Search Results (38,343)

Background: Celiac disease (CD) is a chronic immune-mediated disorder requiring lifelong adherence to a strict gluten-free diet (GFD). Similar to chronic pediatric disorders, primary caregivers are susceptible to significant psychosocial burden, as CD management relies heavily on them. However, evidence regarding their psychological well-being in Jordan remains limited. Objective: This study aimed to investigate the psychosocial burden on Jordanian caregivers of pediatric CD patients and examine associations with clinical and sociodemographic factors. Methods: This cross-sectional study recruited Jordanian caregivers of pediatric CD patients with biopsy-confirmed diagnosis from September to December 2025, and all patients had followed a GFD for at least six months. The Arabic version of the Celiac Disease Parent/Caregiver Quality of Life Questionnaire (CDPCA-QoL) was distributed online, alongside questions on child and caregiver sociodemographic factors. Descriptive and inferential analyses, including t-tests, ANOVA, correlation, and multiple linear regression, were performed. Results: A total of 198 caregivers participated (mean age 39.5 ± 9.8 years; 85.9% female). Overall burden ranged from moderate to moderately high. Parental worries had the highest mean score (3.95 ± 0.66), followed by emotional (3.48 ± 0.73) and social functioning (2.96 ± 0.99). Younger age, lower education, and lower income were significantly associated with greater burden (p < 0.05). Caring for more than one affected child increased emotional and social strain, whereas longer disease duration was linked to lower parental worry. No associations were found with caregiver gender, marital status, employment, or child characteristics. Conclusions: Jordanian caregivers experience considerable psychosocial burden, emphasizing the need for targeted psychosocial and family-centered support. Full article

Mathematical modeling plays a key role in understanding and optimizing transport system operations under uncertain and dynamic conditions. This study proposes a data-driven predictive framework for estimating passenger-accepted vehicle occupancy, addressing a critical gap in transport system planning under public health-related constraints. Using data from a structured survey conducted across seven Southeast European countries (N = 476), the study integrates statistical analysis and machine learning approaches to model acceptable occupancy levels across multiple transport modes, including passenger cars, taxis, tourist buses, and public buses. The problem is formulated as a predictive mapping between multidimensional input variables and occupancy acceptance levels, modeled using both probabilistic and nonlinear function approximation methods. The results highlight that age, gender, and area of residence are the most significant determinants of occupancy acceptance, while education level has limited predictive relevance. Furthermore, a multi-layer feedforward artificial neural network is developed to capture nonlinear relationships between variables, achieving strong predictive performance (minimum MSE = 0.0089). The main contribution of this research lies in linking behavioral data with predictive modeling to quantify acceptable occupancy thresholds and support realistic simulation of passenger responses in crisis conditions. The proposed modeling framework contributes to transport system planning, enabling data-driven capacity management, enhanced safety strategies, and improved resilience of passenger transport operations. Full article

Advances in pediatric oncology have markedly improved survival, shifting attention toward long-term treatment-related morbidity. Targeted agents and immune-based therapies are now widely used across pediatric malignancies and selected non-malignant conditions, often for prolonged periods and during critical windows of growth and development. Because many therapeutic targets regulate physiological pathways involved in growth, pubertal maturation, gonadal function, bone metabolism, and energy homeostasis, clinically relevant endocrine toxicity may emerge during treatment or become apparent only with extended follow-up. This narrative review summarizes pediatric evidence on endocrine and metabolic effects associated with major classes of targeted and immune-based therapies, including tyrosine kinase inhibitors, mTOR inhibitors, MAPK-pathway inhibitors (BRAF/MEK), TRK inhibitors, ALK inhibitors, immune checkpoint inhibitors, and immune effector therapies. Distinct patterns of endocrine vulnerability emerge across drug classes: growth impairment and bone–mineral alterations are most consistently reported with tyrosine kinase inhibitors; weight gain and metabolic changes predominate with MAPK-, TRK-, and ALK-targeted agents; immune checkpoint inhibitors are characterized by early, multi-axis immune-related endocrinopathies with a high likelihood of permanent hormone deficiency once established. In contrast, endocrine abnormalities observed after immune effector therapies largely reflect indirect effects of systemic inflammation, corticosteroid exposure, and prior hematopoietic stem cell transplantation rather than direct endocrine toxicity. Given the limited pediatric-specific data, frequent confounding by multimodal therapy, and the potential for delayed or irreversible endocrine sequelae, structured endocrine monitoring and long-term survivorship care are essential for children exposed to modern anticancer therapies. Full article

Automatic Identification System (AIS) data provide valuable insights into ship behavior, supporting maritime safety, situational awareness, and operational efficiency capabilities that are increasingly required for autonomous ship functions and harbor maneuvering assistance. This review synthesizes recent research on AIS-based ship behavior analysis and modeling published between 2022 and 2024 using a structured literature search and screening process informed by PRISMA principles. The review presents a five-stage workflow, spanning data processing, data analysis, knowledge extraction, modeling, and runtime applications with emphasis on how these stages contribute to perception, prediction, and decision support in automated navigation. Four dimensions are considered in data analysis, including statistical analysis, safety indicators, situational awareness, and anomaly detection. The modeling approaches are categorized into classification, regression, and optimization, highlighting current limitations such as data quality, algorithmic transparency, and real-time performance, while also assessing runtime feasibility for onboard or edge deployment. Three runtime application directions are identified: autonomous vessel functions, remote monitoring and control operations, and onboard decision-support tools, with numerous studies focusing on constrained waterways and port-approach scenarios. Future directions suggest integrating multi-source data and advancing machine learning models to improve robustness in complex traffic and harbor environments. By linking theoretical insights with practical onboard needs, this study provides guidance for developing intelligent, adaptive, and safety-enhancing maritime systems. Full article

Saponins, the primary bioactive constituents with immunomodulatory activities in Baoyuan decoction—a traditional Chinese medicine formula composed of ginseng, astragalus, licorice, and cinnamon—are limited by low extraction yield, poor stability, and easy degradation. In this study, cellulase and pectinase were used for the extraction of saponins from Baoyuan decoction and optimized by response surface methodology. Subsequently, the optimal extracts were microencapsulated by spray drying with soy protein isolate (SPI) or high-oleic acid soy protein isolate (HOSPI) and pectin (PE) as composite wall materials, followed by application evaluation in gummies and in vitro digestion. After optimization, the total saponin yield was 63.68 ± 0.15 mg/g. HOSPI-PE microcapsules (HBP) had a higher encapsulation efficiency (90.38%), smaller particle size, and lower hygroscopicity than SPI-PE ones (SBP). Furthermore, both microcapsules showed good stability during storage and controlled release, with 60.9% of saponins in SBP and 65.8% in HBP being delivered to the intestinal phase during in vitro digestion of microparticles. When applied in gummies, microcapsule gummies retained satisfactory sustained-release in vitro digestion (23.0% released in the stomach and 66.2% in the small intestine). In contrast, the unencapsulated gummies exhibited a burst release (74.4%) at 30 min in gastric digestion. This study provides theoretical and technical insights into the development of plant-derived functional foods and promotes the practical application of microencapsulation in functional gummy candies. Full article

Adrenocortical carcinomas (ACCs) are rare, aggressive tumors often discovered incidentally. These malignancies may present with abnormal hormone secretion or, as in some cases, as non-functioning masses causing discomfort. We present a case of brain metastasis in a patient with a giant ACC. A 50-year-old man presented with headache and dizziness. A computed tomography (CT) scan showed an intracranial lesion within the parenchyma measuring 73*60*46 mm with left internal temporal involvement, abundant vasogenic edema and compressing the lateral left ventricle. Further imaging investigations identified a large necrotic tissue mass measuring 15 cm, located on both sides of the right diaphragmatic dome, in the middle posterior region. Hormonal workup was conducted and excluded a functional adrenal tumor. A CT-guided biopsy was performed, confirming ACC. Despite medical management, the patient’s condition deteriorated rapidly, with the cerebral metastasis proving fatal. This case underscores the challenges posed by advanced ACC, particularly when associated with atypical metastatic sites. Giant ACC, though rare, presents significant diagnostic and therapeutic challenges. Surgical excision with appropriate oncologic management can lead to favorable outcomes. This report contributes to the limited literature on cerebral metastases in ACC, aiming to enhance awareness among clinicians managing this rare entity. Full article

Industrial predictive maintenance programs often rely on SCADA historian signals characterized by low-frequency sampling and asynchronous reporting intervals. These data constraints, specifically non-uniform scan rates and inter-tag time misalignment, limit the applicability of high-resolution or sensor-intensive prognostic models. This study proposes a lightweight, physics-informed health proxy, the temperature-weighted work (TWW) index, designed to monitor motor stator-winding degradation within these industrial limitations. The TWW index accumulates mechanical work derived from torque and speed measurements, weighted by an adaptive exponential temperature-emphasis function that penalizes operation at elevated temperatures. The formulation is inspired by practical thermal-aging heuristics such as Montsinger’s rule in the qualitative sense that higher temperatures are treated as disproportionately more damaging, but it is not intended as a direct implementation of a fixed absolute-temperature life law. Instead, it is designed as a lightweight adaptive index suitable for online SCADA-based implementation. To address SCADA-specific irregularities, the framework incorporates data synchronization and resampling techniques to align heterogeneous tags, alongside power-thresholding to isolate degradation-relevant load periods. The resulting cumulative index is mapped to a normalized health/RUL proxy using failure-referenced thresholds identified from historical events. Validation using field data from industrial three-phase motors demonstrates that the TWW index provides a monotonic degradation profile that is consistent with documented winding-related failures and proactive removals. Case studies confirm that the model enabled proactive maintenance interventions by signaling the terminal phase of insulation life before catastrophic breakdown, offering a hardware-free and scalable solution for real-time asset management. Full article

Background/Objectives. Diarrhea-predominant irritable bowel syndrome (IBS-D) significantly affects patients’ quality of life (QoL). However, data on disease severity and its correlation with QoL among Vietnamese patients remain limited. This study aimed to investigate the clinical characteristics, symptom severity, and the relationship between symptom burden and quality of life in patients with IBS-D in Vietnam. Methods. A cross-sectional study was conducted on patients diagnosed with IBS-D based on the Rome IV criteria at an outpatient clinic of a tertiary hospital. Disease severity and QoL were assessed using the IBS Symptom Severity Score (IBS-SSS) and the standardized Vietnamese version of the IBS Quality of Life (IBS-QoL) questionnaire, respectively. Clinical characteristics, comorbidities, and overlap syndromes were also recorded. Results. Among the 123 patients enrolled (mean age 42.6 ± 14.5 years; 55.3% female), the median IBS-SSS score was 175 (interquartile range: 140–225), and the median IBS-QoL score was 72 (interquartile range: 54–85). The prevalence of overlap syndromes was relatively high, with functional dyspepsia accounting for 46.3% and gastroesophageal reflux disease for 8.9%. A moderate inverse correlation was observed between IBS-SSS and IBS-QoL scores (r = −0.494; p < 0.001). Notably, patients with severe IBS (IBS-SSS ≥ 300) had significantly higher rates of smoking (44.4% vs. 13.2%; p = 0.012) and diabetes (22.2% vs. 5.3%; p = 0.047) compared to the non-severe group. Conclusions. IBS-D imposes a substantial symptom burden and significantly reduces the quality of life in Vietnamese patients, particularly among those with severe disease. The high prevalence of overlap syndromes, along with contributing factors like smoking and diabetes, further increase the complexity and severity of the condition. Full article

Labor shortages and the need for increased productivity have accelerated the development of robotic harvesting systems for greenhouse crops; however, reliable operation under fruit occlusion and clustered arrangements remains a major challenge, particularly due to the limited integration between perception and motion planning modules. The paper presents the design and experimental validation of an autonomous robotic system for greenhouse tomato harvesting. The proposed platform integrates a rail-guided mobile base, a six-degrees-of-freedom robotic manipulator, and an adaptive end effector with a hybrid vision framework that combines convolutional neural networks and watershed-based segmentation to enable robust fruit detection and localization under occluded conditions. The proposed approach enables improved separation of overlapping fruits and provides accurate spatial localization through stereo vision combined with IMU-assisted camera-to-robot coordinate transformation. An occlusion-aware trajectory planning strategy was developed to generate collision-free manipulation paths in the presence of leaves and stems, enhancing harvesting safety and reliability. The system was trained and evaluated using a dataset of real greenhouse images supplemented with synthetic data augmentation. Experimental trials conducted under practical greenhouse conditions demonstrated a fruit detection precision of 96.9%, recall of 93.5%, and mean Intersection-over-Union of 79.2%. The robotic platform achieved an overall harvesting success rate of 78.5%, reaching 85% for unobstructed fruits, with an average cycle time of 15 s per fruit in direct harvesting scenarios. The rail-guided mobility significantly improved positioning stability and repeatability during manipulation compared with fully mobile platforms. The results confirm that integrating hybrid perception with occlusion-aware motion planning can substantially improve the functionality of robotic harvesting systems in protected cultivation environments. The proposed solution contributes to the advancement of automation technologies for greenhouse vegetable production and supports the transition toward more sustainable and labor-efficient agricultural practices. Full article

Population aging has markedly increased the burden of cancer in older adults, in whom frailty, sarcopenia, and reduced physiological reserve limit tolerance to treatment and worsen clinical outcomes. Aging is accompanied by progressive functional decline and by biological processes such as cellular senescence, characterized by irreversible cell cycle arrest, chronic low-grade inflammation, and impaired immune surveillance. The accumulation of senescent cells and the persistence of a senescence-associated secretory phenotype contribute to tissue dysfunction and generate a microenvironment that favors tumor initiation and progression. Physical exercise has been associated with attenuation of inflammation, improvements in metabolic and immune function, and with lower levels of senescence-related biomarkers. Although aerobic exercise has been extensively studied in this setting, resistance training holds relevance for older adults due to its capacity to counteract sarcopenia, preserve muscle strength and power, and sustain functional independence. Structured and periodized approaches to resistance exercise may further enhance these benefits by delivering targeted stimuli aligned with age-related physiological deficits. Block strength training (BST), a periodized model that concentrates training adaptations into sequential phases of maximal strength, power, and muscular endurance, has demonstrated consistent improvements in functional performance and reductions in frailty risk in community-dwelling older adults. BST improves physical function. It may also influence biological processes related to aging and cancer; however, mechanistic evidence specific to BST remains to be established. We hypothesized that the exercise in block as a targeted, a structured and physiologically grounded resistance training intervention highlights the potential of BST to promote functional aging and healthy. In the case of cancer biology, and the environment near to tumour, the relationship between aging mechanisms in older adults and controlled exercise effects are currently in advance, but mechanistic trials are still lacking. Finally, we propose a novel training method, structured and personalized, that could impact different clinical outcomes in older patients with cancer. Full article

Background/Objectives: Pediatric malnutrition is associated with loss of muscle mass and impaired physical function. While anthropometric measurements are widely used for diagnosis, functional indicators that reflect early changes in nutritional status are limited in children. Handgrip strength has been proposed as a simple and objective marker of muscle function; however, pediatric data remain scarce. Methods: In this prospective controlled study, 55 children aged 3–17 years diagnosed with malnutrition and 50 age- and sex-matched healthy controls were evaluated. Anthropometric measurements and muscle strength assessments, including handgrip and pinch grip strength, were performed in both groups. Muscle strength values were additionally converted to age- and sex-adjusted standard deviation scores (SDS). In the malnutrition group, measurements were repeated at 2 and 8 weeks following individualized nutritional therapy to assess treatment response. Results: Children with malnutrition had significantly lower body weight, body mass index, mid-upper arm circumference, triceps skinfold thickness, and lean body mass compared with controls (p < 0.05 for all). Both dominant and non-dominant handgrip strength values were also significantly reduced in the malnutrition group. When adjusted for age and sex, handgrip strength SDS values remained significantly lower in children with malnutrition, whereas pinch grip strength SDS values did not differ significantly between groups. During follow-up, nutritional therapy was associated with significant improvements in anthropometric parameters and absolute muscle strength measurements. However, SDS-based analyses demonstrated that these changes were not uniform across all parameters, suggesting that observed improvements may only partly exceed expected physiological growth. Conclusions: Handgrip strength appears to reflect nutritional status in children, and its association with malnutrition persists after adjustment for growth-related factors. These findings support its potential role as a complementary functional marker. However, longitudinal changes in standardized scores indicate that recovery is variable, and interpretation should consider the influence of normal growth and development. Further large-scale, age-standardized studies are needed to better define their role in clinical practice. Full article

Background/Objectives: Japan’s mental healthcare system is characterized by the world’s highest number of psychiatric beds, widespread “social hospitalization,” and a structurally entrenched managerial support model that frequently undermines patient autonomy. Joint Crisis Plans (JCPs)—collaboratively developed crisis management documents—have been increasingly adopted as a care coordination tool; however, their role in transforming professional practice towards recovery-oriented support remains underexplored. This study aimed to elucidate the experiences of professionals utilizing JCPs across diverse facility types and to develop a theoretical understanding of the process by which they redefine their role from ‘manager’ to ‘recovery companion’. Methods: A qualitative design using the Modified Grounded Theory Approach (M-GTA), grounded in symbolic interactionism, was employed. Semi-structured interviews were conducted with 13 professionals (7 nurses, 6 mental health and welfare workers) across nine facilities (psychiatric hospitals, 24-h residential facilities, outpatient facilities) in the Kanto region of Japan. Theoretical sampling continued until saturation. Data were analyzed using the constant comparative method, with validity ensured through team checking. Results: Nine categories and 23 subcategories were extracted. A three-stage support transformation process emerged: (1) Stage of Motivation and Initial Support, in which professionals confronted the limitations of managerial practice; (2) Stage of Collaborative Role Redefinition and Practice, involving joint crisis management, strength-based support, and network building; and (3) Stage of Integration of Support Perspectives and Recovery-Oriented Practice, in which professionals witnessed individual recovery and integrated new support values into their practice. Negative cases revealed that JCP effectiveness is contingent on the co-construction of shared meaning rather than procedural compliance. Conclusions: JCP was suggested to function as a potential tool to facilitate navigating and reframing structural managerial barriers in Japanese mental healthcare. The creation of a shared language through JCP was associated with supporting conditions for individual self-determination, alleviating professional conflicts, and contributing to shifts in organizational culture. Full article

p-Nitrophenol (PNP) and bis(4-nitrophenyl) phosphate (BNPP), as typical persistent and toxic organic contaminants, present significant risks to both ecological systems and human health. Accurately quantifying these compounds using luminescent sensors remains a formidable task. In this study, we successfully synthesized a zinc-based metal–organic framework (Zn-MOF) that functions as a luminescent sensing material. The synthesized Zn-MOF demonstrates exceptional dual-response luminescent detection toward PNP and BNPP, with detection limits as low as 3.49 × 10⁻⁶ and 8.43 × 10⁻⁶ mol/L, respectively. The sensor maintains high selectivity and functionality even in the presence of various potentially interfering substances commonly found in complex environmental samples. Moreover, the material can be fabricated into a visual sensing film, greatly facilitating its application in on-site rapid detection scenarios. Overall, this work introduces a novel luminescent sensor platform that enables fast and reliable monitoring of PNP and BNPP in environmental contexts, demonstrating strong potential for integration into real-time surveillance and early warning systems. Full article

Industrial emissions of large amounts of CO₂ have seriously affected human health, making it imperative to reduce atmospheric CO₂ concentrations. However, carbon capture technologies such as chemical absorption and membrane separation are still limited by high regenerative energy costs, corrosion, and low efficiency in diluting flue gas. Within this technological landscape, physical adsorption separation technology, due to its advantages such as a wide operating temperature range, low equipment corrosivity, and low regeneration energy consumption, has gradually become a research hotspot in carbon capture technology. The core of physical adsorption lies in finding high-quality adsorbents. Metal–organic frameworks (MOFs), with their ultra-high specific surface area, tunable pore structure, and abundant functionalization sites, are considered highly promising next-generation CO₂ adsorbent materials. This review summarizes strategies for modifying MOFs to improve CO₂ adsorption performance, focusing on aperture adjustment, doped metal ions, functional group doping, and computational screening. Performance enhancements are mechanism-dependent rather than simply additive. Moderate aperture adjustment and defect engineering can improve gas selectivity and CO₂ capture capacity, while excessively narrow pores sacrifice available pore volume and gas diffusion. Doped metal ions, particularly in MOF-74 and related materials, can enhance CO₂ capture capacity while controlling framework integrity and dopant composition. Functional group Doping remains an effective method for capturing low-partial-pressure CO₂. Computational screening is shifting from ranking based on single adsorption capacity to a comprehensive consideration that includes humidity tolerance, stability, and regenerability. Overall, under industrial conditions, modified MOFs should be evaluated by balancing affinity, selectivity, capacity, stability, and energy efficiency. This review provides guidance for the rational design of MOF-based carbon capture adsorbents. Full article