Search Results (795)

Background: Chronic stress in childhood and adolescence leads to excessive cortisol secretion, adipokines production and obesity with all the negative mental and physical effects on the health of individuals and adulthood. Objectives: The aim of the present non-randomized controlled trial was to investigate the effect of a stress management protocol with diaphragmatic breathing (DB) and physiotherapy exercise on stress, body composition, cardiorespiratory and metabolic markers of children and adolescents with morbid obesity. Methods: The study included 31 children and adolescents (5–18 years old) with morbid obesity (22 in the intervention arm and 9 controls). All participants completed anxiety questionnaires and a self-perception scale. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), blood pressure (BP) and SpO₂ were measured. Fasting glucose, uric acid, triglycerides, HbA1c, (AST/SGOT), (ALT/SGPT), HDL, LDL, insulin, ACTH, cortisol, HOMA-IR, 17-OH, S-DHEA, SHBG were assessed, and anthropometric measurements were also performed. Results: In the intervention group, 4 months after the treatment, an improvement was noted in the BMI, BMI z-score, waist-to-height ratio, FEV1, SpO₂, pulse and systolic BP. HDL increased, ALT/SGPT and insulin resistance improved. Positive changes were observed in temporary and permanent stress and self-esteem of children in the intervention group, including anxiety, self-perception, physical appearance, etc. Conclusions: A combined exercise and DB protocol has a positive effect on stress, by improving body composition, reducing insulin resistance, and ameliorating physical and mental health and quality of life of pediatric patients with morbid obesity. Full article

Multistage centrifugal pumps, owing to their high head characteristics, are commonly applied in domains like subsea resource exploitation and groundwater extraction. However, the wear of flow passage components caused by solid particles in the fluid severely threatens equipment lifespan and system safety. To investigate the influence of solid-liquid two-phase flow on pump performance and wear, this study conducted numerical simulations of the solid-liquid two-phase flow within multistage centrifugal pumps based on the Euler–Lagrange approach and the Tabakoff wear model. The simulation results showed good agreement with experimental data. Under the design operating condition, compared to the clear water condition, the efficiency under the solid-liquid two-phase flow condition decreased by 1.64%, and the head coefficient decreased by 0.13. As the flow rate increases, particle momentum increases, the particle Stokes number increases, inertial forces are enhanced, and the coupling effect with the fluid weakens, leading to an increased impact intensity on flow passage components. This results in a gradual increase in the wear area of the impeller front shroud, back shroud, pressure side, and the peripheral casing. Under the same flow rate condition, when particles enter the pump chamber of a subsequent stage from a preceding stage, the fluid, after being rectified by the return guide vane, exhibits a more uniform flow pattern and reduced turbulence intensity. The particle Stokes number in the subsequent stage is smaller than that in the preceding stage, weakening inertial effects and enhancing the coupling effect with the fluid. This leads to a reduced impact intensity on flow passage components, resulting in a smaller wear area of these components in the subsequent stage compared to the preceding stage. This research offers critical theoretical foundations and practical guidelines for developing wear-resistant multistage centrifugal pumps in solid-liquid two-phase flow applications, with direct implications for extending service life and optimizing hydraulic performance. Full article

Background/Objectives: Interstitial lung disease (ILD) is frequently complicated by pulmonary hypertension (PH), which is associated with reduced exercise capacity and poor prognosis. Early and accurate non-invasive detection of PH remains a clinical challenge. This study evaluated whether combining quantitative CT analysis of lung fibrosis with cardiac MRI-derived measures of right ventricular (RV) function improves the diagnostic accuracy of PH in patients with ILD. Methods: We retrospectively analyzed 72 ILD patients who underwent chest CT, cardiac MRI, and right heart catheterization (RHC). Lung fibrosis was quantified using a Gaussian Histogram Normalized Correlation (GHNC) software that computed the proportions of diseased lung, ground-glass opacity (GGO), honeycombing, reticulation, consolidation, and emphysema. MRI was used to assess RV end-systolic volume (RVESV), ejection fraction, and RV longitudinal strain. PH was defined as a mean pulmonary arterial pressure (mPAP) ≥ 20 mmHg and pulmonary vascular resistance ≥ 3 Wood units on RHC. Results: Compared to patients without PH, those with PH (n = 21) showed significantly reduced RV strain (−13.4 ± 5.1% vs. −16.4 ± 5.2%, p = 0.026) and elevated RVESV (74.2 ± 18.3 mL vs. 59.5 ± 14.2 mL, p = 0.003). CT-derived indices also differed significantly: diseased lung area (56.4 ± 17.2% vs. 38.4 ± 12.5%, p < 0.001), GGO (11.8 ± 3.6% vs. 8.65 ± 4.3%, p = 0.005), and honeycombing (17.7 ± 4.9% vs. 12.8 ± 6.4%, p = 0.0027) were all more prominent in the PH group. In receiver operating characteristic curve analysis, diseased lung area demonstrated an area under the curve of 0.778 for detecting PH. This increased to 0.847 with the addition of RVESV, and further to 0.854 when RV strain was included. Combined models showed significant improvement in risk reclassification: net reclassification improvement was 0.700 (p = 0.002) with RVESV and 0.684 (p = 0.004) with RV strain; corresponding IDI values were 0.0887 (p = 0.03) and 0.1222 (p = 0.01), respectively. Conclusions: Combining CT-based fibrosis quantification with cardiac MRI-derived RV functional assessment enhances the non-invasive diagnosis of PH in ILD patients. This integrated imaging approach significantly improves diagnostic precision and may facilitate earlier, more targeted interventions in the management of ILD-associated PH. Full article

A novel prefabricated pile foundation is presented to improve the disaster resistance of the pole line. Bearing performance analysis of prefabricated inclined pile foundations for electric poles under downward pressure-horizontal loading is carried out, and the effects of prefabricated foundation dimensions and pile inclination on the horizontal load–displacement curves at the top of the poles, the horizontal displacement and settlement at the top of the piles, the horizontal displacement and tilt rate of the poles’ bodies and piles bending moments are investigated. The findings indicate the following: as the prefabricated foundation size grows, the bearing capacity of the foundation improves, and the anti-overturning ability of the electric pole improves; the foundation size increases from 0.9 m to 1.35 m, the anti-overturning bearing capacity of the foundation increases by 15.77%, the maximum bending moment of the foundation pile body increases by 19.7%, and the maximum bending moment occurs at about 0.2 m of the pile body; the bearing capacity of inclined piles is larger than that of straight piles—with an increase in the pile inclination angle, the foundation bearing performance increases, and the overturning bearing capacity of the poles increases; the pile inclination angle grows from 0° to 20°, the overturning bearing performance of the foundation increases by 19.2%, the maximum bending moment of the foundation piles reduces by 21.2%, and the maximum of the bending moment occurs at the pile body at a position of about 0.2 m. Full article

Creating a comfortable microclimate in the premises of buildings is currently becoming one of the priorities in the field of architecture, construction and engineering systems. The increased attention from the scientific community to this topic is due not only to the desire to ensure healthy and favorable conditions for human life but also to the need for the rational use of energy resources. This area is becoming particularly relevant in the context of global challenges related to climate change, rising energy costs and increased environmental requirements. Practice shows that any technical solutions to ensure comfortable temperature, humidity and air exchange in rooms should be closely linked to the concept of energy efficiency. This allows one not only to reduce operating costs but also to significantly reduce greenhouse gas emissions, thereby contributing to sustainable development and environmental safety. In this connection, this study presents a parametric assessment of the influence of climatic and geometric factors on the aerodynamic characteristics of the air cavity, which affect the heat exchange process in the ventilated layer of curtain wall systems. The assessment was carried out using a combined analytical calculation method that provides averaged thermophysical parameters, such as mean air velocity ($V_s$), average internal surface temperature ($t_{in.s}^{av}$), and convective heat transfer coefficient (${\alpha }_s$) within the air cavity. This study resulted in empirical average values, demonstrating that the air velocity within the cavity significantly depends on atmospheric pressure and façade height difference. For instance, a 10-fold increase in façade height leads to a 4.4-fold increase in air velocity. Furthermore, a three-fold variation in local resistance coefficients results in up to a two-fold change in airflow velocity. The cavity thickness, depending on atmospheric pressure, was also found to affect airflow velocity by up to 25%. Similar patterns were observed under ambient temperatures of +20 °C, +30 °C, and +40 °C. The analysis confirmed that airflow velocity is directly affected by cavity height, while the impact of solar radiation is negligible. However, based on the outcomes of the analytical model, it was concluded that the method does not adequately account for the effects of solar radiation and vertical temperature gradients on airflow within ventilated façades. This highlights the need for further full-scale experimental investigations under hot climate conditions in South Kazakhstan. The findings are expected to be applicable internationally to regions with comparable climatic characteristics. Ultimately, a correct understanding of thermophysical processes in such structures will support the advancement of trends such as Lightweight Design, Functionally Graded Design, and Value Engineering in the development of curtain wall systems, through the optimized selection of façade configurations, accounting for temperature loads under specific climatic and design conditions. Full article

Background: Infectious complications are common after percutaneous nephrolithotomy (PCNL). Clinical guidelines recommend, previous to surgery, prolonged antibiotic regimens in patients with preoperative positive urine cultures to reduce infectious risk. However, such strategies may increase selective pressure and promote antimicrobial resistance. Evidence supporting the use of a single antibiotic dose tailored to culture sensitivity in these cases is limited but emerging. Methods: We conducted a retrospective observational study including 187 PCNL procedures performed between 2021 and 2023 under an individualized antibiotic prophylaxis protocol. Patients with negative or contaminated urine cultures received a single empirical dose, while those with recent positive cultures received a single dose based on antimicrobial susceptibility testing. Postoperative complications—including fever, sepsis, and a composite outcome—were analyzed through multivariable logistic regression, comparing high- and low-risk patients. Results: A total of 67.9% of procedures were performed in patients meeting at least one high-risk criterion, including a positive preoperative urine culture in 32.1%. The overall incidence of infectious complications was 11.9% (fever 8.7%, sepsis 3.2%), with no significant differences between risk groups. A low concordance was observed between preoperative and intraoperative urine cultures (Spearman = 0.3954). Conclusions: A single preoperative antibiotic dose adjusted to the antibiogram, even in patients with a positive urine culture, was not associated with increased infectious complications. This approach is an initial step that supports a rational and individualized prophylactic strategy aligned with the goals of antimicrobial stewardship programs (ASPs). Full article

Liver cirrhosis is a chronic progressive disease marked by the transition from a compensated to a decompensated stage, associated with severe complications. Central to this progression is portal hypertension, which results from increased intrahepatic vascular resistance and endothelial dysfunction, as well as splanchnic vasodilation and an augmented circulatory state. Non-selective beta-blockers (NSBBs) remain the standard of care for portal hypertension, reducing portal pressure by lowering cardiac output via beta-1 receptor blockade and decreasing splanchnic blood flow through beta-2 receptor antagonism. However, clinical application of NSBBs is often hindered by adverse effects such as bradycardia, hypotension, and fatigue, alongside inconsistent efficacy in certain patient populations. Such limitations have driven the search for alternative therapeutic strategies and effective biomarkers for identifying non-responders. Beta-3 adrenergic receptor agonists have emerged as promising candidates, acting through distinct mechanisms, different from NSBBs. By stimulating nitric oxide release from endothelial cells, beta-3 agonists induce selective vasodilation without negatively impacting cardiac function, potentially overcoming the limitations of traditional therapies. This review discusses the molecular pathways of NSBBs, their clinical role and limitations, introduces potential novel biomarkers, and highlights the growing evidence supporting beta-3 receptor agonists as novel and targeted treatments for portal hypertension. Full article

Pasteurella multocida (Pm) is a zoonotic pathogen that poses a significant threat to animal health and causes substantial economic losses, further aggravated by rising tetracycline resistance. To restore the efficacy of tetracyclines to Pm, we evaluated the synergistic antibacterial activity of doxycycline combined with metformin, an FDA-approved antidiabetic agent. Among several non-antibiotic adjuvant candidates, metformin exhibited the most potent in vitro synergy with doxycycline, especially against capsular serogroup A strain (PmA). The combination demonstrated minimal cytotoxicity and hemolysis in both mammalian and avian cells and effectively inhibited resistance development under doxycycline pressure. At 50 mg/kg each, the combination of metformin and doxycycline significantly reduced mortality in mice and ducks acutely infected with PmA (from 100% to 60%), decreased pulmonary bacterial burdens, and alleviated tissue inflammation and damage. Mechanistic validation confirmed that metformin enhances membrane permeability in Pm without compromising membrane integrity, dissipates membrane potential, increases intracellular doxycycline accumulation, and downregulates the transcription of the tetracycline efflux gene tet(B). Morphological analyses further revealed pronounced membrane deformation and possible leakage of intracellular contents. These findings highlight metformin as a potent, low-toxicity tetracycline adjuvant with cross-species efficacy, offering a promising therapeutic approach for managing tetracycline-resistant Pm infections. Full article

Low-load resistance training combined with vascular occlusion or hypoxia can increase muscle cross-sectional area (CSA), but the effect of such training on hormonal response and cardiovascular response is less clear. Thirty female netball athletes took part in a 5-week training of knee muscles in which low-load resistance exercise (20% 1-RM) was combined with either an occlusion pressure (KT, n = 10), hypoxic air (HT, n = 10), or no additional stimulus (CT, n = 10). Growth hormones (GHs), cardiovascular parameters, and CSA were measured before and after the training program. Compared to CT, both HT and KT showed a substantial increase in GH release after the first training bout (pre). After 5 weeks of training (post), the release of GH was substantially reduced in all groups. Compared to CT, HT showed a substantial decrease in SP (11.7 ± 11.3%, mean ± 90% CL) over the training period. The reduction in systolic blood pressure (SP) after hypoxic training resulted in a substantial decrease in the rate-pressure product (RPP) by 15.6 ± 9.6%, compared to CT. CSA from HT and KT is likely related to the heightened release of GH found after training. The hypoxic training protocol has a greater cardiovascular benefit than similar resistance training with blood flow restriction. Full article

Water environments and sediments are important reservoirs for antibiotic resistance genes (ARGs). Under the pressure of antibiotics, ARGs can transform between microorganisms. Lanthanum-modified bentonite (LMB) is a phosphorus passivation material with good prospects in water environment restoration. After a treatment with LMB, the phosphorus forms in water and sediments will change, which may have an impact on microorganisms and the transmission of ARGs. To investigate the effects of LMB and antibiotics on ARGs and bacterial communities in sediment and aquatic environments, LMB and tetracycline (Tet) were added individually and in combination to mixed samples of sediment and water. The results showed that the addition of either LMB or Tet increased the abundance of intI1 and tetA genes in both the sediment and water, with the Tet addition increasing ARGs to more than 1.5 times the abundance in the control group. However, when LMB and Tet were present simultaneously, the abundance of ARGs showed no significant difference compared to the control group. Tet and LMB also affected the bacterial community structure and function in the samples and had different effects on the sediment and water. A correlation analysis revealed that the potential host bacteria of the intI1 and tetA genes were unclassified_Geobacteraceae, Geothrix, Flavobacterium, Anaeromyxobacter, and Geothermobacter. These findings indicate that Tet or LMB may increase the dissemination of ARGs by affecting microbial communities, while LMB may reduce the impact of Tet through adsorption, providing a reference for the safety of the LMB application in the environment and its other effects (alleviating antibiotic pollution) in addition to phosphorus removal. Full article

Double-suction centrifugal pumps are extensively employed in industrial applications owing to their high efficiency, low vibration, superior cavitation resistance, and operational durability. This study analyzes how impeller oblique cutting angles (0°, 6°, 9°, 12°) affect a double-suction pump at a fixed 4% trimming ratio and constant average post-trim diameter. Numerical simulations and tests reveal that under low-flow (0.7Q_d) and design-flow conditions, the flat-cut (0°) minimizes reflux ratio and maximizes efficiency by aligning blade outlet flow with the mainstream. Increasing oblique cutting angles disrupts this alignment, elevating reflux and reducing efficiency. Conversely, at high flow (1.3Q_d), the 12° bevel optimizes outlet flow, achieving peak efficiency. Pressure pulsation at the volute tongue (P11) peaks at the blade-passing frequency, with amplitudes significantly higher for 9°/12° bevels than for 0°/6°. The flat-cut suppresses wake vortices and static–rotor interaction, but oblique cutting angle choice critically influences shaft-frequency pulsation. Entropy analysis identifies the volute as the primary loss source. Larger oblique cutting angles intensify wall effects, increasing total entropy; pump chamber losses rise most sharply due to worsened outlet velocity non-uniformity and turbulent dissipation. The flat-cut yields minimal entropy at Q_d. These findings provide a basis for tailoring impeller trimming to specific operational requirements. Furthermore, the systematic analysis provides critical guidance for impeller trimming strategies in other double-suction pumps and pumps as turbines in micro hydropower plants. Full article

Background and Clinical Significance: Shock in pediatric patients remains a leading cause of morbidity and mortality, with refractory cases posing significant challenges. While catecholamines like norepinephrine and epinephrine are standard vasopressors, vasopressin (AVP) has emerged as a potential adjunct therapy. However, its role in pediatric shock remains controversial due to concerns about efficacy, safety, and appropriate use. This review assesses the current evidence on AVP in pediatric shock. Methods and Results: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies published in the last five years to capture recent advancements. Articles on AVP’s mechanism of action, pharmacokinetics, clinical applications, and safety were included. For background information, studies were not limited by publication date. AVP increases mean arterial pressure (MAP) and systemic vascular resistance (SVR) yet does not significantly reduce mortality. While AVP may be useful in catecholamine-resistant vasoplegia, its advantage over conventional vasopressors remains uncertain. Concerns about ischemic complications, myocardial dysfunction, and thrombocytopenia further limit its routine use. Conclusions: AVP may serve as an adjunct therapy in catecholamine-resistant vasoplegia, but safety concerns and unclear benefits restrict its routine use. Further research is needed to determine the optimal dosing, patient selection, and long-term outcomes. Until then, AVP should remain a last-line therapy when conventional vasopressors fail. Full article

Pulmonary hypertension (PH) is broadly defined as a mean pulmonary arterial pressure (mPAP) exceeding 20 mm Hg at rest. Pulmonary arterial hypertension (PAH) is a specific subset of PH characterized by a normal pulmonary arterial wedge pressure (PAWP), combined with elevated mPAP and increased pulmonary vascular resistance (PVR), without other causes of pre-capillary hypertension such as lung diseases or chronic thromboembolic pulmonary hypertension. The majority of PAH cases are idiopathic; other common etiologies include connective tissue disease-associated PAH, congenital heart disease, and portopulmonary hypertension. To a lesser extent, genetic and familial forms of PAH can also occur. The pathophysiology of PAH involves the following four primary pathways: nitric oxide, endothelin-1, prostacyclin, and activin/bone morphogenetic protein (BMP). Dysregulation of these pathways leads to a progressive vasculopathy marked by vasoconstriction, vascular proliferation, elevated right heart afterload, and ultimately right-sided heart failure. Diagnosing PAH is challenging and often occurs at advanced stages. The gold standard for diagnosis remains invasive right heart catheterization. Along with invasive hemodynamic measurements, several noninvasive imaging modalities such as echocardiography and ventilation-perfusion scanning are key adjunct techniques. Also, recent advancements in cardiac magnetic resonance (CMR) have opened a new era for PAH management. Additionally, CMR and echocardiography not only enable diagnosis but also aid in evaluating disease severity and monitoring treatment responses. Current PAH treatments focus on targeting molecular pathways, reducing inflammation, and inhibiting right-sided heart failure. Integrating imaging with basic science techniques is crucial for enhanced patient diagnosis, and precision medicine is emerging as a key strategy in PAH management. Additionally, the incorporation of artificial intelligence into both molecular and imaging approaches holds significant potential. There is a growing need to integrate new imaging modalities with high resolution and reduced radiation exposure into clinical practice. In this review, we discuss the molecular pathways involved in PAH, the imaging modalities utilized for diagnosis and monitoring, and current targeted therapies. Advances in molecular understanding and imaging technologies, coupled with precision medicine, could hold promise in improving patient outcomes and revolutionizing the management of PAH patients. Full article

Wide-range electric submersible centrifugal pumps (ESPs) are critical for offshore oilfields but suffer from narrow high-efficiency ranges and frictional losses under dynamic reservoir conditions. This study introduces bio-inspired dimple-type non-smooth surfaces on impeller blades to enhance hydraulic performance. A combined numerical-experimental approach was employed: a 3D CFD model with the k-ω turbulence model analyzed oil–water flow (1:9 ratio) to identify optimal dimple placement, while parametric studies tested diameters (0.6–1.2 mm). Experimental validation used 3D-printed prototypes. Results revealed that dimples on the pressure surface trailing edge reduced boundary layer separation, achieving a 12.98% head gain and 8.55% efficiency improvement at 150 m³/d in simulations, with experimental tests showing an 11.5% head increase and 4.6% efficiency gain at 130 m³/d. The optimal dimple diameter (0.9 mm, 2% of blade chord) balanced performance and manufacturability, demonstrating that bio-inspired surfaces improve ESP efficiency. This work provides practical guidelines for deploying drag reduction technologies in petroleum engineering, with a future focus on wear resistance in abrasive flows. Full article

The implantable capsule grouting pile is a novel pile foundation technology in which a capsule is affixed to the side of the implanted pile to facilitate grouting and achieve extrusion-based reinforcement. This technique is designed to improve the bearing capacity of implanted piles in coastal areas with deep, soft soil. This study conducted model tests involving multiple grouting positions across different foundation types to refine the construction process and validate the enhancement of bearing capacity. Systematic measurements and quantitative analyses were performed to evaluate the earth pressure distribution around the pile, the resistance characteristics of the pile end, the evolution of side friction resistance, and the overall bearing performance. Special attention was given to variations in the lateral friction resistance adjustment coefficient under different working conditions. Furthermore, an actual case analysis was conducted based on typical soft soil geological conditions. The results indicated that the post-grouting process formed a dense soil ring through the expansion and extrusion of the capsule, resulting in increased soil strength around the pile due to increased lateral earth pressure. Compared to conventional piles, the grouted piles exhibited a synergistic improvement characterized by reduced pile end resistance, enhanced side friction resistance, and improved overall bearing capacity. The ultimate bearing capacity of model piles at different grouting depths across different foundation types increased by 6.8–22.3% compared with that of ordinary piles. In silty clay and clayey silt foundations, the adjustment coefficient η_s of lateral friction resistance of post-grouting piles ranged from 1.097 to 1.318 and increased with grouting depth. The findings contribute to the development of green pile foundation technology in coastal areas. Full article