Search Results (23,430)

Background: Studies have demonstrated a positive correlation between high body mass index (BMI) and an increased risk of Clostridioides difficile infection (CDI), independent of antibiotic usage or healthcare exposures. Aim: To compare the outcomes of obese (BMI ≥ 30 kg/m²) and non-obese (BMI < 30 kg/m²) hospitalized patients with CDI. Methods: This retrospective cohort study included patients with CDI hospitalized in Beilinson hospital between January 2013 and January 2020. The primary outcome was 90-day all-cause mortality. Secondary outcomes included 30-day mortality, colectomy, intensive care unit (ICU) admission and length of hospital stay (LOS). Multivariate analysis was performed to identify the risk factors independently associated with 90-day mortality. Results: The study included 889 patients: 131 (15%) obese and 758 (85%) non-obese. The obese group was younger (median age 65 years vs. 73 years (p < 0.01)) and with a higher rate of diabetes mellitus (57/131 (44%) vs. 180/758 (24%) (p < 0.01)). The 90-day mortality was lower in the obese group: 19/131 (15%) vs. 170/752 (23%) (p = 0.04). The 30-day mortality was 8/131 (6%) vs. 96/757 (13%) (p = 0.03). ICU admission was 9/131 (7%) vs. 23/758 (3%) (p = 0.03), and median LOS was 19 vs. 12 days (p < 0.01) in obese and non-obese groups, respectively. In the multivariable analysis, after adjustment for age, Charlson’s comorbidity index ≥3, assistance in activities of daily living, treatment with proton pump inhibitors and severity of illness, obesity was not a significant risk factor for 90-day mortality (OR = 0.65, 95% CI: 0.38–1.01; p = 0.1). Conclusions: In this study, obesity was not significantly associated with 90-day mortality after adjustment for other risk factors; however, ICU admission was higher and LOS longer in this group. Full article

This study aimed to compare the performance of three hydroxyapatite–β-tricalcium phosphate (HA–β-TCP) collagen composite grafts in a canine model for extraction socket preservation. Eight mongrel dogs underwent atraumatic bilateral mandibular premolar extraction, and sockets were randomly grafted with HBC28 (20% high-crystalline HA, 80% β-TCP bovine collagen), HBC37 (30% HA, 70% β-TCP, bovine collagen), or HPC64 (60% HA, 40% β-TCP, porcine collagen). Grafts differed in their HA–β-TCP ratio and collagen origin and content. Animals were sacrificed at 4 and 12 weeks, and the healing sites were evaluated using micro-computed tomography (micro-CT) and histological analysis. At 12 weeks, all groups showed good socket maintenance with comparable new bone formation. However, histological analysis revealed that HBC28 had significantly higher residual graft volume, while HPC64 demonstrated more extensive graft resorption. Histomorphometric analysis confirmed these findings, with statistically significant differences in residual graft area and bone volume fraction. No inflammatory response or adverse tissue reactions were observed in any group. These results suggest that all three HA–β-TCP collagen composites are biocompatible and suitable for socket preservation, with varying resorption kinetics influenced by graft composition. Selection of graft material may thus be guided by the desired rate of replacement by new bone. Full article

Deep coalbed methane (CBM) reservoirs are characterized by high hydrocarbon content and are considered an important strategic resource. Due to their inherently low permeability and porosity, horizontal well drilling is commonly employed to enhance production, with the length of the horizontal section playing a critical role in determining CBM output. However, during extended horizontal drilling, wellbore instability frequently occurs as a result of drilling fluid invasion into the coal formation, posing significant safety challenges. This instability is primarily caused by the physical intrusion of drilling fluids and their interactions with the coal seam, which alter the mechanical integrity of the formation. To address these challenges, interpenetrating and semi-interpenetrating network (IPN/s-IPN) hydrogels have gained attention due to their superior physicochemical properties. This material offers enhanced sealing and support performance across fracture widths ranging from micrometers to millimeters, making it especially suited for plugging applications in deep CBM reservoirs. A self-degradable interpenetrating double-network hydrogel particle plugging agent (SSG) was developed in this study, using polyacrylamide (PAM) as the primary network and an ionic polymer as the secondary network. The SSG demonstrated excellent thermal stability, remaining intact for at least 40 h in simulated formation water at 120 °C with a degradation rate as high as 90.8%, thereby minimizing potential damage to the reservoir. After thermal aging at 120 °C, the SSG maintained strong plugging performance and favorable viscoelastic properties. A drilling fluid containing 2% SSG achieved an invasion depth of only 2.85 cm in an 80–100 mesh sand bed. The linear viscoelastic region (LVR) ranged from 0.1% to 0.98%, and the elastic modulus reached 2100 Pa, indicating robust mechanical support and deformation resistance. Full article

This paper introduces a robust and imperceptible video watermarking framework designed for blind extraction in dynamic video environments. The proposed method operates in the spatial domain and combines multiscale perceptual analysis, adaptive Just Noticeable Difference (JND)-based quantization, and temporal redundancy via multiframe embedding. Watermark bits are embedded selectively in blocks with high perceptual masking using a QIM strategy, and the corresponding DCT coefficients are estimated directly from the spatial domain to reduce complexity. To enhance resilience, each bit is redundantly inserted across multiple keyframes selected based on scene transitions. Extensive simulations over 21 benchmark videos (CIF, 4CIF, HD) validate that the method achieves superior performance in robustness and perceptual quality, with an average Bit Error Rate (BER) of 1.03%, PSNR of 50.1 dB, SSIM of 0.996, and VMAF of 97.3 under compression, noise, cropping, and temporal desynchronization. The system outperforms several recent state-of-the-art techniques in both quality and speed, requiring no access to the original video during extraction. These results confirm the method’s viability for practical applications such as copyright protection and secure video streaming. Full article

The adoption of digital technologies, such as the Internet of Things (IoT), has emerged as a key strategy to improve efficiency, sustainability, and productivity in the agricultural sector, especially in contexts of modernization and digital transformation in developing regions. This study analyzes the key factors influencing the adoption of IoT technologies by farmers in the province of Guayas, Ecuador, and their impact on agricultural yields. The research is grounded in innovation diffusion theory and technology acceptance models, which emphasize the role of perception, usability, training, and economic viability in digital adoption. A total of 250 surveys were administered, with 232 valid responses (92.8% response rate), reflecting strong interest from the agricultural sector in digital transformation and precision agriculture. Using structural equation modeling (SEM), the results confirm that general perception of IoT (β = 0.514), practical functionality (β = 0.488), and technical training (β = 0.523) positively influence adoption, while high implementation costs negatively affect it (β = −0.651), all of which are statistically significant (p < 0.001). Furthermore, adoption has a strong positive effect on agricultural yield (β = 0.795). The model explained a high percentage of variance in both adoption (R² = 0.771) and performance (R² = 0.706), supporting its predictive capacity. These findings underscore the need for public and private institutions to implement targeted training and financing strategies to overcome economic barriers and foster the sustainable integration of IoT technologies in Ecuadorian agriculture. Full article

With the growing severity of environmental pollution, people are paying increasing attention to their health. However, naturally occurring wood with health benefits and applications in human healthcare is still scarce. Natural wood exhibits a limited negative oxygen ion release capacity, and this release has a short duration, failing to meet practical application requirements. This study innovatively developed a humidity-responsive, healthy wood material with a high negative oxygen ion release capacity based on fast-growing poplar. Through vacuum cyclic impregnation technology, hexagonal stone powder was infused into the pores of poplar wood, endowing it with the ability to continuously release negative oxygen ions. The healthy wood demonstrated a static average negative oxygen ion release rate of 537 ions/cm³ (peaking at 617 ions/cm³) and a dynamic average release rate of 3,170 ions/cm³ (peaking at 10,590 ions/cm³). The results showed that the particle size of hexagonal stone powder in suspension was influenced by the dispersants and dispersion processes. The composite dispersion process demonstrated optimal performance when using 0.5 wt% silane coupling agent γ-(methacryloxy)propyltrimethoxysilane (KH570), achieving the smallest particle size of 8.93 μm. The healthy wood demonstrated excellent impregnation performance, with a weight gain exceeding 14.61% and a liquid absorption rate surpassing 165.18%. The optimal impregnation cycle for vacuum circulation technology was determined to be six cycles, regardless of the type of dispersant. Compared with poplar wood, the hygroscopic swelling rate of healthy wood was lower, especially in PEG-treated samples, where the tangential, radial, longitudinal, and volumetric swelling rates decreased by 70.93%, 71.67%, 69.41%, and 71.35%, respectively. Combining hexagonal stone powder with fast-growing poplar wood can effectively enhance the release of negative oxygen ions. The static average release of negative oxygen ions from healthy wood is 1.44 times that of untreated hexagonal stone powder, and the dynamic release reaches 2 to 3 times the concentration of negative oxygen ions specified by national fresh air standards. The water-responsive mechanism revealed that negative oxygen ion release surged when ambient humidity exceeded 70%. This work proposes a sustainable and effective method to prepare healthy wood with permanent negative oxygen ion release capability. It demonstrates great potential for improving indoor air quality and enhancing human health. Full article

Upon reaching stabilized production in waterflooded reservoirs, waterflood performance curves are conventionally used to predict technically recoverable reserves (TRRs). However, as reservoirs enter high water-cut stages, the relationship between the relative permeability ratio and saturation becomes nonlinear, causing deflection in waterflood performance curves. This leads to systematic overestimation of both predicted TRR and ultimate recovery factors. To overcome these limitations in conventional TRR prediction methods, this study establishes a novel relative permeability ratio-saturation relationship based on characteristic relative permeability curve behaviors. The proposed model is validated for three distinct fluid-rock interaction types. We further develop a permeability-driven forecasting model for oil production rates and water cuts. Comparative analyses with a conventional waterflood curve methodology demonstrate significant accuracy improvements. The results show that while traditional methods predict TRR ranging from 78.40 to 92.29 million tons, our model yields 70.73 million tons—effectively resolving overestimation issues caused by curve deflection during high water-cut phases. This approach establishes a robust framework for determining critical development parameters, including economic field lifespan, strategy adjustments, and ultimate recovery factor. Full article

The high cost of hydrogen production is the primary factor limiting the development of the hydrogen energy industry chain. Additionally, due to the inefficiency of hydrogen production by water electrolysis technology, the development of high-performance catalysts is an effective means of producing low-cost hydrogen. In water electrolysis technology, the electrocatalytic activity of the electrode affects the kinetics of the oxygen evolution reaction (OER) and the hydrogen evolution rate. This study utilizes the liquid phase co-precipitation method to synthesize three types of Prussian blue analog (PBA) electrocatalytic materials: Fe/PBA(Fe₄[Fe(CN)₆]₃), Fe-Mn/PBA((Fe, Mn)₃[Fe(CN)₆]₂·nH₂O), and Fe-Mn-Co/PBA((Mn, Co, Fe)₃^II[Fe^III(CN)₆]₂·nH₂O). X-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses show that Fe-Mn-Co/PBA has a smaller particle size and higher crystallinity, and its grain boundary defects provide more active sites for electrochemical reactions. The electrochemical test shows that Fe-Mn-Co/PBA exhibits the best electrochemical performance. The overpotential of the oxygen evolution reaction (OER) under 1 M alkaline electrolyte at 10/50 mA·cm⁻² is 270/350 mV, with a Tafel slope of 48 mV·dec⁻¹, and stable electrocatalytic activity is maintained at 5 mA·cm⁻². All of these are attributed to the synergistic effect of Fe, Mn, and Co metal ions, grain refinement, and the generation of grain boundary defects and internal stresses. Full article

The displacement of bridge towers is relatively large under strong wind action. Changes in tower displacement can reflect the usage status of the bridge towers. Therefore, it is necessary to conduct performance warning research on tower displacement under strong wind action. In this paper, the triple standard deviation method, multiple linear regression method, and interpolation method are used to preprocess monitoring data with skipped points and missing anomalies. An improved multi-rate data fusion method, validated using simulated datasets, was applied to correct monitoring data at bridge tower tops. The fused data were used to feed predictive models and generate structural performance alerts. Spectral analysis confirmed that the fused displacement measurements achieve high precision by effectively merging the low-frequency GPS signal with the high-frequency accelerometer signal. Structural integrity monitoring of wind-loaded bridge towers used modeling residuals as alert triggers. The efficacy of this proactive monitoring strategy has been quantitatively validated through statistical evaluation of alarm accuracy rates. Full article

Objectives: To investigate the reliability and validity of the Singer Reflux Symptom Score (sRSS), a new patient-reported outcome questionnaire documenting the severity of reflux symptoms in singing voice is proposed. Methods: Amateur and professional singers consulting the European Reflux Clinic for laryngopharyngeal reflux disease (LPRD) symptoms and findings were prospectively recruited from January 2022 to February 2023. The diagnosis was based on a Reflux Symptom Score (RSS) > 13 and Reflux Sign Assessment (RSA) > 14. A control group of asymptomatic singer subjects was recruited from the University of Mons. The sRSS was rated within a 7-day period to assess test–retest reliability. Internal consistency was measured using Cronbach’s α in patients and controls. A correlation analysis was performed between sRSS and Singing Voice Handicap Index (sVHI) to evaluate convergent validity. Responsiveness to change was evaluated through pre- to post-treatment sRSS changes. The sRSS threshold for suggesting a significant impact of LPRD on singing voice was determined by receiver operating characteristic (ROC) analysis. Results: Thirty-three singers with suspected LPRD (51.5% female; mean age: 51.8 ± 17.2 years) were consecutively recruited. Difficulty reaching high notes and vocal fatigue were the most prevalent LPRD-related singing complaints. The sRSS demonstrated high internal consistency (Cronbach-α = 0.832), test–retest reliability, and external validity (correlation with sVHI: r = 0.654; p = 0.015). Singers with suspected LPRD reported a significant higher sRSS compared to 68 controls. sRSS item and total scores significantly reduced from pre-treatment to 3 months post-treatment except for the abnormal voice breathiness item. ROC analysis revealed superior diagnostic accuracy for sRSS (AUC = 0.971) compared to sRSS-quality of life (AUC = 0.926), with an optimal cutoff at sRSS > 38.5 (sensitivity: 90.3%; specificity: 85.0%). Conclusions: The sRSS is a reliable and valid singer-reported outcome questionnaire for documenting singing symptoms associated with LPRD leading to personalized management of Singers. Future large-cohort studies are needed to evaluate its specificity for LPRD compared to other vocal fold disorders in singers. Full article

Shaken Baby Syndrome (SBS) is one of the primary causes of fatal head trauma in infants and young children, occurring in about 33 per 100,000 infants annually in the U.S., with mortality rates being between 15% and 38%. Survivors frequently endure long-term disabilities, such as cognitive deficits, visual impairments, and motor dysfunction. Diagnosing SBS remains difficult due to the lack of visible injuries and delayed symptom onset. Existing detection methods—such as neuroimaging, biomechanical modeling, and infant monitoring systems—cannot perform real-time detection and face ethical, technical, and accuracy limitations. This study proposes an inertial measurement unit (IMU)-based detection system enhanced with machine learning to identify aggressive shaking patterns. Findings indicate that wearable-based motion analysis is a promising method for recognizing high-risk shaking, offering a non-invasive, real-time solution that could minimize infant harm and support timely intervention. Full article

Under conservation tillage in the Huang-Huai-Hai wheat–maize rotation area, the ridge-clearing no-till seeder for strip tillage mitigates the adverse impacts of surface residues on seeding quality by clearing stubble specifically within the seed rows, demonstrating significant potential for application and promotion. However, the inadequate understanding of the seeder’s operational performance and governing mechanisms under varying field conditions hinders its high-quality and efficient implementation. To address this issue, this study selected the stubble height, forward speed, and stubble knife rotational speed (PTO speed) as experimental factors. Employing a three-factor quasi-level orthogonal experimental design, coupled with response surface regression analysis, this research systematically elucidated the interaction mechanisms among these factors concerning the seeding depth consistency and seed spacing uniformity of the seeder. An optimized parameter-matching model was subsequently derived through equation system solving. Field trials demonstrated that a lower forward speed improved the seed spacing uniformity and seeding depth consistency, whereas high speeds increased the missing rates and spacing deviations. An appropriate stubble height enhanced the seed spacing accuracy, but an excessive height compromised depth precision. Higher PTO speeds reduced multiple indices but impaired depth accuracy. Response surface analysis based on the regression models demonstrated that the peak value of the seed spacing qualification index occurred within the forward speed range of 8–9 km/h and the stubble height range of 280–330 mm, with the stubble height being the dominant factor. Similarly, the peak value of the seeding depth qualification index occurred within the stubble height range of 300–350 mm and the forward speed range of 7.5–9 km/h, with the forward speed as the primary factor. Validation confirmed that combining stubble heights of 300−330 mm, forward speeds of 8−9 km/h, and PTO speeds of 540 r/min optimized both metrics. This research reveals nonlinear coupling relationships between operational parameters and seeding quality metrics, establishes a stubble–speed dynamic matching model, and provides a theoretical foundation for the intelligent control of seeders in conservation tillage systems. Full article

Gastric-type cervical adenocarcinoma (GCA) is a rare and aggressive subtype of cervical adenocarcinoma. Despite its clinical significance, its molecular carcinogenesis and therapeutic targets remain poorly understood. This study aimed to compare the clinicopathological, immunohistochemical, and molecular profiles of GCA and usual-type cervical adenocarcinoma (UCA), exploring prognostic and therapeutic biomarkers in a Japanese population. A total of 110 cervical adenocarcinoma cases, including 16 GCA and 94 UCA cases, were retrospectively analyzed for clinicopathological features, and a panel of immunohistochemical markers was assessed. Sanger sequences were performed for the KRAS, PIK3CA, and BRAF genes, and survival and clinicopathological correlations were assessed using Kaplan–Meier and Cox regression analyses. GCA was significantly associated with more aggressive features than UCA, including lymph node involvement, advanced FIGO stages, increasing recurrence rate, and poor survival status. High ARID1B expression was observed in a subset of GCA cases and correlated with worse progression-free and overall survival. Additionally, PD-L1 expression was more frequent in GCA than UCA and was associated with unfavorable prognostic factors. Conversely, UCA cases showed strong p16 expression, supporting their HPV-driven pathogenesis. Molecular profiling revealed KRAS and PIK3CA mutations in both subtypes, while BRAF mutations were identified exclusively in GCA. These findings reveal distinct clinical and molecular profiles for both tumor types and underscore ARID1B and PD-L1 as predictive prognostic and therapeutic biomarkers in GCA, implicating the use of subtype-specific treatment strategies. Full article

Basalt-fiber-reinforced polymer (BFRP) composites, utilizing a natural high-performance inorganic fiber, exhibit excellent weathering resistance, including tolerance to high and low temperatures, salt fog, and acid/alkali corrosion. They also possess superior mechanical properties such as high strength and modulus, making them widely applicable in aerospace and shipbuilding. This study experimentally investigated the mechanical properties of BFRP plates under various strain rates (10⁻⁴ s⁻¹ to 10³ s⁻¹) and directions using an electronic universal testing machine and a split Hopkinson pressure bar (SHPB).The results demonstrate significant strain rate dependency and pronounced anisotropy. Based on experimental data, relationships linking the strength of BFRP composites in different directions to strain rate were established. These relationships effectively predict mechanical properties within the tested strain rate range, providing reliable data for numerical simulations and valuable support for structural design and engineering applications. The developed strain rate relationships were successfully validated through finite element simulations of low-velocity impact. Full article

Traditional hydrogel preparation methods typically require multiple steps and certain external stimuli. In this study, rapid and stable gelation of polyvinyl alcohol (PVA)-tannic acid (TA)-based hydrogels was achieved through the regulation of hydrogen bonds. The cross-linking between PVA and TA is triggered by the evaporation of ethanol. Rheological testing and analysis of the liquid-solid transformation process of the hydrogel were performed. The gelation onset time (GOT) could be tuned from 10 s to over 100 s by adjusting the ethanol content and temperature. The addition of polyhydroxyl components (e.g., glycerol) significantly enhances the hydrogel’s water retention capacity (by 858%) and tensile strain rate (by 723%), while concurrently increasing the gelation time. Further studies have shown that the addition of alkaline substances (such as sodium hydroxide) promotes the entanglement of PVA molecular chains, increasing the tensile strength by 23% and the fracture strain by 41.8%. The experimental results indicate that the optimized PVA-TA hydrogels exhibit a high tensile strength (>2 MPa) and excellent tensile properties (~600%). Moreover, the addition of an excess of weakly alkaline substances (such as sodium acetate) reduces the degree of hydrolysis of PVA, enabling the system to form a hydrogel with extrudable characteristics before the ethanol has completely evaporated. This property allows for patterned printing and thus demonstrates the potential of the hydrogel in 3D printing. Overall, this study provides new insights for the application of PVA-TA based hydrogels in the fields of rapid prototyping and strength optimization. Full article