Search Results (21,994)

This study evaluates temporal variability and algorithm differences in soil moisture estimates over Europe using the European Center for Medium-range Weather Forecasts (ECMWF) operational analysis and the passive Soil Moisture Active Passive (SMAP) soil moisture product. While models and satellite retrievals have improved in capturing the timing of soil moisture dynamics, absolute accuracy and temporal variability magnitudes still diverge. This study compares the representation of short-term and seasonal variability of soil moisture in absolute and normalized terms over two different hydrometeorological growing periods (2021 and 2022). Both datasets exhibit intermediate to high temporal correlations with in situ measurements at selected stations (median Pearson correlation coefficients of all stations range between 0.65 and 0.79), confirming previous studies. However, they overestimate the magnitude of absolute soil moisture variability at most stations (median interquartile range of all stations at 0.085 (0.10) m³m⁻³ for ECMWF and 0.072 (0.079) m³m⁻³ for SMAP opposed to 0.063 (0.072) m³m⁻³ for in situ in 2021 (2022)) due to an overestimation of short-term fluctuations, especially at dry stations in southern France and Eastern Europe. The soil wetness index is underestimated, particularly within SMAP estimates. The performance of both is sensitive to hydrometeorological conditions, with the 2022 European drought causing strong seasonal and weak short-term fluctuations. This is easier to capture than conditions with pronounced short-term and weaker seasonal fluctuations, as in 2021. Overall, SMAP and ECMWF time series show considerable coincident timing, whereas the magnitude of temporal variability and accuracy depend on site-specific characteristics and the pre-processing of the data. Full article

Δ¹-Pyrroline-5-carboxylate reductase (EC 1.5.1.2; called ProC in most bacteria) is an enzyme of central metabolism that catalyzes the last step of the proline biosynthetic pathways, namely the NADPH-dependent reduction of pyrroline-5-carboxylate (P5C) to L-proline (L-Pro). The enzyme, however, is also active towards other substrates, and these reactions might have physiological relevance. Herein, the substrate versatility of ProC from Escherichia coli was explored as follows. We initially characterized the reverse reaction carried out by ProC, i.e., the formation of P5C from L-Pro. This reaction was easily measurable at pH 10, allowing the determination of the kinetic parameters. Under the same conditions, we then tested the ability of ProC to oxidize a number of L-Pro analogs, confirming that ProC reacts most effectively with analogs containing a simple five-membered ring such as L-thioproline (THP) and 3,4-dehydro-L-proline (DHP). Larger substrates such as L-pipecolate (PIP) reacted with lower efficiency, and the four-membered ring analog, L-azetidine-2-carboxylate (A2C) showed no detectable reactivity and behaved as a weak inhibitor of the ProC reaction. To interpret these results, we built a structural model of ProC and employed this model for a docking analysis of L-Pro and of its analogs. This approach highlighted the presence of a peculiar “three-point interaction”, in which the L-Pro carboxylate and amino groups form hydrogen bonds with conserved residues in the binding site, while the substrate ring stacks with the nicotinamide ring of NADP⁺. The L-Pro analogs tried to preserve as much as possible these critical interactions for a correct positioning and a favorable binding. The possibility of an inherent multifunctionality of ProC was further explored by examining the genomic context of the proC gene in a large number of bacterial species. Full article

Adult growth hormone deficiency (GHD) is linked to increased cardiovascular and metabolic risk due to oxidative stress (OS), endothelial dysfunction, and unhealthy body composition. Long-term systemic effects of recombinant human growth hormone (rhGH) therapy remain insufficiently defined. This study assessed the impact of 24-month rhGH replacement on OS, vascular markers, body composition, and bone mineral density (BMD) in adults with severe GHD. Fifteen adults with confirmed GHD received rhGH for 24 months. Serum insulin-like growth factor 1 (IGF-1), oxidized LDL (Ox-LDL), thioredoxin (Trx), 8-oxoguanine DNA glycosylase 1 (OGG1), E-selectin, intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) were measured at baseline and 12 and 24 months. Body composition and BMD were evaluated by DXA. IGF-1 increased significantly at 12 and 24 months (p < 0.001). Ox-LDL markedly decreased (p < 0.00001), while Trx and OGG1 increased (p < 0.05). Levels of E-selectin, ICAM-1, and VCAM-1 declined, indicating improved endothelial function. Lean body mass and BMD increased, while body fat parameters showed heterogeneous changes. Lipid profiles were unchanged. Significant correlations were observed between vascular markers and adiposity, and between BMD, triglycerides, and IGF-1. A 24-month course of rhGH therapy improves redox balance, vascular function, and body composition in adults with severe GHD, supporting the use of redox and vascular biomarkers to monitor treatment efficacy. Full article

Modern telemedicine requires advanced analytical solutions for efficient management of chronic diseases. This study presents the development of a comprehensive business intelligence (BI) framework using Microsoft Power BI, applied to the optimization of diabetes mellitus management. The methodology integrates Power Query transformations, 35 DAX measures organized into five functional categories, and Python 3.14.2. capabilities for advanced statistical analysis. The framework was implemented and demonstrated using a public clinical dataset of 100,000 patient records, generating five interactive dashboards covering epidemiological, demographic, clinical, geographical, and equity perspectives. A global prevalence of 8.5%, exponential growth with age, gender differences (9.75% males against 7.62% females), and substantial connections between metabolic indicators (BMI, HbA1c, and blood glucose) are all confirmed by the results. Heart disease rates are 6.2 times higher in diabetic people, according to comorbidity research. Complete methodological openness through thorough documentation, Python integration for sophisticated visualizations, and interactive multidimensional drill-down features are some of the major additions. The predictive elements are included as interpretable, exploratory components embedded in the BI environment rather than as clinically validated prediction models. This approach provides an affordable and user-friendly approach that makes advanced analytical capabilities accessible to a broader range of healthcare organizations managing chronic diseases. Full article

Traditional multi-criteria decision-making methods often operate on the assumption of symmetry, presupposing that the positive impact of a criterion’s presence is perfectly complementary to the negative impact of its absence. However, in real-world decision problems, this relationship is frequently asymmetric; some criteria act merely as “delighters,” while others represent “must-have” constraints. This study proposes a novel methodology, the Presence–Absence Synthesis (PAS) Method, which addresses this asymmetry by treating the “Presence Effect” and “Absence Effect” of criteria as two independent dimensions. The method is built upon intuitionistic fuzzy sets (IFSs) to effectively model the uncertainty and hesitation inherent in expert evaluations. The applicability of the proposed approach is demonstrated through a real-world workforce management problem aimed at assigning employees to the most suitable tasks based on their competencies in a retail store. In the study, the suitability scores derived from the PAS method are integrated into a mathematical optimization model for weekly employee scheduling, presenting a two-stage decision support framework. The results and comparisons with the Technique for Order Preference by Similarity to Ideal Solution method reveal that the PAS method more effectively distinguishes critical competency gaps (i.e., criteria with high absence effects), leading to more realistic task assignments and a measurable reduction in operational risks, such as skill mismatches and infeasible schedules. Furthermore, sensitivity analysis confirms that the proposed model yields consistent and robust results under varying conditions. Beyond the retail context, the proposed PAS framework is applicable to a wide range of decision-making problems, including healthcare staff allocation, project team formation, supplier selection, and other resource allocation settings where their presence cannot compensate for the absence of critical criteria. Full article

Background/Objective: Type 2 Diabetes Mellitus (T2DM) represents a major increasing burden for primary care systems worldwide. Digital health interventions (DHIs) have been proposed as scalable tools to improve glycemic control, yet uncertainty remains regarding which intervention characteristics yield the greatest benefit. To evaluate the effectiveness of DHIs on HbA1c levels in adults with T2DM and to examine whether intervention duration, engagement intensity, glucometer integration, and healthcare provider involvement modify glycemic outcomes. Data Sources: PubMed, Embase, Cochrane Library, and JMIR databases were systematically searched for relevant studies published between January 2020 and May 2025. Study Eligibility Criteria: Randomized controlled trials comparing DHIs plus usual care versus usual care alone in adults with T2DM and reporting HbA1c as the primary outcome. Methods: Data were extracted using the Jadad scale and TIDieR framework. Random-effects meta-analysis estimated pooled mean differences (MD) in HbA1c with 95% CIs. Subgroup analyses examined effects by intervention characteristics. Heterogeneity and sources of variance were assessed through Cochran’s Q, I², meta-regression, and sensitivity analyses (leave-one-out and trim-and-fill). Results: Thirteen RCTs (n ≈ 20,000) met inclusion criteria. DHIs achieved significant HbA1c reductions (range 0.01% to 1.57%; pooled MD −1.08%; 95% CI −1.18 to −0.99; p = 0.001). Short-term (≤6 months), low-intensity interventions showed the largest effect sizes (MD −1.16%, 95% CI 0.94 to 1.39). Glucometer integration and healthcare provider involvement contributed minimally to additional benefit. Meta-regression confirmed substantial heterogeneity, but no single factor explained variance across studies. Limitations: Considerable heterogeneity across interventions and variability in engagement measurement may limit the generalizability of findings. Conclusions: Short-term, low-intensity DHIs significantly improve glycemic control in primary care populations with T2DM. Advanced meta-analytic techniques confirm the robustness of these effects, providing practical guidance for selecting and implementing effective digital interventions in routine diabetes care. Full article

Grounded in Self-Determination Theory (SDT), this study tested the hypothesis that body image perception delineates distinct motivational pathways, linking the perceived interpersonal style of exercise professionals to basic psychological needs, motivation quality, and long-term exercise persistence intentions. A sample of 821 regular exercisers was divided into two groups based on body image: “Satisfied” (n = 276) and “Dissatisfied due to Overweight” (n = 545). Participants completed validated measures of perceived interpersonal behaviors (supportive/thwarting), basic psychological need satisfaction/frustration, motivational regulation, and exercise persistence intention. A clear divergent pattern emerged, strongly supporting the main hypothesis. The “Satisfied” group reported a positive pathway: perceiving more need-supportive behaviors from instructors was associated with greater satisfaction of autonomy, competence, and relatedness, which in turn correlated with more self-determined motivation and stronger persistence intentions. Conversely, the “Dissatisfied” group reported a negative pathway: perceiving more need-thwarting behaviors was associated with greater need frustration, which correlated with more non-self-determined motivation and weaker persistence intentions. Measurement invariance confirmed these pathways are comparable across groups. The findings highlight that body image perception is a key correlate of distinct motivational experiences in exercise settings. Crucially, they underscore the significant association between the professional’s perceived interpersonal style and these pathways. Fostering need-supportive environments that enhance autonomy, competence, and relatedness is associated with more adaptive motivation and adherence, offering a valuable framework for practitioners aiming to support clients, particularly those with body image concerns. Full article

Background/Objectives: Early identification of vasculitic acute kidney injury (AKI) is crucial for timely immunosuppression and improved renal outcomes; however, noninvasive adjunctive diagnostic tools remain limited. Renal elastography, a noninvasive technique that quantifies renal cortical stiffness, has been primarily investigated in chronic kidney disease, whereas evidence in acute kidney injury is scarce. This study aimed to evaluate the diagnostic utility of renal shear wave elastography for differentiating vasculitic from non-vasculitic AKI and to explore the association between baseline renal cortical stiffness and vasculitic renal outcomes. Materials and Methods: This prospective observational study included three groups: vasculitic AKI, non-vasculitic AKI, and healthy controls. Renal cortical stiffness was measured at admission using two-dimensional shear-wave elastography (2D-SWE) by radiologists blinded to clinical information. After clinicopathological confirmation of definitive diagnoses, between-group comparisons were performed and the diagnostic performance of elastography was evaluated. Additionally, in a biopsy-confirmed immunoglobulin A vasculitis nephritis (IgAVN) cohort (n = 12), baseline elastography measurements were examined in relation to one-year renal outcomes to explore potential prognostic associations. Results: The vasculitic AKI group exhibited significantly higher mean renal cortical stiffness values (9.5 ± 1.9 kPa) compared with both healthy controls (5.53 ± 0.92 kPa) and the non-vasculitic AKI group (6.61 ± 1.89 kPa) (both p < 0.01). Mean renal cortical stiffness demonstrated good diagnostic performance for distinguishing vasculitic from non-vasculitic AKI (AUC 0.86, 95% CI 0.73–0.97), with an optimal threshold of 6.79 kPa yielding 91% sensitivity and 72% specificity. In the prospective one-year follow-up of the IgAVN subcohort (n = 12), patients with unfavorable renal outcomes tended to have higher baseline renal cortical stiffness compared with those with favorable outcomes [median (min–max), 11.2 (10.8–13.3) vs. 9.1 (5.6–11.2), p = 0.046]. Conclusions: These findings suggest that renal elastography may aid in distinguishing vasculitic from non-vasculitic acute kidney injury and may provide exploratory information on the relationship between baseline cortical stiffness and renal outcomes in IgAVN. Full article

In this study, we examined the enhancement of erythritol production by the Yarrowia divulgata strain 1485. Although erythritol fermentation has been thoroughly investigated in earlier studies, the influence of inoculum ratio has not been comprehensively addressed. Therefore, this parameter was selected as the focus of the present work. Since industrial-scale erythritol production is typically carried out using more efficient fungal strains, further improvements in economic viability are primarily expected through integration with other biotechnological processes, allowing the simultaneous generation of multiple valuable products. To this end, the erythritol fermentation was coupled with microbial pigment production, and the potential recovery of additional compounds—such as biodetergents and cosmetic ingredients—were also explored. Based on the results, the fermentation with a 15% inoculation rate appears to be the most effective, producing 67.9 ± 6.0 g/L of erythritol, and 61.81 ± 0.02 mg/L of pigment was successfully extracted at the end of the pigment fermentation. The cells seem capable of increasing the skin’s moisturizing effect according to our preliminary tests when glass bead cell disruption is used, and the emulsifier has also proven to be effective, maintaining an emulsification index (EI) above 50% even after 24 h. When performing a kinetic model, we found that the measured data matched the model predictions and confirmed optimal inoculation size (15%), providing a solid basis for subsequent techno-economic analysis. The integration of the two basic fermentations (erythritol and pigment) is therefore considered successful, and the Yarrowia divulgata strain appears to have great biotechnological potential. Full article

This article presents an improved formulation of Newton’s law of cooling using the conformable fractional derivative to model long-term thermal behavior more accurately. A key feature of our approach is the use of the fractional time variable $t^{\gamma }$, which introduces a simple scaling symmetry: the structure of the model remains unchanged even when time is proportionally stretched or compressed. This symmetry-based property provides additional flexibility compared to the classical formulation and enables the derivation of analytical solutions under both constant and non-constant ambient temperature. In particular, we incorporate sinusoidal models for ambient temperature to capture realistic environmental fluctuations over extended periods. Experimental measurements confirm that the conformable model achieves significantly better accuracy than traditional integer-order models. These results highlight the relevance of symmetry and fractional calculus in describing physical processes and demonstrate the potential of conformable methods for improving long-term thermal predictions. Full article

Background/Objective: Hand hygiene is a cornerstone of infection prevention; however, compliance is inconsistent in intensive care units (ICUs), particularly in resource-constrained settings. This study evaluated whether a low-cost, multimodal quality improvement intervention could improve process-level hand hygiene compliance using routine, episode-based audits embedded in the ICU practice. Methods: We conducted a single-cycle Plan-Do-Study-Act quality improvement project in a 12-bed mixed medical–surgical ICU in Pakistan (December 2023–January 2024). Hand hygiene performance was assessed using the unit’s routine weekly episode-based audit protocol, aligned with the WHO Five Moments framework. A targeted multimodal intervention comprising education, point-of-care visual reminders, audit feedback, and leadership engagement was implemented between the pre- and post-intervention phases (four weeks each). Non-applicable moments were scored as “compliant by default” according to the institutional protocol. A sensitivity analysis was performed excluding these moments to calculate pure adherence. Compliance proportions were summarized using exact 95% Clopper–Pearson confidence intervals without inferential testing. Results: A total of 942 audit episodes (471 per phase) generated 4710 moment-level assessments were generated. Composite hand hygiene compliance increased from 63.1% pre-intervention to 82.0% post-intervention [absolute increase: 18.9 percentage points (pp)]. Sensitivity analysis excluding non-applicable moments demonstrated pure adherence improvement from 54.2% to 82.5% (+28.3 pp), confirming a genuine behavioral change rather than a measurement artifact. Compliance improved across all five WHO moments, with the largest gains in awareness-dependent moments targeted by the intervention: before touching the patient (+27.0 pp) and after touching patient surroundings (+40.0 pp). Week-by-week compliance remained stable within both phases, without immediate post-intervention decay. Conclusions: A pragmatic, low-cost multimodal intervention embedded in routine ICU workflows was associated with substantial short-term improvements in hand hygiene compliance over a four-week observation period, particularly for awareness-dependent behaviors. Episode-based audit systems can support directional process monitoring in resource-limited critical care settings without the need for electronic surveillance. However, its long-term sustainability beyond one month and generalizability to other settings remain unknown. Sensitivity analyses are essential when using “compliant by default” scoring to distinguish adherence patterns from measurement artifacts. Full article

Background: Prior research has provided evidence supporting the claim that actigaming may offer benefits for individuals’ emotions. However, the impact of actigaming on emotional attentional biases remains uncertain. Objective: To address this gap in the literature, this study aims to examine whether actigaming affects emotional attentional biases. Methods: We conducted a randomized crossover experiment in this study. A total of 18 college students completed a single session of actigaming and aerobic bicycle exercise for 40 min. Before and after the exercises, each participant completed the Profile of Mood States Questionnaire (POMS), Emotion Regulation Questionnaire (ERQ), and emotional attentional biases task. The heart rates of study participants were measured during the intervention to determine their maximum and average rates. Results: The following two findings were identified in this study: (1) There are no significant differences in maximum heart rate and average heart rate between participants of the aerobic bicycle intervention and the actigaming intervention (p = 0.352; p = 0.643, respectively). (2) Cores of POMS under the baseline condition present no significant difference between the two interventions (p = 0.872). However, the POMS post-test scores of participants in the actigaming intervention are significantly lower than those of participants in the aerobic bicycle intervention (p = 0.002). The main finding of the study is that, under baseline conditions, there are no significant differences in emotional attentional bias scores between the two interventions (p = 0.352). However, post-test scores show that participants in the actigaming intervention exhibit significantly lower attentional bias toward negative emotions compared to those in the aerobic bicycle intervention (p = 0.001). Conclusions: Actigaming more favorably post-exercise mood and significantly attenuates attentional bias toward negative stimuli compared with aerobic cycling. Therefore, the results of this study need to be confirmed by higher-quality studies in the future. Full article

Background/Objectives: Lymphedema is characterized by edema; in severe cases, skin changes and ulceration significantly impair patients’ quality of life. Although several experimental rodent models for lymphedema have been established, a reproducible and practical model remains essential for evaluating new therapeutic and imaging agents. This study aimed to establish a lymphedema animal model and to evaluate the efficacy of a newly synthesized dual-mode imaging reagent as a potential alternative to indocyanine green (ICG). Methods: Eleven Sprague-Dawley rats were classified into two groups. Full-thickness skin excision was performed on the tails of nine rats to induce lymphedema; two rats served as controls. Five rats received ICG injections for 1 week postoperatively, while the remaining six rats were administered tail injections of chemically synthesized indocyanine green-methylene blue (ICG-MB) reagent. Lymphatic flow was photographed using a SPY camera. After euthanasia, tail segments were analyzed by microcomputed tomography (micro-CT) to measure volume and by hematoxylin–eosin staining for histological evaluation. Results: On postoperative day 7, lymphatic flow was confirmed in the ICG-MB group using the SPY Elite^® fluorescence imaging system. On micro-CT scans, the preoperative rat tail volume was 3992.72 ± 144.80 mm³. Rat tail volume was 5216.71 ± 1131.88 and 4614.76 ± 468.29 mm³, respectively, at 1 and 2 weeks after lymphedema was induced. Histology revealed lymphocyte infiltration, inflammatory reaction, and thickened subcutaneous adipose tissue, with no significant difference between groups. Conclusions: The rat tail lymphedema model proved valuable for studying lymphedema pathology and diagnostic agents. The ICG-MB reagents demonstrate stable performance and favorable biocompatibility. Full article

Human interaction with manipulable objects relies heavily on the ability to perceive and execute grasping actions, yet it remains unclear whether the semantics of these actions are processed without conscious awareness. While previous work has identified bottom-up influences on grasp recognition, direct evidence for subliminal semantic processing of grasping actions is limited. Grounded in embodied cognition theory—which posits overlapping neural mechanisms for action language and action execution—the present study examined whether grasp-related verbs can elicit subliminal priming effects on grasping-action recognition. Using a masked priming paradigm, participants classified objects requiring either precision or power grasps while subliminal Chinese action verbs served as primes. Behavioral measures revealed faster responses for semantically congruent cue–target pairs. ERP analyses further demonstrated congruency effects in the N400 and P600 components, reflecting semantic integration and conflict monitoring, as well as modulation of the P300 associated with action-related evaluation. Both grasp types showed evidence of unconscious semantic processing, though precision- and power-grasping actions produced distinct neural patterns. These findings provide direct experimental support for subthreshold semantic activation of grasping actions and confirm the viewpoint of action-language-embodied processing. The study advances the theoretical understanding of unconscious-action semantics and offers a framework for investigating how manipulative-action meaning is accessed below the threshold of awareness. Full article

The ambivalent sexism theory supports differences in the manifestations of sexism among individuals with diverse genders and sexual orientations. However, it still remained unclear whether individuals who share common strong cultural values endorse different levels of sexism according to their gender and sexual orientation. The current study aimed to examine differences in sexist attitudes based on gender and sexual orientation among Korean adults. We first tested measurement invariance in a Korean Multi-dimensional Sexism Inventory (K-MSI) between heterosexuals (n = 374) and sexual minorities (n = 445), and second, we compared the latent means across groups using the Multiple Indicators Multiple Causes (MIMIC) model. The results confirmed the first-order six-factor structure of the K-MSI with adequate internal consistency, and supported partial scalar invariance across heterosexual and sexual minority men and women. The MIMIC model approach revealed significant age, gender, and sexual orientation differences in most of hostile sexism (HS) and benevolent sexism (BS) components. Overall, heterosexuals reported higher levels of sexism than non-heterosexuals within each gender. Gender differences in BS have become nuanced when sexual orientation was considered. The current study also provides an overview of Korean culture that may uniquely influences individuals’ sexist attitudes, which would interest international researchers. Full article