Search Results (6,969)

This study addresses the problems of poor dynamic stability, high vibration coupling, and inefficient energy use in large-farm manure handling machines. A profiling wheel-based multi-disciplinary approach is proposed in the study. With the rocker arm prototype, double-ball heads, and a hydraulic damping system, a parametric design is built that includes vibration and energy consumption. The simulation results in EDEM2022 and ANSYS2022 prove the structure viability and motion compensation capability, while NSGA-II optimizes the damping parameters (k₁ = 380 kN/m, C = 1200 Ns/m). The results show a 14.7% σ_Fc reduction, 14.3% α_RMS decrease, resonance avoidance (14–18 Hz), Δx (horizontal offset of the frame) < 5 mm, 18% power loss to 12.5%, and 62% stability improvement. The new research includes constructing a dynamic model by combining the Hertz contact theory with the modal decoupling method, while interacting with an automatic algorithm of adaptive damping and a mechanical-hydraulic-control-oriented optimization platform. Future work could integrate lightweight materials and multi-machine collaboration for smarter, greener manure cleaning. Full article

Post-exertional malaise (PEM) is a defining symptom of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), yet its molecular underpinnings remain elusive. This study investigated the temporal–longitudinal DNA methylation changes associated with PEM using a structured two-day maximum repeated effort cardiopulmonary exercise testing (CPET) protocol involving pre- and two post-exercise blood samplings from five ME/CFS patients. Cardiopulmonary measurements revealed complex heterogeneous profiles among the patients compared to typical healthy controls, and VO₂ peak indicated all patients had poor normative fitness. The switch to anaerobic metabolism occurred at a lower workload in some patients on Day Two of the test. Reduced Representation Bisulphite Sequencing followed by analysis with Differential Methylation Analysis Package-version 2 (DMAP2) identified differentially methylated fragments (DMFs) present in the DNA genomes of all five ME/CFS patients through the exercise test compared with ‘before exercise’. With further filtering for >10% methylation differences, there were early DMFs (0–24 h after first exercise test) and late DMFs between (24–48 h after the second exercise test), as well as DMFs that changed gradually (between 0 and 48 h). Of these, 98% were ME/CFS-specific, compared with the two healthy controls accompanying the longitudinal study. Principal component analysis illustrated the three distinct clusters at the 0 h, 24 h, and 48 h timepoints, but with heterogeneity among the patients within the clusters, highlighting dynamic methylation responses to exertion in individual patients. There were 24 ME/CFS-specific DMFs at gene promoter fragments that revealed distinct patterns of temporal methylation across the timepoints. Functional enrichment of ME-specific DMFs revealed pathways involved in endothelial function, morphogenesis, inflammation, and immune regulation. These findings uncovered temporally dynamic epigenetic changes in stress/immune functions in ME/CFS during PEM and suggest molecular signatures with potential for diagnosis and of mechanistic significance. Full article

Electro-hydraulic servoactuators have great potential in mobile robotics due to their robustness, high bandwidth and power density, but compared with electromechanical actuators, they can be inefficient and more difficult to integrate into systems. The Integrated Smart Actuator (ISA) developed by Moog Controls Ltd. is a hydromechatronic device that aims to address these issues by combining a novel efficient servovalve, cylinder, sensors and control electronics into a single component. The aim of this work was to develop a robust motion control algorithm that can make integration of the ISA into a robotic system straightforward by requiring minimal controller set-up despite variations in the load characteristics. The proposed controller is a sliding mode controller with a varying boundary layer that contains two robustness parameters and a single bandwidth parameter that defines the response. The controller outperforms a conventional high-performance linear controller in terms of tracking performance and its robustness to variations in the load mass and fluid bulk modulus. The response when the system was subject to some unachievable demand trajectories, such as large step demands, was found to be poor, and an online velocity, acceleration and jerk limited trajectory filter was demonstrated to rectify this issue. The successful implementation of a robust motion controller enables this highly novel integrated actuator to live up to its ‘smart’ epithet. Full article

To address the issues of traditional gels in high-temperature reservoir leakage plugging, such as injection–retention imbalance, poor high-temperature stability, and insufficient thixotropy, this study developed a thixotropic polymer gel system via molecular design and component optimization, aiming to achieve excellent thixotropy, high strength, and wide temperature adaptability (80–140 °C) while clarifying its gelation mechanism. First, the optimal polymer was selected by comparing the high-temperature stability and crosslinking activity of AM/AMPS copolymer (J-2), low-molecular-weight acrylamide polymers (J-3, J-4), and AM/AMPS/NVP terpolymer (J-1). Then, the phenolic crosslinking system was optimized: hexamethylenetetramine (HMTA) was chosen for controlled aldehyde release (avoiding poor stability/dehydration) and catechol for high crosslinking efficiency (enhancing strength via dense crosslinking sites). Urea–formaldehyde resin (UF) was introduced to form a “polymer-resin double network,” improving high-temperature compression resistance and long-term stability. Cyclic shear rheological tests showed the gel system had a larger hysteresis area than the polymer solution, indicating excellent thixotropy before gelation. It gelled completely at 80–140 °C (gelation time shortened with temperature). At 120 °C, its viscosity was 7500 mPa·s, storage modulus (G′) 51 Pa, and loss modulus (G″) 6 Pa, demonstrating good shear thixotropy. The final system (1% J-1, 0.3% catechol, 0.6% HMTA, 15% UF) is suitable for high-temperature reservoir leakage plugging. Full article

Background/Objectives: Recurrences of squamous cell carcinoma (SCC) at the base of the tongue (BoT) after primary radiochemotherapy (RT-CHT) are associated with low survival rates, poor functional outcomes, and high morbidity following salvage surgery. Transoral robotic surgery (TORS) has emerged as a less invasive alternative to open surgical approaches. This study aims to describe our clinical experience with TORS in patients with BoT SCC recurrence after RT-CHT, focusing on oncological outcomes—relapse-free survival (RFS) and disease-specific survival (DSS)—as well as functional outcomes, particularly swallowing function. Methods: We conducted a retrospective review of four patients who underwent salvage TORS for BoT recurrence between September 2013 and September 2014 at a single tertiary referral center. All patients had been previously treated with primary RT-CHT for oropharyngeal squamous cell carcinomas. Oncological events (recurrence, death) and functional endpoints (dietary limitations, MD Anderson Dysphagia Inventory [MDADI] scores) were retrieved from medical records. Results: Four patients were included. All achieved unrestricted oral intake by one month post-TORS, showing functional improvement compared to their preoperative status. Three of the four patients remained free of locoregional recurrence during follow-up. No major perioperative complications were reported. Conclusions: In selected patients with BoT SCC recurrence after primary RT-CHT, TORS may offer a viable and less morbid salvage treatment option with favorable early functional outcomes and acceptable oncologic control. Based on both our institutional experience and the supporting literature, we propose selection criteria to guide TORS indication in this clinical setting. Full article

Background: Immediately after discharge from hospital, COVID-19 patients have poor physical function and impaired performance in activities of daily living. Persisting symptoms and cognitive impairments have been reported, but the long-term impact on objectively measured physical activity (PA) in patients hospitalized for COVID-19 is not clear. Methods: A prospective cohort study was conducted to compare objectively measured PA and physical function 12 months post discharge in patients who were hospitalized for COVID-19 with age- and sex-matched healthy controls and to elucidate the impact of ICU admission on these outcomes. PA was objectively assessed using accelerometry in patients, healthy controls, and in a subset of partners of patients. Additionally, lung function, physical function (six-minute walk distance (6 MWD) and isometric quadriceps and handgrip force), symptom experience, and health-related quality of life (HRQoL) were evaluated in patients with and without ICU admission. Results: Included in the study were 101 patients (60 ± 10 years, 69% male), 36 healthy controls (60 ± 9 years, 58% male), and 14 partners (55 ± 8 years, 21% male). Daily step count and movement intensity (MI) during walking in patients were significantly lower compared with healthy controls (6726 ± 328 vs. 8155 ± 555 n.day⁻¹, p = 0.03 and 1.99 ± 0.04 vs. 2.21 ± 0.07 min/s².day⁻¹, p = 0.005). PA levels of patients and their partners were comparable. Physical function, symptom experience, HRQoL, and PA levels were comparable in patients with and without ICU admission (p > 0.05). Daily step count was weakly positively associated with 6 MWD (r = 0.30). Conclusions: One year post discharge, patients had lower PA levels than healthy controls. ICU admission did not affect physical function, symptoms, HRQoL or activity levels. Full article

Hypertension is a major chronic condition affecting older adults in the United States. The condition imposes clinical and economic burdens. Self-efficacy, or confidence in managing health, is crucial for effective self-management of hypertension. This study explored the relationships between socio-demographics, health status, and confidence in following provider recommendations for controlling hypertension among Medicare beneficiaries. The 2021 Medicare Current Beneficiary Survey was analyzed, including responses from 5838 beneficiaries aged ≥65 years with reported hypertension. A three-level categorical dependent variable ((1) very confident/confident, (2) somewhat confident, and (3) not confident (reference group)) based on provider recommendations for lifestyle changes for hypertension control was created. A survey-weighted multinomial logit model examined associations between socio-demographics and self-reported health status and the dependent variable. Among respondents, 70.8%, 21.4%, and 7.8%, respectively, were very confident/confident, somewhat confident, and not confident in following provider recommendations for lifestyle changes to control hypertension. Beneficiaries with obesity, fair/poor general health, and limitations in basic activities of daily living or instrumental activities of daily living were less likely to report being very confident/confident. The findings of this cross-sectional study highlighted the potential need for targeted support (e.g., tailored health coaching, peer mentoring) of lifestyle changes for at-risk older adults to manage hypertension. Full article

Despite a high disease control rate in the treatment of unresectable or metastatic well-differentiated, somatostatin receptor-positive neuroendocrine tumors (NETs) with peptide receptor radionuclide therapy (PRRT), a certain percentage of patients will experience an unfavorable outcome. Besides clinical, hematological, and biochemical parameters, including widely used inflammatory markers, as well as literature-recognized inflammatory indices, there is a growing need for the identification of novel biomarkers as prognostic factors of therapeutic response. In this prospective single-center study, 51 NET patients treated with PRRT were included and divided into two groups: responders and non-responders in accordance with therapeutic outcome. Cytokine, clinical, and biochemical data were analyzed. Non-responders had significantly higher serum concentrations of IL-33 and IL-4 in comparison to responders, while sST2 was increased in responders. A positive correlation was measured between IL-33 and IL-4, as well as between IL-33 and disease progression. A negative correlation was noted between IL-33 and the neutrophil count %. ROC curve analysis identified values of IL-33 >146.5 pg/mL as a predictor of poor early therapeutic response, and logistic regression confirmed its independent prognostic value. Elevated IL-33 and IL-4 favor the development of a type 2 immune response associated with unfavored therapeutic outcome, while increased sST2 mitigates the IL-33’s effect in responders, contributing to a more favorable response. These findings emphasize IL-33 as an important biomarker of early response in NET patients undergoing PRRT. Full article

Background and Objectives: Eating disorders are one of the most widespread health concerns, mainly among adolescents. Children and adolescents with type 1 diabetes mellitus (T1DM) have been reported to have a high prevalence of eating disorders. The aim of our study is to evaluate the risk of diabetes-specific eating disorders in children with T1DM using continuous subcutaneous insulin infusion (CSII), with real-time glycemic data from continuous glucose monitoring (CGM). Materials and Methods: Sixty-four patients (aged 7–18 years) completed the Diabetes Eating Problem Survey-Revised (DEPS-R). The DEPS-R is a diabetes-specific self-report questionnaire to assess diabetes-specific compensatory behaviors. Auxological findings, sex, age, age at diagnosis, hemoglobin A1c (HbA1c) levels, and all CGM data were obtained from their medical records. Results: Although the median DEPS-R score was higher in children and adolescents using CSII compared to those using multiple daily injections (MDIs) (14 vs. 11), the difference was not statistically significant (p = 0.302). The risk of diabetes-specific eating disorders was identified in six patients (30%) using CSII and in nine patients (20.4%) using multiple daily injections (p = 0.403). Interestingly, in the subgroup with poor glycemic control (HbA1c > 9%), DEPS-R scores were significantly lower among those using CSII compared to the MDI group. Pearson correlation analysis demonstrated positive associations between DEPS-R scores and diabetes duration, weight SDS, body mass index (BMI), BMI SDS, HbA1c, mean glucose, Glucose Management Indicator (GMI), time above range (TAR) (very high), and coefficient of variation (CV), while a moderate negative correlation was observed with time in range (TIR). Conclusions: This study showed that the treatment of CSII had a beneficial effect on the risk of eating disorders in patients with poor glycemic control. As well, from this perspective, CSII maintains its status as a potentially beneficial therapeutic approach in diabetes management. Full article

Glutamine (Gln) supplementation during the weaning period can alleviate stress in piglets. However, free Gln has poor stability and low absorption in the small intestine. Glycyl-glutamine (Gly-Gln), a stable dipeptide form of Gln, has been evaluated as a potential alternative in pig nutrition. This study investigated the effects of Gly-Gln at 0, 0.125%, 0.25%, 0.375%, and 0.50%, as well as a Gly + Gln positive control, on growth performance, intestinal morphology, immunity, antioxidant status, and nutrient apparent digestibility in weaned piglets. The results showed that dietary supplementation with 0.25%, 0.375%, or 0.50% Gly-Gln significantly increased average daily gain, average daily feed intake, and final weight (p < 0.05). Linear and quadratic effects (p < 0.05) were observed for growth performance indicators, suggesting that moderate supplementation levels yielded optimal benefits. Dietary Gly-Gln supplementation with 0.25%, 0.375%, or 0.50% Gly-Gln significantly increased serum immunoglobulin (IgG, IgA, and IgM), insulin, insulin growth factor 1, growth hormone, and T4 and T3 contents, and decreased IFN-γ and IL-1β contents (p < 0.05). Diets supplemented with 0.25, 0.375, or 0.50% Gly-Gln increased total antioxidant capacity and superoxide dismutase content in serum and liver, and decreased MDA content (p < 0.05). Compared with the negative control group, dietary supplementation of 0.25%, 0.375%, or 0.50% Gly-Gln significantly increased the mRNA expression of ZO-1, Occludin, and Claudin-1 in the jejunum (p < 0.05). Furthermore, crude protein digestibility was significantly improved in piglets receiving 0.375% and 0.5% Gly-Gln (p < 0.05), with a significant linear relationship between Gly-Gln level and digestibility. In conclusion, 0.25% is the minimum effective dose of Gly-Gln for improving weaning outcomes. Gly-Gln is more effective than equivalent doses of free glycine and glutamine in enhancing growth performance, gut barrier integrity, and nutrient utilization in weaned piglets. Full article

To ensure the safety and quality of grain during storage requires distributed monitoring of temperature and relative humidity within the bulk material, where hundreds of sensors may be needed. Conventional multi-channel systems are often constrained by the limited number of sensors connectable to a single acquisition unit, high hardware cost, and poor scalability. To address these challenges, this study proposes a novel design method for a multi-channel temperature and relative humidity acquisition system (MTRHAS). The system integrates sequential sampling control and a time-division multiplexing mechanism, enabling efficient data acquisition from multiple sensors while reducing hardware requirements and cost. This system employs sequential sampling control using a single complex programmable logic device (CPLD), and uses multiple CPLDs for multi-channel sensor expansion with a shared address and data bus for communication with a microcontroller unit (MCU). A prototype was developed using two CPLDs and one MCU, achieving data collection from 80 sensors. To validate the approach, a simulated grain silo experiment was conducted, with nine sensors deployed to monitor temperature and relative humidity during aeration. Calibration ensured sensor accuracy, and real-time monitoring results revealed that the system effectively captured spatial and temporal variation patterns of intergranular air conditions. Compared with conventional designs, the proposed system shortens the sampling cycle, decreases the number of acquisition units required, and enhances scalability through the shared bus architecture. These findings demonstrate that the MTRHAS provides an efficient and practical solution for large-scale monitoring of grain storage environments. Full article

To improve the tracking accuracy and the adaptability of intelligent vehicles in various road conditions, an adaptive model predictive controller combining reinforcement learning is proposed in this paper. Firstly, to solve the problem of control accuracy decline caused by a fixed prediction time domain, a low-computational-cost adaptive prediction horizon strategy based on a two-dimensional Gaussian function is designed to realize the real-time adjustment of prediction time domain change with vehicle speed and road curvature. Secondly, to address the problem of tracking stability reduction under complex road conditions, the Deep Q-Network (DQN) algorithm is used to adjust the weight matrix of the Model Predictive Control (MPC) algorithm; then, the convergence speed and control effectiveness of the tracking controller are improved. Finally, hardware-in-the-loop tests and real vehicle tests are conducted. The results show that the proposed adaptive predictive horizon controller (DQN-AP-MPC) solves the problem of poor control performance caused by fixed predictive time domain and fixed weight matrix values, significantly improving the tracking accuracy of intelligent vehicles under different road conditions. Especially under variable curvature and high-speed conditions, the proposed controller reduces the maximum lateral error by 76.81% compared to the unimproved MPC controller, and reduces the average absolute error by 64.44%. The proposed controller has a faster convergence speed and better trajectory tracking performance when tested on variable curvature road conditions and double lane roads. Full article

Chimeric antigen receptor-T (CAR-T) cell immunotherapy constitutes a cornerstone in the management of patients with relapsed/refractory B-cell lineage lymphoid malignancies. Toxicities such as cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and hematotoxicity (ICAHT) have been recognized in the post-infusion period. The initial interplay between CAR-T cells and tumor cells, followed by cytokine release and the bystander activation of the innate immunity cells, result in endothelial cell injury. In the current review, the ongoing research regarding endothelial injury in CAR-T cell recipients is summarized. Various markers of endothelial injury have been investigated in CAR-T cell recipients, including markers of complement activation, such as soluble C5b-9, endothelial dysfunction (angiopoietin-2, VCAM1, ICAM-1), inflammation, and thrombosis (von Willebrand antigen, ADAMTS13, thrombomodulin). The expression level of these endothelial injury markers has been identified as impaired in CAR-T cell recipients, not only when compared with healthy controls but also among patients with severe CRS/ICANS and those with mild toxicities or without toxicities. Furthermore, the Endothelial Activation and Stress Index (EASIX) and modified versions of this score, calculated in the pre- and early post-infusion period, seem to predict development of severe toxicities, ICAHT, and, thus, poor overall survival in CAR-T cell patients. More data concerning the role of these endothelial injury markers and clinical outcomes in CAR-T cell settings are essential. Full article

Vector-borne diseases (VBDs) continue to pose a persistent global health challenge, disproportionately impacting low- and middle-income countries where surveillance and healthcare infrastructure are constrained. Within these countries, residents of remote island communities are particularly vulnerable to emerging VBD threats; however, they remain critically understudied. We conducted a community-based cross-sectional survey of 300 residents from Shahpori Island, Bangladesh, and Gaya Island, Malaysia, to assess knowledge, attitudes, and practices (KAP) related to VBDs. Using a structured questionnaire and mixed-effects Poisson regression modeling, we identified socio-demographic predictors of VBD-related knowledge and compared KAP outcomes across the two islands. Significant disparities were observed between the two settings: the Gaya Island residents demonstrated a higher level of awareness regarding VBDs and preventive practices compared to the Shahpori residents. Education was a strong predictor of VBD knowledge, with individuals possessing secondary education or above exhibiting significantly better knowledge (β = 0.2024, p = 0.0003). Marital status was also a significant factor, with unmarried respondents showing lower levels of knowledge (β = –0.1657, p = 0.0372). Age was positively correlated with VBD knowledge (β = 0.0051, p = 0.0119), indicating a gradual increase with age, while income, gender, occupation, and household size were not significantly associated. Despite basic awareness of VBD symptoms and transmission, detailed understanding of mosquito ecology, disease symptoms, and breeding prevention strategies was remarkably poor, especially among the Shahpori residents. Our findings highlight critical gaps in VBD-related knowledge and prevention behaviors shaped by socio-economic and educational disparities. Community-focused public health strategies including educational campaigns, establishment of health infrastructure, access to trained healthcare providers, and integrated vector control interventions are urgently needed to enhance resilience against emerging VBD threats such as drug-resistant malaria in remote island populations. Full article

Background: Cardiovascular diseases (CVDs) are linked with poor oral health outcomes, yet data on oral health status, behaviors, and awareness among CVD patients in Odisha remain scarce. This study aimed to assess the self-reported oral health status, behaviors, and knowledge among patients with CVD and associated risk factors. Methods: A cross-sectional survey was conducted among 391 patients aged 40–80 years attending dental and cardiology OPDs at a tertiary care center in Bhubaneswar. Participants were grouped into control, at-risk, and established CVD categories. A 24-item questionnaire and panoramic radiographic examination were used to assess oral health. Data were analyzed using the chi-squared test and Kappa statistics. Results: Patients with established CVD reported significantly higher prevalence of oral health problems, poor oral hygiene behaviors, and lower awareness compared to controls. Clinical findings revealed higher rates of periodontal bone loss, caries, and periapical radiolucency in the CVD group. Agreement between radiographic examiners was high. Conclusions: There is a substantial burden of oral disease and poor oral health awareness among patients with CVD in Odisha. These findings emphasize the need for integrated oral health education and care protocols in cardiovascular patient management. Full article