Search Results (29,614)

A cross-sectional qualitative study examined how different pattern types accounted for wide variation in children’s Awareness of Mathematical Pattern and Structure (AMPS), illustrating how spatial and patterning skills are interrelated. An interpretive descriptive analysis of responses was conducted for two interview-based Growing Square Array (GA) and Spatial-Repeating Pattern (SP) tasks with 405 children from Grade 1 (n = 189) and Grade 2 (n = 216). Analysis of developmental levels of AMPS indicated that advanced multiplicative spatial structures were employed in GA patterns for 20% of Grade 1 and 35% of Grade 2 children, respectively. Responses to SP tasks extended beyond the ‘unit of repeat’ to the use of dynamic visualization, and orientation and transformation skills for 60% of children. Responses showing advanced structural features moderately increased at Grade 2 for both tasks. Micro-level analyses of illustrations of interview responses and from a Pattern Construction task, drawn from five case studies, revealed how multiplicative and transformation skills were utilized in forming repetitions and growing patterns in complex and novel ways. While the ‘unit of repeat’ is fundamental, the integration of more complex multi-dimensional patterning with spatial concepts can re-focus learning and pedagogy on establishing interrelationships between patterning and spatial concepts, and broader mathematical knowledge. Full article

Background/Objectives: Mild cognitive impairment (MCI) represents an intermediate stage between normal ageing and dementia, with a high annual progression rate. Despite its clinical relevance, no pharmacological treatment has been definitively approved for this condition; however, multiple pharmacological and non-pharmacological strategies have been investigated for their potential benefits. This systematic review assessed the effectiveness of both types of interventions in adults with MCI, aiming to identify effective strategies to preserve cognitive function. Methods: A systematic search (2017–2025) was conducted in PubMed, Scopus, ScienceDirect, SpringerLink, and WOS, following PRISMA guidelines. Randomised controlled trials and quasi-experimental studies involving adults aged ≥ 50 years with a diagnosis of MCI were included. Outcomes were evaluated in terms of cognitive, functional, behavioural, and quality-of-life improvements. Risk of bias was assessed using the RoB 2 and ROBINS-I tools. Results: Of 108,700 records screened, 40 studies were included. Non-pharmacological interventions, such as cognitive training (conventional, computerised, or virtual reality-based), consistently improved memory, attention, and executive functions (e.g., MoCA: +3.84 points; p < 0.001). Transcranial magnetic stimulation combined with physical exercise also demonstrated significant benefits (p = 0.025). Among pharmacological treatments, only vortioxetine and choline alfoscerate showed modest improvements; cholinesterase inhibitors had limited effects and frequent adverse events. Complementary therapies (yoga, probiotics, and acupuncture) yielded promising outcomes but require further validation. Conclusions: Non-pharmacological strategies, particularly cognitive training and physical exercise, emerge as the most effective and safe approaches for managing MCI. The inclusion of pharmacological interventions with preliminary evidence of benefit should be considered within a personalised, multimodal approach, while recognising the current absence of approved drug treatments for MCI. Further research is needed in underrepresented populations, such as those in Latin America. Full article

Background: Desmoid tumors (DTs) are rare, locally aggressive soft-tissue neoplasms that often affect women of reproductive age. Pregnancy and prior abdominal surgery or trauma have been associated with tumor development and growth, while imaging frequently overlaps with abdominal-wall endometriosis. We present the case of a 39-year-old woman with an abdominal-wall DT and provide a narrative review of the literature focused on pregnancy/postpartum patterns, differential diagnosis, and management. Methods: A narrative review of PubMed/MEDLINE and Web of Science (January 1982–December 2024) was conducted. We included English-language case reports/series, narrative/descriptive reviews, and consensus statements relevant to DTs in pregnancy or reproductive-age women, emphasizing abdominal-wall disease. Results: The patient’s right abdominal-wall mass enlarged during pregnancy and further post-partum imaging repeatedly suggested endometriosis. En bloc resection revealed desmoid-type fibromatosis composed of bland spindle cells in a collagenous stroma, with nuclear β-catenin and lymphoid enhancer–binding factor 1 (LEF1) positivity on immunohistochemistry. Magnetic resonance imaging (MRI) at 12 months showed no recurrence. Across included studies, pregnancy and post-partum enlargement is common, abdominal-wall DTs frequently mimic scar endometriosis, and pre-operative ultrasound has limited specificity. Current practice supports watch-and-wait for stable, asymptomatic lesions and function-preserving surgery for symptomatic progression, while systemic options (anti-estrogens, low-dose chemotherapy, and tyrosine kinase inhibitors) are reserved for progressive or unresectable disease. Recurrence risk relates to age, size, site, and β-catenin status; future pregnancy is not contraindicated. Conclusions: Abdominal-wall DTs, although rare, should be considered in the differential diagnosis of reproductive-age women presenting with abdominal-wall masses, particularly during or after pregnancy. Full article

Tree-covered urban green spaces, including streets, parks, and other public areas, are vital for urban sustainability and people’s well-being. However, such trees face threats from the occurrence of extreme weather. In this study, we investigated wind damage to urban trees in the city of Debrecen, Hungary, during two severe windstorms in July 2025. Field surveys were conducted across three distinct urban zones, covering approximately 515,000 m² in total. We assessed 201 damaged and 325 undamaged trees and recorded the species, size, damage type, and contextual landscape features associated with them being damaged or not. Damage type to trees consisted primarily of broken branches, whilst uprooting and trunk breakage were recorded less often. Most tree characteristics (trunk circumference, height, systematic position, nativity) and the proximity and height of buildings upwind of focal trees were significant predictors of their vulnerability to windstorms. In addition, we surveyed 150 residents in person and received comments from 54 people via online questionnaires and explored their perceptions of storm frequency, the causes of storms, and mitigation measures. Most respondents noted increased storm frequency and attributed that to climate change, and they suggested mitigation measures focused on urban tree management and environmental protection. Some people expressed scepticism about the presence of climate change and/or their ability to address such damage on an individual basis. Our study is the first to integrate assessments of storm-related impacts on urban trees with the opinions of residents living in proximity to them. Our findings highlight the need for climate-adaptive and mechanically robust urban forestry planning and offer insights that guide the management of trees in urban areas globally. Specifically, we propose to undertake the following: (1) Prioritise structurally resilient, stress-tolerant tree species adapted to extreme weather conditions when planting new trees. (2) Integrate wind dynamics, microclimatic effects and artificial stabilisation techniques into urban design processes to optimise tree placement and their long-term stability. Urban planners, builders, developers, and homeowners should be informed about these stabilising practices and incorporate the needs of trees early in the design process, rather than as decorative additions. (3) Develop regionally calibrated risk models and early-warning systems to support proactive and data-driven tree management and public safety. (4) Promote climate literacy and public participation to strengthen collective stewardship and resilience of urban trees. Full article

Background: Modern healthcare environments expose staff to various occupational stressors, with noise being among the most common and harmful stressors. In intensive care units (ICUs), both patients and nurses are frequently exposed to unsafe noise levels, which can adversely affect well-being, recovery, and work performance. Objective: This study aimed to identify sources of noise and their adverse effects from the perspective of ICU nurses, and to examine associations between noise perception, demographic and job-related variables, and outcomes across four domains: subjective, emotional, physiological, and work performance. Methods: A cross-sectional study was conducted from February to September 2023 among 100 ICU nurses employed in three Croatian hospitals: Zagreb, Pula and Slavonski Brod. Data were collected using a validated three-part questionnaire and analyzed with descriptive and inferential statistics. Results: Nurses reported that monitor and ventilator alarms were the most prominent sources of internal noise. Noise perception within and outside ICUs differed significantly depending on the type of institution, ICU, and number of beds (p < 0.05). Significant relationships were found between noise exposure and outcomes across all four domains. Conclusions: Noise in ICUs poses a health risk to both patients and nurses, impairing well-being and work performance. Implementing effective noise reduction strategies should be prioritized in critical care settings. Full article

Background/Purpose: Teeth prepared for fixed dental prostheses are subject to various types of insults in the oral cavity. Therefore, to protect the tooth, the pulp, and supporting structures, provisional restorations are mandatory. Our study aimed to evaluate the knowledge and clinical practices regarding provisional fixed dental prostheses (PFDPs) among dental professionals in Saudi Arabia. Materials and Methods: A cross-sectional study based on a self-administered online survey was conducted among 312 dentists (general practitioners and specialists) across Saudi Arabia. The questionnaire assessed participants’ knowledge (11 items) and clinical practices (9 items) related to PFDPs. Statistical analyses included descriptive statistics, chi-square tests, and multivariate logistic regression. Results: Only 46.5% of respondents demonstrated adequate knowledge of PFDPs. Knowledge was significantly higher among specialists than general practitioners (57.4% vs. 41.7%, p = 0.011), and specialists were more likely to recognize the influence of PFDPs on treatment outcomes. Clinical practice patterns indicated that even though 94.2% of respondents frequently placed PFDPs, only 66.0% always did so. Moreover, 21.2% of respondents rarely or never disinfect PFDPs. Public sector dentists and specialists were more likely to use custom-made PFDPs. Key gaps in knowledge were observed regarding the materials and equipment used in the fabrication of PFDPs, particularly concerning CAD/CAM technology. Conclusions: Although most dentists in Saudi Arabia provided PFDPs to their patients, significant gaps remain in their knowledge, particularly regarding fabrication materials and techniques. Targeted educational interventions, especially for general practitioners, are needed to enhance clinical outcomes. Full article

Stropharia rugosoannulata is a widely cultivated edible fungus with high economic and nutritional value. It is a tetrapolar heterothallic basidiomycete. The development of single nucleotide polymorphism (SNP) markers for mating-type identification holds considerable promise for enhancing breeding efficiency. In our study, one group of test crosses and three-round mating experiments from one parental strain were conducted in order to ascertain the mating type in this species. Segregation distortion in mating types was observed after single-spore isolation, which was deviated from Mendelian inheritance. The monokaryotic strain Q25 was derived from the dikaryotic mycelium S1 of S. rugosoannulata. The genome map of strain Q25 with 48.27 Mb and 14 chromosomes was constructed using genomic, transcriptomic, and high-throughput chromosome conformation capture (Hi-C) sequencing technologies. The locations of mating-type loci were identified using genomic annotation. The mating-type A locus is located in chromosome 1, with the gene sequence of β-fg, HD2, HD1, and MIP. The mating-type B locus is located in chromosome 12. It contains five pheromone receptors and five pheromone precursor genes. Two pairs of highly specific and stable primers were designed based on SNP loci in A and B mating types. A1, A2, B1, and B2 alleles were precisely distinguished with these primers, which were subsequently applied in cultivation experiments. This study lays a foundation for the precise breeding of S. rugosoannulata. Full article

Background: Timely dental care is essential to prevent complications and preserve natural teeth, yet inefficient referral practices, low reimbursement rates and systemic barriers continue to disproportionately affect Medicaid-enrolled children. This study assessed the appropriateness of root canal therapy (RCT) referrals to a University-based Advanced Education in General Dentistry (AEGD) program and examined diagnostic and treatment characteristics of referred cases. Methods: A retrospective review was conducted of pediatric patients aged 6–17 years who were referred by external dental providers to two AEGD clinics in Nevada, United States, between February and August 2024 for endodontic evaluation of carious permanent teeth. Demographic, tooth-type, pulp-status, and treatment outcome data were analyzed using descriptive statistics, chi-square tests, Kruskal–Wallis comparisons, and multivariable logistic regression models. Results: Among 154 referred patients, 96.8% (n = 149) were Medicaid beneficiaries. A total of 247 teeth were evaluated; 74.1% were molars. Pulp testing showed that 41.3% had healthy pulps and 16.6% had reversible pulpitis, while only 37.2% of teeth required RCT. Age differed significantly across pulp diagnoses (p = 0.0012), and older age independently predicted appropriate referral (adjusted OR = 1.18, 95% CI 1.07–1.31). Gender was not associated with follow-up compliance (p = 0.47). By November 2024, 53.4% of referred teeth had completed treatment, and 9.3% had no follow-up. Conclusions: More than half of the referral teeth did not require RCT, indicating a high rate of potentially avoidable referrals and highlighting gaps in diagnostic confidence and decision-making at the primary care level. Practical Implications: Enhancing diagnostic training and decision support for general dentists, particularly in vital pulp therapy for young permanent teeth, along with improving Medicaid reimbursement and standardizing referral protocols, may reduce inappropriate specialty referrals. In combination with broader policy reforms, these measures can improve system efficiency and expand access to timely, equitable pediatric dental care. Full article

The high HIV prevalence among men who have sex with men and transgender women (TW) in Peru calls for innovative HIV prevention strategies to modify social norms, increase social support and promote empowerment and community mobilization. This qualitative article presents the synergistic processes that generated community mobilization throughout Generación Actual (GA, Current Generation in English), an HIV prevention intervention with gay men (GM) and TW in Lima South based on Mpowerment, a U.S.-model intervention program. We conducted 24 interviews with GM and TW participants, informed by observations of GA and the perceptions of its implementing coordinators, and complemented by the number/types of GA activities. Four significant processes occurred throughout GA: (1) high participant engagement, community building and empowerment; (2) an effect on HIV prevention and treatment; (3) the integration of GM and TW and (4) GA’s community center becoming a safe space for socializing, support and information. These processes helped produce positive changes related to self-empowerment, personal agency and the participants’ health, suggesting an impact of GA on HIV prevention, stigma reduction and care engagement. Community mobilization strategies that ensure active community participation and involvement may constitute relevant aspects for an effective approach to HIV prevention for TW and GM in Peru. Full article

Industrial Robots (IRs) are typically employed as flexible machines to perform many types of repetitive and intensive tasks within fenced safe areas, ensuring high productivity and cost efficiency. However, their rigid programming approaches often pose challenges during cell commissioning and reset, hindering the implementation of self-reconfigurable systems. In addition, several production lines still need the presence of skilled operators to conduct assisted assembly operations and inspections. This motivates the growing interest in the development of innovative solutions for supporting safe and efficient human–robot collaborative applications. The manual guidance of the IR end-effector is a representative functionality of such collaboration, as it simplifies heavy-part manipulation and allows intuitive robot teaching and programming. The present study reports a sensor-based approach for enabling manual guidance operations with high-payload IRs and discusses its practical implementation on a production cell with an extended workspace. The setup features a KUKA robot mounted on a custom linear track actuated via Beckhoff technology to enable flexible assembly and machining operations. The developed logic and its software configuration, split into multiple control units to allow the manual guiding of both the 6-axis IR and the linear track unit, are described in detail. Finally, an experimental demonstration involving two users with different levels of expertise was conducted to evaluate the approach during target teaching on a physical cell. The results showed that the proposed manual guidance method significantly reduced task completion time by more than 55% compared with the conventional teach pendant, demonstrating the effectiveness and practical advantages of the developed framework. Full article

Over the service life of several decades, structural damage detection is crucial for ensuring the safety and durability of engineering structures. However, existing methods often overlook the spatiotemporal coupling in multi-sensor data, hindering the full exploitation of structural dynamic evolution and spatial correlations. This paper proposes an autoencoder model integrating Temporal Convolutional Networks (TCN) and Graph Attention Networks (GAT), termed TCNGAT-AE, to establish an unsupervised damage detection method. The model utilizes the TCN module to extract temporal dependencies and dynamic features from vibration signals, while leveraging the GAT module to explicitly capture the spatial topological relationships within the sensor network, thereby achieving deep fusion of spatiotemporal features. The proposed method adopts an “offline training-online detection” framework, requiring only data from the healthy state of the structure for training, and employs reconstruction error as the damage indicator. To validate the proposed method, two sets of experimentally measured data are utilized: one from the Z-24 concrete box-girder bridge under ambient excitation, and the other from the Old Ada Bridge under vehicle load excitation. Additionally, ablation studies are conducted to analyze the effectiveness of the spatiotemporal fusion mechanism. Results demonstrate that the proposed method achieves effective damage detection in both different structural types and excitation scenarios. Furthermore, the explicit modeling of spatiotemporal features significantly enhances detection performance, with the anomaly detection rate showing substantial improvement compared to baseline models utilizing only temporal or spatial modeling. Moreover, this end-to-end framework processes raw vibration signals directly, avoiding complex preprocessing. This makes it highly suitable for practical and near-real-time monitoring. The findings of this study demonstrate that the damage detection method based on TCNGAT-AE can be effectively applied to structural safety monitoring in complex engineering environments, and can be further integrated with real-time monitoring systems of critical structures for online analysis. Full article

When drilling inclined and horizontal sections, a significant part of the drill string is in a compressed state which leads to a loss of stability and longitudinal bending. Modeling of the stress–strain state (SSS) of the drill string (DS), including prediction of its stability loss, is carried out using modern software packages; the basis of the software’s mathematical apparatus and algorithms is represented by deterministic statically defined formulae and equations. At the same time, a number of factors such as the friction of the drill string against the borehole wall, the presence of tool joints, drill string dynamic operating conditions, and the uncertainty of the position of the borehole in space cast doubt on the accuracy of the calculations and the reliability of the predictive models. This paper attempts to refine the actual behavior of the drill string in critical and post-critical conditions. To study the influence of dynamic conditions in the well on changes in the SSS of the DS due to its buckling, the following initial data were used: a drill pipe with an outer diameter of 88.9 mm and tool joints causing pipe deflection under gravitational acceleration of 9.81 m/s² placed in a horizontal wellbore with a diameter of 152.4 mm; axial vibrations with an amplitude of variable force of 15–80 kN and a frequency of 1–35 Hz; lateral vibrations with an amplitude of variable impact of 0.5–1.5 g and a frequency of 1–35 Hz; and an increasing axial load of up to 500 kN. A series of experiments are conducted with or without friction of the drill string against the wellbore walls. The results of computational experiments indicate a stabilizing effect of friction forces. It should be noted that the distance between tool joints and their diametrical ratio to the borehole, taking into account gravitational acceleration, has a stabilizing effect due to the formation of additional contact force and bending stresses. It was established that drill string vibrations may either provide a stabilizing effect or lead to a loss of stability, depending on the combination of their frequency and vibration type, as well as the amplitude of variable loading. In the experiments without friction, the range of critical loads under vibration varied from 85 to >500 kN, compared to 268 kN as obtained in the reference experiment without vibrations. In the presence of friction, the range was 150 to >500 kN, while in the reference experiment without vibrations, no buckling was observed. Based on the results of this study, it is proposed to monitor the deformation rate of the string during loading as a criterion for identifying buckling in the DS stress–strain state monitoring system. Full article

Butterflies are important biological indicators for assessing the environment and habitat quality. Dulongjiang in Yunnan, China, a global biodiversity hotspot, has undergone recent socioeconomic development, yet the impact of resultant land-use changes on its butterfly fauna remains poorly understood. This study conducted a systematic survey across three land-use types (forest, cropland, and construction land) over four months in 2024, employing area-time counts at 12 observatory sites. A total of 4805 individual specimens from 142 species, 88 genera, and 6 families were recorded. Nymphalidae dominated in species richness, while Pieridae was most abundant. Species rarefication curves indicated well-represented sampling. Diversity was significantly different between the four months, with a peak in June, when environment conditions are favourable. The forest harboured the least butterfly richness but higher evenness, while construction land showed the highest richness and lower evenness. Butterfly communities in three land-use types showed no significant differences, attributed to the fragmented topography in the area, which facilitates butterfly dispersal. Our findings reveal that butterfly diversity in Dulongjiang is influenced by a combination of seasonal climatic variations and land use. Full article

This article explores the implications of digital labor intermediation platforms in paid domestic work (PDW) in Chile, a sector historically marked by informality and vulnerability. Drawing on a qualitative study conducted with members of the Federation of Domestic Workers’ Unions of Chile (FESINTRACAP), we analyze the narratives of workers who engage with digital platforms to access employment. We propose that these platforms, while expanding job search opportunities, reproduce and exacerbate precarious working conditions by weakening employment relationships, increasing surveillance through rating systems, and reinforcing structural inequalities such as gender, class, and migratory status. Using a grounded theory approach, we identify six thematic categories: (1) Access and Technological Transition, (2) Recruitment and Labor Matching Modalities, (3) Procedures and Technological Requirements, (4) Use of Ratings and Reputation, (5) Perceptions of Autonomy vs. Dependency, and (6) Lack of Regulation and Legal Guarantees. Our findings suggest that digital intermediation reconfigures labor relations under a neoliberal logic of individual responsibility while failing to provide institutional protections. We argue that the digitalization of labor intermediation in PDW deepens the sector’s historical patterns of invisibility and exclusion, highlighting the urgent need for regulatory frameworks that address the specificities of this type of employment. Full article

Background: Non-communicable diseases represent a major global health challenge. Among these, diabetic ketoacidosis (DKA), an acute complication of type 1 diabetes mellitus in children and adolescents, significantly contributes to worldwide morbidity and mortality. Effective management of DKA relies on adequate insulin therapy, but variability in dosing, administration, and frequency leads to increased risk of complications and delayed DKA resolution. We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the insulin dose and route of administration regimens for managing pediatric DKA. Methods: This review followed the PRISMA guidelines and was registered on PROSPERO (CRD42024568747). A comprehensive search of PubMed, CINAHL, Cochrane Library, and Scopus identified studies examining insulin regimens in pediatric DKA. Eligible studies were assessed for risk of bias using the Cochrane’s Risk of Bias (RoB-2) tool, and data were pooled using Review Manager for meta-analysis. Outcomes included morbidity (cerebral injury, hypoglycemia, hypokalemia), mortality, hospital stay, and adverse events. The quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. This review was commissioned by the WHO for the development of consolidated guidelines on common childhood illnesses. Results: Twelve RCTs, involving 530 participants, were included. A lower insulin dose (0.05 U/kg/h) was associated with a significantly reduced risk of hypoglycemia (RR = 0.39, 95% CI: 0.18–0.88, p = 0.02) and hypokalemia (RR = 0.54, 95% CI: 0.33,0.89, p = 0.01) compared to 0.1 U/kg/h. There were no significant differences in mortality and length of hospital stay between the dosing regimens. Additionally, no significant differences were observed in the incidence of cerebral injury and other adverse events. Conclusions: Findings suggest that lower insulin doses may reduce the risks of hypoglycemia and hypokalemia in children with mild-to-moderate DKA without increasing the risk of mortality, cerebral injury, or length of hospital stay. Further studies are needed to provide an evidence-based core outcome set and refine insulin dosing strategies across the full spectrum of disease severity. Full article