Search Results (7,822)

Background: Proton pump inhibitors (PPIs) are widely used to prevent acid-related complications, yet concerns persist about infectious harm. Observational studies have linked PPIs to Clostridioides difficile infection (CDI) and pneumonia whereas randomized controlled trials (RCTs) consistently show reductions in upper gastrointestinal bleeding. We therefore conducted a systematic review and meta-analysis restricted to randomized controlled trials to evaluate whether PPIs increase the risk of CDI, and to assess pneumonia and gastrointestinal bleeding to contextualize net clinical benefit. Methods: A comprehensive search of randomized controlled trials (RCTs) was conducted using several databases including PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and SCOPUS until July 2025. All published English-language RCTs that met the inclusion criteria were included. Random-effects models were utilized to calculate pooled odds ratios (ORs) with 95% confidence intervals. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 Tool, and heterogeneity was quantified using I² statistics. Analysis was performed using STATA version 18 and RevMan 5.3. Results: Across eight RCTs (n = 30,019), PPIs did not increase C. difficile infection versus placebo (OR 1.29, 95% CI 0.82–2.02; p = 0.27; I² = 16%) with leave-one-out (LOO) analyses showing stable estimates. In six trials reporting pneumonia, there was no significant difference between groups (OR 1.00, 95% CI 0.92–1.09; p = 0.99; I² = 0%). For clinically important upper GI bleeding (seven trials), PPIs were associated with a statistically significant lower risk when compared to placebo (OR 0.51, 95% CI 0.27–0.94; p = 0.03; I² = 56%). Conclusions: Across randomized trials with follow-up ranging from 30 days to 3 years, PPI prophylaxis significantly reduced upper gastrointestinal bleeding without increasing the risk of CDI or pneumonia. These findings support the use of PPIs for prophylaxis when clinically indicated, while recognizing that larger trials are needed to better assess rare adverse events. Full article

Retronasal aroma strongly influences the flavor quality of low-alcohol Jiangxiangxing Baijiu. This study investigated the retronasal aroma differences between high- and low-alcohol samples (Sample-High and Sample-Low). Dynamic sensory evaluation revealed roasted, grain, floral and fruity, hay, and caramel notes were more pronounced in Sample-High, whereas Sample-Low exhibited stronger fatty and smoky notes, indicating insufficient retronasal aroma richness in Sample-Low. Analysis of 67 compounds showed no significant concentration differences, yet their retronasal olfactory thresholds varied markedly between alcoholic systems (ratio 1.04–4.75), leading to higher dose-over-threshold (DoT) values for several compounds in Sample-Low. Further analysis of the DoT distribution intervals showed Sample-High presented a more balanced distribution, whereas Sample-Low was strongly driven by several high-contribution compounds, which reduced the relative contributions of others. This unbalanced distribution may underlie the lower retronasal aroma richness observed in Sample-Low. These findings provide a new perspective for understanding retronasal aroma in low-alcohol Jiangxiangxing Baijiu. Full article

Accurate rice detection is essential for food security, sustainable agriculture, and environmental monitoring. Satellite time series observations provide scalable capabilities for rice detection; however, their application in tropical regions is challenged by persistent cloud contamination, asynchronous crop development cycles, and temporal misalignment among multisensor observations, which reduce classification reliability. This study introduces Multivariate Robust Time Series Boosting (MRTS-Boosting), a quality-aware framework for multivariate time series classification (TSC) designed to improve robustness under noisy and irregular observational conditions. The framework integrates quality-weighted feature construction, joint extraction of full-series and interval-based temporal features, and a flexible multivariate formulation that accommodates heterogeneous satellite inputs without strict temporal alignment. Performance was evaluated using synthetic datasets with controlled cloud contamination, 103 benchmark datasets from the University of California, Riverside (UCR) TSC Archive, and 3261 real-world rice field observations from Indonesia. Comparisons were conducted against representative whole-series, interval-based, shapelet-based, kernel-based, and ensemble classifiers. MRTS-Boosting achieved up to 87% accuracy under severe cloud contamination, an average rank of 2.7 on noise-augmented UCR datasets, and 93% accuracy with Cohen’s kappa of 0.76 for Indonesian rice detection, while maintaining moderate computational cost. These results demonstrate that MRTS-Boosting provides a robust, scalable, and computationally efficient framework for satellite-based rice detection. The framework remains competitive in univariate settings while benefiting from multisensor integration, indicating that performance gains arise from both methodological design and the effective use of heterogeneous data. MRTS-Boosting is therefore well-suited for precision agriculture applications under challenging observational conditions. Full article

Background: Adrenocortical carcinoma (ACC) is a rare and aggressive endocrine malignancy, for which population-level evidence regarding prognostic factors and survival conditions is limited. The available data mostly represent single-institution series, limiting their applicability. This study, therefore, assesses clinicopathological features and determines independent predictive variables of overall survival (OS) in patients with ACC using a population-based cohort. Methods: This retrospective observational cohort study used data from the Surveillance, Epidemiology, and End Results (SEER) Program between 2000 and 2022, initially identifying 1176 patients with ACC. Adult patients (≥18 years) with histologically confirmed ACC were identified using ICD-O-3 histology code 8370/3 and primary site code C74.0. Cases with zero-month survival, missing survival data, or identified only through autopsy or death certificate were excluded. To ensure dataset harmonization, patients with missing or indeterminate tumor grade and unknown stage were also excluded. After applying these inclusion and exclusion criteria, the final analytic cohort consisted of 267 patients. Data on demographic factors, stage of the disease, and treatment (surgery, chemotherapy, radiotherapy) were extracted. OS was evaluated using the Kaplan–Meier method, and independent prognostic factors were identified using Cox proportional hazards regression analysis. Results: The median OS was 54 months [95% confidence intervals (CI): 36–85]. The estimated 1-, 3-, and 5-year OS rates were 77%, 57%, and 48%, respectively. Survival differed significantly according to tumor grade, stage, and surgical treatment. In multivariable Cox regression analysis, increasing age [Hazard ratio (HR): 1.03, 95% CI: 1.02–1.04; p < 0.001], high tumor grade (HR: 2.21, 95% CI: 1.43–3.41; p < 0.001), and distant-stage disease (HR: 3.24, 95% CI: 1.95–5.38; p < 0.001) were independently associated with an increased risk of mortality, whereas surgical treatment was associated with improved survival (HR 0.53, 95% CI 0.30–0.93; p = 0.028). Chemotherapy and radiotherapy were not significantly associated with mortality. Conclusion: In this SEER-based cohort of patients with adrenocortical carcinoma, older age, high tumor grade, and distant-stage disease were independently associated with worse OS, whereas documented receipt of surgery was associated with longer OS. Treatment-related associations should be interpreted cautiously in view of the inherent limitations of registry-based data. Further prospective multicenter studies are needed to confirm these findings. Full article

Background: The pain experienced by people with fibromyalgia (FM) is thought to be the result of altered nociceptive processing, impaired descending inhibition and reduced tolerance to physical load. However, the relationship between the amount of exercise and pain reduction remains unclear. Methods: This study synthesized randomized controlled trials of exercise interventions for FM to quantify the combined analgesic effects of different types of exercise. A secondary aim was to standardize exposure using metabolic equivalent of task (MET)-based metrics and examine the association between cumulative intervention dose (MET·h) and analgesic response (Hedges’ g) across intervention arms. Following the PRISMA guidelines, a search was conducted in PubMed for randomized controlled trials published up to 31 December 2025. After screening and a full-text assessment, 15 trials were included. The protocols were converted into MET-defined intensity and weekly MET·min exposure, and the cumulative dose was calculated as the total MET·h accrued over the intervention period. Random-effects models were used to estimate the pooled effects within modality subgroups. Results: Across modalities, exercise was associated with reductions in pain, with effects typically falling within the small-to-moderate range. Larger improvements were observed in structured or supervised programs. The dose-response scatter plot showed wide variability across the dose range, with overlapping confidence intervals. An exploratory fourth-degree polynomial fit explained limited variance (R² = 0.1615) and did not indicate a monotonic dose-response pattern. This suggests that cumulative workload alone is a weak proxy for therapeutic response. Conclusions: Based on these findings, a pain-responsive algorithm combining weekly Visual Analogue Scale (VAS), ΔVAS and Talk Test thresholds was implemented as a preliminary online calculator to support the prescription of exercise tailored to symptoms. Full article

The collection of high-quality seeds to produce forest seedlings is closely linked with the time of harvesting. Climate warming is already having visible effects in all life stages of forest tree species, including the timing of seed maturation. The purpose of this study was to update the knowledge on seed collection timing and to identify the indicators of physiological maturity for three key Eastern European tree species—silver fir (Abies alba), European larch (Larix decidua), and small-leaved lime (Tilia cordata). Seeds and cones were collected from Romanian clonal seed orchards and evaluated at several stages of seed maturation using germination tests for European larch and tetrazolium viability tests for silver fir and small-leaved lime. The results revealed species-specific differences in seed maturation timing: in silver fir seed viability increased slightly from late August to early September, in European larch germination remained low (≈20%) regardless of harvest time, while small-leaved lime viability declined significantly after late August. These findings suggest that the harvest period observed during the study years occurred earlier than the traditionally recommended intervals and could be linked to recent warming trends. This study highlights the relevance of re-evaluating seed collection schedules under changing climatic conditions, while further multi-year studies are required to confirm these patterns and refine practical recommendations. Full article

We propose a fully nonparametric empirical autoregressive copula framework for univariate time series, designed to capture nonlinear and asymmetric serial dependence while exactly preserving the empirical marginal distribution. The method decouples marginal behavior from temporal dependence by (i) constructing a shape-preserving empirical marginal via monotone interpolation and mapping observations to the unit interval, and (ii) estimating the lag–lead dependence through a nonparametric conditional AR(1) copula density on ${(0,1)}^2$. To ensure stable estimation near the boundaries, we employ reflection-based kernel methods that mitigate edge effects and yield well-behaved conditional densities on the unit support. Forecasts are obtained from the implied conditional predictive density: we compute point forecasts either as conditional modes (maximum a posteriori) on the copula scale or as conditional means, and then back-transform exactly using the empirical quantile function, guaranteeing marginal fidelity and support-respecting predictions. Empirically, we evaluate the approach on three CBOE volatility indices (VIX, VXD, and RVX) and benchmark it against linear ARMA models, copula-based parametric competitors, and state-space/heteroskedasticity baselines (Local level, TVP–AR, and ARMA–GARCH). The results highlight that modeling the full conditional transition density nonparametrically can deliver competitive—often best or near-best—forecast accuracy across horizons, particularly in the presence of pronounced volatility regimes and asymmetric adjustments. Full article

Aim: We aimed to evaluate the clinical efficacy and safety of Shenqu Xiaoshi Oral Liquid in the treatment of functional constipation in children. Methods: A comprehensive literature search was conducted from inception to 20 October 2025, across PubMed, Embase, Scopus, Web of Science, the Cochrane Library, Chinese VIP Information Database, China National Knowledge Infrastructure (CNKI), and Wan Fang Med Database. For quantitative analysis, the mean difference (MD) was used for continuous outcomes and the risk ratio (RR) for dichotomous outcomes. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. Statistical analyses were performed using RevMan 5.3 and Stata 13 software. Results: Eight studies involving 692 pediatric patients were included (Shenqu Xiaoshi Oral Liquid group: 345; control group: 347). Compared to the control group, Shenqu Xiaoshi Oral Liquid demonstrated superior clinical effectiveness [RR = 1.36, 95% CI: (1.25, 1.47); z = 7.11, p < 0.00001] and a lower recurrence rate [RR = 0.49, 95% CI: (0.26, 0.93); z = 2.18, p = 0.03]. Both the post-treatment [WMD = −0.91, 95% CI: (−0.97, −0.86); z = 31.94, p < 0.00001] and post-recurrence [WMD = −1.49, 95% CI: (−1.56, −1.41); z = 40.12, p < 0.00001] defecation intervals were shorter in the Shenqu Xiaoshi Oral Liquid group. No significant difference was observed in the incidence of adverse reactions between the two groups [RR = 0.67, 95% CI: (0.35, 1.29); z = 1.20, p = 0.23]. Furthermore, serum levels of motilin [WMD = 41.66, 95% CI: (34.17, 49.16); z = 10.90, p < 0.00001] and gastrin [WMD = 23.74, 95% CI: (7.30, 40.19); z = 2.83, p = 0.005] were significantly higher in the Shenqu Xiaoshi Oral Liquid group. Conclusions: Shenqu Xiaoshi Oral Liquid shows favorable clinical efficacy and an acceptable safety profile for treating functional constipation in children. However, these outcome measures are influenced by the limited sample size and potential heterogeneity of the included studies, warranting cautious interpretation of the results. Full article

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly employed in patients with hemorrhagic shock and cardiovascular collapse; however, its impact on mortality remains controversial. Differences in geographic regions and patient populations may influence clinical outcomes. Methods: We conducted a systematic review and meta-analysis of observational studies comparing mortality between patients receiving REBOA and those managed without REBOA. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses were performed according to propensity score (PS) matching, trauma versus non-trauma populations, and geographic regions. Results: A total of 10 studies involving 18,611 patients were included. Overall, REBOA was not associated with a significant reduction in mortality compared with non-REBOA (pooled OR = 0.52, 95% CI: 0.19–1.39, p = 0.19). In PS-matched studies, the pooled OR was 0.82 (95% CI: 0.34–1.98, p = 0.66), whereas in non-PS-matched studies it was 0.40 (95% CI: 0.12–1.26, p = 0.12). Geographic analyses revealed no significant mortality benefit in either Western studies (OR = 0.47, 95% CI: 0.12–1.89; p = 0.29) or non-Western studies (OR = 0.60, 95% CI: 0.11–3.38; p = 0.56). No survival benefit was observed among trauma patients (OR = 0.57, 95% CI: 0.20–1.61; p = 0.29), whereas a significant reduction in mortality was observed in non-trauma patients (OR = 0.21, 95% CI: 0.05–0.88; p = 0.03). Conclusions: In this systematic review and meta-analysis, REBOA was not associated with a significant reduction in mortality in the overall population or in trauma patients. However, in a single small non-trauma study (n = 53), REBOA was associated with significantly reduced mortality; this finding is exploratory and requires confirmation in larger prospective studies. These findings suggest that the clinical benefit of REBOA may depend on patient population and underlying etiology of hemorrhage. Full article

Offshore pipeline systems associated with floating platforms operate under complex environmental and operational conditions that significantly influence their structural integrity and inspection requirements. Limited accessibility, harsh marine environments, and time-dependent degradation mechanisms require inspection planning to be supported by structured decision-making frameworks capable of explicitly accounting for both degradation processes and failure consequences. In this study, a Risk-Based Inspection (RBI)-driven integrity assessment is applied to three carbon steel pipeline systems associated with a SPAR offshore platform. The analysis integrates system description, identification of dominant damage mechanisms, and RBI quantification to evaluate probability of failure and consequence-related risk under offshore operating conditions. Internal corrosion is identified as the dominant long-term degradation mechanism for all analyzed pipelines, while external corrosion governs short-term inspection interval definition due to its higher growth rate and sensitivity to insulation characteristics and environmental exposure. Although all pipelines are classified within the same overall qualitative risk category, significant differences in failure probability, risk intensity, and consequence-driven risk behavior are observed, reflecting variations in system configuration, insulation systems, length, and functional role within the offshore production infrastructure. To enable meaningful comparison between pipeline systems of significantly different total lengths, normalized risk indicators per unit length are introduced. These indicators provide additional insight into local risk intensity and spatial risk distribution that are not evident from absolute risk values alone. The results highlight the importance of treating risk as a dynamic quantity rather than a static classification and demonstrate that RBI-based assessment supported by normalized risk metrics can enhance inspection prioritization and maintenance decision-making for SPAR-associated offshore pipeline systems. Full article

The Xinqiao Cu-S polymetallic deposit is located in the Tongling ore concentration area of the Middle-Lower Yangtze River metallogenic belt. The orebodies consist of skarn orebodies and stratiform sulfide orebodies, but the genetic link between them remains controversial. In this study, magnetite was used as a proxy to systematically constrain the hydrothermal evolution from the intrusion to the contact zone and further to the stratiform orebodies. A representative drill hole (E603) was logged, and samples were systematically collected from the Jitou pluton outward to the contact zone. Composite samples from the 8–28 m interval were crushed and prepared as resin mounts for integrated TIMA automated mineralogy, BSE textural observation, and in situ LA-ICP-MS trace element analysis. Five types of magnetite (Mt1 to Mt5) were systematically identified. Mt1 occurs as inclusions within feldspar in the quartz monzodiorite. It exhibits typical magmatic magnetite characteristics and contains grid-like ilmenite exsolution, indicating crystallization during the late magmatic stage. Mt2 is distributed in the interstices of magmatic minerals, commonly showing hematitization and replacement of ilmenite exsolution lamellae by titanite. Its trace element geochemistry displays magmatic–hydrothermal transitional features. Mt3–Mt5 in the skarn and stratiform orebodies are paragenetic with retrograde alteration minerals (e.g., epidote, chlorite, and actinolite) and sulfides, and are characterized by low Ti, Al, and V contents and high Mg, Mn, and Sn contents, indicating a hydrothermal origin. From Mt3 to Mt5, (Ti + V) and (Al + Mn) decrease, while Zn and Mn increase, accompanied by a decrease in the (Si + Al)/(Mg + Mn) ratio. This reflects a trend of decreasing fluid temperature and progressively enhanced wall-rock buffering. The Mg-in-magnetite geothermometer yields relatively consistent results for Mt1–Mt3, but anomalously high temperatures for Mt4–Mt5. This suggests that the elevated Mg activity in the fluid, caused by reaction with carbonate wall rocks, can significantly influence the calculated temperatures. Therefore, this geothermometer should be used cautiously for magnetite in the outer skarn zone and interpreted in combination with other temperature constraints. The textures, paragenetic mineral assemblages, and trace element characteristics of magnetite collectively reveal a continuous mineralization process linking the skarn and stratiform orebodies at Xinqiao, providing robust mineralogical and geochemical evidence for the contribution of Yanshanian magmatic–hydrothermal activity to the stratiform mineralization. Full article

Background: Intravenous anti-infectives are an important part of postoperative care, but discrepancies between prescribed and documented administrations remain widespread and require systematic evaluation. Methods: In an exploratory study, prescribed and documented intravenous anti-infective administrations were retrospectively analyzed using patient charts, digital nursing reports and, in cases of deviations, consultations with the responsible staff. The discrepancies were classified into three categories: (I) documentation, (II) administration, and (III) a combination of both. The relationship between discrepancies and dosing interval, time of administration (weekday and shift assignment), and intravenous administration route was statistically analyzed (Χ² test, residual analysis). Results: Of 5016 anti-infective administrations in 219 patients, 1135 (22.6%) had at least one discrepancy, of which 68.2% (774 of 1135) belonged to category I. Significant differences in the frequency of discrepancies between surgical wards and the dosing intervals were observed. On weekdays, 23.6% of drug administrations (832 of 3519) showed discrepancies compared to 20.2% on weekends (303 of 1497, OR = 1.22, 95% CI 1.05–1.42, p = 0.008). Although the early shift had the lowest administration rate, it showed significantly more discrepancies than expected (313.6 expected vs. 553 observed; adjusted standardized residual +18.1; p < 0.001). Drug administration via the peripheral venous route was more susceptible to discrepancies than the central venous administration route (23.2% [963 of 4149] vs. 19.8% [172 of 867]), OR 1.18; 95% CI 1.01–1.38; p = 0.031). Conclusions: Approximately a quarter of anti-infective administrations were affected by discrepancies, predominantly in category I, with the highest incidences occurring during the early shift and on weekdays. This requires a multi-step improvement program. Full article

Background/Objectives: In real-world gastric cancer cohorts, incomplete TNM staging and heterogeneous biomarker testing may result from structural characteristics of diagnostic pathways rather than random data loss. This study aimed to evaluate staging completeness and tumour marker availability as pathway-linked phenomena and to examine their associations with metastatic presentation and treatment allocation at diagnosis. Methods: This retrospective observational study included consecutive patients with histologically confirmed gastric carcinoma or adenocarcinoma diagnosed between 2018 and 2021 at a tertiary referral centre. Incomplete staging was defined a priori as the presence of Tx and/or Nx and/or Mx. The primary analytic endpoint was incomplete staging within the subset of patients with defined M status. Secondary analyses evaluated the availability of both CEA and CA19-9. Univariable associations were assessed using Pearson’s χ², and multivariable logistic regression models estimated adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Predefined pathway-oriented endpoints were analysed using multivariable logistic regression models adjusted for key clinical and diagnostic variables. Results: Among 375 patients, incomplete staging occurred frequently and was strongly associated with metastatic disease (M1) and non-surgical management. In multivariable analysis, metastatic presentation remained independently associated with incomplete staging, whereas surgical management and explicit documentation of disease extension were inversely associated. Concurrent availability of CEA and CA19-9 was concentrated within non-surgical and metastatic pathways and was independently associated with documented disease extension. These findings suggest that both staging completeness and tumour marker testing are determined by pathway-specific structures rather than random processes. Conclusions: In real-world gastric cancer care, incomplete TNM staging and tumour marker availability function as measurable features of diagnostic architecture rather than random data limitations. By modelling documentation completeness and testing availability as pathway-dependent phenomena, this study provides a pragmatic framework for improving transparency and interpretability in observational oncology research. Full article

Background: Determining the optimal duration of extracorporeal cardiopulmonary resuscitation (ECPR) remains challenging, as patient outcomes may vary significantly based on individual characteristics. We aimed to establish critical time thresholds for achieving favorable neurological outcomes with ECPR across different risk groups, potentially providing more tailored guidance for clinical decision-making. Methods: This single-center retrospective study screened 279 adult patients who received ECPR between 2013 and 2020. Through multivariate analysis of various clinical parameters, we developed a pragmatic bedside risk stratification framework to identify groups with different prognostic profiles. The primary outcome was neurological status at discharge, assessed by the Cerebral Performance Categories scale. Results: In multivariate analysis, age greater than 50 years with asystole (adjusted odds ratio [OR]: 4.89, 95% confidence interval [CI]: 1.41–17.00) or pulseless electrical activity (adjusted OR: 9.70, 95% CI: 2.80–33.60), aspartate transaminase (adjusted OR: 1.52, 95% CI: 1.15–1.99), creatinine (adjusted OR: 2.08, 95% CI: 1.30–3.34), initial lactate (adjusted OR: 1.88, 95% CI: 1.27–3.45), and low-flow time (adjusted OR: 3.50, 95% CI: 2.02–6.06) were associated with poor neurological outcomes. Based on these findings, we identified three distinct risk groups showing different acceptable low-flow time thresholds: low-risk (38 min), moderate-risk (27 min), and high-risk (20 min). Notably, no favorable neurological outcomes were observed beyond 70 min in the low-risk group and 90 min in moderate/high-risk groups. Risk group stratification effectively predicted neurological outcomes across different low-flow time intervals. Conclusions: Risk-stratified evaluation of low-flow time (cardiac arrest to ECMO pump-on) provides clinically relevant thresholds for different patient groups, suggesting that continuation of ECPR may be warranted in low-risk patients even with extended low-flow times. This approach may enable more personalized decision-making in ECPR implementation. Full article

This study develops a multiregional forecasting framework for road traffic accidents in Ecuador, addressing a critical limitation in existing predictive approaches that rely predominantly on point error metrics without validating the statistical assumptions underlying forecast uncertainty. Although the analysis is conducted at the provincial level, the spatial dimension is used primarily for cross-regional comparison and risk classification rather than for explicit spatial interaction modeling. Using a dataset of 27,648 monthly observations covering all 24 provinces from 2014 to 2025, the study applies the Prophet model within a Design Science Research paradigm and a CRISP-DM implementation cycle. Separate provincial models are estimated with a 24-month forecasting horizon, and methodological rigor is ensured through systematic residual diagnostics using the Shapiro–Wilk test for normality and the Ljung–Box test for temporal independence. Empirical results indicate that the Prophet-based artifact outperforms a naïve seasonal benchmark in 70.8% of the provinces, demonstrating excellent predictive accuracy in structurally stable regions such as Tungurahua (MAPE = 10.9%). At the same time, the framework enables the identification of critical emerging risks in provinces such as Santo Domingo and Cotopaxi, where projected increases exceed 49% despite acceptable point forecasts. The findings confirm that point accuracy alone does not guarantee the validity of confidence intervals and that residual validation is essential for trustworthy uncertainty quantification. Overall, the proposed approach provides a robust foundation for a predictive surveillance system capable of supporting differentiated, evidence-based road safety policies in territorially heterogeneous contexts. Full article