Search Results (4,814)

Background: Heart transplantation (HTx) remains the gold-standard therapy for patients with end-stage heart failure. Cardiac rehabilitation (CR) is a multidisciplinary intervention that improves cardiovascular prognosis and quality of life. The aim of this randomized controlled trial was to evaluate the impact of cardiac telerehabilitation on cardiovascular events after HTx. Methods: Forty patients who had undergone HTx were recruited at a single Italian institution and randomly allocated 1:1 to an experimental group (on-site CR followed by 12 weeks of telerehabilitation) or a control group (on-site CR followed by standard homecare and an exercise program). The primary outcome was a 6-month composite of major cardiovascular events, including acute allograft rejection, heart failure hospitalization, coronary allograft vasculopathy, stroke, and all-cause mortality. Secondary outcomes included return to work within 6 months, physical and functional activity levels and treatment adherence. Results: Forty patients were equally allocated to control and experimental groups, with well-balanced baseline demographic, clinical, and functional characteristics. At 6 months, the primary composite endpoint occurred in 35% of patients in both groups, with no significant between-group differences. Return to work was observed in 72.2% of the controls and 64.3% of intervention patients. Physical activity levels were comparable between groups, with most patients classified as sufficiently active. Adherence to the cardiac telerehabilitation program was complete in only 50% of the patients. Conclusions: In this randomized trial on HTx patients, a hybrid telerehabilitation program was as safe as standard care regarding major cardiovascular events at 6 months. The low adherence observed suggests that future digital interventions must focus on enhancing patient engagement. Full article

This study examines the impact of recovered steel fibers (WTSFs) and waste tire aggregates of varying sizes—fine (FWTR), small coarse (SCWTR), and large coarse (LCWTR)—on the compressive strength of concrete subjected to elevated temperatures. Forty mixes were formulated utilizing four distinct WTR replacement ratios (0%, 5%, 10%, 20%) and four WTSF doses (0%, 0.5%, 1%, 2%), and evaluated at temperatures of 24 °C, 100 °C, 200 °C, and 300 °C. The findings indicate that elevated temperatures consistently diminish compressive strength, although the reference concrete saw around 18% loss at 300 °C, with WTR-containing mixes demonstrating losses ranging from 25% to 45%, contingent upon rubber size and dose. The type of WTR was critical—LCWTR mixes exhibited superior residual strength retention due to enhanced particle–matrix interlocking, whereas FWTR mixtures saw the most significant decline. The inclusion of WTSF increased strength by 2–10% at 0.5–1.0% fiber content through crack bridging, but excessive fiber addition (2.0%) decreased workability and caused clustering, leading to up to 40% strength loss. The ideal combination was 5LCWTR–1WTSF, which sustained 36.97 MPa at 24 °C and 29.65 MPa at 300 °C, indicating superior performance across all temperature ranges. Predictive modeling utilizing machine learning techniques (SVR, KRR, 1D-CNN, and DRL) corroborated the experimental results, with the CNN attaining the maximum generalization accuracy (R² = 0.9374) and the KRR exhibiting the most consistent performance (R² = 0.9305). The models indicated that WTR and temperature were the primary variables diminishing strength, although modest WTSF ratios enhanced overall thermal resilience. SHAP and ALE analysis further validated that WTR content exhibited the most significant negative feature contribution (~−6 MPa), succeeded by temperature, although modest fiber inclusion demonstrated a positive SHAP effect (+2–4 MPa), corroborating the experimentally observed non-linear reinforcement threshold. The combined experimental–computational framework demonstrates that the combination of coarse rubber aggregates (5–10%) with appropriate WTSF content (0.5–1.0%) improves sustainability and high-temperature durability. The integration of physical testing and interpretable AI modeling creates a hybrid approach that can anticipate and enhance thermo-mechanical performance in sustainable concrete systems. Full article

Objective: The aim of this retrospective study was to evaluate clinical and laboratory characteristics in adult patients with neuroinvasive West Nile virus (WNDD). We also studied the phylogeny and molecular characteristics of some of the WNV strains. Methods: A retrospective analysis was conducted at “Annunziata” Hub Hospital, a secondary referral facility in Calabria region, in Southern Italy. Sample pre-processing, sequencing and bioinformatic analyses were carried out at IRCCS Sacro Cuore Don Calabria Hospital in Negrar di Valpolicella, Verona, Veneto region in North-East Italy. Results: Nine cases of WNDD were analyzed, involving eight males and one female, with a mean age of 70.33 years (range 60–85). The overall average hospital stay was 20.6 days (range 6–46). Six patients made a full recovery after a mean of 35.3 days of acute care. Thirty-day mortality rate was 23%. VNDD in some of our patients manifested itself in the form of cerebral hemorrhage (ICH) in three patients, causing lethality in two patients and other unusual manifestations, such as Guillain–Barré syndrome with fatal outcome and severe facial palsy. Phylogenetic analysis shows that our sequences are closely related to other southern-Italian and cluster with Central–Southern–Eastern European sequences, while being evidently separated from northern Italian and Central–Western European ones, belonging to the sub-lineage 2a of the WNV-2, clustering with sequences from the Central–South–Eastern clade, mainly to Hungary. Conclusions: Cerebrovascular complications of WNE may be an important clinical manifestation of WNV neuroinvasive infection. Preliminary data do not allow us to determine whether our strains, closely related to other southern-Italian and cluster with Central–Southern–Eastern European sequences, really presented an increased neurovirulence. Full article

Background/Objectives: The diagnosis of infection with Strogyloides stercoralis, recently targeted for control by the World Health Organization, (WHO), is challenging. Specific coproparasitological methods (agar plate culture [APC], Baermann sedimentation), recommended by the WHO for public health use, are labor-intensive and require bulky disposable materials as well as experienced microscopists. We explored the sensitivity of an alternative stool culture method using recyclable glass beads, followed by microscopy and PCR in comparison to routine APC and PCR performed on uncultured stool. Methods: We conducted a diagnostic sensitivity study on samples from patients with positive serology for strongyloidiasis who submitted stool specimens to our laboratory between January 2023 and December 2025 for parasitological confirmation. Samples were processed by routine APC and PCR on fresh stool, as well as experimental culture on bead-based plates (BPC), PCR on APC- and BPC-cultured stool, and PCR on stool incubated directly in the collection container. Results: Twenty-six of 110 samples (23.6%) tested positive in at least one technique. Within this subset, the most sensitive techniques were the APC and PCR after APC (both 84.62%); PCR on fresh stool was the least sensitive (42.31%) (p = 0.002). The sensitivity of BPC (65.38%) was lower than that of APC, although not statistically significantly. Comparable sensitivity was observed between microscopy and PCR after APC or BPC. PCR after incubation in the container showed a sensitivity of 57.69%. Agreement ranged from 50 to 84.6%. Conclusions: Alternative culture methods with more field-friendly implementation features could be interesting alternatives to standard methods. Further studies evaluating their performance and applicability in public health and clinical contexts are warranted. Full article

Pediatric neurological disorders comprise a highly heterogeneous group of conditions that together represent a substantial global public health burden. Many have a strong genetic basis and are associated with significant morbidity, premature mortality, and long-term disability, with far-reaching consequences for affected children, their families, and healthcare systems worldwide. Clinical heterogeneity is a hallmark of these disorders, as pathogenic variants in the same gene can give rise to diverse phenotypes with variable severity, age at onset, and disease course. In children, ongoing brain development and somatic growth further complicate diagnosis, often leading to nonspecific or atypical presentations that differ from classical adult neurological phenotypes. Advances in genetics and genomics have fundamentally transformed the understanding, diagnosis, and classification of pediatric neurological diseases. The widespread use of high-throughput sequencing, genome-wide association studies, and integrative bioinformatics approaches has enabled the rapid and precise identification of disease-associated genes, even in sporadic and complex conditions, facilitating earlier and more accurate diagnoses and highlighting the role of genetic background and gene–environment interactions in disease pathogenesis. Here we provide an overview of the genetic and genomic landscape of key pediatric neurological disorders with well-characterized molecular etiologies, including neuromuscular disorders, epilepsies, neurodevelopmental disorders, neurodegenerative diseases, and movement disorders. Current knowledge is synthesized with emphasis on clinical presentation, genetic architecture, and genotype–phenotype correlations. Gene-specific management strategies and emerging precision therapies are discussed for selected conditions, underscoring the central role of genetic diagnosis in guiding clinical decision-making and improving outcomes in affected children. Full article

Fusarium head blight (FHB), caused by Fusarium graminearum, severely threatens wheat production in China’s Huang-Huai region. In order to clarify the resistance status of F. graminearum to pydiflumetofen in Henan Province, the mycelial growth rate method was used to assess the sensitivity of 345 strains isolated from 15 Henan cities during 2021–2024. The EC₅₀ of F. graminearum isolates to pydiflumetofen was determined to be 0.016–3.981 μg/mL, with a right-skewed unimodal pattern, and the Shapiro–Wilk test confirmed a non-normal distribution (W = 0.4936, p < 0.05). Significantly higher mean EC₅₀ values were observed in 2024 relative to 2021–2023, and resistant isolates were predominantly distributed in southwestern Henan Province. Fitness assays conducted in the absence of fungicide showed that most pydiflumetofen-resistant isolates exhibited similar mycelial growth, conidiation, pathogenicity, and deoxynivalenol (DON) production compared with sensitive isolates, suggesting no obvious fitness costs associated with pydiflumetofen resistance. Spearman rank correlation analysis demonstrated positive cross-resistance between pydiflumetofen and fluxapyroxad, but no cross-resistance to prothioconazole, phenamacril, or pyraclostrobin. Resistant strains had mutations in the FgsdhC2 (C89S, A93V) and FgsdhD (A21T, S30F) subunits of succinate dehydrogenase (SDH). Low-frequency pydiflumetofen resistance in F. graminearum from Henan Province highlights that pydiflumetofen should be applied alternately or in combination with fungicides showing no cross-resistance to delay the development of resistance. Full article

Background/Objectives: Childhood cancer survivors face long-term cancer-related health risks, and daily behaviours, such as physical activity and recreational screen use, may influence their long-term overall wellbeing. Yet, little is known about survivors’ knowledge and understanding of recommended guidelines or their patterns of structured and unstructured activity. This study aimed to (i) assess survivors’ knowledge of physical activity and screen time guidelines, (ii) describe their self-reported (un)structured activity and screen use across weekdays and weekends, and (iii) examine associations with health-related quality of life. Methods: This secondary analysis used data from a feasibility pilot study of an intervention for survivors aged 8–13 years who had completed cancer treatment at least 12 months earlier. Participants self-reported physical activity, recreational screen use, knowledge of guidelines, and health-related quality of life (HRQoL). We used descriptive statistics and non-parametric tests to analyse behavioural patterns and associations. Results: Over one-third of survivors underestimated or overestimated the recommended physical activity and screen time (35%), whilst 23–50% reported ‘don’t know’. Participation in ‘Physical Education’ classes at school did not differ between summer and winter school terms, yet there was greater participation in structured physical activities in winter compared to summer school terms (median 270 vs. 170 min/week). For unstructured physical activities, 69% reported engaging in a median of 60 min/week at school on most days of the week in summer, whilst most survivors (96%) did not report any unstructured activity in winter. Only 19% met the recommended daily minimum of 60 min of physical activity year-round. Excessive screen use increased from school days (19%) to weekends (46%), notably handheld device screen time. We did not find any significant associations between meeting physical activity and screen time recommendations and HRQoL. Conclusions: Survivors frequently engage in irregular structured and unstructured physical activity levels and increased screen time. These findings emphasise the need for targeted, year-round interventions to improve physical activity, reduce recreational screen use, and support long-term survivorship health. Full article

This paper addresses the position control problem for a Lagrangian pendulum. Using a strict Lyapunov function, a rigorous analysis is presented to prove that the closed-loop system equilibrium point composed of the pendulum dynamics and a classical linear PID control is globally asymptotically stable. Motivated by these results, the theoretical proposal is extended to analyze a novel hyperbolic PID-type control scheme; reformulating the Lyapunov function, global asymptotic stability of the equilibrium point for the corresponding closed-loop equation is demonstrated. The proposed hyperbolic scheme is a rational function with bounded control action composed of a suitable combination of hyperbolic sine and cosine functions. The hyperbolic structure is used in the proportional, integral, and derivative terms of the control algorithm to drive the position error and joint velocity to zero. Experimental results of both a linear PID and a novel hyperbolic PID-type controller on a direct-drive pendulum are presented to illustrate the effectiveness and performance of the proposed control algorithm. Full article

The article presents the first scholarly study of a silver ark preserved in the “Dudian” Museum of the Armenian Diocese of Romania, Bucharest. The object is examined through an interdisciplinary art-historical approach that integrates typological, iconographic, stylistic, and symbolic analysis. The donative inscription links the ark to pilgrimage practices, identifying it as a memorial commissioned in Constantinople in 1799 by Mahtesi Asfatur from the city of Focșani. Stylistically, the ark exemplifies the “Constantinople style”, reflecting a synthesis of Eastern and Western artistic traditions. Its church-shaped form and iconography are interpreted as a symbolic representation of the Heavenly Jerusalem. Full article

Zearalenone (ZEN) and Deoxynivalenol (DON) are common Fusarium toxins that are found worldwide in contaminated wheat, corn, oats, and other foods. This study investigated the spatial distribution of ZEN and DON within bagged oat bran and the relationships among fungal taxa. A total of 168 oat bran bags arranged in a three-dimensional space (X = 4, Y = 6, Z = 7) were tested for ZEN and DON concentrations via Enzyme-linked Immunosorbent Assay (ELISA) and fungal communities were analyzed by Internal Transcribed Spacer (ITS) sequencing. Samples were grouped by air-exposed surfaces: G0 (no exposure, n = 48), G1 (one exposed surface, n = 80), G2 (two or three exposed surfaces, n = 40). Results showed strong positive correlations between ZEN and DON spatial distributions (r = 0.691~0.930), with G2 having significantly lower toxin levels than G0 and G1 (p < 0.05). Fusarium spp. (e.g., F. aethiopicum, F. pseudonygamai, and F. fujikuroi) were positively correlated with ZEN and DON (p < 0.05), indicating that they are the primary producers of these mycotoxins. Talaromyces (T. funiculosus and T. stollii) and Sarocladium (S. kiliense and S. strictum) were positively correlated with ZEN, DON, and Fusarium spp., while the yeasts D. hungarica, V. victoriae, and H. sinensis exhibited a negative association with those (p < 0.05). Overall, the distribution of ZEN and DON in bagged oat bran was heterogeneous in three-dimensional space, and the distribution pattern was related to air exposure. The extent of air exposure influenced the composition of the fungal community, and the taxa correlating with Fusarium spp. showed potential synergistic or antagonistic associations, collectively influencing the accumulation of mycotoxins. This study provides a reference basis for the prevention of mold contamination during the stacked bag storage of feedstuffs. Full article

Fusarium graminaerum causes Fusarium Head Blight (FHB) on wheat, reduces yield, and contaminates food and feed. It is therefore of paramount importance to control its growth or convert its harmful mycotoxins. This study aimed to find yeasts with biocontrol activity against F. graminearum, and to identify genes with potential detoxifying activities, using microbiological, molecular methods and bioinformatics. Co-cultivation tests showed that Schizosaccharomyces japonicus was able to inhibit the growth of F. graminearum. Transcriptomic analysis of the yeast cells co-cultured with F. graminearum highlighted differentially expressed genes (DEGs) encoding various enzymes, such as oxidoreductases, transferases, hydrolases, or genes involved in transmembrane transport. Three trichothecene-3-O-acetyltransferase homologous genes, which can convert trichothecenes to less toxic forms, were also among them. A database search showed that several yeast species contained this gene, including S. japonicus, which unexpectedly had seven copies. Real-time PCR analysis and mycotoxin tolerance tests confirmed that some of these genes could be induced by deoxynivalenol (DON), and S. japonicus had stronger DON tolerance than the related S. pombe, whose genome did not contain such a gene. This study is the first to report the biocontrol efficacy of S. japonicus against F. graminearum and the identification of its potential detoxification genes, offering promising new avenues for biotechnological applications in food safety. Full article

Natural and human-made hazards are increasing due to global warming and human activities. Occupant evacuation in complex buildings remains challenging due to unfamiliar building layouts, communication failures, and unpredictable occupant behavior. Therefore, this study aims to explore how integrating digital technologies enhances emergency preparedness, supports occupant decision-making during evacuation, and improves occupants’ situational awareness. We conducted a PRISMA-guided systematic literature review across Scopus, IEEE Xplore, and ProQuest Discover, analyzing 31 high-quality journal articles relevant to the research. The focus was on integrating digital technologies to support occupant situational awareness and evacuation outcomes. This review explores the integration of Internet of Things (IoT), Building Information Modeling (BIM), Virtual Reality (VR) /Augmented Reality (AR), Artificial Intelligence (AI), and Digital Twins (DTs) for emergency preparedness, supporting real-world applications. This review highlights three research questions: (1) Evaluate how current digital technologies affect occupant emergency preparedness in buildings; (2) Identify the challenges that limit the effectiveness of digital technologies across key emergency preparedness stages; (3) Understand how digital technologies can support occupant emergency preparedness. The review compiles evidence and presents a conceptual framework to support the integration of digital technologies into occupant-focused emergency preparedness, providing practical guidance for the future direction of risk management research. Full article

Human African Trypanosomiasis (HAT) and Malaria are serious infectious diseases endemic in tropical regions, caused by protozoan parasites, and necessitating an urgent development of new antiprotozoal drugs. As part of our ongoing search for new antiprotozoal steroidal alkaloids from plants, we investigated the methanolic stem bark extract of Holarrhena pubescens (Apocynaceae). H. pubescens is a tropical tree that some Kenyan coastal communities have long used to treat various ailments, including fever and stomach pain. The crude extract, alkaloid fraction, and 16 subfractions acquired through centrifugal partition chromatography (CPC) displayed promising in vitro antiprotozoal activity against Trypanosoma brucei rhodesiense (Tbr) and Plasmodium falciparum (Pf). Partial least squares (PLS) regression modeling of UHPLC/+ESI QqTOF-MS data and the antiprotozoal activity data of the crude extract and its fractions was performed to predict compounds that may be responsible for the observed antiplasmodial activity. Chromatographic separation of the alkaloid fraction afforded one new steroidal alkaloid (5), along with 18 known compounds (1, 2, 4, 6–20), and one artifact (3) that was presumably formed during the acid–base extraction process. The structural characterization of the isolated compounds was accomplished using UHPLC/+ESI-QqTOF-MS/MS and NMR spectroscopy. The isolated compounds were tested for their in vitro antiprotozoal properties against the two aforementioned pathogens, as well as for their cytotoxicity against mammalian cells (L6 cell line). Compounds 2 and 16 (IC₅₀ = 0.2 μmol/L) demonstrated the highest antitrypanosomal activity, with compound 2 showing the highest selectivity (SI = 127). The new compound 5 exhibited the strongest antiplasmodial activity and selectivity against Pf (IC₅₀ = 0.7 μmol/L, SI = 43). Our findings provide further promising antiprotozoal leads for HAT and Malaria. Full article

For historically marginalized groups and residents of low-resource rural communities, contact tracing is a critical tool for controlling the spread of communicable diseases. To improve its effectiveness, more research on identifying factors that influence an individual’s willingness to comply with contact tracers is needed. Therefore, we examined the association of race/ethnicity, contextual factors, and willingness to engage in contact tracing during the COVID-19 pandemic. The sample included 337 adults (56% Black/African American and 66% female). Approximately 80% of the participants indicated they would disclose the names of contacts. The results from the multivariate logistic regression analyses indicated lack of access to COVID-19 testing sites (aOR = 2.20; 95% CI = 1.08–4.48) and trust in health care providers (aOR = 7.57; 95% CI = 3.82–14.88) were significantly associated with willingness to share information with contact tracers. Race did not moderate the relationship between trust and engaging with contact tracers. The results suggest contact tracing is a viable strategy for mitigating disease transmission in rural communities, particularly when trust in health care providers is high and access to testing is limited, regardless of race. Public health officials should invest in maintaining contact tracing teams that include medical providers and prioritize building trusting relationships with all community members. Full article

Currently, foam concrete is a prevalent energy-efficient building material, which is applicable for multiple purposes in a wide variety of buildings and structures. Improving the environmental performance of foam concrete and reducing its production costs through the use of industrial waste is a relevant and promising area. The goal of this study is to create innovative foam concrete (FC) mixtures using industrial waste, focusing on their environmentally friendly and energy-efficient properties for structural and thermal insulation purposes. The production of FC involved industrial waste products like fly ash (FA) and microsilica (MS). Nanosilica (NS) was used as an additional modifying additive. The study experimentally investigated the impact of the proposed formulation and process solutions on FC’s density, compressive strength (CS), and thermal conductivity (TC). The most effective FC modification parameters were identified for FA, MS, and NS. The best combination of 15% FA, 6% MS, and 0.4% NS produces environmentally friendly FC with improved properties: a density of 1142 kg/m³ and a TC of 0.268 W/m×°C, which are 3.8% and 15.2% lower than the control composition, respectively, and a CS of 15.1 MPa, which is 46.6% higher than the control value. Scanning Electron Microscopy (SEM) analysis validates that incorporating pozzolanic additives FA, MS, and NS into the FC composition fosters the development of more robust interpore partitions. This is due to the generation of a significant quantity of supplementary calcium hydrosilicates and a more homogenous pore structure. The structural quality factor of FC with 15% FA, 6% MS, and 0.4% NS increases to 52.4%. The structural and thermal insulation of FCs developed in this study are environmentally friendly building materials with reduced environmental impact and improved performance properties. Full article