Search Results (1,838,879)

In this paper, a two-phase spatio-temporal point process (STPP) defined on a countable metric space and characterized by a conditional intensity function is introduced. In the first phase, the process is memoryless, generating completely random point patterns. In the second phase, the location and occurrence time of each event depend on the spatial configuration of previous events, thereby inducing spatio-temporal correlation. Theoretical results that characterize the distributional properties of the process are established, enabling both efficient numerical simulation and Bayesian inference. A statistical inference framework is developed, for the setting in which the STPP is observed at discrete calendar dates while the spatial locations of events are recorded, their exact occurrence times are unobserved, i.e., interval-censored. This partial observation scheme commonly arises in ecological and epidemiological applications, such as the monitoring of plant disease or insect pest spread across a spatial grid over time. The methodology is illustrated through an analysis of the spatio-temporal spread of sugarcane yellow leaf virus (SCYLV) in an initially disease-free sugarcane plot in Guadeloupe, FrenchWest Indies. Full article

Hard-to-heal wounds remain a significant challenge for healthcare professionals, particularly in aging populations. Although most chronic wounds are associated with diabetes or chronic venous insufficiency, rare etiologies should also be considered. One such cause is envenomation by Phoneutria spp. (native to South America, rare in Europe). Their venom contains potent neurotoxins. While systemic manifestations are more commonly reported, localized necrotic skin lesions may also occur. This case report presents a rare chronic wound following a suspected Phoneutria spider bite and highlights the importance of an individualized, multimodal treatment approach. A 61-year-old male patient with a progressive thigh wound following a spider bite sustained during work. Despite initial self-treatment and pharmacotherapy the wound deteriorated. The patient was admitted to the authors’ facility, where surgical treatment included necrosectomy and a sandwich graft using an acellular dermal matrix combined with a split-thickness skin graft. Adjunctive therapies included negative pressure wound therapy and hyperbaric oxygen therapy. After discharge, outpatient wound care was continued. Treatment was monitored with photographic documentation and serial microperfusion measurements. Complete wound closure was achieved after 4 months of specialized therapy. Management of chronic wounds requires a multidisciplinary and individualized approach with surgical intervention, advanced wound care and specialized outpatient follow-up. Full article

Background/Objectives: Acute generalized exanthematous pustulosis (AGEP) is a severe drug-induced cutaneous reaction characterized by the abrupt onset of sterile pustules, fever, neutrophilia, and a T cell-mediated type IVd hypersensitivity response. This narrative review synthesizes current evidence on pharmacological triggers, immunopathogenic mechanisms, diagnostic criteria, and differential diagnosis to provide a clinically oriented framework. Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, ScienceDirect, and SpringerLink for studies published between 2000 and 2025, complemented by selected clinical reference sources. Studies addressing clinical features, immunological pathways, pharmacovigilance signals, and diagnostic tools for AGEP were included. Synthesis of Evidence: β-lactam antibiotics remain the most frequent triggers, while increasing associations have been reported with hydroxychloroquine, targeted therapies, immune checkpoint inhibitors, psychotropic agents, and vaccines. Immunopathogenesis is driven by IL-36 activation, CXCL8/IL-8–mediated neutrophil recruitment, and IL36RN mutations, explaining overlap with pustular psoriasis. Diagnostic accuracy improves through integration of drug latency, clinical morphology, histopathology, biomarkers, and standardized tools such as the EuroSCAR score. Conclusions: AGEP is a complex pustular reaction induced by diverse drugs and amplified by IL-36-mediated inflammation. Accurate diagnosis requires a multidimensional approach supported by structured algorithms and robust pharmacovigilance to identify evolving drug-associated patterns. Full article

Background: Treatment of chronic painful insertional Achilles tendinopathy is known to be challenging. If non-surgical treatment does not give sufficient relief of symptoms, surgery may be indicated. Treatment with ultrasound (US)- and colour Doppler (CD)-guided wide-awake-local-anaesthetic-no-tourniquet (WALANT) surgery for insertional Achilles tendinopathy is a new approach with promising clinical results. This study aimed to evaluate clinical results of this new approach on patients suffering from insertional Achilles tendinopathy. Methods: Forty-eight consecutive patients with 53 symptomatic tendons (33 men with 34 tendons, mean age 49.3 ± 12.0 years; 14 women with 18 tendons, mean age 55.0 ± 7.4 years) and a duration of more than 12 months with painful insertional Achilles tendinopathy (including tendon, bursae, bone, and plantaris pathology) were included. US- and CD-guided WALANT surgery with removal of pathological bursae, bone, and tendons was used. Immediate weight-bearing loading was allowed, followed by a structured rehabilitation protocol for the first 12 weeks after surgery. VISA-A scores before and after surgery and a questionnaire that evaluated subjective satisfaction with the treatment and current activity level were used. Results: In total, 42/48 patients with 46/53 tendons participated in a 3-year follow-up (mean 34 ± 9 months) by an independent examiner; 39/42 patients with 43/46 tendons were satisfied (n = 37) with the treatment. The mean VISA-A score increased significantly from 41.9 ± 18.2 pre-operatively to 87.7 ± 18.2 post-operatively (p < 0.001). There were three surgical complications, two superficial wound infections, and one minor wound rupture. Conclusions: Patients who suffered from chronic painful insertional Achilles tendinopathy treated with US- and CD-guided WALANT surgery followed by immediate weight-bearing showed high patient subjective satisfaction rates and better functional scores at the 3-year follow-up with a low complication rate. This novel treatment approach warrants more study, including randomised trials comparing it against traditional surgical procedures according to Nunley and Keck and Kelly. Full article

As space systems evolve towards cis-lunar missions and beyond, the demand for precise yet low-size, -weight, and -power (SWaP) clocks and synchronization methods becomes increasingly critical. We introduce a novel clock synchronization approach based on the Kuramoto oscillator model that facilitates the creation of an ensemble timescale for satellite constellations. Unlike traditional ensembling algorithms, the proposed Kuramoto method leverages nearest-neighbor interactions to achieve collective synchronization. This method simplifies the communication architecture and data-sharing requirements, making it well suited for dynamically connected networks such as proliferated low Earth orbit (pLEO) and lunar or Martian constellations, where intersatellite links may frequently change. Through simulations incorporating realistic noise models for small-scale atomic clocks, we demonstrate that the Kuramoto ensemble can yield an improvement in stability on the order of 1/√N, while mitigating the impact of constellation fragmentation and defragmentation. The results indicate that the Kuramoto oscillator-based algorithm can potentially deliver performance comparable to established techniques like Equal Weights Frequency Averaging (EWFA), yet with enhanced scalability and resource efficiency critical for future spaceborne PNT and communication systems. Full article

In response to the growing interest in sustainable and material-efficient architectural solutions, this study focuses on innovative applications of engineered timber in lightweight structural systems. It investigates the material optimization and structural performance of engineered timber thin-shell structures through an integrated parametric design approach. The study compares three prefabricated, panelized building systems, gridshell, segmented full-plate shell, and ribbed shell, to evaluate their efficiency in terms of material intensity, stiffness, and geometric behavior. Using Rhinoceros and Grasshopper environments with Karamba3D, Kiwi3D, and Kangaroo plugins, a comprehensive parametric workflow was developed that integrates geometric modeling, structural analysis, and material evaluation. The results show that segmented ribbed shell and two segmented gridshell variants offer up to 70% reduction in material usage compared with full-plate segmented timber shells, with hybrid timber shells achieving the best balance between stiffness and mass, offering functional advantages (roofing without additional load). These findings highlight the potential of parametric and computational design methods to enhance both the environmental efficiency (LCA) and digital fabrication readiness of timber-based architecture. The study contributes to the ongoing development of computational timber architecture, emphasizing the role of design-to-fabrication strategies in sustainable construction and the digital transformation of architectural practice. Full article

Background/Objectives: Stenotrophomonas maltophilia is an opportunistic pathogen causing severe infections, particularly in patients with cystic fibrosis (CF). Its intrinsic multidrug resistance and biofilm-forming capacity complicate treatment. Although biofilms are generally associated with antimicrobial tolerance, the relationship between biofilm formation and planktonic antibiotic resistance in S. maltophilia remains poorly understood. This study investigated the association between antibiotic resistance profiles and biofilm production in clinical isolates from CF and non-CF patients. Methods: A total of 86 clinical isolates (40 from CF airways and 46 from non-CF patients) were analyzed. Susceptibility to seven antibiotics was assessed by disk diffusion, and multidrug resistance profiles were defined using standard criteria. Biofilm formation was quantified after 24 h using a crystal violet microtiter plate assay and categorized by using a semiquantitative scale. Results: High resistance rates were observed, particularly to meropenem (87.2%), ciprofloxacin (80.2%), and rifampicin (72.1%). CF isolates exhibited significantly higher resistance to piperacillin/tazobactam and a greater prevalence of multidrug resistance. Biofilm formation was detected in 94.2% of isolates, with strong or powerful producers predominating. However, CF isolates formed significantly less biofilm than non-CF isolates. Notably, resistance to piperacillin/tazobactam and meropenem was associated with reduced biofilm biomass and a lower proportion of high biofilm producers. Across all isolates, an inverse correlation was observed between the number of antibiotic resistances and biofilm biomass. These trends persisted after stratification by clinical origin, although some comparisons did not reach statistical significance. Conclusions: This study reveals an unexpected inverse relationship between planktonic antibiotic resistance and biofilm-forming capacity in S. maltophilia. Enhanced biofilm production may represent an alternative persistence strategy in more antibiotic-susceptible strains, with important implications for infection management and therapeutic failure. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly linked to systemic metabolic disturbances and features a lipid-driven cascade that promotes hepatic inflammation and fibrosis. Choline insufficiency contributes to disease advancement by altering phospholipid turnover and redox homeostasis; however, its spatial and temporal regulatory roles throughout MASLD progression remain insufficiently defined. A 10-week high-fat, choline-deficient (HFCD) mouse model was established, and liver pathology was evaluated at weeks 6, 8, and 10. Time-resolved assessments combined untargeted metabolomics, magnetic resonance imaging–proton density fat fraction (MRI-PDFF), serum biochemistry, histological staining, immunofluorescence, and transmission electron microscopy to characterize dynamic alterations in lipid metabolism, redox status, inflammation, and fibrogenesis. The HFCD diet produced a clear temporal sequence of liver injury. Steatosis, phosphatidylcholine depletion, and early antioxidant loss appeared by week 6. By week 8, mitochondrial structural damage and pronounced cytokine elevation were evident. At week 10, collagen deposition and α-SMA activation signaled fibrotic progression. Metabolomics indicated significant disruptions in pathways related to ATP-binding cassette (ABC) transporters, one-carbon metabolism, and the tricarboxylic acid (TCA) cycle. Using integrated analytical strategies, this study suggests that choline deficiency may be associated with a time-dependent pathological cascade in MASLD, beginning with phospholipid destabilization and extending to altered mitochondria–endoplasmic reticulum crosstalk at mitochondria-associated membranes, alongside amplified oxidative–inflammatory responses, which collectively may contribute to progressive fibrogenesis as the disease advances. Full article

Background: Long-distance hiking usually requires carrying a backpack, adding external load to the lower limbs and modifying plantar loading patterns. Excessive loads may contribute to overuse injuries, but quantitative evidence to support current recommendations on backpack weight is still scarce. This study aimed to examine how different backpack loads influence plantar pressure in long-distance hikers. Methods: A cross-sectional observational study was conducted in adults who had walked at least 20 km during the previous 24 h. Sociodemographic and clinical variables were recorded, and barefoot plantar pressure was assessed using the Podoprint^® system under four conditions: without a backpack, with the habitual backpack, and with backpacks loaded to 10% and 20% of body weight. Static and dynamic plantar pressure parameters were analyzed using repeated-measures comparisons. Results: A progressive increase in plantar force was observed in both feet as backpack load increased. Compared with the unloaded condition, static forefoot pressure rose by 5.41% with a 10% load and by 8.73% with a 20% load (p = 0.005); rearfoot pressure increased by 5.01% and 10.17% (p = 0.015); and total foot pressure by 5.04% and 9.61% (p = 0.002). Loads above 10% of body weight significantly modified static plantar pressures and were associated with measurable changes during dynamic assessment. Conclusions: In long-distance hikers, carrying a backpack that exceeds approximately 10% of body weight leads to a clear, load-dependent increase in plantar pressure. These findings provide biomechanical support for recommendations that advise limiting backpack load to around 10% of body weight to reduce plantar stress during hiking. Full article

Lactic acid accumulates in the tumour microenvironment (TME) at concentrations reaching up to 40 mM. Initially, lactic acid was considered merely a metabolic by-product of aerobic glycolysis, a phenomenon commonly referred to as the Warburg effect and observed in the majority of tumours. Recent evidence, however, has demonstrated that lactic acid is not merely a waste product; rather, it plays a pivotal role in tumour biology. High plasma lactic acid levels correlate with increased metastatic potential and lower survival rates. Elevated lactic acid levels in the TME have been shown to suppress antitumour immune responses, facilitate both metastasis and cellular senescence, and might modulate gene expression through novel epigenetic mechanisms such as histone lactylation. This review aims to summarize current knowledge on the multifaceted impact of elevated lactic acid in the TME on tumour progression and biology. Full article

Urban resilience has emerged as a critical paradigm for addressing the intertwined challenges of climate change, rapid urbanization, and social inequality, positioning green public spaces as catalysts for social, ecological, and institutional transformation. This article presents a systematic review conducted under the PRISMA 2020 guidelines, examining how collaborative and community participation influenced transformative urban resilience in green public spaces between 2021 and 2025. A total of 6179 records were initially identified across ScienceDirect and MDPI (last search: July 2025), of which 26 empirical studies met the inclusion criteria (peer-reviewed, empirical, published 2021–2025). Methodological rigor was strengthened through the application of the Mixed Methods Appraisal Tool (MMAT, 2018) and confidence in qualitative evidence was assessed using the GRADE-CERQual approach, enhancing transparency and reliability. Data extraction and synthesis followed a theoretical-methodological coding framework, allowing for the comparison of participatory strategies, typologies of green spaces, resilience dimensions, and applied instruments. The results show that multi-actor co-management, co-design, and community self-organization are the most frequent participatory strategies, while urban green infrastructure, pocket parks, and urban gardens constitute the predominant spatial contexts. Socio-ecological and social-participatory resilience emerged as dominant theoretical perspectives, with qualitative and mixed-methods designs prevailing across studies. Evidence synthesis through GRADE-CERQual identified seven key pathways—multi-actor co-management, Nature-based Solutions, community-based actions, social equity, cultural identity, institutional innovation, and planned densification—each contributing differently to resilience dimensions. Overall, the findings highlight that transformative resilience depends on deep, inclusive participatory processes, multi-level governance, and the integration of social, ecological, and cultural dimensions. Despite the heterogeneity of designs and unequal data adequacy, this review confirms that transformative urban resilience is a co-produced process grounded in community action, ecological sustainability, and collaborative governance. Strengthening underexplored areas—technological innovation, cultural resilience, and standardized methodological instruments—is essential for advancing comparative research and practice. Full article