Search Results (4,339)

Background: Liver biopsy performed after less invasive workup, including imaging, for evaluation of abnormal liver function studies occasionally reveals large bile duct obstruction on histology without evidence of biliary obstruction on prior imaging. The utility of ERCP in this setting has not been studied in pediatrics. In the present study, we address this important clinical issue. Methods: A retrospective review of pediatric pathology and clinical records from 2010 to 2019 identified 123 pediatric patients with large duct obstruction on liver biopsy performed after imaging revealed no evidence of biliary obstruction. The absolute standardized difference (ASD) was used to compare baseline covariates between patients who underwent ERCP vs. all others. Covariates included age, gender, race, ethnicity, BMI, and labs (total bilirubin, GGT, alkaline phosphatase, AST, ALT, platelets, and INR). Results: Of 85 unique patients who met inclusion/exclusion criteria, 15 (17.6%) underwent ERCP. The majority of these patients who underwent ERCP (80%) had a therapeutic endoscopic intervention with a favorable impact on clinical trajectory. The mean age of patients with large duct obstruction was 7 years old. Most patients were white (47%), followed by Asian (17%). Only 25% of patients identified as Hispanic. The mean laboratory values were as follows: total bilirubin 4.61 mg/dL, GGT 353 U/L, alkaline phosphatase 403 U/L, AST 343 U/L, ALT 251 U/L, platelets 289 K/uL, and INR 1.19. Absolute standardized differences comparing baseline covariates between the ERCP and non-ERCP groups are included in Table 1. The largest absolute standardized difference between the two groups was for race (1.17), ethnicity (0.553), and GGT (0.463). Age, alkaline phosphatase, and INR were not significantly different between the two groups (ASD <0.2 for both). Conclusions: Only 17.6% of pediatric patients with large ducts undergo ERCP. Pediatric patients who underwent ERCP were more likely to be white, non-Hispanic, and have elevated GGT. Of interest, age did not differ significantly between the two groups, which may reflect enhanced uniformity of utilization of ERCP across age groups in pediatrics. Additional multi-center studies, including more patients and focused on understanding the utility of ERCP and the range of outcomes following the diagnosis of large duct obstruction in pediatrics, would be informative to guide pediatric hepatology and endoscopic practices. Full article

This study investigated the incorporation of Salicornia perennans powder as a natural antioxidant and functional ingredient in cooked sausages, with the aim of improving product quality and promoting sustainable production strategies. The inclusion of 3% Salicornia perennans resulted in a nutritionally favorable shift in the fatty acid profile, with a 1.5-fold increase in α-linolenic acid ALA and the presence of long-chain ω-3 fatty acids EPA and DHA, along with improved PUFA/SFA and ω-6/ω-3 ratios. Lipid and protein oxidation were significantly suppressed during refrigerated storage, as evidenced by the reduced peroxide value of 10.6 vs. 12.8 meq/kg, thiobarbituric acid-reactive substance value of 0.158 vs. 0.210 mg MDA/kg, acid value of 4.6 vs. 5.5 mg KOH/g, and carbonyl compound value of 101.9 vs. 112.3 nmol/mg protein compared to the control. Color stability was enhanced, with ΔE* values remaining below perceptible thresholds in Salicornia perennans-supplemented sausages, highlighting its role in preserving visual quality. Antioxidant capacity was markedly higher, with FRAP values of 14.5 mg GAE/g undetected in the control and improved DPPH radical-scavenging activity of 22.6% vs. 12.5%. These findings demonstrate that Salicornia perennans not only enriches meat products with bioactive compounds and health-promoting lipids but also reduces oxidative spoilage, thereby extending shelf life. The results emphasize the potential of halophyte-based ingredients to support technological innovation, environmental impact reduction, and the development of clean-label functional meat products aligned with sustainable production strategies. Full article

The Chuankou deposit is a super-large W deposit formed during the Indosinian collision event in South China, and its mineralization is suggested to be related to the Indosinian muscovite granite. However, two types of W mineralizations were discovered in the Caledonian granite porphyry in the Chuankou W deposit: disseminated scheelite and quartz-wolframite-scheelite vein mineralizations. The genesis of W mineralization in the Caledonian granite porphyry is not yet clear. This paper focuses on fluid microthermometry and stable isotopes (C, H, O, S) analysis of the quartz and scheelite in the ores in the Caledonian granite porphyry in the Chuankou W deposit. The aims are to determine the nature and evolution of the ore-forming fluids, the origin of the ore-forming materials involved in the two types of W mineralization in the Caledonian granite porphyry, and to provide a detailed discussion of the deposit’s genesis. Microthermometry results of fluid inclusions with scheelite and quartz from two stages show that the average homogenization temperature in the quartz-veins within the Caledonian granite porphyry is 248 °C, and the average salinity is 6.31 wt.% NaCl eq (n = 85), the average homogenization temperature in the quartz-veins within the slate is 219 °C, and the average salinity is 5.57 wt.% NaCl eq (n = 49). The ore-forming fluids experienced an evolution from high temperature and high salinity to low temperature and low salinity. Sulfur isotope compositions show that the δ³⁴S values of pyrite and arsenopyrite in the quartz-veins within the Caledonian granite porphyry are 2.06 to 3.28‰ and −0.38 to 0.21‰, respectively, and the δ³⁴S value of pyrite in the quartz-veins within the slate is −1.72 to 0.47‰. The δ³⁴S values of each stage are close to 0‰, indicating that the origin of sulfur mainly from magma. The H-O isotope compositions of the quartz indicate that the ore-forming fluid was primarily magmatic water. The low δ¹⁸O_H2O values (1.74 to 1.58‰) are influenced by fluid–rock interactions or the incorporation of atmospheric precipitation. The carbon isotopes (δ¹³C = −9.5 to 8.3‰) indicate a magmatic origin, but the C isotopes of quartz in the quartz-veins within the slate shift toward sedimentary rocks, reflecting the incorporation of rock components in the late mineralization period. These isotopic differences indicate that the fluid–rock interaction gradually strengthened during fluid evolution. Full article

Background: Atezolizumab plus bevacizumab is the standard first-line therapy for unresectable hepatocellular carcinoma (uHCC). Immune-related liver injury (IrLI) is common; however, the association between IrLI severity and patient outcomes remains unknown. This study aimed to investigate the prognostic value of irLI in such patients. Methods: One hundred and sixteen patients who fulfilled the IMBrave150 inclusion criteria were enrolled. IrLI was defined as an increase in serum ALT and/or AST levels attributed to treatment and was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0. Results: A total of 61 patients (52.6%) developed any grade of irLI, with a median onset time of 1.7 months. Multivariate analysis revealed that grade II ALBI (hazard ratio [HR] = 2.003, p = 0.028) and BCLC stage C (HR = 3.876, p = 0.016) were associated with worse OS and PFS (HR = 1.327, p = 0.044 and HR = 1.790, p = 0.039, respectively), whereas grade 2 irLI was associated with better OS (HR = 0.223, p = 0.046) and PFS (HR = 0.244, p = 0.011). Patients with grade 2 irLI showed better median OS (not reached) than those without irLI (16.7 months), those with grade 1 (17.5 months), and those with grade ≥ 3 (7.3 months) (overall log-rank p = 0.037). Furthermore, patients with grade 2 irLI demonstrated significantly enhanced PFS (not reached) compared to those without irLI (5.7 months), grade 1 (4.6 months), or grade ≥ 3 (2.3 months), with an overall log-rank p = 0.010. In addition, patients with grade 2 irLI had the highest disease control rate (overall p = 0.053). Conclusion: In patients with uHCC treated with Ate/Bev, moderate elevation of liver enzymes (grade 2 irLI) was associated with significantly improved survival and tumor control. Full article

The shift from techno-centric to human-centric development is essential for smart cities to effectively leverage technological innovations and enhance the quality of life of citizens. Despite this recognition, there are limited studies that address the challenges and frame the conditions and impacts involved. This study employs a mixed-method approach, namely the combination of literature review, expert consultation, and case analysis, to investigate human-centered smart city development based on the example of Saudi Arabia. Drawing from the literature, it develops a conceptual framework that provides guidance for achieving human-centric smart cities. The findings indicate that while Saudi Arabia has achieved notable progress in smart city development, inclusivity, centralized planning, public engagement, capacity building, and data security hinder advancement. This study demonstrates that smart city initiatives must aim to go beyond mere buzzwords and integrate components in line with human values and societal expectations. The study’s findings may help in framing urban humanization policies aligned with of Saudi Arabia’s Vision 2030 and offer guidance for cities with similar contexts. Full article

This paper presents the development and characteristics of geopolymer foams modified with paraffin-based phase change materials (PCMs) encapsulated in diatomite. The aim was to increase both the thermal insulation and heat storage capacity of the foams while maintaining sufficient mechanical strength for construction applications. Eleven variants of composites with different PCM fractions (5–10% by mass) and grain sizes (<1.6 mm to >2.5 mm) were synthesized and tested. The inclusion of PCM encapsulated in diatomite modified the porous structure: the total porosity increased from 6.6% in the reference sample to 19.6% for the 1.6–1.8 mm_10% wt. variant, with pore diameters ranging from ~4 to 280 µm. Thermal conductivity (λ) ranged between 0.090–0.129 W/m·K, with the lowest values observed for composites 2.0–2.5 mm_5–10% wt. (≈0.090–0.091 W/m·K), which also showed high thermal resistance (R ≈ 0.287–0.289 m²·K/W). The specific heat (Cp) increased from 1.28 kJ/kg·K (reference value) to a maximum value of 1.87 kJ/kg·K for the 2.0–2.5 mm_10% mass variant, confirming the effective energy storage capacity of PCM-modified foams. Mechanical tests showed compressive strength values in the range of 0.7–3.1 MPa. The best structural performance was obtained for the 1.6–1.8 mm_10% wt. variant (3.1 MPa), albeit with a higher λ (≈0.129 W/m·K), illustrating the classic trade-off between porosity-based insulation and mechanical strength. SEM microstructural analysis and mercury porosimetry confirmed the presence of mesopores, which determine both thermal and mechanical properties. The results show that medium-sized PCM fractions (1.6–2.0 mm) with moderate content (≈10% by weight) offer the most favorable compromise between insulation and strength, while thicker fractions (2.0–2.5 mm) maximize thermal energy storage capacity. These findings confirm the possibility of incorporating natural PCMs into geopolymer foams to create multifunctional materials for sustainable and energy-efficient building applications. A unique contribution to this work is the use of diatomite as a natural PCM carrier, ensuring stability, compatibility, and environmental friendliness compared to conventional encapsulation methods. Full article

Aligning with the UN Sustainable Development Goals (SDGs 11 and 13), this study examines how dynamic subsidy thresholds steer environmental resilience, social inclusion, and fiscal sustainability in China’s urban renewal. Using evolutionary game theory (EGT) and system dynamics (SD), stakeholder strategies are modeled under varying policy interventions, with key parameters calibrated through Chongqing’s LZ case and MATLAB simulations. These include government subsidies (M₁, M₂), penalties (S₂), and stakeholder benefits (R₁–R₅). The results reveal the following two distinct types of critical thresholds: a universal and robust fiscal warning line for developers (M₁ > 600 k RMB) and a threshold for residential subsidies that is moderated by psycho-social factors (M₂), with its value fluctuating within a certain range (approximately 550 k RMB to 850 k RMB). A sequential synergy pathway is proposed: “government-led facilitation → developer-driven implementation (when R₃ > 450 k RMB) → resident participation (triggered by R₂ > 150 k RMB).” The study advocates differentiated incentives and penalties, prioritizing early-stage governmental leadership to foster trust, promote inclusive participation, and align with environmental, social, and economic sustainability goals. This integrated framework reveals critical policy leverage points for enhancing social and fiscal resilience, providing a replicable model for sustainable and resilient urban governance in the Global South. Full article

This research evaluates the stabilization of a clay collected from the northern expansion zone of Cartagena de Indias, Colombia. Laboratory analyses, including particle size distribution, Atterberg limits, compaction, specific gravity, and XRF/XRD, classified the soil as a highly plastic clay (CH) with moderate dispersivity, as confirmed by pinhole and crumb tests. The soil was treated with 3–9% lime, with and without the addition of NaCl (0% and 2%), and tested for unconfined compressive strength (q_u), small-strain stiffness (G_o), and microstructural properties under curing periods of 14 and 28 days at two compaction densities. Results showed that lime significantly improved mechanical behavior, while the inclusion of NaCl further enhanced q_u (up to 185%) and G_o (up to 3-fold), particularly at higher lime contents and curing times. Regression models demonstrated that both q_u and G_o follow power-type relationships with the porosity-to-lime index, with consistent exponents (−4.75 and −5.23, respectively) and high coefficients of determination (R² > 0.79). Normalization of the data yielded master curves with R² values above 0.90, confirming the robustness of the porosity-to-lime framework as a predictive tool. The G_o/q_u ratio obtained (3737.4) falls within the range reported for cemented geomaterials, reinforcing its relevance for comparative analysis. SEM observations revealed the transition from a porous, weakly aggregated structure to a dense matrix filled with C–S–H and C–A–H gels, corroborating the macro–micro correlation. Overall, the combined use of lime and NaCl effectively converts dispersive clays into non-dispersive, mechanically improved geomaterials, providing a practical and sustainable approach for stabilizing problematic coastal soils in tropical environments. Full article

Okara, a protein-rich byproduct of soymilk production, is highly perishable because of its high moisture content. This study evaluated the preservation and nutritional value of okara fermented by lactic acid bacteria for use in dairy cattle diets. Fermentation effectively reduced pH within 2 weeks and maintained quality for up to 6 weeks. However, aerobic exposure increased the concentration of ammonia, indicating a decline in stability. In vitro assessments revealed no significant differences in in vitro true dry matter digestibility, in vitro neutral detergent fiber digestibility, or gas production between fermented and fresh okara, although fermented okara had a higher concentration of ammonia nitrogen. In situ analysis revealed slightly lower dry matter effective degradability (ED) in fermented okara, but similar rumen-degradable and undegradable protein fractions. When fermented okara was used to replace soybean meal in total mixed rations, 25–50% inclusion-maintained digestibility and fermentation characteristics, with 25% replacement yielding the highest ED at a low ruminal passage rate (0.02 h⁻¹). Taken together, these results suggest that fermented okara can be strategically incorporated into dairy rations as a sustainable protein alternative, supporting both rumen function and bypass protein supply. Full article

Pastoralist socio-ecological systems across Africa, Asia, and Latin America are transforming under climate stress, with adaptation patterns shaped by gendered power. I systematically reviewed 35 empirical studies (2013–2025) using PRISMA 2020 and the SWiM protocol. Searches in Web of Science and Scopus applied pre-registered inclusion criteria (empirical, pastoralist/agro-pastoralist focus, gender analysis); screening used a single reviewer with a 25% independent audit. The objective of the research was to examine power as an organising principle across four interconnected domains: labour redistribution, resource control, decision-making authority, and knowledge recognition. Most studies (≈70–80%), report increased women’s workloads alongside male control of land, water, and high-value stock, decision-making that is mitigated by committee presence without agenda/budget authority, and women’s knowledge being recorded as informal rather than actionable. Exceptions arise where inheritance or titling and decision procedures change. The paper’s innovation is a relational agency framework that links roles, rights, and records to specify tractable, auditable levers that convert participation into consequential authority. The goal is to guide context-sensitive reforms that redistribute power and improve adaptation in pastoralist systems. Full article

Reliable information on the chemical and physical makeup of mine tailings is critical in meeting environmental and regulatory requirements, as well as identifying whether contained elements, including critical minerals, might be economically recovered in future to meet growing demands. Detailed mineralogical characterization, supported by chemical assays and automated mineralogy (MLA) data on different size fractions, underpins a case study of flotation tailings from the processing plant at the Carrapateena mine, South Australia. The study provides valuable insights into the deportment of minor and critical elements, including rare earth elements (REEs), along with uranium (U). REE-minerals are represented by major phosphates (monazite and florencite) and subordinate REE-fluorocarbonates (bastnäsite and synchysite). More than half the REE-minerals are concentrated in the finest size fraction (−10 μm). REEs in coarser fractions are largely locked in gangue, such that economic recovery is unlikely to be viable. MLA data shows that the main REE-minerals all display specific associations with gangue, which change with particle size. Quartz and hematite are the most common associations, followed by sericite. Synchysite shows a strong affiliation to carbonates. The contents of other critical elements (e.g., tungsten, molybdenum, cobalt) are low and for the most part occur within other common minerals as submicron-sized inclusions or in the lattice, rather than discrete minerals. Nevertheless, analysis of mine tailings from a large mining–processing operation provides an opportunity to observe intergrowth and replacement relationships in a composite sample representing different ore types from across the deposit. U-bearing species are brannerite (associated with rutile and chlorite), coffinite (in quartz), and uraninite (in hematite). Understanding the ore mineralogy of the Carrapateena deposit and how the ore has evolved in response to overprinting events is advanced by observation of ore textures, including between hematite and rutile, rutile and brannerite, zircon and xenotime, and the U-carbonate minerals rutherfordine and wyartite, the latter two replacing pre-existing U-minerals (uraninite, coffinite, and brannerite). The results of this study are fundamental inputs into future studies evaluating the technical and economic viability of potentially recovering value metals at Carrapateena. They can also guide efforts in understanding the distributions of valuable metals in analogous tailings from elsewhere. Lastly, the study demonstrates the utility of geometallurgical data on process materials to assist in geological interpretation. Full article

Background/Objectives: Cervical spine disease requiring surgical intervention is a major cause of disability. Anterior cervical discectomy and fusion (ACDF) is a well-established procedure for treating cervical pathology; however, there remains no consensus on whether 1-level versus 2-level ACDF yields comparable outcomes. This study compares 1-level versus 2-level ACDF by evaluating surgery-related and postoperative outcomes, radiographic parameters, and patient-reported outcome measures (PROMs). Methods: PubMed, Embase, Scopus, and Cochrane Library were searched through 10 July 2024. Studies comparing 1-level with 2-level ACDF were included. Data on operating room (OR) time, estimated blood loss (EBL), length of hospital stay (LOS), complications, and PROMs, including Neck Disability Index (NDI) and Visual Analogue Scale (VAS) for neck and arm pain, were extracted. Results: Thirteen studies met our inclusion criteria, comprising 2091 patients (1078 undergoing 1-level and 1013 2-level ACDF). No statistically significant differences were observed in EBL or LOS between the cohorts. However, the 2-level ACDF group showed significantly longer OR times (p-value < 0.001) and higher odds of developing dysphagia (p-value = 0.05). Patients undergoing 2-level ACDF showed greater correction in cervical lordosis. Both cohorts reported similar statistically and clinically significant improvements in VAS neck and NDI scores at final follow-up. There was no difference in adjacent segment disease or revision surgery at final follow-up. Conclusions: Both 1-level and 2-level ACDF improve clinical and radiographic outcomes. The choice should be tailored to the patient’s pathology and anatomy while considering the higher dysphagia risk with additional fusion levels. This study highlights the importance of individualized surgical planning to optimize postoperative outcomes while minimizing complications. Full article

We present a unified framework for fuzzy statistical convergence of Grünwald–Letnikov (GL) fractional differences in Bag–Samanta fuzzy normed linear spaces, addressing memory effects and nonlocality inherent to fractional-order models. Theoretically, we establish the uniqueness, linearity, and invariance of fuzzy statistical limits and prove a Cauchy characterization: fuzzy statistical convergence implies fuzzy statistical Cauchyness, while the converse holds in fuzzy-complete spaces (and in the completion, otherwise). We further develop an inclusion theory linking fuzzy strong Cesàro summability—including weighted means—to fuzzy statistical convergence. Via the discrete Q-operator, all statements transfer verbatim between nabla-left and delta-right GL forms, clarifying the binomial GL↔discrete Riemann–Liouville correspondence. Beyond structure, we propose density-based residual diagnostics for GL discretizations of fractional initial-value problems: when GL residuals are fuzzy statistically negligible, trajectories exhibit Ulam–Hyers-type robustness in the fuzzy topology. We also formulate a fuzzy Korovkin-type approximation principle under GL smoothing: Cesàro control on the test set $\{1,x,x^2\}$ propagates to arbitrary targets, yielding fuzzy statistical convergence for positive-operator sequences. Worked examples and an engineering-style case study (thermal balance with memory and bursty disturbances) illustrate how the diagnostics certify robustness of GL numerical schemes under sparse spikes and imprecise data. Full article

Neopterin is a well-characterized marker of cell-mediated immunity. Here, we used neopterin as a biomarker to identify the cellular immunity status of breeding giant pandas throughout gestation. Urine samples were collected from captive adult female giant pandas that had entered estrus and were either naturally bred and/or artificially inseminated (AI) during the breeding seasons at the Chengdu Research Base of Giant Panda Breeding. This study was divided into two parts. In the first part, we examined the urinary neopterin and progesterone (Pg) profiles during pregnancy in parturient and nonparturient individuals. From the day of mating to the Pg peak, there was no correlation between neopterin and Pg in both parturient individuals (n = 3) and nonparturient individuals (n = 3). During the period when the Pg dropped from its peak to approximately 100 ng/mg Cr, the changes in neopterin and Pg showed a negative correlation in parturient individuals, while there was no correlation between the changes in neopterin and Pg in nonparturient individuals. Subsequently, urine samples were categorized into four phases based on the reproductive status of giant pandas: (1) Estrus phase (Es); (2) Primary Pg increase phase (S1), during which Pg levels rise from the day of mating to 100 ng/mg Cr; (3) Secondary Pg increase phase (S2), during which Pg levels rise from 100 ng/mg Cr (inclusive) to their peak value; and (4) Post-peak Pg decline phase (S3), during which Pg levels decrease from their peak (inclusive) until they drop to approximately 200 ng/mg Cr. Analysis revealed that differences between parturient and nonparturient females emerged in the S3 phase. Compared to nonparturient individuals, neopterin concentrations showed sustained elevation in parturient pandas during the S3 phase. The second part of the study, building on the findings of the first part, specifically focused on analyzing the urine samples of giant pandas during the S2 and S3 phases. Statistical analysis of an expanded sample of individuals (including those from the first part) revealed a significant difference in the neopterin mean S3/S2 ratio between the parturient group (mean S3/S2 = 1.71 ± 0.12; n = 14) and the nonparturient group (mean S3/S2 = 0.85 ± 0.04; n = 17). Correspondingly, parturient individuals gave birth 5 to 16 days after the end of the S3 phase (this time corresponds to the point when Pg levels decrease to approximately 200 ng/mg Cr). The results revealed the validity and applicability of using the neopterin mean S3/S2 ratio (1.71 ± 0.12) for diagnosing successful pregnancy in mated female giant pandas. Full article

This article explores a participatory and Geomedia-based approach to urban planning through the concept of place design. Place design as an approach emphasises the integration of collective knowledge, sociocultural values, and digital representation into planning processes. The integration of Geomedia studies further enriches this approach by examining how media technologies influence spatial experiences, representations, and power relations. By introducing place design as a transformative and participatory approach, physical, digital, and social dimensions of place bridge heritage and future aspirations. Through case studies from Kristinehamn, Sunne, and Sysslebäck in Sweden, the article examines methods for in-depth interviewing, capturing diverse representations. The article advocates for a participatory planning approach, establishing the groundwork for more democratic, inclusive, and context-aware development. It concludes by urging urban planners to adopt working methods that respond to the complexity of place, people and technology, promote new ways of thinking and working with design, and make a clear shift from planning for places to designing with people and places. Full article