Search Results (7,217)

Background/Objectives: Anti-tumour necrosis factor (anti-TNF) medications were historically commonly prescribed as the first-line biologic treatment for chronic inflammatory pouch conditions. However, their use in these conditions is mainly based on retrospective studies of relatively small numbers of patients with short follow up periods. We aimed to describe the long-term outcomes of first-line anti-TNF therapy in a large, multi-centre, multi-national patient cohort with chronic inflammatory pouch conditions. Methods: This was an observational, retrospective, multi-centre, multi-national study. We included patients with chronic inflammatory pouch conditions initially treated with anti-TNF drugs infliximab (IFX) or adalimumab (ADA), who had a follow up of at least 1 year. The primary outcome was anti-TNF treatment persistence, defined as continuation of anti-TNF throughout the study period. The secondary outcome was pouch failure, defined by the need for a defunctioning ileostomy or pouch excision. Results: We recruited 98 patients with chronic inflammatory pouch conditions initially treated with anti-TNF medications—63 (64.3%) treated with IFX and 35 (35.7%) treated with ADA. Average follow up length was 94.2 months (±54.5). At the end of the study period only 22/98 (22.4%) patients were still on anti-TNF treatment. In those in whom the first-line anti-TNF was discontinued, the median time to discontinuation was 12.2 months (range 5.1–26.9 months). The most common cause for anti-TNF discontinuation was lack of efficacy despite adequate serum drug levels and absence of anti-drug antibody formation (30 patients, 30.6%). Loss of response due to anti-drug antibody formation was the cause for discontinuation in 18 patients (18.4%), while 12 patients (12.2%) stopped treatment because of adverse events or safety concerns. Out of the 76 patients discontinuing anti-TNF treatment, 34 (34.7% of the cohort) developed pouch failure, and 42 (42.8% of the cohort) are currently treated with a different medical therapy. Conclusions: First-line anti-TNF therapy for chronic pouch inflammatory conditions is associated with low long-term persistence rates. This is due to a combination of lack of efficacy and adverse events. A significant percentage of patients initially treated with anti-TNF therapy develop pouch failure. Full article

Background/Objectives: Compared to in the general pregnant population, pregnancy in women with type 1 diabetes (T1D) is still associated with an increased number of perinatal complications affecting both the fetus and the mother. The Great Orchestra of Christmas Charity Foundation (GOCCF) program enables the use of continuous subcutaneous insulin infusion (CSII) enhanced by a hypo-stop function and real-time continuous glucose monitoring (rtCGM) during the preconception or early pregnancy period in patients with T1D. This observational study aimed to analyze the association between pregnancy planning and pregnancy outcomes in patients who qualified for the GOCCF program. Methods: Ninety-eight women with T1D, aged 21–41 years, who began using the CSII + rtCGM system at the planning/early pregnancy stage or at a later stage in the case of an unplanned pregnancy, were eligible for this study. We analyzed glucose control, the insulin requirements, the pregestational BMI, the maternal weight gain, the occurrence of preterm births, congenital malformations and the birthweight of newborns. Results: Women who planned their pregnancies had significantly better glycemic control before and throughout the entire pregnancy, and a significantly higher proportion of them achieved a TIR (time in range) > 70% (58.7% vs. 28.9%, p = 0.014) and TAR (time above range) < 25% (65.2% vs. 24.4%, p < 0.001). Their glucose variability at the end of the pregnancy was significantly lower (29.4 ± 5.5 vs. 31.9 ± 5.1, p = 0.030). They also gave birth later, at a mean of 37.8 ± 0.9 weeks compared to 36.9 ± 1.8 weeks in the non-planned group (p = 0.039). Preterm birth occurred in five women (10.4%) who planned their pregnancies and in fifteen women (30%) who did not, with p = 0.031. Conclusions: Pregnancy planning in women with type 1 diabetes (T1D) is associated with better glucose control before conception and throughout the entire pregnancy, resulting in better pregnancy outcomes. Full article

Addressing the challenges of bulky, low-efficiency sound-insulation materials at low frequencies, this work proposes an acoustic metamaterial based on curve fractal channels. Each unit cell comprises a concentric circular-ring channel recursively iterated: as the fractal order increases, the channel path length grows exponentially, enabling outstanding sound-insulation performance within a deep-subwavelength thickness. Finite-element and transfer-matrix analyses show that increasing the fractal order from one to three raises the number of bandgaps from three to five and expands total stop-band coverage from 17% to over 40% within a deep-subwavelength thickness. Four-microphone impedance-tube measurements on the third-order sample validate a peak transmission loss of 75 dB at 495 Hz, in excellent agreement with simulations. Compared to conventional zigzag and Hilbert-maze designs, this curve fractal architecture delivers enhanced low-frequency broadband insulation, structural lightweighting, and ease of fabrication, making it a promising solution for noise control in machine rooms, ducting systems, and traffic environments. The method proposed in this paper can be applied to noise reduction of transmission parts for ceramic automation production. Full article

This study investigates the propagation characteristics and field distribution of photonic crystals composed of epsilon-near-zero (ENZ) materials and metal cylinders. The research reveals that the cutoff frequency of the photonic crystal formed by combining metal cylinders with an ENZ background is independent of the volume fraction of the metal cylinders and exhibits a stop-band profile within the measured frequency range. This unique behavior is attributed to the scattering of long-wavelength light when the wavelength approaches the effective wavelength range of the ENZ material. Taking advantage of this feature, the study selectively filters specific wavelength ranges from the mid-frequency band by varying the ratio of cylinder radius to lattice constant (R/a). Decreasing the R/a ratio enables the design of waveguide devices that operate over a broader guided wavelength range within the intermediate-frequency band. The findings emphasize the importance of the interaction between light and ENZ materials in shaping the transmission characteristics of photonic crystal structures. Full article

This paper explores emotional analysis in Hebrew texts, focusing on improving machine learning techniques for depression detection by integrating psychological feature lexicons. Hebrew’s complex morphology makes emotional analysis challenging, and this study seeks to address that by combining traditional machine learning methods with sentiment lexicons. The dataset consists of over 350,000 posts from 25,000 users on the health-focused social network “Camoni” from 2010 to 2021. Various machine learning models—SVM, Random Forest, Logistic Regression, and Multi-Layer Perceptron—were used, alongside ensemble techniques like Bagging, Boosting, and Stacking. TF-IDF was applied for feature selection, with word and character n-grams, and pre-processing steps like punctuation removal, stop word elimination, and lemmatization were performed to handle Hebrew’s linguistic complexity. The models were enriched with sentiment lexicons curated by professional psychologists. The study demonstrates that integrating sentiment lexicons significantly improves classification accuracy. Specific lexicons—such as those for negative and positive emojis, hostile words, anxiety words, and no-trust words—were particularly effective in enhancing model performance. Our best model classified depression with an accuracy of 84.1%. These findings offer insights into depression detection, suggesting that practitioners in mental health and social work can improve their machine learning models for detecting depression in online discourse by incorporating emotion-based lexicons. The societal impact of this work lies in its potential to improve the detection of depression in online Hebrew discourse, offering more accurate and efficient methods for mental health interventions in online communities. Full article

Per- and polyfluoroalkyl substances (PFAS) are synthetically produced chemicals that are causing a major One Health crisis. These “forever chemicals” are widely distributed globally in air, water, and soil, and because they are highly mobile and extremely difficult to degrade in the environment. They cause additional health concerns in a circular bioeconomy and food system that recycles and reuses by-products and numerous types of waste materials. Uptake of PFAS by plants and food-producing animals ultimately leads to the consumption of PFAS-contaminated food that is associated with numerous adverse health and developmental effects in humans. Contaminated meat, milk, and eggs are some of the main sources of human PFAS exposure. Although there is no safe level of PFAS exposure, maximum tolerable PFAS consumption guidelines have been established for some countries. However, there is no international PFAS monitoring system, and there are no standardized international guidelines and mechanisms to prevent the consumption of PFAS-contaminated foods. Urgent action is needed to stop PFAS production except for critical uses, implementing effective water-purification treatments, preventing spreading sewage sludge on land and pastures used to produce food, and requiring marketers and manufacturers to use packaging that is free of PFAS. Full article

The common bed bug, Cimex lectularius L., is a pervasive pest of humans throughout the world. Insecticide resistance, cryptic habits, and proclivity for harborage on human belongings have contributed to its global status as a difficult pest to control. Leaves from common bean plants, Phaseolus vulgaris L., which include numerous trichomes, have traditionally been used to capture wandering bed bugs in southeastern Europe. However, fresh leaves rapidly desiccate once removed from plants, losing their trapping ability. A leaf-derived trapping material was developed that does not desiccate as rapidly as fresh leaves and retains the potential to trap bed bugs. In this study, we tested the efficacy of the leaf-derived material in capturing bed bugs. We tested the leaf-derived material in both horizontal and vertical orientations, using fresh bean leaves as positive controls. When deployed horizontally, the leaf-derived material captured bed bugs of all life stages and both sexes (adults). Leaf-derived material was also found to capture bed bugs in a vertical orientation (only evaluated for adult male bed bugs). Because this experimental leaf-derived material was effective in both horizontal and vertical orientations and against all life stages, it may have great potential for development into bed bug monitoring or exclusion devices. Full article

Purpose: Exercise is recommended for survivors of breast cancer to alleviate adverse reactions and reduce the psychological burden. In recent years, however, environmental factors (e.g., pandemics and climate change) have made it difficult to exercise outdoors. Therefore, this study focused on the COVID-19 pandemic in Japan and evaluated the relationship between changes in physical activity (PA) and mental and physical health in breast cancer survivors. Methods: A questionnaire survey was conducted among 345 outpatient female breast cancer survivors aged between 29 and 69 years. The questionnaire was based on the International Physical Activity Questionnaire, the Patient Health Questionnaire-9, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, and the Fear of COVID-19 Scale and included patient characteristics, changes in PA during pandemic restrictions, and needs for exercise support. The analysis categorized PA changes into two groups according to activity levels. The relationship between changes in PA and physical and mental health was evaluated using logistic regression analysis. Results: Patients with decreased PA accounted for 65.5% of the study population. Regardless of their activity level, these patients were aware of an increased susceptibility to COVID-19, showed a fear of the disease and a tendency for depression, and reported low life satisfaction and declined physical function. Of the patients who stopped exercising, 82.9% reported a decline in PA. Compared with those who had never exercised, those who stopped exercising saw their risk of depression increase by 15.6%. There was a high demand for personalized exercise support from healthcare professionals. Conclusions: Regardless of their activity level, decreasing PA during the pandemic decreased mental health and physical function in breast cancer survivors. There was a higher risk of depression among patients who stopped exercising. Because it is possible that similar situations may occur in the future, interventions by healthcare professionals must be considered in order to continue exercise. Full article

Optimizing passenger train line planning is a complex task that involves balancing operational costs and passenger service quality. This study investigates the adjustment and optimization of train line plans to better align with passenger demand and operational constraints, while minimizing systematic costs. These costs include train operation expenses (e.g., line usage fees and station service fees), passenger travel costs, and hidden costs such as imbalances in station stops. Line usage fees refer to charges for using railway tracks, whereas station service fees cover services provided at train stations. The optimization process employs a Simulated Annealing Algorithm to adjust train compositions, capacity configurations, and stop patterns to better match passenger demand. The results indicate a 13.89% reduction in the objective function value, reflecting improved overall efficiency. Notably, most costs are reduced, including train operating costs and passenger travel costs. However, ticketing service fees—which are calculated as a percentage of passenger fare revenue—increased slightly due to additional backtracking in passenger travel paths, which raised the total fare collected. Overall, the optimization improves the operational performance of the train network, enhancing both efficiency and service quality. Full article

The integration of autonomous vehicles (AVs) into urban transportation systems has significant potential to enhance traffic efficiency and reduce environmental impacts. This study evaluates the impact of different AV penetration scenarios (0%, 10%, 30%, 50%) on traffic performance and carbon emissions along Prince Mohammed bin Salman bin Abdulaziz Road in Riyadh, Saudi Arabia. Using microscopic simulation (SUMO) based on real-world datasets, we assess key performance indicators such as travel time, stop frequency, speed, and CO₂ emissions. Results indicate notable improvements with increasing AV deployment, including up to 25.5% reduced travel time and 14.6% lower emissions at 50% AV penetration. Coordinated AV behavior was approximated using adjusted simulation parameters and Python-based APIs, effectively modeling vehicle-to-vehicle (V2V), vehicle-to-infrastructure (V2I), and vehicle-to-network (V2N) communications. These findings highlight the benefits of harmonized AV–human vehicle interactions, providing a scalable and data-driven framework applicable to smart urban mobility planning. Full article

Light intensity and spectral quality play crucial roles in microalgal growth and biochemical biosynthesis. This study investigates the effects of different light intensities (3000, 8000 and 15,000 lux) and colors (red, white, yellow and green) on the growth and metabolites of Nephroselmis sp. Moderate intensity (8000 lux) of white light is sufficient to produce this microalga. The colors of light strongly affect the parameters of the growth of Nephroselmis under each light intensity (p < 0.05). The yellow and green light supported the highest growth rates for the three intensities. Blue and green light at 15,000 Lux stimulates high levels of chl-a corresponding to antenna size 2.80 and 2.46. Nephroselmis illuminated with red light synthesizes carotenoids reaching 13 µg mL⁻¹ at 15,000 lux. This latter for each color stops the proliferation of Nephroselmis, and cells shift their metabolism towards the accumulation of protein. Nephroselmis accumulates more protein, followed by carbohydrates, lipids and polyphenols. Nephroselmis exhibited the highest protein (64% D.W) content when cultured under white light, and the green at 15,000 lux enhanced their production. Nephroselmis is rich in carbohydrates, which accounted for more than 20% D.W under all combinations of light intensities and colors. The accumulation of polyphenols and carotenoids under high-intensity red and white light may reflect an oxidative stress response, suggesting their role as protective antioxidants. The capacity of Nephroselmis sp. to thrive and synthesize valuable metabolites under variable light regimes underscores its potential as a robust candidate for the production of various molecules. Full article

This study aimed to re-evaluate a historical war supply route within the context of cultural tourism, to revitalize its natural, historical, and cultural values, and to integrate it with existing hiking and trekking routes. Remote sensing (RS) and geographic information system (GIS) technologies were utilized, and land surveys were conducted to support the analysis and validate the existing data. Data for slope, one of the most critical factors for hiking route selection, were generated, and the optimal route between the starting and destination points was identified using least cost path analysis (LCPA). Historical, touristic, and recreational rest stops along the route were mapped with precise coordinates, and both the existing and the newly generated routes were assessed in terms of their accessibility to these points. Field validation was carried out based on the experiences of expert hikers. According to the results, the length of the existing hiking route was determined to be 15.72 km, while the newly developed trekking route measured 17.36 km. These two routes overlap for 7.75 km, with 9.78 km following separate paths in a round-trip scenario. It was concluded that the existing route is more suitable for hiking, whereas the newly developed route is better suited for trekking. Full article

The electrical ventricular storm (VES) is defined as multiple sustained ventricular arrhythmias arising in a short time, often refractory to standard antiarrhythmic treatment. The three pillars of the physiopathogenesis of the VES are autonomic dysfunction, triggers, and an altered ventricular substrate. Incessant or highly recurrent ventricular arrhythmia impacts the hemodynamic status by worsening heart failure and increasing mortality. A stepwise, team-based, and tailored therapeutic approach is required to stop ventricular arrhythmia and regain the hemodynamic and electric stability of the patient. The authors focused on describing all currently available therapeutic approaches for VES, intending to establish the best VES therapeutic approaches. This process involves considering the patient’s specific condition, responses to previous treatments, and the potential risks and benefits of each approach. The options range from adjusting antiarrhythmic therapy to reprogramming of the ICD, sedation, epidural anaesthesia, stellate ganglia anaesthetic block, and the use of ECMO or left ventricular assist devices and radiofrequency catheter ablation. Particular attention is paid to the detailed management of genetic primary arrhythmia syndromes like long-QT syndrome, catecholaminergic polymorphic ventricular tachycardia, Brugada syndrome and Wolff–Parkinson–White syndrome, early repolarisation syndrome, right ventricular arrhythmogenic dysplasia, and idiopathic ventricular fibrillation. After overcoming the acute events of VES and obtaining hemodynamic stability, the treatment should shift toward an optimal balance of heart failure therapy, controlling the substrate by revascularisation procedures and resolving other pathology-generating ventricular arrhythmias. This article provides a comprehensive overview of ESV’s current management options using the most efficient strategies known to date. Full article

Background/Objectives: Vedolizumab is a gut-selective anti-integrin monoclonal antibody approved for the treatment of inflammatory bowel disease (IBD). While clinical trials have demonstrated a favorable safety profile, real-world studies are essential for identifying rare adverse events (AEs) and evaluating post-marketing safety. This study assessed vedolizumab’s safety in a real-world cohort and supported the detection of potential safety signals. Methods: A retrospective chart review was conducted on adult IBD patients treated with vedolizumab at a tertiary center in the Republic of Serbia between October 2021 and August 2022. Data included demographics, AEs, and newly reported extraintestinal manifestations (EIMs). Exposure-adjusted incidence rates were calculated per 100 patient-years (PYs). Disproportionality analysis using the FDA Adverse Event Reporting System (FAERS) was performed to identify safety signals, employing reporting odds ratios (RORs) and proportional reporting ratios (PRRs) for AEs also observed in the cohort. Prior IBD therapies and reasons for discontinuation were evaluated. Results: A total of 107 patients (42.1% Crohn’s disease, 57.9% ulcerative colitis) were included, with a median vedolizumab exposure of 605 days. There were 92 AEs (56.51/100 PYs), most frequently infections (23.95/100 PYs), gastrointestinal disorders (4.30/100 PYs), and skin disorders (4.30/100 PYs). The most frequently reported preferred terms (PTs) included COVID-19, COVID-19 pneumonia, nephrolithiasis, and nasopharyngitis. Arthralgia (12.90/100 PYs) was the most frequent newly reported EIM. No discontinuations due to vedolizumab AEs occurred. FAERS analysis revealed potential signals for events not listed in prescribing information but observed in the cohort: nephrolithiasis, abdominal pain, diarrhea, malaise, cholangitis, gastrointestinal infection, blood pressure decreased, weight decreased, female genital tract fistula, respiratory symptom, and appendicectomy. Most patients had received three prior therapies, often stopping one due to AEs. Conclusions: Vedolizumab demonstrated a favorable safety profile in the IBD cohort. However, FAERS-identified signals, such as nephrolithiasis, gastrointestinal infections, and decreased blood pressure, warrant further investigation in larger, more diverse populations. Full article

The environmental detriments of the growing global production and overconsumption of beef, including greenhouse gas emissions, deforestation, and biodiversity loss, are well-documented. However, public awareness of how dietary choices affect the environment remains limited. This study examines sustainability views on beef consumption and the potential for behavioral change as a step toward more sustainable intake levels. An observational web-based survey was conducted (n = 1367) to assess respondents’ current beef intake frequency, views on beef consumption related to planetary health, tropical deforestation, greenhouse gas emissions, and climate change, and willingness to modify beef consumption behavior. Chi-square tests were used for group comparisons, and weighted average scores were applied to rank levels of resistance to reducing beef intake. Environmental concern related to beef consumption was associated with greater beef cutback intentions and lower long-term intake reduction resistance amongst beef eaters. Beef eaters who strongly agreed that global beef consumption negatively impacts the environment were considerably more likely to express intentions to reduce their long-term beef intake compared to those who strongly disagreed (94.4% vs. 19.6%). Overall, 76.6% of beef eaters indicated wanting to eat less beef or phase it out entirely (30.7% reduce, 29.4% minimize, 16.6% stop), with only 23.4% of them intending to keep their consumption unchanged. Compelling messages that help translate awareness into action, such as the #NoBeefWeek concept explored in this study, may support individuals in adopting more sustainable food choices. These cross-national findings provide evidence for a ‘knowledge–intent’ gap in sustainable diet research, with relevance for health communicators and policymakers. Future research could examine the factors and motivations influencing decisions to modify beef consumption, including the barriers to achieving sustainable consumption levels and the role of suitable alternatives in facilitating this transition. Full article