Search Results (1,552)

Background/Objectives: Prehospital advanced airway management significantly affects patient outcomes. The King Laryngeal Tube (King LT) has been a standard method for managing compromised airways in various emergency medical services (EMSs). However, in-depth analyses of first-attempt success and influencing factors are limited. This study explores the use of the King LT in Saudi Arabia to assess the first-attempt success rate and predictors of successful management. Methods: This retrospective cross-sectional study was conducted to analyze cases requiring the King LT in the main EMS provider in Saudi Arabia between October 2021 and September 2022. A descriptive analysis was employed for categorical data, and Chi-square test, Fisher’s exact test, and a regression analysis were applied to assess the significance of the association. Results: Of the 239 analyzed cases, adults (58.6%) and males (70.7%) were predominant. The highest proportions of cases were medical cases (36.8%) and indoor incidents (69.9%), with a significant association of indoor incidents with female and elderly patients (p = 0.001). The first-attempt success rate reached 82.4%, with significant success likelihood in afternoon incidents (adjusted odds ratio [OR] = 2.92, 95% confidence interval [CI] [0.53–3.57]; p = 0.03). Conclusions: This first nationwide study of King LT outlines advanced airway management characteristics in Saudi Arabia. The high use rates in adults, males, medical cases, and indoor incidents could suggest tailored training strategies. Noted temporal variations may provide insights for policy improvements. While first-attempt success rates are high, reflecting literature findings; performance could improve with further training. Full article

There have been reports of an association between the gut microbiota and the development of chronic liver disease, fibrosis, and carcinogenesis; however, it is not yet possible to reach a definite conclusion. In this cross-sectional study, we examined the association between the presence or absence of hepatocellular carcinoma (HCC) and the gut microbiota in patients with chronic hepatitis B virus (HBV) infection. The study subjects consisted of 62 consecutive HBV patients admitted to our hospital who provided informed consent to participate in the study. We performed 16S rRNA analysis using DNA extracted from fecal pellets. The sequencing depth per sample was 80,000 to 90,000 reads. We calculated the proportion of each bacterial genus so that the total for each sample added up to 100%. The male-to-female ratio was 49/13, the median age was 67 years, and 46 of the patients had HCC. Twenty microbial phyla spanning 41 classes, 79 orders, 163 families, and 431 genera were identified. Receiver operating characteristic (ROC) analysis was performed on the identified bacterial taxa, from the level of phylum down to genus, to assess their ability to distinguish between patients with and without HCC. Several bacteria with an area under the curve (AUC) > 0.65 were identified as follows: TM7 phylum TM7-3 class (AUC = 0.700); Firmicutes phylum Clostridiales class Lachnobacterium genus, Dialister genus, Ruminococcus genus, and Roseburia genus (AUC = 0.670, 0.668, 0.667, and 0.660, respectively); and Firmicutes phylum Erysipelotrichi class (AUC = 0.656). Combining three of these taxa resulted in high discriminative power (p = 0.000585) with a sensitivity and specificity of 0.761 and 0.750, respectively. A similar trend was observed in the subgroup analysis based on liver reserve capacity. Even after adjusting for factors related to liver reserve capacity in the multivariate analysis, an association between these bacterial genera and HCC was confirmed. Our results suggest that gut microbiota may be associated with the prevalence of HCC in HBV patients. Full article

Rectangular piles are increasingly utilized in engineering due to their high lateral bearing capacity, which benefits from an adjustable cross-sectional stiffness. However, research on rectangular piles within slope topography remains relatively scarce. Therefore, based on the principle of equal cross-sectional area, this paper establishes four sets of finite element models for rectangular piles with varying aspect ratios to conduct numerical analyses of their bearing characteristics under combined loading at slope angles of 0°, 15°, 20°, and 30°. The results demonstrate that: (1) Under combined loading, the lateral and vertical bearing capacities of rectangular piles interact; as the loading angle increases, the lateral bearing capacity decreases while the vertical bearing capacity increases. (2) Increasing the aspect ratio can significantly enhance the bearing capacity of rectangular piles. Under flat-ground conditions, compared to a pile with an aspect ratio of 1, a rectangular pile with an aspect ratio of 4 exhibits a roughly 75% increase in ultimate lateral bearing capacity and a 15.8% increase in vertical bearing capacity. (3) The critical section of the pile typically occurs within a depth range of 0.28 L to 0.43 L, where its stress mode gradually transitions from predominantly lateral bending and shearing to primarily vertical axial compression. (4) Slopes induce a reduction in the pile’s bearing capacity, but the bearing capacity curve for the pile with an aspect ratio of 4 declines more gently. Thus, rectangular piles with large aspect ratios possess greater engineering applicability in slope topography. This study reveals the bearing mechanism of rectangular piles under the combined influence of the slope weakening effect and the cross-section enhancement effect, providing a methodological reference for the design and application of novel pile foundations in slope terrains. Full article

Trajectory optimization during the terminal area energy management (TAEM) phase is pivotal for achieving accurate runway alignment and enhancing landing safety in autonomous aircraft operations. In the presence of initial state uncertainties in TAEM phase, conventional pseudo-spectral methods still suffer from robustness limitations and exhibit a strong dependence on the quality of the initial guess. Therefore, this paper proposes the composite African vulture optimization algorithm (CAVOA), a meta-heuristic framework designed to automate trajectory optimization. An in-depth examination of the heading alignment cone (HAC) trajectory model enables effective heading adjustments prior to landing, augmented by a tailored dynamic pressure profile to ensure safe touchdown velocities. By incorporating dynamic opposition learning, intelligent boundary processing, and composite exploration, CAVOA enhances global search efficiency. These enhancements are substantiated through comparisons with benchmark function optimization, Wilcoxon rank sum tests, and convergence analysis. Numerical simulations validate that CAVOA reliably directs autonomous aircraft to predefined touchdown states, demonstrating superior performance in complex aerial environments. Full article

Background/Objectives: To explore potential associations between pediatric obesity and retinal and anterior segment ocular structures using OCT and ocular biometry. This study was designed as an exploratory, hypothesis-generating analysis without a pre-specified primary endpoint; all findings should be interpreted accordingly. Methods: This retrospective cross-sectional study included 52 children (104 eyes): 27 obese children (body mass index (BMI) percentile ≥95%) and 25 healthy controls (BMI percentile 5–85%). Optical coherence tomography (OCT) and ocular biometry were used to assess retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), focal loss volume (FLV), global loss volume (GLV), Early Treatment Macular Map 5 (EMM5), corneal parameters, axial length (AL), anterior chamber depth (ACD), and white-to-white corneal diameter (WTOW). Group comparisons and cluster-robust bootstrap regression adjusted for inter-eye dependency, age, and sex; Bonferroni correction was applied. Results: Obese children showed nominally higher GCC average thickness, RNFL, and EMM5 values and shallower ACD; however, no parameter survived Bonferroni correction. ACD showed the most internally consistent exploratory pattern (unadjusted p = 0.006; adjusted p = 0.018; Bonferroni p = 0.249); however, this finding did not survive Bonferroni correction and should not be interpreted as a confirmed association. Other corneal and biometric parameters were not significantly different. Conclusions: Pediatric obesity may be associated with subtle ocular structural variations, but all findings are exploratory and hypothesis-generating. Larger prospective, pre-registered studies are needed to determine whether pediatric obesity is associated with structural ocular changes. Full article

With the rapid development of urban construction, modern foundation pits present increasing excavation depth and scale. Most pits are close to building red lines, characterized by complex surrounding environments and rigorous deformation control limits. Targeting the defects of conventional monitoring methods, this study optimizes equipment layout and monitoring technologies based on the Vanke Nanbeikang B-6 project, and proposes an improved monitoring scheme for deep and large foundation pits. Monitoring results reveal that the maximum horizontal displacement at the pit top is 25.20 mm, and the maximum deep horizontal displacement reaches 26.18 mm at a depth of 17.0 m. Field verification indicates that the proposed scheme can quantify foundation pit deformation with measured data and guide dynamic construction adjustment. Through analysis of field deformation data, an efficient monitoring system is established and reasonable deformation control indicators are determined. The research results can provide technical references for similar foundation pit excavation projects. Full article

Background/Objectives: This prospective observational cohort study aimed to evaluate the influence of heated tobacco (HT) and electronic cigarettes (ECs) on bone remodeling markers such as receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG), and periodontal status, at baseline and at 3 months after initial periodontal therapy. Methods: The sample comprised 236 participants (130 women, 106 men; mean age 38.96 ± 7.69 years), distributed across non-smokers (n = 72), heated tobacco/HT product users (n = 83), and electronic cigarette/EC users (n = 81). For each patient, the periodontal charting included periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL). Unstimulated saliva samples were analyzed for RANKL and OPG levels. All patients underwent nonsurgical periodontal therapy (scaling and root planing). Between-group comparisons were performed using the Kruskal–Wallis test followed by Bonferroni-adjusted pairwise comparisons, while within-group changes over time were assessed using the Wilcoxon signed-rank test. To complement the primary nonparametric analyses, two-way mixed-design ANOVA and ANCOVA models adjusted for baseline values and periodontitis stage were performed as sensitivity analyses. Statistical significance was set at p < 0.05. Results: At baseline, both product user groups exhibited significantly higher PPD (p = 0.005) and CAL (p = 0.001) compared with non-smokers, with no differences between HT and EC users. Salivary RANKL levels were significantly higher in HT and EC users than in non-smokers, and OPG levels did not differ significantly. Following non-surgical periodontal therapy, all parameters improved significantly across groups (p < 0.001). At the 3-month follow-up, both product user groups maintained higher PPD (p = 0.008), CAL (p = 0.001), and salivary RANKL levels, compared with non-smoking individuals (p < 0.001). The RANKL/OPG ratio remained significantly different only for EC users compared with non-smokers (p < 0.001). Conclusions: HT and EC use were associated with differences in periodontal parameters and higher RANKL levels, while differences in the RANKL/OPG ratio were observed in EC users compared with non-smokers. Non-surgical periodontal therapy improved clinical parameters and reduced the RANKL/OPG ratio, highlighting the importance of biofilm control. Full article

This study presents a reproducible evaluation framework for hybrid quantum-classical neural networks (HQCNNs) in healthcare classification, rather than a new architecture. We assess a four-qubit HQCNN combining a compact classical encoder, a two-layer parameterized quantum circuit (PQC), and a classical readout (441 trainable parameters) against carefully tuned classical baselines on the Wisconsin Diagnostic Breast Cancer (WDBC) dataset under identical five-fold cross-validation. The work is framed as a single-dataset proof-of-concept: the contribution is a documented, shared-fold evaluation protocol with a parameter-matched classical control and a quantified epistemic-informativeness analysis, not a demonstration of general quantum advantage. The HQCNN reached $96.49\pm 1.96\%$ accuracy and $99.44\pm 0.60\%$ ROC-AUC. A parameter-matched classical multilayer perceptron (441 parameters) reached $95.08\pm 1.81\%$ accuracy; the HQCNN’s $+1.41$ percentage-point edge at equal capacity was not statistically significant (paired t, $p=0.056$). Across five shared folds, no HQCNN-versus-classical accuracy difference survived Holm–Bonferroni correction (all adjusted $p\ge 0.625$), so we report the HQCNN as competitive with, not superior to, strong tuned classical baselines. A multi-split depth ablation showed that circuit depth $L\in \{1,2,3\}$ had no statistically detectable effect on accuracy ($L=2$ vs. $L=3$: Wilcoxon $p=1.00$); we therefore adopt two variational layers as a practical default rather than an optimum. Under a low-noise simulator (depolarising and amplitude-damping channels, $p=0.01$), accuracy was $96.49\%$, indicating robustness only at modest uniform error rates; realistic hardware noise is higher. We additionally apply Bayesian surprise as an epistemic-informativeness heuristic—not a formal generative model—to rank which findings are most worth building on. The framework offers a reproducible, documented evaluation procedure that can support cumulative comparison of hybrid quantum-classical models in healthcare. Full article

Rainstorm-induced disaster chains are characterized by high suddenness, immense destructive power, and complex chain propagation mechanisms. Traditional static assessment methods rely on fixed parameters and struggle to depict the dynamic evolution of such disasters. Existing dynamic models are mostly based on predefined structures and lack the capability to integrate multi-source data and quantify uncertainty, thereby constraining the accurate prediction of rainstorm disaster chains. To address these issues, this study proposes a rainstorm disaster chain prediction model (SW-DBN) that integrates a large language model (LLM)-optimized sliding window mechanism with a dynamic Bayesian network (DBN). The model first performs dynamic segmentation and feature extraction on multi-source time-series data through the sliding window mechanism and constructs an LLM-driven module for semantic understanding of multi-source information and latent parameter mining. By leveraging the LLM’s in-depth analysis of data pattern variations within the window, the model excavates latent parameters, adaptively adjusts the DBN network topology, and feeds back to optimize the window width and sliding step, thereby maintaining adaptive alignment between the sliding window’s feature extraction and the dynamic evolution of the disaster chain. Ultimately, the cascade propagation process of the rainstorm disaster chain is modeled, reasoned, and validated through the DBN, forming an integrated prediction framework of “perception–reasoning, dynamic regulation, and cascade verification.” A case study in the Xi’an area demonstrates that the proposed model can effectively simulate the temporal evolution of rainstorm disaster chains. The average prediction accuracy for four key types of disaster nodes reaches 84.8%, representing an improvement of 7.5 percentage points over the standard DBN model, with clear advantages in early warning timeliness for critical nodes. The proposed model provides technical support for the probabilistic prediction of rainstorm disaster chains and disaster prevention decision-making, featuring both dynamic adaptability and interpretability. Full article

As a prominent high-efficiency metal cutting process, plunge milling has found increasing applications in the rough machining of integral impellers. However, challenges arise due to the time-consuming process of avoiding interference-induced overcutting at the blade-root fillet, leading to excessive residual material. Consequently, the full potential of plunge milling’s high-efficiency advantages is constrained. To address these issues, a method to avoid overcutting caused by cutter interference at the blade-root fillet in integral impeller plunge milling is proposed. First, a parameterized model of the blade-root fillet is established using a rolling ball model. Second, a semi-analytical model for identifying cutter interference at the blade-root fillet is established through micro-element discretization. Lastly, the cutter position is adjusted along the direction of the vertical cutter axis vector to avoid overcutting. The modeling error of the blade-root fillet remains within 0.1%, ensuring high accuracy in overcut detection. Furthermore, the identification process is completed in less than 1s, demonstrating its computational efficiency. Compared with the conventional depth-reduction method, the proposed interference elimination strategy reduces the excessive residual material volume by 66% while avoiding overcutting, with only a 26% increase in plunge roughing time. Simulation and experimental validation on an 820 mm diameter impeller confirm the method’s effectiveness in balancing interference avoidance and material removal efficiency. Full article

This study presents field measurements for a non-conventional mobile square cylinder fish enclosure, with permeable ends, evaluated under both towed and moored conditions at a semi-open ocean test site. Novelty lies within the enclosure design that enables both mobility and control of internal flow through the incorporation of an adjustable aft-end perimeter constriction to regulate internal flow and support fish welfare by enabling control of swimming conditions. Enclosure motion, internal flow speeds and hydrodynamic loads were measured for three constrictions (0%, 40% and 60%). The primary objective was to assess the effectiveness of aft-end constriction in regulating internal flow to levels compatible with sustainable swimming speeds for finfish culture. The enclosure remained stable at approximately 9 m depth across all vessel speeds and constriction settings in both towed and moored scenarios. During towing, increasing constriction to 40% reduced time-averaged internal flow by up to 24% without a significant increase in hydrodynamic load. A 60% constriction achieved a larger reduction (~51%) but resulted in a substantial load increase (~90% relative to 0% constriction), indicating a trade-off between flow control and towing resistance. Under moored conditions, aft-end constriction had minimal influence on both internal flow and hydrodynamic load. Mooring loads showed no clear relationship with wave height and only a weak correlation with ambient current speed. Overall, the results demonstrate that aft-end constriction is an effective mechanism for controlling internal flow during towing, but has limited impact when moored. The enclosure’s stability and controllability highlight its potential advantages over conventional gravity cages for mobile open-ocean finfish aquaculture applications. Full article

Background/Objectives: Inflammatory bowel disease (IBD) represents a growing therapeutic challenge, and the identification of novel treatment strategies remains an unmet clinical need. Drug repurposing offers a pragmatic and cost-effective alternative to de novo drug development. This study aimed to identify candidate drugs for repurposing in IBD through inverse signal detection within a large spontaneous pharmacovigilance database. Methods: In this observational, retrospective pharmacovigilance study, data from the FDA Adverse Event Reporting System (FAERS) were analyzed using OpenVigil 2.1. Drugs inversely associated with IBD were identified based on a ROR < 1 and an adjusted p-value < 0.05. Candidates were subsequently filtered to exclude agents with implausible indications, unfavorable pharmacokinetic profiles, or recognized contraindications to use in IBD. Although this screening process yielded a broader set of repurposing candidates across multiple drug classes, the present study focused specifically on antidiabetic medications, which were subjected to a targeted literature review evaluating their immunomodulatory properties, anti-inflammatory mechanisms, and existing preclinical and clinical evidence in the context of IBD. Results: Of 3585 initial drug–event combinations evaluated, 73 candidates met predefined criteria for statistical significance, pharmacokinetic feasibility, and clinical relevance. Within this broader pool, ten antidiabetic agents which demonstrated meaningful inverse signal strength were selected for in-depth analysis: dulaglutide (ROR 0.181, 95% CI 0.136–0.242), insulin lispro (ROR 0.206, 95% CI 0.161–0.263), insulin glargine (ROR 0.246, 95% CI 0.205–0.295), insulin (ROR 0.340, 95% CI 0.295–0.390), insulin aspart (ROR 0.349, 95% CI 0.267–0.455), empagliflozin (ROR 0.400, 95% CI 0.311–0.514), liraglutide (ROR 0.419, 95% CI 0.319–0.552), metformin (ROR 0.446, 95% CI 0.407–0.489), sitagliptin (ROR 0.460, 95% CI 0.376–0.563), and semaglutide (ROR 0.622, 95% CI 0.507–0.764). The subsequent literature review discussed relevant immunomodulatory and anti-inflammatory properties for each of these agents, providing a mechanistic rationale for their potential therapeutic role in IBD. Conclusions: This study identifies antidiabetic drugs as plausible repurposing candidates for IBD, supported by both pharmacovigilance-derived inverse signals and a body of mechanistic and clinical literature suggesting shared pathophysiological pathways between the two conditions. However, it should be acknowledged that the clinical evidence supporting the therapeutic efficacy of several candidates remains variable or incomplete, and robust interventional data are largely lacking. Ultimately, the findings of this study generate testable hypotheses and highlight a set of candidate therapies that warrant dedicated experimental and clinical investigation, including well-designed prospective trials, to determine their true therapeutic potential in IBD management. Full article

Tellurene has a wide bandwidth and low propagation loss at near-infrared wavelengths due to its nonlinear absorption coefficient. Therefore, we prepared tellurene–polyvinyl alcohol (Te-PVA) film as a saturable absorber in an Er-doped fiber laser by liquid phase exfoliation and spin-coating. The modulation depth was 5.25% and the saturation intensity was 17.02 MW/cm. The nonlinear optical properties of the film and its application in high-stability mode-locked operation were studied. A mode-locked pulse with a fundamental frequency of 8.48 MHz and a central wavelength of 1560.10 nm was obtained, with a signal-to-noise ratio which was greater than 75 dB. A traditional soliton mode-locked operation with a pulse width of 1.41 ps was achieved. In addition, eighth- and 19^th-harmonic mode-locked operations were obtained by adjusting the pump power and polarization controller. Our results show that Te-PVA film functioned as a saturable absorber which enabled harmonic mode-locking with an SNR of 75 dB in an Er-doped fiber laser. It is thus an excellent ultra-fast photonics material. Full article

The paper outlines soil–tool interaction investigations according to parameters of the trencher disc cutter with a variable installation angle relative to the rotation axis that ensure the required trench shape and dimensions. The research results make it possible to improve the quality of the technological process for obtaining the needed trench shape. The movement of soil particles on the knife surface and after their removal was considered using the principles of soil mechanics, mathematical analysis, and computer (3D) modelling taking into account centrifugal force, gravity and friction. Research has shown that the soil particles’ movement is spatially complex and can be described by parabolic dependencies when projected onto coordinate planes. It is proved that changing the angle of installation of the disc in the range of 90–80° allows the furrows’ width to be adjusted within the range of 0.1–0.5 m while maintaining the required depth of cultivation. The reduction indicators of trench depth that are dependent on changing the disc installation angle were also determined. The obtained dependencies, design and technological recommendations can be used in designing of planting machines for garden and forest crops, as well as in the justification of rational operating modes for them in intensive horticulture conditions. Full article

The foot structure plays a decisive role in the trafficability of legged robots on granular media. Traditional foot-ends (spherical, cylindrical, flat-bottomed) are prone to sinkage and slippage, resulting in unstable locomotion. To solve this problem, a novel bionic-inspired reconfigurable foot with active opening and closing adjustment capability is designed based on bionics, combining the stable phalangeal contour of goat hoof capsules and the high-adhesion feature of beetle foot-end spines. A coupled EDEM–Adams simulation model is established, and physical experiments combined with simulation inversion are used to calibrate contact parameters between particles and between particles and the foot, including the coefficient of restitution, static friction and rolling friction. A high-fidelity numerical platform for foot–ground dynamic interaction is thus constructed. By comparing and analyzing the differences in anti-sinkage and traction performance between the bionic-inspired foot and traditional foot-ends, this study systematically revealed the influence law of bionic morphology on the mechanical behavior of the foot, and clarified the intrinsic mechanism through which bionic design improves foot–ground interaction. The results demonstrate that the spine structures of the bionic-inspired foot reshape the mechanical constitutive relationship of granular media. By expanding the ground contact area and optimizing contact pressure distribution, the maximum reduction in foot sinkage depth reaches 70.11%, and the traction coefficient is increased by up to 37.13%. Full article