Search Results (2,775)

High-quality listening is a multifaceted social behavior, and theories and research concerning listening and how to train people to listen are mixed in terms of listening definitions and recommendations. The current study canvassed lay practitioners’ understanding of optimal listening qualities and training, drawing on a wide range of listening training materials (N = 207) sourced from the World Wide Web. Thematic analysis results were critically examined to systematically position praxis against our current understanding of listening theories. Findings are presented as a “dialectical listening theory,” which posits that at its core, listeners’ behaviors often exist in direct tension with their mindset or intuition. Furthermore, we posit that this tension is amplified when individuals are faced with conversations that conflict with their perspectives or values, making learning to listen challenging in practice. We conclude that high-quality listening requires direct recognition and strategic management of these tensions throughout the listening process and make recommendations based on listening and cognitive theories to inform best practice in listening training. Full article

Motor neuron diseases (MNDs) encompass a clinically heterogeneous group of neurodegenerative conditions with varying impact on dexterity, mobility, decision making, respiratory and bulbar dysfunction. While consensus best-practice recommendations exist for genetic screening, diagnostic work-up, pharmacological and respiratory management, disease-specific facets of driving safety, assessment approaches and intervention strategies to support patients for safe driving have not been comprehensively reviewed. MNDs have unique, phenotype-specific clinical features, which are distinct form other neuromuscular conditions which necessitate a careful and systematic approach to evaluate driving safety. While MNDs are primarily associated with progressive motor impairment, extrapyramidal, cerebellar, cognitive, behavioural, and respiratory manifestations of the disease also affect driving safety and necessitate comprehensive driving assessments and individualised strategies to enable patients to continue to drive. The majority of existing papers focus on amyotrophic lateral sclerosis, and low-incidence MND phenotypes, such as PLS, SBMA, PPS, are glaringly understudied from a driving safety perspective despite the relatively slower progression of these conditions. Beyond the review of specific aspects of driving in MNDs, the main objective of this review paper is to raise awareness of non-motor aspects of MNDs with regard to driving safety and to explore viable strategies to support patients to maintain their independence. Despite the considerable differences in driving regulations around the globe, there are core, disease-specific aspects of MND which are universal. The careful consideration of these clinical factors, comprehensive domain-by-domain assessments, and the implementation of practical, individualised adaptations may enable patients to continue driving safely, maintain their independence and enhance their quality of life. Full article

From an environmental perspective, the use of clam shells contributes positively to marine waste management and promotes more sustainable construction practices. This study aims to analyze the influence of clam shell-derived filler on the mechanical properties of cementitious mortars, evaluating its effect as a function of dosage and particle fineness, in order to determine its potential as a sustainable additive in construction applications. The shells were ground for 0.5, 1.0, and 1.5 h and incorporated at percentages ranging from 0.5% to 5.0% by mass of cement. Slump (reduced Abram’s cone) was performed in the fresh state for each specimen mixture, while flexural strength, and compressive strength tests were performed at 7, 14, and 28 days of curing. Microstructural characterization was also performed using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) analysis. In addition, particle size distribution parameters were determined to quantify the effect of grinding time on particle refinement and its relationship with mechanical performance. A multifactor ANOVA was conducted to evaluate the statistical significance of grinding time and filler dosage on compressive strength. The results showed that the combination of 0.5 h of grinding and 1.0% filler provided the best mechanical performance for both flexural and compressive strength, with values of 7.27 MPa and 26.16 MPa, respectively. Dosages higher than 2.0% tended to decrease strength, which is associated with saturation of non-cementing particles. EDX analysis showed adequate calcium distribution without generating chemical segregation. The results showed that the combination of 0.5 h of grinding and 1.0% filler provided the best mechanical performance for both flexural and compressive strength, with values of 7.27 MPa and 26.16 MPa, respectively. Dosages higher than 2.0% tended to decrease strength, which is associated with saturation effects and increased specific surface area. The statistical analysis confirmed that both grinding time and filler dosage significantly influence compressive strength, highlighting the importance of optimizing particle size distribution and filler content to achieve improved mechanical performance. Full article

The increasing demand for environmentally sustainable and efficient laundry detergents has prompted the exploration of innovative biotechnological solutions. This study aims to integrate solid fermentation and by-product valorization for high-quality proteases suitable for laundry detergents. Of 486 strains isolated from fruit by-products, 9 were selected for their proteolytic activity, but only 3 showed proteolytic activity in the presence of detergent components. Strain M17, identified as Yarrowia lipolytica (Yl), proved to be the most effective in producing proteolytic extracts with activity similar to that found in commercial detergents. The produced proteases were incorporated into laundry detergent formulations, and their enzyme activity was compared with that of commercial laundry detergents. The results showed that the proteolytic extracts have enzyme activity similar to that of commercial laundry detergents. Culture media were developed to enhance protease production using fruit by-products. The highest activity (43.71 U (g dm)⁻¹) was achieved at C/N = 20.04, while the best productivity (1.37 U (g dm·h)⁻¹) at pH 7.0 and 30 °C was observed. The results demonstrate that culture media based on fruits and vegetable by-products enhance protease yield and activity. This approach not only reduces waste but also adds value to natural resources through an environmentally friendly process. This study underscores the potential of combining solid-state fermentation with by-products. Using Yl in combination with fruit and vegetable by-products is a practical, eco-friendly method for producing high-quality proteases for laundry detergents. This green enzyme innovation offers significant promise for advancing the detergent proteolytic enzymes and promoting sustainable practices in by-product management. Full article

A water company’s water supply network is responsible for distributing good-quality water in quantities that meet customer needs, ensuring proper operation of the water supply network to ensure adequate pressure at the receiving points, efficiently repairing faults, and planning and executing maintenance, modernization, and expansion work. Managing a water supply network is a complex and complex process. A crucial challenge in water company management is detecting and locating hidden water leaks in the water supply network. Leak location in water distribution networks is a key challenge for utilities, as undetected leaks lead to water losses, increased energy consumption, and reduced service reliability. With the development of cyber-physical systems (CPSs), the integration of physical infrastructure with real-time digital monitoring has enabled more adaptive and responsive water operations. Data-driven decision-making in CPS in the water industry leverages classification and regression trees (C&RTs) to analyze real-time sensor data—such as pressure, flow, and consumption—to classify system states and predict potential faults. By transforming operational data into interpretable decision rules, C&RTs enable automated and timely maintenance actions that improve reliability, reduce water loss, and support intelligent infrastructure management. The aim of this study is to develop and evaluate AI-based optimization methods to enhance sustainability, efficiency, and resilience in the water industry by enabling autonomous, data-driven decision-making within CPSs, supporting smart industry practices, and addressing practical challenges associated with the actual implementation of smart water management solutions using simple solutions such as C&RTs. The accuracy of the best classifier was 86.15%. Further research will focus on using other types of decision trees that will improve classification accuracy. Full article

Patients leave millions of medical reviews annually, providing critical data for quality management. However, manual processing is infeasible, and existing systems fail to distinguish medical from organizational problems—a distinction essential for complaint routing. The consequences of misrouting are significant: clinical issues may go unaddressed when medical complaints reach administrative staff, while systemic service problems remain unresolved when organizational complaints reach medical directors. We developed a hybrid approach combining expert annotation with Large Language Models (LLMs). Fifteen prompt iterations on 1500 reviews with expert validation (modified Cohen’s kappa (κ_mod), which weights errors hierarchically, reached 0.745) preceded the LLM annotation of 15,000 mixed-sentiment and positive reviews. These were combined with 7417 expert-annotated negative reviews to form a corpus of 22,417 reviews. Eight architectures, ranging from Logistic Regression to a BERT + TF-IDF + LightGBM ensemble, were compared using both standard metrics and domain-specific practical metrics tailored to complaint routing. The best model, scaled to 4.3 million Russian-language reviews from the Prodoctorov.ru platform, achieved 92.9% Practical Accuracy—the proportion of reviews classified without critical medical–organizational misclassification errors (M ↔ O)—compared to 68.0% standard accuracy, which treats all errors equally. Critical errors were reduced to 1.4%, yielding 144,000 more correctly processed complaints than traditional methods (TF-IDF + Logistic Regression). Analysis of the scaled data revealed the following: 46.1% M (medical), 21.0% O (organizational), and 32.9% C (combined) reviews; medical ratings were highest (4.75 vs. 4.59 for organizational, p < 0.001); combined reviews were longest (802 characters); zero-star reviews comprised 3.8% of feedback, with organizational complaints dominating (38.2%) among extreme negatives; and average ratings rose by 1.24 points over 14 years. This hybrid approach yields expert-comparable corpora, automates 93% of feedback processing, ensures correct complaint routing, and contributes to healthcare sustainability by reducing administrative burden, accelerating resolution, and enabling data-driven quality management without proportional increases in human resources. All analyses were conducted on Russian-language patient reviews. Full article

Hybrid renewable energy systems (HRES) combining photovoltaic, wind, fuel cell, and energy storage technologies are becoming established as viable options for reliable, environmentally friendly distributed electricity generation. In this review, we examine the key architectures, monitoring and forecast approaches, and control systems that improve the efficiency of HRES and facilitate the just-energy transition to low-carbon power generation systems. The main optimization and decision-aware approaches, particularly the evolutionary generation algorithms and machine learning-based prediction models, are addressed with a focus on improving energy allocation, cost minimization, and increased use of clean renewable energy sources. Technical, economic, and environmental performance indicators, such as the levelized cost of energy (LCOE), net present cost (NPC), renewable fraction (RF), and CO₂ emissions reduction, have been compared to demonstrate the feasibility of various system scenarios. This paper evaluates and summarizes recent case studies from around the world and presents the best practices and the challenges they encounter, including resource availability, governance, and economic drivers. The balance of the paper demonstrates that smart forecasting with advanced energy management approaches is crucial for developing sustainable and resilient hybrid distributed power systems for the future. Full article

Heat stress is a major challenge for broiler production worldwide and is expected to intensify with more frequent heatwaves. This study focuses on mechanically ventilated broiler houses in South Korea, where heatwaves have become increasingly frequent. Three regression meta-models were developed to predict the indoor temperature–humidity index (THI) directly from weather forecast data, using simulated results from a validated building energy simulation (BES) model. A TRNSYS-based BES model was validated against field measurements from four rearing cycles in a commercial broiler house (RMSE 1.31–2.16; MAPE < 2.00%). Using 3072 simulation cases that combined multiple sites, thermal-transmittance levels, cooling conditions, building sizes, and broiler body weights, three regression meta-model approaches were evaluated: a condition-specific regression meta-model for each condition set, a unified regression meta-model with categorical predictors, and a single variable meta-model using only external THI as a predictor. All three showed strong predictive performance, and the unified regression meta-model achieved R² = 0.978, RMSE = 0.817, and MAPE = 0.829, providing the best balance between accuracy and simplicity. This unified model offers a practical tool to link weather forecasts with broiler-house design and environmental-control decisions for heat-stress risk management. Full article

This narrative review integrates landmark studies, recent publications, and major clinical guidelines to highlight the current state of the art concerning acute pancreatitis, a well-known yet still challenging condition. We will focus on recent practice transitions and future perspectives arising from advances in diagnostic imaging and interventional endoscopy. Pathogenesis and etiology: We carry out an overview of the fundamental mechanisms underlying acute pancreatitis, followed by an analysis of both common and uncommon causes, along with emerging evidence regarding idiopathic forms. Diagnosis and risk stratification: We pursue two objectives: on one hand, to emphasize the enduring importance of clinical assessment in the diagnosis of acute pancreatitis; on the other, to analyze the increasingly central role that imaging has acquired over recent decades. Identification of patients at higher risk for complications or an unfavorable prognosis is crucial. Several scoring systems have been proposed over the past decades, but with limited impact on daily clinical practice. Treatment: Therapeutic approaches have undergone significant revisions over time. Our objective is to provide an overview of the current standards together with best evidence-based medical approaches, targeted and interventional therapies, with focus on the endoscopic ones. Furthermore, we want to clarify the importance of nutrition and its proper management. Conclusions: Acute pancreatitis continues to stimulate discoveries and improvements in clinical management. We will place emphasis on unmet needs and emerging innovations that may importantly influence future practice also promoting evidenced-based standards of care. Full article

Allium spp. (alliums) are susceptible to rot-diseases caused by pathogenic Fusarium spp., including F. proliferatum (FP) and F. oxysporum (FO), which can cause severe crop losses. A series of pathogenicity tests of four FP isolates from garlic (Allium sativum), four FO isolates from garlic and three FO isolates from onion (Allium cepa var. cepa) were conducted on garlic seedlings and cloves, onion seedlings and bulbs, and shallot (Allium cepa var. aggregatum) bulbs to determine the virulence of the isolates. A combination of PCRs and whole-genome sequencing (WGS), using ONT long-read technology, was used to identify genes encoding putative effectors. The FP isolates caused moderate to severe symptoms in garlic and contained homologues of SIX2, CRX1 and CRX2, and either SIX9 or SIX13. The FOC ex onion isolates caused severe disease symptoms in all allium species tested, while FO from garlic caused moderate to severe disease in garlic but only mild symptoms in onion and shallot. Fusarium oxysporum f. sp. cepae ex onion potentially contained homologues of SIX3, SIX5, SIX7, SIX9, SIX10, SIX12, SIX14, C5, CRX1 and CRX2. The most pathogenic FO isolate to garlic was Fo_VPRI44630 ex garlic, which contained SIX9, SIX13, C5, CRX1 and CRX2. The difference in virulence and putative effector profiles suggests evidence of host-associated differentiation, and as such, the f. sp. or race designation between FO ex garlic and FO ex onion should be investigated further. This is an important finding for future research into best management practices and breeding for disease resistance to FO and FP in garlic. Full article

Storm-driven turbidity is a major water-quality concern in urban watersheds, reflecting the mobilization and transport of fine sediment during runoff events. This study examines how seasonal storm characteristics influence turbidity and associated sediment transport responses in the Middle Fork of Beargrass Creek, Louisville, Kentucky, over a two-year period. Forty-one erosive storm events were identified and characterized using high-resolution rainfall data to capture storm magnitude and structure. Study objectives were to: (1) quantify event-scale turbidity responses to erosive storms, (2) compare upstream and downstream turbidity behavior to assess spatial variability, (3) evaluate seasonal variation in these relationships, and (4) assess implications for sediment-focused best management practice (BMP) design. Event-based regression models related downstream turbidity to lagged upstream turbidity and downstream erosivity. Turbidity ratios and turbidity–discharge hysteresis characterized spatial and temporal sediment transport dynamics. Results showed that winter and spring storms exhibited longer durations, stronger upstream–downstream turbidity coupling, and more stable lag relationships, indicating integrated sediment transport. Short-duration, high-intensity summer storms produced elevated turbidity ratios, pronounced clockwise hysteresis, and greater model sensitivity, consistent with localized sediment mobilization. Findings support seasonally adaptive BMP strategies, with volume-reduction approaches most effective during winter–spring and source control measures critical during summer-fall. Full article

Background and Objectives: Endometrial polyps are common in women presenting with subfertility, yet uncertainty persists regarding which lesions warrant removal and how best to integrate hysteroscopic management with contemporary fertility treatment pathways. This narrative review synthesizes current evidence on pathophysiological mechanisms, diagnostic approaches, fertility outcomes, and practical clinical management for women under 40 years of age. Materials and Methods: PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched for English-language human studies published between January 2005 and December 2025. From 2352 records identified, 83 studies were included after screening of 1517 unique records (7 randomized controlled trials, 12 systematic reviews/meta-analyses, 14 prospective cohort studies, 31 retrospective cohort studies, 5 case–control and other study designs, 11 narrative reviews and supporting evidence studies, 1 clinical guideline, and 2 targeted 2025 additions). This structured narrative review employed a systematic search strategy to ensure comprehensive coverage, with evidence synthesized thematically in accordance with the SANRA guidelines. No formal risk-of-bias assessment or pre-registered protocol was used. Results: Across treatment modalities, hysteroscopic polypectomy was consistently associated with improved fertility outcomes. The landmark Pérez-Medina randomized trial reported a relative risk of 2.1 (95% CI 1.5–2.9) for pregnancy after polypectomy before intrauterine insemination. For IVF/ICSI, reported clinical pregnancy rates after polypectomy range from 53–72% and live birth rates from 43–66%. Proposed mechanisms include mechanical interference, chronic inflammation with cytokine dysregulation, altered endometrial receptivity (including dysregulation of HOXA10/HOXA11), and impaired decidualization. Conclusions: Current evidence supports hysteroscopic polypectomy as an effective intervention to improve fertility outcomes in subfertile women with endometrial polyps, particularly prior to intrauterine insemination. For IVF/ICSI, polypectomy of documented polyps appears beneficial, though evidence quality is moderate and heterogeneity exists across studies. It is critical to distinguish routine screening hysteroscopy before IVF from targeted polypectomy when a polyp has been documented. Contemporary guidance (including the 2024 SOGC guideline) favors polypectomy for symptomatic polyps and those that meet specific clinical criteria; for small asymptomatic polyps (<10 mm), individualized decision-making is appropriate, given limited direct evidence and the potential for spontaneous regression. Future research should clarify molecular predictors of polyp-associated infertility, optimal timing relative to fertility treatment, and long-term reproductive outcomes. Full article

Working conditions in the offshore oil and gas industry can expose workers to fatigue and sleep deprivation due to extended working hours, irregular shift schedules, and highly complex operational environments. This study aimed to conduct a systematic review of scientific literature on fatigue and sleep deprivation in the offshore oil and gas sector and their implications for health, performance, and safety. The systematic review was conducted in accordance with the PRISMA 2020 guidelines and included primary studies published between 2015 and 2025, retrieved from the Scopus, Web of Science, ScienceDirect, PubMed, and Embase databases. Following the eligibility assessment, fifty studies were included in the final analysis. The selected studies were classified according to their level of direct relevance to offshore oil and gas operations, distinguishing evidence derived from offshore platforms from that obtained in analogous operational settings. The findings demonstrate consistent associations between fatigue and chronic sleep deprivation and adverse occupational health outcomes. Regulatory gaps were also identified when comparing different international approaches to fatigue risk management in the offshore sector. Overall, the results underscore the need for integrated fatigue management strategies aligned with best international practices to enhance health and safety in offshore operations. Full article

Within the hospital sector, digitalization brings smarter, more resilient and more sustainable systems. Advancements in remote sensing technologies and building information modeling (BIM) are revolutionizing infrastructure design and construction. The aim of the study is to investigate the impact of digitalization on the spatial configuration of hospitals and its effects on operational efficiency and environmental sustainability, combining theoretical insights with an empirical survey of fourteen hospitals in Italy. The methodology adopted consisted of the following steps: (i) the conduct of a literature review; (ii) the analysis of international best practice; (iii) the definition of criteria to support the design of digital hospitals; (iv) the investigation on the Italian context through a survey; (v) data collection and analysis to support the formulation of strategies for smart hospital development. The findings highlight how the adoption of innovative solutions related to clinical and management sector can optimize hospital workflow, enhance management efficiency, and create safer and more functional and sustainable environments. However, the persistence of outdated infrastructures and the need for significant adaptation still represent major barriers: only 28.7% of hospitals have a fully centralized logistics hub, and just 7.1% have implemented a Digital Twin. In conclusion, this research provides a reference framework for designers, healthcare administrators, and policymakers, outlining strategies for the development of smart and sustainable hospitals. Full article

To further enhance nutrient use efficiency for maize cultivation in the Changbai Mountains—Liaodong Hilly Region and to safeguard both grain production and soil quality, 2441 pairs of data points extracted from 47 publicly published papers were selected for analysis to investigate the effects of different fertilizer types, their application rates, and field management practices on spring maize yield enhancement, crop growth, and soil physicochemical properties. According to the subgroup analysis of the above indicators, the results demonstrated that various fertilization management practices can effectively increase maize yield and soil nutrient content. Specifically, applications of nitrogen fertilizer (39.78%) and top-dressing (34.10%) had the best effect on increasing maize yield. The combination of organic–inorganic application (22.93%) and straw returning (20.46%) had the best effect on increasing soil organic matter. Based on grain yield and its components, crop physiology and soil physicochemical properties, we recommend an optimal nutrient management strategy for this region: an application rate of 180 kg/ha for nitrogen and 70–100 kg/ha for both phosphorus and potassium, and the field management practice of combined application of chemical fertilizers and manure based on full-amount straw returning in the field. This study provides a reference for nutrient management of maize fields in the Changbai Mountains—Liaodong Hilly Region. Full article