Search Results (871)

Background/Objectives: Prurigo nodularis (PN) is associated with considerable disease burden. Limited information exists about the epidemiology, treatment patterns, and impact of PN. This retrospective study used Japanese health insurance claims data to investigate the prevalence and incidence of PN from 2006 to 2021. Methods: A cross-sectional study design was used to estimate prevalence and incidence longitudinally; a cohort design was used to assess comorbidities, treatment patterns, and healthcare resource utilization (HCRU). Results: Over the study period, data from 297,545 to 10,081,414 individuals were available annually; in 2020, 1946 individuals were diagnosed with PN. The prevalence and incidence of PN showed little variation over the study period; in 2021, the prevalence was 41 per 100,000 persons. Although there was a tendency for a higher prevalence of PN in childhood, the prevalence and incidence were similar in other age groups and were slightly higher in females. Inflammatory skin diseases and atopic diathesis were common comorbidities. The most prescribed treatments for adults with PN were topical steroids (78%), oral antihistamines (68%), and moisturizers (54%). Oral steroids, macrolides, and psychotropics were prescribed to >10% of patients. Individuals with PN who also had atopic dermatitis (AD) received higher cumulative doses of stronger potency topical steroids, local steroid injections, and oral steroids than those without concomitant AD. Additionally, HCRU was higher in individuals with AD. Conclusions: Although patients are usually treated according to the guidelines, there is an unmet need for more effective treatments for PN due to the frequent use of intensive and late-line treatments. Full article

Background/Objectives: Suicidal behaviors (SBs) and non-suicidal self-injury (NSSI) are significant mental health concerns in children and adolescents. The hypothalamic–pituitary–adrenal (HPA) axis, of which cortisol is a key hormone, has been implicated in these behaviors. This narrative review aims to explore whether cortisol levels play a role in SBs and NSSI in youth and to synthesize current evidence on this topic. Methods: A comprehensive literature search was conducted on studies published through November 2024, using PubMed, Web of Science, and Google Scholar databases. Studies were screened for eligibility, including only human studies published in English, with no animal models or studies excluding cortisol levels. A narrative synthesis approach was used due to the methodological diversity across studies. Due to limited adolescent-focused research, studies involving adults were also considered. Results: Findings indicate inconsistent cortisol patterns in relation to SBs and NSSI. Elevated cortisol levels are linked to SBs, with some studies suggesting they may predict future suicide attempts, though no definitive cause-and-effect relationship is established. Conversely, cortisol levels in relation to NSSI show mixed results, with some studies reporting no differences. Cortisol responses to stress, measured by saliva, blood, and hair, reveal complex interactions with psychological factors such as depression and impulsivity, influencing cortisol secretion. Discussion: Despite some evidence pointing to a role of cortisol dysregulation in SBs and NSSI, the relationship remains unclear due to study heterogeneity, including small sample sizes and methodological variations. Gender and the type of stressor used in studies also complicate the findings. Future research should prioritize longitudinal studies, better control for confounding factors, and utilize more diverse cortisol assessment methods to clarify these links. Conclusions: While cortisol may play a role in the pathophysiology of SBs and NSSI, further research is needed to establish clearer, more reliable patterns. Identifying alterations in cortisol levels may aid in early detection and targeted interventions for at-risk adolescents. Full article

Quarter-wave plate (QWP) metasurfaces provide a novel approach for generating three-dimensional (3D) hybrid-order Poincaré sphere (HyOPS) beams and enabling longitudinal polarization modulation, owing to their unique spin-decoupling properties. In this work, we designed a set of QWP meta-atom metasurfaces that generate 3D HyOPS beams with continuously varying polarization states along the propagation direction. The third-, fourth- and fifth-order HyOPS beams are generated by three metasurface devices, respectively. The HyOPS beams exhibit a focal depth of 30 μm, a stable longitudinal propagation, and a continuously evolving polarization state. Notably, complete polarization evolution along the equator of the HyOPS occurs within a depth of 20 μm. Numerical calculations in MATLAB R2022b validated the feasibility of the designed QWP metasurfaces. The finite-difference time-domain (FDTD) simulations further confirmed the stable propagation and continuous polarization evolution of the longitudinal light field. Additionally, the concentric arrangement of the QWP meta-atoms on the metasurface effectively mitigates scattering crosstalk caused by abrupt edge phase variations. This work offers new insights into the generation and control of HyOPS light fields and contributes significantly to the development of miniaturized, functionally integrated high-performance nanophotonics. Full article

Background: Respiratory infections pose a significant public health challenge, particularly among healthcare workers (HCWs). The COVID-19 pandemic exacerbated absenteeism due to respiratory illnesses, affecting healthcare workforce stability. Identifying factors influencing absenteeism is crucial for workforce resilience and effective care. Methods: This retrospective longitudinal study analyzed HCW absenteeism due to respiratory diseases from 2017 to 2023 at the “Sf. Maria” Children’s Emergency Hospital in Iași, Romania. Data from 3827 HCWs were examined, including demographic and occupational variables (age, gender, job role) and disease types. Statistical analyses (chi-square tests, ANOVA, and regression models) were conducted using SPSS to assess absenteeism trends and associated risk factors. Results: Sick leave peaked in 2020 (8322 days) and remained high in 2021 (8134 days), gradually decreasing in 2022–2023 but not returning to pre-pandemic levels (~5000 days/year). Nurses accounted for most leave days, while male staff and HCWs aged 41–50 were most affected. Seasonal variations showed higher absenteeism in transitional months and lower rates in summer. COVID-19 was the leading cause of absenteeism during the pandemic, with quarantine measures further increasing sick leave duration. Conclusions: Pediatric hospitals must strengthen infection control measures to protect HCWs and sustain care continuity. Preventive actions such as immunization, staff training, and health monitoring are critical in reducing absenteeism, maintaining a resilient workforce, and ensuring quality care during health crises. Full article

Reducing distortion of spectral simulation signals in infrared detection systems is essential to improve the precision of detecting fine spectra in space-based carbon monitoring satellites. The rigid-flex printed circuit board (PCB), a vital interconnection structure between detectors and signal conditioning circuits, exhibits signal quality variations due to impedance fluctuations and parasitic capacitance changes induced by its meshed return plane geometry. This periodically varying structure necessitates full-wave field solutions to include longitudinal discontinuity. Although full-wave simulations provide accurate characterization, they demand substantial computational resources and time. To address these challenges, we propose an innovative approach to effectively determine optimal meshed return plane designs across various transmission rates. The method integrates a convolutional neural network (CNN) with improved particle swarm optimization (IPSO). First, a CNN model is employed efficiently to predict scattering parameters (S-parameters) for different design configurations, thereby overcoming the inefficiencies associated with iterative full-wave simulation optimization. Then, an IPSO algorithm has been implemented to address the optimization challenge of crosstalk and inter-symbol interference (ISI) in signal transmission. Furthermore, to increase the optimization speed and evaluate the system performance under extreme conditions, we propose a fitness function construction method based on double-edge responses (DER) to rapidly generate a worst-case peak distortion analysis (PDA) eye diagram within the IPSO algorithm. The proposed methodology reduces computational complexity by two orders of magnitude relative to the full-wave simulation. Quantitative analysis conducted at a transmission rate of 5 Gbps demonstrates substantial signal quality improvements compared to empirical PCB design: the eye height increased by 49.7%, and the eye width expanded by 35.7%. The effectiveness of these improvements has been verified through commercial simulation software, proving that the method can provide design support for infrared detection systems. Full article

Longitudinal dispersion coefficient is a key parameter governing solute transport in porous media, with significant implications for various industrial processes. However, the impact of microfractures on the longitudinal dispersion coefficient remains insufficiently understood. In this study, pore-scale direct numerical simulations are performed to analyze solute transport in microfractured porous media during unstable miscible displacement. Spatiotemporal concentration profiles were fitted to the analytical solution of the convection–dispersion equation to quantify the longitudinal dispersion coefficient across different microfracture configurations. The results indicate that the longitudinal dispersion coefficient is highly sensitive to microfracture characteristics. Specifically, an increased projection length of microfractures in the flow direction and a reduced lateral projection length enhance longitudinal dispersion at the outlet. When Peclet number ≥1, the longitudinal dispersion coefficient follows a three-stage variation pattern along the flow direction, with microfracture connectivity and orientation dominating its scale sensitivity. Furthermore, both diffusion-dominated and mixed advective-diffusion regimes are observed. In diffusion-dominated regimes, significant channeling alters the applicability of traditional scaling laws, with the relationship between longitudinal dispersion coefficient and porosity holding only when the Peclet number is below 0.07. These results provide a comprehensive scale-up framework for CO₂ miscible flooding in unconventional reservoirs and CO₂ storage in saline aquifers, offering valuable insights for the numerical modeling of heterogeneous reservoir development. Full article

Background/Objectives: This study compares the clinical features and treatment outcomes of granulomatosis with polyangiitis (GPA) based on age at onset. Methods: A retrospective longitudinal cohort of patients with GPA diagnosed between January 1978 and December 2015 was analyzed, stratified by age at diagnosis: ≤30 years (young group), 31–59 years (middle-aged group), and ≥60 years (older group). The comparative analysis included demographic data, organ involvement, laboratory results, anti-neutrophil cytoplasmic antibody (ANCA) status, comorbidities, treatments, and outcomes. Results: The analysis included 264 patients newly diagnosed with GPA. Older patients exhibited significantly higher rates of peripheral neuropathy and liver involvement. They had more severe lung diseases and required lung biopsies more frequently. Patients in the middle-aged group exhibited the highest likelihood of severe anemia. Peripheral neuropathy was more common in this group than in younger patients, and their lung disease was less severe than in older patients but more severe than in younger patients. Young patients exhibited mild disease with the least severe lung involvement, mild anemia, and highest albumin levels. Baseline comorbidities and post-treatment adverse events increased significantly with age at diagnosis. Treatment strategies and efficacy were similar across groups, although older patients tended to receive lower initial doses of cyclophosphamide and corticosteroids. Conclusions: Age at diagnosis influenced GPA clinical characteristics. While the treatment did not vary significantly by age at onset, tailoring therapy to a patient’s age is crucial to optimize outcomes and minimize complications. Full article

Carbon fiber composite sucker rods represent a technological innovation in oil production systems, exhibiting excellent performance. This sucker rod not only improves oil production efficiency and reduces accidents, but also saves energy and lowers the operating costs of oil wells. However, the working conditions of the carbon fiber composite sucker rod oil extraction system are relatively complex. The carbon fiber composite sucker rod body adopts a symmetrical structure formed by one-time solidification of three layers of fiber (carbon/glass fiber) materials, requiring the use of steel sucker rods in combination, and the impact of various system parameters is not fully understood. This paper focuses on the carbon fiber composite sucker rod as the research object, analyzing the external loads of the carbon fiber composite sucker rod oil extraction system. It also establishes a mechanical model of carbon fiber composite sucker rods, adopts a new finite element modeling method for sucker rod pumping systems, conducts transient dynamic analysis on the lifting motion of carbon fiber composite sucker rods in oil wells, and optimizes system parameters. The example verifies the rationality and feasibility of the finite element model. The results show that the higher the dynamic viscosity of crude oil, the more polished rod dynamometer cars tend to approach a “parallelogram”, and the polished rod load becomes more stable during the lifting process. With larger strokes, the maximum polished rod load increases, the longitudinal vibration amplitude of the carbon fiber composite sucker rod increases, and the load variation becomes more unstable. As the number of strokes increases, the maximum polished rod load and the pump plunger stroke length both increase, leading to higher pump efficiency, but the fluctuation amplitude of the polished rod dynamometer cars also increases, which affects the stability of the sucker rod’s lifting motion. When the carbon fiber sucker rod ratio exceeds 0.5, the difference between the self-weight and polished rod load initially decreases, then increases. As the carbon fiber sucker rod ratio increases, the pump plunger stroke length gradually decreases, and pump efficiency declines. Full article

The present study seeks to analyze the impact of the externalities of investments in infrastructure on economic growth in Peru during the period 2000–2022. The methodology used is quantitative, with a non-experimental and longitudinal design, based on the Solow model, using VAR and VEC to analyze the relationship between investment in infrastructure and economic growth in Peru (2000–2022). The results indicate that the coefficient of variation in private income and the labor force is significantly and positively explained by GDP with an adjusted R2 of 0.94 that explains the variability of the model. It was found that investments in infrastructure and labor have a positive and significant impact on GDP. It is concluded that investments in infrastructure, especially private ones, have had a positive and significant impact on the economic growth of Peru during the period 2000–2022. These investments have acted as a key driver for the recovery and increase in GDP and thus the reduction in unemployment, while externalities, such as improvements in connectivity and productivity, have been fundamental for strengthening long-term economic development. Full article

A precast concrete segmental box-girder bridge (PCSBGB) is one of the most popular styles of Accelerated Bridge Construction (ABC). To address some common challenges (low durability, poor integrity, and construction inconvenience) in PCSBGBs, this paper proposes a precast ultra-high-performance concrete (UHPC) segmental box-girder bridge (PUSBGB). In comparison to conventional PCSBGBs that use three-dimensional prestress, the PUSBGB adopts only one-dimensional (longitudinal) prestress. In addition, the thickness of the bottom/top plate and web of the UHPC box-girder are relatively thin, and as a result, the self-weight is significantly reduced. Considering the fact that the thickness of box-girder is thinner than the NC structure, the shear lag effect and risk of girder cracking may correspondingly increase when a PUSBGB is adopted in a long-span bridge. Thus, it is of essential necessity to explore the flexural behavior of a PUSBGB. In this work, a specimen with a scale (1:4) associated with a field bridge (a 102 m long simply supported PUSBGB with externally unbonded tendons) is fabricated and experimentally investigated. The mechanical behaviors of the PUSBGB are discussed, including the failure mode, the crack distribution pattern, the longitudinal strain of the UHPC plate, and the variation of tendon strain. It is found that in the elastic stage, the top slab of the UHPC box girder exhibits a significant shear lag effect, and this phenomenon is even more obvious after cracking. With the development of the cracks, the effective flange width is decreased (with a minimum value of 0.76), and the second-order effect is kept the same before the dominant crack appears (the reduction factor is around 0.95). Moreover, four existing code equations, e.g., ACI 440, ACI 318, ASSHTO, BS 8100, used to predict the stress in the externally unbonded tendons are examined. Furthermore, a finite element analysis (FEA) of the field bridge is conducted, and the theoretical calculation demonstrates that the flexural resistances of the proposed PUSBGB can comply with the design requirements of Chinese code under the ultimate limit states (ULSs). Full article

AIM: Higher exercise blood pressure in adults correlates with many cardiometabolic markers. The aim of this study was to investigate the main determinants of longitudinal variations in exercise blood pressure in young athletes. METHODS: A longitudinal retrospective study was conducted on adolescent athletes who underwent at least two sport-related pre-participation screening visits, including exercise testing with a standardized incremental ramp protocol on treadmill. Blood pressure was assessed at rest (SBP_rest), at the 3rd minute of exercise (SBP_3min), and at peak exercise (SBP_peak). Predictors of blood pressure response (i.e., respective changes vs. baseline (Δ)) were determined by multivariate regression models after adjustment for age, sex, follow-up duration, related baseline SBP values, characteristics of sport, and ΔBMI. RESULTS: A total of 351 young athletes (mean age at baseline 13 ± 2 years, 54% boys, average follow-up duration 3.4 ± 2.2 years) were enrolled. BMI increased by 1.5 ± 1.8 kg/m² (p < 0.001) during follow-up. At baseline, mean SBP_rest was 103 ± 14 mmHg, mean SBP_3min 124 ± 18 mmHg, and mean SBPpeak 154 ± 23 mmHg. A significant between-visit increase in SBP_rest (ΔSBP_rest 7.0 ± 17.4 mmHg; p < 0.001), ΔSBP_3min (4.8 ± 11 mmHg, p < 0.001), and ΔSBP_peak (11.7 ± 24 mmHg, p < 0.001) was observed. ΔSBP_3min was significantly predicted by male sex (p < 0.01), baseline BMI (p < 0.01), ΔBMI (p < 0.01), and number of practiced sports (p < 0.05), whereas ΔSBP_peak was positively predicted by male gender (p < 0.01), baseline BMI (p < 0.05), and ΔBMI (p < 0.01) and negatively by baseline resting heart rate (p < 0.01). In a logistic regression model, ΔBMI was the only independent determinant of passing from a lower to an upper quartile of SBP_3min (p < 0.001), while ΔBMI and male sex were independent determinants of moving to a higher quartile of SBP_peak (p < 0.001). CONCLUSIONS: Increase in BMI during development and male sex are independent determinants of the increase in exercise blood pressure, both at light and maximal intensity, in a population of adolescent athletes. Full article

Background/Objectives: Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder affecting up to 15% of reproductive-age women, characterized by hyperandrogenism, chronic oligo-ovulation, and metabolic dysfunction. This study aims to evaluate serum sortilin levels in women with PCOS for the first time and investigate their potential associations with metabolic and hormonal alterations. Material and Methods: Eighty PCOS patients and 80 healthy controls were included; serum sortilin levels were measured using ELISA kits, with documented intra-assay and inter-assay variations below 6% and 8%, respectively, ensuring high specificity and sensitivity. Results: Serum sortilin levels were significantly elevated in PCOS patients (69.51 ± 27.75 pg/mL) versus controls (48.60 ± 21.20 pg/mL) (p < 0.001). PCOS patients exhibited higher mean HOMA-IR, free androgen index values, serum glucose, insulin, triglycerides, high-sensitivity C-reactive protein, luteinizing hormone, total testosterone, and DHEA-S levels, alongside reduced high-density lipoprotein cholesterol and sex hormone-binding globulin levels (all, p < 0.05). Notably, inverse correlations were observed between sortilin and low-density lipoprotein cholesterol levels in both groups (p = 0.028 and 0.033). Conclusions: This pioneering study indicates that serum sortilin may be implicated in PCOS pathogenesis and serves as a potential biomarker for metabolic dysfunction in PCOS. Larger, diverse studies with longitudinal designs are needed for further validation. Full article

This study presents part of a pilot work for the structural health monitoring of a large tied-arch reinforced concrete aqueduct in eastern China. Based on field-monitored data for over a year, it mainly focuses on the effect of air temperature and water load variations on the static behavior of a typical span of the aqueduct through field monitoring and 3D FE model analysis. It is found that the longitudinal deformation of the composite tied-arch shows a good linear relationship with the air temperature during the non-operation period and also has a good bilinear correlation with the air temperature and water level during operation. However, isolation of the air temperature effect from the second bilinear correlation using the first linear relationship results in a poor correlation between the longitudinal deformation and water level due to the dominance of the temperature effect. Therefore, it is recommended to use the bilinear regression to predict the longitudinal deformation of the tied-arch during operation. The vertical deformation of the tied-arch is insignificantly affected by air temperature, whereas it shows a fair bilinear correlation with the air temperature and water level during operation, which can be used to provide a reasonable estimation of the vertical deformation of the tied-arch. The strain measurements of the tied-arch using vibrating-string gauges are more complicated due to the notable influence of the ambient temperature and solar radiation, but the relatively consistent bilinear regression of the strains versus the air temperature and water level can still give fair predictions for the strains of the bottom tension rods during operation. The 3D FE model can provide a fair estimation for the vertical deformation of the tied-arch under water load, but its predictions for longitudinal deformation and strains are less satisfactory when compared to monitored data excluding temperature effects. Full article

The narrow bandgap InN material, with exceptional physical properties, has recently gained considerable attention, encouraging many scientists/engineers to design infrared photodetectors, light-emitting diodes, laser diodes, solar cells, and high-power electronic devices. The InN/Sapphire samples of different film thicknesses that we have used in our methodical experimental and theoretical studies are grown by plasma-assisted molecular-beam epitaxy. Hall effect measurements on these samples have revealed high-electron-charge carrier concentration, η. The preparation of InN epifilms is quite sensitive to the growth temperature T, plasma power, N/In ratio, and pressure, P. Due to the reduced distance between N atoms at a higher P, one expects the N-flow kinetics, diffusion, surface components, and scattering rates to change in the growth chamber which might impact the quality of InN films. We believe that the ionized N, rather than molecular, or neutral species are responsible for controlling the growth of InN/Sapphire epifilms. Temperature- and power-dependent photoluminescence measurements are performed, validating the bandgap variation (~0.60–0.80 eV) of all the samples. High-resolution X-ray diffraction studies have indicated that the increase in growth temperature caused the perceived narrow peaks in the X-ray-rocking curves, leading to better-quality films with well-ordered crystalline structures. Careful simulations of the infrared reflectivity spectra provided values of η and mobility μ, in good accordance with the Hall measurements. Our first-order Raman scattering spectroscopy study has not only identified the accurate phonon values of InN samples but also revealed the low-frequency longitudinal optical phonon plasmon-coupled mode in excellent agreement with theoretical calculations. Full article

Background/Objectives: Guidelines for the risk stratification of thyroid nodules are based on certain well-recognized sonographic features of nodules. However, significant variations in reported sensitivity and specificity values are observed due to the overlap of imaging characteristics between benign and malignant nodules. Additionally, differences in ultrasound (US) equipment and the varying experience levels of radiologists performing the imaging procedures contribute to these discrepancies. Inevitably, there are also interobserver differences. The aim of this study was to investigate interobserver agreement on these criteria using the international thyroid imaging reporting and data system (I-TIRADS) thyroid evaluation framework, independently assessed by three residents and one consultant. Methods: We included 393 patients who underwent ultrasound-guided fine needle aspiration biopsy (FNAB) within four months. In each case, longitudinal and transverse video images of the thyroid gland, neck chain, and biopsied nodules were recorded. The evaluations of the parameters defined in the I-TIRADS dictionary were then performed by a radiologist with 15 years of experience and radiology assistants with 3, 3, and 2 years of experience, respectively, blinded to the images, pathology data, and patient demographics. The parameters evaluated included composition, echogenicity, margin, direction of growth, calcification, extension beyond the thyroid, and lymph node. An interobserver comparison between the US lexicon classifications of thyroid nodules was then performed. Results: The results of our study showed that the highest level of consensus was observed in the ‘mixed predominantly cystic’ classification, indicating a solid consistency between the assessors (κ = 0.729). Conversely, the subcategories ‘Solid’, ‘Mixed Predominantly Solid’ and ‘Spongiform’ showed moderate agreement, while the “Pure Cyst” subcategory exhibited the lowest level of agreement among the assessors (κ = 0.292). Agreement among the three radiology assistants was strong concerning the evaluation of nodule composition, growth direction, and lymph node assessment. In contrast, a moderate level of consensus was noted regarding the assessment of extrathyroidal extension, margins, and echogenicity. Notably, the parameter exhibiting moderate agreement across all readers was the presence of echogenic foci or calcifications. Conclusions: the reproducibility observed in the parameters defined within the lexicon supports its potential to enhance consistency and interobserver agreement in thyroid nodule assessment. Full article