Search Results (162)

Background/Objectives: With the global rise in chronic diseases among older adults, rehabilitation services have become essential, particularly for those with cerebrovascular and central nervous system (CNS) disorders, which lead to significant long-term disabilities. To determine the impact of designated rehabilitation medical institutions on the readmission rates of older patients with CNS disorders who receive surgical interventions. Methods: This was a population-based cohort study. Data was obtained from the National Health Insurance Service database (2002–2019). Fifteen designated institutions participated in the pilot project for convalescent rehabilitation. We analyzed the data of 1019 patients before and after the implementation of the designated rehabilitation institution. The study sample included (1) patients admitted to 15 designated institutions participating in the pilot project for convalescent rehabilitation and (2) patients diagnosed with conditions classified under the rehabilitation patient group, Rehabilitation Impairment Category 1 to 7. The intervention was the pilot project for designated rehabilitation institutions, launched in October 2017. The primary outcome of interest was the readmission rate of older patients with CNS disorders who received surgical interventions. Interrupted time series analysis with segmented regression was used to assess changes in the 30-day readmission rates. Results: Post-intervention, an 8% reduction in 30-day readmission rates (estimate, 0.9225; 95% confidence interval: 0.9129–0.9322, p < 0.0001) was observed. Subgroup analysis showed a significant decline in readmission rates across various patient groups, including those with disabilities, high Charlson Comorbidity Index scores, and extended hospital stays. The regions outside Seoul (capital city), particularly Gyeonggi/Incheon (areas around Seoul) and other areas (i.e., rural), also showed a significant decrease in readmission trends after the intervention. Conclusions: Designated rehabilitation medical institutions led to a significant reduction in readmission rates of older patients with CNS disorders, suggesting that these institutions effectively support recovery and reduce the burden of readmission for patients with severe conditions and those residing in non-capital cities. Full article

Background: Body dysmorphic disorder (BDD) is a psychiatric condition characterized by a preoccupation with perceived appearance flaws. It is highly prevalent among aesthetic surgery candidates and can negatively impact surgical outcomes. The Body Dysmorphic Disorder Questionnaire (BDDQ) is used for BDD screening, but objective validation is limited. This study aimed to determine whether individuals screening positive for BDD exhibit different visual perception patterns of their own and model faces compared to controls, using eye-tracking technology. Methods: We conducted a cross-sectional study among 79 participants, including psychiatric patients and medical students. Participants completed the BDDQ and underwent eye-tracking while evaluating standardized photographs of models and their own faces. Gaze fixation patterns were recorded across pre-defined facial areas of interest. Perception and aesthetic assessment differences between the BDDQ-positive and BDDQ-negative groups were studied. Results: Participants focused most frequently on the nose, eyes and eyebrows. Compared to model faces, more attention was directed toward their own chin and cheeks. However, BDDQ screening results did not significantly influence fixation patterns or eye-tracking metrics. Psychiatric patients, regardless of BDDQ status, exhibited more numerous and shorter fixations than students. All participants rated model faces as significantly more attractive (i.e., higher aesthetic rating) than their own, with the largest difference observed in the BDDQ-positive group. Conclusions: While individuals screening positive for BDD reported lower self-attractiveness, eye-tracking patterns did not differ significantly from those of healthy participants. These findings suggest that BDDQ remains a useful screening tool for subjective dissatisfaction but may not correspond to objective differences in facial visual processing. Full article

Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by persistent social communication difficulties, restricted interests, repetitive behaviors, and frequent medical comorbidities. Although early brain development in ASD has been extensively investigated, its biological progression across adulthood and aging remains largely unexplored. Growing evidence suggests that perivascular space (PVS) abnormalities may indicate impaired neurovascular integrity and reduced glymphatic clearance in ASD. Enlarged perivascular spaces (ePVS) in children commonly present alongside increased extra-axial CSF accumulation and more severe clinical manifestations, consistent with early alterations in CSF homeostasis and neuroimmune signaling. However, whether these abnormalities persist or evolve with aging remains unknown. Given that glymphatic and vascular integrity decline with age, and adults with ASD show elevated rates of sleep, metabolic, and cardiovascular disorders, PVS alterations may represent a unifying mechanism linking early neurodevelopmental divergence with later neurovascular vulnerability and cognitive aging. Advances in ultra-high-field MRI and automated segmentation now enable precise in vivo quantification of PVS burden, offering new opportunities for lifespan studies. By combining structural and functional methodologies, researchers may determine whether PVS constitute enduring traits, dynamic indicators of disease, or actionable therapeutic targets. Understanding their trajectories could provide critical insights into the continuum between neurodevelopmental and neurodegenerative phenomena in autism. Full article

Background/Objectives: Genicular artery embolization (GAE) is an emerging, minimally invasive treatment for symptomatic osteoarthritis. This study assesses global online search trends for GAE compared with traditional knee replacement using Google Trends data. Methods: This retrospective observational study analyzed global search trends for osteoarthritis treatments using the publicly accessible Google Trends platform. Monthly relative search volumes (RSV; scaled 0–100) for English-language queries were retrieved from January 2018 to December 2024. Three emerging minimally invasive terms (“genicular artery embolization”, “knee embolization”, “interventional radiology”), and three traditional surgical terms (“knee arthroplasty”, “knee replacement”, “total knee replacement”) were included. Temporal trends were evaluated using linear and non-linear regression models, with model fit evaluated using coefficients of determination (R²), ANOVA, and accuracy measures. Statistical significance was defined as p < 0.05. Results: GAE-related terms demonstrated significant growth over time. “Genicular artery embolization” increased by 0.9% per month (R² = 0.795, p < 0.001), and “knee embolization” increased at 0.9% per month (R² = 0.627, p < 0.001) in a linear model. Traditional terms showed slower growth rates of 0.13–0.23% per month (R² = 0.159–0.271). Exponential and quadratic models confirmed these patterns. Mean RSV values over the study period were higher for traditional procedures (e.g., “total knee replacement”: 83.13) than for GAE-related terms (e.g., “genicular artery embolization”: 22.5). Conclusions: Global online interest in GAE-related terms is increasing at a substantially faster rate than interest in traditional knee replacement. Rapidly growing search interest highlights the need for accurate and accessible online patient education regarding emerging treatments. Full article

The purpose of this work is twofold: first, it aims to derive an exact analytical form of the Pareto index based on the already developed model of the economy as a scale-free network comprising a given amount of either wealth or income (total number of links, each link representing a non-zero amount or quantum of income or wealth) distributed among its variable number of actors (nodes), all of whom have equal access to the system), and second, it aims to employ the derived analytical form of the Pareto index to determine the degree to which the observed inequality in wealth and in income as measured by the respective empirical values of the Pareto index is inherent in the economic system rather than the result of externally imposed factors invariably reflecting a lack of equal access. The derived analytical form of the Pareto index for wealth or for income is described by an exponential function whose exponent is the inverse of the average number of wealth or of income per actor (one-half of the average number of links per node) in the economic model. This exponent features prominently in the scale-free model of the economy and has a numerical value of 0.69 when the Pareto index attains a numerical value of 2, which signifies the optimal, albeit still unequal, distribution of wealth or of income in the economy under the condition of equal access. Because of the correspondence of the scale-free model of the economy to a physical system comprising quantum particles such as photons in thermodynamic equilibrium or state of maximum entropy in accordance with the laws of statistical mechanics, the inverse of the exponent is proportional to the temperature of the economic system, and a new parameter introduced to describe in a comprehensible manner the deviation in the economic system from its optimal distribution of wealth or income. A comparison of the empirical wealth and income Pareto indexes based on economic data for the four largest economies in the word, i.e., USA, China, Germany, and Japan, which account for over 50% of the global GDP, versus the corresponding optimal values per the scale-free model of the economy reveals interesting trends that can be explained away by the prevailing degrees of equal access, as manifested by inadequate education, health care, and housing, as well as the existence of rules and institutions favoring certain actors over others, particularly with regard to the accumulation of wealth. It has also been determined that the newly introduced parameters in the scale-free model of the economy of temperature as well as the quanta of wealth and of income should be expressed in power purchase exchange rates for meaningful comparisons among national economies over time. Full article

While increasingly popular for their aesthetic appeal and energy efficiency, reflective materials may also create harsh glare, disorientation, and psychological strain. Despite their prevalence in modern architectural design, the impact of these facades on mental well-being remains underexplored. Drawing from environmental psychology and perceptual science, this study assesses how different reflective materials influence both visual perception and psychological response, particularly among residents and students in Leicester. Two contrasting case studies, the reflective metal Highcross centre facade and the reflective glass Mattioli Woods PLC facade, served as focal points. Using a structured online questionnaire incorporating visual stimuli and Likert-scale questions, responses from 30 participants were analysed using descriptive and statistical analysis (i.e., one-way ANOVA) to determine differences in visual discomfort (due to brightness, glare, or shine), visual attractiveness, visual disorientation, and perception of the surroundings, as well as the associated physiological responses such as stress, tension, and mood. Results show that the Highcross Centre facade was consistently perceived as more visually discomforting and disorienting than the Mattioli Woods facade, with statistically significant differences. However, both facades were rated similarly high for visual interest, suggesting that aesthetic value can coexist with discomfort. Finally, the analysis shows that buildings’ reflective facades evoke only low levels of perceived stress, tension, or unease, with median scores remaining low overall. These findings highlight the importance of human-centred facade design, suggesting that, as cities adapt to climate change, architects and urban planners consider not only environmental performance but also perceptual and psychological effects. Full article

Background: There is limited published evidence on the prevalence of potentially inappropriate prescribing of medicines in relation to kidney function in older Australians, particularly those with dementia. Objectives: To examine the prevalence, temporal trends and factors associated with potentially inappropriate prescribing of renally-dependent medicines in patients with dementia, using Australian general practice data. Methods: This comparative study was reported in accordance with the STROBE guidelines for cohort studies. Retrospective analyses of the National Prescribing Service (NPS) MedicineInsight dataset were performed to determine the proportion of patients aged ≥ 65 years with a recorded diagnosis of dementia, along with matched controls, who had potentially inappropriate prescribing based on their estimated glomerular filtration rate (eGFR) during the study period (2011–2020). Each patient was included only once throughout the study. Potentially inappropriate prescribing was evaluated for 33 commonly used medicines, using the Cockcroft-Gault equation for estimated creatinine clearance or eGFR, in accordance with the guidelines from the Australian Medicines Handbook (AMH). Each patient’s medicines were included if they were prescribed within 180 days after the most recent recorded lowest eGFR value for the patient. Medicines having prescribed doses exceeding those recommended for an individual’s renal function were classified as ‘inappropriate dosage’, while those whose use was advised against were labelled ‘contraindicated’. Both categories were regarded as inappropriate prescriptions. Descriptive statistics were used to summarise patient characteristics and medication use. Temporal trends were displayed in graphs, with statistical significance determined using the Cochran-Armitage test. Binary logistic regression models were used to examine the associations between sociodemographic and clinical factors and the prescribing of medicines inconsistent with AMH guidelines. Results: The unmatched cohorts included 33,101 patients, comprising 4092 with dementia and 29,009 without. Among them, 58.4% were female, and the overall median age was 82 years [interquartile range (IQR): 77–87]. After propensity score matching, there were 4041 patients with dementia and 8031 without dementia. Over the study period, potentially inappropriate prescribing increased slightly, but insignificantly, in both groups of patients; the prevalence of inappropriate use of at least one of the 33 drugs of interest rose from 6.5% (95% CI 4.5–9.1%) in 2011 to 8.9% (95% CI 6.0–12.7%; p for trend: 0.966) in 2020 in the dementia group, and 9.2% (95% CI 8.0–10.5%) to 11.1% (95% CI 10.3–12.0%; p for trend: 0.224) in the matched controls. Over the ten-year period, approximately 9.3% (377) of patients with dementia in the matched cohort received at least one potentially inappropriate prescription. Among these, 154 (40.8%) were for contraindicated medicines, and 223 (59.1%) were for inappropriate doses based on renal function. Among patients with dementia in the matched cohort, fenofibrate, nitrofurantoin, and moxonidine were the most frequently prescribed medicines at doses inconsistent with AMH guidelines. In the unmatched dementia cohort, potentially inappropriate prescribing was not significantly associated with demographic characteristics or most comorbidities; however, it occurred more frequently in patients with an eGFR below 30 mL/min/1.73 m² or those with concomitant diabetes. Conclusions: Positively, the prevalence of potentially inappropriate prescribing of renally-dependent medicines in primary care patients with dementia in Australia was similar to their matched controls. However, there was room for improvement in the prescribing of these drugs in both patients with and without dementia. Full article

Botanical insecticides derived from neem (Azadirachta indica A. Juss.) seeds have gained significant interest due to their sustainable characteristics and low environmental impact. However, their use in sericulture remains contentious due to the heightened sensitivity of domesticated silkworms to environmental stressors. This study systematically investigates the toxicodynamic effects of aqueous neem seed extract (ANSE) on fifth instar larvae of Thai multivoltine Bombyx mori L., focusing on larval mortality and carboxylesterase (CarE) enzyme activity in essential detoxification organs. Larvae were exposed to ANSE concentrations ranging from 5 to 50 mg L⁻¹ for up to 72 h. Key findings highlight a pronounced dose- and time-dependent increase in mortality, with an accurately determined LC₅₀ value of 17 mg L⁻¹ at the longest time exposure, accompanied by mortality rates reaching approximately 83% at the highest concentration tested, indicating considerable susceptibility. Additionally, notable and distinct organ-specific responses were observed, with significant inhibition of CarE activity in the midgut contrasting with elevated activities in the fat body and Malpighian tubules. These differential enzymatic responses reveal previously undocumented adaptive detoxification mechanisms. Consequently, the study advocates cautious and regulated application of neem-based insecticides in sericulture, recommending precise management of concentrations and exposure durations according to silkworm strain sensitivities to ensure optimal silk production. Full article

The advancement of optical materials has garnered significant interest from the global scientific community in the pursuit of efficient photocatalysts for the purification of water using light. This challenge, which cannot be addressed using traditional methods, is tackled in the present study utilizing unconventional approaches. This study presents the fabrication of an effective photocatalyst using an unconventional approach that employs explosive reactions. This method successfully produces 3D nanostructures composed of carbon nanotubes (CNTs), carbon nanofibers (CNFs), and silica–alumina nanoparticles at temperatures below 270 °C. Gold-supported silica–alumina–CNT–CNF nanostructures were synthesized and characterized using XRD, TEM, SEM, and EDX, in addition to mapping images. To study and determine the photoactivity of these produced nanostructures, two well-known photocatalysts—titanium dioxide and zinc oxide—were synthesized at the nanoscale for comparison. The results showed that the presence of CNTs and CNFs significantly reduced the band gap energy from 5.5 eV to 1.65 eV and 3.65 eV, respectively, after modifying the silica–alumina structure. In addition, complete degradation of green dye was achieved after 35 min of light exposure using the modified silica–alumina structure. Additionally, the surface properties of the modified silica–alumina had a positive role in accelerating the photocatalytic decomposition of the green dye NGB. A kinetic study confirmed that the modified silica–alumina functions as a promising additive for optical applications, accelerating the photocatalytic degradation of NGB to a rate three times faster than that of the prepared titanium dioxide and six times that of the prepared zinc oxide. Full article

Objectives: The purpose of this study was to analyze image quality and radiation exposure of thoracic computed tomography angiography (CTA) in children with congenital heart diseases (CHDs) using either manual contrast medium (CM) injection or automated power injectors with bolus tracking. Methods: A total of 137 thoracic CTAs of 120 consecutive pediatric patients were included in this retrospective study. We analyzed the method of CM administration (power injection with bolus tracking (PI) or manual injection (MI)), injection routes, volumes and flow rates of CM. For the evaluation of objective image quality, attenuation values in the heart chambers and great thoracic vessels were determined by region-of-interest (ROI) analysis and signal-to-noise (SNR) and contrast-to-noise (CNR) ratios calculated thereof. Visual image quality was assessed by two blinded readers (four-point Likert-scale) analyzing the presence of artifacts and the depiction of relevant anatomical structures. Effective radiation doses were calculated with dose length products and specific conversion factors. Results: CM administration was performed using PI in 119/137 CTAs, whereas MI was conducted in 18/137. The smallest size of peripheral venous cannulas was 24 gauge in 36/137 (26.3%) cases. Overall mean CM volume was 17 mL ± 16 mL (mean ± SD). In PI, the mean flow rate of CM was 1.52 ± 0.90 mL/s with a range between 0.5 and 5.0 mL/s. When comparing the overall PI population and an age-, size- and weight-matched PI subpopulation (18 cases) with the MI population, attenuation values in Hounsfield units (HU) and CNR values were significantly higher in the PI groups than in the MI group for each relevant cardiac structure (left ventricle, right ventricle, ascending aorta and pulmonary trunk, p = 0.02–0.001). Overall image quality and depiction of cardiac structures were rated significantly better in CTAs with PI (interquartile ranges: “good” to “excellent” (Likert 3–4)) in PI compared with CTAs acquired with MI (interquartile ranges: “fair” to “good” (2–3)) in MI by both readers (p < 0.001). The inter-observer reliability was strong, with a Kendall’s Tau-b correlation coefficient of τ = 0.802 (p < 0.001). The mean effective radiation dose (E) did not differ significantly when comparing the stratified samples (i.e., the matched PI subgroup and the MI group; 0.5 (±0.3) mSv in both, p = 0.76). There were no complications associated with the CM injections for both application approaches. Conclusions: Automated contrast agent applications with power injectors and bolus tracking ensure better image quality in pediatric CTA, even when low volumes and flow rates need to be applied. There is a slight increase in radiation associated with bolus tracking. This approach represents a suitable imaging technique for the work-up of congenital heart disease. Full article

Fibers are widely used in concrete structures to control crack propagation and widening due to sustained or impact loads. Nevertheless, the concrete’s mechanical and structural properties are strongly affected by the fibers’ spatial distribution and clumping tendency within the mass material. The main objective of this paper is to assess the efficiency of stochastic finite element modeling to predict the shear strength properties of fiber-reinforced concrete (FRC) beams without stirrups, as tested by four-point loading. Polypropylene and polyvinyl alcohol micro-filament fibers are investigated in this experimental program at relatively high rates, varying from 0.5% to 1% by volume. A stochastic sensitivity analysis is performed using both random fields and random variables to determine the effect of fiber additions on the concrete’s mechanical properties (i.e., splitting tensile strength and modulus of elasticity) including the beam cracking patterns, ductility, mid-span deflection, and ultimate load. Such data could be of interest to civil engineers and structural designers to reduce the effort and resources needed to assess the FRC strength variability and failure behaviors of structural members. Full article

A sustainable reaction of electrocatalytic nitrate conversion in ammonia production (NO₃RR) occurring under ambient conditions is currently of prime interest, as well as urgent research due to the real potential replacement of the environmentally unfavorable Haber–Bosch process. Herein, a series of electrocatalysts based on two-component cobalt alloys was synthesized using low-cost non-noble metals Co, Fe, Cr, and also Si. The samples of electrocatalysts were characterized and studied by the following methods: SEM, EDX, XRD (both transmission and reflection), UV–VIS spectroscopy, optical microscopy, linear (and cyclic) voltammetry, chronoamperometry, and electrochemical impedance spectroscopy. Beyond that, the determination of electrochemically active surface area was also carried out for all samples of electrocatalysts. Unexpectedly, the sample having an intermetallic compound (IMC) of the composition Co₂Si turned out to be the most highly effective. The highest Faradaic efficiency (FE) of 80.8% at E = −0.585 V (RHE) and an ammonia yield rate of 22.3 µmol h⁻¹ cm⁻² at E = −0.685 V (RHE) indicate the progressive role of IMC as the main active component of the electrocatalyst. Thus, this study demonstrates the promise and enormous potential of IMC as the main component of highly efficient electrocatalysts for NO₃RR. This work can serve primarily as a starting point for future studies of electrocatalytic conversion reactions in the production of ammonia using IMC catalysts containing non-noble metals. Full article

Cronobacter sakazakii is an opportunistic food-borne pathogen that causes severe infections with high morbidity and mortality rates in neonates, the elderly, and immunocompromised individuals. The plant extracts containing natural antibacterial compounds are currently under consideration as alternatives to synthetic artificial preservatives for the control of C. sakazakii. There has been increasing interest in using plant-derived antimicrobials in combination with mild heat to control pathogens in preservative-free foods. In this study, the individual and combined effects of four independent variables, i.e., polyphenol-rich haskap extract (HE) concentration (2–10%), tannic acid (TA) concentration (0.1–0.5), temperature (35–55 °C), and time (1–5 min), on C. sakazakii inactivation were investigated by response surface methodology (RSM) with a five-level four factor central composite design (CCD) and an optimal combination for maximum inhibition was determined. The statistic metrics of R², R²_adjusted, R²_predicted, coefficient of variation (CV), Predicted Residual Error Sum of Squares (PRESSs), adequate precision, and lack-of-fit were used to reveal the prediction performance. The results revealed that all the independent variables, except time, influenced C. sakazakii inactivation. Among the independent variables, the temperature was the most effective variable (p < 0.0001) as regards inactivation. The synergistic effects of HE with TA and temperature were observed. Many possible optimum conditions of mild heat treatment that maximized the inhibition of C. sakazakii were obtained. The findings indicated that two distinct combinations were identified as the most effective inhibition of C. sakazakii: high concentration at low temperature and high temperature at low concentration. It can be concluded that haskap polyphenol extract, alone or in combination with tannic acid, has the potential to be used as a natural preservative to reduce the risk of C. sakazakii. Full article

The pursuit of electrochemical carbon dioxide reduction reaction (CO₂RR) as a means of energy generation and mitigation of global warming is of considerable interest. In this study, a novel RuO₂-incorporated SnO₂-fabricated glassy carbon electrode (GCE) with a Nafion binder was used for the electrochemical reduction of CO₂ in an aqueous alkaline imidazole medium. The electrode fabrication process involved the drop-casting method, where RuO₂.SnO₂ was incorporated onto the surface of the GCE. Electrochemical studies demonstrated that the GCE-RuO₂.SnO₂ electrode facilitated CO₂ reduction at −0.58 V vs. the reversible hydrogen electrode (RHE) via a diffusion-controlled pathway with the transfer of two electrons. Importantly, the first electron transfer step was identified as the rate-determining step (RDS). A Tafel slope of 144 mV dec⁻¹ confirmed the association of two-electron transfer kinetics with CO₂RR. Moreover, the standard rate constant (k_o) and formal potential (E°′) were evaluated as 2.89 × 10⁻⁵ cm s⁻¹ and 0.0998 V vs. RHE, respectively. Kinetic investigations also reveal that the deprotonation and electron release steps took place simultaneously in the CO₂RR. Based on the reported results, the GCE-RuO₂.SnO₂ electrode could be a promising candidate for CO₂ reduction, applicable in renewable energy generation. Full article

Human nails have recently become a sample of interest for toxicological purposes. Multiple studies have proven the ability to detect various analytes within the keratin matrix of the nail. The analyte of interest in this study is fentanyl, a highly dangerous and abused drug in recent decades. In this proof-of-concept study, ATR–FTIR was combined with machine learning methods, which are effective in detecting and differentiating fentanyl in samples, to explore whether nail samples are distinguishable from individuals who have used fentanyl and those who have not. PLS-DA and SVM-DA prediction models were created for this study and had an overall accuracy rate of 84.8% and 81.4%, respectively. Notably, when classification was considered at the donor level—i.e., determining whether the donor of the nail sample was using fentanyl—all donors were correctly classified. These results show that ATR–FTIR spectroscopy in combination with machine learning can effectively differentiate donors who have used fentanyl and those who have not and that human nails are a viable sample matrix for toxicology. Full article