Search Results (3,143)

Background/Objectives: Critical limits define quantitative thresholds for life-threatening diagnostic test results that require immediate clinician notification and may prompt urgent intervention to prevent adverse outcomes. This study aims to (1) characterize point-of-care (POC) critical limits for adults and newborns using a comprehensive U.S. national database, (2) identify POC instruments associated with these limits, and (3) support harmonization of point-of-care testing (POCT) practices. Methods: We gathered critical limit notification lists from 417 hospitals across all 50 states and Washington D.C., comprising university hospitals, trauma and heart centers, centers of excellence, community hospitals, and network hospitals. We extracted POC and central laboratory critical limits (at hospitals with POC), adult international normalized ratio (INR) data, and instrument usage. Results: Low and high glucose critical limits were the most frequently listed POC thresholds, with median values of 50 and 450 mg/dL, respectively, reported by 73 hospitals (17.5%). Troponin was listed by ten hospitals, specified as troponin (n = 4), troponin I (n = 5), or “troponin TnI” (n = 1). A few hospitals assigned instrument-specific critical limits for the same analyte, and 55 hospitals did not specify instrument usage for any measurand. Median differences in matched pairs of laboratory versus POC critical limits differed significantly (Wilcoxon signed-rank, p < 0.05) for low and high ionized calcium (n = 21), low hemoglobin (n = 23) and high INR critical limits for adults (n = 27) and newborns (n = 10). In some cases, matched pair analytes demonstrated identical critical limits. Conclusions: Harmonizing critical limit notification thresholds across point-of-care testing and different devices may improve consistency in clinical decision-making and patient outcomes. Despite the potential of POCT to shorten time to urgent intervention, relatively few hospitals currently include POCT critical limits on notification lists. Establishing standards, annual updating, and enforcing risk mitigation could enhance adoption and reliability. Broader inclusion and transparent sharing of POCT critical values could harmonize practices across institutions, facilitate inter-institutional collaboration, and promote more timely and reliable responses to life-threatening diagnostic results. Full article

In this article, the motion control of ferromagnetic particles through varying a non-invasive magnetic field is addressed. Within an experimental test bench, three experiments are proposed to verify motion control, which consist of control of the distance between electromagnets, retention of particles over the flow, and manipulation of the direction of particle flow at a “Y”-type bifurcation emulating an “OR” gate. At each experimental stage, instrumented test benches were integrated with current, distance, and flow sensors, enabling measurement and feedback of the system’s physical variables. These benches were configured using pulse-width-modulation (PWM) and Proportional–Integral–Derivative (PID) controllers to regulate the current supplied to the electromagnets and, thereby, control the intensity of the induced electromagnetic field according to the requirements of each experiment. Different study cases were defined to analyze the operational limits of the system by varying the current influencing the electromagnetic field and the configuration of the electromagnets. The results describe the response of the magnetic field, the induced force, and the behavior of the suspended particles under each condition, providing elements to characterize the performance of the electromagnetic system in operational scenarios and contributing to the understanding of the phenomena associated with the non-invasive manipulation of ferromagnetic particles by means of controlled magnetic fields. Full article

The purpose of this instrumental case study, employing both qualitative and quantitative data, was to investigate how novice teachers from non-local and urban areas used community assets and local funds of knowledge (FoK) in their STEM instruction in a remote Montana town. While non-local teachers often make up a large share of many rural communities’ teaching workforce, those teachers might lack the social, cultural, and community knowledge that they need to teach with place-conscious approaches. Therefore, this study explored how “new-to-town” teachers, with limited personal ties to a community, learn about their rural community and how they apply this knowledge to their teaching context. Additionally, this study examined which research-established factors that improve rural STEM education were deemed most important for novice, rural teachers. The exploration employed a floodlight research approach, whereby a census of the authentic pedagogical actions of the subjects was documented rather than investigating the efficacy of a single method. Data sources included qualitative instruments like concept maps and semi-structured interviews, alongside quantitative measures like ranked best-practices data and place-conscious lesson ratios, to provide both depth of interpretation and breadth of comparison across participants. Results from the deductive thematic analysis suggest that novice teachers aspire to implement asset-based pedagogical approaches in STEM instruction and possess some methods for integration but struggle to learn of local community assets without modeling and mentorship. Additionally, an unexpected pattern emerged from the findings: Novice, newcomer teachers that employed place-conscious lessons were more likely to remain teaching in their position. While this association cannot be interpreted causally, it might suggest that place-conscious mentorship practices may play a role in improving instruction and support the retention of non-local teachers in rural communities however, further, more robust exploration is warranted of this exploratory finding. Findings from this study can be used to inform recommendations for school districts, post-secondary institutions, and rural communities on how best to support beginning rural teachers with limited community connections. Full article

This review provides a comprehensive overview of the most adopted 3D surveying techniques in Cultural Heritage, offering practical guidance for the selection of appropriate methods when three-dimensional documentation of artworks is required. The analysis focuses on the most effective technologies for the 3D documentation of sites and objects of artistic value, with selection criteria primarily centred on non-invasiveness, given the uniqueness and cultural significance of the case studies, and the instrument flexibility, a crucial requirement for non-transportable items. A broad spectrum of 3D techniques is currently available for the multiscale diagnostic investigation of artworks, providing information at both macroscopic and microscopic levels. This review reports on the state of the art of such systems and evaluates the main characteristics of each technology in relation to its applicability in the heritage field. Particular attention is given to highlighting advantages and limitations, and to assessing performance in terms of resolution, gauge volume/area, acquisition time, and cost. In addition, the review discusses exemplary cases in which 3D methods are integrated with other analytical techniques to enable a more comprehensive understanding of the object under investigation. Finally, recent studies are examined to identify the most suitable approaches and the specific requirements for the digitization of real-world heritage assets. Full article

Background/Objectives: Instrument fracture remains a significant complication in endodontics. This study compared the resistance to cyclic fatigue failure between rotary and reciprocating nickel–titanium file systems, as well as differences related to file size and taper. Methods: Nineteen rotary and reciprocating file types (n = 10 per group) were evaluated in three independent test series, harmonized according to file size and system. Cyclic fatigue testing was conducted using a static model with a stainless-steel artificial canal, with an internal diameter of 0.9 mm, a 75° curvature angle, and a fixed radius for each series. Files were operated using preset programs on the X-Smart Plus, Rooter X3000, and Sendoline Endo torque-controlled motors. Time to fracture was recorded digitally, and the total number of full rotations to failure was calculated. The fractured fragments were examined with scanning electron microscopy and fractographic analysis. The data were analyzed using linear models in Stata version 19, with significance set at p ≤ 0.05. Results: Reciprocating file systems demonstrated greater time-to-fracture fatigue resistance than rotary systems. However, these differences were diminished or, in some cases, eliminated when normalized to the number of complete rotations. Fractographic analysis indicated that fractures predominantly resulted from tensile stress rather than shear forces. Conclusions: Reciprocating kinematics generally enhanced fatigue resistance compared with continuous rotation. The results suggest that fatigue resistance in machine-driven nickel–titanium instruments cannot be predicted by motion type or file design alone but reflects a complex interaction between alloy composition, heat treatment, and cross-sectional geometry. Full article

Ecological zoning is a critical instrument for coordinating economic development with environmental conservation, ensuring regional ecological security, and fostering sustainable development. Using the Western Sichuan Plateau (WSP) as a case study and taking 2000, 2010, and 2020 as the time nodes, this research employed an optimized landscape ecological risk assessment model to comprehensively evaluate the spatiotemporal evolution of regional landscape ecological risk (LER) and ecosystem services (ESs). By analyzing the spatial correlation between LER and ESs, we constructed an ecological zoning framework, identified key driving factors, and proposed differentiated management strategies. The results showed the following: (1) The LER generally declined from 2000 to 2020, with the high-risk areas mainly distributed in the high-elevation meadow belt in the west and north, and the low and lowest-risk areas concentrated in the eastern part of the plateau continued to expand in area. (2) The overall level of ESs showed a downward and then upward trend, with a spatial pattern of “high in the east and low in the west”. (3) LER was significantly negatively correlated with most ESs (except WY), and localized agglomeration was clearly characterized. (4) Based on the four-quadrant model, the study area was categorized into four types of ecological zones, high LER–high ES, low LER–high ES, low LER–low ES and high LER–low ES, whose spatial patterns were mainly significantly influenced by factors such as elevation, per capita GDP and precipitation (PRE). The “risk-service” synergistic zoning framework proposed in this study provides a spatially explicit decision-making basis for ecological protection and restoration on the WSP, and is useful for the sustainable management of similar ecologically fragile areas. Full article

Although financial statements are increasingly recognised as containing rich economic and governance information, the existing research on zero-carbon factory certification has primarily focused on external policy instruments, technological pathways, and governance mechanisms, while generally overlooking the role of internal corporate financial information systems in carbon emissions measurement and certification. To address this research gap, this study examines the validity, representational capacity, and underlying mechanisms of financial-statement-based carbon emission intensity as a proxy for actual corporate carbon emissions, using Shanghai and Shenzhen A-share listed companies from 2010 to 2022 as the sample. Findings reveal a significant positive correlation between the two, with this relationship positively moderated by the sustainability of corporate innovation outputs and market competitive position. This effect operates through optimising resource allocation efficiency and strengthening financing constraints. Heterogeneity analysis indicates that explicit environmental signals and engagement levels enhance this representational effect, whereas high green technology levels inhibit it. Furthermore, using the steel industry as a case study, this paper constructs a four-dimensional, nine-indicator zero-carbon factory evaluation system. Employing Entropy-VIKOR model to certify 37 A-share listed steel enterprises in 2022. Carbon emission intensity was identified as the core metric, with C₆ and C₁₅ serving as zero-carbon benchmarks. Evaluation results demonstrated high alignment with official certifications, providing empirical evidence and policy implications for assessing carbon emissions through financial information and establishing zero-carbon factory certification standards. Full article

Lujo virus (LUJV) is an arenavirus that causes Lujo Hemorrhagic Fever (LHF), a viral hemorrhagic fever that emerged in a 2007 outbreak in Zambia and South Africa with an 80% case fatality rate and evidence of human-to-human nosocomial transmission. There are no approved medical countermeasures for LHF, although several screens have identified lead antiviral compounds. The lack of accessible animal models limits the development of lead compounds and characterization of broadly protective anti-arenavirus compounds such as ribavirin for the treatment of LHF. Here, we present preliminary data characterizing the partially lethal disease caused by LUVJ in STAT-1 deficient mice. Several key hematological, clinical chemistry, and histologic findings common to LHF disease are recapitulated in this model. This work suggests that further characterization of LUJV infection in STAT-1 deficient mice may allow development of a model that would be instrumental in the development of medical countermeasures for LHF. Full article

Background: Almost all correlation measures currently available are unable to directly handle missing values. Typically, missing values are either ignored completely by removing them or are imputed and used in the calculation of the correlation coefficient. In either case, the correlation value will be impacted based on the perspective that the missing data represents no useful information. However, missing values occur in real datasets for a variety of reasons. In metabolomics datasets a major reason for missing values is that a specific measurable phenomenon falls below the detection limits of the analytical instrumentation (left-censored values). These missing data are not missing at random, but represent potentially useful information by virtue of their “missingness” at one end of the data distribution. Methods: To include this information due to left-censored missingness, we propose the information-content-informed Kendall-tau (ICI-Kt) methodology. We develop a statistical test and then show that most missing values in metabolomics datasets are the result of left-censorship. Next, we show how left-censored missing values can be included within the definition of the Kendall-tau correlation coefficient, and how that inclusion leads to an interpretation of information being added to the correlation. We also implement calculations for additional measures of theoretical maxima and pairwise completeness that add further layers of information interpretation in the methodology. Results: Using both simulated and over 700 experimental data sets from the Metabolomics Workbench, we demonstrate that the ICI-Kt methodology allows for the inclusion of left-censored missing data values as interpretable information, enabling both improved determination of outlier samples and improved feature–feature network construction. Conclusions: We provide explicitly parallel implementations in both R and Python that allow fast calculations of all the variables used when applying the ICI-Kt methodology on large numbers of samples. The ICI-Kt methods are available as an R package and Python module on GitHub. Full article

Objective: To compare perioperative outcomes between robotic and conventional total laparoscopic hysterectomy in terms of operative time, intraoperative blood loss, and postoperative recovery in surgically complex cases. Methods: This retrospective cohort study included patients that underwent total laparoscopic hysterectomy between 2020 and 2022. As robotic surgery was preferentially applied to more complex cases in an effort to minimize the risk of open conversion, propensity score matching based on uterine weight and history of abdominal surgery was performed. The normality of continuous variables was assessed using the Shapiro–Wilk test; non-normally distributed variables are reported as median [interquartile range] and compared using the Mann–Whitney U test. Multivariate linear regression with log-transformed estimated blood loss was conducted to evaluate the independent association of surgical approach with hemostatic outcomes. Results: After 1:1 matching, 93 patients were analyzed per group. Robotic surgery was associated with longer operative time but lower estimated blood loss when compared with conventional laparoscopy. Postoperative hemoglobin decline, length of hospital stay, and complication rates were comparable between groups. In multivariate analysis, uterine weight and operative time were the primary determinants of estimated blood loss; surgical approach showed a modest, independent association with lower log-transformed estimated blood loss after adjustment for these factors. Conclusions: Robotic and conventional total laparoscopic hysterectomy demonstrated comparable perioperative safety profiles with different operative trade-offs. Observed differences in estimated blood loss reflect complex interactions between surgical difficulty, operative time, and instrumentation rather than inherent platform superiority. These findings support an individualized approach to surgical modality selection based on case complexity, to minimize risk of intraoperative complication leading to open conversion. Full article

This paper investigates crowd–structure interaction (CSI) on low-frequency floors during concert events. The findings are based on a full-scale experimental study conducted on a floor prototype designed for a specific infrastructure project. Both the structure and the participants were instrumented while performing various rhythmic activities, such as bouncing and jumping. The study emphasizes the necessity of defining load cases based on the music signal, as its frequency and amplitude may have a variable probability of occurrence. Furthermore, human sensitivity to floor vibrations is examined, with specific comfort thresholds identified for different activities. The core contribution of this work lies in quantifying coordination levels for groups of up to 97 jumping individuals, extending the limited existing literature and refining the definition of jumping crowd actions. Additionally, modal characterization of the unoccupied prototype was performed to evaluate the equivalent damping provided by individuals during standing, walking, bouncing, or jumping. The results demonstrate that while the crowd has a significant impact on the system’s equivalent damping, this effect remains highly variable. Finally, the implications of these findings for structural engineering and design practices are discussed. Full article

Energy performance certification of buildings is a key instrument for assessing energy efficiency within the framework of the Energy Performance of Buildings Directive (EPBD). In practice, significant discrepancies are often observed between the predicted and actual energy performance of buildings. One of the main causes of this discrepancy is non-compliance with technological procedures during construction. This paper analyses the energy and economic consequences of such deviations through a case study of a newly constructed residential building in northern Slovakia that was originally certified in the A0 energy class. The research methodology included in situ inspection of the building, thermographic measurements, destructive probes of the building envelope, analysis of project documentation, and recalculation of energy performance using measured building parameters. The results revealed significant deficiencies in the thermal insulation of the building envelope, roof construction, and window airtightness. After recalculation based on measured parameters, the building’s energy classification deteriorated from A0 to B. The total energy demand increased by 46%, while primary energy demand increased by 141%. The results demonstrate that construction deviations can significantly affect the reliability of energy performance certification. The study highlights the importance of verifying the actual condition of buildings during construction to ensure the reliability of EPC assessments. Full article

Background/Objectives: To study the hypothesis that cognitive functions and learning skills are impaired in child/adolescent childhood cancer survivors (CCS). Secondary outcomes included psychosocial parameters and quality of life. Methods: This case–control study was conducted over four years (2017–2021) at the largest pediatric Aghia Sophia Children’s Hospital, in Greece. Eligible participants were children and adolescents in Greece. For CCS, ≥1 year should have elapsed from completion of cancer treatment. Assessments of neurocognitive function, learning and psychosocial skills and health-related quality of life (HRQoL) were performed with validated instruments (WISC-III, LAMDA software, Achenbach CBCL/6-18 and YSR, KIDSCREEN-52, respectively). Results: In total, 219 participants (47.49% males, mean age ± SD 11.72 ± 2.32 years), 70 CCS and 149 controls (matched for age, sex, family income), were included. Cases were CCS of acute lymphoblastic leukemia (n = 25)/brain tumors (n = 19)/lymphoma (n = 17)/nephroblastoma (n = 5)/Ewing sarcoma (n = 3)/rhabdomyosarcoma (n = 1). CCS had worse scores in full-scale Intelligence Quotient (FSIQ) (p = 0.004), verbal IQ (VIQ) (p = 0.005) and all its subscales, performance IQ (PIQ) (p = 0.021), and almost all learning parameters than controls. Attention, working memory, writing/visual–motor coordination, processing accuracy/speed, language acquisition/expression, all psychosocial scales, and HRQoL domains of mood and emotions, were negatively affected in CCS. Female CCS demonstrated lower FSIQ (p = 0.019) and VIQ (p = 0.014) than control females, whereas male CCS retained their total IQ unaffected. Among CCS, those with non-central nervous system (CNS) tumors, higher parental educational level or higher family income had significantly higher IQ than those with CNS tumors, lower parental educational level or lower family income, respectively. Conclusions: CCS in Greece carry a significant burden of cognitive and psychological morbidity. Cognitive/educational and psychosocial support to CCS is imperative. Full article

The escalating scale and complexity of cybercrime necessitate standardized digital forensic protocols to ensure the integrity and admissibility of digital evidence. This study empirically assesses the use of ISO/IEC 27037 and ISO/IEC 27041 through three real-world digital forensic case studies conducted in organizational settings. A multi-case methodology was employed, encompassing a multinational corporate criminal investigation, an internal employee misbehaviour probe, and an examination into mobile- and cloud-based data leaks. The effect of synchronized standard implementation was evaluated using audit-based and quantitative indicators that measure forensic process quality as a system attribute. The findings demonstrate that the systematic implementation of ISO/IEC 27037 and ISO/IEC 27041 improves investigative traceability, documentation quality, and evidentiary robustness. In the worldwide case study, documentation completeness increased by 18%, and all digital evidence was deemed admissible in judicial proceedings, surpassing the institutional baseline admissibility rate of 82%. In other instances, evidence gathered within the same framework was acknowledged in organizational or disciplinary review processes, resulting in similar enhancements in documentation quality and procedural consistency, notwithstanding technological and organizational limitations. The paper develops and empirically substantiates an integrated procedural validation model that connects evidence-handling practices with method and instrument validation. The results indicate that the synchronized implementation of ISO/IEC forensic standards improves the transparency, dependability, and auditability of digital forensic investigations. Full article