The 2023 MDPI Annual Report has
been released!
 
17 pages, 7181 KiB  
Article
Immunohistochemical Expression Levels of Epidermal Growth Factor Receptor, Cyclooxygenase-2, and Ki-67 in Canine Cutaneous Squamous Cell Carcinomas
by João Miguel Luís, Rita Files, Cláudia Cardoso, José Pimenta, Gabriela Maia, Filipe Silva, Felisbina L. Queiroga, Justina Prada and Isabel Pires
Curr. Issues Mol. Biol. 2024, 46(5), 4951-4967; https://doi.org/10.3390/cimb46050297 (registering DOI) - 19 May 2024
Abstract
Squamous cell carcinoma (SCC) stands as the second most prevalent skin cancer in dogs, primarily attributed to UV radiation exposure. Affected areas typically include regions with sparse hair and pale or depigmented skin. The significance of spontaneous canine cutaneous SCC as a model [...] Read more.
Squamous cell carcinoma (SCC) stands as the second most prevalent skin cancer in dogs, primarily attributed to UV radiation exposure. Affected areas typically include regions with sparse hair and pale or depigmented skin. The significance of spontaneous canine cutaneous SCC as a model for its human counterpart is underscored by its resemblance. This study assesses the expression of key markers—Epidermal Growth Factor Receptor (EGFR), Cyclooxygenase-2 (Cox-2), and Ki-67—in canine cutaneous SCC. Our objective is to investigate the association between their expression levels and classical clinicopathological parameters, unraveling the intricate relationships among these molecular markers. In our retrospective analysis of 37 cases, EGFR overexpression manifested in 43.2% of cases, while Cox-2 exhibited overexpression in 97.3%. The EGFR, Cox-2 overexpression, and Ki-67 proliferation indices, estimated through immunohistochemistry, displayed a significant association with the histological grade, but only EGFR labeling is associated with the presence of lymphovascular emboli. The Ki-67 labeling index expression exhibited an association with EGFR and Cox-2. These findings propose that EGFR, Cox-2, and Ki-67 hold promise as valuable markers in canine SCC. EGFR, Cox-2, and Ki-67 may serve as indicators of disease progression, offering insights into the malignancy of a lesion. The implications extend to the potential therapeutic targeting of EGFR and Cox-2 in managing canine SCC. Further exploration of these insights is warranted due to their translational relevance and the development of targeted interventions in the context of canine SCC. Full article
(This article belongs to the Special Issue Future Challenges of Targeted Therapy of Cancers)
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27 pages, 3028 KiB  
Article
Dengue Virus and Zika Virus Seroprevalence in the South Pacific Populations of the Cook Islands and Vanuatu
by Charlotte E. B. Saretzki, Gerhard Dobler, Elizabeth Iro, Nicole Heussen and Thomas Küpper
Viruses 2024, 16(5), 807; https://doi.org/10.3390/v16050807 (registering DOI) - 19 May 2024
Abstract
Arboviral diseases are serious threats to global health with increasing prevalence and potentially severe complications. Significant arthropod-borne viruses are the dengue viruses (DENV 1-4), the Zika virus (ZIKV), and the chikungunya virus (CHIKV). Among the areas most affected is the South Pacific Region [...] Read more.
Arboviral diseases are serious threats to global health with increasing prevalence and potentially severe complications. Significant arthropod-borne viruses are the dengue viruses (DENV 1-4), the Zika virus (ZIKV), and the chikungunya virus (CHIKV). Among the areas most affected is the South Pacific Region (SPR). Here, arboviruses not only cause a high local burden of disease, but the region has also proven to contribute to their global spread. Outpatient serum samples collected between 08/2016 and 04/2017 on three islands of the island states of Vanuatu and the Cook Islands were tested for anti-DENV- and anti-ZIKV-specific antibodies (IgG) using enzyme-linked immunosorbent assays (ELISA). ELISA test results showed 89% of all test sera from the Cook Islands and 85% of the Vanuatu samples to be positive for anti-DENV-specific antibodies. Anti-ZIKV antibodies were identified in 66% and 52%, respectively, of the test populations. Statistically significant differences in standardized immunity levels were found only at the intranational level. Our results show that in both the Cook Islands and Vanuatu, residents were exposed to significant Flavivirus transmission. Compared to other seroprevalence studies, the marked difference between ZIKV immunity levels and previously published CHIKV seroprevalence rates in our study populations is surprising. We propose the timing of ZIKV and CHIKV emergence in relation to recurrent DENV outbreaks and the impact of seasonality as explanatory external factors for this observation. Our data add to the knowledge of arboviral epidemics in the SPR and contribute to a better understanding of virus spread, including external conditions with potential influence on outbreak dynamics. These data may support preventive and rapid response measures in the affected areas, travel-related risk assessment, and infection identification in locals and returning travelers. Full article
(This article belongs to the Special Issue Mosquito-Borne Virus Discovery, Diagnostics and Vaccines)
10 pages, 2808 KiB  
Article
Controlling Thermoelectric Properties of Laser-Induced Graphene on Polyimide
by Cem Kincal and Nuri Solak
Nanomaterials 2024, 14(10), 879; https://doi.org/10.3390/nano14100879 (registering DOI) - 19 May 2024
Abstract
In the field of wearable thermoelectric generators, graphene-based materials have attracted attention as suitable candidates due to their low material costs and tunable electronic properties. However, their high thermal conductivity poses significant challenges. Low thermal conductivity due to porous structure of the laser-induced [...] Read more.
In the field of wearable thermoelectric generators, graphene-based materials have attracted attention as suitable candidates due to their low material costs and tunable electronic properties. However, their high thermal conductivity poses significant challenges. Low thermal conductivity due to porous structure of the laser-induced graphene, combined with its affordability and scalability, positions it as a promising candidate for thermoelectric applications. In this study, thermoelectric properties of the laser-induced graphene (LIG) on polyimide and their dependence on structural modifications of LIG were investigated. Furthermore, it was shown that increasing the laser scribing power on polyimide results in larger graphene flakes and a higher degree of graphitization. Electrical conductivity measurements indicated an increase with increasing laser power, due to a higher degree of graphitization, which enhances charge carrier mobility. Our findings reveal that LIG exhibits p-type semiconducting behavior, characterized by a positive Seebeck coefficient. It was shown that increasing laser power increased the Seebeck coefficient and electrical conductivity simultaneously, which is attributed to a charge carrier energy filtering effect arising from structures occurred on the graphene flakes. Moreover, the porous structure of LIG contributes to its relatively low thermal conductivity, ranging between 0.6 W/m·K and 0.85 W/m·K, which enhances the thermoelectric performance of LIG. It has been observed that with increasing laser power, the figure of merit for laser-induced graphene can be enhanced by nearly 10 times, which holds promising applications for laser-induced graphene due to the tunability of its thermoelectric performance by changing laser parameters. Full article
(This article belongs to the Special Issue 2D and Carbon Nanomaterials for Energy Conversion and Storage)
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22 pages, 5653 KiB  
Article
Effects of Nozzle Retraction Elimination on Spray Distribution in Middle-Posterior Turbinate Regions: A Comparative Study
by Amr Seifelnasr, Xiuhua Si and Jinxiang Xi
Pharmaceutics 2024, 16(5), 683; https://doi.org/10.3390/pharmaceutics16050683 (registering DOI) - 19 May 2024
Abstract
The standard multi-dose nasal spray pump features an integrated actuator and nozzle, which inevitably causes a retraction of the nozzle tip during application. The retraction stroke is around 5.5 mm and drastically reduces the nozzle’s insertion depth, which further affects the initial nasal [...] Read more.
The standard multi-dose nasal spray pump features an integrated actuator and nozzle, which inevitably causes a retraction of the nozzle tip during application. The retraction stroke is around 5.5 mm and drastically reduces the nozzle’s insertion depth, which further affects the initial nasal spray deposition and subsequent translocation, potentially increasing drug wastes and dosimetry variability. To address this issue, we designed a new spray pump that separated the nozzle from the actuator and connected them with a flexible tube, thereby eliminating nozzle retraction during application. The objective of this study is to test the new device’s performance in comparison to the conventional nasal pump in terms of spray generation, plume development, and dosimetry distribution. For both devices, the spray droplet size distribution was measured using a laser diffraction particle analyzer. Plume development was recorded with a high-definition camera. Nasal dosimetry was characterized in two transparent nasal cavity casts (normal and decongested) under two breathing conditions (breath-holding and constant inhalation). The nasal formulation was a 0.25% w/v methyl cellulose aqueous solution with a fluorescent dye. For each test case, the temporospatial spray translocation in the nasal cavity was recorded, and the final delivered doses were quantified in five nasal regions. The results indicate minor differences in droplet size distribution between the two devices. The nasal plume from the new device presents a narrower plume angle. The head orientation, the depth at which the nozzle is inserted into the nostril, and the administration angle play crucial roles in determining the initial deposition of nasal sprays as well as the subsequent translocation of the liquid film/droplets. Quantitative measurements of deposition distributions in the nasal models were augmented with visualization recordings to evaluate the delivery enhancements introduced by the new device. With an extension tube, the modified device produced a lower spray output and delivered lower doses in the front, middle, and back turbinate than the conventional nasal pump. However, sprays from the new device were observed to penetrate deeper into the nasal passages, predominantly through the middle-upper meatus. This resulted in consistently enhanced dosing in the middle-upper turbinate regions while at the cost of higher drug loss to the pharynx. Full article
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21 pages, 15320 KiB  
Article
Examining the Impacts of Pre-Fire Forest Conditions on Burn Severity Using Multiple Remote Sensing Platforms
by Kangsan Lee, Willem J. D. van Leeuwen, Jeffrey K. Gillan and Donald A. Falk
Remote Sens. 2024, 16(10), 1803; https://doi.org/10.3390/rs16101803 (registering DOI) - 19 May 2024
Abstract
Pre-fire environmental conditions play a critical role in wildfire severity. This study investigated the impact of pre-fire forest conditions on burn severity as a result of the 2020 Bighorn Fire in the Santa Catalina Mountains in Arizona. Using a stepwise regression model and [...] Read more.
Pre-fire environmental conditions play a critical role in wildfire severity. This study investigated the impact of pre-fire forest conditions on burn severity as a result of the 2020 Bighorn Fire in the Santa Catalina Mountains in Arizona. Using a stepwise regression model and remotely sensed data from Landsat 8 and LiDAR, we analyzed the effects of structural and functional vegetation traits and environmental factors on burn severity. This analysis revealed that the difference normalized burn ratio (dNBR) was a more reliable indicator of burn severity compared to the relative dNBR (RdNBR). Stepwise regression identified pre-fire normalized difference vegetation index (NDVI), canopy cover, and tree density as significant variables across all land cover types that explained burn severity, suggesting that denser areas with higher vegetation greenness experienced more severe burns. Interestingly, residuals between the actual and estimated dNBR were lower in herbaceous zones compared to denser forested areas at similar elevations, suggesting potentially more predictable burn severity in open areas. Spatial analysis using Geary’s C statistics further revealed a strong negative autocorrelation: areas with high burn severity tended to be clustered, with lower severity areas interspersed. Overall, this study demonstrates the potential of readily available remote sensing data to predict potential burn severity values before a fire event, providing valuable information for forest managers to develop strategies for mitigating future wildfire damage. Full article
(This article belongs to the Special Issue Vegetation Mapping through Multiscale Remote Sensing)
28 pages, 13072 KiB  
Article
An Inverse Problem for Estimating Spatially and Temporally Dependent Surface Heat Flux with Thermography Techniques
by Cheng-Hung Huang and Kuan-Chieh Fang
Mathematics 2024, 12(10), 1584; https://doi.org/10.3390/math12101584 (registering DOI) - 19 May 2024
Abstract
In this study, an inverse conjugate heat transfer problem is examined to estimate temporally and spatially the dependent unknown surface heat flux using thermography techniques with a thermal camera in a three-dimensional domain. Thermography techniques encompass a broad set of methods and procedures [...] Read more.
In this study, an inverse conjugate heat transfer problem is examined to estimate temporally and spatially the dependent unknown surface heat flux using thermography techniques with a thermal camera in a three-dimensional domain. Thermography techniques encompass a broad set of methods and procedures used for capturing and analyzing thermal data, while thermal cameras are specific tools used within those techniques to capture thermal images. In the present study, the interface conditions of the plate and air domains are obtained using perfect thermal contact conditions, and therefore we define the problem studied as an inverse conjugate heat transfer problem. Achieving the simultaneous solution of the continuity, Navier–Stokes, and energy equations within the air domain, alongside the heat conduction equation in the plate domain, presents a more intricate challenge compared to conventional inverse heat conduction problems. The validity of our inverse solutions was verified through numerical simulations, considering various inlet air velocities and plate thicknesses. Notably, it was found that due to the singularity of the gradient of the cost function at the final time point, the estimated results near the final time must be discarded, and exact measurements consistently produce accurate boundary heat fluxes under thin-plate conditions, with air velocity exhibiting no significant impact on the estimates. Additionally, an analysis of measurement errors and their influence on the inverse solutions was conducted. The numerical results conclusively demonstrated that the maximum error when estimating heat flux consistently remained below 3% and higher measurement noise resulted in the accuracy of the heat flux estimation decreasing. This underscores the inherent challenges associated with inverse problems and highlights the importance of obtaining accurate measurement data in the problem domain. Full article
(This article belongs to the Special Issue Computational and Analytical Methods for Inverse Problems)
10 pages, 2458 KiB  
Article
The Efficacy and Safety of Endoscopic Balloon Dilatation in the Treatment of Functional Post-Sleeve-Gastrectomy Stenosis
by Mohamed A. Elsebaey, Mohamed Elsayed Enaba, Heba Elashry, Waleed Elrefaey, Rasha Youssef Hagag, Neveen A. Shalaby, Mohamed Sabry Aboelnasr, Mohamed Elsayed Sarhan, Omneya Mohamed Darrag, Assem Mohamed Elsokkary, Mohamed Abd Allah Alabd, Ahmed Mohamed El Nakib, Abdulrashid Onimisi Abdulrahim, Yousry Esam-Eldin Abo-Amer, Mohammad Shaaban Mahfouz, Amina Mahmoud Fouad, Raghda Samir Abd El latif, Khaled Asem Allam and Amro Abdelaziz Mohammed Ismail
Medicina 2024, 60(5), 833; https://doi.org/10.3390/medicina60050833 (registering DOI) - 19 May 2024
Abstract
Background and Objectives: Functional gastric stenosis, a consequence of sleeve gastrectomy, is defined as a rotation of the gastric tube along its longitudinal axis. It is brought on by gastric twisting without the anatomical constriction of the gastric lumen. During endoscopic examination, [...] Read more.
Background and Objectives: Functional gastric stenosis, a consequence of sleeve gastrectomy, is defined as a rotation of the gastric tube along its longitudinal axis. It is brought on by gastric twisting without the anatomical constriction of the gastric lumen. During endoscopic examination, the staple line is deviated with a clockwise rotation, and the stenosis requires additional endoscopic manipulations for its transposition. Upper gastrointestinal series show the gastric twist with an upstream dilatation of the gastric tube in some patients. Data on its management have remained scarce. The objective was to assess the efficacy and safety of endoscopic balloon dilatation in the management of functional post-sleeve gastrectomy stenosis. Patients and Methods: Twenty-two patients with functional post-primary-sleeve-gastrectomy stenosis who had an endoscopic balloon dilatation between 2017 and 2023 were included in this retrospective study. Patients with alternative treatment plans and those undergoing endoscopic dilatation for other forms of gastric stenosis were excluded. The clinical outcomes were used to evaluate the efficacy and safety of balloon dilatation in the management of functional gastric stenosis. Results: A total of 45 dilatations were performed with a 30 mm balloon in 22 patients (100%), a 35 mm balloon in 18 patients (81.82%), and a 40 mm balloon in 5 patients (22.73%). The patients’ clinical responses after the first balloon dilatation were a complete clinical response (4 patients, 18.18%), a partial clinical response (12 patients, 54.55%), and a non-response (6 patients, 27.27%). Nineteen patients (86.36%) had achieved clinical success at six months. Three patients (13.64%) who remained symptomatic even after achieving the maximal balloon dilation of 40 mm were considered failure of endoscopic dilatation, and they were referred for surgical intervention. No significant adverse events were found during or following the balloon dilatation. Conclusions: Endoscopic balloon dilatation is an effective and safe minimally invasive procedure in the management of functional post-sleeve-gastrectomy stenosis. Full article
(This article belongs to the Section Gastroenterology & Hepatology)
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18 pages, 3933 KiB  
Article
Flood Propagation Characteristics in a Plain Lake: The Role of Multiple River Interactions
by Qiuqin Wu, Zhichao Wang, Xinfa Xu, Zhiwen Huang, Tianfu Wen, Wensun You and Yang Xia
Water 2024, 16(10), 1447; https://doi.org/10.3390/w16101447 (registering DOI) - 19 May 2024
Abstract
Plain lakes play a crucial role in the hydrological cycle of a watershed, but their interactions with adjacent rivers and downstream water bodies can create complex river–lake relationships, often leading to frequent flooding disasters. Taking Poyang Lake as an example, this paper delves [...] Read more.
Plain lakes play a crucial role in the hydrological cycle of a watershed, but their interactions with adjacent rivers and downstream water bodies can create complex river–lake relationships, often leading to frequent flooding disasters. Taking Poyang Lake as an example, this paper delves into its interaction with the Yangtze River, revealing the spatiotemporal patterns of flood propagation within the lake and its impact on surrounding flood control measures. The aim is to provide insights for flood management in similar environments worldwide. This study employs a comprehensive approach combining hydrological statistical analysis and two-dimensional hydrodynamic modeling, based on extensive hydrological, topographic, and socio-economic data. The results indicate that the annual maximum outflow from Poyang Lake is primarily controlled by floods within the watershed, while the highest annual lake water level is predominantly influenced by floods from the Yangtze River. The peak discharge typically reaches the lake outlet within 48 h, with the peak water level taking slightly longer at 54 h. However, water storage in the lake can shorten the time that it takes for the peak discharge to arrive. When converging with floods from the Yangtze River, the peak water level may be delayed by up to 10 days, due to the top-supporting interaction. Furthermore, floods from the “Five Rivers” propagate differently within the lake, affecting various lake regions to differing degrees. Notably, floods from the Fu River cause the most significant rise in the lake’s water level under the same flow rate. The top-supporting effect from the Yangtze River also significantly impacts the water surface slope of Poyang Lake. When the Yangtze River flood discharge significantly exceeds that of the “Five Rivers” (i.e., when the top-supporting intensity value, f, exceeds four), the lake surface becomes as flat as a reservoir. During major floods in the watershed, the water level difference in the lake can increase dramatically, potentially creating a “dynamic storage capacity” of up to 840 million cubic meters. Full article
(This article belongs to the Special Issue Flood Risk Identification and Management)
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18 pages, 5076 KiB  
Article
Practical Guidelines for Farm Waste Utilization in Sustainable Kale Production
by Ornprapa Thepsilvisut, Nuengruethai Srikan, Preuk Chutimanukul, Dusit Athinuwat, Wilawan Chuaboon, Rusama Marubodee and Hiroshi Ehara
Horticulturae 2024, 10(5), 525; https://doi.org/10.3390/horticulturae10050525 (registering DOI) - 19 May 2024
Abstract
Natural amendments from agricultural waste to improve soil physicochemical properties continuously attract research interest in promoting eco-friendly plant production. The present study evaluated the proper use of sawdust, biochar, and compost made from farm waste for kale production from seedling propagation to field [...] Read more.
Natural amendments from agricultural waste to improve soil physicochemical properties continuously attract research interest in promoting eco-friendly plant production. The present study evaluated the proper use of sawdust, biochar, and compost made from farm waste for kale production from seedling propagation to field conditions. From the seedling propagation process, the results demonstrate that the most suitable growing medium for kale seedings was 0.5:1:1 v/v of sawdust + biochar + compost, which gave the fastest mean germination times (2.71 days) and the highest seed germination percentage (78.33%). In addition to investigating the selected growing media as the soil amendments at five different rates (0, 6.25, 12.50, 18.75, 25.00, and 31.25 t ha−1), the result reveals that the fresh weight of marketable leaves was significantly highest under the 31.25 t ha−1 treatment. The application rate that yielded the highest gross profit margins was eight times higher than the control. Moreover, in some harvesting periods, the kale leaf yields under the treatment of 31.25 t ha−1 showed higher total chlorophyll and carotenoid contents. Full article
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13 pages, 4288 KiB  
Article
Ti3C2 Nanosheets Functionalized with Ferritin–Biomimetic Platinum Nanoparticles for Electrochemical Biosensors of Nitrite
by Rongqiu Mu, Danzhu Zhu and Gang Wei
Biosensors 2024, 14(5), 258; https://doi.org/10.3390/bios14050258 (registering DOI) - 19 May 2024
Abstract
Nitrites widely exist in human life and the natural environment, but excessive contents of nitrites will result in adverse effects on the environment and human health; hence, sensitive and stable nitrite detection systems are needed. In this study, we report the synthesis of [...] Read more.
Nitrites widely exist in human life and the natural environment, but excessive contents of nitrites will result in adverse effects on the environment and human health; hence, sensitive and stable nitrite detection systems are needed. In this study, we report the synthesis of Ti3C2 nanosheets functionalized with apoferritin (ApoF)–biomimetic platinum (Pt) nanoparticle (Pt@ApoF/Ti3C2) composite materials, which were formed by using ApoF as a template and protein-inspired biomineralization. The formed nanohybrid exhibits excellent electrochemical sensing performance towards nitrite (NaNO2). Specifically, the Pt@ApoF catalyzes the conversion of nitrites into nitrates, converting the chemical signal into an electrical signal. The prepared Pt@ApoF/Ti3C2-based electrochemical NaNO2 biosensors demonstrate a wide detection range of 0.001–9 mM with a low detection limit of 0.425 μM. Additionally, the biosensors possess high selectivity and sensitivity while maintaining a relatively stable electrochemical sensing performance within 7 days, enabling the monitoring of NaNO2 in complex environments. The successful preparation of the Pt@ApoF/Ti3C2 nanohybrid materials provides a new approach for constructing efficient electrochemical biosensors, offering a simple and rapid method for detecting NaNO2 in complex environments. Full article
(This article belongs to the Special Issue Nanomaterial-Based Biosensors to Support the One Health Concept)
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21 pages, 2158 KiB  
Article
A Quantitative Model to Measure the Level of Culture and Tourism Integration Based on a Spatial Perspective: A Case Study of Beijing from 2000 to 2022
by Dandan Xu, Xiangliang Li, Shuo Yan, Liying Cui, Xiaokun Liu and Yaomin Zheng
Sustainability 2024, 16(10), 4276; https://doi.org/10.3390/su16104276 (registering DOI) - 19 May 2024
Abstract
The integration of culture and tourism has become an important factor in the development of the cultural tourism industry, and a quantitative measure of the degree of integration is important for understanding and promoting the high-quality development of the global cultural tourism industry. [...] Read more.
The integration of culture and tourism has become an important factor in the development of the cultural tourism industry, and a quantitative measure of the degree of integration is important for understanding and promoting the high-quality development of the global cultural tourism industry. This study aims to put forward a comprehensive analysis model to show the development trend of cultural and tourism integration, measure the degree of cultural and tourism integration, and analyze the factors affecting the regional heterogeneity of cultural and tourism integration. Using the spatial quantification method of entropy, the spatial coupling coordination degree model, and the geographical weighting model, this paper analyzes the effect and influencing factors of cultural and tourism integration in various districts and counties in Beijing. The results show that the cultural tourism resource endowment of Beijing presents an upward trend and a gradual spillover trend, with obvious spillover to the east and north. The effect of district integration in Beijing has gradually weakened from the city center to the outside, but there is still a serious phenomenon of two levels of differentiation. Factors such as the economic development level, tourism output, cultural output, policy support, and consumption level have spatial heterogeneity on the effect of cultural and tourism integration in each district of Beijing, but the degree of influence is small. Full article
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13 pages, 2500 KiB  
Article
Genome-Wide and Transcriptome-Wide Association Analysis Identifies qRS-6D and Its Candidate Genes Regulating Root Development of Wheat Seedlings
by Mingzhu Cheng, Pengcheng Wang, Xueting Liu, Zhiwei Zhu, Sichun Qiu, Yuxiu Liu, Xue Shi, Wanquan Ji, Shengbao Xu and Xiaoming Wang
Agronomy 2024, 14(5), 1075; https://doi.org/10.3390/agronomy14051075 (registering DOI) - 19 May 2024
Abstract
Wheat (Triticum aestivum L.) is one of the most important cereal crops worldwide, and its production is challenged by global climate change and a shortage of resources. The root system plays a vital role in uptaking water and nutrients and sensing soil [...] Read more.
Wheat (Triticum aestivum L.) is one of the most important cereal crops worldwide, and its production is challenged by global climate change and a shortage of resources. The root system plays a vital role in uptaking water and nutrients and sensing soil environmental signals, and it has great potential to improve the final yield and stress tolerance of wheat. In order to further explore the genes regulating root development, this study focused on qRS-6D, located on chromosome 6D and spanning from 462,701,391 to 465,068,943, which was significantly associated with the total root length, root volume, root surface, and root fresh weight in our previous GWAS analysis. Firstly, its genetic effects were validated using an F6 segregating population by comparing the root-related traits of homologous lines harboring the alternative haplotypes of this QTL. Then, the number of causal genes of this QTL was narrowed down to four with a transcriptome-wide association study. Additionally, qRS-6D has been demonstrated to have genetic effects on several yield- (kernel length, kernel width, and thousand-kernel weight) and plant structure-related traits (plant height, peduncle length, total tiller number, productive tiller number, flag leaf length, and flag leaf angle). Relatively, the frequency of the favorable haplotype increased with the wheat breeding practice. This study provides a reliable genetic locus to improve root development and structure and evaluate its application potential in wheat breeding improvement. Full article
(This article belongs to the Special Issue Advances in Wheat Molecular Genetics and Genomics)
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25 pages, 531 KiB  
Article
Unraveling the Major Determinants behind Price Changes in Four Selected Representative Agricultural Products
by Nisa Sansel Tandogan Aktepe and İhsan Erdem Kayral
Agriculture 2024, 14(5), 782; https://doi.org/10.3390/agriculture14050782 (registering DOI) - 19 May 2024
Abstract
This study aims to analyze the drivers behind price changes in agricultural products in Türkiye from 2002 to 2021, considering the impacts of three crises of different causes which are the global food crisis, the Russia–Türkiye aircraft crisis, and the COVID-19 pandemic. The [...] Read more.
This study aims to analyze the drivers behind price changes in agricultural products in Türkiye from 2002 to 2021, considering the impacts of three crises of different causes which are the global food crisis, the Russia–Türkiye aircraft crisis, and the COVID-19 pandemic. The potential factors are categorized into four subgroups: governmental effects, agricultural inputs, macroeconomic indicators, and climatic conditions. The selected agricultural goods for price change measurement include wheat and maize representing subsistence goods, and olive oil and cotton as marketing goods. The autoregressive distributed lag (ARDL) model is applied to observe both the short- and long-term impacts of the variables on price developments. The results suggest that government effectiveness, regulatory quality, nitrogen use, water price, money supply, exchange rate, and GDP under the related categories are the most effective factors in price changes. Among the variables under the category of climatic conditions, significant values are obtained only in the analysis of the temperature impact on olive oil. The analysis also reveals the variable impact of crises on the prices of the chosen products, depending on the goods involved. The maize and wheat analyses yield particularly noteworthy results. In the long run, nitrogen use demonstrates a substantial positive impact, registering at 29% for wheat and 19.47% for maize, respectively. Conversely, GDP exhibits a significant negative impact, with 26.15% and 20.08%. Short-term observations reveal that a unit increase in the governmental effect leads to a reduction in inflation for these products by 17.01% and 21.42%. However, changes in regulatory quality result in an increase in inflation by 25.45% and 20.77% for these products, respectively. Full article
11 pages, 1777 KiB  
Article
Can the Pathological Response in Patients with Locally Advanced Gastric Cancer Receiving Neoadjuvant Treatment Be Predicted by the CEA/Albumin and CRP/Albumin Ratios?
by Ertugrul Bayram, Mehmet Mutlu Kidi, Yasemin Aydınalp Camadan, Sedat Biter, Sendag Yaslikaya, Tugba Toyran, Burak Mete, Ismail Oguz Kara and Berksoy Sahin
J. Clin. Med. 2024, 13(10), 2984; https://doi.org/10.3390/jcm13102984 (registering DOI) - 19 May 2024
Abstract
Background: The purposes of neoadjuvant chemotherapy are to tumor size to improve the tumor removal rate, extend survival, and prevent metastasis. In this study, the importance of CRP/albumin ratio and CEA/albumin ratio in the prediction of neoadjuvant treatment response in gastric cancer [...] Read more.
Background: The purposes of neoadjuvant chemotherapy are to tumor size to improve the tumor removal rate, extend survival, and prevent metastasis. In this study, the importance of CRP/albumin ratio and CEA/albumin ratio in the prediction of neoadjuvant treatment response in gastric cancer patients was evaluated. Methods: This study retrospectively included 135 gastric cancer patients who received neoadjuvant chemotherapy at Çukurova University Balcalı Hospital between January 2018 and December 2023. Preoperative CRP/albumin and CEA/albumin ratios were compared according to treatment response and multivariate logistic regression analysis was performed to determine the potential importance of these ratios in predicting pathological response. Results: The mean age of the 135 patients was 58.79 ± 10.83 (min = 26–max = 78). The CRP/albumin and CEA/albumin ratios were found to be significantly lower in patients who did not respond to neoadjuvant therapy. Each 1-unit increase in the CRP/albumin ratio was associated with a 1.16-fold decrease in the odds of pathological complete response to neoadjuvant therapy. Both CRP/albumin and CEA/albumin ratios were found to be significant in distinguishing neoadjuvant therapy response. The optimal cut-off value was 2.74 for the CRP/albumin ratio (sensitivity = 60%, specificity = 78.4%) and 1.40 for the CEA/albumin ratio (sensitivity = 74.2%, specificity = 67.6%). Values below these cut-off points favored neoadjuvant therapy response. Pathological complete response to neoadjuvant therapy was 4.75 times higher in patients with a CRP/albumin ratio below 2.74 and 5.14 times higher in patients with a CEA/albumin ratio below 1.40. Conclusions: Findings demonstrate that in patients with locally advanced gastric cancer receiving neoadjuvant treatment, CRP/Albumin and CEA/Albumin ratios are significant markers of pathological response. Full article
(This article belongs to the Section Oncology)
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15 pages, 5458 KiB  
Article
Muscle Synergy during Wrist Movements Based on Non-Negative Tucker Decomposition
by Xiaoling Chen, Yange Feng, Qingya Chang, Jinxu Yu, Jie Chen and Ping Xie
Sensors 2024, 24(10), 3225; https://doi.org/10.3390/s24103225 (registering DOI) - 19 May 2024
Abstract
Modular control of the muscle, which is called muscle synergy, simplifies control of the movement by the central nervous system. The purpose of this study was to explore the synergy in both the frequency and movement domains based on the non-negative Tucker decomposition [...] Read more.
Modular control of the muscle, which is called muscle synergy, simplifies control of the movement by the central nervous system. The purpose of this study was to explore the synergy in both the frequency and movement domains based on the non-negative Tucker decomposition (NTD) method. Surface electromyography (sEMG) data of 8 upper limb muscles in 10 healthy subjects under wrist flexion (WF) and wrist extension (WE) were recorded. NTD was selected for exploring the multi-domain muscle synergy from the sEMG data. The results showed two synergistic flexor pairs, Palmaris longus–Flexor Digitorum Superficialis (PL-FDS) and Extensor Carpi Radialis–Flexor Carpi Radialis (ECR-FCR), in the WF stage. Their spectral components are mainly in the respective bands 0–20 Hz and 25–50 Hz. And the spectral components of two extensor pairs, Extensor Digitorum–Extensor Carpi Ulnar (ED-ECU) and Extensor Carpi Radialis–Brachioradialis (ECR-B), are mainly in the respective bands 0–20 Hz and 7–45 Hz in the WE stage. Additionally, further analysis showed that the Biceps Brachii (BB) muscle was a shared muscle synergy module of the WE and WF stage, while the flexor muscles FCR, PL and FDS were the specific synergy modules of the WF stage, and the extensor muscles ED, ECU, ECR and B were the specific synergy modules of the WE stage. This study showed that NTD is a meaningful method to explore the multi-domain synergistic characteristics of multi-channel sEMG signals. The results can help us to better understand the frequency features of muscle synergy and shared and specific synergies, and expand the study perspective related to motor control in the nervous system. Full article
(This article belongs to the Section Biomedical Sensors)
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25 pages, 5295 KiB  
Article
Expanding Possibilities for Foreign Gene Expression by Cucumber Green Mottle Mosaic Virus Genome-Based Bipartite Vector System
by Anirudha Chattopadhyay, A. Abdul Kader Jailani, Anirban Roy, Sunil Kumar Mukherjee and Bikash Mandal
Plants 2024, 13(10), 1414; https://doi.org/10.3390/plants13101414 (registering DOI) - 19 May 2024
Abstract
Expanding possibilities for foreign gene expression in cucurbits, we present a novel approach utilising a bipartite vector system based on the cucumber green mottle mosaic virus (CGMMV) genome. Traditional full-length CGMMV vectors face limitations such as a restricted cargo capacity and unstable foreign [...] Read more.
Expanding possibilities for foreign gene expression in cucurbits, we present a novel approach utilising a bipartite vector system based on the cucumber green mottle mosaic virus (CGMMV) genome. Traditional full-length CGMMV vectors face limitations such as a restricted cargo capacity and unstable foreign gene expression. To address these challenges, we developed two ‘deconstructed’ CGMMV genomes, DG-1 and DG-2. DG-1 features a major internal deletion, resulting in the loss of crucial replicase enzyme domains, rendering it incapable of self-replication. However, a staggered infiltration of DG-1 in CGMMV-infected plants enabled successful replication and movement, facilitating gene-silencing experiments. Conversely, DG-2 was engineered to enhance replication rates and provide multiple cloning sites. Although it exhibited higher replication rates, DG-2 remained localised within infiltrated tissue, displaying trans-replication and restricted movement. Notably, DG-2 demonstrated utility in expressing GFP, with a peak expression observed between 6 and 10 days post-infiltration. Overall, our bipartite system represents a significant advancement in functional genomics, offering a robust tool for foreign gene expression in Nicotiana benthamiana. Full article
(This article belongs to the Special Issue Cross Protection and Biocontrol of Plant Viruses and Viroids)
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12 pages, 1059 KiB  
Article
Evolocumab Treatment in Dyslipidemic Patients Undergoing Coronary Artery Bypass Grafting: One-Year Safety and Efficacy Results
by Giuseppe Nasso, Walter Vignaroli, Vincenzo Amodeo, Francesco Bartolomucci, Claudio Larosa, Gaetano Contegiacomo, Maria Antonietta Demola, Cataldo Girasoli, Antongiulio Valenzano, Flavio Fiore, Raffaele Bonifazi, Vera Triggiani, Vincenza Vitobello, Giacomo Errico, Angela Lamanna, Dritan Hila, Tommaso Loizzo, Rosalba Franchino, Stefano Sechi, Giovanni Valenti, Giuseppe Diaferia, Mario Siro Brigiani, Serena Arima, Mario Angelelli, Antonio Curcio, Francesco Greco, Ernesto Greco, Giuseppe Speziale and Giuseppe Santarpinoadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(10), 2987; https://doi.org/10.3390/jcm13102987 (registering DOI) - 19 May 2024
Abstract
Background: The inhibition of PCSK9 lowered LDL cholesterol levels, reducing the risk of cardiovascular events. However, the effect on patients who have undergone surgical myocardial revascularization has not yet been evaluated. Methods: From January 2017 to December 2022, 180 dyslipidemic patients who underwent [...] Read more.
Background: The inhibition of PCSK9 lowered LDL cholesterol levels, reducing the risk of cardiovascular events. However, the effect on patients who have undergone surgical myocardial revascularization has not yet been evaluated. Methods: From January 2017 to December 2022, 180 dyslipidemic patients who underwent coronary artery bypass were included in the study. Until December 2019, 100 patients optimized therapy with statin ± ezetimibe (SG). Since January 2020, 80 matched patients added treatment with Evolocumab every 2 weeks (EG). All 180 patients were followed-up at 3 and 12 months, comparing outcomes. Results: The two groups are homogenous. At 3 months and 1 year, a significant decrease in the parameter mean levels of LDL cholesterol and total cholesterol is detected in the Evolocumab group compared to the standard group. No mortality was detected in either group. No complications or drug discontinuation were recorded. In the SG group, five patients (5%) suffered a myocardial infarction during the 1-year follow-up. In the EG group, two patients (2.5%) underwent PTCA due to myocardial infarction. There is no significant difference in overall survival according to the new treatment (p-value = 0.9), and the hazard ratio is equal to 0.94 (95% C.I.: [0.16–5.43]; p-value = 0.9397). Conclusions: The use of Evolocumab, which was started immediately after coronary artery bypass graft surgery, significantly reduced LDL cholesterol and total cholesterol levels compared to statin treatment alone and is completely safe. However, at one year of follow-up, this result did not have impact on the reduction in major clinical events. Full article
(This article belongs to the Special Issue New Progress and Challenges in Clinical Cardiac Surgery)
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12 pages, 493 KiB  
Article
The Intersection of a Child’s Demographics and Household Socioeconomic Status in the Multimorbidity of Malaria, Anaemia, and Malnutrition among Children Aged 6–59 Months in Nigeria
by Phillips Edomwonyi Obasohan, Stephen J. Walters, Richard M. Jacques and Khaled Khatab
Int. J. Environ. Res. Public Health 2024, 21(5), 645; https://doi.org/10.3390/ijerph21050645 (registering DOI) - 19 May 2024
Abstract
Multimorbidity of malaria, anemia, and malnutrition (MAMM) is a condition in which an individual has two or more of these health conditions, and is becoming an emergent public health concern in sub-Saharan African countries. The independent associations of a child’s demographic variables and [...] Read more.
Multimorbidity of malaria, anemia, and malnutrition (MAMM) is a condition in which an individual has two or more of these health conditions, and is becoming an emergent public health concern in sub-Saharan African countries. The independent associations of a child’s demographic variables and household socioeconomic (HSE) disparities with a child’s health outcomes have been established in the literature. However, the effects of the intersection of these factors on MAMM, while accounting for other covariates, have not been studied. Therefore, this study aimed to determine how children’s sex, age, and household socioeconomic status interact to explain the variations in MAMM among children aged 6–59 months in Nigeria. Data from the 2018 Nigeria Demographic and Health Survey and the 2018 National Human Development Report (NHDR) were used. This study included weighted samples of 10,184 children aged 6–59 months in Nigeria. A three-level multilevel mixed effect ordinal logistic regression model was used, such that individual characteristics at level 1 were nested in communities at level 2 and nested in states at level 3. Subsequently, predictive probability charts and average adjusted probability tables were used to interpret the intersectional effects. Five models were created in this scenario. Model 1 is the interaction between the child’s sex and household wealth status; model 2 is the interaction between the child’s sex and age; model 3 is the interaction between the child’s age and household wealth status; model 4 has the three two-way interactions of the child’s sex, age, and household wealth status; and model 5 includes model 4 and the three-way interactions between a child’s sex, age, and household wealth quintiles; while accounting for other covariates in each of the models. The prevalence of children with a ‘none of the three diseases’ outcome was 17.3% (1767/10,184), while 34.4% (3499/10,184) had ‘only one of the diseases’, and 48.3% (4918/10,184) had ‘two or more’ MAMMs. However, in the multivariate analyses, model 3 was the best fit compared with other models, so the two-way interaction effects of a child’s age and household wealth status are significant predictors in the model. Children aged 36–47 months living in the poorest households had a probability of 0.11, 0.18, and 0.32 of existing with MAMM above the probability of children of the same age who live in the middle class, more prosperous, and richest households, respectively, while all other covariates were held constant. Thus, the variation in the prevalence of MAMM in children of different ages differs depending on the household wealth quintile. In other words, in older children, the variations in MAMM become more evident between the richer and the poorer household quintiles. Therefore, it is recommended that policies that are geared toward economic redistribution will help bridge the disparities observed in the prevalence of multiple diseases among children aged 6–59 months in Nigeria. Full article
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24 pages, 914 KiB  
Review
Ultraviolet Filters: Dissecting Current Facts and Myths
by Thomas Breakell, Isabel Kowalski, Yannick Foerster, Rafaela Kramer, Michael Erdmann, Carola Berking and Markus V. Heppt
J. Clin. Med. 2024, 13(10), 2986; https://doi.org/10.3390/jcm13102986 (registering DOI) - 19 May 2024
Abstract
Skin cancer is a global and increasingly prevalent issue, causing significant individual and economic damage. UV filters in sunscreens play a major role in mitigating the risks that solar ultraviolet radiation poses to the human organism. While empirically effective, multiple adverse effects of [...] Read more.
Skin cancer is a global and increasingly prevalent issue, causing significant individual and economic damage. UV filters in sunscreens play a major role in mitigating the risks that solar ultraviolet radiation poses to the human organism. While empirically effective, multiple adverse effects of these compounds are discussed in the media and in scientific research. UV filters are blamed for the disruption of endocrine processes and vitamin D synthesis, damaging effects on the environment, inducement of acne and neurotoxic and carcinogenic effects. Some of these allegations are based on scientific facts while others are simply arbitrary. This is especially dangerous considering the risks of exposing unprotected skin to the sun. In summary, UV filters approved by the respective governing bodies are safe for human use and their proven skin cancer-preventing properties make them indispensable for sensible sun protection habits. Nonetheless, compounds like octocrylene and benzophenone-3 that are linked to the harming of marine ecosystems could be omitted from skincare regimens in favor of the myriad of non-toxic UV filters. Full article
(This article belongs to the Section Dermatology)
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14 pages, 1537 KiB  
Article
Propeller Optimization in Marine Power Systems: Exploring Its Contribution and Correlation with Renewable Energy Solutions
by Bruna Bacalja Bašić, Maja Krčum and Zdeslav Jurić
J. Mar. Sci. Eng. 2024, 12(5), 843; https://doi.org/10.3390/jmse12050843 (registering DOI) - 19 May 2024
Abstract
The goal of increasing fuel efficiency and decreasing greenhouse gas (GHG) emissions has increased interest in the application of renewable energy sources and the usage of new technologies in the maritime industry. In order to implement the most suitable source, factors such as [...] Read more.
The goal of increasing fuel efficiency and decreasing greenhouse gas (GHG) emissions has increased interest in the application of renewable energy sources and the usage of new technologies in the maritime industry. In order to implement the most suitable source, factors such as voyage duration, storage availability, and the condition of existing vessels as well as those that are still under construction should be taken into account. Propeller optimization is proposed as a long-term solution. This paper investigates the environmental aspects of propeller optimization, focusing on its potential to reduce ship vibrations fuel consumption, and, therefore, the ship’s carbon footprint. The case study presents propeller optimization on a Ro-Ro passenger ship. The data collected during sea trials before and after propeller optimization will be compared. Expected fuel oil consumption will be correlated to the CO2 emission reduction. Besides propeller optimization, the paper performs a SWOT (strengths, weaknesses, opportunities, threats) analysis comparing it with solar and wind power applications on ships. Full article
(This article belongs to the Section Ocean Engineering)
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14 pages, 6060 KiB  
Article
Catalytic Pyrolysis of Polypropylene for Cable Semiconductive Buffer Layers
by Xiaokai Meng, Hua Yu, Zhumao Lu and Tao Jin
Polymers 2024, 16(10), 1435; https://doi.org/10.3390/polym16101435 (registering DOI) - 19 May 2024
Abstract
With the progress of the power grid system, the coverage area of cables is widening, and the problem of cable faults is gradually coming to affect people’s daily lives. While the vast majority of cable faults are caused by the ablation of the [...] Read more.
With the progress of the power grid system, the coverage area of cables is widening, and the problem of cable faults is gradually coming to affect people’s daily lives. While the vast majority of cable faults are caused by the ablation of the cable buffer layer, polypropylene (PP), as a common cable buffer material, has pyrolysis properties that critically impact cable faults. Studying the semiconductive buffer layer of polypropylene (PP) and its pyrolysis properties allows us to obtain a clearer picture of the pyrolysis products formed during PP ablation. This understanding aids in the accurate diagnosis of cable faults and the identification of ablation events. In this study, the effects of temperature and catalyst (H-Zeolite Standard Oil Corporation Of New York (Socony) Mobil-Five (HZSM-5)) content on the PP thermolysis product distribution were studied by using an online tubular pyrolysis furnace-mass spectrometry (MS) experimental platform. The results showed that PP/40% HZSM-5 presented the highest thermolytic efficiency and relative yield of the main products at 400 °C. Full article
(This article belongs to the Special Issue Polymer Combustion and Pyrolysis Kinetics)
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13 pages, 4516 KiB  
Article
Broadband High-Linear FMCW Light Source Based on Spectral Stitching
by Liang Sun, Xinguang Zhou, Haohao Zhao, Shichang Xu, Zihan Wu, Guohui Yuan and Zhuoran Wang
Photonics 2024, 11(5), 477; https://doi.org/10.3390/photonics11050477 (registering DOI) - 19 May 2024
Abstract
The key to realizing a high-performance frequency-modulated continuous wave (FMCW) laser frequency-sweeping light source is how to extend the frequency-swept bandwidth and eliminate the effect of nonlinearity. To solve these issues, this paper designs a broadband high-linear FMCW frequency-sweeping light source system based [...] Read more.
The key to realizing a high-performance frequency-modulated continuous wave (FMCW) laser frequency-sweeping light source is how to extend the frequency-swept bandwidth and eliminate the effect of nonlinearity. To solve these issues, this paper designs a broadband high-linear FMCW frequency-sweeping light source system based on the combination of fixed temperature control and digital optoelectronic phase-locked loop (PLL), which controls the temperatures of the two lasers separately and attempts to achieve the coarse spectral stitching based on a time-division multiplexing scheme. Furthermore, we uses the PLL to correct the frequency error more specifically after the coarse stitching, which achieves the spectrum fine stitching and, meanwhile, realizes the nonlinearity correction. The experimental results show that our scheme can successfully achieve bandwidth expansion and nonlinearity correction, and the sweeping bandwidth is twice as much as that of the original single laser. The full-width half-maximum (FWHM) of the FMCW output is reduced from 150 kHz to 6.1 kHz, which exhibits excellent nonlinear correction performance. The relative error of the FMCW ranging system based on this frequency-swept light source is also reduced from 1.628% to 0.673%. Therefore, our frequency-swept light source with excellent performance has a promising application in the FMCW laser ranging system. Full article
(This article belongs to the Special Issue Advanced Lasers and Their Applications II)
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11 pages, 247 KiB  
Article
Poor Response to Gonadotropin Stimulation and Perinatal Outcomes in Fresh In Vitro Fertilization Embryo Transfer Cycles—A Retrospective Cohort Study
by Alyssa Hochberg, Avital Wertheimer, Rita Zlatkin, Onit Sapir, Eyal Krispin, Tzippy Schohat, Eran Altman, Avi Ben-Haroush and Yoel Shufaro
J. Clin. Med. 2024, 13(10), 2985; https://doi.org/10.3390/jcm13102985 (registering DOI) - 19 May 2024
Abstract
Objective: The objective was to examine the association between poor ovarian response to gonadotropin stimulation for in vitro fertilization (IVF) and adverse perinatal outcomes in singleton gestations in young patients. Methods: This was a retrospective cohort study including women aged 17–39 who underwent [...] Read more.
Objective: The objective was to examine the association between poor ovarian response to gonadotropin stimulation for in vitro fertilization (IVF) and adverse perinatal outcomes in singleton gestations in young patients. Methods: This was a retrospective cohort study including women aged 17–39 who underwent fresh embryo transfer and delivered a singleton neonate at a single center (pre-implantation genetic testing excluded) (2007–2022). Patients were classified as one of the following categories: poor responders—daily follicle-stimulating hormone (FSH) ≥ 150 IU yielding ≤ 3 retrieved oocytes; normal responders—4–15 oocytes; and high responders with ≥16 oocytes. The primary outcome was a composite of pre-eclampsia (mild or severe), small-for-gestational-age, gestational diabetes mellitus, and preterm birth (<37 weeks). We compared maternal and neonatal outcomes between the three groups. Multivariable logistic regression was used to control for confounders. Results: Overall, 507 women met the inclusion criteria. Of them, there were 44 (8.68%) poor responders, 342 (67.46%) normal responders, and 121 (23.87%) high responders. Poor responders, compared to normal and high responders, were characterized by a higher maternal age (34.64 ± 4.01 vs. 31.4 ± 5.04 vs. 30.01 ± 4.93, p < 0.001, respectively) and total FSH dosage (3028.41 ± 1792.05 IU vs. 2375.11 ± 1394.05 IU vs. 1869.31 ± 1089.63 IU, p < 0.001). The perinatal outcomes examined, including cesarean delivery (CD) rate and the composite outcome, were comparable between groups. Using multivariable logistic regression and adjusting for ovarian response group, maternal age, nulliparity, and estradiol level and endometrial thickness before ovulation triggering, poor response was not associated with CD rate or the composite outcome, with maternal age associated with CD (p = 0.005), and nulliparity with the composite outcome (p = 0.007). Similar results were obtained when comparing poor responders to each other group separately or to all other responders. Conclusions: Poor ovarian response is not associated with increased adverse maternal or neonatal outcomes. Full article

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