Search Results (42,308)

This study aims to clarify the mesoscopic damage evolution mechanisms of concrete subjected to rigid projectile penetration and provide support for the optimal design of high-performance protective structures. Based on the ABAQUS/Explicit finite element framework, a three-phase mesoscopic numerical model of concrete considering aggregate, mortar matrix, and interfacial transition zone (ITZ) is constructed. By combining the random convex polygon algorithm with the background mesh mapping technique, the intrinsic geometric features of stochastic materials such as crushed stone and pebble are accurately characterized. The effects of aggregate geometric characteristics, volume fraction, and projectile motion/geometry parameters (velocity, length–diameter ratio, curvature radius of the warhead CRH) on the damage evolution of the target, penetration depth, and velocity attenuation law are systematically investigated. The results reveal that increased aggregate angularity substantially enlarges both tensile and compressive damage zones and promotes crack bifurcation, which collectively enhances kinetic energy dissipation, reduces penetration depth, and accelerates projectile deceleration. Increasing the aggregate volume fraction can significantly enhance the anti-penetration resistance of the target. A high proportion of aggregate grains effectively enhances the structural toughness by blocking the crack propagation path. Penetration velocity, length–diameter ratio, and CRH are the core elements determining the penetration efficiency, and the increase in their values will lead to a significant increase in penetration depth and induce a change in the damage mode from local failure to large-scale cracking. The mesoscopic model and related conclusions established in this study can provide a theoretical foundation and numerical benchmark for the impact resistance design, optimization, and damage assessment of high-strength concrete protective structures. Full article

Background/Objectives: COPD is a chronic, progressive, heterogeneous disease. While volume-reducing procedures are available for advanced emphysema-predominant COPD, options remain limited for chronic bronchitis-predominant COPD. Broncho Muco Cleaner Balloon (BMCB) dilation therapy is a method that aims to provide clinical and functional benefit by causing damage to the goblet cells in the bronchial system. This study evaluated the safety and effects of this method on exacerbations, dyspnea and exercise capacity in chronic bronchitis-predominant COPD. Methods: In this prospective interventional study, a total of 35 patients with stage II–IV chronic bronchitis-predominant COPD underwent BMCB therapy. The results of 25 patients who completed the 12-month-follow-up period were analyzed. Dyspnea was assessed using the modified Medical Research Council (mMRC) scale, pulmonary function with spirometry, exercise capacity with the 6 min walk test (6MWT), and quality of life with the St. George’s Respiratory Questionnaire (SGRQ). Results: At the 12-month follow-up, there were significant improvements in mMRC scores (p < 0.001), moderate/severe exacerbations (p = 0.022), and in the symptom, activity, impact, and total scores of the SGRQ (all p < 0.05). However, no significant changes were observed in FEV₁ (p = 0.291) or 6MWT distance (p = 0.420). No procedure-related mortality occurred during the study period. In one patient, bradycardia was observed during the procedure, but it did not cause hemodynamic instability. Conclusions: Based on the results of this study, BMCB dilation therapy in patients with chronic bronchitis-predominant COPD appears to be safe. It reduces the perceived severity of dyspnea, decreases the number of moderate/severe exacerbations, and improves quality of life, without causing significant changes in pulmonary function or exercise capacity. Full article

Background and Objectives: Periodontal diseases are highly prevalent worldwide and have been associated with impaired oral health-related quality of life (OHRQoL). However, the strength and direction of this association remain inconsistent, particularly when sociodemographic and behavioural factors are considered. The aim of this study was to evaluate the independent association between periodontal status and OHRQoL in Bulgarian adults attending a university dental clinic, while accounting for sociodemographic factors and sleep quality, which was included as a clinically relevant behavioural determinant of oral health-related quality of life. Materials and Methods: This cross-sectional study included 504 adult participants (≥18 years) who underwent comprehensive periodontal examination and completed validated questionnaires. OHRQoL was assessed using the culturally adapted Bulgarian version of the Oral Health Impact Profile (OHIP-14), and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Due to the skewed distribution of OHIP-14 scores, the outcome was dichotomized at the sample median. Multivariable logistic regression analysis was performed to assess independent associations, adjusting for age, sex, education, financial status, place of residence, and sleep quality. Results: Periodontal status, sex, and sleep quality were independently associated with impaired OHRQoL. Females demonstrated lower odds of impaired OHRQoL compared to males (OR = 0.636; 95% CI: 0.428–0.924; p = 0.025). Poor sleep quality was associated with increased odds of impaired OHRQoL (OR = 1.554; 95% CI: 1.041–2.321; p = 0.031). Periodontitis was significantly associated with impaired OHRQoL (OR = 3.526; 95% CI: 2.073–5.998; p < 0.001), reflecting a complex relationship between clinical periodontal status and subjective health perception. Conclusions: OHRQoL is influenced by a multifactorial framework integrating periodontal status, behavioural factors, and sociodemographic characteristics. These findings highlight the importance of incorporating patient-reported outcomes into periodontal assessment and support a biopsychosocial approach to oral health research. Full article

This study evaluated the effects of a Bacillus-based direct-fed microbial on broiler performance, excreta properties, and the impact on the survival of house fly larvae. A completely randomized design was used comprising two dietary treatments: (1) basal standard broiler diet (CON) and (2) CON + Amnil^® at 500 PPM (AMN). Each treatment consisted of 48 replicate cage pens, each containing six male chicks, and were raised until 23 d of age. The average body weight (BW), feed consumption (FC), and feed conversion ratio (FCR) were measured weekly. On d21, blood was collected via the brachial vein for the measurement of corticosterone (CORT) concentrations and heterophil/lymphocyte ratio (H/L). Poultry excreta was collected three times on d14, d18, and d23. Excreta properties were evaluated using proximate analysis. For fly assessment, two assays were conducted: (1) oviposition and (2) fly larval development. For oviposition, adult house flies were provided with a choice between excreta from chicks fed with and without Amnil. For fly larval development, 100 fly larvae (<12 h old) were fed either control excreta or excreta from birds fed Amnil. The data were subjected to ANOVA to determine the treatment differences. BW was higher (p = 0.05) in the AMN group on d 14, but no other differences were found at any other time points. Additionally, BW-adjusted feed conversion ratio was improved (p = 0.046) in the AMN group. Excreta from the AMN group had lower (p < 0.05) moisture, pH, Zinc, Neutral Detergent Fiber, and Acid Detergent Fiber on d18 and lower (p < 0.05) pH and Zn on d 23. No statistical differences (p > 0.05) were observed in the CORT and H/L ratios. There were no differences (p > 0.05) between treatments for preference in oviposition. However, flies showed a significant preference for colonizing bird excreta at d23 than at d14 or d18, regardless of Amnil use. For the development experiment, a reduction (p < 0.001) of 32.2% in resulting pupal survival was observed when excreta from birds fed AMN compared to the control. In conclusion, AMN supplementation improved cumulative FCR and modified the properties of excreta, resulting in the disturbance of normal oviposition and reduction in the survival of fly larvae compared to the CON group. Full article

Interest in electric vehicles (EVs) is rising as the world shifts toward sustainable transportation, yet consumer adoption remains highly uneven, particularly in developing countries. This study examines how five dimensions of consumption value—functional, social, emotional, novelty, and conditional—influence consumers’ purchase intention toward EVs in Indonesia, while also testing the moderating role of infrastructure readiness. Using a quantitative approach, data were collected through an online survey with purposive sampling, yielding 455 valid responses. Partial least squares structural equation modeling (PLS-SEM) was applied to assess the measurement and structural models. The results reveal that functional, social, emotional, and conditional values significantly influence consumers’ purchase intention toward EVs, whereas novelty value has no significant effect. Infrastructure readiness also significantly moderates most consumption values, with negative coefficients indicating that limited charging access and inadequate maintenance support weaken the positive impact of consumer values on EV adoption. The findings show that although consumers value performance, social image, emotional appeal, and situational factors, poor charging infrastructure hinders purchase intention toward EVs. This study contributes to EV adoption literature by integrating consumption value theory with infrastructure readiness as a moderator. The results emphasize that developing charging infrastructure, expanding service availability, and maintaining supportive government policies are critical steps for accelerating EV adoption in emerging markets. Full article

Background/Objectives: Accurate assessment of dietary behaviors is essential for understanding their impact on health and guiding nutritional policies. Given the escalating prevalence of noncommunicable diseases in the MENA region, the availability of culturally adapted and psychometrically validated Arabic-language instruments is essential for accurate health assessment. This systematic review aims to identify and evaluate studies that have translated, adapted, or validated dietary behavior measurement instruments into Arabic. Methods: Following the PRISMA guidelines and registered in PROSPERO (CRD420251157552), a search was conducted in PubMed, Scopus, and Web of Science. Studies including the validation, translation, or adaptation of instruments into Arabic among Arabic-speaking populations were included. Methodological quality was assessed using the COSMIN checklist. Results: Thirty-two studies were included, published between 2006 and 2025, primarily in Lebanon (n = 14) and Saudi Arabia (n = 6). The instruments measured various concepts: dietary intake, diet quality, eating disorders, etc. While internal consistency and structural validity were frequently assessed with adequate methodological quality, content validity, measurement error, and responsiveness were either under-reported or failed to meet COSMIN standards. Conclusions: Despite an increasing volume of publications, the methodological quality of Arabic instrument validation remains heterogeneous, with significant gaps in the assessment of longitudinal properties. Efforts are needed to improve the rigor of adaptation processes and to evaluate key properties such as responsiveness in order to ensure reliable tools for research and clinical practice in the MENA region. Full article

Skin cancer is considered a deadly disease globally, and the timely identification of the disease may save human life. This research presents a CNN–Transformer-based fusion framework for automated multi-class skin lesion classification. This approach combines ResNet50 and Vision Transformer (ViT) to categorize skin lesions using the HAM10000 dataset. To assess their efficacy, a comparison with CNN and ViT models is also carried out. Seven classes of skin cancer are used for training the models, and class weighting is used to correct dataset asymmetry. According to the experimental dataset, the suggested hybrid framework shows improved performance over CNN and ViT, considering the accuracy (0.97) and macro-averaged F1-score (0.95). Furthermore, the efficiency of the suggested model is demonstrated by the fact that it delivers performance that is competitive with several existing approaches. Overall results indicate that hybrid CNN–Transformer architectures present a viable path for automated skin lesion categorization. Grad-CAM++ is integrated to enhance model understanding and promote medical confidence by enabling physicians to view visualizations that show the areas impacting the model’s conclusions. But there are still issues, including poor generalization, computational complexity, and a lack of external validation. Future research will concentrate on enhancing interpretability for practical implementation, integrating clinical information, and evaluating several datasets. Full article

Background/Objectives: We aim to characterize, through a survey-based approach conducted in Spain, the perspectives of healthcare professionals (HCPs) and patients regarding geographic atrophy (GA). Methods: A survey-based study assessed ophthalmologists’, optometrists’, and AMD patients’ perceptions and practices regarding geographic atrophy management in Spain, including disease journey challenges. Results: The study sample comprised 30 ophthalmologists, 35 optometrists, and 37 patients. A substantial majority of ophthalmologists followed a specific protocol for the management of GA, in which optical coherence tomography, visual acuity assessment, and fundus examination constituted the core diagnostic procedures. Although most HCPs reported recommending low vision aids, only 5.4% of patients reported having received such a recommendation or prescription (p < 0.001). Considerable variability among the optometrists surveyed was identified regarding visual rehabilitation programmes involving low vision aids. Furthermore, while most ophthalmologists and optometrists reported having provided various types of disease-related information, a significantly lower proportion of patients reported having received information on several aspects such as the disease itself (p < 0.001), disease progression (p < 0.001), impact on quality of life (p < 0.001), or low vision aids (p < 0.001). Multiple limitations in daily living activities were reported by patients, with those diagnosed with GA experiencing significantly greater difficulty reading television subtitles (p = 0.026) and performing manual tasks (p = 0.005). Conclusions: HCPs appear to follow specific protocols and guidelines in the management of GA; however, a potential deficit in effective HCP–patient communication has been identified that should be investigated further. Full article

The sustainable use of industrial raw materials requires accurate characterization and strategic sourcing. In Portugal, the ceramic sector is economically important and depends heavily on aluminosilicate raw materials such as feldspar, kaolin, and clay. This study evaluates twelve Portuguese samples—four feldspars, four kaolins, and four clays—collected near major ceramic industry hubs in central and northern Portugal. The aim is to assess their suitability for industrial use. The characterization areas included chemical and mineralogical composition, particle size, specific surface area, skeletal density, thermal behaviour, plasticity, colour, and fusibility. The results reveal that feldspars exhibited greater compositional variability, particularly in alkali content, with lithium-bearing samples showing enhanced fluxing behaviour, whereas kaolins and clays presented more homogeneous, kaolinite-rich compositions, consistent thermal behaviour and plasticity suitable for ceramic processing. The proximity of these raw material sources to ceramic production centres reduces transportation costs and environmental impact, supporting sustainable supply chains. Overall, the findings indicate that Portuguese aluminosilicates show properties consistent with ceramic processing requirements, and may serve as local alternatives to imported raw materials, reducing dependence on imports while enhancing the sustainability, resilience, and competitiveness of the national ceramic industry. Future work should focus on the formulation and technological validation in ceramic products. Full article

The present study investigates the effects of neutron shielding by concrete slabs in the context of nuclear fusion (14 MeV neutrons). MCNP and Geant4 numerical simulations have been performed to characterize neutron transport through concrete slabs with thicknesses ranging from 1 to 160 cm. Using a monoenergetic, normally incident 14 MeV neutron source, we examine neutron-flux attenuation and spectral evolution after propagation through concrete. The results show that multiple elastic and inelastic scattering processes dominate the transport, leading to a strong spectral redistribution and a significant build-up of scattered neutrons. For intermediate thicknesses (50–100 cm), the transmitted flux is largely composed of scattered and secondary neutrons, with a pronounced epithermal slowing-down component approximately following a $1/E$ behavior, a thermal peak resulting from hydrogen moderation, and a residual high-energy tail corresponding to partially degraded primary neutrons. At larger thicknesses (≥100 cm), absorption and capture of thermalized neutrons become dominant, resulting in a sharp decrease in the transmitted flux. The impact of these spectral modifications on the soft-error rate (SER) of microelectronic devices is evaluated by folding the transmitted neutron spectra with energy-dependent single-event upset (SEU) cross-sections representative of advanced semiconductor technologies. The results indicate that, although total neutron flux decreases significantly with increasing concrete thickness, the spectral redistribution and the persistence of intermediate-energy neutrons can maintain a non-negligible contribution to SER in certain configurations. These findings highlight the importance of using full transport simulations, including spectral effects, when assessing radiation-induced reliability risks in fusion facilities. Full article

Climate variability represents a major threat to agricultural systems, particularly in arid and semi-arid regions such as the Beni-Amir irrigated perimeter, located in the Tadla plain in central Morocco. In this perimeter, olive trees are exposed to multiple environmental and management-related factors that are associated with variations in phenology and vegetation vigor, such as successive drought episodes. This study represents a spatio-temporal assessment of drought impact on olive using satellite- derived vegetation indices from Sentinel-2 imagery and precipitation satellite data from CHIRPS over the period 2015–2024. The Standardized Precipitation Index (SPI-12) was used to identify wet and dry phases over this period. The results indicate an alternation of dry and wet periods between 2015 and 2021, followed by a predominance of dry conditions from September 2021. Over the same period, the time series of the Normalized Difference Vegetation Index (NDVI) and the other vegetation indices reveals marked interannual variability and a progressive degradation of olive tree phenological cycles. A land cover map derived from a supervised support vector machine (SVM) under three classification scenarios achieved high overall accuracies exceeding 94%. Post-classification change detection highlights a substantial reduction in mapped olive-growing areas between 2016 and 2024, with an estimated 72% loss of the initial area. The findings reported in this study indicate that the succession of drought episodes may have contributed to olive grove degradation, including disruptions in phenological cycles and a decline in maximum NDVI values. Even the most resilient olive groves appeared affected following the severe drought period after 2021. The study underscores the usefulness of satellite-derived vegetation indices and drought indicators for the effective monitoring of drought-related stress and supporting improved management practices under climate change. Full article

Background/Objectives: Federated electronic health record networks are increasingly used for real-world evidence generation, but publication-use patterns for TriNetX remain incompletely characterized. This study mapped Web of Science-indexed articles that explicitly mentioned TriNetX and examined their distribution across clinical domains and study purposes. Methods: We searched the Web of Science Core Collection for articles published during 2018–2025 with “TriNetX” in the title, abstract, or author keywords. Bibliometric indicators, journal sources, citation impact, author-keyword co-occurrence, and trend topics were analyzed using R, bibliometrix, Biblioshiny, and VOSviewer. A reproducible rule-based dictionary classified clinical domains and study purposes, and a supplementary Scopus analysis assessed pattern-level reproducibility. Results: The corpus included 1573 articles. Annual output increased from 1 article in 2018 to 871 in 2025. Corresponding-author output was concentrated in the United States and Taiwan. Highly cited studies were dominated by COVID-19 research. Keyword analyses suggested a shift from pandemic-related topics toward mortality, cardiometabolic disease, and medication-related outcomes. Domain–purpose mapping showed that risk/prognosis studies were most common, whereas effectiveness, health services, and method/validation studies were less frequent. Scopus validation reproduced the main annual, source-level, and domain–purpose patterns. Conclusions: TriNetX-based publications expanded rapidly and diversified across clinical fields. Domain–purpose mapping shows where research has concentrated and where it remains sparse; lower frequency, however, should not be read as a definitive clinical evidence gap, since some areas may be less suited to the platform. Where the network is well suited, future work could give greater attention to comparative effectiveness, long-term safety, care pathways, and phenotype validation. Full article

Background: Mucinous adenocarcinoma (MAC) of the colorectum is a biologically distinct histological subtype whose prognostic significance may vary substantially according to primary tumor location. The impact of anatomical site on clinicopathological characteristics and long-term survival in MAC remains incompletely characterized. This study aimed to evaluate the influence of tumor location on oncological outcomes in patients with mucinous colorectal cancer using a large population-based dataset. Methods: Patients diagnosed with mucinous colorectal adenocarcinoma between 2000 and 2023 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Operated patients were stratified by anatomical location into three groups: right colon (cecum, ascending colon, hepatic flexure, transverse colon), left colon (splenic flexure, descending colon, sigmoid colon, rectosigmoid junction), and rectum. The primary endpoints were overall survival (OS) and cancer-specific survival (CSS). Survival analyses were performed using the Kaplan–Meier method with log-rank testing. Multivariable Cox proportional hazards regression was used to assess the independent association of tumor location with survival outcomes, adjusting for age at diagnosis, year of diagnosis, sex, AJCC (American Joint Committee on Cancer) stage, tumor grade, receipt of radiotherapy and chemotherapy. Temporal trends in survival were evaluated across four consecutive diagnostic periods: 2000–2005, 2006–2011, 2012–2017, and 2018–2023. Results: A total of 40,698 patients with mucinous colorectal cancer were identified, of whom 40,174 underwent cancer-directed surgery (right colon n = 25,317; left colon n = 10,408; rectum n = 4449). The right colon was the predominant site of disease (62.9%). Median age was highest in the right colon group (74.0 years) and lowest in the rectum (65.0 years), while female sex predominated in right-sided tumors (55.7%) and male sex in rectal tumors (61.1%). Chemotherapy and radiotherapy utilization were markedly higher in the rectal group (68.6% and 64.5%, respectively) compared with the right colon (28.8% and 1.1%). Median OS was equivalent in the right and left colon groups (87.0 months each) but declined to 80.0 months in the rectal group. All pairwise CSS comparisons were statistically significant (all p < 0.001). On multivariable analysis, using the right colon as reference, the adjusted hazard ratios for CSS were 1.33 (95% CI: 1.28–1.39) for the left colon and 1.45 (95% CI: 1.34–1.57) for the rectum (both p < 0.001). Despite receiving the highest rates of multimodal therapy, rectal MAC demonstrated the worst long-term CSS across all anatomical groups. Temporal analyses revealed consistent CSS improvements in right-sided and left-sided MAC over the study period, whereas rectal MAC showed a non-linear trajectory with a plateau in the most recent diagnostic cohort (2018–2023). Conclusions: Mucinous colorectal adenocarcinoma demonstrates substantial biological and prognostic heterogeneity according to anatomical tumor location. Right-sided MAC was the most prevalent subtype and exhibited superior cancer-specific survival despite older patient age and lower treatment intensity. Rectal MAC demonstrated the worst long-term outcomes despite high utilization of multimodal neoadjuvant therapy, consistent with the established reduced responsiveness of mucinous tumors to conventional chemoradiotherapy. These findings underscore the necessity of incorporating anatomical location and tumor biology into individualized risk stratification and therapeutic planning for patients with mucinous colorectal cancer. Full article

Background: Supplemental oxygen and aerosol therapy may be used simultaneously to treat neonates suffering from hypoxemia caused by respiratory diseases. Due to the cost and lack of availability of oxygen cylinders in some countries, oxygen concentrators are a reported substitute. We assessed whether an oxygen concentrator compared to low-flow oxygen therapy impacts neonatal aerosol drug delivery. Methods: A vibrating mesh nebulizer (A-VMN; Aerogen Solo) was used to aerosolize a 500 µg dose of salbutamol. The aerosol was delivered via a nasal cannula to a neonate head model in combination with oxygen concentrator at gas flow rates of 0.2, 1.0, and 5.0 L per minute (LPM), and low-flow oxygen therapy at gas flow rates of 1.0, 4.0, and 5.0 LPM. Emitted and tracheal doses were recorded. The impact of A-VMN operation and refill on circuit pressure in both systems was also measured. Results: The oxygen concentrator delivered a higher emitted dose than the low-flow system, the largest emitted dose (%) being 20.58 ± 0.50% and 14.69 ± 0.89%, respectively, at 1.0 LPM, p = 0.018. At 5.0 LPM, the tracheal dose was 11.01 ± 0.29% for the oxygen concentrator compared to 9.66 ± 1.53% for low-flow oxygen therapy, p = 0.073. Refill and operation of the A-VMN did not impact the circuit pressure in either system. Conclusions: This study shows that the system used to provide concurrent aerosol and supplemental oxygen therapy has a significant impact on the quantity of nebulized drug delivered to patients. Full article

Rigid polyurethane foams are used in impact-attenuation systems due to their tunable cellular structure and energy dissipation capacity. However, expanded polystyrene (EPS), commonly used for impact protection, presents limitations related to impact attenuation performance and limited design flexibility. This study evaluates the impact performance of rigid polyurethane foams modified with diethanolamine and assesses formulation efficiency using Data Envelopment Analysis (DEA). Rigid PU foam formulations containing 0–3 wt% DEOA were synthesized and characterized by impact testing, apparent density measurements, Scanning Electron Microscopy, Fourier Transform Infrared Spectroscopy, and Thermogravimetric Analysis/Derivative Thermogravimetry. DEA was applied to correlate diethanolamine content with impact absorption efficiency. Excessive crosslinking and reduced energy dissipation were observed above 2 wt%, while concentrations below 0.5 wt% resulted in poorly structured foams. The formulation containing 1 wt% DEOA was identified as the most efficient among the investigated formulations, exhibiting the best overall performance, reducing transmitted peak acceleration by 13.8% compared with neat PU foam, while exhibiting an approximately 48% increase in apparent density, more complete consumption of NCO groups, a more uniform cellular structure, and only modest changes in thermal degradation behavior. These findings indicate that the improved impact performance is associated with the combined effects of increased apparent density, modified cellular morphology, and changes in the polyurethane network promoted by DEOA, underscore the promise of diethanolamine-modified rigid polyurethane (PU) foams for protective applications. Full article