Search Results (6,181)

Background: Non-invasive respiratory supports (High-Flow Nasal Oxygen, HFNO; Continuous Positive Airway Pressure, CPAP; Non-Invasive Ventilation, NIV) are frequently used in Acute Hypoxemic Respiratory Failure (AHRF). However, the experience of assisted breathing may profoundly affect patients’ psychological balance, particularly during acute critical illness and subsequent rehabilitation. Aims and objectives: This longitudinal study investigated the psychological burden associated with non-invasive respiratory support use in patients with COVID-19-related AHRF, exploring changes in psychological functioning from acute hospitalization (RICU/ICU) (T0) to follow-up, conducted at a mean of 6.0 ± 3.1 months after respiratory rehabilitation (T1). Methods: Fifty-two patients (mean age = 66.9 ± 9.17 years) were assessed at T0 and T1. Standardized measures evaluated anxiety, psychological distress, post-traumatic stress symptoms, depression, and resilience, in relation to perceived illness severity and subjective experience of non-invasive respiratory support. Results: During acute care, patients reported high levels of fear and anxiety related to illness severity and uncertainty. The experience of non-invasive respiratory support, often perceived as a marker of critical condition, was associated with increased fear and anxiety (t(14) = 2.79, p = 0.014) compared to the recovery phase, leading to feelings of loss of control and diminished psychological well-being (t(17) = 2.35, p = 0.031). However, resilience significantly improved over time (t(16) = −4.78, p < 0.001). Conclusions: Non-invasive respiratory support may represent a psychologically demanding experience, often perceived as challenging to patients’ sense of safety and control. Encouragingly, psychological adaptation and resilience can improve during rehabilitation. Integrating structured psychological support within respiratory rehabilitation pathways may promote recovery and restore psychological balance in patients requiring assisted ventilation. Full article

This study investigated the association between serum hypoxia-inducible factor 1-alpha (HIF-1α) levels and clinical severity in patients with coronavirus disease 2019 (COVID-19). This prospective case–control study included 91 patients with confirmed COVID-19, of whom 51 had severe-critical disease with pneumonia and 40 had mild disease without pneumonia, as well as 39 healthy controls. Vital signs, including body temperature, pulse rate, respiratory rate, oxygen saturation, and blood pressure, were recorded. Biochemical parameters such as complete blood count, D-dimer, ferritin, creatinine, urea, and high-sensitivity cardiac troponin T were analyzed. Serum HIF-1α levels were measured using ELISA. Median HIF-1α levels were 132.9 pg/mL (IQR: 131.7–138.0) in the severe-critical disease group, 137.35 pg/mL (IQR: 131.65–152.75) in the mild disease group, and 136.6 pg/mL (IQR: 132.2–162.2) in controls. Significant differences were observed between groups (p = 0.012). ROC analysis showed a discriminatory performance for HIF-1α, with a sensitivity of 89.01% and specificity of 35.90% at a cut-off value of ≤154 pg/mL for distinguishing mild disease from controls, and a sensitivity of 86.3% and specificity of 42.5% at a cut-off value of ≤141.1 pg/mL for distinguishing severe-critical disease from mild disease. HIF-1α levels decreased with increasing disease severity. HIF-1α levels were found to be associated with disease severity; however, the low AUC values indicate that this parameter has limited discriminative ability for clinical use when used alone. Full article

Direct current (DC) surface flashover on polystyrene (PS) remains a critical bottleneck that impedes its reliable application in high-voltage insulation apparatus. To circumvent the protracted processing durations and stringent film-forming conditions inherent in conventional surface modification techniques, this study proposes a novel “liquid-film-assisted in situ rapid plasma curing” strategy. By harnessing atmospheric-pressure dielectric barrier discharge (DBD) technology within an argon ambient, the rapid (<6 min) and efficient deposition of a fluorosilane (FAS-13) functional coating onto the substrate was achieved. Microscopic characterizations coupled with isothermal surface potential decay (SPD) measurements reveal that this coating substantially mitigates the detrapping and surface migration of charge carriers. Macroscopic DC flashover testing corroborates that, under the optimal modification ratio, the surface breakdown voltage of PS is elevated to 14.04 kV, yielding an insulation gain of 26.94%. To elucidate the underlying physical mechanisms, density functional theory (DFT) calculations were conducted, revealing that the energy band misalignment between the wide-bandgap fluorinated layer and the substrate facilitates the construction of a high-density deep trap network (with a depth of ~0.8 eV) at the coating–substrate interface. By robustly anchoring primary electrons and inducing the formation of a homopolar space charge shielding layer, these deep traps physically arrest the evolution of the secondary electron emission avalanche (SEEA). Consequently, this work not only establishes a viable engineering framework for the rapid, large-scale surface reinforcement of DC insulation equipment but also provides profound quantum chemical insights into interfacial trap regulation within all-organic dielectrics. Full article

Background: Asymptomatic intracranial atherosclerotic arterial stenosis (ICAS) is an underrecognized entity for which vascular risk-factor optimization is the primary management strategy, with no current indication for routine antiplatelet therapy or endovascular intervention for primary stroke prevention. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce major adverse cardiovascular events, including stroke, in high-risk cardiometabolic populations, but their association with outcomes in asymptomatic ICAS is yet to be evaluated. The present study aims to evaluate the association between GLP-1RA use and cerebrovascular outcomes in adults with asymptomatic ICAS. Materials and Methods: We used the TriNetX US Collaborative Network (71 healthcare organizations) to identify adults (≥18 years) with ICAS between 1 January 2016 and 31 December 2025, and excluded patients with prior cerebral infarction, intracranial hemorrhage, or cerebrovascular ischemic syndromes. Exposure was defined as initiation of any GLP-1 receptor agonist (lixisenatide, semaglutide, liraglutide, tirzepatide, dulaglutide) during the 6 months before or on the date of index ICAS diagnosis. Outcomes were assessed at 1 year, and included ischemic stroke, all-cause mortality, and a composite of ischemic stroke or mortality. Propensity-score matching (1:1) was performed, including demographics, vascular risk factors, comorbidities, antithrombotics, lipid/diabetes therapies, and cardiometabolic laboratory/physiologic measures. Results: Before matching, 1746 GLP-1RA users and 71,792 non-users met inclusion criteria; after matching, 1728 patients remained in each cohort. GLP-1RA use was associated with lower 1-year risk of ischemic stroke (4.40% vs. 6.10%; hazard ratio [HR] 0.70, 95% CI 0.52–0.95; p = 0.044), lower all-cause mortality (3.40% vs. 9.40%; HR 0.35, 95% CI 0.26–0.47; p < 0.001), and lower composite outcome risk (7.50% vs. 15.00%; HR 0.48, 95% CI 0.39–0.59; p < 0.001). Notably, these associations were observed despite matching for HbA1c, LDL cholesterol, BMI, and systolic blood pressure, suggesting potential effects beyond measured cardiometabolic risk profiles. Conclusions: In this large, propensity-matched cohort of adults with a-ICAS, GLP-1RA use was associated with lower ischemic stroke, all-cause mortality, and composite outcome at 1 year. These findings are hypothesis-generating and require further prospective studies to confirm this observation. Full article

Kiwifruit (Actinidia deliciosa cv. Hayward) is a high-demand crop due to its nutritional value. Climate change increasingly challenges its cultivation, particularly under Mediterranean conditions, due to limited water resources. Therefore, the early detection of water stress onset is crucial for optimizing irrigation water use and enhancing kiwi productivity. In this context, advanced sensors capable of continuously monitoring critical hydrodynamic parameters, combined with machine learning approaches, offer a promising solution for reliable prediction of plant water status, supporting irrigation decision-making systems. This study develops and evaluates machine learning (ML) models to predict trunk water potential (Ψtrunk), integrating soil moisture, climatic variables, and plant-based measurements, including sap flow. Various machine learning models were evaluated including Ridge Regression, Lasso Regression, Random Forest, Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM), using soil moisture, trunk water potential (Ψtrunk), sap flow, and microclimatic variables (relative humidity, wind speed, temperature, solar radiation, vapor pressure deficit, and reference evapotranspiration). Among the tested models, XGBoost demonstrated the best performance, achieving an accuracy of approximately 0.80, followed by Ridge, Lasso and SVM, which showed similar accuracy. Full article

Fluctuating pressure generated during ship operation is closely related to propeller vibration, noise, and structural safety, and its frequency spectrum is a key design indicator in the propeller design stage. However, water tunnel experiments to measure fluctuating pressure generated by high-speed propellers require high-pressure facilities and involve complex procedures, high costs, and long lead times when experimental conditions are modified or new propellers are tested. To overcome these limitations, this study proposes a deep learning-based network, referred to as MSPFS-Net (Model-Test Ship Pressure Frequency Spectra Network), to estimate the frequency spectrum of fluctuating pressure from model test data. The proposed method uses propeller CAD data, principal design parameters, wake data, and water tunnel test conditions as inputs, and is trained in a supervised learning framework using frequency-domain data obtained by transforming experimentally measured fluctuating pressure signals. The trained network can predict the fluctuating pressure frequency spectrum without direct sensor measurements, even under conditions not present in the training dataset. The results of this study demonstrate the potential to reduce dependence on water tunnel experiments and to efficiently evaluate fluctuating pressure characteristics in the early design stage, indicating that the proposed approach can serve as a practical design support tool in terms of both cost and time efficiency. Full article

Rail transport is the basis for the proper functioning of a transport system that is sustainable for future generations. It is safe and environmentally friendly; moreover, it is suitable for carrying a large number of passengers. Train connections should be operated following the requirements of the traveling public, as well as with the potential to reach those who have hitherto preferred individual car transport. The study aimed to identify the needs of current as well as potential rail users and to propose measures for improving service provision and supporting more sustainable transport possibilities. Given the ecological nature of rail transport and the high numbers of tourists using individual car transport in the summer and winter seasons, the study sought solutions to shift transport from road to rail infrastructure. Visitors to the area were approached directly during their visit as part of a transport–sociological survey conducted during periods of peak visitation, specifically in the summer and winter seasons. Drawing on findings from previous studies and the results of the transport–sociological survey, four universal variants were developed. The study applies to the method of practical permeability indicators. It evaluates variants of measures involving timetable adjustments, line modifications, and construction of new stations. It assesses their impact on reducing travel times and proper timetable management. The result of the study is to propose building a station on the railway infrastructure, which brings fundamental changes in increasing the practical capacity of the line and meets the goal of sustainability concerning increasing the number of connections and thus increasing the number of public service opportunities. The study addresses the growing pressure of individual car transport in a protected natural area and the need to shift demand towards more sustainable rail transport. Full article

Background: Hypertension is being increasingly observed among young adults in urban India, alongside rapid dietary transitions and rising consumption of ultra-processed foods (UPFs). The current study aimed to assess the frequency and patterns of UPF consumption and examine their association with high blood pressure among urban college students. Methods: A cross-sectional study was conducted among 311 undergraduate students aged 18–24 years from three colleges in Hyderabad, India. Our study used a validated automated device to measure blood pressure. Dietary intake over the previous month was assessed using a 24-item food frequency questionnaire capturing commonly consumed UPFs. After adjusting for age, sex, and socioeconomic variables, multivariable logistic regression was performed to assess the relationships between UPF consumption categories and high blood pressure. Ninety-five percent confidence intervals (CIs) for adjusted odds ratios (AORs) were reported. Results: Overall, 12.5% of participants had high BP (≥140/90 mmHg). The prevalence was higher among males and those aged >20 years. In the adjusted analyses, males had significantly higher odds of having high BP (AOR: 4.96; 95% CI: 1.64–15.01), as did students from higher-income households (AOR: 3.22; 95% CI: 1.07–9.66). Consumption of high-fat and/or high-salt UPFs at or above the median was independently associated with high BP (AOR: 2.85; 95% CI: 1.16–6.99). Taste, availability, and low cost were common drivers of UPF intake. Conclusions: Higher consumption of high-fat and/or high-salt ultra-processed foods was associated with higher odds of elevated blood pressure among urban young adults. These findings warrant further longitudinal investigation and may help inform the development of targeted dietary awareness and food environment interventions in college settings. Full article

Continuous intraocular pressure (IOP) monitoring is crucial for glaucoma management. Currently, traditional static IOP measurements often fail to detect circadian fluctuations, leading to a clinical dilemma where “normal IOP” is observed despite persistent visual field deterioration. This study presents a wireless, passive localized surface plasmon resonance (LSPR) sensing platform integrated into flexible silicone hydrogel contact lenses. Gold nanoparticles (AuNPs), synthesized via the sodium citrate reduction method, were incorporated into the lens periphery using a “swelling-induced nano-doping” technique to transduce IOP-induced corneal strain into detectable spectral shifts. Ex vivo porcine eye investigations established a physical mapping model, confirming significant LSPR peak wavelength response trends in correlation with IOP variations (10–50 mmHg) and corneal curvature changes. Subsequent 21-day in vivo rabbit studies demonstrated excellent ocular surface biocompatibility; quantitative histopathological analysis (HE, PAS, and Ki67 staining) revealed no significant adverse alterations in corneal endothelial cell density or conjunctival goblet cell function compared to control groups (p > 0.05). Furthermore, the platform maintained high structural integrity and anterior segment tolerance under transient high-IOP conditions. While currently a proof-of-concept, these results indicate that the LSPR-active hybrid system effectively captures dynamic IOP fluctuation patterns as an optical response to acute interventions, providing a foundational engineering path for next-generation, battery-free wearable diagnostics in personalized glaucoma care without the need for built-in electronics. Full article

Background/Objectives: In Europe, Pseudomonas aeruginosa is the second most common cause of ventilator-associated pneumonia in intensive care units. Intrinsic antibiotic resistance and acquired carbapenemases can lead to high mortality. To guide more targeted antimicrobial therapy and adequate infection control measures, we performed a multicenter study on the prevalence and genetic basis of carbapenem resistance among P. aeruginosa (CR-PA) across 17 community hospitals in Austria. Methods: During a 3-month period, we collected 621 P. aeruginosa isolates from 560 patients. Antibiotic susceptibility testing was performed according to EUCAST guidelines, and all CR-PA isolates were subjected to whole genome sequencing. Results: Antibiotic susceptibility testing revealed carbapenem resistance in 5.41% (36/621) of the investigated P. aeruginosa isolates. Only 3 produced a carbapenemase (2 Verona Integron-encoded Metallo- ß-lactamases and 1 Imipenemase Metallo-ß-lactamase) and carried a carbapenemase-encoding gene. Among the studied P. aeruginosa isolates there was a high genetic diversity, excluding a single driving epidemic lineage in the included Austrian hospitals. Conclusions: The absence of interhospital clonal dominance suggests that carbapenem resistance emerged independently in different centers, likely driven by local antibiotic selection pressures rather than regional clonal spread. Full article

Persistent uncertainty in translating low-field nuclear magnetic resonance (NMR) T₂ relaxation spectra into geometrically meaningful pore–throat metrics has long hindered the quantitative characterization of tight reservoirs. To address this issue, this study develops an enhanced conversion framework that incorporates scale-dependent pore geometry, enabling more realistic estimation of pore–throat radius distributions. Core samples were collected from the first member of the Shanxi Formation and the eighth member of the Shihezi Formation in the Ordos Basin. A comprehensive experimental dataset was established, including porosity and permeability measurements, X-ray diffraction (XRD) mineral analysis, NMR experiments, high-pressure mercury intrusion (HPMI), and constant-rate mercury injection (CRMI). The results demonstrate that total clay content exhibits weak correlations with pore size and porosity. In contrast, the occurrence and morphology of specific clay minerals exert significant control on pore connectivity and flow behavior. In particular, fibrous illite increases pore–throat complexity, while early chlorite coatings help preserve primary intergranular pores. A single geometric model cannot fully represent the complex pore–throat system in tight sandstones. For pores, a spherical geometry is most appropriate and indeed necessary. Smaller throats connecting these pores often exhibit geometries more consistent with cylindrical shapes. Within the coarse pore size range, large pores dominate the reservoir space and generally exhibit geometries that better conform to a spherical shape. And larger pores dominate the volumetric contribution in the coarse pore-size range. These observations suggest that a scale-dependent composite model could further improve the accuracy of NMR-based pore-size estimations. Therefore, the spherical-pore model provides a physically meaningful framework for characterizing pore structures in tight reservoirs. At the same time, incorporating scale-dependent considerations offers a promising avenue for future methodological development. Full article

The SF₆ circuit breaker is an essential piece of high-voltage equipment in ensuring the safe operation of the power grid. Regarding the arc-extinguishing chamber, as the most essential component, its performance is directly related to the breaking capacity of the circuit breaker. This study applies the Double Distribution Function Lattice Boltzmann Method (DDF-LBM), combined with the Smagorinsky sub-grid scale (SGS) model, to systematically simulate the dynamic breaking process of a 252 kV SF₆ arc-extinguishing chamber under 50 kA breaking current conditions. Two independent distribution functions are employed to describe the fluid field and the temperature field, respectively, thereby simulating the physical flow–heat coupling process. A dynamic simulation framework is constructed using the D2Q9 model to describe the mechanical motion of the contacts and the fluid flow. The description of contact movement is achieved by dynamically updating the geometric mesh, thereby realizing fluid–solid transformation. The research results indicate that the proposed method can simulate the pressure variation of the fluid field during the breaking process. The value of the Smagorinsky constant (C_s) exhibits a non-negligible influence on the pressure field predictions. The optimal value of C_s = 0.10 is determined through analysis, and the peak pressures at the upstream and throat measurement points reach 1.11 MPa and 1.37 MPa, respectively. Numerical simulations are conducted on the dynamic breaking process of the arc-extinguishing chamber, revealing the evolution of the pressure field upstream of the nozzle and at the throat regions. This study provides new numerical simulation methods for the investigation of SF₆ arc-extinguishing chambers and establishes a foundation for the application of the Lattice Boltzmann Method in the field of high-voltage electrical appliances. Full article

Objectives: To systematically synthesize existing evidence on functional biomechanical tests of the foot and ankle in physiotherapy and sports, focusing on their outcome measures, compatibility with wearable sensor technologies, and psychometric properties. Methods: We performed a systematic review (PRISMA-guided) of PubMed, Web of Science, PEDro, and SPORTDiscus from inception to December 2025. Eligible studies evaluated functional foot/ankle biomechanics in athletes, healthy adults, or adults with musculoskeletal foot/ankle conditions using wearable sensors (e.g., IMUs, wireless pressure insoles). Two reviewers independently screened, extracted data, and appraised methodological quality using the COSMIN Risk of Bias tool, applying property-specific ratings. Heterogeneity precluded meta-analysis; findings were narratively synthesized and tabulated. Results: Twenty full texts were reviewed; four studies (n = 83 participants) met the inclusion criteria. Wearable devices included foot- or trunk-mounted IMUs and wireless pressure insoles. Reported outcomes spanned temporal gait events and inner-stance phases, vertical ground reaction force (vGRF) and centre-of-pressure trajectories, running step rate/stride length, and jump counts in competition. Validity was most frequently assessed: foot-worn IMUs showed millisecond-level agreement with in-shoe pressure references for stance and inner-stance events; pressure insoles demonstrated acceptable agreement with force plates for vGRF/COP alongside fair-to-excellent test–retest reliability; foot- vs. shank-mounted IMUs provided strong agreement for running step rate and stride length; and competition-based jump detection using IMUs achieved high sensitivity. Across studies, reliability indices were inconsistently reported, measurement error (SEM/MDC) was sparse, and MCID was not reported. The COSMIN appraisal ranged from very good/adequate to inadequate, driven primarily by small sample sizes, non-gold-standard comparators, and incomplete psychometric reporting. Full article

The increasing adoption of alternative fuels such as hydrogen and ammonia in energy systems has created a growing need for advanced diagnostic techniques capable of monitoring combustion products with high specificity and flexibility. In this context, Raman spectroscopy represents a promising optical approach for gas analysis, as it enables the simultaneous detection of multiple species without requiring sample preparation. In this work, the performance of a cost-effective Raman-based system on quantitative detection of nitrogen oxides (NO and NO₂) and nitrous oxide (N₂O) is presented. The experimental setup is based on a multi-pass optical configuration designed to enhance the Raman signal and employs off-the-shelf components, including an uncooled CMOS detector. Calibration measurements were carried out using gas mixtures at known partial pressures, and gas concentrations were retrieved through a nonlinear least-squares fitting procedure applied to the measured spectra. The results show that the system provides linear and repeatable responses for NO and N₂O over the investigated pressure ranges, with low mean errors and limited data dispersion, while NO₂ performance could not be fully quantified in a comparable manner due to the high reactivity of the species under the tested conditions. Overall, the proposed system represents a viable and cost-effective solution for multi-species gas analysis in emerging combustion applications. This work aims to extend the industrial applicability of Raman spectroscopy to NO_x and NO₂ diagnostics. Full article

Background/Objectives: Dietary adherence to the Dietary Approaches to Stop Hypertension (DASH) pattern is associated with lower blood pressure; however, most prior studies have relied on office-based measurements and non-specific dietary assessment tools. This study examined the association between DASH diet quality, assessed by the validated DASH-Q questionnaire, and 24-h ambulatory blood pressure in treatment-naive adults referred for diagnostic ambulatory blood pressure monitoring (ABPM). Materials and Methods: This cross-sectional study enrolled 227 consecutive treatment-naive adults referred for diagnostic 24-h ABPM at a cardiology outpatient clinic. DASH diet quality was assessed using the validated Turkish version of the DASH-Q questionnaire and categorized as low (<36), moderate (36–49), or high (≥50). Hypertension was defined by ABPM-based thresholds. Multivariable linear regression was performed to identify independent predictors of 24-h mean systolic and diastolic blood pressure, and binary logistic regression was used to evaluate independent predictors of ABPM-defined hypertension, with both models adjusted for age, sex, BMI, smoking, physical activity, and self-reported discretionary salt-adding behavior. Results: DASH-Q total score was the sole statistically significant independent predictor of both 24-h mean systolic blood pressure (B = −1.068, 95% CI: −1.270 to −0.866; β = −0.589; p < 0.001) and diastolic blood pressure (B = −0.560, 95% CI: −0.706 to −0.414; β = −0.470; p < 0.001) in the adjusted models. Each one-unit higher DASH-Q score was also associated with 14.6% lower odds of ABPM-defined hypertension (OR = 0.854, 95% CI: 0.820–0.890; p < 0.001). Higher DASH-Q scores were further associated with a more favorable metabolic profile, including lower LDL cholesterol, triglycerides, glucose, and C-reactive protein levels. Conclusions: DASH diet quality was independently and inversely associated with 24-h ambulatory blood pressure and the odds of ABPM-defined hypertension in this treatment-naive population. Given the cross-sectional design and the possibility of reverse causality, these results should be interpreted as hypothesis-generating and require confirmation in prospective studies. Full article