Search Results (1,765)

This study presents a comparative analysis of batch and continuous lubricant supply strategies in internal combustion engines (ICEs), focusing on precursor consumption and material efficiency. A phenomenological model based on mass balance equations was developed to describe the dynamics of lubricant precursor depletion, film formation, and film removal under both supply strategies. The results demonstrate that the continuous supply strategy achieves a steady-state condition that ensures stable film thickness and a significant reduction in precursor consumption compared with the batch strategy. Sensitivity analyses reveal that both the kinetic constant and the film removal rate strongly influence lubricant make-up requirements, defining a feasibility region for system operation. Under supercritical conditions, the batch strategy exhibits rapid precursor overconsumption; in contrast, the continuous strategy maintains minimal excess. The proposed framework provides a system-level tool for evaluating lubrication strategies based on precursor utilization efficiency. The findings suggest that continuous lubrication strategies can improve material efficiency and environmental performance, with associated economic benefits, when properly designed and operated within feasible kinetic and mechanical limits. Full article

Background: Post-Traumatic Stress Disorder (PTSD) is among the most prevalent and disabling mental health conditions affecting military veterans in Western countries. In recent decades, PTSD has increasingly been conceptualized as a systemic neuropsychological injury shaped not only by individual psychopathology, but also by institutional, cultural, and political contexts, particularly in settings of prolonged conflict and political violence. This shift has given rise to diverse national rehabilitation models that extend beyond symptom-focused care. This narrative comparative review aims to examine national models of PTSD rehabilitation among military veterans and to derive policy-relevant insights for Israel. Methods: We conducted a narrative comparative review of peer-reviewed literature and national policy documents published between 2014 and 2023, examining military and veteran PTSD rehabilitation frameworks in six Western countries: the United States, Canada, the United Kingdom, Germany, Australia, and the Netherlands. Sources were identified through PubMed, PsycINFO, Google Scholar, and governmental repositories. The review focused on system-level rehabilitation structures, including clinical services, peer-based programs, occupational integration, community and cultural components, and national monitoring practices. Results: Across countries, recurring challenges included persistent stigma limiting help-seeking, fragmented service delivery, inconsistent access to evidence-based care and a lack of standardized outcome indicators capturing functional and social recovery. Innovative approaches included biopsychosocial-spiritual rehabilitation models, peer-led interventions, intra-systemic employment pathways, and symbolic forms of social recognition. In this context, the biopsychosocial-spiritual approach refers to integrative rehabilitation models that extend beyond traditional frameworks by incorporating meaning-making, identity reconstruction, and value-based recovery processes. Conclusions: The findings highlight the need to reconceptualize PTSD rehabilitation as a multidimensional, system-level process. In light of the 2023 “Iron Swords” war and the scale of trauma exposure in Israel, the review informs actionable recommendations for developing a coordinated national rehabilitation strategy that integrates clinical care with occupational, community and cultural recovery. Full article

Coffee is among the primary agricultural commodities in international trade; however, mapping coffee crops in mountainous regions faces limitations due to high spectral variability and complex canopy structures. This study hypothesized that optimized spectral band combinations focused on the visible spectrum may outperform configurations including near-infrared (NIR) for coffee crop segmentation. This work aimed to evaluate how different spectral band combinations affect the performance of the U-Net for segmenting coffee crops in mountainous regions. Seven PlanetScope images (4 m resolution) from Matas de Minas, Brazil, covering different phenological stages in 2023–2024, were divided into 316 training patches and 25 test patches of 256 × 256 pixels and used to train U-Net models across five spectral band combinations: (B, G, R), (B, G, NIR), (B, R, NIR), (G, R, NIR), and (B, G, R, NIR). The visible spectrum combination (B, G, R) demonstrated superior performance with an overall Accuracy of 0.8669 and, for the Coffee Crops class, an F1-score of 0.8682 and an IoU of 0.7671, outperforming all NIR-inclusive configurations. Visible bands’ sensitivity to pigmentation variations proved more effective in heterogeneous environments, while NIR increased spectral confusion near native vegetation and crop edges. The model overestimated cultivated area by 18.3% due to mixed pixels from 4 m resolution and mountainous terrain. These findings confirm that visible-spectrum bands offer a cost-effective alternative for coffee segmentation, though higher spatial resolution is needed for improved boundary delineation. Full article

Traffic accidents represent a significant threat to individuals, with motorcycles frequently involved. Despite concerted efforts by organizations like the World Health Organization and governments worldwide, reducing accident rates remains a challenge. Notably, Indonesia has witnessed a surge in traffic accidents, with motorcycles being a prominent mode of transport. This study aims to evaluate situational awareness and motorcycle riders’ behavior among Indonesians, with respect to factors such as riding time and age. This study involves laboratory-based research and uses quantitative primary data collected with the Situation Awareness Global Assessment Technique (SAGAT), the Situation Present Assessment Method (SPAM), and the Motorcycle Rider Behavior Questionnaire (MRBQ). The results indicate that overall situation awareness is low, with the lowest level among young riders. Nighttime situational awareness is also lower than during the daytime. Recommendations to improve situation awareness include periodic training with scenario-based sessions for motorcycle riders, strict adherence to driving regulations, the potential integration of motorcycle simulators, and prioritizing the program to enhance young riders’ situation awareness. These recommendations aim to boost rider safety and reduce motorcycle accidents. Full article

Background/Objectives: Acute myocardial infarction (AMI) remains a leading cause of death worldwide and sometimes occurs as the inaugural presentation of CAD. Studies have been heterogeneous in reporting what proportion this population represents; therefore, we sought to review the evidence of myocardial infarction as the initial manifestation of CAD. Methods: We conducted a scoping review of 25 studies (1979–2021) assessing the prevalence, risk factors, and outcomes of patients who experience AMI as the first clinical manifestation of CAD. Results: Across studies, most found that half of AMI patients present with no prior angina or CAD diagnosis. These patients tend to be younger and have fewer traditional risk factors. Sex differences were inconsistently reported, though some studies suggest that women may be more likely to present with unheralded AMI. Diabetes and hypertension were interestingly more common in patients with known CAD. Patients with unheralded AMI demonstrate a larger infarct size and may have a higher likelihood of adverse cardiovascular events compared to those with known CAD. Conclusions: Our findings highlight a critical gap in the current risk models of CAD evaluation, which are often symptom-based and focused on detecting ischemia, thus failing to detect a significant proportion that present with AMI as their initial manifestation of CAD. Full article

(1) Background: The local divergence exponent (LDE) is a sensitive measure of walking stability deterioration and risk of falling in older adults. We aim to determine the validity the LDE measured using a mobile phone and to assess its ability to discriminate between healthy young and older adults; (2) Methods: 20 older adults (76.4 ± 4.6 years) and 20 young adults (29.1 ± 6.5 yrs) walked for 6 min on a 20-m walkway while wearing a research-grade inertial measurement unit (IMU) and a mobile phone placed on the sternum to record 3D acceleration data. The LDE was calculated using data from both devices for 3D, vertical (VT), mediolateral (ML), anteroposterior (AP), and norm (N) accelerations. ICC (3,1) was used to determine the validity of the mobile phone’s LDE. Mann–Whitney U tests were used to determine age-group discriminability of LDE measures; (3) Results: LDEs demonstrated excellent absolute agreement between the wearable IMU and mobile phone (ICC = 0.844). Mobile phone-derived LDEs demonstrated excellent validity relative to the wearable IMU (ICC > 0.75). No significant age-related differences in LDE were observed; wearable or mobile sensors (both p > 0.05); (4) Conclusions: LDEs measures obtained with a mobile phone are valid. No age group differences were identified. Full article

Background/Objectives: Ovarian cancer is the most lethal gynecologic malignancy, largely due to late diagnosis and the high prevalence of malignant ascites, a hallmark of advanced disease that is difficult to control and contributes to immune suppression and treatment failure. Despite advances in standard care, durable responses are rare. This study investigates a novel immunotherapeutic strategy designed to overcome the suppressed peritoneal microenvironment using an oncolytic vaccinia virus engineered to express a decoy-resistant IL-18 mutein. Methods: We generated a vaccinia virus (vvDD-nsmDR-18) expressing a non-secreted, mature, decoy-resistant IL-18. Viral expression was validated via RT-qPCR and fluorescence microscopy, while cytotoxicity was confirmed using CCK-8 assays. The antitumor efficacy of vvDD-nsmDR-18 was evaluated in the aggressive murine ID8a ovarian cancer model. The underlying mechanisms of action were investigated using flow cytometry and transcriptional profiling. Results: Treatment with vvDD-nsmDR-18 significantly prolonged survival and was associated with reduced abdominal distension consistent with decreased ascites burden. Immune analyses indicated enhanced T cell activation across multiple anatomical compartments, including tumors, peritoneal cavity, and spleens, the latter recently suggested to serve as a reservoir for tumor-reactive T cells. This systemic activation was characterized by increased IFN-γ and perforin expression. In addition, vvDD-nsmDR-18 treatment was associated with expansion of CD39⁺CD103⁺CD8⁺ tumor-reactive T cells and a shift toward a lower PD-1 expression phenotype within this population. Conclusions: These findings demonstrate that nsmDR-18-expressing oncolytic viruses can remodel the immunosuppressive landscape of advanced ovarian cancer, suggesting this approach is a promising candidate for further clinical development. Full article

Background: Polysubstance use, particularly the combination of opioids and stimulants, represents a growing public health concern due to its high risk of severe multisystem complications and mortality. Here, we present a case illustrating the lethal synergy of opioid–stimulant co-use. Methods: A 37-year-old male with chronic Hepatitis C and documented polysubstance use reported recent use of fentanyl, cocaine, methamphetamine, and cannabis. He presented with generalized weakness, left lower limb pain, tense edema, and anuria. Clinical assessment included monitoring of vital signs, physical examination, capillary blood gas analysis, extended laboratory panels (muscle and cardiac enzymes, electrolytes, and coagulation parameters), urinalysis, and Doppler imaging. Management over five days included intravenous hydration, diuretics, urinary alkalinization, electrolyte correction, anticoagulation, metabolic and vitamin therapy, hemodialysis, and comprehensive supportive care. Results: Laboratory evaluation revealed massive rhabdomyolysis (peak CK 161,050 U/L), severe hyperkalemia (K⁺ 8.4 mmol/L), metabolic acidosis, acute kidney injury with oligoanuria, and left-sided deep vein thrombosis. Despite intensive multidisciplinary interventions, the patient’s repeated refusal of ongoing treatment critically contributed to a fatal outcome. Conclusions: This case underscores the high mortality risk associated with opioid–stimulant co-use and the crucial impact of treatment refusal. Clinicians and public health stakeholders should recognize the rapid progression of multisystem dysfunction in polysubstance users and prioritize early, aggressive interventions combined with patient engagement strategies to mitigate fatal outcomes. Full article

Caffeine is widely consumed and generally considered safe at customary doses. How-ever, high-dose preparations available online pose a risk of severe and potentially fatal intoxication. Although uncommon, lethal caffeine poisoning is associated with profound cardiovascular and neurological toxicity. A rare case of intentional acute caffeine intoxication with fatal outcome is presented. A 25-year-old woman ingested an estimated 60 tablets containing 200 mg of caffeine each, purchased online. She was admitted to hospital shortly after ingestion of the caffeine tablets with palpitations, agitation, dizziness, and repeated vomiting. On examination, she presented with arterial hypotension (90/60 mmHg) and marked sinus tachycardia (150 beats/min), accompanied by psychomotor agitation. Her blood caffeine concentration measured by means of high-performance liquid chromatography (HPLC) was 177 µg/mL. The patient’s condition rapidly deteriorated, with the development of convulsive syndrome progressing to coma, extreme ventricular tachycardia, exotoxic shock, and toxic cardiomyopathy. Despite intensive care management, including mechanical ventilation and advanced cardiopulmonary resuscitation, the patient died several hours after admission. In conclusion, this case underscores the life-threatening potential of acute high-dose caffeine ingestion and highlights the risk associated with unrestricted access to concentrated caffeine products. Early recognition and aggressive management are crucial, yet may be insufficient in cases of massive overdose. Full article

A deeper understanding of the relationships between the local and landscape scales in herbivore foraging should place the management of rangeland production systems on a firmer footing. The objective was to test whether local-scale landscape features modulate the coupling between locomotion and eating, thereby altering the pattern of landscape-scale grazing pressure. We studied shepherded small-ruminant herds on hilly semiarid rangeland by integrating acoustic monitoring to detect jaw movements, GPS to track location and movement, and GIS to link location to landscape attributes. Based on 69 one-day foraging routes, minutely rate of jaw movement (RJM) as a function of time-into-foraging-route showed a unimodal concave shape but did not respond to path angle. Minutely movement velocity responded convexly to time-into-foraging-route, and the quadratic term for path angle was negative and highly significant. The response to path angle was concave and symmetrical for uphill and downhill travel. Based on the empirical evidence that increasing path angle reduces velocity but not RJM and a set of reasonable associated assumptions, it is inferred that more jaw movements are performed per unit area scanned by the animal. It is further inferred abductively that more bites are removed per unit area and that more mass is removed per unit area, and hence, grazing pressure is more intense on sloping terrain than on level areas. For a given duration of foraging route, an increase in density of bite placement at the local behavioral scale implies a contraction in the surface area of the daily herd footprint at the landscape scale. This has implications for how carrying capacity of such areas should be defined. Full article

Introduction: Myxoid liposarcoma (MLPS) is a rare soft tissue sarcoma comprising 5–10% of adult cases, most often in the thigh. Diagnosis is challenging due to nonspecific imaging findings and resemblance to benign lesions. Case Report: A 42-year-old male presented with a painless, enlarging upper right medial thigh mass. CT and ultrasound suggested a complex solid lesion, possibly benign. Outpatient surgical excision revealed a red, gelatinous, non-encapsulated mass. Frozen section suggested a myxomatous spindle cell tumor. Final pathology confirmed MLPS FNCLCC grade 2 (intermediate grade) with DDIT3 rearrangement on fluorescence in situ hybridization (FISH). Margins were negative but close. Postoperative PET scan and Signatera MRD assay were negative for metastasis. Given the tumor’s size (>10 cm) and known radiosensitivity, adjuvant radiotherapy (60–66 Gy) was initiated. Discussion: MLPS features myxoid stroma, plexiform vasculature, and, in high-grade tumors, a round cell component. The FUS::DDIT3 fusion gene is diagnostic. While MRI offers superior soft tissue characterization, definitive diagnosis requires pathology and molecular testing. Surgical excision with negative margins remains standard, with radiotherapy recommended for large tumors or close margins to reduce recurrence. This case highlights the limitations of preoperative imaging and the value of intraoperative pathology in guiding management. Conclusions: Early recognition, accurate diagnosis, and tailored multimodal treatment are essential for MLPS. Given the potential for recurrence, late extrapulmonary metastases, long-term surveillance with imaging, and molecular assays are critical for optimizing outcomes. Full article

Virtual reality (VR)-based evacuation training provides a safe and immersive environment for participants to experience disaster scenarios. However, existing systems often prioritize the experience itself, leaving the critical stage of reflection—essential for refining and stabilizing evacuation knowledge—under-supported. This study presents a qualitative pilot investigation into an extended reflection support function for a VR-based evacuation training system. Unlike traditional replay functions that only visualize avatar movements, our system synchronizes spatialized environmental sounds and recorded verbal utterances, i.e., voices of the user and non-player characters (NPCs), with the visual replay. A preliminary experiment involving eight university students was conducted to evaluate how these auditory clues influence the reflection-on-action process. Qualitative results indicate that audio clues help participants recall their internal decision-making processes and provide essential context for understanding the actions of others (NPCs). The findings suggest that the integration of auditory information facilitates evacuation knowledge refinement, i.e., the transition from mere experience to the formulation of concrete survival concepts. Although limited by a small sample size, this study highlights the potential of multi-modal reflection support in VR-based evacuation training. Full article

Secondary succession in tropical forests is traditionally described as a linear process driven by time since disturbance. However, growing evidence suggests that recovery pathways depend strongly on historical and environmental contexts. We evaluated how disturbance legacies and edaphic constraints interact to shape successional trajectories in a tropical karst landscape of the Maya Forest, Mexico. We sampled 100 plots along a chronosequence, quantifying vegetation structure, floristic diversity, biomass (NDVI), disturbance legacies, and soil properties. Using unsupervised clustering (K-means) and multivariate ordination, we identified four contrasting ecological typologies that represent distinct successional states rather than transient stages. Our results show a pronounced dichotomy in vegetation dynamics following the abandonment of land-use practices: while some sites are experiencing diverse development due to positive forest legacies (Typology B), others remain stalled (Typology C), dominated by lianas, where biotic barriers inhibit tree regeneration despite decades of abandonment. Additionally, we documented an asynchronous recovery between floristic recovery and vertical development; in sites with edaphic constraints, forests reach high diversity and biomass but exhibit stunted growth (Typology D). This suggests that severe abiotic constraints—specifically high rockiness and shallow soils—limit the dominance of highly competitive species, thereby acting as a filter that maintains high levels of diversity despite structural limitations. Edaphic analysis confirmed that chemical fertility and physical constraints (rockiness and shallow depth) act as orthogonal filters. This explains the persistence of structurally constrained yet functionally mature forests as stable, edaphically determined outcomes. Overall, secondary succession in tropical karst is nonlinear and path-dependent, governed by a hierarchical filtering model where historical land use dictates community identity and physical substrate limits structural architecture. These findings highlight the need for trajectory-specific management and the abandonment of uniform expectations of forest recovery in karst landscapes. Full article

This paper explores Indigenous Maya practices, ways of sensing, from a personal perspective to provoke discussion on ways to ground mathematics education through land and ancestors. This paper is largely based on my doctoral research work (2018–2022). I adopt a sensory ethnography approach as a viable means to explore Maya Elders’ ways of knowing. Over a period of three years, I walked alongside my Elders and journeyed into a world of mysticism and mathematical wonder. These experiences evoked the questions: “What are the challenges in engaging with this form of knowing as a learner and translator? How can these experiences help us to ground Indigenous forms of mathematical knowing? What insights can we learn via our own Indigenous mathematical heritage?” I argue that an embodied and sensory approach to mathematics through the ways of our ancestors leads to a more meaningful and purposeful mathematics. In this more-than-human context, the predominant view of mathematics as a-human, a-cultural, and a-historical is blurred to reveal mathematics as human and very much grounded in our ways of yearning to make sense of the world around us. Full article

The Mam Mayan Christians of Guatemala’s Western Highlands regularly ascend sacred mountains to pray for the precarious migration journey across Mexico and into the United States. This paper describes and explicates the cultural logic connecting mountains, migration, and prayer through an analysis of linguistic practices across three domains: (1) the tacit and habitual reference to mountains in common Mam grammatical form classes, (2) the discourse patterns that link the precarities of migration to mountaintop prayer, and (3) the context for and structure of mountaintop prayer rituals. Taken together, the analysis of these three domains describes a Mam ontology of mountains that render mountaintop prayer the most important venue for facing the precarities of international migration. The paper closes by considering the habitus of Mam Maya Evangelical Christians as a source of Indigenous theological praxis. Full article