Search Results (2,087)

Directive (EU) 2022/2555 (NIS2) designated healthcare a sector of high criticality, with a transposition deadline of 17 October 2024. Only four of twenty-seven Member States met it: Croatia transposed eight months early and Italy one day before the deadline. Because the formal regulatory gap between them is small—and, on the primary instrument, favours Croatia—this paper asks not whether but how two Member States with near-identical transposition timelines diverge in the operational practice and transparency of healthcare-sector incident reporting. Drawing on neo-institutional theory and the economics of information security, it synthesises the literature and compares the two transposition instruments against the primary legal texts. Both reproduce the NIS2 notification timeline faithfully, so divergence cannot be attributed to differing statutory obligations. Public-reporting transparency is therefore operationalised as a measurable dependent variable: Italy’s Agenzia per la Cybersicurezza Nazionale (ACN), an autonomous agency since 2021, publishes healthcare-specific data, whereas Croatia’s National Cybersecurity Centre (NCSC-HR)—competent authority only since 2025—publishes only aggregate figures. The asymmetry is autonomy and mandate, not institutional age. A portable four-indicator transparency index is proposed and demonstrated in a two-coder pilot (κ_w = 0.80); an independent incident-composition cross-check is consistent with the asymmetry. Full article

The timing and nature of the tectonic transition from Neo-Tethyan subduction to India-Asia collision along the NW Himalaya remain debated, particularly regarding the relationship between continental arc and post-collisional magmatism in the Karakoram and Kohistan batholiths. We present zircon U-Pb ages, whole-rock geochemistry, and zircon trace-element data from three granitoid samples from the Attabad Lake area (Karakoram Batholith) and the Nomal area (Kohistan Batholith). Zircon U-Pb dating yields crystallization ages of 103.4 ± 1.7 Ma for the Karakoram diorite, and 46.10 ± 0.79 Ma and 43.59 ± 0.88 Ma for the Kohistan enclave and host quartz monzonite, respectively. The Karakoram diorite shows LREE enrichment [(La/Yb)_N = 5.93–78.52] and positive zircon Ce anomalies (Ce/Ce* = 9.00–18.70), features broadly consistent with crystallization from an oxidized, subduction-related magma. In contrast, the Kohistan quartz monzonite exhibits elevated SiO₂ (65.01–66.35 wt%), low Mg# (25.9–27.2), and a flat to slightly negative Eu anomaly (Eu/Eu* = 0.94), which may reflect crustal melting during post-collisional extension. The enclave displays mantle-like signatures with high Sr (1623 ppm) and a positive Eu anomaly (Eu/Eu* = 1.14), suggesting a mafic recharge event. Zircon Th/U ratios (>0.1) and magmatic REE patterns support a magmatic origin for the dated zircons. These results are compatible with, but do not independently establish, previously proposed regional models. They provide additional local constraints that point to spatially heterogeneous magmatic evolution along the NW Himalayan syntaxis, with continental arc magmatism in the Attabad Lake area during the mid-Cretaceous and a transition to post-collisional extension in the Nomal area during the Eocene. Full article

The widespread penetration of generative artificial intelligence is reshaping adolescents’ social ecosystems and emotional experiences, while challenging the interpretive boundaries of traditional connectedness theories. Following the logical path of “connotation reconstruction–extension transformation–concept construction”, this study integrates the ethics of care and neo-ecological theory to systematically construct a theoretical framework of artificial intelligence connectedness. First, tracing theories across philosophy, sociology, and psychology, this research reconstructs the core connotation of connectedness rooted in the ethics of care, proposes the continuum hypothesis of caring relationships, and clarifies AI’s unique position on this continuum. Second, from the neo-ecological perspective, this paper sorts out the extended structure of connectedness and demonstrates the ecological shifts brought by the rise of virtual microsystems and the entry of AI actors. On this basis, the study formally defines artificial intelligence connectedness and establishes its three-dimensional structure: demand identification, two-way behavioral engagement, and responsive confirmation. Through systematic comparison with adjacent concepts, this paper identifies its uniqueness and positions it as a specific subtype of connectedness for the digital era. It defines it as a perceived bond that is both psychologically real and ethically asymmetric, carrying asymmetric risks under particular usage conditions and design logics. Finally, this paper builds a dual interpretive framework integrating traditional connectedness and artificial intelligence connectedness, verifies its incremental validity and unique predictive power, and puts forward falsifiable research propositions. This study expands the boundary of connectedness theory and provides an integrated analytical framework for parsing the complex mental health mechanisms of adolescents in the digital age. However, it should be noted that the artificial intelligence connectedness proposed in this study is currently a theoretical construct; its scientific validity and applicability remain to be verified through the development of standardized measurement tools and systematic empirical research. Full article

Beyoğlu emerged as one of the principal centers of Western influence in the late Ottoman Empire due to the presence of Levantine communities and European institutions. This study investigates the role of the Sixth Municipal Department, the first modern municipal organization in the Ottoman Empire, in shaping urban governance, architecture, and cultural transformation in Beyoğlu. Using a historical-analytical approach, the research examines Ottoman archival documents, travelogues, memoirs, contemporary newspapers, architectural evidence, and secondary literature. The findings demonstrate that Levantines occupied influential positions within the municipal administration and significantly shaped urban development through investments in transportation, lighting, sanitation, public spaces, and architectural projects. However, municipal services were distributed unevenly and primarily benefited affluent Levantine and European residents, while poorer Muslim and non-Muslim neighborhoods received limited attention. The study further reveals that the Sixth Municipal Building, designed in a European Neo-Classical style, symbolized the institutional and architectural dimensions of Ottoman Westernization. Beyond urban administration, Levantine influence contributed to transformations in social life, consumption patterns, language, and architectural culture. The article concludes that the Sixth Municipal Department played a pioneering role in the emergence of modern municipal governance in the Ottoman Empire, while simultaneously reflecting the social inequalities and cultural dynamics that accompanied the Westernization process. Full article

The Baraul Banda Formation preserves an important Paleocene–Eocene sedimentary record within the western Kohistan–Ladakh Arc (KLA) and provides new constraints on sediment provenance and tectonic evolution during the final stages of Neo-Tethyan closure. This study integrates stratigraphic observations, detrital zircon U-Pb geochronology, and quantitative provenance analyses to investigate sediment sources and basin development within the western India–Eurasia collision zone. The formation comprises a thick marine siliciclastic succession of conglomerate, sandstone, siltstone, mudstone, and slate deposited in a tectonically active forearc basin. Detrital zircon age spectra are dominated by Mesozoic–Cenozoic populations (48%) with major peaks at ~57–61 Ma, ~70 Ma, ~85–90 Ma, and ~114–115 Ma, accompanied by subordinate Neoproterozoic, Mesoproterozoic, Paleoproterozoic, and minor Archean populations. These age components closely resemble those of the KLA, Karakoram Block, and Lhasa Block. Statistical provenance analyses indicate the strongest affinity with Eurasian arc-related terranes and contemporaneous forearc basin deposits of the Tar and Indus groups, whereas affinity with Indian Plate sources is minor. The provenance record indicates that sediment supply was dominated by erosion of the KLA and the adjacent Karakoram–Lhasa continental margin, with only minor recycled contributions from Indian-derived sources. The youngest zircon populations constrain deposition to the Paleocene–Early Eocene and record rapid erosion of active arc terranes immediately prior to the India–KLA collision. Placed within the regional magmatic chronology, these results support initiation of the KLA by ca. 155 Ma, Late Cretaceous amalgamation with the Karakoram–Lhasa margin at ca. 80–70 Ma, and subsequent collision with India at ca. 60–55 Ma. The KLA therefore remained an active pre-India-collision arc system for approximately 95–100 Myr, whereas collision-related magmatism continued until ca. 40 Ma, extending its complete magmatic history to approximately 115 Myr. Full article

To address the problems of complex process knowledge sources, heterogeneous representations, dispersed semantic associations, and limited reusability in the domain of machining distortion of thin-walled parts, this study proposes a knowledge graph construction method for the workpiece machining distortion domain, together with an intelligent decision-making framework driven by the collaboration of knowledge graphs and large language models. First, a domain ontology model is established around core concepts, including workpiece objects, deformation-driving factors, analytical resources, analytical methods, and optimization knowledge, thereby providing a unified semantic foundation for domain knowledge organization. Second, considering the characteristics of domain texts, such as dense technical terminology, ambiguous entity boundaries, and complex relation expressions, a dual-channel knowledge extraction method integrating BERT-BiLSTM-CRF and Universal Information Extraction (UIE) is developed to achieve high-precision extraction of entities and relations from unstructured texts. Knowledge fusion is further carried out through cross-validation, entity disambiguation, coreference resolution, and semantic alignment, and the extracted knowledge is ultimately stored and organized in Neo4j. Furthermore, an intelligent decision-making framework based on the collaboration of knowledge graphs and large language models is constructed. In this framework, a LoRA-tuned Qwen model is employed for user intent recognition and key information extraction, RapidFuzz WRatio is adopted for similar-node retrieval, and local subgraph construction, Label Propagation-based community detection, Betweenness Centrality-based key-node analysis, and evidence fusion are integrated to support process recommendation and intelligent question answering. Based on the proposed framework, an intelligent decision-making system is further developed for process recommendation and intelligent question answering in machining distortion scenarios. Experimental results show that the proposed dual-channel knowledge extraction model achieves an F1-score of 0.88, demonstrating its effectiveness in knowledge acquisition for the machining distortion domain. The constructed knowledge graph contains 4639 entities and 5822 relations, enabling a systematic representation of machining distortion knowledge. Case studies further demonstrate that the proposed method can generate interpretable recommendation results under complex process constraints in real industrial query scenarios. Overall, the proposed approach provides a feasible pathway for the structured organization, intelligent retrieval, and decision support of workpiece machining distortion knowledge. Full article

Cardiovascular diseases remain the leading global cause of mortality, necessitating continuous monitoring solutions that extend beyond clinical settings. This paper proposes a real-time, end-to-end Edge-IoT framework for cardiovascular risk assessment that integrates biomedical signal acquisition, edge processing, and interpretable deep learning. The system includes a three-tier architecture: (i) physiological signal acquisition using AD8232 ECG, MAX30102 photoplethysmography, DS18B20 temperature, and NEO-6M GPS sensors interfaced with an ESP32 microcontroller; (ii) real-time signal preprocessing, including digital filtering, normalisation, and PQRST feature extraction performed at the edge; and (iii) cloud-based analytics using an Enhanced TabNet classifier with modified attention mechanisms for cardiovascular risk prediction. The Enhanced TabNet architecture incorporates Entmax-based sparse attention and modified Gated Linear Units to improve predictive performance and clinical interpretability. Signal quality enhancement using Kalman filtering and class imbalance correction using SMOTE further support robust model performance. The Enhanced TabNet model achieves 97.43% accuracy, 96.18% precision, and 97.24% recall on the combined Cleveland, Hungarian, Switzerland, Long Beach VA, and Statlog heart disease datasets ($n=1190$). The developed Edge-IoT prototype maintains an end-to-end communication and processing latency below 200 ms. The framework also includes automated risk alert generation via SMS when the predicted cardiovascular risk probability exceeds a predefined threshold (e.g., 0.85), including the patient’s vital information and geolocation to support emergency response. The integrated edge-cloud architecture with attention-based feature selection provides interpretable cardiovascular risk predictions while maintaining the computational efficiency required for potential continuous patient monitoring outside hospital settings. Full article

Background/Objectives: Leaflet thrombosis after transcatheter aortic valve replacement (TAVR), typically identified as hypoattenuated leaflet thickening (HALT) on multidetector computed tomography (MDCT), is increasingly recognized as an early manifestation of bioprosthetic valve dysfunction. However, factors associated with early HALT in Southeast Asian populations remain poorly characterized. The objective of this study was to characterize MDCT features of leaflet thrombosis and identify factors independently associated with early HALT after TAVR. Methods: In this two-center observational study, patients undergoing MDCT 1–3 months after TAVR were evaluated. Leaflet thrombosis was defined as HALT. Leaflet involvement, thrombus severity, anatomical distribution, and post-implantation geometric parameters were analyzed. Multivariable logistic regression identified factors associated with early HALT. Results: Among 65 patients, HALT was detected in 30.8%, predominantly as subclinical leaflet thrombosis (29.2%), whereas clinical valve thrombosis was rare (1.5%). Most cases involved one or two leaflets, with preferential involvement of the non-coronary cusp. Patients with HALT showed greater increases in transvalvular peak gradients, and a peak gradient increase ≥10 mmHg was more frequent than in patients without HALT (30.0% vs. 4.4%; p = 0.008). Severe RCA ostial eccentricity (grade 3–4) combined with a neo-sinus–RCA distance > 13 mm was independently associated with HALT (adjusted OR 5.52; p = 0.006). Lack of left ventricular ejection fraction improvement after TAVR was also independently associated with HALT (adjusted OR 4.44; p = 0.018), though given the limited number of HALT events (n = 20), these multivariable associations should be regarded as exploratory and hypothesis-generating. Conclusions: Early post-TAVR leaflet thrombosis is common and predominantly subclinical. CT-derived neo-sinus geometry and impaired ventricular recovery were independently associated with HALT, supporting the hypothesis that altered neo-sinus washout contributes to thrombus formation. Full article

Background/Objectives: Blood group antigen frequencies vary across ethnic populations and are critical for safe transfusion practice, inventory management, and alloimmunization prevention. This study aimed to determine ABO blood group, extended Rh phenotype (D, C, c, E, e), and K antigen frequencies among blood donors at the Riyadh Regional Blood Bank, and to examine their associations with donor ethnicity. Methods: This retrospective cross-sectional study analyzed 10,463 blood donors (January–December 2021) using the Immucor NEO Iris fully automated immunohematology analyzer. Donors were classified into five ethnic groups. Chi-square tests assessed associations (p < 0.05), the primary scientific contribution is the descriptive frequency data, with hypothesis testing presented as secondary and exploratory. Results: Most donors were male (95.2%). Blood group O+ was most prevalent (31.6%); AB− was rarest (0.9%). Rh D-positivity was 84.7%, lowest among Saudis (81.1%). The most frequent Rh phenotypes were CcDee (24.2%), ccDee (19.9%), and CCDee (17.7%). K antigen positivity was 13.7%. Significant associations were found between D antigen and ethnicity (p < 0.001), Rh phenotype and ethnicity (p = 0.003), and ABO and ethnicity (p < 0.001). A hypothesis-generating association between Rh phenotype and K antigen (p = 0.019) did not meet the Bonferroni-corrected threshold and is considered exploratory. Conclusions: This study provides, to our knowledge, one of the largest ethnically stratified blood group datasets from Riyadh to date. The high D-negativity among Saudi donors (18.9%) has direct implications for extended phenotyping protocols and rare donor registry development. The association between Rh phenotype and K antigen requires molecular confirmation before any biological or clinical conclusions can be drawn. Full article

Quality assurance has become a major force reordering the contemporary university, and in Chile, its most visible expression is the ascent of quality units, which have moved from peripheral offices to, in many cases, vice-rectorate rank. This article examines that trajectory through a descriptive–comparative documentary analysis reconstructing the hierarchical position of these units in the 51 universities recognized by the Ministry of Education and comparing it with the 2008–2009 and 2019 time points, distinguishing the state, traditional private, and private non-Council of Rectors subsectors. Read through neo-institutional theory, the results show that the quality unit has become universal and has consolidated at the top of the hierarchy, albeit unevenly, since vice-rectorate rank remains almost exclusively a private-sector phenomenon, now spreading to the traditional sector. The analysis is organized as a congruence test between the framework’s expectations and the observed patterns, complemented by exact and trend tests. The resulting distribution is consistent with a reading in which legal coercion accounts for the widespread existence of these units, while imitation and market signaling correspond to their elevation, so that isomorphism produces homogeneity within each subsector and divergence between them. The documentary design, however, describes a form whose substantive integration remains undemonstrated. Full article

The ti-yong (體用, substance-and-function) dyad is one of the most fundamental theoretical patterns in Chinese philosophy. As the primary framework for articulating the relationship between noumenal ground and phenomenal manifestation, it runs continuously through the Xuanxue (玄學), Buddhist, and Neo-Confucian traditions, with the core presupposition that ti (substance) independently precedes and governs yong (function). When this presupposition entered the Buddhist context and encountered the Mahāyāna logic of dependent origination and emptiness (yuanqi xingkong 緣起性空), a deep structural tension was generated. Taking this tension as its point of departure, this article examines changes in Buddhist accounts of ganying (感應, stimulus-and-response) during the Jin-Song (晉宋) transitional period through the writings of Huiyuan (慧遠), Kumārajīva (鳩摩羅什), and Daosheng (道生). Huiyuan’s questions concerning the dharmakāya (法身) expose a persistent difficulty: How can that which is unchanging and beyond determinate form become perceptible and effective in responsive activity? Kumārajīva’s discussions of “not-form” (fei se 非色), the pool-water analogy, and “responding without fixed mode” (wu fang zhi ying 無方之應) shift attention from identifying a fixed body of the dharmakāya to explaining the varied conditions of its manifestation. Daosheng’s accounts of inherent Buddha-nature (foxing benju 佛性本具) and ji (機, capacity) further bring the recipient’s capacity into the explanation of effective response. Read together, these positions show a shift in explanatory focus: from distinguishing an enduring source from responsive activity to asking how that source becomes accessible through activity. The expression ji-yong-jian-ti (即用見體, perceiving substance through function) names this disclosure of ti through yong: the ground is not produced by responsive activity but becomes perceptible and soteriologically effective through it. This development illuminates an important change in early Chinese Buddhist reflections on dharmakāya, manifestation, and the capacities of sentient beings. Full article

The transition to a circular economy (CE) is central to achieving SDG 12, yet institutional transformation varies significantly across countries. This study conducts a comparative institutional analysis of CE transitions in China and Russia to quantify Russia’s institutional lag and assess the maturity of both systems in the context of SDG indicator 12.5.1 (Circular Material Use Rate—CMUR). Drawing on neo-institutional theory, multi-level governance, and institutional trap theory, we develop an original methodology that computes institutional lag through three key milestones, an integrated maturity index across eight institutional components, and CMUR estimates based on official statistics, legislative acts (1998–2025), and industry reports. Our results show that Russia’s average institutional lag relative to China is 15.3 years: Russia’s 2024 municipal solid waste recycling rate (13.9%) matched China’s 2009–2010 level, while China achieved Russia’s 25% target for 2030 in 2018. The integrated maturity index is 8.25 for China versus 5.25 for Russia, with the largest gaps in industrial symbiosis, R&D and human capital, and international integration. Russia’s CMUR stands at 5–7%, compared to 25–30% in China. We also demonstrate that Russia’s high recycling growth is driven by a low-base effect and is not evidence of institutional efficiency; the compound annual growth rate (CAGR) of Russian recycling volume (33.0%) significantly exceeds China’s (13.1%), but this reflects the much lower starting point rather than systemic maturity. We conclude that without systemic institutional reforms—including eco-industrial parks, green finance, and competence centres—Russia will remain at an early CE stage, failing to substantially contribute to SDG 12 by 2030. Full article

Background: Neoadjuvant chemoimmunotherapy is now a standard approach for resectable stage II–III non-small cell lung cancer (NSCLC), demonstrating improved pathological response and survival. However, its safety in physiologically high-risk surgical patients is unclear, as these groups are underrepresented in trials. This study compares 30-day and 90-day mortality and oncological outcomes of neoadjuvant chemoimmunotherapy followed by surgery versus upfront surgery within a high-risk multidisciplinary team (MDT) cohort. Methods: A retrospective single-centre study was performed, including consecutive high-risk MDT patients undergoing resection for stage II -III NSCLC between January 2022 and December 2025. High-risk status was defined by established physiological, cardiopulmonary, and comorbidity criteria. Patients were stratified into neoadjuvant chemoimmunotherapy followed by surgery (Chemo-IO; n = 33) or upfront surgery (n = 57). The primary outcome was 30-day mortality. Secondary outcomes included 90-day mortality, R0 resection rate, and length of hospital stay. Inverse probability of treatment weighting (IPTW) based on propensity scores was used to balance baseline differences between groups. Results: Ninety patients were included. Patients receiving neoadjuvant therapy had a greater comorbidity burden (Charlson Comorbidity Index 3.2 ± 1.5 vs. 1.4 ± 1.7, p < 0.001) and more advanced disease (stage III: 57.6% vs. 29.8%, p = 0.014). Thirty-day mortality was 0% in the Chemo-IO group and 1.8% following upfront surgery. After IPTW adjustment, neoadjuvant therapy was not associated with increased perioperative mortality. Ninety-day mortality was similar between groups (3.0% vs. 3.5%; IPTW OR 0.91, 95% CI 0.05–15.39, p = 0.948). R0 resection rates were numerically higher following Chemo-IO (87.9% vs. 78.9%; IPTW OR 3.42, 95% CI 0.71–16.59, p = 0.127). Median hospital stay was identical in both cohorts (6 days), with no significant difference after weighting (p = 0.722). Conclusions: Neoadjuvant chemoimmunotherapy appears safe and feasible in carefully selected high-risk patients with resectable stage II–III NSCLC. Despite greater comorbidity burden and more advanced disease, short-term perioperative outcomes were not compromised, while a trend towards improved R0 resection rates was observed. These findings support the consideration of multimodal treatment strategies within high-risk MDT pathways. Full article

Background: The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) of the left main coronary artery remains uncertain because this lesion involves a large myocardial territory and requires a careful balance between ischemic protection and bleeding risk. This review aimed to provide an updated, left-main-focused synthesis of the evidence on DAPT duration after PCI and to clarify how treatment should be individualized according to clinical presentation, lesion complexity, procedural strategy, intravascular imaging, and validated ischemic and bleeding risk scores. Methods: This narrative review with a structured literature search examined studies published from January 2010 through May 2026 in PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Google Scholar. From 248 identified records, 62 studies met the eligibility criteria and were included in the qualitative synthesis, comprising 38 randomized controlled trials and 24 observational studies or pooled analyses. The review prioritized direct left-main-specific evidence while also incorporating broader PCI studies with left-main subgroups and indirect contextual evidence relevant to antiplatelet decision-making. Independent screening, duplicate data extraction, and qualitative risk-of-bias assessment were performed, but the review was not prospectively registered, and no meta-analysis was conducted. Results: The available evidence supports an individualized rather than fixed DAPT strategy after left main PCI. In stable patients with anatomically simple left main lesions and acceptable bleeding risk, 6–12 months of DAPT appears generally sufficient, whereas patients with acute coronary syndromes, two-stent distal bifurcation strategies, high thrombotic burden, or other high-ischemic-risk features may derive greater benefit from extending therapy beyond 12 months when bleeding risk is low. Contemporary guideline recommendations are broadly aligned with this risk-adapted approach, and recent trials further refine decision-making: PARTHENOPE provided randomized support for risk-score-guided personalization of DAPT duration, whereas NEO-MINDSET cautioned against immediate aspirin withdrawal after PCI in acute coronary syndromes. Intravascular imaging, especially IVUS and OCT, improves procedural optimization and may help contextualize post-PCI thrombotic risk, although current data do not validate imaging findings alone as a stand-alone criterion for abbreviated DAPT. Conclusions: DAPT duration after left main PCI should be individualized by integrating clinical presentation, lesion and procedural complexity, intravascular imaging, and validated ischemic and bleeding risk tools. A personalized, risk-adapted strategy currently offers the most appropriate framework for balancing ischemic benefit against bleeding harm in this high-risk population. Full article

Visual quality control increasingly relies on machine learning (ML), but reliable production adoption requires a governed data-model-service lifecycle rather than an isolated detector. This article presents an implementation-grounded Open Access Platform (OAP) blueprint and audit protocol for visual quality control as a service. The contribution is not a new detector backbone. It is a reproducible governance pattern that connects ontology-based data validation, Neo4j knowledge-graph traceability, Eclipse Arrowhead service discovery, human-in-the-loop annotation, dataset and model registries, operational quality gates, and controlled model adaptation. The platform context is supported by implemented OAP tools for battery carbon-footprint analysis and production planning, while the visual inspection modules are reported at the notebook level. The benchmark protocol uses leakage-safe splits and OK samples with empty label files, separates the MVTec AD augmentation corpus from the unlearning stress-test corpus, and requires FP-on-OK gating with a retrained post-removal reference. The resulting architecture supports semantic traceability, controlled promotion and rollback, human accountability and Industry 5.0-aligned industrial AI governance without overstating the completed evidence. Compared with existing MLOps architectures, OAPs add inspection-specific semantic enforcement, knowledge-graph lineage, and governed adaptation. Full article