Search Results (1,700)

Objective: Accurate risk stratification at an early stage may reduce the incidence of infection and improve the survival rate of recipients by adopting targeted interventions. This study aimed to develop a nomogram to predict the risk of multidrug-resistant organism (MDRO) infections in liver transplant (LT) recipients. Methods: We retrospectively collected clinical data from 301 LT recipients and randomly divided them into a training set (210 cases) and validation set (91 cases) using a 7:3 split ratio. Factors related to the risk of MDRO infection after LT were determined using univariate and multivariate bidirectional stepwise logistic regression. The model’s predictive performance and discrimination ability were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Results: 56 (18.60%) patients developed a MDRO infection, including 37 (17.62%) in the training cohort and 19 (20.88%) in the validation cohort. Ultimately, five factors related to MDRO infection after LT surgery were established: ascites (OR = 3.48, 95% CI [1.33–9.14], p = 0.011), total bilirubin (OR = 1.01, 95% CI [1.01–1.01], p < 0.001), albumin (OR = 0.85, 95% CI [0.75–0.96], p = 0.010), history of preoperative ICU stay (OR = 1.09, 95% CI [1.01–1.17], p = 0.009), and length of ICU stay (OR = 3.70, 95% CI [1.39–9.84], p = 0.019). The model demonstrated strong discrimination, and the area under the curve (AUC), sensitivity, and specificity of the training set were 0.88 (95% CI [0.81–0.94]), 0.82 (95% CI [0.76–0.87]), and 0.86 (95% CI [0.75–0.98]), respectively, while for the validation set, they were 0.77 (95% CI [0.65–0.90]), 0.76 (95% CI [0.67–0.86]), and 0.68 (95% CI [0.48–0.89]). The mean absolute error (MAE) in the validation cohort was 0.029, indicating a high accuracy. DCA showed a clinical benefit within a threshold probability range of 0.1 to 0.7. Conclusions: This study developed a clinically accessible nomogram to predict the risk of MDRO infection in LT recipients, enabling early risk stratification and the real-time assessment of infection risk based on the length of postoperative ICU stay. The model incorporates five easily obtainable clinical parameters (ascites, total bilirubin, albumin, preoperative ICU stay history, and length of ICU stay) and demonstrates strong predictive performance, facilitating the early identification of high-risk patients. Future research should focus on refining the model by incorporating additional clinical factors (e.g., immunosuppressive therapy adherence) and validating its generalizability in multicenter, large-sample cohorts to enhance its clinical utility. Full article

Peste des Petits Ruminants (PPR) is a highly contagious viral disease of small ruminants that severely threatens rural livelihoods and global food security. Under the Global Framework for the Progressive Control of Transboundary Animal Diseases (GF-TADs), the international animal health community has set the ambitious goal of eradicating PPR by 2030. However, significant disparities persist in the progression of PPR control across regions. This scoping review assesses the setbacks, deviations, and progress of 42 countries in Eastern, Western, and Northern Africa, as well as West Eurasia, toward achieving official freedom-from-PPR status. Progress was evaluated across key areas using the stepwise PPR Global Control and Eradication Strategy (GCES) approach and the PPR Monitoring and Assessment Tool (PMAT). The eligibility criteria included PubMed peer-reviewed studies, FAO/WOAH reports, presentations, guidelines, and country/region-specific PPR control plans from 2014 through 2024. The data are generated using qualitative and quantitative analyses, including spatial mapping and GCES stepwise progress evaluation. The findings reveal that many (31%) countries in the assessed regions remain in Stage 1 of the Progressive Stepwise Approach, whereas 59.5% have reached Stages 2 and 3, and only 4.8% are in Stage 4. Countries in Western Eurasia have achieved significant progress towards PPR control, with countries achieving PPR-free status, whereas, compared to Eastern and Northern Africa, the Western African region remains in the early control stages due to infrastructure gaps and resource constraints. Additionally, the recent suspension of PPR-free status in Romania, Greece and Hungary following disease emergence underscored vulnerabilities in historically free countries. The analysis results reiterate the critical role of regional collaboration, surveillance tools, and the integration of wildlife monitoring in advancing PPR control. These insights provide actionable pathways to addressing persistent barriers, highlighting the importance of adaptable, evidence-based approaches in achieving the global goal of PPR eradication by 2030. Full article

Cyclacenes with the general formula C_4nH_2n are cyclic analogs of acenes. Acenes are well-known for their high reactivity, which increases with the number of fused benzene rings. The cyclic strain, absence of a Clar sextet, and diradical or polyradical nature are expected to render cyclacenes highly reactive under ambient conditions. Their primary decomposition pathway is anticipated to involve dimerization or polymerization. We explore the reaction pathway of the [_π4_s + _π4_s] dimerization of [n]-cyclacenes for 6 ≤ n ≤ 20 by density functional theory (DFT) using spin-unrestricted and thermally-assisted-occupation (TAO) formalisms. Computational analysis predicts a stepwise reaction mechanism that starts with the formation of a van der Waals complex and proceeds through a transition state to an intermediate with a single new C–C bond and two unsaturated valences. A subsequent second transition state results in the formation of the dimerization product. However, for smaller cyclacenes (n < 10), neither the van der Waals complex nor the first transition state is involved, and the intermediate is formed without a barrier. The largest [20]-cyclacene investigated exhibits the highest barriers for these processes. However, with a barrier as low as 3.9 kcal/mol at the UB3LYP-D3(BJ)/6-31G(d) level of theory, dimerization is anticipated to occur very rapidly. Full article

In recent decades, the interferometric synthetic aperture radar (InSAR) technique has emerged as a powerful tool for monitoring ground subsidence and geohazards. Various satellite SAR systems with different modes, such as Sentinel-1 and Lutan-1, have produced abundant SAR datasets with wide coverage and large historical archives, which have significantly influenced long-term deformation monitoring applications. However, large-scale InSAR data have posed significant challenges to conventional InSAR methods. These issues include the computational burden and storage of multi-temporal InSAR (MT-InSAR) methods, as well as temporal decorrelation for coherent scatterers with long temporal baselines. In this study, we propose a stepwise MT-InSAR with a temporal coherent scatterer method to address these problems. First, a batch sequential method is introduced in the algorithm by grouping the SAR dataset in the time domain based on the average coherence distribution and then applying permanent scatterer interferometry to each temporal subset. Second, a multi-layer network is employed to estimate deformation for partially coherent scatterers using small baseline subset interferograms, with permanent scatterer deformation parameters as the reference. Finally, the final deformation rate and displacement time series were obtained by incorporating all the temporal subsets. The proposed method efficiently generates high-density InSAR deformation measurements for long-time series analysis. The proposed method was validated using 9 years of Sentinel-1 data with 229 SAR images from Jakarta, Indonesia. The deformation results were compared with those of conventional methods and global navigation satellite system data to confirm the effectiveness of the proposed method. Full article

Background: Recent evidence has shown that insulin resistance (IR), a hallmark of nonalcoholic fatty liver disease, predicts bladder cancer (BC) presence. However, the best surrogate marker of IR in predicting BC is still unclear. This study examined the relationships among ten surrogate markers of IR and the presence of BC. Methods: Data from 209 patients admitted to two urology departments from September 2021 to October 2024 were retrospectively analyzed. Individuals (median age 70 years) were divided into two groups (123 and 86 patients, respectively) based on the presence/absence after cystoscopy/TURB of non-metastatic BC. Univariate logistic regression was used to determine the relationships between groups, and the following IR parameters: Triglyceride–Glucose (TyG) index, TyG-BMI, HOMA-IR HOMAB, MetS-IR, Single Point Insulin Sensitivity Estimator, Disposition Index, non-HDL/HDL, TG/HDL-C ratio and Lipoprotein Combine Index. Stepwise logistic regressions were carried out to evaluate the significant predictions and LASSO regression to confirm any significant variable(s). The predictive value of the index test for coexistent BC was evaluated using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). Results: The univariate analysis revealed that the TyG index and MetS-IR were associated with the BC presence. Specifically, the associations of the TyG index and MetS-IR were more significant in participants =/> 65 years old. In multivariate analysis, the stepwise logistic regression, evaluating the most representative variables at univariate analysis, revealed a prediction of BC by only TyG index (OR 2.51, p = 0.012), confirmed by LASSO regression, with an OR of 3.13, p = 0.004). Assessing the diagnostic reliability of TyG, it showed an interesting predictive value for the existence of BC (AUC = 0.60; 95% CI, 0.51–0.68, cut-off 8.50). Additionally, a restricted cubic spline model to fit the dose–response relationship between the values of the index text (TyG) and the BC evidenced the presence of a non-linear association, with a high predictive value of the first knot, corresponding to its 10th percentile. The decision curve analysis confirmed that the model (TyG) has utility in supporting clinical decisions. Conclusions: Compared to other surrogate markers of IR, the TyG index is effective in identifying individuals at risk for BC. A TyG threshold of 8.5 was highly sensitive for detecting BC subjects and may be suitable as an auxiliary diagnostic criterion for BC in adults, mainly if less than 65 years old. Full article

Construction projects in developing countries indicate many implementation problems, such as the technical incompatibility of the implemented structure with the design, incorrect management, the prolongation of a very high percentage of projects up to several times of the planned period, and the increase in costs; it is vital for construction firms to gather, integrate, and communicate the results of project management procedures using tools and methods, including information systems, in order to reduce these problems. Evaluating the results of project management procedures, using tools and methods such as information systems, can be helpful to avoid implementation problems, technical incompatibility of the constructed structure with the design, improper management, delays, and cost overruns. Hence, this study aims to evaluate the influence of information systems on project management success through the mediator variable of project risk management in construction firms. To accomplish this, 95 Iraqi building specialists were picked as a statistical sample using snowball sampling. Three questionnaires were used as data collection tools including an information systems questionnaire with four dimensions and 27 questions, a project management success questionnaire with 27 questions, and a project risk management questionnaire with six dimensions and 25 questions based on a five-point Likert scale measurement. The validity and reliability of the questionnaires were checked and confirmed. Smart PLS 4 and SPSS 28 softwares were used for analyzing the data. Finally, the findings indicated that the impact effect as well as the full effect of information system variables on project management success without the presence of a mediator is significant. Moreover, the indirect effect of information system variables on project management success with the presence of a mediator is also significant. In addition, project risk management has a partial mediator effect on the effect of information system variables on project management success. Also, there is a considerable correlation between the use of information systems and the success of project and risk management. Moreover, in the first phase of stepwise regression, capacity development predicts project management success and risk management variables. The regression analysis revealed that among the dimensions of information systems, the Capacity Development dimension has the ability to predict the success of project management and project risk management. Full article

Background and Objectives: Despite ongoing research and evolving diagnostic criteria, progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) remain notoriously difficult to differentiate, largely due to their overlapping clinical presentations and the absence of definitive biomarkers. Materials and Methods: We provide a comprehensive review of cerebrospinal fluid (CSF) biomarkers, which have proven valuable in the diagnosis of other neurodegenerative conditions, and their application to PSP and CBS. Results: The most promising results derive from a combination of biomarkers associated with Parkinson’s disease, Alzheimer’s disease, and neurofilament light chain. Furthermore, CSF proteomics analysis offers valuable insights into the pathogenesis of PSP and CBS and could also contribute to accurate diagnosis. Conclusions: CSF biomarkers hold significant potential for improving the differential diagnosis of PSP and CBS. A stepwise combination approach—starting with CSF α-synuclein and neurofilament light chain, followed by amyloid-β42 and total and phosphorylated tau—may provide clinicians with a practical framework for distinguishing PSP and CBS from other neurodegenerative disorders. To advance this field, future efforts should prioritize large-scale, multicenter studies employing standardized methodologies to enhance the validity and reproducibility of biomarker-based diagnostics. Importantly, considering the frequent pathological overlap between PSP and CBS, future studies would greatly benefit from pathology-confirmed cohorts to ensure diagnostic accuracy and to better delineate biomarker profiles across these challenging conditions. Full article

Understanding the influence of urban morphology on Land Surface Temperature (LST) is essential for urban planning, development, and mitigating the urban heat island effect. Leveraging high-resolution remote sensing data, this study systematically extracted 64 2D urban morphological parameters (UMPs) and 28 3D UMPs, along with their corresponding summer and winter LST data, at both the grid level (using a 30 m × 30 m grid as the minimum unit) and the block level (using an urban block as the minimum unit). The 2D UMPs were derived from landscape indices of land cover, while the 3D UMPs included 3D building-related UMPs (BUMPs) and tree-related UMPs (TUMPs). Ultimately, multiple statistical methods were employed to investigate the complex mechanisms through which these 2D and 3D UMPs influence LST across summer and winter. This study showed the following results: (1) Most 2D and 3D UMPs significantly correlated with LST in both seasons at the grid/block levels, with stronger correlations at block level. (2) Stepwise regression revealed that combining 2D and 3D UMPs enhanced LST explanation, achieving R² = 70.9% (summer) and 65.7% (winter) for the entire area, with consistent results in built-up zones. (3) Relative importance analysis identified 35 (summer) and 28 (winter) influential features, which were ranked as follows: 2D UMPs > 3D BUMPs > 3D TUMPs. This highlights 2D UMPs’ dominance while confirming 3D UMPs’ significance. These findings emphasize the need for integrated 2D and 3D urban design, considering both planar layouts and vertical configurations of buildings/vegetation. This study provides practical guidance for thermal environment mitigation and sustainable urban development through optimized spatial planning. Full article

The maintenance of critical maritime infrastructure is essential for ensuring the safe, reliable, and efficient operations of marine seaports. This paper proposes a novel fuzzy multi-criteria decision framework for evaluating the maintenance practices and culture of maintenance-critical maritime infrastructure, such as port loading and unloading machinery and equipment. The proposed framework incorporates three distinct multi-criteria decision-making tools Step-wise Weight Assessment Ratio Analysis, Weighted Aggregate Sum Product Assessment, and Technique for Order of Preference by Similarity to Ideal Solution. Fuzzy logic is incorporated into the framework to enhance the precision and robustness of the evaluation process. To form the basis of the assessment, the framework is structured around five key maintenance practice criteria: planning and scheduling; data collection and analysis; documentation and record keeping; maintenance personnel training; and competency, and four important maintenance culture criteria: leadership commitment, proactive and preventive approach, safety and compliance focus, and continuous improvement and learning. To validate the framework, an empirical evaluation was conducted, analyzing maintenance practices and culture across six Nigerian seaports. Data collection uses a questionnaire administered to relevant maintenance experts in the ports, ensuring a comprehensive and expert-informed analysis. The data collected was then analyzed using the fuzzy multi-criteria decision framework. The results provide valuable and actionable insights into the current maintenance practices and maintenance culture of the ports, identifying areas for improvement. Full article

Caregiving for dependent older adults presents significant health and occupational challenges, particularly in rural Thailand. This study examines predictors of health-related quality of life (HR-QOL) among in-home caregivers, focusing on health promotion, non-communicable diseases (NCDs) prevention, and occupational health practices. An analytic cross-sectional study was conducted among 701 caregivers across 23 districts in Nakhon Si Thammarat, southern Thailand. Data were collected through structured questionnaires assessing socio-demographics, health behaviors, working conditions, and HR-QOL using the Thai SF-36V2. Stepwise regression analysis identified key predictors of HR-QOL. Our findings indicate that most caregivers were female (81.5%), middle-aged (mean age: 47.7 years), and had moderate education levels. Over half experienced moderate exposure to occupational hazards, including physical, biological, ergonomic, and psychosocial risks, contributing to job strain, inadequate rest, and strained relationships. HR-QOL scores suggested that a significant proportion of caregivers had moderate to poor quality of life, particularly in physical health domains. Stepwise regression analysis showed that better self-reported health promotion behaviors and occupational hazard prevention practices were positively associated with HR-QOL, whereas the presence of NCDs had a negative impact. These findings highlight the need for targeted interventions to enhance caregivers’ well-being and inform public health strategies for strengthening community-based care systems. Full article

The Yangtze River Delta region is facing the demand for high-quality economic development, and the study of urban network as a manifestation of the interaction between cities is becoming increasingly important. This study focused on the node structure of the urban network in the Yangtze River Delta urban agglomeration from 2010 to 2021, used the modified gravity model to construct a polycentric city network from the perspective of economic flow, used the spatial Durbin model for spatial econometric analysis, and identified the conduction path through the two-step method of causal stepwise regression mediating effect test. The results show that Shanghai, as the core node city, has significantly promoted the economic development of Hangzhou, Nanjing, Hefei, and other cities and formed a metropolitan network structure characterized by “one core and five circles”. Under different spatial weight matrices, the polycentric city network has a significant positive impact on economic growth, and its impact is not only related to the economic level of the city itself but also closely related to the economic status of its neighboring cities. The polycentric city network significantly enhances economic growth by accelerating the flow of regional factors, promoting regional industrial division of labor and cooperation, and enhancing regional innovation capabilities. Full article

Traditional VO_2max testing methods are often impractical for manual wheelchair users, as they rely on lower-body exercise protocols, require specialized equipment, and trained personnel. The 6-Minute Push Test (6MPT) is a widely used cardiovascular assessment that may provide a feasible alternative for estimating aerobic capacity in this population. This study aimed to develop a predictive model for VO_2max using physiological variables recorded during the 6MPT. Twenty-eight participants (14 novice and 14 expert manual wheelchair users) completed the test while wearing a VO₂ mask and heart rate monitor. Spearman correlation analysis showed that distance covered during the 6MPT significantly correlated with VO_2max (r = 0.685, p < 0.001). A stepwise linear regression identified two predictive models: one using distance alone (R² = 0.416, p < 0.001) and another incorporating both distance and maximum heart rate (R² = 0.561, p < 0.001). These models offer practical estimations of VO_2max, eliminating separate protocols. Our findings suggest that the 6MPT can serve as a simple, cost-effective alternative to laboratory-based VO₂ testing, facilitating routine cardiovascular fitness assessments for manual wheelchair users in clinical and community settings. Future research should focus on validating these models in a larger, more diverse cohort to enhance their generalizability. Full article

This study developed a nitrogen management framework that simultaneously addresses photosynthetic limitations and water scarcity challenges, providing a scalable solution for sustainable wheat production in arid farming systems. Focusing on Xinjiang’s arid region, we investigated how different ratios of basal to topdressed nitrogen fertilization affect photosynthetic mechanisms in drip-irrigated spring wheat. We implemented a split-plot design during the 2020–2021 growing seasons, using two wheat cultivars as main plots: strong-gluten Xinchun 37 (XC37) and medium-gluten Xinchun 6 (XC6). The subplots consisted of five N application treatments: N00: (no nitrogen application, control), N28 (base fertilizer 20%, top dressing 80%, and so on), N37 (3:7), N46 (4:6), and N55 (5:5). The vast majority of indicators performed best under N37 treatment. And LAI, RuBPC (ribulose-1,5-diphosphate ribulose carboxylase) activity, net photosynthetic rate (P_n), yield, and its composition were higher than the rest of the treatments by 0.21~31.75%, 6.94~25.21%, 7.42~40.78%, 0.86~25.44%, and 0.44~12.02%. And intercellular CO₂, concentration (C_i) was lower than other treatments by 7.63~50.60%. Yield showed q highly significant positive correlation with P_n, G_s, T_r, Φ_PSⅡ, and chlorophyll fluorescence parameters, but a negative correlation with C_i. Stepwise regression analysis showed that LAI, P_n, C_i, and RuBPC activity had a significant impact on yield and its compositions. In addition, all index performances of XC37 were better than XC6. Under drip irrigation in arid zones, allocating 30% basal + 70% topdressed N optimally enhances photosynthetic capacity and yield formation in spring wheat, offering a practical pathway for sustainable intensification in water-limited agroecosystems. Full article

In this study, a quantitative profiling method for detecting free fatty acids in crude lanolin based on the Quality by Design (QbD) concept was developed. High-performance liquid chromatography (HPLC) equipped with a charged aerosol detector (CAD) and a Proshell 120 EC C18 column was employed for the separation of crude lanolin components. Initially, the analytical target profile and critical method attributes were defined. Potential critical method parameters, including column temperature, flow rate, isocratic run time, gradient end organic phase ratio, and gradient time, were identified using fishbone diagrams and single-factor experiments. The definitive screening design (DSD) was then utilized to screen and optimize these parameters. Stepwise regression was applied to establish quantitative models between the critical method attributes and the method parameters. Subsequently, the method operable design region (MODR) was calculated and was successfully verified. The analytical conditions established were configured with 0.1% formic acid in water and 0.1% formic acid in acetonitrile serving as the mobile phases. The flow rate was set at 0.8 mL/min, and the column temperature was maintained at 35 °C with the evaporation tube temperature also set at 35 °C. An injection volume of 10 μL was used for each analysis. The gradient elution conditions were as follows: from 0 to 30 min, 75% of solvent B was used, and from 30 to 60 min, the proportion of solvent B was increased from 75% to 79%. Ten components, including 12-hydroxystearic acid, 2-hexyldecanoic acid, and palmitic acid, were identified by mass spectrometry, and seven common peaks were found in the fingerprints. The contents of palmitic acid, oleic acid, and stearic acid in the crude lanolin were quantitatively determined. Both the fingerprint and quantitative analysis methods were validated. The method was applied to analyze 15 batches of crude lanolin from different sources. The new established quantitative profiling method for free fatty acids can be potentially used for industrial applications to enhance the quality control of crude lanolin. Full article

The standardization of catch per unit effort (CPUE) is essential for accurate stock assessment in fisheries management. This study focuses on CPUE standardization for red snow crab (Chionoecetes japonicus) in South Korea, incorporating both spatiotemporal and socioeconomic factors into a generalized additive model (GAM) framework. Using fishery-dependent data from 2009 to 2023, we analyzed the influence of variables such as the proportion of live catch, oil prices, global export prices, and the COVID-19 pandemic on CPUE trends. To quantify the contribution of each variable, a stepwise exclusion analysis was conducted. The results show that excluding socioeconomic variables leads to a more stable CPUE trajectory, indicating that nominal CPUE fluctuations are partially driven by economic conditions rather than changes in biological abundance. These findings highlight the importance of accounting for external drivers, particularly socioeconomic factors when standardizing CPUE. By doing so, the year effect extracted from the model can more accurately reflect relative stock abundance. The approach presented here offers a practical solution for improving CPUE estimates in data-limited fisheries and supports adaptive, evidence-based fisheries management. Full article