Search Results (143,982)

Objectives: To assess the incidence rate of anterior acute uveitis (AAU) in patients with longstanding axial spondyloarthritis (axSpA); to evaluate demographic and clinical characteristics associated with AAU development; and to determine the influence of AAU on bDMARD initiation and retention in this population. Methods: This two-timepoint cohort study analysed data from patients enrolled in the Spanish SpA registry REGISPONSER (2004–2007), who were re-evaluated 17 years later in the REGISPON-3 follow-up study (2021–2023). Information on the date of first AAU episode and bDMARD initiation was collected. Kaplan–Meier and Cox proportional hazards models were used to assess AAU incidence, predictors, and its association with time to bDMARD initiation and treatment retention. Results: A total of 299 patients with longstanding axSpA were included, of whom 33.4% experienced at least one episode of AAU, corresponding to an incidence rate of 1.15 per 100 person-years. The cumulative probability of a first episode of AAU increased with disease duration. The relative risk for developing a second episode after the first, compared to the overall risk of any episode in the total population, was 1.85 (95% CI: 1.34–2.57). In multivariable cox analysis, female sex and baseline enthesitis were independently associated with a higher risk of AAU. AAU did not significantly affect the likelihood of subsequent bDMARD initiation, with similar cumulative treatment probabilities in patients with and without AAU. Among treated patients, adalimumab was more frequently prescribed in those with a history of AAU. bDMARD retention rates at two and five years were comparable regardless of AAU status, suggesting that AAU was not associated with long-term treatment persistence. Conclusions: In patients with longstanding axSpA, the incidence of AAU increased steadily over time. However, the presence of AAU did not significantly influence bDMARD initiation or long-term retention in routine clinical practice. Full article

We demonstrate coating-free optoacoustic generation and focusing of ultrasound using a mechanically Q-switched (MQS) erbium-doped yttrium aluminum garnet (Er:YAG) source (~100 ns, ≤20 mJ) combined with a concave water interface that simultaneously serves as converter and acoustic lens. Axial, lateral, and focal-point measurements mapped the pressure field while varying beam diameter (2w = 5–15 mm) and pulse energy (E = 10–20 mJ). The maximum focal positive pressure (p_max = 7 MPa) occurs at an intermediate diameter (~10 mm), whereas the tightest lateral/axial confinement and strongest spectral enhancement arise at larger diameters (14–15 mm) with f_c = ~5 MHz and −6 dB bandwidth up to 7 MHz. Pressure increases nearly monotonically with energy. For equal fluence, larger diameters yield higher focal pressures due to greater focusing gain. Small beams (2w ≈ 5–7 mm) show shorter apparent time-of-flight (TOF) and waveform broadening, consistent with early shock-like emission from locally vaporizing region. These results provide practical rules for tuning amplitude, spectrum, and confinement, enabling sub-millimeter focusing for contamination-sensitive and therapeutic applications. Full article

Achieving optimal daylighting in buildings necessitates complex and expensive control systems. This research addresses this challenge by proposing a simple and more practical solution: a parametric louver system based on rotating slats controlled by stepper motors, powered by an Integrated Circuit platform (Arduino board), which can translate the digital figures (the rotation angles) to a physical action. The system automatically adjusts the slats in accordance with solar altitudes and reflects them to specific targets over the ceiling. This ensures a uniform and comfortable distribution of daylight throughout a room. This system was developed using Grasshopper as the parametric software, with future control planned via a user-friendly mobile app through a preliminary prototype. This daylighting system prioritises human visual comfort while targeting a significant 53% reduction in electrical lighting energy consumption. The system aims to enhance occupant well-being to significantly increase energy savings, making it a compelling solution for sustainable building design. Full article

Background/Objective: Timely identification of bloodstream pathogens is critical for sepsis management; however, PCR inhibitors such as sodium polyanetholesulfonate (SPS) in blood culture broth compromise nucleic acid recovery and long read sequencing. We assessed whether coupling a benzyl alcohol SPS-removal step to the fully automated LabTurbo AIO extractor improves Oxford Nanopore-based pathogen detection. Methods: Thirteen positive blood culture broths were pre-treated with benzyl alcohol and divided: half volumes were purified on the LabTurbo AIO; paired aliquots underwent manual QIAamp extraction. DNA purity was evaluated by NanoDrop and Qubit. Barcoded libraries were sequenced on MinION R9.4.1 flow cells for 6 h. Results: Automated eluates showed a median A₂₆₀/A₂₈₀ of 1.92 and A₂₆₀/A₂₃₀ of 1.96, versus 1.80 and 1.48 for manual extracts. The automated workflow generated 1.69 × 10⁶ total reads compared with 3.9 × 10⁵ reads for manual extraction. The median N50 read length increased from 5.9 kb to 8.7 kb, and the median proportion of reads classified to species increased from 62% to 84%. The hands-on time was <5 min and the sample-to-answer turnaround was <8 h, compared with >9 h and 90 min for the manual protocol, respectively. Conclusions: Benzyl alcohol SPS removal integrated into the LabTurbo AIO extractor yielded purer, longer, and higher read counts, enhancing nanopore sequencing depth and accuracy while compressing diagnostic turnaround to a single working day. This represents a practical advance for rapid blood culture pathogen identification in critical care settings. Full article

Background and Objectives: To evaluate the prognostic value of the Clinical–Pathologic Stage–Estrogen receptor status and Grade (CPS+EG) staging system, which combines clinical staging, pathological staging, oestrogen receptor (ER) status, and tumour grade in predicting survival outcomes in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer receiving neoadjuvant therapy (NACT). Materials and Methods: A retrospective review was performed on 245 female breast cancer patients who received anti-HER2 therapy alongside NACT at the Medical Oncology Department of Kartal Dr Lütfi Kırdar City Hospital, University of Health Sciences, from April 2012 to June 2024. The CPS+EG score was calculated using the MD Anderson Cancer Centre neoadjuvant treatment response calculator. Patients were categorised into two groups based on their CPS+EG score < 3 and ≥3. The primary outcomes assessed were disease-free survival (DFS) and overall survival (OS). Kaplan–Meier and log-rank tests were utilised for time-to-event analysis; Cox regression was used for multivariate analysis. A significance level of ≤0.05 was considered. Results: The median age of the patient cohort was 51 years (range: 27–82 years). Among these patients, 183 (74.6%) had a CPS+EG score less than 3, while 62 (25.3%) exhibited a score of 3 or higher. The median follow-up duration was 37.6 months. The pathological complete response (pCR) rate across the entire cohort was 51.8%. Specifically, the pCR rate was 56.3% in the group with CPS+EG scores below 3, and 38.7% in those with scores of 3 or higher (p = 0.017). Patients with CPS+EG scores less than 3 demonstrated superior overall survival (OS), which reached statistical significance in univariate analysis. Multivariate analysis identified the CPS+EG score as an independent prognostic factor for both overall survival and disease-free survival (DFS), with hazard ratios of 0.048 (95% CI: 0.004–0.577, p = 0.017) and 0.35 (95% CI: 0.14–0.86, p = 0.023), respectively. Conclusions: The CPS+EG score is an independent and practical prognostic marker, particularly for overall survival, in patients with HER2-positive breast cancer who have received neoadjuvant therapy. Patients with a CPS+EG score < 3 have higher pCR rates and survival rates. When used in conjunction with pCR, it can improve risk categorisation and contribute to the individualisation of adjuvant strategies in the post-neoadjuvant period. Due to its ease of calculation and lack of additional costs, this score can be instrumental in clinical practice for identifying high-risk patients. Our findings support the integration of the CPS+EG score into routine clinical decision-making processes, although prospective validation studies are necessary. Full article

Accurate leaf area measurement is essential for plant growth monitoring and ecological research; however, it is often challenged by perspective distortion and color inconsistencies resulting from variations in shooting conditions and plant status. To address these issues, this study proposes a visual and semi-automatic measurement system. The system utilizes Hough transform-based perspective transformation to correct perspective distortions and incorporates manually sampled points to obtain prior color information, effectively mitigating color inconsistency. Based on this prior knowledge, the level-set function is automatically initialized. The leaf extraction is achieved through level-set curve evolution that minimizes an energy function derived from a multivariate Gaussian distribution model, and the evolution process allows visual monitoring of the leaf extraction progress. Experimental results demonstrate robust performance under diverse conditions: the standard deviation remains below 1 cm², the relative error is under 1%, the coefficient of variation is less than 3%, and processing time is under 10 s for most images. Compared to the traditional labor-intensive and time-consuming manual photocopy-weighing approach, as well as OpenPheno (which lacks parameter adjustability) and ImageJ 1.54g (whose results are highly operator-dependent), the proposed system provides a more flexible, controllable, and robust semi-automatic solution. It significantly reduces operational barriers while enhancing measurement stability, demonstrating considerable practical application value. Full article

Familial hypercholesterolemia (FH) is a common genetic disorder with a fairly constant worldwide prevalence of 1 case per 311 individuals worldwide. It is characterized by severe hypercholesterolemia from birth, early atherosclerosis and death from cardiovascular disease at a young age. Diagnosis and treatment from childhood are essential to reduce cardiovascular mortality. Many countries have developed a strategy of implementing pediatric screening, which has led to an increase in diagnoses. This paper evaluates the screening strategies implemented in different countries worldwide. First, we examined which schemes were preferred in various national contexts in Europe. Next, we evaluated the screening methods used in the US, Canada, Australia and Japan. Finally, we researched the screening strategies proposed in some low-resource countries, discovering the difficulties and limitations they face. We have highlighted a wide range of realities, from small-scale pilot studies to cutting-edge proposals. We have also emphasized that, while the topic is certainly of interest, it is burdened by multiple difficulties and unresolved questions. Full article

As the core refrigeration equipment in cooling systems, the operational state of chiller units is crucial for ship support, equipment cooling, and mission stability. However, because of their sensitivity and the complexity of operating environments, obtaining large volumes of complete, fault-labeled data is difficult in practical engineering appli-cations. This limitation makes it challenging for traditional data-driven approaches to deliver accurate fault diagnoses. Furthermore, data collected from different devices or under varying operating conditions often differ significantly in both feature dimensions and distributions, i.e., data heterogeneity, which further complicates model transfer. To address these challenges, this study proposes a deep transfer learning–based fault di-agnosis method designed to leverage abundant knowledge from the source domain while adaptively learning features of the target domain. Given the persistent difficulties in collecting sufficient high-quality labeled fault data, traditional data-driven models continue to face restricted diagnostic performance on target equipment. At the same time, data heterogeneity across devices or operating conditions intensifies the challenge of cross-domain knowledge transfer. To overcome these issues, this study develops a heterogeneous transfer learning method that integrates a dual-channel autoencoder, domain adversarial training, and pseudo-label self-training. This combination enables precise small-sample knowledge transfer from the source to the target domain. Specifi-cally, the dual-channel autoencoder is first applied to align heterogeneous feature di-mensions. Then, a Gradient Reversal Layer (GRL) and a domain discriminator are in-troduced to extract domain-invariant features. In parallel, high-confidence pseu-do-labeled samples from the target domain are incorporated into joint training to im-prove generalization and robustness. Experimental results confirm that the method achieves high fault diagnosis accuracy in typical industrial application scenarios, ena-bling effective identification of common faults in various types of chiller units under conventional operating conditions, the proposed method achieves higher accuracy and F1-scores in multi-class fault diagnosis tasks compared with both traditional approaches and existing transfer learning methods. These findings provide a novel perspective for advancing the intelligent operation and maintenance of chiller units. Full article

In this article, we establish a constructive nonparametric scheme for monitoring the quality of services provided by a transportation company. The proposed methodology aims at achieving the diligent tracking of the underlying process and the swift detection of any potential malfunctions. The implementation of the new framework requires the construction of appropriate schemes, which follow the set-up of a Shewhart chart and are connected to ranks and multiple run decision criteria. The dispersion and the mean value of the run length distribution for the suggested distribution-free scheme are investigated for the special case k = 2. For illustration purposes, a real-data logistics environment is discussed, whereas the proposed approach is applied for improving the quality of the provided services. Full article

Background: The accuracy and consistency of complete-arch digital impressions are fundamental for long-term success of implant-supported rehabilitations. Recently, artificial intelligence (AI)-assisted tools, such as SmartX (Medit Link v3.4.2, MEDIT Corp., Seoul, South of Korea), have been introduced to enhance scan body recognition and data alignment during intraoral scanning. Objective: This in vitro study aimed to evaluate the impact of SmartX on impression accuracy, consistency, operator confidence, and technique sensitivity in complete-arch implant workflows. Methods: Seventy-two digital impressions were recorded on edentulous mandibular models with four dummy implants, using six experimental subgroups based on scan body design (double- or single-wing), scanning technique (occlusal or combined straight/zigzag), and presence/absence of SmartX tool. Each group was scanned by both an expert and a novice operator (n = 6 scans per subgroup). Root mean square (RMS) deviation and scanning time were assessed. Data were tested for normality (Shapiro–Wilk). Parametric tests (t-test, repeated measures ANOVA with Greenhouse–Geisser correction) or non-parametric equivalents (Mann–Whitney U, Friedman) were applied as appropriate. Post hoc comparisons used Tukey HSD or Dunn–Bonferroni tests (α = 0.05). Results: SmartX significantly improved consistency and operator confidence, especially among novices, although it did not yield statistically significant differences in scan accuracy (p > 0.05). The tool mitigated early scanning errors and reduced dependence on operator technique. SmartX also enabled successful library alignment with minimal data; however, scanning time was generally longer with its use, particularly for beginners. Conclusions: While SmartX did not directly enhance trueness, it substantially improved scan reliability and user experience in complete-arch workflows. Its ability to minimize technique sensitivity and improve reproducibility makes it a valuable aid in both training and clinical settings. Further clinical validation is warranted to support its integration into routine practice. Full article

Male fertility is important to ensure herd health and productivity. The camelid male breeding soundness examination (BSE) is strongly recommended because natural mating remains the primary breeding method due to the challenges in semen cryopreservation and artificial insemination. Guidelines for the BSE have been proposed but not adopted in practice. The investigation of male reproductive failure includes history, general health examination, examination of the genitalia, semen evaluation, and testing for contagious diseases. Difficulties in ejaculate collection and semen viscosity are challenges in camelid male fertility investigation. This review summarizes the outcomes of BSE in our practice on South American camelids (SACs) and camels. The results and discussion are presented under four main categories: congenital defects, impotentia coeundi, impotentia generandi, and male reproductive emergencies. There is a difference between camels and SACs in the incidence of various disorders. Congenital defects are common in SACs in particular cryptorchidism, testicular hypoplasia and rete testis cysts. Orchitis is more common in camels, particularly in areas where brucellosis is prevalent. Testicular degeneration occurs in all camelids and has been associated with heat stress, aging, systemic diseases and overuse of anabolic steroids. Precise diagnosis of fertility impairment may require disease testing, testicular biopsy, cytogenetics and endocrine evaluation. A significant proportion of males are referred because of reproductive emergencies, due to poor management, which results in loss of genetic potential. Implementation of regular BSE is possible in SACs but can be difficult in dromedaries because of the large variation in breed characteristics and management systems. Full article

Long bone fractures are breaks or cracks in a long bone of the body typically caused by trauma like a fall, sport injury, accidents etc. This study investigates the effectiveness of experimental methods for fast and safe healing of long bone fractures in humans, highlighting both their advantages and disadvantages, respectively finding the most effective and safe methods for evaluating the types of fixators that can be used in the consolidation of fractured long bones. As for the preliminary data, numerical methods and applied mathematics were used to address this problem. After collecting of preliminary data there were performed a series of experimental analysis as follows: Electrical Strain Gauges (ESGs); the Moiré Fringes method; Photo-Elasticity, with the particular technique thereof, the so-called Photo-Stress method; Holographic Interferometry (HI); Speckle Pattern Interferometry (ESPI) and Shearography; and Video Image Correlation (VIC), which is also called Digital Image Correlation (DIC). By analyzing different methods, the following two methods resulted to be widely applicable, namely, ESG and DIC/VIC. The findings highlight the net advantages regarding the objective choice of these types of fixators, thereby contributing to a possible extension of these approaches for the benefit of medical surgical practice Full article

As an emerging innovation paradigm in the digital economy era, digital innovation has become an important means for manufacturing firms to build supply chain resilience for sustainable development, but its intrinsic mechanism requires clarification. This research explores the impact of digital innovation (digital organizational innovation and digital product innovation) on supply chain resilience (supply chain readiness, supply chain responsiveness, and supply chain recovery) and sustainable performance via structural equation modeling involving data from 226 Chinese manufacturing firms. The results show that digital organizational innovation can promote digital product innovation. Digital organizational innovation and digital product innovation contribute to supply chain readiness, supply chain responsiveness, and supply chain recovery. Supply chain readiness, supply chain responsiveness, and supply chain recovery enhance sustainable performance. Finally, supply chain resilience mediates the relationship between digital innovation and sustainable performance. These findings reveal the role of digital innovation in improving sustainable performance through supply chain resilience and provide practical guidance for manufacturing companies to better conduct digital innovation to build supply chain resilience and thus realize sustainable development. Full article

This study presents a comparative investigation of combustion and emission characteristics in a two-stroke MAN 5S35ME-B9.5 marine diesel engine equipped with a Controllable Pitch Propeller and an Exhaust Gas Recirculation system. Experimental data were obtained from both factory shop tests conducted under the IMO NOx Technical Code 2008 E2 cycle and sea trials performed onboard the T/S Baek-Kyung. Engine performance was evaluated under Tier II-FB, ecoEGR, and Tier III modes, focusing on specific fuel oil consumption, peak cylinder pressure, exhaust gas temperature, and regulated emissions. Results indicate that Tier III achieved the greatest NOx abatement, reducing emissions by up to 76.4% (1464 to 346 ppm), but with penalties of 16.8% higher SFOC and 45.2% higher CO₂ concentration. EcoEGR provided a more favorable compromise, reducing NOx by 52.3% while limiting SFOC increases to ≤15.4% and CO₂ increases to ≤30.9%. Strong correlations were observed between NOx, Pmax, and exhaust gas temperature, reaffirming fundamental trade-offs, while O₂ and CO correlations showed greater variability under sea operation. Despite operational scatter, sea trial results reproduced the key patterns observed in shop tests, confirming robustness across conditions. Overall, this correlation-based analysis provides quantified evidence of performance–emission trade-offs and offers a practical foundation for optimizing CPP-equipped two-stroke engines under varying EGR strategies. Full article

Higher education institutions play a critical role in the transition to a low-carbon future due to their research capacity and societal influence. Accordingly, the calculation of greenhouse gas (GHG) emissions and the prioritization of mitigation strategies are of particular importance. In this study, a comprehensive campus-level GHG inventory was prepared for a public university in Türkiye in alignment with the ISO 14064-1:2018 standard, and mitigation strategies were evaluated. To prioritize these strategies, both the classical Policy Modeling Consistency (PMC) index and, for the first time in the literature, a fuzzy extension of the PMC model was applied. The results reveal that the total GHG emissions for 2023 amounted to 4888.63 tCO₂e (1.19 tCO₂e per capita), with the largest shares originating from investments (31%) and purchased electricity (28.38%). While the classical PMC identified only two high-priority actions, the fuzzy PMC reduced score dispersion, resolved ranking ties, and expanded the number of high-priority actions to seven. The top strategies include awareness programs, energy-efficiency measures, virtual meeting practices, advanced electricity monitoring, and improved data management systems. By comparing the classical and fuzzy approaches, the study demonstrates that integrating fuzzy logic enhances the transparency, reproducibility, and robustness of strategy prioritization, thereby offering a practical roadmap for campus decarbonization and sustainability policy in higher education institutions. Full article