Search Results (21,985)

The rapid evolution of ventilators and their circuits, coupled with varying maximum usage durations set by different hospitals globally, poses a significant risk for the proliferation and transmission of nosocomial infections in intensive care settings. This study investigated temporal changes in bacterial community structure and predicted metabolic functions in ventilator circuits over a three-week period, with a specific focus on ESKAPE pathogens. The results of full-length 16S rRNA sequencing revealed dynamic shifts in bacterial communities, with an increased bacterial diversity and unique species prevalence in week-2 compared to week-1 and week-3. However, a marked emergence of pathogenic bacteria, including Serratia marcescens and Chryseobacterium indologenes, was observed in week-3 compared to week-1 and week-2. Additionally, the abundance of ESKAPE pathogens, including Klebsiella pneumoniae and Acinetobacter baumannii, was higher in week-3 compared to week-1 and week-2. Furthermore, the PCR analysis revealed a higher detection rate of Pseudomonas aeruginosa and K. pneumoniae in week-3 than in the previous weeks. FAPROTAX analysis further revealed a high abundance of specific functions associated with the pathogens of pneumonia, nosocomial, and septicemia in week-3 compared to the other two weeks, suggesting a shift toward more virulent or opportunistic pathogens with increased utilization of ventilator circuits. These findings highlight the microbial risks associated with prolonged use of ventilator circuits, underscoring the need for continuous microbial surveillance throughout their usage, and provide a foundation for optimizing infection control strategies in intensive care settings. Full article

Objective: This study aims to explore the relationship between mandibular asymmetry (MA), generalized joint hypermobility (GJH), and temporomandibular disorders (TMD) in pre-orthodontic growing individuals. Methods: This cross-sectional study included 74 pre-orthodontic individuals aged 8–16 years. Mandibular asymmetry was evaluated through posteroanterior cephalometric analysis, using menton deviation ≥ 4 mm as the threshold for asymmetry. GJH was assessed using the Beighton Score (BS ≥ 4 = GJH-positive), while TMD was diagnosed based on Axis I of the DC/TMD. Associations among the variables were tested using a chi-square test (p < 0.05; SPSS v.24). Results: The study included 74 patients (25.7% males; mean age 12.7 ± 2.16 years). The GJH-positive group (n = 41) showed a higher prevalence of TMD (85.4%) compared to the GJH-negative group (51.5%) (p = 0.002). MA was more frequent in the GJH-positive group (68.3% vs. 45.5%; p = 0.041). A significant association was also found between TMD and MA (71.2% vs. 27.3%; p < 0.001). In both groups, patients with TMD were more likely to present MA (GJH-negative p = 0.022; GJH-positive p = 0.046). Conclusions: MA emerged as a key factor associated with the presence of TMD, particularly when combined with GHJ. These findings indicate that MA alone is significantly related to the occurrence of TMD, regardless of joint hypermobility status. However, the risk appears to be amplified in individuals who also present with GJH. Effect size analysis indicated that most associations were small, with only the one between TMD and MA reaching a moderate level. This highlights the importance of evaluating statistical significance in the context of effect size to better assess clinical relevance. Full article

Inclusive education continues to face significant challenges nowadays due to a lack of resources, specialized support, and teacher training. In the context of primary education in Europe, families of students with functional diversity express their concern about the lack of adequate responses to their needs. However, there are merely a few studies that delve into the reality of inclusion from the family perspective. Therefore, this study aims to analyze the perceptions of families of students with functional diversity in Extremadura (Spain), regarding the quality of the educational response offered by schools. For this purpose, the study sample consisted of 70 family members of students with functional diversity in this region. For data collection and analysis, a semi-structured interview was used, applying thematic analysis and chi-square statistical tests in order to explore significant differences in the perceptions gathered. The interviews were transcribed and the answers gathered were categorized. The results show that almost half of the families consider the information received about the disability and the progress of their relatives to be insufficient. Likewise, there is a low level of satisfaction with the support and resources provided by both associations and the public administration. Consequently, the need to strengthen effective communication between schools and families is highlighted as a fundamental pillar to advance toward true educational inclusion. Full article

Background: Endometrioid ovarian carcinoma is a subtype of epithelial ovarian carcinoma and is the second most common type of malignant ovarian neoplasm. Studies investigating delayed treatment of ovarian cancer have identified significant impacts on overall survival rates. This study utilizes the Surveillance, Epidemiology, and End Results (SEER) database to identify cases of endometrioid ovarian carcinomas and factors associated with delays in time to treatment (TTT) greater than one month. Methods: The SEER database was queried to identify females with biopsy-confirmed cases of ovarian endometrioid carcinoma from 2010 to 2015. Chi-square tests, two-sided Fisher’s exact tests, and multivariable binary logistic regressions were completed using SPSS version 29.0.2. Statistical significance was confirmed when p < 0.05. Results: A total of 11,235 relevant patients were identified within the SEER database. A majority were Non-Hispanic White (69.2%), aged 50–59 (30.1%), had an annual income of $75,000+ (58.9%), resided in urban communities (90.0%), and were diagnosed with AJCC stage 1 disease (62.0%). When investigating treatment, 94.9% of patients received treatment within 1 month of diagnosis, while 5.1% experienced a delay of over 1 month before starting treatment. Multivariable binary logistic regression analysis demonstrated that American Indian and Alaksa Native (AIAN) patients independently experienced a +376% increased likelihood of treatment delays exceeding 1 month (aOR 4.76; 95% CI 1.32–17.08; p = 0.017). Patients diagnosed at AJCC stage III (aOR 1.88; 95% CI: 1.22–2.91; p = 0.004) or stage IV (aOR: 4.50; 95% CI: 2.75–7.38; p < 0.001) additionally had +88% and +350% higher odds of treatment delays greater than 1 month, respectively. Conclusions: AIAN patients and those presenting with later stage disease for endometrioid ovarian carcinoma face significantly longer TTT, indicating disparities in timely care. Our findings demonstrate an urgent need for targeted interventions to address systemic barriers contributing to delayed treatment in these populations. Full article

Background/Objective: Adequate serum vitamin D levels are essential for overall health, particularly in preventing oropharyngeal infections. This study aims to explore the relationship between serum vitamin D (25(OH)D3) levels and the prevalence of oropharyngeal diseases—specifically rhinosinusitis, otitis media, and nasopharyngitis—in patients at a private specialist medical clinic. Materials and Methods: The study involved 311 patients with an average age of 15.96 ± 15.06 years. Statistical analyses, including Student’s t-test and chi-square test, were conducted to evaluate the significance of the findings. Results: Nasopharyngitis was highly prevalent, affecting 83.27% of participants, with higher recurrence rates in those with lower vitamin D levels (p = 0.001). Otitis media was present in 53.37% of cases, while rhinosinusitis was less common and more frequently associated with higher vitamin D levels. Patients with behavioral disorders had significantly higher mean vitamin D levels (34.82 ng/mL ± 11.85) compared to those without (28.49 ng/mL ± 14.37) (p = 0.001). Conclusions: A subgroup of children with neutropenia (ANC < 1500/μL) exhibited significantly lower vitamin D levels and higher infection recurrence rates, underscoring their heightened vulnerability. This study highlights the importance of maintaining optimal vitamin D levels for pediatric health and suggests that higher vitamin D levels may reduce the risk of oropharyngeal infections. Full article

This study combines three optimization algorithms, Tunicate Swarm Algorithm (TSA), Whale Optimization Algorithm (WOA), and Jellyfish Search Optimizer (JSO), with random forest (RF) to predict the shear bond strength of cable bolts under different types and grouting conditions. Based on the original dataset, a database of 860 samples was generated by introducing random noise around each data point. After establishing three hybrid models (RF-WOA, RF-JSO, RF-TSA) and training them, the obtained models were evaluated using six metrics: coefficient of determination (R²), root mean squared error (RMSE), mean absolute error (MAE), mean absolute percentage error (MAPE), variance account for (VAF), and A-20 index. The results indicate that the RF-JSO model exhibits superior performance compared to the other models. The RF-JSO model achieved an excellent performance on the testing set (R² = 0.981, RMSE = 11.063, MAE = 6.457, MAPE = 9, VAF = 98.168, A-20 = 0.891). In addition, Shapley Additive exPlanations (SHAP), Partial Dependence Plot (PDP), and Local Interpretable Model-agnostic Explanations (LIME) were used to analyze the interpretability of the model, and it was found that confining pressure (Stress), elastic modulus (E), and a standard cable type (cable type_standard) contributed the most to the prediction of shear bond strength. In summary, the hybrid model proposed in this study can effectively predict the shear bond strength of cable bolts. Full article

This paper explores how blockchain technology, widely known as the backbone of cryptocurrencies, can be harnessed to address limitations of traditional water quality monitoring (WQM) systems. Blockchain offers a decentralized, tamper-proof ledger that enables secure, transparent, and traceable data management across distributed networks. When applied to water quality monitoring, blockchain facilitates real-time data acquisition, enhances data integrity, and enables smart contracts for automated regulatory compliance and alerts. These features not only improve the accuracy and efficiency of WQM systems but also build public trust in the reported data. Key insights from current research and pilot applications highlight blockchain’s capacity to integrate with IoT devices for real-time sensing, support adaptive water governance, and empower local stakeholders through decentralized control and transparent access to information. The implications for policy and practice are significant: blockchain-based WQM can support stronger regulatory enforcement, encourage cross-sector collaboration, and provide a robust digital foundation for sustainable water management in smart cities and rural areas alike. As such, this review paper positions blockchain as a transformative tool in the digital transition toward more resilient and equitable water management systems. Full article

Influenza A virus pandemics pose a persistent global health threat, and emerging antiviral resistance underscores the critical importance of developing novel broad-spectrum therapeutic agents. Building on licorice’s (Glycyrrhiza spp.) historical use in traditional Chinese medicine for respiratory infections—as documented in the Chinese Guidelines for Diagnosis and Treatment of Influenza—and its demonstrated anti-SARS-CoV-2 activity, we identified licoflavone B as a potent anti-influenza agent, bridging ethnopharmacological knowledge with mechanistic validation. In this study, we identified licoflavone B, a natural flavonoid derived from licorice (Glycyrrhiza spp.), as a potent inhibitor of diverse influenza viruses, including multiple influenza A subtypes and type B virus. Mechanistic studies revealed that licoflavone B selectively targets the viral RNA-dependent RNA polymerase (RdRp), effectively suppressing viral replication. The compound exhibits a favorable selectivity index (SI = 14.9–29.9), indicating a promising therapeutic window. Molecular docking simulations identified potential binding interactions between licoflavone B and regions of the RdRp complex, which were further validated by dose-dependent inhibition of viral nucleoprotein (NP) and polymerase subunit PB2 expression in Western blot and immunofluorescence assays. In addition, licoflavone B maintained broad-spectrum antiviral activity against multiple influenza strains, including H1N1 (A/Puerto Rico/8/34), H3N2 (A/Darwin/9/2021), and a clinical influenza B isolate (B/Beijing/ZYY-B18/2018). These findings position licoflavone B as a promising lead compound for developing next-generation, broad-spectrum antiviral therapies against influenza and potentially other viruses. Full article

Background/Objectives: Isotretinoin is a highly effective therapy for severe acne, but its potential neuropsychiatric adverse reactions (NPsRs) have been controversial. This study evaluated EudraVigilance data from 2005 to 2025 to better understand the frequency, typology, and predictors of such events. Methods: We conducted a retrospective analysis of 33,381 individual case safety reports (ICSRs) related to isotretinoin. Using descriptive statistics, chi-square tests, and logistic regression, we assessed associations between NPsRs and variables such as age, sex, geographic region, and reporter type. Results: A total of 9793 cases (29.3%) involved at least one NPsR. Depression (31%) and suicidal ideation (8.6%) were the most frequently reported symptoms. Adolescents (12–17 years) had the highest proportion of NPsR cases, while male patients and reports submitted by non-healthcare professionals were significantly overrepresented. Reports from non-European Economic Area countries also had slightly increased odds of including NPsRs. All predictors were statistically significant in the logistic regression model, though the explained variance was modest (Nagelkerke R² = 0.065). Conclusions: Neuropsychiatric reactions remain a prominent and persistent signal in isotretinoin pharmacovigilance, particularly among younger patients and non-professional reporters. Although causality cannot be inferred from spontaneous reporting data and confounding factors like acne-related depression cannot be excluded, these findings highlight the clinical value of pre-treatment psychiatric screening, patient-centered education, and proactive mental health monitoring throughout isotretinoin therapy. Full article

This paper presents the design and implementation of an autonomous mobile robot system able to deliver objects from one location to another with minimal hardware requirements. Unlike most existing systems, our robot uses only a single camera—mounted on its robotic arm—to guide both its movements and the pick-and-place process. The robot detects target signs and objects, automatically navigates to desired locations, and accurately grasps and delivers items without the need for complex sensor arrays or multiple cameras. The main innovation of this work is a unified visual control strategy that coordinates both the vehicle and the robotic arm through homography-based visual servoing. Our experimental results demonstrate that the system can reliably locate, pick up, and place objects, achieving a high success rate in real-world tests. This approach offers a simple yet effective solution for object delivery tasks and lays the groundwork for practical, cost-efficient mobile robots in automation and logistics. Full article

Background/Objectives: Pediatric episodic vestibular syndrome (EVS) is increasingly recognized, with recurrent vertigo of childhood (RVC) and vestibular migraine of childhood (VMC) being the most prevalent disorders. In 2021, the Bárány Society and the International Headache Society proposed new diagnostic criteria for RVC, VMC, and probable VMC (pVMC), replacing the older term benign paroxysmal vertigo (BPV). This study aimed to evaluate the clinical applicability of these new criteria. Methods: We conducted a cross-sectional study at a pediatric neurotology clinic within a tertiary hospital, including patients under 18 years with episodic vestibular symptoms evaluated between 2018 and 2025. All patients underwent a standardized neuro-otological assessment. Diagnoses were assigned using both the 2018 ICHD-3 and the 2021 Bárány criteria. Patients who did not fulfill any of the three new diagnostic categories, nor met criteria for any other specific vestibular disorder, were grouped into an undetermined category referred to as episodic vestibular syndrome without hearing loss (EVSw/oHL). Demographic and clinical variables were compared across diagnostic groups using non-parametric and chi-squared tests. Results: Among the 202 children evaluated, 109 met the inclusion criteria and were classified as RVC (n = 55), VMC (n = 23), pVMC (n = 13), or EVSw/oHL (n = 18). All patients previously diagnosed with BPV met the new criteria for RVC. Application of the Bárány criteria significantly reduced the proportion of unclassified EVS cases (from 35.78% to 16.51%). Significant clinical differences were observed among the groups in terms of episode duration, presence of vomiting, migraine and headache, and family history of migraine. Conclusions: The new Bárány criteria provide a more inclusive and clinically meaningful framework for classifying pediatric EVS. They improve diagnostic clarity, reduce the proportion of unclassifiable cases, and support earlier and more tailored management strategies. Full article

Background/Objectives: There has been growing interest in understanding the impact of social determinants of health (SDoHs) on health outcomes. Since 2015, healthcare providers have begun to document patients’ SDoH systematically using ICD-10 Z-codes. Methods: We extracted claims data from a nationally representative hospital chargemaster database for 586,929 eligible HF patients between January 2019 and December 2021. We investigated the association between SDoH Z-codes and 30-day hospital readmission for heart failure (HF) patients in U.S. hospitals using a Chi square test and adjusted odds ratios from logistic regression models. Results: We found that four major SDoH Z-code categories and five specific sub-Z-code factors within the major categories are significantly associated with 30-day readmission for HF patients. We also found that patients with two or more SDoH Z-codes have a higher risk of readmission than those with one. Conclusions: Our study indicates that ICD-10 Z-codes are useful in identifying SDoH risk factors for hospital readmission among HF patients. Policymakers and healthcare providers should consider Z-codes when assessing HF readmission risk and developing interventions to lower HF readmission rates. Full article

This work investigated the effect of high-nitrogen/low-hydrogen mixed atmosphere heat treatment on the electrochemical corrosion and wear resistance of plasma-sprayed FeCoNiCrAl high-entropy alloy (HEA) coatings. The HEA coatings were sequentially prepared through annealing at 400, 600, and 800 °C for 6 h. The heat treatment method was conducted in a vacuum tube furnace under 0.1 MPa total pressure, with gas flow rates set to 300 sccm N₂ and 100 sccm H₂. The XRD results indicated that the as-deposited coating exhibited α-Fe (BBC) and Al_0.9Ni_4.22 (FCC) phases, with an Fe_0.64N_0.36 nitride phase generated after 800 °C annealing. The electrochemical measurements suggested that an exceptional corrosion performance with higher thicknesses of passive film and double-layer capacitance can be detected based on the point defect model (PDM) and effective capacitance model. Wear tests revealed that the friction coefficient at 800 °C decreased by 3.84% compared to that in the as-sprayed state due to the formation of a dense nitride layer. Molecular orbital theory pointed out that the formation of bonding molecular orbitals, resulting from the overlap of valence electron orbitals of different atomic species in the HEA coating system, stabilized the structure by promoting atomic interactions. The wear mechanism associated with stress redistribution and energy balance from compositional synergy is proposed in this work. Full article

This review provides a comprehensive overview of the evolution and application of artificial intelligence (AI) and large language models (LLMs) in engineering, with a specific focus on chemical engineering. The review traces the historical development of LLMs, from early rule-based systems and statistical models like N-grams to the transformative introduction of neural networks and transformer architecture. It examines the pivotal role of models like BERT and the GPT series in advancing natural language processing and enabling sophisticated applications across various engineering disciplines. For example, GPT-3 (175B parameters) demonstrates up to 87.7% accuracy in structured information extraction, while GPT-4 introduces multimodal reasoning with estimated token limits exceeding 32k. The review synthesizes recent research on the use of LLMs in software, mechanical, civil, and electrical engineering, highlighting their impact on automation, design, and decision-making. A significant portion is dedicated to the burgeoning applications of LLMs in chemical engineering, including their use as educational tools, process simulation and modelling, reaction optimization, and molecular design. The review delves into specific case studies on distillation column and reactor design, showcasing how LLMs can assist in generating initial parameters and optimizing processes while also underscoring the necessity of validating their outputs against traditional methods. Finally, the review addresses the challenges and future considerations of integrating LLMs into engineering workflows, emphasizing the need for domain-specific adaptations, ethical guidelines, and robust validation frameworks. Full article

Background/Objectives: The os supranaviculare (OSSN), also known as os talonaviculare dorsale, astragalo-scaphoid ossicle, or Pirie’s bone, is a small extra bone that was first described in 1921 by A.H. Pirie and is located at the top front part of the navicular bone or talonavicular joint. The knowledge regarding the epidemiology of the OSSN is scarcely established, as its prevalence remains unknown and varies significantly among multiple studies. This meta-analysis aims to clarify and systematically summarize all available data on the characteristics and prevalence of the OSSN. Methods: Four major databases (PubMed/Medline, Embase, ScienceDirect, Scopus) were thoroughly searched for studies reporting original data regarding the OSSN up until May 2025. The protocol of this study was pre-registered on PROSPERO (ID: CRD42025638111) and adhered to PRISMA guidelines. To evaluate the between-study heterogeneity, the 95% prediction intervals (95%PI) were calculated; I² statistic and Chi² test were also used. The AQUA-tool was used to assess the quality of included studies. Results: In total, 13 studies (18,745 feet) qualified for inclusion in the quantitative analysis. The pooled prevalence estimate (PPE) of the OSSN in the general population was found to be 0.88% (95%CI: 0.62–1.24%). The PPE of the OSSN was higher in males (0.87%, 95%CI: 0.58–1.32%) than in females (0.48%, 95%CI: 0.14–1.64%). The os supranaviculare was similarly prevalent in both European (1.04%, 95%CI: 0.55–1.96%) and Asian (0.87%, 95%CI: 0.66–1.13%) populations. Conclusions: the os supranaviculare is a very rare anatomical variation that is present in less than one in a hundred feet. Moreover, although usually asymptomatic, it can occasionally be associated with dorsal foot pain or navicular stress fractures. Accurate differentiation from avulsion fractures is essential to avoid unnecessary invasive treatment. Full article