Search Results (4,530)

Electric vehicles (EVs) are emerging as cost-effective and eco-friendly alternatives to gasoline cars, but widespread adoption still faces hurdles, notably the scarcity of public fast-charging stations. This paper proposes an optimal method to locate and size a fast-charging station in Barcelona, integrating solar photovoltaics (PV) and a battery energy storage system (BESS). The goal is to reduce range anxiety, cut investment costs, and minimize environmental impact. We introduce a modular, scalable station design compatible with second-life batteries and PV panels. Our methodology is twofold: first, determining the optimal charging infrastructure configuration; second, calculating financial viability via net present value (NPV) and internal rate of return (IRR). Results indicate that PV and BESS installation represents the largest cost component, yet energy independence enables rapid capital recovery, with payback in around four years. Selling surplus energy can generate an additional ~4% profit. NPV and IRR values confirm feasibility for scenarios using PV, BESS, or both. Particularly in the highway deployment scenario, combining PV and BESS yields a 72% reduction in greenhouse gas emissions. Overall, our study demonstrates that integrating renewable generation and storage into fast-charging infrastructure in Barcelona is both economically viable and environmentally beneficial. Full article

As a large-scale flexible structure, the free-vibration characteristics of a horizontal single-axis solar tracking bracket (HSSTB) hold significance for its dynamic optimization design. However, due to material fabrication, construction processes, and harsh field service environments, structural parameters such as the elastic modulus inevitably exhibit uncertainty, leading to discrepancies between actual free-vibration characteristics and design values. This study considers the randomness of the steel elastic modulus and conducts a global sensitivity analysis of a real-life five-column HSSTB. First, the Kriging method is employed to build a surrogate model to describe the natural frequencies of the HSSTB and its stochastic parameters, which enables efficient evaluation of the statistical characteristics of the HSSTB’s natural frequencies. Further, the Sobol indices are utilized to quantify the influence of parameter randomness on the natural frequencies. The results indicate that the mean values of the first five natural frequencies are slightly lower than the design values. The first, fourth, and fifth natural frequencies of the five-column HSSTB are predominantly influenced by the middle three columns, while the second and third natural frequencies are more susceptible to the two edge columns. Full article

Elexacaftor/tezacaftor/ivacaftor (ETI) is a cystic fibrosis (CF) transmembrane conductance regulator modulator, which has shown efficacy in people with CF (pwCF) carrying the F508del (F) variant, both in homozygosity and heterozygosity with a minimal function (MF) variant. Limited data exist on the effects of ETI in pwCF with advanced lung disease. Our aim was to investigate ETI safety and effectiveness in this patient group in a real-life setting over 2 years. A multicenter observational cohort study was designed to gather real-world information on the effect of ETI treatment on CF patients (aged >12 years, genotype: F/MF mutation) with advanced lung disease as defined by a FEV1 < 40% predicted. Retrospective demographic and clinical data were recorded for the two years preceding and the two years following ETI initiation. The following outcomes were investigated: treatment-associated adverse events (AEs), drug interruptions (temporary or permanent), variations in percent predicted FEV1 (ppFEV1), sweat chloride concentration (SwCl), antibiotic use, body mass index (BMI), and quality of life. A total of 124 (51.6% males) pwCF were treated with ETI over 2 years. The median (IQR) age and ppFEV₁ were 34 (26, 43) years and 34 (29, 41) percentage points, respectively. ETI was discontinued in two pwCF due to lung transplantation, and temporarily interrupted in two because of skin rash, and in three following elevated levels of aminotransferase. Most AEs were mild and short-lasting. In 12.1% pwCF, we registered an increase greater than twice the upper limit of the normal range in alanine aminotransferase, and in 16% we registered an increase in conjugated bilirubin with no increase in aminotransferase. Both increases were recurrent in about half of the subjects. The mean differences (95% CI) for ppFEV₁ and SwCl, assessed as mean values in the pre-ETI and ETI treatment periods, were +11.8 (11.1 to 12.6) and −43.7 (−47.6 to −39.9) mmol/L. A modest increase in ppFEV₁ persisted during the second year of treatment. Number of oral and IV antibiotic cycles/year, as well as hospitalizations/year, decreased significantly from 3.6 to 1.2, from 2.4 to 0.6, and from 2.1 to 0.5 during ETI treatment. A total of 8 of 16 (50%) pwCF were taken off the waiting list for lung transplantation, and significant reductions in the percentages of pwCF using long-term oxygen therapy and non-invasive ventilation were observed. A poor concordance between ppFEV1 and SwCl was found. In only 3/82 (3.7%), subjects with chronic airway infection by Pseudomonas aeruginosa cultures were always negative during ETI treatment. In CF patients with advanced lung disease on ETI treatment, we observed an improvement in a number of clinically significant outcomes over a 2-year study period. However, several additional observations, such as liver dysfunction, variable degrees of lung function improvement, and limited impact on chronic airway infection, underscore the fact that the benefit–risk profile of ETI treatment in cystic fibrosis patients with advanced lung disease has not been fully elucidated and warrants prolonged-term monitoring. Full article

Background: Stress urinary incontinence (SUI) is quite common in women, impairing the quality of life. Diabetes mellitus may exacerbate pelvic floor dysfunction and alter treatment response. Platelet-rich plasma (PRP) is a regenerative option to treat SUI; however, data in women with diabetes are limited. This prospective, non-randomized comparative cohort study evaluated PRP outcomes in diabetic versus non-diabetic women with SUI. Methods: Women with SUI (n = 102; non-diabetic n = 80, diabetic n = 22) received up to three PRP injections at 4–6-month intervals. They were evaluated using the Stamey scale before and after treatment, via the King’s Health Questionnaire (KHQ), assessed at baseline and after each session. Within-group change was tested using Friedman’s test with Dunn–Bonferroni post hoc comparisons; between-group differences used Mann–Whitney U tests. Results: PRP was associated with significant improvements across KHQ domains, with the largest gains by the second injection and smaller increments thereafter. Non-diabetic participants showed earlier, more uniform improvement and additional gains from post-PRP1 to post-PRP2/3. Diabetic participants improved later, with fewer between-session differences. Regarding the Stamey scores, our study concluded that diabetics and non-diabetics improve with PRP treatment, whereas the diabetics treated with insulin have not reached statistical significance in improving SUI. Conclusions: PRP was associated with meaningful, multi-domain improvement in women with SUI, with the most benefit by the second injection and continued reduction in symptom burden thereafter. Although patients with diabetes improved, they had higher total KHQ scores at baseline and later visits, supporting tailored counseling and potential protocol optimization for this subgroup. Full article

This study takes the power battery pack of a pure electric vehicle as the research object, focusing on safety—a core concern widely emphasized in the automotive industry. In practical application scenarios, evaluating the safety of the power battery pack through a single operating condition fails to fully reflect its comprehensive safety performance throughout the vehicle’s entire life cycle. To overcome this limitation, a systematic analysis process was established. First, Catia geometric modeling software was used to simplify the battery pack structure, and HyperMesh was then employed for mesh generation. Second, three core analyses were conducted: static analysis, modal analysis, and extrusion condition analysis. A multi-condition safety evaluation system for electric vehicle battery packs during computer simulation analysis was proposed, which evaluates the battery pack from three dimensions: “dynamic stiffness-static strength-extrusion safety”. Results show that: modal analysis reveals the battery pack’s low-order natural frequencies exceed the vehicle’s excitation frequency (excitation point on the case cover); static analysis confirms it meets operational requirements; extrusion verification proves its safety complies with new national standards. The coupling effect of this multi-dimensional analysis breaks through the limitations of safety performance evaluation under a single operating condition, more realistically reflecting the battery pack’s comprehensive safety over its life cycle and providing a more systematic basis for power battery pack optimization. Full article

In order to offer holistic, patient-centred care, attention needs to be paid to spiritual needs. For long-term paediatric patients, this need can be crucial as they may be facing a range of challenges, including life-limiting or life-changing illnesses. This article is based on two pieces of case study research. The first developed a phenomenological definition of spirituality drawing on both the literature and thirty-six case studies of oncology patients where interpretive spiritual encounters (ISEs) were used to identify spiritual needs. The spiritual needs identified were meaning-making, transcendence, connectedness, security, hope, and significance. A challenge for chaplains is then to identify interventions which can respond to the spiritual needs assessed; examples are offered demonstrating this. The second piece of case study research draws on existing taxonomy research in which thirteen paediatric case studies were analysed for practice-based methods of responding to spiritual needs. This offers the possibility of a common language to describe the chaplain’s response to identified spiritual needs, which informs the interventions chosen. Full article

Background and objectives: Digital deformities in pediatrics are one of the reasons why parents go to podiatry clinics with their children. There is a great diversity of digital alterations in the feet; the origin of the vast majority is genetic. Due to this diversity, different treatments are offered depending on deformity and age, ranging from monitoring progress and changing footwear to deformities that are directly evaluated for surgery. The main objective of this study is to describe and identify the different podiatric digital deformities present in pediatric patients, as well as the most commonly used treatments depending on the deformity. Methods: This study is a bibliographic review that has been carried out after using different search equations and applying a series of inclusion and exclusion criteria, obtaining a total of 10 articles (N = 10). Results: A total of 50% of the studies belong to samples where the authors affirm that surgical treatment is the most appropriate in deformities such as polydactyly and macrodactyly, treated in the first months of life. Half of the studies reviewed were clinical studies with a sample, and the other half were bibliographic reviews. Conclusions: Clinodactyly, syndactyly, and macrodactyly are the most frequent deformities, with the first, second, and third toes being the most affected. Full article

The study estimated the shelf life of specialty coffee packaged in six types of packaging (Tocuyo bag (TB), Double-bilaminate foil and aluminuim bag (DFAB), Ecotac vacuum bag (EV), Pressed cardboard box (PCB), Double-laminated bag without valve, with opening and zipper (DBOZ), Double-laminated bag with degassing valve and zipper (DBDVZ) and Triple-laminated bag with degassing valve and zipper (TBDVZ)). The estimation of shelf life was conducted by means of cup scores provided by six coffee tasters for coffee stored at 40, 50, and 60 °C. The Arrhenius equation was employed to obtain accelerated models for predicting shelf life. It was determined that green coffee beans are most effectively preserved in DBOZ, maintaining their freshness for a period of up to 55.13 days. The second-best option was EV, which has a shelf life of up to 35.21 days. The sole packaging alternative that was subjected to testing for roasted coffee beans was found to allow for their preservation for a period of up to 32 days. However, for roasted and ground coffee, of the four alternatives evaluated, the TBDVZ proved to be the optimal alternative, at 12.18 days. However, the other alternatives (DBOZ and DBDVZ) allow for very similar storage times, at 11.99 and 11.48 days, respectively. PCB does not appear to be a viable packaging alternative for roasted and ground coffee (7.85 days). Finally, we found that coffee stored in DFAB and aluminum bags at 20 °C has been shown to retain its quality for up to 250 days. Furthermore, if the temperature is reduced to 10 °C, the coffee’s shelf life is extended to more than 600 days. The insights derived from this research are of significant value to industry stakeholders, consumers, and developers of specialty coffee packaging. Full article

This article explores Ludwig Wittgenstein’s conception of the will through close engagement with his primary texts, the Tractatus Logico-Philosophicus, Notebooks 1914–1916, and Philosophical Investigations, demonstrating profound resonances with Catholic mystical theology and social teaching. By integrating insights from Peter Tyler’s analysis of mystical strategies, Richard McDonough’s defense of Wittgenstein’s persistent mysticism, and the grammatical Thomism of Herbert McCabe, David Burrell, and Fergus Kerr, this study shows how Wittgenstein’s distinction between empirical and ethical will enriches Catholic theology in three crucial ways: First, it provides a philosophically rigorous account of the transcendental dimensions of moral agency that avoids both determinism and Pelagianism. Second, through Wittgenstein’s analysis of language-games and forms of life, it offers resources for articulating how Catholic doctrine operates within distinctive practices of prayer, sacrament, and ethical commitment. Third, by revealing the grammatical constraints on God-talk, it strengthens the apophatic tradition’s emphasis on divine transcendence while grounding concrete ethical action in subsidiarity and solidarity. Drawing upon Continental philosophy’s emphasis on responsibility and transcendence, this article demonstrates that Wittgenstein’s mystical philosophy, far from being merely speculative, provides essential conceptual tools for contemporary Catholic theological method and pastoral practice. Full article

Background: Obstructive sleep apnea (OSA) impacts daytime alertness, mood, cognition, and quality of life (QoL). Initial alterations in these patient-reported outcomes (PROs) following CPAP therapy, along with their association with adherence and residual respiratory events, are only partially understood. Materials and methods: We conducted a retrospective, observational study from January 2024 to May 2025 involving adult patients with OSA. Standardized assessments were performed at baseline and at six months following the initiation of CPAP: Epworth Sleepiness Scale (ESS), WHOQOL-BREF, MoCA, DASS-21, GAD-7, and PHQ-9. The primary endpoint was the change in Patient-Reported Outcomes (PROs) and cognitive performance. The second was to identify associations between these improvements and the degree of adherence to CPAP therapy and residual AHI. Results: Seventy-two patients (median age, 57; 65.3% male) with moderate to severe OSA had a baseline median AHI of 34.5/h, ODI of 35.5/h, and a mean nocturnal SpO₂ of 92.4%. The initial burden was high: median ESS was 14, indicating excessive daytime sleepiness (EDS), present in 68.9%; median MoCA was 24, with 98.6% scoring below 26; median PHQ-9 was 7; median GAD-7 was 5; and 56.8% and 47.9% scored below 50 in physical and psychological domains of WHOQOL-BREF, respectively. After 6 months, group averages showed improvement: ESS decreased to 8.6 ± 3.7, with a 27.0% residual EDS; PHQ-9 was 7.1 ± 4.5; GAD-7 was 6.2 ± 4.1; and MoCA increased to 25.3 ± 2.7, although 48.6% still showed impairment. WHOQOL-BREF scores improved across domains: physical 58.7 ± 14.2, psychological 61.5 ± 13.6, social 63.2 ± 15.4, and environmental 59.8 ± 14.7, with fewer scores below 50 (physical 23.0%, psychological 18.9%). CPAP adherence was high, with a mean of 87.7% and a median of 95%, predicting a greater ESS reduction (p = 0.027) and showing a trend toward improvement in PHQ-9 scores (ρ = 0.218; p = 0.066). Residual respiratory indices at 6 months (AHI, ODI, SpO₂) did not correlate with PRO or cognitive scores at the same time point (all p > 0.16), nor with their change scores. Conclusions: Over the course of six months, CPAP therapy led to notable improvements in sleepiness, mood, anxiety, cognition, and overall quality of life. Nonetheless, many patients continued to face residual problems, mainly excessive daytime sleepiness (EDS) and cognitive challenges. The positive effects were more closely associated with how well patients adhered to the treatment than with remaining levels of residual AHI or ODI. Full article

Background/Objectives: The rate of periprosthetic joint infection (PJI) is expected to increase in the next years worldwide, mainly due to increasing volume of total joint replacement, longer prosthesis lifespans, and patients with multiple comorbidities. The aim of this study is to describe our personal technique, the modified Hofmann Articulated Spacer (mHAS), in which a CR femoral shield and a partially threaded cannulated screw are inserted into the liner replicating a tibial stem, and to evaluate the efficacy of the spacer as a definitive treatment option in selected patients with knee infections. Methods: A consecutive series of 132 patients were treated for orthopedic infection at the Orthopedic and Trauma Center, University of Turin, between November 2023 and May 2025. All patients included in the study had undergone knee prosthesis removal followed by the implantation of a modified Hofmann Articulated Spacer (mHAS). Functional recovery was evaluated through clinical examination, particularly knee range of motion, and patient-reported outcome measures (PROMs), including the Knee Society Score (KSS), Oxford Knee Score (OKS), and the EQ-5D-5L Visual Analogue Scale (VAS). Results: Nine patients were enrolled in the study, at a mean follow-up of 8.12 months (range: 3–13). The mean range of motion of the knee was 95 degrees (range: 80–120°, SD: 15°). The Knee Society Score (KSS) presented a mean value of 71.9 (SD: 18.11). The Oxford Knee Score (OKS) showed a mean value of 30.8 (SD: 8.5). The EuroQol-5 Dimension-5 Level Visual Analogue Scale (EQ-5D-5L VAS) scores demonstrated an excellent quality of life among the participants. Conclusions: The Modified Hofmann Articulated Spacer demonstrated good functional, qualitative outcomes and eradication rates in patients who underwent the first-stage revision TKA for PKI. This has led us to propose it as a definitive treatment option for more critical and low-demand patients and to postpone the second-stage surgery in the remaining cohort due to satisfactory spacer joint function without pain. Full article

This study investigates the relationship between community commercial center spaces and elderly behavior, focusing on governance mechanisms that shape these spaces and their impact on enhancing elderly life and the community environment. Field research was conducted in the ‘Guohe 1000’ community commercial project in Shanghai, targeting individuals aged 60 and above with independent mobility, including wheelchair users. Through behavioral observation and interviews, both individual and group activities were examined, emphasizing behavioral patterns, spatial domains, and social interactions. Findings reveal that factors such as gender, age, and social networks are positively correlated with the spatial development of community commercial centers. To foster elderly-friendly environments, improvements are needed in utilization balance, secondary activity spaces, age-sensitive design, and operational management. The paper’s novelty lies in two aspects: first, it broadens research into community commercial centers by tracing the construction process of spatial forms; second, it applies environmental behaviorism and environmental gerontology frameworks to integrate individual and collective elderly behaviors into systematic data collection and quantitative analysis. Together, these insights contribute to more inclusive strategies for designing and managing community commercial complexes that support active aging and enhance urban social sustainability. Full article

Electric vehicle (EV) charging presents both a challenge and an opportunity for modern power systems, particularly in workplace environments with grid constraints and dynamic energy pricing. This study presents a real-life implementation and experimental validation of a hierarchical distributed control system for smart EV charging. The proposed architecture combines upper-level receding horizon optimization with lower-level priority-based dispatch, enabling cost-efficient energy allocation and fair distribution among EVs. The system was deployed at the Risø campus of the Technical University of Denmark (DTU) and tested over two days under realistic operational conditions, including heterogeneous EV behavior and limited grid capacity. The control system demonstrated autonomous operation, responsiveness to price signals, and effective coordination between control layers. High energy delivery rates were achieved, nearly 100% on the first test day and close to 90% on the second, despite operating under a constrained energy budget. The study also documents practical challenges encountered during deployment, such as charger communication faults and EV-side issues, and proposes adaptation strategies. These results confirm the feasibility of distributed smart charging in real-world conditions and provide actionable insights for future implementations. Full article

Background and Objectives: Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer’s disease, and its incidence increases with age, being particularly high in people over 70 years of age. For patients with this condition, medical rehabilitation can have a profound impact, helping to improve mobility, preserve functional autonomy, and enhance quality of life. Focal vibration stimulation is a promising, well-tolerated, and easy-to-apply method with potential to facilitate motor activity and support the motor learning process, making it also useful in gait reeducation for patients with various neurological conditions. This systematic review aims to analyze the existing scientific evidence on the effectiveness of focal muscle vibration therapy in managing symptoms of Parkinson’s disease. Materials and Methods: This systematic review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO under the protocol registration number CRD420251120737. Searches were conducted in five databases (PubMed, PEDro, ScienceDirect, Cochrane Library, Web of Science). The selection criteria targeted original clinical studies, published in English between 2010 and the present, that investigated focal muscle vibration therapy in patients with Parkinson’s disease and were fully available, excluding review papers, meta-analyses, books, and articles inaccessible in full text. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess the quality of the included studies. Results: The results of the studies were interpreted individually for each study, and the main information was synthesized in a comparative table to facilitate analysis. The final analysis included five studies that investigated the effects of focal muscle vibration in patients with Parkinson’s disease. The results suggest that this form of stimulation may offer benefits for patients with gait disorders, improving balance and stability. Among the study’s limitations are the small number of included articles (n = 5) and the restriction to English-language publications, which may limit the applicability of the results. Conclusions: Given the promising results, focal muscle vibration therapy could represent a useful option in the management of Parkinson’s disease. Integrating this method into rehabilitation plans could bring significant functional benefits, but further studies are needed to confirm its long-term effectiveness and to establish standardized application protocols. No external funding was received for the conduct of this review. Full article

Enhancing ultra-capacitor (UC) utilization and mitigating battery stress are pivotal for improving the energy management efficiency and service life of hybrid energy storage systems (HESSs). Conventional energy management strategies (EMSs), however, rely on fixed parameters and therefore struggle to allocate power flexibly or reduce battery degradation. This paper proposes a VMD-LSTM-based EMS that incorporates auto-tuning weight and constraint to address these limitations. First, a VMD-LSTM predictor was proposed to improve the velocity and road gradient prediction accuracy, thus leading an accurate power demand for EMS and enabling real-time parameter adaptation, especially in the nonlinear area. Second, the model predictive controller (MPC) was adopted to construct the EMS by solving a multi-objective problem using quadratic programming. Third, a combination of rule-based and fuzzy logic-based strategies was introduced to adjust the weights and constraints, optimizing UC utilization while alleviating the burden on batteries. Simulation results show that the proposed scheme boosts UC utilization by 10.98% and extends battery life by 19.75% compared to traditional MPC. These gains underscore the practical viability of intelligent, optimizing EMSs for HESSs. Full article