Search Results (19,302)

Background: Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y gastric bypass (RYGB) remains technically challenging. Device-assisted ERCP (DAE-ERCP) is widely used for uncomplicated pancreaticobiliary disease but is associated with prolonged procedure times and high failure rates. Endoscopic ultrasound-directed transgastric ERCP (EDGE) offers high technical success but introduces additional cost and the risk of a persistent fistula. We aimed to prospectively identify intra-procedural predictors of DAE-ERCP failure and define an actionable, real-time threshold for early cross-over to EDGE. Methods: We prospectively evaluated consecutive RYGB patients undergoing DAE-ERCP at a tertiary referral center. Patients with established pre-procedural features associated with complex or low-yield DAE-ERCP were triaged directly to EDGE and excluded. Intra-procedural variables were recorded in real time. Univariate and multivariable logistic regression identified predictors of DAE-ERCP failure. Received operating characteristic (ROC) analysis determined optimal cutoffs for cross-over. Results: A total of 94 patients with RYGB underwent ERCP. Amongst these, 42 patients (11 males, 31 females) were included in the analysis and underwent DAE-ERCP with a success rate of 73.8% (n = 31). Significant risk factors of DAE-ERCP failure included excessive resistance to scope advancement (p < 0.0001), failure to reach the ampulla (p < 0.0001), patient position (p = 0.009), BMI (p = 0.004), and time to reach the jejuno-jejunal (J-J) anastomosis (p < 0.0001). Additionally, time needed to reach the J-J anastomosis of ≥23 min [OR 1.360 (95% CI: 1.079–1.713), p = 0.009], excess resistance to scope advancement [OR 2.223 (95% CI: 2.001–4.167)], and failure to reach the ampulla [OR 9.929 (95% CI: 2.004–4.033)] were statistically significant predictors of DAE-ERCP failure. When ≥2 predictors of BA-ERCP failure were present, the likelihood of DAE-ERCP failure was 2.370 with 95.50% sensitivity and 90% specificity with AUC= 0.929 (p = 0.0001). Conclusions: DAE-ERCP remains an effective first-line strategy in appropriately selecting RYGB patients without pre-procedural high-risk features. Real-time intra-procedural predictors can reliably identify impending failure. A structured algorithm incorporating both pre-procedural triage and intra-procedural checkpoints supports timely transition to EDGE, optimizing efficiency, safety, and resource utilization. Full article

Personality traits are well-established predictors of safety behavior in construction, yet the cognitive mechanisms through which these traits influence such behavior remain poorly understood. In particular, hazard recognition and risk perception are underexamined cognitive mediators that elucidate how personality traits shape safety behavior. Moreover, the mediating effects of these cognitive processes are likely to vary across individuals, reflecting heterogeneity in background characteristics. Neglecting these mediating processes and their differentiated effects not only limits theoretical understanding of the pathways linking personality traits to safety behavior but also undermines the effectiveness of safety interventions. To address this gap, this study develops a framework incorporating cognitive mediators to examine how personality traits influence safety behavior (safety compliance and participation). The hypothesized cognitive-mediation pathways were tested using structural equation modeling based on offline questionnaire data collected from 213 site managers and workers. The findings reveal distinct cognitive pathways through which personality traits shape safety behavior. Extraversion and openness indirectly reduced safety compliance and safety participation by weakening hazard recognition and risk perception, either independently or sequentially. In contrast, agreeableness and conscientiousness enhanced safety behavior by strengthening these same cognitive processes. Higher education levels positively moderated certain mediating effects, whereas extensive work experience exerted mixed influences on specific pathways, facilitating some and inhibiting others depending on context. These findings deepen understanding of the internal mechanisms through which personality traits influence safety behavior via risk cognition. By identifying differentiated pathways across groups, this study further refines the theoretical framework explaining construction workers’ safety behavior. In addition, the theoretical insights generated by this study offer proactive and effective directions for safety practice, including improving person–job fit, designing targeted risk cognition training, and implementing stratified safety management strategies. Full article

This study focuses on the development and physicochemical evaluation of an alternative liquid carrier for coal dust combustion modifiers containing solid catalyst particles. A commercially used acrylic-polymer-based carrier, whose viscosity is regulated by sodium hydroxide addition, was investigated and compared with a proposed safer substitute based on an aqueous sodium carboxymethyl cellulose (Na-CMC) solution. Rheological properties were measured in the shear-rate range relevant to industrial transport and injection systems, while sedimentation behavior was assessed using image-based analysis. The results show that the Na-CMC carrier exhibits shear-thinning behavior and viscosity levels comparable to the commercial formulation, enabling stable suspension of catalyst particles without the need for alkali additives. Unlike the reference system, the alternative carrier does not generate gas during storage, eliminating potential safety hazards associated with hydrogen evolution. Although no direct combustion experiments were performed, the obtained rheological and stability characteristics indicate that the proposed Na-CMC-based carrier is suitable for short-term storage and injection of catalyst-containing modifiers in coal dust combustion systems. Direct validation of combustion performance is planned in future work. Full article

Background: Early surgical intervention is associated with improved outcomes in hip fracture care, yet in patients using Direct Oral Anticoagulants (DOACs), surgery is frequently delayed due to concerns about increased intraoperative bleeding. Despite the increasing prevalence of hip fracture patients on DOACs, no consensus exists on optimal surgical timing. This has led to substantial practice variation between hospitals, with some operating within 24 h of last DOAC intake and others delaying surgery beyond 24 h. This study hypothesizes that early surgery within 24 h results in a non-inferior blood transfusion risk compared to delayed surgery 24 h or more after last DOAC intake in hip fracture patients on DOACs. This protocol describes the design and methodological rationale of a natural experiment. Methods and analysis: A multicenter cohort study designed as a natural experiment will be conducted across seven Dutch level 2 trauma centers, using predefined and standardized prospectively collected variables from electronic health records. Centers will adhere to distinct local surgical timing protocols, forming two cohorts: early surgery within 24 h and delayed surgery 24 h or more after last DOAC intake. Patients presenting with an isolated hip fracture who are using a DOAC and have taken their last dose within 24 h before admission will be included. The primary endpoint is postoperative blood transfusion. Secondary endpoints include additional bleeding-related outcomes, thrombotic and postoperative complications, and hospital length of stay. The primary analysis will be conducted on a per-protocol basis, with an intention-to-treat analysis performed as a supplementary assessment. Non-inferiority will be established if the upper bound of the one-sided 95% confidence interval for the risk difference does not exceed the predefined margin of 5%. Ethics and dissemination: Ethical approval was obtained from the Medical Ethics Committee United, Utrecht, The Netherlands. As this is a cohort study without altering clinical care, individual informed consent is not required. All data will be pseudonymized, and findings will be disseminated through peer-reviewed journals and scientific conferences. Registration details: Medical Ethics Committee United, Utrecht, The Netherlands, registration number W25.034 Full article

Due to a number of advantages, such as the high power-to-weight ratio of the system, the possibility of easy control and the freedom of arrangement of the system components on the machine, hydrostatic drive is one of the most popular methods of machine drive. The actuators in such a system are hydraulic cylinders that convert fluid pressure energy into mechanical energy for reciprocating motion. One disadvantage of conventional actuators is their weight, so research is being conducted to make them as light as possible. Directions for this research include the use of modern engineering materials such as composites and plastics. This paper presents the possibility of using new lightweight yet strong materials for the design of a hydraulic cylinder. The base of the hydraulic cylinder were designed and subjected to FEM numerical analyses. The base was made of PET. In addition, a composite cylinder made of wound carbon fibre was subjected to numerical analyses and experimental validation. The numerical calculations were verified in experimental studies. To improve the reliability of the numerical calculations, the material parameters of the composite materials were determined experimentally instead of being taken from the manufacturer’s data sheets. The composite cylinder achieved a weight reduction of approximately 94.4% compared to a steel cylinder (95.5 g vs. 1704 g). Under an internal pressure of 20 MPa, the composite cylinder exhibited markedly higher circumferential strain (4329 μm/m) than the steel cylinder (339.6 μm/m), and axial strain was also greater (−1237 μm/m vs. −96.4 μm/m). Full article

Chronic inflammation constitutes a well-established driver of colorectal carcinogenesis, yet the molecular circuitry linking inflammatory receptor signalling to tumour cell survival remains incompletely delineated. Here we demonstrate that the HMG-CoA reductase inhibitors atorvastatin and rosuvastatin modulate inflammatory survival pathways in colorectal cancer cells in a manner consistent with targeted interference with the protease-activated receptor 2 (PAR-2)–extracellular signal-regulated kinase (ERK)–tumour necrosis factor-α (TNF-α) signalling axis. Using lipopolysaccharide-stimulated HT-29 and Caco-2 cells as complementary models of inflammatory colorectal malignancy, we show that both statins selectively attenuate PAR-2 expression at the protein and transcript levels while leaving structurally related PAR-1 unaffected. This pattern of receptor modulation is accompanied by suppression of total ERK1/2 expression, ERK1/2 phosphorylation, and the transcriptional target DUSP6, together with attenuation of TNF-α secretion. Importantly, these signaling shifts are associated with dual apoptotic programs; the extrinsic pathway, reflected by transcriptional upregulation and proteolytic activation of caspase-8; and the intrinsic mitochondrial pathway, evidenced by reciprocal modulation of Bcl-2 family proteins favoring Bax over Bcl-2. Both pathways converge upon activation of executioner caspase-3 and an increase in Annexin V-defined apoptotic fractions, indicating re-engagement of programmed cell death under inflammatory stress. Notably, rosuvastatin consistently demonstrates superior potency across signaling endpoints, achieving comparable biological effects at lower concentrations than atorvastatin. Collectively, these data indicate that clinically deployed statins target the PAR-2–ERK axis and are associated with re-activation of apoptotic pathways in inflammatory colorectal cancer models, while leaving open the possibility that additional statin-responsive networks contribute to their pro-apoptotic effects. This mechanistic framework provides biological plausibility for epidemiologic observations linking statin use with reduced colorectal cancer risk and improved outcomes, and supports further translational evaluation of PAR-2-directed statin strategies in colorectal malignancy. Full article

This study investigates the behaviour of Compressed Earth Cylinders (CECs) and Compressed Earth Blocks (CEBs) during direct compression tests and examines the influence of aspect ratio and the effects of platen restraint. The experimental investigation utilises two soil types and examines the impact of jute fibre reinforcement on the failure mechanism of CECs with aspect ratios ranging from 0.50 to 2.00. Through experimental analysis and numerical modelling, the effects of platen restraint are examined, and a novel hypothesis of intersecting cones is presented. The results show that specimens with a lower aspect ratio exhibited higher compressive strength due to confinement caused by platen restraint. Moreover, this research has derived new aspect ratio correction factors that enable conversion from Apparent Compressive Strength (ACS) to Unconfined Compressive Strength (UCS) of unstabilised and fibre-reinforced CECs. The experimental results indicate that the derived conversion factor of 0.861 allows for the prediction of CEB strength from CEC specimens with an accuracy of 2.7%. Furthermore, the addition of jute fibres at a 0.25% dosage increased the Apparent Compressive Strength across all aspect ratios. The outcome of this research recommends a standard approach to the application of aspect ratio correction factors when interpreting and reporting the compressive strength of CECs and CEBs. Full article

This article presents an integrated framework for robust control and cybersecurity of an industrial robot, combining Quantitative Feedback Theory (QFT), digital twin (DT) technology, and a programmable logic controller–based architecture aligned with the requirements of the NIS2 Directive. The study considers a five-axis industrial manipulator modeled as a set of decoupled linear single-input single-output systems subject to parametric uncertainty and external disturbances. For position control of each axis, closed-loop robust systems with QFT-based controllers and prefilters are designed, and the dynamic behavior of the system is evaluated using predefined key performance indicators (KPIs), including tracking errors in joint space and tool space, maximum error, root-mean-square error, and three-dimensional positional deviation. The proposed architecture executes robust control algorithms in the MATLAB/Simulink environment, while a programmable logic controller provides deterministic communication, time synchronization, and secure data exchange. The synchronized digital twin, implemented in the FANUC ROBOGUIDE environment, reproduces the robot’s kinematics and dynamics in real time, enabling realistic hardware-in-the-loop validation with a real programmable logic controller. This work represents one of the first architectures that simultaneously integrates robust control, real programmable logic controller-based execution, a synchronized digital twin, and NIS2-oriented mechanisms for observability and traceability. The conducted simulation and digital twin-based experimental studies under nominal and worst-case dynamic models, as well as scenarios with externally applied single-axis disturbances, demonstrate that the system maintains robustness and tracking accuracy within the prescribed performance criteria. In addition, the study analyzes how the proposed architecture supports the implementation of key NIS2 principles, including command traceability, disturbance resilience, access control, and capabilities for incident analysis and event traceability in robotic manufacturing systems. Full article

Large-scale frames are increasingly used in engineering structures, particularly in aerospace structures. Among them, planar phased array satellite antennas used for global observations and target tracking have received much attention. Considering that structural deformation will degrade the coherence of antennas, a frame with inherent diagonal cables that serves to control the antennas’ static configuration is thoroughly studied. These inherent cables of planar phased arrays are pre-tensioned to preserve the structural integrity and increase the stiffness of the antenna. However, they are also used as actuators in our research; in this way, additional control devices are not needed. As a result, the antenna’s mass will decrease, and its reliability will increase. For high observation accuracy, the antennas tend to be very large. Accordingly, there is a significant deformation of space antennas when they are loaded. For this reason, a nonlinear finite element method is used to consider the structures’ geometrical nonlinearity. In order to achieve shape adjustment, the difference between active and passive cables must be carefully investigated. Furthermore, for the nonlinear structure in this paper, the active cables will deform in tandem with the structure as a whole so that the direction of the active cables’ control forces will also change during the entire control process. This paper elaborates on this problem and proposes a nonlinear optimization method considering this characteristic of the cables. Simulations of a simplified 2-bay and 18-bay satellite antenna are performed to validate the proposed method. Results of the numerical simulation demonstrate that the proposed method can successfully adjust the large-scale antenna’s static shape and achieve high precision. Full article

This study introduces a novel hybrid model for an electromembrane stack, unifying an equivalent electrical circuit model incorporating specific resistance ($R_M,R_s$) and capacitance ($C_{gs},C_{dl}$) parameters with an empirical fouling model in a single framework. The model simplifies the traditional approach by serially connecting N ($N=10$) ion exchange membranes (anionic PC-SA and cationic PC-SK) and is validated using $NaCl$ and $N{a}_{2}S{O}_4$ solutions in comparison with laboratory tests using various voltage signals, including direct current and electrically pulsed reversal operations at frequencies of 2000 and 4000 Hz. The model specifically accounts for the chemical stratification of the cell unit into bulk solution, diffusion, and Stern layers. We also included a calibration method using correction factors (${\alpha }_i$) to fine-tune the electrical current signals induced by voltage stimulation. The empirical component of the model uses experimental data to simulate membrane fouling, ensuring consistency with laboratory-scale desalination processes performed under pulsed reversal operations and achieving a prediction error of less than 10%. In addition, a comparative analysis was used to assess the increase in electrical resistance due to fouling. By integrating electronic and empirical electrochemical data, this hybrid model opens the way to the construction of simple, practical, and reliable models that complement theoretical approaches, signifying an advance for a variety of electromembrane-based technologies. Full article

Through the mechanical analysis of AlCoCrFeNi thin-walled high-entropy alloy materials fabricated by plasma arc additive manufacturing, this study examines the practical application prospects of plasma arc manufacturing technology for thin-walled high-entropy alloys and explores its future development directions. Using a plasma arc oscillation process, a 50-layer fine additive experiment was conducted on AlCoCrFeNi high-entropy alloy materials employing both reciprocating and layer-by-layer accumulation methods. The samples were analyzed for overall appearance, microstructure, hardness, and tensile properties. The results indicate that the proportions of columnar and intergranular dendrites in the thin-walled high-entropy alloy specimens are similar, and the columnar dendrites exhibit a uniformly sized cross shape. The variation in Vickers microhardness along the horizontal direction shows lower strength at the edge positions, gradually increasing with horizontal distance. A comparison of the alloy’s transverse and longitudinal tensile specimens revealed that samples parallel to the deposition direction exhibit more regular structural arrangements, while specimens perpendicular to the deposition direction show unavoidable stress concentration at the deposition sites during tensile testing. With the increase in the height of the longitudinal specimens, the FCC structures in the alloy are significantly refined, the organizational arrangement becomes more regular, and the elongation increases. This study elucidates the plasma arc preparation technique for thin-walled high-entropy alloy materials, which is expected to achieve precise control over material composition, accurate observation of grain refinement, and uniform distribution of Vickers hardness, thereby enhancing the mechanical properties and thermal stability of the materials, with promising applications in aerospace, energy, and industrial fields. Full article

High frame rate imaging of synthetic aperture radar (SAR), also known as video SAR (ViSAR), has attracted extensive research in recent years. When ViSAR system parameters are fixed, there is a technical trade-off between high frame rates and high resolution. In traditional ViSAR, the frame rate is usually increased by increasing the carrier frequency to increase the azimuth modulation frequency and reducing the synthetic aperture time. This paper attempts to propose a strip non-overlapping mode ViSAR based on Orbital Angular Momentum (OAM) beams, which uses the topological charge of vortex electromagnetic wave (VEW) to improve the azimuth modulation frequency, to improve the frame rate. By introducing the concept of VEW frame splitting, a corresponding time-varying topological charge mode is designed for ViSAR imaging. This design successfully introduces an additional azimuth modulation frequency while maintaining the original imaging resolution, thus significantly improving the frame rate performance of the ViSAR system. However, the Bessel function term in VEW causes amplitude modulation in the echo signal, while the additional frequency modulation causes the traditional matching filter to fail. To address these problems, an improved Range-Doppler algorithm (RDA) is proposed in this paper. By employing the range cell center approximation method, the negative effect of the Bessel function on imaging is reduced effectively. Furthermore, for the introduction of tuning frequency, the azimuth matched filter is specially improved, which effectively prevents the defocusing issues caused by the mismatch of tuning frequency. Finally, the computer simulation results prove that the ViSAR system and imaging algorithm based on VEW can effectively improve the frame rate of ViSAR and maintain the imaging resolution, which provides a research direction for the development of ViSAR technology. Full article

Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system marked by inflammatory demyelination and progressive neurodegeneration. Although current immunomodulatory therapies can reduce relapse rates, they are often associated with limited long-term efficacy and adverse effects, highlighting the need for safer and more comprehensive complementary approaches. Dietary bioactive phytochemicals—notably, the polyphenols epigallocatechin-3-gallate (EGCG), curcumin, and resveratrol—have demonstrated potential to modulate the immune and inflammatory pathways implicated in MS pathogenesis. In addition to their immunomodulatory roles, emerging evidence suggests that these compounds also exert neuroprotective effects independent of immune modulation, including antioxidant activity, mitochondrial stabilization, and enhancement of neurotrophic signaling. Furthermore, recent studies identify the gut microbiota as a central mediator of MS pathophysiology and of how dietary phytochemicals are metabolized and exert their effects. This review examines experimental data evaluating the therapeutic potential of selected bioactive phytochemicals in MS, focusing on their mechanisms of action—including both immune-dependent and immune-independent neuroprotective effects—and interactions with the gut microbiota. Current limitations in translating findings from animal models to clinical settings are also discussed, and future directions for research in this evolving area are highlighted. Full article

Background: Sodium–glucose cotransporter 2 inhibitors (SGLT2 inhibitors), initially developed for glycemic control in type 2 diabetes, have demonstrated robust cardiovascular and renal benefits. Emerging evidence suggests that these agents may also affect valvular pathobiology, particularly in degenerative aortic stenosis (AS), through anti-inflammatory and antifibrotic mechanisms. Objectives: This study evaluated whether SGLT2 inhibitor use is associated with improved clinical outcomes in degenerative AS, including all-cause mortality and the need for SAVR or TAVR, recognizing that these endpoints represent surrogate rather than direct measures of valve hemodynamic progression. Methods: A retrospective cohort analysis was conducted using TriNetX, a federated electronic medical record-based research network. Diagnoses are captured using ICD-9/ICD-10-CM codes and medications using ATC codes. Adults with non-rheumatic AS were stratified by SGLT2 inhibitors use. Propensity score matching (1:1) was performed to balance baseline characteristics between treated and untreated groups (n = 10,912 per group). Primary outcomes included all-cause mortality, TAVR, and SAVR during follow-up. Echocardiographic parameters (AVA, Vmax, mean gradient) were not systematically available. Results: After adjustment for comorbidities, SGLT2 inhibitor use was independently associated with lower all-cause mortality (6.15% vs. 9.34% HR 0.595; 95% CI 0.552–0.641; p < 0.001), TAVR (2.81% vs. 2.89% HR 0.835; 95% CI 0.746–0.934; p = 0.002), SAVR (1.28% vs. 1.90% HR 0.514; 95% CI 0.442–0.599; p < 0.001), cardiac arrest (0.82% vs. 1.21% HR 0.71; 95% CI 0.582–0.867; p < 0.001), and end-stage kidney disease (0.40% vs. 1.0% HR 0.292; 95% CI 0.222–0.384; p < 0.001). Although these associations may suggest slower disease progression, interpretation is limited by the lack of systematic echocardiographic follow-up. Conclusions: In addition to their established benefits in heart failure and renal protection, SGLT2 inhibitors may have valve-preserving effects in degenerative AS. Because true hemodynamic progression could not be evaluated, these results should be viewed as associations with surrogate clinical endpoints. Prospective studies with standardized imaging are required to determine whether SGLT2 inhibition can directly alter the course of this currently untreatable disease Full article

Metal–organic frameworks (MOFs) and porous organic frameworks (POFs) have been extensively explored in recent years as lubricant additives for various systems due to their structural designability, pore storage capacity, and tunable surface chemistry. These materials are utilized to construct low-friction, low-wear interfaces and investigate the potential for superlubricity. This paper systematically reviews the tribological behavior and key mechanisms of MOFs/POFs in oil-based, water-based, and solid coating systems. In oil-based systems, MOFs/POFs primarily achieve friction reduction and wear resistance through third-body particles, layer slip, and synergistic friction-induced chemical/physical transfer films. However, limitations in achieving superlubricity stem from the multi-component heterogeneity of boundary films and the dynamic evolution of shear planes. In water-based systems, MOFs/POFs leverage hydrophilic functional groups to induce hydration layers, promote polymer thickening, and soften gels through interfacial anchoring. Under specific conditions, a few cases exhibit superlubricity with coefficients of friction entering the 10⁻³ range. In solid coating systems, two-dimensional MOFs/COFs with controllable orientation leverage interlayer weak interactions and incommensurate interfaces to reduce potential barriers, achieving structural superlubricity at the 10⁻³–10⁻⁴ level on the micro- and nano-scales. However, at the engineering scale, factors such as roughness, contamination, and discontinuities in the lubricating film still constrain performance, leading to amplified energy dissipation and degradation. Finally, this paper discusses key challenges in achieving superlubricity with MOFs/POFs and proposes future research directions, including the design of shear-plane structures. Full article