Search Results (114,380)

Accurate classification of physical activity (PA) intensity is essential for exercise prescription, rehabilitation monitoring, and evaluation of guideline adherence. However, widely used wrist-worn accelerometer cut-points may substantially misclassify physiological intensity. This study evaluated absolute accelerometer thresholds during a maximal 2400 m run in military office workers and examined whether individualized cut-points improve agreement with physiological intensity. Seventy-four military office workers completed the test while wearing a wrist-worn ActiGraph GT9X Link and a chest-worn Zephyr BioHarness. Participants achieved near-maximal physiological effort, with peak heart rate averaging 187 ± 11 bpm (95 ± 4.2% age-predicted HRmax). Despite this high intensity, absolute wrist-worn cut-points classified only 34.5% of participants as performing vigorous activity for most of the test. Individualized cut-points, derived from each participant’s individual reference intensity, calculated as the three highest consecutive one-minute epochs during the 2400 m test, substantially improved agreement between accelerometer-derived classifications and physiological intensity. Agreement with %HRmax increased from fair (κ = 0.31), using absolute thresholds, to good (κ = 0.74), using individualized thresholds, and intraclass correlation increased from 0.52 to 0.81. These findings demonstrate that absolute cut-points markedly underestimate high-intensity activity, potentially leading to inaccurate exercise load monitoring and misinterpretation of training intensity. Individualized calibration during a standardized maximal running test provides a feasible strategy to improve the validity of intensity assessment using wearables. Although the study population consisted of military office workers, the approach may be applicable to other active populations. However, further validation in independent samples is needed. Full article

Background: Healthcare systems contribute significantly to environmental pollution, energy consumption, and resource depletion, making sustainability an increasingly important environmental and public health priority. Nurses, as frontline healthcare professionals, play a critical role in promoting environmentally responsible practices and advocating for sustainable healthcare within clinical settings. Objective: The study aimed to examine the associations between nurses’ sustainability consciousness, green advocacy, and work grit in hospital settings. Methods: A descriptive cross-sectional correlational study was conducted among 377 nurses working in two university-affiliated hospitals in Egypt. Data were collected using validated instruments assessing sustainability consciousness, green advocacy, and work grit. Descriptive statistics were calculated to summarize participant characteristics and study variables. Associations among sustainability consciousness, green advocacy, and work grit were examined using Pearson correlation analysis. Multiple linear regression analysis was conducted to identify significant predictors of green advocacy, while noting that the study design allows for identification of associations rather than causal relationships. Results: The findings indicated generally high levels of sustainability consciousness among nurses. Significant positive associations were observed between sustainability consciousness, green advocacy, and work grit (p < 0.01). Multiple linear regression analysis identified sustainability consciousness and work grit as significant predictors of green advocacy, explaining 34.2% of its variance. Conclusions: These findings highlight the interconnected roles of sustainability awareness, advocacy behaviors, and psychological resilience in promoting environmentally sustainable healthcare practices. Strengthening nurses’ sustainability consciousness and work grit may enhance green advocacy and contribute to the development of sustainable healthcare systems, supporting global environmental and public health goals aligned with the United Nations Sustainable Development Goals. Full article

Background/Objectives: Measures of excess body fat are often more informative for predicting health risk than body mass index (BMI) alone. With obesity prevalence increasing among young adults, this study evaluated whether adding dominant handgrip strength improves prediction of body fat percentage (BF%) and BF%-defined obesity in a university population. Methods: Cross-sectional data from 895 students (401 women, 494 men; mean age 19.9 years; fall 2015–spring 2016) in Kentucky, USA were analyzed. BMI was calculated from self-reported height and weight. BF% was estimated using bioelectrical impedance analysis (BIA), and dominant handgrip strength was measured with a hydraulic hand grip dynamometer. Sex-specific linear and logistic regression models assessed associations among BMI, grip strength, relative grip strength, and BF%. Results: BMI was a strong predictor of BF% in linear models (R² = 0.74 in women; 0.68 in men). Grip strength alone was not associated with BF% but showed an inverse association when combined with BMI. For BF%-defined obesity, BMI remained the most influential predictor, with grip strength contributing additional predictive value. Among men, age significantly modified these relationships, with marked differences between those aged 18–19 years versus older participants. Conclusions: BMI strongly predicted BF% and BF%-based obesity in this cross-sectional study of a predominantly white young adult population. Incorporating handgrip strength modestly improved classification, particularly among women, suggesting that a functional measure like hand grip strength may enhance obesity screening and health communication in young adults. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disorder linked to obesity, insulin resistance, and dyslipidemia. Nutrition plays a central role in modulating hepatic lipid metabolism, oxidative stress, and inflammation, yet practical, evidence-based dietary strategies remain limited. This study aimed to develop Mediterranean diet-based meal plans with varying macronutrient compositions and to characterize their nutritional profiles, as well as to evaluate them using established nutritional indices and diet score calculations, such as the Dietary Inflammatory Index, Dietary Antioxidant Index, and dietary lipid indices. Methods: Clinical practice guidelines (CPGs) from various academic and professional organizations were reviewed to assess current non-pharmacological treatments for MASLD, with a focus on determining whether the Mediterranean diet is the most recommended dietary pattern. Traditional, low-carbohydrate, and low-fat MedDiet patterns were translated into food-based meal plans. A 7-day meal plan was developed and analyzed for nutrient composition, then evaluated using the Dietary Inflammatory Index (DII), Dietary Antioxidant Index (DAI), Dietary Lipophilic Index (DLI), and Dietary Lipophilic Load (DLL). A Western diet (WD) that is characterized by ultra-processed food (UPF) was included as a comparative reference. Results: The validated dietary score calculations showed that all MedDiet patterns demonstrated consistently low DII scores (−2.00 to −2.81) and high DAI scores (3 to 20.03), whereas the WD showed high DII scores (5.0 to 6.09) and low DAI scores (−12.47 to −17.99). Despite these variations in macronutrients, the menu developed in the study on three MedDiet patterns showed negative DII and positive DAI scores. When comparing the traditional MedDiet with the WD, which have similar macronutrient distributions, the WD was characterized by less favorable DII and DAI scores. Conclusions: This study provides a descriptive, guideline-informed framework for Mediterranean diet-based meal plans with varying macronutrient compositions. Utilizing DII, DAI, DLI, and DLL offers a potential framework for designing dietary interventions. Further validation through clinical studies is needed to justify the potential for practical and digital translation. Nevertheless, the study provides initial insights that may inform future research on nutritional approaches for MASLD integrating dietary indices. Full article

Background/Objectives: Haemoadsorption has recently emerged as an extracorporeal treatment option for sepsis, septic shock, intoxications, and cardiac surgery to modulate dysregulated inflammatory responses or remove a wide range of circulating molecules. To ensure appropriate clinical use of the CytoSorb^® haemoadsorber, it is essential to understand the extent to which specific drugs are adsorbed by the device. Methods: We conducted a systematic literature review using the PubMed and Ovid MEDLINE database to identify studies on drug binding to the CytoSorb^® haemoadsorber, including both in vivo and in vitro studies. Publications in English language, available up to 31 December 2025 that reported or enabled calculation of percentage of drug removal, CytoSorb^® clearance or half-life during CytoSorb^® therapy were included. Records were screened, eligibility and quality were assessed, and data were extracted independently by two reviewers. Results: We found that 26 studies reported on the binding of 56 drugs to CytoSorb^®, with most available information relating to antibiotics used in the treatment of sepsis and septic shock. CytoSorb^® appears to remove vancomycin and linezolid but not meropenem, although data for other antibiotics are insufficient to assess clinical relevance. Data on the removal of anticoagulant and antithrombotic drugs with CytoSorb^® before and during cardiac surgery indicate that using this procedure to reduce complications associated with apixaban and ticagrelor is feasible and safe. The available evidence on the use of CytoSorb^® for drug poisoning is of very low quality. Conclusions: Although the number of studies on drug binding to the CytoSorb^® is increasing, the review is limited by the marked heterogeneity among the included studies. It is advised to use therapeutic drug monitoring whenever possible during CytoSorb^® treatment. Research of binding of drugs to CytoSorb^® is crucial for its safe and effective clinical use, but adequate methodology is necessary. Full article

Solid-state studies evaluating intermolecular geometries in methylated nucleobases are not extensively explored. In the course of the present study, we have solved the crystal structures of 1-, 3- and 7-methylated adenines and guanines, including the monohydrate and sesquihydrate forms of 3-methyladenine and 3-methylguanine, respectively, by means of single-crystal X-ray diffraction and synchrotron/laboratory X-ray powder diffraction (XRPD). In situ high temperature XRPD experiments, coupled with differential thermal analysis/thermogravimetry (DTA/TG) measurements, allowed for monitoring crystallographic changes after water removal of N3-methylated compounds, and the discovery of a high temperature polymorph in the case of 3-methyladenine. Our findings indicate that H-bonding schemes describe ribbon planar motifs of molecules in the majority of cases, or linear double-bonded strands of molecules in a few cases. π-π stacking interactions were compared with existing findings of theoretical calculations and existing crystallographic data, showing how N-methylated purine bases follow the trend predicted by Hunter and Sanders, 1990. The present study provides the first systematic experimental insights into the solid state of the presented compounds. Full article

The transformation of religious authority in the digital age is shaped by the interactions between human actors, digital media and algorithmic systems. This study uses digital ethnography to examine how religious authority is constructed and negotiated on digital platforms used by Muslims in Indonesia and globally. This study focuses on seven authoritative figures in the digital Islamic landscape, representing different spectra of authority, from traditional pesantren in Indonesia to transnational apologetics and urban liberalism. The findings reveal patterns of authority delegation in which digital platforms replace human roles in da’wah and Islamic institutions. Religious authority is formed through articulative work that connects the Sunnah, intermediaries (religious scholars), and congregations. Public search data show that digital spaces function as a medium of distribution, where religious authority is shaped by audience responses, message repetition, symbolic affiliation, and the dynamics of debate. This study highlights the role of algorithmic culture and authority representation aesthetics in mediating religious authority in the digital age. Algorithms shape exposure and reach audiences, and representational aesthetics are crucial for disseminating religious content. The study concludes that clerical authority in the digital era results from technocultural mediation, in which the cleric becomes both a figure and representation calculated by machines and validated by the audience’s participation. Full article

Understanding the intrinsic Li–H₂ interaction, decoupled from substrate effects, is essential to rationalize the performance of lithium-decorated hydrogen storage materials. To address the current lack of a clean theoretical baseline, we characterized the sequential H₂ adsorption on the gas-phase Li₆ superatomic cluster using high-level density functional theory (DFT), complemented by Energy Decomposition Analysis (EDA), QTAIM, and NICS(0) calculations. Li₆ acts as a structurally rigid platform (RMSD < 0.032 Å) where ligand-induced polarization progressively strengthens its σ-aromaticity (NICS(0) from −2.917 to −13.98 ppm) and increases the HOMO–LUMO gap up to 5.05 eV. EDA identifies the binding as field-activated physisorption, electrostatically dominated (65–67%) and mechanistically distinct from Kubas coordination, as confirmed by QTAIM closed-shell interaction parameters. Negative cooperativity governs an effective loading capacity of n = 2 molecules under cryogenic conditions (T_eq = 143.76 and 114.64 K), while an entropic bottleneck renders higher loading non-spontaneous at all temperatures. These results establish Li₆(H₂)_n as a foundational gas-phase reference, providing a systematic, contamination-free descriptor set for the intrinsic Li–H₂ interaction. This framework is essential for isolating the electronic role of the lithium superatom and unambiguously identifying substrate-induced modulations in supported hydrogen storage materials. Full article

In semi-arid regions, sustainable groundwater management for irrigation is critical for agricultural productivity and food security. This study presents an integrated methodological framework combining hydrochemical characterization, machine learning (ML) modeling, and explainable artificial intelligence (XAI) to predict the Irrigation Water Quality Index (IWQI) in the Ain Oussera plain, Djelfa Province, Algeria. A total of 191 groundwater samples were collected from November 2023 to September 2024 and analyzed for major ions and physicochemical parameters. Multiple irrigation suitability indices were calculated, including Sodium Adsorption Ratio (SAR), Sodium Percentage (Na%), Magnesium Hazard (MH), Permeability Index (PI), Residual Sodium Carbonate (RSC), Soluble Sodium Percentage (SSP), and Kelly’s Ratio (KR). Five ML models were developed and evaluated for IWQI prediction: Random Forest, Gradient Boosting, XGBoost, K-Nearest Neighbors, and Support Vector Regression. Results showed that 55% of groundwater samples exhibited low to no restrictions for irrigation use, while 19% required high to severe restrictions. The XGBoost model demonstrated superior performance, with the highest R² (0.95) and the lowest RMSE (3.22) among all tested algorithms. SHAP (SHapley Additive exPlanations) analysis provided a transparent interpretation of model predictions, identifying electrical conductivity and Sodium Adsorption Ratio as the most influential parameters affecting IWQI, while chloride, sodium, total hardness, and magnesium had minimal impact. Spatial mapping using Inverse Distance Weighting (IDW) interpolation in ArcGIS 10.8 revealed considerable spatial variability in water quality throughout s the plain. This research addresses a critical gap in North African groundwater management by integrating ML predictive capabilities with XAI transparency, providing water resource managers and agricultural stakeholders with interpretable, data-driven tools for sustainable irrigation planning in water-stressed semi-arid environments. Full article

This paper proposes a numerical method combining a fixed-point harmonic balance finite element method (FEM) with a dynamic hysteresis model to accurately calculate the loss distribution of laminated cores under complex operating conditions. This method primarily employs the frequency-domain FEM to solve the magnetic field distribution of silicon steel laminated cores under various excitations, including power frequency multi-harmonic conditions. The resulting magnetic flux density distribution is substituted into the dynamic hysteresis model, enabling the accurate simulation of the hysteresis loop at any position of the laminated core. Hence, the loss distribution of the laminated core can be obtained. Compared to the modified Steinmetz formula, the proposed method is validated with better performance. The relative error is less than 6% between the measured and the calculated core losses of the proposed method. These results can improve the accuracy and efficiency of transformer iron loss calculation in engineering applications. Full article

Objective: This umbrella review synthesizes and critically appraises the evidence on the efficacy and safety of tegoprazan-based versus proton pump inhibitor (PPI)-based regimens for Helicobacter pylori (H. pylori) eradication. Methods: This umbrella review was pre-registered in PROSPERO (CRD420251271120). Systematic reviews and meta-analyses published between 1 January 2018 and 10 December 2025 were identified through MEDLINE/PubMed, EMBASE, and the Cochrane Library. Reviews comparing tegoprazan-based and PPI-based eradication regimens in adult patients were included. Methodological quality was assessed using AMSTAR-2, risk of bias with ROBIS, and certainty of evidence with GRADE. Pooled relative risks (RRs) were calculated, with subgroup analyses by study design, treatment duration, and therapeutic regimen. Results: Eight systematic reviews and meta-analyses encompassing 17 primary studies and 12,714 participants were included. Tegoprazan-based regimens were associated with a statistically significant improvement in eradication efficacy compared with PPI-based therapies (RR = 1.019; 95% CI: 1.003–1.035; p = 0.021). In randomized controlled trials, the benefit was more pronounced (RR = 1.037; 95% CI: 1.015–1.061; p = 0.001), whereas no statistically significant benefit was observed in non-randomized studies (RR = 1.014; 95% CI: 0.991–1.037; p = 0.235). The efficacy advantage was mainly confined to quadruple therapy regimens (RR = 1.044; 95% CI: 1.002–1.088; p = 0.038). Tegoprazan-based regimens were associated with a lower incidence of overall adverse events compared with the PPI group (RR = 0.930; 95% CI: 0.885–0.976; p = 0.003). Conclusions: Tegoprazan-containing regimens were associated with a modest but statistically significant improvement in H. pylori eradication compared with PPI-containing regimens, particularly in randomized controlled trials and quadruple therapy regimens. Full article

Introduction: The costs associated with ambulance services are varied and poorly understood, which may contribute to financial burden and barriers to care for patients. Methods: We describe differences in ambulance service costs, comparing public versus private companies, by using the Centers for Medicare and Medicaid Services public use files. We determined the two largest public and two largest private ambulance companies in each state and calculated the average miles traveled per ambulance ride, number of trips by company, adjusted cost, and CPT code usage. We compared these variables between 2019 and 2021, across nine geographic divisions of the US. Results: In both 2019 and 2021, the average costs (adjusted for total service) of public companies were higher than the average costs of private companies. In both years, public companies had fewer average miles traveled compared to private companies. The distribution of CPT codes used was significantly different in public and private companies. The CPT code used most frequently by public companies was more expensive than the CPT code used most often by private companies. Conclusions: Differences in ambulance billing practices may contribute to financial uncertainty for patients. This study underscores the need for further investigation into the factors driving these disparities to inform policy decisions and improve cost transparency for patients. Full article

Background: Surface roughness in turning operations is still verified predominantly after machining, which limits the possibility of timely corrective intervention. Methods: This study examined whether normal-direction peak-to-peak vibration displacement can serve as a practical low-frequency indicator of surface roughness during finish turning of EN AW-2011 aluminum alloy. The analysis was based on 190 synchronized displacement-roughness observation pairs obtained in one controlled experimental campaign on a CQ6230 conventional precision lathe, using a VB-8206SD displacement logger mounted radially on the tool holder and contact profilometry measurements reported as Ra and Rz. The analytical workflow included explicit quality-control safeguards for malformed rows, missing values, and obvious artefacts; in the present dataset, these checks did not indicate a failure state that would invalidate the main calculations. The workflow combined descriptive statistics, moving-average trend inspection, low-frequency FFT and STFT descriptors, Pearson correlation analysis, and ordinary least squares regression. Results: The displacement signal exhibited a mean value of 0.0446 mm with a standard deviation of 0.0256 mm and showed strong within-dataset linear relations with roughness parameters: Ra = 14.204 + 24.191 V (R² = 0.9929, RMSE = 0.052 µm) and Rz = 63.207 + 105.253 V (R² = 0.9905, RMSE = 0.264 µm). Conclusions: The results support setup-specific roughness-related process-state assessment using low-rate normal-direction displacement measurements. However, because the 190 records represent a time-ordered synchronized sequence rather than 190 independent cutting trials, and because no separate validation set was available, the fitted equations should be interpreted as descriptive within-setup calibration rather than as universally validated predictive models. Full article

Background/Objectives: Influenza remains a primary cause of severe illness and death in adults over 60. In this group, immunosenescence and existing health conditions make infections more dangerous and traditional vaccines less effective. The MF59-adjuvanted vaccine was specifically designed to overcome these limitations by enhancing the body’s immune activation and antigen presentation. While the vaccine shows clear benefits, some recent concerns regarding vaccine safety have been raised without supporting scientific evidence. Therefore, this systematic review focuses on providing a comprehensive evaluation of its safety outcomes compared to standard vaccines. Methods: Following the PRISMA guidelines, a systematic review and meta-analysis were conducted; two researchers independently assessed the eligibility of the studies, and the risk of bias was assessed using RoB2 and ROBINS tools for randomized clinical trials and observational studies, respectively. Pooled risk estimates were calculated using a random-effects model. Results: Ten RCTs and three non-RCTs meeting the inclusion criteria were included. No significant differences were found for severe systemic outcomes: Guillain–Barré syndrome (RR 1.01, 95% CI 0.64–1.80) and encephalitis (RR 1.23, 95% CI 0.85–1.78). For other systemic adverse effects, there were no significant differences between adjuvanted and non-adjuvanted vaccines; only myalgia showed a small but significant increase with adjuvanted vaccines (RR 1.35, 95% CI 1.02–1.78) compared with non-adjuvanted vaccines. Conclusions: MF59-adjuvanted influenza vaccines have a favorable and well-characterized safety profile in adults aged 60 years and older. Adverse events are predominantly mild and transient, with no evidence of increased risk of serious or immune-mediated outcomes compared with non-adjuvanted vaccines. Full article

Shelterbelts are increasingly used to mitigate strong wind damage, but the complex canopy structures create challenges for numerical studies of windbreak effectiveness, such as the trade-off between computational cost and accuracy of results. To address these challenges and accurately investigate the downstream wind fields, most conventional studies represent shelterbelts as rectangular porous media with a uniformly distributed aerodynamic resistance coefficient. However, due to the vertical variation in canopy diameter and the irregular distribution of leaf density, the aerodynamic resistance of natural shelterbelts becomes nonuniform accordingly. To quantify the discrepancies arising from this simplification, this study first proposes a non-destructive approach to calculate canopy porosity profiles, which are further used to derive aerodynamic resistance at different heights. Then, by comparing the results obtained from the conventional and proposed approaches in Large-Eddy Simulations, the discrepancies caused by ignoring the vertical variation in canopy structures are analyzed. Finally, these discrepancies are further investigated for double-row shelterbelts. The results show that ignoring the vertical variation in canopy diameter leads to significant differences in windbreak effectiveness, especially for the downstream velocity and pressure fields at the top and middle heights of the canopy. The proposed approach provides a computationally efficient and more accurate representation of near-surface wind fields downstream of shelterbelts, thereby contributing to the accurate prediction of local wind fields for meteorological services. Full article