Search Results (166)

Despite the focus on improving cybersecurity awareness, the number of cyberattacks has increased significantly, leading to huge financial losses, with their risks spreading throughout the world. This is due to the techniques deployed in cyberattacks that mainly aim at exploiting humans, the weakest link in any defence system. The existing literature on human factors in phishing attacks is limited and does not live up to the witnessed advances in phishing attacks, which have become exponentially more dangerous with the introduction of generative artificial intelligence (GenAI). This paper studies the implications of AI advancement, specifically the exploitation of GenAI and human factors in phishing attacks. We conduct a systematic literature review to study different human factors exploited in phishing attacks, potential solutions and preventive measures, and the complexity introduced by GenAI-driven phishing attacks. This paper aims to address the gap in the research by providing a deeper understanding of the evolving landscape of phishing attacks with the application of GenAI and associated human implications, thereby contributing to the field of knowledge to defend against phishing attacks by creating secure digital interactions. Full article

Alzheimer’s disease (AD) is a neurodegenerative condition in which amyloid-beta (Aβ) plaques trigger oxidative stress (OS) and neuroinflammation, causing memory loss. OS and neurodegeneration can also be caused by reactive astrocytes, thereby promoting AD via toxic metabolite accumulation in the astrocytic urea cycle. However, the effect of molecular hydrogen (H₂) on this cycle remains unknown. Therefore, we investigated whether H₂ treatment could reduce OS-induced neurodegeneration and memory loss. 5xFAD (n = 14) and wild-type (n = 15) mice were randomized into four groups and treated with either 3% hydrogen gas (H₂) or vehicle for 60 days. Cognitive behaviors were evaluated using the Morris water maze and Y-maze tests. In addition, we used biochemical assays to measure ammonia and hydrogen peroxide (H₂O₂) levels in the hippocampi of the mice and AβO-treated primary mouse astrocytes. Aβ, γ-aminobutyric acid (GABA), and the expression of inflammatory markers were evaluated using immunohistochemistry (IHC) and quantitative real-time polymerase chain reaction (qRT-PCR). We observed that H₂ treatment significantly prevented cognitive deficits, oxidative stress, the accumulation of toxic metabolites, and the increase in inflammatory markers in 5xFAD mice. These results suggest that H₂ therapy can mitigate toxic metabolites in the astrocytic urea cycle, thereby reducing neurodegeneration and memory loss in AD. Full article

Background: Quantitative Flow Ratio (QFR) is a novel, wire-free, and hyperemia-free physiological assessment for guiding Percutaneous Coronary Intervention (PCI), which may offer advantages over traditional angiography-guided PCI. This systematic review with meta-analysis compares clinical outcomes after one year in patients who underwent QFR-guided versus angiography-guided PCI. Methods: This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered on 4 November 2024 in PROSPERO (ID: CRD42024609799). A systematic search was performed across multiple databases to identify clinical trials comparing QFR-guided and angiography-guided PCI. Random-effects models were used to assess one-year outcomes of major adverse cardiovascular events (MACEs), revascularization, and rehospitalization, with heterogeneity measured using I², H², and Cochran’s Q statistics. Study quality was evaluated using the Cochrane Risk of Bias 2 (RoB 2) tool. Results: Compared to traditional angiography-guided PCI, QFR-guided PCI was associated with numerically lower but statistically non-significant risks of MACEs (risk difference: −0.08, 95% CI: −0.20 to 0.04), revascularization (risk difference: −0.02, 95% CI: −0.08 to 0.03), and rehospitalization (risk difference: −0.02, 95% CI: −0.08 to 0.04) over one year. Substantial heterogeneity was observed for MACEs (I² = 84.95%, H² = 6.64) and revascularization (I² = 94.18%, H² = 17.18), whereas rehospitalization exhibited low heterogeneity (I² = 17.17%, H² = 1.21). The risk of bias was assessed by the RoB 2 tool, which revealed low to some concern risk of bias across key domains. Conclusions: Quantitative Flow Ratio (QFR) has demonstrated comparable one-year clinical outcomes to traditional angiography for PCI guidance, with a trend toward improved results. However, the high heterogeneity among studies and the risk of bias necessitate the need for larger, high-quality trials to validate these findings. Full article

Red sage (Salvia miltiorrhiza Bunge) is a perennial herb containing various bioactive compounds that promote human health. In this study, single-factor experiments were first conducted, followed by the optimization of extraction conditions to maximize the saponin content from red sage root extracts. In the single-factor experiments, the highest saponin content (47.5 ± 0.88 mg/g) was obtained using 80% ethanol, a solvent-to-material ratio of 40:1 (mL/g), an extraction period of 3 h, and an extraction temperature of 60 °C. Response Surface Methodology (RSM) was performed to optimize the extraction parameters with a material-to-solvent ratio of 41.31:1 (mL/g), an extraction temperature of 58.08 °C, and an extraction time of 3.16 h. Under these optimized conditions, the experimental saponin content reached 47.71 ± 0.15 mg/g. Additionally, crude extract of red sage exhibited antioxidant activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals with an IC₅₀ value of 16.24 µg/mL. This extract also demonstrated anticancer against 61.79 ± 3.57% HepG2 cancer cells at a concentration of 100 µg/mL. Full article

Proton pump inhibitors (PPIs) are widely prescribed medications primarily used to treat gastroesophageal reflux disease, peptic ulcer disease, and upper gastrointestinal bleeding. Despite clear therapeutic benefits in appropriate contexts, widespread overprescribing and extended use without clear indications have prompted significant concerns about associated risks. Accumulating evidence, predominantly from observational studies, suggests that long-term PPI use may lead to complications such as vitamin and mineral deficiencies, increased risks of infections, dysbiosis, renal dysfunction, bone fractures, cardiovascular disease, and certain malignancies. This narrative review not only synthesizes the current evidence surrounding PPI-related harms and existing deprescribing guidelines but also offers a novel perspective on how stewardship principles can be applied to promote responsible PPI prescribing. In particular, we propose a stewardship-oriented deprescribing framework rooted in implementation science, focusing on provider behavior, patient engagement, and health system-level integration. Recognizing these potential harms, evidence-based deprescribing strategies such as tapering, intermittent dosing, and transitions to alternative therapies are critical to mitigate unnecessary patient exposure. Effective implementation of deprescribing requires addressing patient, provider, and institutional barriers through educational initiatives, policy support, and structured monitoring. By promoting judicious PPI prescribing and proactive stewardship practices, clinicians can significantly reduce medication-related harm and improve patient safety. Full article

Spondylocostal dysostosis (SCDO) is a group of rare genetic disorders characterized by segmental vertebral defects and rib deformities due to congenital misalignment, fusion, or reduction in the number of ribs. The causes of the disease have been found in seven genes, including DLL3 (SCDO1, OMIM 602768), MESP2 (SCDO2, OMIM 608681), LFNG (SCDO3, OMIM 609813), HES7 (SCDO4, OMIM 608059), TBX6 (SCDO5, OMIM 602427), RIPPLY2 (SCDO6, OMIM 616566), and DLL1 (SCDO7). Among these, SCDO4, characterized by a short trunk, short neck, and mild nonprogressive scoliosis, is a rare form of reported cases. SCDO4 is identified as caused by homozygous or compound heterozygous variants in the HES7 gene (NM_001165967.2; NP_001159439.1). This study reports a novel homozygous HES7 splice variant (c.43-9T>A) detected in an SCDO4 patient by whole-exome sequencing and confirmed by Sanger sequencing. This variant was evaluated as an acceptor loss variant in intron 1 in the HES7 transcript by in silico analysis and was inherited from the patient’s parent. This study also reviews previous reports to provide a comprehensive overview of SCDO and help us to understand the pathogenesis to develop future treatment strategies. Full article

Vectorcardiography (VCG) is an electrophysiological investigation technique, giving supplementary information about the electrical activation of the heart, compared to traditional 12-lead electrocardiography (ECG). Whereas the 12-lead ECG has found its way into global clinical cardiology practice in numerous cardiac pathophysiological instances, VCG has not. In an investigation of the electrical activation of the heart in cardiac resynchronization therapy (CRT), in order to understand the baseline pathology in potentially eligible patients, and to understand and optimize CRT-derived paced activation of the heart in the therapy’s recipients, all of these aspects are essential to the success of the therapy. Due to a consistently present group of non-responders in CRT, VCG has gained interest as a potential improvement in this field. This review comprehensively summarizes the contemporary evidence for the additional value of VCG in CRT, as well as current deficiencies in evidence, to support its implementation in global practice in addition to, or as a substitution for, traditional 12-lead ECG. Full article

This paper aims to comprehensively investigate the axial and flexural performance of circularized square reinforced concrete (CSRC) columns discontinuously and continuously confined with carbon fiber-reinforced polymer (CFRP). The test results of twenty reinforced concrete (RC) columns, consisting of twelve CSRC columns and eight square RC (SRC) columns, are presented to compare the axial and flexural performance of discontinuously CFRP-confined CSRC (CFRPC-CSRC) columns with those of continuously CFRPC-CSRC and CFRPC-SRC columns. It was found that to enhance the load-bearing capacity (LBC) of SRC columns, circularizing the SRC columns before applying either discontinuous or continuous FRP confinement was more effective than applying continuous FRP confinement alone. Additionally, the theoretical strength interaction diagrams of test columns were developed using the strip-by-strip method, showing a strong agreement with the experimental results. Full article

This study aimed to assess the co-incorporation of mung bean residue and rice husk biochar with reduced NPK fertilizer rates on rice yield and nutrient uptake in the subsequent rice crop. A field experiment was conducted in five treatments (T1 to T5). In the spring–summer (SS) of 2023, rice was cultivated and its straw was burned (T1), while mung bean was cultivated and its residue was incorporated (T2 to T5). In the next summer–autumn crop (SA), rice was cultivated with different levels of inorganic fertilizers. T1 was added with the conventional fertilizer (95 kg N, 45 kg P₂O₅, and 35 kg K₂O ha⁻¹). T2 included the same amount of NPK fertilizer as T1 with mung bean incorporation. In T3 to T5, rice husk biochar was amended at a rate of 10 Mg ha⁻¹ before SA. In T3, inorganic fertilizers were reduced by 30% of N and 50% of P₂O₅ and K₂O; in T4, by 15% of N, 30% of P₂O₅ and K₂O; and in T5, by 15% of N only. The rice grain yield was 26.6–35.3% significantly higher in T3, T4, and T5 compared to T1. P accumulation in straw and grain was significantly higher in T3, T4, and T5 than in T1. Furthermore, K accumulation in grain was markedly higher in T3, T4, and T5. No significant differences were observed in any of the soil chemical properties among treatments at harvest in SA. This study highlights that the combination of residue incorporation and biochar may substitute a part of chemical fertilizers and contribute to more sustainable rice production. Full article

As Vietnam navigates challenges to its animal, human, and environmental health (One Health) during rapid economic transitions, understanding local perceptions of sustainable food systems, particularly aquatic foods, is vital. This study employs a transdisciplinary, autoethnographic approach to exploring the cultural significance of aquatic food perceptions within Vietnamese communities. Data were primarily sourced through an autoethnographic triangulation method, involving detailed field diaries, vignettes, and interactive workshop data collected from local stakeholders. Our distinctive approach, involving researchers from environmental science, computer science, linguistics, political ecology, aquaculture, nutrition, human physiology, marketing, and accounting and accountability, as both participants and observers, illuminates the lived experiences that shape food perceptions within Vietnam’s specific food agro-ecosystems. By embedding aquatic food perceptions within the One Health framework, we identify key intersections between human, animal, and environmental health. Through cross-disciplinary narrative analysis, our study uncovers the social, political, economic, cultural, and linguistic dimensions surrounding aquatic food perceptions at local, regional, and national levels in Vietnam. Our study highlights the unique contribution of qualitative methods to addressing questions that hard data cannot answer in understanding perceptions of aquatic foods. The study emphasizes the need for an integrated, culturally informed, and transdisciplinary approach to addressing the complex factors influencing One Health outcomes in Vietnam. This research contributes to the broader discourse on sustainable food practices and One Health initiatives, proposing culturally informed interventions aimed at enhancing ecological resilience and public health. Full article

During the past two decades, Hue city has undergone significant changes in its economic development, leading to a rapid transformation of its land-use and land-cover (LULC) patterns. This study used remote sensing data and Geographic Information Systems (GIS) to analyze changes in the land-use and land-cover in Hue city, providing essential insights for the city’s future development. This research examines indicators such as area and land-cover changes, urban development trends, and the morphology of urban areas during the period from 2000 to 2020, with assessments conducted at ten-year intervals. The results showed that built-up and forest land have increased, while agricultural and unused land have decreased over time. By 2020, the urban area had expanded by more than 60% in the north and northeast directions. Hue city developed through infilling and edge expansion of existing urban areas, while some regions primarily expanded into outlying sections in the east and south by constructing high-end residential areas on former paddy rice fields. These findings yield valuable policy implications that extend beyond the case study of Hue city, offering insights for other cities to pursue inclusive and prosperous futures. Full article

The increasing prevalence of heart diseases has driven the development of automated arrhythmia classification systems using machine learning and electrocardiograms (ECGs). This paper presents a novel ensemble learning method for classifying multiple arrhythmia types using 12-lead ECG signals through a blending technique. The framework employs a predetermined meta-model from foundation models, while the remaining models serve as potential base estimators, ranked by accuracy. Using sequential forward selection and meta-feature augmentation, the system determines an optimal base estimator set and creates a meta-dataset for the meta-model, which is optimized through grid search with k-fold cross-validation. Experiments conducted with seven diverse machine learning algorithms (Adaptive Boosting, Extreme Gradient Boosting, Decision Trees, k-Nearest Neighbors, Logistic Regression, Random Forest, and Support Vector Machine) demonstrate that the proposed blending solution, utilizing an LR meta-model with three optimal base models, achieves a superior classification accuracy of 96.48%, offering an effective tool for clinical decision support. Full article

Kidney transplantation (KT) is a preferred treatment for end-stage renal disease (ESRD) because it offers better long-term survival and cost-effectiveness compared to dialysis. Significant global disparities persist in access to KT, particularly in low- and middle-income countries (LMICs). This study aims to assess the epidemiology and outcomes of KT in LMICs while examining the relationship between a country’s income level and its KT prevalence. A systematic review of the literature was conducted, with searches of PubMed, Scopus, and Web of Science from inception to 31 May 2024. Relevant articles reporting on the epidemiology and outcomes of KT or ESRD patients undergoing kidney replacement therapy (KRT) in LMICs were included. A total of 8054 articles were identified, with 972 articles selected for full-text screening after initial title and abstract review. Following full-text screening, 35 articles met the inclusion criteria. The data showed significant variation in KRT and KT prevalence across different geographical locations. Higher-income countries within LMICs tended to have higher KT prevalence rates. Barriers such as inadequate healthcare infrastructure, limited financial resources, and insufficient organ donation frameworks were identified as contributing factors to the low KT rates in these regions. The study highlights the disparities in KT access and prevalence in LMICs, underscoring the need for targeted interventions and international collaboration to address these gaps. Efforts to increase both living and deceased donor transplants, expand health system capacity, and incorporate KT in healthcare planning are needed to close this gap. Global partnerships spearheaded by organizations such as The Transplantation Society (TTS) and the International Society of Nephrology (ISN) are crucial for improving KT rates and outcomes in LMICs. Full article

Background: In the research of coronary artery disease, the precise initial injury that starts the atherosclerotic cascade remains unidentified. Moreover, the mechanisms governing the progression or regression of coronary plaque are not yet fully understood. Based on the concept that the cardiovascular system is a network of pumps and pipes, could fluid mechanics principles and practices elucidate the question of atherosclerosis using flow dynamics images from a novel angiographic technique, focusing on antegrade and retrograde flows and their collisions in iliac and coronary arteries? Methods: From January 2023 to May 2024, coronary angiograms of all hemodynamically stable patients with stable or unstable angina were screened. The angiograms displaying either no lesions (normal) or mild-to-moderate lesions were selected. Each patient underwent an evaluation of flow dynamics and arterial phenomena in both iliac and right coronary arteries. For each artery, data were categorized based on the following parameters: laminar versus non-laminar flow, presence versus absence of collisions, and presence versus absence of retrograde flow. Additionally, in two sub-studies, we analyzed the relationship between retrograde flow and blood pressure, and artificial intelligence algorithms were used to detect the retrograde flow in the right coronary artery. Results: A total of 95 patients were screened, and 51 were included in this study. The results comprised quantitative data (prevalence of laminar flows, collisions, and retrograde flows) and qualitative data (morphological characteristics of antegrade laminar flow, retrograde contrast flow, and instances of flow collision). The results showed that in the iliac artery, laminar flow was observed in 47.06% (24/51) of cases, with collisions noted in 23.53% (12/51). Retrograde flow was present in 47.06% (24/51) of cases, and notably, 75% (18/24) of these cases were associated with uncontrolled diastolic blood pressure (DBP) above 80 mmHg (p < 0.001). Conversely, in the RCA, laminar flow was observed in 54.9% (28/51) of cases, with collisions noted in only 3.92% (2/51). Retrograde flow was identified in 7.84% (4/51) of cases, and all these cases (100%, 4/4) were associated with uncontrolled systolic blood pressure (SBP) above 120 mmHg, though statistical significance was not reached due to the small sample size (p > 0.05). Conclusions: Based on the concept that the cardiovascular system is a network of pumps and pipes, this research methodology provides intriguing insights into arterial flow behaviors by integrating fluid mechanics practices with novel angiographic observations. The preliminary results of this study identified laminar flow as the predominant pattern, with retrograde flow and collisions occurring infrequently. The implications of vortex, collision, and disorganized flow highlight potential mechanisms for endothelial damage and atherosclerosis initiation. Moreover, the correlation with blood pressure underscores the critical role of hypertension management in preventing adverse hemodynamic events. Future directions include refining imaging techniques and further exploring the mechanistic links between flow dynamics and vascular pathophysiology to enhance diagnostic and therapeutic strategies for cardiovascular diseases. Full article

Green roofs (GRs) have been widely adopted as an effective Green Infrastructure (GI) practice in cities worldwide, offering ecosystem services such as stormwater management and reduction of the urban heat island effect. However, their widespread implementation is still limited by a lack of local research and uncertain research findings. As a result, the potential benefits of GRs often cannot justify their high investment costs. Previous studies have sought to enhance the effectiveness of GRs by evaluating new GR systems, such as integrating GRs with green walls, blue roofs, photovoltaic (PV) panels, radiant cooling systems, as well as the use of innovative materials in GR substrates. Biochar, a carbon-rich substrate additive, has been recently investigated. The addition of biochar improves water/nutrient retention of GRs, thereby increasing substrate fertility and promoting plant performance. Although studies have examined the effects of biochar on GR plant growth, long-term observational studies focusing on the impacts of various biochar-related parameters remain necessary. Therefore, this research aims to assess the performance of GR plants with different biochar parameters, namely, amendment rates, application methods, and particle sizes. A one-year-long observational data of plant height, coverage area, and dry weight from six GR test beds was collected and analyzed. Results demonstrate the positive impacts of biochar on plant growth in different biochar-GR setups and types of plant species (wallaby grass, common everlasting, and billy buttons). The GR with medium biochar particles at the amendment rate of 15% v/v had the best plant performance. This contributes to increasing the feasibility of GRs by maximizing GR benefits to buildings where they are installed while reducing GR costs of irrigation and maintenance. The conclusions were further supported by observed data indicating reduced substrate temperature, which in turn reduces building energy consumption. Since vegetation is crucial in determining the effectiveness of a GR system, this study will offer valuable insights to GR designers and urban planners for developing optimal biochar-amended GR systems. Such systems provide numerous benefits over traditional GRs, including enhanced plant growth, reduced building energy costs, a shorter payback period, and reduced structural requirements. Full article