Search Results (25,237)

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition commonly assessed through clinical interviews, behavioral observation, and rating scales. Although electroencephalography (EEG) has emerged as a promising complementary tool for ADHD assessment, robust, subject-independent classification remains challenging due to inter-subject variability, limited datasets, and the need for interpretable computational models. This work introduces EEG-TACT, a compact end-to-end deep learning architecture for identifying ADHD subjects from EEG epochs. The proposed model integrates an EEGNet-inspired convolutional embedding, a Transformer encoder operator, and an attention-based pooling mechanism. Together, these components capture local spatiotemporal EEG patterns, contextual temporal dependencies, and task-relevant latent representations. EEG-TACT was evaluated on a publicly available EEG dataset using strict, subject-independent stratified group partitions, ensuring no data leakage across subjects in the training, validation, and test subsets. Learned temporal filter responses, class-conditioned self-attention maps, and latent-space projections provide model interpretability. An ablation study quantifies the contribution of each architectural component. Performance analysis includes evaluation at the fold, subject, and epoch levels, together with statistical significance comparisons against representative state-of-the-art architectures. EEG-TACT achieved competitive performance among the contrasted models, reaching subject-level accuracy of 87.5%, recall of 96.0%, and precision of 82.8%, while requiring only a few thousand trainable parameters. By exhaustively repeating the initialization, the proposed model demonstrated improved labeling reliability and achieved the best average ranking among the evaluated architectures. The reported results therefore support evidence that EEG-TACT provides a compact, stable, and interpretable model for EEG-based ADHD identification under subject-independent evaluation settings. They also motivate further validation on larger, multi-site, and medication-controlled datasets. Full article

Polyethylene terephthalate (PET) is one of the most widely used plastics for single-use applications, with annual global production exceeding 80 Mt. Enzymatic degradation of PET has emerged as a promising and sustainable alternative to conventional recycling methods, enabling the hydrolysis of PET into its constituent monomers. While amorphous PET can be efficiently degraded by polyester hydrolases identified from environmental sources, crystalline PET remains highly recalcitrant to enzymatic attack and constitutes a major bottleneck for the industrial implementation of enzymatic PET recycling. Although physicochemical pretreatments can increase PET amorphicity, these approaches often require substantial energy input, thereby compromising the overall sustainability of the process. Consequently, the development of enzymes capable of directly degrading crystalline PET has long been sought; however, currently engineered enzymes exhibit insufficient catalytic activity toward highly crystalline PET owing to multiple factors, including limited substrate surface accessibility, highly ordered polymer morphology, incompatible binding-pocket geometries, restricted chain mobility, and unfavorable conformational energetics at the polymer–enzyme interface. This review aims to evaluate the factors limiting the enzymatic degradation of crystalline PET and to assess current strategies for overcoming low degradation rates. Specifically, it examines advances in substrate modification as well as enzyme- and process-engineering approaches designed to improve the depolymerization of crystalline PET. The advantages and limitations of these strategies are critically compared and discussed, highlighting the remaining challenges and future directions toward efficient and scalable biocatalytic PET recycling. Full article

Surgical intervention in Crohn’s disease remains a significant contributor to patient morbidity, with postoperative complication rates reported between 20% and 50%. These complications include a broad spectrum of adverse outcomes, such as surgical site infections, intra-abdominal abscesses, and anastomotic leakage, all of which can substantially impact recovery, healthcare costs, and long-term prognosis. Although several clinical and perioperative risk factors have been identified, accurate prediction of postoperative outcomes remains challenging, highlighting the need for improved risk stratification strategies. In recent years, the evolution of biological therapies has transformed the management of Crohn’s disease, raising important questions regarding their influence on surgical outcomes and postoperative healing. Consequently, a more nuanced understanding of the interplay between medical and surgical approaches is required to optimize patient care. This systematic review aims to evaluate established and emerging predictive biomarkers associated with postoperative complications in Crohn’s disease surgery. Particular emphasis is placed on inflammatory markers, nutritional parameters, and novel molecular signatures. Furthermore, the review explores the growing role of multiomics approaches—including genomics, proteomics, and metabolomics—as well as the integration of machine learning models to enhance predictive accuracy. By synthesizing current evidence, this study underscores the potential of combining biomarkers with advanced analytical tools to support personalized risk assessment and guide clinical decision-making in Crohn’s disease surgery. Full article

This study critically addresses the challenge of selecting optimal insulation materials for contemporary, energy-efficient building envelopes, a decision with profound environmental, structural, and occupational health consequences. The paper responds to the growing demand for sustainable, resilient solutions by comparing wool, a bio-based, regenerative material, and expanded polystyrene (EPS), a synthetic polymer widely implemented in the construction industry, and advanced laboratory testing (thermal conductivity, moisture buffering, freeze–thaw resistance) is discussed in a comprehensive synthesis of the recent literature. Also, field evaluations from European retrofits and pilot projects (UK, Denmark, Finland, Iceland, Norway, Sweden, Germany and France) further contextualize performance outcomes, and life cycle impacts are considered. Recent results reveal that wool insulation achieves a moisture buffering value (MBV) between 1.8 and 2.7 (g/m²) % RH, minimal vapor resistance (mvr = 1–2), and preserves functional and structural integrity through more than 100 freeze–thaw cycles, leading to significant stabilization of the interior microclimate and enhanced durability. In contrast, EPS delivers lower thermal conductivity (0.032–0.037 (W/mK), critical for reducing heating/cooling demand, but exhibits limited vapor permeability (lvp = 60–150 MN·s/(g·m)), increased risk of condensation and mold, and reduced compressive strength (<22% after 30 cycles), especially when ventilation details are inadequate. Hybrid envelope systems leveraging both EPS and wool are demonstrated to optimize energy efficiency (up to 23% seasonal savings) and reduce interior humidity fluctuations, while lifecycle and recycling assessments show wool panels to be markedly superior in carbon footprint reduction and circularity. The stratification of insulation layers incorporating wool for vapor and moisture control, and EPS for pure thermal resistance is emerging as best practice in sustainable retrofit and new-build projects. Recommendations highlight the necessity for rigorous laboratory validation, international standards alignment, and integrated material design for robust hygrothermal comfort and environmental performance. The review also covers wool- and EPS-based hybrid composites, showing how natural fibers can improve key mechanical properties without compromising thermal insulation performance or environmental benefits. Full article

Soil amendments are widely applied for water conservation in urban turfgrass, yet whether establishment-phase benefits persist into a mature-stand remains unclear. This study evaluated biochar, biosolids, and greenwaste on tall fescue (Schedonorus arundinaceus) over a 108-day mature-stand trial under deficit (50% ET₀) and moderate (85% ET₀) irrigation, both below full replacement. Canopy performance was assessed by visual quality and NDVI, with van Genuchten soil-water retention modeling. Unlike the establishment-phase advantages reported for the organic amendments in Part I, the second-year results reversed sharply: moderate biochar (12.36 t ha⁻¹) was most hydraulically stable, holding the highest plant-available water (PAW ≈ 0.18 cm³ cm⁻³, above the control and organic amendments) and the most stable canopy. High-rate biochar (24.71 t ha⁻¹) underperformed the control under deficit irrigation, indicating constraints beyond water retention at the highest rate. Greenwaste and biosolids raised volumetric water content but provided lower PAW than moderate biochar. For greenwaste, a reduced field capacity offset this; for biosolids, an elevated permanent wilting point limited the extractable fraction. Biosolids failed to maintain acceptable quality even under the 85% ET₀. Because first-year success does not guarantee mature-stand resilience, amendment stability and rate optimization, rather than application volume, emerge as long-term management priorities under water-limited conditions. Full article

Maritime communication systems are among the most important infrastructure of global maritime safety and security. They consist of very high frequency (VHF) radio, the Global Maritime Distress and Safety System (GMDSS), contemporary satellite nets, Automatic Identification System (AIS) networks, and the emerging VHF Data Exchange System (VDES). These systems are essential for distress signaling, navigational coordination, and vessel traffic management. As maritime operations are experiencing accelerated digitalisation, the safety and security dimensions of maritime communication systems have attracted substantial and growing scientific attention. This study presents a comprehensive literature review and bibliometric analysis of the safety and security of maritime communication systems. Guided by the PRISMA 2020 guidelines and Systematic Literature Review (SLR) methodology, a structured search was conducted across three major scientific databases: Scopus, Web of Science (WoS), and IEEE Xplore. Starting from a raw pool of 6648 records retrieved between 2000 and 2026, the dataset was reduced through successive filtering to a final body of 68 high-relevance publications. Bibliometric analysis reveals a significant upward publication trend from 2015 onwards, with a marked acceleration after 2019. Thematic analysis identifies seven principal research clusters: GMDSS modernisation, AIS safety and security, VDES and VHF next-generation systems, maritime cybersecurity, satellite communications, risk assessment frameworks, and emerging technologies, including artificial intelligence and autonomous vessel communications. The review identifies significant research gaps, including the absence of integrated cross-system risk frameworks, insufficient attention to human factors in cybersecurity, limited studies addressing emerging regulatory, legal governance components and a brief analysis of the maritime communications market. This study provides a structured foundation for future research and policy development in maritime communication security. Full article

Cancer patients receiving systemic therapy experience substantial treatment-related symptoms. Nurse-led digital health interventions, e.g., interactive voice response systems, web platforms, mobile apps, and telehealth, have emerged as strategies to strengthen supportive care. To evaluate its effectiveness, this systematic review summarizes evidence exclusively from randomized controlled trials (RCTs). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, four databases were searched from inception to January 2025 for eligible RCTs involving adults undergoing anticancer therapy; evaluating nurse-led or nurse-co-led interventions using digital or telecommunication technologies; reporting validated symptom or health-related quality of life (HRQoL) outcomes. Risk of bias was assessed. Nine RCTs (N = 3344) met criteria; seven had low risk of bias. Interventions using telephone systems, web portals, mobile apps, or videoconferencing reduced symptom burden and improved HRQoL. The Symptom Care at Home system reduced symptom burden by ~43%, with greatest effects from combined automated monitoring and nurse practitioner follow-up. Additional benefits included improved anxiety, self-efficacy, patient participation, fewer severe toxicities and hospitalization days. In conclusion, nurse-led digital interventions effectively reduce symptom burden and support HRQoL during systemic therapy. Multicomponent models integrating automated monitoring with structured nursing follow-up and decision support appear most beneficial. Full article

Background: Foot degloving injuries are associated with extensive soft-tissue disruption, compromised perfusion, and a high risk of flap necrosis. Hyperbaric oxygen therapy (HBOT) is known to enhance tissue oxygenation and support flap survival; however, its application in pediatric patients may be limited due to poor cooperation, intolerance to chamber-based treatment, and limited accessibility. Case Presentation: A 7-year-old girl presented with a crush injury to the left foot after being run over by a vehicle, resulting in severe soft-tissue damage. Evaluation revealed a dorsal foot degloving injury, a proximal phalanx fracture of the great toe, and dislocations of the fourth proximal interphalangeal and fifth distal interphalangeal joints. Emergency surgery included open reduction, K-wire fixation, debridement, and artificial dermal grafting using Pelnac. On postoperative day 1, the flap showed signs of compromised perfusion. As HBOT was not feasible, topical oxygen therapy using Natrox was applied continuously for 17 days. Serial wound assessments demonstrated gradual improvement in flap viability. Although ischemic changes developed in the toes, necrosis remained superficial and was successfully managed with local debridement and dressings. Residual skin defects with partial necrosis were treated with split-thickness skin grafting, which healed without major complications. The patient resumed ambulation after splint removal. Conclusions: In pediatric patients with compromised flaps in whom HBOT is not feasible, topical oxygen therapy may serve as a practical adjunctive treatment option. Although its independent effect cannot be established in a single case, this report suggests its potential role in flap salvage and in limiting tissue necrosis. Full article

Insufficient physical activity (IPA) among university students remains an important public health concern associated with adverse health outcomes. Although barriers to physical activity (PA) are widely documented, less is known about how these barriers cluster within different university contexts and student subgroups. This study examined hierarchical configurations of perceived barriers associated with IPA in a multicountry university sample. A cross-sectional analytical study was conducted with 686 undergraduate students (60.8% women; mean age = 22.4 ± 5.1 years) from Chile, Mexico, Spain, and Italy. Perceived barriers were assessed using the BBAQ-21 and self-reported PA using the IPAQ–Short Form. CART and Exhaustive CHAID decision-tree models were applied to identify subgroup configurations based on cumulative barrier burden. Country-based subsamples and self-reported post-pandemic PA emerged as the principal segmentation variables. The Mexican subsample showed the highest barrier burden. Students reporting increased PA generally clustered within lower-barrier configurations, whereas stable or reduced PA tended to coincide with greater perceived barrier burden. Perceived barriers formed differentiated and context-dependent configurations associated with PA patterns. These findings provide exploratory insight into how barriers cluster within university populations and support more context-aware interpretation of PA-related constraints within higher education settings. Full article

Background and Clinical Significanc: Neuropathic corneal pain is a debilitating condition characterized by ocular pain disproportionate to clinical signs, often resulting from peripheral and central sensitization of the corneal somatosensory pathway. Emerging evidence suggests that chronic involuntary muscle contraction in blepharospasm may lead to irritation of trigeminal afferents and corneal neurogenic inflammation, potentially predisposing patients to neuropathic corneal pain. Given its debilitating nature, early recognition can prevent the progression of neuropathic sequelae. This study examines the potential role of blepharospasm as a predisposing factor contributing to neuropathic corneal pain. Case Presentation: This retrospective case series describes three cases (median age: 50 years) of neuropathic corneal pain in association with blepharospasm and their clinical course following multimodal treatment over a median follow-up period of one year. Ocular surface was evaluated using slit-lamp biomicroscopy, while corneal nerve structure and morphology were assessed with in vivo confocal microscopy. All the three subjects presented with minimal ocular surface staining but disproportionate ocular pain characterized by burning sensation and photophobia. Proparacaine challenge testing was performed to determine the subtype of neuropathic corneal pain. Pain symptoms and quality of life were evaluated using the Ocular Pain Assessment Survey and Ocular Surface Disease Index questionnaires. In vivo confocal microscopy demonstrated characteristic corneal nerve abnormalities including reduced corneal nerve density, increased nerve tortuosity, and the presence of microneuromas. Treatment included oral Pregabalin or Gabapentin, topical lubricants, Cyclosporine 0.05% (1 case), and 20% autologous serum eye drops (1 case). Two of the three cases received four to five injections of botulinum toxin for blepharospasm, whereas one had undergone a single injection prior to review. All patients also received weekly periorbital quantum molecular resonance electrotherapy for two months. Improvements were observed across multiple domains of the Ocular Pain Assessment Survey and Ocular Surface Disease Index evaluation, including ocular pain, photophobia, non-ocular pain, and quality-of-life measures following multimodal treatment. The co-existence of blepharospasm and neuropathic corneal pain observed in our cases supports a possible association between chronic periocular muscle hyperactivity and corneal nociceptor sensitization. Proposed mechanisms include chronic trigeminal nerve irritation, neurogenic inflammation, and sensitization mediated by pro-inflammatory neuropeptides. Multimodal treatment targeting both motor hyperactivity and neuropathic pain pathways appeared to provide symptomatic relief, including the use of quantum molecular resonance electrotherapy, which might modulate pain pathways, block nociceptor neurotransmission, and accelerate corneal nerve regeneration. Given the complexity of the neural pathways responsible for ocular discomfort, further studies are required to elucidate the relationship between neuropathic corneal pain and blepharospasm in larger cohorts, as well as refine existing therapeutic approaches, including evaluating the therapeutic role of electrotherapy. Conclusions: Blepharospasm may represent a potential predisposing factor of neuropathic corneal pain. Early recognition and concurrent treatment of blepharospasm and neuropathic corneal pain can effectively relieve symptoms and improve quality of life. Adopting a multimodal treatment approach is therefore recommended. Full article

Waste lubricating oils (WLOs) represent a major stream of hazardous petroleum-based residues, with global generation exceeding 24 million tons annually. Improper disposal of WLOs poses risks to soil, water, and air quality, while their chemical composition makes them a potential secondary resource within circular economy frameworks. This review summarizes conventional, advanced, and emerging technologies reported for the recycling and valorization of WLOs into high-value petrochemicals and carbon-based materials. Established processes such as acid–clay treatment, solvent extraction, and vacuum distillation are discussed together with more recent approaches, including catalytic upgrading, hydrotreatment, membrane separation, and thermochemical conversion methods such as pyrolysis and catalytic cracking. Reported data on process performance, environmental considerations, techno-economic indicators, and life cycle assessment outcomes are comparatively analyzed to outline current trends, technical challenges, and future development directions in WLO recycling. Particular attention is given to thermochemical pathways capable of generating carbonaceous materials, including carbon black, porous carbons, and functional carbon nanostructures with potential applications in adsorption, catalysis, electrochemical systems, and tribological formulations. Hybrid and integrated process configurations described in the literature are highlighted for their potential to improve recovery efficiency, enhance product quality, and reduce environmental burdens. In addition, recent life cycle assessment (LCA) and techno-economic analysis (TEA) studies are reviewed to provide insight into the environmental and economic implications of advanced re-refining systems. Overall, the reviewed literature indicates that WLO recycling represents not only an important element of sustainable lubricant management but also a promising waste-to-carbon strategy for the production of value-added carbon-based materials and petrochemical products. Full article

There is no proven therapy for Long COVID, a post-acute condition characterized by persistent symptoms following SARS-CoV-2 infection. Extracellular vesicles (EVs) are emerging as mediators of disease pathogenesis through their molecular cargo. We investigated whether EV glycosylation is altered in Long COVID plasma and whether these vesicles can be selectively targeted using a glycan-binding affinity resin. Large (100–500 nm) and small (40–200 nm) EVs were isolated from post-acute COVID-19 plasma and analyzed by nanoparticle flow cytometry to assess surface glycosylation. Small EV capture assays were performed using Galanthus nivalis agglutinin (GNA) affinity resin. Plasma miRNA profiles before and after GNA treatment were evaluated using NanoString nCounter analysis, and potential downstream pathway effects were computationally inferred using validated miRNA–mRNA interactions and PROGENy. Mannose-positive large EVs were significantly increased in Long COVID compared to recovered controls (p < 0.05). GNA-mediated small EV capture correlated with mannose-positive EV abundance (r = 0.341, p < 0.05), and seven miRNAs were significantly reduced following treatment. Computational pathway analysis suggested modulation of key signaling pathways, including JAK-STAT, Estrogen, VEGF, and PI3K. These findings suggest a glycan-associated EV signature in Long COVID and support further investigation of lectin-based capture as a potential strategy to target vesicle-associated molecular cargo. Full article

Background: Suicide is a major mental health concern, particularly among university students facing unique stressors. Understanding their attitudes toward suicide is essential for effective prevention, yet the existing literature lacks a systematic review on this population. This review synthesises and evaluates the literature on attitudes toward suicide among university students. Methods: A systematic search was conducted on four databases (MEDLINE, Web of Science, Scopus, and PubMed) using Medical Subject Headings terms and keywords identified from previous studies. The search, conducted in February 2024, included studies published between 2014 and 2024. One researcher screened the titles and abstracts, while two independent researchers extracted the data. Twenty-one articles (N participants = 13,424) were selected for further assessment. Quantitative designs were the most common (n = 18), followed by qualitative (n = 2) and mixed-method designs (n = 1), spanning multiple regions. Themes were derived by organising findings into thematic categories based on recurring patterns across the studies. Results: Two core themes emerged: Factors associated with attitudes toward suicide and their associations with suicide outcomes. Conclusions: The review underscores the need for culturally sensitive approaches to address negative attitudes toward suicide and promote help-seeking among university students, highlighting the importance of further research in this area. Full article

Background/objectives: To describe and compare Korean AYAs’ and parental perspectives on the family environment in terms of agreement and significant differences and examine which variables were associated with AYAs’ symptom distress. Sample and setting: Self-report data were collected from a total sample of 113 AYAs, recruited from a pediatric-oncology outpatient clinic at a university-affiliated hospital and community group in South Korea. Because each study aim required different data sources, different analytic samples were used. Specifically, 54 AYA–parent dyads were included for Aim 1, whereas self-report data from 111 AYAs with complete data were used for Aim 2. Methods and variables: This subgroup analysis used a quantitative–descriptive, cross-sectional design. AYAs’ and parent perceptions of the family environment (family cohesion and adaptability, family strength, and social support from family) and AYAs’ symptom distress were collected using reliable and validated self-report questionnaires and analyzed using descriptive and inferential statistics. Results: AYAs and their parents showed low (family support) to moderate agreement (family strength, family cohesion, and adaptability) on perceptions of family environment (ICC = 0.374–0.612). AYAs reported significantly lower perceptions of family support than their parents, with a small to moderate effect (p < 0.001, d = 0.48). All family environment variables were correlated with AYAs’ symptom distress (p < 0.05). Among these variables, AYAs’ perceived family strength emerged as the only family environment variable significantly associated with their symptom distress (F = 14.309, p < 0.001, R² = 0.359, R²adj = 0.334), which was stronger during treatment. Conclusions: AYAs’ perceived family strength should be routinely assessed, especially during cancer treatment. Additional nursing interventions focusing on enhancing AYAs’ families as a support group are needed. Full article

Early identification of anatomically significant coronary artery disease (CAD) remains a major clinical challenge despite advances in cardiovascular diagnostics. Novel circulating biomarkers may improve risk stratification and diagnostic discrimination beyond conventional parameters. We investigated the diagnostic utility of four emerging biomarkers—Phoenixin-14, Syntenin-1, Alamandine, and Cerebellin-1—for the assessment of CAD severity. In this prospective observational study, 90 participants undergoing coronary angiography were categorized into three groups: severe CAD (≥70% stenosis; n = 30), non-obstructive/non-critical CAD (<70% stenosis; n = 30), and angiographically normal controls (n = 30). Patients with acute coronary syndrome, diabetes mellitus, prior coronary revascularization, cardiomyopathy, or significant systemic disease were excluded. Circulating biomarker concentrations were quantified using the enzyme-linked immunosorbent assay. Comparative analyses, correlation testing, and receiver operating characteristic (ROC) analyses were performed to evaluate discriminatory performance. Circulating Phoenixin-14 concentrations progressively declined across the control, non-critical CAD, and severe CAD groups [40.1 (29.0–49.7) vs. 24.4 (18.5–30.1) vs. 16.7 (13.4–19.0) pg/mL, respectively; p < 0.001]. Phoenixin-14 demonstrated outstanding discrimination for severe CAD, achieving an area under the ROC curve (AUC) of 0.969 (95% CI, 0.888–0.997), with 86.7% sensitivity and 96.7% specificity at a threshold of ≤20.2 pg/mL. Diagnostic performance was substantially lower for Syntenin-1 (AUC, 0.795), Alamandine (AUC, 0.661), and Cerebellin-1 (AUC, 0.597). Phoenixin-14 also showed robust discrimination for non-critical CAD (AUC, 0.832). Biomarker concentrations exhibited correlations with metabolic indices while remaining largely independent of traditional cardiovascular risk factors. Among the evaluated novel circulating biomarkers, Phoenixin-14 demonstrated superior diagnostic performance for both obstructive and non-obstructive CAD, markedly outperforming Syntenin-1, Alamandine, and Cerebellin-1. These findings identify Phoenixin-14 as a promising candidate biomarker for CAD severity assessment and clinical risk stratification. Larger multicenter studies are warranted to validate these exploratory findings and determine their incremental value in contemporary cardiovascular practice. Full article