Search Results (1,401)

Pseudomonas aeruginosa elastase LasB accelerates refrigerated food spoilage through proteolytic degradation of muscle and milk proteins. While Marrubium vulgare essential oil terpenes exhibit antimicrobial activity, their weak potency and nonspecificity limit direct food preservation applications. This computational study aimed to rationally redesign terpene scaffolds into predicted selective LasB inhibitors. A virtual library of 635 terpene–peptide–phosphinic acid hybrids (expanded to 3940 conformers) was evaluated using consensus molecular docking (Glide/Flare) against LasB (PDB: 3DBK) and three human off-target proteases. Top candidates underwent duplicate 150 ns molecular dynamics simulations with MM/GBSA binding free-energy calculations. Computational screening identified thymol–Leu–Trp–phosphinic acid as the lead candidate with predicted binding affinity of −12.12 kcal/mol, comparable to reference inhibitor phosphoramidon (−11.87 kcal/mol), and predicted selectivity index of +0.12 kcal/mol representing a 2.3 kcal/mol advantage over human proteases. Molecular dynamics simulations indicated exceptional stability (98.7% stable frames, 0.12 Å inter-replica RMSD) with consistent zinc coordination. Structure–activity analysis revealed phosphinic zinc-binding groups (+1.57 kcal/mol), Leu–Trp linkers (+2.47 kcal/mol), and phenolic scaffolds (+1.35 kcal/mol) as predicted optimal structural features. This in silico study provides a computational framework and prioritized candidate set for developing natural product-derived food preservatives. All findings represent computational predictions requiring experimental validation through enzymatic assays, food model studies, and toxicological evaluation. Full article

Autologous serum (AS) tears are an effective therapeutic option for advanced DED, mimicking the biochemical composition of natural tears. However, the absence of universally accepted guidelines has resulted in variability in AS tear concentration, diluents, processing of collected blood, and storage conditions, raising questions regarding the optimal parameters for AS tear use. This perspective provides a framework to inform clinical implementation and to guide future research on AS tear therapy optimization. PubMed, Scopus, and the Cochrane Library were searched for English-language articles from January 2022 through September 2025 using the terms “autologous serum,” “dry eye disease,” “dry eye syndrome,” “dry eye,” and “DED.” Evidence suggests that AS tears diluted to 20% are widely used for moderate DED, whereas higher concentrations may provide faster, more pronounced and more durable improvements, particularly in severe cases. Levofloxacin-containing eye drops, artificial tears without emphasis on a specific component, sodium hyaluronate (SH)-containing eye drops, cyclosporine A (CsA)-containing ultra-nano emulsions, and methylcellulose have been investigated as alternatives to conventional diluents. Standardization of clotting, centrifugation and storage parameters is expected to enhance efficacy of AS tears and ensure stability of growth factors. Combination with estrogen replacement therapy in perimenopausal women or with topical insulin eye drops, as well as perioperative prophylactic use in patients with graft-versus-host disease (GVHD)-associated dry eye undergoing cataract surgery, represent emerging applications of AS tears that demonstrate potential to improve therapeutic outcomes. Overall, this perspective highlights the need for consensus protocols, supports severity-based concentration tailoring, and notes that diluents and processing methods require further refinement. Full article

Cervical dystonia (CD) is the most common adult-onset focal dystonia, with heterogeneous clinical presentation and significant functional impairment. Currently, no structured Italian good clinical practice documents specifically addressing CD have been published. Optimizing CD management requires expert-based recommendations to guide diagnosis, treatment, and follow-up. A two-round Delphi process was conducted, involving a scientific board of six neurologists with expertise in CD management and an external panel of 56 Italian experts (neurologists and physiatrists managing CD patients). Fifty-two statements were developed, discussed, and voted using a 5-point Likert scale, with consensus defined as ≥75% agreement (‘strongly agree’ or ‘somewhat agree’). In Round 1, 48 of 52 statements (92.4%) reached consensus; the four remaining statements were revised, and two were re-voted in Round 2, both achieving consensus. Final recommendations emphasize comprehensive patient assessment in multiple postural conditions; individualized botulinum neurotoxin type A (BoNT-A) dosing taking into account tonic and phasic components, pain, and dysphagia; the use of instrumental guidance; standardized outcome measures; and integration of physiotherapy and psychological support. This article provides structured good clinical practice recommendations for CD management and offers clinicians, especially those with limited experience, a practical framework to standardize care, optimize treatment, and improve patient outcomes. Full article

Background/Objectives: During intrauterine development, cell proliferation, differentiation, and apoptosis are strictly regulated for organogenesis to be ensured; disruption of these processes, e.g., by oxidative stress, may lead to congenital anomalies. This systematic review aimed to examine the role of selenium (Se), an important antioxidant, during gestation in the development of congenital anomalies. Methods: To identify relevant original research studies in English, PubMed, Embase, and Cochrane Library were systematically searched up to December 2025. A qualitative synthesis, quality appraisal, and assessment of predefined sources of bias and heterogeneity were performed. Results: 2743 titles and abstracts were screened, 473 full texts assessed, and 31 papers included. Selenium exposure did not affect the risk of all/any congenital anomalies (n = 20,815), abdominal (n = 89,273) and limb anomalies (n = 551,547), chromosomal anomalies (n = 1242), or fetal alcohol syndrome (n = 41). Higher concentrations of Se were associated with increased risk for urinary tract anomalies (n = 2150), but decreased risk for congenital heart defects (n = 1807), neural tube defects (max n = 12,188), and orofacial clefts (max n = 1155). Conclusions: Available scientific evidence arises from observational studies and is prone to confounding mainly by gestational age, while only one randomized controlled trial has been identified. Given the major contribution of congenital anomalies to neonatal morbidity, mortality, and long-term impairment of quality of life, well-designed prospective studies are required to establish scientific consensus, define optimal maternal Se levels during pregnancy, and provide evidence-based recommendations for Se supplementation during pregnancy. Full article

Photovoltaic-storage direct current (DC) flexible (PEDF) systems are susceptible to DC bus voltage disturbances, with the constant power load (CPL) characteristics further exacerbating the risk of system instability. To address these challenges, a collaborative control scheme integrating distributed consensus and demand-side response (DSR) based on a consensus protocol is proposed in this study. A fully distributed control architecture is constructed, wherein the upper layer achieves power coordination through voltage deviation of parallel DC/DC converters and neighborhood interaction, whilst the lower layer dynamically optimizes inter-unit power allocation via the DSR mechanism. Distributed state estimation (DSE) is incorporated to enhance voltage control accuracy. Simulations conducted in the MATLAB (R2022a)/Simulink environment demonstrate that the proposed strategy enables rapid stabilization of bus voltage under load step changes and photovoltaic fluctuation scenarios, with system disturbance rejection capability being effectively enhanced. The effectiveness of the approach in maintaining stable system operation and optimizing power distribution is validated. The results indicate that the voltage deviation of the PEDF system remains below 2% under compound disturbances, with the steady-state error being controlled within 2%. The proposed control strategy, through the integration of the power DSR mechanism, effectively improves the system’s anti-disturbance capability. Compared with conventional droop control methods, which typically result in voltage deviations of 3–5%, the proposed strategy achieves a reduction in voltage deviation of over 50%, demonstrating superior voltage regulation performance. Full article

Classroom acoustic conditions significantly affect students’ learning outcomes and teachers’ occupational health, yet a systematic gap persists between optimal acoustic standards established in research and their implementation in practice. Although peer-reviewed literature has defined performance thresholds, guidance on which design strategies effectively achieve these targets across different school spaces remains limited. Grey literature—project documentation from architectural firms, acoustic consultants, and material suppliers—contains valuable practice-based evidence. This study aimed to map practice-based evidence in K–12 school acoustic design, identify dominant space–strategy patterns, and appraise evidence quality through systematic mapping of grey literature. Following PRISMA-ScR guidelines, systematic searches were conducted across 27 websites representing three source types, yielding 142 projects from 22 countries. Data extraction employed a standardised coding framework encompassing project metadata, 19 space types, and 16 acoustic strategy subcategories within five major categories. Evidence quality was assessed using a quantified AACODS framework (score range 6–30), with inter-rater reliability (ICC = 0.989). The evidence landscape revealed geographic concentration in North America (41.5%) and the Asia–Pacific region (26.8%), with architectural firms contributing most documentation (54.2%). Space–strategy analysis identified dominant patterns: classrooms and corridors primarily employed absorptive ceilings combined with wall treatment, gymnasiums relied on suspended absorbers, and performance spaces used multi-strategy packages including variable acoustics systems. Open-plan learning spaces displayed high strategy diversity without consensus solutions. Mean quality score was 15.2/30 (SD = 3.0), with only 16.9% of projects reporting quantitative performance indicators. These findings reveal a substantial research-to-practice gap and provide an empirical basis for developing targeted acoustic design guidance for practitioners, informing policy, standards, and future research directions. Full article

Over the past decade, given safety, reduced heart failure-related hospitalizations, and, above all, 5-year mortality rates nearly identical to those of heart transplants, left ventricular assist devices (LVADs) have increasingly become a treatment option for patients with advanced heart failure. However, improvements in functional capacity after LVAD implantation are minimal or modest, depending on pre-implantation right ventricular function, the patient’s hemodynamic status, the optimization of guideline-directed medical therapy, and noncardiac factors (physical deconditioning, skeletal muscle alterations, anemia, and alterations in alveolar gas exchange). Therefore, cardiac rehabilitation (CR) is a fundamental element from the early stages after LVAD implantation, as it is not only safe but also highly effective, leading to improved functional capacity and fewer episodes of worsening heart failure, and may be associated with reduced mortality. To perform safe and effective CR in patients with LVADs, it is crucial to account for the unique issues in this group. This includes the difficulty of detecting an arterial pulse with standard tools during CPR and the importance of closely monitoring the transmission line and LVAD controller to prevent unintended damage. Overall, the clinical trial indicates that exercise-based CR has the potential to improve functional capacity. Furthermore, some data suggest that CR is associated with fewer HF-related hospitalizations and may be linked to lower mortality; however, there is no consensus on this matter, partly because most studies supporting this assertion are observational. Full article

Smart campuses employ advanced digital technologies and intelligent communication systems to enhance educational, operational, and living environments. This study investigates stakeholder perceptions of smart campus priorities in Saudi Arabia through a structured questionnaire administered to students and faculty. The study considered King Fahd University of Petroleum and Minerals (KFUPM) in Dhahran as a case study in this regard. The survey examined 22 smart campus aspects grouped into six domains: smart education, smart mobility, smart energy and waste management, smart buildings and work environment, smart safety and security, and smart open spaces. The results indicated strong consensus regarding the importance of all domains, with an overall mean rating of 4.3 out of 5.0 and Relative Importance Index (RII) values ranging from 0.77 to 0.91. The highest-ranked aspects included IoT-enabled cooling energy optimization, smart public transportation, smart lighting systems, smart workflow management, e-libraries, and fire prevention and detection systems, reflecting a pronounced emphasis on infrastructure quality, energy efficiency, and operational effectiveness. The findings suggest that smart campus development in Saudi Arabia should prioritize high-impact, user-valued initiatives that align with Vision 2030 objectives including digital transformation. Strategic early investments in smart buildings, energy management, and mobility systems can deliver measurable benefits in this regard. Further research is recommended to consider additional case studies in the Saudi context to ensure that smart campuses remain contextualized and responsive to user needs. Full article

With the development of wireless communication technologies, cooperation of automated vehicles (CAVs) becomes a key roadmap to promote the intelligent level and traffic efficiency. In this study, a distributed optimization framework is firstly designed to utilize more computation resources by introducing auxiliary variables and equality constraints to separate the coupling parts in the original centralized optimization problem. Bench test results show that more resources can be used by this framework compared with the centralized one, which is beneficial to the real time performance and scale of CAVs. But extra exchanges of the consensus variables between nodes lead to much more communication load, which easily causes packet loss. To ensure the cooperative performance, a robust interactive algorithm is further designed to ensure the convergence of the numerical optimization process in the presence of packet loss. Its global convergence is analyzed theoretically by the operator method under the assumption that the feasible domain is convex. The performances of CAVs controlled by the robust distributed optimization algorithm are validated and verified by several comparative tests under the intersection scenario. The test results show that compared with the centralized structure, the balance of computation load among different nodes is improved by 5 times at least, and the maximum computation period is smaller than 50 ms. Full article

Contemporary medical practitioners increasingly recognize the critical impact of healing-environment design on patients’ recovery, positioning it as a pivotal consideration in healthcare facility planning. While existing research has predominantly focused on enhancing the functionality and efficiency of healthcare environments, it has often overlooked the significance of individual patient needs and their distinct experiences. This paper aims to utilize the principles of epidemiology and empirical analysis to explore the application and research trends of the patient-centered care (PCC) concept in healthcare facility design, to promote interdisciplinary collaboration and achieve customized healthcare environments. Based on bibliometric analysis and key literature review methods, this paper systematically examines and interprets the research development trends of PCC in healing environment design, integrating both macro and micro perspectives, and reveals how design factors in therapeutic environments support the realization of PCC principles, thereby improving patients’ rehabilitation experiences and health outcomes. The results indicate that current research on PCC is trending towards increasingly diversified integration via high-frequency keywords such as recovery, healing environment, and evidence-based design, highlighting the shift from functional optimization to emotional care, technological integration, and nature-based interactions in design. Notably, patient-centered care has become a consensus and core integrating concept in this field. This paper not only reveals the key role of healing environments in constructing PCC practice pathways but also provides theoretical support and strategic reference for the planning of healthcare spaces and the collaborative design of nursing processes, and demonstrates that healing environments have evolved from passive spaces into active rehabilitation mediums through interdisciplinary collaboration, thereby facilitating the implementation of the patient-centered healthcare philosophy. Full article

This paper addresses the problem of cooperative coverage control for heterogeneous Autonomous Underwater Vehicle (AUV) swarms operating in complex underwater environments. The objective is to achieve optimal coverage of a target region while simultaneously ensuring collision avoidance—both among AUVs and with static obstacles—and satisfying the inherent dynamic constraints of the AUVs. To this end, we propose a hierarchical control framework that fuses Control Barrier Functions (CBFs) with consensus theory. First, addressing the heterogeneity and limited sensing ranges of the AUVs, a cooperative coverage model based on a modified Voronoi partition is constructed. A nominal controller based on consensus theory is designed to balance the ratio of task workload to individual capability for each AUV. By minimizing a Lyapunov-like function via gradient descent, the swarm achieves self-organized optimal coverage. Second, to guarantee system safety, multiple safety constraints are designed for the AUV double-integrator dynamics, utilizing Zeroing Control Barrier Functions (ZCBFs) and High-Order Control Barrier Functions (HOCBFs). This approach unifies the handling of collision avoidance and velocity limitations. Finally, the nominal coverage controller and safety constraints are integrated into a Quadratic Programming (QP) formulation. This constitutes a safety-critical layer that modifies the control commands in a minimally invasive manner. Theoretical analysis demonstrates the stability of the framework, the forward invariance of the safe set, and the convergence of the coverage task. Simulation experiments verify the effectiveness and robustness of the proposed method in navigating obstacles and efficiently completing heterogeneous cooperative coverage tasks in complex environments. Full article

This paper proposes a novel method, the Convergent Radiation Algorithm (CRA), aimed at multi-attribute group decision-making (MAGDM) in circular intuitionistic fuzzy settings. The approach is aimed at reaching geometric consensus among experts, with uncertainties and hesitancies expressed via circular intuitionistic fuzzy numbers (CIFNs). First, the qualitative judgment in professionals is converted into a geometric space where experts’ assessments are represented as spatial points that reflect the differences between the opinions. All these points are gradually combined with the help of a radiation–reflection–convergence mechanism, which iteratively finds the Optimal Consensus Point (OCP) to minimize the overall weighted divergence over the evaluations. After that, a projection-based scoring method is used to locate good and bad optimal solutions, and the alternatives are ranked based on a comparison of their projection distance. It presents a numerical example with data supplied by the Hubei agro-ecological zone to demonstrate that the offered method helps to capture collective agreement and convergence behavior that is consistent, and makes the decision results readable and reliable. Full article

Background/Objectives: Drug-induced sleep endoscopy (DISE) is used in obstructive sleep apnea (OSA) to visualize dynamic upper airway collapse, but sedation protocols vary widely with no consensus on the optimal agent or technique. This narrative review aims to clarify current sedation strategies for DISE in OSA and their clinical implications. Methods: We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library for English-language publications on DISE sedation (2000–2025). Relevant clinical studies, guidelines, and reviews were included. Data were qualitatively synthesized due to heterogeneity among studies. Results: Sedation approaches in DISE varied considerably. Propofol, dexmedetomidine, and midazolam were the primary agents identified. Propofol provided rapid, titratable sedation but increased airway collapsibility at higher doses; dexmedetomidine produced a more natural sleep-like state with minimal respiratory depression; midazolam was less favored due to prolonged effects. Use of target-controlled infusion (TCI) and pharmacokinetic–pharmacodynamic (PK–PD) models improved control of propofol sedation. Co-sedative adjuncts (e.g., opioids) reduced the required sedative dose but added risk of respiratory depression. Careful titration to the lowest effective dose-often guided by bispectral index (BIS) monitoring—was emphasized to achieve adequate sedation without artifactual airway collapse. No universal DISE sedation protocol was identified. Conclusions: Optimal DISE sedation balances adequate depth with patient safety to ensure reliable findings. Using the minimum effective dose, guided by objective monitoring (e.g., BIS), is recommended. There is a need for standardized sedation protocols and further research (e.g., in obese patients) to resolve current controversies and improve DISE’s utility in OSA management. Full article

The purpose of this article is to develop optimal control strategies for discrete-time multi-agent systems (DT-MASs) with unknown disturbances, with the goal of enhancing their consensus performance and disturbance rejection capabilities. Complex flight conditions, such as the scenario of multi-unmanned aerial vehicle (multi-UAV) maintaining consensus under strong wind gusts, pose significant challenges for MAS control. To address these challenges, this article develops an optimal controller for UAV-based MASs with unknown disturbances to reach consensus. First, a novel improved nonlinear extended state observer (INESO) is designed to estimate disturbances in real time, accompanied by a corresponding disturbance compensation scheme. Subsequently, the consensus error systems and cost functions are established based on the disturbance-free DT-MASs. Building on this, a policy iterative algorithm based on a momentum-accelerated Actor–Critic network is proposed for the disturbance-free DT-MASs to synthesize an optimal consensus controller, whose integration with the disturbance compensation scheme yields an optimal disturbance rejection controller for the disturbance-affected DT-MASs to achieve consensus control. Comparative quantitative analysis demonstrates significant performance improvements over a standard gradient Actor–Critic network: the proposed approach reduces convergence time by 12.8%, improves steady-state position accuracy by 22.7%, enhances orientation accuracy by 42.1%, and reduces overshoot by 22.7%. Finally, numerical simulations confirm the efficacy and superiority of the method. Full article

Cooperative task allocation is one of the critical enablers for multi-Autonomous Underwater Vehicle (AUV) missions, but existing approaches often assume reliable communication that rarely holds in real underwater acoustic environments. We study here the performance and robustness of the Consensus-Based Bundle Algorithm (CBBA) for multi-AUV task allocation under realistically degraded underwater communication conditions with dynamically appearing tasks. An integrated simulation framework that incorporates a Dubins-based kinematic model with minimum turning radius constraints, a configurable underwater acoustic communication model (range, delay, packet loss, and bandwidth), and a full implementation of improved CBBA with new features, complemented by 3D trajectory and network-topology visualization. We define five communication regimes, from ideal fully connected networks to severe conditions with short range and high packet loss. Within these regimes, we assess CBBA based on task allocation quality (total bundle value and task completion rate), convergence behavior (iterations and convergence rate), and communication efficiency (message delivery rate, average delay, and network connectivity), with additional metrics on the number of conflicts during dynamic task reallocation. Our simulation results indicate that CBBA maintains performance close to the optimum when the conditions are good and moderate but degrades significantly when connectivity becomes intermittent. We then introduce a local-communication-based conflict resolution strategy in the face of frequent task conflicts under very poor conditions: neighborhood-limited information exchange, negotiation within task areas, and decentralized local decisions. The proposed conflict resolution strategy significantly reduces the occurrence of conflicts and improves task completion under stringent communication constraints. This provides practical design insights for deploying multi-AUV systems under weak underwater acoustic networks. Full article