Search Results (2,205)

Hypophosphatemia, defined as serum phosphate levels below 2.5 mg/dL, is a common yet underrecognized electrolyte disturbance in critically ill patients, with prevalence estimates reaching up to 80%. This review explores the intricate bidirectional relationship between hypophosphatemia and hyperventilation, emphasizing its profound implications for respiratory function and critical care management. Hypophosphatemia impairs oxygen delivery by depleting 2,3-diphosphoglycerate (2,3-DPG), disrupts central respiratory drive, and weakens respiratory muscles, leading to hyperventilation, ventilatory failure, and prolonged mechanical ventilation. Conversely, hyperventilation exacerbates hypophosphatemia through respiratory alkalosis, triggering intracellular phosphate shifts and metabolic cascades that rapidly deplete serum levels. This cycle creates significant challenges for ventilator weaning and increases morbidity and mortality. Underlying mechanisms include impaired ATP synthesis, altered chemoreceptor sensitivity, and systemic inflammatory responses. Hypophosphatemia-induced hyperventilation manifests as unexplained tachypnea and respiratory alkalosis, often misdiagnosed as anxiety or pain, while hyperventilation-induced hypophosphatemia contributes to diaphragmatic dysfunction and poor ventilatory performance. Common precipitating factors include refeeding syndrome, diabetic ketoacidosis, continuous renal replacement therapy, and malnutrition. Complications extend beyond respiratory dysfunction to include cardiac depression, immune dysfunction, prolonged ICU stays, and increased healthcare costs. Current diagnostic approaches rely on serum phosphate measurements, which poorly reflect total body stores due to significant intracellular shifts. Emerging biomarkers such as fibroblast growth factor 23 (FGF23) and advanced monitoring technologies, including continuous phosphate tracking, may enhance recognition. Treatment strategies emphasize targeted phosphate repletion based on severity, with intravenous supplementation and ventilatory support tailored to minimize complications. Preventive measures, including risk stratification, prophylactic supplementation, and ventilator management, are critical for high-risk populations. Despite advances, knowledge gaps persist in optimizing monitoring and repletion protocols, understanding genetic variations, and identifying ideal phosphate targets for improved respiratory outcomes. This review provides a comprehensive framework for recognizing and managing hypophosphatemia’s impact on respiratory dysfunction in critically ill patients. Adopting evidence-based interventions and leveraging emerging technologies can significantly improve clinical outcomes, reduce ICU complications, and enhance recovery in this vulnerable population. Full article

This study examines the potential of satellite internet technologies to enhance crisis management in urban evacuation scenarios in Italy, with a specific focus on the Starlink system as a case study. In emergency situations, traditional mobile and WiFi networks often become inaccessible, significantly impairing timely communication and coordination. Reliable connectivity is therefore imperative for effective rescue operations and public safety. This research analyzes how satellite-based internet can provide robust, uninterrupted connectivity even when conventional infrastructures fail. The study discusses operational advantages such as rapid deployment, broad coverage, and scalability during disasters, as well as key constraints including line-of-sight requirements, environmental sensitivity, and regulatory challenges. Empirical findings from the deployment of Starlink during an actual urban evacuation event in Italy indicate that latency dropped below 200 ms and sustained upload/download speeds averaged approximately 50 Mbps—up to three times faster than ground networks in disrupted zones. By evaluating both benefits and limitations, this paper provides a comprehensive understanding of the integration of satellite internet services within Italian emergency response systems, aiming to improve the performance of urban evacuation strategies. Full article

Following the significant disruption of traditional teaching by the COVID-19 pandemic, gamified education—an approach integrating technology and cognitive strategies—has gained widespread attention and use among educators and learners. This study explores how game-based learning, supported by situated learning theory and game design elements, can boost learner motivation and knowledge construction. Using 20,293 user comments from the Chinese video platform Bilibili, the study applies sentiment analysis and LDA to uncover users’ sentimental tendencies and cognitive themes. The analysis identifies four core themes: (1) The application of contextual strategies in language learning, (2) Autonomous exploration and active participation in gamified learning, (3) Progressive enhancement of logical thinking in gamified environments, and (4) Teaching innovation in promoting knowledge construction and deepening. Building on these findings, the study further develops a cognitive scaffolding model integrating “contextualization–procedural logic–active construction” to explain the mechanisms of motivation–cognition interaction in gamified learning. Methodologically, this study innovatively combines LDA topic modeling with sentiment analysis, offering a new approach for multidimensional measurement of learner attitudes in gamified education. Theoretically, it extends the application of situated learning theory to digital education, providing systematic support for instructional design and meaning-making. Findings enrich empirical research on gamified learning and offer practical insights for optimizing educational platforms and personalized learning support. Full article

Laccases, a class of multicopper oxidases found in diverse biological sources, have emerged as key green biocatalysts with significant potential for eco-friendly pollutant degradation. Their ability to drive electron transfer reactions using oxygen, converting pollutants into less harmful products, positions laccases as promising tools for scalable and sustainable treatment of wastewater, soil, and air pollution. This review explores laccase from a translational perspective, tracing its journey from laboratory discovery to real-world applications. Emphasis is placed on recent advances in production optimization, immobilization strategies, and nanotechnology-enabled enhancements that have improved enzyme stability, reusability, and catalytic efficiency under complex field conditions. Applications are critically discussed for both traditional pollutants such as synthetic dyes, phenolics, and pesticides and emerging contaminants, including endocrine-disrupting chemicals, pharmaceuticals, personal care products, microplastic additives, and PFAS. Special attention is given to hybrid systems integrating laccase with advanced oxidation processes, bioelectrochemical systems, and renewable energy-driven reactors to achieve near-complete pollutant mineralization. Challenges such as cost–benefit limitations, limited substrate range without mediators, and regulatory hurdles are evaluated alongside solutions including protein engineering, mediator-free laccase variants, and continuous-flow bioreactors. By consolidating recent mechanistic insights, this study underscores the translational pathways of laccase, highlighting its potential as a cornerstone of next-generation, scalable, and eco-friendly remediation technologies aligned with circular bioeconomy and low-carbon initiatives. Full article

The reliability of health monitoring technologies has become increasingly critical as Ambient Intelligence (AmI) becomes integrated into healthcare. However, a significant gap remains in systematically evaluating reliability, particularly in resource-constrained environments. This study addresses this gap by introducing a comprehensive framework specifically designed to evaluate the reliability of AmI-based health monitoring systems. The proposed framework combines robust simulation-based techniques, including reliability block diagrams (RBDs) and Monte Carlo Markov Chain (MCMC), to evaluate system robustness, data integrity, and adaptability. Validation was performed using real-world continuous glucose monitoring (CGM) and heart rate monitoring (HRM) systems in elderly care. The results demonstrate that the framework successfully identifies critical vulnerabilities, such as rapid initial system degradation and notable connectivity disruptions, and effectively guides targeted interventions that significantly enhance overall system reliability and user trust. The findings contribute actionable insights for practitioners, developers, and policymakers, laying a robust foundation for further advancements in explainable AI, proactive reliability management, and broader applications of AmI technologies in healthcare. Full article

The paradigm shift from FinFET to gate-all-around nanosheet (GAA-NS) transistor architectures necessitates fundamental innovations in channel material engineering. This work addresses the critical challenge of pFET performance degradation in GAA-NS technologies through the development of an advanced selective etching process for strain-engineered SiGe channel formation. We present a systematic investigation of Si selective etching using CF₄/O₂/N₂ gas mixture in a remote plasma source reactor. It is demonstrated that the addition of N₂ to CF₄/O₂ plasmas significantly improves the selectivity of Si to SiGe (up to 58), by promoting NO* radical-induced passivation layer disruption on Si surfaces. Furthermore, an increase in the F:O ratio has been shown to mitigate stress-induced lateral micro-trenching (“Si-tip”), achieving near-zero tip length at high CF₄ flow (500 sccm) while retaining selectivity (>40). Transmission electron microscopy and energy-dispersive X-ray spectroscopy confirm the complete removal of the Si sacrificial layer with minimal SiGe channel loss, validating the process for high-performance SiGe GAA-NS FET integration. These findings provide critical insights into strain-engineered SiGe channel fabrication, enabling balanced NFET/PFET performance in next-generation semiconductor technologies. Full article

Additive manufacturing (AM), or 3D printing, is increasingly recognised as a disruptive production technology with the capacity to reduce greenhouse gas (GHG) emissions across manufacturing and transportation sectors. By enabling material efficiency, lightweighting, part consolidation, and decentralised, on-demand production, AM offers pathways to lower embodied energy, minimise waste, and shorten supply chains. This review critically evaluates AM’s role in decarbonisation, with a focus on clean transportation applications, including electric vehicles, fuel cells, and hydrogen storage systems. Case studies quantify energy savings, operational efficiency gains, and life-cycle GHG reductions compared to conventional manufacturing routes. The analysis also addresses technical and economic limitations—such as material availability, scalability, certification, and cost competitiveness—and explores synergies with circular economy principles, digital design optimisation, and artificial intelligence. Policy recommendations and industry–academia collaboration models are proposed to accelerate AM adoption, integrate renewable energy sources, and strengthen recycling infrastructure. By synthesising technical, economic, and policy perspectives, the study positions AM as a critical enabler of net-zero manufacturing and a catalyst for sustainable industrial transformation. Full article

The Sustainable Development Goals (SDGs), established by the United Nations in 2015, aim to address global challenges like poverty, inequality, and climate change, yet only 17% of these goals are on track for 2030. This study investigates the geopolitical, economic, and technological barriers to SDG progress, focusing on the middle-income trap, trade regionalisation, and automation’s impacts. Using quantitative and qualitative methods, we analysed World Bank, IMF, UN, and OECD data (2005–2024) on GDP, FDI, exports, and public debt across various income-level countries. Findings reveal that economic growth is hindered by market saturation, ageing populations, high debt, and declining FDI, while global trade stagnation since 2011 and regionalisation impede cooperation. Automation reduces employment, shrinks the middle class, and threatens stability, with geopolitical tensions disrupting supply chains. The current economic model, reliant on consumption, investment, and exports, is insufficient for sustainable development. The novelty of this study lies in its integrated analysis of three structural global trends—trade stagnation, regionalisation, and automation—over the period 2005–2024. Unlike previous works that typically examine these factors in isolation or over shorter time horizons, our approach highlights their combined impact on SDG achievement. By formulating and testing specific hypotheses, the study contributes to the literature by providing empirical evidence on how these interrelated processes jointly hinder sustainable development under the current global economic model. Full article

N-polar GaN HEMT technology has emerged as a disruptive technology that outperforms Ga-polar GaN HEMTs in terms of high-frequency power amplification capability. In this paper, the authors present a comprehensive review of the evolution of N-polar GaN HEMT technology from the perspective of crystal growth, dielectrics, and metals on N-polar GaN, transistor design, and performance. Specifically, the authors discuss the progress of the N-polar GaN HEMTs toward high-frequency, high-power, and high-efficiency applications with recent record-level performances, demonstrated by the authors, at mmWave frequencies. Full article

Access to microbiologically safe water in preschool educational settings constitutes a pressing public health challenge, particularly in rural areas with deficient infrastructure. Repeated exposure to enteropathogens present in contaminated water has been associated with acute gastrointestinal infections, environmental enteropathy, and disruptions in the intestinal microbiota of young children. Motivated by this concern, the present study evaluates the microbiological quality of water in 32 public preschool facilities in the municipality of Matehuala, San Luis Potosí—18 urban and 14 rural—by analyzing the presence of aerobic mesophilic bacteria (AMB), total coliforms (TC), fecal coliforms (FC), and helminth eggs. The assessment was conducted in accordance with Mexican standards NOM-092-SSA1-1994 and NOM-230-SSA1-2002 and supplemented with the World Health Organization’s guidelines for drinking-water quality. The findings revealed a marked territorial disparity: 100% of rural schools that relied on rooftop water tanks exceeded permissible limits for TC, and 35.7% tested positive for FC. In contrast, all urban schools—supplied through piped water systems—complied with current regulations. Statistical analysis (Mann–Whitney U test, p < 0.05) confirmed significant differences in microbiological contamination based on geographic location and type of water supply. In all FC-positive cases, a lack of sewage infrastructure and inadequate sanitation practices in storage containers were documented. These results demonstrate that formal access to water does not ensure its microbiological safety, particularly in settings with poor structural conditions. The study underscores the urgent need to implement point-of-use water treatment technologies, establish regular microbiological monitoring protocols, and provide training for educational staff in water hygiene practices. Full article

The evolution of industrial automation toward Industry 3.0 and 4.0 has driven the emergence of Industrial Edge-Cloud Platforms, which increasingly depend on web interfaces for managing and monitoring critical operational technology. This convergence introduces significant security risks, particularly from Broken Access Control (BAC)—a vulnerability consistently ranked as the top web application risk by the Open Web Application Security Project (OWASP). BAC flaws in industrial contexts can lead not only to data breaches but also to disruptions of physical processes. To address this urgent need for robust web-layer defense, this paper presents VeriFlow, a static verification framework for access control in web applications. VeriFlow reformulates access control verification as a consistency problem between two core artifacts: (1) a Formal Access Control Policy (P), which declaratively defines intended permissions, and (2) a Navigational Graph, which models all user-driven UI state transitions. By annotating the graph with policy P, VeriFlow verifies a novel Path-Permission Safety property, ensuring that no sequence of legitimate UI interactions can lead a user from an authorized state to an unauthorized one. A key technical contribution is a static analysis method capable of extracting navigational graphs directly from the JavaScript bundles of Single-Page Applications (SPAs), circumventing the limitations of traditional dynamic crawlers. In empirical evaluations, VeriFlow outperformed baseline tools in vulnerability detection, demonstrating its potential to deliver strong security guarantees that are provable within its abstracted navigational model. By formally checking policy-graph consistency, it systematically addresses a class of vulnerabilities often missed by dynamic tools, though its effectiveness is subject to the model-reality gap inherent in static analysis. Full article

Background/Objectives: The COVID-19 pandemic has significantly disrupted healthcare systems worldwide, exposing longstanding weaknesses, particularly in the prevention and control of healthcare-associated infections (HAIs). Regional disparities in infection prevention and control (IPC) strategies offered valuable lessons for improving public health preparedness. This systematic review aims to identify and compare regional IPC approaches adopted during and after the pandemic, highlighting best practices to strengthen healthcare resilience. Methods: The review was conducted in line with PRISMA guidelines and registered in the PROSPERO database (CRD420251032525). Articles published between 1 January 2020 and 31 March 2025, were retrieved from PubMed, Scopus, and Web of Science. Only full-text studies in English were included. The risk of bias was assessed using the ROBINS-I tool. Results: Of the 63 articles initially identified, 8 met the inclusion criteria. The selected studies demonstrated substantial variability in the implementation of IPC. The availability of infrastructure, funding, coordination capacity, and training of medical staff had a significant impact on outcomes. In regions with well-defined protocols and a solid infrastructure, there was a significant decrease in HAIs, while in resource-poor areas, there was a significant increase. Effective measures included continuous monitoring, regular staff training, provision of adequate equipment, expansion of testing capacity, reorganisation of hospitals, and introduction of technological innovations in healthcare. Conclusions: COVID-19 emphasised the importance of adaptable IPC frameworks. Strengthening health systems requires context-specific standards, sustained investment in infrastructure, continuous training, and increased international cooperation to better prepare for future health emergencies. Full article

This empirical paper explores South African preservice accounting teachers’ perceptions of ICT integration in secondary schools’ accounting curriculum practices. Since 2020, curriculum practices have been characterised by disruptions to traditional teaching and learning methods, including those brought on by the COVID-19 pandemic. Curriculum practices in accounting were not unnoticed. These sparked discussions about pedagogical changes, academic continuity, and the future of accounting curriculum practices. The theoretical framework used to guide the research process is connectivism. The theory is about forming connections between people and technology and teaching and learning in a connectivist learning environment. Connectivism promotes a lifelong learning perspective by training teachers and students to adapt to a fast-changing environment. An interpretive paradigm underpins this qualitative research paper. The data were collected from semi-structured interviews with five preservice accounting teachers about how they navigated pedagogy while switching to digital curriculum practices. Thematic analysis was used. The findings revealed that preservice accounting teachers faced challenges in ICT integration during school-based training, including limited resources, inadequate infrastructure, and insufficient hands-on training. While ICT tools enhanced learner engagement, barriers such as low digital skills and a lack of technical support hindered effective use. Participants highlighted a disconnect between theoretical training and classroom practice, prompting self-directed learning to bridge skill gaps. The study underscores the need for teacher education programs to provide practical, immersive ICT training to equip future educators for technology-driven classrooms. Full article

Under the multiple pressures of intensifying global climate change disruption and rapid economic growth, China has become one of the countries facing the most serious water scarcity problems. Based on the ISO 14046 standard and the framework of water scarcity footprint theory, this study will break through the static limitations and lack of dimensions of traditional characteristic factors (i.e., water stress) and construct a water stress evaluation index system that combines nature, economy, and society. The results indicate that in recent years, regional water stress in China has exhibited significant spatiotemporal variations and spatial clustering, primarily driven by composite factors, with an overall decreasing trend. Among them, Shanghai is the highest-pressure area and Shaanxi is the lowest-pressure area, which is mainly due to the spatial projection of the coupling effect of multi-dimensional factors. In addition, the obstacle degree analysis method shows that indicators such as the utilization rate of water resource development constitute cross-regional constraints. To this end, all regions should make efforts to regulate and control the water use structure, introduce water-saving technologies, and strengthen water-saving publicity according to their needs. Therefore, this study not only provides a scientific basis for in-depth understanding of the distribution law and influencing mechanism of water stress but also provides an important reference for the rational allocation and sustainable use of water resources by upgrading the characteristic factors to system control signals. Full article

Heavy metals (HMs) including cadmium (Cd), lead (Pb), arsenic (As), zinc (Zn), copper (Cu), chromium (Cr), and nickel (Ni) pose significant challenges to bioenergy crop production due to their persistence, toxicity, and bioaccumulation in soils and plants. This study not only summarizes the mechanisms of HM absorption, translocation, and accumulation in bioenergy crops, but also critically assesses their impact on crop development, biomass quality, and biorefinery processes. Heavy metals disrupt key physiological processes and modify lignocellulosic composition, which is important for biofuel and biogas production. Global soil contamination from sources like industrial emissions, mining, and agricultural activities exacerbates these problems, posing a threat to both energy security and environmental sustainability. Sustainable management strategies, including phytoremediation, microbial bioremediation, soil amendments, and genetic engineering, are explored to mitigate HM effects while enhancing crop resilience. This review emphasizes the importance of integrating techniques to balance bioenergy production with environmental and human health and safety, including the use of HM-tolerant crop varieties, enhanced biorefinery processes, and robust policy frameworks. Future research should focus on developing scalable remediation technologies and interdisciplinary solutions that align with the United Nations’ Sustainable Development Goals and meet global bioenergy needs. Full article