Search Results (2,897)

Synthetic Data Generation (SDG) is a promising solution for healthcare, offering the potential to generate synthetic patient data closely resembling real-world data while preserving privacy. However, data scarcity and heterogeneity, particularly in under-resourced regions, challenge the effective implementation of SDG. This paper addresses these challenges using Federated Learning (FL) for SDG, focusing on sharing synthetic patients across nodes. By leveraging collective knowledge and diverse data distributions, we hypothesize that sharing synthetic data can significantly enhance the quality and representativeness of generated data, particularly for institutions with limited or biased datasets. This approach aligns with meta-learning concepts, like Domain Randomized Search. We compare two FL techniques, FedAvg and Synthetic Data Sharing (SDS), the latter being our proposed contribution. Both approaches are evaluated using variational autoencoders with Bayesian Gaussian mixture models across diverse medical datasets. Our results demonstrate that while both methods improve SDG, SDS consistently outperforms FedAvg, producing higher-quality, more representative synthetic data. Non-IID scenarios reveal that while FedAvg achieves improvements of 13–27% in reducing divergence compared to isolated training, SDS achieves reductions exceeding 50% in the worst-performing nodes. These findings underscore synthetic data sharing potential to reduce disparities between data-rich and data-poor institutions, fostering more equitable healthcare research and innovation. Full article

The complex integration of Industry 4.0 technologies into SMEs necessitates robust frameworks to address adoption barriers and enhance sustainability. The present study investigates the impact of artificial intelligence (AI), the Internet of Things (IoT), and blockchain on smart manufacturing, logistics, and sustainability in SMEs. Using a cross-sectional design, data were collected from 300 SMEs across manufacturing, logistics, and retail sectors through purposive sampling, focusing on technology adoption, and sustainability performance from 2018 to 2022. Data were analyzed using advanced machine learning models, including XG Boost and Random Forest, alongside Recursive Feature Elimination (RFE) for dimensionality reduction and quantile regression for an inferential analysis. Findings revealed that IoT adoption improved resource utilization efficiency, while blockchain enhanced ethical sourcing—furthermore, AI-driven predictive maintenance reduced operational downtimes. XG Boost achieved a Mean Squared Error (MSE), highlighting its superior predictive capability, while Random Forest achieved perfect fitness but risked overfitting. However, adoption varied significantly across firms due to financial and technical constraints, with SMEs reporting limited access to capital and skilled labor. This study underscores the need for policy interventions and targeted support for SMEs to bridge adoption gaps. The study advances the existing body of knowledge by highlighting the synergistic benefits of integrating Industry 4.0 technologies to enhance SME sustainability. Practical implications include policy recommendations for financial incentives, technical support, and capacity-building programs, empowering SMEs with actionable insights to overcome adoption barriers and achieve sustainable growth. These findings offer industry leaders and policymakers’ actionable insights to drive SME transformation in Industry 4.0, empowering them to make a difference. Full article

Thermal modification improves the properties of wood, especially its stability and durability. We thermally treated spruce wood with the Thermowood process at three temperatures (160 °C, 180 °C, and 210 °C) and subjected it to accelerated aging in wet mode. We evaluated the chemical composition (wet chemistry, infrared spectroscopy), color, surface morphology, and wetting of the wood surface with water. Thermal treatment caused a significant decrease in hemicelluloses (up to 72.39% at a temperature of 210 °C), which initiated an increase in the content of more resistant wood components—cellulose and lignin. With accelerated aging, the hemicellulose content decreased by another 5%. The most significant differences between the infrared spectra of thermally modified wood before and after exposure to accelerated aging were in the absorption bands of lignin (1509 and 1596 cm⁻¹) and in the region of carbonyl groups between 1800 and 1630 cm⁻¹. Thermal treatment also caused a change in the color of the wood to dark brown; the overall color difference ΔE increased several times. The thermal-induced shortening of polysaccharide fibers and reduction in their width were even more manifested during accelerated aging. This work contains new knowledge about the properties critical for the reuse of thermally modified wood after accelerated aging, simulating the end of its life cycle. Full article

Autophagy and mitophagy are critical cellular processes that maintain homeostasis by removing damaged organelles and promoting cellular survival under stress conditions. In the context of diabetic kidney disease, these mechanisms play essential roles in mitigating cellular damage. This review provides an in-depth analysis of the recent literature on the relationship between autophagy, mitophagy, and diabetic kidney disease, highlighting the current state of knowledge, existing research gaps, and potential areas for future investigations. Diabetic nephropathy (DN) is traditionally defined as a specific form of kidney disease caused by long-standing diabetes, characterized by the classic histological lesions in the kidney, including mesangial expansion, glomerular basement membrane thickening, nodular glomerulosclerosis (Kimmelstiel–Wilson nodules), and podocyte injury. Clinical markers for DN are albuminuria and the gradual decline in glomerular filtration rate (GFR). Diabetic kidney disease (DKD) is a broader and more inclusive term, for all forms of chronic kidney disease (CKD) in individuals with diabetes, regardless of the underlying pathology. This includes patients who may have diabetes-associated kidney damage without the typical histological findings of diabetic nephropathy. It also accounts for patients with other coexisting kidney diseases (e.g., hypertensive nephrosclerosis, ischemic nephropathy, tubulointerstitial nephropathies), even in the absence of albuminuria, such as a reduction in GFR. Full article

Promoting rapid healing is a concern in skin wound treatment, as the increased pain and the loss of functional ability when wounds become chronic create a complex problem to manage. This scoping review aimed to explore the literature and synthesize existing knowledge on the therapeutic use of CO₂ in treating cutaneous wounds. The literature was selected using previously defined inclusion and exclusion criteria, and 22 articles were selected for data extraction. The most researched type of injury was chronic wounds located on the extremities of the limbs. Carboxytherapy was performed in five different ways: subcutaneous, intradermal, or intralesional injections; in hot water baths with temperatures ranging from 30 to 42 °C; transcutaneous application; intra-abdominal insufflation; and a paste for transcutaneous local application. The main effects of CO₂ therapy described were as follows: improved blood flow and local oxygenation, reduction of the inflammatory process, increased collagen production, and improved clinical aspects of wounds, with faster healing. Carboxytherapy can be considered a good alternative for treating skin wounds, although further studies should be pursued to elucidate its molecular mechanisms and enhance its efficacy. Full article

Organizations face fundamental challenges in managing knowledge flows across complex networks, yet existing frameworks often lack quantitative tools for optimization. We develop a novel stochastic multi-scale model introducing knowledge flow viscosity (KFV) to analyze organizational learning dynamics. This model quantifies resistance to knowledge transfer using a time-varying viscosity tensor, capturing both continuous learning processes and discrete knowledge acquisition events. Through renormalization group analysis, we establish the existence of critical thresholds in knowledge diffusion rates, characterizing phase transitions in organizational learning capacity. Numerical simulations demonstrate that targeted reductions in communication barriers near these thresholds can significantly enhance knowledge flow efficiency. The findings provide a mathematical foundation for understanding multi-level knowledge flow dynamics, suggesting precise conditions for effective interventions to optimize learning in complex organizational systems. Full article

Adversarial attacks deliberately modify deep learning inputs, mislead models, and cause incorrect results. Previous adversarial attacks on sentiment analysis models have demonstrated success in misleading these models. However, most existing attacks in sentiment analysis have applied a generalized approach to input modifications, without considering the characteristics and objectives of the different analysis levels. Specifically, for aspect-based sentiment analysis, there is a lack of attack methods that modify inputs in accordance with the evaluated aspects. Consequently, unnecessary modifications are made, compromising the input semantics, making the changes more detectable, and avoiding the identification of new vulnerabilities. In previous work, we proposed a model to generate adversarial examples in particular for aspect-based sentiment analysis. In this paper, we assess the effectiveness of our adversarial example model in negatively impacting aspect-based model results while maintaining high levels of semantic inputs. To conduct this evaluation, we propose diverse adversarial attacks across different dataset domains, target architectures, and consider distinct levels of victim model knowledge, thus obtaining a comprehensive evaluation. The obtained results demonstrate that our approach outperforms existing attack methods in terms of accuracy reduction and semantic similarity, achieving a 65.30% reduction in model accuracy with a low perturbation ratio of 7.79%. These findings highlight the importance of considering task-specific characteristics when designing adversarial examples, as even simple modifications to elements that support task classification can successfully mislead models. Full article

Barley (Hordeum vulgare L.) is the second winter crop in Argentina. In the national market, grains are mainly destined to produce malt for beer manufacture. Fusarium species are common, causing Fusarium Head Blight (FHB) in barley, which generates yield and quality losses, as well as mycotoxin occurrence. The aims of this study were to determine (a) the incidence of the main species causing FHB in different locations of the barley-growing region of Argentina, (b) their ability to produce mycotoxins, and (c) the levels of deoxynivalenol (DON) and nivalenol (NIV) natural occurrence in grains at the harvest stage. Additionally, a strain of Bacillus velezensis was studied as a biocontrol agent in order to control F. graminearum sensu stricto and mycotoxin accumulation during the malting process, with the final objective being to reduce DON contamination in the beer manufacture chain. Fusarium graminearum ss was the most prevalent species causing FHB, with Fusarium poae being less distributed. Both species produced several mycotoxins, including NX-2 and NX-3, which is the first report of their production by strains isolated from barley in Argentina. Deoxynivalenol contamination was found in 95% of barley grains during the 2016 harvest season (mean: 0.4 mg/kg), while NIV contamination was present in 29% of samples (mean: 0.49 mg/kg). In the 2017 harvest season, 53.6% of grains were contaminated with DON (mean: 0.42 mg/kg), and 21% with NIV (mean: 0.8 mg/kg). Quantification of F. graminearum ss by real-time PCR during the micro-malting process showed that application of the biocontrol agent before the germination stage was the most effective treatment, with a 45% reduction in fungal DNA levels. Reduction in DON contamination (69.3–100%) in artificially infected grains with F. graminearum ss, was also observed. The present work contributes to the knowledge of FHB in Argentina and to the development of a strategy to control this disease and mycotoxin contamination in barley, promoting at the same time food security. Full article

Background: Congenital mesoblastic nephroma represents 3–10% of all pediatric renal tumors. With the advancement of ultrasound diagnostics and magnetic resonance imaging, the diagnosis of this renal neoplasm is increasingly being established prenatally and at birth. It usually presents as a benign tumor, but it can severely affect pregnancy outcomes, contributing to perinatal morbidity and mortality. Lissencephaly belongs to a rare category of neurodevelopmental disorders marked by the absence of a substantial reduction in the typical folds and grooves in the cerebral cortex. The prognosis for patients with lissencephaly is extremely poor, carrying with it a high mortality rate. Case Presentation: We present a case of congenital mesoblastic nephroma (CMN) diagnosed with polyhydramnios at 28 weeks of gestation, which led to preterm delivery at 29 weeks and a fatal outcome for the newborn. Histopathological examination confirmed the diagnosis of CMN along with fetal pachygyria/lissencephaly. The aim of this study is to point out the characteristics and unique correlation between CMN and lissencephaly, and to illustrate the histopathological features of CMN and lissencephaly through an educational example derived from our presented index case. To the best to our knowledge, the association of CMN with lissencephaly has not been described in the literature so far. Conclusions: Outlining the prenatal progression of CMN and the outcome of pregnancies involving fetal CMN and lissencephaly, this case underscores the importance of comprehensive ultrasound examinations, including central nervous system evaluation, to identify potential coexisting anomalies and refine prenatal diagnostic practices. Full article

Background/objectives: Malnutrition and sarcopenia are interrelated health concerns among the elderly. Each condition is associated with increased mortality, morbidity, rehospitalization rates, longer hospital stays, higher healthcare costs, and reduced quality of life. Their combination leads to the development of “Malnutrition–Sarcopenia Syndrome” (MSS), characterized by reductions in body weight, muscle mass, strength, and physical function. Despite being preventable and reversible through nutritional and physical interventions, the clinical competence of physical therapists (PTs) in managing MSS remains underexplored. This study aims to assess the clinical competency of PTs in MSS management. Methods: An anonymous cross-sectional survey was conducted from January to August 2024 among 337 certified PTs in Israel, using the “Qualtrics” platform. The survey assessed prior familiarity with MSS concepts, MSS knowledge levels, screening and treatment skills, attitudes and beliefs toward MSS management, and interprofessional collaboration practices. Results: While 52% of PTs were familiar with MSS, familiarity with diagnostic guidelines was low (EWGSOP2: 3.6%; GLIM: 0.6%). The MSS knowledge score was moderate, but screening and treatment skills were low. Attitudes toward MSS management were moderately positive, but self-belief in diagnosing and treating MSS was low. Interprofessional collaboration was limited, particularly in malnutrition care. PTs familiar with MSS had higher knowledge, better skills, more positive attitudes and beliefs, and greater interprofessional collaboration. Conclusions: Significant gaps exist in the clinical competency of Israeli PTs in MSS management. Integrating MSS content into physical therapy curricula and providing continuing professional development are necessary to enhance competencies. Equipping PTs with essential tools, clarifying roles, and promoting interprofessional collaboration can optimize MSS management and improve patient outcomes. Full article

In today’s world, with its continuing advancements in genetics, the identification of Lynch syndrome (LS) increasingly relies on sophisticated genetic testing techniques. Most guidelines recommend a tailored surveillance program, as well as personalized prophylactic and therapeutic approaches, according to the type of dMMR gene mutation. Carriers of path_MLH1 and path_MSH2 genes have a higher risk of developing colorectal cancer (CRC), despite intensive colonoscopic surveillance. Conversely, carriers of path_MSH6 and path_PMS2 genes have a lower risk of developing CRC, which may be due to their lower penetrance and later age of onset. Thus, carriers of path_MLH1 or path_MSH2 would theoretically derive greater benefits from total colectomy, compared to low-risk carriers (path_MSH6 and path_PMS2), in which colonoscopic surveillance might achieve an efficient prophylaxis. Furthermore, regarding the risk of endometrial/ovarian cancer development, there is a global agreement to offer both hysterectomy and bilateral salpingo-oophorectomy to path_MLH1, path_MSH2 and path_MSH6 carriers after the age of 40. In patients with CRC, preoperative knowledge of the diagnosis of LS is of tremendous importance, due to the high risk of metachronous CRC. However, this risk depends on the type of dMMR gene mutation. For carriers of the high-risk variants (MLH1, MSH2 and EPCAM) who have already developed colon cancer, it is strongly recommended a subtotal or total colectomy is performed, while partial colectomy followed by endoscopic surveillance is an appropriate management approach to treat colon cancer in carriers of the low-risk variants (MSH6 and PMS2). On the other hand, extended surgery for index rectal cancer (such as total proctocolectomy) is less effective than extended surgery for index colon cancer from the point of view of metachronous CRC risk reduction, and is associated with a decreased quality of life. Full article

Honey is abundant in bioactive compounds, which demonstrate considerable therapeutic effects, particularly on oxidative stress and inflammation. Objectives: This work sought to evaluate the antioxidant mechanisms of Manuka honey (MH) and Ohia Lehua honey (OLH), correlating them with phytochemical analyses in a rat model of experimentally induced inflammation. Methods: The identification of polyphenolic compounds in the extracts was carried out using HPLC-ESI MS. The extracts’ antioxidant activity was evaluated in vitro through DPPH, FRAP, H₂O₂, and NO scavenging assays, while in vivo assessments included measurements of total oxidative status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), advanced oxidation protein products (AOPP), malondialdehyde (MDA), nitric oxide (NO), and total thiols (SH). Results: The phytochemical analysis found a rich content of phenolic compounds in MH and lower quantities in OLH. In terms of in vitro activity, both MH and OLH exhibited strong DPPH radical scavenging abilities, effective NO and H₂O₂ scavenging capacities, and high FRAP-reducing power. In vivo, OLH proved highly effective in enhancing antioxidant capacity and lowering oxidative stress markers, showing significant increases in TAC and substantial reductions in TOS and OSI levels. Conversely, MH displayed limited and dose-dependent antioxidant activity, a considerable increase in TAC and SH, and a moderate decrease in TOS and OSI levels. Conclusions: To our knowledge, this is the first study to assess the phenolic content of OLH and to show its capacity to scavenge free radicals and reduce oxidative stress. The effectiveness of MH primarily relies on its increased antioxidant properties and depends on concentration. These results highlight the importance of investigating natural products in developing antioxidant strategies. Full article

Moodle quizzes are a convenient way of online assessment, benefiting both teachers and students. Unfortunately, their preparation is slow, cumbersome, and error-prone. In addition to the effort of designing the questions, it is necessary to enter them in Moodle. Furthermore, for questions that require images, these must first be created and then uploaded to Moodle. If this process has to be repeated with many questions, the required work becomes prohibitive. This paper presents a tool that solves all these problems, allowing the automatic and massive generation of questions for the evaluation of the knowledge about lexical analysis algorithms. The evaluation of these algorithms is relevant in the subjects of both automata and formal languages and in those of compiler design. The tool allows the creation of exercises of configurable complexity, after which the text, tables, and associated images are generated for quick upload to Moodle. The main impact of this tool is the substantial reduction of question preparation time, reducing hundreds or thousands of interactions with Moodle forms to just a few simple steps. In addition, the ease of question generation makes it possible to prepare self-assessment questionnaires for the students, something that they greatly appreciate as a study aid. Full article

Background/Objectives: Rotavirus (RV) is the primary cause of gastroenteritis in children worldwide, contributing significantly to morbidity and mortality, particularly among children under five years of age. The introduction of Rotavirus vaccines (RVV) has markedly reduced RV-related childhood deaths, especially in Europe, where substantial reductions in hospitalizations and disease prevalence have been observed. Despite these advances, RVV uptake in Italy remains below the desired targets, with notable regional disparities. In Sicily, vaccination rates have fluctuated, with current coverage failing to meet national goals. Safety concerns and insufficient parental awareness are major barriers to RVV acceptance. Methods: This case-control study was conducted in Southern Italy to identify factors influencing parental acceptance of RVV. Data were collected from parents using a structured questionnaire that assessed socio-demographic factors, vaccine knowledge, and attitudes based on the Health Belief Model (HBM). Results: Overall, 226 parents were enrolled. Higher perceived benefit of RVV was significantly associated with increased vaccine adherence (Odds Ratio = 13.65; 95% Confidence Interval = 6.88–27.09; p < 0.001). Conclusions: These results highlight the need for targeted interventions to improve vaccine coverage and address regional and socio-economic barriers to RVV acceptance. Furthermore, tailored educational campaigns and univocal information from healthcare providers could play pivotal roles in achieving higher vaccine uptake. Full article

Background: Inflammatory bowel diseases (IBDs) have been associated with a higher risk of colorectal cancer (CRC) development and chronic colonic inflammation seems to have a critical role in the pathogenesis of CRC in patients suffering from IBD. In respect to that, surveillance colonoscopy at regular intervals is recommended in patients with colitis. Objective: This review aims to explore the chemopreventive potential of a range of agents, including mesalazine, thiopurines, anti-TNF agents, statins, ursodeoxycholic acid, aspirin, folic acid, and nutraceuticals. Results: These agents target inflammation, oxidative stress, and oncogenic pathways, thereby offering the potential to reduce the risk of CRC in patients with IBD. Anti-TNF agents, such as infliximab and adalimumab, not only reduce colonic inflammation, but also play a protective role against CRC by lessening the carcinogenic effects associated with prolonged inflammatory processes. Furthermore, mesalazine and thiopurines have demonstrated established efficacy, while newer biologics, including interleukin inhibitors, show promising advancements. Although nutraceuticals and dietary interventions require further clinical validation, they offer additional possibilities for non-pharmacological prevention. Conclusion: Despite progress, knowledge gaps persist regarding the long-term safety, optimal dosing, and combined use of these agents. A significant reduction in the incidence of CRC in patients with IBD could be achieved by advancing chemoprevention and personalizing strategies. Full article