Search Results (2,300)

In this work, we propose a definition of the random fractional Riemann–Liouville integral operator, where the order of integration is given by a random variable. Within the framework of random operator theory, we study this integral with a random kernel and establish results on the measurability of the random Riemann–Liouville integral operator, which we show to be a random endomorphism of $L^1[a,b]$. Additionally, we derive the semigroup property for these operators as a probabilistic version of the constant-order Riemann–Liouville integral. To illustrate the behavior of this operator, we present two examples involving different random variables acting on specific functions. The sample trajectories and estimated probability density functions of the resulting random integrals are then explored via Monte Carlo simulation. Full article

This article explores strategies for integrating anti-racist approaches into university-level study of religion teaching on multiple levels, including curriculum design, selection of teaching materials, self-reflection practices, responses to concrete classroom situations and fostering environments that protect students of colour while encouraging “white” students to critically examine their own privileges. To contextualize this endeavour, the article first outlines the current situation and describes some challenges related to racism and anti-racism efforts within a Swiss university context, drawing on recent empirical studies. This is followed by an examination of the historical development of racial thought, culminating in contemporary discussions of neo-racism and its connection with the classification category religion. A working definition of racism suitable for academic teaching is then proposed. The article further investigates the relationship between racism and the study of religion, arguing that the discipline has a crucial role to play in addressing and combating racist ideologies. This argument is supported by some empirical data from the author’s doctoral research, as well as examples drawn from the author’s teaching experience at the University of Zurich. By combining historical analysis with practical teaching strategies, thearticle aims to provide a coherent framework for embedding anti-racist principles in higher education. Full article

Oncology physiotherapists frequently provide care for patients experiencing severe immunosuppression. Exercise immunology, the science that studies the effects of exercise on the immune system, is a rapidly evolving field with direct relevance to oncology physiotherapists. Understanding oncology physiotherapists’ perspectives on the subject of immune functioning is essential to explore its possible integration into clinical reasoning. This study aimed to assess the perspectives of oncology physiotherapists concerning immune functioning in oncology physiotherapy. For this qualitative research, semi-structured interviews were performed with Dutch oncology physiotherapists. Results were analyzed via inductive thematic analysis, followed by a validation step with participants. Fifteen interviews were performed. Participants’ ages ranged from 30 to 63 years. Emerging themes were (1) the construct ‘immune functioning’ (definition, and associations with this construct in oncology physiotherapy), (2) characteristics related to decreased immune functioning (in oncology physiotherapy), (3) negative and positive influences on immune functioning (in oncology physiotherapy), (4) tailored physiotherapy treatment, (5) treatment outcomes in oncology physiotherapy, (6) the oncology physiotherapist within cancer care, and (7) measurement and interpretation of immune functioning. In conclusion, oncology physiotherapists play an important role in the personalized and comprehensive care of patients with cancer. They are eager to learn more about immune functioning with the goal of better informing patients about the health effects of exercise and to tailor their training better. Future exercise-immunology research should clarify the effects of different exercise modalities on immune functioning, and how physiotherapists could evaluate these effects. Full article

Climate change poses an escalating threat to cultural heritage (CH), driven by intensifying climate-related hazards and systemic vulnerabilities. In response, risk assessment frameworks and methodologies (RAFMs) have emerged to evaluate and guide adaptation strategies for safeguarding heritage assets. This study conducts a state-of-the-art (SotA) review of 86 unique RAFMs using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic approach to assess their scope, methodological rigor, alignment with global climate and disaster risk reduction (DRR) frameworks, and consistency in conceptual definitions of hazard, exposure, and vulnerability. Results reveal a growing integration of Intergovernmental Panel on Climate Change (IPCC)-based climate projections and alignment with international policy instruments such as the Sendai Framework and United Nations Sustainable Development Goals (UN SDGs). However, notable gaps persist, including definitional inconsistencies, particularly in the misapplication of vulnerability concepts; fragmented and case-specific methodologies that challenge comparability; and limited integration of intangible heritage. Best practices include participatory stakeholder engagement, scenario-based modeling, and incorporation of multi-scale risk typologies. This review advocates for more standardized, interdisciplinary, and policy-aligned frameworks that enable scalable, culturally sensitive, and action-oriented risk assessments, ultimately strengthening the resilience of cultural heritage in a changing climate. Full article

Background: Patients with resected stage IIB and IIC melanoma are at high risk of recurrence and distant metastasis, despite surgical treatment. The recent emergence of immune checkpoint inhibitors (ICIs) has led to their evaluation in the adjuvant setting for early-stage disease. This review aims to synthesize current evidence regarding adjuvant immunotherapy for stage IIB/IIC melanoma, explore emerging strategies, and highlight key challenges and future directions. Methods: We conducted a comprehensive literature review of randomized clinical trials, observational studies, and relevant mechanistic and biomarker research on adjuvant therapy in stage IIB/IIC melanoma. Particular focus was placed on pivotal trials evaluating PD-1 inhibitors (KEYNOTE-716 and CheckMate 76K), novel vaccine and targeted therapy trials, mechanisms of resistance, immune-related toxicity, and biomarker development. Results: KEYNOTE-716 and CheckMate 76K demonstrated significant improvements in recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) with pembrolizumab and nivolumab, respectively, compared to placebo. However, no definitive overall survival benefit has yet been shown. Adjuvant immunotherapy is linked to immune-related adverse events, including permanent endocrinopathies. Emerging personalized approaches, such as circulating tumor DNA monitoring and gene expression profiling, may enhance patient selection, but remain investigational. Conclusions: Adjuvant PD-1 blockade offers clear RFS benefits in high-risk stage II melanoma, but optimal patient selection remains challenging, due to uncertain overall survival benefit and toxicity concerns. Future trials should integrate biomarker-driven approaches to refine therapeutic decisions and minimize overtreatment. Full article

With the large-scale integration of high-penetration distributed photovoltaic (DPV) into distribution networks, its output volatility and reverse power flow characteristics are prone to causing voltage violations, necessitating the accurate identification of weak nodes to enhance operational reliability. This paper investigates the definition, quantification criteria, and multi-indicator comprehensive determination methods for weak nodes in distribution networks. A multi-criteria assessment method integrating voltage deviation rate, sensitivity analysis, and power margin has been proposed. This method quantifies the node disturbance resistance and comprehensively evaluates the vulnerability of voltage stability. Simulation validation based on the IEEE 33-node system demonstrates that the proposed method can effectively identify the distribution patterns of weak nodes under different penetration levels (20~80%) and varying numbers of DPV access points (single-point to multi-point distributed access scenarios). The study reveals the impact of increased penetration and dispersed access locations on the migration characteristics of weak nodes. The research findings provide a theoretical basis for the planning of distribution networks with high-penetration DPV, offering valuable insights for optimizing the siting of volatile loads such as electric vehicle (EV) charging stations while considering both grid safety and the demand for distributed energy accommodation. Full article

An indicator-based approach was implemented to assess the contributions of soils in supplying ecosystem services, providing a scalable tool for modeling the spatial heterogeneity of soil functions at regional and local scales. The method consisted of (i) the definition of soil-based ecosystem services (SESs), using available point data and thematic maps; (ii) the definition of appropriate SES indicators; (iii) the assessment and mapping of potential SESs provision for the Emilia-Romagna region (22.510 km²) in NE Italy. Depending on data availability and on the role played by terrain features and soil geography and its complexity, maps of basic soil characteristics (textural fractions, organic C content, and pH) covering the entire regional territory were produced at a 1 ha resolution using digital soil mapping techniques and geostatistical simulations to explicitly consider spatial variability. Soil physical properties such as bulk density, porosity, and hydraulic conductivity at saturation were derived using pedotransfer functions calibrated using local data and integrated with supplementary information such as land capability and remote sensing indices to derive the inputs for SES assessment. Eight SESs were mapped at 1:50,000 reference scale: buffering capacity, carbon sequestration, erosion control, food provision, biomass provision, water regulation, water storage, and habitat for soil biodiversity. The results are discussed and compared for the different pedolandscapes, identifying clear spatial patterns of soil functions and potential SES supply. Full article

Nephrogenic diabetes insipidus (NDI) is a rare hereditary disorder characterized by renal resistance to arginine vasopressin (AVP), resulting in the kidneys’ inability to concentrate urine. Approximately 90% of NDI cases follow an X-linked inheritance pattern and are associated with pathogenic variants in the AVPR2 gene, which encodes the vasopressin receptor type 2. The remaining 10% are attributed to mutations in the AQP2 gene, which encodes aquaporin-2, and may follow either autosomal dominant or recessive inheritance patterns. We present the case of a male infant, younger than nine months of age, who was clinically diagnosed with NDI at six months. The patient presented recurrent episodes of polydipsia, polyuria, dehydration, hypernatremia, and persistently low urine osmolality. Despite adjustments in pharmacologic treatment and strict monitoring of urinary output, the clinical response remained suboptimal. Given the lack of improvement and the radiological finding of an absent posterior pituitary (neurohypophysis), the possibility of coexistent central diabetes insipidus (CDI) was raised, prompting a therapeutic trial with desmopressin. Nevertheless, in the absence of clinical improvement, desmopressin was discontinued. The patient’s management was continued with hydrochlorothiazide, ibuprofen, and a high-calorie diet restricted in sodium and protein, resulting in progressive clinical stabilization. Whole-exome sequencing identified a novel homozygous missense variant in the AQP2 gene (c.398T > A; p.Val133Glu), classified as likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria: PM2 (absent from population databases), PP2 (missense variant in a gene with a low rate of benign missense variation), and PP3 (multiple lines of computational evidence supporting a deleterious effect)]. NDI is typically diagnosed during early infancy due to the early onset of symptoms and the potential for severe complications if left untreated. In this case, although initial clinical suspicion included concomitant CDI, the timely initiation of supportive management and the subsequent incorporation of molecular diagnostics facilitated a definitive diagnosis. The identification of a previously unreported homozygous variant in AQP2 contributed to diagnostic confirmation and therapeutic decision-making. The diagnosis and comprehensive management of NDI within the context of polyuria-polydipsia syndrome necessitates a multidisciplinary approach, integrating clinical evaluation with advanced molecular diagnostics. The novel AQP2 c.398T > A (p.Val133Glu) variant described herein was associated with early and severe clinical manifestations, underscoring the importance of genetic testing in atypical or treatment-refractory presentations of diabetes insipidus. Full article

Industrial Vision Inspection Systems (VISs) often struggle to adapt to increasing variability of modern manufacturing due to the inherent rigidity of their hardware architectures. Although the Reconfigurable Manufacturing System (RMS) paradigm was introduced in the early 2000s to overcome these limitations, designing such reconfigurable machines remains a complex, expert-dependent, and time-consuming task. This is primarily due to the lack of structured methodologies and the reliance on trial-and-error processes. In this context, this study proposes a novel theoretical framework to facilitate the design of fully reconfigurable handling systems for VISs, with a particular focus on fixture design. The framework is grounded in Model-Based Definition (MBD), embedding semantic information directly into the 3D CAD models of the inspected product. As an additional contribution, a general hardware architecture for the inspection of axisymmetric components is presented. This architecture integrates an anthropomorphic robotic arm, Numerically Controlled (NC) modules, and adaptable software and hardware components to enable automated, software-driven reconfiguration. The proposed framework and architecture were applied in an industrial case study conducted in collaboration with a leading automotive half-shaft manufacturer. The resulting system, implemented across seven automated cells, successfully inspected over 200 part types from 12 part families and detected more than 60 defect types, with a cycle below 30 s per part. Full article

Lower respiratory tract infections remain a leading cause of morbidity and mortality among Intensive Care Unit patients, with severe cases often progressing to acute respiratory distress syndrome (ARDS). This life-threatening syndrome results from alveolar–capillary membrane injury, causing refractory hypoxemia and respiratory failure. Early detection and management are critical to treat the underlying cause, provide protective lung ventilation, and, eventually, improve patient outcomes. The 2012 Berlin definition standardized ARDS diagnosis but excluded patients on non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) modalities, which are increasingly used, especially after the COVID-19 pandemic. By excluding these patients, diagnostic delays can occur, risking the progression of lung injury despite ongoing support. Indeed, sustained, vigorous respiratory efforts under non-invasive modalities carry significant potential for patient self-inflicted lung injury (P-SILI), underscoring the need to broaden diagnostic criteria to encompass these increasingly common therapies. Recent proposals expand ARDS criteria to include NIV and HFNCs, lung ultrasound, and the SpO₂/FiO₂ ratio adaptations designed to improve diagnosis in resource-limited settings lacking arterial blood gases or advanced imaging. However, broader criteria risk overdiagnosis and create challenges in distinguishing ARDS from other causes of acute hypoxemic failure. Furthermore, inter-observer variability in imaging interpretation and inconsistencies in oxygenation assessment, particularly when relying on non-invasive measurements, may compromise diagnostic reliability. To overcome these limitations, a more nuanced diagnostic framework is needed—one that incorporates individualized therapeutic strategies, emphasizes lung-protective ventilation, and integrates advanced physiological or biomarker-based indicators like IL-6, IL-8, and IFN-γ, which are associated with worse outcomes. Such an approach has the potential to improve patient stratification, enable more targeted interventions, and ultimately support the design and conduct of more effective interventional studies. Full article

Background and Objectives: Heart failure (HF) and chronic kidney disease (CKD) frequently coexist and are closely interrelated, significantly affecting clinical outcomes. Among CKD-related markers, albuminuria and estimated glomerular filtration rate (eGFR) have emerged as key prognostic indicators in HF. However, their specific predictive value across different HF phenotypes—namely HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF)—remains incompletely understood. This systematic review aims to evaluate the prognostic significance of albuminuria and eGFR in patients with HF and to compare their predictive roles in HFpEF versus HFrEF populations. Materials and Methods: We conducted a systematic search of major databases to identify clinical studies evaluating the association between albuminuria, eGFR, and adverse outcomes in HF patients. Inclusion criteria encompassed studies reporting on cardiovascular events, all-cause mortality, or HF-related hospitalizations, with subgroup analyses based on ejection fraction. Data extraction and quality assessment were performed independently by two reviewers. Results: Twenty-one studies met the inclusion criteria, including diverse HF populations and various biomarker assessment methods. Both albuminuria and reduced eGFR were consistently associated with increased risk of mortality and hospitalization. In HFrEF populations, reduced eGFR demonstrated stronger prognostic associations, whereas albuminuria was predictive across both HF phenotypes. Heterogeneity in study design and outcome definitions limited comparability. Conclusions: Albuminuria and eGFR are valuable prognostic biomarkers in HF and may enhance risk stratification and clinical decision-making, particularly when integrated into clinical assessment models. Differential prognostic implications in HFpEF versus HFrEF highlight the need for phenotype-specific approaches. Further research is warranted to validate these findings and clarify their role in guiding personalized therapeutic strategies in HF populations. Limitations: The current evidence base consists primarily of observational studies with variable methodological quality and inconsistent reporting of effect estimates. Full article

The incorporation of digital health into the medical curricula is becoming more important to better prepare doctors in the future. Digital health comprises a wide range of tools such as electronic health records, health information technology, telemedicine, telehealth, mobile health applications, wearable devices, artificial intelligence, and virtual reality. The present study aimed to explore the medical and biomedical students’ perspectives on the integration of digital health in medical curricula. A cross-sectional study was conducted on the medical and biomedical undergraduate students at the College of Medicine and Health Sciences at Sultan Qaboos University. Data was collected using a self-administered questionnaire. The response rate was 37%. The majority of respondents were in the MD (Doctor of Medicine) program (84.4%), while 29 students (15.6%) were from the BMS (Biomedical Sciences) program. A total of 55.38% agreed that they were familiar with the term ‘e-Health’. Additionally, 143 individuals (76.88%) reported being aware of the definition of e-Health. Specifically, 69 individuals (37.10%) utilize e-Health technologies every other week, 20 individuals (10.75%) reported using them daily, while 44 individuals (23.66%) indicated that they never used such technologies. Despite having several benefits, challenges exist in integrating digital health into the medical curriculum. There is a need to overcome the lack of infrastructure, existing educational materials, and digital health topics. In conclusion, embedding digital health into medical curricula is certainly beneficial for creating a digitally competent healthcare workforce that could help in better data storage, help in diagnosis, aid in patient consultation from a distance, and advise on medications, thereby leading to improved patient care which is a key public health priority. Full article

This paper presents a comprehensive review of research on Historic Building Information Modeling (HBIM), focusing on its role as a tool for managing knowledge and supporting conservation practices of Architectural Heritage. While previous review articles and most research works have predominantly addressed geometric modeling—given its significant challenges in the context of historic buildings—this study places greater emphasis on the integration of non-geometric data within the BIM environment. A systematic search was conducted in the Scopus database to extract the 451 relevant publications analyzed in this review, covering the period from 2008 to mid-2024. A bibliometric analysis was first performed to identify trends in publication types, geographic distribution, research focuses, and software usage. The main body of the review then explores three core themes in the development of the information system: the definition of model entities, both semantic and geometric; the data enrichment phase, incorporating historical, diagnostic, monitoring and conservation-related information; and finally, data use and sharing, including on-site applications and interoperability. For each topic, the review highlights and discusses the principal approaches documented in the literature, critically evaluating the advantages and limitations of different information management methods with respect to the distinctive features of the building under analysis and the specific objectives of the information model. Full article

The emission and presence of volatile organic compounds (VOCs) in the indoor air of houses and factories has been a growing topic of debate in the industry and related research fields. Given the extended times people in modern society spend indoors, monitoring VOCs is crucial due to the associated potential health hazards, with formaldehyde being particularly noteworthy. Wood and wood-based panels (WBPs) (the latter constituting a significant segment of the wood-transforming industry, being widely used in furniture, construction, and other applications) are known sources for the emission of VOCs to indoor air. In the case of the WBPs, the emission of VOCs depends on the type and species of wood, together with industrial processing and addition of additives. This review integrates perspectives on the production processes associated with WBPs, together with the evolving global regulations, and thoroughly examines VOC sources associated with WBPs, health risks from exposure, and current analytical methods utilized for VOC detection. It comprises an overview of the WBP industry, providing relevant definitions, descriptions of manufacturing processes and adhesive use, analysis of legal constraints, and explanations of VOC source identification and describing analysis techniques utilized for VOCs in WBPs. Full article

Software-Defined Wide Area Networks (SD-WANs) require optimal controller placement to minimize latency, balance loads, and ensure reliability across geographically distributed infrastructures. This paper introduces NA-GMM (Network-Aware Gaussian Mixture Model), a novel multi-objective optimization framework addressing key limitations in current controller placement approaches. Three principal contributions distinguish NA-GMM: (1) a hybrid distance metric that integrates geographic distance, network latency, topological cost, and link reliability through adaptive weighting, effectively capturing multi-dimensional network characteristics; (2) a modified expectation–maximization algorithm incorporating node importance-weighting to optimize controller placements for critical network elements; and (3) a robust clustering mechanism that transitions from probabilistic (soft) assignments to definitive (hard) cluster selections, ensuring optimal placement convergence. Empirical evaluations on real-world topologies demonstrate NA-GMM’s superiority, achieving up to 22.7% lower average control latency compared to benchmark approaches, maintaining near-optimal load distribution with node distribution ratios, and delivering a 12.9% throughput improvement. Furthermore, NA-GMM achieved exquisite computational efficiency, executing 68.9% faster and consuming 41.5% less memory than state of the art methods, while achieving exceptional load balancing. These findings confirm NA-GMM’s practical viability for large-scale SD-WAN deployments where real-time multi-objective optimization is essential. Full article