Search Results (229)

Background/Objectives: Electronic fetal monitoring (EFM) has been used for intrapartum fetal surveillance for over 50 years. Despite numerous trials comparing EFM with standard fetal heart rate (FHR) auscultation, it remains contentious whether continuous monitoring with standard interpretation has reliably improved perinatal outcomes, specifically lower rates of perinatal morbidity and mortality. This review examines previous attempts to improve fetal monitoring and presents future directions for novel intrapartum fetal surveillance systems. Methods: We conducted a chronological review of EFM developments, including ancillary methods such as fetal ECG analysis, automated systems for FHR analysis, and artificial intelligence applications. We analyzed the evolution from visual interpretation to intelligent systems and evaluated the performance of various automated monitoring platforms. Results: Various ancillary methods developed to improve EFM accuracy for predicting fetal compromise have shown limited success. Only a limited number of studies demonstrated that adding fetal ECG analysis to visual FHR pattern interpretation resulted in better fetal outcomes. Automated systems for FHR analysis have not consistently enhanced intrapartum fetal surveillance. However, novel approaches such as the Fetal Reserve Index (FRI) show promise by incorporating clinical risk factors with traditional FHR patterns to provide higher-level risk assessment and prognosis. Conclusions: The shortcomings of visual interpretation of FHR patterns persist despite technological advances. Future intelligent intrapartum surveillance systems must combine conventional fetal monitoring with comprehensive risk assessment that incorporates maternal, fetal, and obstetric factors. The integration of artificial intelligence with contextualized metrics like the FRI represents the most promising direction for improving intrapartum fetal surveillance and clinical outcomes. Full article

The electronic judicial evidence preservation systems face various challenges including regulatory control, data exchange, poor credibility, etc. To address these issues, a blockchain-based judicial evidence preservation framework, JudicBlock, is proposed in the present study. It combines the scalability of the Interplanetary File System with the transparency and security of public blockchain. By decentralizing data management and using cryptographic integrity, the system ensures reliable chronological tracking of investigative changes. Unlike traditional approaches, JudicBlock incorporates smart contracts and advanced consensus mechanisms to enforce strict access controls with secure collaboration among the stakeholders. The simulation results show that JudicBlock provides better results over traditional ELR (electronic law records) storage schemes in terms of mining cost, query fetching time, block processing IPFS (Interplanetary file systems) throughput, etc. At a USD 6 mining cost, it appends an average of 23,601 transactions. For 25 blocks, the average query fetching time is 0.852 ms with the cache support of 32 KB. The proposed scheme achieves an average ELR uploading latency improvement of 6.79% over traditional schemes. The results indicate the efficacy of the proposed scheme over the conventional schemes. Full article

This article addresses the multifaceted challenges inherent in the development of the novel REEFS (Renewable Electric Energy From Sea) wave energy converter (WEC). Building on the submerged pressure differential principle, it frames similar WECs before focusing on REEFS that combines renewable energy generation with coastal protection, functioning as an artificial reef. The review follows chronological criteria, encompassing experimental proof-of-concept, small-scale laboratory modeling, simplified and advanced computational fluid dynamics (CFD) simulations, and the design of a forthcoming real-sea model deployment. Key milestones include the validation of a passive variable porosity system, demonstration of wave-to-wire energy conversion, and quantification of wave attenuation for coastal defense. Additionally, the study introduces a second patent-protected REEFS configuration, isolating internal components from seawater via an elastic enveloping membrane. Challenges related to scaling, numerical modeling, and funding are thoroughly examined. The results highlight the importance of the proof-of-concept as the keystone of the development process, underscore the relevance of mixed laboratory-computational approaches and emphasize the need for a balanced equilibrium between intellectual property safeguard and scientific publishing. The REEFS development trajectory offers interesting insights for researchers and developers navigating the complex innovation seas of emerging wave energy technologies. Full article

Youth purpose is a critical developmental asset linked to well-being, academic engagement, and vocational success. However, traditional assessments often fail to capture its complexity. This study introduces an innovative qualitative approach that combines semi-structured interviews with visual mapping to help adolescent participants articulate their journey toward purpose development. Thirty-eight diverse high school students participated in creating visual maps to illustrate their personal paths toward finding purpose. Results revealed three salient themes: (1) chronology, with the road map serving as a way to depict purpose development across time, (2) the common shapes of purpose paths, revealing insights into the developmental experience of purpose, and (3) complementary enhancements, with the visual maps enriching the interviews. This approach offers a rich understanding of how meaningful relationships and formative experiences shape adolescents’ purpose development and highlights the potential of visual methods to capture these complex processes. We discuss practical applications for educational and counseling interventions aimed at cultivating youth purpose. Full article

As critically important global carbon sinks, the net primary productivity (NPP) of boreal forests is crucial for understanding the terrestrial carbon cycle. However, a lack of long-term, high-resolution data has hindered progress in this field. In this study, we used a standardized tree ring chronology of Larix gmelinii to identify the dominant factors driving NPP changes in the Northern Greater Khingan Range, applying both Pearson correlation coefficients and SHAP importance values. We then integrated XGBoost and Extreme Random Forest (ERF) models to reconstruct interannual forest NPP across the region from 1968 to 2020. Our results reveal a significant correlation between NPP and tree radial growth, with both processes dominated by growing season drought. The combination of machine learning and tree ring methods proved to be a reliable approach, with the XGBoost model achieving higher reconstruction accuracy than the ERF model. The reconstructed NPP series showed strong regional correlation with MODIS NPP products (r > 0.6) and revealed interdecadal cycles of 10, 28, and 49 years, as well as shorter periodicities of 2–8 and 15–18 years. This study establishes a novel framework for high-resolution NPP reconstruction and clarifies the response mechanisms of the boreal forest carbon cycle to climate change. Full article

In this study, we present the dating results of an ancient kiln excavated near Ceva (Northern Italy) obtained through combined archaeomagnetic and thermoluminescence approaches. For archaeomagnetic dating, the full geomagnetic field vector (both direction and intensity) was determined. The archaeomagnetic direction was defined through stepwise alternating field demagnetization of in situ-oriented samples of baked clay, and the archaeointensity value was obtained through the Thellier–Coe protocol, including corrections for magnetic anisotropy and cooling rate effects. Thermoluminescence analyses were obtained individually on three samples, using the conventional multiple-aliquot, additive dose procedure. Archaeomagnetic dating was carried out twice, once using the directional results only and once using the full geomagnetic field vector. The independent dating provided by the thermoluminescence analysis was used for comparison, examining the added value of incorporating archaeointensity measurements alongside directional data. The new archaeomagnetic and thermoluminescence results were integrated with previously available radiocarbon dating, using Bayesian modeling for chronological reconstructions. Our results show that the use of archaeointensity in archaeomagnetic dating can be advantageous, better refining the dating. This multidisciplinary strategy underscores the significance of cross-dating in establishing robust chronological frameworks and highlights the crucial role of transdisciplinary methodologies in advancing and refining dating techniques in archaeology. Full article

The construction industry is recognized as high-risk due to frequent accidents and injuries, prompting extensive research and bibliometric analysis of construction safety. However, little attention has been given to the evolution and interconnections of key research topics in this field. This study applies semantic network analysis (SNA) to examine relationships and trends in construction safety research over the past 30 years. SNA enables quantitative exploration of topic interrelationships that is difficult to achieve with other approaches. Chronological network graphs are evaluated using the number of nodes, edges, density, average clustering coefficient, and average path length. Prominent topics are identified through degree, betweenness, and eigenvector centrality measures. The analysis combines a global overview of the main network, a chronological perspective, and local examination of clusters based on five macro keywords: accident, safety management, worker behavior, machine learning, and safety training. Results show a shift from traditional concerns with mortality and injuries to contemporary issues, such as safety climate, worker behavior, and technological innovations, including building information modeling, machine learning, and real-time monitoring. Topics with lower centrality scores are identified as under-researched. Overall, SNA offers a comprehensive view of the construction safety knowledge system, guiding researchers toward emerging topics and helping practitioners prioritize resources and design integrated safety risk strategies. Full article

Identifying the mineral pigments used in the decoration of prehistoric pottery is a significant step for understanding the evolution of the technological practices over time. On the Balkan Peninsula during late prehistory, the techniques used for red and dark-colored decorations underwent a significant transformation. In the Early Neolithic period, pottery was often decorated with dark-toned paints, ranging from deep red to brown. However, this approach declined noticeably during the Chalcolithic period, when red pigment pseudo-incrustation became the predominant decorative method. This study aims to identify the mineral pigments used in red and dark decorations on Neolithic and Chalcolithic pottery from Bulgaria and to trace possible technological, regional, or chronological variations in their composition. A total of 34 ceramic sherds, decorated in shades from red to brown and black, were analyzed using two complementary spectroscopic techniques: laser-induced breakdown spectroscopy (LIBS) and Fourier-transform infrared spectroscopy (FTIR). LIBS data were further evaluated using principal component analysis (PCA) to classify materials based on elemental composition. The results indicate that red decorations are consistently composed of hematite and remain compositionally stable regardless of the region, time period, or application technique. In contrast, dark decorations contain various combinations of iron oxides (magnetite and hematite) and manganese oxides, often including barium-rich manganese compounds—potentially indicating pigment provenance. Additionally, the dark decorations display regional differences. Full article

Background and Objectives: AIDS-related mortality has significantly decreased due to antiretroviral therapy (ART), leading to a substantial increase in average lifespan. Consequently, cardiovascular diseases have become a growing concern among people living with HIV (PLWH). This study aimed to assess the cardiovascular risk profile of people living with HIV receiving ART and to explore the association between traditional and HIV-related factors with increased cardiovascular risk. Materials and Methods: We conducted a case study involving 112 PLWH receiving ART at a specialized clinic in southeastern Romania to estimate cardiovascular risk (CVR) using the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D^®) score. For participants aged 40 and above, the SCORE2 algorithm was additionally applied. Results: Most participants were male and under 40 years of age, including 34 individuals from Romania’s distinct pediatric HIV cohort. We observed a substantial cardiovascular risk burden: abdominal obesity was present in 24.1% of participants, active smoking was reported by 55.4%, and over 70% had low physical activity levels. Among participants aged 40 and above, the D:A:D^® and SCORE2 scores were strongly correlated, with an average cardiovascular age exceeding chronological age by a mean of 7.5 years. Although CVR remained similarly low among subgroups of PLWH under 40, the prevalence of metabolic syndrome was higher in patients from the pediatric cohort compared to those diagnosed later. Traditional risk factors—such as age, obesity, hypertension, dyslipidemia, smoking, and alcohol use—as well as elevated C-reactive protein levels, were significantly associated with increased CVR. Conclusions: Residual inflammation in PLWH, despite complete viral suppression in combination with metabolic syndrome, is associated with increased cardiovascular risk even in younger and clinically stable populations. Routine integration of metabolic and cardiovascular risk screening into HIV care may support timely prevention and personalized management strategies starting at an early age. Full article

Spatial environments influence users’ behavioral patterns and psychological perceptions, affecting health outcomes—a professional consensus in architecture, particularly within healthy buildings. Growing attention to spatial design’s health benefits has rapidly increased quantitative research. Relationships between spatial elements (e.g., green spaces, water features, facilities) and health indicators (e.g., emotional state, mental health, physical activity) are increasingly clear. Due to collective behavior patterns on campuses, the space–health relationship is particularly pronounced. This paper examines campus open spaces via meta-analysis to explore spatial elements’ relative influence on health outcomes. After a chronological review of qualitative research, it cross-sectionally extracts quantitative data. The independent variable (“campus open space”) is categorized into natural landscapes, service facilities, and built environment (design organization). The dependent variable (“health”) is subdivided into physical health, mental health, and positive social adaptation. The main conclusions of the study are as follows: Campus open spaces significantly impact student health, with the built environment exerting the strongest influence. Combining landscape/facility elements with spatial guidance yields more significant results. Furthermore, based on the calculated impact factor data for each element, this study has developed an evaluation scale that could serve as an empirical foundation for future assessments of campus health benefits, thereby guiding health-oriented campus spatial design. Full article

Climate-driven hydrological extremes and anthropogenic interventions are increasingly altering streamflow regimes worldwide. While prior studies have explored climate or regulation effects separately, few have integrated multiple teleconnection indices and reservoir chronologies within a cross-basin comparative framework. This study addresses this gap by assessing long-term streamflow nonstationarity and its drivers at two key stations—Khabarovsk on the Amur River and Datong on the Yangtze River—representing distinct hydroclimatic settings. We utilized monthly discharge records, meteorological data, and large-scale climate indices to apply trend analysis, wavelet transform, percentile-based extreme diagnostics, lagged random forest regression, and slope-based attribution. The results show that Khabarovsk experienced an increase in winter baseflow from 513 to 1335 m³/s and a notable reduction in seasonal discharge contrast, primarily driven by temperature and cold-region reservoir regulation. In contrast, Datong displayed increased discharge extremes, with flood discharges increasing by +71.9 m³/s/year, equivalent to approximately 0.12% of the mean flood discharge annually, and low discharges by +24.2 m³/s/year in recent decades, shaped by both climate variability and large-scale hydropower infrastructure. Random forest models identified temperature and precipitation as short-term drivers, with ENSO-related indices showing lagged impacts on streamflow variability. Attribution analysis indicated that Khabarovsk is primarily shaped by cold-region reservoir operations in conjunction with temperature-driven snowmelt dynamics, while Datong reflects a combined influence of both climate variability and regulation. These insights may provide guidance for climate-responsive reservoir scheduling and basin-specific regulation strategies, supporting the development of integrated frameworks for adaptive water management under climate change. Full article

With increasing life expectancy, the number of older people living with comorbid diabetes and frailty is increasing. The development of frailty accelerates diabetes-related adverse outcomes. Frailty is a multidimensional syndrome with physical, mental and social aspects which is associated with increased risk of hypoglycaemia, dementia and hospitalisation. Therefore, regular screening for all aspects of frailty should be an integrated part of the care plans of older people with diabetes. In addition, every effort should be made for prevention, which includes adequate nutrition combined with regular resistance exercise training. In already frail older people with diabetes, metabolic targets should be relaxed and hypoglycaemic agents should be of low hypoglycaemic risk potential. Furthermore, the metabolic phenotype of frailty should be considered when choosing hypoglycaemic agents and determining targets. With increasing severity of frailty, proactive chronological plans of de-escalation, palliation and end-of-life care should be considered. These plans should be undertaken in a shared decision-making manner which involves patients and their families. This ensures that patients’ views, wishes and preferences are in the heart of these plans. Full article

Background/Objectives: Growth prediction may be used by the clinical orthodontist in growing individuals for diagnostic purposes and for treatment planning. This process appraises chronological age and determines the degree of skeletal maturity to calculate residual growth. In developmental deviations, overlooking such diagnostic details might culminate in erroneous conclusions, unstable outcomes, recurrence, and treatment failure. The present review aims to systematically present and explain the available means for predicting growth in humans. Traditional, long-known, popular methods are discussed, and modern digital applications are described. Materials and methods: A search on PubMed and the gray literature up to May 2025 produced 69 eligible studies on future maxillofacial growth prediction without any orthodontic intervention. Results: Substantial variability exists in the studies on growth prediction. In young orthodontic patients, the study of the lateral cephalometric radiography and the subsequent calculation of planes and angles remain questionable for diagnosis and treatment planning. Skeletal age assessment is readily accomplished with X-rays of the cervical vertebrae and the hand–wrist region. Computer software is being implemented to improve the reliability of classic methodologies. Metal implants have been used in seminal growth studies. Biochemical methods and electromyography have been suggested for clinical prediction and for research purposes. Conclusions: In young patients, it would be of importance to reach conclusions on future growth with minimal distress to the individual and, also, reduced exposure to ionizing radiation. Nevertheless, the potential for comprehensive prediction is still largely lacking. It could be accomplished in the future by combining established methods with digital technology. Full article

In Jer 15:19, Yhwh calls the prophet Jeremiah “my mouth”. This unique designation highlights his importance and finds support in several other features: Jeremiah is portrayed as the promised successor to Moses (Jer 1:7, 9), opposes all other contemporary prophets (e.g., Jer 20; 23; 26–29), and has many additional roles and activities. Furthermore, he shares traits with Yhwh’s servant from Isa 49 and 53. His ‘biography’ is extraordinary and is shown at length, unusual for the Latter Prophets, ranging from before his birth (Jer 1:5) to his disappearance in Egypt (Jer 43–44). His ‘confessions’ in Jer 11–20 testify to immense suffering and have become models for personal prayer. Like the prophet, his scroll is unique, too. No other biblical writing deals so extensively with trauma, exemplified at the downfall of Jerusalem in 587 BC, its roots, and its impact. This even leads to an uncommon structure of the scroll, ending with disaster in Jer 52, whereas all other scrolls of prophets contain hope as conclusions. Jer stands out with the analysis of guilt as cause for the catastrophe, yet it conveys also consolation, especially in Jer 29–33. In these chapters, elements for a renewed society emerge, corresponding to the name of the prophet, which signifies “Yhwh will raise up”. The real source for this change lies in the way Jer conceives the biblical God. No other writing in the Bible tells about his weeping, as a sign of helplessness vis-à-vis the continuing resistance of his people. Many prayers in the scroll, including the confessions, focus on the importance of an intimate, personal relationship with him, going beyond traditional piety in several aspects; Moshe Weinfeld has called them “spiritual metamorphosis”. The singularity of Jer applies also to its literary features. Its mixtures of poetry and prose, of divine and human speaking, of narratives about the prophet in first and third person are a challenge for every reader, as well as the ‘unordered’ chronology and retarded information. Jer excels in the use of other scrolls; the degree of intertextuality and the way of combining motifs from ‘foreign’ sources in a synthetic way are outstanding. To grasp fully its message requires familiarity with more than half of what later became the Hebrew Bible. Full article

Heart failure (HF) treatment evolved in the last 5 years with the introduction of new agents capable of reducing HF hospitalization and HF-related mortality. However, some categories such as patients with renal dysfunction tend to be excluded from larger randomized clinical trials. Additionally, most patients with HF experienced unavoidable glomerular filtration rate (GFR) deterioration during the clinical course. This is related to both cardio–renal interaction pathways and common cardiovascular risk factors that affect HF and chronic kidney disease (CKD). However, mineralocorticoid antagonists (MRAs) remain a cornerstone of HF therapy regardless of left ventricular ejection fraction (LVEF) values; some concerns remain about their utilization in CKD. Nevertheless, three studies (FIDELIO, FIGARO, and FINEARTS) have recently showed beneficial effects in both patients with HF and CKD associated with diabetes. Notably, finerenone a new non-steroidal MRA represents a significant step forward in cardiovascular therapy; its application spans a wide spectrum of HF phenotypes and CKD stages, and ongoing investigations will further elucidate its role in combination regimens and in broader patient populations. Further study may investigate the role of the drug in patients with heart failure with reduced ejection fraction (HFrEF) and in the severe CKD stage of non-diabetic etiology. In the current review paper, we provide a chronological overview of major trials evaluating the renal outcomes of MRAs, culminating in the emergence of finerenone as a novel therapeutic option for high-risk CKD populations, particularly those with type 2 diabetes mellitus (T2DM). Full article