Search Results (443)

Background/Objectives: Rifampicin-resistant tuberculosis (RR-TB) and HIV co-infection remain major contributors to morbidity and mortality, particularly in high-burden settings. HIV-related clinical factors, including viral suppression, CD4-defined immune status, HIV drug resistance, virological failure, and ART failure, may influence RR-TB treatment response; however, existing evidence remains fragmented. This systematic review and meta-analysis protocol aims to synthesize evidence on the impact of HIV viral suppression, immune status, and HIV drug resistance/ART resistance status on RR-TB treatment outcomes. Methods: This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Published peer-reviewed studies and relevant grey literature from January 2005 to December 2025 will be searched in PubMed/MEDLINE, Cochrane Library, Embase, Web of Science, ScienceDirect, EBSCOhost, PsycINFO, Google Scholar, and other relevant sources. No language restriction will be applied at the search stage. Where feasible, non-English records will be translated for title/abstract and full-text screening. Two reviewers will independently screen studies, extract data, and assess study quality, with disagreements resolved by a third reviewer. Study-level risk of bias will be assessed using design-appropriate tools, and the certainty of evidence for each outcome will be evaluated using GRADE. Results: Evidence will be synthesized narratively and, where studies are sufficiently homogeneous, quantitatively through meta-analysis. Outcomes of interest will include treatment success, treatment failure, mortality, treatment completion, microbiological cure, and adverse events. Subgroup analyses will be considered by viral suppression status, CD4-defined immune status, HIV drug resistance/ART resistance status, geographic region, and treatment regimen where data permit. Conclusions: This review will provide evidence on how HIV viral suppression, immune status, and HIV drug resistance/ART resistance influence RR-TB treatment outcomes. The findings may inform integrated TB/HIV care, clinical monitoring, and treatment strategies for individuals co-infected with HIV and RR-TB. Full article

Accurate monitoring of the leaf area index (LAI) throughout the entire growth cycle of walnut trees using UAV multispectral imagery is essential for digital orchard management. In this study, focusing on the ‘Wen 185’ walnut variety in Xinjiang, we simultaneously acquired UAV multispectral images and ground-measured LAI data during four critical growth stages: expansion, hard shell, oil conversion, and maturity. A total of 25 vegetation indices and 48 texture features derived from the gray-level co-occurrence matrix were extracted. Hybrid feature selection combining linear (Pearson correlation), nonlinear (maximum information coefficient and random forest importance), and multiple consensus strategies was employed to reduce redundancy. LAI prediction models were constructed using four algorithms: Random Forest (RF), Support Vector Machine (SVM), LASSO, and Ridge Regression (RR), with model interpretability enhanced by SHAP analysis. Results showed that the multiple consensus screening reduced feature redundancy by an average of 69.6%. SHAP identified five core features: Redge_750_Mean, NDVI, B_Mean, RENDVI, and G_Homogeneity. Importantly, predictor importance shifted significantly with phenology: texture features dominated during the expansion stage, while red-edge indices (RENDVI and Redge_750_Mean) became predominant during the hard shell and oil conversion stages, effectively mitigating the saturation problem commonly observed in traditional indices such as NDVI within the LAI range of 1.5–5.8 in this study. The hybrid feature subset combining “red-edge spectrum + spatial texture” with the Random Forest algorithm achieved superior performance across all stages, with the RPD value exceeding 2.0 during the oil conversion stage, indicating excellent estimation capability. This study demonstrates that a “quality over quantity” feature selection strategy not only reduces model complexity but also enables high-precision, dynamic LAI monitoring throughout the entire walnut growth cycle, providing a scientific basis for intelligent management of large-scale orchards in arid regions. Full article

Air pollution is primarily caused by human activities such as industrial emissions, road traffic, waste incineration, and fossil fuel power plants. Pollution refers to the presence of harmful substances in the air, such as nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃), carbon monoxide (CO), and other environmental pollutants. Some pollutants pose health risks even at low doses. Given the critical importance of air quality, monitoring air pollution has become an urgent and essential subject. Air quality monitoring relies on accurate data, so changeable environments and sensor issues make using interval diagnostic techniques for addressing uncertainty in systems interesting. In this article, we focus on three key aspects to achieve precise and efficient results: (1) the use of an accurate fault detection method that accounts for data uncertainty while maintaining model symmetry, (2) the implementation of a reliable detection index invariant to symmetric sensor behaviors, and (3) the combination of both to improve fault localization accuracy. This paper presented a fault detection and localization framework designed for uncertain and nonlinear monitoring environments. A novel fault-sensitive detection index was developed and integrated into an elimination-based localization strategy within a reduced-rank interval kernel PCA (RR-IKPCA) model. By exploiting information contained in modified residual subspaces and explicitly accounting for measurement uncertainty, the proposed approach enhances fault sensitivity while preserving robust localization capability, as validated on the AIRLOR air quality monitoring network. Full article

The electrochemical carbon dioxide reduction reaction (CO₂RR) offers a promising route to mitigate excessive CO₂ emissions while enabling the production of value-added chemicals. However, achieving high catalytic selectivity and activity toward specific products remains a critical challenge. Here, we engineer a confined interfacial environment formed between adjacent copper nanoparticles and systematically investigate its impact on CO₂RR performance toward CO production. Our theoretical calculations reveal that the confined space effectively stabilizes the *COOH intermediate, a key species governing the CO₂-to-CO conversion pathway. In contrast, this geometric confinement exerts a negligible influence on the adsorption energetics of *H, which is associated with the competing hydrogen evolution reaction (HER). As a consequence, the catalyst exhibits a markedly reduced onset potential for CO₂RR, accompanied by enhanced selectivity and catalytic activity toward CO formation. These findings highlight the critical role of nanoscale confinement in modulating reaction energetics and provide a viable strategy for the rational design of highly efficient and selective catalysts for CO₂RR. Full article

Background/Objectives: The recreational use of fentanyl (FT) combined with xylazine (XZ), known as “tranq-dope,” poses a growing public health threat due to its high toxicity and mortality. This study evaluated the effectiveness of naloxone (NX), its lipophilic prodrug NX90, and their combinations with the mixed κ-agonist/µ-antagonist nalbuphine (NB) in reversing overdose and restoring respiratory function in a rat model. Methods: Male and female Wistar rats received intramuscular FT (0.104 mg/kg) + XZ (1 mg/kg) to induce overdose, followed by intranasal administration of NX, NX90, or combinations with NB. Physiological parameters, reflex recovery, time to overdose, and reversal outcomes were assessed during individualized clinical monitoring. Results: At the low FT dose (0.052 mg/kg), adding XZ (1 mg/kg) shortened time to overdose by ~2600 s compared with FT alone, whereas onset times were similar at medium and high FT doses. In the dose-finding cohort, FT + XZ co-administration was associated with a higher respiratory rate than FT alone at the highest fentanyl dose tested, an exploratory finding warranting confirmation in larger studies. Most interventions did not significantly shorten time to reversal; however, NX + NB (females) and NX90 + NB (both sexes) showed shorter reversal times than NX alone. However, respiratory rate at reversal was significantly improved with NX + NB, ½NX90 + NB and NX90 + NB (90 ± 6, 86 ± 5 and 92 ± 5 breaths/min) compared with naloxone alone (80 ± 6 breaths/min). Interventions containing nalbuphine (κ-agonist/µ-antagonist) yielded higher RR and HR at reversal than NX alone, consistent with an interpretive framework in which κ–µ opioid balance may influence observed physiological recovery patterns. Conclusions: Comparable or improved reversal outcomes could be achieved using half-doses of NX or NX90 with NB—potentially reducing the total dose of naloxone and mitigating the risk of precipitated withdrawal in individuals with opioid use disorder. Full article

The concurrent accumulation of plastic waste and CO₂ emissions poses a critical environmental challenge while presenting a compelling opportunity for integrated carbon management. Coupled plastic waste reforming and CO₂ conversion has recently emerged as a promising strategy to valorize these abundant waste streams into fuels and value-added chemicals, enabling a closed carbon cycle. This review systematically summarizes recent advances in integrated electrochemical and photoelectrochemical systems for the co-conversion of plastic waste and CO₂. Fundamental reaction pathways, including plastic depolymerization, reforming, and oxidation, are discussed in conjunction with their thermodynamic and kinetic coupling to CO₂ reduction. Particular emphasis is placed on paired electrochemical processes, such as plastic-derived alcohol oxidation coupled with CO₂ reduction processes, all of which offer enhanced energy efficiency. Photoelectrochemical approaches driven by renewable energy are further highlighted for their potential to operate under mild conditions. In addition, key design strategies for catalysts and electrodes—focusing on earth-abundant materials, redox stability, interfacial engineering, and selectivity control—are critically evaluated. Finally, current challenges and future opportunities are outlined to accelerate the development of scalable, efficient, and sustainable technologies for circular chemical manufacturing. Full article

Background/Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is of great concern because of the difficulties encountered in the management of infections it may cause. This study aims to identify possible difficulties in the management of K. pneumoniae infections in the current context of antibiotic resistance, particularly regarding carbapenem resistance. Methods: This is a retrospective, cross-sectional study that analyses epidemiological, clinical and bacteriological features identified in all patients with CRKP infections/colonization admitted during 2024 in an infectious diseases hospital. Results: Carbapenemase-producing K. pneumoniae isolates were co-harboring NDM+OXA-48 in 55.2% of cases. NDM+OXA-48-producing K. pneumoniae (116 isolates, 55.2%) was correlated with high resistance to aztreonam (100%, p = 0.01), ceftazidime–avibactam (100%, p < 0.01), trimethoprim–sulfamethoxazole (99.1%, p < 0.01), gentamycin (94.8%, p < 0.01), amikacin (93.8%, p < 0.01), colistin (79.8%, p < 0.01). OXA-48-producing K. pneumoniae (29 isolates, 13.8%) was correlated with lower resistance to ceftazidime–avibactam (11.5%, p < 0.01), amikacin (48.1%, p < 0.01), colistin (51.7%, p = 0.01), and gentamycin (65.5%, p < 0.01). We found in vitro synergistic effects of ceftazidime/avibactam + aztreonam for 32/32 CRKP isolates and of colistin + tigecycline for 12/14 CRKP isolates. Higher recurrence of CRKP infections was recorded in patients with urinary tract conditions (RR = 11.58, 95%CI: 1.58–81.91) and upper urinary tract devices (RR = 3.53, 95% CI: 1.72–7.22). In this study, adequate antibiotic treatment, compared to excessive antibiotic treatment in CRKP infections, was associated with shorter treatment duration (p = 0.02) and shorter length of hospitalization (p = 0.04). Conclusions: In our study, CRKP is frequently coharboring NDM+OXA-48, having limited treatment options. Implementing new treatment strategies, testing antibiotic synergies for older antibiotics in order to identify alternative treatment options and avoiding unnecessary carbapenem consumption are essential for decreasing the burden of CRKP infections. Full article

Electrocatalytic CO₂ reduction reaction (CO₂RR) to ethylene (C₂H₄) has emerged as a promising approach for converting CO₂ into valuable chemicals while utilizing renewable electricity. To facilitate the commercialization of this technology, a process-level techno-economic assessment (TEA) is constructed for a plant producing 100 tons/day of C₂H₄ from coal-power flue gas CO₂ using a membrane electrode assembly (MEA) electrolyzer and downstream gas separations. The model integrates (i) flue gas CO₂ capture by chemical absorption, (ii) CO₂RR to C₂H₄ with H₂ as the only co-product, and (iii) cathode off-gas separation by pressure swing adsorption (PSA) plus anode off-gas CO₂ recovery and recycle. A Cu₁₀–Sn catalyst measured in an H-cell is projected to MEA operation by scaling current density by 10×, yielding a “Case Study in This Article” scenario of j = 246 mA·cm⁻² and FE(C₂H₄) = 48.74%. Under this scenario, the total cost is 592.61 thousand USD/day (5926 USD/ton), dominated by electricity (39.8%). Scenario analysis shows that the total cost can decrease to 76,755.0 USD/day (767.6 USD/ton) under a future-outlook case with improved electrolyzer performance and low-cost power, enabling a net profit of 19,945.0 USD/day at an ethylene selling price of 967 USD/ton. Sensitivity analysis identifies FE(C₂H₄), full-cell voltage, and electricity price as the most influential variables. The results translate laboratory catalyst metrics into industrial cost drivers and clarify quantitative performance targets for commercialization. Full article

Maropitant has been proposed as an adjunct for pain relief in dogs undergoing surgeries like ovariohysterectomy (OVH), but its effectiveness has not yet been definitively proven. This study aimed to assess the intraoperative analgesic effect of intravenously administered maropitant citrate at a constant rate infusion through monitoring parasympathetic tone activity in female dogs undergoing OVH. Thirty healthy females of various breeds, with an average age of 3.8 ± 2.7 years, an average weight of 16.75 ± 10.68 kg, were randomly assigned to two treatment groups. The group receiving maropitant (G_Maro, n = 15) was given a 1 mg kg⁻¹ maropitant bolus intravenously (IV), followed by a continuous infusion of 100 mcg kg⁻¹ min⁻¹. The lidocaine group (G_Lido, n = 15) received a 2 mg/kg lidocaine IV bolus, with subsequent infusion at 50 mcg kg⁻¹ min⁻¹. Cardiorespiratory variables and the PTA index were evaluated at 11 anesthetic time points. Overall, cardiovascular variables such as Heart Rate (HR) and systolic arterial pressure (SAP) significantly decreased during anesthesia induction in the G_Maro (p = 0.0001; p = 0.01, respectively) and in G_Lido (p = 0.01). Differences between groups during induction were observed in HR (p = 0.03), SAP (p = 0.04), and mean arterial pressure (MAP) (p = 0.03). MAP showed significant changes from baseline at the start of surgery and during clamping in both G_Maro (p = 0.03) and G_Lido (p = 0.003). Regarding ventilatory variables—pulse oximetry (SpO₂), respiratory rate (RR), inspired oxygen fraction (FiO₂), end-tidal CO₂ (EtCO₂)—no group differences were found, but RR (G_Maro; p = 0.001, G_Lido; p = 0.0001) and SpO₂ (G_Maro; p = 0.004, G_Lido; p = 0.04) differed significantly from baseline due to the controlled clinical setting. During anesthesia maintenance, end-tidal isoflurane (ET_Iso) increased significantly in the G_Lido (p = 0.009), with no difference between groups (p = 0.94). Finally, only the PTA energy variable showed a significant decrease in the G_Maro (p = 0.0006), and a significant difference in this parameter was observed during right ovarian pedicle manipulation between groups (p = 0.02). In conclusion, continuous intravenous infusion of maropitant citrate at 100 mcg kg⁻¹ h⁻¹ effectively reduced the sympathetic response related to nociception, similar to lidocaine, in healthy female dogs undergoing OVH. Full article

The electrochemical nitrate reduction reaction (NO₃RR) represents a promising strategy for wastewater remediation and sustainable ammonia (NH₃) production. However, its practical application is hindered by low selectivity and competition from the hydrogen evolution reaction (HER). Herein, a series of PtBi-Co_X (X = 4.9, 5.3, and 6.1) ternary alloy nanoplates was synthesized via a one-pot method with tunable Co content. Structural characterization indicates that Co incorporation does not significantly alter the hexagonal crystal structure of the PtBi phase. Electrochemical measurements reveal that the NO₃RR performance varies with PtBi-Co_X (X = 4.9, 5.3, 6.1), with PtBi-Co_5.3 exhibiting the optimal balance of activity and selectivity among the studied samples. At −0.5 V vs. RHE, it achieves a Faradaic efficiency (FE) of 97.75 ± 0.75% and an NH₃ yield rate of 9.33 ± 0.50 mg h⁻¹ mg_cat⁻¹ under the tested conditions. In addition, the catalyst exhibits relatively suppressed HER activity compared to samples with higher Co content, along with good stability. These findings provide useful insights into the design of PtBi-based ternary alloy catalysts for efficient nitrate reduction. Full article

In this paper, we introduce topological information systems between objects with a distance and attributes with a distance based on a complete co-residuated lattice. We can obtain two distances and Alexandrov topologies for objects and attributes from an information system. Moreover, we investigate the relations between residuated frames and residuated connections on Alexandrov topologies induced by distances instead of fuzzy equalities. We define a fuzzy concept lattice based on Alexandrov topologies and show that it is a complete lattice. We study its properties as a topological viewpoint and provide examples. Moreover, we introduce R-R embedding maps and R-R frame embedding maps. Full article

Background/Objectives: Excess consumption of energy-dense foods (EDF; ultra-processed snacks, sweets, and sugar-sweetened beverages) among preschool-aged children is a public health concern, particularly in low-income families. Caregiver parenting style, psychological stress, and food-parenting practices (FPP) may shape children’s EDF consumption, yet little is known about how these factors operate in real time. This exploratory pilot study examined (1) associations between baseline characteristics and EDF feeding episodes across 1 week and (2) whether caregivers’ momentary stress during EDF episodes related to FPP used. Methods: In total, 22 caregivers of Head Start children (ages 3–5) completed baseline measures and 7 days of ecological momentary assessment (up to seven prompts/day). At each prompt, caregivers reported child EDF consumption in the past hour; if confirmed, they reported FPP used and rated momentary stress. Aim 1 used Poisson regression to model caregiver-level EDF episode counts. Aim 2 tested momentary stress–practice associations during EDF episodes using GEE, with within-person and between-person stress modeled separately. Results: Authoritarian parenting was associated with a higher weekly rate of EDF episodes (RR = 1.43, 95% CI 1.23–1.66, p < 0.001); authoritative parenting trended lower (RR = 0.90, p = 0.065). Higher baseline stress was associated with more EDF episodes (RR = 1.25, p = 0.001). Momentarily, elevated stress above a caregiver’s own average increased odds of using food as a reward (OR = 1.08 per +10 points, p = 0.011), while higher average momentary stress was associated with co-eating (OR = 1.59, p = 0.042). Domain-level FPP composites showed no association with momentary stress. Conclusions: Authoritarian parenting and higher caregiver stress were associated with increased EDF feeding, and momentary stress was linked to reward-based feeding during those episodes. These hypothesis-generating findings suggest potential behavioral targets for just-in-time adaptive intervention, pending replication in adequately powered studies. Full article

Background: Air pollution, antimicrobial use, and population ageing are increasingly recognised as co-occurring pressures shaping population health. This study explores their ecological association with mortality patterns in the province of Messina (Southern Italy), within a One Health-informed framework. Methods: An ecological analysis was conducted using district-by-year data (2015–2024), integrating environmental monitoring (PM₁₀, PM_2.5, NO₂, O₃), outpatient antibiotic consumption, and cause-specific mortality rates. Multivariable regression models were used to assess associations between exposures and mortality outcomes. A post-2020 indicator was included to account for COVID-19-related disruption. Results: Marked geographic variability in pollutant concentrations was observed, with higher levels in urban-industrial districts. Infectious disease mortality increased from 13.8 to 44.6 per 100,000 inhabitants between the pre-pandemic and post-pandemic periods. In Poisson regression models, particulate matter showed a small and non-significant association with respiratory mortality (RR = 1.02, 95% CI: 0.89–1.18), while antibiotic consumption was not independently associated with mortality (RR = 0.99, 95% CI: 0.94–1.05). The post-2020 period was associated with higher mortality estimates (RR = 1.15, 95% CI: 0.72–1.83), although with wide confidence intervals. Conclusions: The findings suggest the co-occurrence of environmental, demographic, and pharmaceutical pressures within the same territories, rather than demonstrating formal synergistic interaction. The observed post-pandemic increase in mortality highlights the importance of accounting for COVID-19-related disruption. These results should be interpreted as exploratory, given the ecological design and limited sample size, but support the need for integrated surveillance approaches within a One Health perspective. Full article

Background: Drug-resistant tuberculosis (DR-TB) remains a major public health challenge in South Africa, particularly in rural settings with high HIV co-infection rates. Understanding predictors of treatment response among people living with HIV is essential for improving clinical management and programmatic outcomes. This study aimed to identify socio-demographic and clinical predictors of treatment outcomes among HIV-positive individuals diagnosed with multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR-TB) in rural Eastern Cape Province, South Africa. Methods: A retrospective cohort study was conducted using routinely collected clinical records of DR-TB patients initiated on treatment between January 2020 and December 2024 at two public healthcare facilities. A total of 239 patients with complete treatment outcome data were included. Treatment outcomes were classified as favourable (cured or treatment completed) or unfavourable (death, treatment failure, or loss to follow-up). Descriptive statistics were used to summarise patient characteristics, while univariate and multivariable logistic regression analyses were performed to identify factors associated with treatment outcomes. Results: Most participants were aged ≤ 39 years (58%), male (60%), unemployed (90%), and without income (80%). MDR-TB accounted for 40% of cases, rifampicin-resistant-TB (RR-TB) for 53%, and XDR-TB for 7.1%. Multivariable analysis showed that XDR-TB was the strongest independent predictor of unfavourable treatment outcome (AOR = 0.18; 95% CI: 0.06–0.58; p = 0.004). Income status was also significantly associated with outcome, with participants reporting some incomes having lower odds of favourable outcomes (AOR = 0.46; 95% CI: 0.23–0.92; p = 0.036). The model demonstrated modest predictive performance (AUC = 0.67). Conclusions: These findings highlight the dominant influence of resistance phenotype, particularly XDR-TB, on treatment prognosis among HIV-positive DR-TB patients in rural Eastern Cape. Integrating early resistance profiling, intensified clinical management of XDR-TB, and socioeconomic support mechanisms may improve treatment outcomes in high-burden rural settings. Full article

Background: Respiratory syncytial virus (RSV) is a leading cause of hospitalization for acute respiratory tract infection (ARTI) in young children. Respiratory viral coinfections are frequently identified in RSV-related ARTIs, yet their impact on disease severity remains controversial and may vary according to the co-pathogen involved. In the context of evolving RSV prevention strategies, a clearer understanding of RSV coinfection phenotypes is needed. Methods: We conducted a multicenter retrospective cohort study of children aged ≤ 5 years hospitalized for ARTI at two Italian tertiary-care pediatric hospitals between 1 September 2022 and 30 April 2025. Children with laboratory-confirmed RSV infection detected by multiplex polymerase chain reaction were included. Patients were classified as having RSV monoinfection, RSV–rhinovirus coinfection, or RSV–non-rhinovirus coinfection. Severe disease was defined as a composite outcome including intensive care unit (ICU) admission, need for respiratory or hemodynamic support, or death. Association between infection status and severe disease was evaluated using a Poisson regression model with robust variance, adjusted for age, sex, and comorbidities. Results: Among 231 RSV-related hospitalizations, 118 (51.1%) were classified as RSV monoinfection, 65 (28.1%) as RSV–rhinovirus coinfection, and 48 (20.8%) as RSV–non-rhinovirus coinfection. Children with RSV–rhinovirus coinfection were older and had shorter hospital stays. Severe disease occurred in 80.5% of RSV monoinfections, 70.8% of RSV–rhinovirus coinfections, and 75.0% of RSV–non-rhinovirus coinfections. After adjustment, neither RSV–rhinovirus coinfection (adjusted risk ratio [aRR]: 0.93; 95% confidence interval [95% CI]: 0.80–1.13) nor RSV–non-rhinovirus coinfection (aRR: 0.99; 95% CI: 0.83–1.18) was associated with increased disease severity compared with RSV monoinfection. Conclusions: RSV–rhinovirus and RSV–non-rhinovirus coinfections were not associated with greater disease severity compared with RSV monoinfection in hospitalized children. These findings support pathogen-specific interpretation of multiplex diagnostic results and inform clinical risk stratification in the era of expanding RSV prevention strategies. Full article