Search Results (1,345)

Parental adverse childhood experiences (ACEs) are linked to negative outcomes in children, including emotional and behavioral problems, developmental delays, and higher risk for psychopathology. Most research focuses on school-aged children or community samples, with few studies examining preschool-aged children in child psychiatric care. Understanding parental ACEs in this population is crucial, as early childhood is a sensitive developmental period, and intergenerational effects may be particularly pronounced in children already presenting with psychiatric symptoms. Background/Objectives: The goal of this study was to analyze how parents of patients in an early childhood (0–5.9 yrs) mental health outpatient clinic differ from the general population in terms of the frequency of ACEs. In addition, we investigated the connection between mental health disorders in young children and the specific ACE scores of their parents. Methods: A total of 116 caregivers (34.45 years (SD = 5.28)) and their children (71.6% boys, 28.4% girls) at an average age of 3.99 years (SD = 1.35, range = 0.31–5.95) were included in the analysis. The legal guardians completed the 10-item ACE questionnaire. The young children were diagnosed as part of outpatient treatment using the DC:0–5 classification system. We analyzed the ACE scores and diagnoses descriptively and in comparison to a community sample. Results: An average value of 2.38 parental ACEs was reported by our sample, and 68.1% (n = 79) reported at least one ACE. The high-risk group with four or more ACEs comprised 30.2% (n = 35). The most common diagnosis in young children was the Disorder of Dysregulated Anger and Aggression of Early Childhood, followed by global developmental delay. Adjustment disorder was third in terms of frequency. Among the examined child psychiatric diagnoses, adjustment disorder showed a significant correlation with parents being affected by the ACE category of neglect (OR = 2.54; 95% CI: 1.012–6.369; p = 0.047). Conclusions: Parents who presented their children at an early childhood mental health outpatient clinic reported significantly more ACEs as compared to representative data on ACEs in adulthood. These results highlight the need for further studies with larger samples to enable a more in-depth analysis of the general intergenerational transmission processes and the differential transmission of specific ACEs to specific diagnoses in preschool-aged children. Full article

Objective: The objective of this study was to assess clinical-functional vulnerability (CFV) and associated factors in community-dwelling older adults treated in primary care. Methods: A cross-sectional study was conducted with non-institutionalized elderly individuals ≥60 years randomly selected from five Health Units in Jundiaí/SP, Brazil, in 2023. Sociodemographic data, health behaviors, and data on oral health (number of teeth; chewing: good/fair/poor), cognitive function (10-CS), nutritional status (MNA), health literacy (HLS-14), sarcopenia (SARC-F+CC) and frailty (IVCF-20) were collected. Descriptive and bivariate analyses between the outcome (CFV) and the independent variables were performed using the chi-squared test and binary logistic regression models (p < 0.05). Results: A total of 211 older adults participated in this study; 72% were female and the mean age was 70.41 years (±7.45). Regarding CFV, a high risk was identified in 9.5% of the participants (n = 19), a moderate risk in 34.6% (n = 73), and a low risk in 55.9% (n = 118). After adjusting the regression model, the following variables were associated with CFV: lower income (OR = 1.90; 95%CI: 1.02–3.55), poor (OR = 5.18; 95%CI: 2.13–12.63) and fair (OR = 2.36; 95%CI: 1.10–5.05) chewing, risk of malnutrition or malnourished (OR = 2.36; 95%CI: 1.23–5.52), and low literacy (OR = 1.86; 95%CI: 1.09–3.45). Conclusion: Socioeconomic factors, nutritional status (underweight or malnourished), poor or fair chewing, and low health literacy were associated with CFV among older people. Strengthening primary health care through targeted interventions may help prevent frailty or delay its progression. Understanding the predictors of frailty can guide health professionals, managers, and researchers in designing preventive and health promotion strategies, as well as public policies within Primary Health Care. Full article

Transformer-based models have accelerated EEG motor imagery (MI) decoding by using self-attention to capture long-range temporal structures while complementing spatial inductive biases. This systematic survey of Scopus-indexed works from 2020 to 2025 indicates that reported advances are concentrated in offline, protocol-heterogeneous settings; inconsistent preprocessing, non-standard data splits, and sparse efficiency frequently reporting cloud claims of generalization and real-time suitability. Under session- and subject-aware evaluation on the BCIC IV 2a/2b dataset, typical performance clusters are in the high-80% range for binary MI and the mid-70% range for multi-class tasks with gains of roughly 5–10 percentage points achieved by strong hybrids (CNN/TCN–Transformer; hierarchical attention) rather than by extreme figures often driven by leakage-prone protocols. In parallel, transformer-driven denoising—particularly diffusion–transformer hybrids—yields strong signal-level metrics but remains weakly linked to task benefit; denoise → decode validation is rarely standardized despite being the most relevant proxy when artifact-free ground truth is unavailable. Three priorities emerge for translation: protocol discipline (fixed train/test partitions, transparent preprocessing, mandatory reporting of parameters, FLOPs, per-trial latency, and acquisition-to-feedback delay); task relevance (shared denoise → decode benchmarks for MI and related paradigms); and adaptivity at scale (self-supervised pretraining on heterogeneous EEG corpora and resource-aware co-optimization of preprocessing and hybrid transformer topologies). Evidence from subject-adjusting evolutionary pipelines that jointly tune preprocessing, attention depth, and CNN–Transformer fusion demonstrates reproducible inter-subject gains over established baselines under controlled protocols. Implementing these practices positions transformer-driven BCIs to move beyond inflated offline estimates toward reliable, real-time neurointerfaces with concrete clinical and assistive relevance. Full article

The construction of nuclear power plants (NPPs) involves complex and long-duration projects where schedule delays critically affect project performance. To overcome this challenge, Advanced Work Packaging (AWP) has emerged as a promising alternative approach. It offers a more integrated and structured way to plan and execute projects, aiming to improve efficiency and reduce the risk of delays. To evaluate the potential benefits, this preliminary study developed and compared a traditional phase-based schedule and two AWP-based schedules. Delay simulations and productivity adjustments were conducted to analyze schedule resilience and mitigation performance. The results show that AWP-based schedules enhance traceability, expand work package granularity, and improve recovery against engineering delays through structured segmentation and Workface Planning (WFP). These findings quantitatively demonstrate the potential of AWP to improve scheduling efficiency not only in NPP projects but also mega construction projects while also identifying gaps in maturity, boundary definition, and integration practices that must be addressed for broader adoption. Full article

Digitally controlled DC–DC converters are vulnerable to sensor-side spoofing, motivating plant-level anomaly detection that respects the converter physics. We present a physics-informed LSTM (PI–LSTM) autoencoder for a 24→12 V buck converter. The model embeds discrete-time circuit equations as residual penalties and uses a fixed decision rule ($\tau =\mu +3\sigma$, $N=3$ consecutive samples). We study three voltage-sensing attacks (DC bias, fixed-sample delay, and narrowband noise) in MATLAB/Simulink. We then validate the detection path on a TMS320F28379 DSP. The detector attains F1 scores of 96.12%, 91.91%, and 97.50% for bias, delay, and noise (simulation); on hardware, it achieves 2.9–4.2 ms latency with an alarm-wise FPR of ≤1.2%. We also define a unified safety box for DC rail quality and regulation. In simulations, we evaluate a confusion index (CI) policy for safety-bounded performance adjustment. A operating point yields $\mathrm{CI}\approx 0.25$ while remaining within the safety limits. In hardware experiments without CI actuation, the $V_{r,pp}$ and IRR stayed within the limits, whereas the ±2% regulation window was occasionally exceeded under the delay attack (up to ≈2.8%). These results indicate that physics-informed detection is deployable on resource-constrained controllers with millisecond-scale latency and a low alarm-wise FPR, while the full hardware validation of CI-guided deception (safety-bounded performance adjustment) under the complete safety box is left to future work. Full article

Based on the perspective of multi-stage dynamic competition, this study constructs a discrete dynamic model of price competition between the “direct sales” and “resale” channels in cross-border e-commerce (CBEC) under three blockchain deployment modes. Drawing on nonlinear dynamics theory, the Nash equilibrium of the system and its stability conditions are examined. Using numerical simulations, the effects of factors such as the channel price adjustment speed, tariff rate, and commission ratio on the dynamic evolution, entropy, and stability of the system under the empowerment of blockchain technology are investigated. Furthermore, the impact of noise factors on system stability and the corresponding chaos control strategies are further analyzed. This study finds that a single-channel deployment tends to induce asymmetric system responses, whereas dual-channel collaborative deployment helps enhance strategic coordination. An increase in price adjustment speed, tariffs, and commission rates can drive the system’s pricing dynamics from a stable state into chaos, thereby raising its entropy, while the adoption of blockchain technology tends to weaken dynamic stability. Therefore, after deploying blockchain technology, each channel should make its pricing decisions more cautiously. Moderate noise can exert a stabilizing effect, whereas excessive disturbances may cause the system to diverge. Hence, enterprises should carefully assess the magnitude of disturbances and capitalize on the positive effects brought about by moderate fluctuations. In addition, the delayed feedback control method can effectively suppress chaotic fluctuations and enhance system stability, demonstrating strong adaptability across different blockchain deployment modes. Full article

Background/Objectives: The transition from pediatric to adult care in inborn errors of metabolism (IEM) is considered important to ensure continuity of care, adherence to treatment, and long-term metabolic control. However, transition processes are often delayed, and standardized protocols are lacking, which can negatively impact patient outcomes. This study aimed to evaluate the impact of structured transition consultations on adult care engagement, nutritional management, and follow-up adherence in patients with IEM. Methods: This retrospective study included 160 patients (59.4% women) diagnosed with IEM and with a mean age of 36.2 ± 11.6 years. Patients were divided into two groups: those who underwent a structured transition consultation (n = 41) and those who did not (n = 119). Data on demographic and clinical characteristics, dietary management, and follow-up adherence were collected. Results: Patients who underwent structured transition consultations were significantly younger at diagnosis (1 [IQR 131] months vs. 66 [IQR 359] months, p = 0.001) and at their first adult visit (24.4 ± 9.5 vs. 32.3 ± 10.6 years, p < 0.001) compared to those who did not. Neonatal screening (45% of the overall cohort) was more common among these patients (65.9% vs. 37.8%, p = 0.007) suggesting a trend toward smoother integration into adult care. The absence of dietary records was considerably more frequent in the non-transition group (43.7% vs. 17.1%), with a significant crude association (p = 0.007) that was attenuated after age adjustment (p = 0.064). Overall follow-up adherence was high (88.1%) and comparable between groups. Conclusions: Structured transition consultations in patients with IEM were associated with earlier participation in adult care, better maintenance of dietary records, and high overall follow-up adherence, even among younger patients typically at higher risk of disengagement. Full article

This paper proposes a coalition-based framework for the coordinated operation of multi-regional power systems subject to extreme uncertainty in demand surges, renewable variability, and resource mobilization delays. Methodologically, we integrate Bayesian learning with distributionally robust optimization (DRO), embedding dynamically updated scenario posteriors into a Wasserstein ambiguity set. This construction captures both stochastic variability from renewable and load realizations and epistemic uncertainty from incomplete knowledge of probability distributions. To align individual incentives with system-level efficiency, we design a risk-adjusted utility mechanism that combines VCG transfers, Shapley allocations, and nucleolus refinements. These mechanisms explicitly consider agent heterogeneity, risk aversion, and coalition stability, ensuring that cooperation remains both efficient and sustainable. The optimization model maximizes expected social welfare while incorporating constraints on transmission corridor capacities, mobilization logistics, demand–response rebound effects, and mobile energy storage operations. A hierarchical decomposition algorithm integrates the Bayesian-DRO dispatch layer with cooperative game-theoretic allocations to maintain tractability and robustness at large scale. A case study on a six-province interconnected system with 14–26 GW peak demand, 10.2 GW solar, 8.6 GW wind, 14 GW peaking units, and 6.8 GW mobile storage demonstrates the effectiveness of the approach. Results indicate that the proposed framework raises expected welfare by nearly 10% relative to a non-cooperative baseline, reduces the probability of unserved energy exceeding 1.5% from almost 2% to negligible levels, and narrows payment disparities across provinces to strengthen coalition stability. Demand response peaks at 250–300 MW with rebound averaging 25%, while mobile BESS units cycle frequently to enhance local reliability. Overall, the findings highlight a robust and incentive-compatible pathway for resilient inter-provincial operation, providing both methodological advances and policy-relevant insights for multi-regional energy governance. Full article

Background/Objectives: Clozapine remains the gold standard for treatment-resistant schizophrenia. However, its narrow therapeutic window and risk of severe side effects require close monitoring of both clozapine and its primary metabolite, norclozapine. Existing therapeutic drug monitoring (TDM) methods are limited by delays, high costs, and operational complexity. This study introduces three rapid point-of-care (POC) assays utilizing a miniature mass spectrometer (Mini-MS) to quantify clozapine and norclozapine in plasma, whole blood, and dried blood spots (DBSs), facilitating applications across diverse clinical settings. Methods: The analytical performance of the assay was evaluated for sensitivity, specificity, reproducibility, and correlation with reference methods. Clinical samples from two hospitals were analysed and validated against conventional liquid chromatography tandem mass spectrometry (LC-MS/MS) reference standards at New South Wales Health Pathology (NSWHP) and Tsinghua University laboratories. Results: The Mini-MS assay accurately quantified both analytes within therapeutic ranges across all matrices. Inter-assay coefficients of variation ranged from 7.9 to 14.1% for clozapine and from 1.6 to 14.6% for norclozapine. Accuracy fell between 85 and 117% in plasma and blood extracts. Strong linearity was demonstrated (R² = 0.98–0.99) over the concentration range of 10–1000 ng/mL. Results from the Mini-MS analysis showed excellent correlations with LC-MS/MS results (r = 0.998). Conclusions: In this proof-of-concept study, the Mini-MS-based POC assays enable rapid, reliable quantification of clozapine and norclozapine, with performance comparable to conventional laboratory methods. This platform supports real-time TDM, facilitating timely dose adjustments, adherence monitoring, and ultimately improving patient outcomes. Full article

Low Earth orbit (LEO) satellites, characterized by low altitudes, high velocities, and strong ground signal reception, have become an essential and dynamic component of modern global navigation satellite systems (GNSS). However, orbit decay induced by atmospheric drag poses persistent challenges to maintaining stable trajectories. Frequent orbit maneuvers, though necessary to sustain nominal orbits, introduce significant difficulties for precise orbit determination (POD) and navigation augmentation, especially under complex operational conditions. Unlike most existing methods that rely on Two-Line Element (TLE) data—often affected by noise and limited accuracy—this study directly utilizes onboard GNSS observations in combination with real-time precise ephemerides. A novel time-series indicator is proposed, defined as the geometric root-mean-square (RMS) distance between reduced-dynamic and kinematic orbit solutions, which is highly responsive to orbit disturbances. To further enhance robustness, a sliding window-based adaptive thresholding mechanism is developed to dynamically adjust detection thresholds, maintaining sensitivity to maneuvers while suppressing false alarms. The proposed method was validated using eight representative maneuver events from the GRACE-FO satellites (May 2018–June 2022), successfully detecting seven of them. One extremely short-duration maneuver was missed due to the limited number of usable GNSS observations after quality-control filtering. To examine altitude-related applicability, two Sentinel-3A maneuvers were also analyzed, both successfully detected, confirming the method’s effectiveness at higher LEO altitudes. Since the thrust magnitudes and durations of the Sentinel-3A maneuvers are not publicly available, these cases primarily serve to verify applicability rather than to quantify sensitivity. Experimental results show that for GRACE-FO maneuvers, the proposed method achieves near-real-time responsiveness under long-duration, high-thrust conditions, with an average detection delay below 90 s. For Sentinel-3A, detections occurred approximately 7 s earlier than the reported maneuver epochs, a discrepancy attributed to the 30 s observation sampling interval rather than methodological bias. Comparative analysis with representative existing methods, presented in the discussion section, further demonstrates the advantages of the proposed approach in terms of sensitivity, timeliness, and adaptability. Overall, this study presents a practical, efficient, and scalable solution for real-time maneuver detection in LEO satellite missions, contributing to improved GNSS augmentation, space situational awareness, and autonomous orbit control. Full article

Background/Objectives: Delayed graft function (DGF) is a major complication after kidney transplantation, affecting graft and patient survival. Although well-studied in Western populations, data from Eastern Europe are limited, and the prognostic significance of DGF severity, particularly renal replacement therapy (RRT) duration, is not well-defined. Methods: We conducted a retrospective analysis of 479 adult recipients of brain-dead donor (DBD) kidney transplants at a high-volume transplant center in Romania (2017–2024). DGF was defined as the need for dialysis within seven days’ post-transplant. Baseline characteristics, graft function, and survival outcomes were compared between DGF and non-DGF groups. Kidney function was evaluated using the Estimated Glomerular Filtration Rate (eGFR). Patient and graft survival were assessed using Kaplan–Meier curves and log-rank tests. DGF severity was stratified by RRT duration (≤14 vs. >14 days). Results: DGF occurred in 28.8% of patients (adjusted 24%). Those with DGF had a higher Body Mass Index (BMI), greater comorbidity (Charlson Index, Estimated Post-Transplant Survival (EPTS) score), longer pre-transplant dialysis, and higher Kidney Donor Profile Index (KDPI) donor kidneys. DGF was associated with lower graft survival at one, three, and five years and reduced patient survival at three and five years. Longer RRT was associated with progressively worse outcomes, with the poorest prognosis in patients needing >14 days. Conclusions: Delayed graft function was significantly associated with reduced graft and patient survival. Prolonged DGF time was found to be predictive for poorer outcomes. Full article

In extra-large spaces, the varying distances between distributed loudspeakers and listeners lead to sound delays in the loudspeakers’ concentrated projection areas. When combined with the inherent long-delay reflected sounds in those spaces, this dual effect exacerbates the echo problems and poses challenges to maintaining speech intelligibility. To explore the influence mechanism of echo interference on speech intelligibility in extra-large spaces, a questionnaire survey was carried out in two representative extra-large buildings, and then listening experiments were conducted in the laboratory under different echo conditions and impulse characteristics. The results highlighted that (1) apparent echo problems existed in extra-large spaces and severely affected speech intelligibility; (2) the echo phenomenon can be classified into three groups—no echo (0 ms), short delay (100 or 200 ms), and long delay (≥300 ms)—with the detrimental effect on intelligibility increasing across the groups; and (3) a curve was established to describe the relationship between speech intelligibility and STI in extra-large spaces, and compared with the standard curve, the STI thresholds require further adjustment. These findings indicate that echoes in extra-large spaces significantly impair speech intelligibility and reduce the accuracy of its prediction, and therefore should not be neglected. Full article

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disease that develops with age and is related to a decline in motor function. Studies suggest that the causes may be based on genetic dysfunction including PARK gene mutations and environmental factors. Methods: To explore those factors, we used multivariable logistic regression to obtain odds ratios (ORs) and adjusted ORs by using the All of Us Dataset which contains genomic, blood test, and other environmental data. Results: On Chromosome 12, there were 3709 candidate genetic polymorphisms (GPs) that are associated with PD. Of those GPs, fourteen GPs had high ORs which are similar to the OR of the PARK8 gene G2019S mutation. Of those 3709 GPs, a 2.00-fold change in OR was observed in five GPs located at bases 53,711,362 (OR = 4.86, 95% CI [1.46, 16.18]), 31,281,818 (OR = 4.37, 95% CI [1.02, 18.82]), 101,921,705 (OR = 5.38, 95% CI [1.23, 23.51]), 47,968,795 (OR = 7.82, 95% CI [1.81, 33.83]), and 112,791,809 (OR = 8.05, 95% CI [1.85, 35.05]) by calcium, Vitamin D, and alcohol intake and were statistically significant. Conclusions: The results suggest that the progression of some PD caused by certain GPs can be delayed or prevented by the environmental factors above. In February 2025, All of Us released the CT Dataset v.8 which has a 50% increase in the number of participants. Potentially, it may be possible to research more GPs and environmental factors. In future studies, we would like to explore other environmental factors and GPs on other chromosomes. It is believed that specific GPs may tailor current treatments and qualify patients for clinical trials. Additionally, genetic knowledge may help increase accuracy in clinical trials. Full article

The widening of entrance lanes at urban intersections improves the capacity. However, limited by length, vehicles queuing in different functional lanes often interfere with each other, causing wasted green time. This study analyses turning demand, lane division, and signal timing at short-lane intersections, identifying four types of blockages: left-turn queues overflow blocking straight-ahead, straight-ahead blocking left-turn, right-turn queues overflow blocking straight-ahead, and straight-ahead blocking right-turn. Then, various strategies, including signal timing adjustment, phase sequence, and variable lane functions, are considered. The lane capacity matching rate is calculated, and a model for matching the capacity of different functional lanes at signal-controlled intersections is established. The results show that the matching effect of left-turn is significant, with an improvement of 8.0%, followed by a 7.0% increase in right-turn. The corresponding lane delays are also improved, which demonstrates the effectiveness of the model. Full article

Extreme natural disasters can force microgrids into islanded operation, where low system inertia and asynchronous, time-varying communication delays present severe challenges to frequency stability. These challenges threaten not only short-term reliability but also the sustainable operation of renewable-dominated energy systems. Existing frequency control methods are often unable to robustly handle heterogeneous delays, thereby limiting the resilience of power systems with high shares of renewables. To address this issue, we propose a parametric Riccati equation-based frequency control method that adaptively adjusts control parameters to balance system robustness and optimality under asynchronous delays. Controller stability is guaranteed by Barbalat’s lemma. The main contributions include: (i) developing a microgrid frequency control model that incorporates asynchronous delays, (ii) designing a delay-aware controller using the parametric Riccati equation, and (iii) validating its effectiveness on a modified New England 39-bus system. Simulation results confirm that the proposed method enhances frequency stability under disaster-induced islanding scenarios. By ensuring robust and reliable operation of renewable-rich power systems, the proposed approach contributes to the sustainable integration of renewable energy, reduces blackout risks, and supports long-term environmental and socio-economic sustainability goals. Full article