Search Results (14,277)

This study reconstructs and projects relative sea-level change (RSLC) along Chesapeake Bay, a global hotspot for sea-level rise, from 1900 to 2100 by statistically extrapolating observed tide gauge trends, rather than employing climate model-based scenarios. The approach integrates global mean sea-level rise (GMSLR), regional sea-level rise (RSLR), and local land subsidence (LS) to evaluate both past and future behavior. Tide gauge data reveal that Chesapeake Bay’s sea level has accelerated at 0.099 ± 0.013 mm/year² since 1992, with a linear rate of 1.26 mm/year since 1900, slightly outpacing global averages. LS, primarily driven by glacial isostatic adjustment (GIA) and sediment compaction, has been the dominant contributor to RSLC since the early 20th century, accounting for up to 71% of the RSLC prior to 1992 across 15 tide gauge stations. However, with GMSLR accelerating at 0.120 ± 0.025 mm/year², the relative contribution of LS to RSLC is projected to decline to 31–43% by 2100. The reconstructed RSLC for the 20th century ranges between 32 and 44 cm, while extrapolated projections for the 21st century indicate a further increase of 53–99 cm. By 2100, GMSLR is expected to contribute to 60–70% of total RSLC. Spatial variability in RSLC across 15 tide gauge stations reflects differing geological conditions and anthropogenic influences such as groundwater withdrawal and construction-induced subsidence. These findings highlight the critical need for adaptive strategies to mitigate the impact of rising sea levels on coastal communities and infrastructure in the Chesapeake Bay region. Continued monitoring, improved modeling, and targeted resilience planning are essential to address the accelerating threats posed by sea-level rise and to ensure the sustainability of vulnerable coastal areas. Full article

Background and Objectives: Despite modern therapy algorithms, ST-elevation myocardial infarction (STEMI) substantially contributes to cardiovascular morbidity and mortality worldwide. Early Risk assessment is crucial to guide therapy allocation, especially in countries with limited healthcare resources. Electrocardiographic parameters such as QRS fragmentation (fQRS) evolved as an important prognostic marker. The underlying mechanisms and specific risk factors for the occurrence of fQRS in patients with STEMI undergoing PCI have not been analyzed yet. Materials and Methods: Between 09/2020 and 06/2021, out of 179 consecutive patients with STEMI undergoing primary percutaneous coronary intervention (pPCI), 122 patients were included in this study. The occurrence of fQRS was analyzed and correlated to clinical as well as biochemical parameters. Results: In this population, the fQRS pattern was present in 33.6% (n = 41) of patients. Besides gender, no statistically significant differences in baseline characteristics or comorbidities were observed between the two groups. In univariable logistic regression analysis, both glomerular filtration rate (GFR) (p = 0.050) and C-reactive protein (CRP) (p = 0.014) were significantly associated with the presence of fQRS. However, in the multivariable logistic regression model, only CRP levels on admission remained independently associated with fQRS (OR = 3.44, 95% CI: 1.95; 6.05), (p = 0.029). Conclusions: In this analysis, a correlation between fQRS and CRP levels in patients with STEMI undergoing pPCI could be demonstrated. Consequently, fQRS might serve as a marker for extensive inflammation in the context of myocardial ischemia. Full article

This study used Q methodology to explore and categorise caregivers’ subjective perceptions of artificial intelligence (AI)-powered ‘virtual human’ (AVH) devices in caring for older adults. We derived 123 initial statements from literature and focus groups and narrowed them to 34 statements as the final Q sample. Seventeen caregivers, nurses, and social workers completed the Q-sorting procedure. Using principal component analysis and Varimax rotation in Ken-Q, we identified three perception types: Active Acceptors, who emphasise the devices’ practical utility in patient communication; Improvement Seekers, who conditionally accept the technology while seeking greater accuracy and effectiveness; and Emotional Support Seekers, who view the device as a tool for emotional relief and psychological support. These findings suggest that technology acceptance in caregiving extends beyond functional utility. It also involves trust, affective experience, and interpersonal interaction. This study integrates multiple frameworks, including the Technology Acceptance Model (TAM), the Unified Theory of Acceptance and Use of Technology (UTAUT), Science and Technology Studies (STS), and Human–Machine Communication (HMC) theory, to provide a multifaceted understanding of caregivers’ acceptance of AI technology. The results offer valuable implications for designing user-centred AI care devices and enhanced emotional and communicative functions. Full article

In the modern age of data enrichment, it has become necessary to incorporate adaptive inference processes into survey-based estimation systems in order to achieve efficient and consistent population summaries. In this work, a new type of data-adaptive approach to the prospective estimation of central tendency under stratified random sampling (StRS) frameworks is presented. The suggested structure takes advantage of the auxiliary information based on locally tuned, non-parametric smoothing plans that dynamically adapt to a heterogeneity of sampled and unsampled domains. The estimator wisely reacts to an intricate pattern of the data, ensured by the application of variable bandwidth functions, stratified weighting plans, which ensure resilience to model misspecification and outlier effects. Substantial Monte Carlo simulations and two empirical studies, i.e., solar radiation data and fish market data, are performed to confirm its performance in a variety of bandwidth and sample size settings. The findings have consistently shown that the suggested adaptive inference mechanism is significantly more precise and stable than traditional estimators, not only when auxiliary expectations are known, but also when they have to be estimated. This study brings into play a flexible, design-conscious framework that connects model-driven estimation with design-driven survey inference, which is of importance in contemporary information-gathering settings of informational diversity and enrichment. Full article

Background/Objectives: Although systematic reviews and meta-analyses have examined immune-inflammatory indices in cardiovascular disease (CVD), the evidence remains scattered and inconsistent. This umbrella review aims to synthesize findings and evaluate the overall predictive value of these indices for clinical outcomes. Methods: We systematically searched PubMed, Cochrane Library, Web of Science, Embase, Scopus, and Medline for systematic reviews with meta-analyses assessing neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI) in patients with CVD. Study quality and certainty of evidence were appraised using AMSTAR-2 and GRADE, respectively. Results: A total of 35 meta-analyses covering 106 unique outcomes were included, of which 87 showed significant associations. Elevated NLR and SII were consistently linked to higher risks of CVD mortality, major adverse cardiovascular events, myocardial infarction, heart failure, and stroke. PLR and SIRI were primarily associated with poor recovery from stroke and increased mortality in ST-elevation myocardial infarction. Specifically, the methodological quality of the included reviews was generally moderate to high according to AMSTAR-2, whereas none of the associations reached high certainty based on GRADE, with most rated as low or very low and about one-quarter as moderate certainty. Conclusions: The overall certainty of evidence remains limited according to GRADE, alongside methodological heterogeneity, population variability, and inconsistent thresholds that further restrict the direct applicability of these findings in clinical practice. Nevertheless, available evidence indicates that elevated immune-inflammatory indices are likely associated with worse clinical outcomes in patients with CVD. Future research should prioritize establishing standardized cutoffs, improving methodological consistency, and validating these indices across diverse populations to support their integration into clinical risk-stratification frameworks. Full article

Objective: Evaluating the in vitro marginal adaptation of conventional, flowable and restorative bulk-fill resin composites placed in large class II cavities with supra- and sub-gingival margins, using a bulk-fill or layering approach, before and after thermo-mechanical loading (TML) simulating parafunctional forces. A total of 40 prepared teeth were divided and assigned to each of the five experimental groups. In group 1, restorations were made of layered high-viscosity conventional composite (Tetric EvoCeram); in groups 2 and 3 restorations were made of a high-viscosity bulk-fill composite (Tetric Powerfill) applied in one (group 2) or three layers (group 3); in groups 4 and 5 restorations were made of a flowable bulk-fill composite (SDRflow) applied in one (group 4) or two layers (group 5), underneath a layer of high-viscosity composite (Ceram-X Spectra ST). The same adhesive (OptiBond FL) was used in all groups. All specimens were submitted to a TML comprising a loading phase of 250,000 cycles at 100 N combined to 1675 thermal cycles (5 to 55 °C). The proximal tooth-restoration interfaces were analyzed quantitatively by SEM, prior and after TML. Results: Repeated measures ANOVA followed by Fisher’s LSD (Least Significant Difference) post hoc tests served for comparing inter-group marginal adaptation percentages between the pre- (T0) and post- (T1) loading conditions and intra-group marginal adaptation percentages. The lowest pre-loading values were for the cervical dentin adaptation ranging from 94.79% (SDRflow layered) to 66.06% (Tetric Powerfill layered) while the post-loading values of continuous cervical dentin adaptation varied from 61.20% (SDRflow layered) to 33.36% (SDRflow Monolayer). TML with higher axial forces led to a marked reduction in continuous adaptation at enamel or dentin margins in all groups. Overall, the low-viscosity bulk-fill SDRflow layers showed the best behavior while other products showed varying levels of degradation. Conclusions–Clinical significance: Simulated bruxism loading conditions induced severe marginal adaptions of class II composite restorations, which could potentially impact their lifespan. Full article

Background/Objectives: Klebsiella pneumoniae ST258 and ST11 are global high-risk antimicrobial-resistant clones known for their virulence and resistance gene dissemination. This study aims to identify these clones in a Greek tertiary hospital and understand their resistance profiles and transmission dynamics. Methods: In January 2025, we isolated two distinct carbapenem-resistant K. pneumoniae in a Greek tertiary hospital: INT18S from an ICU patient’s bronchioalveolar lavage and INT20U from a urine sample in the emergency unit. Antimicrobial susceptibility testing (via Microscan system) and Whole-Genome Sequencing (WGS) were conducted on both isolates and their genomes were submitted to the NCBI. Results: The INT18S isolate carried the bla_KPC-2 gene and belonged to the ST258 clone. The INT20U isolate carried the bla_NDM-1 gene and belonged to the ST11 clone lineage. Both isolates contained at least one of the extended spectra β-lactamase genes tested (TEM, SHV, OXA-1 and CTX-M group). Conclusions: The co-existence of the high-risk K. pneumoniae clones ST258 and ST11 in different hospital departments increases the risk of resistance gene transfer and suggests potential intra-hospital transmission pathways. Understanding their resistance profiles is critical for guiding treatment strategies and preventing the spread of multidrug-resistant pathogens. Full article

The energy-saving performance of the building envelope, which plays a pivotal role in energy conservation and thermal insulation, has been the subject of extensive research. In the context of China’s high-quality green development, this study proposes a building energy-saving strategy based on optimal thermal comfort. It analyzes the impact of factors such as regional dwell time and PMV types on energy-saving effects, summarizes the optimal comfort parameters under the highest energy efficiency rate, and sets relevant parameters in the DeST building energy simulation software to analyze a typical public building. The analysis examined the impact of changing the heat transfer coefficients of exterior walls and windows on the annual cumulative heating and cooling loads. It established the relationship between the thermal transmittance of building envelopes and energy consumption and assessed the carbon emissions during the building’s operation and maintenance phase. The results indicate that as building envelope thermal transmittance coefficient decreases, particularly that of external windows and walls, overall cumulative heating and cooling loads decline accordingly. Notably, the reduction in external windows’ thermal transmittance coefficient has the most significant impact on total building thermal load. Furthermore, as the envelope thermal transmittance coefficient decreases, seasonal heating and cooling demands decline simultaneously, with the most substantial effect on heating load reduction during winter. Total annual building carbon emissions also decrease with the reduction in envelope thermal transmittance coefficient, particularly external wall thermal transmittance coefficient. Based on the findings of this study, the building envelope of the public building was redesigned, taking into account construction costs, the owner’s requirements, and energy efficiency alongside the reduction in carbon emissions. Comparisons of the redesigned building’s envelope thermal performance, experimental testing, and in situ measurements confirmed that it fulfilled the engineering requirements. This study also demonstrates that DeST software provides reliable technological support for low-carbon building design, retrofitting, and operation. Full article

Background: We aimed to compare the perinatal outcomes of dichorionic/diamniotic twin (DC/DA) pregnancies resulting from in vitro fertilization (IVF) with those resulting from spontaneous DC/DA pregnancies. Methods: The study group included 99 women with DC/DA pregnancies resulting from IVF, and the control group included 92 women with spontaneous DC/DA pregnancies. Maternal demographic characteristics (age, parity, and gravidity), pre-existing conditions (chronic hypertension and pregestational diabetes mellitus), and obstetric history were recorded. Pregnancy outcomes included gestational age at delivery, number of fetuses, and mode of delivery. The antepartum complications that we evaluated include first- and second-trimester bleeding, placenta previa, preterm birth, fetal growth restriction (FGR), oligohydramnios, and tocolytic use. The obstetric complications that we assessed include prematurity, twin-to-twin transfusion syndrome (TTTS), and hydrops fetalis. Additionally, neonatal data such as 1st minute and 5th minute Apgar scores, birth weight, neonatal intensive care unit (NICU) admission, presence of congenital anomalies, and neonatal death were recorded, and comparisons were made between the groups. Results: Women in the IVF group were older (34.7 ± 6.9 vs. 32.3 ± 6.1 years, p = 0.03) and more frequently primiparous (73.7% vs. 37.0%, p < 0.001). The mean gestational age at delivery was slightly lower in the IVF group, though this was not statistically significant (34.3 ± 3.5 vs. 35.1 ± 2.5 weeks, p = 0.101). Cesarean delivery was common in both groups, with comparable overall rates (90.9% vs. 94.6%, p = 0.411), but emergency cesarean section occurred more frequently in IVF pregnancies (81.8% vs. 55.8%, p = 0.001). No significant differences were found regarding chronic hypertension or pregestational diabetes. However, several differences were demonstrated in terms of obstetric complications. For example, preterm births and fetal growth restriction (FGR) were significantly more frequent in IVF pregnancies (59.8% vs. 30.4%, p < 0.001), and tocolytic use was also more frequent (56.6% vs. 29.7%, p < 0.001). No significant differences were observed in terms of placenta previa, oligohydramnios, TTTS, hydrops fetalis, and neonatal outcomes. The logistic regression analysis revealed that IVF pregnancies were associated with an increased risk of preterm birth: OR 3.45, 95% CI 1.85–6.78 (p < 0.001); the risk of FGR was also higher in IVF pregnancies: OR 2.11, 95% CI 1.02–4.37 (p = 0.015). However, tocolytic use was not significantly associated with IVF: OR 1.49, 95% CI 0.50–4.44 (p = 0.471). Conclusions: Although DC/DA pregnancies conceived through IVF have a higher risk of preterm birth, fetal growth restriction, and greater use of tocolytic agents than spontaneous DC/DA pregnancies, their neonatal outcomes are similar. Full article

Over the 21st century, the confluence between engineering and universal accessibility has emerged as a key research domain, reflecting the growing awareness of the importance of inclusive layout in technological innovation. Despite the growing number of studies on sustainability and inclusion, there is still a lack of comprehensive analyses exploring how engineering contributes to universal accessibility within the framework of the United Nations Sustainable Development Goals. This study addresses this gap by providing the first large-scale mapping of research trends, collaborations, and thematic evolution in this field. The present bibliometric analysis examines the evolution of engineering research in relation to the United Nations Sustainable Development Goals, stressing its role in encouraging universal accessibility. Through a systematic review of scholarly works produced over the last twenty years, this study uncovers dominant issues, evolving research fronts, and the global relevance of engineering-based approaches to improve accessibility for persons with disabilities. Analyzing citation dynamics, publication trajectories, and institutional involvement, this study underlines the contribution of engineering to building inclusive societies and ensuring equitable access to technology and infrastructure. Discoveries underscore that cross-sector collaboration and technological innovation are essential to overcoming accessibility challenges among disfavored populations, directly advancing SDG 10 on reducing disparities and SDG 11 on sustainable urban development. Full article

Owing to the high altitude and short frost-free period of the Tibetan Plateau, potato plants are frequently exposed to cold stress (CS), which severely restricts their growth and productivity. Thus, understanding the mechanisms underlying cold tolerance in potato varieties is crucial for breeding improvement. This study aims to investigate the role of caffeic acid in potato cold tolerance and to elucidate the molecular mechanisms underlying the CS response. To achieve this, we conducted comprehensive metabolomic and transcriptomic analyses of KY130 (cold-tolerant) and KY140 (cold-sensitive) potato cultivars under CS at the seedling stage. ELISA results showed that caffeic acid levels were higher in KY130 than in KY140, while CS-KY130 exhibited higher levels than those of CS-KY140. Across all treatments, KY130 showed significantly higher activities of antioxidant enzymes (CAT and SOD) and higher contents of osmolytes (proline, soluble protein, and soluble sugar) than those of KY140. Caffeic acid and naringenin* were identified as candidate metabolites potentially involved in the direct and indirect cold resistance of potatoes. StPAL(Soltu.Atl.03_2G004060, Soltu.Atl.03_2G004070, Soltu.Atl.03_2G008130) and StCSE(Soltu.Atl.04_1G006370 and Soltu.Atl.04_3G005440), identified as upstream regulators of caffeic acid, were associated with the direct and indirect cold resistance of potatoes. KEGG pathway analysis of differentially accumulated metabolites and differentially expressed genes revealed several key metabolic pathways, including “flavonoid-related metabolism,” “lipid metabolism,” and “amino acid metabolism.” This research enhances our understanding of caffeic acid and the molecular mechanisms involved in the response of potatoes to CS, and supports future efforts in potato screening and breeding programs. Full article

Amid mounting calls for socio-ecological transition, many social sciences studies have been exploring the processes of societal change. The well-known Science Technology Society studies (STS) approach focuses on the diffusion of innovation niches as an open-ended process ultimately leading to the stabilization of a new regime. Other works have suggested reversing the perspective, i.e., ‘thinking about transitions from the end’. This is a defining characteristic of system building perspectives, which are inherently goal- and sustainability-oriented. This paper presents the state of the art in the social sciences based on a review of international academic journals in English. We use both quantitative and qualitative approaches. Using Web of Science data collected for a period of ten years and the free software IRaMuTeQ (version 2), we have conducted statistical, similarity, and textual analyses of a corpus of 151 texts, following the PRISMA methodology. We discuss the findings of the lexicometric analysis by looking at the content of the article abstracts. While system building is not always mentioned as such, this new perspective is reflected in the literature, especially in research on the energy and food transition, in two main ways: (i) the procedural and substantive dimensions of sustainability transition are both taken into account; (ii) the issue of governance occupies a central place—involving the definition of appropriate instrument mixes and policy mixes—given the need to deal with stakeholders with diverging interests and values rather than only focusing on technological innovations. Full article

Computational thinking (CT) is recognized as a core competency for the 21st century, and its development is shaped by multiple factors, including students’ individual characteristics and their use of information and communication technology (ICT). Drawing on large-scale international data from the 2023 cycle of the International Computer and Information Literacy Study (ICILS), this study analyzes a sample of 81,871 Grade 8 students from 23 countries and one regional education system who completed the CT assessment. This study is the first to apply a predictive modeling framework that integrates two machine learning techniques to systematically identify and explain the key variables that predict CT and their nonlinear effects. The results reveal that various student-level predictors—such as educational expectations and the number of books at home—as well as ICT usage across different contexts, demonstrate significant nonlinear patterns in the model, including U-shaped, inverted U-shaped, and monotonic trends. Compared with traditional linear models, the SHapley Additive exPlanations (SHAP)-based approach facilitates the interpretation of the complex nonlinear effects that shape CT development. Methodologically, this study expands the integration of educational data mining and explainable artificial intelligence (XAI). Practically, it provides actionable insights for ICT-integrated instructional design and targeted educational interventions. Future research can incorporate longitudinal data to explore the developmental trajectories and causal mechanisms of students’ CT over time. Full article

Northern Nigeria’s Qur’an schools (also known as ‘Almajiri Schools’) have existed for several centuries and remain a key source of education and socialisation for many young boys in rural northern Nigeria. The schools are the subject of often harmful and stigmatising representations and elitist discontent due to the students being seen as ‘out of school’ and ill-educated for the 21st century. The boys can sometimes be seen begging and at the mercy of the streets as the schools fall out of the purview of the state. Importantly, this system of schooling and education is largely understood as male-dominated, from the teachers to the students and the fathers who do the sending. This study therefore explores the historical and contemporary roles of women within northern Nigeria’s Qur’anic system of schooling and Islamic education more widely, paying close attention to the continuities and disruptions. By focusing on women and girls and making apparent their places in a practice regarded primarily as an avenue for educating boys, the exploration reveals ways that women have and still play an integral part especially as co-educators. From prominent women historical figures to the wives of the teachers; present-day scholars to women who act as mother figures within the local communities, women shape and influence Islamic education within northern Nigeria. Making these contributions, their roles, and agency apparent and visible is therefore a key goal, especially in a context where they have always been present yet disregarded (sometimes wilfully, sometimes inadvertently unseen), and subsequently ‘invisiblised’. Full article

Conventional wavefront sensors face challenges when detecting frequency-domain information. In this study, we developed a high-precision, and fast multi-spectral wavefront detection technique based on neural networks. Using an etalon and a diffractive optical element for spectral encoding, the measured pulses were spatially dispersed onto the sub-apertures of the Shack-Hartmann wavefront sensor (SHWFS). We employed a neural network model as the decoder to synchronously calculate the multi-spectral wavefront aberrations. Numerical simulation results demonstrate that the average calculation time is 21.38 ms, with a root mean squared (RMS) wavefront residual error of approximately 0.010 μm for 4-wavelength, 21st-order Zernike coefficients. By comparison, the conventional modal-based algorithm achieves an average calculation time of 102.98 ms and wavefront residuals of 0.090 μm. Remarkably, for 10-wavelength analysis, traditional centroid algorithms fail; this approach maintains high simulation accuracy with the RMS wavefront residual error below 0.016 μm. The proposed approach significantly enhances the measurement capabilities of SHWFS in multi-spectral and single-shot wavefront detection, particularly for single-shot spatio-temporal characterization in ultra-intense and ultra-short laser systems. Full article