Search Results (303)

This study investigated the effects of storage temperature on the functional quality of kimchi during short- and long-term fermentation. Pretreated napa cabbage (NC) quality was analyzed, and kimchi was prepared using pretreated NC and stored at either 4 °C or 15 °C until reaching optimal and excessive fermentation stages. Fermented kimchi samples were analyzed for pH, lactic acid bacteria (LAB) counts, total polyphenol content (TPC), DPPH and ABTS radical scavenging activities, and glucosinolates and their breakdown products. Fermentation at 15 °C progressed rapidly, reaching the optimal pH range (4.0–4.5) within 3 days, and resulted in significantly higher LAB counts and TPC compared to samples stored at 4 °C (p < 0.05). In contrast, prolonged storage at 4 °C led to a decrease in both TPC, radical scavenging activities, and LAB counts during the excessive fermentation stage. Glucosinolates were progressively degraded overtime; however, their breakdown product, ascorbigen, increased under short-term fermentation at 15 °C than during prolonged storage at 4 °C. These results suggest that short-term fermentation at 15 °C is more effective than long-term fermentation at 4 °C in enhancing the functional quality of kimchi by promoting LAB growth and preserving bioactive compounds. Full article

Background: Healthcare systems are increasingly strained by limited operating room resources and rising demand, a situation intensified by the COVID-19 pandemic. These pressures have resulted in overcrowded surgical departments, prolonged waiting times for elective procedures, worsened patient health outcomes, and increased hospital expenditure costs. Methods: To address these challenges, this study proposes a multi-objective mathematical optimization model as the analytical core of a decision support approach for OR resource allocation. The model considers multiple constrained resources, including OR time, intensive care units, medium care units, and nursing staff, and aims to minimize both elective patients’ waiting times and total incurred costs over a one-week planning horizon. Developed using real hospital data from a large facility in Thailand, the model was implemented in LINGO version 16.0, and a sensitivity analysis was conducted to assess the impact of surgical department priorities and overtime allowances. Results: Compared to current practices, the optimized OR schedule reduced average waiting times by approximately 7% and total costs by 5%, while balancing resource utilization. Conclusions: This study provides a data-driven tool to support hospital resource planning, improve OR efficiency, and respond effectively to future healthcare crises. Full article

Patient unpunctuality substantially complicates appointment scheduling in integrated telemedicine–traditional outpatient systems. The current research frequently ignores behavioral distinctions between telemedicine patients and outpatients, while neglecting to measure the intangible burden on physicians from service mode switches. To address these gaps, this study incorporates patient heterogeneity and introduces two novel cost metrics. Specifically, we implement penalties for service-mode switching and penalties for consecutive telemedicine sessions. We develop a Stochastic Mixed-Integer Programming (SMIP) model. This stochastic model is transformed into a deterministic Mixed-Integer Linear Programming (MILP) formulation via Sample Average Approximation (SAA). Linearization techniques enhance computational efficiency. In numerical experiments, the dual-penalty model yields balanced schedules with moderate patient mix, reducing physician overtime by 62.5% and service mode switches by 55% compared to baseline approaches. Sensitivity analysis confirms that narrowing outpatient unpunctuality ranges significantly reduces patient waiting and overtime, while raising telemedicine patient proportions bolsters system stability at the cost of increased physician idle time. These insights offer actionable guidance for healthcare institutions managing integrated online–offline services. Full article

This study examines the relationships between job satisfaction, overtime hours, perceived stressors, and burnout symptoms among academic mid-level staff at German universities, with a particular focus on gender differences. Drawing on survey data from 1442 academics collected in April/May 2023, this study applies t-tests and regression analyses to examine the effects of structural and personal factors on job satisfaction. The findings suggest that job satisfaction is primarily shaped by psychosocial and institutional conditions. Negative predictors are perceived job insecurity, burnout symptoms, and excessive overtime, whereas a strong dedication to work buffers against these. Variables such as gender, age, parenthood, and participation in structured PhD programs did not show substantial effects. Notably, respondents who postponed having children for professional reasons reported lower job satisfaction, pointing to potential conflicts between career and personal life expectations. Full article

During red wine production, managing the pomace cap is key for a successful fermentation, allowing the extraction of phenolics and other metabolites and providing the necessary oxygen for yeast activity. In recent years, automatic cap management systems based on the injection of gases have gained popularity, despite the limited scientific information regarding the outcomes of their use. This trial aimed to evaluate the composition of wine during industrial red wine fermentations using an automatic sequential air injection system (i.e., AirMixing MI^TM). Fourteen lots of Cabernet Sauvignon grapes were fermented using four air injection regimes, where the intensity and daily frequency of air injections were set to either low or high. As expected, the treatment combining high-intensity and high-frequency air injection produced the largest dissolved oxygen peaks reaching up to 1.9 mg L⁻¹ per cycle, compared to 0.1 mg L⁻¹ in the low-intensity and low-frequency treatment. Yet, in all cases, little to no accumulation of oxygen overtime was observed. Regarding phenolics, the highest intensity and frequency of air injections led to the fastest increase in total phenolics, anthocyanins, short polymeric pigments, and tannin concentration, although compositional differences among treatments equilibrate by the end of fermentation. The main differences in phenolic compounds observed during fermentation were mediated by temperature variation among wine tanks. Based on these findings, it is advisable to keep the characterizing kinetics of phenolic extraction and expand the study to the aroma evolution of wines fermented with this technology. Full article

Background: Overtime adversely affects physical and mental health, contributing to irritability, anxiety, reduced sleep, and even cardiovascular issues, ultimately lowering care quality and increasing turnover intentions. This study aimed to investigate whether prolonged overtime increases the risk of occupational burnout over time among healthcare workers. Methods: We conducted a four-year longitudinal observational study using secondary data from annual surveys (2021–2024) of healthcare workers at a medical university hospital in Taichung, Taiwan. Burnout was assessed using the personal burnout (PB) scale from the Copenhagen Burnout Inventory (CBI), with high PB levels (HPBL) defined as scores in the upper quartile of the 2021 baseline. Survival analysis utilizing the Kaplan–Meier method and Cox regression investigated burnout progression and the effects of overtime. Results: HPBL was defined as PB scores ≥45.83 (upper quartile in 2021). The proportions of HPBL were 30.28% (2021), 33.29% (2022), 36.75% (2023), and 32.51% (2024). Survival analysis confirmed that the risk of burnout increased over time, with the survival time estimated at 2.50 ± 0.03 years and lower survival probabilities observed among participants working overtime (Log-rank test, p < 0.0001). Multivariate logistics revealed overtime work, female gender, being a physician/nurse, and reduced sleep as independent risk factors for HPBL (OR = 3.14 for overtime, p < 0.001). These findings support the hypotheses on burnout progression and the impact of overtime. Conclusions: Overtime significantly heightens the risk of burnout, which worsens over time. Female sex, healthcare roles, obesity, and insufficient sleep are additional risk factors. Limiting overtime and proactive interventions are crucial to preventing burnout in healthcare workers. Full article

Background/Objectives: Operating rooms represent valuable and pivotal units of any hospital. Therefore, their management affects healthcare service delivery through rescheduling, staff shortage/overtime, cost inefficiency, and patient dissatisfaction, among others. To optimize scheduling, we aim to assess preoperative evaluation criteria that influence the prediction of surgery duration for gastric cancer (GC) patients. In GC, radical surgery with curative intent is the ideal treatment. Nevertheless, the intervention sometimes must be palliative if the patient’s status and tumor staging prove too advanced. Methods: A 6-year retrospective cohort study was performed in a tertiary care hospital, including all cases diagnosed with GC (ICD-10 code C16), confirmed through histopathology, and undergoing surgical treatment (N = 108). Results: The results of our study confirm male predominance (63.89%) among GC surgery candidates while bringing new perspectives on patient evaluation criteria and choice of surgical intervention (curative—Group 1, palliative—Group 2). Surgery duration, including anesthesiology (175.19 [95% CI (157.60–192.77)] min), shows a direct correlation with the number of lymph nodes dissected (Surgical duration [min] = 10.67 × No. of lymph nodes removed − 32.25). Interestingly, the aggressiveness of the tumor based on histological grade (highly differentiated being generally less aggressive than poorly differentiated) shows differential correlation with surgery duration among curative and palliative surgery candidates. Similarly, TNM staging indicates the need for a longer surgical duration (pTNM stage IIA, IIB, and IIIA) for curative interventions in patients with less advanced stages, as opposed to shorter surgery duration for palliative interventions (pTNM stage IIIC and IV). Conclusions: The study quantitatively presents the resources needed for the optimal surgical treatment of different groups of GC patients, as the disease coding systems in use regard the treatment of each pathology as “standard” in terms of patient management. The results obtained are anchored in the global perspectives of surgical outcomes and aim to improve the management of operating room scheduling, staff, and resources. Full article

This study addresses the multi-period, multi-item, single-stage capacitated lot sizing problem (CLSP) in a parallel machine environment with machine eligibility constraints under a make-to-order production policy. A mixed-integer linear programming (MILP) model is developed to minimize total operational costs, including production, overtime, extra shifts, inventory holding, and backorders. The make-to-order setting introduces additional complexity by requiring individualized customer orders, each with specific due dates and product combinations, to be scheduled under constrained capacity and setup requirements. The model’s performance is evaluated in the context of a real-world production planning problem faced by a manufacturer of cold-formed steel profiles. In this setting, parallel forming machines process galvanized sheets of cold-rolled steel into a variety of profiles. The MILP model is solved using open-source optimization tools, specifically the HiGHS solver. The results show that optimal solutions can be obtained within reasonable computational times. For more computationally demanding instances, a runtime limit of 300 s is shown to improve solution quality while maintaining efficiency. These findings confirm the viability and cost-effectiveness of free software for solving complex industrial scheduling problems. Moreover, experimental comparisons reveal that solution times and performance can be further improved by using commercial solvers such as CPLEX, highlighting the potential trade-off between cost and computational performance. Full article

Spinocerebellar ataxia type 7 (SCA7), a rare form of ataxia, possesses a wide phenotypic spectrum ranging from classic ataxic symptoms to blindness, multiorgan failure, cardiomyopathy, and early death among younger age groups. Biomarkers associated with disease progression and severity could aid in disease prognostication. We evaluated the utility of glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) in distinguishing patients with SCA7 from healthy controls and estimating patient prognosis. GFAP and NfL levels were measured in 23 plasma and 20 cerebrospinal fluid (CSF) samples from asymptomatic (N = 3) and symptomatic SCA7 participants (N = 10) and from healthy controls (N = 8). GFAP concentrations were elevated in the plasma (82.7 pg/mL) and CSF (9318 pg/mL) of patients with SCA7 compared to controls (plasma: 48.0 pg/mL; CSF: 89,056 pg/mL). Similarly, NfL plasma (21.6 pg/mL) and CSF (2615.0 pg/mL) levels were also significantly upregulated in SCA7 compared to controls (plasma: 8.2 pg/mL; CSF: 414.6 pg/mL). Higher levels of NfL, but not of GFAP, significantly discriminated symptomatic SCA7 patients from controls (area under de curve, AUC: 0.898, p = 0.0059, in plasma, and AUC: 1.0, p = 0.0012, in CSF). The levels of both biomarkers increased overtime, with plasma NfL levels strongly associated with a worse score in the scale for the assessment and rating of ataxia (SARA) (Spearman r: 0.8354, p = 0.0007; regression analysis: β: 0.021, 95% CI: 0.008–0.035, p = 0.0048). These findings suggest that NfL could serve as a valuable biomarker for monitoring disease progression and prognosis in SCA7 patients. Full article

While the transformation of and improvements in productivity are taking place under the guidance of new technologies, overtime work—which is still prevalent in the workplace—is simultaneously introducing substantial physical and mental burdens to workers. Based on baseline data from the China Labor Dynamics Survey (CLDS), we analyze employees’ willingness to work overtime and their overtime cognition and intensity using labor process theory. It is observed that skill control directly increases the probability of employees’ objective overtime work, mandatory overtime work, and unconscious overtime work; furthermore, de-skilling prolongs working hours while hiding the prevalence and blurring the boundaries of overtime work. De-skilling also results in reduced employee job autonomy and further extends overtime hours, increasing the probability of mandatory overtime. Bureaucratic control reinforces the relationship between de-skilling and voluntary overtime, unconscious overtime, and overtime intensity by fostering employees’ career development orientation. It is necessary to accurately grasp the characteristics of new technologies in the changing labor environment of the new era, strive to create an equal and open labor market, and respect and protect the legitimate rights and interests of workers. Full article

Background/Objectives: Breast cancer chemotherapy patients and survivors face cognitive side effects that are not fully understood. Neuroimaging can provide a unique way to study these effects; however, it can be difficult to recruit large numbers of subjects. Our meta-analysis aims to synthesize volumetric neuroimaging data to highlight consistent findings in regional brain volume changes to further advance our understanding of the chemotherapy-related cognitive impairments faced by breast cancer patients and survivors. Methods: An Activation Likelihood Estimation analysis was conducted across the data from eight voxel-based morphometry experiments examining changes in the brains of breast cancer patients and survivors exposed to chemotherapy over time and three voxel-based morphometry experiments comparing chemotherapy-exposed subjects to controls with and without breast cancer. Results: There were consistent volume reductions across the whole brain in both experiment groups. The subjects’ over-time analysis showed peak consistency among the studies in the right inferior frontal gyrus and the left insula. Conclusions: Chemotherapy for non-central nervous system cancers such as breast cancer can cause physical changes throughout the brain that can be quantitatively measured by neuroimaging methodologies and may underlie persistent cognitive deficits in some individuals. Full article

Background: Baló’s concentric sclerosis stands out as a rare form of multiple sclerosis that features large tumor-like demyelinating lesions, which resemble brain tumors and create significant diagnostic and therapeutic obstacles for pediatric patients. Case Presentations: We present two case studies of pediatric patients, aged 11 and 15, diagnosed with extensive cerebral tumefactive inflammatory lesions indicative of Balo’s type multiple sclerosis (MS). Both cases highlight the unique challenges faced in the diagnosis and treatment of this rare form of MS, characterized by the presence of large, tumor-like lesions that can mimic primary brain tumors. We will explore the diagnostic complexities, including the need for advanced imaging techniques, MR (Magnetic Resonance) spectroscopy, along with the time needed for differential diagnoses, which might delay the start of proper treatment. Current therapies, such as corticosteroids and immunomodulators, require customization to individual patients, carefully monitoring of clinical outcomes and possible side effects. This paper emphasizes that handling these cases requires a multidisciplinary approach, addressing not only the medical treatment but also the psychosocial needs of affected children and their families. By sharing these experiences, we aim to increase awareness about Balo’s type MS in pediatric populations and provide clinical insights into effective management strategies for similar cases in clinical practice. Conclusions: Timely detection of atypical demyelinating lesions together with immediate treatment intervention plays a crucial role in pediatric Baló-type MS. These cases demonstrate the essential role of advanced imaging and immunological testing in precise diagnosis while showcasing successful treatment approaches through corticosteroids and second-line immunotherapies, which improve patient outcomes in this atypical MS variant. Full article

Despite the growing popularity of women’s basketball in recent years, scientific literature on the subject remains significantly less extensive compared to its male counterpart. The main objective of this research was to analyze successful offensive actions and patterns during critical moments in the Women’s EuroLeague. The sample consisted of 377 technical–tactical actions corresponding to plays with score differences of three points or less (one-possession games) in the final minute and overtime periods of the Women’s EuroLeague during the 2021/22 and 2022/23 seasons. This study was based on an observational design, utilizing the LINCE PLUS software together with a customized observation tool. Descriptive statistics and chi-square (χ²) tests were carried out using SPSS version 25, while T-Pattern detection was performed through Theme 5 software. A threshold for statistical significance was established at p < 0.05. The findings indicated that home teams achieved a higher percentage of successful plays compared to visiting teams. Most successful patterns occurred during the final phase of possession (8”–0”), regardless of game location or team result. Additionally, layups, plays involving shots after on-ball screen, and actions following personal fouls demonstrated the highest success rates. The practical implications discussed in this research provide valuable insights for coaches to optimize offensive strategies during high-pressure moments in elite women’s basketball. Full article

Background: Nanocrystals, a carrier-free nanotechnology, offer significant advantages for pulmonary drug delivery by enhancing the dissolution and solubility of poorly soluble drugs while maintaining favorable biological properties and low toxicity. This study aims to investigate the aerodynamic performance and stability of nanocrystal-based dry powders (NC-DPs). Methods: Nanocrystalline suspensions were produced via wet media milling and subjected to stability studies before undergoing nano spray drying. A factorial design was employed to optimize the process parameters. The influence of mannitol and leucine, individually and in combination, was evaluated in terms of aerodynamic properties (Aerodynamic Particle Sizer (APS), in silico modeling) and the physicochemical stability at room temperature (in a desiccator) and accelerated conditions (40 ± 2 °C, 75 ± 5% relative humidity). Results: APS analysis revealed that leucine-containing powders (K-NC-Ls) exhibited the smallest median (1.357 µm) and geometric mean (1.335 µm) particle sizes, enhancing dispersibility. However, in silico results indicated the highest exhaled fraction for K-NC-L, highlighting the need for optimized excipient selection. Although mannitol showed the lowest exhaled fraction, it was mainly deposited in the extra-thoracic region in silico. The mannitol/leucine combination (K-NC-ML) revealed a low exhaled fraction and high lung deposition in silico. Also, K-NC-ML demonstrated superior stability, with a 6% reduction in D[0.5] and a 5% decrease in span overtime. Furthermore, no significant changes in crystallinity, thermal behavior, drug release, or mass median aerodynamic diameter were observed under stress conditions. Conclusions: These findings confirm that combined incorporation of mannitol and leucine in NC-DP formulations enhances stability and aerodynamic performance, making it a promising approach for pulmonary drug delivery. Full article

Production of plant-based products is still on the rise. There is a need for new plant-based dairy alternatives in the food market due to lactose intolerance, allergens to dairy and nuts and a rise in gluten-free products. Rice is a key source for these types of products because it is hypoallergenic. This study focused on the comparison storage stability and in vitro digestion of milk-based yogurt (MY) to yogurt alternatives (YA) made with four different rice flours. YAs and MY were prepared using L. delbrueckii and S. thermophilus for fermentation and L. rhamnosus (LGG) as a probiotic. Samples were stored refrigerated for up to 28 days and analyzed for titratable acidity, pH, color, syneresis, viscosity and bacterial counts every seven days. Probiotic survivability was tested under simulated gastric and intestinal conditions. YAs had lower syneresis than MY. There were few changes in color over time. Titratable acidity was lower in YAs (0.1 to 0.5%) than in MY (1%) while pH decreased in all samples during storage. Bacteria counts were stable throughout storage in all samples. MY had higher counts of LGG at the beginning of storage which significantly decreased during exposure to in vitro gastric conditions. Under in vitro intestinal conditions, both the white rice flour YAs and the MY retained the highest levels of LGG. This study indicated that it is possible for YAs made with rice flour to be stable overtime and with survivability of probiotic bacteria under gastric conditions. Full article