Search Results (231)

Introduction: Occupational allergic rhinitis (OAR) is a common respiratory condition that can lead to varying degrees of symptom severity, significantly impacting workers’ quality of life and productivity. While occupational risk factors are well established, the influence of nonoccupational factors, such as obesity, that contribute to OAR severity remains largely unexplored. Aims: This study aims to study the association between obesity and the severity of OAR. Methods: A cross-sectional analytical study was conducted among patients diagnosed with OAR at the Occupational Medicine Department of Farhat Hached University Hospital of Sousse. It combines a retrospective review of medical records (2013–2021) with prospective structured telephone interviews (January–March 2023). Data were collected from medical records and supplemented with telephone interviews. The severity of OAR was assessed via the PAREO score and rhinomanometry results. Results: A total of 196 patients were included. The mean age was 39.69 ± 7.92 years, with a sex ratio of 0.53. The most frequently reported symptoms were nasal obstruction (78.6%) and sneezing (88.8%). The mean PAREO score was 5.78 ± 1.61, with severe OAR reported in 59.2% of the patients. Obesity was significantly associated with increased severity of OAR symptoms (p < 0.001; OR = 5.4; 95% CI [2.6–11.1]), a finding confirmed after adjustment for variables such as age, sex, and occupational seniority. Conclusion: Obesity appears to be a modifiable risk factor influencing OAR severity. Integrating weight management strategies into the treatment of OAR patients may contribute to significant symptom relief and improved quality of life. Further longitudinal studies are needed to confirm these findings and explore the underlying mechanisms involved. Full article

(1) Background: The Iowa Oral Performance Instrument (IOPI) is the well-established device for assessing tongue strength. The current study aimed to assess the effectiveness of the HEAL device in patients with obstructive sleep apnea (OSA) exhibiting varying degrees of tongue base obstruction, as determined by drug-induced sleep endoscopy (DISE). All participants had undergone modified uvulopalatopharyngoplasty (UPPP), and tongue strength was measured using the IOPI. (2) Methods: This retrospective observational study utilized DISE to assess patterns of upper airway collapse in patients with OSA who were candidates for surgical intervention. Based on DISE findings, patients were divided into two groups: the M group (no or partial tongue base obstruction) and the S group (severe obstruction). The first tongue strength assessment using the IOPI was conducted one month after modified UPPP, prior to initiating HEAL training. Patients then underwent tongue muscle training with the HEAL device, starting one-month post-surgery. A second IOPI assessment was performed after at least one month of training. (3) Results: Forty-nine OSA patients with varying degrees of tongue base obstruction (assessed via DISE) received modified UPPP and were included in the analysis. The mean age was 38.3 ± 7.4 years, and mean BMI was 27.8 ± 3.9 kg/m². After training with the HEAL, average tongue strength increased by 20.6 ± 11.5 kPa. The M group showed significantly greater improvement than the S group (22.45 ± 11.77 vs. 13.33 ± 6.93 kPa, p = 0.024). Linear regression confirmed this difference remained significant (p = 0.024). (4) Conclusions: In this study, participants who received modified UPPP exhibited improvements in tongue base strength following a minimum of one month of training with the HEAL device. Those with no or mild tongue base obstruction, as determined by DISE prior to surgery, experienced greater improvements in tongue strength compared to those with severe tongue base obstruction. Full article

Obstruction differential diagnosis involves tumors, “acute abdomen”, and chronic pseudo-obstruction (CIPO). Pediatric CIPO cases have different backgrounds than adults’ and impairs development. The cases are rare; diagnosis and treatment are still not well established. Diagnosis is complex; clinical, radiological, molecular, and manometric pathologic data are essential. The performance of broad radiological investigations and manometry is cumbersome in a small intestine. Herein, we present cases of a 14-year-old girl and 11-year-old boy with visceral myopathies (VMs). Presented cases show unique hardship in the analysis of standing and contrast bedside X-ray images—the colon distension alone speaks to Hirschsprung, and the clinicians could not confirm suspected short-segment disease for a long time. VMs are usually diagnosed up to 12 months of life and accompanied by other organ dysfunctions, which are herein absent. The key features here were also the involvement of the small intestine, lack of distant colon contraction, and for the long-lasting case in the boy, loss of haustration. The initial diagnosis relied on clinical data (vomiting, malabsorption, >6-month obstruction, and uncharacteristic biochemical tests), radiology (lack of tumor, enlargement of diameter, and fluid in small and large intestines), and manometry (presence of propagation wave and of anal inhibitory reflex in recto–anal manometry). Examination of intestinal muscle biopsies involved hematoxylin-eosin, trichrome-Masson staining, and immunohistochemistry. The characteristics were fibrosis, small vacuoles, muscle layer thinning, and decreased expression of smooth muscle actin and desmin. The localization of biopsies was chosen after X-ray examination, due to interruption and with various degree changes. The final diagnosis was put forward after the analysis of all accessible data. The diagnosis of VM underlines the importance of interdisciplinary co-work. An earlier intestine muscle biopsy and well-designed molecular panel might fasten the process of diagnosis. Deeper exploration of phenotype–genotype correlation of various VM presentations in the future is crucial for personalized treatment. Full article

Amid demographic restructuring, analyzing the dynamic interplay between public services and population development is vital for advancing coordinated regional development in the Beijing–Tianjin–Hebei Urban Agglomeration (BTHUA). This study developed an integrated evaluation framework, applying relative development indices, coupling coordination models, and obstacle analysis to examine the spatiotemporal evolution, coordination dynamics, and key constraints of the public service system and population system development from 2012 to 2023. The findings reveal the following: (1) Coordinated development policies have significantly boosted public service levels in cities near Beijing, whereas growth in Beijing and Tianjin has slowed. (2) Although overall coupling coordination across the BTHUA has improved, a marked core–periphery disparity persists. Beijing maintains high-level coordination, while most Hebei cities remain at marginal coordination levels. (3) The constraints on coordinated development vary substantially: Beijing primarily encounters structural challenges in population dynamics, whereas Tianjin and Hebei face basic infrastructural deficiencies. The study recommends developing a public service delivery system aligned with evolving demographic trends and proposes targeted strategies to optimize regional service structures based on each city’s core challenges. Full article

Background/Objectives: Magnetic drug targeting (MDT) using polyethene glycol (PEG)-coated magnetoresponsive nanoclusters (MNCs) can localize therapeutics, but washout from high-shear arterial flow limits efficacy. This study assesses how PEG molecular weight influences MNC deposition and washout resistance under a pulsatile flow. Methods: Magnetite MNCs were synthesized via solvothermal polyol reactions and PEGylated with PEG-2000, PEG-6000, or PEG-10,000. Characterization included TEM, DLS, zeta potential, FTIR, TGA, XPS, magnetic analysis, and rheology. In vitro assays used a 3 mm diameter glass phantom with pulsatile flow (0.10–0.45 m/s, 1 Hz) and a rectangular NdFeB (N35) permanent magnet (30 × 20 × 20 mm, 0.45 T) positioned 11 mm from the vessel wall. Washout performance was quantified by obstruction degree (OD), magnet coverage degree (MCd), washout degree (WD), washout rate constant (k_out), and half-life (τ₁/₂). Results: MNC-6000 balanced magnetic responsiveness (Ms = 72 emu/g), colloidal stability (ζ = +13.1 mV), and hydrodynamic size (535 nm), yielding superior retention (MCd = 72.3%, OD = 19.6%, WD = 17.9%, τ₁/₂ = 6.93 min). MNC-2000 exhibited faster loss (k_out = 0.14 min⁻¹, τ₁/₂ = 4.95 min), while MNC-10,000 produced higher OD (≈53%) with embolic risk. Magnetic mapping indicated vessel wall thresholds of B ≥ 0.18 T and ∇B ≥ 10 T/m for stable capture. Limitations: Limitations of this work include the use of a single-magnet geometry, an in vitro phantom model without endothelial biology, and a maximum targeting depth of ~12–14 mm. Conclusions: The PEG molecular weight modulates MDT performance through its effects on nanocluster stability, deposition morphology, and washout kinetics. The proposed OD, MCd, and WD metrics provide clinically relevant endpoints for optimizing MDT nanoparticle design and magnet configurations. Full article

Accurate estimation of urban land surface temperature (ULST) is critical for studying urban heat islands, but complex three-dimensional (3D) structures and materials in urban areas introduce significant adjacency effects into remote sensing retrievals. To investigate the influence of different factors on the adjacency effects, this study employed the DART model to quantify brightness temperature differences (ΔTb) of urban pixels by comparing their simulated radiance in two scenarios: (1) an isolated state (no adjacent buildings) and (2) an adjacent state (with surrounding buildings). ΔTb, representing the adjacency effect, was systematically analyzed across spatial resolutions (1–120 m), building geometry (building height BH, roof area index ${\lambda }_p$, adjacent obstruction degree SVF_Obs.), and material reflectance (reflectance R = 0.05, 0.1, 0.15) to determine key influencing factors. The results demonstrate that (1) adjacency effects intensify significantly with higher spatial resolution (mean ΔTb ≈ 5 K at 1 m vs. ≈2 K at 30 m), with 60–90 m identified as the critical resolution range where the adjacency-induced error is attenuated to a level (ΔTb < 1 K) that is commensurate with the intrinsic uncertainty of current mainstream ULST algorithms; (2) increased building height, reduced density (${\lambda }_p$), and greater adjacent obstruction (SVF_Obs.) exacerbate adjacency effects; (3) material emissivity (ε = 1 − R) is the dominant factor, where low-ε materials (high R) exhibit markedly stronger adjacency effects than geometric influences (e.g., ΔTb at R = 0.15 is approximately three times higher than at R = 0.05); and (4) temperature differences among surface components exert minimal influence on adjacency effects (ΔTb < 0.5 K). This study clarifies key factors driving adjacency effects in high-resolution ULST retrieval and defines the critical spatial resolution for simplifying inversions, providing essential insights for accurate urban temperature estimation. Full article

The evolution of traditional rural settlements is a dynamic process. During urbanization, traditional rural settlements, as dual carriers of natural and cultural heritage, face the structural contradiction between preservation and development. The 2008 Wenchuan earthquake caused systemic damage to the Linpan settlements in western Sichuan. The post-seismic reconstruction (2008-) and rural revitalization (2017-) phases have offered a unique case for exploring sustainable cultural landscape patterns. This study innovatively devises a “preservation–development” dual-system evaluation framework. Using the coupling coordination degree model, it analyzes the characteristics of Linpan at different stages within a composite cultural–economic–social system. The study found that while tangible carriers can be quickly repaired through financial support, intangible culture is often at risk of losing its inheritors. Over 60% of Linpan depend on government support, exposing the fragility of “dependence-based development”, and few achieve high-quality “preservation–development” synergy (coupling coordination degree D > 0.8). Most remain in a “preservation lag–development obstruction” cycle (D < 0.5). This paper explores ways to balance Linpan preservation and development dynamically and suggests creating a self-cycling “resource empowerment–cultural identity–value transformation” development pattern. It provides a theoretical reference for cultural heritage preservation and disaster resilience building and contributes a unique solution for the revitalization of traditional settlements. Full article

In urban construction, the efficient demolition of concrete structures imposes high-precision requirements on blasting technology. The mesoscopic evolution mechanism of concrete blasting damage is the key to optimizing blasting parameters. In this study, a numerical model of concrete blasting is established using Particle Flow Code (PFC). By comparing it with an experimental model containing a blast hole and a horizontal single fissure, the rationality and reliability of the model in simulating blasting damage evolution are verified. On this basis, four groups of control variable schemes are designed (concrete particle size distribution, aggregate content, prefabricated fissure inclination angle, and fissure length) to systematically explore the effects of mesoscopic structures and macroscopic defects on blasting damage. The results show that larger concrete particles make it easier for damage cracks to avoid large particles, forming sparse and irregular crack networks. A higher aggregate content enhances the “obstruction-guidance” effect of aggregate distribution on damage. When the aggregate content is 40%, the vertical damage expansion is the most prominent, reaching up to 3.05 cm. Fissure inclination angle affects the damage direction by guiding the propagation path of stress waves. Fissures inclined at 30°~60° serve as preferential damage channels, while 90° vertical fissures make vertical damage more significant. An increased fissure length expands the damage range, and the damage degree is the highest for a 40 mm long fissure, being 1.29 times that of a 30 mm fissure. The research results reveal the mesoscopic evolution laws of concrete blasting damage, providing a theoretical basis for the optimization of engineering blasting parameters and safety control. Full article

Background: Newborns with Pierre Robin Sequence (PRS) usually show varying degrees of upper airway obstruction and difficulty feeding due to severe micrognatia. Mandibular distraction osteogenesis has become popular as an alternative treatment option when other medical or surgical techniques are unsatisfactory. The aim of this study is to test a three-dimensional (3D) cephalometric method in computed tomography (CT) to measure effective mandibular and midface length, and maxillomandibular ratio (Md/Mx ratio), as a mode of growth normalization expression in PRS patients before and after Fast and Early Mandibular Osteo-distraction (FEMOD), for assessing the diagnostic method and the efficacy of surgical treatment. Methods: In this retrospective pilot study, six PRS patients treated via the FEMOD surgical protocol were included. The measurements of effective maxillary and mandibular length were performed on 3D reconstructions from pre-surgical (T1) and post-surgical CT (T2). The growth disparity between the mandible and the maxilla was verified in T1 and was compared with the measurements obtained from the adaptation of the McNamara Norms; the correction of growth disproportion after FEMOD was assessed. Results: In T1, the PRS patients’ mandibular length and the Md/Mx ratio were smaller than the expected mandibular length (p = 0.029) and the expected Md/Mx ratio (p = 0.028). In T2, the PRS patients’ mandibular length and the Md/Mx ratio did not show significant differences from the expected results (p = 0.461 and p = 0.400). Conclusions: The 3D cephalometric analysis identifies the disproportion in pre-surgical maxillomandibular growth between PRS and reference measurements, and demonstrates that FEMOD allows the achievement of proportionality in the growth of the maxillomandibular complex in PRS patients. Full article

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease predominantly of the small airways and parenchyma. COPD lungs exhibit an influx of circulating innate immune cells, which, when isolated, display impaired functions, including imbalanced protease secretion. In addition to immune cells, the extracellular matrix (ECM) plays a crucial role in COPD pathology. Remodeling of the ECM can generate ECM fragments, which can be released into circulation and subsequently induce pro-inflammatory responses. COPD is a heterogeneous disease, and serological biomarkers can be used to sub-categorize COPD patients for targeted treatments and optimal recruitment in clinical trials. This study evaluated fragments of calprotectin, collagen type VI, and versican, generated by neutrophil elastase and matrix metalloproteinases (MMP-) 2 and 12, respectively, as potential biomarkers of COPD disease, severity, and endotypes. Lower plasma levels of a neoepitope marker of calprotectin, indicative of activated neutrophils (nordicCPa9-HNETM), were detected in COPD donors compared to controls. CPa9-HNE was associated with milder disease, higher degree of air-trapping, and higher serum levels of MMP-2. Deposition of CPa9-HNE levels in lung tissue revealed no differences between groups. Taken together, CPa9-HNE was found to be a potential marker of mild COPD, but further studies are warranted to validate our findings. Full article

Against the background of intensifying human–land contradictions, evaluation of land use benefits and identification of obstacles are crucial for sustainable land management and socioeconomic development. Taking Henan Province as an example, this research employed the entropy weight method and TOPSIS model to assess the land use benefits across its cities from 2011 to 2020, a period of rapid land use transformation, analyzed their spatiotemporal evolution, and identified key obstacles via an obstacle degree model. The results showed the following. (1) The social land use benefits consistently exceeded the ecological and economic benefits, with steady improvements observed in both the individual and comprehensive benefits. Spatially, the benefits showed a “one city dominant” pattern, decreasing gradually from the central region to the south, north, east, and west, with this spatial gradient further intensifying over time. (2) Economic factors were the primary obstacles, with significantly higher obstruction degrees than social or ecological factors. The main obstacles were the general budget revenue of government finance per unit land area, domestic garbage removal volume, and total retail sales of social consumer goods per unit land area. (3) The policy implications focus on strengthening regional differentiated development by leveraging Zhengzhou’s core role to boost the land-based economic benefits, integrating social–ecological strengths with agricultural modernization, and promoting “core–periphery linkage” to narrow gaps through targeted industrial and infrastructure strategies. This study could provide region-specific insights for sustainable land management in agricultural provinces undergoing rapid urbanization. Full article

Background/Objectives: Tl-201 myocardial perfusion single-photon emission computed tomography (MPS) is a minimally invasive test for patients with suspected coronary artery disease (CAD). While its predictive and prognostic values are well established, diagnostic performance varies. A recent meta-analysis reported that the sensitivity and specificity of MPS range from 48.8 to 100% and 46.7 to 94.7%, respectively, reflecting discordance between CAG. Little is known, however, about the influence of patients’ characteristics and CAD risk factors on the diagnostic performance of MPS. This study aims to evaluate these factors in relation to MPS performance. Methods: We screened 4817 consecutive patients referred to our Nuclear Medicine Department in 2015 for Tl-201 MPS. Patients with clinically suspected ischemic heart disease who underwent CAG within 60 days post-MPS were included in the present analysis. The percentage of agreement/disagreement between the MPS-abnormal/normal and CAG-positive/negative groups was evaluated. Additionally, patient characteristics, CAD risk factors, co-morbidities, and single-photon emission computed tomography (SPECT) image-derived parameters were compared among the patients. Results: Among 635 patients with abnormal MPS, 583 had coronary stenosis. For the 52 without stenosis, causes included non-obstructive CAD (34.6%), prior infarction with scarring (32.7%), and imaging artifacts (32.7%). Significant stenosis was associated with older age, male sex, diabetes, dyslipidemia, CKD, and prior PCI, while hypertension and higher BMI were more common in insignificant CAD. Among 104 patients with normal MPS, 79 had stenosis, mainly in the LAD. Clinical risk factors were more prevalent in patients with any degree of stenosis. Conclusions: In patients with an abnormal MPS, the incorporation of visual interpretation, parameters, and CAD risk factors increases specificity and helps differentiate obstructive from non-obstructive CAD. Full article

We are living in a world filled with artifacts, including daily-use and durable products. In the context of sustainable consumption and production (SCP), the term “sufficiency” is an essential keyword. The concept of sufficiency is important for grasping the overall contribution of product functions to the fulfillment of human needs in terms of social sustainability. Sufficiency is also understood to be a necessary component for reducing the environmental impact of daily-use and durable products on the natural environment. Therefore, sufficiency is regarded as a key factor in promoting environmental sustainability. Generally, a product itself is not as essential as the functions it provides to the user. However, product functions have not only positive aspects that satisfy human needs, but also negative aspects that do not. Most existing methods for assessing the satisfaction of human needs are based on direct approaches, such as life satisfaction surveys, which do not take product functions into account. In the previous study, we proposed a living-sphere approach that integrates the traditional engineering design framework with Max-Neef’s framework of needs, relating product functions to fundamental human needs. In Max-Neef’s framework, a key concept is the “satisfier,” which refers to a conceptual method of satisfying universal human needs; however, this concept varies according to regional or local circumstances, such as culture, climate, and history. This study proposes a method to evaluate net sufficiency, which is the overall impact of product functions, both positive and negative, on fulfilling fundamental human needs. Through introducing not only a satisfier that fulfills but also a barrier that obstructs fundamental human needs, it is possible to comprehensively evaluate the degree to which a product’s functions fulfill such needs. Two case studies from Osaka and Hanoi were carried out independently, showing that the proposed method enables comprehensive evaluation of the net sufficiency of meeting fundamental needs in terms of the positive and negative aspects of product functions. Full article

Peripheral artery disease (PAD) is a chronic progressive accumulation of atherosclerotic lesions with varying degrees of arterial obstruction determining ischemic symptoms of the involved extremities. PAD is associated with decreased bioavailable nitric oxide due to endothelial cell dysfunction and the development and progression of vascular arterial stiffening (VAS). Atherosclerosis also plays an essential role in the development and progression of vascular arterial stiffening (VAS), which is associated with endothelial cell activation and dysfunction that results in a proinflammatory endothelium with a decreased ability to produce bioavailable nitric oxide (NO). NO is one of three gasotransmitters, along with carbon monoxide and hydrogen sulfide, that promotes vasodilation. NO plays a crucial role in the regulation of PAD, and a deficiency in its bioavailability is strongly linked to the development of atherosclerosis, VAS, and PAD. A decreased arterial patency may also occur due to a reduction in the elasticity or diameter of the vessel wall due to the progressive nature of VAS and atherosclerosis in PAD. Progressive atherosclerosis and VAS promote narrowing over time, which leads to impairment of vasorelaxation and extremity blood flow. This narrative review examines how atherosclerosis, aging and hypertension, metabolic syndrome and type 2 diabetes, tobacco smoking, and endothelial cell activation and dysfunction with decreased NO and VAS with its increased damaging pulsatile pulse pressure result in microvessel remodeling. Further, the role of ischemia and ischemia–reperfusion injury is discussed and how it contributes to ischemic skeletal muscle remodeling, ischemic neuropathy, and pain perception in PAD. Full article

Water resources are fundamental to sustaining life, fostering social development, and maintaining ecological balance. This study focuses on Anhui Province (AP) as the research area, employing 22 indicators from the Water-Socio-Ecological (WSE) framework for the water resource-water environment carrying capacity (WR-WECC) of AP. The WR-WECC of AP is assessed via differential evolution projection pursuit modeling (DE-PPM). Additionally, the degree of coupled coordination model (DCCM) is utilized to analyze the coordinated development among the municipalities of AP, whereas the obstacle degree model is employed to identify the primary obstacles affecting the enhancement of the WR-WECC and to forecast them via autoregressive composite moving averages. The findings of the study are as follows: (1) WR-WECC in AP showed a steady upward trend, and the water, socio-economic, and ecological subsystems showed a fluctuating upward trend, with ES increasing the fastest. The overall WR-WECC of each city shows a fluctuating upward trend, and the spatial gap narrows, with Southern Anhui (SA) > Central Anhui (CA) > Northern Anhui (NA). (2) The DCC of the WSE carrying capacity of AP also shows a fluctuating upward trend, gradually transitioning from barely coordinated to well coordinated. The DCC level of the WR-WECC in SA is better than that in CA and NA, and the growth rate is greater than that in CA and NA, whereas the DCC level in CA is better than that in NA, and the DCCs of the three major regions show an upward trend. (3) The degree of obstruction at the criterion level of AP’s WR-WECC basically maintains the following order: WS > SS > ES. In the indicator layer, the water supply modulus, water production modulus, and proportion of tertiary industry are the main obstacle factors restricting the enhancement of the WR-WECC of AP. (4) The prediction results for 2025–2040 indicated that the WR-WECC level and the three subsystem levels of AP showed a continuous increasing trend. Measuring WR-WECC plays a crucial role in regional sustainable development. Full article