Search Results (2,681)

The COVID-19 pandemic triggered unprecedented economic disruptions, raising critical questions about the resilience and adaptability of macroeconomic productivity across countries. This study examines the impact of COVID-19 on macroeconomic efficiency and productivity dynamics in 37 OECD countries using quarterly data from 2018Q1 to 2024Q4. By employing a Slack-Based Measure Data Envelopment Analysis (SBM-DEA) and the Malmquist Productivity Index (MPI), we decompose total factor productivity (TFP) into efficiency change (EC) and technological change (TC) across three periods: pre-pandemic, during-pandemic, and post-pandemic. Our framework incorporates both desirable (GDP) and undesirable outputs (inflation, unemployment, housing price inflation, and interest rate distortions), offering a multidimensional view of macroeconomic efficiency. Results show broad but uneven productivity gains, with technological progress proving more resilient than efficiency during the pandemic. Post-COVID recovery trajectories diverged, reflecting differences in structural adaptability and innovation capacity. Regression analysis reveals that stringent lockdowns in 2020 were associated with lower productivity in 2023–2024, while more adaptive policies in 2021 supported long-term technological gains. These findings highlight the importance of aligning crisis response with forward-looking economic strategies and demonstrate the value of DEA-based methods for evaluating macroeconomic performance beyond GDP. Full article

Though the pursuit of sustainable desalination processes with high water recovery has intensified the research interest in membrane distillation (MD), the influence of module connection configuration on performance stability remains poorly explored. The current study provided a comprehensive multiparameter assessment of hollow fibre membrane modules connected in parallel and series in direct contact membrane distillation (DCMD) for the first time. The configurations were evaluated under varying process parameters such as temperature (50–70 °C), flow rates (22.1–32.3 mL·s⁻¹), magnesium concentration as scalant (1.0–4.0 g·L⁻¹), and flow direction (co-current and counter-current), assessing their influence on temperature gradients (∆T), flux and pH stability, salt rejection, and crystallisation. Interestingly, the parallel module configuration maintained high operational stability with uniform flux and temperature differences (∆T) even at high recovery factors (>75%). On one hand, the serial configuration experienced fluctuating ∆T caused by thermal and concentration polarisation, causing an early crystallisation (abrupt drop in feed conductivity). Intensified polarisation effects with accelerated crystallisation increased the membrane risk of wetting, particularly at high recovery factors. Despite these changes, the salt rejection remained relatively high (99.9%) for both configurations across all tested conditions. The findings revealed that acidification trends caused by MgSO₄ were configuration-dependent, where the parallel setup-controlled rate of pH collapse. This study presented a novel framework connecting membrane module architecture to mass and heat transfer phenomena, providing a transformative DCMD module configuration design in water desalination. These findings not only provide the critical knowledge gaps in DCMD module configurations but also inform optimisation of MD water desalination to achieve high recovery and stable operation conditions under realistic brine composition. Full article

Climate change negatively affects agriculture, causing desertification, salinisation, and drought. The biochar hydroinfiltrator (ES Patent No.: ES2793448 B2) is a device that increases the capture of rainwater or irrigation water for crops by increasing infiltration rates. Biochar, produced via biomass pyrolysis, has emerged as a promising agricultural amendment, as it helps to optimise moisture retention and improve soil structure, key aspects for boosting crop yields. There is growing interest in microorganisms’ plant-growth-promoting activity (PGP) by carrying out different activities considered growth promoters. The aim of the present study is to evaluate the use of a biochar hydroinfiltrator as a promoter of microbial activity when it is used in soil. Metagenomic analysis of soils with and without the device reveals that genera Bacillus and Sphingomonas became particularly enriched in soils with hydroinfiltrators. Also, in order to understand the interaction between the uses of biochar together with bacteria PGP, an in vitro test was carried out. Two microorganisms, previously selected for their characteristics as plant growth promoters, were inoculated in soils with and without biochar and they grew better after 15 to 30 days of inoculation, showing major CFU counts. This combined strategy—biochar hydroinfiltrator and PGP bacteria—offers an innovative, eco-friendly approach to sustainable agriculture, particularly under drought stress. Full article

In recent years, significant attention has been directed toward the development of coating materials capable of tailoring surface properties for various functional applications. Transition metal nitrides, in particular, have garnered interest due to their superior physical and chemical properties, including high hardness, excellent wear resistance, and strong corrosion resistance. In this study, a fabrication process for CrN-based thin films was developed by combining reactive direct current magnetron sputtering (dcMS) with post-deposition annealing in air. CrN coatings were deposited by reactive dcMS using different argon-nitrogen (Ar:N₂) gas ratios (4:1, 3:1, 2:1, and 1:1), followed by annealing at 550 °C for 1.5 h in ambient air. XRD and EDS analysis revealed that this treatment results in the formation of a composite phase comprising CrN and Cr₂O₃. The resulting coating exhibited favorable mechanical and tribological properties, including a maximum hardness of 12 GPa, a low wear coefficient of 0.254 and a specific wear rate of 7.05 × 10⁻⁶ mm³/N·m, making it a strong candidate for advanced protective coating applications. Full article

Background/Objectives: In the era of treat-to-target strategies in inflammatory bowel disease (IBD), transmural healing (TH) is gaining recognition as a promising therapeutic goal. TH has been associated with significantly better long-term outcomes, including reduced rates of hospitalization, surgery, and the need for therapy escalation. Cross-sectional imaging techniques, such as intestinal ultrasound (IUS), magnetic resonance imaging (MRI), and computed tomography enterography (CTE), offer a comprehensive, non-invasive means to assess this deeper level of healing. This review explores how TH is currently defined across various imaging modalities and evaluates the feasibility and cost-effectiveness of achieving TH with available therapies. Methods: A literature search was conducted across PubMed, Scopus, and Embase using keywords, including “transmural healing”, “intestinal ultrasonography”, “magnetic resonance imaging”, “computed tomography enterography”, “Crohn’s disease”, “ulcerative colitis”, and “inflammatory bowel disease”. Only English-language studies were considered. Results: Despite growing interest, there is no standardized definition of TH across imaging platforms. Among the modalities, IUS emerges as the most feasible and cost-effective tool, owing to its accessibility, accuracy (sensitivity 62–95.2%, specificity 61.5–100%), and real-time capabilities, though it does have limitations. Current advanced therapies induce TH in roughly 20–40% of patients, with no consistent differences observed between biologics and small molecules. However, TH has only been evaluated as a formal endpoint in a single randomized controlled trial to date. Conclusions: A unified and validated definition of transmural healing is critically needed to harmonize research and guide clinical decision-making. While TH holds promise as a meaningful treatment target linked to improved outcomes, existing therapies often fall short of achieving complete transmural resolution. Further studies are essential to clarify its role and optimize strategies for deep healing in IBD. Full article

Background and Objectives: Peptide receptor radionuclide therapy (PRRT) using radiopharmaceuticals labelled with Lutetium-177 is currently a therapeutic option for patients with advanced neuroendocrine neoplasms overexpressing somatostatin receptors (SSTRs). One promising option that has gained interest for PRRT is using alpha-emitting radioisotopes such as Actinium-225. The aim of this study was to perform a systematic review and meta-analysis on the efficacy and safety of radioligand therapy with Actinium-225 DOTATATE in advanced, metastatic or inoperable neuroendocrine neoplasms. Materials and Methods: A comprehensive literature search of studies on radioligand therapy with Actinium-225 DOTATATE in neuroendocrine neoplasms was carried out. Three different bibliographic databases (Cochrane Library, Embase, and PubMed/MEDLINE) were screened up to May 2025. Eligible articles were selected, relevant data were extracted, and the main findings on efficacy and safety are summarized through a systematic review. Furthermore, proportional meta-analyses on the disease response rate and disease control rate were performed. Results: Five studies (153 patients) published from 2020 were included in the systematic review. The pooled disease response rate and disease control rate of radioligand therapy using Actinium-225 DOTATATE were 51.6% and 88%, respectively. This treatment was well-tolerated in most patients with advanced, metastatic or inoperable neuroendocrine neoplasms. Conclusions: Radioligand therapy with Actinium-225 DOTATATE in advanced, metastatic or inoperable neuroendocrine neoplasms is effective with an acceptable toxicity profile and potential advantages compared with SSTR-ligands labelled with Lutetium-177. Currently, the number of published studies on this treatment is still limited, and results from multicenter randomized controlled trials are needed to translate this therapeutic option into clinical practice. Full article

Semantic communication has attracted considerable interest due to its potential to support emerging human-centric services, such as holographic communications, extended reality (XR), and human-machine interactions. Different from traditional communication systems that focus on minimizing the symbol-level distortion (e.g., bit error rate, signal-to-noise ratio, etc.), semantic communication targets at delivering the intended meaning at the destination user which is often quantified by various statistical divergences, often referred to as the semantic distances. Currently, there still lacks a unified framework to quantify the rate-distortion tradeoff for semantic communication with different task-specific semantic distance measures. To tackle this problem, we propose the task-specific rate-distortion theory for semantic communication where different task-specific statistic divergence metrics can be considered. To investigate the impact of different semantic distance measures on the achievable rate, we consider two popular tasks, classification and signal generation. We present the closed-form expressions of the semantic rate-distortion functions for these two different tasks and compare their performance under various scenarios. Extensive experimental results are presented to verify our theoretical results. Full article

Background/Objectives: The increased accessibility of information has resulted in a rise in patients trying to self-diagnose and opting for self-medication, either as a primary treatment or as a supplement to medical care. Our objective was to evaluate the reliability, comprehensibility, and readability of the responses provided by ChatGPT 4.0 when queried about the most prevalent orthopaedic problems, thus ascertaining the occurrence of misguidance and the necessity for an audit of the disseminated information. Methods: ChatGPT 4.0 was presented with 26 open-ended questions. The responses were evaluated by two observers using a Likert scale in the categories of diagnosis, recommendation, and referral. The scores from the responses were subjected to subgroup analysis according to the area of interest (AoI) and anatomical region. The readability and comprehensibility of the chatbot’s responses were analyzed using the Flesch–Kincaid Reading Ease Score (FRES) and Flesch–Kincaid Grade Level (FKGL). Results: The majority of the responses were rated as either ‘adequate’ or ‘excellent’. However, in the diagnosis category, a significant difference was found in the evaluation made according to the AoI (p = 0.007), which is attributed to trauma-related questions. No significant difference was identified in any other category. The mean FKGL score was 7.8 ± 1.267, and the mean FRES was 52.68 ± 8.6. The average estimated reading level required to understand the text was considered as “high school”. Conclusions: ChatGPT 4.0 facilitates the self-diagnosis and self-treatment tendencies of patients with musculoskeletal disorders. However, it is imperative for patients to have a robust understanding of the limitations of chatbot-generated advice, particularly in trauma-related conditions. Full article

Introduction/Objectives: Osteoarthritis (OA) is a chronic systemic disease that affects the entire array of joint structures. It is one of the most common chronic, socially significant diseases, associated with a decline in the quality of life of patients and constantly increasing the cost of treatment. Clinical trial outcomes are largely inconclusive, and OA remains one of the few musculoskeletal diseases without an established disease-modifying therapy. One potential explanation is the use of ineffective tools for OA classification, patient stratification, and the assessment of disease progression. There is growing interest in musculoskeletal ultrasonography (MSK US), as it enables the dynamic visualization of the examined structures and gives information about both inflammatory and structural changes that have occurred. Determining the leading ultrasound phenotype, which depends on the most damaged tissue at a given time (bone, cartilage, synovial membrane, joint capsule, ligaments, tendons, menisci, etc.), can rationalize therapy use by selecting patients more suitable for specific treatments. This article aims to evaluate and summarize the potential of MSK US in the process of determining the clinical phenotype of OA and to emphasize the importance of this imaging modality in evaluating further therapeutic strategies. Method: A single-center prospective study conducted in the period of September 2023–June 2024 enrolled 259 consecutive patients with proven OA. The statistical program Minitab version 22.2.1 (2025) was used to analyze the data. The predominant and secondary phenotypes were tabulated for each OA localization and were presented numerically and as relative proportions (%). The rate of the most frequently occurring phenotypes was compared against that of the less frequent ones through paired z-tests. The initially acceptable type I error was set at 5%; it was further adjusted for the number of comparisons (Bonferroni). Results: The most frequent and predominant US phenotype for patients with knee OA was intra-articular effusion (n = 47, 37.90%). It was significantly higher compared to the rest of the US phenotypes: synovial proliferation (n = 22, 17.70%; p < 0.001), cartilage destruction (n = 26, 21%; p = 0.001), altered subchondral bone (n = 8, 6.50%; p < 0.001), extra-articular soft tissue changes (n = 12, 9.70%; p < 0.001), crystal deposits (n = 6, 4.8%; p < 0.001), and post-traumatic (n = 3, 2.40%; p < 0.001). The most common US phenotype for hip OA was altered subchondral bone (n = 32, 47.1%), with significant differences from intra-articular effusion (n = 12, 17.60%; p = 0.001), synovial proliferation (n = 5, 7.40; p = 0.001), cartilage destruction (n = 12, 17.60%; p = 0.001), extra-articular soft tissue changes (n = 3, 4.40%; p = 0.001), crystal deposits (n = 3, 4.40%; p = 0.001), and post-traumatic (n = 0). Altered subchondral bone was also the leading US phenotype for hand OA (n = 31, 55.40%), with significant differences compared to intra-articular effusion (n = 1, 1.80%; p < 0.001), synovial proliferation (n = 7, 12.50%; p < 0.001), cartilage destruction (n = 11, 19.60%; p < 0.001), extra-articular soft tissue changes (n = 2, 3.60%; p < 0.001), crystal deposits (n = 3, 5.40%; p < 0.001), and post-traumatic (n = 1, 1.80%, p < 0.001). For shoulder OA, extra-articular soft tissue changes were the most frequent (n = 8, 46.20%), followed by post-traumatic (n = 4, 30.70%), as the rate of both phenotypes was significantly higher compared to that of intra-articular effusion (n = 0), synovial proliferation (n = 0), cartilage destruction (n = 1, 7.70%; p = 0.003), and crystal deposits (n = 0). Conclusions: The therapeutic approach for OA is a dynamic and intricate process, for which the type of affected joint and the underlying pathogenetic mechanism at a specific stage of the disease’s evolution is essential. MSK US is one of the options for the clinical phenotyping of OA. Some of the suggested ultrasound subtypes may serve as the rationale for selecting a particular treatment. Full article

This research investigates the liability management of Thai life insurers in a prolonged low-interest rate environment. It examines the impact of interest rate changes on life insurance products, solvency, and profitability. The study identifies a significant shift in product portfolios toward non-interest-sensitive products, which helps mitigate financial risk and enhance solvency. The solvency of Thai life insurers is influenced by their return on assets, with higher risk exposures requiring more capital, potentially lowering solvency levels. However, the proportion of risky investment assets is not significantly related to the solvency position in the Thai market. The market index return is a significant predictor of stock returns for Thai life insurers, while changes in interest rate sensitivity are not statistically significant between low-rate and normal periods. The average solvency level under Thailand’s regulatory regime is also not statistically different between normal and prolonged low-interest rate situations. This study contributes to the understanding of liability management practices among life insurers in Thailand and provides insights into the challenges and strategies for maintaining solvency and profitability in a low-interest rate environment. Full article

Background/Objectives: The Bentall procedure represents the gold standard therapy in patients with ascending aorta or aortic root aneurysm combined with aortic valve disease precluding a valve-sparing procedure. The aim of this study was to compare early and late outcomes in patients undergoing a Bentall procedure with either a biological or a mechanical valved conduit. Methods: All patients undergoing the Bentall procedure with either a biological or a mechanical valved conduit at our institution between 2001 and 2022 were retrospectively reviewed. A propensity-score (PS) matching analysis was performed to account for imbalances between the two groups. Clinical outcomes of interest included mortality and reintervention. Results: 548 patients underwent the Bentall procedure with a biological (n = 356, 65%) or a mechanical (n = 192, 35%) valved conduit during the study period. After PS-matching, two homogeneous groups of 154 patients were obtained, and no difference was observed in mean survival time between patients with mechanical Bentall and patients with biological Bentall (16 ± 0.8 vs. 16.3 ± 0.7 years, respectively; p = 0.72). Patients with a mechanical Bentall had a significantly higher mean survival time free from reintervention compared to patients with a biological Bentall (23.6 ± 0.4 vs. 21.4 ± 0.7 years, respectively, p = 0.02). PS-adjusted Cox regression showed that age >65 years, postoperative ECMO, and CVA were predictive risk factors of mortality. Conclusions: Bentall operation is a safe procedure for the treatment of ascending aorta and aortic root disease with good early and long-term survival and a low rate of reintervention. PS-matched analysis showed no difference in mortality between patients with a mechanical Bentall and patients with a biological Bentall; however, patients with a mechanical Bentall had a lower rate of reintervention. Full article

Remanufacturing in reverse logistics can not only support sustainable development but also provide a tractable way to achieve carbon neutrality. This study evaluates whether an original equipment manufacturer (OEM) should remanufacture outsource or authorize this reverse channel activity in the presence of government subsidies. Additionally, the model considers the equilibrium acquisition quantities, collection rates, prices, and effects of government subsidy under three reverse channel options: centralizing remanufacturing, outsourcing remanufacturing, and authorization remanufacturing. The analysis indicates that (i) a centralized approach with manufacturing and remanufacturing operations under a fixed government subsidy is always in the interest of the supply chain; (ii) that for the profit-maximizing third-party remanufacturer (3PR), the differentials in variable collection costs drive the strategy choice, and that a higher fixed scaling parameter of the collection cost favors outsourcing; and (iii) when the government aspires to reduce environmental effects and subsidy payments, the OEM and government have different reverse channel choice preferences. Surprisingly, profitability and environmental goals align under a high consumer acceptance of the remanufactured product. This paper extends the understanding of the remanufacturing strategy of an OEM and provides new insights on which reverse channel is optimal. Full article

Background/Objectives: This review aimed to compare the efficacy of antibiotic treatment vs. non-antibiotic treatment in mild and moderate clinical mastitis in lactating dairy cows, categorized by the causative pathogen. Methods: The initial systematic review plan, which resulted in only four relevant articles, was altered due to limited available studies and significant heterogeneity among them. Consequently, five additional articles, closely meeting our criteria with minor differences, were included to ensure comprehensive analysis, resulting in nine included articles. Due to these pragmatic constraints, this review represents a hybrid between a systematic and a narrative review. The outcome of interest was the bacteriological cure (BC). Results: The findings revealed that antibiotic treatment resulted in improved BC rates for cases caused by Streptococci. For cases caused by Escherichia (E.) coli, antibiotic therapy showed no significant improvement in BC rates compared to non-antibiotic treatment, suggesting that antibiotics may be often unnecessary for these cases due to self-limiting tendencies. However, severe E. coli mastitis warrants systemic antibiotic treatment due to potentially life-threatening complications. Klebsiella spp. mastitis showed better cure rates with antibiotic therapy. Conclusions: This study underscores the importance of regular pathogen diagnostics to guide appropriate treatment, advocating for the use of on-farm rapid tests to reduce unnecessary antibiotic use while ensuring effective treatment outcomes. Full article

Cyclic Solvent Injection (CSI), one of the most promising solvent-based enhanced oil recovery (EOR) methods, has attracted the oil industry’s interest due to its energy efficiency, produced oil quality, and environmental suitability. Previous studies revealed that foamy oil flow is considered as one of the main mechanisms of the CSI process. However, due to the presence of complex high-permeable channels known as wormholes in Post-Cold Heavy Oil Production with Sands (Post-CHOPS) reservoirs, understanding the effect of each operational parameter on the performance of the CSI process in these reservoirs requires a pore-scale investigation of different wormhole configurations. Therefore, in this project, a comprehensive microfluidic experimental investigation into the effect of symmetrical and asymmetrical wormholes during the CSI process has been conducted. A total of 11 tests were designed, considering four different microfluidic systems with various wormhole configurations. Various operational parameters, including solvent type, pressure depletion rate, and the number of cycles, were considered to assess their effects on foamy oil behavior in post-CHOPS reservoirs in the presence of wormholes. The finding revealed that the wormhole configuration plays a crucial role in controlling the oil production behavior. While the presence of the wormhole in a symmetrical design could positively improve oil production, it would restrict oil production in an asymmetrical design. To address this challenge, we used the solvent mixture containing 30% propane that outperformed CO₂, overcame the impact of the asymmetrical wormhole, and increased the total recovery factor by 14% under a 12 kPa/min pressure depletion rate compared to utilizing pure CO₂. Moreover, the results showed that applying a lower pressure depletion rate at 4 kPa/min could recover a slightly higher amount of oil, approximately 2%, during the first cycle compared to tests conducted under higher pressure depletion rates. However, in later cycles, a higher pressure depletion rate at 12 kPa/min significantly improved foamy oil flow quality and, subsequently, heavy oil recovery. The interesting finding, as observed, is the gap difference between the total recovery factor at the end of the cycle and the recovery factor after the first cycle, which increases noticeably with higher pressure depletion rate, increasing from 9.5% under 4 kPa/min to 16% under 12 kPa/min. Full article

Objective: To evaluate the role of nurses in self-management interventions for chronic inflammatory arthritis (CIA). Key areas of interest included the following: (1) providing education on self-injection techniques for biologic disease-modifying antirheumatic drugs (bDMARDs), (2) promoting healthy lifestyles, and (3) supporting mental health. Patients’ satisfaction with the care received was also examined. Methods: A cross-sectional study involving CIA patients, rheumatologists, and nurses was conducted. Participants assessed nurses’ competence in areas such as training for bDMARD self-injection, lifestyle guidance, and emotional support. Satisfaction scores and preferences in managing side effects were also analyzed. Results: The participants expressed high confidence in the nurses’ ability to support CIA self-management. The patients rated the nurses significantly higher than doctors in training for self-injection (p = 0.002) and offering guidance on nutrition and healthy habits (p = 0.002). Although it was not a statistically significant difference, the patients also showed stronger trust in the nurses’ ability to provide psychological and emotional support. Most patients (93.0%) would contact a rheumatologist in case of side effects; 35.5% would seek a nurse. The patients attended by both a doctor and nurse reported significantly higher satisfaction compared to those seen only by a rheumatologist (p < 0.001). Both the doctors and nurses acknowledged the importance of the nurse–patient relationship for effective care (p = 0.527). Conclusions: The findings highlight the critical role of nurses in patient education—particularly in training for self-injection and promoting a healthy lifestyle and mental well-being. Their involvement is strongly associated with higher patient satisfaction and contributes significantly to the overall effectiveness of care in CIA management. Full article