Search Results (30,682)

A systematic fuzzy multi-criteria decision making (MCDM) framework is proposed to prioritize near-Earth asteroids (NEAs) for a boulder capture mission, addressing the requirement for rigorous prioritization of asteroid candidates under conditions of data uncertainty. Twenty-eight NEA candidates were first selected through filtering based on physical and orbital properties. Then, objective fuzzy weighting MCDM methods (statistical variance, CRITIC, and MEREC) were applied to determine the importance of criteria such as capture cost, synodic period, rotation rate, orbit determination accuracy, and similarity to other candidates. Subsequent fuzzy ranking MCDM techniques (WASPAS, TOPSIS, MARCOS) generated nine prioritization schemes whose coherence was assessed via correlation analysis. An innovative sensitivity analysis employing Dirichlet-distributed random sampling around reference weights quantified ranking robustness. All methodologies combinations consistently identified the same top four asteroids, with 2013 NJ ranked first in every scenario, and stability metrics confirmed resilience to plausible weight variations. The modular MCDM methodology proposed provides mission planners with a reliable, adaptable decision support tool for asteroid selection, demonstrably narrowing broad candidate pools to robust targets while accommodating future data updates. Full article

Background. Sex-based disparities in chronic obstructive pulmonary disease (COPD) diagnosis remain underexplored, particularly in primary care settings. This study assessed sex differences in clinical burden, diagnostic delay, and missed diagnostic opportunities using conventional and composite metrics. Methods. A cross-sectional analysis was conducted in 166 newly diagnosed COPD patients (76 women, 90 men) from Spanish primary care. Clinical severity, healthcare use, and diagnostic timing were compared using Mann–Whitney and chi-squared tests. Composite indices included the Symptom Intensity Score, Diagnostic Inertia Indices, DOSE Index, and Diagnosis Complexity Score. Multivariable regressions evaluated independent associations. Results. At diagnosis, women showed a greater clinical and functional burden (FEV₁ % predicted: 50.4% vs. 61.4%, p < 0.001; symptom intensity z-score: 0.13 vs. −0.67, p < 0.001), higher diagnostic complexity (Diagnosis Complexity Score: 403.5 vs. 272.0, p < 0.001), and longer diagnostic delay (median: 133.0 vs. 66.5 days, p < 0.001). Stratified and composite analyses confirmed consistent sex-based asymmetries. In adjusted models, being female independently predicted a longer diagnostic delay (β = 0.888, p = 0.005), but was not significantly associated with the burden of missed diagnostic opportunities (MDOs) (β = 0.112, p = 0.395). Conclusions. Women with newly diagnosed COPD experience greater symptom burden and longer diagnostic delays. Composite metrics may improve the identification of diagnostic disparities in routine clinical settings. Full article

Background/Objectives: The objective of this study is to compare the optical and visual quality provided by the advanced monofocal intraocular lens (IOL) ISOPure and the standard monofocal IOL MicroPure in cataract patients, using objective and subjective assessments. Methods: This prospective, single-blind clinical study includes 28 patients with cataracts, bilaterally implanted with either the ISOPure or MicroPure IOL. Eligible eyes had no ocular comorbidities and regular corneal astigmatism ≤ 1.00 D. Three months postoperatively, uncorrected distance and intermediate (UDVA, UIVA) and corrected distance and intermediate (CDVA, DCIVA) visual acuities were measured at 4 m, 80 cm, and 66 cm under photopic (85 cd/m²) and mesopic (3.5 cd/m²) conditions. Photic phenomena, including halo and glare, were evaluated. Objective optical quality was assessed using Objective Scattering Index (OSI), Modulation Transfer Function (MTF), Strehl Ratio (SR), and ocular aberrations. Subjective patient satisfaction was evaluated using Quality of Vision (QoV) and Catquest-9SF questionnaires. Results: Under photopic conditions, logMAR DCIVA at 80 cm, UIVA at 66 cm, and DCIVA at 66 cm were 0.18 ± 0.06, 0.25 ± 0.12, and 0.20 ± 0.13, respectively, for ISOPure, and 0.22 ± 0.06, 0.30 ± 0.09, and 0.25 ± 0.09 for MicroPure (p = 0.05, 0.02, and 0.05, respectively). No significant differences were observed in halo/glare size or intensity, OSI, MTF, or SR. However, statistically significant differences were found in higher-order total aberrations for pupil sizes of 3.0, 4.0 mm, and 5.0 mm. Questionnaires indicated greater satisfaction and functional intermediate vision with ISOPure. Conclusions: The ISOPure IOL offers superior intermediate vision without compromising distance vision, delivering a balanced combination of optical quality, functional performance, and patient satisfaction. Full article

In cemented endoprosthetics, closed prepacked mixing systems represent the most advanced generation of cementing technology. (1) Background: The purpose of the present study is to evaluate four approved prepacked systems—Palacos^® R+G pro, SmartMix™ Cemvac GHV, Optipac^® Refobacin and Cemex^® System Genta—with a focus on practical handling and intraoperative hygiene. (2) Method: The systems were evaluated according to established standard test methods for bone cements (ISO 5833), including dough time, setting time, additional mechanical tests and the level of system closure. (3) Results: The results show that all systems are safe to use and meet the general requirements, but there are relevant differences in terms of intraoperative hygiene. The Palacos R+G pro system shows significantly shorter doughing and setting times, which helps to minimize wound exposure during surgery and thus significantly reduces the overall operating time and the risk of bacterial contamination. Two of the systems cannot be classified as completely closed “pre-packaged systems.” In two cases, the system must be temporarily opened before mixing to insert the mixing element, which may result in a temporary but clinically relevant impairment of sterility and a corresponding potential risk of contamination. (4) Conclusion: From a hygienic point of view, systems that remain completely closed throughout the entire preparation process can offer advantages in terms of infection prevention. This was the case for all systems tested. Short handling times, reduced exposure of the surgical site and a shorter overall duration of the procedure could further improve intraoperative safety and reduce the risk of contamination. In terms of intraoperative hygiene, the Palacos R+G pro system achieved the best results compared to the three other systems tested due to its rapid readiness for use and comparatively short setting time (according to ISO 5833). Cemex System Genta performed worst in this respect due to its late doughing time and setting time. Full article

Background/Objectives: Multiple myeloma (MM) predominantly affects older adults, a heterogeneous population. Comprehensive Geriatric Assessment (CGA) and abbreviated tools support individualized treatment planning. This study aimed to evaluate the feasibility of CGA and its impact on clinical outcomes in this subgroup of patients. Methods: Prospective, observational, and single-center study including patients aged ≥65 years assessed at MM diagnosis and one year later in an onco-hematogeriatrics clinic. A CGA was performed, and frailty was evaluated using the following: G8, Geriatric Assessment in Hematology (GAH), Clinical Frailty Scale (CFS), Frail-VIG Index (FI-VIG), modified Fried phenotype, International Myeloma Working Group Frailty Index (IMWG-FI), and Revised Myeloma Comorbidity Index (R-MCI). At one year, patients were reassessed; treatment response (IMWG criteria), adverse events (CTCAE v5.03), and mortality were recorded. Results: Fifty-five patients (mean age 78.0 ± 5.4 years, 58.2% female) diagnosed between December 2019 and May 2024 were included. CGA completion exceeded 90% at both time points. At one year, 9 patients (16.4%) had died, and 16 (29.1%) achieved complete response, with daratumumab-lenalidomide-dexamethasone (DRd) being the most used regimen. Frailty prevalence significantly declined (FRAIL: p = 0.012; CFS: p = 0.016; IMWG-FI: p = 0.020). GAH was significantly associated with ≥grade 3 hematologic toxicity (OR = 5.67, p = 0.004) and mortality (AUC = 0.750, p = 0.027). FI-VIG also predicted mortality (OR = 14.67, p = 0.026). Conclusions: CGA and its abbreviated forms are feasible and clinically valuable tools for identifying vulnerable older adults with MM, enabling treatment individualization and improved risk stratification. Full article

The junctional sarcoplasmic reticulum (jSR) is a critical organelle in cardiomyocytes, regulating calcium homeostasis and Excitation–Contraction Coupling (ECC). A quantitative understanding of its protein composition is essential for investigating cardiac physiology and related pathologies. However, isolating intact jSR vesicles, particularly those enriched in membrane proteins, remains a challenging task. Here, we describe our optimized protocol for reproducible enrichment of jSR vesicles from a single murine heart, without the use of antibodies. The protocol enables the recovery of low-abundance membrane proteins while preserving their native interactions with partners. This strategy facilitates the straightforward identification by Mass Spectrometry of highly relevant yet challenging jSR proteins, including the cardiac Ryanodine Receptor and calsequestrin. Our protocol provides a robust tool for studying the structural and stoichiometric organization of the cardiac jSR components in a widely used animal model. Full article

This paper highlights recent activities associated with the design of an uninstalled open fan propulsor for next-generation civil aircraft in the high-subsonic flight regime. The concept comprises a transonic propeller–rotor and a subsequent guide vane, which are both subject to pitch-variability in order to account for the strong variations in flight conditions over the entire mission profile. The engine-scale design aimed for high technological maturity and to comply with a high number of industrially relevant requirements to ensure a competitive design, meeting performance requirements in terms of high efficiency levels at cruise and maximum climb conditions, operability in terms of stability margins, good acoustic characteristics, and structural integrity. During the design iterations, rapid 3D-RANS-based optimisations were only used as a conceptual design tool to derive sensitivities, which were used to support and justify major design choices in addition to established relations from propeller theory and common design practice. These design-driven optimisation efforts were complemented with more sophisticated CFD analysis focusing on rotor tip vortex trajectories and resulting in unsteady blade row interaction to optimise the guide vane clipping, as well as investigations of the entire propulsor under angle-of-attack conditions. The resulting open fan design will be the very basis for wind tunnel experiments of a downscaled version at low and high speed. Full article

Background: Intravascular catheters (ICs) are critical medical devices but require frequent replacement due to the risk of bacterial colonization, which can lead to bloodstream infections. This process causes patient discomfort and incurs significant health and economic costs. Aim: To evaluate the inhibitory activity of natural extracts as potential IC coatings to prevent colonization by methicillin-resistant Staphylococcus aureus (MRSA). Methods: Thirty-six clinical MRSA isolates, obtained from ICs using the Maki technique, were tested. Three natural extracts were evaluated: garlic extract enriched in thiosulfinates (allicin: 7 mg/g), grape extract enriched in proanthocyanidins (92% proanthocyanidins), and propolis extract. Chlorhexidine gluconate (CHG) served as the bactericidal control. The minimum inhibitory concentration (MIC) was determined using the broth microdilution technique with optical density measurements and resazurin-based viability confirmation. The minimum bactericidal concentration (MBC) was assessed from viable cells in wells exceeding the MIC. Results: All tested extracts exhibited bacteriostatic activity against MRSA isolates. The grape extract demonstrated the lowest MIC₉₀ (3.125 mg/mL), followed by propolis extract (MIC₉₀ = 12.5 mg/mL) and garlic extract (MIC₉₀ = 50 mg/mL). Only the propolis extract showed bactericidal activity (MBC = 25 mg/mL). While CHG outperformed the natural extracts, their activity against MRSA suggests potential clinical utility. Conclusion: The natural extracts studied display promising bacteriostatic activity against MRSA isolates from ICs, with propolis extract additionally showing bactericidal effects. Although less potent than CHG, these extracts offer a potential alternative for combating multidrug-resistant pathogens in clinical settings, warranting further investigation for use as IC coatings. Full article

Salt stress severely constrains agricultural productivity in arid and semi-arid regions. This study evaluated exogenous proline as an osmoprotector in Physalis ixocarpa Brot. (Mexican husk tomato) under salinity. Germination screening identified 75 mM NaCl as a threshold stress level, reducing germination by 38.9% while maintaining seedling viability. Proline pretreatment (30-min imbibition) at 8 mM restored germination to 78% and fresh weight to control levels under salt stress. In vitro experiments revealed that 8 mM proline enhanced chlorophyll content above salt-stressed controls while reducing root length from 9.72 to 5.08 cm, indicating resource reallocation toward photosynthetic protection. Infrared spectroscopy showed characteristic polysaccharide shifts and bands potentially associated with proline incorporation. Gas chromatography–mass spectrometry metabolomics of stem–leaf extracts revealed salt-induced synthesis of nitrogenous osmolytes (such as long-chain amines) and carbohydrate reorganization from α-D-glucopyranoside to β-D-riboside. Proline treatment restored the original carbohydrate profile while generating pyrrolidine derivatives (2.83%), evidence of active proline metabolism. Phenolic antioxidants (e.g., catechol) present in controls were absent under both salt stress and proline treatment, suggesting that proline’s protective mechanism may operate through metabolic regulation of osmolyte pathways and membrane stabilization rather than inducing phenolic antioxidant synthesis. These findings demonstrate proline’s multifaceted protective mechanisms and support its potential application for enhancing salt tolerance in this crop. Full article

Leishmaniasis is a parasitic disease transmitted by female sandflies of the genus Lutzomyia. Ecuador is divided into three distinct natural regions: the Andes, the Coast, and Amazonia, each characterized by significant variations in altitude and climate. While most reported cases of leishmaniasis are associated with humid, low-altitude rural areas, our study uncovered an unexpected trend: confirmed cases occurring in traditionally cold Andean regions. To investigate this issue, we conducted a cross-sectional ecological study using official morbidity and mortality records from the Ecuadorian Health Care Registration Platform, focusing on the cantons of Alausí and Chunchi in Chimborazo Province from 2013 to 2022. Chimborazo Province, in the Andes, is characterized by higher altitudes (2740 m above sea level) and a cold climate (averaging 13 °C throughout the year). Among a population of 44,089 residents in Alausí, we reported a total of 40 confirmed cases, with 97.5% classified as cutaneous and 2.5% as mucocutaneous, predominantly affecting children and males. No mortality cases were recorded during the study period. To further explore environmental influences, we examined the Alausí region, where climate change has led to rising average temperatures, deforestation, and changes in humidity levels. Leishmaniasis cases in Alausí showed seasonal peaks, particularly in 2018 and 2019, correlating with warmer and more humid conditions. Environmental factors such as temperature and humidity were strongly associated with the prevalence of the disease, suggesting that climate change may be increasing transmission risks. These findings point to the value of incorporating environmental monitoring into public health strategies for vector-borne diseases that affect vulnerable populations in the Andes. Full article

Artificial intelligence is transforming higher education, particularly in flipped classroom settings, in which students learn independently prior to class and collaborate during in-person sessions. This study examines the role of ChatGPT as a virtual peer in a veterinary anatomy course centered on cardiovascular and respiratory systems. Over two academic years (2023–2025), 297 first-year veterinary students worked in small groups to explore anatomy through structured prompts in English and Spanish using ChatGPT versions 3.5 and 4. Activities involved analyzing AI output, evaluating anatomical accuracy, and suggesting alternative names for vascular variations. Learning outcomes were assessed using Bloom’s Taxonomy-based questions, and student perceptions were captured via online surveys. Progressive performance improvement was noted across three instructional phases, particularly in higher-level cognitive tasks (Bloom level 4). Responses to English prompts were more accurate than those to Spanish prompts. While students appreciated ChatGPT’s role in reinforcing knowledge and sparking discussion, they also flagged inaccuracies and emphasized the need for critical evaluation. Peer collaboration was found to be more influential than chatbot input. Conclusions: ChatGPT can enrich flipped anatomy instruction when paired with structured guidance. It supports content review, fosters group learning and promotes reflective thinking. However, developing digital literacy and ensuring expert oversight are essential to maximizing the educational value of AI. Full article

Background. Food resilience is the ability of the food system to adapt to external and internal disturbances and maintain the outcome of food security. This paper focuses on shaping the concept of urban food resilience regarding the operation of urban food infrastructure and its capacity to provide food security. Methods. To achieve this, a methodology based on the pillars defined by the Food and Agriculture Organization (FAO) for food security, i.e., availability, accessibility, and stability, is used, operationalized from a spatial approach, and evaluated in terms of urban food resilience. Three simple indexes are built, i.e., diversity, redundancy, and short-term stability, and combined into a composite index: the Urban Food Resilience Index (UFRI). Results. The results are analysed from a spatial and quantitative perspective, linking scores with urban surface area, population, and density. The study examines the reality of Chilean intermediate cities distributed throughout the country, using the La Serena–Coquimbo Conurbation as a case study. Conclusions. The ultimate goal is to provide a straightforward methodology for assessing urban food resilience in countries with limited data access, thereby providing a foundation for informed urban planning decision-making. Full article

Background/Objectives: Fulminant myocarditis (FM) is an uncommon but potentially reversible form of myocardial inflammation that can rapidly progress to cardiogenic shock (CS). In patients who are refractory to conventional treatment, venoarterial extracorporeal membrane oxygenation (VA-ECMO) represents an effective life support strategy. However, the factors that determine functional recovery remain uncertain. The primary objective of this study was to characterize patients who recover ventricular function. Secondary objectives included analyzing VA-ECMO-related complications and overall patient survival. Methods: This was a retrospective, single-center, observational study including all consecutive patients diagnosed with FM between 2008 and 2025 who were supported with VA-ECMO (n = 22). Clinical, biochemical, echocardiographic, and imaging variables were collected. Patients were classified based on their outcomes as either recovery or death/transplantation. Differential factors potentially affecting myocardial recovery, survival, and complications were analyzed. Results: The mean age was 49.7 ± 11 years, with 36% being male. Severe cardiogenic shock was the most common initial presentation (86%), and the average time from symptom onset to hospital admission was 5.7 days. Regarding mechanical support, the non-recovery group required longer ECMO support (328 ± 225 h vs. 188 ± 103 h; p = 0.03). The presence of fibrosis on cardiac magnetic resonance imaging (MRI) was associated with a lower probability of recovery (100% vs. 44.4%; p = 0.03). Renal failure and vascular complications were more frequent in the non-recovery group, with a significantly higher rate of surgical reintervention (50% vs. 10%; p = 0.04). Echocardiography performed before discharge (recovery group) vs. before death/transplant (non-recovery group) showed significant differences in left ventricular ejection fraction (51.1% vs. 29.5%; p = 0.04), along with better levels of creatinine, N-terminal pro-B-type natriuretic peptide (NT-proBNP), leukocytes, and C-reactive protein (CRP) in the recovery group. In-hospital survival for the entire cohort was 63.6%, significantly higher in the recovery group (100% vs. 33.3%; p < 0.01). One-year survival was 59%, which was also greater among those who recovered (90% vs. 33.3%; p = 0.02). Conclusions: FM is associated with an acceptable in-hospital survival rate. The presence of myocardial fibrosis on MRI and longer ECMO support duration were observed to be associated with a lower likelihood of cardiac recovery. Patients who recovered showed better ventricular function at discharge, as well as reduced systemic inflammation and renal dysfunction. These findings highlight the importance of early identification of predictors of myocardial recovery to optimize management and therapeutic decision making in this high-risk population. Full article