Search Results (314)

Background/Objectives: Atrial fibrillation (AF) is the most significant modifying risk factor for the development of cardioembolic stroke, which is associated with worse outcomes and higher intrahospital mortality compared to other types of ischemic stroke. Antithrombotic medications are administered as prophylactic treatment in patients with a risk of stroke. The aim of this study was to determine outcome measures in patients with first-ever ischemic stroke and AF regarding prior antithrombotic therapy. Methods: We collected data on stroke risk factors, CHADS₂ score, and international normalized ratio (INR) value in the context of warfarin therapy, as well as data related to localization, stroke severity, and functional outcome at discharge. Results: A total of 754 subjects with first-ever ischemic stroke and AF were included in this cross-sectional study (122 on warfarin, 210 on acetylsalicylic acid, and 422 without prior antithrombotic therapy). The diagnosis of AF was previously unknown in 31% of the subjects. Stroke risk factors (arterial hypertension, hyperlipidemia, diabetes mellitus, and cardiomyopathy) were significantly lower in the group without prior antithrombotic therapy. The anticoagulant group was significantly younger (p = 0.001). Overall, 45.4% of subjects with a previously known AF event and a high risk of developing stroke received anticoagulant therapy. Participants on warfarin had a significantly better functional outcome than those on antiplatelet therapy or without prior antithrombotic therapy (median mRS 4 vs. 5 vs. 5; p = 0.025) and lower NIHSS scores, although the difference was not statistically significant (median 10 vs. 12 vs. 12; p = 0.09). There was no difference between stroke localization among groups (p = 0.116). Conclusions: Our study showed that, in our cohort, first-ever ischemic stroke due to AF was more common in women. Subjects on prior anticoagulant therapy had more favorable outcomes at discharge. Full article

Agrivoltaic (Agri-PV) systems face the critical challenge of balancing photovoltaic energy generation with crop productivity, yet systematic approaches to quantifying the trade-offs between these objectives remain scarce. In this study, we identify nine essential design indicators: panel tilt angle, elevation, photovoltaic coverage ratio, shading factor, land equivalent ratio, photosynthetically active radiation (PAR) utilization, crop yield stability index, water use efficiency, and return on investment. We introduce a novel dual matrix Analytic Hierarchy Process (AHP) to evaluate their relative significance. An international panel of eighteen Agri-PV experts, encompassing academia, industry, and policy, provided pairwise comparisons of these indicators under two objectives: maximizing annual energy yield and sustaining crop output. The high consistency observed in expert responses allowed for the derivation of normalized weight vectors, which form the basis of two Weighted Influence Matrices. Analysis of Total Weighted Influence scores from these matrices reveal distinct priority sets: panel tilt, coverage ratio, and elevation are most influential for energy optimization, while PAR utilization, yield stability, and elevation are prioritized for crop productivity. This methodology translates qualitative expert knowledge into quantitative, actionable guidance, clearly delineating both synergies, such as the mutual benefit of increased elevation for energy and crop outcomes, and trade-offs, exemplified by the negative impact of high photovoltaic coverage on crop yield despite gains in energy output. By offering a transparent, expert-driven decision-support tool, this framework enables practitioners to customize Agri-PV system configurations according to local climatic, agronomic, and economic contexts. Ultimately, this approach advances the optimization of the food energy nexus and supports integrated sustainability outcomes in Agri-PV deployment. Full article

Significant progress has been made in the low-temperature toughness and crack resistance of polypropylene fiber-reinforced composites. However, there is still a gap in the research on damage evolution under freeze–thaw cycles and complex stress ratios. To solve the problem of durability degradation of traditional rubble masonry in cold regions, this paper focuses on the study of polypropylene fiber-mortar-masonry blocks with different fiber contents. Using acoustic emission and digital image technology, the paper conducts a series of tests on the scaled-down polypropylene fiber-mortar-masonry structure, including uniaxial compressive tests, three-point bending tests, freeze–thaw cycle tests, and tests with different stress ratios. Based on the Kupfer criterion, a biaxial failure criterion for polypropylene fiber mortar-masonry stone (PPF-MMS) was established under different freeze–thaw cycles. A freeze–thaw damage evolution model was also developed under different stress ratios. The failure mechanism of PPF-MMS structures was analyzed using normalized average deviation (NAD), RA-AF, and other parameters. The results show that when the dosage of PPF is 0.9–1.1 kg/m³, it is the optimal content. The vertical stress shows a trend of increasing first and then decreasing with the increase in the stress ratio, and when α = 0.5, the degree of strength increase reaches the maximum. However, the freeze–thaw cycle has an adverse effect on the internal structure of the specimens. Under the same number of freeze–thaw cycles, the strength of the specimens without fiber addition decreases more rapidly than that with fiber addition. The NAD evolution rate exhibits significant fluctuations during the middle loading period and near the damage failure, which can be considered precursors to specimen cracking and failure. RA-AF results showed that the specimens mainly exhibited tensile failure, but the occurrence of tensile failure gradually decreased as the stress ratio increased. Full article

This paper presents some of the most significant findings in the design of a hydraulic servomechanism for flight controls, which were primarily achieved by the first author during his activity in an aviation institute. These results are grouped into four main topics. The first one outlines a classical theory, from the 1950s–1970s, of the analysis of nonlinear automatic systems and namely the issue of absolute stability. The uninformed public may be misled by the adjective “absolute”. This is not a “maximalist” solution of stability but rather highlights in the system of equations a nonlinear function that describes, for the case of hydraulic servomechanisms, the flow-control dependence in the distributor spool. This function is odd, and it is therefore located in quadrants 1 and 3. The decision regarding stability is made within the so-called Lurie problem and is materialized by a matrix inequality, called the Lefschetz condition, which must be satisfied by the parameters of the electrohydraulic servomechanism and also by the components of the control feedback vector. Another approach starts from a classical theorem of V. M. Popov, extended in a stochastic framework by T. Morozan and I. Ursu, which ends with the description of the local and global spool valve flow-control characteristics that ensure stability in the large with respect to bounded perturbations for the mechano-hydraulic servomechanism. We add that a conjecture regarding the more pronounced flexibility of mathematical models in relation to mathematical instruments (theories) was used. Furthermore, the second topic concerns, the importance of the impedance characteristic of the mechano-hydraulic servomechanism in preventing flutter of the flight controls is emphasized. Impedance, also called dynamic stiffness, is defined as the ratio, in a dynamic regime, between the output exerted force (at the actuator rod of the servomechanism) and the displacement induced by this force under the assumption of a blocked input. It is demonstrated in the paper that there are two forms of the impedance function: one that favors the appearance of flutter and another that allows for flutter damping. It is interesting to note that these theoretical considerations were established in the institute’s reports some time before their introduction in the Aviation Regulation AvP.970. However, it was precisely the absence of the impedance criterion in the regulation at the appropriate time that ultimately led, by chance or not, to a disaster: the crash of a prototype due to tailplane flutter. A third topic shows how an important problem in the theory of automatic systems of the 1970s–1980s, namely the robust synthesis of the servomechanism, is formulated, applied and solved in the case of an electrohydraulic servomechanism. In general, the solution of a robust servomechanism problem consists of two distinct components: a servo-compensator, in fact an internal model of the exogenous dynamics, and a stabilizing compensator. These components are adapted in the case of an electrohydraulic servomechanism. In addition to the classical case mentioned above, a synthesis problem of an anti-windup (anti-saturation) compensator is formulated and solved. The fourth topic, and the last one presented in detail, is the synthesis of a fuzzy supervised neurocontrol (FSNC) for the position tracking of an electrohydraulic servomechanism, with experimental validation, in the laboratory, of this control law. The neurocontrol module is designed using a single-layered perceptron architecture. Neurocontrol is in principle optimal, but it is not free from saturation. To this end, in order to counteract saturation, a Mamdani-type fuzzy logic was developed, which takes control when neurocontrol has saturated. It returns to neurocontrol when it returns to normal, respectively, when saturation is eliminated. What distinguishes this FSNC law is its simplicity and efficiency and especially the fact that against quite a few opponents in the field, it still works very well on quite complicated physical systems. Finally, a brief section reviews some recent works by the authors, in which current approaches to hydraulic servomechanisms are presented: the backstepping control synthesis technique, input delay treated with Lyapunov–Krasovskii functionals, and critical stability treated with Lyapunov–Malkin theory. Full article

Thermal safety issues of sodium-ion batteries have become a major challenge, particularly under abusive conditions where the risk of thermal runaway is heightened. This study investigates the effects of overcharging on the thermal safety of sodium-ion batteries. Discharge capacity and time, internal resistance, and electrochemical impedance spectroscopy (EIS) at different states of charge (SOCs) are analyzed. Additionally, heat generation behaviors are evaluated at both normal/elevated temperatures. It is found that the overcharged batteries (OBs) demonstrate a significant increase in internal resistance from 46.72 Ω to 65.99 Ω. The discharge time of OBs at 1 C current (the ratio of the rate at which a battery discharges per unit time to its rated capacity) is reduced by 4.26% compared to normal batteries (NBs). The peak temperature and temperature difference increase by 5.6% and 36.1%, respectively. When discharged at 1 C at 40 °C, OBs have a 5.47% reduction in discharge time compared to NBs. Furthermore, the OBs exhibit an increase in the peak discharge temperature and temperature difference of 0.99 °C and 0.4 °C, respectively. Microscopic analysis of the electrode materials makes clear the irreversible damage to the internal structures of the sodium-ion battery caused by overcharging. This study potentially provides fundamental data support and theoretical insights for sodium-ion battery module thermal safety. Full article

This study addresses the formation, detection, and repair of cracks in concrete elements exposed to temperatures above 25 °C, where accelerated evaporation compromises their structural strength. An automated intelligent curing system with embedded sensors (DS18B20, HD-38) and Arduino controllers was developed and applied to solid slabs, columns, and concrete test specimens (1:2:3.5 mix ratio). The electronic design was simulated in Proteus and validated experimentally under tropical conditions. Data with normal distribution (p > 0.05) showed a significant correlation between internal and ambient temperature (r = 0.587; p = 0.001) and a low correlation in humidity (r = 0.143; p = 0.468), indicating hygrometric independence. The system healed cracks of 0.01 mm observed two hours after pouring the mixture, associated with an evaporation rate of 1.097 mL/s in 4 m². For 28 days, automated irrigation cycles were applied every 30 to 60 min, with a total of 1680 L, achieving a 20% reduction in water consumption compared to traditional methods. The system maintained stable thermal conditions in the concrete despite ambient temperatures of up to 33.85 °C. A critical evaporation range was identified between 11:00 and 16:00 (UTC-5). The results demonstrate the effectiveness of the embedded system in optimizing curing, water efficiency, and concrete durability. Full article

The present study aimed to compare pulmonary vein (PV) diameters between Cavalier King Charles Spaniels (CKCSs) with myxomatous mitral valve disease (MMVD) and healthy CKCSs, assess correlations between PV diameters and echocardiographic parameters, and identify the optimal PV diameter cut-off value that distinguishes stage C from stage B2. CKCSs were recruited both retrospectively and prospectively and classified according to the ACVIM guidelines (stages A, B1, B2, and C). From a left apical view, the diameters of three PVs (PV1, PV2, and PV3) were measured with high reproducibility. In healthy dogs, the PV2 diameter showed no correlation with body weight. The PV2 diameter was significantly higher in stage B2 compared to B1 and in stage C compared to B2, while no difference was found between stages A and B1. The median (IQR) PV2 diameters were 4.9 mm (3.9–5.2) in stage A, 5.1 mm (4.0–6.0) in stage B1, 9.3 mm (7.3–11.1) in stage B2, and 13.7 mm (9.9–15.1) in stage C. Positive correlations were observed between the PV2 diameter and the left ventricular internal diameter normalized for body weight, the left atrium-to-aorta ratio, mitral E wave peak velocity, tricuspid regurgitation pressure gradient, and regurgitant fraction. A PV2 diameter cut-off value of 12.8 mm discriminated stage C from stage B2 with 57% sensitivity and 93% specificity. The PV2 diameter is a reproducible echocardiographic measure that increases with MMVD severity and could assist in the early detection of congestive heart failure. However, the modest sensitivity observed reflects the overlap of PV2 measurements between stages B2 and C. Therefore, PV2 should be interpreted with caution and considered a supportive, rather than exclusive, tool in disease staging and therapeutic decision-making. Full article

Introduction: The clinical implementation of noninvasive tests for liver fibrosis assessment has attracted increasing attention, particularly for diagnosing advanced fibrosis (≥F3). This observational study aimed to evaluate the stratification accuracy of nine direct and seven indirect biomarkers across four etiologies: chronic hepatitis B (CHB), chronic hepatitis C (CHC), alcoholic liver cirrhosis (ALC), and nonalcoholic liver cirrhosis (NALC). Materials and Methods: Our study was conducted on 116 participants, including 96 with chronic liver disease (16 CHB, 15 CHC, 49 ALC, and 16 NALC) and 20 healthy controls. The values of direct (aspartate aminotransferase, alanine aminotransferase, total bilirubin, serum albumin, platelet count, international normalized ratio, gamma-glutamyl transpeptidase, CD5 antigen-like, and transforming growth factor-beta 1) and indirect non-serological biomarkers (De Ritis ratio, albumin–bilirubin score, gamma-glutamyl transpeptidase-to-platelet ratio, aspartate aminotransferase-to-platelet-ratio index, fibrosis-4 index, INR-to-platelet ratio, and fibrosis quotient) were analyzed for their discriminative power in fibrosis stratification. Results: Statistical analyses revealed a significant correlation (0.05 level; two-tailed), and AUC 95% CI ranged within 0.50–1.00 between the direct and indirect biomarker values across all etiologies. Among the evaluated biomarkers, the recorded AUC was 0.998 in CHB for APRI, 0.981 in CHC for FIB-4, and 1.000 in ALC and NALC for APRI and AST, respectively, while CD5L consistently achieved an AUC of 1.000 across all etiologies. Conclusions: These findings suggest that applying a multifactorial approach in liver pathology may improve diagnosis accuracy compared to the use of individual biomarkers and can provide data that may inform the development of clinically applicable mathematical models. Full article

Since the beginning of the 21st century, the supercritical carbon dioxide (sCO₂) Brayton cycle has emerged as a hot topic of research in the energy field. Among its key components, the sCO₂ compressor has received significant attention. In particular, axial-flow sCO₂ compressors are increasingly being investigated as power systems advance toward high power scaling. This paper reviews global research progress in this field. As for performance characteristics, currently, sCO₂ axial-flow compressors are mostly designed with large mass flow rates (>100 kg/s), near-critical inlet conditions, multistage configurations with relatively low stage pressure ratios (1.1–1.2), and high isentropic efficiencies (87–93%). As for internal flow characteristics, although similarity laws remain applicable to sCO₂ turbomachinery, the flow dynamics are strongly influenced by abrupt variations in thermophysical properties (e.g., viscosities, sound speeds, and isentropic exponents). High Reynolds numbers reduce frictional losses and enhance flow stability against separation but increase sensitivity to wall roughness. The locally reduced sound speed may induce shock waves and choke, while drastic variation in the isentropic exponent makes the multistage matching difficult and disperses normalized performance curves. Additionally, the quantitative impact of a near-critical phase change remains insufficiently understood. As for the experimental investigation, so far, it has been publicly shown that only the University of Notre Dame has conducted an axial-flow compressor experimental test, for the first stage of a 10 MW sCO₂ multistage axial-flow compressor. Although the measured efficiency is higher than that of all known sCO₂ centrifugal compressors, the inlet conditions evidently deviate from the critical point, limiting the applicability of the results to sCO₂ power cycles. As for design and optimization, conventional design methodologies for axial-flow compressors require adaptations to incorporate real-gas property correction models, re-evaluations of maximum diffusion (e.g., the DF parameter) for sCO₂ applications, and the intensification of structural constraints due to the high pressure and density of sCO₂. In conclusion, further research should focus on two aspects. The first is to carry out more fundamental cascade experiments and numerical simulations to reveal the complex mechanisms for the near-critical, transonic, and two-phase flow within the sCO₂ axial-flow compressor. The second is to develop loss models and design a space suitable for sCO₂ multistage axial-flow compressors, thus improving the design tools for high-efficiency and wide-margin sCO₂ axial-flow compressors. Full article

Background: Chronic kidney disease (CKD) and its advanced stage, end-stage renal disease (ESRD), affect millions worldwide and are associated with a paradoxical hemostatic imbalance—marked by both increased thrombotic and bleeding risks—which complicates anticoagulant use and demands clearer, evidence-based clinical guidance. Design: This study is a critical review synthesizing the current literature on anticoagulant therapy in CKD and ESRD, with emphasis on altered pharmacokinetics, clinical complications, and therapeutic adjustments. Data Sources: PubMed, Scopus, and Google Scholar were searched for articles discussing anticoagulation in CKD/ESRD, focusing on pharmacokinetics, clinical outcomes, and dosing recommendations. Study Selection: Studies examining the safety, efficacy, and pharmacokinetics of anticoagulants—including heparin, low-molecular-weight heparin (LMWH), warfarin, and direct oral anticoagulants (DOACs)—in CKD and ESRD populations were included. Data Extraction and Synthesis: Key findings were summarized to highlight the dose modifications, therapeutic considerations, and clinical challenges in managing anticoagulation in CKD/patients with ESRD. Emphasis was placed on balancing thrombotic and bleeding risks and identifying gaps in existing guidelines. Results: Patients with CKD and ESRD exhibit a paradoxical hypercoagulable state marked by platelet dysfunction, altered coagulation factors, and vascular endothelial damage. This condition increases the risk of thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE), while simultaneously elevating bleeding risks. Hemodialysis and CKD-associated variables further complicate the management of coagulation. Among anticoagulants, unfractionated heparin (UFH) is preferred due to its short half-life and adjustability based on activated partial thromboplastin time (aPTT). Low-molecular-weight heparins (LMWHs) offer predictable pharmacokinetics but require dose adjustments in CKD stages 4 and 5 due to reduced clearance. Warfarin necessitates careful dosing based on the estimated glomerular filtration rate (eGFR) to maintain an international normalized ratio (INR) ≤ 4, minimizing bleeding risks. Direct oral anticoagulants (DOACs), particularly Apixaban, are recommended for patients with eGFR < 15 mL/min or those on dialysis, although data on other DOACs in CKD remain limited. The lack of comprehensive guidelines for anticoagulant use in CKD and ESRD highlights the need for individualized, patient-centered approaches that account for comorbidities, genetics, and clinical context. Conclusions: Managing anticoagulation in CKD/ESRD is challenging due to complex coagulation profiles and altered pharmacokinetics. Judicious dosing, close monitoring, and patient-centered care are critical. High-quality randomized controlled trials are needed to establish clear guidelines and optimize therapy for this vulnerable population. Full article

Background/Objectives: Individuals with childhood obesity exhibit significant metabolic heterogeneity, necessitating precise biomarkers for risk stratification and assessment. This multi-omics investigation characterizes metabolic and microbial signatures underlying divergent metabolic phenotypes in the context of pediatric obesity. Methods: We analyzed 285 Chinese children (5–7 years) stratified into five groups: wasting (WAS, n = 55), metabolically healthy/unhealthy and normal weight (MHWH, n = 54; MUWH, n = 67), and metabolically healthy/unhealthy obesity (MHO, n = 36; MUO, n = 73). Untargeted metabolomics (Orbitrap ID-X Tribrid™) and 16S rRNA sequencing were integrated with multivariate analyses (OPLS-DA with VIP > 1, FDR < 0.05; Maaslin 2 with TSS normalization and BH correction, FDR < 0.10). Results: Analysis identified 225 differential metabolites and 12 bacterial genera. The proportion of steroids and their derivatives among differential metabolites in the MUO/MHO group was significantly lower than that in the OVOB/NOR and OVOB/WAS groups (2.12% vs. 7.9–14.1%). MUO displayed elevated C17 sphinganine and LysoPC (O-18:0) levels but reduced PI (16:0/14:1) levels. In contrast, OVOB showed upregulated glycerol phospholipids (LPCs and PSs) and downregulated PE species (e.g., PE(16:0/16:0)) as well as gut microbiota dysbiosis characterized by a higher Firmicutes/Bacteroidetes (F/B) ratio (2.07 vs. 1.24 in controls, p = 0.009) and reduced α diversity (Ace index, Chao1 index, and Shannon index values were lower in the OVOB group, Shannon index: 2.96 vs. 3.45, p = 0.03). SCFA-producing genera were negatively correlated with the OVOB group, while positively associated with PE(16:0/16:0). Internal validation showed differential metabolites had potential predictive efficacy for MUO/MHO (AUC = 0.967) and OVOB/NOR (AUC = 0.888). Conclusions: We identified distinct lipid disruptions characterizing obesity subtypes, including steroid/terpene deficits and sphingolipid/ether lipid dysregulation in the MUO/MHO groups as well as phospholipid imbalance (↑LPC/PS↓PE) in the OVOB/NOR groups. The gut microbiota exhibited a profile characterized by low diversity, an increased F/B ratio, and a reduced abundance of SCFA-producing genera. These findings suggest potential biomarkers for childhood obesity stratification, though further validation is warranted. Full article

Global climate warming and rapid urbanization have intensified the urban heat island effect (UHI). Previous studies indicated that urban parks could effectively mitigate the UHI and improve urban thermal environments. This study aimed to quantify the cooling effect of 64 urban park green spaces in downtown Qingdao. Park cooling intensity (PCI), park cooling gradient (PCG), park cooling area (PCA), and park cooling efficiency (PCE) were selected as indicators to quantify the cooling effect of park green space. These four indicators comprehensively assessed park cooling effects in terms of the maximum value and cumulative value, respectively. Key factors influencing cooling factors and their relative importance were analyzed. The results showed that the mean PCI, PCG, PCA, and PCE were, respectively, 0.02 °C, 0.71, 63.72 ha, and 10.71 °C for the 64 park green spaces. The average temperature reduction and cooling distance were, respectively, 3.35 °C and 211.53 m. Correlation analysis revealed that park area, park perimeter, and NDVI (Normalized Difference Vegetation Index) were significantly positively correlated with PCA, PCI, and PCG. Conversely, these factors presented a significant negative correlation with PCE. Additionally, water body ratio and green space ratio were positively correlated with PCA, while green space ratio was also positively correlated with PCI. The threshold value of efficiency (TVoE), which was calculated based on PCA, was 30.24 ha. TVoE represented the minimum area of urban park green space required to maximize cooling benefits. By means of Ward’s hierarchical clustering method, the 64 park green spaces were classified into four cooling clusters, which were dominated by differentiated cooling metrics and characterized by distinct internal landscapes and surrounding environments. Cluster 1 accounted for 43.75% of the 64 park green spaces, and it was dominated by PCI and PCG. These findings would provide crucial insights for optimizing urban thermal environments, enhancing livability, and promoting sustainable urban planning. Full article

Objectives: Type 1 diabetes is characterized by hyperglycemic episodes influenced by diet, sleep quality, chronotype, and physical activity, among others. While aerobic exercise is known to improve glycemic control, its effect on blood glucose regulation remains underexplored. Thus, this case study aimed to evaluate the effects of a prolonged and differentiated indoor and outdoor exercise intervention on glycemic control in an individual with type 1 diabetes. Methods: The participant (age: 23 years; weight: 95 kg; height: 1.90 m; Body Mass Index: 26.3 kg/m²; waist to hip ratio: 0.98; basal metabolic rate: 2015 kcal; Heart Rate Maximum (HRmax): 197 beats·min⁻¹) completed two outdoor (~3800 m) and two indoor sessions with self-selected speed, in the initial 2 min stage, at a 0% grade slope. The grade increased by 2% at each stage during the uphill phase until reaching volitional fatigue, followed by a 2% decrease at each stage during the downhill phase until returning to a 0% grade. Blood pressure was assessed before and after each session. Daily nutrition intake, insulin intake, and blood glucose were continuously monitored. Dietary adherence (PREvención con DIeta MEDiterránea), sleep quality (Pittsburgh Sleep Quality Index), chronotype (Morningness–Eveningness Questionnaire), and physical activity levels (International Physical Activity Questionnaire) were assessed before each session. The Physical Activity Enjoyment Scale was used to measure enjoyment after each session. Results: The sessions were completed in ~44 and ~39 min with the participant achieving 84% (outdoor) and 96% (indoor) of their theoretical HRmax. The intervention resulted in glycemic improvements, with time spent in hyperglycemia (>250 mg/dL) decreasing from 56.46% to 0%, while time in the normal range (70–180 mg/dL) increased to 63.96%. A 47% reduction in insulin units showed that insulin sensitivity also improved. Conclusions: Despite differences in intensity, indoor and outdoor activities yielded comparable benefits, with outdoor activities being perceived as more enjoyable (outdoor: 28.5 ± 0.7; indoor: 24.0 ± 5.6) and positively impacting glycemic control, thus supporting the need for tailored strategies in diabetes management. Full article

The identification of tiny objects via single-frame infrared is a significant challenge in computer vision, primarily due to large variances in target dimensions, overcrowded backgrounds, suboptimal signal-to-noise ratios, the propensity of bounding box regression to vary with target size, and potential partial occlusion scenarios. Addressing these challenges, we propose a sturdy network for enhancing features in the infrared detection of small targets utilizing multi-scale attention. In particular, the introduction of the Iterative Attentional Feature Fusion (iAFF) module at the detection network’s neck aims to tackle the issue of minor target features being overshadowed in the process of cross-scale feature fusion. Additionally, we present the Occlusion-Aware Attention Module (OAAM), which demonstrates greater tolerance for target localization errors in regions where local features are missing due to partial occlusion. By combining the scale and spatial attention mechanisms of the Dynamic Head, our approach adaptively learns the relative importance of different semantic layers. Furthermore, the integration of Normalized Wasserstein–Gaussian Distance (NWD) aims to tackle the convergence issues associated with the increased sensitivity of bounding box regression in identifying minor infrared targets. For assessing our technique’s efficiency, we present a novel benchmark dataset, IRMT-UAV, noted for its considerable discrepancies in target size, intricate backdrops, and substantial variations in the signal-to-noise ratio. The outcomes of our experiments using the public IRSTD-1k dataset and the internally developed IRMT-UAV dataset reveal that our technique surpasses cutting-edge (SOTA) methods, with mAP50 enhancements of 1.4% and 4.9%, respectively, thus proving our method’s efficiency and sturdiness. Full article

Background: Thromboelastography-6s (TEG^®6s), a novel device developed to assess coagulation status, presents advantages such as less frequent calibration, ease of use, and greater stability against movements compared to the previous system (TEG5000). This is the first study in the literature to compare coagulation profiles in the early postoperative period of liver resection (LR) using conventional coagulation tests (CCTs) and TEG^®6s. Methods: Forty-six adult patients admitted to the ICU post-surgery after elective LR for malignancy were included. CCTs were used to classify patients into hypocoagulable (HCG) (platelet count < 80 × 10⁹/L, international normalized ratio ≥ 1.4, or activated partial thromboplastin time > 38 s) and normocoagulable (all other cases) groups. Mann–Whitney tests, Spearman’s correlation, and linear regression were used. Results: On ICU admission, nineteen (41.3%) patients had a hypocoagulable profile based on CCTs, but only two (10.5%) of them were rated as hypocoagulable by TEG (p = 0.165). Intraoperatively, HCG patients experienced higher estimated blood loss (EBL) (p = 0.002); they required more fluids (p = 0.019), and more of them received red blood cell transfusions (p = 0.025). They also had higher postoperative arterial lactate levels (p = 0.036). Postoperative 12 h EBL was similar in the two groups (around 150 mL). The ICU stay was longer for HCG group (p = 0.010). Weak associations were observed between TEG/CCTs measures of coagulation initiation [e.g., between R time citrated rapid TEG, and international normalized ratio (r² = 0.448; p < 0.001)], clot formation [i.e., between conventional fibrinogen value using Clauss method and α-angle citrated rapid TEG (r² = 0.542; p < 0.001)], and clot strength [e.g., between conventional fibrinogen and citrated kaolin maximum amplitude (r² = 0.484; p < 0.001)]. Conclusions: CCTs revealed hypocoagulability that was not confirmed by TEG^®6s. However, the thromboelastography coagulation profile was more consistent with the detected non-relevant postoperative bleeding. Full article