Search Results (2,469)

Background/Objectives: Real-world evidence on ofatumumab (OFA) beyond 12 months remains limited in relapsing–remitting multiple sclerosis (RRMS). We assessed 24-month effectiveness and safety, compared treatment-naïve and previously treated patients, and explored predictors of failure to achieve No Evidence of Disease Activity-3 (NEDA-3). Methods: This multicenter retrospective cohort study included adult RRMS patients treated with OFA in routine clinical practice. Effectiveness analyses were restricted to patients with complete 24-month follow-up and full clinical and magnetic resonance imaging (MRI) assessment (complete-case analysis). Outcomes included relapses, MRI activity, Expanded Disability Status Scale (EDSS) progression, NEDA-3, and adverse events (AEs). Exploratory multivariable logistic regression was used to assess baseline predictors of NEDA-3 non-achievement. Results: Of 258 patients who initiated OFA, 148 had completed 24-month clinical and MRI follow-up and were evaluable for effectiveness. Over 24 months, 71.5% achieved NEDA-3; relapses occurred in 15.5% of patients, MRI activity in 15.5%, gadolinium-enhancing lesions (GELs) in 4.7%, and EDSS progression in 17.6%. Disease activity was minimal during months 12–24, with relapses in 2.7%, MRI activity in 2.0%, and no GELs. In unadjusted analyses, no statistically significant differences were observed between treatment-naïve and previously treated patients. Higher baseline EDSS was associated with failure to achieve NEDA-3. In the 24-month safety subgroup, AEs were recorded in 28.4% of patients; infections occurred in 26.4% of patients (all grade 1–2), and no serious adverse events were observed. Conclusions: In this multicenter real-world cohort, OFA was associated with low inflammatory disease activity over 24 months in RRMS patients with complete follow-up. These findings should be interpreted cautiously because the effectiveness analysis was restricted to a complete-case cohort and safety data were collected retrospectively. Full article

Objectives: Myofascial pain syndrome (MPS) is a common musculoskeletal condition, and while percutaneous needle electrolysis (PNE) and intramuscular electrical stimulation (IMES) are emerging therapies for myofascial pain syndrome and tendinopathies, their effects remain unclear. This systematic review aimed to characterize the methodological features and synthesize the evidence on the clinical improvement and adverse events rates of PNE and IMES in treating MPS and tendinopathies. Data Sources: PubMed, Scopus, Web of Science, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform, Google Scholar, and reference lists. Searches were carried out on 10 July 2025 and repeated on 16 March 2026, just before final analysis. New results found during final searches were screened for inclusion to ensure currency of the review. Methods: We selected studies based on the PICOS framework and predefined selection criteria: Population: adults with MPS or active myofascial trigger points (TrPs), or tendinopathies; Intervention: PNE or IMES; Comparator: sham procedures, other interventions, or no intervention; Outcomes: pain intensity (e.g., Visual Analogue Scale or Numeric Pain Rating Scale), pressure pain threshold (PPT), and functional measures; and Study Design: experimental studies. Studies focused exclusively on post-surgical or neuropathic pain, studies without a relevant comparator, and studies not reporting clinically meaningful outcomes were excluded. We assessed the risk of bias of included studies and performed a narrative synthesis. Results: From 737 identified records, 30 studies met the selection criteria. PNE was generally effective in reducing pain and improving function in tendinopathies and MPS, although results varied across outcomes and follow-ups. IMES showed moderate evidence for reducing pain and enhancing function, particularly cervical range of motion and PPT. However, both interventions had inconsistent clinical improvement and adverse events rates on disability indices and quality of life. Most studies had a high risk of bias due to challenges in blinding. Reported adverse events were minor and self-limiting, indicating that both therapies are generally safe when performed by trained clinicians. Conclusions: PNE and IMES may improve pain and some functional outcomes in MPS and tendinopathies; however, these findings should be interpreted cautiously because most included studies had a high risk of bias. Full article

Background: Among individuals with type 2 diabetes (T2D), lifestyle improvements can restore glycemic control, yet few studies have examined deprescribing in settings where it was necessitated by improvements in health. This study aimed to (1) identify instances of medication deprescribing among adults with T2D in a primary care setting where patients had access to lifestyle medicine (LM), (2) document lifestyle changes among deprescribed patients, (3) assess changes in body mass index (BMI), glucose, and hemoglobin A1c (HbA1c) following deprescribing, and (4) assess the safety of deprescribing in the context of LM-informed care by identifying adverse events. Methods: A retrospective review of electronic health records (EHR) was conducted among 650 adults with a diagnosis of T2D per ICD-10 code at two primary care practices. To be included in the study, individuals had to be seen at least two times during the study period, from 2014 to 2023. Using a previously developed deprescribing framework, records were reviewed to identify deprescribing events. Among patients who were identified as deprescribed, BMI, glucose, and HbA1c, were extracted from the EHR, and age-, sex-, and time-adjusted differences in least squares means were calculated. Mentions of lifestyle change in provider notes in the EHR were also extracted pre- vs. post-deprescribing. Results: Forty-one deprescribing events were confirmed, totaling 6.3% of the study population. The most common medication changes included metformin dose reduction 34%, metformin discontinuation 19.5%, and insulin dose reduction 19.5%. Among patients with follow-up data, mean BMI decreased by 2.25 kg/m², p = 0.0003. Mean decreases of 25% in glucose and 13% in HbA1c were also observed, p < 0.0003 and p < 0.0013, respectively. Lifestyle modifications were specifically cited in 51% of records among deprescribed patients, most frequently related to diet and exercise. No serious adverse events were identified in patients who were deprescribed. Conclusions: In a primary care setting where patients had access to lifestyle medicine, a subset of adults with T2D experienced meaningful health improvements and were able to reduce glucose-lowering medications without any serious adverse events noted in the EHR. Full article

The thermal history of petroliferous basins controls the thermal evolution of source rocks and the diagenetic evolution of reservoirs. However, although various thermal events are common in such basins, previous studies have largely focused on the outcomes of thermal anomalies rather than systematically evaluating the spatiotemporal extent of their thermal effects. This oversight has impeded accurate assessment of source rock maturation and the timing of hydrocarbon accumulation. This study takes the Baiyun Deep Water Area in the Pearl River Mouth Basin as a case study, aiming to identify types of thermal events and systematically evaluate the extent of their impacts using geologic thermometers, numerical simulations, and measured data. Magmatic activity and hydrocarbon charging are two widely distributed types of thermal events in this area. Apatite fission track (AFT) data reveal two magmatic underplating events in the southern part of the area at 20 Ma and 10 Ma, which led to a rapid increase in vitrinite reflectance (R_o) in the overlying strata. COMSOL Multiphysics 6.2 simulations of the B6-1 diapir show that its thermal impact extends laterally up to 10 km, with the Wenchang Formation source rocks within 2 km of the diapir rapidly heating to 310 °C and reaching over-maturity. Abnormally high homogenization temperatures recorded by saline inclusions associated with hydrocarbon inclusions provide evidence of thermal anomalies induced by hydrocarbon charging. By reconstructing the trapping depths of these inclusions, the timing of their formation was determined. Comparison with normal burial-thermal histories indicates that their homogenization temperatures are 20–30 °C higher than the ambient formation temperatures. Current thermal anomalies in the Enping Formation reservoir of Well K18-1, caused by ongoing hydrocarbon charging, were simulated using COMSOL. The results show that hydrocarbon charging only causes mild thermal anomalies confined to the reservoir and adjacent strata, with a temperature increase of about 29 °C. Present-day measured vitrinite reflectance data further confirm that hydrocarbon charging does not lead to an increase in R_o. Clarifying the types and effects of thermal events is essential for accurately reconstructing the thermal evolution of source rocks and the history of hydrocarbon accumulation. This study provides a new methodology for geothermal field research in petroliferous basins. By integrating AFT, R_o, and fluid inclusion analyses, we reveal past thermal events, and through numerical simulation, quantify the spatiotemporal influence of magmatic activity and hydrocarbon charging on the geothermal field. Full article

Background: Our study retrospectively investigated the therapeutic effects of SGLT2 inhibitors on multiple outcomes in patients with Type 2 Diabetes, capitalizing on the agent’s proven benefits in glycemic, cardiovascular, and renal systems. Methods: This retrospective cohort study investigated a total of 200 patients with T2DM, 100 SGLT2I-treated and 100 treated without SGLT2Is. Clinical data were retrieved from the electronic health record system of the hospital. Patients were followed for more than 6 months to assess the effects of SGLT2Is on metabolic, biochemical, and renal parameters. Results: In the SGLT2I-treated cohort, a higher prevalence of males, non-geriatrics, and comorbidities such as HF and ASCVD was observed with greater use of concomitant medications (beta-blockers, antithrombotics, antilipidemics). SGLT2I treatments show a greater reduction in FBG (control: −6.3 mg/dL vs. treatment: −24.2 mg/dL; p ≤ 0.05), HbA1c (control: −0.093% vs. treatment: −0.76%; p ≤ 0.001), weight (control: −0.6 kg vs. treatment: −3.6 kg; p ≤ 0.001), SBP (control: 5.8 mmHg vs. treatment: −9.2 mmHg; p ≤ 0.001), and DBP (control: 2.2 mmHg vs. treatment: −4.7 mmHg; p ≤ 0.05) compared to the control group. The analysis of the mean change in eGFR showed no statistically significant difference in both groups. The SGLT2I’s safety profile was favorable, with no difference in adverse events and no cases of euglycemic ketoacidosis or Fournier’s gangrene. Conclusions: In this study, SGLT2Is demonstrated strong clinical efficacy in improving multiple cardiometabolic parameters without compromising patient safety in short-term follow-up. Large-scale and long-term real-world studies are needed to monitor the long-term safety profile, characterize the incidence of rare adverse events in general clinical practice, and validate results from this study. Full article

The geochronological framework of the Late Mesozoic volcanic succession in the Great Xing’an Range is crucial for understanding the tectonic regime transition in Northeast Asia. However, the ages and stratigraphic relationships of key volcanic units remain poorly constrained. This study presents zircon LA-ICP-MS U–Pb geochronological data from volcanic rocks above and below the basal unconformity of the Longjiang Formation in the Zhalantun–Jalaid Banner area, central Great Xing’an Range, aiming to determine the timing of volcanic activity, constrain the formation age of the unconformity, and explore its regional tectonic implications. The volcanic–stratigraphic succession in the study area, from base to top, comprises the Baiyingaolao Formation, the basal andesitic conglomerate of the Longjiang Formation, and the Longjiang Formation andesites. Geochronological results indicate that the underlying rhyolitic tuff of the Baiyingaolao Formation yields an age of 130.0 ± 0.1 Ma. Within the andesitic conglomerate overlying the unconformity, andesitic clasts yield an age of 135.8 ± 1.1 Ma, whereas the matrix provides a youngest detrital zircon population age of 130.7 ± 1.0 Ma, constraining the maximum depositional age of the conglomerate. The overlying andesite of the Longjiang Formation gives an eruption age of 125.6 ± 0.8 Ma. These data indicate that the main phase of Longjiang Formation volcanism occurred at ~125.6 Ma, and the basal conglomerate was deposited after ~130.7 Ma. Combined with the ~130 Ma age of the underlying Baiyingaolao Formation and the presence of weathering crusts and erosional surfaces between the two formations, the sedimentary hiatus and exhumation event represented by this unconformity are precisely constrained to have occurred between ~130 Ma and 125.6 Ma. The timing of this unconformity closely coincides with the regional transition in magmatic assemblages from bimodal to andesitic compositions, suggesting that it records a significant tectonic adjustment event in the Great Xing’an Range during the middle to late Early Cretaceous. This finding provides key chronological evidence for understanding the episodic tectonic evolution of Northeast Asia during the Late Mesozoic. Full article

Background and Objectives. Mother-to-child transmission (MTCT) or vertical transmission of human immunodeficiency virus (HIV) is largely preventable in settings where prevention of MTCT (PVT) strategies are consistently implemented. Romania represents a particular epidemiological context, as individuals from the historical pediatric HIV cohort have now reached reproductive age. This study assessed current PVT outcomes in northeastern Romania and explored the remaining circumstances in which transmission still occurs. Materials and Methods. We performed a retrospective observational analysis at the Regional HIV/AIDS Center of Iași (“Sfânta Parascheva” Clinical Hospital of Infectious Diseases), including all pregnant women living with HIV and their HIV-exposed infants followed between 2023 and 2025. Maternal data comprised age, place of residence, origin from the Romanian pediatric cohort, antiretroviral therapy (ART) adherence, and HIV RNA viral load in the third trimester. Obstetric characteristics, delivery mode, neonatal antiretroviral prophylaxis, and infant HIV RNA PCR results during follow-up up to 18–24 months were also evaluated. Results. A total of 61 HIV-positive pregnant women and 53 HIV-exposed infants were included. Viral suppression during pregnancy was documented in 59 women (96.7%), while two cases of detectable viremia in late pregnancy were linked to poor ART adherence. All women delivered by elective cesarean section, and all infants received neonatal antiretroviral prophylaxis, with Raltegravir added in selected higher-risk situations. Overall, MTCT was 3.8% (2/53). No transmission events were recorded in 2023 or 2024; both cases occurred in 2025 (15.4% of infants born that year) and exclusively in the context of maternal viremia. Women originating from the historical pediatric HIV cohort accounted for 31.1% (19/61) of pregnancies, and no transmission was observed among their infants. Conclusions. In northeastern Romania, PVT programs remain highly effective when maternal viral suppression is achieved. Residual transmission was confined to situations of maternal viremia driven by ART non-adherence, highlighting the continued importance of adherence support during pregnancy. Full article

Background: Chinese immigrant families of autistic children in the United States face intersecting barriers related to language, culture, immigration, and fragmented service systems. Yet little is known about how Chinese immigrant parents engage in advocacy or how such efforts relate to disability and human rights. Methods: This qualitative study draws on in-depth interviews with fourteen Chinese immigrant parents of autistic children across multiple U.S. regions. Data were triangulated with analyses of publicly recorded advocacy events and parent-produced textual materials. Reflexive thematic analysis was used to examine motivations for advocacy, advocacy practices, and structural, linguistic, and cultural constraints. Results: Advocacy rarely emerged as an intentional or identity-driven pursuit. Instead, parents were compelled into advocacy through institutional exclusion, service denial, and unmet care needs. Parents engaged in diverse forms of advocacy, including migration, negotiation within institutions, information translation, community-building, and grassroots organizational leadership. Cultural norms shaped advocacy strategies, producing quiet, relational, and collective forms of action often overlooked in dominant rights-based models. Conclusions: Interpreted through a disability justice lens, parental advocacy functions as burdened and unequally distributed labor compensating for systemic failures. Findings underscore the need for institutional reforms that reduce reliance on families’ capacity to fight for access, dignity, and care. Full article

Floods are among the extreme events associated with climate variability in the Lacramarca River basin, located in the department of Ancash, Peru. Meteorological phenomena such as El Niño during the periods 1982–1983 and 1997–1998, as well as the Coastal El Niño in 2017, constitute key reference events that motivated the development of the present study, based on a case study conducted in the area between the rural settlements of Santa Clemencia and Pampadura. This research is based on maximum precipitation data derived from historical climate records and from the climate scenarios ACCESS 1-3, HadGEM2-ES, and MPI-ESM-MR, as well as the median projected scenario for 2050, obtained from the National Meteorology and Hydrology Service of Peru (SENAMHI) data platform. This information was analyzed considering the spatial location of the basin and its position relative to the area of interest, using Intensity–Duration–Frequency (IDF) curves. To demonstrate the changes in the river hydrological behavior before and after the 2017 Coastal El Niño event, a Random Forest modeling approach was applied using Sentinel-2 satellite imagery. Design peak discharges for return periods of 50, 100, and 140 years were estimated using the HEC-HMS software. Hydraulic simulation of the Lacramarca River basin, carried out using HEC-RAS version 6.7 beta 3 and IBER version 3.3.1 software, made it possible to identify flood-prone areas affecting agricultural land and areas adjacent to population centers, covering 149,000 m² and 172,000 m² for return periods of 100 and 140 years, respectively, based on information from the historical scenario. In contrast, using data from the 2050 projection scenario, affected areas of 242,000 m² and 323,000 m² were estimated for the same return periods. Full article

Open and reusable road-safety microdata remain scarce in Latin America, particularly when incident records combine detailed temporal information, geocoded event locations, and a clear pathway for extracting fatal outcomes. This article documents a curated administrative dataset for Medellín, Colombia, containing 702,540 reported road-traffic incidents recorded between 1 January 2008 and 31 August 2025. The dataset includes 13 variables describing incident identifier, date, time, incident class, severity, interpolated address, geographic coordinates (latitude and longitude), and planning-unit identifiers. Although the complete dataset contains three severity levels—property damage only, injured, and fatal—it also enables the construction of a fully reproducible fatality subset by filtering incidents classified as fatal, yielding 2762 records. The database covers 21 planning units (communes) in Medellín and includes named neighborhood information for 394 neighborhoods in the complete dataset and 274 neighborhoods in the fatal subset. Spatial completeness is high for administrative data: geographic coordinates are available for 93.63% of all records and 90.77% of fatal incidents. To keep the emphasis on dataset documentation, this data descriptor focuses on compact statistical tables and an illustrative grouped logistic regression model of fatal outcomes. The dataset, accompanied by a complete data dictionary and reproducible R script, is intended to support secondary research in road-traffic safety, spatial epidemiology, transportation planning, urban mobility, and public health. Full article

Background: High recurrence rates for non-muscle-invasive bladder cancer (NMIBC) remain a clinical challenge. Recommended post-operative treatments are underutilized, highlighting the need for alternative strategies. Given the variability in bladder cancer prognosis, personalized treatment approaches are highly relevant. In this study, we evaluated post-operative two-hour continuous sterile water bladder irrigation (CSWBI) regarding recurrence and safety, as a potential addition to the treatment arsenal for bladder cancer. Method: In 2018, two-hour CSWBI was implemented as routine treatment after all transurethral resection procedures of the bladder (TURB), at the urology department of Sundsvall Hospital. All patients who underwent TURBs four years prior (control group) and four years after the implementation of CSWBI (intervention group) were analyzed. Primary NMIBC were included, MIBC and CIS were excluded. Data were collected retrospectively from patient records, including baseline characteristics, adverse events, and recurrence rates within 12 months follow-up. Statistical analyses included Chi-squared test, Wilcoxon rank-sum test, univariate and multivariate logistic regression analyses, Kaplan–Meier curves and log-rank test. Results: A total of 168 patients were included (control group n = 90, irrigation group n = 78). Median age was 73 years, 23% were female, 77% were male, and 74% were active or previous smokers. The recurrence rate within twelve months for the intervention group vs. the control group was: 27% vs. 21% (p = 0.4) respectively. CSWBI had no statistically significant impact on recurrence (OR 1.25, 95% CI 0.58–2.68, p = 0.6). Adverse effects were limited and equal between groups. Conclusions: Post-operative two-hour CSWBI did not significantly reduce NMIBC recurrence within twelve months in this cohort. Full article

A substantial proportion of wildfires in Mediterranean regions continue to be recorded without information about the cause or source of ignition, limiting our ability to understand ignition drivers and design effective prevention strategies. In this study, we develop a spatially harmonised wildfire database for mainland Spain by integrating ignition records from the Spanish General Fire Statistics (EGIF) with fire perimeters generated from satellite images. We then apply a Random Forest classifier to infer ignition causes for events lacking cause attribution. To interpret model behaviour, we use Shapley Additive Explanation (SHAP) values at both global and local scales. Results indicate that human-caused ignitions are dominant, with intentional and negligence-related fires accounting for 52.13% of all known events, although they are associated with contrasting climatic and land-use settings. Negligence-related fires tend to occur under hot, dry and windy conditions, often in agricultural interfaces, whereas intentional fires are more frequent under cooler and wetter conditions and in areas with higher population density and land-use change. Lightning-caused fires represent a small fraction of total ignitions (3%) but exhibit a distinct climatic signature, occurring primarily in sparsely populated areas, under intermediate moisture conditions, and often leading to larger burned areas. Despite strong overall model performance (F1-score = 0.82), minority classes (e.g., lightning and fire rekindling, 0.17%) remain challenging to classify, reflecting both data imbalance and uncertainty in causal attribution. Overall, the combined use of machine learning and explainable AI provides a coherent spatial characterisation of wildfire ignition drivers across mainland Spain, highlights systematic differences among ignition causes, and identifies key limitations in existing fire cause records. This framework represents a practical step towards improving fire cause information by integrating remote sensing products with field-based fire reports, thereby supporting more targeted and evidence-based fire risk management. Full article

Swallowing is a critical marker of neurological and emotional health. The ability to monitor it continuously and non-invasively, especially through smart ear-worn devices, holds significant promise for clinical applications. Despite this potential, no public audio datasets currently support reliable swallowing sound detection. Existing datasets focus primarily on speech and breathing, offering limited coverage and lacking detailed annotations for swallowing events. To address this gap, we introduce an in-ear audio dataset specifically designed to capture a wide range of verbal and non-verbal sounds. It includes comprehensive labeling focused on swallowing. The dataset was collected from 34 healthy adults (14 females and 20 males) between the ages of 20 and 29. Each participant performed a series of predefined tasks involving both non-verbal and verbal events. Non-verbal tasks included swallowing, clicking, forceful blinking, touching the scalp, and physical movements such as squatting or walking in place. Verbal tasks consisted of speaking (e.g., describing an image). Recordings were conducted in both quiet and noisy environments to better reflect real-world conditions. Data were captured using a combination of in-/outer-ear microphones, a chest belt to record electrocardiogram (ECG), respiration and acceleration signals, and an ultrasound probe to track tongue movement, which served as a reference for swallowing annotation. All signals were precisely synchronized. To ensure high data quality, the recordings were reviewed using both algorithmic analysis and manual inspection. Swallowing events were identified based on ultrasound signals and validated by an expert to guarantee accurate labeling. As a proof of concept that in-ear audio supports swallow classification, we fine-tune a fully connected neural network on YAMNet embeddings plus zero-crossing rate (ZCR) features. Across the completed folds, the model reaches an F1 score of 0.875 ± 0.013. Full article

Background: Breakpoints in the pre-examination processes and at organizational interfaces are a significant source of failures in specimen identification and tracking in anatomic pathology. While ISO 15189 emphasizes end-to-end traceability and risk-based quality management, implementing these principles in complex, multi-actor specimen pathways remains challenging. This study explores expert perspectives on specimen process chains, tracking mechanisms, and ISO 15189-oriented quality and risk management in pathology. Methods: We conducted 10 semi-structured expert interviews across three settings. Interviews were audio-recorded, transcribed, pseudonymized, and analyzed using structured qualitative content analysis (Mayring) supported by MAXQDA. A deductive category system derived from the theoretical framework and interview guide comprised six main categories and twelve subcategories. Results: Across 512 coded text segments, participants identified several factors as critical for effective implementation, including: (i) interface management along the specimen pathway, with recurrent vulnerabilities at handovers between operating theater/ward/transport and accessioning; (ii) the central role of barcode-based identification and the need for closed-loop traceability; (iii) the importance of measurable quality indicators and incident learning systems to operationalize risk management; (iv) persistent paper–digital handoffs and heterogeneous IT landscapes that undermine data integrity; (v) the need for clearly assigned responsibilities, training, and SOP governance; and (vi) implementation barriers including resources, change management, and vendor integration, alongside practical enablers such as incremental roll-out and cross-professional governance. Conclusions: Experts converge on a pragmatic ISO 15189-aligned roadmap: prioritize interface risks, standardize identifiers and handover rules, define a minimal KPI set for tracking and misidentification events, and reduce paper–digital handoffs by interoperable IT. Future work should quantify baseline error rates and evaluate the impact of digital tracking interventions on patient safety and turnaround times. Full article

The proliferation of Internet of Things (IoT) devices has intensified the need for efficient real-time anomaly and intrusion detection, making the selection of an appropriate Complex Event Processing (CEP) engine a critical architectural decision for security-aware data pipelines. Python-based CEP frameworks offer compelling advantages through the seamless integration with data science and machine learning ecosystems; however, rigorous comparative evaluations of such frameworks under realistic IoT security workloads remain absent from the literature. This study presents the first systematic comparative evaluation of Faust and Streamz—two Python-native CEP engines representing fundamentally different architectural philosophies—specifically in the context of IoT network intrusion detection. Faust was selected for its actor-based stateful processing model with native Kafka integration and distributed table support, while Streamz was selected for its reactive, lightweight pipeline design targeting high-throughput stateless processing, making them representative of the two dominant paradigms in Python stream processing. Although both engines target different application niches, their performance characteristics under realistic CEP workloads have never been rigorously compared, leaving practitioners without empirical guidance. The primary evaluation employs an IoT network intrusion dataset comprising 583,485 events from 83 heterogeneous devices. To assess whether the observed performance characteristics are specific to this single dataset or generalize across different workload profiles, a secondary IoT-adjacent benchmark is included: the PaySim financial transaction dataset (6.4 million records), selected because its event schema, fraud-pattern temporal structure, and volume differ substantially from the intrusion dataset, providing a stress test for cross-workload robustness rather than a claim of domain equivalence. We acknowledge the reviewer’s valid point that a second IoT-specific intrusion dataset (such as TON_IoT or Bot-IoT) would constitute a more directly comparable validation; this is identified as a priority for future work. The load levels used in scalability experiments (up to 5000 events per second) intentionally exceed the dataset’s natural rate to stress-test each engine’s architectural ceiling and identify saturation thresholds relevant to large-scale or multi-sensor IoT deployments. We conducted controlled experiments with comprehensive statistical analysis. Our results demonstrate that Streamz achieves superior throughput at 4450 events per second with 89% efficiency and minimal resource consumption (40 MB memory, 12 ms median latency), while Faust provides robust intrusion pattern detection with 93–98% accuracy and stable, predictable resource utilization (1.4% CPU standard deviation). A multi-framework comparison including Apache Kafka Streams and offline scikit-learn baselines confirms that Faust achieves detection quality competitive with JVM-based alternatives (Faust: 96.2%; Kafka Streams: 96.8%; absolute difference of 0.6 percentage points, not statistically significant at $p=0.318$) while retaining the Python ecosystem advantages. Statistical analysis confirms significant performance differences across all metrics ($p<0.001$, Cohen’s $d>0.8$). Critical scalability thresholds are identified: Streamz maintains efficiency above 95% up to 3500 events per second, while Faust degrades beyond 2500 events per second. These findings provide IoT security engineers and system architects with actionable, empirically grounded guidance for CEP engine selection, establish reproducible benchmarking methodology applicable to future Python-based stream processing evaluations, and advance theoretical understanding of the accuracy–throughput trade-off in stateful versus stateless Python CEP architectures. Full article