Search Results (1,069)

The associations between sialylated anti-cyclic citrullinated peptide (anti-CCP) antibodies bearing α-2,6-sialic acid (SIA), ST6Gal1 and Neu1 enzymes, and clinical disease activity measures such as disease activity score 28 (DAS28), the Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) are unknown in rheumatoid arthritis (RA). To address this gap, this study included 97 patients with RA evaluated at baseline (month 0) and at 6 and 12 months. At each visit, blood cells were analyzed for B-cell ST6Gal1 and Neu1 expressions, and plasma samples were assessed for ST6Gal1 and Neu1 levels. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), monocyte chemotactic protein-1 (MCP-1), and IgG anti-CCP with its α-2,6-SIA modification were measured. Disease activity measures, namely DAS28-ESR, DAS28-CRP, DAS28-MCP-1, SDAI, and CDAI, were calculated. Correlations and Receiver Operating Characteristics among ST6Gal, Neu1, SIA/anti-CCP ratios, and disease activity measures were assessed. Multivariate regression analyses were performed to reveal confounding factors in such correlations. The total SIA content of anti-CCP antibodies was inversely correlated with B-cell Neu1 levels (ρ = −0.317 with p = 0.013. Plasma (free-form) Neu1 levels were inversely correlated with SIA/IgG anti-CCP ratios (ρ = −0.361, p = 0.001) in the DAS28-MCP-1 < 2.2 (remission) subgroup. No such correlation was observed for the DAS28-ESR, DAS28-CRP, SDAI, or CDAI subgroups. B-cell ST6Gal1 levels correlated inversely with SDAI ≤ 11 and DAS28-MCP-1 ≤ 3.6 combined remission and low-disease-activity subgroups (ρ = −0.315 with p = 0.001 and ρ = −0.237 with p = 0.008, respectively). The same was observed for B-cell ST6Gal1/Neu1 ratios correlating with the SDAI ≤ 11 subgroup (ρ = −0.261, p = 0.009). Nevertheless, B-cell ST6Gal1/Neu1 ratios against SDAI ≤ 11 and DAS28-MCP-1 ≤ 3.6 subgroups produced significant area-under-curve (AUC) values of 0.616 and 0.600, respectively (asymptotic p-Values 0.004 and 0.018, respectively). Through multivariate regression analyses, we found that biologics (a confounding factor) interfered with p-Values related to the B-cell ST6Gal1 enzyme but did not interfere with p-Values related to the pure B-cell Neu1 enzyme. In addition, disease duration interfered with p-Values related to the pure Neu1 enzyme on B-cells or in plasma. Moreover, plasma ST6Gal1/Neu1 ratios against the DAS28-MCP-1 < 2.2 remission subgroup produced an AUC of 0.628 and asymptotic p = 0.003. Therefore, it is suggested that B-cell ST6Gal1/Neu1 ratios can be used as clinical indicators for the combined remission and low-disease-activity subgroup of SDAI and DAS28-MCP-1 formulae. Plasma ST6Gal1/Neu1 ratios are also good indicators of DAS28-MCP-1 remission. Full article

Background/Objectives: Drug-resistant tuberculosis (DR-TB) presents significant challenges to public health, particularly in rural South Africa, where limited infrastructure, high HIV co-infection rates, and weak clinical governance contribute to poor treatment outcomes. This study evaluates treatment trajectories and the impact of clinical governance and public health interventions on DR-TB outcomes in the rural Eastern Cape. Methods: A retrospective cohort study was conducted among 323 laboratory-confirmed DR-TB patients treated between 2018 and 2021. Kaplan–Meier curves and Cox proportional hazards analysis identified predictors of unfavorable outcomes. Logistic regression analysis simulated the impact of enhanced clinical governance scenarios on treatment success. Results: Treatment outcomes included cure (36.2%), completion (26.0%), loss to follow up (LTFU) (9.0%), death (9.3%), failure (2.2%), and transfer (9.3%). The median treatment duration was 10 months (IQR: 9–11). Survival analysis indicates the highest risk of death and LTFU occurred in the first 6–8 months of treatment. Multivariate Cox regression revealed that primary (HR = 0.39; 95% CI: 0.23–0.68; p = 0.0017) and secondary education (HR = 0.50; 95% CI: 0.31–0.85; p = 0.0103) were significantly protective. Paradoxically, patients with pre-XDR (HR = 0.13; p = 0.034) and XDR TB (HR = 0.16; p = 0.043) showed lower hazard of poor outcomes, likely due to early mortality or referral. HIV-negative status was associated with higher risk of poor outcomes (HR = 1.74; p = 0.010). Simulations suggested that improved clinical governance via better follow-up, TB/HIV integration, and adherence support could improve treatment success by up to 20 percentage points in high-impact scenarios. Conclusions: Strengthening clinical governance through targeted interventions could substantially reduce LTFU and mortality, especially in vulnerable subgroups. A coordinated, patient-centered approach is critical for improving DR-TB outcomes in rural, high-burden settings. Full article

The relationship between concentration and discharge (C/Q) is widely studied to understand the behavior of solute transport in complex natural media during storm events. The causes of C/Q hysteresis are due to the delay between the signals of C and Q at a given observation point. Many indices are used to characterize the C/Q hysteresis curve, like the hysteresis index (HI) and the flushing index (FI). The limitation of relating C/Q hysteresis relationships or indices to storm event parameters is because, in real-world situations, we ignore and do not control storm event parameters. This paper is the first attempt to study the variability of C/Q relationships under a well-known storm event on a controlled experimental channel. We tested nine scenarios where the storm event consisted of a triangular input signal with a constant peak and a variable duration. The main parameter of this study is the storm event duration. We calculated known indices, like the hysteresis index (HI) and the flushing index (FI), and we introduced the following two new indices: the saturation index (SI) and the bisector index (BI). Then we related all calculated indices to the storm duration parameter. The importance of our study is that it presents, for the first time, a quantitative description of how the magnitude of the hysteresis indices varies with the storm duration parameter. We found that the most popular HI index does not follow a monotonic behavior for increasing storm duration. Conversely, the FI index and the two newly introduced indices (SI and BI) follow a monotonic behavior for increasing storm duration according to a Fermi-type function. The SI varies between 0.11 and 0.93, while the BI varies between 1 and 0.32 for an increasing storm event duration. Full article

Background: Femoral neck fractures (FNFs) are common injuries among the elderly and are a significant cause of morbidity and mortality. Hemiarthroplasty (HA) is the most suitable choice for elderly patients with multiple comorbidities and reduced functional demands. The direct anterior approach (DAA) to perform HA is widely used because, among other attractive features, it facilitates recovery of functional outcomes by limiting iatrogenic muscle damage. The learning curve for surgeons who perform minimally invasive HA using the DAA approach is unknown. The purpose of the study is to perform this determination. Methods: 850 patients (age: 82 ± 6 years) who had suffered FNFs were enrolled for the study between January 2017 and September 2022. The patients underwent minimally invasive hemiarthroplasty (using the anterior minimally invasive surgical (AMIS) technique) and DAA (AMIS + DAA). The patients were divided into three groups, one operated on by surgeons who have substantial experience in HA using DAA (Group A), another operated on by surgeons who have experience in adult hip arthroplasty (≥5 y) but had not specialized in using DAA (Group B), and surgeons who are being trained to perform adult hip arthroplasty (Group C). The metrics determined were duration of surgery, skin incision length, drop in hemoglobin level, length of hospital stay, complications experienced within 2 y of the procedure and the Harris Hip Score. For each of these metrics, the results were used to determine the learning curve for Groups B and C surgeons. Results: Using the learning curve profiles obtained, it was calculated that in order to achieve the competence of Group A surgeons, Group B and Group C surgeons need to perform 46 and 102 consecutive procedures, respectively. Conclusion: For an HA patient to achieve outcomes when treated for FNF using AMIS + DAA requires that the surgeon should have performed a large number of this procedure. In other words, the surgeon learning curve is modest for Group B surgeons but substantial for Group C surgeons. Full article

Accurate parametric modeling of lithium-ion batteries is essential for battery management system (BMS) design in electric vehicles and broader energy storage applications, enabling reliable state estimation and effective thermal control under diverse operating conditions. This study presents a detailed characterization of lithium-ion cells to support advanced BMS in electric vehicles and stationary storage. A second-order equivalent circuit model is developed to capture instantaneous and dynamic voltage behavior, with parameters extracted through Hybrid Pulse Power Characterization over a broad range of temperatures (−10 °C to 45 °C) and state-of-charge levels. The method includes multi-duration pulse testing and separates ohmic and transient responses using two resistor–capacitor branches, with parameters tied to physical processes like charge transfer and diffusion. A weakly coupled electro-thermal model is presented to support real-time BMS applications, enabling accurate voltage, temperature, and heat generation prediction. This study also evaluates open-circuit voltage and direct current internal resistance across pulse durations, leading to power capability maps (“fish charts”) that capture discharge and regenerative performance across SOC and temperature. The analysis highlights performance asymmetries between charging and discharging and confirms model accuracy through curve fitting across test conditions. These contributions enhance model realism, thermal control, and power estimation for real-world lithium-ion battery applications. Full article

Background/Objectives: Patients with chronic hypoparathyroidism are at increased risk of kidney complications. Also, chronic kidney disease is associated with increased cardiovascular risk. The aim was to analyze the factors that influence kidney function, including cardiovascular diseases (CVD), in a cohort of patients with chronic hypoparathyroidism. Methods: This was a retrospective longitudinal study that included 100 patients with chronic hypoparathyroidism. Results: The estimated glomerular filtration rate (eGFR) was associated with the duration of disease (p = 0.014). During follow-up, a significant decrease in eGFR was observed over time (p < 0.001), and changes in the eGFR were associated with the duration of disease (p < 0.001). We found that the eGFR was lower in patients with urolithiasis (p = 0.003), hypertension (p < 0.001), type 2 diabetes (p = 0.031) and dyslipidemia (p < 0.001). In total, 14% of patients had a chronic kidney disease (CKD), and these patients had a longer duration of disease (p < 0.001). The percentage of patients with urolithiasis (p = 0.003), nephrocalcinosis (p = 0.008), hypertension (p = 0.005), type 2 diabetes (p < 0.001), dyslipidemia (p < 0.001), coronary heart disease (p = 0.008), and arrhythmia (p < 0.001) was higher in patients with CKD. Logistic regression models showed that disease duration was associated with CKD (OR = 1.11; 95% CI [1.03–1.22]; p = 0.008). We used ROC curves to assess the usefulness of disease duration as a marker of CKD, and the AUC was 0.850 (95% CI 0.763–0.937, p < 0.001). A duration of disease > 15.5 years had a sensitivity of 85.7% and a specificity of 71.9% for a diagnosis of CKD. Conclusions: The duration of disease appears to be a predictor of the presence of renal dysfunction in patients with chronic hypoparathyroidism. In addition, the coexistence of CVD factors could result in greater renal damage. Full article

The bore field in ground source heat pump (GSHP) systems usually encounters thermal accumulation in long-term operation, but there is no quantitative index evaluating this process and its magnitude. A heat accumulation evaluation metric has been proposed, based on the linear trend Slope (°C/a) of the curve of soil temperature variation. Using this metric, the influence of various factors on soil temperature has been quantitatively analyzed. The results indicate that, under constant heating durations, each 10-day extension of cooling periods leads to an increase of 0.038 °C/a in soil temperature. Extending the recovery period within an annual cycle facilitates soil self-recovery and mitigates subsurface thermal accumulation. Increasing the spacing between boreholes effectively reduces thermal interference, whereas a greater number of boreholes exacerbates thermal accumulation. Deepening vertical boreholes from 100 m to 200 m reduces the average annual soil temperature increase by 0.1076 °C. Appropriately increasing backfill thermal conductivity enhances heat exchange efficiency and suppresses thermal accumulation. Higher water flow rates result in logarithmic increases in the evaluation metric, thereby intensifying soil thermal accumulation. Intermittent operation extends recovery periods, thereby alleviating soil thermal imbalance. Under balanced cooling and heating loads, increasing the system lifespan from 10 a to 30 a reduces the evaluation metric by 47.2%. Full article

Modeling heavy rainfall patterns is essential for designing hydraulic structures, planning land use and water resources, and predicting disasters, among others. Usually, heavy rainfall is characterized by curves that relate the intensity, duration, and frequency (IDF), adjusted from the analysis of pluviograms. Alternatively, these equations can be adjusted using disaggregated daily rainfall data, whose reliability is currently questioned due to the use of common coefficients to disaggregate the maximum daily precipitation (h_day) into rainfall associated with shorter durations. This study proposes the Transformation of Maximum Daily Precipitation method (TMDP) using the maximum daily precipitation of the station of interest and the curve of heavy rainfall of the nearest location, denoting the local characteristic, to transform the h_day associated with a return period into rainfall intensities for shorter durations. The TMDP proved to be slightly superior to the most widely used rainfall disaggregation method in Brazil, particularly in regions with a higher density of data for the IDF equation. The TMDP is a potential tool for regions with low density of rainfall data, although it has limitations in regions where such data are scarce. Full article

Amaranth is considered a gluten-free, protein-rich pseudocereal. However, seed dormancy affects the germination rate and production. The aim of this study was to investigate the effects of osmopriming, hydropriming, priming with Algal and chia-seed extract biostimulants, scarification, and different combinations of them on seed germination. The results showed that hydropriming, osmopriming, (at least by 13%), and speed (two days earlier) of germination compared to the control. The same trend was observed, to a lesser extent, for priming with a biostimulant. The production of osmopriming has recently started in France. However, seed priming offers a promising solution to overcome the lack of germination. The aim of this study was to test several priming methods and their impact on amaranth seed germination. An imbibition curve was first established and showed that the first two germination phases were reached at 12 h after imbibition. Duration had no effect on germination compared to the control. In contrast, increasing the rate measurement of polyphenol oxidase (PPO) activity revealed a peak during the first few hours. The largest peak was observed for this. These results suggest growing amaranth by increasing the germination rate. Full article

Background/Objectives: Microvascular complications are a major source of disability in type 2 diabetes mellitus (T2DM). We investigated whether body composition indices derived from multifrequency bioelectrical impedance analysis (BIA) independently predict neuropathy, retinopathy, nephropathy, and stroke, and whether they improve risk discrimination beyond the established clinical variables. Methods: In this cross-sectional analytical study (March 2024–February 2025), 124 adults with T2DM ≥ 12 months attending the outpatient diabetes clinic of the Universidad Técnica de Ambato (Ecuador) were enrolled. After an overnight fast and 15 min supine rest, thirteen whole-body BIA metrics including skeletal muscle mass (SMM), intracellular water (ICW), phase angle (PhA), and visceral fat area (VFA) were obtained with a segmental analyzer (InBody S10). Complications were ascertained with standard clinical and laboratory protocols. Principal component analysis (PCA) summarized the correlated BIA measures; multivariable logistic regression (adjusted for age, sex, diabetes duration, HbA1c, BMI, and medication use) generated odds ratios (ORs) per standard deviation (SD). Discrimination was assessed with bootstrapped receiver-operating characteristic curves. Results: The first principal component, driven by SMM, ICW, and PhA, accounted for a median 68% (range 65–72%) of body composition variance across all complications. Each SD increase in SMM lowered the odds of neuropathy (OR 0.54, 95% CI 0.41–0.71) and nephropathy (OR 0.70, 0.53–0.92), whereas VFA raised the risk of neuropathy (OR 1.55, 1.22–1.97) and retinopathy (OR 1.47, 1.14–1.88). PhA protected most strongly against stroke (OR 0.55, 0.37–0.82). Composite models integrating SMM, PhA, and adiposity indices achieved AUCs of 0.79–0.85, outperforming clinical models alone (all ΔAUC ≥ 0.05) and maintaining good calibration (Hosmer–Lemeshow p > 0.20). Optimal probability cut-offs (0.39–0.45) balanced sensitivity (0.74–0.80) and specificity (0.68–0.72). Conclusions: A lean tissue BIA signature (higher SMM, ICW, PhA) confers independent protection against neuropathy, retinopathy, nephropathy, and stroke, whereas visceral adiposity amplifies the risk. Because the assessment is rapid, inexpensive, and operator-independent, routine multifrequency BIA can be embedded into diabetes clinics to triage patients for early specialist referral and to monitor interventions aimed at preserving muscle and reducing visceral fat, thereby enhancing microvascular risk management in T2DM. Full article

Rock creep, a key factor in the long-term stability of deep geotechnical engineering, remains challenging to study due to the complexity of its microscopic damage mechanisms. Laboratory creep tests are limited by long durations and scale effects, while phenomenological models cannot fully capture the underlying processes. This study employs the parallel-bonded stress corrosion (PSC) model in PFC2D to simulate sandy mudstone’s creep behavior, systematically correlating macroscopic creep deformation with microscopic damage evolution and energy conversion. The model reproduces the four stages of the idealized creep curve and quantifies the effects of axial stress level and confining pressure on creep lifetime, rate, and failure mode. Increasing axial stress shortens creep lifetime; every 10% increase raises the creep rate by a factor of 4–14, and high stress enhances nonlinear deformation, producing stair-stepping curves due to unstable microcrack propagation. In contrast, confining pressure prolongs lifetime; at 90% uniaxial compressive strength (UCS), 15 MPa extends it from 2.78 h to ~25 years. Confinement also enhances ductility by suppressing tensile stresses and delaying damage accumulation. This study reveals the coupling mechanism of stress-corrosion-induced subcritical crack propagation and energy dissipation, clarifies the microscopic origin of stepped creep curves, and provides a micromechanical framework for long-term stability evaluation in deep geotechnical engineering. Full article

Background: Despite the survival benefit of ICDs in patients with HFrEF, most recipients do not receive appropriate therapy during follow-up. Existing risk models based on echocardiographic and clinical parameters show limited predictive accuracy for arrhythmic events. This study aimed to assess whether ECG-derived markers outperform conventional measures in predicting appropriate ICD shocks. Methods: This retrospective observational study included 375 patients with HFrEF who underwent ICD implantation for primary prevention at least six months before study enrollment. Twelve-lead surface ECGs were analyzed for a QTc interval, Tp-e/QT ratio, frontal QRS-T angle, and maximum deflection index (MDI). Clinical, echocardiographic, and arrhythmic event data obtained from device interrogations were evaluated. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were performed to identify independent predictors of appropriate ICD shocks. Results: Patients who experienced appropriate ICD shocks had significantly higher rates of a complete bundle branch block, digoxin use, QRS duration, QTc, Tp-e/QT ratio, frontal QRS-T angle, MDI, and right-ventricular pacing ratio. Conversely, beta-blocker use was significantly lower in this group. In multivariate analysis, independent predictors of appropriate shocks included the patient’s digoxin use (OR = 2.931, p = 0.003), beta-blocker use (OR = 0.275, p = 0.002), frontal QRS-T angle (OR = 1.009, p < 0.001), QTc interval (OR = 1.020, p < 0.001), and Tp-e/QT ratio (OR = 4.882, p = 0.050). The frontal QRS-T angle had a cutoff value of 105.5° for predicting appropriate ICD shocks (sensitivity: 73.6%, specificity: 85.2%, AUC = 0.758, p < 0.001). Conclusions: Electrocardiographic markers, particularly the frontal QRS-T angle, QTc interval, and Tp-e/QT ratio, demonstrated superior predictive power for appropriate ICD shocks compared to conventional echocardiographic and clinical measures. These easily obtainable, non-invasive ECG parameters may improve current risk stratification models and support more individualized ICD implantation strategies. Full article

The piston-type expander (PTE), as the primary output component, significantly influences the performance of an energy storage system. This paper proposes a non-cam variable valve actuation system for the PTE, supported by a mathematical model. An enhanced S-curve trajectory planning method is used to design the valve lift curve. The study investigates the effects of various valve lift design parameters on output power and efficiency at different rotational speeds, employing orthogonal design and SPSS Statistics 27 (Statistical Product and Service Solutions) simulations. A grey comprehensive evaluation method is used to identify optimal valve lift parameters for each speed. The results show that valve lift parameters influence PTE performance to varying degrees, with intake duration having the greatest effect, followed by maximum valve lift, while intake end time has the least impact. The non-cam PTE outperforms the cam-based PTE. At 800 rpm, the optimal design yields 7.12 kW and 53.5% efficiency; at 900 rpm, 8.17 kW and 50.6%; at 1000 rpm, 9.2 kW and 46.8%; and at 1100 rpm, 12.09 kW and 41.2%. At these speeds, output power increases by 18.37%, 11.42%, 11.62%, and 9.82%, while energy efficiency improves by 15.01%, 15.05%, 14.24%, and 13.86%, respectively. Full article

The paper presents the results of investigations into the relationship between selected water quality parameters and hydrological streamflow drought in a small river situated in the Mazovian Lowlands in Poland. As hydrological streamflow drought periods become more frequent in Poland, investigations about the relationship between flow and water quality parameters can be an essential contribution to a better understanding of the impact of low flow on the status of water rivers. Data from a three-year study of a small lowland river along with significant agricultural land management was used to analyze the connection between low flows and specific water quality indicators. The separation of low-flow data from water discharge records was achieved using two criteria: Q90% (the discharge value from a flow duration curve) and a minimum low-flow duration of 10 days. During these periods, the concentration of water quality indicators was determined based on collected water samples. In total, 30 samples were gathered and examined for pH, suspended sediments, dissolved substances, hardness, ammonium, nitrates, nitrites, phosphates, total phosphorus, chloride, sulfate, calcium, magnesium, and water temperature during sampling. The study’s main aim was to describe the relation between hydrological streamflow droughts and chosen water quality parameters. The analysis results demonstrate an inverse statistically significant relationship between concentration and low-flow values for total hardness and sulfate. In contrast, there was a direct relationship between nutrient indicators, suspended sediment concentration, and river hydrological streamflow drought. Statistical tests were applied to compare the datasets between years, revealing statistical differences only for nutrient indicators. Full article

Research has widely validated three-band spectral index as a simple, valid, and highly accurate method of estimating the copper content of soil. However, selecting the best band combination from hundreds of thousands, even millions of candidate combinations in hyperspectral data, is a very complicated problem. To address this issue, this study collected a total of 170 soil samples from the Aktas copper-gold mining area in Fuyun County, Xinjiang, China. Then, two algorithms including Competitive Weighted Resampling (CARS) and Stepwise Regression Analysis (STE) were applied to pick the bands from the original and first-order derivative spectra, respectively. A three-band index model was developed using the selected feature bands to estimate soil copper content. Results showed the first-order derivative spectrum transforms the spectral curve into a sharper one, with more peaks and valleys, which is beneficial for increasing the correlation between bands and copper content compared with the original spectrum. Moreover, integrating first-order derivative spectroscopy with CARS makes it possible to precisely identify key spectral bands and outperforms the dimensionality-reduction capabilities compared with the integration of STE. This strategy drastically reduces the time spent screening and is proven to have similar model accuracy, as compared to the individual group lifting method. Specifically, it reduces the duration of an 8 h task down to a mere 2 s. An intelligent screening of three-band indices is proposed in this study as a method of rapidly estimating copper content in soil. Full article