Search Results (180)

This study aims to develop an integrated wireless monitoring system named MANTiS-32, which leverages an open-source platform to enable autonomous modular operation, high-speed large-volume data transmission via Wi-Fi, and the integration of multiple complex sensors. The MANTiS-32 system is composed of ESP32-based MANTiS-32 hubs connected to eight MPU-6050 sensors each via RS485. Four MANTiS-32 hubs transmit data to a main PC through an access point (AP), making the system suitable for real-time monitoring of modal information necessary for structural performance evaluation. The fundamental performance of the developed MANTiS-32 system was validated to demonstrate its effectiveness. The evaluation included assessments of acceleration and frequency response measurement performance, wireless communication capabilities, and real-time data acquisition between the MANTiS-32 hub and the eight connected MPU-6050 sensors. To assess the feasibility of using MANTiS-32 for performance monitoring, a flexible model cable-stayed bridge, representing a mid- to long-span bridge, was designed. The system’s ability to perform real-time monitoring of the dynamic characteristics of the bridge model was confirmed. A total of 26 MPU-6050 sensors were distributed across four MANTiS-32 hubs, and real-time data acquisition was successfully achieved through an AP (ipTIME A3004T) without any bottleneck or synchronization issues between the hubs. Vibration data collected from the model bridge were analyzed in real time to extract dynamic characteristics, such as natural frequencies, mode shapes, and damping ratios. The extracted dynamic characteristics showed a measurement error of less than approximately 1.6%, validating the high-precision performance of the MANTiS-32 wireless monitoring system for real-time structural performance evaluation. Full article

Objective: This study aimed to compare the clinical and radiological outcomes of dynamic rod stabilization with and without transforaminal lumbar interbody fusion (TLIF) in patients undergoing surgery for degenerative lumbar instability. Specifically, we evaluated the prognostic value of hybrid systems in reducing adjacent segment disease (ASD), enhancing fusion rates, and improving functional outcomes. Methods: A retrospective analysis was conducted on 62 patients treated between 2019 and 2022. Group 1 (n = 34) underwent dynamic rod stabilization alone, while Group 2 (n = 28) received dynamic stabilization combined with TLIF. Radiological assessments included disk height index (DHI) and fusion rates. Clinical outcomes were measured using the Visual Analog Scale (VAS) for back and leg pain at baseline, 12, and 24 months. Statistical analysis was performed using Jamovi^® software (version 2.4.1). Results: The hybrid group (dynamic + TLIF) demonstrated significantly higher anterior fusion rates (p < 0.001) and greater improvement in VAS scores for back (p = 0.005) and leg pain (p < 0.001) at 12 months. Although operative time was longer (p = 0.002), there was no significant difference in hospital stay (p = 0.635). No significant differences were observed in ASD development (p = 0.11) or pseudoarthrosis (p = 0.396). The hybrid group maintained better lumbar lordosis and higher adjacent segment DHI. Conclusions: Hybrid dynamic stabilization combined with TLIF provides superior clinical outcomes and fusion rates compared to dynamic stabilization alone, without significantly increasing the risk of ASD. These findings support the use of hybrid constructs as a balanced strategy for treating degenerative lumbar instability. Full article

Background/Objectives: Irritable bowel syndrome (IBS) is a common disorder of brain–gut interaction characterized by abdominal pain and altered bowel habits. While stress and anxiety are known to exacerbate IBS symptoms, less is understood about how these factors interact on a daily timescale. This study aimed to clarify the relationship between daily stress and abdominal pain in IBS and to examine whether trait anxiety moderates this association. Methods: Forty-nine IBS patients completed daily assessments of stress and abdominal pain over a 14-day period. Participants rated abdominal pain three times daily and reported daily stress levels across seven life domains each evening. Trait anxiety was assessed at baseline using the STAI-T. Results: Hierarchical linear modeling was used to analyze within-person and between-person effects. An increase in between-person stress was associated with increased probability of abdominal pain among individuals with low-to-moderate trait anxiety, while this was not observed in patients with high trait anxiety. Even though within-person (day-to-day) stress variations had an impact on pain probability, the effects of between-person variations were multiple times greater. Conclusions: These findings suggest that the interplay between stress and anxiety in IBS might not be uniform. High trait anxiety may, under certain conditions, attenuate rather than amplify the link between stress and pain, possibly pointing to a more dynamic relationship. Full article

Power hardware-in-the-loop (PHIL) creates a safe test environment to connect simulations with real hardware under test (HuT). Therefore, an interface algorithm (IA) must be chosen. The ideal transformer method (ITM) and the partial circuit duplication (PCD) are popular IAs, where a distinction is made between voltage- (V-) and current-type (C-) IAs. Depending on the sample time of the simulator and further delays, simulation accuracy is reduced and instability can occur due to negative feedback in the V-ITM and C-ITM control loops, which makes PHIL operation impossible. In the case of positive feedback, such as with the V-PCD and C-PCD, the delay causes destructive interference, which results in a phase shift and attenuation of the output signal. In this article, a novel damped Smith predictor (SP) for positive feedback PHIL IAs is presented, which significantly reduces destructive interference while allowing stable operation at low linking impedances at V-PCD and high linking impedances at C-PCD, thus reducing losses in the system. Experimental results show a reduction in phase shift by 21.17° and attenuation improvement of 24.3% for V-PCD at a sample time of 100 µs. The SP transfer functions are also derived and integrated into the listed negative feedback IAs, resulting in an increase in the gain margin (GM) from approximately one to three, which significantly enhances system stability. The proposed methods can improve stability and accuracy, which can be further improved by calculating the HuT impedance in real-time and dynamically adapting the SP model. Stable PHIL operation with SP is also possible with SP model errors or sudden HuT impedance changes, as long as deviations stay within the presented limits. Full article

Understanding how hospital length of stay (LoS) evolves with successive SARS-CoV-2 variants is central to the multiscale modeling and forecasting of COVID-19 and other respiratory virus dynamics. Using records from 1249 COVID-19 patients admitted to Chungbuk National University Hospital (2021–2023), we quantified LoS across three distinct variant phases (Pre-Delta, Delta, and Omicron) and three age groups (0–39, 40–64, and 65+ years). A gamma-distributed multi-state model—capturing transitions between semi-critical and critical wards—incorporated variant phase and age as log-linear covariates. Parameters were estimated via maximum likelihood with 95% confidence intervals derived from bootstrap resampling, and Monte Carlo iterations yielded detailed LoS distributions. Omicron-phase stays were 5–8 days, shorter than the 10–14 days observed in earlier phases, reflecting improved treatment protocols and reduced virulence. Younger adults typically stayed 3–5 days, whereas older cohorts required 8–12 days, with prolonged admissions (over 30 days) clustering in the oldest group. These time-dependent transition probabilities can be integrated with real-time bed-availability alert systems, highlighting the need for variant-specific ward/ICU resource planning and underscoring the importance of targeted management for elderly patients during current and future pandemics. Full article

Cable-stayed bridge cables experience significant tension over time, making the bridge cables prone to corrosion and fatigue. The direct measurement of cable length is not a standard capability in most current structural health monitoring systems, nor is long-term monitoring of cable changes. Bridge displacements are caused by both dynamic loads (wind and traffic) and quasi-static factors, primarily temperature. This study filtered out dynamic responses by the three-sigma rule, multiple linear regression, interpolation method, and not-a-number calibration. Monitoring data were used to analyze the bridge’s thermal field distribution and the time-dependent variation of tower displacements. Correlation analysis revealed a strong linear correlation between air temperature and quasi-static tower-girder displacements. This research proposes to use the tower-girder distance (effective cable length) to represent the length of the cable, take the thermal expansion coefficient of the effective length of the cable as the quantitative index for long-term monitoring, and take its error as the performance early warning indicator. This method effectively monitors cable health and provides damage warnings. Full article

Managers often need to stay motivated and effectively motivate others. Therefore, they should rely on evidence-based interventions to effectively motivate and self-motivate. This research investigated how self-determination theory-based interventions affect employees’ motivation dynamics and motivational consequences within short time frames (i.e., within an hour, within a few weeks or months) in two empirical studies. Study one focused on assessing the effectiveness of a one-day training workshop in helping to improve managers’ work motivation, basic psychological needs satisfaction/frustration, subordinates’ motivation, and perceptions of managers’ needs-supportive/thwarting behaviors within a few weeks. Results support the effectiveness of the training, as managers were rated by their direct subordinates as having fewer needs-thwarting behaviors and reported self-improvement in needs satisfaction and frustration six weeks after completing the training program. Study two used the mean and covariance structure analysis and tested the impact of three types of basic psychological needs-supportive/thwarting and control conditions (3 × 2 × 1 factorial design) on participants’ situational motivation, vitality, and general self-efficacy for playing online word games within 30 min. Multi-group confirmatory factor analysis (CFA) confirmed the scalar measurement invariance, then latent group mean comparison results show consistently lower controlled motivation across the experimental conditions. During a quick online working scenario, the theory-based momentary intervention effectively changed situational extrinsic self-regulation in participants. Supplementary structural equation modeling (SEM; cross-sectional) analyses using experience samples supported the indirect dual-path model from basic needs satisfaction to vitality and general efficacy via situational motivation. We discussed the theoretical implications of the temporal properties of work motivation, the practical implications for employee training, and the limitations. Full article

Objectives: Pott’s puffy tumor (PPT) is a rare and life-threatening infection of the frontal sinuses, predominantly affecting children but with less frequent reports in adults. Therefore, we present an analysis of one hundred and eighty-one cases of adult patients diagnosed with PPT, along with a description of one of our cases. The purpose of this research is to identify the most common symptoms, predisposing medical history, predominant microorganisms, commonly used antibiotics, treatment options, long-term outcomes, and possible complications in adults. Despite its rarity, PPT has a dynamic course, necessitating familiarization with appropriate treatment methods to improve patient well-being. Methods: Methods involved a systematic search of PubMed, Medline, Google Scholar, Web of Science, EBSCO, and Scopus, following PRISMA guidelines. A total of 122 articles were screened, providing 180 adult patients aged 18 to 86, alongside 1 additional patient treated at our institution, bringing the total to 181 patients. Results: The results showed that the patients ranged from 18 to 86 years of age (mean age of 47 years), with 72.2% being males. The most common symptoms were forehead swelling (74.7%), frontal headache (67%), fever (59.3%), and acute/chronic rhinosinusitis (39.6%). The risk factors associated with its development include sinusitis (49.5%) and previous head trauma (12.6%). Intracranial involvement was found in 38.1% of patients. Streptococcus spp. (19.3%) and Staphylococcus spp. (16.6%) were the most commonly identified pathogens. Surgical intervention was employed in 87.3% of cases, with a mean hospital stay of 23 days. There was no significant difference in hospital stay or rehospitalization rates between those with and without intracranial involvement. Antibiotic therapy was used in 87.3% of cases, with a mean duration of 61 days. A combination of Cephalosporin, Metronidazole, and Nafcillin was the most common empirical antibiotic therapy. The mean follow-up period was 14 months, with a mortality rate of 1.6%. Conclusions: The conclusion highlights the importance of the prompt initiation of empirical antibiotic therapy, followed by targeted treatment based on microbiological cultures. Recognizing that PPT symptoms are not exclusive to pediatric patients but can also affect adults is crucial. PPT warrants further research to optimize its management and outcomes. It is believed that PPT may be more treatable in adults when identified early, which emphasizes the need for PPT recognition among adults. Timely empirical antibiotics based on microbiological results, along with appropriate surgical intervention, are critical for improving outcomes. Multidisciplinary care involving otolaryngologists, neurologists, and infectious disease specialists is essential. Further studies should be developed for the evaluation of diagnostic protocols and long-term management strategies. Full article

Pre-trip anxiety is a critical yet understudied factor influencing participation and engagement in Outdoor Experiential Education (OEE) programs. Anxiety can serve as both a motivator and a barrier, shaping participants’ willingness to engage in challenging activities. This study examines the sources, predictors, and temporal progression of pre-trip anxiety among OEE participants, with a focus on experience level, gender differences, and activity type. Using a cross-sectional design, data were collected from students and staff at two Midwestern universities across three time points leading to an OEE program. Measures included the State–Trait Anxiety Inventory (STAI) and a course-specific worry scale assessing concerns such as physical ability, social dynamics, and environmental risks. Results indicate that experience level can predict anxiety, with less experienced participants reporting higher levels of concern. Gender differences were also observed, with female participants exhibiting greater pre-trip anxiety, particularly in water-based activities. However, anxiety remained relatively stable across time intervals, suggesting that interventions may be effective at multiple stages before a program begins. These findings have practical implications for OEE design, including targeted pre-trip interventions, adjusted program marketing, and tailored support strategies to reduce barriers to participation and enhance student preparedness. Full article

Background/Objectives: Boarding refers to the period when patients deemed stable in the emergency department (ED) are temporarily monitored, wait to be admitted, and receive appropriate care. As life expectancy increases, so does the importance of understanding the dynamics and experiences of older adults with frailty in emergency settings. The absence of a care environment tailored to specific needs could diminish the overall quality of care provided, threatening the health and well-being of this population. To our knowledge, how frail older adults experience this has not yet been synthesized in a qualitative systematic review. The aim of this study was to explore the lived experiences of frail older adults during the emergency department (ED) boarding phase Methods: This systematic review was conducted using PubMed, OVID, and Scopus in October 2024. No time restrictions were settled and only articles published in English were included. Following the predefined inclusion criteria, two researchers independently extracted and synthesized the data using the Joanna Briggs Institute (JBI) meta-aggregation methodology and instruments. Results: Seven studies were included. Thirty-one findings were identified and grouped into seven categories and three themes regarding the lived experiences of frail people in ED boarding areas. The themes we identified were discomfort, distress, frustration, the experience of positive/negative attitudes of healthcare providers, and the supportive role of family members during ED LOS (length of stay). Conclusions: Older frail adults experience significant physical and psychological distress during ED boarding. It is necessary to manage their specific needs through targeted actions aimed at improving their overall experience and quality of care in emergency settings. Full article

This study explores how rural tourism destinations in the Eastern Carpathians of Romania have recovered in the aftermath of the COVID-19 pandemic. Using data from 2016–2019 and 2021–2023, five core indicators—tourist arrivals, overnight stays, accommodation capacity, occupancy rates, and active units—were analyzed at the local level. Based on these indicators, a cluster analysis was conducted for us to identify groups of communes with similar tourism performance profiles. After clustering, composite indicators were calculated to track how each group evolved over time. The findings show that recovery has not been uniform: while some destinations bounced back or even improved, others continue to face structural challenges. These results suggest that local infrastructure, destination type, and governance capacity all play a role in shaping recovery paths. The paper offers a spatial overview of rural tourism dynamics and highlights the value of using data-driven tools for understanding uneven development in post-crisis contexts. Full article

Background/Objective: Cardiomyopathy is a key cause of cardiovascular mortality in critically ill patients. Although red blood cell distribution width (RDW) is recognized as a potential prognostic biomarker, its variations during ICU admission and its interaction with treatments such as β-blockers are not well understood across different cardiomyopathy subtypes. To assess the prognostic significance of RDW dynamics and their interaction with β-blocker therapy in predicting 365-day mortality among ICU patients with dilated, hypertrophic, and restrictive cardiomyopathy, utilizing longitudinal data and advanced modeling techniques. Methods: A retrospective analysis was conducted on 317 cardiomyopathy patients from the MIMIC-IV database. Their RDW dynamics were assessed over their ICU stay. Cox regression (including time-dependent Cox models) and logistic regression identified independent mortality risk factors. Key predictors were identified using Least absolute shrinkage and selection operator (LASSO) regression and the Boruta algorithm. Restricted cubic splines (RCSs) were used to examine nonlinear relationships. Machine learning models were used to evaluate predictive performance, with SHapley Additive Explanations (SHAP) and tree-based feature selection identifying influential variables. Repeated-measures ANOVA was used to analyze RDW trends and β-blocker associations. A Bayesian multivariate joint model (BMJM) integrated RDW dynamics and β-blocker therapy, incorporating repeated measures and survival outcomes. Results: RDW was an independent predictor of 365-day mortality (HR = 1.14, 95% CI: 1.01–1.29, p = 0.03), alongside the systemic immune-inflammation index (SII) (HR = 1.01, 95% CI: 1.00–1.01, p = 0.03), whereas β-blockers significantly reduced mortality risk (HR = 0.2, 95% CI: 0.1–0.39, p < 0.001). Comparative analysis demonstrated that RDW exhibited greater predictive value over the aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), and SII. Machine learning identified logistic classification as the best predictive model (AUC = 0.811), with SHAP and tree-based selection confirming RDW and β-blockers as key predictors. A repeated-measures ANOVA revealed a significant interaction between RDW and β-blocker use (F = 6.65, p < 0.0001), with β-blockers lowering RDW levels. The BMJM demonstrated strong predictive performance (AUC = 0.80). The patient-specific BMJM indicated that discontinuing β-blockers increased the risk of mortality, while initiating β-blockers reduced it. Conclusions: This study highlights dynamic RDW monitoring and β-blocker therapy as strong predictors of 365-day mortality in ICU-admitted cardiomyopathy patients. The BMJM enables personalized risk assessment by integrating longitudinal biomarker data. These findings support RDW as a dynamic biomarker and advocate for its integration into personalized treatment strategies. Full article

As the span of cable-stayed bridges continues to increase, traditional steel cables face challenges such as excessive self-weight, significant sag effects, and sensitivity to wind-induced vibrations. This study proposes two super-long-span cable-stayed bridge schemes with a main span length of 1500 m and identical girder cross-sections, employing steel cables and CFRP cables, respectively. Based on a discretized finite element model of stay cables, the global dynamic responses, cable vibration characteristics, and fatigue performance of both schemes were systematically evaluated using time-domain buffeting analysis and Miner’s linear fatigue damage accumulation theory. The results demonstrate that CFRP cables, benefiting from their lightweight and high-strength properties, significantly reduce the vertical, lateral, and torsional RMS responses of the main girder under the critical 3° angle of attack, achieving reductions of 31.6%, 28.5%, and 20.6% at mid-span, respectively. Additionally, CFRP cables suppress cable–girder internal resonance through frequency decoupling. Fatigue analysis reveals that the annual fatigue damage of CFRP cables under the design wind speed is far lower than that of steel cables and remains well below the critical threshold, highlighting their superior fatigue resistance. This research confirms that CFRP cables can effectively enhance the aerodynamic stability and long-term durability of super-long-span cable-stayed bridges, providing theoretical support for span breakthroughs. To further ensure long-term service safety, this study recommends implementing damping measures at critical cable locations. Full article

Purpose: To assess the impact of beta-lactam therapeutic drug monitoring (TDM) timing and therapy adjustment on clinical cure and 30-day mortality. Methods: This was a prospective study of critically ill patients admitted to the University of Florida Health Shands Hospital intensive care unit (ICU) between 2021 and 2022, ≥18 years old, and requiring beta-lactam therapy for a suspected or confirmed infection. Beta-lactam concentrations were measured per standard of care, pharmacokinetic/dynamic (PK/PD) target attainment was calculated, and therapy was adjusted if needed. Multiple regression and time-to-event (TTE) analyses were performed. Results: A total of 297 infection episodes from 268 patients were included. The mean (SD) age was 56 years (17), weight was 82 kg (32), and 14% received renal replacement therapy. The most common infection source was the lung, and the most common beta-lactam was cefepime. The most common infusion duration was 30 min. The median (IQR) time to first TDM was 2.7 days (1.7–4.7). Fifty-seven percent of patients required therapy adjustment. Increases in beta-lactam dose, frequency, or infusion duration were associated with lower 30-day mortality compared to continuing the same regimen (aOR 0.30, p = 0.015). Delay in performing TDM was associated with lower probability of clinical cure (aOR 0.92, p = 0.0023). Patients who had the regimen increased had shorter hospital stay compared to those who had it decreased. Timing of beta-lactam TDM in ICU patients was a significant predictor of clinical cure, while adjusting beta-lactam therapy to achieve higher exposure was a significant predictor of 30-day mortality. Full article

Social media (SM) platforms allow users to communicate rapidly, exchange information, and create and share real-time content. Currently, 4.5 billion people use social media worldwide, making it an influential part of daily life. Beyond information sharing, social media facilitates communication, transfers information, and serves as a platform for advertising and shaping public opinion. Researchers analyse these aspects to understand and describe societal realities. The primary purpose of this paper is to analyse social media’s impact on global research. The research included an analysis of the most popular social platforms, considering the number of Web of Science (WoS) articles relating to them and the year in which the platform was established or the Monthly Active Users (MAU) factor. Data were collected based on the WoS database in the topic (which contains texts of title, abstract, author keywords, and Keywords Plus) of the articles, where phrases containing names of SM platforms were used. Quantitative research is a type of research that analyses data numerically to find relationships and statistical regularities of searched phrases. The impact of social media on the dissemination of research and findings was analysed based on the results of the study and also on the literature data. This research reveals a lack of correlation between the number of articles indexed in the WoS and the MAU of individual social media platforms. This observation raises an important question: do social media researchers focus on studying the platforms used by the majority, thereby providing a more accurate representation of current social dynamics? This article is helpful for researchers, policymakers, and social media platform developers seeking to understand the role of social media in shaping modern communication and public discourse. The most important finding of the paper is the low correlation between the number of SM users and the impact of social media platforms on learning, as exemplified by the Twitter (Note: Twitter was an American social networking service rebranded as X in 2023. As the period of data analysed in this paper covered the years up to 2022, the authors decided to stay with the name Twitter) platform, which is the 17th largest SM platform but is the 2nd (after Facebook) in implications for science. Full article