Search Results (4,419)

This study proposes a barrier-oriented application of conventional failure mode and effects analysis (FMEA) and fuzzy weighted geometric mean (FWGM)-based fuzzy-FMEA for laboratory-scale solvent-based electrospinning. The process was decomposed into 14 sequential steps, and one representative failure mode was defined for each step. Severity, occurrence, and detection were rated by a five-member expert panel, and hazard-type-specific weights were assigned to chemical-dominant, electrical-dominant, fire/static-dominant, and combined-dominant hazards. Conventional FMEA identified material review/approval, equipment setup, pre-start inspection, and response to abnormalities as the highest-risk steps (RPN = 60). FWGM-based fuzzy-FMEA re-ranked tied RPN groups and identified response to abnormalities and equipment setup as the joint highest-FRPN failure modes (FRPN = 79.35), followed by pre-start inspection (77.39) and material review/approval (75.89). Barrier-oriented interpretation revealed four dominant mechanisms: upstream information-based hazards, direct high-voltage access, pre-start combined hazards, and intervention under abnormal or residual-energy states. Scenario-based post-control analysis showed that grounded enclosures, interlocks, de-energize-discharge-verify procedures, pre-start checklists, and bonding/grounding measures reduced FRPN by 25.88–43.79% for prioritized failure modes. The proposed framework supports SOP development, equipment improvement, training prioritization, and laboratory risk-assessment documentation for solvent-based nanofiber manufacturing. Full article

Background/Objectives: Parathyroid hormone (PTH), which rises compensatory with vitamin D insufficiency and has been shown to down-regulate vitamin D receptor expression, represents a biologically plausible effect modifier. We investigated whether pretreatment serum PTH modifies the effect of postoperative vitamin D supplementation on relapse-free survival, and whether adding tumor p53 status further refines subgroup identification in an exploratory analysis. Methods: This post hoc analysis utilized data from the AMATERASU trial (UMIN000001977), a single-center, randomized, double-blind, placebo-controlled trial evaluating vitamin D3 (2000 IU/day) versus placebo in patients with curatively resected stage I–III digestive tract cancers (maximum follow-up, 7.5 years). Patients were dichotomized at the cohort median PTH (41 pg/mL). The primary outcome was relapse-free survival (RFS), analyzed using multivariable Cox proportional hazards models. Results: Of 417 randomized patients, 410 had baseline PTH data. In the lower PTH subgroup (≤41 pg/mL), vitamin D significantly improved RFS compared with placebo (fully adjusted hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.24–0.81; p = 0.008). Conversely, no benefit was observed in the higher PTH subgroup (>41 pg/mL; fully adjusted HR, 1.25; 95% CI, 0.64–2.44; p for interaction = 0.016). Exploratory stratification of 365 patients with p53 data showed that the supplementation benefit appeared greatest in patients with both low PTH (≤41 pg/mL) and p53-positive tumors (fully adjusted HR, 0.38; 95% CI, 0.18–0.78; p = 0.009). Conclusions: Pretreatment serum PTH is a candidate effect modifier of postoperative vitamin D supplementation in digestive tract cancers. Full article

The potential health hazards caused by microwave exposure have attracted increasing attention. Microwave radiation has been reported to induce oxidative stress in neural tissues, which is considered one of the primary mechanisms underlying its adverse effects on central nervous system function. The hippocampus is sensitive to microwave radiation, whereas underlying cellular and molecular mechanisms remain incompletely understood. In this study, microwave-exposed mice exhibited significantly impaired performance in the Go/No-go, Y-maze, and novel object recognition tests at 6 h and 7 days post-exposure, indicating deficits in hippocampus-dependent working memory. Single-cell RNA sequencing of hippocampal tissues from control and microwave-exposed mice yielded 94,088 high-quality cells across eight major cell types. Astrocyte sub-clustering identified five transcriptionally distinct subpopulations, with Astrocyte_S100a6 and Astrocyte_Son proportions increased and Astrocyte_Serpinf1 decreased in the radiation group. Analysis of astrocyte transcriptional state transitions showed microwave-exposed astrocytes were preferentially distributed toward terminal reactive states with depletion at early homeostatic nodes. Cell–cell communication analysis revealed increased total interactions and interaction strength following radiation. Astrocyte outgoing signaling was increased for pathways associated with vascular remodeling, phagocytic regulation, and neuroinflammation, while pathways related to trophic support were decreased. Incoming signaling showed increased activity in pathways linked to phagocytic recruitment and inflammatory mediation. Taken together, these findings indicate that microwave exposure is associated with hippocampus-dependent working memory deficits accompanied by transcriptional remodeling of astrocyte subpopulation composition, directional astrocyte state transitions toward reactive phenotypes, and broad alterations in astrocyte-centered intercellular communication, providing a cellular and molecular framework for understanding astrocyte involvement in microwave radiation-associated hippocampal dysfunction. Full article

Background/Objectives: Despite widespread antiretroviral therapy (ART) use, whether the expected transition from AIDS-defining to non-AIDS-defining cancers has occurred in settings with persistent late HIV presentation remains unclear. We examined long-term cancer patterns, determinants, and survival outcomes in a large HIV cohort. Methods: This retrospective, single-center cohort included 1419 people living with HIV followed between 2006 and 2024. Patients who developed malignancy were classified as AIDS-defining cancers (ADC) or non-AIDS-defining cancers (NADC). Immuno-virological parameters were assessed at HIV and cancer diagnosis. Survival was analyzed using Kaplan–Meier methods, and predictors of mortality were evaluated using Cox proportional hazards regression. Determinants of ADC development were assessed using multivariable logistic regression. Temporal changes were evaluated by trend analysis. Results: Sixty-six patients (4.6%) developed malignancy (31 ADC, 35 NADC). Late HIV presentation was common, with 72.7% having CD4+ T-lymphocyte counts < 350 cells/mm³ at cancer diagnosis, particularly among ADC cases. Most ADCs (93.5%) occurred within 24 months of HIV diagnosis. Overall survival did not differ between ADC and NADC groups (log-rank p = 0.14). Although mortality declined after 2015, temporal changes in ADC and NADC proportions did not reach statistical significance (p = 0.14). In Cox regression analysis, viral suppression before death or last follow-up was independently associated with lower mortality risk (HR 0.12; 95% CI 0.05–0.31). Lower CD4+ T-lymphocyte counts were associated with ADC development, and a CD4+ T-lymphocyte threshold of 295 cells/mm³ showed good discriminative performance (AUC = 0.83), although this cutoff should be interpreted cautiously due to the lack of external validation. Conclusions: In this long-term cohort from Türkiye, a clear epidemiological transition from ADC to NADC could not be demonstrated. The cancer spectrum remained strongly influenced by late HIV presentation and advanced immunodeficiency. Sustained viral suppression was independently associated with lower mortality risk, supporting the importance of early HIV diagnosis, timely ART initiation, and sustained virological control. Full article

The Chishui River Basin, a core production area for Chinese sauce-aroma Baijiu (exemplified by Moutai), supports sorghum cultivation critical to the liquor’s distinctive quality. The soil environment quality within this region, therefore, directly impacts the safety and quality of both raw material and the final distilled spirit. To underpin the safe production and sustainable development of this iconic beverage, it is essential to assess soil heavy metal contamination in the soils and quantify the contributions from various sources. In this study, 172 surface soil samples were collected from typical sorghum planting bases in the Renhuai area. Concentrations of eight heavy metals (loids) (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) were determined. The contamination status was evaluated using the geostatistical inverse distance weighting interpolation, the Nemerow pollution index (P_N), and the potential ecological risk index (RI). Source identification and quantification were performed using the positive matrix factorization receptor model (PMF). Results revealed significant enrichment of Cd and Hg in the soil, with mean concentrations 2.07 times and 2.54 times the soil background values for Guizhou Province, respectively. Pollution index results (P_i, P_N) indicated that soil Cd contamination is relatively severe, whereas contamination from other elements is minimal. Overall, approximately 86.5% of the study area was classified as clean or only slightly polluted. Cd poses a moderate ecological risk and was the primary contributor to the total ecological hazard. Other elements exhibited lower risk, resulting in a slight overall potential ecological risk. The soil environmental quality in certified organic sorghum bases was generally favorable. PMF analysis identified three principal sources: historic industrial emissions and traffic-related sources (contributing 46%), weathering of carbonate rocks combined with agricultural activities (37%), and natural background coupled with organic fertilizer application (17%). In conclusion, while the overall soil heavy metal pollution level in the sorghum planting areas is low, the notable enrichment and higher ecological risk of Cd necessitate enhanced dynamic monitoring and targeted risk control measures to ensure long-term soil health and product safety. Full article

Background/Objectives: Metastatic triple-negative breast cancer (mTNBC) carries a poor prognosis and limited treatment options. Sacituzumab govitecan (SG), an anti-Trop-2 antibody–drug conjugate, has shown activity in this setting, but a quantitative synthesis integrating randomized and real-world evidence—particularly in underrepresented subgroups—was lacking. We aimed to summarize the comparative benefit of SG, which derives from a single randomized trial, and to assess whether trial-level efficacy is consistent with the activity observed in routine practice. Methods: Following PRISMA 2020, we searched PubMed/MEDLINE and Web of Science (January 2017–April 2026) for trials and observational cohorts of SG monotherapy in mTNBC. Comparative effects were taken from randomized data; single-arm efficacy (objective response rate [ORR], clinical benefit rate [CBR], median progression-free [PFS], and overall survival [OS]) was pooled using random-effects models. Risk of bias was assessed with RoB 2 and ROBINS-I. The review was registered in the Open Science Framework. Results: Nine studies (1242 patients; 980 SG-treated) were included: one randomized trial (ASCENT), two single-arm trials, and six real-world cohorts. In ASCENT, SG improved PFS (hazard ratio [HR] 0.41, 95% CI 0.33–0.63) and OS (HR 0.51, 0.42–0.64). Pooled ORR was 31.1% (28.0–34.4), and CBR was 42.2% (37.7–46.8), with the median PFS being 4.8 months (4.4–5.3) and OS being 11.0 months (9.3–13.0); trial-derived and real-world estimates were concordant. The benefit persisted in older patients (HR 0.25) and Black women (HR 0.44) but not in those with brain metastases (HR 0.68, 0.38–1.23). Conclusions: SG shows clinically meaningful activity in mTNBC that is broadly consistent between controlled trials and routine practice. Comparative superiority over chemotherapy rests on a single randomized trial (ASCENT); the pooled single-arm estimates describe activity and its consistency rather than a comparative effect. Full article

This study presents an intelligent framework for the analysis of multidimensional geomechanical states in underground mining systems based on numerical simulation and machine learning methods. A three-dimensional geomechanical model of the Zholymbet deposit was developed in the RS3 environment using the generalized Hoek–Brown failure criterion. Numerical simulations were performed for representative mining scenarios characterized by complex excavation interaction and stress redistribution. The modelling results were transformed into a multidimensional geomechanical dataset containing stress, deformation, displacement, and yielding parameters. Principal component analysis (PCA) was applied to investigate the internal structure of the geomechanical state space and identify dominant patterns controlling the rock mass behavior. Clustering analysis revealed several geomechanical regimes corresponding to stable, transitional, and instability-prone conditions. Isolation Forest anomaly detection demonstrated that atypical geomechanical states are not randomly distributed but spatially localized near excavation systems and mining horizons. The obtained results indicate that hazardous geomechanical conditions are governed by complex interactions between stress concentration, deformation intensity, yielding processes, and excavation geometry. The proposed approach provides a basis for intelligent interpretation of large-scale numerical modelling results and may support geomechanical risk assessment in underground mining operations. Full article

Background: Soft tissue sarcomas (STS) disproportionately affect older adults, yet patients aged ≥65 years remain markedly underrepresented in pivotal trials, limiting evidence on pazopanib in this population. We aimed to characterise the real-world efficacy and safety of pazopanib in elderly patients with advanced STS. Methods: This multicentre retrospective cohort study included consecutive patients aged ≥65 years with locally advanced unresectable or metastatic STS who received pazopanib between July 2010 and June 2022 at four tertiary Turkish oncology centres. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS) and the safety profile. Results: A total of 109 patients (median age, 70 years; 50.5% female; 48.6% with Eastern Cooperative Oncology Group [ECOG] performance status ≥ 2) were analysed. The objective response rate was 11.0% (95% CI, 5.8–18.4), and the disease control rate was 45.9%. Median PFS was 4.11 months (95% CI, 3.25–4.47), and median OS was 7.85 months (95% CI, 6.91–9.00) over a median follow-up of 17.6 months. PFS showed a borderline difference across age tertiles (log-rank p = 0.078), whereas a marked monotonic OS gradient was observed (9.00, 7.86, and 5.71 months for ages 65–69, 70–74, and ≥75 years, respectively; p < 0.001). In age-stratified multivariable Cox analysis, ECOG ≥ 2 (adjusted hazard ratio [aHR], 1.68; 95% CI, 1.01–2.80; p = 0.045) and female sex (aHR, 1.66; 95% CI, 1.02–2.72; p = 0.043) were independently associated with shorter OS. Grade ≥ 3 treatment-emergent adverse events occurred in 27.5% of patients, most commonly hypertension. Because only the single most clinically prominent treatment-emergent adverse event per patient was recorded, these figures represent a conservative, non-cumulative estimate of toxicity. No treatment-related deaths occurred. Conclusions: Pazopanib retains clinically meaningful activity in unselected patients aged ≥65 years with advanced STS. Performance status, rather than chronological age, is the dominant predictor of overall survival and should guide treatment decisions in this population. Full article

Aluminium powder, an energetic material, is prone to thermal runaway upon water exposure under local heat sources, yet the nonadiabatic mechanisms of micron-sized accumulated aluminium powder under localised heating remain unclear. This study employs a proprietary characterisation platform to investigate the effects of particle size, water content, and local heat source power on heat transfer in the dry state and on parameters including induction time, onset temperature, peak heat release rate, and reaction heat during the induction and main reaction phases. In the dry state, decreasing particle size enhances effective thermal conductivity and accelerates temperature rise, whereas elevated local heat source power exacerbates thermal inertia. Under local heating upon water exposure, reduced particle size significantly enhances reactivity; the reaction heat of 2 μm powder reaches 983 J/g, approximately fourfold that of 106 μm powder. Water content exhibits a nonmonotonic effect, with the onset temperature reaching a minimum of 66.4 °C at a water content of 25%, while the reaction heat peaks at 33% water content. Interestingly, increasing local heat source power was found to suppress reaction intensity, and reaction heat at 10 W is one sixth of that at 2.5 W, attributed to rapid product layer densification and the possible steam-film barrier effect shifting the controlling mechanism from chemical to diffusion control. A coupled multifactorial predictive model incorporating the three factors was established with a correlation coefficient R² of 0.92, providing a theoretical basis and practical guidance for hazard assessment and safe storage of aluminium powder. Full article

As tunnel engineering continues to advance toward deeper, longer, and more complex projects, the risks encountered during the construction phase have evolved into a combination of various disaster types and the accumulation of multiple contributing factors. Traditional empirical and semi-empirical risk management methods are increasingly revealing shortcomings in terms of timeliness, accuracy, and the ability to process multi-source data. In recent years, driven by advancements in computing power and sensor technology, artificial intelligence algorithms (AI algorithms) such as machine learning and deep learning have been rapidly adopted in tunnel construction risk management. This paper retrieved relevant literature from the Web of Science database covering the period from 2010 to 2025. After rigorous screening, 96 highly relevant papers were selected for bibliometric analysis. This paper systematically reviews research progress from two perspectives: algorithmic models and engineering applications. The review indicates that, in terms of algorithmic models, traditional machine learning, convolutional neural network, recurrent neural network, generative adversarial network, Transformer, and graph neural network constitute a multi-level technical framework encompassing feature representation, risk perception, and intelligent decision-making. In terms of applications, AI algorithms have been widely integrated into typical scenarios such as geological hazard identification and prediction, surrounding rock stability and deformation prediction, rock burst assessment and early warning, lining defect detection and structural safety assessment, construction-induced ground settlement prediction, and tunnel gas and fire hazard prediction, significantly enhancing risk identification and early warning capabilities. However, several challenges remain, including the scarcity of high-quality datasets, the prevalence of noisy, incomplete, and heterogeneous monitoring data, insufficient coupling between model interpretability and engineering mechanisms, limited cross-project transferability, and the lack of integrated management systems for multi-hazard lifecycle control. Based on this, this paper proposes future research directions in areas such as data infrastructure development, integration of mechanism constraints, and multi-hazard collaborative modeling, aiming to provide guidance for the further development of intelligent risk management in tunnel construction. Full article

Candida auris is a multidrug-resistant fungal pathogen associated with high mortality in healthcare settings. Although colonization is recognized as the harbinger of invasive infection, predicting which patients will develop bloodstream infection (BSI) and when this transition will occur remains a clinical challenge. In this study, patients aged ≥18 years with C. auris colonization identified at İzmir City Hospital between January 2023 and June 2025 were retrospectively analyzed. Colonization was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Of 71 colonized patients (median age 65 years; 69.0% male; 93.0% intensive care unit (ICU)-admitted), 31 (43.7%) developed bloodstream infection (BSI). In-hospital mortality was 62.0%, rising to 74.2% in the BSI group, though this difference did not reach statistical significance (p = 0.105). Competing risks analysis using the Aalen–Johansen method showed a cumulative BSI incidence of 38.2% (95% confidence interval (CI): 28–50%) by day 10 and 43.0% (95% CI: 32–54%) by day 30 following colonization detection. On multivariate logistic regression, diabetes mellitus was the sole variable independently associated with a lower risk of BSI development (adjusted odds ratio (OR): 0.19; 95% CI: 0.06–0.68; p = 0.010); this finding was directionally consistent but did not reach statistical significance in the multivariable Fine–Gray competing risks model (subdistribution hazard ratio (SHR): 0.334; 95% CI: 0.108–1.040; p = 0.057). All 40 tested isolates had high fluconazole minimum inhibitory concentration (MIC) values; micafungin susceptibility was 92.5%, while anidulafungin resistance was observed in 32.5% of isolates. Our findings demonstrate that nearly half of colonized patients developed BSI, with no identifiable safe window for intervention, underscoring the necessity of sustained infection control measures and susceptibility-guided antifungal therapy. Full article

Mosquito control personnel work within health departments, public works, private companies, and other agencies. These essential outdoor workers have highly specialized training and are faced with a variety of potential health and safety hazards (e.g., arthropod bites and stings, exposure to insecticides and other chemicals, working with heavy equipment, noise, heat, solar ultraviolet radiation, slips, trips, and/or falls). Mosquito control personnel undergo employer-provided and other types of training on a variety of topics from regulatory updates to new surveillance and control techniques that are required for safety purposes and to maintain their applicator license. Here, an exploratory baseline survey was conducted among members of the North Carolina Mosquito and Vector Control Association (NCMVCA) and the Virginia Mosquito Control Association (VMCA). There was a 28% response rate so results should be interpreted with caution in this pilot study. Most respondents reported utilizing ultra-low volume insecticide application equipment for controlling adult mosquitoes. Backpack sprayers were utilized by less than half of respondents. Those who reported using respirators showed higher concern about insecticide-related health effects than those who did not use respirators. Outdoor workers encounter various potential hazards and utilize several forms of personal protective equipment to reduce risks. This baseline work can be considered a starting point for implementing and strengthening occupational safety and health awareness and preventive measures for mosquito control workers. Knowledge of health and safety hazards can reduce workplace risk. Full article

Introduction: Pedestrians lying on the road—collapsed through medical emergency, intoxication, or displacement following a prior collision—represent a disproportionately lethal and underaddressed category in road traffic safety. Forensic database analyses derived from Japan’s national police records document a fatality rate of 33.0% for collisions involving pedestrians lying on the road, more than double the rate for upright pedestrian collisions. Standard Advanced Driver-Assistance Systems (ADAS) yield a True Positive Rate (TPR) of only 21.4% for detecting pedestrians lying on the road under night conditions—a classification gap of 73.3 percentage points. Methods: In simulation trials, we evaluated the Advanced Falling Object Detection System (AFODS—where “falling object” denotes the low-profile human form at road level, distinguishing the prone pedestrian from the upright postures addressed by conventional ADAS) on a composite dataset of 3200 annotated fall events and 12,000 negative samples (training/validation), with 320 independent controlled simulation trials used for performance evaluation, spanning real-world, forensic-reconstruction, and Total Human Body Model for Safety (THUMS)-validated synthetic scenarios. No physical prototype has been evaluated; all performance data are derived from simulation, and 37.5% of positive samples are synthetically generated. These simulation conditions represent a first feasibility demonstration pending real-world hardware validation. This paper introduces three original contributions absent from prior work: a three-stage quantitative injury-risk model, a formal ISO 26262 Hazard Analysis and Risk Assessment (HARA), and a medicolegal SHAP interpretability framework. The injury-risk model translated detection latency via impact velocity to Head Injury Criterion (HIC) and estimated fatal injury probability (AIS ≥ 5); these model outputs should be interpreted as exploratory estimates pending ATD validation. Reporting follows principles consistent with the TRIPOD statement. Results: Under clear daytime conditions, AFODS demonstrated a TPR of 98.2% (95% CI: 97.4–98.8%) in simulation, decreasing to 95.6% under night dry-road conditions and 89.4% under night rain. The system achieved an AUC of 0.981 and a mean end-to-end latency of 46.5 ms, representing a 76.8 percentage-point improvement in simulation over the monocular RGB baseline (p < 0.001). The injury-risk model projects a reduction in estimated fatal head injury probability from 66.2% (Monte Carlo mean) (no detection, 50 km/h full-speed impact) to 0.7% under AFODS worst-case night/rain conditions, and to ≈0% under clear daytime simulation conditions. Conclusions: A 73.3 percentage-point classification gap places pedestrians lying on the road outside the effective detection envelope of current ADAS, compounded by the systematic exclusion of non-upright postures from regulatory test protocols and benchmark datasets. AFODS supports proof-of-concept feasibility under simulation conditions. Three translational steps are required: prototype validation on real-world hardware using instrumented Anthropomorphic Test Devices (ATDs); prone-posture biomechanical injury modelling using HIC and BrIC criteria; and regulatory extension of pedestrian AEB test standards to non-upright scenarios. Full article

Mining activities in the Iberian Pyrite Belt have generated large volumes of legacy wastes that may pose both environmental and radiological concerns, potentially limiting their reuse and valorization. However, integrated assessments combining chemical, mineralogical, and radiological characterization of these materials remain scarce. In this work, representative mining wastes from twelve sites across the Iberian Pyrite Belt were investigated through X-ray fluorescence, X-ray diffraction, scanning electron microscopy, standardized leaching tests, alpha and gamma spectrometry, and radon emanation measurements. The results revealed significant enrichment in potentially toxic elements, particularly Cu, Zn, Pb, and As, with concentrations exceeding local soil background values by up to several orders of magnitude. Leaching tests identified oxidized sulfide-rich residues as the materials with the highest pollutant mobility and greatest acid-generating potential. In contrast, radiological characterization showed that uranium-series, thorium-series radionuclides, and ⁴⁰K activities, together with radiological hazard indices and radon exhalation rates, were generally comparable to those of surrounding natural soils and remained below internationally recommended limits. These findings indicate that chemical contamination represents the main environmental constraint of these wastes, whereas radiological impact is generally low, supporting their case-by-case evaluation for remediation, valorization, and potential exclusion from radiological control. Full article

This study develops and validates risk-based emergency response scenarios for Biosafety Level 2 (BSL-2) and Animal Biosafety Level 2 (ABSL-2) facilities. Utilizing Bow-tie analysis, three multidimensional scenarios were constructed: infrastructure failure, biosecurity breach, and compound disaster. Four domain experts independently evaluated the scripts using the Content Validity Index (CVI), with an absolute consensus threshold of I-CVI = 1.00. To address operational gaps identified during initial evaluations, the revised protocols were strictly aligned with the Taiwan Centers for Disease Control (CDC) mandatory reporting thresholds for high-hazard incidents. Furthermore, the scripts explicitly defined the Incident Command System (ICS) to prevent communication fragmentation and integrated the NC3Rs tunnel handling technique to minimize occupational bite risks. Following these targeted refinements, all items achieved absolute expert consensus. This research translates static biosafety regulations into dynamic, stress-tested training tools. By providing a standardized instrument for resilience assessment, this study equips frontline personnel with the critical capacity to navigate cascading crises while strictly adhering to a “life safety first” paradigm. Full article