Search Results (15,023)

Sustainable landslide risk management is critical for achieving resilient communities and supporting the United Nations Sustainable Development Goals, particularly in vulnerable mountainous regions of developing countries. This study presents experimental evidence supporting dimensionless analysis approaches for characterizing granular flow behavior, contributing to cost-effective landslide hazard assessment frameworks. We designed a 4 m experimental flume to investigate the influence of particle characteristics on flow velocity and runout distance, using two materials with contrasting shapes but similar density (~460 kg/m³) and nominal size (~5 mm): uniform crystal beads (φ = 25.2°) and non-uniform crushed granite particles (φ = 36.9°). High-resolution imaging (30 fps, 2336 × 1752 pixels) captured 30 flow experiments from initiation to deposition. Results demonstrate significant differences in flow behavior: crystal beads achieved 50% longer runout distances and 46% higher maximum velocities (380 cm/s vs. 260 cm/s) compared to granite particles. The Savage number ($N_{sav}$) effectively captured fundamental flow-regime differences, with granite particles exhibiting values seven times lower than crystal beads (3.69 vs. 23.91, p < 0.001), indicating greater frictional energy dissipation relative to collisional energy transfer. The Bagnold number confirmed inertially dominated regimes ($N_{Bag}$ > 10⁶) with negligible viscous effects in both materials. These findings demonstrate that accessible material characterization using standard triaxial testing and dimensionless analysis can significantly improve landslide runout prediction accuracy, supporting evidence-based decision-making for sustainable territorial planning and community protection. This research supports the development of practical risk assessment methodologies implementable in resource-limited settings, promoting sustainable development through improved natural hazard management. Full article

Background: Celiac disease (CD) is a chronic immune-mediated enteropathy that is treated exclusively with a lifelong gluten-free diet (GFD). Hepatic involvement, including hepatic steatosis (HS), is common in both newly diagnosed and long-term GFD-treated CD patients. Limited data exist regarding HS prevalence and risk factors in CD, and the effects of dietary patterns, including GFD and the Mediterranean diet (MD), remain unclear. Objective: This study investigated the prevalence and severity of HS in newly diagnosed, pre-GFD and GFD-treated CD patients compared to non-celiac control subjects, while assessing the influence of dietary adherence. Methods: In a nested cross-sectional study within the ARCTIC trial (NCT05530070), 290 Hungarian adults were enrolled (60 pre-GFD CD, 156 CD on GFD, and 74 control subjects). HS was assessed by ultrasonography, and dietary adherence was evaluated using the Standardized Dietitian Evaluation and Mediterranean Diet Score (MDS). Binary regression models were applied to identify predictors of HS. Results: HS was diagnosed in 34% of participants, most frequently in pre-GFD CD patients. BMI was the strongest predictor of HS both overall and within the CD cohort (OR = 1.27; 95% CI: 1.16, 1.42; p < 0.001). Neither adherence to GFD nor overall MD adherence significantly influenced the prevalence of HS. Severity of HS correlated with higher BMI, older age, and diabetes prevalence, while individual MD components, including olive oil consumption, were associated with milder HS. Conclusions: HS is more prevalent in CD patients, particularly pre-GFD patients, and is strongly associated with BMI. While overall dietary patterns did not significantly impact HS, certain diet components may modulate severity. Full article

Accurate prediction of blast-induced air overpressure (AOp) is vital for environmental management and safety in mining and construction. Traditional empirical models are simple but fail to capture complex meteorological effects, while accurate black-box machine learning models lack interpretability, creating a significant dilemma for practical engineering. This study resolves this by applying explainable AI (XAI) to develop a transparent, “white-box” model that explicitly quantifies how meteorological parameters, wind speed, direction, and air temperature influence AOp. Using a dataset from an urban excavation site, the methodology involved comparing a standard USBM empirical model and a Multivariate Non-linear Regression (MNLR) model against a Symbolic Regression (SR) model implemented with the PySR tool. The SR model demonstrated superior performance on an independent test set, achieving an R² of 0.771, outperforming both the USBM (R² = 0.665) and MNLR (R² = 0.698) models, with accuracy rivaling a previous “black-box” neural network. The key innovation is SR’s ability to autonomously generate an explicit, interpretable equation, revealing complex, non-linear relationships between AOp and meteorological factors. This provides a significant engineering contribution: a trustworthy, transparent tool that enables engineers to perform reliable, meteorologically informed risk assessments for safer blasting operations in sensitive environments like urban areas. Full article

Osteoprotegerin (OPG) is a glycoprotein involved in bone metabolism and cardiovascular health, with emerging evidence suggesting its role in heart failure (HF). Despite its potential as a biomarker, the association between circulating OPG levels and HF severity remains unclear. This systematic review and meta-analysis aimed to evaluate OPG levels in HF patients and their relationship with disease severity according to the New York Heart Association (NYHA) classification. A comprehensive search of PubMed, EMBASE, and Scopus was conducted to identify observational studies assessing OPG levels in HF patients. Studies were included if they reported OPG levels in HF patients and controls, with subgroup analyses according to NYHA classification when available. Risk of bias assessment was performed using the Newcastle–Ottawa Scale (NOS). The principal outcome was the mean difference (MD) in circulating OPG levels between HF patients and controls. Random-effects meta-analysis models were used to pool the data. Thirteen studies with a total of 1387 participants were included in the quantitative and qualitative synthesis. Overall, OPG levels were significantly elevated in HF patients compared to healthy controls (2.490 [95% CI 0.531, 4.449]). Subgroup analysis showed a significant decrease in OPG levels in controls versus NYHA II patients (−1.503 [95% CI −2.402, −0.604]). However, no statistically significant difference was found when comparing OPG levels between the combined NYHA II/III group and controls (−1.019 [95% CI −2.451, 0.412]). OPG levels are significantly elevated in HF patients compared to controls, with a progressive increase in NYHA II patients. However, the lack of significance in the NYHA II/III group highlights the need for further studies with a more comprehensive NYHA classification breakdown. Full article

Background and Objectives: Hyperuricemia is frequent in patients with uncontrolled type 2 diabetes (T2D) and may reflect intertwined renal and metabolic dysfunction. Simple tools to identify those at highest risk are lacking. Materials and Methods: We retrospectively analyzed 253 adults with uncontrolled T2D (HbA1c ≥ 7%) hospitalized at a tertiary center (2022–2023). Patients were stratified by hyperuricemia status (serum uric acid >7.0 mg/dL in men and >6.0 mg/dL in women). Demographic, clinical, biochemical, and pharmacological data were compared. Independent predictors were explored with multivariable modeling. A two-parameter Renal–Metabolic Risk Score (serum urea and triglyceride-to-LDL cholesterol ratio [TG/LDL]) was derived and evaluated by ROC analysis. Results: Compared with non-hyperuricemic patients (n = 20), those with hyperuricemia (n = 233) had higher serum urea (32.15 ± 21.21 vs. 19.76 ± 10.02 mg/dL; p < 0.001) and numerically higher TG/LDL (2.94 ± 6.73 vs. 1.95 ± 1.28; p = 0.062). Serum uric acid was lower in the hyperuricemia group due to categorical definition thresholds and treatment effects (5.69 ± 1.87 vs. 6.77 ± 2.12 mg/dL; p = 0.038). The derived Renal–Metabolic Risk Score showed an AUC = 0.67 and differed significantly between groups (p ≈ 1.2 × 10⁻⁵). Conclusions: The derived RMRS, based on simple and inexpensive laboratory parameters, offers a preliminary tool for assessing hyperuricemia risk in uncontrolled T2D. From a clinical and assistive practice perspective, this score may help nephrology nurses and multidisciplinary teams identify high-risk patients who require closer monitoring of renal and metabolic complications. It could further guide early dietary counseling, pharmacological optimization, and frailty assessment in chronic kidney disease care. Future studies are needed to validate the score in larger and more diverse populations before its integration into routine practice. Full article

Obesity and overweight conditions, frequently accompanied by hypercholesterolemia, are major risk factors for cardiovascular disease. Lifestyle interventions remain the cornerstone of non-pharmacological treatment; however, their effectiveness in improving lipid profiles is limited. Intermittent hypoxic training (IHT) has recently emerged as a potential strategy to enhance metabolic outcomes. This study aimed to evaluate the effects of a 4-week intensive IHT program combined with a calorie-restricted diet on lipid profile and body composition in men with overweight or obesity and secondary hypercholesterolemia. Twenty physically inactive men (35.3 ± 5.4 years) were randomly assigned to either a hypoxic group (H, n = 10) or a normoxic control group (C, n = 10). Both groups followed the same training protocol and diet, differing only in environmental training conditions. Body composition, resting metabolic rate, and blood lipid parameters (total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C; non-high-density lipoprotein cholesterol, non-HDL-C; Triglycerides, TG) were assessed before and after the intervention. Compared with the C group, participants in the H group achieved significantly greater reductions in body mass (−5.4% vs. −2.6%, p < 0.05) and fat mass (−14.7% vs. −7%, p < 0.01). IHT also induced marked decreases in TC (−22.6%, p < 0.001), LDL-C (−25.8%, p < 0.001), non-HDL-C (−26.5%, p < 0.001), and TG (−31.4%, p < 0.01), along with a significant improvement in the atherogenic index of plasma (AIP, −24.4%, p < 0.05). In contrast, the C group showed only non-significant downward trends. No significant changes in HDL-C were observed in either group. These findings suggest that IHT combined with dietary restriction produces more favorable changes in lipid profile and body composition than normoxic training. IHT may therefore represent a promising adjunct to conventional lifestyle-based interventions in the management of obesity-related hypercholesterolemia. Full article

Background/Objectives: Multidrug-resistant (MDR) Escherichia coli is a critical One Health challenge, with rising resistance in both humans and animals. The present study aimed to compare antimicrobial resistance (AMR) profiles of E. coli isolates from hospitalized patients and food-producing animals in Satu Mare, a county located in northwestern Romania. Methods: Between 2022–2023, 701 samples were collected, leading to 571 non-duplicate E. coli isolates (420 human, 151 animal). Human strains were recovered from 21 hospital departments and originated from feces, urine, blood, sputum, ear secretions, cerebrospinal fluid, purulent wound secretions, and puncture fluids. Animal isolates were obtained from ceca collected at local slaughterhouses serving farms in north-west Romania, including samples from turkeys, broilers, and pigs. Antimicrobial susceptibility testing was performed against eight antimicrobials (amikacin, ampicillin, cefotaxime, ceftazidime, cefepime, ciprofloxacin, gentamicin, sulfamethoxazole/trimethoprim) using standardized methods. Resistance classification followed international definitions of MDR. Statistical associations between host species and resistance were assessed with chi-square tests. Results: Resistance levels were consistently higher in E. coli strains isolated from animals compared with those from humans (p < 0.05). Among human isolates, resistance to ampicillin (41.9%), ciprofloxacin (41.4%), and sulfamethoxazole/trimethoprim (45.7%) approached, but did not exceed 50%. In contrast, E. coli strains recovered from animals showed markedly higher resistance, exceeding 50% for ampicillin (78.8%), ciprofloxacin (65.6%), and cefotaxime (55.0%). Amikacin retained full activity against all animal isolates, whereas 2.8% of human strains were resistant. Overall, multidrug resistance (MDR) was observed in 70.0% of E. coli isolates from humans and 79.7% from animals, with the highest resistance burden in pig-derived isolates. Conclusions: The study underscores the veterinary sector as a key contributor to the maintenance and spread of MDR E. coli. Even in clinically healthy animals, resistance levels exceeded those observed in human isolates. These findings emphasize the need for coordinated One Health monitoring and stricter antimicrobial use policies in livestock to reduce transmission risks across human and animal populations. Full article

Background/Objectives: This study evaluated the association between nutrient intake adequacy during early pregnancy and gestational diabetes mellitus (GDM) risk through a prospective cohort study of Korean pregnant women. Methods: A total of 2227 singleton pregnant women were included in this study. Dietary assessment was conducted once during early pregnancy enrollment using the 24 h dietary recall method. The collected dietary data were analyzed using the CAN-Pro Korean food composition database to calculate nutrient-specific intake levels. Nutrient Adequacy Ratio (NAR) for each nutrient and Mean Adequacy Ratio (MAR), which integrates individual NARs, were calculated based on intake levels. GDM diagnosis was determined using oral glucose tolerance test (OGTT) results conducted between 24 and 28 weeks of gestation. Relative risk (RR) for each individual nutrient was calculated, and logistic regression analysis was performed to estimate odds ratios (OR) for GDM risk according to MAR quartiles. Results: Among 2227 participants, 157 women developed GDM. Compared to the highest MAR quartile, women in the lowest quartile showed significantly increased GDM risk (OR = 1.82, 95% CI: 1.10–2.99), with the second lowest quartile demonstrating similarly elevated risk (OR = 1.75, 95% CI: 1.06–2.88). Among individual nutrients, inadequate vitamin D intake was associated with the highest GDM risk (RR = 3.84), followed by insufficient intakes of vitamin K (RR = 1.89), vitamin B₆ (RR = 1.62), niacin (RR = 1.54), and calcium (RR = 1.39). Body mass index-stratified analysis revealed that the association between low nutritional adequacy and GDM risk was particularly pronounced in women with BMI ≥ 25.0 kg/m², showing up to a four-fold increased risk in the lowest adequacy groups. Conclusions: These findings suggest that low overall dietary adequacy and nutritional imbalance during early pregnancy are associated with increased GDM risk. The results underscore the importance of ensuring adequate and balanced nutrition during early pregnancy for GDM prevention. Full article

In this paper, we establish the existence and uniqueness of the minimum intrinsic risk equivariant (MIRE) estimator for univariate linear normal models. The estimator is derived under the action of the subgroup of the affine group that preserves the column space of the design matrix, within the framework of intrinsic statistical analysis based on the squared Rao distance as the loss function. This approach provides a parametrization-free assessment of risk and bias, differing substantially from the classical quadratic loss, particularly in small-sample settings. The MIRE is compared with the maximum likelihood estimator (MLE) in terms of intrinsic risk and bias, and a simple approximate version (a-MIRE) is also proposed. Numerical evaluations show that the a-MIRE performs closely to the MIRE while significantly reducing the intrinsic bias and risk of the MLE for small samples. The proposed intrinsic methods could extend to other invariant frameworks and connect with recent developments in robust estimation procedures. Full article

Background and Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common cause of liver disease in the United States and frequently coexists with other liver diseases. Despite growing interest, the presence of MASLD in patients with primary sclerosing cholangitis (PSC) remains underexplored. This study aimed to assess the prevalence and characteristics of the MASLD-PSC overlap syndrome, with a specific focus on patient-reported outcomes such as pruritus and fatigue. Methods: A cross-sectional analysis was performed within a prospective cohort of patients with PSC enrolled in the Autoimmune Liver Diseases Registry at a United States tertiary medical center (2018–2024). MASLD overlap was established based on evidence of hepatic steatosis on liver imaging or biopsy, combined with at least one cardiometabolic risk factor. Fatigue and pruritus were assessed using the Chronic Liver Disease Questionnaire (CLDQ) and the 5D Itch Scale. Ordinal logistic regression models were used to explore the potential impact of MASLD overlap on fatigue and pruritus severity. Results: Among 103 PSC patients, 33% had MASLD overlap. These patients were older (55 vs. 46 years, p = 0.006), had a higher BMI (30 vs. 25 kg/m², p < 0.001), and were more likely to have small bile duct involvement (43% vs. 12%, p = 0.002). A history of liver transplantation (LT) was noted in 18% of PSC-only patients, compared to 3% of those with PSC/MASLD (p = 0.055). MASLD overlap was significantly associated with higher pruritus intensity (OR 3.09, 95% CI 1.02–9.28, p = 0.044), but was paradoxically linked to lower fatigue levels (OR 0.37, 95% CI 0.16–0.85, p = 0.020). Conclusions: Patients with PSC/MASLD exhibit distinct clinical features. MASLD overlap was found to significantly impact patient-reported outcomes, with lower fatigue intensity but increased pruritus severity, suggesting a role for metabolic or inflammatory pathways, warranting further investigation. Full article

Background/Objectives: Premature births below 32 weeks of gestation generally require respiratory oxygen support, leading to a relatively hyperoxic environment compared to in utero conditions. Transient hyperoxia exposure has been linked to an elevated risk of chronic lung disease and retinopathy of prematurity; however, its effects on skeletal muscles remain elusive. This study aimed to investigate the effects of hyperoxic exposure in rats as a model of premature infants receiving supplemental oxygen (30–60% O₂ for several weeks). We hypothesized that rats exposed to postnatal hyperoxia would exhibit muscle fiber atrophy and alterations in fiber type. Methods: We used a rat model in which newborns were exposed to 80% oxygen from birth until postnatal day 12. We assessed the gastrocnemius muscles of rat legs at 12 weeks. Results: Rats exposed to hyperoxia showed substantially increased protein expression of Atrogin-1, along with elevated levels of adipophilin, myogenic differentiation factor 1, and myogenin. No significant changes were observed in the expression of slow or fast myosin heavy chain proteins. However, myofiber size in the gastrocnemius muscle was reduced in the hyperoxia-exposed group compared to the control group. Conclusions: Thus, transient hyperoxia exposure during early life can impede skeletal muscle development, potentially extending into adulthood. Full article

The prevalence of atrial fibrillation (AF) is increasing and often coexists with frailty. The management of anticoagulation therapy in frail older adults with AF is especially challenging due to the high risk of bleeding complications. The aim of this narrative review is to provide a comprehensive overview of current evidence about the management of anticoagulation in frail older adults with non-valvular AF. First, frailty itself should not be considered a contraindication. A comprehensive geriatric assessment is recommended to identify and potentially address conditions that may increase the risk of bleeding, such as inappropriately prescribed medications or malnutrition. Overall, the net clinical benefit remains in favour of oral anticoagulation in frail older adults, even if it decreases with increasing frailty severity. Direct Oral Anticoagulants (DOACs) show a better effectiveness and safety profile compared with Vitamin K antagonists (VKAs) in this population. Among DOACs, apixaban seems to be the safest. Also, edoxaban at a very low dosage (15 mg/day) could be an effective therapy in patients for whom the standard anticoagulation is contraindicated. Moreover, switching from VKAs to DOACs in frail older adults is a complex decision and should be personalized according to the stability of the ongoing anticoagulant therapy, the bleeding risk profile, and the severity of frailty. Finally, although further studies are required to confirm their effectiveness, factor XIa inhibitors are emerging as new promising alternative therapies because they have been associated with a lower bleeding risk compared with DOACs. Full article

Photon-counting computed tomography (PCCT) introduces a new era in thoracic imaging by offering ultra-high spatial resolution, reduced noise, spectral imaging capabilities, and lower radiation dose compared to conventional CT. These features are particularly relevant in thoracic surgery, where precise anatomical and functional assessment is essential throughout the perioperative period. This narrative review outlines the clinical potential of PCCT in surgical planning, intra- and postoperative evaluation, and follow-up of both oncologic and non-oncologic thoracic conditions. PCCT enables accurate bronchovascular mapping and iodine-based perfusion imaging, supporting sublobar resection planning and risk stratification in patients with complex anatomy or reduced lung function. Postoperatively, it enhances detection of subtle complications—such as air leaks or hematomas—and improves image quality near metallic implants through advanced artifact reduction techniques. The ability to combine high-resolution imaging with functional data allows for comprehensive evaluation in a single scan and may aid in differentiating fibrosis from local recurrence. Despite its promises, PCCT adoption is currently limited by high cost, restricted availability, and the need for training and system integration. Furthermore, prospective clinical studies are still needed to determine its impact on surgical outcomes. As technological and infrastructural challenges are addressed, PCCT may become a valuable component of image-guided thoracic surgery, contributing to safer, more personalized care. Full article

De-sealing, or depaving, is increasingly adopted to restore soil permeability and support green infrastructure, yet its potential to recover soil functions remains insufficiently understood. This study reports one year of soil monitoring following the de-sealing of a brownfield site in Milan (Italy). It compares the evolution of pedoclimatic parameters in sealed and de-sealed soils and assesses the suitability of recycled aggregates (RAs) from demolition waste as a soil-forming material. Buried sensors continuously recorded pedoclimatic parameters, temperature, water content, and oxygen concentration, while periodic sampling was carried out to analyse soil chemical properties, bacterial community composition, and the quality of percolation water (heavy metal content). De-sealing immediately improved pedoclimatic conditions, enhancing soil aeration, water regulation, and heat exchange capacity. No significant variation was detected in soil chemical properties, apart from pH fluctuations linked to the leaching of alkaline ions from concrete-based RAs. The presence of RAs caused no adverse effects on either soil or percolation water. Bacterial community composition was strongly associated with soil organic carbon, C:N ratio, and soil water content, without showing clear temporal trends. Overall, the study demonstrates that de-sealing rapidly triggers soil functional recovery and that, when properly characterised for composition and contamination risk, RAs pose no evident threat to the surrounding environment. Full article

Emesis is one of the most common side effects of ketamine sedation; however, predictors like species and sex have not been studied in macaques. This study aimed to determine the incidence and predictors of emesis in macaques undergoing ketamine sedation and to assess the efficacy of orally administered antiemetics in preventing emesis. A retrospective analysis was performed using medical records from rhesus and cynomolgus macaques who received ketamine sedation for veterinary examination events from August 2023 to April 2024. Among the 70 sedations performed using IM ketamine, the overall incidence of emesis was 26%. Cynomolgus macaques had a significantly higher risk of emesis (odds ratio (OR) 46.14, 95% confidence interval (CI): 7.08–493.9; p < 0.0001), with an emesis incidence of 55%. Females showed a higher incidence of emesis (75%) with an odds ratio of 3.72 (95% CI: 0.55–17.91; p = 0.24), though this difference was not statistically significant. In a prospective, randomized study, we compared the prophylactic use of oral maropitant citrate at a dose of 2 mg/kg or oral ondansetron at a dose of 1 mg/kg versus placebo for the prevention of emesis in cynomolgus macaques undergoing veterinary examination. Emesis was reduced from 58% in the control group to 50% in the maropitant group and 33% in the ondansetron group. However, the reduction in relative risk with either treatment did not reach statistical significance. Prophylactic oral administration of maropitant appears ineffective in preventing emesis in cynomolgus macaques. In contrast, prophylactic oral ondansetron is a more effective alternative in preventing emesis in these animals. Full article