Search Results (5,229)

With the increasing deployment of unmanned aerial vehicles (UAVs) in indoor environments, the demand for high-precision six-degrees-of-freedom (6-DoF) localization has grown significantly. Ultra-wideband (UWB) technology has emerged as a key enabler for indoor UAV navigation due to its robustness against multipath effects and high-accuracy ranging capabilities. However, conventional UWB-based systems primarily rely on range measurements, operate at low measurement frequencies, and are incapable of providing attitude information. This paper proposes a tightly coupled error-state extended Kalman filter (TC–ESKF)-based UWB/inertial measurement unit (IMU) fusion framework. To address the challenge of initial state acquisition, a weighted nonlinear least squares (WNLS)-based initialization algorithm is proposed to rapidly estimate the UAV’s initial position and attitude under static conditions. During dynamic navigation, the system integrates time-difference-of-arrival (TDOA) and angle-of-arrival (AOA) measurements obtained from the UWB module to refine the state estimates, thereby enhancing both positioning accuracy and attitude stability. The proposed system is evaluated through simulations and real-world indoor flight experiments. Experimental results show that the proposed algorithm outperforms representative fusion algorithms in 3D positioning and yaw estimation accuracy. Full article

We planned a systemic review and meta-analysis to evaluate the diagnostic accuracy of Monocyte Distribution Width (MDW) in aiding the diagnosis of sepsis in the Emergency Department (ED) and Intensive Care Unit (ICU). A systematic literature search was performed in PubMed, Scopus, and OVID to retrieve studies published up to 29 January 2024. We examined results using mean difference and conducted a diagnostic test accuracy (DTA) meta-analysis using a bivariate random effects model. Pooled results showed that MDW was significantly higher in sepsis patients admitted to the ED (MD = 5.59, 95%CI: 4.14–7.05) or to the ICU (MD = 8.30, 95%CI: 2.98–13.62). Nine studies conducted in the ED were included in the DTA review. The overall sensitivity was 0.80 (95%CI: 0.75–0.85), the specificity was 0.76 (95%CI: 0.66–0.83), and the false-positive rate (FPR) was 0.24 (95%CI: 0.17–0.34). Three studies were conducted in the ICU, but only two were included in the DTA meta-analysis. Of the 662 patients admitted to the ICU, 175 developed sepsis, showing higher MDW values than non-septic patients. However, significant heterogeneity was noted among the studies. MDW is a helpful biomarker for sepsis in adult patients admitted to the ED and ICU. In the ED, MDW could aid clinicians in ruling out sepsis. Full article

Background/Objectives: Bronchiolitis is the leading cause of hospitalization in infants under 12 months. While often self-limiting, a subset of cases evolves into severe disease requiring intensive care. This study aimed to identify risk factors for severe bronchiolitis in two consecutive respiratory syncytial virus (RSV) seasons (before and after the introduction of nirsevimab) in Southern Italy. Methods: A retrospective, multicenter cohort study was conducted on all infants ≤12 months hospitalized with bronchiolitis from October 2023 to March 2025. Patients were categorized by disease severity: those requiring Sub-Intensive or Intensive Care (IC group) and others (n-IC group). Demographic and clinical data, virological testing, and therapeutic interventions were analyzed. Multivariable logistic regression was used to identify independent risk factors for severe disease. Results: Among 1056 hospitalized infants, 10.5% required intensive care. RSV was detected in 73.5% of tested patients and was significantly associated with severe outcomes. Independent risk factors for IC admission included younger age (<3 months), comorbidities, and RSV infection. A 33% reduction in bronchiolitis admissions was observed in the second season (post-nirsevimab), although the rate of severe cases remained stable (about 10% in both seasons). Conclusions: Younger age, comorbidities, and RSV infection are significant predictors of severe bronchiolitis. Although overall admissions decreased post-nirsevimab, severe cases persisted. These findings underscore the need for targeted preventive strategies and highlight the potential role of intermediate care approaches in managing bronchiolitis severity. Full article

Promoting sustainable development requires a clear understanding of how short-term fluctuations in anthropogenic emissions affect urban environmental quality. This is especially relevant for cities experiencing rapid industrial changes or emergency policy interventions. Among key environmental concerns, variations in ambient pollutants like ozone (O₃) are closely tied to both public health and long-term sustainability goals. However, traditional chemical transport models often face challenges in accurately estimating emission changes and providing timely assessments. In contrast, statistical approaches such as the difference-in-differences (DID) model utilize observational data to improve evaluation accuracy and efficiency. This study leverages the synthetic difference-in-differences (SDID) approach, which integrates the strengths of both DID and the synthetic control method (SCM), to provide a more reliable and accurate analysis of the impacts of interventions on city-level air quality. Using Shanghai’s 2022 lockdown as a case study, we compare the deweathered ozone (O₃) concentration in Shanghai to a counterfactual constructed from a weighted average of cities in the Yangtze River Delta (YRD) that did not undergo lockdown. The quasi-natural experiment reveals an average increase of 4.4 μg/m³ (95% CI: 0.24–8.56) in Shanghai’s maximum daily 8 h O₃ concentration attributable to the lockdown. The SDID method reduces reliance on the parallel trends assumption and improves the estimate stability through unit- and time-specific weights. Multiple robustness checks confirm the reliability of these findings, underscoring the efficacy of the SDID approach in quantitatively evaluating the causal impact of emission perturbations on air quality. This study provides credible causal evidence of the environmental impact of short-term policy interventions, highlighting the utility of SDID in informing adaptive air quality management. The findings support the development of timely, evidence-based strategies for sustainable urban governance and environmental policy design. Full article

This article examines how digital innovation ecosystems have emerged as strategic institutions of power in contemporary world politics. It argues that, unlike Cold War technological rivalries driven by centralized, state-led control, today’s digital competition depends on states’ capacity to orchestrate scalable, multistakeholder ecosystems. Using a cultural–institutional framework, we explain how differences in strategic culture and institutional governance impact the ecosystem’s vitality and performance. A qualitative comparative analysis of the United States, China, and Russia reveals that constructive orchestration, aligning state institutions with generative, commercial-to-national innovation flows, enhances digital leadership, whereas rigid, obstructive governance limits it. This highlights ecosystem governance as a critical dimension of statecraft in the digital age. The findings underscore that the positions of great powers in the global technological hierarchy depend not only on resources or capabilities but also on the effectiveness of ecosystem governance as an evolving instrument of geopolitical power. Full article

The intersection of green finance and artificial intelligence (AI) represents a rapidly emerging and high-impact research domain with the potential to reshape sustainable economic systems. This study presents a comprehensive bibliometric and network analysis aimed at mapping the scientific landscape, identifying research hotspots, and highlighting methodological trends at this nexus. A dataset of 268 peer-reviewed publications (2014–June 2025) was retrieved from the Web of Science Core Collection, filtered by the Business Economics category. Analytical techniques employed include Bibliometrix in R, VOSviewer, and science mapping tools such as thematic mapping, trend topic analysis, co-citation networks, and co-occurrence clustering. Results indicate an annual growth rate of 53.31%, with China leading in both productivity and impact, followed by Vietnam and the United Kingdom. The most prolific affiliations and authors, primarily based in China, underscore a concentrated regional research output. The most relevant journals include Energy Economics and Finance Research Letters. Network visualizations identified 17 clusters, with focused analysis on the top three: (1) Emission, Health, and Environmental Risk, (2) Institutional and Technological Infrastructure, and (3) Green Innovation and Sustainable Urban Development. The methodological landscape is equally diverse, with top techniques including blockchain technology, large language models, convolutional neural networks, sentiment analysis, and structural equation modeling, demonstrating a blend of traditional econometrics and advanced AI. This study not only uncovers intellectual structures and thematic evolution but also identifies underdeveloped areas and proposes future research directions. These include dynamic topic modeling, regional case studies, and ethical frameworks for AI in sustainable finance. The findings provide a strategic foundation for advancing interdisciplinary collaboration and policy innovation in green AI–finance ecosystems. Full article

Introduction: Breakfast has emerged as a critical factor in preventing cardiovascular diseases, driven not only by its nutritional content but also by its alignment with circadian rhythms. However, gaps remain in the literature regarding its clinical impact and thematic evolution. Objective: To characterize the global scientific output on the relationship between breakfast quality and cardiovascular health through a systematic bibliometric analysis. Methodology: The PRISMA 2020 protocol was applied to select 1436 original articles indexed in Scopus and Web of Science (1957–2025). Bibliometric tools, including R (v4.4.2) and VOSviewer (v1.6.19) were used to map productivity, impact, collaboration networks, and emerging thematic areas. Results: Scientific output has grown exponentially since 2000. The most influential journals are the American Journal of Clinical Nutrition, Nutrients, and Diabetes Care. The United States, United Kingdom, and Japan lead in publication volume and citations, with increasing participation from Latin American countries. Thematic trends have shifted from traditional clinical markers to innovative approaches such as chrononutrition, digital health, and personalized nutrition. However, methodological gaps persist, including a predominance of observational studies and an underrepresentation of vulnerable populations. Conclusions: Breakfast is a dietary practice with profound implications for cardiometabolic health. This study provides a comprehensive overview of scientific literature, highlighting both advancements and challenges. Strengthening international collaboration networks, standardizing definitions of a healthy breakfast, and promoting evidence-based interventions in school, clinical, and community settings are recommended. Full article

In recent decades, the rapid expansion of the food processing industry has led to significant losses and waste, with the fruit and vegetable sector among the most affected. According to the Food and Agriculture Organization of the United Nations (FAO), losses in this category can reach up to 60%. Vegetable waste includes edible parts discarded during processing, packaging, distribution, and consumption, often comprising by-products rich in bioactive compounds such as polyphenols, carotenoids, dietary fibers, vitamins, and enzymes. The underutilization of these resources constitutes both an economic drawback and an environmental and ethical concern. Current recovery practices, including their use in animal feed or bioenergy production, contribute to a circular economy but are often limited by high operational costs. In this context, fermentation has emerged as a promising, sustainable approach for converting vegetable by-products into value-added food ingredients. This process improves digestibility, reduces undesirable compounds, and introduces probiotics beneficial to human health. The present review examines how fermentation can improve the nutritional, sensory, and functional properties of plant-based foods. By presenting several case studies, it illustrates how fermentation can effectively valorize vegetable processing by-products, supporting the development of novel, health-promoting food products with improved technological qualities. Full article

Background/Objectives: Cystic fibrosis-associated liver disease (CFLD) is a significant complication in individuals with cystic fibrosis (CF), contributing to morbidity and mortality, with no universally accepted, reliable, non-invasive diagnostic tool for early detection. Current diagnostic methods, including liver biopsy and imaging, remain resource-intensive and invasive. Non-invasive biomarkers like the Fibrosis-4 (FIB-4) index have shown promise in diagnosing liver fibrosis in various chronic liver diseases. This study explores the potential of the FIB-4 index to predict CFLD in an adult CF population and assesses its correlation with transient elastography (TE) as a potential diagnostic tool. The aim of this study is to evaluate the diagnostic performance of the FIB-4 index for CFLD in adults with CF and investigate its relationship with TE-based liver stiffness measurements (LSM). Methods: The study was conducted in a regional cystic fibrosis unit, including 261 adult CF patients. FIB-4 scores were calculated using an online tool (mdcalc.com) based on patient age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count. In parallel, 29 patients underwent liver stiffness measurement using TE (Fibroscan^®). Statistical analyses included non-parametric tests for group comparisons and Pearson’s correlation to assess the relationship between FIB-4 scores and TE results. Results: The mean FIB-4 score in patients diagnosed with CFLD was higher (0.99 ± 0.83) compared to those without CFLD (0.64 ± 0.38), although the difference was not statistically significant (p > 0.05). TE results for CFLD patients (5.9 kPa) also did not show a significant difference compared to non-CFLD patients (4.2 ± 1.6 kPa, p > 0.05). However, a positive correlation (r = 0.401, p = 0.031) was found between FIB-4 scores and TE-based LSM, suggesting a potential complementary diagnostic role. Conclusions: The FIB-4 index, while not sufficient as a standalone diagnostic tool for CFLD in adults with CF, demonstrates potential when used in conjunction with other diagnostic methods like TE. This study introduces a novel approach for integrating non-invasive diagnostic markers in CF care, offering a pathway for future clinical practice. The combination of FIB-4 and TE could serve as an accessible, cost-effective alternative to invasive diagnostic techniques, improving early diagnosis and management of CFLD in the CF population. Additionally, future research should explore the integration of these tools with emerging biomarkers and clinical features to refine diagnostic algorithms for CFLD, potentially reducing reliance on liver biopsies and improving patient outcomes. Full article

The rapid emergence of generative AI technologies has sparked significant transformation across educational landscapes worldwide. This study presents a comprehensive bibliometric analysis of GAI in education, mapping scholarly trends from 2022 to 2025. Drawing on 3808 peer-reviewed journal articles indexed in Scopus, the analysis reveals exponential growth in publications, with dominant contributions from the United States, China, and Hong Kong. Using VOSviewer, the study identifies six major thematic clusters, including GAI in higher education, ethics, technological foundations, writing support, and assessment. Prominent tools, especially ChatGPT, are shown to influence pedagogical design, academic integrity, and learner engagement. The study highlights interdisciplinary integration, regional research ecosystems, and evolving keyword patterns reflecting the field’s transition from tool-based inquiry to learner-centered concerns. This review offers strategic insights for educators, researchers, and policymakers navigating AI’s transformative role in education. Full article

The fast-maturing photonic integration technology is calling for a versatile platform that supports both active and passive functions as well as high scalability through component miniaturization. Indium phosphide (InP) has long been recognized for its ability to deliver a comprehensive suite of photonic components. InP membrane technology has emerged as a next-generation solution that could unite the functional completeness with high scalability. This paper describes recent advancements in the InP-membrane-on-Si (IMOS) platform, which supports high-performance passives, polarization and mode handling, native light sources, amplifiers, modulators and detectors, and novel material integration. Full article

Due to globalization, companies are exposed to a culturally diversified workforce; therefore, great emphasis is placed on identifying the most effective leadership style that would be able to manage such a workforce. Although numerous studies have attempted to identify successful leadership styles in different cultural settings, none have focused on the perceptions of top managers who work in multinational corporations (MNCs) in culturally diversified surroundings. Thus, our research attempts to identify the most preferred leadership style and characteristics from the perspective of top managers in MNCs in the United Arab Emirates (UAE). The 13 leadership characteristics analyzed in this study were generated from the 21 characteristics found by Global Leadership and Organizational Behavior Effectiveness (GLOBE) research. The participants, top managers in MNCs, needed to evaluate leadership styles by considering leadership characteristics. To ensure the objectiveness of the study, we analyzed their answers by applying the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. The results indicated that the most preferred leadership characteristics were visionary, inspirational, collaborative team-oriented, and performance-oriented. Moreover, the transformational leadership style emerged as the most preferred leadership style. The study’s findings show that top managers believe that employees in MNCs in the UAE seek a leader with a vision who will inspire, motivate, and help them fulfill their true potential. Full article

Introduction: The World Health Organization has declared carbapenem-resistant organisms a research and development priority. Although ceftazidime–avibactam was approved around a decade ago, there is still a lack of prospective data on the treatment of resistant pathogens with this agent. Methods: We conducted a prospective, observational, single-center, investigator-initiated study of patients treated with ceftazidime–avibactam for infections caused by carbapenem-resistant organisms. The primary outcome was clinical cure 14 days after the initiation of ceftazidime-avibactam treatment. Secondary outcomes, which were assessed on day 30, included microbiological failure, development of resistance, all-cause mortality, and length of stay in the intensive care unit. Results: A total of 50 patients were included in the study. At baseline, the median Charlson Comorbidity Index and Sequential Organ Failure Assessment Score were 5.5 and 7. Approximately three-quarters of the patients were treated in an intensive care unit and had undergone mechanical ventilation within the previous 7 days prior to the commencement of ceftazidime–avibactam treatment. Half of the patients were diagnosed with nosocomial pneumonia. Most infections were caused by Pseudomonas aeruginosa (48%) and Klebsiella pneumonia (28%). Clinical cure at day 14 was achieved in 59% of patients. Four deaths (9%) and two cases of microbiological failure (4%) were observed. The median length of stay in the intensive care unit was 14 days. There was no emergence of resistance to ceftazidime–avibactam. Discussion: Our study contributes to the growing body of evidence supporting the effectiveness of ceftazidime–avibactam in treating infections caused by carbapenem-resistant organisms. In this cohort of critically ill patients, our results in terms of both clinical success and survival are in the upper range compared to those from mainly retrospective and some prospective studies. Although the benefits of ceftazidime–avibactam have been demonstrated in this and other studies, it must be prescribed cautiously to ensure it remains effective. Full article

Background/Objective: In-hospital cardiac arrest has high incidence and poor survival rates, posing a significant healthcare challenge. It is important to intervene in the hours before the cardiac arrest to prevent poor outcomes. The modified early warning score (MEWS) is a validated tool for identifying a deteriorating patient. It is an aggregate of vital signs and level of consciousness. We retrospectively evaluated MEWS for trends that might predict patient outcomes. Methods: We performed a single-center, one-year, retrospective study. A comprehensive review was conducted for patients aged 18 years and above who experienced a cardiac arrest. Cases that occurred within an intensive care unit, emergency department, during a procedure, or outside the hospital were excluded. A total of 87 cases met our predefined inclusion criteria. We collected data at 12 h, 6 h and 1 h time periods prior to the cardiac arrest. A trend analysis using a linear model with analysis of variance with Bonferroni correction was performed. Results: Out of 87 patients included in the study, 59 (67.8%) had an immediate return of spontaneous circulation (ROSC). Among those who achieved ROSC, 41 (69.5%) died during the admission. Only 20.7% of the patients that sustained a cardiac arrest survived to discharge. A significant increase in the average MEWS was noted from the 12 h period (MEWS = 3.95 ± 2.4) to the 1 h period (MEWS = 5.98 ± 3.5) (p ≤ 0.001) and the 6 h period (4.65 ± 2.6) to the 1 h period (5.98 ± 3.5) (p = 0.023) prior to cardiac arrest. Conclusions: An increase in the MEWS may be a valuable tool in identifying at-risk patients and provides an opportunity to intervene at least 6 h before a cardiac arrest event. Further research is needed to validate the results of our study. Full article

Background/Objectives: Access to health services is often limited due to socio-economic and organizational determinants of health systems, which lead to increased unmet healthcare needs. This study aimed to identify access barriers for the general population in Greece, including those that may have emerged following the COVID-19 pandemic. Methods: This was a cross-sectional survey of 1002 Greek citizens. A questionnaire regarding socio-demographics, healthcare utilization, and access to health services was used. Interviews took place between October and November 2022. Results: Of 837 participants who used health services in 2022, 82.6% had a medical consultation, 80.6% took diagnostic tests, and 63.6% visited a pharmacy for pharmaceuticals. Of those having a medical consultation, 33.1% did so at an NHS health unit, while 75% of the participants taking diagnostic tests visited a contracted private laboratory. Out of the 135 participants requiring hospitalization, 62% were hospitalized in a public hospital, while 85% of the participants requiring pharmaceuticals visited a private pharmacy. Access barriers in the past year were reported by 48% of the participants requiring a medical consultation, 34% of the participants requiring diagnostic tests, and 40% of the participants requiring hospitalization. The most common barriers were long waiting times and financial constraints. The main barrier to accessing pharmaceuticals was the availability and administration of the product. Conclusions: The identified healthcare access barriers highlight the vulnerabilities of the current health system in Greece, which were further exposed during the COVID-19 pandemic crisis. Addressing socioeconomic factors that are considered key access indicators should be the focus of future health policy initiatives. Full article