Search Results (22,837)

Background: Treatment compliant with the Global Initiative for Asthma (GINA) can promote more effective disease control. Single-inhaler triple therapy (SITT) is one method that is used to optimize therapy in this context, but TRIPLE therapy is still employed by physicians to a limited extent. Objective: This study aimed to describe the factors influencing challenges in optimizing asthma therapy. Methods: A 19-question survey, created via the CATI system, was distributed among pulmonologists, allergologists, general practitioners, and internal medicine specialists in Poland, Greece, Sweden, Slovenia, and Austria. Results: Statistically significant percentage differences in the use of TRIPLE therapy in the context of asthma management were observed among countries as well as between pulmonologists, allergists, and other specialists. Overuse of oral corticosteroids (OCSs) to treat nonsevere and severe asthma in the absence of an approach that focuses on optimizing inhalation therapy among asthma patients receiving TRIPLE therapy was observed in different countries as well as among physicians with different specialties. Twenty elements associated with the challenges involved in diagnosing and managing difficult-to-treat and severe asthma were identified. Six clinical categories for the optimization of asthma therapy via SITT were highlighted. The degree of therapeutic underestimation observed among severe asthma patients was assessed by comparing actual treatment with the recommendations of the GINA 2023 guidelines. Conclusions: Physicians of various specialties in Europe are subject to therapeutic inertia in terms of their compliance with the GINA 2023 guidelines. Full article

Barrel tools are increasingly used in high-precision machining of free-form surfaces. However, limited studies evaluate their performance specifically on spherical geometries, where tool–surface contact characteristics differ significantly. Understanding how tool geometry and process parameters influence surface quality and cutting forces in such cases remains underexplored. This study evaluates how barrel cutter radius and varying machining parameters affect cutting forces and surface roughness when milling internal and external spherical surfaces. Machining tests were conducted on structural steel 1.1191 using two barrel cutters with different curvature radii (85 mm and 250 mm) on a 5-axis CNC machine. Feed per tooth and radial depth of cut were systematically varied. Cutting forces were measured using a dynamometer, and surface roughness was assessed using the Rz parameter, which is more sensitive to peak deviations than Ra. Novelty lies in isolating spherical surface shapes (internal vs. external) under identical path trajectories and systematically correlating tool geometry to force and surface metrics. The larger curvature tool (250 mm) consistently generated up to twice the cutting force of the smaller radius tool under equivalent conditions. External surfaces showed higher Rz values than internal ones due to less favorable contact geometry. Radial depth of the cut had a linear influence on force magnitude, while feed rate had a limited effect except at higher depths. Smaller-radius barrel tools and internal geometries are preferable for minimizing cutting forces and achieving better surface quality when machining spherical components. The aim of this paper is to determine the actual force load and surface quality when using specific cutting conditions for internal and external spherical machined surfaces. Full article

The stability of shield tunnel segmental linings is highly sensitive to the lateral pressure coefficient, especially under weak, heterogeneous, and variable geological conditions. However, the mechanical behavior of steel plate-reinforced linings under such conditions remains insufficiently characterized. This study aims to investigate the effects of varying lateral pressures on the structural performance of reinforced tunnel linings. To achieve this, a custom-designed full-circumference loading and unloading self-balancing apparatus was developed for scaled-model testing of shield tunnels. The experimental methodology allowed for precise control of loading paths, enabling the simulation of realistic ground stress states and the assessment of internal force distribution, joint response, and load transfer mechanisms during the elastic stage of the structure. Results reveal that increased lateral pressure enhances the stiffness and bearing capacity of the reinforced lining. The presence and orientation of segment joints, as well as the bonding performance between epoxy resin and expansion bolts at the reinforcement interface, significantly influence stress redistribution in steel plate-reinforced zones. These findings not only deepen the understanding of tunnel behavior in complex geological environments but also offer practical guidance for optimizing reinforcement design and improving the durability and safety of shield tunnels. Full article

This study was conducted to examine the moderating effect of size on the impact of human capital on bank performance, using data from 26 commercial banks in Vietnam from 2008 to 2023 through panel data regression methods. The results indicate that bank size and human capital are important resources for commercial banks to increase their performance, which is consistent with the resource-based view and economies of scale theory. However, bank size fails to exhibit a significant moderating effect on the impact of human capital on the bank performance in Vietnam. This phenomenon can be explained by the relatively limited influence of size effects on human capital, coupled with the fact that the majority of Vietnamese commercial banks place significant strategic emphasis on human capital development within their operational frameworks. In addition, this study highlights the impact of some internal factors and the macroeconomic conditions on bank performance. From these empirical findings, this paper recommends several critical policies. Full article

The use of opioids for cancer-related pain is essential but poses significant challenges due to the risk of misuse and the development of opioid use disorder (OUD). This review takes a multidisciplinary perspective based on the current scientific literature to analyze the pharmacological mechanisms, classification, and therapeutic roles of opioids in oncology. Key risk factors for opioid misuse—including psychiatric comorbidities, prior substance use, and insufficient clinical monitoring—are discussed in conjunction with validated tools for pain assessment and international guidelines. The review emphasizes the importance of integrating toxicological, pharmacological, physiological, and public health perspectives to promote rational opioid use. Pharmacogenetic variability is explored as a determinant of treatment response and addiction risk, underscoring the value of personalized medicine. Evidence-based strategies such as early screening, psychosocial interventions, and the use of buprenorphine-naloxone are presented as effective measures for managing OUD in cancer patients. Ultimately, this work advocates for safe, patient-centered opioid prescribing practices that ensure effective pain relief without compromising safety or quality of life. Full article

This case report presents a multidisciplinary forensic investigation into a cold case involving a missing person in Italy, likely linked to a homicide that occurred in 2008. The investigation applied a standardized protocol integrating satellite imagery analysis, site reconnaissance, vegetation clearance, ground-penetrating radar (GPR), and cadaver dog (K9) deployment. A dedicated decision tree guided each phase, allowing for efficient allocation of resources and minimizing investigative delays. Although no human remains were recovered, the case demonstrates the practical utility and operational robustness of a structured, evidence-based model that supports decision-making even in the absence of positive findings. The approach highlights the relevance of “negative” results, which, when derived through scientifically validated procedures, offer substantial value by excluding burial scenarios with a high degree of reliability. This case is particularly significant in the Italian forensic context, where the adoption of standardized search protocols remains limited, especially in complex outdoor environments. The integration of geophysical, remote sensing, and canine methodologies—rooted in forensic geoarchaeology—provides a replicable framework that enhances both investigative effectiveness and the evidentiary admissibility of findings in court. The protocol illustrated in this study supports the consistent evaluation of large and morphologically complex areas, reduces the risk of interpretive error, and reinforces the transparency and scientific rigor expected in judicial settings. As such, it offers a model for improving forensic search strategies in both national and international contexts, particularly in long-standing or high-profile missing persons cases. Full article

Academic English support is crucial for English as an Additional Language (EAL) nursing students in English-medium nursing education programmes. However, empirical research on content and language integrated learning (CLIL) within this specific context remains limited. This study, informed by recent advancements in translanguaging and trans-semiotising (TL-TS) theory, investigates the patterns of teacher collaboration in nursing CLIL and its impact when employing a TL-TS pedagogical approach. Analysis of students’ pre- and post-tests and multimodal classroom interactions reveals that effective collaboration between nursing specialists and language experts in CLIL can be fostered by (1) aligning with language education principles through the incorporation of internally persuasive discourse (IPD) about language learning and TL-TS practices; (2) simulating potential professional contingencies and co-developing coping strategies using TL-TS; and (3) elucidating nursing language norms through TL-TS and IPD. We advocate for re-imagination of CLIL in English-medium nursing education through an organistic–procedural TL perspective and highlight its potential to enhance EAL nursing students’ development of language proficiency and professional competencies. Full article

An Analog-to-Digital Converter (ADC) is an indispensable part of image sensor systems. This paper presents a silicon-based 13-bit 100 kS/s two-step single-slope analog-to-digital converter (TS-SS ADC) for infrared image sensors with a frame rate of 100 Hz. For the charge leakage and offset voltage issues inherent in conventional TS-SS ADC, a four-terminal comparator was employed to resolve the fine ramp voltage offset caused by charge redistribution in storage and parasitic capacitors. In addition, a current-steering digital-to-analog converter (DAC) was adopted to calibrate the voltage reference of the dynamic comparator and mitigate differential nonlinearity (DNL)/integral nonlinearity (INL). To eliminate quantization dead zones, a 1-bit redundancy was incorporated into the fine quantization circuit. Finally, the quantization scheme consisted of 7-bit coarse quantization followed by 7-bit fine quantization. The ADC was implemented using an SMIC 55 nm processSemiconductor Manufacturing International Corporation, Shanghai, China. The post-simulation results show that when the power supply is 3.3 V, the ADC achieves a quantization range of 1.3 V–3 V. Operating at a 100 kS/s sampling rate, the proposed ADC exhibits an effective number of bits (ENOBs) of 11.86, a spurious-free dynamic range (SFDR) of 97.45 dB, and a signal-to-noise-and-distortion ratio (SNDR) of 73.13 dB. The power consumption of the ADC was 22.18 mW. Full article

Electroless nickel deposition (ELD) is an autocatalytic technique extensively used to impart conductive, protective, and mechanical functionalities to inherently non-conductive synthetic substrates. This review systematically explores the fundamental mechanisms of electroless nickel deposition, emphasising recent advancements in surface activation methods, solvent systems, and microstructural control. Critical analysis reveals that bio-inspired activation methods, such as polydopamine (PDA) and tannic acid (TA), significantly enhance coating adhesion and durability compared to traditional chemical etching and plasma treatments. Additionally, solvent engineering, particularly using polar aprotic solvents like dimethyl sulfoxide (DMSO) and ethanol-based systems, emerges as a key strategy for achieving uniform, dense, and flexible coatings, overcoming limitations associated with traditional aqueous baths. The review also highlights that microstructural tailoring, specifically the development of amorphous-nanocrystalline hybrid nickel coatings, effectively balances mechanical robustness (hardness exceeding 800 HV), flexibility, and corrosion resistance, making these coatings particularly suitable for wearable electronic textiles and smart materials. Furthermore, commercial examples demonstrate the real-world applicability and market readiness of nickel-coated synthetic fibres. Despite significant progress, persistent challenges remain, including reliable long-term adhesion, internal stress management, and environmental sustainability. Future research should prioritise environmentally benign plating baths, standardised surface activation protocols, and scalable deposition processes to fully realise the industrial potential of electroless nickel coatings. Full article

Economic growth, especially in emerging economies, has altered the composition of international tourism. It is therefore essential to possess the skills necessary to understand the influence of culture on human behaviour, thereby enabling an appropriate response to the traveller. This research aims to develop a tool for identifying openness, flexibility, awareness, and intercultural preparedness. It focuses on the metacognitive and cognitive aspects of cultural intelligence that shape the development of empathy in customer service staff in hotels in Quintana Roo. The variables were validated and incorporated into a quantitative study using multivariate analysis and inferential statistics. A sample of 77 questionnaires was analysed using simple random sampling under a proportional design. Multiple Correspondence Analysis (MCA) was employed as a discriminatory technique to identify the most significant independent variables. These were subsequently entered as regressors into ordinal logistic regression (OLR), along with age and work experience, in order to estimate the probabilities associated with each level of the dependent variable. The results indicated that age had minimal influence on the metacognitive and cognitive variables, whereas years of experience among tourism staff exerted a significant effect. Full article

Thermoplastic polyurethane (TPU) electrospun fiber membranes possess unique micro-nano structures and excellent properties. Adjusting their wettability enables the directional transportation of lubricants. A conventional method for adjusting porosity and wettability involves inducing membrane shrinkage using absolute ethanol and heat treatment. However, the shrinkage response and the corresponding changes in the tensile properties of TPU fiber membranes after induction remain unclear, limiting their applications. Thus, in this study, after being peeled off, the samples were first left to stand at room temperature (RT) for 24 h to release residual stress and stabilize their dimensions, and then treated with dehydrated ethanol at RT and high temperature, respectively, with their shrinkage behaviors observed and recorded. The results showed that TPU nanofiber membranes shrank significantly in absolute ethanol, and the degree of shrinkage was temperature-dependent. The shrinkage rates were 2% and 4% in dehydrated ethanol at room temperature and high temperature, respectively, and heating increased the shrinkage effect by 200%. These findings prove that absolute ethanol causes TPU fibers to shrink, and high temperatures further promote shrinkage. However, although the strong synergistic effect of heat and solvent accelerates shrinkage, it may induce internal structural defects, resulting in the deterioration of mechanical properties. The contraction response induced by anhydrous ethanol stimulation can be used to directionally adjust the local density and modulus of TPU nanofiber membranes, thereby changing the wettability. This approach provides new opportunities for applications in areas such as medium transportation and interface friction reduction in lubrication systems. Full article

Soft soils, characterized by high compressibility, low shear strength, and high water sensitivity, pose serious challenges to geotechnical engineering in infrastructure projects. Traditional stabilization methods such as lime and cement face limitations, including environmental concerns and poor durability under chemical or cyclic loading. Ionic soil stabilizers (ISSs), which operate through electrochemical mechanisms, offer a promising alternative. However, their long-term performance—particularly under environmental stressors such as acid/alkali exposure and cyclic wetting–drying—remains insufficiently explored. This study evaluates the strength and durability of ISS-modified soil through a comprehensive experimental program, including direct shear tests, permeability tests, and cyclic wetting–drying experiments under neutral, acidic (pH = 4), and alkaline (pH = 10) environments. The results demonstrate that ISS treatment increases soil cohesion by up to 75.24% and internal friction angle by 9.50%, particularly under lower moisture conditions (24%). Permeability decreased by 88.4% following stabilization, resulting in only a 10–15% strength loss after water infiltration, compared to 40–50% in untreated soils. Under three cycles of wetting–drying, ISS-treated soils retained high shear strength, especially under acidic conditions, where degradation was minimal. In contrast, alkaline conditions caused a cohesion reduction of approximately 26.53%. These findings confirm the efficacy of ISSs in significantly improving both the mechanical performance and environmental durability of soft soils, offering a sustainable and effective solution for soil stabilization in chemically aggressive environments. Full article

Difficult, extreme operating conditions of parabolic antennas under precipitation and sub-zero temperatures require the creation of effective heating systems. The purpose of the research is to develop a multilayer coating containing two metal-ceramic layers, epoxy composite layers, carbon fabric, and an outer layer of basalt fabric, which allows for effective heating of the antenna, and to study the properties of this coating. The multilayer coating was formed on an aluminum base that was subjected to abrasive jet processing. The first and second metal-ceramic layers, Al₂O₃ + 5% Al, which were applied by high-speed multi-chamber cumulative detonation spraying (CDS), respectively, provide maximum adhesion strength to the aluminum base and high adhesion strength to the third layer of the epoxy composite containing Al₂O₃. On this not-yet-polymerized layer of epoxy composite containing Al₂O₃, a layer of carbon fabric (impregnated with epoxy resin) was formed, which serves as a resistive heating element. On top of this carbon fabric, a layer of epoxy composite containing Cr₂O₃ and SiO₂ was applied. Next, basalt fabric was applied to this still-not-yet-polymerized layer. Then, the resulting layered coating was compacted and dried. To study this multilayer coating, X-ray analysis, light and raster scanning microscopy, and transmission electron microscopy were used. The thickness of the coating layers and microhardness were measured on transverse microsections. The adhesion strength of the metal-ceramic coating layers to the aluminum base was determined by both bending testing and peeling using the adhesive method. It was established that CDS provides the formation of metal-ceramic layers with a maximum fraction of lamellae and a microhardness of 7900–10,520 MPa. In these metal-ceramic layers, a dispersed subgrain structure, a uniform distribution of nanoparticles, and a gradient-free level of dislocation density are observed. Such a structure prevents the formation of local concentrators of internal stresses, thereby increasing the level of dispersion and substructural strengthening of the metal-ceramic layers’ material. The formation of materials with a nanostructure increases their strength and crack resistance. The effectiveness of using aluminum, chromium, and silicon oxides as nanofillers in epoxy composite layers was demonstrated. The presence of structures near the surface of these nanofillers, which differ from the properties of the epoxy matrix in the coating, was established. Such zones, specifically the outer surface layers (OSL), significantly affect the properties of the epoxy composite. The results of industrial tests showed the high performance of the multilayer coating during antenna heating. Full article

This study explores how corporate governance reforms can enhance financial reporting quality and organizational transparency, focusing on Greece’s transition from Law 3016/2002 to Law 4706/2020. The legislative reform aimed to modernize governance structures, align national practices with international standards, and strengthen investor protection in a post-crisis economic environment. Moving beyond a simple legal comparison, the study examines how Law 3016/2002’s formal compliance model contrasts with Law 4706/2020’s more substantive accountability framework. We hypothesize that Law 4706/2020 introduces substantively stronger governance mechanisms than its predecessor, thereby improving transparency and investor protection, while compliance with the new law imposes materially greater administrative and financial burdens, especially on small- and mid-cap firms. Methodologically, the research employs a narrative literature review and a structured comparative legal analysis to assess the administrative and financial implications of the new law for publicly listed companies, focusing on board composition and diversity, internal controls, suitability policies, and disclosure requirements. Drawing on prior comparative evidence, we posit that Law 4706/2020 will foster governance and disclosure improvements, enhanced oversight, and clearer board roles. However, these measures also impose compliance burdens. Due to the heterogeneity of listed companies and the lack of firm-level data following Law 4706/2020’s implementation, the findings are neither fully generalizable nor quantifiable; future quantitative research using event studies or panel data is required to validate the hypotheses. We conclude that Greece’s new framework is a critical step toward sustainable corporate governance and more transparent financial reporting, offering regulators, practitioners, and scholars examining legal reform’s impact on governance effectiveness and financial reporting integrity. Full article

This quantitative study examines the determinants of financial reporting quality in Indonesian local governments, focusing on good governance, regional financial accounting systems, internal control systems, organizational commitment, and information technology utilization, with HR competencies as a moderator. Data were collected via surveys from 170 Local Government Work Units (SKPDs) across South Sulawesi Province, Indonesia. Employing Structural Equation Modeling (SEM), the findings indicate that good governance, regional financial accounting systems, internal control systems, organizational commitment, and information technology utilization all positively influence financial reporting quality. Crucially, human resource competencies were found to significantly moderate the relationship between the internal control system and organizational commitment with financial reporting quality. However, this moderating effect was not significant for the relationships involving good governance, regional financial accounting systems, and information technology utilization. These results highlight the essential role of human resource development and systemic enhancements in fostering greater financial accountability and transparency within the public sector. Therefore, policy recommendations should focus not only on enhancing individual competencies but also on synergistically strengthening systems and governance frameworks to achieve transparent and reliable public financial reporting. Full article