To evaluate the relationship between cardiopulmonary bypass (CPB) duration, change in thoracic fluid content (ΔTFC) measured using electrical cardiometry, and postoperative oxygenation in infants undergoing ventricular septal defect (VSD) closure. Prospective observational study. Single tertiary academic cardiac center. Thirty infants (1-12 months) undergoing elective VSD closure with CPB. Thoracic fluid content was measured using an electrical cardiometry (ICON monitor) before CPB and after separation from CPB. Arterial blood gases and ventilatory parameters were recorded at corresponding time points. CPB duration was positively correlated with ΔTFC (r = 0.50, p = 0.0045) and negatively correlated with a change in PaO2/FIO2 ratio (ΔP/F; r = -0.60, p = 0.0005) and dynamic compliance (r = -0.48, p = 0.007). Receiver operating characteristic analysis demonstrated excellent discrimination for postoperative oxygenation impairment (P/F <300) for both ΔTFC (area under the curve [AUC] = 0.91) and CPB duration (AUC 0.92). The optimal thresholds obtained were ΔTFC ≥13 kΩ-1 and CPB ≥84 minutes. In the multivariate linear regression adjusted for IL-6, prime volume/kg, transfusion/kg, and conventional ultrafiltration, ΔTFC independently predicted the postoperative P/F ratio (β = -5.68; p = 0.013), whereas CPB duration was not independently associated. Prolonged CPB is associated with greater thoracic fluid accumulation and impaired oxygenation in infants undergoing VSD closure. However, the relationship between CPB duration, ΔTFC, and pulmonary dysfunction appeared multifactorial and was influenced by perioperative inflammatory and fluid-related variables. Perioperative ΔTFC monitoring may provide a useful noninvasive adjunct for assessing postoperative pulmonary status after pediatric cardiac surgery.
It is generally accepted that non-coding DNA constitutes the vast majority of most eukaryotic genomes and is concentrated at the nuclear periphery and nucleolar surface. Building upon this spatial organization, we have previously proposed that this layer of abundant, peripherally localized non-coding DNA functions as a 3D buffer that transiently absorbs or permanently excludes DNA damage to protect the genome and the relatively central exome from external and internal mutagens in somatic cells. This review explores the potential role of non-coding DNA as a physical barrier in genome safeguarding during early developmental stages and major evolutionary transitions. During gametogenesis and early embryogenesis the barrier is first provided by abundant non-coding DNA; as heterochromatin matures from non-coding DNA, many species programmatically eliminate the now-redundant non-coding DNA. Across evolution, whole-genome duplications and repeat amplification expand the shield, facilitating major evolutionary transitions such as vertebrate origins, water-to-land colonization and survival through mass-extinction crises. Conversely, in stable ecosystems selection favors genome streamlining: redundant non-coding DNA is lost to reduce fitness costs. Thus, the dosage of non-coding DNA is negatively correlated with the strength of apomorphic safeguards (adaptive immunity, viviparity) and positively correlated with ecological or developmental stress. By integrating comparative genomics, 3D nuclear architecture and evolution, we unify a single conceptual framework: non-coding DNA acts as a malleable fortress whose thickness is tuned to the variable need for genome protection during both ontogeny and phylogeny. This perspective offers new explanatory power for the accumulation or loss of non-coding DNA and can predict genome-size trajectories.
To evaluate the initial and longitudinal alterations of peripapillary optic disc vessel index in eyes with a history of acute primary angle closure (APAC) and to explore the better predictor of glaucoma progression. Twenty-one consecutive Chinese patients who were successfully treated for a unilateral episode of APAC were included in the study. The observation group consisted of eyes with the history of acute episode, while the contralateral eyes without an attack served as the control group. All APAC eyes underwent phacoemulsification cataract extraction, intraocular lens implantation and goniosynechialysis one day after the remission of episode. Moreover, the contralateral eyes were performed laser peripheral iridotomy (LPI). Patients were followed-up at 1 day after remission of APAC and 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. All participants underwent ophthalmic examinations after remission of the acute episode but before surgery, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), axial length (AL), visual field (VF), and retinal nerve fiber layer (RNFL) thickness and circumpapillary vessel density (cpVD) obtained by swept-source optical coherence tomography(SS-OCT). Correlation analysis was performed to identify the cpVD as a predictor of glaucoma progression. The vascular network was visibly attenuated and focal capillary dropout was evident in APAC eyes. The cpVD 1 day after APAC episode and 1 week postsurgery in APAC eyes was 45.96% (45.96 ± 3.41), and 46.19% (46.19 ± 3.15) which were significantly (P=0.020 and P༝0.035) reduced compared to 48.35% in the unaffected eyes. However, it remained stable during the follow-up in the subsequent year. The retinal nerve fiber layer (RNFL) thickness initially showed thickening at 1 day (P༝0.05), and followed by a progressive thinning from 1 week (P༝0.04) to 6 months (P༝0.02), and eventually reached a stable state. At the last follow-up in APAC eyes, peripapillary retinal VD was positively correlated with RNFL thickness (P༝0.01) and negatively correlated with VF mean deviation (P༝0.04). In APAC eyes, the circumpapillary VD decreased significantly 1 day after the APAC episode was fully resolved, and remained stable during the follow-up. However, the RNFL thickness ultimately plateaued at a stable level at 6 months. Thus, cpVD may be the more sensitive predictor than the RNFL thickness for the glaucomatous progression of APAC patients. Not applicable.
To investigate the factors influencing exercise intention among the people after stroke by developing a comprehensive causal model. This study is the first to examine the factors influencing exercise intention among people after stroke using the Health Action Process Approach (HAPA) theory and structural equation modeling. Data were collected from 299 people after stroke. Perceived benefits and barriers to exercise were evaluated with the Exercise Benefits/Barriers Scale (EBBS). Exercise self-efficacy was assessed using the Exercise self-efficacy scale. Exercise intention was assessed using the Exercise Intention Scale. People after stroke's EBBS score was (112.54 ± 13.67); exercise self-efficacy score was (41.68 ± 10.95); and exercise intention score was (14.41 ± 3.48). The total score of EBBS was positively correlated with the total score of exercise self-efficacy and the total score of exercise intention (r = 0.623, 0.681, both P < 0.05), and the total score of exercise self-efficacy was positively correlated with the total score of exercise intention (r = 0.646, P < 0.05). Structural equation modeling showed several causal pathways. Perceived barriers to exercise had an indirect effect on exercise intentions through exercise self-efficacy (β = -0.183, 95% CI -0.286 to -0.101, P < 0.05). Perceived benefits to exercise not only directly affected exercise intentions (β = 0.246, 95% CI 0.073 to 0.424, P < 0.05), but also indirectly affected exercise intentions through exercise self-efficacy (β = 0.152, 95% CI 0.084 to 0.231, P < 0.05). Additionally, perceived benefits and perceived barriers to exercise negatively influenced each other (β = -0.681, P < 0.05). The perceived benefits and barriers to exercise, exercise intention and exercise self-efficacy level of people after stroke need to be improved. Among them, the influence of exercise self-efficacy on exercise intention is the most significant. Consequently, attention and active measures should be directed toward improving exercise self-efficacy in this population, as this would increase their exercise intention and reduce the risk of relapse.
The importance of HLA mismatch in haploidentical hematopoietic cell transplantation (HaploHCT) with post-transplant cyclophosphamide (PTCy) is debated. If HLA mismatch does impact outcomes, a molecular mismatch model could predict transplant outcomes more effectively than allele mismatch. In this retrospective study, we quantified molecular HLA disparity using eplet mismatch for 265 patient-donor pairs undergoing HaploHCT with PTCy for hematologic malignancy. We discovered an interaction among eplet mismatch (EpMM), HLA class, and mismatch vector that was associated with clinical outcomes. This interaction was termed Class-wise HLA Imbalance of Mismatched Eplets (CHIME), which comprised risk scores of 0, 1, and 2. The CHIME score retained association with non-relapse mortality (CHIME 1 vs. 0, HR 2.85 (1.10-7.37); CHIME 2 vs. 0, HR 3.63 (1.36-9.68), adjusted p = 0.046) and severe aGvHD grade III-IV (CHIME 1 HR 7.82 (1.03-59.22); CHIME 2 HR 8.08 (1.01-64.63), adjusted p = 0.046) after adjustment for transplant-related variables. The CHIME score, when combined with CD3 cell dose, correlated with higher rates of cytokine release syndrome (CRS). The CHIME model may improve clinical outcome prediction over HLA antigen or allele mismatch.
Adolescent screen exposure is increasing, yet clinically interpretable thresholds for cognitive risk are unclear. This study examined associations between daily screen time and cognitive screening performance and derived a screen-time cutoff associated with cognitive impairment. We conducted an observational cross-sectional study (March-April 2022) at a private junior high school in Indonesia during online learning. Students completed digital questionnaires reporting educational and recreational screen time and a directly reported overall estimate; a computed overall (educational + recreational) was generated to assess reporting consistency. Cognitive function was assessed using the MoCA-Ina, with < 24 as the primary impairment threshold based on recent psychometric evidence favoring lower cutoffs for improved classification accuracy. Sixty-seven adolescents were included (34 girls, 50.7%; 33 boys, 49.3%), with median age 13.0 years (12.0-16.0) and median MoCA-Ina 25.0 (19.0-31.0). MoCA-Ina did not differ by sex (girls 25.0 [19.0-31.0] vs. boys 26.0 [20.0-30.0]; p = 0.244). Recreational screen time correlated inversely with MoCA-Ina (ρ = -0.446, p < 0.001), as did overall screen time (ρ = -0.360, p = 0.003), whereas educational screen time was not associated (ρ = -0.061, p = 0.624). In adjusted regression, overall screen time remained negatively associated with MoCA-Ina (β = -0.24 per hour/day; 95% CI - 0.41 to - 0.07; p = 0.007), while age was positively associated (β = 0.96; 95% CI 0.07 to 1.85; p = 0.034). All variance inflation factors were below 2.5, indicating no substantial multicollinearity. ROC analysis showed fair discrimination (AUC 0.66; optimism-corrected AUC after bootstrap internal validation [1,000 resamples]: 0.63) with an optimal cutoff > 8.97 h/day (sensitivity 83.3%, specificity 48.8%, PPV 47.6%, NPV 84.0%); risk of impairment was higher above the cutoff (RR 2.98; 95% CI 1.15-7.72; p = 0.010; OR 4.77; 95% CI 1.40-16.31). High daily screen exposure was associated with poorer cognitive screening performance. The > 8.97-hour/day threshold represents a preliminary, hypothesis-generating cutoff that may help identify adolescents at elevated likelihood of cognitive impairment, pending external validation in larger, more diverse samples. 071/K-LKJ/ETIK/II/2022.
This study examined how intracochlear voltage distributions obtained from impedance field telemetry (IFT) in cochlear implant (CI) users with straight lateral wall electrodes related to electrically evoked cervical and ocular vestibular myogenic responses (e-cVEMPs and e-oVEMPs). e-cVEMPs and e-oVEMPs were recorded in adult MED-EL Synchrony CI users by stimulating at intracochlear electrodes E3, E6, E10 and E11. IFT provided voltage matrices characterizing intracochlear electric field distribution. Voltage data were adjusted using a current-dependent scaling factor to account for stimulation-level differences, and both qualitative and quantitative analyses were performed to compare participants with and without e-VEMP responses and to assess spatial dependencies between voltage profiles and vestibular activation. The study included 18 implanted ears of 17 participants. Qualitative evaluation of the difference matrices across all stimulation electrodes revealed local variations within individual stimulation sites, but no consistent group-specific pattern that persisted across electrodes for either e-cVEMPs or e-oVEMPs. Quantitative analysis of voltage line graphs showed higher voltages and e-oVEMP thresholds across all sites in participants with e-oVEMPs, reaching significance only at E3. For e-cVEMPs, analysis showed no significant group differences. Detection rates demonstrated a spatial trend, with e-cVEMPs occurring predominantly during basal stimulation and e-oVEMPs during apical stimulation. These data suggest that there could be different current pathways for saccular and utricular co-stimulation. Intracochlear electric field distributions could not be directly correlated with e-VEMP occurrence. Spatial dependencies and voltage decay patterns suggest separate mechanisms, possibly related to differences in local field orientation and tissue conductivity, which have to be further examined with respect to anatomical data.
To systematically evaluate the methodological and reporting quality of clinical guidelines and expert consensus statements in the Chinese nursing field published in journals from 2023 to 2024. We searched databases including CNKI, WanFang Data, SinoMed/CBM, PubMed, Embase, Web of Science, supplemented by searches of guideline repositories (e.g., GIN) and academic organization websites. The search period spanned from January 1, 2023, to December 31, 2024. Two researchers independently screened the literature, extracted data, and assessed quality using AGREE II and RIGHT tools. A total of 28 guidelines and consensus statements were included. The mean standardized percentages for AGREE II domains were: Scope and Purpose, 46.74%; Stakeholder, Involvement 32.13%; Rigor of Development, 30.64%; Clarity of Presentation, 39.22%; Applicability, 29.42%; and Editorial Independence, 42.77%. RIGHT reporting rates were highest for items 1a, 1b, 3, 4, 18a, and 19a 28/28 (100%). Although the small number of guidelines (n = 5) limits inferential strength, descriptive comparisons suggested consistently higher scores in guidelines than in consensus statements across all AGREE II domains and in total RIGHT score (P < 0.05), and these findings should be regarded as exploratory. Evidence-based documents outperformed expert opinion-based documents (P < 0.05). Team size was positively correlated with the RIGHT score (P < 0.05). Current guidelines and consensus statements in the domestic nursing field exhibit significant shortcomings in methodological rigor, reporting completeness, and clinical applicability. Future development processes should strictly adhere to AGREE II and RIGHT standards, strengthen evidence-based methodology, emphasize multidisciplinary collaboration and patient involvement, and enhance reporting transparency and clinical translation support.
Systemic residual inflammation plays a pivotal role in the pathophysiology of coronary artery disease (CAD). Cardiovascular protection by SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1Ra) is associated with reduced inflammatory burden but underlying cellular mechanisms remain incompletely defined. We investigated whether SGLT2i and GLP-1Ra synergistically suppress monocyte activation and prevent both systemic inflammatory mediator-induced and monocyte-driven endothelial dysfunction in CAD. Plasma and circulating monocytes were analyzed in healthy individuals (n = 20), patients with cardiovascular disease without CAD (n = 20), and patients with stable CAD (n = 55), and their effects on endothelial cell responses were assessed. CAD plasma showed increased IL-1β, IL-6, TNF-α, MCP-1, soluble ICAM-1, and VCAM-1, and a proteomic profile enriched in complement, innate immune, and extracellular matrix remodeling pathways. CAD plasma induced oxidative stress in endothelial cells, reduced nitric oxide, increased leukocyte and platelet adhesion, and enhanced procoagulant activity, correlating with circulating TNF-α and sICAM-1. CAD monocytes exhibited a metabolically activated phenotype with increased oxidative stress, mitochondrial activity, glucose and cholesterol uptake, calcium signaling, procoagulant activity, and adhesion to endothelial cells. These changes correlated with circulating TNF-α, sICAM-1, and plasma-induced endothelial dysfunction. CAD monocytes showed increased NF-κB, NOX2, and NLRP3 signaling with reduced CREB/NRF2 pathways, produced elevated levels of pro-inflammatory cytokines, while CAD monocytes-conditioned medium induced endothelial oxidative stress and blunted nitric oxide production. GLP-1Ra or SGLT2i attenuated these effects, while combined treatment provided synergistic protection, reducing CAD plasma-induced endothelial oxidative stress (~ 80%) and restoring endothelial function, reducing CAD monocytes oxidative stress (~ 82%), metabolic activation and pro-thrombotic activity, reprogramming monocytes toward anti-inflammatory phenotype and preventing CAD monocytes-induced endothelial dysfunction. CAD features systemic inflammation that drives monocyte activation and endothelial dysfunction. Combined SGLT2i and GLP-1Ra synergistically suppress monocyte pro-inflammatory and pro-thrombotic activity and subsequently driven endothelial dysfunction.
To identify clinical determinants of axial length (AL) before and after early surgery in infantile persistent fetal vasculature (PFV). Single-center retrospective cohort of 58 unilateral PFV eyes (2019-2022). All infants underwent lensectomy, posterior capsulectomy, vitrectomy, and targeted cauterization under general anesthesia before 12 months. Baseline AL, phenotype, and structural findings (enlarged ciliary processes, retrolental membrane, posterior capsular defect, corneal opacity, posterior synechiae, retinal detachment, Morning Glory disc anomaly) were recorded. Mean follow-up was 21.9 ± 11.4 months (12-48). poor growth, defined a priori as an absolute postoperative inter-eye AL difference ≥ 2.0 mm at last visit. preoperative inter-eye asymmetry and postoperative AL change (ΔAL). Multivariable models evaluated predictors. All surgeries occurred < 12 months. Preoperatively, anterior PFV, corneal opacity, posterior synechiae, retinal detachment, and Morning Glory anomaly were associated with shorter AL versus the fellow eye (all P < 0.05), whereas posterior capsular defect correlated with longer AL (P < 0.05). Postoperatively, greater ΔAL occurred when enlarged ciliary processes, retrolental membrane, and posterior capsular defect were absent (all P < 0.05). Poor growth occurred in 12.1%; presentation ≤ 6 months independently predicted poor growth (OR 11.62; 95% CI 1.20-112.46; P = 0.034). In infantile PFV, age at onset, phenotype, and specific structural abnormalities determine AL trajectories. Early standardized surgery may favorably modify growth, whereas complicated cataract in early infancy signals risk for subnormal postoperative elongation and warrants closer surveillance.
Oral Squamous Cell Carcinoma exhibits variable clinicopathological behavior and prognosis across different geographic populations. Limited data are available regarding the clinicopathological characteristics and prognostic factors of this disease in Middle Eastern populations, particularly in Egypt, where late presentation and advanced disease stages remain common challenges. To evaluate the clinicopathological characteristics of Oral squamous cell carcinoma and assess the prognostic significance of American Joint Committee on Cancer 8th edition staging, histopathological parameters, and combined risk patterns on survival and recurrence in an Egyptian cohort. This retrospective study included 150 Oral squamous cell carcinoma patients treated at Alexandria University between 2018 and 2022. Tumors were re-staged according to American Joint Committee on Cancer 8th edition criteria. Clinical, histopathological, and follow-up data were analyzed, including tumor differentiation, surgical margin status, perineural invasion, lymphovascular invasion, depth of invasion, and extranodal extension. Recurrence and survival outcomes were correlated with clinicopathological and combined histopathological risk factors. Mean age of patients was approximately 56 years, with tongue being the commonest tumor site. Re-staging according to American Joint Committee on Cancer 8th edition resulted in significant stage migration toward advanced disease stages, particularly stage IVb. Moderately differentiated tumors represented the commonest histopathological grade. Advanced AJCC stages, depth of invasion > 10 mm, positive surgical margins, higher histological grades, positive extranodal extension, and perineural and lymphovascular positivity were significantly associated with poorer survival and higher recurrence rates. Smoking and positive family history were also significantly associated with adverse outcomes. In contrast, traditional TNM staging showed no significant association with recurrence or survival outcomes. American Joint Committee on Cancer 8th edition staging demonstrated improved risk stratification and stronger associations with recurrence and survival outcomes compared to traditional TNM staging in Oral Squamous Cell Carcinoma patients. Depth of invasion, extranodal extension, and the combined histopathological risk pattern were strongly associated with aggressive tumor behavior and poorer outcomes. These findings provide valuable data from an Egyptian and Middle Eastern population and support the integration of updated staging systems with histopathological risk assessment in Oral Squamous Cell Carcinoma management.
The development of label-free cell permeability assays for the detection and quantification of peptide therapeutics remains analytically challenging. Accurate and rapid evaluation of target-agnostic peptides and other beyond-rule-of-five (BRO5) compounds in the pharmaceutical industry would accelerate discovery programs aimed at intracellular targets by enabling earlier prioritization based on intracellular availability. We report a label-free assay designed to quantify intact intracellular peptides, rank-order permeability, and assess intracellular stability. Cumulative peptide levels were quantified from a cytosol-enriched soluble intracellular fraction for azide-modified cell-penetrating peptides and for designed macrocycles; an impermeable negative control was included to benchmark assay specificity. Multiple cell lines were evaluated, and internalized peptides were measured over time using electrospray mass spectrometry (ESI-MS). Total ion count (TIC) for cell lysate served as a quantitative normalization tool; it mitigated the discrepancies that can originate from cell count and cell lysis efficiency. MS permeability rankings correlated with published cellular half-maximal effective concentration (EC50) values for the azide-modified peptides and with reported parallel artificial membrane permeability assay (PAMPA) apparent permeability coefficient (Papp) values for the macrocycles, supporting external validity. This label-free assay discriminates permeable from impermeable peptides across two cell lines, quantifies intact internalized peptides without routine use of isotopically labeled internal standards. The end-to-end protocol requires ∼ two days from cell seeding to data acquisition, making it suitable for medium-throughput comparative studies in peptide lead triage.
Understanding dimensions of both sinus tarsi (ST) and tarsal canal (TC) in normal and flatfeet may influence the design, usage and possible control of postoperative complications of arthroereisis. This study was to assess 3D features of the tarsal sinus and canal complex (TSCC) in both normal control and flatfeet in children under non-weightbearing and weightbearing conditions. Three-dimensional (3D) computer-aided design modeling from WBCT scans of 22 children with flexible flatfeet (age 9-14) and 14 with normal control feet (age 9-15) were used to evaluate volume and dimensions of TSCC. Correlations between Meary's angle, hindfoot alignment, and volume of TSCC were calculated on non-weightbearing and weightbearing CT scans. The volume of TSCC was smaller in the flatfoot group compared with the control group both under weightbearing and non-weightbearing conditions. From non-weightbearing to weightbearing the volume of TSCC decreased by 19.1% in the flatfoot group and 13.1% in the control group while the long axis of TSCC moved superiorly and anteriorly with internal rotation in both groups. When bearing weight, TSCC volume was negatively linearly correlated with the hindfoot alignment and Meary's angle. This study demonstrates that weightbearing has different influences in 3D features of the tarsal sinus and canal complex in children with control and flatfeet. These findings may help understanding biomechanics of pediatric flatfoot and guiding treatment in particular when arthroereisis is used. Level III, Retrospective Comparative Study.
This study aimed to characterize cyclin-dependent kinase 1 (CDK1) expression in bladder cancer (BC), elucidate its role in intercellular signaling and mitosis, and identify small-molecule inhibitors targeting CDK1. RNA sequencing data from multiple databases were integrated, with immunohistochemistry on tissue microarrays validating protein expression. Single-cell RNA sequencing (scRNA-seq), spatial transcriptomics (ST), gene set enrichment analysis (GSEA), and molecular docking with molecular dynamics (MD) simulations were performed. CDK1 mRNA and protein were significantly overexpressed in BC tissues. CDK1 expression correlated with patient age and race. CDK1 was predominantly expressed in epithelial cells and central to pleiotrophin (PTN) pathway-mediated intercellular communication; virtual CDK1 knockout markedly reduced PTN signaling strength. ST confirmed CDK1 enrichment in tumor regions. GSEA linked CDK1 to mitosis and chromosome segregation, and scRNA-seq analyses revealed a PTN-CDK1-mitosis regulatory axis active specifically in epithelial cells. Dinaciclib showed favorable MD stability as a CDK1 inhibitor. CDK1 is significantly overexpressed in BC with good discriminatory ability. Predominantly expressed in BC epithelial cells, CDK1 may be activated by PTN signaling to drive mitosis. MD simulations support Dinaciclib as a promising CDK1-targeting inhibitor. Bladder cancer is one of the most common cancers of the urinary tract worldwide. Many patients face a difficult challenge: after standard treatments, tumors frequently come back, and existing targeted therapies work for only a small proportion of people. There is therefore an urgent need to better understand what drives bladder cancer growth and to find new treatment targets.This study focused on a protein called CDK1, which acts like a molecular “switch” controlling how and when cells divide. Using data from hundreds of bladder cancer tissue samples across multiple international databases, alongside laboratory staining experiments on tumor tissue, we confirmed that CDK1 levels are significantly higher in bladder cancer than in normal bladder tissue, and that CDK1 can reliably distinguish cancerous from healthy tissue.By examining individual cancer cells using advanced single-cell technologies, we found that CDK1 is concentrated mainly in the lining cells of the bladder tumor. We also identified that a signaling molecule called PTN appears to “switch on” CDK1 in these cells, which in turn drives tumor cells to divide and multiply more rapidly.Finally, using computer-based drug-screening methods, we identified Dinaciclib as a particularly promising molecule capable of blocking CDK1 activity, with stable binding behavior confirmed by computer simulations.
Existing chaotic image encryption schemes have made progress in improving keystream randomness and dynamic substitution; however, the coupling between the underlying chaotic dynamics, S-box construction, and the overall encryption architecture remains limited, especially for high-resolution color images. To address this issue, this paper proposes a color image encryption method that integrates a CML-ECA neurodynamic chaotic system with a TV-BST-based permutation-diffusion framework. Specifically, an ECA-CML composite chaotic model is first established, in which a local-entropy adaptive coupling strategy is combined with Wilson-Cowan excitatory-inhibitory neurodynamic feedback to modulate the Logistic-sine control parameters and lattice states, thereby generating spatiotemporal chaotic sequences with enhanced sensitivity, entropy, and finite-precision robustness. The resulting chaotic flow is then used to construct an initial S-box through a Fisher-Yates shuffle, which is further optimized by a genetic mechanism under joint cryptographic objectives to obtain a high-quality chaotic S-box. At the architecture level, the TV-BST module performs key-dependent row-column permutation for global scrambling, while each color channel undergoes forward and backward chained diffusion together with S-box substitution. Experimental results show that the proposed method produces nearly uniform histograms, low adjacent-pixel correlation, high key sensitivity, and NPCR/UACI values close to their theoretical expectations. In addition, the scheme exhibits robustness against common disturbances such as noise contamination and cropping attacks. These results indicate that the proposed co-designed framework provides an effective and secure solution for color image encryption.
Understanding the agro-climatic structure of morphological diversity is essential for the effective utilization and improvement of drumstick (Moringa oleifera Lam.), a multipurpose tree species of high nutritional and economic value. The present study aimed to evaluate morphological diversity and phenotypic variation of M. oleifera across ten agro-climatic zones of Rajasthan, India, and to identify key traits and morphotypes relevant for breeding, conservation, and climate-resilient cultivation. A total of 367 accessions were characterized using 17 morphological traits, including eight quantitative and nine qualitative descriptors. Quantitative traits were analyzed using non-parametric statistics and Principal Component Analysis (PCA), while qualitative traits were evaluated through Multiple Correspondence Analysis (MCA). An integrated approach using Factor Analysis of Mixed Data (FAMD) was employed to assess overall variation, followed by hierarchical and FAMD-based clustering. Correlation analysis was conducted to identify relationships among traits. The results revealed significant variations among agro-climatic zones for all quantitative traits (Kruskal-Wallis, p < 0.01), with moderate to high effect sizes (ε² = 0.07-0.26). PCA indicated that the first two components explained 56.9% of total variance, primarily driven by stem girth and leaf-related traits. MCA showed that qualitative variation was largely influenced by stem morphology, canopy size, and branching density. FAMD further confirmed the integration of qualitative and quantitative traits, with the first two dimensions explaining 56.4% of total variability. Correlation analysis demonstrated strong positive associations among leaf traits, indicating a coordinated leaf development system. Clustering analysis grouped the accessions into distinct morphotypes, with substantial overlap across agro-climatic zones, suggesting that morphological variation is governed by both environmental factors and inherent genetic diversity. Two major groups identified through FAMD represented broadly adapted and high growth morphotypes. From an applied perspective, accessions with larger canopy and higher leaf area are recommended for biomass-oriented breeding and cultivation in favourable environments, while stable, moderate-growth accessions are suitable for arid and semi-arid regions. The study also highlights leaf traits as reliable selection indices and emphasizes the need for stratified germplasm conservation across agro-climatic zones. This study provides a robust framework for understanding morphological diversity in M. oleifera and offers practical insights for its genetic improvement, conservation and climate-resilient utilization.
Reconstruction of advanced vertical and combined alveolar ridge defects still remains a challenge in implant dentistry. Digital technologies and virtual planning may potentially improve the predictability of guided bone regeneration (GBR). This study aimed to evaluate a fully digital, reverse-planning workflow for vertical ridge augmentation using membrane-cutting guides. This retrospective case series included 15 surgical sites presenting with vertical or combined alveolar ridge defects. A digital workflow integrating cone-beam computed tomography (CBCT), intraoral scanning, and virtual prosthetic planning was used to simulate ideal implant positions and corresponding hard tissue augmentation. Membrane-cutting guides were designed and fabricated using additive manufacturing to shape dense polytetrafluoroethylene membranes. Vertical GBR was performed using a split-thickness flap design and a tent-pole approach. Linear and volumetric hard tissue changes were assessed by comparing baseline and 9-month postoperative CBCT scans. Significant vertical bone gain was observed at all measurement points (p = 0.007), with mean increases from 15.70 mm ± 4.34 mm to 19.96 mm ± 3.83 mm at the central site. The mean volumetric hard tissue gain was 755.33 mm3 ± 411.22 mm3, closely matching the planned volume (757.50 mm3 ± 417.78 mm³), with no significant difference (p = 0.649). Using Spearman's correlation, a strong positive correlation was found between planned and achieved volumes (Spearman's ρ = 0.825, p = 0.0004). The mean augmentation efficacy was 20.13 ± 15.21 mm3/mm. The proposed 3D-driven reverse-planning workflow enabled predictable vertical ridge augmentation with high agreement between planned and achieved outcomes. This approach represents a feasible and accessible alternative to fully customized systems; however, further prospective controlled studies are required to validate these findings.
Macular degeneration MD is a chronic, lifestyle-related eye disease developing in increasingly younger people. The cause is not fully understood, but oxidative stress is among the most critical factors. The subject of our research is the wet form of MD. The tested materials were whole blood and plasma from 84 patients with exudative MD and from 127 healthy volunteers, from SW Poland. The concentration of toxic metals (Hg, Cd, Pb, As, Be), macroelements (Ca, Mg, Na, K, P) and microelements (Mn, Fe, Zn, Cu, Se, Mo, Cr, Li, V, Co, Ag, Ba, Ti, Tl, Sr, Al, Ni, Sn, B, Sb) was analyzed (ICP-MS) in the blood to determine environmental exposure. The activity of antioxidant enzymes (superoxide dismutase SOD, catalase CAT, glutathione peroxidase GPx, glutathione reductase GR) was determined to demonstrate the ability to eliminate the effects of reactive oxygen species ROS. The activity of nonenzymatic antioxidant mechanisms (reduced glutathione GSH, bilirubin, uric acid, vitamins A and E) was examined to assess the body's ability to activate defense mechanisms against ROS. The intensity of lipoperoxidation (malondialdehyde, MDA), and the importance of ceruloplasmin CP in patients with exudative MD and their exposure to oxidative stress were determined. The presence of glutathione-S-transferase GST polymorphisms (GSTT1, GSTM1) was examined to determine their role in generating MD. The genetic polymorphism of interleukin-4 IL-4 and vascular endothelial growth factor VEGF-A was analyzed, and it was determined whether there is a genetic burden that can potentially increase the chance of developing MD. The activity of SOD, CAT, GPx, and GR, and the activity of nonenzymatic antioxidants (GSH, bilirubin, uric acid, all-trans retinol, and alpha-tocopherol) were determined using Cayman kits and HPLC chromatography. MDA was determined using Cayman reagents, and CP was determined using Wuhan reagents. In our exudative MD patients, P, Ca, Mn, Fe, Cu, and Zn were most involved in interactions, whereas in the control group, Pb, Ca, Mn, Zn, and Ba were most important. In the analysis of antioxidant parameters, significant differences were found between the studied groups for SOD, CAT, GPx, bilirubin, all-trans retinol, alpha-tocopherol, and uric acid. Also, MDA and CP showed significant differences. In MD patients and healthy individuals, many correlations were found. Significant differences were noted for IL-4 in the frequency of the T allele in MD patients, and for Sr. The frequency distributions of GSTT1 and GSTM1 polymorphisms showed no significant differences between the groups, whereas differences were observed for all-trans retinol. Changes within VEGF-A genotypes showed no significant differences between the studied groups (p > 0.5). Due to the presence of mutagenic substances in the environment, the changed genome plays an important role in MD development. The pathogenic process can be observed by analyzing the effectiveness of enzymatic and nonenzymatic mechanisms. The low diagnostic value of MDA and CP for patients with MD was indicated. The results highlighted the significant role of environmental factors and indicated new directions for research into MD etiology. They identified new parameters to be considered when examining predisposition to this disease (Na, P, Cr, Mn, Ba, MDA, bilirubin, A and E vitamins, SOD, CAT, GPx, IL-4). We compare the aspects we examine holistically, making this the first study of this type. Despite many elements of MD development being known so far, there are still many unanswered questions in this field that will require further analysis, especially regarding K, Pb, As, Hg, Cd, Sr, Al, Ba, V, Fe, mutations in IL-4, GSTM1, and GSTT1.
Potato is a critical staple crop, and enhancing its carotenoid content is a promising strategy to improve its nutritional value. However, the synergistic mechanisms underlying carotenoid accumulation, superior nutritional traits, and the role of the endophytic microbiome remain unclear. Using an integrated multi-omics strategy, we systematically analyzed two high-zeaxanthin/lutein hybrids and four commercial cultivars. The hybrids accumulated significantly higher levels of zeaxanthin, lutein, and minerals, while exhibiting superior processing traits (e.g., higher dry matter/starch, lower reducing sugars). Integrated metabolomic and transcriptomic profiling revealed a coordinated upregulation of carotenoid and phenylpropanoid biosynthesis, alongside enrichment of stress-responsive phenolic acids. Notably, the endophytic microbiome in high-carotenoid tubers was distinct, dominated by Firmicutes and Proteobacteria, with genera like Bacillus and Latilactobacillus positively correlating with carotenoid content. Weighted gene co-expression network analysis identified a core regulatory module containing key genes (e.g., CCD4, BCH2) and novel transcription factors. Our findings elucidate a synergistic network linking metabolism, gene regulation, and the endophytic microbiome that collectively is associated with carotenoid accumulation and tuber quality. This provides critical targets for breeding nutritionally enhanced potatoes with desirable agronomic performance, supporting nutritional security and sustainable agriculture.
Frailty is a common and clinically significant condition among older adults undergoing surgical procedures and is associated with adverse postoperative outcomes. In addition to biological vulnerability, psychosocial factors such as social support may influence recovery processes. However, studies examining the relationship between frailty and perceived social support in older orthopedic surgical patients remain limited. This study aimed to examine the relationship between frailty and perceived social support in older orthopedic surgical patients and to determine how these variables differ according to sociodemographic and clinical characteristics. This cross-sectional study was conducted with 241 older orthopedic surgical patients aged 65 years and older who underwent orthopedic surgical procedures. Data were collected using the Descriptive Characteristics Form, the Edmonton Frail Scale, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics, independent samples t-tests, one-way ANOVA, and Spearman correlation analysis were used. A p value of < 0.05 was considered statistically significant. Participants showed clinically relevant levels of frailty, with many classified as mildly, moderately, or severely frail, and reported moderate to high levels of perceived social support. Social support was highest from family and lowest from a significant other. A substantial proportion of patients were identified as having mild, moderate, or severe frailty. No significant relationship was found between total perceived social support and frailty; however, family support was significantly and inversely associated with frailty (p < 0.05). Frailty levels were significantly higher among female participants and those with lower educational levels (p < 0.05). Frailty remains a prevalent condition among older orthopedic surgical patients, even in the presence of relatively high levels of perceived social support. Family-based support was significantly and inversely associated with frailty; however, this finding should be interpreted as an association rather than evidence of a protective or causal effect. Integrating frailty screening with the assessment of social support in perioperative care may support the development of individualized and patient-centered nursing interventions. Future studies should explore causal relationships using longitudinal designs and include detailed clinical variables such as surgical type.