Search Results (542)

Background/Objectives: Electroencephalography (EEG) is increasingly used in pediatric anesthesia to detect abnormal brain activity such as burst suppression (BS), a marker of profound cortical inactivation. The objective of this study was to assess anesthetic depth using bilateral spectral edge frequency (SEF) and to determine the incidence of frontal cortical BS in young children undergoing cardiac surgery with extracorporeal circulation (ECC) under sevoflurane anesthesia. Methods: Twelve children, divided into two age groups (<12 months and 12–36 months), were included. EEG sensors were placed on the forehead and continuously monitored with SedLine^®. BS and SEF were analyzed using linear mixed-effects models, accounting for age group and repeated measurements across the procedure. Results: BS did not differ significantly over time. Across the full surgical procedure, higher SEF was associated with lower BS. However, children <12 months exhibited a stronger SEF–BS relationship, suggesting greater susceptibility to BS compared to older children. Before and during ECC, SEF and age group were not significantly related to BS. Random effects indicated moderate to substantial between-subject variability. Scatterplots showed a negative SEF–BS relationship overall, but weak and inconsistent associations during specific perioperative phases, underscoring the phase-dependent nature of SEF–BS dynamics. Conclusions: SEF is an age-sensitive marker of anesthetic depth during sevoflurane anesthesia with ECC, with children <12 months showing greater susceptibility to BS. These findings highlight the importance of individualized, age-adjusted anesthesia monitoring strategies in pediatric cardiac surgery. Full article

Phosphorus (P) is essential to life yet constrained by finite reserves, heterogeneous distribution, and strong chemical binding to soil minerals. Pedogenesis progressively alters the availability of P: in ‘young’ soils, P associated with Ca and Mg is relatively labile, while in ‘old’ soils, acidification and leaching deplete base cations, shifting P into organic matter and recalcitrant Al- and Fe-bound pools. Podzolized soils (Spodosols) provide a unique lens for studying this transition because podzolization vertically segregates these dynamics into distinct horizons. Organic cycling dominates the surface horizon, while downward translocation of Al, Fe, and humus creates a spodic horizon that immobilizes P through sorption and co-precipitation in amorphous organometal complexes. This spatial separation establishes two contrasting P pools—biologically dynamic surface P and mineral-stabilized deep P—that may be variably accessible to plants and microbes depending on depth, chemistry, and hydrology. We synthesize mechanisms of spodic P retention and liberation, including redox oscillations, ligand exchange, root exudation, and physical disturbance, and contrast these with strictly mineral-driven or biologically dominated systems. We further propose that podzols serve as natural experimental models for ecosystem aging, allowing researchers to explore how P cycling reorganizes as soils develop, how vertical stratification structures biotic strategies for nutrient acquisition, and how deep legacy P pools may be remobilized under environmental change. By framing podzols as a spatial analogue of long-term weathering, this paper identifies them as critical systems for advancing our understanding of nutrient limitation, biogeochemical cycling, and sustainable management of P in diverse ecosystems. Full article

Introduction: Ambiguous loss is a profound yet underexplored phenomenon in the lives of aging migrants. Older adults who have experienced migration often face disruptions to their sense of belonging, identity, and continuity across borders. These losses are compounded by aging, health challenges, and social isolation. Despite its significance, ambiguous loss among aging migrants has not been conceptually analyzed in depth, limiting the development of culturally responsive care practices. Aim: This concept analysis aimed to identify the defining attributes of ambiguous loss among aging migrants and to develop a conceptual definition that enhances our understanding of the phenomenon and informs future research and practice. Method: Walker and Avant’s eight-step concept analysis framework was applied to examine the concept of ambiguous loss in the context of aging migrants. A systematic keyword search was conducted across four databases (CINAHL, Medline, SCOPUS, PsycINFO), Google Scholar, and relevant gray literature, covering the years of 2010–2024. Covidence software supported the screening process. From 367 records identified, 146 underwent full-text review, and 74 met inclusion criteria. The analysis drew on literature synthesis, case exemplars, antecedents, consequences, and empirical referents. This review followed PRISMA (2020) reporting guidelines. Results: Four defining attributes of ambiguous loss among aging migrants were identified: (a) physical, social, and emotional loss; (b) displacement and loss of homeland; (c) erosion of social identity and agency; and (d) cultural and transnational bereavement. A conceptual definition emerged, describing ambiguous loss as a multifaceted experience of disconnection, intensified by aging, illness, economic hardship, and social isolation. The analysis also highlighted antecedents such as forced migration and health decline, as well as consequences including diminished well-being, resilience challenges, and barriers to integration. Conclusions: Ambiguous loss among aging migrants is a complex construct encompassing intertwined physical, social, and cultural dimensions of loss. This conceptual clarity provides a foundation for developing culturally responsive care models that promote adaptation, resilience, and social inclusion among older migrants. Full article

The Carpathian Basin holds exceptional significance for Quaternary research, particularly in loess studies. In this study, we attempted to create age-depth models based on age data from scientific journals to investigate accumulation rates. We examined eleven open profile sections for loess and paleosol, including seven in Hungary, two in Croatia, and two in Serbia. We demonstrated that radiocarbon age data are much more useful and reliable than OSL/IRSL data for this type of investigation. The results indicate that the Pécel, Dunaszekcső, Madaras and Katymár sections exhibit accumulation rates an order of magnitude higher than the other sections, exceeding one millimeter per year. These findings suggest that, owing to the basin’s geographic position, these areas were consistently exposed to dust deposition, irrespective of changes in climate or wind direction. A secondary accumulation maximum was also detected along the Katymár–Surduk axis, indicating an additional phase of intensified sediment deposition within this transect. The absence of a young sediment maximum in the Máza section is interpreted as resulting from a shift in prevailing wind direction, which caused the incoming dust to be intercepted by the Mecsek Mountains. Full article

Annuity insurance is a crucial financial tool for mitigating risks associated with aging, yet it has not gained significant traction in China’s insurance market, especially amid the challenges posed by an aging population. This study develops a discrete-time multi-period life-cycle model to analyze optimal annuity purchases for China’s middle-aged population under disability risk and explores in depth the impact and underlying mechanisms of disability risk on their annuity insurance purchase decisions. Disability is endogenized via two channels: financial-constraint effects (medical costs and pre-retirement income loss) and stochastic health state transitions with recovery and mortality. Using data from China Health and Retirement Longitudinal Study (2018–2020) to estimate age- and gender-specific transition matrices and data from China Household Finance Survey (2019) to link income with initial assets, we solve the model by the endogenous grid method and simulate actuarially fair annuities. The findings reveal substantial under-demand for annuities among China’s middle-aged population. Under inflation, the modest yield premium of annuities over inflation significantly depresses purchases by middle- and low-wealth households, while high-wealth individuals are jointly constrained by rapidly rising health expenditures and inadequate annuity returns. Notably, behavioral patterns could shift fundamentally under a hypothetical zero-inflation scenario. Full article

Background/Objectives: General anesthesia is occasionally required for cesarean delivery (CD). Propofol target-controlled infusion (TCI) enables dosing based on pharmacokinetic modeling. During the transition from induction to maintenance, infusion pauses. This simulation study assessed propofol from induction to delivery and the proportion of deliveries estimated during this pause. Methods: Surgical data from women undergoing CD were compiled, and the demographics were entered into a TCI pump using the Schnider model. Effect-site targets (6 and 8 mcg/mL) were simulated for induction, followed by 2.5 mcg/mL for maintenance. Outcomes were estimated propofol dose from induction to delivery and timing of delivery relative to infusion pause. Results: Among 50 women, the estimated mean propofol dose from induction to delivery was 19 ± 22 mg (0.2 ± 0.3 mg/kg) at 6 mcg/mL and 13 ± 17 mg (0.2 ± 0.2 mg/kg) at 8 mcg/mL. Delivery occurred during the infusion pause in 40% and 50% of cases, and it was more often in emergency than elective procedures. Emergency status, but not age or body mass index, predicted delivery during the pause. Conclusions: Standardized TCI with reduced effect-site targets for maintenance resulted in modest propofol administration between induction and delivery. These findings require confirmation in clinical studies, where dosing should be guided by depth-of-anesthesia monitoring. Full article

Background: currently, there is a growing trend toward multifunctional cosmetics, which combine several active ingredients in a single product to enhance efficacy and user convenience. As ingredients may influence one another, it is important to study the behavior of mixing multiple compounds in complex formulations, especially regarding their interaction with the skin. Piceatannol, for instance, is a naturally occurring stilbene recognized for its in vitro potent antioxidant, anti-inflammatory, and anti-aging activities, making it a promising candidate for dermocosmetic use in suncare. But despite its beneficial biological activities, its cutaneous permeation remains poorly understood, particularly when delivered from complex formulations containing multiple ingredients. Objectives: in this sense, this study aimed to evaluate the in vitro skin diffusion profile of piceatannol from a passion fruit seed extract (P_ext) incorporated into a topical base (B_em) or an organic sunscreen emulsion (O_em), with or without a spilanthol-rich Acmella oleracea extract (J_ext) used as a natural permeation enhancer. Methods: due to ethical and variability issues with human and animal skins, the Strat-M™ synthetic membrane was chosen as a standardized model for the in vitro skin permeation assays. Piceatannol localization within membrane layers was examined by confocal Raman microscopy (CRM), while compound identification in donor and receptor compartments was performed via UHPLC-DAD. Results: piceatannol from B_em was detected up to 140 µm from the Strat-M™ surface and exceeded 180 µm in depth when J_ext and organic sunscreens were included in the formulation. Notably, formulations containing J_ext and those based on O_em promoted enhanced accumulation in both the stratum corneum and deeper skin layers, suggesting an improved delivery potential in lipid-rich vehicles. Conclusions: even though some instability issues were observed, piceatannol penetration into Strat-M™ from the proposed formulations was confirmed, and the results provide a foundation for further research on its topical delivery, supporting the rational development of formulations capable of harnessing its demonstrated biological properties. Full article

Rapid urbanization and frequent extreme events have made urban flooding a growing threat to residents. This issue is acute in old urban districts, where extremely limited land resources, outdated standards and poor infrastructure have led to inadequate drainage and uneven pipe settlement, heightening flood risk. This study applies InfoWorks ICM Ultimate (version 21.0.284) to simulate flooding in a typical old urban district for six return periods. A risk assessment was carried out, flood causes were analyzed, and mitigation strategies were evaluated to reduce inundation and cost. Results show that all combined schemes outperform single-measure solutions. Among them, the green roof combined with pipe optimization scheme eliminated high-risk and medium-risk areas, while reducing low-risk areas by over 78.23%. It also lowered the ponding depth at key waterlogging points by 70%, significantly improving the flood risk profile. The permeable pavement combined with pipe optimization scheme achieved similar results, reducing low-risk areas by 77.42% and completely eliminating ponding at key locations, although at a 50.8% higher cost. This study underscores the unique contribution of cost-considered gray-green infrastructure retrofitting in old urban areas characterized by land scarcity and aging pipeline networks. It provides a quantitative basis and optimization strategies for refined modeling and multi-strategy management of urban waterlogging in such regions, offering valuable references for other cities facing similar challenges. The findings hold significant implications for urban flood control planning and hydrological research, serving as an important resource for urban planners engaged in flood risk management and researchers in urban hydrology and stormwater management. Full article

This study explores the evolving role of architecture centers in the digital age by analyzing the case of Casa da Arquitectura (CdA) in Matosinhos, Portugal, a hybrid institution that functions as both archive and museum. Positioned within the broader context of museum digitization and liminality theory, the research investigates how CdA navigates the spatial, social, and procedural shifts inherent in digital transformation. Drawing on qualitative methods, including in-depth interviews with key personnel and on-site observations, the study examines the institution’s strategies in acquisition, curation, and exhibition design. The findings highlight CdA’s innovative approach to archival visibility, the creation of a multipurpose digital platform (“edifício digital”), and the integration of archival acquisitions with exhibition practices. These practices illustrate a condition of triple liminality of the digital museum concerning its process, position, and place. The study also discusses how digitization reconfigures the museum’s organizational model in terms of accessibility and curatorial complexity. By analyzing CdA’s operational and curatorial choices, the paper discusses how digital museums can act as speculative, process-oriented spaces that challenge traditional boundaries between archive and exhibition, physical and virtual, institutional and public. Full article

Modern healthcare systems are under growing strain from aging populations, urbanization, and rising chronic disease burdens, creating an urgent need for real-time monitoring and informed decision-making. This survey examines how the convergence of Integrated Sensing and Communication (ISAC) and digital-twin technologies can meet that need by analyzing how ISAC unifies sensing and communication to gather and transmit data with high timeliness and reliability and how digital-twin platforms use these streams to maintain continuously updated virtual replicas of patients, devices, and care environments. Our synthesis compares ISAC frequency options across sub-6 GHz, millimeter-wave, and terahertz bandswith respect to resolution, penetration depth, exposure compliance, maturity, and cost, and it discusses joint waveform design and emerging 6G architectures. It also presents reference architecture patterns that connect heterogeneous clinical sensors to ISAC links, data ingestion, semantic interoperability pipelines using Fast Healthcare Interoperability Resources (FHIR) and IEEE 11073, and digital-twin synchronization, and it catalogs clinical and operational applications, together with validation and integration requirements. We conduct a targeted scoping review of peer-reviewed literature indexed in major scholarly databases between January 2015 and July 2025, with inclusion restricted to English-language, peer-reviewed studies already cited by this survey, and we apply a transparent screening and data extraction procedure to support reproducibility. The survey further reviews clinical opportunities enabled by data-synchronized twins, including personalized therapy planning, proactive early-warning systems, and virtual intervention testing, while outlining the technical, clinical, and organizational hurdles that must be addressed. Finally, we examine workflow adaptation; governance and ethics; provider training; and outcome measurement frameworks such as length of stay, complication rates, and patient satisfaction, and we conclude that by highlighting both the integration challenges and the operational upside, this survey offers a foundation for the development of safe, ethical, and scalable data-driven healthcare models. Full article

Background/Objectives: As global aging accelerates, there is a pressing and empirically substantiated demand for integrated and sustainable strategies, as evidenced by the rising prevalence rates of chronic conditions, social isolation, and digital exclusion among older adults worldwide. These factors underscore the urgent need for multidimensional interventions that simultaneously target physical, psychological, and social well-being. The HOPE-FIT (Hybrid Outreach Program for Exercise and Follow-up Integrated Training) model and the SAGE (Senior Active Guided Exercise) program were designed to address this need through a hybrid framework. These programs foster inclusive aging by explicitly bridging digitally underserved groups and mobility-restricted populations into mainstream health promotion systems through tailored exercise, psychosocial support, and smart-home technologies, thereby functioning as a scalable meta-model across healthcare, community, and policy domains. Methods: HOPE-FIT was developed through a formative, multi-phase process grounded in the RE-AIM framework and a Hybrid Type II effectiveness–implementation design. The program combines professional health coaching, home-based and digital exercise routines, Acceptance and Commitment Performance Training (ACPT)-based psychological strategies, and smart-home monitoring technologies. Empirical data from pilot studies, large-scale surveys (N = 1000), and in-depth user evaluations were incorporated to strengthen validity and contextual adaptation. Culturally tailored content and participatory feedback from older adults further informed ecological validity and program refinement. Implementation Strategy/Framework: The theoretical foundation integrates implementation science with behavioral and digital health. The RE-AIM framework guided reach, fidelity, and maintenance planning, while the Hybrid E–I design enabled the concurrent evaluation of effectiveness outcomes and contextual implementation strategies. Institutional partnerships with community centers, public health organizations, and welfare agencies further facilitated the translation of the model into real-world aging contexts. Dissemination Plan: The multi-pronged dissemination strategy includes international symposia, interdisciplinary academic networks, policy briefs, localized community deployment, and secure, authenticated data sharing for reproducibility. This design facilitates evidence-informed policy, empowers practitioners, and advances digital health equity. Ultimately, HOPE-FIT constitutes a scalable and inclusive model that concretely addresses health disparities and promotes active, dignified aging across systems and disciplines. Full article

Background: Periodontitis is linked to a range of systemic non-communicable diseases, including hepatic diseases. The aim of this study was to investigate whether periodontal health status is associated with liver cirrhosis (LC). Methods: Patients were recruited from the Department of Internal Medicine at the University Clinical Hospital “Sestre Milosrdnice” and categorized into two groups. The case group comprised patients with LC, while age-matched individuals without LC served as controls. Systemic health status was evaluated through laboratory tests, medical history, and clinical parameters, and the Model for End-Stage Liver Disease (MELD) score was calculated for each participant. A comprehensive clinical periodontal assessment was conducted, measuring bleeding on probing (BoP), probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), and the Periodontal Inflamed Surface Area (PISA) score. Stepwise logistic regression was employed to assess possible predictors of LC, including periodontal status. Results: A total of 100 patients were included in the analysis, consisting of 50 cases with LC and 50 controls. The mean age was 56.79 years (SD = 11.16) of participants, and 58% were male. The majority of LC cases were attributed to alcohol abuse (41/50, 82%), and the median MELD score was 16 (IQR 6–33). Comparison of the two groups revealed significantly worse clinical periodontal parameters in the LC group and a higher prevalence of periodontitis (p = 0.012). Among the 50 LC patients, 46 (92%) exhibited severe forms of periodontitis (stages III and IV). Logistic regression analysis identified alcohol consumption and the PISA score as independent predictors of LC (OR = 23.81, 95% CI 4.48–126.47, p < 0.001; OR = 1.006, 95% CI 1.003–1.01, p < 0.001, respectively). Conclusions: Within the limits of the present study, the higher prevalence of periodontal disease in the LC group suggests an association between LC and periodontitis. Full article

The growing frequency of extreme rainstorms has increasingly exposed tunnels to flooding risks, underscoring the urgent need for effective flood prevention and drainage measures. In this context, an evaluation framework for tunnel flood hazards was developed based on three criteria—hazard-inducing factors, hazard-formative environment, and disaster-bearing body—encompassing nine specific indicators. This study employs the Decision Making Trial and Evaluation Laboratory (DEMATEL) method to construct a causal analysis model and assess the interrelationships and influence levels of risk factors associated with tunnel flooding disasters. Rainfall intensity (C1), rainfall duration (C2), ground elevation (C4), road slope (C5), and impervious surface area (C6) exhibit high causal values, acting as external input factors that drive the occurrence of tunnel flooding incidents. Conversely, water depth (C3), tunnel drainage capacity (C7), emergency flood control measures (C8), and infrastructure aging (C9) display high centrality values, serving as internal factors that reflect the tunnel’s flood prevention capability and determine the extent of disaster losses. Simply enhancing tunnel drainage capacity from the perspective of internal factors alone is insufficient; optimizing the tunnel’s flood resilience requires a combined consideration of both internal and external factors. Full article

The basal forebrain (BF)-hippocampus (HPC) circuit is indispensable for learning and memory, and in vitro models are essential for dissecting its age-related decline. Nonetheless, current culture methods endure brief survival or confine cells to two dimensions, leaving the circuit’s progressive degeneration refractory to long-term investigation. Here, we developed a simple, three-dimensional (3D) compartmentalized co-culture model that mimics the anatomical organization of BF and HPC neurons. Results demonstrate that basal forebrain cholinergic neurons (BFCNs) co-cultured with primary HPC neurons remain viable for more than two months without exogenous growth factors, significantly promoting BFCNs growth, polarity development, and functional maturation. In this system, BFCNs somata were confined within the hydrogel, whereas cholinergic axons extended toward adjacent hippocampal area, reaching 1681.9 ± 351.8 μm by week 5—significantly longer than in BFCNs monocultures. This model can successfully recapitulate age-dependent progressive neuronal degeneration during long-term culture, validating this long-term co-culture as a platform for studying circuit aging and degeneration. Therefore, this low-cost and highly physiological platform provides a new avenue for in-depth investigations into the mechanisms of neurodegenerative diseases. Full article

The geriatric syndrome known as frailty is characterized by diminished physiological reserves and heightened susceptibility to unfavorable health consequences. As the world’s population ages, it is crucial to detect frailty early and accurately in order to reduce hazards, including falls, hospitalization, and death. In particular, functional tests are frequently used to evaluate physical frailty. However, current evaluation techniques are limited in their scalability and are prone to inconsistency due to their heavy reliance on subjective interpretation and manual observation. In this paper, we provide a completely automated, impartial, and comprehensive frailty assessment system that employs computer vision techniques for assessing physical frailty tests. Machine learning models have been specifically designed to analyze each clinical test. In order to extract significant features, our system analyzes the depth and joint coordinate data for important physical performance tests such as the Walking Speed Test, Timed Up and Go (TUG) Test, Functional Reach Test, Seated Forward Bend Test, Standing on One Leg Test, and Grip Strength Test. The proposed system offers a comprehensive system with consistent measurements, intelligent decision-making, and real-time feedback, in contrast to current systems, which lack real-time analysis and standardization. Strong model accuracy and conformity to clinical benchmarks are demonstrated by the experimental outcomes. The proposed system can be considered a scalable and useful tool for frailty screening in clinical and distant care settings by eliminating observer dependency and improving accessibility. Full article