Search Results (843)

The built environment requires retrofitting on a massive scale to both mitigate the impacts of climate change and adapt to future conditions. Buildings of high thermal mass offer useful insights into the limits of passive measures in futureproofing against overheating. Historic buildings typically have a higher thermal mass and also offer a paragon case to study improvement options that do not compromise heritage or character. This paper focuses on the Tower of London as a case study. Data from pre- and post-COVID-19 allows insights into the building performance in the absence of end users. A thermal model is calibrated to accurately represent both the physics of the building and the impacts of its occupants in use. Future weather files then test the extent to which the building’s thermal mass can mitigate against overheating under a range of climate warming scenarios. The results suggest that prolonged heat waves pose a serious risk to passive mitigation strategies as the mass of the building stores heat it cannot shed overnight. These scenarios also reduce the heating demand in winter. The results suggest that the built environment faces subtle design challenges in understanding the limits for passive design techniques versus the need for cooling in a warming climate. For the Tower in particular, a significant increase in overheating is likely in the coming decades. Full article

The integrity measurement mechanism (IMM) is key to creating a trusted execution environment (TEE) for containers. It ensures that files inside containers are real and have not been tampered with. However, traditional IMMs are inefficient. This is because they rely on message-digest algorithms (MDAs), which require a lot of time and space. This makes them hard to use in environments where resources are limited. To solve these problems, we present two novel metadata-driven IMMs, the Overlay2 IMM and the Btrfs IMM, which use the built-in metadata structures of the Overlay2 and Btrfs filesystems, respectively. Compared to MDA-based IMMs, these new IMMs are much more efficient in operation. They are also more secure because they use an external validation mechanism that does not depend on the container’s running state. This effectively reduces security risks in dynamic environments. We built complete prototypes of these new IMMs. We tested them on edge servers with Intel CPUs and embedded devices with ARM CPUs. When we compared them with traditional MDA-based methods (including MD5 and SHA256), we found significant improvements. Our methods are more efficient in computation. They reduce the need for space and time by using filesystem metadata instead of hashing entire files. This makes them suitable for environments with limited resources. They run outside the container, so malicious actors inside the container cannot detect them, ensuring robust protection. In addition, they can check file integrity consistently no matter the container’s state (running, paused, or stopped). This is because they use metadata from the container image, which improves the overall reliability and consistency of the integrity measurement process. Full article

Background/Objectives: The management of immature teeth with wide apical foramina presents significant challenges in endodontic treatment due to difficulties in achieving a hermetic seal. The aim of this study was to evaluate void formation in apical plugs created using three calcium silicate-based materials—Biodentine, NuSmile NeoPUTTY, and Well-Root PT—applied with the help of manual, ultrasonic, or rotary file condensation (XP-endo Shaper) in 3D-printed immature teeth. Methods: Micro-computed tomography analysis was used to assess the internal, external, and total void percentage of material volume. The statistical analysis was performed using two-way ANOVA and the post hoc Bonferroni test. Statistical significance was set at p < 0.05. Results: The materials and techniques used individually do not significantly influence the formation of internal voids, but their combination does (F(4, 99) = 2.717, p = 0.034). Both factors and their interaction are significant for external voids (F(4, 99) = 4.169, p = 0.004), and all have a notable effect on total void percentages (F(4, 99) = 3.456, p = 0.012). No significant differences were observed in internal voids across the groups (p > 0.05), ranging from 0.635% to 1.078%. External voids varied significantly, with Well-Root PT and ultrasonic condensation showing the highest values with a significant difference (p < 0.05), while NeoPUTTY and Biodentine with XP-endo Shaper exhibited the lowest. Total voids remained below 4%, with no significant differences among manual condensation groups. Neither material type nor application technique consistently influenced void formation, except for Well-Root PT with ultrasonic condensation. Conclusions: These findings suggest that modern bioceramic materials and application techniques produce comparable, low-void apical plugs, with XP-endo Shaper showing promise for minimizing external voids. The interaction between material and application technique plays a crucial role during the creation of apical plugs. Full article

Background: Undergraduate nursing students (UNSs) often enter clinical training just as they are still mastering the emotional labor of the profession. In Nepal, where teaching hierarchies discourage upward dialogue and hospitals routinely struggle with overcrowding, supply shortages, and outward nurse migration, these learners confront a distinct, under-documented burden of psychological distress. Objective: This study examines how UNSs interpret, negotiate, and cope with the mental health challenges that arise at the intersection of cultural deference, resource scarcity, and migration-fueled uncertainty. Methods: A qualitative design employing reflexive thematic analysis (RTA), guided by the Reflexive Thematic Analysis Reporting Guidelines (RTARG), was used. Fifteen second-, third-, and fourth-year Bachelor of Science in Nursing students at a major urban tertiary institution in Nepal were purposively recruited via on-campus digital flyers and brief in-class announcements that directed students (by QR code) to a secure sign-up form. Participants then completed semi-structured interviews; audio files were transcribed verbatim and iteratively analyzed through an inductive, reflexive coding process to ensure methodological rigor. Results: Four themes portray a continuum from silenced struggle to systemic constraint. First, Shrouded Voices, Quiet Connections captures how students confide only in trusted peers, fearing that formal disclosure could be perceived as weakness or incompetence. Second, Performing Resilience: Masking Authentic Struggles describes the institutional narratives of “strong nurses” that drive students to suppress anxiety, adopting scripted positivity to satisfy assessment expectations. Third, Power, Hierarchy, and the Weight of Tradition reveals that strict authority gradients inhibit questions in classrooms and clinical placements, leaving stress unvoiced and unaddressed. Finally, Overshadowed by Systemic Realities shows how chronic understaffing, equipment shortages, and patient poverty compel students to prioritize patients’ hardships, normalizing self-neglect. Conclusions: Psychological distress among Nepalese UNSs is not an individual failing but a product of structural silence and resource poverty. Educators and policymakers must move beyond resilience-only rhetoric toward concrete reforms that dismantle punitive hierarchies, create confidential support avenues, and embed collaborative pedagogy. Institutional accountability—through regulated workloads, faculty-endorsed wellbeing forums, and systematic mentoring—can shift mental health care from a private struggle to a shared professional responsibility. Multi-site studies across low- and middle-income countries are now essential for testing such system-level interventions and building a globally resilient, compassionate nursing workforce. Full article

Background/Objectives: The application of additive manufacturing in medicine, and specifically in personalised medicine, has achieved notable development. This article aims to present the results and benefits of applying a comprehensive methodology to simulate, plan, and manufacture customised three-dimensional medical prosthetic devices for use in surgery to restore bone structures with congenital and acquired malformations. Methods: To digitally reconstruct a bone structure in three dimensions from a medical image, a segmentation process is developed to correlate the anatomical model. Then, this model is filtered using a post-processing step to generate stereolithography (STL) files, which are rendered using specialised software. The segmentation of tomographic images is achieved by the specific intensity selection, facilitating the analysis of compact and soft tissues within the anatomical region of interest. With the help of a thresholding algorithm, a three-dimensional digital model of the anatomical structure is obtained, ready for printing the required structure. Results: The described cases demonstrate that the use of anatomical test models, cutting guides, and customised prostheses reduces surgical time and hospital stay, and achieves better aesthetic and functional results. Using materials such as polylactic acid (PLA) for presurgical models, appropriate resins for cutting guides, and biocompatible materials such as polyether ether ketone (PEEK) or polymethylmethacrylate (PMMA) for prostheses, the described improvements are achieved. Conclusions: The achievements attained demonstrate the feasibility of applying these techniques, their advantages and their accessibility in Ecuador. They also reinforce the ideas of personalised medicine in the search for medical treatments and procedures tailored to the needs of each patient. Full article

Background/Objectives: Archery is a technical sport involving repetitive and asymmetrical movements that requires trunk stability to enable good performance of the upper extremities. Being an asymmetrical sport, imbalances between sides might appear in the abdominal and back muscles. To assess trunk muscle function and symmetry in young competitive archers. Methods: Analyzing pre-season screening evaluation tests from medical files. This included an ultrasound examination of back and abdominal muscles (transverse abdominus and internal oblique) during rest and contraction and trunk muscle clinical strength tests. Results: Data on 15 elite archery athletes (mean age 17.2 (±2.7) years) were included. No athletes reported low back pain. No differences were found between the dominant and non-dominant sides in all outcome measurements (absolute thickness and percentage difference). Internal oblique muscle thickness during rest and contraction for the dominant side was higher in males compared with females (p < 0.05). The back muscles were more symmetrical than the abdominal muscles. Conclusions: Despite the asymmetrical functional demands of sport archery, young athletes displayed trunk muscle symmetry, particularly in their back muscles. While some variability in abdominal muscle asymmetry was observed, these differences were not statistically significant. Full article

The jet fan system is a widely adopted form of longitudinal ventilation due to its cost-effectiveness, operational flexibility, and high reliability. However, in large-section highway tunnels with a low height-to-span ratio, the limited clearance between the tunnel ceiling and surrounding structural boundaries imposes significant constraints on improving ventilation performance by adjusting the installation height or pitch angle of the jet fan. To address this limitation, this study proposes a deflector shield system to enhance the aerodynamic efficiency of jet fans. A total of thirteen test cases, including a control group, three deflector plate quantities, and four deflector pitch angles, were tested in a full-scale field test conducted in a large-section tunnel. The objective of this study was to evaluate the influence of the number and pitch angle of deflector plates on tunnel ventilation efficiency and to identify the optimal parameter combination for application in large-section tunnels. The results show that static pressure along the tunnel initially rises with distance from the fan, peaks, and then declines sharply. The pressure rise coefficient is significantly enhanced under several configurations, particularly with four deflector plates at 8° and 10° pitches, and with five plates at 4° to 10° pitches. When the number of deflector plates is five, a sharp drop in average wind speed is observed 15 m downstream of the fan, and extensive low-velocity regions appear further downstream. In contrast, the configurations with four deflector plates at 8° and 10° exhibit better wind speed uniformity in the downstream flow field. Considering both the pressure rise coefficient and wind speed uniformity, the optimal ventilation performance of the jet fan system is achieved with four deflector plates at a pitch angle of 8°. Full article

Rugby union involves intermittent high- and low-intensity activities, making it essential for strength and conditioning practitioners to understand specific physical demands. While GPS technology has enhanced this understanding, limited research focuses on Tier 2 national teams. This study aimed to describe the speed-related physical demands of a Tier 2 national rugby union team. This retrospective observational study analyzed 230 GPS files from 55 professional male players of an international Tier 2 national rugby union team, collected across 17 international matches. Speed-related performance variables were analyzed. Players who played ≥55 min were included. A Kruskal–Wallis test with post hoc comparisons was used to examine positional differences. Principal Component Analysis (PCA) identified four main components explaining 84.65% of the variance, while a two-step cluster analysis grouped players into Low-, Mid-, and High-Demand profiles based on these components. Backs showed greater high-intensity running demands compared to forwards. This study’s results provide novel insights into the physical demands of Tier 2 international rugby union, highlighting differences among player positions and clustering players based on their specific speed demands. These findings can help strength and conditioning practitioners design position-specific training loads, implement tailored recovery strategies, and reduce injury risk in Tier 2 international rugby union. Full article

Objectives: Migrants are at greater risk of psychiatric hospitalization. This study aims to improve care for migrants hospitalized in psychiatric wards in Morocco by studying comprehensive clinical and epidemiological characteristics, focusing on potential risk factors to guide mental health intervention efforts. Methods: The present retrospective multicenter study retrieved sociodemographic, clinical data, and patient records of migrants admitted to a large Moroccan psychiatric hospital in the Rabat region between 2013 and 2023 in order to delineate characteristics and risk factors for psychiatric hospitalizations. Descriptive and univariable analyses were conducted using chi-square, Fisher’s exact, and Mann–Whitney tests, and multivariable logistic regression analyses were performed by Jamovi 2.3.28.0 software to predict rehospitalization. Results: A total of 102 patient files were analyzed. Of these, 72.5% were single men, 27.5% had mental health problems prior to migration, 23.5% had attempted suicide, and 88.2% had negative insight. Some 94.86% were hospitalized against their will, 73.5% were diagnosed with psychosis, and only 2 were diagnosed with a stress-related disorder. Some 34.3% were hospitalized. Factors significantly associated with hospitalized were divorced family status, presence of psychotic pathology, and number of family members between five and nine with OR = 5.28, CI [1.04–26.68], p = 0.044; OR = 5.95, CI [2.02–17.44], p = 0.001; and OR = 6.02, CI [1.71–21.11], p = 0.005, respectively. Shorter length of stay in Morocco, unemployment, asylum seekers, and use of restraints were more frequent in hospitalized patients. Conclusions: Identifying at-risk migrants and setting up culturally appropriate, trauma-informed services can reduce the number of hospital admissions and boost the training and awareness of healthcare professionals in this area. Full article

The objective of the research was to use sigmoidal mathematical models for the planning and control of rigid pavement works. A dataset was constructed using 140 technical files, which were then analyzed to extract the valued work schedules. These schedules contained the variables time and cost per month. Subsequently, two groups were created from the dataset: a training group comprising 80% of the data and a test group comprising the remaining 20%. Subsequently, the variables were normalized and adjusted with the proposed logistic, Von Bertalanffy, and Gompertz models using Python 3.11.13. Following the implementation of training and validation procedures, the logistic model was identified as the optimal fit, as indicated by the following metrics: R² = 0.9848, MSE = 0.0026, RMSE = 0.0506, and MAE = 0.0278. The implementation of the aforementioned model facilitates the establishment of an early warning system with a high degree of effectiveness. This system enables the evaluation of the discrepancy between the actual progress and the planned progress with an R² greater than 98%, thereby serving as a robust instrument for the adjustment and revalidation of activities before and following their execution. Full article

In the modern era of smart grids, integrating advanced Geographic Information Systems (GISs) with protection coordination functionalities is pivotal for enhancing the reliability and efficiency of distribution networks. This paper presents an implementation of a web-based distribution network GIS platform that seamlessly integrates distribution system feeder GIS monitoring with the system model file layout, fault current analysis, and coordination simulation functions. The system can provide scalable and accessible solutions for power utilities, ensuring that protective devices operate in a coordinated manner to minimize outage impacts and improve service restoration times. The proposed GIS platform has demonstrated significant improvements in fault management and relay coordination through extensive simulation and field testing. This research advances the capabilities of distribution network management and sets a foundation for future enhancements in smart grid technology. Full article

Objective: To evaluate the concordance of automated 3D superimposition methods applied to digital models, with a focus on methods that consider stable palatal regions as geometric reference landmarks versus those that do not. Design and setting: This was a prospective, cross-sectional study using digital model files of patients undergoing orthodontic treatment in a university clinical setting. Participants: Sixty-one patients were prospectively enrolled and divided into three groups based on the type of orthodontic treatment they received: (20) non-extractive orthodontic treatment without intermaxillary elastics, (21) intermaxillary elastics, and (20) control subjects with no orthodontic movement. The inclusion criteria included the availability of complete pre- and post-treatment digital casts and the absence of significant craniofacial anomalies. Methods: Three superimposition methods were tested: (1) superimposition according to palate and palatal ridges, (2) best-fit superimposition of arches in occlusion, and (3) best-fit superimposition of individual arches. Discrepancies were identified by comparing the spatial positions derived from each method. Within three spatial axes, deviations of ±0.5 mm and ±1.15° were not considered significant. Bland–Altman plots were used to quantify palatal rugae based and non-based spatial differences between methods. Differences in the superimposition results between the three patient groups were evaluated using ANOVA tests. Results: Differences in spatial position between the superimposition methods often exceeded the acceptable range. The results were compared between the three patient groups with a statistical significance of α = 0.05. In the present study, the high reliability of the superimposition method based on the palate and palatal ridges was observed. Conclusion: Superimposition methods based on the palate and palatal rugae provide superior accuracy in determining treatment-related changes in upper arch digital models. These findings illustrate the need for appropriate selection of superimposition techniques based on the study objective of using clinically relevant techniques. Full article

Background: Mobility limitation is a pivotal but under-documented dimension of disability in Saudi Arabia. Leveraging the 2017 National Disability Survey, this cross-sectional study provides a population-wide profile of mobility-related physical difficulty. Objectives: Five research aims were pursued: (1) estimate national prevalence and severity by sex; (2) map regional differentials; (3) examine educational and marital correlates; (4) characterize cause, duration, and familial context among those with multiple limitations; and (5) describe patterns of assistive-aid and social-service use. Methods: Publicly available aggregate data covering 20,408,362 Saudi citizens were cleaned and analyzed across 14 mobility indicators and three baseline files. Prevalence ratios and χ² tests assessed associations. Results: Overall, 1,445,723 Saudis (7.1%) reported at least one functional difficulty; 833,136 (4.1%) had mobility difficulty, of whom 305,867 (36.7%) had mobility-only impairment. Severity was chiefly mild (35% of cases), with moderate (16%) and severe (7%) forms forming a descending pyramid. Prevalence varied more than threefold across the thirteen regions, peaking in Aseer (9.4%) and bottoming in Najran (2.9%). Mobility difficulty clustered among adults with no schooling (36.1%) and widowed status (18.5%), with sharper female disadvantage in both domains (p < 0.001). Among those with additional limitations, chronic disease dominated etiology (56.3%), and 90.1% had lived with disability for ≥25 years; women were overrepresented in the longest-duration band. Aid utilization was led by crutches (47.7%), personal assistance (25.3%), and wheelchairs (22.6%), while 83.8% accessed Ministry rehabilitation services, yet fewer than 4% used home or daycare support. Conclusions: These findings highlight sizeable, regionally concentrated, and gender-patterned mobility burdens, underscoring the need for education-sensitive prevention, chronic-care management, investment in advanced assistive technology, and distributed community services to achieve Vision 2030 inclusion goals. Full article

Background/Objectives: This paper presents a medical image analysis application designed to facilitate advanced edge detection and fuzzy processing techniques within an intuitive, modular graphical user interface. Methods: Key functionalities include classical edge detection, Ant Colony Optimization (ACO)-based edge extraction, and fuzzy edge generation, which offer improved boundary representation in images where uncertainty and soft transitions are prevalent. Results: One of the main novelties in contrast to the initial innovative Medical Image Analyzer, iMIA, is the fact that the system includes fuzzy C-means clustering to support tissue classification and unsupervised segmentation based on pixel intensity distribution. The application also features an interactive zooming and panning module with the option to overlay edge detection results. As another novelty, fuzzy performance metrics were added, including fuzzy false negatives, fuzzy false positives, fuzzy true positives, and the fuzzy index, offering a more comprehensive and uncertainty-aware evaluation of edge detection accuracy. Conclusions: The application executable file is provided at no cost for the purposes of evaluation and testing. Full article

The efficient and reliable maintenance and repair of industrial machinery depend critically on circuit diagrams, which serve as essential references for troubleshooting and must be updated when machinery is modified. However, many circuit diagrams are not available in structured, machine-readable format; instead, they often exist as unstructured PDF files, rendered images, or even photographs. Existing digitization methods often address isolated tasks, such as symbol detection, but fail to provide a comprehensive solution. This paper presents a novel pipeline for extracting the underlying graph structures of circuit diagrams, integrating image preprocessing, pattern matching, and graph extraction. A U-net model is employed for noise removal, followed by gray-box pattern matching for device classification, line detection by morphological operations, and a final graph extraction step to reconstruct circuit connectivity. A detailed error analysis highlights the strengths and limitations of each pipeline component. On a skewed test diagram from a scan with slight rotation, the proposed pipeline achieved a device detection accuracy of 88.46% with no false positives and a line detection accuracy of 94.7%. Full article