Search Results (7,990)

Accurately predicting how quickly people will adopt electric vehicles (EVs) is vital for planning charging stations, managing supply chains, and shaping climate policy. We present a forecasting model that uses three separate Long Short‑Term Memory (LSTM) branches—one for past EV sales, one for infrastructure and policy signals, and one for economic trends. An attention mechanism first highlights the most important weeks in each branch, then decides which branch matters most at any point in time. Trained end‑to‑end on publicly available data, the model beats traditional statistical methods and newer deep learning baselines while remaining small enough to run efficiently. An ablation study shows that every branch and both attention steps improve accuracy, and that adding policy and economic data helps more than relying on EV history alone. Because the network is modular and its attention weights are easy to interpret, it can be extended to produce confidence intervals, include physical constraints, or forecast adoption of other clean‑energy technologies. Full article

This study was conducted in the context of China’s latest “double carbon” policy. The objective of this study was twofold: firstly, to examine the characteristics of traditional Chinese residential skywell; and secondly, to investigate and develop climate-adaptive technologies for these structures. To this end, a study was conducted on the Huizhou skywell architecture in China. Firstly, we obtained a large amount of basic data, such as traditional buildings and skywell parameters in Huizhou through field research and on-site mapping. Second, we combined a large number of parameters and typical cases to analyze the data and determine a more scientifically typical model of Huizhou architecture and experimental coverage of skywell data. Different shapes and sizes of skywell were formed by changing the combination of skywell length and width, and the indoor wind environments of these skywell dwelling models were simulated one by one using PHOENIX (v2016) software. Finally, the data obtained from these simulations are analyzed using the variable control method, and the simulated indoor wind environments of skywells under different scale combinations in terms of skywell length, width, and length–width coupling effects are summarized and compared. The following conclusions were drawn: (1) The length of the skywell has a certain effect on all indoor wind environments, and the variation in indoor wind speed is smallest when the length of the skywell is 7.5 m. When selecting the design size of the skywell, the length of the skywell can be increased accordingly. (2) The width of the skywell for the indoor wind environment is divided into two cases, when the length of the skywell is less than 3.75 m, increasing the width of the skywell will make the indoor wind environment more unstable. However, when the length of the skywell is greater than 3.75 m, the width of the skywell is positively related to the comfort of the indoor wind environment. (3) The area of the skywell should not be too large, usually between 11.25 m² and 18.75 m². A slender skywell is more likely to provide a comfortable indoor wind environment. (4) After extensive evaluation, we found that the comfort of the indoor wind environment is high when the width of the skywell is 2 m. The optimum dimensions for the ventilation performance of the skywell are 7.5 m in length and 2 m in width. Full article

Background/Objectives: Anti-tumour necrosis factor (anti-TNF) medications were historically commonly prescribed as the first-line biologic treatment for chronic inflammatory pouch conditions. However, their use in these conditions is mainly based on retrospective studies of relatively small numbers of patients with short follow up periods. We aimed to describe the long-term outcomes of first-line anti-TNF therapy in a large, multi-centre, multi-national patient cohort with chronic inflammatory pouch conditions. Methods: This was an observational, retrospective, multi-centre, multi-national study. We included patients with chronic inflammatory pouch conditions initially treated with anti-TNF drugs infliximab (IFX) or adalimumab (ADA), who had a follow up of at least 1 year. The primary outcome was anti-TNF treatment persistence, defined as continuation of anti-TNF throughout the study period. The secondary outcome was pouch failure, defined by the need for a defunctioning ileostomy or pouch excision. Results: We recruited 98 patients with chronic inflammatory pouch conditions initially treated with anti-TNF medications—63 (64.3%) treated with IFX and 35 (35.7%) treated with ADA. Average follow up length was 94.2 months (±54.5). At the end of the study period only 22/98 (22.4%) patients were still on anti-TNF treatment. In those in whom the first-line anti-TNF was discontinued, the median time to discontinuation was 12.2 months (range 5.1–26.9 months). The most common cause for anti-TNF discontinuation was lack of efficacy despite adequate serum drug levels and absence of anti-drug antibody formation (30 patients, 30.6%). Loss of response due to anti-drug antibody formation was the cause for discontinuation in 18 patients (18.4%), while 12 patients (12.2%) stopped treatment because of adverse events or safety concerns. Out of the 76 patients discontinuing anti-TNF treatment, 34 (34.7% of the cohort) developed pouch failure, and 42 (42.8% of the cohort) are currently treated with a different medical therapy. Conclusions: First-line anti-TNF therapy for chronic pouch inflammatory conditions is associated with low long-term persistence rates. This is due to a combination of lack of efficacy and adverse events. A significant percentage of patients initially treated with anti-TNF therapy develop pouch failure. Full article

Diabetic nephropathy affects approximately 30–40% of individuals with diabetes mellitus (DM) and is a major contributor to end-stage renal disease (ESRD). While angiotensin II receptor blockers (ARBs) have long served as a standard treatment, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have recently gained attention for their renal and cardiovascular benefits. However, comparative real-world data on their long-term renal effectiveness remain limited. We conducted a retrospective, longitudinal study over a 2-year period to compare the impact of ARB monotherapy versus SGLT2i and angiotensin-converting enzyme inhibitor (ACEi) combination therapy on the progression of chronic kidney disease (CKD) in patients with DM. A total of 126 patients were included and grouped based on treatment regimen. Renal biomarkers were analyzed using t-tests and ANOVA (p < 0.01). Albuminuria was qualitatively classified via urinalysis as negative, level 1 (+1), level 2 (+2), or level 3 (+3). The ARB group demonstrated higher estimated glomerular filtration rate (eGFR) and lower serum creatinine (sCr) levels than the combination therapy group, with glycated hemoglobin (HbA1c), potassium (K⁺), and blood pressure remaining within normal limits in both cohorts. Albuminuria remained stable over time, with 60.8% of ARB users and 73.1% of combination therapy users exhibiting persistently or on-average negative results. Despite the expected additive benefits of SGLT2i/ACEi therapy, ARB monotherapy was associated with slightly more favorable renal function markers and a lower incidence of severe albuminuria. These findings suggest a need for further controlled studies to clarify the comparative long-term renal effects of these treatment regimens. Full article

After the first release of synthalin B (dodecamethylenbiguanide) in 1928 and its later retraction in the 1940s in Germany, the retraction of phenformin (N-Phenethylbiguanide) and of Buformin in the USA (but not outside) because of the lethal complication of acidosis seemed to have put an end to the era of the biguanides as oral antidiabetics. The strongly hygroscopic metformin (1-1-dimethylbiguanide), first synthesized 1922 and resuscitated as an oral antidiabetic (type 2 of the elderly) compound first released in 1959 in France and in other European countries, was used in the first large multicenter prospective long-term trial in England in the UKPDS (1977–1997). It was then released in the USA after a short-term prospective trial in healthy overweight “young” type 2 diabetics (mean age 53 years) in 1995 for oral treatment of type 2 diabetes. It was, however, prescribed to mostly multimorbid older patients (above 60–65 years of age). Metformin is now the most used oral drug for type 2 diabetes worldwide. While intravenous administration of biguanides does not have any glucose-lowering effect, their oral administration leads to enormous increase in their intestinal concentration (up to 300-fold compared to that measured in the blood), to reduced absorption of glucose from the diet, to increased excretion of glucose through the stool, and to decrease in insulin serum level through increased hepatic uptake and decreased production. Intravenously injected F18-labeled glucose in metformin-treated type 2 diabetics accumulates in the small and even more in the large intestine. The densitometry picture observed in metformin-treated overweight diabetics is like that observed in patients after bowel-cleansing or chronically taking different types of laxatives, where the accumulated radioactivity can even reach values observed in colon cancer. The glucose-lowering mechanism of action of metformin is therefore not only due to inhibition of glucose uptake in the small intestine but also to “attraction” of glucose from the hepatocyte into the intestine, possibly through the insulin-mediated uptake in the hepatocyte and its secretion into the bile. Furthermore, these compounds have also a diuretic effect (loss of sodium and water in the urine) Acute gastrointestinal side effects accompanied by fluid loss often lead to the drugs’ dose reduction and strongly limit adherence to therapy. Main long-term consequences are “chronic” dehydration, deficiency of vitamin B12 and of iron, and, as observed for all the biguanides, to “chronic” increase in fasting and postprandial lactate plasma level as a laboratory marker of a clinical condition characterized by hypotension, oliguria, adynamia, and evident lactic acidosis. Metformin is not different from the other biguanides: synthalin B, buformin, and phenformin. The mechanism of action of the biguanides as antihyperglycemic substances and their side effects are comparable if not even stronger (abdominal pain, nausea, vomiting, diarrhea, fluid loss) to those of laxatives. Full article

As the climate problem is getting more and more serious and the “low-carbon revolution” of globalization is emerging, the logistics industry, as a high-end service industry, must also take the road of low-carbon development. Improving logistics carbon emission efficiency (LCEE) is gradually becoming an inevitable choice to maintain sustainable social development. The study uses the Super-SBM (Super-Slack-Based Measure) model to evaluate the urban LCEE from 2013 to 2022, explores the contribution of efficiency changes and technological progress to LCEE through the decomposition of the GML (Global Malmquist–Luenberger) index, and reveals the influence of digital transformation and energy consumption structure on LCEE by using the Spatial Durbin Model, concluding as follows: (1) LCEE declines from east to west, with large regional differences. (2) LCEE has steadily increased over the past decade, with slower growth from east to west. It fell in 2020 due to COVID-19 but has since recovered. (3) LCEE shows a catching-up effect among the three major regions, with technological progress being a key driver of improvement. (4) LCEE has significant spatial dependence. Energy consumption structure has a short-term negative spillover effect, while digital transformation has a positive spillover effect. Full article

Suspension bridges, as a type of long-span bridge, usually have a larger longitudinal displacement at the end of the beam (LDBD). LDBD can be used to evaluate the safety of bridge components at the end of the beam. However, due to factors such as sensor failure and system maintenance, LDBD in the bridge health monitoring system is often missing. Therefore, this study reconstructs the missing part of LDBD based on the long short-term memory network (LSTM) and various data. Specifically, first, the monitoring data that may be related to LDBD in a suspension bridge is analyzed, and the temperature and beam end rotation angle data (RDBD) at representative locations are selected. Then, the temperature data at different places of the bridge are used as the input of the LSTM model to compare and analyze the prediction effect of LDBD. Next, RDBD is used as the input of the LSTM model to observe the prediction effect of LDBD. Finally, temperature and RDBD are used as the input of the LSTM model to observe whether the prediction effect of the LSTM model is improved. The results show that compared with other parts of the bridge, the prediction effect of the temperature inside the box girder in the main span as the model input is better; when RDBD is used as the input of the LSTM model, it is better than the prediction effect of temperature as the model input; temperature and RDBD have higher prediction accuracy when used as the input of the LSTM model together than when used separately as the input of the LSTM model. Full article

Like in many countries, the transfer of increased land value created by public actions without landowner contributions back to the public is under debate in Türkiye. Although various Land Value Capture (LVC) mechanisms are employed worldwide to finance infrastructure investments, no comprehensive system has been established in Türkiye for this purpose. In this study, an improved LVC model that integrates land value and development rights is proposed. This model, termed Hybrid Land Readjustment (hLR), is designed to ensure that land value increases triggered by public investments are returned to the public. To this end, existing Turkish value capture instruments with potential are examined. Under the proposed hLR framework, equal basic development rights are granted to cadastral parcels, parcel and building-block value maps are utilized, basic rights are adjusted according to land-value changes, and a portion of additional development rights is transferred to the public. A practical application scenario is provided to illustrate the model’s operation. The system is configured for seamless integration into Türkiye’s existing legal and planning framework, offering a sustainable mechanism for financing infrastructure and implementing zoning plans. Full article

Background: This study aims to compare the logistical challenges of Home Health Care (HHC) services in Portugal and Brazil, highlighting the structural and operational differences between both systems. Methods: Guided by an abductive research approach, data were collected using a semi-structured survey with open-ended questions, applied to 13 HHC teams in Portugal and 18 in Brazil, selected based on national coordination recommendations. The data collection process was conducted in person, and responses were analyzed using descriptive statistics and qualitative content analysis. Results: The results reveal that Portugal demonstrates higher productivity, stronger territorial coverage, and a more integrated inventory management system, while Brazil presents greater multidisciplinary team integration, more flexible fleet logistics, and more advanced digital health records. Despite these strengths, both countries continue to address key logistical aspects, such as scheduling, supply distribution, and data management, largely through empirical strategies. Conclusions: This research contributes to the theoretical understanding of international HHC logistics by emphasizing strategic and systemic aspects often overlooked in operational studies. In practical terms, it offers insights for public health managers to improve resource allocation, fleet coordination, and digital integration in aging societies. Full article

Background and Objectives: Anesthetic agents may influence brain function, and emerging evidence suggests possible neurotoxicity under certain conditions. S100β is a well-established biomarker of brain injury and blood–brain barrier disruption, and its prolonged elevation beyond 6–12 h, despite a short half-life, may indicate ongoing neuronal injury. Its use in cesarean section (C-section) remains limited, despite the potential neurological implications of both surgical stress and anesthetic technique. This study evaluates potential brain injury during caesarean section by comparing maternal and neonatal S100β levels under general and spinal anesthesia. Materials and Methods: This observational prospective study compared changes in the S100β brain damage biomarker in maternal (pre- and post-surgery) and umbilical artery blood during elective c-sections under general or spinal anesthesia. The 60 parturient women who underwent a C-section from 1 July 2021 to 30 December 2023 were evenly distributed into 2 groups: General anesthesia (GA) (n = 30) and Spinal anesthesia (SA) group (n = 30). It included healthy term pregnant women aged 18–40, ASA I–II and excluded those with major comorbidities or emergency conditions. Results: S100β concentrations slightly increased once the C-section was over in both the SA and GA groups, but without notable differences. In the SA and GA groups, preoperative S100β concentration in maternal blood was 195.1 ± 36.2 ng/L, 193.0 ± 54.3 ng/L, then increased to 200.9 ± 42.9 ng/L, 197.0 ± 42.7 at the end of operation. There was no statistically significant difference in S100β concentrations between the spinal and general anesthesia groups (p = 0.86). Conclusions: S100β concentrations slightly increased after C-section in both groups. The form of anesthesia seems to be irrelevant for the S100β level. However, further research is needed to confirm these findings and fully evaluate any potential long-term effects. Full article

Nephronophthisis (NPH) is the leading genetic cause of end-stage renal disease in children and young adults, but no effective disease-modifying therapies are currently available. Here, we identify glucagon-like peptide-1 (GLP-1) signaling as a novel therapeutic target for NPH through a systematic drug repurposing screen in zebrafish. By simultaneously depleting nphp1 and nphp4, we developed a robust zebrafish model that reproduces key features of human NPH, including glomerular cyst formation. Our screen revealed that dipeptidyl peptidase-4 (DPP4) inhibitors (Omarigliptin and Linagliptin) and GLP-1 receptor agonists (Semaglutide) significantly reduce cystogenesis in a dose-dependent manner. Genetic analysis demonstrated that GLP-1 receptor signaling is important for maintaining pronephros integrity, with gcgra and gcgrb (GLP-1 receptor genes) playing a particularly important role. Transcriptomic profiling identified adenosine receptor A2ab (adora2ab) as a key downstream effector of GLP-1 signaling, which regulates ciliary morphology and prevents cyst formation. Notably, nphp1/nphp4 double mutant zebrafish exhibited the upregulation of gcgra as a compensatory mechanism, which might explain their resistance to cystogenesis. This compensation was disrupted by the targeted depletion of GLP-1 receptors or the inhibition of adenylate cyclase, resulting in enhanced cyst formation, specifically in the mutant background. Our findings establish a signaling cascade from GLP-1 receptors to adora2ab in terms of regulating ciliary organization and preventing cystogenesis, offering new therapeutic opportunities for NPH through the repurposing of FDA-approved medications with established safety profiles. Full article

The diagnosis of opioid use disorder (OUD) is prevalent due to increased prescribing of opioids. Long-term oxycodone self-administration can lead to addiction-like behavioral responses in rats. Herein, we sought to identify molecular pathways consequent to long-term exposure to oxycodone self-administration. Towards that end, we used male Sprague Dawley rats that self-administered oxycodone for 20 days according to short-(ShA, 3 h) and long-access (LgA, 9 h) paradigms. LgA rats escalated their oxycodone intake and developed into 2 phenotypes, labeled Long-access High (LgA-H) and Long-access Low (LgA-L) rats, based on their escalation. RNA sequencing analysis revealed the LgA-H has significantly different DEGs in comparison to other groups. DAVID analysis revealed the participation of LgA-H DEGs in potassium transport. RT-PCR analysis of striatal samples validated the increased levels of potassium channels. Since these increases correlated with oxycodone intake, we believe potassium channels are potential targets for the treatment of oxycodone use disorder Full article

Background/Objectives: Heart transplantation is a life-saving procedure for patients with end-stage heart failure, yet it involves significant psychological and emotional challenges throughout its various stages. International guidelines recommend a multi-professional approach to the care of these patients and a psycho-social assessment for listing. The recommendations focus on content aspects, but not on the psychometric measure to be administered to patients as part of the assessment. Therefore, the purpose of this study is to provide the preliminary results of administering the protocol used by our center, measuring coping strategies, cognitive functioning, quality of life, and psychological distress in a sample of patients who are candidates for and undergo cardiac transplantation, and to observe any variations after the procedure. Methods: We conducted a comprehensive psychological-clinical assessment involving 40 patients, focusing on psychosocial functioning, cognitive reserves, mental health, and coping strategies. Tools such as the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Beck Depression Inventory-II (BDI-II), Montreal Cognitive Assessment (MoCA), General Anxiety Disorder 7 (GAD-7), and Medical Outcomes Survey Short Form 36 (SF-36) were employed to evaluate readiness for transplantation and post-transplant adaptation. Results: Results showed high levels of clinical anxiety (52.5%) and low perceived physical health (98%) before the transplant, while post-operative evaluations indicated reduced anxiety (13.51%) and depressive symptoms (10.81%), along with improved psychological well-being and reintegration into daily life. Conclusions: These results show improvement in physical and cognitive levels, accompanied by a state of enhanced psychological well-being after transplantation. A longitudinal psychological approach, from pre-transplant screening to post-discharge follow-up, is needed to address distress, improve coping mechanisms, and promote treatment adherence. This integrative strategy is critical to improving the quality of life and long-term outcomes for heart transplant recipients. Full article

Regional shrinkage, driven by declining birth rates, an aging population, and population concentration in the capital region, has become an increasingly serious issue in South Korea, threatening the long-term sustainability of local communities. Among various factors, youth out-migration is a key driver, undermining the economic resilience and vitality of local areas. This study aims to predict youth population trends across 229 municipalities by incorporating diverse regional socioeconomic factors and providing a foundation for policy implementation to mitigate demographic disparities. To this end, a long short-term memory (LSTM) model, based on a direct approach that independently forecasts each future time point, was employed. The model was trained using the youth population data from 2003 to 2022 and socioeconomic variables, including employment, education, housing, and infrastructure. The results reveal a persistent nationwide decline in the youth population, with significantly sharper decreases in local areas than in the capital region. These findings underscore the deepening spatial imbalance and highlight the urgent need for region-specific demographic policies to address the accelerating risk of regional population decline. Full article

Background: Enzymes secreted by the digestive glands are excreted from the body with urine, sweat and feces, and they are also removed from the blood due to their participation in the enzymatic provision of the secretion entering the gastrointestinal tract. Objective: The aim of this work was to analyze the activity of pepsinogen, amylase and lipase in the coprofiltrate of pregnant women in each trimester of pregnancy and in the postpartum period, taking into account the timing and type of delivery (term, premature, late delivery or cesarean section). Methods: Data from studies of non-pregnant (n = 45) and pregnant (n = 193) women were analyzed. The materials for preparation coprofiltrate were collected during delivery. Pepsinogen activity was determined by proteolytic activity at pH = 1.5–2.0 using the tyrosine spectrophotometric method, while amylase activity was determined by the amyloclastic method of Karavey, and lipolytic activity was determined by a unified kinetic method using olive oil as a substrate. Outcomes: A small amount of pepsinogen was excreted in the coprofiltrate, and while the level of its excretion increased after childbirth, it remained below the control values. At the same time, an increase in the amylolytic activity of the coprofiltrate was observed in all groups of pregnant women examined from the first to the third trimester of pregnancy. In pregnant women, multidirectional changes in lipase activity were observed depending on the timing and type of delivery. Conclusions: At the end of pregnancy, amylolytic activity increased in all women, and pepsinase activity decreased compared to the indicators of non-pregnant women. No reliable differences were found in the lipolytic activity of the coprofiltrate in pregnant women at the end of pregnancy and the indicators of non-pregnant women. Full article