI at one, three, and five years postoperatively. Suspected disease is confirmed during revision surgery when indicated. Secondary outcomes include hearing, complications, quality of life, and economic evaluation. Discussion This is the first prospective RCT comparing CWU with and without obliteration. By establishing the follow-up period at five years, we aim to assess the true rates of recidivism, as literature indicates that most recurrent diseases are detected several years after surgery, with incidence appearing to rise approximately three years postoperatively. Key strengths include comparative hearing outcome assessment, quality of life evaluation, and economic evaluation. This multicentre trial aims to provide high-quality evidence to inform clinical guidelines and support evidence-based decision-making in cholesteatoma treatment. Trial registration Netherlands Trial Register (CCMO): NL86362.041.24. Registered on 13 March 2025.

Loss of TGR5-activating bile acids is associated with disease activity in inflammatory bowel disease

Abstract The gut microbiota communicates extensively with its host through small metabolites, such as bile acids. Primary bile acids are synthesized by the host and secreted into the intestine, where they are actively converted by the microbiota into secondary bile acids. Depending on the resulting bile acid composition, the host’s bile acid receptor, Takeda G protein–coupled receptor 5 (TGR5), is activated and mediates immune tolerance. It has been suggested that a disturbed bile acid profile in inflammatory bowel disease (IBD) might lead to inflammation via reduced activation of TGR5. Our study is the first to investigate whether bile acid-induced TGR5 activation differs between healthy individuals and patients with IBD. Bile acid profiles in stool and plasma were quantified by mass spectrometry, and TGR5 bioactivity was assessed from these profiles. In parallel, metagenomic sequencing was performed on fecal samples. We demonstrate that reduced alpha diversity in IBD is associated with a loss of microbial capacity for bile acid transformation, resulting in a significantly decreased secondary-to-primary bile acid ratio (sBA/pBA) in both stool and circulation. TGR5 bioactivity induced by bile acid profiles was substantially reduced in IBD patients, and a lower TGR5 bioactivity correlated with increased inflammatory activity.

Polarons are probes of the dynamic nanoscale environments found in electrochemically doped π-conjugated polymers

Charge carriers (i.e., polarons) in electrochemically doped organic (semi)conductors are proposed to be regulated by several physicochemical features, including the chemical compositions and structures of the π-conjugated frameworks of the semiconductor building blocks, the chemistry of the electrolyte (considering both the salt and solvent), multiscale and time-dependent morphology variations across the material as a function of electrochemical processes, and assorted permutations of these and other factors. To address these hypotheses, we investigate the energetic, optoelectronic, chemical, and local structural properties of negative polarons (radical anions) as a function of electrochemical doping in the donor–acceptor, π-conjugated redox copolymer P(NDI2OD-T2), also referred to as N2200. A critical finding is that there is not just “one type” of polaron in electrochemically doped P(NDI2OD-T2). Rather, an ensemble of polarons exists, with the polarons having optoelectronic signatures that are defined by their nanoscale environments. Importantly, the polaron optical signatures serve as local probes for how the operando electrochemical environments are dynamically working in concert to facilitate charge transport. Collectively, the distinctive and extensive integration of theory and measurement science presented here establishes a baseline for the roles that semiconductor and electrolyte chemistries and dynamic structural features have on polarons in electrochemically doped organic semiconductors and how these factors influence the energetics and rates of polaron transport.

Penalization method to convert Bayesian optimization methods into batch multi-objective Bayesian optimization methods

Bayesian optimization is a surrogate-based global optimization method that is increasingly being used for engineering design. However, most methods are designed to be sequential, and in optimization problems where the functional evaluation can be easily parallelized, batch methods are more effective at reducing real-time computation. While existing batch multi-objective Bayesian optimization (B-MOBO) methods achieve strong performance, they are typically purpose-built from scratch, limiting ability to leverage the extensive library of proven sequential acquisition functions for parallel settings. In this paper, a generalizable transformation methodology is developed that converts compatible single- or multi-objective sequential Bayesian optimization methods into B-MOBO methods. The key innovation is a Euclidean distance-based composite acquisition function with multi-objective penalization averaging, which combines multiple sequential acquisition functions while incorporating objective-wise penalization information from all objectives and preventing redundant sampling in batch selection. To demonstrate the schema, this methodology is applied to two representative sequential acquisition strategies, the expected improvement method (single-objective) and the quality metrics method (multi-objective), to develop two new B-MOBO variants. These new methods are then compared against their sequential counterparts and established B-MOBO methods using both computation time and real-time analysis. Results show that the new B-MOBO methods are as effective as existing methods at solving optimization problems in terms of solution quality and show improvements when real-time is considered.

Early postural dynamics reveal the rapid processing of fake social cues for deceptive actions in sports

Abstract Deceptive actions such as head fakes are a hallmark of interactive sports, yet it is not well understood how decisions and whole-body responses to head fakes unfold over time. In the present study, participants viewed video sequences of a basketball player passing to the left or right, either with or without a head fake. In the buzzer task, participants moved laterally to press a response button as if to intercept the pass. In the vocal task, they verbally indicated pass direction. Reaction times (RTs), movement times (MTs), and medio-lateral center-of-pressure (CoP) displacements were recorded to investigate whether motor output is rapid and stimulus-driven or rather requires continuous integration of fake and pass cues. Further, we investigated whether the mere observation of a basketball player leads to overt micromovements even if no response movement is intended. The data analysis shows that head fakes increased RTs in both the buzzer and vocal tasks. In the buzzer task, head fakes induced an initial, small erroneous CoP shift, which was then rapidly corrected. When CoP trajectories were aligned by head orientation, fake and non-fake trajectories diverged shortly after movement onset. In the present dynamic sport-related context, this pattern is more compatible with the early integration of head and pass information than with a strictly sequential prime-target account, although the paradigm differs from classic Rapid Chase Theory designs with discrete primes and target events. In the vocal task, participants were not instructed to move, yet CoP traces showed tiny but systematically lateralized micromovements with a temporal structure resembling that in the buzzer task, albeit without an initial erroneous shift for head fakes. These postural fluctuations are consistent with action-observation-related motor activation, although they do not uniquely identify motor resonance and may also reflect attentional or generalized embodied response tendencies. A clear deceptive response conflict at the postural level emerged only when a lateralized action was prepared.

Ultrafast temperature diagnosis of dynamically compressed matter using millielectronvolt inelastic x-ray scattering beyond the first Brillouin zone

We present calculations of the millielectronvolt-scale x-ray scattering spectra of multilayered dynamic-compression targets comprising an unstructured ablator layer and a crystalline, textured sample layer. Our model builds on the classic formulation of x-ray thermal diffuse scattering by Warren [Acta Crystallogr. 6, 803 (1953)] and includes both elastic and first-order (single-phonon) inelastic scattering contributions to the dynamic structure factor S(q, ω). We focus on the umklapp scattering regime (i.e., at momentum transfers outside the first Brillouin zone) where the ablator scattering that threatens to overwhelm the inelastic scattering from the crystalline layer of interest is suppressed. We show that, despite the considerably more complex structure of the inelastic scattering spectra in this intermediate-q regime, it is still possible to reliably deduce the temperature of the crystal using Dornheim’s Laplace-transform–based formalism [Dornheim et al., Phys. Plasmas 30, 042707 (2023)], regardless of the details of the sample’s texture.

Correction for Sudhakar et al., Human tumstatin and human endostatin exhibit distinct antiangiogenic activities mediated by αvβ3 and α5β1 integrins

The future of births via medically assisted reproduction in Italy:Scenarios to 2050

Delayed childbearing is increasingly common in high-income societies, contributing to rising demand for medically assisted reproduction (MAR). This paper presents nine possible scenarios of the future share of MAR births on the total number of births in Italy, a country internationally known for its latest-late mean age at childbearing. We combined the latest (2023) official data and three hypotheses on the evolution of maternal mean age at childbirth (no change, slow ageing, rapid ageing) with three hypotheses on the age-specific MAR-related fertility rates (no change, moderate increase, rapid increase). Our projections indicate that changes in the age structure of women of reproductive age will likely have a negligible effect on future MAR prevalence. In contrast, delayed childbearing and continued expansion of MAR use could raise the share of MAR births from 4.3% in 2023 to 11–12% by mid-century, with a plausible upper bound exceeding 15% under sustained trends. These results underscore the growing demographic, social and economic significance of MAR in Italy and highlight important implications for public health planning, resource allocation, and policies aimed at supporting earlier childbearing.

Employees show greater willingness to voice toward algorithmic than human leaders in cognitive tasks through fairness perception and psychological safety