Search Results (65,348)

Drying and storage conditions play a critical role in shaping the quality of aged citrus peel. This study investigated the effects of different processing strategies on the volatile composition, microstructure, and sensory characteristics of five-year-aged Citrus Reticulata ‘Chachi’ Peel (CRP). Four treatments were evaluated using SPME/GC–MS, GC–IMS, electronic nose analysis, sensory assessment, scanning electron microscopy (SEM), and multivariate statistical tools. GC–IMS identified 96 volatile compounds, demonstrating that aging combined with varied drying–storage conditions promoted the formation of diverse aroma-active substances. Terpenes and related compounds predominated, with the indoor-dried and warehouse-stored XH sample showing significantly higher concentrations of key terpenoids and sesquiterpenes, including α-terpineol, γ-muurolene, germacrene, β-selinenol, α-farnesene, and nerolidol. These compounds contributed to enhanced citrus, floral, fruity, and woody notes. Principal component analysis of electronic nose data (93.46% cumulative variance) clearly distinguished XH from other samples. Sensory results supported instrumental findings, indicating stronger fruity and sweet attributes in XH and C, while sun-dried samples exhibited more hay-like characteristics. SEM revealed better structural integrity in indoor-dried samples, potentially facilitating volatile retention. Overall, indoor drying and controlled storage improved aroma complexity and sensory quality, providing a scientific basis for optimized CRP processing. Full article

Background: This study aimed to evaluate the prognostic performance of four albumin-anchored ratios—blood urea nitrogen/albumin ratio (BAR), C-reactive protein/albumin ratio (CAR), lactate/albumin ratio (LAR), and albumin/creatinine ratio (ACR)—in predicting short-term mortality among intensive care unit (ICU) patients with pre-existing chronic comorbidities. Additionally, we assessed their incremental prognostic value beyond established severity scores such as APACHE II and SOFA. Materials and Methods: This retrospective cohort study included 520 chronically ill adult ICU patients admitted between July 2022 and July 2025. Patients with missing laboratory data, ICU stay <24 h, or postoperative monitoring only were excluded. BAR, CAR, LAR, and ACR were calculated from admission laboratory values. The primary outcome was 28-day mortality. Receiver operating characteristic (ROC) analyses, multivariate logistic regression, and model improvement metrics (C-statistics, NRI, IDI) were used to assess predictive performance. Results: Non-survivors had significantly higher BAR (15.0 vs. 8.2), CAR (39.2 vs. 19.1), and LAR (0.86 vs. 0.44) values and lower ACR (2.0 vs. 3.4) (all p < 0.001). In multivariate analysis, all four ratios independently predicted 28-day mortality (p < 0.001 for each). CAR showed the highest AUC (0.80), followed by LAR (0.79), BAR (0.78), and ACR (0.76). Incorporating all four ratios improved model discrimination (C-statistic 0.872 vs. 0.823; Δ = +0.049, p < 0.001) and reclassification (NRI = 0.162; IDI = 0.052). Conclusions: BAR, CAR, LAR, and ACR are independent and complementary predictors of short-term mortality in ICU patients with chronic comorbidities. Among them, CAR exhibited the best discriminative power. The combined use of these ratios enhanced risk prediction beyond traditional severity scores, suggesting their utility as simple, cost-effective markers for early mortality assessment. Because these indices are calculated from routinely measured laboratory parameters, they may represent practical and widely accessible tools for mortality risk stratification in routine ICU practice. Full article

This study presents a comparative evaluation of Environmental Product Declarations (EPDs) within the traditional ceramic industry, emphasizing how differences in data structures, reporting formats, and background databases influence the interpretation of environmental performance. Four product categories—ceramic tiles, sanitary ware, clay bricks, and clay roof tiles—were analyzed using datasets from One Click LCA and the International EPD System. Environmental indicators assessed include fossil-based and total Global Warming Potential (GWP), freshwater consumption, and energy demand, standardized per 1 kg of product. The analysis reveals that discrepancies between platforms arise primarily from the limited level of process-specific information required by current EPD formats, rather than from the platforms themselves. Missing details on raw material composition, firing conditions, and energy sources restrict comparability and hinder the development of robust benchmarks. Furthermore, the study highlights the need for harmonized databases, more transparent PCR requirements, and consistent reporting rules to support meaningful cross-platform comparisons. As the first study to examine EPD data structures for ceramic products across two major reporting systems, it highlights the need to expand product-specific benchmarks and enhance disclosure practices to strengthen the role of EPDs in sustainable market design and climate policy. Full article

The paper proposes a groundbreaking strategy for merging corporate digitalization and low-carbon transition (digital–carbon integration) for Chinese companies, using data from A-share listed companies in China from 2013 to 2022. The deep integration of the digital transformation and green low-carbon development has emerged as a crucial route by which to enhance sustainable development and attain high-quality development, due to the quick iterations of digital technology and the growing severity of global climate challenges. The study uses a dual fixed effects model for regression analysis and gathers 24,074 sample observations. The findings show the following: (1) The level of digital–carbon integration has been gradually increasing, which has had a major positive impact on sustainable development. Several robustness tests confirm the validity of this conclusion. (2) Mechanism analysis shows that, by encouraging green technology innovation and increasing operational management efficiency, digital–carbon integration can improve sustainable development. (3) According to heterogeneity analysis, non-state-owned businesses and high-technology corporations are more affected by digital–carbon integration on sustainable development. This study gives a path reference for improving sustainable development and attaining high-quality growth, in addition to offering a theoretical foundation for advancing digital–carbon integration in Chinese businesses. Full article

This paper presents an experimental investigation of a low-temperature ejector-based air-conditioning system designed to utilize waste heat from Combined Heat and Power (CHP) plants. The system operates with isobutane (R600a) as the working fluid and is driven by low-grade heat sources in the temperature range of 80–120 ${}^{\circ }$C. A prototype experimental rig was developed to evaluate the influence of key operating parameters, including motive steam pressure and evaporator temperature, on the system’s Coefficient of Performance (COP) and entrainment ratio. The results demonstrate that the system can maintain stable operation even at ultra-low heat source temperatures, achieving a maximum COP of 0.35 under optimal conditions. The findings confirm the feasibility of using R600a in ejector-based systems for sustainable cooling applications. Furthermore, the study highlights the potential for integrating such systems into existing district heating networks to enhance overall energy efficiency. Overall, the presented results provide valuable experimental data supporting the development of sustainable, thermally driven cooling technologies that reduce reliance on grid electricity and high-GWP refrigerants. Full article

Objective: This exploratory study presents an international, multi-stakeholder snapshot of perceptions regarding real-world data and real-world evidence in health technology assessment. The aim is to identify perceived opportunities, barriers, and enabling conditions rather than to generate generalizable conclusions. Methods: A 21-item, expert-validated questionnaire was distributed via LimeSurvey to diverse health technology assessment stakeholders, including academia, industry, health technology assessment agencies, healthcare providers, policymakers, patients, and payers. The survey explored perceptions of value, methodological and regulatory challenges, and future outlooks for RWD/RWE use in HTA. Ethical approval was obtained by the University of West Attica Ethics Committee, and pilot testing was conducted prior to dissemination. Data were analyzed using descriptive statistics, consistent with the study’s exploratory intent and acknowledging that results are preliminary and not statistically generalizable. Results: Thirty-two completed responses demonstrated preliminary stakeholder support for integrating real-world data and real-world evidence into health technology assessment. Respondents represented academia, industry, HTA agencies, healthcare providers, policymakers, and patient/advocacy groups; however, no payer responses were obtained. Respondents emphasized the value of real-world data in complementing clinical trials by capturing real-world effectiveness, patient diversity, and long-term outcomes, especially in rare diseases and cancer. Key challenges included poor data quality, confounding biases, and regulatory barriers. Stakeholders highlighted the importance of standardization, transparency, and international collaboration. Opportunities included better decision-making, personalized healthcare, and improved post-market monitoring, with strong calls for robust infrastructure, clear methodologies, patient involvement, and supportive health policy frameworks. Conclusions: Real-world data and evidence enhance health technology assessment by supporting better decisions and personalized care. However, issues like data quality, methods, and trust must be addressed through standardization, strong infrastructure, and collaboration to ensure effective and impactful implementation in healthcare, while acknowledging these insights are based on a small exploratory sample. Full article

Background: Antinuclear antibodies (ANAs) are frequently detected in patients with rheumatoid arthritis (RA); however, their prognostic relevance for predicting treatment escalation and biologic therapy initiation remains incompletely understood. Identifying biomarkers associated with earlier transition to advanced therapies may enhance individualized, treat-to-target disease management. Objectives: We aimed to evaluate the association of ANA status and titer levels with clinical characteristics, treatment trajectories, and time to biologic therapy initiation in patients with RA. Methods: In this retrospective cohort study, 223 patients with RA were stratified according to ANA status (112 ANA-positive, 111 ANA-negative). Baseline demographic data, disease activity (DAS28), and serological markers (RF, anti-CCP) were analyzed. Time to biologic therapy initiation, defined from the date of RA diagnosis to first biologic or targeted synthetic DMARD use, was assessed using Kaplan–Meier survival analysis and Cox proportional hazards regression. Multivariate models adjusted for clinically relevant covariates (age, sex, disease duration, RF, anti-CCP). Within the ANA-positive group, exploratory analyses compared low–moderate (1:80–1:320) and high (>1:320) ANA titers, highlighting potential non-linear effects. Results: Baseline demographic and clinical characteristics were comparable between groups (all p > 0.05). ANA-positive patients more frequently initiated biologic therapy (48.2% vs. 24.3%, p < 0.001) and experienced multiple biologic switches (29.5% vs. 16.2%, p = 0.028). In multivariate analysis, ANA positivity independently predicted earlier biologic therapy initiation (adjusted HR 2.14; 95% CI 1.32–3.46; p = 0.002), whereas RF and anti-CCP status were not significant predictors. Exploratory subgroup analysis revealed the “titer paradox,” whereby high ANA titers (>1:320) were associated with a lower hazard of biologic therapy initiation compared with low–moderate titers (HR 0.24; 95% CI 0.06–0.98; p = 0.048). Conclusions: ANA positivity serves as an independent prognostic marker for earlier biologic therapy initiation in RA, providing incremental information beyond traditional serological markers. The observed non-linear association between ANA titers and treatment escalation underscores the need for cautious interpretation and validation in prospective, mechanistic studies, and highlights the potential value of integrating ANA profiling into personalized treatment strategies. Full article

Background: Tendons adapt to mechanical loading by increasing cross-sectional area (CSA), stiffness, and matrix organization, with structural remodeling critical for both rehabilitation and performance. Collagen supplementation has been proposed to enhance this process by supplying key amino acids for collagen synthesis; however, inconsistent results across trials have limited its clinical and athletic application. Methods: A systematic review of randomized controlled trials evaluating collagen supplementation in humans was conducted. PubMed, EMBASE, CINAHL, and Web of Science were searched from database inception through May 2025. Risk of bias was assessed using the PEDro scale (≥6/10 classified as good-to-excellent quality). Due to substantial heterogeneity in supplementation protocols, training modalities, and outcome measures, results were synthesized narratively without meta-analysis. Data extraction included collagen type, dose, training modality, intervention duration, and outcome measures. Results: Of 887 unique citations, eight RCTs (n = 257; ages 18–52; 246 M:11 F) met the inclusion criteria. All studies incorporated resistance or plyometric training (3–15 weeks). Three of four studies reported significantly greater increases in tendon CSA in collagen groups versus placebo. Four studies investigated tendon stiffness and Young’s modulus; the two using higher doses (15–30 g/day) demonstrated significant between-group improvements favoring collagen, while lower-dose studies (~5 g) showed only within-group effects. Muscle strength improved with training in all trials, but no additive effects of collagen were observed. One study reported improvements in eccentric rate of force development and deceleration impulse with collagen, though gross explosive metrics (e.g., jump height) were unaffected. Conclusions: Collagen supplementation (15–30 g) with vitamin C (≥50 mg) may enhance tendon remodeling when combined with high-intensity resistance training (≥70% 1 RM). The current literature suggests strong evidence (GRADE A) for increases in tendon CSA and stiffness, strong evidence (GRADE A) against an effect on muscle strength, and conflicting evidence (GRADE C) for muscle cross-sectional area and physical performance. Limitations include small sample sizes, heterogeneous protocols, and short intervention durations. Full article

Background/Objectives: Teucrium polium L. is widely used in traditional medicine and has been proposed as a source of antimicrobial adjuvants in the context of antimicrobial resistance. Here, we characterized the essential oil (EO) and polar extracts of T. polium and evaluated their antioxidant activity, antimicrobial potency against clinical multidrug-resistant (MDR) isolates, and the interaction of the EO with conventional antibiotics using a chequerboard assay (FICI); further, we investigated in silico molecular interactions with some targets related to resistance. Methods/Results: The EO, which was hydrodistilled and subsequently analyzed by GC–MS, is characterized by dominant limonene content (24.13%) and contents of oxygenated sesquiterpenes such as β-eudesmol (10.48%) and α-muurolol (8.10%). HPLC/UV–ESI–MS characterization of the extracts (decoction and Soxhlet) demonstrated that they were rich in polyphenolic compounds and flavonoids, which matched the standard phytochemical characteristics of this species. The extracts exhibited significant reducing capabilities, and the hydroethanolic extract exhibited the highest antioxidant activity (DPPH IC₅₀ = 15.41 μg/mL; FRAP EC₅₀ = 30.65 μg /mL), while the EO revealed at most moderate capacity in these tests. In antimicrobial assays, the EO inhibited fungi more effectively than the extracts (MIC of 1.17 mg/mL against Aspergillus niger; 4.69 mg/mL against Candida spp.), while antibacterial MICs for both the EO and extracts were generally high (up to 50 mg/mL). Combination testing nevertheless identified synergistic or additive effects of the EO with selected antibiotics, notably with ceftazidime against ESBL-producing Escherichia coli (FICI = 0.141) and Staphylococcus aureus (FICI = 0.039) and with amikacin against Klebsiella pneumoniae (FICI = 0.313); the EO–ceftriaxone pairing against ESBL E. coli was additive (FICI = 0.516). Docking simulations further supported these observations by showing the favorable predicted binding of oxygenated sesquiterpenes, most notably β-eudesmol and α-muurolol (up to −8.6 kcal/mol), to resistance-related targets such as RND efflux pumps, β-lactamases, and porins. Conclusions: Taken together, the in vitro and in silico data suggest that T. polium could be explored as a natural antimicrobial option and as an adjuvant to enhance antibiotic activity against multidrug-resistant pathogens. Full article

Sustainable human resource management (HRM) has attracted growing attention as a new paradigm for enhancing organizational resilience. However, prior studies mainly examined the effects of individual practices, offering a limited explanation of how organizational resilience emerges as an integrated mechanism. To address this theoretical gap, we conceptualize sustainable HRM as an integral talent management process in which multiple practices operate interdependently and investigate the configurational mechanisms through which organizational resilience is generated in Japanese firms and discuss these from the perspective of socioformation. Based on six analytical dimensions derived from a tertiary literature review, we conducted a crisp-set qualitative comparative analysis (csQCA) using securities report data from 36 listed Japanese companies. The results revealed that organizational resilience is not achieved through a single best practice, but rather points to a new form of integrated human resource management aimed at sustainable value creation. From a socioformation perspective, employees are viewed not merely as productive inputs but as agents capable of continuous development through sustained investment in human potential. From this perspective, sustainable social development cannot be reduced to well-being or inclusion indicators alone but also encompasses ethical, collaborative, territorial, and interdisciplinary dimensions of transformation. The findings clarify the theoretical role of integral talent management in sustainable value creation and provide practical implications for human-centred management. Full article

A critical aspect of virtual reality is the extent to which the user forgets their real surroundings and becomes completely engaged within the virtual environment. Diverse factors affect this user perception, which are grouped into two main concepts: immersion and presence. Although the study of presence is extensive, researchers have not reached a consensus on a protocol with specific instruments and stages to evaluate it. This leads to a wide variety of results with different assessment methods, experimental setups, stimuli implemented, and applications. Therefore, this article aims to provide an analysis of the state-of-the-art methods for assessing presence in VR systems during the last few years. This study seeks to determine and improve the understanding of current techniques used for presence assessment, human data collected, data analysis methods, and the technologies and virtual environments implemented. In addition, four opportunities are discussed to provide researchers guidelines that can lead to enhanced presence assessments and personalized VR experiences. Full article

Background and Objectives: The aim of this study is to evaluate impulsivity in childhood anxiety disorders and to examine its relationship with anxiety sensitivity and emotion regulation. Materials and Methods: The study group consisted of a total of 60 children aged 8–12 years diagnosed with generalized anxiety disorder (GAD, n = 30) and other anxiety disorders (n = 30). The control group consisted of 40 healthy children of similar age without a psychiatric diagnosis. Data collection forms included the Barratt Impulsiveness Scale Short Form (BIS-S), the Children’s Anxiety Sensitivity Index (ASI-3), the Emotion Regulation Checklist (ERC), and The Screen for Child Anxiety Related Emotional Disorders (SCARED). Results: Our study found no significant differences in BIS-S scores between GAD, other anxiety disorders, and the control group. The total/physical and ERC subscales of the ASI-3 were higher in the generalized anxiety disorder and other anxiety disorder group than in the control group. However, there were no significant differences in the social dimension and cognitive dimension scores of the ASI-3. It has been determined that anxiety sensitivity does not significantly mediate the relationship between emotion regulation and impulsivity, and that emotional variability/negativity is directly and completely related to impulsivity. Conclusions: Our study suggests that children with anxiety disorders experience greater difficulties in regulating their emotions compared to healthy children, and that emotional variability is directly related to impulsivity. In this context, enhancing emotion regulation skills in anxiety disorders may prove to be a pivotal factor in the efficacy of treatment and the maintenance of behavioral control. Full article

The integration of digital tools into mathematics education has the potential to transform teaching and learning for students with special needs by fostering inclusion, accessibility, and engagement. Guided by the principles of Universal Design for Learning (UDL) and Vygotsky’s social constructivist theory, this study investigates how digital technologies can enhance learning experiences and promote inclusive education in mathematics classrooms. Using a mixed-method design, data were collected from 110 mathematics teachers and 210 Grade 11 students in special schools across Nigeria to assess the availability, utilization, and impact of digital tools on students’ engagement, motivation, collaboration, and problem-solving. Findings indicate that while access to digital tools remains limited, their effective use significantly improves students’ learning experiences and supports inclusive pedagogical practices. The study underscores the importance of policy alignment to ensure equitable access to digital resources for all students. Findings contribute to global discussions on inclusive digital pedagogies by providing empirical insights into how technology can mediate participation, interaction, and achievement in mathematics for students with special needs. Full article

Assistive mobility devices for small animals require reliable monitoring to ensure safe and comfortable operation without increasing system complexity or invasiveness. This study presents a low-cost monitoring platform that integrates a laser-induced graphene (LIG) contact-temperature sensor into a passive mobility device for small dogs, supported by a lightweight Internet of Things (IoT) architecture. The system combines contact temperature, ambient temperature, speed, and obstacle distance using an energy-aware acquisition strategy and prioritized wireless transmission for near-real-time monitoring. An unsupervised anomaly detection framework based on Isolation Forest identifies potentially unsafe operating conditions without labeled pathological data by leveraging absolute temperature and the differential feature $\Delta T$ between contact and ambient measurements. Experimental validation was conducted under controlled indoor conditions across six independent sessions with a small-breed dog, including static and dynamic phases to ensure repeatability. The system achieved packet delivery ratios of approximately 95%, with typical end-to-end latencies below 500 ms and worst-case delays below 850 ms. The proposed approach detected localized thermal deviations associated with friction or prolonged contact while remaining robust to normal activity- and environment-driven variations. These results demonstrate the feasibility of integrating LIG-based sensing and unsupervised analytics into assistive animal mobility platforms to enhance safety through continuous, non-invasive monitoring. Full article

Background: Immediate prepectoral implant-based breast reconstruction (IBR) following skin-reducing mastectomy (SRM) preserves the pectoralis major muscle, improving recovery and aesthetics. A dual-layer technique combining porcine-derived acellular dermal matrix (ADM) with an inferior autologous dermal sling may enhance implant support, vascularization, and lower-pole stability, particularly in patients with macromastia or ptosis. Methods: This retrospective single-center study included 20 patients (24 breasts) who underwent SRM with immediate prepectoral IBR using the dual-layer technique between January 2023 and May 2025. Demographic, oncologic, and perioperative data were collected prospectively. Complications were classified by severity, and patient-reported outcomes were evaluated using the BREAST-Q scale preoperatively and at 1, 3, 6, and 12 months postoperatively. Statistical analysis included paired t-tests, Shapiro–Wilk tests, and effect size estimation (Cohen’s dz). Results: Mean age was 42 ± 6.3 years and BMI 26.1 ± 3.2 kg/m². Mean mastectomy specimen weight was 432.5 ± 120.8 g, and implant volume 375 ± 60 cc. No reconstruction failures or infections occurred. Early complications were reported in 20.8% of breasts, including superficial nipple–areola complex epidermolysis (8.3%), seroma (4.2%), and hematoma (4.2%), all managed conservatively. At 12 months, BREAST-Q scores improved significantly: satisfaction with breasts increased from 63 ± 8 to 89 ± 11 (p < 0.001); psychosocial well-being from 60 ± 10 to 81 ± 11 (p < 0.001); and physical well-being from 62 ± 7 to 82 ± 10 (p < 0.001). Conclusions: Dual-layer prepectoral reconstruction using porcine ADM and autologous dermal sling is safe, provides durable implant stability, and significantly improves patient satisfaction and quality of life following SRM. Full article