Search Results (841)

Background/Objectives: Platelets play a role in bone metabolism and fracture healing. This study aimed to investigate the association between platelet indices and the derived systemic immune inflammation index (SII) with fracture risk in postmenopausal women. Methods: Platelet count, mean platelet volume, platelet distribution width (PDW), platelet crit, percentage of large platelets (P-LCR), platelet–lymphocyte ratio, and the SII, calculated as (NxP)/L, where N, P, and L represented neutrophils, platelets and lymphocytes counts, respectively, were evaluated. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Results: A total of 124 women (mean age 68.4 ± 9 years) were stratified into two groups based on the median platelet count; the “lower platelet count group” (n = 58) had a count of 200,000 (174,000 to 226,000), while the “higher platelet count group” (n = 66) had a count of 281,500 (256,500 to 308,500). The higher platelet count group showed a higher hip fracture risk (7.4 vs. 4.5%, p = 0.08) and lower lumbar spine BMD (0.773 vs. 0.83 gr/cm², p = 0.03). By dividing the participants into two groups with higher SSI (950,848.6 ± 746,097.99) (n = 61) and lower SII (355,751.2 ± 88,662.6) (n = 63), the group with the higher SII showed the higher hip fracture risk (7.4 vs. 3.6%, p = 0.01). Univariate regression analysis revealed correlations between chronological age and PDW (r = 0.188, p = 0.047), and P-LCR (r = 0.208, p = 0.03), as well as associations between vitamin D status and P-LCR (r = −0.301, p = 0.034), and between SII and hip fracture risk (r = 0.12, p = 0.007). Conclusions: Platelet count and SII were associated with fracture risk in postmenopausal women undergoing osteoporosis assessment. Given their reproducibility and cost-effectiveness, these markers warrant further investigation in future prospective studies focused on bone fragility. Full article

The growing need for secure and privacy-preserving identity management in industrial environments has exposed the limitations of traditional, centralized authentication systems. In this context, SIBERIA was developed as a modular solution that empowers users to control their own digital identities, while ensuring robust protection of critical services. The system is designed in alignment with European standards and regulations, including EBSI, eIDAS 2.0, and the GDPR. SIBERIA integrates a Self-Sovereign Identity (SSI) framework with a decentralized blockchain-based infrastructure for the issuance and verification of Verifiable Credentials (VCs). It incorporates multi-factor authentication by combining a voice biometric module, enhanced with spoofing-aware techniques to detect synthetic or replayed audio, and a behavioral biometrics module that provides continuous authentication by monitoring user interaction patterns. The system enables secure and user-centric identity management in industrial contexts, ensuring high resistance to impersonation and credential theft while maintaining regulatory compliance. SIBERIA demonstrates that it is possible to achieve both strong security and user autonomy in digital identity systems by leveraging decentralized technologies and advanced biometric verification methods. Full article

Students, particularly those in the medical field, are exposed to various stressors that can affect their health-related behaviors, including smoking habits, with implications for oral health and quality of life. Background and Objectives: to analyze the relationship between smoking, oral health, perceived stress level, and self-assessed quality of life in a sample of dental students. Materials and Methods: The cross-sectional study included 338 students, who completed validated questionnaires and were clinically examined. Lifestyle was assessed using a smoking behavior questionnaire, stress levels were measured with the Student Stress Inventory (SSI), and quality of life was evaluated using the EQ-5D-5L instrument. The DMFT index was calculated to determine oral health status. Results: Among the 338 participating students, 53.8% were smokers. The lifestyle analysis revealed slightly higher average scores among non-smokers across all domains—social (3.26 vs. 3.09), attitudinal (2.75 vs. 2.97), and behavioral (3.82 vs. 3.49), but without statistically significant differences (p > 0.25). The mean DMFT score was 12.48, with no significant differences between smokers and non-smokers (p = 0.554). The SSI total score averaged 83.15, indicating a moderate level of perceived stress, again with no statistically significant differences between the groups (p > 0.05). However, slightly higher average stress scores among smokers may suggest the use of smoking as a coping mechanism. In contrast, quality of life as measured by EQ-5D-5L showed significantly worse outcomes for smokers across all five dimensions, including mobility (78.6% vs. 95.5%, p = 0.000) and self-care (93.4% vs. 100%, p = 0.001). Multivariable logistic regression identified smoking (OR = 1.935; p = 0.047) and moderate stress levels (OR = 0.258; p < 0.001) as independent predictors of oral health status. Conclusions: The results obtained suggest that smoking may function as a stress management strategy among students, supporting the relevance of integrating specific psychobehavioral interventions that address stress reduction and oral health promotion among student populations. Full article

The crystal structures of the 2-amino-5-halogenopyridines (halogen = Cl (1), Br (2)) and 2,3-diamino-5-halogenopyridines (halogen = Cl (3), Br (4)) were compared with respect to their intermolecular interactions. An ab-initio-based method for evaluating the interaction energies between molecules was employed to estimate the driving forces of crystal formation. As a result, regularities in crystal structure organization were identified. For compounds 1 and 2, a dimeric building unit is formed by two N–H…N_pyr hydrogen bonds. These dimers are further connected to neighboring units by C–H…π, C–H…N, N…X (X = Cl, Br), and non-specific interactions. The aforementioned intermolecular interactions give rise to layered structures that are similar but not isotypical. No significant contributions from π–π or N–H…N(H₂) interactions are observed in 1 and 2. The structures of 3 and 4 are isotypical and crystallize in the non-centrosymmetric space group P2₁2₁2₁. The most important intermolecular interactions are N–H…N_pyr, N–H…N(H₂), and stacking interactions. These interactions lead to identical columnar-layered structures in both 3 and 4. No significant contributions from halogen bonds of the type N…X (X = Cl, Br) are found in 3 and 4. Full article

This paper proposes a pseudo full-channel signal integrity (SI) simulation method tailored for high-bandwidth memory (HBM) interconnects. In this approach, real interconnect models are applied to selected portions of the channel, while the remaining sections are replaced with synchronized current loads that emulate the electrical behavior of actual signal transmission. This technique enables accurate modeling of the HBM interface under full-channel parallel data transfer conditions. In addition to the simulation methodology itself, this study focuses on three specific implementation schemes for the synchronized current loads and explores their practical applications. Comparative analysis demonstrates the necessity and effectiveness of using synchronized current loads as substitutes for real transmission loads, offering a viable and efficient solution for SI analysis in HBM interconnect systems. Full article

Background and Objectives: Surgical site infections (SSIs) are a frequent complication after lower extremity fracture surgery, yet tools for individualized risk prediction remain limited. This study aimed to develop and internally validate a nomogram for individualized SSI risk prediction based on perioperative clinical parameters. Materials and Methods: This retrospective cohort study included adults who underwent lower extremity fracture surgery between 2022 and 2025 at a tertiary care center. Thirty candidate predictors were evaluated. Feature selection was performed using six strategies, and the final model was developed with logistic regression based on bootstrap inclusion frequency. Model performance was assessed by area under the curve, calibration slope, Brier score, sensitivity, and specificity. Results: Among 638 patients undergoing lower extremity fracture surgery, 76 (11.9%) developed SSIs. Of six feature selection strategies compared, bootstrap inclusion frequency identified seven predictors: red blood cell count, preoperative C-reactive protein, chronic kidney disease, operative time, chronic obstructive pulmonary disease, body mass index, and blood transfusion. The final model demonstrated an AUROC of 0.924 (95% CI, 0.876–0.973), a calibration slope of 1.03, and a Brier score of 0.0602. Sensitivity was 86.2% (95% CI, 69.4–94.5) and specificity was 89.5% (95% CI, 83.8–93.3). Chronic kidney disease (OR, 88.75; 95% CI, 5.51–1428.80) and blood transfusion (OR, 85.07; 95% CI, 11.69–619.09) were the strongest predictors of infection. Conclusions: The developed nomogram demonstrates strong predictive performance and may support personalized SSI risk assessment in patients undergoing lower extremity fracture surgery. Full article

On 22 May 2012, a magnitude Mw 5.6 earthquake struck the Pernik region of western Bulgaria, causing structural damage in nearby cities, including Sofia. This study assesses the seismic response of a six-story reinforced concrete building in central Sofia, utilizing real accelerogram data recorded at the basement (SGL1) and sixth floor (SGL2) levels during the earthquake. Using the Kanai–Yoshizawa (KY) model, the study estimates inter-story motion and assesses amplification effects across the structure. Analysis of peak ground acceleration (PGA), velocity (PGV), displacement (PGD), and spectral ratios reveals significant dynamic amplification of peak ground acceleration and displacement on the sixth floor, indicating flexible and dynamic behavior, as well as potential resonance effects. The analysis combines three spectral techniques—Horizontal-to-Vertical Spectral Ratio (H/V), Floor Spectral Ratio (FSR), and the Random Decrement Method (RDM)—to determine the building’s dynamic characteristics, including natural frequency and damping ratio. The results indicate a dominant vibration frequency of approximately 2.2 Hz and damping ratios ranging from 3.6% to 6.5%, which is consistent with the typical damping ratios of mid-rise concrete buildings. The findings underscore the significance of soil–structure interaction (SSI), particularly in sedimentary basins like the Sofia Graben, where localized geological effects influence seismic amplification. By integrating accelerometric data with advanced spectral techniques, this research can enhance ongoing site-specific monitoring and seismic design practices, contributing to the refinement of earthquake engineering methodologies for mitigating seismic risk in earthquake-prone urban areas. Full article

Background and Objectives: Diabetes mellitus (DM) significantly impacts post-surgical recovery and fracture healing; however, few studies have specifically investigated the impact of DM on outcomes in patients undergoing surgical stabilization of rib fractures (SSRF). This study investigated the potential influence of DM on perioperative outcomes following SSRF, using data from Taiwan’s National Health Insurance Research Database (NHIRD). Materials and Methods: Data of 1603 patients with multiple rib fractures who underwent SSRF between 2001 and 2019 were retrospectively analyzed. Patients were categorized into three groups: no DM, DM without chronic complications, and DM with chronic complications. The associations between DM status and perioperative outcomes, including hospital length of stay (LOS), in-hospital mortality, readmission rates, and complications such as pneumonia, surgical site infection (SSI), acute myocardial infarction (AMI), and total hospital costs were determined using univariate and multivariable regression analyses. Results: The mean age of the 1603 patients was 52.0 years, and 71% were male. Patients with DM and chronic complications had higher risks of 14-day readmission (adjusted odds ratio [aOR] = 2.99; 95% confidence interval [CI]: 1.18–7.62), 15–30 day readmission (aOR = 3.28; 95% CI: 1.25–8.60), SSI (aOR = 2.90; 95% CI: 1.37–6.14), AMI (aOR = 3.44; 95% CI: 1.28–9.24), and acute respiratory distress syndrome (ARDS) (aOR = 1.96; 95% CI: 1.03–3.74). In conclusion, DM, particularly DM with chronic complications, significantly increases the risk of adverse short-term outcomes following SSRF. Conclusions: These findings emphasize the need for enhanced care for patients with DM to optimize the outcomes of SSRF. Full article

Background: Deep surgical site infections (SSIs) represent a serious complication following abdominal trauma surgery; however, comprehensive risk factor analysis in large trauma populations remains limited. Although surgical site infections are recognized as preventable complications, little is known about the specific risk factors and clinical outcomes associated with deep SSIs in trauma patients at the national level. Methods: A retrospective cohort study analyzed data from the National Trauma Data Bank from 2020–2022, including 1,198,262 trauma patients with complete demographic, injury severity, and surgical procedure data. Deep SSI development, length of hospital stay, intensive care unit utilization, duration of mechanical ventilation, discharge disposition, and in-hospital mortality were assessed. Multivariate logistic regression was used to identify independent risk factors and quantify associations between patient characteristics and deep SSI occurrence. Results: Deep SSIs occurred in 601 patients (0.05%). Affected patients were younger (median 41 vs. 54 years, p < 0.001), predominantly male (73.7% vs. 61.8%, p < 0.001), and exhibited higher injury severity scores (median 17.0 vs. 5.0, p < 0.001). Major abdominal surgery was the strongest independent predictor (OR 3.08, 95% CI: 2.21–4.23, p < 0.001), followed by injury severity score (OR 1.05, 95% CI: 1.04–1.06, p < 0.001) and ICU length of stay (OR 1.04 per day, 95% CI: 1.03–1.05, p < 0.001). Patients with deep SSIs demonstrated dramatically increased hospital stays (89.5% vs. 4.5% exceeding 21 days, p < 0.001), reduced home discharge rates (28.5% vs. 48.9%, p < 0.001), and higher mortality (4.2% vs. 1.2%, p < 0.001). Conclusions: Major abdominal surgery and injury severity are primary risk factors for deep SSIs in trauma patients, with profound impacts on clinical outcomes and healthcare resource utilization. These findings highlight the importance of targeted prevention strategies for high-risk trauma patients undergoing major abdominal procedures and emphasize the significant burden that deep SSIs place on healthcare systems. Full article

Seismic responses of Nuclear Island (NI) structures have great significance in the foundation adaptability analysis and the seismic design of equipment. However, with the increasing complexity of nuclear power site conditions, establishing a reasonable and effective soil–pile–structure dynamic interaction model has become the key technical problem that needs to be solved. In this study, a pseudo three-dimensional soil–pile–structure dynamic interaction model considering soil nonlinearity and heterogeneity is developed for seismic response analysis of NI structures. Specifically, the nonlinearity of the near-field soil is described via the equivalent linear method, the radiation damping effect of half space is simulated through viscous boundary, and the displacement/stress conditions at lateral boundaries of the heterogeneous site are derived from free-field response analysis. Meanwhile, an equivalent stiffness–mass principle is established to simplify NI superstructures, while pile group effects are incorporated via a node-coupling scheme within the finite-element framework. Two validation examples are presented to demonstrate the accuracy and efficiency of the proposed model. Finally, seismic response analysis of two typical NI structure of reactor types (CPR1000 and AP1000) based on the actual complex site conditions in China is also presented to study the effect of radiation damping, soil conditions, and pile foundation. Key findings demonstrate the necessity of integrating SSI effects and nonlinear characteristics of non-rock foundations. While the rock-socketed pile exhibits superior performance compared to the CFG pile alternative; this advantage is offset by higher costs and construction complexity. The research findings can serve as a valuable reference for the foundation adaptability analysis and optimizing the design of equipment under the similar complex condition of the soil site. Full article

Background and Objectives: Postoperative pancreatic fistula and post-hepatectomy liver failure remain significant complications after HPB surgery; however, superficial surgical site infection (SSI) is the most frequent wound-related complication. Closed-incision negative-pressure wound therapy (ciNPWT) has been proposed to reduce superficial contamination, yet no liver-focused quantitative synthesis exists. We aimed to evaluate the effectiveness and safety of prophylactic ciNPWT after hepatopancreatobiliary (HPB) surgery. Methods: MEDLINE, Embase, and PubMed were searched from inception to 30 April 2025. Randomized and comparative observational studies that compared ciNPWT with conventional dressings after elective liver transplantation, hepatectomy, pancreatoduodenectomy, and liver resections were eligible. Two reviewers independently screened, extracted data, and assessed risk of bias (RoB-2/ROBINS-I). A random-effects Mantel–Haenszel model generated pooled risk ratios (RRs) for superficial SSI; secondary outcomes were reported descriptively. Results: Twelve studies (seven RCTs, five cohorts) encompassing 15,212 patients (3561 ciNPWT; 11,651 control) met the inclusion criteria. Device application lasted three to seven days in all trials. The pooled analysis demonstrated a 29% relative reduction in superficial SSI with ciNPWT (RR 0.71, 95% CI 0.63–0.79; p < 0.001) with negligible heterogeneity (I² 0%). Absolute risk reduction ranged from 0% to 13%, correlating positively with the baseline control-group SSI rate. Deep/organ-space SSI (RR 0.93, 95% CI 0.79–1.09) and 90-day mortality (RR 0.94, 95% CI 0.69–1.28) were unaffected. Seven studies documented a 1- to 3-day shorter median length of stay; only two reached statistical significance. Device-related adverse events were rare (one seroma, no skin necrosis). Conclusions: Prophylactic ciNPWT safely reduces superficial SSI after high-risk HPB surgery, with the greatest absolute benefit when baseline SSI risk exceeds ≈10%. Its influence on deep infection and mortality is negligible. Full article

This article examines the seismic assessment and strengthening of a traditional load-bearing masonry structure subjected to strong motion data, with particular emphasis on the effects of soil–structure interaction (SSI). The case study is the Archaeological Museum of Lemnos (AML)—a three-storey building with a composite load-bearing system of timber-framed stone masonry. Over time, the structure has undergone irreversible modifications, primarily involving reinforced concrete (RC) interventions. The building’s seismic performance was evaluated using two finite element models developed in the SAP2000 software (v. 25.3.00). The first model simulates the original structure, strengthened by grout injections, while the second represents the current condition of the structural system following RC additions. Soil–structure interaction was also investigated, given that the local soil is classified as Category D according to Eurocode 8 (EC8). Each model was analyzed under two different support conditions: fixed-base and SSI-inclusive. A suite of appropriate accelerograms was applied to both models, in compliance with Eurocode 8 using the SeismoMatch software, and linear time-history analyses were conducted. The results underscore the significant impact of SSI on the increase of peak tensile stress and interstorey drift ratios (IDRs), and highlight the influence of different strengthening techniques on the seismic response of historic load-bearing masonry structures. Full article

Background: Surgical site infections (SSIs) are among the most common postoperative complications. Environmental factors, including intraoperative traffic and door openings in the operating room (OR), have been identified as critical contributors to microbial air contamination. Nurses play a pivotal role in managing these factors, directly influencing infection control practices. Methods: An integrative review was conducted to synthesize current evidence on the association between intraoperative traffic, door openings, and SSIs. A structured methodology was employed to identify, assess, and analyze the existing literature, with a specific focus on the nursing role in infection prevention. Results: Findings from a single-center prospective cohort study indicate that ORs with more than 10 personnel present exhibit a threefold increase in SSI risk [Relative Risk (RR) = 3.12; 95% Confidence Interval (CI): 0.71–13.66] compared to ORs with fewer personnel. Additionally, every five door openings per procedure were associated with a significant increase in SSI incidence [Hazard Ratio (HR) = 2.00; 95% CI: 1.24–3.20, p = 0.005]. Conclusions: These findings underscore the importance of strict protocols to limit intraoperative traffic and unnecessary OR access. A multidisciplinary approach plays a crucial role in ensuring surgical safety and preventing SSIs by regulating OR access and adhering to infection control best practices. Full article

Lumped plasticity models available in commercial software offer a limited resolution of damage distribution along structural members. This study presents an open-source workflow that combines force-based fiber elements in OpenSeesPy with automated 3D post-processing for visualizing distributed plasticity in reinforced concrete piles. A 60 cm diameter pile subjected to monotonic lateral loading is analyzed using both SAP2000’s default plastic hinges and OpenSeesPy fiber sections (Concrete02/Steel02). Although the fiber model incurs a runtime approximately 2.5 times greater, it captures the gradual spread of yielding and deterioration with improved fidelity. The presented workflow includes Python routines for interactive stress–strain visualization, facilitating the identification of critical sections and verification of strain limits. This approach offers a computationally feasible alternative for performance-based analysis with enhanced insight into member-level behavior. Because the entire workflow—from model definition through post-processing—is fully scripted in Python, any change to geometry, materials, or loading can be re-run in seconds, dramatically reducing the time taken to execute sensitivity analyses. Full article

Background/Objectives: Ketorolac is commonly used for pain management after orthopedic surgery, but concerns regarding its effects on postoperative complications remain. This study evaluates the impact of ketorolac use on short- and long-term outcomes in adult patients undergoing uncemented primary total hip arthroplasty (THA), where implant stability relies on biological fixation through bone ingrowth into a porous-coated prosthesis rather than bone cement. Methods: A retrospective cohort study was conducted using the TriNetX Research Network. Patients aged 18 years or older who underwent uncemented primary THA between 1 January 2004 and 1 January 2024 were included. Two cohorts were compared: those who received ketorolac on the day of or within one week of surgery and those who did not. Cohorts were propensity score-matched. Outcomes were assessed at 30 days, 1 year, and 5 years postoperatively. Results: At 30 days, ketorolac use was associated with significantly lower risks of transfusion (RR: 0.6, p < 0.01). However, it was linked to higher rates of acute posthemorrhagic anemia (RR: 1.2, p < 0.01) and periprosthetic fracture (RR: 1.4, p < 0.01). At 1 year, ketorolac use was associated with reduced risks of death (RR: 0.8, p < 0.01) and transfusion (RR: 0.7, p < 0.01), but increased risks of acute posthemorrhagic anemia (RR: 1.2, p < 0.01), deep surgical site infection (SSI) (RR: 1.8, p = 0.01), superficial SSI (RR: 1.9, p < 0.01), periprosthetic joint infection (RR: 1.1, p < 0.01), wound dehiscence (RR: 1.2, p < 0.01), periprosthetic mechanical complication (RR: 1.2, p < 0.01), and periprosthetic fracture (RR: 1.5, p < 0.01). Conclusions: Our findings highlight the complex risk profile of ketorolac in uncemented THA patients and suggest that clinicians should carefully consider individual patient factors and engage in shared decision-making when counseling patients on the use of ketorolac in the perioperative setting. Full article