Search Results (202)

Background/Objectives: People experiencing homelessness (PEH) face greater morbidity, multimorbidity, and premature mortality than the general population. Medical data on this population in Gdańsk remain scarce. The aim of this study was to assess the prevalence, age distribution, comorbidity burden, and healthcare utilization of selected neurological and vascular diseases among homeless men in Gdańsk, Poland. Methods: A retrospective secondary analysis was performed using data from 551 men residing in shelters operated by the largest PEH support organization in Gdańsk. A random sample of 226 individuals (95% confidence level) was analyzed, selected by randomization in Microsoft Excel. Data were extracted from interviews, verified medical documentation, and staff records. Results: Mean age was 57.0 (SD 12.9) years (median 60). Among the studied sample, essential (primary) hypertension (20.4%), heart failure (10.2%), atrial fibrillation (8.9%), and chronic obstructive pulmonary disease (8.4%) were the most common conditions. Sequelae of cerebrovascular disease (ICD-10: I69) affected 8.9% of participants; this subgroup was older and had higher rates of disability certification and hospitalization than the overall sample. Epilepsy (12.0%) and polyneuropathy (4.0%) differed in age distribution, disability rates, and comorbidity burden, with the epilepsy subgroup displaying high substance-use prevalence. Overall, 44.0% of the sample had been hospitalized since 2019. Conclusions: Homeless men in Gdańsk present a high burden of neurological and vascular disease at comparatively young ages, along with substantial multimorbidity. These findings highlight structural inequalities in healthcare access and the need for integrated, equity-oriented health and social care interventions. Full article

Polyethylene (PE) is one of the most persistent pollutants in the environment. Here, we enriched a microbial consortium (PEH) and isolated a bacterial strain, Bacillus cereus PE-1, capable of degrading PE from landfill soil using PE as the sole carbon source. Scanning electron microscopy revealed significant surface erosion, while weight loss reached up to 4.57% after 30 days. TGA showed a 5.88% decrease in onset degradation temperature, and contact angle measurements indicated increased hydrophilicity. Elemental analysis confirmed oxygen incorporation into the polymer matrix. Genome sequencing revealed genes associated with biofilm formation (epsA, epsB, pgaC), oxidation (laccase, copper oxidase), hydrolysis (esterase, lipase, PHB depolymerase), and β-oxidation pathways. While these genomic findings indicate a predicted capacity for assimilation, no transcriptomic or proteomic validation was performed in this study. These findings suggest that PE-1 can colonize PE, initiate oxidative cleavage, and potentially assimilate breakdown products. This study provides new insights into the microbial degradation of polyolefins and identifies a promising bacterial candidate for plastic bioremediation. Full article

Background/Objectives: Postoperative early hypocalcemia (PEH) is a key postoperative issue after parathyroidectomy in primary hyperparathyroidism. It often leads to long-lasting hypocalcemia, requiring more calcium and active vitamin D supplements. This study aimed to determine whether the extent of intraoperative parathyroid hormone (PTH) decline, measured 15 min after parathyroid tumor excision, could serve as a reliable intraoperative rule-out marker for PEH. Methods: We conducted a retrospective review of 88 adult patients who underwent surgical intervention for a solitary parathyroid tumor at a single institution. Postoperative early hypocalcemia (PEH) was defined as a total serum calcium level <8.5 mg/dL within the postoperative 6th hour or on postoperative day 1, requiring clinical calcium supplementation (oral and/or intravenous), with active vitamin D when appropriate. The percentage decrease in PTH at 15 min post-excision was calculated using morning-of-surgery preoperative PTH values alongside the 15-min post-excision levels. Additional variables assessed included preoperative alkaline phosphatase (ALP), parathyroid tumor weight, and serum concentrations of calcium, phosphate, magnesium, and 25-hydroxyvitamin D. Predictive factors were identified by logistic regression, and the diagnostic accuracy of the 15-min PTH decline was evaluated using receiver operating characteristic (ROC) curve analysis, optimizing cutoff selection with Youden’s index. Odds ratios were standardized per 10-unit increments for ALP and parathyroid tumor weight for interpretability. Results: Of the studied cohort, 10 patients (11.4%) developed PEH. The intraoperative 15-min PTH decline was notably greater in those who developed PEH compared to those who did not (81.2 ± 4.4% vs. 69.9 ± 8.3%; p < 0.001). Univariate logistic regression showed a significant association between the 15-min PTH decline and PEH (OR 1.22 per 1% increment; 95% CI 1.08–1.38). That said, when we added ALP and parathyroid tumor weight to the multivariate models, PTH decline no longer predicted independently. In contrast, ALP (OR 3.11 per 10 U/L; 95% CI 1.34–7.93; p = 0.011) and parathyroid tumor weight (OR 1.22 per 10 mg; 95% CI 1.10–1.48; p = 0.004) stayed significant. Thus, the incremental prognostic contribution of the 15-min PTH decline beyond ALP and parathyroid tumor weight appears limited. The ROC curve for the 15-min PTH decline produced an AUC of 0.883, with an optimal cutoff of 75% providing 100% sensitivity and 74.4% specificity. No patients with a PTH decline below 75% developed PEH. Conclusions: Preoperative ALP and parathyroid tumor weight showed the strongest independent associations with PEH following parathyroid tumor surgery. An intraoperative PTH decline of less than 75% at 15 min may serve as a practical rule-out tool for PEH, although further validation in larger patient populations is warranted. Full article

Invasive alien species (IAS) can cause the extinction of a taxon. However, debate continues over the significance of IAS as drivers of extinction globally, the level of threat they pose to endangered species, and whether conservation efforts against IAS should take priority over other factors, such as habitat loss or climate change. We provide new insights from the IUCN Red List, focusing on species classified as extinct or extinct in the wild that are linked exclusively to IAS. Many extinction events are also caused by multiple synergistic threats, including IAS, but the relative contributions of these threats remain uncertain. We suggest using Structural Equation Models (SEMs) to tease out the effects of IAS and other interacting factors on threatened species, to better understand the role of IAS in potential extinctions. Full article

Broadband piezoelectric energy harvesters (PEHs) are attractive for powering self-sustained sensing nodes in industrial monitoring, structural health monitoring, and distributed IoT systems, where ambient vibration spectra are often uncertain, drifting, and broadband. However, tuning multiple resonant peaks in PEH arrays usually relies on time-consuming finite element (FE) parameter sweeps or iterative optimizations, which becomes a practical bottleneck when rapid, site-specific customization is required. This study presents a data-driven inverse-design framework for a five-beam PEH array based on a tandem neural network (TNN). A forward multilayer perceptron (MLP) surrogate is first trained using 10,000 COMSOL-generated samples to predict the array’s characteristic frequencies from the design variables (end masses $M_1$–$M_5$ and tilt angle $\alpha$), achieving >98% prediction accuracy with a prediction time <1 s, thereby enabling efficient replacement of repeated FE evaluations during design. The trained MLP is then coupled with an inverse-design network to form the TNN, which maps target characteristic-frequency sets directly to physically feasible parameters through the learned surrogate. Multiple representative target frequency sets are demonstrated, and the TNN-generated designs are independently verified by COMSOL frequency–response simulations. The resulting arrays achieve broadband operation, with bandwidths exceeding 10 Hz. By shifting most computational cost to offline dataset generation and training, the proposed spectrum-to-parameter pathway enables near-instant parameter design and reduces reliance on exhaustive FE tuning, supporting rapid, application-specific deployment of broadband PEH arrays. Full article

The widespread adoption of low-power devices and microelectronic systems has intensified the need for efficient energy harvesting solutions. While cantilever-beam piezoelectric energy harvesters (PEHs) are popular for their simplicity, their performance is often limited by conventional mass block designs. This study addresses this by proposing a comprehensive structural optimization framework for a triangular cantilever PEH to significantly enhance its electromechanical conversion efficiency. The methodology involved a multi-stage approach: first, an embedded coupling design was introduced to connect the mass block and cantilever beam, improving space utilization and strain distribution. Subsequently, the mass block’s shape was optimized. Furthermore, a negative Poisson’s ratio (NPR) honeycomb structure was integrated into the cantilever beam substrate to induce biaxial strain in the piezoelectric layer. Finally, a variable-density mass block was implemented. The synergistic combination of all optimizations—embedded coupling, NPR substrate, and variable-density mass block—culminated in a total performance enhancement of 69.07% (17.76 V) in voltage output and a 44.34% (28.01 Hz) reduction in resonant frequency. Through experimental testing, the output performance of the prototype machine showed good consistency with the simulation results, successfully verifying the effectiveness of the structural optimization method proposed in this study. These findings conclusively show that strategic morphological reconfiguration of key components is highly effective in developing high-performance, low-frequency adaptive piezoelectric energy harvesting systems. Full article

Introduction: People experiencing homelessness (PEH) often live in adverse and changing environments and have high rates of mental illness and social exclusion, factors that could influence information processing. However, it is unknown whether these conditions could be related to sensory processing problems. Objectives: Analyse sensory processing in PEH. Methodology: A descriptive cross-sectional study was conducted with 150 participants (mean age of 47.43 ± 10.94 years), using the Adult/Adolescent Sensory Profile and a sociodemographic questionnaire. Results. PEH aged 18–64 showed significantly higher scores in low registration (M = 36.9), sensory sensitivity (M = 41.1) and sensation avoiding (M = 45.5) compared to the control group (p < 0.001), suggesting a distinct form of sensory processing in this population. Discussion: These results may be linked to factors such as chronic exposure to unpredictable and stressful situations, as well as to the presence of diverse mental health issues. Conclusion: It is important to consider the sensory characteristics of this population when designing person-centered interventions, in order to reduce social isolation and promote self-regulation strategies, environmental adaptation and greater occupational participation. Full article

To broaden the operating bandwidth of the vibration energy harvester at low frequencies, this paper presents a cantilever beam piezoelectric energy harvester (PEH) based on the sloshing of a liquid-filled container. The harvester is designed to recover energy from the multi-order sloshing modes of the liquid in the container. A mathematical model of the coupled system comprising the liquid within the container and the PEH was established. Based on the fluid–structure interaction (FSI) theory, the coupling mechanism between the liquid natural sloshing frequency and the immersed natural frequency of the beam was revealed. Experimental validation shows that the resonance characteristics of the PEH are mainly dominated by the liquid antisymmetric sloshing mode. Through comparative experiments, the effect of liquid-filled container and cantilever beam parameters on the PEH’s peak output voltage and operating bandwidth was systematically analysed. The performance of the PEH was significantly improved when the first-order natural frequency of the partially immersed beam approached the liquid natural sloshing frequency, with the bandwidth coefficient increasing by nearly fourfold under this condition. This research provides new ideas for the design and optimisation of piezoelectric energy harvesters in liquid sloshing environments. Full article

Background and Objectives: People experiencing homelessness (PEH) face a disproportionately high burden of vision impairment, most commonly from uncorrected refractive error (RE), and encounter significant barriers to accessing care. Despite these challenges, there is limited knowledge about effective approaches to providing ophthalmic services to this population. This review aims to categorize and evaluate existing models of eye care delivery for PEH in North America. Materials and Methods: A literature search was conducted for publications between 2013 and 2023. Eligible studies included those describing direct ophthalmic interventions for PEH in North America. Identified studies were reviewed and classified into distinct models of care delivery. Results: Four models of care emerged: office-based, shelter-based, mobile/temporary-based, and street medicine-based. Each model demonstrated unique strengths and limitations related to accessibility, continuity of care, and resource intensity. Across models, on-site correction of RE, particularly through provision of eyeglasses at the point of care, led to documented improvement of vision. However, referral completion and follow-up rates to tertiary care centers were low, especially in programs where services were fragmented across multiple locations. Strategies that emphasize same-location diagnosis and treatment for RE increase service delivery rates. Further studies are needed to evaluate referral pathways, long-term outcomes, and policy strategies to reduce vision-related disparities in this underserved population. Conclusions: No single model of care proved universally superior. Instead, hybrid approaches that integrate multiple models tailored to community infrastructure and patient needs appear most effective for expanding access to ophthalmic services among PEH. Full article

The assessment of donor corneas is currently based solely on central endothelial cell (EC) density, which potentially overlooks the transition zone (TZ) regenerative potential. Therefore, the present study characterizes TZ using multimodal imaging techniques to understand its regenerative potential and refine the assessment of donor tissue. Ex vivo donor corneas (n = 41) were examined using phase-contrast microscopy for EC counting and reflectance confocal microscopy (HRTII/RCM) for non-invasive visualization of the TZ. A subset of eight of these corneas underwent ultrastructural analysis using field-emission scanning electron microscopy (SEM) and immunostaining analysis using confocal microscopy. We observed a significant decrease in central EC density (p < 0.001) with increasing storage duration and donor age, while TZ width and TZ surface cell count remained stable. HRTII/RCM and SEM revealed distinct morphological differences (small, polygonal cells, irregular arrangement) in the TZ compared to the peripheral endothelium (PE). Immunostaining revealed elevated expression of progenitor markers (Nestin, ABCG2, SOX2, Lgr5, Vimentin) and reduced expression of endothelial markers (ZO1 and Na/K-ATPase) in the TZ compared to the PE, indicating the presence of a stem cell-like population. These findings suggest that TZ may contribute to endothelial cell regeneration, and HRTII/RCM could serve as a novel tool for TZ evaluation in low EC count donor corneas. Full article

The Dual Fluid Reactor (DFR) is a Generation IV concept that relies on a phased development pathway using a low-temperature microdemonstrator ($\mu$DEMO) and a high-temperature minidemonstrator (mDEMO). A rigorous methodology is required to scale experimental data between these facilities to ensure the reliable design of the final reactor. This paper establishes such a methodology grounded in Similarity Theory. The Cathare-2 system code was used to perform a parametric study on a simplified model of the demonstrators, which use lead–bismuth eutectic and pure liquid lead, respectively. This study focused on identifying the specific operating conditions required to match key “defining” dimensionless numbers—the Reynolds number (Re) for dynamic similarity and the Peclet number (Pe_h) for thermal similarity. The analysis successfully identified and presented the distinct operating ranges of fluid velocity and mass flow required to achieve either state. Results show that matching the Reynolds number allows for the dimensionless pressure drop to be scaled with a deviation below 0.2%, while matching the Peclet number allows for the dimensionless temperature profile to be scaled with a deviation under 2.5%. The central finding is that dynamic and thermal similarity cannot be achieved simultaneously due to the different working fluids and temperatures of the demonstrators. This forces a strategic choice in experimental design, where an experiment must be tailored to investigate either fluid dynamics or heat transfer. This work provides the foundational “rulebook” for designing these crucial experiments, ensuring that data from the DFR demonstrator program is both reliable and scalable. Full article

Background: People experiencing homelessness (PEH) face significant health disparities and systemic barriers to healthcare, elevating their risk for cancer and other chronic diseases. To tackle PEHs’ challenges in accessing cancer preventive care, the CANCERLESS project implemented the Health Navigator Model (HNM)—a person-centered intervention that utilizes trained Health Navigators to provide tailored support and facilitate service access. Recognizing housing as a key determinant of health, this analysis assessed changes in housing status associated with participation in the HNM among CANCERLESS participants in Austria, Greece, Spain, and the UK. Methods: This was a secondary analysis of cross-national data collected during a single-arm interventional study. Of 652 enrolled PEH, 277 (42.5%) completed the HNM intervention follow-up and were included in the analysis. Changes in housing status from baseline to follow-up were categorized using the European Typology of Homelessness and Housing Exclusion (ETHOS) and treated as an ordered outcome. Descriptive statistics were complemented by a cumulative link mixed model with a participant random intercept to estimate the association between time (follow-up vs. baseline) and housing transitions among completers, adjusting for age, residence/legal status, and daily smoking. Results: Participants had a mean age of 47.4 (SD 13.8), primarily identified as male (64.1%), reported upper secondary education (33.9%), and were from Western European countries (39.7%), with varying housing situations. Among intervention completers, time (follow-up vs. baseline) was associated with higher odds of being in a higher ETHOS category (OR = 1.49, 95% CI = 1.02–2.20, p = 0.042), consistent with a modest improvement in housing status. Larger estimates were observed among migrants without legal documents (OR = 24.13, 95% CI = 6.41–90.89, p < 0.001), while daily smoking was associated with lower odds (OR = 0.33, 95% CI = 0.11–0.96, p = 0.041); other residence status categories were not statistically significant. Conclusions: Suggesting that tailored, navigation-based models, such as the HNM, may be linked to improved housing stability for PEH, these findings can inform piloting and context-aligned integration of the HNM within public health strategies as an alternative approach to address the complex, interconnected health and social needs of PEH. However, the lack of a comparison group and high attrition limit the results’ conclusiveness, and future evaluations should aim to include assessments of housing-associated contextual factors. Full article

At present, energy harvesting technologies are gradually replacing batteries and have become a research hotspot as power sources for low-power components in wearable electronic devices. To collect and utilize the energy generated by skiers during the process of pushing against the skis, a piezoelectric energy harvesting system (PEHS) for self-powered ski boots was proposed and designed to supply power for low-power wearable devices. The output voltage of the PEHS was modeled and simulated using the finite element method, and the causes of the simulation results were analyzed. An energy harvesting experiment of the prototype was conducted under loading conditions using a universal testing machine. Under a uniform sinusoidal load of 800 N at 1 Hz, the prototype of the PEHS for self-powered ski boots achieved a maximum output power of 57.44 mW with an optimal matching load resistance of 404 kΩ. A skiing tester wearing the self-powered ski boots conducted real-motion experiments, performing three different actions: (1) alternating single-foot stepping for propulsion, (2) alternating left and right ski edge stepping for propulsion, and (3) alternating forefoot and heel stepping for propulsion. The instantaneous peak voltages measured in these tests were statistically analyzed, and the corresponding peak power values were calculated through theoretical computation to be 6.48 ± 0.27 mW, 4.47 ± 0.21 mW, and 13.21 ± 0.48 mW for the three actions, respectively (expressed with a 95% confidence interval). Full article

Background: Breast cancer polygenic risk scores (PRS) and traditional risk models (e.g., the Gail model [Gail]) are known to contribute largely independent information, but it is unclear how the overlap varies by ancestry, age, disease type (invasive breast cancer, DCIS), and risk threshold. Methods: In a retrospective case–control study, we evaluated risk prediction performance in 180,398 women (161,849 of European ancestry; 18,549 of Asian ancestry). Odds ratios (ORs) from logistic regression models and the area under the receiver operating characteristic curve (AUC) were estimated. Results: PRS for invasive disease showed a stronger association in younger (<50 years) women (OR = 2.51, AUC = 0.622) than in women ≥ 50 years (OR = 2.06, AUC = 0.653) of European ancestry. PRS performance in Asians was lower (OR range = 1.62–1.64, AUC = 0.551–0.600). Gail performance was modest across groups and poor in younger Asian women (OR = 0.94–0.99, AUC = 0.523–0.533). Age interactions were observed for both PRS (p < 0.001) and Gail (p < 0.001) in Europeans, whereas in Asians, age interaction was observed only for Gail (invasive: p < 0.001; DCIS: p = 0.002). PRS identified more high-risk individuals than Gail in Asian populations, especially ≥50 years, while Gail identified more in Europeans. Overlap between PRS, Gail, and family history was limited at higher thresholds. Calibration analysis, comparing empirical and model-based ROC curves, showed divergence for both PRS and Gail (p < 0.001), which indicates miscalibration. In Europeans, family history and prior biopsies drove Gail discrimination. In younger Asians, age at first live birth was influential. Conclusions: PRS adds value to risk stratification beyond traditional tools, especially in younger women and Asian ancestry populations. Full article

Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign, chronic inflammatory breast condition that poses diagnostic and therapeutic challenges. While corticosteroids are standard first-line therapy, some patients require additional immunomodulation, such as methotrexate. Predictive factors for step-up therapy remain poorly characterized. This study aimed to identify clinical, imaging, and pathological factors predictive of step-up therapy in IGM and evaluate associations between treatment approach and outcomes. Methods: A retrospective cohort study of women diagnosed with IGM was conducted between May 2022 and June 2024 at a tertiary center in Singapore. Data on demographics, clinical presentation, imaging, histopathology, and treatment were extracted. Step-up therapy was defined as methotrexate use following corticosteroids. Primary outcome was predictors of step-up therapy; secondary outcomes included treatment success, relapse, surgery, and time to remission. Statistical analyses included chi-square/Fisher’s exact tests, Cox models, and Kaplan-Meier analysis. Results: Fifty-two women (median age 39 years) were included; 26 (50%) required step-up therapy. Predictors included oral contraceptive (OCP) use (RR 1.92; 95% CI 1.45–2.53; p < 0.001), smoking (RR 2.00; 95% CI 1.49–2.69; p < 0.001), flares (RR 2.33; 95% CI 1.44–3.79; p = 0.002), and percutaneous aspiration (RR 2.10; 95% CI 1.53–2.88; p = 0.025). Patients receiving methotrexate had lower relapse rates (RR 1.23; 95% CI 1.12–1.36; p < 0.001) but longer time to remission (adjusted HR 0.09; 95% CI 0.02–0.46; p = 0.004). Conclusions: OCP use, smoking, flares, and aspiration need may predict step-up therapy in IGM. Early identification could guide a more personalized, potentially top-down treatment. Full article