Science Citation Index Expanded (Web of Science)

Objective. To evaluate efficacy and safety at 5 years after treatment with hydrogel-based autologous chondrocyte implantation (ACI) for large cartilage defects in the knee.

Background: Inflammatory mechanisms contribute to major depressive disorder (MDD) in a subset of patients. Lipopolysaccharide (LPS), a potent inflammatory endotoxin, can induce depressive-like symptoms, but its relationship with specific depressive symptom profiles remains unclear. Methods: In total, 95 adults with MDD (mean age was 44 ± 14 years) were recruited from psychiatric inpatient and outpatient services. Depressive symptom severity was assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS). Serum concentrations of LPS, IL-10, TNF-α, IL-6, and IFN-γ were measured by ELISA. Associations between inflammatory markers and depressive symptoms were examined using group comparisons, correlation analyses, multivariable linear regression, quantile regression, and mediation analyses adjusted for demographic and clinical covariates. Results: Patients with severe depression exhibited significantly lower circulating LPS levels than those with mild-to-moderate depression (95.6 vs. 165.2 pg/mL, p = 0.007), despite no significant differences in cytokine concentrations. LPS levels were inversely associated with depression severity, anhedonia factor score, and MADRS item 8 (“inability to feel”). Lower LPS concentrations were independently predicted by higher inability to feel, reduced appetite and combined pharmacotherapy use. Quantile regression demonstrated heterogeneity across the LPS distribution, with symptom–LPS associations evident among patients with higher LPS concentrations. Higher LPS levels were associated with greater apparent sadness, concentration difficulties, and reduced sleep, but lower levels of anhedonia, less reduced appetite, less lassitude, lower inner tension, and lower suicidality. Mediation analyses indicated that anhedonia mediated the association between LPS levels and depression severity. Conclusions: Higher circulating LPS may characterize a biologically distinct subgroup of MDD patients with lower symptom severity and less anhedonia, supporting biological heterogeneity within MDD.

Canine periodontitis is one of the most prevalent chronic diseases for dogs over two years of age. Periodontal pockets may serve as a reservoir for opportunistic bacteria including Pasteurella stomatis, Neisseria animaloris, and Streptococcus canis; however, data on their antimicrobial susceptibility and potential One Health relevance remain limited. This pilot study investigated culturable bacterial isolates recovered from periodontal pockets of dogs with different stages of periodontal disease. Subgingival samples were collected under general anesthesia after periodontal probing and dental radiographic assessment during routine comprehensive oral health assessment and treatment (COHAT) procedures. Bacterial isolates were cultured, identified using MALDI-TOF MS, and tested for minimum inhibitory concentrations (MIC) against amoxicillin (AML), doxycycline (DX), trimethoprim–sulfamethoxazole (SXT), gentamicin (CN), chloramphenicol (C), and ciprofloxacin (CIP). In total, 122 isolates from 101 dogs were analyzed, including Pasteurella stomatis (n = 54), Neisseria animaloris (n = 33), and Streptococcus canis (n = 35). MIC distributions varied between bacterial species and antimicrobial agents, while interpretation was limited by the lack of species-specific veterinary medicine breakpoints for some isolates. These preliminary findings highlight the need for larger standardized studies to support antimicrobial resistance surveillance in canine oral microbiota.

Colorectal cancer (CRC) is one of the most common malignancies worldwide. Early and accurate diagnosis remains a clinical priority, yet current biopsy techniques are invasive, spatially limited, and may not capture the molecular heterogeneity of tumors. We evaluated the feasibility and diagnostic potential of electroporation-based biopsy (e-biopsy) as a minimally invasive technique for proteomic sampling of colorectal cancer tissues. We conducted a multicenter, multinational study involving 19 patients undergoing surgical resection for CRC. Paired tumor and adjacent normal tissues were sampled ex vivo using e-biopsy. Proteins extracted from each sample were analyzed via LC-MS/MS. Bioinformatics pipelines, including differential expression, PCA, and pathway analysis, were used to identify CRC-specific signatures. E-biopsy consistently retrieved more proteins from tumor tissues than from adjacent healthy tissues (mean: 1300 vs. 800). Of the 3246 proteins identified, 54% were significantly upregulated in tumor tissues. Notably, proteins such as DLAT, LETM1, RBBP4, PPIB, and BCAP31 emerged as potential CRC biomarkers. Functional analyses revealed dysregulation in RNA processing, immune response, and metabolic pathways, consistent with known CRC biology. The integrated workflow, spanning tissue collection, electroporation, protein isolation, and mass spectrometry analysis across four institutions in two countries, was successfully executed, demonstrating the feasibility of multi-institutional implementation of the e-biopsy protocol while preserving tissue integrity throughout. E-biopsy enables rapid, reproducible, and minimally invasive molecular sampling of CRC tissue. This study demonstrates its potential to complement standard histopathology, aid in early diagnosis, and support molecularly guided treatment strategies in colorectal oncology.

Adequate hydration and nutrition are crucial for preventing health complications and functional decline in older adults, especially those with dysphagia. This study examined the use of direct frozen and reverse spherification, with different residence times, to create alginate-based, high-water-content (>95%) bite-sized structures that are safe to swallow and capable of encapsulating vitamins B9 and B12 for delayed release in the gastrointestinal tract. Residence time notably affected the beads’ microstructure and texture. Reverse-spherified liquid-core beads were soft and stable, maintaining high water content; however, they were not suitable for people with dysphagia because of their uneven texture and water release when compressed or bitten. Conversely, direct frozen spherification yielded solid-core alginate beads with low hardness (77.46–136.25 g), minimal adhesiveness (~11 g·s), good cohesiveness (>0.3), and rheological properties compatible with swallowing. A fiberoptic endoscopic swallowing assessment found that the patients rated these solid-core beads as easy to chew and comfortable to swallow. Over six weeks, vitamin retention was 59.4–79.4% for vitamin B9 and 69.6–97.0% for vitamin B12, with 80–90% released during simulated digestion. These results highlight frozen direct spherification’s potential to create dysphagia-friendly, high-water-content finger foods that improve hydration, nutrition, and vitamin encapsulation.

This study aimed to select lactic acid bacteria (LAB) strains based on their antagonistic activity and mycotoxin mitigation capacity, develop a biocompatible multistrain consortium, and evaluate its application for the fermentation of extruded wheat bran. The selected strains were assessed for biocompatibility, and a four-strain consortium comprising Lacticaseibacillus casei, Levilactobacillus brevis, Pediococcus acidilactici, and Latilactobacillus curvatus was established. The consortium was propagated in supplemented sour whey and subsequently applied to wheat bran fermentation. Compared with the two-strain formulations, the four-strain consortium reduced the total bacterial count by 1.6-fold and the yeast and mold count by 1.75-fold after 36 h of fermentation. The consortium also produced the most pronounced acidification of the substrate, reducing the pH from 5.65 to 3.82 and increasing titratable acidity from 0.20 to 4.40 °N (22.0-fold). In contrast, fermentation with the two-strain formulations reduced the pH to 4.02 ± 0.01, while titratable acidity increased by 20.5–20.6-fold. After 36 h of fermentation, the viable LAB count in the substrate fermented with the four-strain consortium reached 7.23 ± 0.11 log10 CFU/g, compared with 6.23 ± 0.02 and 6.42 ± 0.01 log10 CFU/g in the substrates fermented with the two-strain formulations. These findings indicate that the developed four-strain consortium represents a promising starter culture for wheat bran fermentation and highlight its potential for the valorization of cereal by-products into value-added feed material through LAB fermentation. All experiments were conducted in vitro, and the effectiveness of the proposed approach under animal feeding conditions requires further experimental validation.

Background The proliferation of acronyms in abdominal wall surgery has fragmented procedural language, limiting comparability across studies, registries, and operative reports. The Muysoms A–H–M–T–F nomenclature was proposed to standardize hernia repair description across five key dimensions; however, its inter-rater reproducibility among independent surgeons has not previously been evaluated.

Introduction. Colonic diverticulosis is the most common structural abnormality of the colon in developed countries, with an increasing global prevalence. Approximately 20-25% of affected individuals develop symptoms, collectively referred to as diverticular disease. Given its wide clinical spectrum, evolving pathophysiological insights and growing disease burden, updated guidance is essential.

Background and Objectives: Early-stage glottic cancer requires highly precise radiotherapy due to laryngeal motion and the proximity of critical structures. Magnetic resonance-guided radiotherapy (MRgRT) enables real-time visualization and motion management, potentially improving dose conformity while reducing treatment margins. This pilot comparative planning study compared the dosimetric characteristics of MR-guided intensity-modulated radiotherapy (IMRT) delivered on the Unity MR-linac with volumetric modulated arc therapy (VMAT) plans generated for the TrueBeam STx and Halcyon systems. Materials and Methods: Ten patients with T1–T2N0 glottic squamous cell carcinoma were included. For each patient, treatment plans prescribing 42.5 Gy in five fractions were generated using all three systems. Planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), organ-at-risk (OAR) doses, monitor units, and beam-on times were compared using Friedman and post hoc Wilcoxon signed-rank tests. Results: Unity achieved superior dose conformity (CI 0.97 ± 0.01 vs. 0.78 ± 0.15 for TrueBeam STx and 0.58 ± 0.19 for Halcyon; p < 0.001) and the highest mean dose, while PTV coverage (D95% and D98%) was comparable to TrueBeam STx and higher than Halcyon. Reduced treatment margins resulted in significantly smaller PTV volumes (11.09 ± 3.87 cm3 vs. 17.43 ± 4.75 cm3; p = 0.0001). Halcyon demonstrated the most homogeneous dose distribution (HI 7.88 ± 3.14), whereas TrueBeam STx showed intermediate homogeneity (HI 12.81 ± 3.90). Most OAR dose metrics were comparable among techniques, although selected laryngeal structures and the esophagus differed significantly. Beam-on time was longest for Unity. Conclusions: MR-guided IMRT provided superior dose conformity while maintaining target coverage comparable to TrueBeam STx with clinically acceptable OAR sparing. Prospective clinical studies are required to determine whether these dosimetric advantages translate into improved patient outcomes.

Background: Accurate segmentation of calcified plaques in coronary computed tomography angiography (CCTA) images is critical for reliable assessment of coronary atherosclerotic burden and for supporting interpretation of luminal stenosis, yet it remains a challenging task due to annotation inconsistencies, blooming artifacts and low contrast at lesion boundaries. These limitations may affect both automated model performance and the clinical trustworthiness of AI systems. This study explores the impact of annotation refinement on segmentation performance and model explainability, as well as the influence of representation learning on explanation quality. Methods: We trained a deep convolutional neural network to segment calcified plaques in coronary arteries using a dataset of expert-labeled CT slices. Initial training on radiologist-provided annotations yielded suboptimal results. To address this, annotations were manually revised and validated by radiologists. In addition to a standard ImageNet-pretrained model, we evaluated a self-supervised representation learning approach using DINOv2. Grad-CAM was used to generate visual explanations for model predictions before and after annotation refinement. Results: Models trained with refined annotations achieved notably improved segmentation accuracy, with clearer delineation of calcified regions. Grad-CAM localization analysis demonstrated improved concentration of model attention within plaque and vessel regions. Furthermore, models incorporating DINOv2 representations produced more spatially coherent attention maps, with improved anatomical localization consistent with coronary vessel regions and reduced off-target activations, as qualitatively confirmed by expert radiologists. Conclusions: Our findings emphasize the importance of high-quality, validated annotations in developing accurate and interpretable AI models for medical imaging. In addition, the results suggest that representation learning influences the reliability and clinical relevance of explainability outputs. The combination of manual annotation refinement, expert validation, and improved feature representations provides a practical workflow for human-in-the-loop AI development in cardiovascular imaging. This study demonstrates that annotation quality is a critical and often underestimated determinant of XAI reliability, and suggests that explainability methods can serve as feedback tools for iterative, clinician-guided dataset curation in cardiovascular imaging.