Search Results (1,119)

Introduction/Objective: Patient satisfaction with nursing care quality is an important patient-reported indicator of hospitalization experience. Previous studies have mainly examined sociodemographic, clinical, and organizational factors, while personality traits have rarely been included in explanatory models. This study examined the association of sociodemographic characteristics, hospitalization-related variables, and personality traits with patient satisfaction. Methods: A single-center cross-sectional study was conducted among hospitalized patients in a general hospital in Croatia. Data were collected at discharge using a demographic and hospitalization questionnaire, the NEO Five-Factor Inventory, and the Croatian version of the Patient Satisfaction with Nursing Care Quality Questionnaire. Group differences were analyzed using non-parametric tests, and hierarchical regression analysis was performed. Results: Younger age, employment, male gender, and better self-rated health were associated with higher satisfaction. Patients admitted on a scheduled basis and those staying alone or with one other person in the room were more satisfied. Sociodemographic variables explained 21.5% of the variance in satisfaction (R² = 0.215; adjusted R² = 0.168). After hospitalization-related variables were added, the explained variance increased to 30.1% (R² = 0.301; adjusted R² = 0.232). The addition of personality traits further increased the explained variance to 45.6% (R² = 0.456; adjusted R² = 0.385). In the final model, staying with two or more persons was negatively associated with satisfaction, whereas agreeableness and conscientiousness were positively associated with satisfaction. Conclusions: Patient satisfaction with nursing care quality was associated with patient characteristics, hospitalization conditions, and personality traits. Accommodation conditions and individual psychological differences should be considered when interpreting satisfaction as an indicator of nursing care quality. Full article

As the aviation industry explores sustainable solutions for next-generation aircraft, the strut-braced wing (SBW) concept has emerged as a promising configuration, combining the enhanced aerodynamic efficiency of high-aspect-ratio (HAR) wings with a significant reduction in wing structural weight compared to conventional cantilever designs. Given the inherent aerodynamics and structural complexities of SBW concepts, developing innovative design methodologies is essential for fully investigating their potential. This work presents a low-fidelity, two-fold design methodology combining an overall aircraft design framework with finite element structural analysis. The approach enables overall aircraft design (OAD) sizing, exploration, and optimization of regional strut-braced wing configurations and assessing the effects of strut connections and jury on the wing’s static and buckling behavior. Trade-off and optimization studies based on the reference ATR-72 aircraft led to an optimal SBW configuration with an aspect ratio of 17.64 and a strut position ratio of 0.543, achieving reductions of about 24% in wing weight and 6.78% in fuel burn. The structural analysis of the optimized SBW indicates that a clamped–clamped strut connection provides superior buckling performance, and incorporating a jury strut effectively mitigates buckling issues while achieving approximately 20% wing weight reduction compared to the configuration without a jury. Full article

The seismic retrofit of existing reinforced concrete (RC) buildings equipped with dissipative bracing systems requires not only a global performance-based assessment, but also a rigorous verification of the local behavior of critical structural connections. In this context, the present study focuses on the numerical seismic performance of a beam–column connection extracted from a retrofitted RC hospital building located in Italy. The investigated joint represents a central node where two orthogonal steel bracing systems converge and transfer seismic forces to an RC column strengthened with heavy steel jacketing and anchorage devices. A detailed three-dimensional finite element model of the connection is developed using solid elements for concrete and steel components, explicit modeling of reinforcement bars, bolts, and anchor rods, and advanced nonlinear constitutive laws for both materials. Two modeling strategies are considered, including the explicit simulation of contact interfaces between steel components, in order to capture local stress redistribution and potential interaction effects. The connection is subject to seismic demand derived from the global structural analysis, corresponding to different values of the behavior factor, thus ensuring consistency between global design assumptions and local verification. The results highlight the progressive activation of nonlinear mechanisms within the steel components, the development of cracking and compression damage in the concrete core, and the preservation of a clear hierarchy of resistances under design-level seismic actions. The numerical outcomes allow a critical discussion on the role of local connection behavior in supporting the global dissipative strategy and provide quantitative insights into the evaluation of the behavior factor from a local-response perspective. The study emphasizes the importance of detailed connection-level analyses in the seismic retrofit of strategic facilities and supports a more consistent integration between global performance objectives and local structural design. Full article

This study evaluated the effects of abiotic factors and extraction conditions on the yield, chemical composition, and antimicrobial activity of essential oil (EO) from Pistacia lentiscus L. leaves collected at four Adriatic locations during three phenological stages. Steam distillation was performed at 0.3, 0.7, and 1 bar. EO yield increased significantly with pressure, reaching a maximum at 1 bar, while the flowering stage provided the highest yields overall. Leaves from Vela Luka produced the highest EO yield, whereas Pag samples yielded the least. GC–MS analysis identified 56 components, accounting for 99.19–99.99% of total EO, with α-pinene, limonene, myrcene, and β-pinene as the dominant constituents, confirming a monoterpene-rich chemotype. All EO samples showed low but measurable inhibitory activity against Escherichia coli AB1157 and Erwinia amylovora EaED, as assessed by the disk diffusion method. Pearson correlation and PCA analyses indicated a positive association between monoterpene content and inhibition zone diameter against E. coli, and a positive association between monoterpene alcohol content and inhibition against E. amylovora. As antimicrobial activity was assessed exclusively by the disk diffusion method, the present findings may serve as an indicative basis for future investigations into the relationship between EO chemical composition and antimicrobial potential, and they require validation through quantitative, standardized antimicrobial testing. Full article

Traditional rolling stock dynamics studies often rely on simplified 2D models, limiting stability predictions for innovative designs at high speeds. This work proposes a refined spatial multi-mass mathematical model that accounts for nonlinear interrelationships and the superposition of deterministic and random disturbances. This approach enables a detailed reproduction of components with variable stiffness and diagonal connections, identifying critical dependencies inaccessible to standard analytical methods. The model describes spatial vibrations using linear differential equations, considering vertical and horizontal perturbations to simulate real-world operational conditions. To ensure accuracy, the simulation results were validated against field test data, showing high correspondence in force levels and displacements. The study optimizes spring suspension parameters for speeds of 40–140 km/h. Key findings include: Relative friction coefficients (${\phi }_0$) should be adjusted: reduced to 6% for new bogie designs, but increased to 12% for model 18-9996 equipped with diagonal braces. Dynamic stability improves significantly with increased horizontal coupling stiffness. This is achieved through the integration of diagonal braces with side frames and the use of elastic-roller side bearers. This methodology provides a robust framework for evaluating the stability and performance of innovative railway vehicle designs. Full article

Background/Aim: This study aims to assess the prevalence of self-reported oral ulcers and their associated factors among patients with type 2 diabetes mellitus (T2DM) in Bangladesh. Materials and Methods: A hospital-based cross-sectional study was conducted among 260 patients with T2DM attending outpatient dental services at three tertiary hospitals in Dhaka. Data were collected using a semi-structured questionnaire covering sociodemographic characteristics, behavioral and dietary factors, medical history, and self-reported oral mucosal conditions. Associations between oral ulcers and potential risk factors were analyzed using Chi-square and Fisher’s exact tests. Results: Most participants were middle-aged (50–59 years), female, of low educational status and married, with a high prevalence of regular tooth-brushing but low use of oral hygiene aids such as mouthwash. Traumatic ulcers (21.5%) and oral lichen planus (19.6%) were the most frequently observed oral mucosal lesions followed by recurrent aphthous ulcers, oral lichenoid reactions, and oral candidiasis. Traumatic ulcers and oral lichenoid reactions showed associations with sharp teeth, dentures or braces, and amalgam restorations, while lichen planus and aphthous ulcers were significantly associated with smoking, systemic conditions such as hypertension, and coexisting oral lesions such as oral candidiasis. Multivariable logistic regression showed that sharp teeth, denture or brace use, amalgam restorations, and tobacco-related habits were associated with oral lesions. Conclusions: Oral ulcers and related mucosal lesions were found to be common among patients with T2DM in Bangladesh, with traumatic ulcers being most frequent and several local and behavioral factors showing significant associations. Full article

Gate hoist structures are safety-critical appurtenant systems in hydropower projects, yet their seismic behavior has received far less attention than that of dam bodies. This study investigates the seismic performance of a gate hoist structure in a roller-compacted concrete gravity dam using a three-dimensional finite element model of the foundation–dam–gate hoist structure system. Linear-elastic time-history analyses are performed for both unreinforced and brace-reinforced configurations under the design earthquake. Seismic performance is evaluated using principal stress, the point safety factor, the section safety factor, and demand-to-capacity ratio (DCR). The results show that tensile stress is concentrated mainly at beam–column joints in the unreinforced structure, where the maximum principal stress exceeds the concrete tensile strength and local cracking may occur. Brace reinforcement reduces the peak tensile stress and improves the safety level at critical locations, while vulnerable regions may shift to the beam–brace joints rather than being completely eliminated. These findings indicate that the seismic safety of gate hoist structures is better assessed within an integrated dam–structure system, while multi-index evaluation provides a more comprehensive basis for identifying vulnerable regions and assessing reinforcement effectiveness. Full article

Many people suffer from cervical disc herniation, which significantly affects the lives of individuals, causing chronic pain and functional limitations. This paper presents the development and evaluation of an AI-powered inflatable neck collar designed to provide personalized and adaptive support for individuals experiencing neck pain, particularly those with disc herniations. The system seamlessly integrates motion sensors, a robust AI model trained on a dataset of MRI scans, and a custom-designed inflatable collar. The AI model accurately detects disc herniations and segments vertebral structures, enabling real-time, targeted inflation adjustments based on the user’s unique anatomy, posture, and movements. A user-centered design approach ensures a seamless and intuitive user experience, allowing for personalized profile management, control over inflation levels, and data logging for tracking progress. Extensive simulations using 3D models and real-time data flow systems validated the effectiveness of the AI-guided system. Results demonstrated accurate detection and segmentation of disc herniations, robust real-time response, and adaptability to user needs. The proposed system, reviewed and validated by a neurosurgeon, demonstrates significant potential as a novel and effective solution for personalized treatment of neck pain, particularly in cases of disc herniation. Further development and research will focus on expanding the dataset to improve fairness and accuracy for diverse demographics and increasing the robustness and generalizability of the system. Full article

Concrete building systems require decisions at both the member and the building level, because locally efficient cross sections do not necessarily lead to a favorable whole-building response. This study presents a two-level comparative framework comprising (i) a member-level parametric assessment of nine reinforced-concrete and composite cross-section families across six concrete grades (54 scenarios) and (ii) a building-level ETABS assessment of seven structural configurations (Models A–G) derived from a residential reinforced-concrete frame benchmark. At the member level, the alternatives were evaluated based on axial resistance, along with simplified screening-level CO₂ and cost proxies. At the member level, axial resistance increased with concrete grade, although the marginal benefit diminished at higher grades for steel-dominant layouts. Balanced composite sections showed the most favorable normalized strength-to-material-proxy trends, whereas steel-heavy alternatives provided high absolute resistance but lower overall efficiency. The comparison between the member-level hybrid-section screening and the building-level composite configuration further showed that promising local section behavior does not automatically translate into superior whole-building performance. At the building level, the compared configurations were assessed through vertical base reactions, modal properties, and top-level lateral displacement response. Replacing solid beams and columns with hollow members of identical outer dimensions reduced the self-weight-related base reaction from 9591 to 8832 kN (7.9%) but slightly increased the top-level displacement response, indicating a mass–stiffness trade-off. Larger improvements were obtained when the global lateral-force-resisting mechanism was modified directly: the braced configuration produced the shortest fundamental period ($T_1=0.433$ s) and the lowest displacement response, while the core-wall configuration also reduced both period and displacement substantially. By contrast, the height-extended configuration produced the most flexible response among Models A–F. An additional exploratory variant with semi-rigid beam-to-column connections (Model G) confirmed that connection-level flexibility produces a measurable but moderate increase in period and displacement relative to the reference frame, without altering the global load-resisting mechanism. Overall, the results confirm that member-level and building-level assessments should be treated as complementary decision levels in early-stage structural design. Full article

This study investigates the leaching behavior of the LiNi_0.65Co_0.25Mn_0.10O₂ cathode material in a phosphoric acid medium, with metallic copper recycled from spent battery components serving as a reducing agent. The aim was to develop an efficient approach for the recovery of Li, Ni, Co, and Mn while providing a mechanistic understanding. Leaching experiments were performed by varying key parameters, including copper addition, acid concentration (0.2–0.8 mol·L⁻¹), cathode mass (0.2–1.0 g), stirring rate (0–600 rpm), and temperature (35–80 °C). Thermodynamic analysis, supported by Pourbaix and species distribution diagrams, was used to interpret metal behavior. The results show that lithium is readily dissolved, whereas the extraction of Ni, Co, and Mn depends on the presence of copper, which enables their reduction and dissolution. Optimal conditions (0.4 mol·L⁻¹ H₃PO₄, 0.2 g Cu, 600 rpm, 80 °C) enabled rapid extraction, exceeding 90% within 30 min, while near-complete extraction (~100%, 99%, 99%, and 97% for Li, Ni, Co, and Mn) was achieved after 60 min. Structural analysis revealed a transformation from the layered structure to spinel-like intermediates, followed by their dissolution and formation of copper phosphate phases. The proposed system represents an efficient approach for the sustainable recycling of NMC cathodes. Full article

Renal cell carcinoma (RCC) is acknowledged as a heterogeneous malignancy underlined by complex genetic, metabolic, and immune dysregulation. In particular, molecular studies have revealed distinct oncogenic mechanisms that have been exploited and studied as therapeutic intervention targets. These include hypoxia-driven signaling, chromosomal translocations, and gene fusion events that affect tumor progression. This review provides a comprehensive overview of these targets and rethinks RCC management. Therapeutic concepts include the targeting of genomic fusion biology with emerging cell-based immunotherapies or targeted molecular inhibition, and orthomolecular therapeutic strategies are presented. Two clinical and pathological features are highlighted—namely, the TFE3 fusion proteins in translocation RCC and the growing role of hypoxia-inducible factor-2α (HIF-2α) inhibitors in clear-cell RCC. We also present recent data on novel immunotherapeutic approaches, including autologous hematopoietic stem and progenitor cell-based interferon-α gene therapy, as well as chimeric antigen receptor T-cell therapy. These therapies are discussed in light of their mechanistic rationale, translational potential, and existing clinical challenges due to unwanted side effects. At last, orthomolecular and natural product-based therapies are reviewed for their potential as adjunctive therapies that might be used for oxidative stress management, the targeting of tumor metabolism and immune effects, and to increase standard treatment tolerance. This review points to a multidimensional framework that might support further research and studies in precision-guided RCC management, as integrative approaches may enhance therapeutic efficacy, reduce toxicity, and support the development of personalized interventions for advanced or treatment-resistant RCC. Full article

Resolving the dichotomy between wide detection ranges and low mechanical hysteresis remains a critical challenge in flexible electronics, largely governed by the intrinsic viscoelastic creep of polymeric dielectrics. Drawing inspiration from the distinctive load-bearing mechanisms of traditional Chinese Sparrow Brace architecture, we report a mechanically optimized tilted micro-architecture designed to enhance structural resilience. Unlike conventional soft elastomeric pillars that easily succumb to mechanical failure, this BOPS-based tilted geometry provides excellent load-bearing capacity, effectively preventing premature failure. Finite element analysis (FEA) confirms that this tilted geometry forces a fundamental shift from conventional bulk compression to structural bending. Because this bending-dominated architecture drives rapid elastic recovery, it significantly mitigates the severe effects of the polymer’s viscoelastic creep under the tested loading conditions, achieving reliable signal reversibility with low hysteresis. We fabricated this specific architecture via programmable femtosecond laser direct writing (FsLDW) on biaxially oriented polystyrene (BOPS) films, harnessing the material’s entropy-driven self-growth kinetics. By merging this localized growth mechanism with the architectural design, we effectively bypassed the complexities of traditional molding, achieving mask-free, in situ growth of large-scale, highly uniform dielectric micro-arrays. The resulting sensor delivers a remarkably broad working range (up to ~2.28 MPa) coupled with a negligible recovery error (~1.3%), an agile dynamic response (~70/80 ms), and consistent operational durability. Ultimately, this work combines architecture-inspired structural design with advanced femtosecond laser surface microengineering, providing a conceptually novel and scalable pathway for next-generation flexible sensing. Full article

In designing tall buildings, the primary concern is ensuring an effective lateral load-resisting system in addition to the gravity load system, since it largely governs the overall design. This study investigates the influence of X-cable bracing on the structural weight of tall steel frame buildings subjected to service and wind loading. Three numerical case studies, 10-story, 20-story, and 30-story planar steel frames, were modeled and analyzed using SAP2000, then optimized using Differential Evolution (DE) and Enhanced Colliding Bodies Optimization (ECBO) algorithms. These designs were evaluated under both service and wind load conditions, considering strength and drift constraints. The results indicate that the inclusion of wind loads in addition to service loads leads to a higher total structural weight than considering service loads alone, while cable bracing effectively reduces the overall mass by up to 6%, 38%, and 20% for the 10-story, 20-story, and 30-story frames, respectively, compared to unbraced structures, by improving the internal force distribution among structural components. Strength demands, reflected by the interaction ratio, governed all design cases, while lateral displacement was always less than the maximum limit according to AISC and ASCE requirements. Overall, the results highlight the potential of cable bracing systems to deliver efficient tall building designs; however, further studies are needed to generalize these findings to a broader range of building configurations. Full article

Background: Sleep bruxism involves repetitive jaw-muscle activity, including teeth clenching, grinding, or mandibular bracing. Despite the growing interest in botulinum toxin type A (BTX-A) as a therapeutic intervention for bruxism, evidence remains limited, particularly regarding studies using portable electromyography (EMG) monitoring devices. This study evaluated the effects of BTX-A injections into the masseter muscle on the reduction of bruxism activity, as measured using the portable electromyographic Holter Bruxoff system. Methods: Adult patients with diagnosed sleep bruxism were monitored for two nights using the Bruxoff device to record masseter EMG activity, respiratory rate, and heart rate. After receiving standardized bilateral masseter BTX-A injections, participants underwent the same monitoring protocol 40 days later. Statistical analyses compared pre- and post-treatment values, and effect sizes were calculated. Results: Ten participants (60% women; mean age 47.6 ± 4.4 years) completed the study. The Bruxism Index showed a marked reduction, dropping from 12.2 ± 1.32 at baseline to 7.4 ± 1.35 after 40 days, a statistically significant change (t (9) = 10.23, p < 0.001; Cohen’s d = 3.25). Average heart rate also decreased significantly, from 64.4 ± 2.99 to 62.6 ± 2.63 (t (9) = 2.86, p = 0.018; Cohen’s d = 0.91). However, the respiratory rate measurement remains stable. Conclusions: BTX-A injections into the masseter muscles produced a marked reduction in sleep-related bruxism activity as measured by portable EMG. These findings support BTX-A as a promising and effective treatment option for sleep bruxism. Full article

Scoliosis is a three-dimensional spinal deformity that may affect musculoskeletal alignment, respiratory mechanics, and neuromotor control. Rigid thoraco-lumbo-sacral orthoses (TLSOs) remain the primary conservative treatment during skeletal growth. Most brace systems rely on three-point pressure mechanisms that primarily generate lateral compression forces, while the contribution of shear components to corrective biomechanics has been insufficiently quantified. This study presents the experimental and analytical validation of the Canali Front-Push Orthopedic Brace, a rigid orthotic system designed to generate controlled compressive and shear forces through a frontal thrust mechanism and anterior rib cage engagement. By applying anterior force, the device reduces the frontal-plane lever arm, thereby limiting the mechanical moment that contributes to transverse plane rotation. An instrumented four-segment torso model derived from the internal CAD geometry of the brace was developed to independently measure upper compression, lower compression, and intersegmental shear forces. Controlled misalignment conditions (0 mm, 2 mm, and 4 mm) were introduced to simulate asymmetric engagement of the orthosis. Three load cell configurations (200 N and 500 N capacity) were tested. Mechanical endurance of the rack–latch fastening system was also evaluated. A predictive shear–misalignment relationship was derived and experimentally validated. Peak compressive forces reached approximately 370 N, while shear forces increased from less than 40 N under symmetric alignment (D0) to approximately 170 N under maximal misalignment (D4). Shear activation demonstrated near-linear proportionality to imposed geometric asymmetry (R² > 0.94). Following cyclic loading, the fastening system stabilized mechanically around 300 N. Measurement repeatability showed a coefficient of variation below 5%. These findings demonstrate that the brace produces predictable and controllable shear activation while maintaining high mechanical repeatability. The results provide a quantitative biomechanical framework for understanding shear-induced corrective mechanics in scoliosis bracing and support future studies integrating computational modeling and clinical validation. The proposed mechanical framework may contribute to the development of next-generation orthotic strategies aimed at controlling spinal rotation through vector modulation rather than purely compressive correction. Full article