Search Results (4,291)

Nowadays, two major pathways seem to be responsible for the development and progression of atherosclerosis, namely, high levels of low-density lipoprotein-cholesterol (LDL-C) and low-grade vascular inflammation. Indeed, the concentration of C-reactive protein (CRP), mirroring low-grade systemic inflammation, has been recognized as a more powerful determinant of recurrent cardiovascular (CV) events, death, and all-cause mortality than LDL-C levels. Gut microbiota (GM) dysbiosis is a causal factor for the development of different inflammatory-based pathologies, such as CV disease (CVD). In addition, pre/probiotics showed beneficial effects on GM dysbiosis, by influencing both inflammation and immunity. It has been well documented that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) exert triglyceride (TG)-lowering and antithrombotic effects and play a seminal role in the resolution of inflammatory processes. We showed the recent studies indicating the relationship between pharmacological reduction in inflammatory cytokines and CV outcomes. The principal aim of our review is to highlight the anti-inflammatory and immune-modulatory activities of GM, EPA, and DHA. Then, we pointed out how developing patient-specific pre/probiotic and EPA/DHA interventions alongside the standard of care (SOC) is needed in order to answer several of the questions raised, ranging from diminishing drug toxicity to including frailty individuals. Therefore, hypothetical tailored clinical studies are presented, aiming to treat all the patients at high-risk of CV events, as well as aged people. Full article

Background/Objectives: This study examines the effect of the 2024 update to the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, on lower limb impairment determinations in comparison to the 2008 edition. It also explores the broader influence of these changes on regulatory, economic, and adjudicative considerations relevant to physician application and interpretation. Methods: Two experienced evaluators independently reviewed 23 standardized lower limb case scenarios, applying both the 2008 and 2024 methodologies. Each assessment was based solely on clinical history, physical examination findings, and diagnostic test results. Impairment values were then calculated and analyzed for consistency across editions. Results: The 2024 lower limb impairment framework produced outcomes that closely mirrored those of the 2008 edition, with intraclass correlation coefficients of 0.9962 for the lower limb and 0.9951 for whole-person impairment, underscoring the strong consistency between editions. Conclusions: The revised 2024 edition for lower limb assessment enhances procedural clarity and integrates improved diagnosis-based impairment tools without disrupting prior impairment values. These refinements are intended to improve utility for clinical and nonclinical stakeholders, ensuring reliable evaluations while minimizing systemic disruption. Full article

The increasing threat of terrorism involving Radiological Dispersal Devices (RDDs) necessitates comprehensive evaluation and preparedness strategies, especially in densely populated public areas. This study aims to assess the potential consequences of RDD detonation, focusing on the effective doses received by individuals and the ground deposition of radioactive materials in a hypothetical urban environment. Utilizing the HotSpot code, simulations were performed to model the dispersion patterns of ¹³⁷Cs and ²⁴¹Am under varying meteorological conditions, mirroring the complexities of real-world scenarios as outlined in recent literature. The results demonstrate that ¹³⁷Cs dispersal produces a wider contamination footprint, with effective doses exceeding the public exposure limit of 1 mSv at distances up to 1 km, necessitating broad protective actions. In contrast, ²⁴¹Am generates higher localized contamination, with deposition levels surpassing cleanup thresholds near the release point, creating long-term remediation challenges. Dose estimates for first responders highlight the importance of adhering to operational dose limits, with scenarios approaching 100 mSv under urgent rescue conditions. Overall, the findings underscore the need for rapid dose assessment, early shelter-in-place orders, and targeted decontamination to reduce population exposure. These insights provide actionable guidance for emergency planners and first responders, enhancing preparedness protocols for RDD incidents in major urban centers. Full article

Artificial intelligence-based image processing is critical for sensor fusion and image transformation in mobility systems. Advanced driver assistance functions such as forward monitoring and digital side mirrors are essential for driving safety. Degradation due to raindrops, fog, and high-dynamic range (HDR) imbalance caused by lighting changes impairs visibility and reduces object recognition and distance estimation accuracy. This paper proposes a diffusion framework to enhance visibility under multi-degradation conditions. The denoising diffusion probabilistic model (DDPM) offers more stable training and high-resolution restoration than the generative adversarial networks. The DDPM relies on large-scale paired datasets, which are difficult to obtain in raindrop scenarios. This framework applies the Palette diffusion model, comprising data augmentation and raindrop-removal modules. The data augmentation module generates raindrop image masks and learns inpainting-based raindrop synthesis. Synthetic masks simulate raindrop patterns and HDR imbalance scenarios. The raindrop-removal module reconfigures the Palette architecture for image-to-image translation, incorporating the augmented synthetic dataset for raindrop removal learning. Loss functions and normalization strategies improve restoration stability and removal performance. During inference, the framework operates with a single conditional input, and an efficient sampling strategy is introduced to significantly accelerate the process. In post-processing, tone adjustment and chroma compensation enhance visual consistency. The proposed method preserves fine structural details and outperforms existing approaches in visual quality, improving the robustness of vision systems under adverse conditions. Full article

This study investigates the structural behavior of composite double-web steel beams filled with different types of concrete made from a combination of recycled concrete aggregates and normal aggregates. The research includes both experimental and numerical analyses. Seven specimens were tested under symmetrical two-point loading, all having identical geometric properties: a span length of 1100 mm, flange plates 120 mm wide and 6 mm thick, and web plates 3 mm thick and 188 mm deep. The specimens were divided into two groups, with a control beam without concrete infill. Group one included beams filled with normal concrete in different locations (middle region, two sides, and fully filled), while group two mirrored the same fill locations but used recycled concrete instead. The experimental results showed that using normal concrete improved the ultimate load by 10.19% to 55.30%, with the fully filled beam achieving a maximum increase in ductility of about 568% and a stiffness improvement ranging from 2.6% to 39% compared to the control beam. Beams filled with recycled concrete showed increases in ultimate load from 9.52% to 42.03%, ductility improvements of up to 380%, and stiffness enhancements between 4.5% and 8.03%. Numerical modeling using ABAQUS (2021) showed excellent agreement with the experimental results, with differences in ultimate load and maximum deflection averaging 5.5% and 7.9%, respectively. Full article

Introduction: YouTube™ is a widely accessible platform with unfiltered medical information. This study aimed to evaluate the educational value and reliability of YouTube™ videos on Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced epithelial ovarian cancer treatment. Methods: YouTube™ videos were searched using the keywords “ovarian cancer”, “debulking surgery”, “hyperthermic”, and “HIPEC”. Patient Education Materials Assessment Tool for Audiovisual Content (PEMAT A/V) score, DISCERN, Misinformation Scale, and the Global Quality Scale (GQS) were employed to assess the clarity, quality, and reliability of the information presented. Results: Of the 150 YouTube™ videos screened, 71 were suitable for analysis and categorized by target audience (general public vs. healthcare workers). Most (57, 80.2%) were uploaded after the “Ov-HIPEC” trial (18 January 2018), with a trend toward more videos for healthcare workers (p = 0.07). Videos for the general public were shorter (p < 0.001) but received more views (p = 0.06) and likes (p = 0.09), though they were of lower quality. The DISCERN score averaged 50 (IQR: 35–60), with public-targeted videos being less informative (p < 0.001), a trend mirrored by the Misinformation Scale (p < 0.001) and GQS (p < 0.001). The PEMAT A/V scores showed 80% Understandability (IQR: 62–90) and 33% Actionability (IQR: 25–100), with no significant difference between groups (p = 0.15, p = 0.4). Conclusions: While YouTube™ provides useful information for healthcare professionals, it cannot be considered a reliable source for patients seeking information on HIPEC for ovarian cancer. Many videos contribute to misinformation by not properly explaining treatment indications, timing, adverse effects, multimodal approaches, or clinical trial findings. Full article

High-precision angular positioning mechanisms are essential across diverse scientific and industrial applications, from optical instrumentation to automated mechanical systems. Conventional bronze–steel gear reduction units, while reliable, are often heavy, costly, and unsuitable for chemically aggressive or vacuum environments, limiting their use in advanced research setups. This work introduces a novel 1:360 gear reduction system manufactured by resin-based additive manufacturing, designed to overcome these limitations. The compact worm–gear assembly translates a single crank rotation into a precise one-degree indicator displacement, enabling fine and repeatable angular control. A primary application is the alignment of parabolic mirrors in schlieren systems, where accurate tilt adjustment is critical to correct optical alignment; however, the design is broadly adaptable to other precision positioning tasks in laboratory and industrial contexts. Compared with conventional assemblies, the resin-based reducer offers reduced weight, chemical and vacuum compatibility, and lower production cost. Its three-stage reduction design further enhances load-bearing capacity, achieving approximately double the theoretical torque transfer of equivalent commercial systems. These features establish the device as a robust, scalable, and automation-ready solution for high-accuracy angular adjustment, contributing both to specialized optical research and general-purpose precision engineering. Full article

Background/Objectives: Ocular wavefront aberrations are clinically relevant for optimizing vision correction and predicting surgical outcomes. This study aimed to establish normative reference ranges for a Korean population by quantifying wavefront aberrations using a Hartmann–Shack wavefront sensor and Zernike coefficients, and to assess correlations with age, sex, and spherical equivalent (SE). Methods: Wavefront aberrations were measured in 98 Koreans (196 eyes) using a Hartmann–Shack aberrometer without cycloplegia. Five repeated measurements per eye at a 6 mm pupil size were averaged. Parameters included Zernike coefficients (Z3–Z20), higher-order aberration (HOA) root mean square (RMS, Z6–Z20), and total RMS (Z3–Z20). Associations with age, sex, and SE were assessed using univariable and multivariable linear mixed-effects models. Second-order polynomial regression assessed nonlinear relationships. Interocular symmetry was evaluated using mirror-symmetry-adjusted Spearman’s correlation and intraclass correlation coefficients (ICCs). Results: Vertical coma (Z7, 0.208 ± 0.174 μm) and spherical aberration (Z12, 0.200 ± 0.161 μm) were the largest contributors to HOA RMS. Mean HOA RMS and total RMS were 0.51 ± 0.21 μm and 3.03 ± 2.51 μm, respectively. HOA RMS increased with age (β = 0.003 μm/year, p = 0.010), whereas total RMS decreased with SE (β = −0.678 μm/D, p < 0.001). Most Zernike coefficients showed positive interocular correlations, with ICCs of 0.75 for total RMS and 0.64 for HOA RMS. Conclusions: In normal Korean eyes, HOAs increased with age and exhibited significant interocular symmetry. Vertical coma and spherical aberration were predominant components. While the pattern was similar to that in Western populations, the absolute values were greater. These normative values may aid future wavefront-guided refractive surgery and presbyopia correction procedures. Full article

Respiratory syncytial virus (RSV) remains a leading cause of pneumonia in young children in Mexico and worldwide. To investigate RSV dynamics in Mexico, we conducted a multicenter study from August 2021 to July 2023 in six hospitals across five States, analyzing respiratory samples from children under five years with pneumonia. Multiplex RT-PCR identified 203 RSV-positive cases, of which 123 were RSV-B and 80 RSV-A. Interestingly, 77% of the collected samples showed evidence of coinfection with other respiratory pathogens, with rhinovirus, Haemophilus influenzae, and Streptococcus pneumoniae being the most common. Also, RSV-B dominated in 2021–2022, whereas RSV-A prevailed in 2022–2023, mirroring trends observed in the United States. Sequences of the genes encoding G and F proteins showed that RSV-A lineages were more diverse, with A.D.1, A.D.1.8, and A.D.5.2 being frequently detected. In contrast, nearly all RSV-B sequences belonged to lineage B.D.E.1. Finally, ancestral state inference suggests repeated introductions from the USA and other North American countries, with limited evidence of sustained local circulation. These findings show different trends in RSV circulation between two consecutive seasons and the importance of genomic surveillance to monitor RSV diversity, evaluate vaccine impact, and inform public health strategies in Mexico’s evolving post-pandemic respiratory virus landscape. Full article

Background/Objectives: Stroke often results in lasting upper limb deficits. Mirror visual feedback (MVF) supports motor recovery, and electromyography-triggered electrical stimulation (ES) could enhance engagement. However, the effects in healthy older adults, age-matched to typical patient cohorts, remain insufficiently understood. We tested MVF and MVF + ES using functional near-infrared spectroscopy. Methods: Seventeen right-handed older adults performed left-wrist flexion under three visual conditions: circle fixation, viewing the right hand at rest, and mirror viewing, with/without electrical stimulation to the right-wrist flexors time-locked to left-forearm electromyography. Oxygenated hemoglobin (oxy-Hb) was recorded over the bilateral inferior frontal gyrus (IFG), precentral gyrus (PrG), postcentral gyrus (PoG), supramarginal gyrus (SMG), superior parietal lobule (SPL), and supplementary motor area. Effects were assessed with linear mixed-effects models (stimulation × visual condition); pairwise comparisons of estimated marginal means used Fisher’s least significant difference. Left-forearm electromyography verified comparable effort across conditions. Results: Linear mixed-effects models revealed left-lateralized increases in oxy-Hb, most prominently under mirror viewing with stimulation. Post hoc tests showed high oxy-Hb in the left IFG, PrG, PoG, SMG, and SMA. The left EMG did not differ. Conclusions: In healthy older adults, MVF paired with EMG-triggered ES enhances frontoparietal–motor engagement beyond MVF alone, with recruitment shaped by visuo–proprioceptive congruence. These findings support mechanistic plausibility and motivate dose–response optimization and patient-focused trials testing behavioral transfer in stroke. Full article

Voltage supraharmonics present in the electrical grid can trigger chain reactions in grid-connected household and industrial power supplies equipped with Power Factor Correction (PFC). A single source of voltage supraharmonics may significantly increase the current in switching devices with PFC, leading to higher-amplitude disturbances throughout the electrical network. When addressing issues in a real low-voltage (LV) grid, it was observed that activation of a single device emitting supraharmonics caused oscillating currents across all feeders connected to the transformer’s busbars, matching the frequency of the supraharmonic source. To investigate this phenomenon further, the grid voltage containing supraharmonics was replicated in a controlled laboratory environment and used to supply various power electronic devices. The laboratory results closely mirrored those observed in the field. Supraharmonics present in the supply voltage caused current oscillations in the power electronic devices at the same frequency. Moreover, the amplitude of the observed current oscillations increased with the amplitude of the injected supply voltage supraharmonics. In some cases, the root mean square (RMS) value of the current drawn by the power electronic devices doubled, indicating a substantial impact on device behaviour and potential implications for grid stability and energy efficiency. Full article

In recent years, convolutional neural network-based object detectors have achieved extensive applications in remote sensing (RS) image interpretation. While multi-scale feature modeling optimization remains a persistent research focus, existing methods frequently overlook the symmetrical balance between feature granularity and morphological diversity, particularly when handling high-aspect-ratio RS targets with anisotropic geometries. This oversight leads to suboptimal feature representations characterized by spatial sparsity and directional bias. To address this challenge, we propose the Parallel Interleaved Convolutional Kernel Network (PICK-Net), a rotation-aware detection framework that embodies symmetry principles through dual-path feature modulation and geometrically balanced operator design. The core innovation lies in the synergistic integration of cascaded dynamic sparse sampling and symmetrically decoupled feature modulation, enabling adaptive morphological modeling of RS targets. Specifically, the Parallel Interleaved Convolution (PIC) module establishes symmetric computation patterns through mirrored kernel arrangements, effectively reducing computational redundancy while preserving directional completeness through rotational symmetry-enhanced receptive field optimization. Complementing this, the Global Complementary Attention Mechanism (GCAM) introduces bidirectional symmetry in feature recalibration, decoupling channel-wise and spatial-wise adaptations through orthogonal attention pathways that maintain equilibrium in gradient propagation. Extensive experiments on RSOD and NWPU-VHR-10 datasets demonstrate our superior performance, achieving 92.2% and 84.90% mAP, respectively, outperforming state-of-the-art methods including EfficientNet and YOLOv8. With only 12.5 M parameters, the framework achieves symmetrical optimization of accuracy-efficiency trade-offs. Ablation studies confirm that the symmetric interaction between PIC and GCAM enhances detection performance by 2.75%, particularly excelling in scenarios requiring geometric symmetry preservation, such as dense target clusters and extreme scale variations. Cross-domain validation on agricultural pest datasets further verifies its rotational symmetry generalization capability, demonstrating 84.90% accuracy in fine-grained orientation-sensitive detection tasks. Full article

This work presents a methodology for designing deployable reflector antennas that combine origami structures and the Fresnel zone plate lens to obtain a compact antenna structure. In particular, Miura and Yoshimura’s origami patterns have been considered for the design of the Fresnel reflector mirror and the conical horn antenna feeder, respectively. A set of memory-form alloy (MFA) actuators have been used to deploy the antenna. The MFA actuators are activated by a direct current aimed at increasing the temperature and activating the memorized shape. The combination of these techniques provides light, inexpensive, and very compact antennas, particularly suitable for satellite applications. A numerical and experimental assessment campaign has been carried out on antenna prototypes operating in the $K_u$ band at 15 GHz. The obtained experimental results are quite promising. Full article

Background/Objectives: Surgical ward rounds are central to trainee education but are often associated with stress, cognitive overload, and inconsistent learning. Advances in artificial intelligence (AI), particularly large language models (LLMs), offer new ways to support trainees by simulating ward-round questioning, enhancing preparedness, and reducing anxiety. This study explores the role of generative AI in surgical ward-round education. Methods: Hypothetical plastic and reconstructive surgery ward-round scenarios were developed, including flexor tenosynovitis, DIEP flap monitoring, acute burns, and abscess management. Using de-identified vignettes, AI platforms (ChatGPT-4.5 and Gemini 2.0) generated consultant-level questions and structured responses. Outputs were assessed qualitatively for relevance, educational value, and alignment with surgical competencies. Results: ChatGPT-4.5 showed a strong ability to anticipate consultant-style questions and deliver concise, accurate answers across multiple surgical domains. ChatGPT-4.5 consistently outperformed Gemini 2.0 across all domains, with higher expert Likert ratings for accuracy, clarity, and educational value. It was particularly effective in pre-ward round preparation, enabling simulated questioning that mirrored consultant expectations. AI also aided post-round consolidation by providing tailored summaries and revision materials. Limitations included occasional inaccuracies, risk of over-reliance, and privacy considerations. Conclusions: Generative AI, particularly ChatGPT-4.5, shows promise as a supplementary tool in surgical ward-round education. While both models demonstrated utility, ChatGPT-4.5 was superior in replicating consultant-level questioning and providing structured responses. Pilot programs with ethical oversight are needed to evaluate their impact on trainee confidence, performance, and outcomes. Although plastic surgery cases were used for proof of concept, the findings are relevant to surgical education across subspecialties. Full article

Semi-rigid tool polishing is widely used in the high-precision manufacturing of electroless nickel surface due to its stable material removal and high efficiency in correcting mid- and high-frequency profile errors. However, predicting mid-frequency errors remains challenging due to the complexity of their underlying sources. In this study, a theoretical model for semi-rigid tool polishing was developed based on multi-scale contact theory, incorporating a bridging model, rough surface contact, and Hertzian contact mechanics. The model accounts for the effects of tool surface roughness, polishing force, and path spacing. A series of experiments on diamond-turned electroless nickel mirrors was conducted to quantitatively evaluate the model’s feasibility and accuracy. The results demonstrate that the model can effectively predict mid-frequency errors, reveal the material removal mechanisms in semi-rigid polishing, and guide the optimization of process parameters. Ultimately, a surface with mid-frequency errors of 0.59 nm Rms (measured over a 1.26 mm × 0.94 mm window) was achieved, closely matching the predicted value of 0.64 nm. Full article