Search Results (3,429)

Automatic sleep staging technology based on wearable photoplethysmography can provide a non-invasive and continuous solution for large-scale sleep health monitoring. This study accordingly developed a novel cross-scale dynamically coupled extended long short-term memory network (SleepXLSTM) to realize automatic sleep staging based on heart rate signals collected by wearable devices. SleepXLSTM models the relationship between heart rate fluctuations and sleep stage labels by correlating physiological features with clinical semantics using a knowledge graph neural network. Furthermore, an excitation–inhibition dual-effect regulator is applied in an improved multiplicative long short-term memory network along with memory mixing in a scalar long short-term memory network to extract and strengthen the key heart rate timing features while filtering out noise produced by motion artifacts, thereby facilitating subsequent high-precision sleep staging. The benefits and functions of this comprehensive heart rate feature extraction were demonstrated using sleep staging prediction and ablation experiments. The proposed model exhibited a superior accuracy of 91.25% and Cohen’s kappa coefficient of 0.876 compared to an extant state-of-the-art neural network sleep staging model with an accuracy of 69.80% and kappa coefficient of 0.040. On the ISRUC-Sleep dataset, the model achieved an accuracy of 87.51% and F1 score of 0.8760. The dynamic coupling strategy employed by SleepXLSTM for automatic sleep staging using the heterogeneous temporal representation of heart rate data can promote the development of smart wearable devices to provide early warning of sleep disorders and realize cost-effective technical support for sleep health management. Full article

Climate variability necessitates the optimization of sowing dates for vegetable crops to stabilize yields and mitigate abiotic stress risks. This study aimed to evaluate the effect of sowing dates on the productivity of daikon radish (Raphanus sativus L. convar. acanthiformis Sazon.) cultivars Gulliver and Minowase under medium-podzolic, light loamy soil conditions with a pH (pHKCl) of 6.74 during the period 2022–2024. Field experiments were conducted across four sowing dates (ranging from July to early August), accounting for the hydrothermal conditions of the growing season. Effective air temperatures ranged from 428 to 950 °C, with precipitation levels between 36.9 and 252.3 mm. It was established that the sowing date significantly influenced daikon yield (p < 0.001). A significant positive correlation was identified between yield and precipitation (r = 0.76–0.84; p < 0.05), whereas the correlation between yield and the sum of effective temperatures was weak to moderate and predominantly negative (r = −0.62 to −0.10). The highest yields were achieved with sowing in the third ten-day period of July: 54.6 t ha⁻¹ for the Gulliver cultivar and 58.9 t ha⁻¹ for the Minowase cultivar. The Minowase cultivar consistently outperformed Gulliver in terms of yield and exhibited higher ecological plasticity under fluctuating hydrothermal conditions. These findings confirm the feasibility of optimizing sowing dates as an effective adaptive tool for enhancing the stability of daikon production amidst climate change. Full article

The disposal of phosphogypsum has emerged as a significant challenge for the phosphorus chemical industry in China in recent years. Utilizing phosphogypsum in alkali-activated materials represents an effective approach to valorize this byproduct. The alkali modulus is a critical parameter affecting the performance characteristics of phosphogypsum-based alkali-activated materials. This study aims to investigate the effects of the alkali modulus on the early-age properties (setting time, fluidity, flexural strength, and compressive strength) and hydration mechanisms of slag–phosphogypsum composite alkali-activated materials (HSFP) across various slag–phosphogypsum–fly ash systems, thereby identifying the optimal alkali modulus. The findings demonstrate that an alkali modulus of 1.35 optimally enhances the mechanical performance of HSFP. At this specific modulus, the equilibrium between alkalinity and soluble silica availability facilitates complete hydration, resulting in a dense gel-crystal microstructure characterized by the highest C-(A)-S-H gel content (58.2%) after 28 days. The effect of the alkali modulus on mechanical properties is contingent upon the fly ash-to-phosphogypsum (FA:PG) ratio, whereas its effect on fluidity and setting time is negligible. The effect of alkali modulus on the strength of HSFP is significantly affected by the fly ash-to-phosphogypsum (FA:PG) ratio. At an FA:PG ratio of 4:6, the flexural strength initially decreases and then increases as the alkali modulus values increase, while the compressive strength shows a consistent upward trend. At FA:PG ratios of 1:5 and 1:9, the flexural strength increases linearly with the alkali modulus, whereas the compressive strength first rises and then experiences a slight decline. These results offer both theoretical insights and practical guidance for the optimization of phosphogypsum-based cementitious material formulations, thereby supporting their potential for large-scale application. Full article

Belatacept, a selective costimulation blocker targeting the CD28–CD80/86 pathway, represents a major innovation in solid organ transplantation immunosuppression. By providing upstream inhibition of T-cell activation without calcineurin inhibition, belatacept offers the potential for improved long-term graft and patient outcomes with reduced nephrotoxicity and metabolic adverse effects. This review summarizes the mechanistic rationale, pivotal evidence, and clinical experience supporting the use of belatacept as first-line or conversion therapy in solid organ transplantation, while addressing safety, pharmacoeconomic impact, and future research directions. A comprehensive analysis of pivotal phase II–III trials (BENEFIT, BENEFIT-EXT), recent prospective conversion studies, and ongoing trials in liver, heart, and lung transplantation was performed. Safety data and health–economic evaluations were critically appraised. In kidney transplantation, belatacept-based immunosuppression provides superior renal function and improved metabolic profiles compared with calcineurin inhibitors (CNIs), though with higher early acute rejection rates. In liver, heart, and lung transplantation, evidence remains limited, with de novo use contraindicated in liver grafts due to excess mortality and rejection. Conversion from CNI to belatacept in selected patients improves renal outcomes without compromising graft survival. Safety considerations include a higher risk of post-transplant lymphoproliferative disorder (PTLD) in Epstein–Barr virus-negative recipients. Belatacept represents a paradigm shift in transplant immunology by targeting upstream T-cell activation. While currently approved only for kidney transplantation, ongoing studies in thoracic and hepatic grafts may expand its therapeutic role. Personalized patient selection, combination regimens mitigating rejection risk, and real-world cost-effectiveness analyses will define its place in future precision immunosuppression strategies. Full article

Background: Catheter ablation is a validated treatment for ventricular arrhythmias (VA), but conventional radiofrequency (RF) energy may cause collateral injury due to non-selective thermal damage. Pulsed Field Ablation (PFA), a non-thermal modality based on irreversible electroporation, offers myocardial tissue selectivity and enhanced safety. While PFA is widely adopted for atrial arrhythmias’ ablation, its application in the ventricles remains an evolving frontier. Methods: We report a single-center experience using the Centauri PFA system integrated with a focal, contact-force sensing irrigated catheter (Tacticath™ SE, Abbott Laboratories, St. Paul, MN, USA) in four consecutive patients with drug-refractory VA. Two patients presented with frequent premature ventricular complexes (PVC) arising from the right and left ventricular outflow tract, respectively, while two had ischemic cardiomyopathy with recurrent scar-related ventricular tachycardia (VT). All procedures were guided by high-density mapping using the EnSite X system (Abbott Laboratories, St. Paul, MN, USA). Procedural safety, acute efficacy, and early follow-up outcomes were assessed. Results: All ablations achieved acute procedural success without complications. In both PVC cases, PFA led to immediate and complete suppression of ectopy, with a ≥95% reduction in arrhythmic burden at 12- and 9-months follow-up, respectively. In the VT cases, the arrhythmogenic substrate was effectively modified, rendering the clinical VT non-inducible. ICD interrogation during a 9-month follow-up showed complete absence of recurrent sustained VT. No coronary spasm, atrioventricular block, pericardial effusion, or other adverse events occurred. Conclusions: In this initial experience, focal PFA using a contact-force sensing catheter appeared feasible and effective for both focal and scar-related VA. This system provides an intuitive workflow similar to RF ablation. While our data suggest a favourable safety profile, larger studies are required to definitively confirm safety margins near critical structures. Full article

The temperature at the base of the ear is highly correlated with the core body temperature of sheep and responds sensitively to febrile conditions, making it a valuable indicator of sheep health. In northern China, the closed housing environment during winter increases the incidence of seasonal diseases such as upper respiratory infections and pneumonia, which severely affect the economic efficiency of sheep farming. To address this issue, this study proposes an early-warning method for winter diseases in sheep based on ear-base temperature. Ear temperature, body weight, and environmental data were collected, and Random Forest was employed for feature selection. Bayesian optimization was used to fine-tune the hyperparameters of a one-dimensional convolutional neural network to construct a predictive model of ear-base temperature using data from healthy sheep. Based on the predicted normal range, an early-warning strategy was established to detect abnormal temperature patterns associated with disease onset. Experimental results demonstrated that the proposed method achieved a high detection rate for common winter diseases while maintaining a low false positive rate, and validation experiments confirmed its effectiveness under practical farming conditions. Combined with low-cost temperature-sensing ear tags, the proposed approach enables real-time health monitoring and provides timely early warnings for winter diseases in large-scale sheep farming, thereby improving management efficiency and economic performance. Full article

Background/Objectives: The hepcidin–ferroportin (Fpn1) axis is central to intestinal iron absorption, and dysregulation of this axis underlies all known forms of iron disorders. Hemochromatosis, the most common iron overload disorder in humans, results from systemic iron accumulation due to decades of uncontrolled intestinal absorption. Despite major advances in medicine in recent years, strategies for iron overload management are still lagging as they primarily rely on iron chelation and repeated phlebotomies. Fpn1, the cellular iron exporter, is ubiquitously expressed and plays a critical role in maintaining systemic iron homeostasis. Methods: To investigate the specific contribution of intestinal Fpn1 to systemic iron overload, we employed a CRISPR-based adenoviral hepcidin knockout mediated mouse iron overload model, combined with intestine-specific deletion of Fpn1. Results: An initial time-dependent experiment establishes the efficiency of hepcidin knockout (KO) by as early as 1 week of adenovirus injection. At 2 weeks of injection, a perfect reciprocal relationship between hepcidin gene suppression and liver iron levels (5–7-fold induction from the baseline) was established. Finally, intestine-specific Fpn1 deletion effectively prevented iron accumulation in hepcidin KO mice, as evidenced by nearly 4-fold lower liver iron levels compared to hepcidin KO animals with intact intestinal Fpn1. Conclusions: In summary, our results demonstrate that ablation of intestinal Fpn1 is sufficient to attenuate systemic iron accumulation in this mouse model of hemochromatosis. These findings suggest that selective targeting of intestinal Fpn1 may represent a promising strategy for the management of iron overload. Full article

Zinc-based alloys are promising candidates for biodegradable implant applications; however, their rapid initial corrosion and limited cytocompatibility remain major challenges. In this study, a Zn-Ca-P layer in a form of parascholzite (CaZn₂(PO₄)₂·2H₂O) was prepared on a Zn-0.8Mg-0.2Sr alloy via anodic oxidation followed by short-time biomimetic calcium–phosphate deposition. The formation mechanism, corrosion behaviour, and preliminary biological response of the modified surface were systematically investigated. The Zn-Ca-P layer formed a compact and crystalline phosphate layer that significantly altered the corrosion response of the zinc substrate in Leibovitz L-15 medium containing foetal bovine serum. Electrochemical measurements revealed a pronounced improvement in corrosion resistance and a transition from rapid active dissolution to a controlled, ion-exchange-driven degradation mechanism. The moderate solubility of parascholzite enabled the gradual release of Zn²⁺ and Ca²⁺ ions while maintaining surface stability during immersion. Preliminary cell adhesion experiments demonstrated a clear enhancement of cytocompatibility for the Zn-Ca-P-layer-coated samples, where cells readily adhered and spread, in contrast to the bare alloy surface, which showed lower cell attachment. The improved biological response is attributed to the phosphate-rich surface chemistry, favourable surface morphology, and moderated corrosion behaviour. Overall, the parascholzite-like layer provides an effective strategy with which to regulate both corrosion and early cell–material interactions of zinc-based biodegradable alloys, highlighting its potential for temporary biomedical implant applications. Full article

This study examines outcomes associated with a short-term intensive pedagogical experience aimed at developing social entrepreneurship competencies among university students at an Ashoka U–affiliated institution in Mexico. The program, Semana Tec de Agencia de Cambio, is a five-day experiential learning experience grounded in the SEL4C (Social Entrepreneurship Learning for Complexity) framework and designed to promote changemaking through interdisciplinary collaboration, reflection, and action. Using a quantitative quasi-experimental pre–post design (n = 210), data were collected through the validated Social Entrepreneur Profile (SEP), which assesses four dimensions: self-control, leadership, social awareness and social value, and social innovation and financial sustainability. Paired-samples t-tests indicated statistically significant increases (p < 0.001) across all dimensions, with small to medium effect sizes (Cohen’s d = 0.40–0.63). Multiple regression analysis showed that changes in social awareness and social value (β = 0.33, p < 0.001), leadership (β = 0.27, p = 0.004), and innovation and sustainability (β = 0.24, p = 0.006) were most strongly associated with overall changes in self-perceived competencies, explaining 58% of the variance (R² = 0.58). Overall, the findings suggest that short-term intensive educational experiences grounded in active and interdisciplinary pedagogical approaches may contribute to measurable changes in students’ self-perceived social entrepreneurship competencies. Rather than evidencing consolidated transformation, the results are best interpreted as early indicators of competency activation within changemaker-oriented learning environments. The study contributes empirical insight into the use of intensive formats in social entrepreneurship education and situates the SEL4C framework as a coherent pedagogical reference within the Ashoka U context, without implying causal validation. Full article

Background: Parasitic skin-related conditions represent a frequent and evolving challenge in human dermatology, as they often mimic other dermatoses, and are increasingly complicated by therapeutic resistance. With this study, we aimed to provide a practical, clinician-oriented overview of our experience, contextualising it within the current literature. Materials and Methods: We conducted a retrospective, single-centre observational study, reporting a case series of 88 patients diagnosed with parasitic or arthropod-related skin infestations at the San Raffaele Hospital Dermatology Unit (Milan) between 2019 and 2024, and integrated a concise narrative review of contemporary evidence on diagnosis, non-invasive imaging and management. For each case, we documented clinical presentation, dermoscopic or reflectance confocal microscopy (RCM) findings, and treatment response. Non-invasive tools (dermoscopy, videodermoscopy, RCM) were used when appropriate. Results: The spectrum of conditions included flea bites, bed bug bites, cutaneous larva migrans, subcutaneous dirofilariasis, Dermanyssus gallinae dermatitis, pediculosis, tick bites (including Lyme disease), myiasis, scabies, and cutaneous leishmaniasis. One case of eosinophilic dermatosis of haematologic malignancy was also considered due to its possible association with arthropod bites. Non-invasive imaging was critical in confirming suspected infestations, particularly in ambiguous cases or when invasive testing was not feasible. Several cases highlighted suspected therapeutic resistance: a paediatric pediculosis and three adult scabies cases required systemic therapy after standard regimens failed, raising concerns over putative resistance to permethrin and pyrethroids. In dirofilariasis, the persistence of filarial elements visualised by RCM justified the extension of antiparasitic therapy despite prior surgical removal. Conclusions: Our findings underline that accurate diagnosis, early intervention, and tailored treatment remain essential for the effective management of cutaneous infestations. The observed vast spectrum of isolated parasites reflects broader health and ecological dynamics, including zoonotic transmission, international mobility, and changing environmental conditions. At the same time, diagnostic delays, inappropriate treatments, and neglected parasitic diseases continue to pose significant risks. To address these challenges, clinicians should remain alert to atypical presentations, and consider a multidisciplinary approach including the consultation with parasitologists and veterinarians, as well as the incorporation of high-resolution imaging and alternative therapeutic strategies into their routine practice. Full article

In this study, we created multifunctional bone tissue engineering scaffolds that combine prophylactic antifungal action with structural support. We produced PVA/CS/HA/BA nanofiber matrices via a specifically designed electrospinning technique to stop early cross-linking. Through SEM, our examination of fiber shape revealed diameters ranging from 178 ± 53 nm to 330 ± 69 nm. We discovered that this variation was closely correlated with the Boric Acid (BA) level. Our EDS and FTIR studies further showed that HA and BA were effectively mixed, with a specific focus on the production of borate-ester linkages inside the network. Mechanical examination revealed that 0.25 wt.% BA maximizes the tensile strength at 9.15 MPa, thereby closely matching HA-reinforced standards, while HA incorporation improved thermal stability. Moreover, in vitro hFOB experiments showed sustained cytocompatibility at 0.25 wt.% BA. While 0.5 wt.% BA showed strong antifungal action against Candida albicans, it sadly harmed cell viability. The 0.25 wt.% BA concentration ultimately offers a better balance between mechanical integrity and antibacterial action, therefore presenting a potential method for scaffold generation for bone regeneration in immunocompromised patients. Full article

Background and objectives: Suicide attempts and self-harm are critical issues in adolescence, often leading to serious and irreversible consequences. These behaviours frequently co-occur and share common biopsychosocial risk factors. Identifying these factors enables a more comprehensive assessment of suicide and self-harm risk, helping specialists recognize high-risk individuals and implement effective preventive measures. This study aimed to examine the association between suicide attempts, self-harm and psychosocial factors among hospitalized adolescents. Materials and methods: A retrospective data analysis was performed using the database of the University Department of Children and Adolescents of the Republican Vilnius Psychiatric Hospital. The study covered patients’ records from December 2022 to February 2025. Information on gender, age, suicide attempts, self-harm, adverse events (bullying, psychological abuse, physical violence within the family, and sexual abuse) and unhealthy habits (smoking, harmful alcohol consumption, and psychoactive substance use), was selected and analyzed in this study. A Chi-square test was used to assess the difference between groups. Results were considered statistically significant when p < 0.05. Results: The study included 599 hospitalized adolescents (26.9% boys; mean age 15.1 ± 1.4 years), of whom 70.8% reported at least one episode of self-harm and 37.8% at least one suicide attempt. Rates of self-harm and suicide attempts were significantly higher in girls than in boys (self-harm: 81.3% vs. 42.2%, $\varphi =0.381$, $p<0.001$; suicide attempts: 45.5% vs. 16.5%, $\varphi =0.304$, $p<0.001$), and adolescents with self-harm had a significantly higher prevalence of suicide attempts than those without self-harm (46.7% vs. 15.8%, $\varphi =0.308$, $p<0.001$). Adverse childhood experiences and unhealthy behaviours were significantly more frequent in adolescents with self-harm and suicide attempts, although effect sizes were small to moderate ($\varphi$ range 0.086–0.230, all $p<0.05$). In multivariable models, female gender ($\beta =0.355$, $p<0.001$) and smoking ($\beta =0.330$, $p<0.001$) were the strongest predictors of self-harm, whereas alcohol use ($\beta =0.337$, $p<0.001$) and self-harm ($\beta =0.232$, $p<0.001$). Conclusions: Exposure to adverse childhood experiences and engagement in unhealthy habits were associated with higher rates of both self-harm and suicide attempts. A comprehensive assessment and early detection of self-harm behaviours and adverse psychosocial circumstances are crucial elements of effective suicide prevention strategies and prompt intervention among high-risk adolescents. Full article

During the process of digital-system development from prototype to live implementation, differences in user interactions, perceived usability, and overall satisfaction can emerge. These differences often arise due to various factors, which may include the fidelity of the software prototype, the limitations of the prototyping tool, and the complexity of the live digital system. Recognizing these potential usability discrepancies between prototypes and live digital systems, assessment of how well user experience (UX) test approaches, such as usability testing and the System Usability Scale (SUS), reflect the UX in using the digital-system prototype and its counterpart deployed live system emerged as an important research gap. To address this gap, this study compares usability testing and SUS results among a Figma web prototype and its counterpart live web digital system, for the telecom service extension process as a representative digital-system case study. The research study involved a testing process with a total of 10 participants across the Figma prototype and live-web-system test environments, in which different sensing devices that included versatile types of mobile phones were utilized. The research study presents usability testing results related to the overlap in perceived usability issues for the same digital-product developments in both testing environments, which are experienced on different types of mobile sensing devices. The usability testing results are presented as reports on the frequency of occurrence of web system usability issues and corresponding severity levels. The obtained results demonstrated that prototype testing is highly effective for detecting a wide range of usability issues early in the digital-product development phase. The paper also evaluates the predictive capabilities of SUS assessment for the case of the Figma web prototype and its counterpart live web system in the phase of digital-product development. The results show that the SUS evaluation, when applied to digital-system prototype testing, can provide early in the development process a reliable indication of the perceived usability of its counterpart digital system, once it is developed and deployed. The findings presented in the paper offer valuable guidance for software designers and developers seeking to make prototypes and their counterpart real digital-product deployments with improved digital-product overall user experience. Full article

Drying shrinkage cracking of hydraulic cementitious materials, induced by moisture loss under varying environmental conditions, significantly compromises structural durability. The utilization of construction waste powder (CWP) in cement composites presents a sustainability opportunity, but its impact on shrinkage behavior remains poorly understood. This study aims to systematically investigate the drying shrinkage characteristics of cement-CWP composite mortar and to identify optimal mix proportions and curing conditions for shrinkage control. A series of experiments were conducted on mortar specimens with varying water-to-binder ratios (W/B = 0.45, 0.50, 0.55) and CWP incorporation rates (0, 5%, 10%, 20%). Three curing regimes were employed: outdoor curing, standard curing (20 °C, 95% RH), and outdoor film curing. Drying shrinkage was monitored over time. Key findings indicate that the optimal CWP content for shrinkage mitigation is 10%. Excessive CWP (>10%) induces a “weak bonding” effect, leading to an increase in shrinkage due to reduced cohesion. Increasing the W/B ratio to 0.55 effectively reduced shrinkage, with the minimum shrinkage value observed at this ratio. Among curing methods, outdoor film demonstrated superior performance in maintaining moisture and suppressing shrinkage. Predictive modeling revealed that the logarithmic model in accurately capturing the nonlinear evolution of shrinkage over time, effectively reflecting the influences of CWP content, W/B ratio, and curing condition. The drying shrinkage of cement-CWP composite mortar can be effectively optimized by incorporating 10% CWP, utilizing a W/B ratio of 0.55, and implementing outdoor film curing. This paper reveals, for the first time, the dual-mechanism regulation of early-age drying shrinkage behavior in cement-based materials by CWP as a supplementary cementitious material and establishes a shrinkage prediction model applicable to various mix proportions and curing conditions, offering practical strategies for enhancing the durability of sustainable construction materials utilizing construction waste powder. Full article

Glioblastoma (GB) is one of the most aggressive and invasive cancers. Current treatment protocols for GB include surgical resection, radiotherapy, and chemotherapy with temozolomide. However, despite these treatments, physicians still struggle to effectively image, diagnose, and treat GB. As such, patients frequently experience recurrence of GB, demanding innovative strategies for early detection and effective therapy. Bioconjugated quantum dots (QDs) have emerged as powerful nanoplatforms for precision imaging and targeted drug delivery due to their unique optical properties, tunable size, and surface versatility. Due to their extremely small size, QDs can cross the blood–brain barrier and be used for precision imaging of GB. This review explores the integration of QDs with click chemistry for robust bioconjugation, focusing on artificial intelligence (AI) to advance GB therapy, mechanistic insights into cellular uptake and signaling, and strategies for mitigating toxicity. Click chemistry enables site-specific and stable conjugation of targeting ligands, peptides, and therapeutic agents to QDs, enhancing selectivity and functionalization. Algorithms driven by AI may facilitate predictive modeling, image reconstruction, and personalized treatment planning, optimizing QD design and therapeutic outcomes. We discuss molecular mechanisms underlying interactions of QDs with GB, including receptor-mediated endocytosis and intracellular trafficking, which influence biodistribution and therapeutic efficacy. Use of QDs in photodynamic therapy, which uses reactive oxygen species to induce apoptotic cell death in GB cells, is an innovative therapy that is covered in this review. Finally, this review addresses concerns associated with the toxicity of metal-based QDs and highlights how QDs can be coupled with AI to develop new methods for precision imaging for detecting and treating GB for induction of apoptosis. By converging nanotechnology and computational intelligence, bioconjugated QDs represent a transformative platform for paving a safer path to smarter and more effective clinical interventions of GB. Full article