Search Results (605)

The reliability and safety of five-axis CNC abrasive water jet machining are critical for many industries. This study employs Failure Mode and Effects Analysis (FMEA) to identify and mitigate potential failures in this machining system. Traditional FMEA, which relies on crisp numerical values, often struggles with handling uncertainty in risk assessment. To address this limitation, this paper introduces an Interval-Valued Spherical Fuzzy FMEA (IVSF-FMEA) approach, which enhances risk evaluation by incorporating membership, non-membership, and hesitancy degrees. The IVSF-FMEA method leverages the inherent rotational symmetry of interval-valued spherical fuzzy sets and the permutation symmetry among severity, occurrence, and detectability criteria, resulting in a transformation-invariant and unbiased risk assessment framework. Applying IVSF-FMEA to seven periodic failure (PF) modes in five-axis CNC water jet machining achieves a more precise prioritization of risks, leading to improved decision-making and resource allocation. The findings highlight improper fixturing of the workpiece (PF6) as the most critical failure mode, with the highest RPN value of −0.54, followed by mechanical vibrations (PF2) and tool wear and breakage (PF1). This indicates that ensuring proper fixturing stability is essential for maintaining machining accuracy and preventing defects. Comparative analysis with traditional FMEA demonstrates the superiority of the proposed fuzzy-based approach in handling subjective assessments and reducing ambiguity. The findings highlight improper fixturing, mechanical vibrations, and tool wear as the most critical failure modes, necessitating targeted risk mitigation strategies. This research contributes to advancing risk assessment methodologies in complex manufacturing environments. Full article

Improving urban wastewater treatment efficiency and quality is urgent for most cities. The accurate wastewater flowrate forecast of a wastewater treatment plant (WWTP) is crucial for cutting energy use and reducing pollution. In this study, two hybrid models are proposed: ARIMA–Markov and ARIMA–LSTM–Transformer. Using 5 min-interval inlet flowrate data from a WWTP in 2024, the two models were verified and compared. Forecasts for 1 day, 7 days, and 2 months ahead were made, and model accuracies were compared. Ten repetitions with the same dataset assess stability, and ARIMA–LSTM–Transformer, with better performance, were selected. Then, the Whale Optimization Algorithm (WOA), Particle Swarm Optimization (PSO) algorithm, and Sparrow Search Algorithm (SSA) were used for optimization, with the WOA excelling in accuracy and stability. Experimental results show that compared to the single model Transformer, WOA–ARIMA–LSTM–Transformer did better in forecasting wastewater flowrate. The combined model enables efficient and accurate wastewater flowrate forecasting, highlighting the combined model’s application potential. Full article

Background: Chronic rhinosinusitis with or without nasal polyps (CRSwNPs/CRSsNPs) is an inflammatory disease that is becoming increasingly associated with laryngopharyngeal reflux disease (LPRD). Although symptom-based questionnaires, such as the Reflux Symptom Index (RSI) and Reflux Symptom Score (RSS), are widely used, there is a lack of objective endoscopic tools for assessing the nasopharyngeal and nasal manifestations of reflux. The Nasopharyngeal Reflux Endoscopic Score (NRES) is a novel endoscopic scoring system that was developed to address this issue. Objective: The objective of this study was to evaluate the diagnostic accuracy of the NRES in identifying LPRD in patients with CRS, compared with a clinical reference standard. Methods: A prospective diagnostic accuracy cohort study was conducted at two tertiary care centers in Astana, Kazakhstan, from September 2023 to February 2025. A total of 216 adults were enrolled and divided into three groups: CRS with suspected LPRD (n = 116), CRS without LPRD (n = 69), and healthy controls (n = 31). CRS was diagnosed according to the EPOS 2020 criteria. LPRD was defined using a composite reference standard comprising clinical assessment, RSS > 13, RSI, and selective 24 h pH monitoring and gastrointestinal endoscopy. All participants underwent nasopharyngeal and laryngeal endoscopy, with NRES, L-K, RFS, RSI, and RSS assessments at baseline and at 6 and 12 months. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance, and Wilcoxon tests were used to analyze the changes in scores. Correlation and regression analyses were used to explore associations between scales and predictive factors. Results: At baseline, NRES scores were significantly higher in the CRS with LPRD group (mean: 11.59) than in the CRS without LPRD group (mean: 3.10) and the healthy control group (mean: 2.16) (p < 0.001). ROC analysis demonstrated excellent diagnostic accuracy, with an area under the curve (AUC) of 0.998 (95% confidence interval (CI): 0.994–1.000), a sensitivity of 98% (95% CI: 94–100%) and a specificity of 96% (95% CI: 91–99%) at an optimal cut-off point of 8.5. NRES scores showed strong correlations with RSI, RSS, and RFS scores (r > 0.76, p < 0.001). A longitudinal assessment revealed significant reductions in all scores after treatment with proton pump inhibitors and lifestyle modifications, with sustained improvement at 12 months. Regression analysis found no significant effect of age, gender, or GERD severity (LA classification) on NRES scores. Conclusions: The NRES is a highly sensitive and specific endoscopic tool for identifying nasopharyngeal changes associated with LPRD in CRS patients. It demonstrates strong correlations with established symptom-based and laryngoscopic reflux assessments and responds to anti-reflux therapy over time. The NRES may, therefore, be a valuable objective adjunct in the comprehensive evaluation and longitudinal monitoring of LPRD-associated CRS. Full article

Background and Objectives: The role of adenosine deaminase (ADA) in pulmonary tuberculosis (PTB) remains insufficiently defined in advanced forms of disease. Likewise, the systemic immune inflammatory index (SII) has not been validated in severe PTB. This 6-year prospective observational study aims to evaluate biomarker signatures of serum ADA and SII. Materials and Methods: According to the PTB case definition, 232 adult patients were divided into group 1, with a positive bacteriologic exam (n = 168), and group 2, without bacteriological confirmation (n = 64). ADA serum levels were compared by age, gender, nutritional status, morphologic and bacteriological pattern of PTB lesions, survival status, along with serum levels of other inflammatory biomarkers. All patients with comorbidities, interfering with the level of ADA, were excluded to avoid bias. Results: A total cohort of 208 PTB adults, aged 54.37 ± 14.365 years, included 156 males. The overall mortality was 11.53%. Death occurred after a mean interval of 1.63 ± 3.228 months after PTB diagnosis. ADA serum mean levels were 32.94 ± 9.146 IU/L, significantly higher in G1 (p = 0.002), in patients with delayed diagnosis of PTB (p = 0.000), with lung cavitation (p = 0.003), and death as a poor outcome (p ˂ 0.02). SII had a mean value of 1752.226 ± 2704.150, significantly increased in bacteriologically confirmed PTB cases (p = 0.018), delayed diagnosis (p = 0.002), cavitary advanced pulmonary tuberculosis (APT) (p = 0.002), and deceased (p = 0.003). Both an ADA cut-off elevated risk value of over 30 IU/L and SII of over 902 were fulfilled by 73 patients, with 2.10 higher risk of advanced PTB (p = 0.006) and 4.49 higher risk of mortality (p = 0.000). Conclusions: Serum ADA and SII are recommended as predictors of advanced and severe pulmonary TB. These findings indicate that ADA and SII, when elevated together, delineate a high-risk PTB phenotype with greater disease severity and early mortality. The combination offers a pragmatic, biomarker-based approach to risk stratification in PTB. Full article

Selection forestry sustains timber production and stand structural complexity via partial harvesting. However, regeneration initiated by harvesting may function as fuel ladders, providing pathways for fire to reach the forest canopy. We sought potential mitigation approaches by simulating stand growth and potential wildfire behavior over a century in stands dominated by coast redwood (Sequoia sempervirens (Lamb. ex. D. Don) Endl.) on California’s north coast. We used the fire and fuels extension to the forest vegetation simulator (FFE-FVS) to compare group selection (GS) to single-tree selection silviculture with either low-density (LD) or high-density (HD) retention on a 20-year harvest return interval. These three approaches were paired with six options involving vegetation management (i.e., hardwood control or pre-commercial thinning (PCT)) with and without fuels treatments (i.e., prescribed fire or pile burning), or no subsequent vegetation or fuel treatment applied after GS, HD, or LD silviculture. Fuel treatment involving prescribed fire reduced hazardous fuel loading but lowered stand density and hence productivity. Hardwood control followed by prescribed fire mitigated potential wildfire behavior and promoted dominance of merchantable conifers. PCT of small young trees regenerating after selection harvests, followed by piling and burning of these cut trees, sustained timber production while reducing potential wildfire behavior by approximately 40% relative to selection silviculture without vegetation/fuel management, which exhibited the worst potential wildfire behavior. Full article

Background: Hypolipidemia has been shown to be a factor that elevates the risk of bleeding. This study aimed to investigate the relationship between cholesterol levels and the risk of peptic ulcer bleeding (PUB). Methods: A total of 15,547 patients who underwent esophagogastroduodenoscopy (EGD) between May 2017 and December 2020 were screened. Of these, 317 were included in this retrospective cohort study. PUB was diagnosed by EGD. Serum cholesterol levels were measured at six-month intervals, and cumulative mean cholesterol concentrations were calculated using all available data during the observation period. Results: Ulcer bleeding was detected in 173 (45.6%) patients with peptic ulcer. Patients with bleeding peptic ulcer exhibited significantly lower TC, LDL-C, and HDL-C levels compared to non-bleeding peptic ulcer patients and controls (p < 0.001). The optimal LDL cut-off was 91.50 (p < 0.001), with 75.1% sensitivity and 24.1% specificity. For HDL, the cut-off was 42.50 (p < 0.001), yielding 72.3% sensitivity and 30.1% specificity. A one-unit increase in LDL and HDL reduced the risk of PUB by 0.95-fold and 0.97-fold, respectively. Conclusions: Our findings suggest that reduced cholesterol levels, particularly LDL-C and HDL-C, may elevate the risk of PUB. Therefore, monitoring cholesterol levels in peptic ulcer patients, especially those at higher bleeding risk, could be beneficial. Full article

Background/Objectives: Randomised trials show that screening with prostate-specific antigen (PSA) and systematic prostate biopsies can reduce prostate cancer mortality but leads to high rates of overdiagnosis. Today, improved diagnostic methods more selectively detect potentially lethal, high-grade prostate cancer. Methods: This is a narrative review of modern diagnostic methods, ongoing trials, national policies and knowledge gaps related to screening and early detection of prostate cancer. Results: Screening intervals can be prolonged in men with PSA values below around 1 ng/mL as these men are at very low long-term risk of prostate cancer death. Overdiagnosis can be reduced by magnetic resonance imaging (MRI) and lesion-targeted prostate biopsies. Risk calculators and ancillary biomarkers can select men for further investigation and thereby reduce resource needs. These new methods are evaluated in large, randomised screening trials. The remaining knowledge gaps include optimal PSA cut-offs, screening intervals, start and stop ages, and the long-term balance between benefits and harm. Until recently, almost no national healthcare authority recommended population-based screening for prostate cancer. Now, the European Union Council recommends an evaluation of the feasibility of organised, risk-stratified screening. This has led to several pilot projects. In some other parts of the world, such as sub-Saharan Africa and the Caribbean, such initiatives are lacking despite high prostate cancer mortality rates. Conclusions: Risk-stratified prostate cancer screening including MRI and targeted biopsy reduces overdiagnosis. Results from ongoing research are needed to optimise screening protocols and to define long-term benefits and harms. Initiatives for early detection and screening are emerging across the world but are still lacking in many countries with high prostate cancer mortality. Full article

Background: Serum uric acid and serum creatinine ratio (SUA/sCr) is strongly linked to increased cardiovascular risk. Atherosclerotic renal artery stenosis (ARAS) is a secondary cause of hypertension and is associated with ischemic nephropathy, congestive heart failure, accelerated cardiovascular disease, and autonomic dysfunction. The aim of this study was to investigate whether SUA levels and SUA/sCr could represent markers of autonomic dysfunction and increased left ventricular mass index (LVMI) in patients with ARAS. Methods: Patients diagnosed with ARAS were enrolled in the study. All patients underwent clinical evaluation, biochemical analysis, 24 h electrocardiogram (ECG), and Renal Doppler Ultrasound with renal resistive index parameters. Heart rate variability for global autonomic dysfunction was assessed through the analysis of a 24 h ECG to detect the standard deviation of normal-to-normal RR intervals (SDNN). Echocardiographic measurement of LVMI was performed. Results: A total of 27 patients (F = 16 (59%), median age 67 years (IQR 60–77)) diagnosed with ARAS were enrolled in the study. We found a statistically significant negative linear correlation between SUA/sCr and SDNN (r = −0.519, p < 0.01). We found a statistically significant positive linear correlation between SUA/sCr and LVMI (r = 0.413, p < 0.05). Median SDNN was significantly lower in patients with SUA ≥ 5.6 mg/dL than in patients with SUA < 5.6 mg/dL (94.2 (IQR 86.8–108.1) vs. 112.8 (IQR 108.9–114.7), p < 0.01). Median LVMI was significantly higher in patients with SUA ≥ 5.6 mg/dL compared to patients with SUA < 5.6 mg/dL (133 g/m² (IQR 120–149) vs. 111 g/m² (IQR 99–129), p < 0.05). Conclusion: In patients with ARAS, SUA/sCr is associated with autonomic dysfunction and LVMI in ARAS patients. The ratio and related cut-off value of SUA/sCr could represent a useful biomarker to evaluate cardiovascular risk in ARAS patients. Full article

To resolve the critical issues of severe deformation, structural failure, and maintenance difficulties in the advanced reuse zone of gob-side-entry retaining roadways under pillarless mining conditions in ultra-long fully mechanized top-coal caving isolated mining faces, this study proposes a surrounding rock control technology incorporating pressure relief through roof cutting. Taking the 3203 ultra-long isolated mining face at Nanyang Coal Industry as the engineering case, an integrated methodology combining laboratory experiments, theoretical analysis, numerical simulations, and industrial-scale field trials was implemented. The deformation and failure mechanism of flexible formwork walls in gob-side-entry retaining and the fundamental principles of pressure relief via roof cutting were systematically examined. The vertical stress variations in the advanced reuse zone of the retained roadway before and after roof cutting were investigated, with specific focus on the strata pressure behavior of roadways and face-end hydraulic supports on both the wide coal-pillar side and the pillarless side following roof cutting. The key findings are as follows: ① Blast-induced roof cutting reduces the cantilever beam length adjacent to the flexible formwork wall, thereby decreasing the load per unit area on the flexible concrete wall. This reduction consequently alleviates lateral abutment stress and loading in the floor heave-affected zone, achieving effective control of roadway surrounding rock stability. ② Compared with non-roof cutting, the plastic zone damage area of surrounding rock in the gob-side entry retained by flexible formwork concrete wall is significantly reduced after roof cutting, and the vertical stress on the flexible formwork wall is also significantly decreased. ③ Distinct differences exist in the distribution patterns and magnitudes of working resistance for face-end hydraulic supports between the wide coal-pillar side and the pillarless gob-side-entry retaining side after roof cutting. As the interval resistance increases, the average working resistance of hydraulic supports on the wide pillar side demonstrates uniform distribution, whereas the pillarless side exhibits a declining frequency trend in average working resistance, with an average reduction of 30% compared to non-cutting conditions. ④ After roof cutting, the surrounding rock deformation control effectiveness of the track gateway on the gob-side-entry retaining side is comparable to that of the haulage gateway on the 50 m wide coal-pillar side, ensuring safe mining of the working face. Full article

One of the greatest challenges in crop science worldwide is balancing crop production and water management. In the context of sustainability and vertical production growth, understanding water relations is fundamental for improving crop management in irrigated and rainfed sugarcane fields. Adequate irrigation management can improve water use efficiency and agronomic performance. Nicaragua, due to its limited research and information on irrigation, has significant opportunities to increase crop yields and enhance water efficiency. Therefore, the aim of this study was to evaluate the response of sugarcane growth, yield, and water use efficiency under different irrigation management strategies. The study was performed in a field area from Casur Sugarcane mill in Nicaragua during the crop cycle 2021/2022. The experimental area was cultivated in high clay soil, with the variety CP72-2086 in the second cut with the furrow irrigation method. Two treatments were evaluated, irrigation based on soil moisture (ISw) and irrigation with fixed intervals (IFI), and their effect on growth variables and crop yield. On a temporal analysis, the plants showed compensatory growth in IFI, recovering from water-deficit stress in most measured variables. Sugarcane yield was statistically different between the treatments with 97.87 and 83.84 Mg ha⁻¹ for ISw and IFI, respectively. The water use efficiency was similar for both irrigation strategies. Based on the results found by the authors, it is recommendable to manage irrigation based on soil moisture content because of the best growth response and sugarcane yield. Full article

This paper investigates the construction of confidence intervals for multiple change points in linear regression models. First, we detect multiple change points by performing variable selection on blocks of the input sequence; second, we re-estimate their exact locations in a refinement step. Specifically, we exploit an orthogonal greedy algorithm to recover the number of change points consistently in the cutting stage, and employ the sup-Wald-type test statistic to determine the locations of multiple change points in the refinement stage. Based on a two-stage procedure, we propose bootstrapping the estimated centered error sequence, which can accommodate unknown magnitudes of changes and ensure the asymptotic validity of the proposed bootstrapping method. This enables us to construct confidence intervals using the empirical distribution of the resampled data. The proposed method is illustrated with simulations and real data examples. Full article

9Cr18MoV stainless steel is widely employed in cutting-tool applications owing to its exceptional hardness and corrosion resistance. In this study, we systematically optimized the wire electrical discharge machining (WEDM) process parameters for 9Cr18MoV stainless steel through an L₁₆ (4⁴) orthogonal experimental design. The key parameters investigated include pulse width (T_on), pulse interval (T_off), peak current (IP), and wire feed speed (WS), with cutting efficiency (CE) and surface roughness (R_a) serving as the primary optimization objectives. A signal-to-noise ratio (SNR) analysis was applied to assess the effects of the individual parameters and derive single-objective optimal configurations. Subsequently, grey relational analysis (GRA) integrated with analytic hierarchy process (AHP)-based weighting was employed to establish a multi-objective optimal parameter set, which was experimentally validated. The results reveal that the optimal multi-objective performance was attained at T_on = 28 μs, T_off = 3 μs, IP = 9 A, and WS = level 3. SEM characterization confirmed that this parameter combination yields a more uniform surface morphology, with diminished oxidation and molten debris deposition, thereby significantly enhancing surface integrity. The adoption of this optimized parameter set not only ensures superior machining efficiency but also results in improved surface quality. Full article

The study aims to improve the efficiency of oil field development at the Kalamkas field through the implementation of new methods for analyzing hydrodynamic survey data and monitoring well conditions. It is hypothesized that the use of integrated geophysical and hydrodynamic methods will enhance forecasting accuracy, optimize field operations, and increase the hydrocarbon recovery factor. An integrated approach combining pulsed neutron logging (PNL), acoustic cementometry (AC), inflow and injectivity profile evaluation methods, and specialized software for advanced data interpretation was applied, significantly improving the accuracy of well condition analysis. The analysis enabled the identification of oil and gas saturation intervals, zones of increased water cut, and cementing defects in casing, and allowed for a quantitative assessment of reservoir permeability dynamics. Hydraulic fracturing application resulted in a 10–15% increase in permeability in certain zones, with an average oil recovery factor increase of 5%. Analysis of PNL data demonstrated the transition of oil-saturated reservoirs to water saturation during development, confirmed by geophysical and pressure build-up survey results. The study identified the primary causes of increased water cut and key factors leading to production rate decline. Proposed measures for optimizing operating modes and well grid efficiency contribute to improving existing field management practices. Full article

Objective: To assess the associations between academic study- and non-study-related sedentary behaviors and the risk of overweight/obesity in children and adolescents, as well as their joint association with sugar-sweetened beverage (SSB) consumption. Methods: Sedentary behaviors and SSB consumption were assessed using self-reported questionnaires. Overweight/obesity were defined by age- and sex-specific body mass index cut-off values according to the criteria of “Screening for overweight and obesity among school-age children and adolescents” in China. Poisson regression with robust error variance was used to assess the associations of sedentary behaviors and/or SSB consumption with the risk of overweight/obesity, yielding relative risks (RRs) and 95% confidence intervals (CIs). The Shapley additive explanations (SHAP) method was used to rank the contribution of five specific sedentary behaviors to obesity risk. Results: Among 47,148 participants with a 3-year follow-up, longer durations of screen-related, academic study-related, and total sedentary time were each associated with a higher risk of overweight/obesity (adjusted RR (95% CI) per hour increment: 1.01 (1.00–1.02), 1.03 (1.01–1.06), and 1.02 (1.01–1.03)). After mutual adjustment, the associations of engaging in homework, attending tutorial classes, and using mobile electronic devices remained significantly associated with higher overweight/obesity risk. The SHAP summary plot shows that using mobile electronic devices, attending tutorial classes, and doing homework were the three most important sedentary obesogenic contributors. A significant interaction of age with sedentary time was found (p for interaction < 0.05). No significant interaction was found between SSB consumption and sedentary time. Conclusions: Excessive sedentary behaviors were associated with a higher risk of overweight/obesity, particularly due to mobile electronic device use, attending tutorial classes, and doing homework. Full article