Search Results (2,845)

Leakage from defective buried pipelines can lead to progressive soil erosion and void formation, ultimately resulting in ground collapse or sinkhole development. To better understand the underlying mechanisms of this process, this research utilizes a coupled computational fluid dynamics (CFD)–discrete element method (DEM) modeling approach to investigate soil erosion processes driven by water leakage from defective underground pipelines. The numerical model captures fluid–particle interactions at both macroscopic and microscopic scales, providing detailed insights into erosion initiation, void zone evolution, and particle transport dynamics under varying hydraulic and geometric conditions. Parametric studies were conducted to evaluate the effects of exfiltration pressure, defect size, and particle diameter on erosion behavior. Results show that erosion intensity and particle migration increase with hydraulic pressure up to a threshold, beyond which compaction and particle bridging reduce sustained transport. The intermediate defect size (12.7 mm) consistently produced the most continuous and stable erosion channels, while smaller and larger defects exhibited localized or asymmetric detachment patterns. Particle size strongly influenced erosion susceptibility, with finer grains mobilized more readily under the same flow conditions. The CFD–DEM simulations successfully reproduce the nonlinear and self-reinforcing nature of internal erosion, revealing how hydraulic gradients and particle rearrangement govern the transition from local detachment to large-scale cavity development. These findings advance the understanding of subsurface instability mechanisms around leaking pipelines and provide a physically consistent CFD–DEM framework that aligns well with published studies. The model effectively reproduces the key stages of erosion observed in the literature, offering a valuable tool for assessing erosion-induced risks and for designing preventive measures to protect buried infrastructure. Full article

Alcohol misuse is twice as prevalent among people living with HIV (PWH), and this increases the risk of pulmonary complications even in those receiving antiretroviral therapy. Our prior work showed that the alcohol metabolite, acetaldehyde, activates nuclear factor kappa B p65 (p65), leading to HIV replication and interleukin (IL)-1β activation in alveolar macrophages (AMs). Since the aforementioned processes are energy-demanding, which conversely impair mitochondrial functions, we hypothesized that acetaldehyde-induced p65 drives AMs to a mitochondrial hyperactive state to promote HIV replication and IL-1β release and induces oxidative stress and mitochondrial dysfunction. Since we found pioglitazone (PIO) to be a negative regulator of p65, we postulate that PIO suppresses HIV replication and IL-1β activation in AMs by restricting p65-induced mitochondrial hyperactivation. Murine AMs were exposed to acetaldehyde via the acetaldehyde generating system (AGS) and infected in vitro with EcoHIV, a chimeric ecotropic HIV construct. AGS + EcoHIV activated p65, resulting in enhanced ATP-linked mitochondrial respiration, proton leak, non-mitochondrial respiration and the generation of reactive oxygen species (ROS) in AMs. Inhibition of mitochondrial ATP synthesis with low-dose oligomycin attenuated AGS-induced HIV replication and AGS + EcoHIV-induced IL-1β release from AMs. PIO treatment, which attenuated AGS-induced p65 activation, suppressed proton leak, non-mitochondrial oxygen consumption, ROS, and IL-1β and p24 release. While p65-induced mitochondrial hyperactivation represents AMs’ adaptive response to the energy demands imposed by HIV replication and proinflammatory activation when exposed to acetaldehyde, PIO treatment may offer a novel therapeutic strategy to restore adequate mitochondrial bioenergetics in the AMs of PWH who misuse alcohol. Full article

Purpose: This study investigates the association between obstructive sleep apnea (OSA), dry eye disease (DED), and glaucoma, focusing on the impact of positive airway pressure (PAP) usage and air leakage. Methods: This retrospective cross-sectional study included 57 adults with polysomnography-confirmed OSA between 2010 and 2023. Participants were grouped into PAP users (PAP+, n = 40) and non-users (PAP−, n =17). Ocular assessments included tear film break-up time, Schirmer’s test, Oxford staining, meibomian gland evaluation, intraocular pressure, cup-to-disc (C/D) ratio, and retinal nerve fiber layer thickness. PAP device data (usage duration and air leak rate) and OSA severity metrics were recorded. Group comparisons used chi-square and Student’s t-test, and regression analyses identified associations between PAP leakage and ocular parameters. Results: Among the 57 OSA patients, PAP users showed a trend toward a higher risk of glaucoma (OR = 0.83) and DED (OR = 0.69) compared to non-users, but neither trend was statistically significant. PAP users had significantly more severe OSA, including longer N1 sleep stage (p = 0.0005), higher apnea-hypopnea index (AHI, p = 0.0001), and poorer oxygenation. PAP leakage: 95% (mean = 25.84 L/min) exceeded the 24 L/min threshold specified in ResMed’s clinical guidelines, suggesting suboptimal therapy. Higher PAP leak was significantly associated with a lower Schirmer’s test value (p = 0.031) and a higher C/D ratio (p = 0.040) on regression analysis. However, no significant differences were found in ophthalmic parameters between PAP+ and PAP− groups. Conclusion: Suboptimal PAP therapy as mask leakage or nocturnal hemodynamic changes may worsen evaporative dry eye and affect intraocular pressure. Our findings highlight the association between PAP mask leakage and reduced tear production, and suggest that OSA-related optic nerve stress may persist unless both hypoxia and nocturnal IOP fluctuations are properly managed. However, due to the relatively small sample size and retrospective cross-sectional design, future prospective studies with larger cohorts are needed to confirm these associations. Full article

Smart phones have become an integral part of our lives in modern society, as we carry and use them throughout a day. However, this “body part” may maliciously collect and leak our personal information without our knowledge. When we install mobile applications on our smart phones and grant their permission requests, these apps can use sensors embedded in the smart phones and the stored data to gather and infer our personal information, preferences, and habits. In this paper, we present our preliminary results on quantifying the privacy risk of mobile applications by assessing whether requested permissions are necessary based on app descriptions through textual entailment decided by language models (LMs). We observe that despite incorporating various improvements of LMs proposed in the literature for natural language processing (NLP) tasks, the performance of the trained model remains far from ideal. Full article

Mitral annular calcification makes conventional mitral valve surgery extremely challenging and has led to growing interest in less invasive alternatives such as transcatheter mitral valve replacement. Alongside percutaneous approaches, some centers have explored open transatrial implantation of transcatheter heart valves in patients with heavily calcified annuli. This systematic review examines the current evidence on this hybrid “valve-in-MAC” technique, tracing its clinical evolution, technological refinements, patient outcomes, and ongoing debates. Key themes emerging from the literature include the adaptation of existing balloon-expandable and mitral-specific devices to the complex anatomy of calcified mitral annuli, the open transatrial approach as a safer alternative to extensive surgical debridement, and advances in imaging and device design aimed at reducing left ventricular outflow tract obstruction and paravalvular leak. Persistent uncertainties remain, particularly regarding patient selection, long-term valve performance, and comparisons with conventional surgical repair or replacement. Although open transatrial implantation appears technically feasible and provides favorable hemodynamic results compared with fully percutaneous procedures, reported 30-day mortality remains high (approximately 19–27%). This reflects the advanced age, frailty, and multiple comorbidities typical of this patient group rather than procedural shortcomings. Current evidence is limited, with few comparative studies and little data on valve durability. Future work should prioritize multicenter prospective registries and well-designed comparative studies to better define the role of this emerging salvage strategy. Full article

Localising leaks in pressurised water distribution networks (WDNs) is crucial for reducing water loss but remains challenging because of model uncertainties and limited sensor data. Nevertheless, many state-of-the-art methods rely on idealised assumptions that are perfectly known, like time-invariant demands, noise-free pressure sensors, a single, stationary leak, and a known leak-free baseline. These assumptions rarely hold in practice, creating a gap between expected performance and field reality. This article provides a comprehensive review of current leak localisation techniques based on sensor data and hydraulic or data-driven models. This study critically examines how recent studies have addressed these unrealistic assumptions. Advanced methods incorporate demand uncertainty and sensor noise into leak detection algorithms to improve robustness, estimate unknown demand variations using physics-informed machine learning, and employ Bayesian inference to locate multiple simultaneous leaks. The analysis indicates that accounting for such real-world complexities markedly improves localisation accuracy; for instance, even minor demand estimation errors or sensor noise can dramatically degrade performance if not addressed. Finally, bridging the gap between the models and reality is essential for the practical deployment of water utilities. Thus, this review recommends that future studies integrate uncertainty quantification, adaptive modelling, and enhanced sensing into leak localisation frameworks, thereby guiding the development of more resilient and field-ready leak management solutions. Full article

Mitsugumin 23 (MG23) is a transmembrane protein expressed in the nuclear membrane and endo/sarcoplasmic reticulum (ER/SR) of various tissues, including skeletal and cardiac muscle. MG23 is a non-selective cation channel that has been implicated in the leakage of calcium ions (Ca²⁺) under diverse pathophysiological conditions. SR Ca²⁺ leak is considered to be a contributing factor of skeletal muscle weakness and is also implicated in the progression of heart failure. The absence of MG23 has been reported to alleviate negative outcomes associated with SR Ca²⁺ leak. Targeting MG23 could represent a new therapeutic strategy against muscle disorders. This review discusses the potential role of MG23 in skeletal and cardiac muscle, and highlights MG23 as both a regulator of basal SR Ca²⁺-handling and a mediator of pathophysiological remodelling in muscle. Full article

Background: Prenatal detection of congenital lung lesions has increased with improved imaging. These abnormalities are safely treated with thoracoscopic lobectomy. We implemented an enhanced recovery after surgery (ERAS) protocol to standardize care and aim to evaluate its safety and efficacy compared to a non-ERAS cohort. Methods: A single-center retrospective chart review was conducted for twenty patients (n = 10 ERAS, n = 10 non-ERAS) undergoing thoracoscopic lobectomy from 2014–2024. Results: ERAS patients were generally younger at the time of surgery (ERAS: 4.25 ± 2.76 months vs. non-ERAS: 6.45 ± 6.78 months, p = 0.17). Postoperative length of stay was shorter in ERAS (1.77 ± 0.60 days) vs. non-ERAS patients (5.25 ± 3.79 days, p = 0.03) as well as chest tube duration (ERAS: 1.44 ± 0.73 days vs. non-ERAS 3.64 ± 2.38 days, p = 0.01). ERAS patients received lower amounts of opioid analgesics compared to non-ERAS (p = 0.0046). Use of the ERAS protocol also decreased cost for the healthcare system compared to non-ERAS patients (p = 0.0037). ERAS patients had no reintubations or prolonged air leaks (defined as >48 h), compared to four reintubations (p = 0.04) and three prolonged air leaks (p = 0.07) in the non-ERAS group. Crucially, there were no complications in the ERAS group, whereas five non-ERAS patients experienced Clavien–Dindo level III (one IIIa, two IIIb, two IVa) complications (p = 0.02). Conclusions: Our preliminary findings demonstrate the successful integration of a novel ERAS protocol in pediatric thoracoscopic lobectomies and its efficacy in reducing standard post-operative recovery times without an increased rate of complications. Earlier discharge in the ERAS group constitutes less healthcare burden with improved resource utilization and less family, work, and social disruption. Full article

Accurate potentiometric sensing critically depends on the stability and reproducibility of the reference electrode potential. Conventional liquid-filled Ag/AgCl or calomel electrodes, though well-established, are poorly compatible with miniaturized, portable, or long-term in situ sensing devices due to electrolyte leakage, junction potential instability, and maintenance requirements. Recent advances in solid-state and membrane-based reference electrodes offer a promising alternative by eliminating the liquid junction while maintaining stable and well-defined potential. This review summarizes the advancements in polymer-based and composite reference membranes, focusing on material strategies, stabilization mechanisms, and integration approaches. Emphasis is placed on ionic-liquid-doped membranes, conducting polymers, lipophilic salts, and carbon nanomaterials as functional components enhancing interfacial stability and charge transfer. The performances of various architectures, solid-contact, liquid-junction-free, and quasi-reference systems, are compared in terms of potential drift, matrix resistance, biocompatibility, and manufacturability. Furthermore, recent developments in printed, microfluidic, and wearable potentiometric platforms demonstrate how reference membrane innovations enable reliable operation in compact, low-cost, and flexible analytical systems. The review outlines current trends, challenges, and future directions toward universal, miniaturized, and leak-free reference electrodes suitable for innovative sensing technologies. Full article

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons; respiratory problems are the leading cause of death and hospital admissions and are secondary to progressive weakness of the respiratory muscles and upper airway. Noninvasive ventilation (NIV) can increase survival, alleviate symptoms, reduce hospital admissions, and improve the quality of life of these patients. The key factor in respiratory management of patients with ALS is achieving effective NIV; ineffective NIV has a negative impact on survival, with a reduction of up to 50% compared to patients with an effective technique. The most common cause of ineffective NIV is air leaks; other causes include upper airway obstruction events, residual hypoventilation, hyperventilation, and upper airway obstruction secondary to an oronasal mask. Regular monitoring of the effectiveness of NIV is essential given its impact on survival; the key tools that detect the main problems are the presence of hypoventilation symptoms, arterial blood gases, nocturnal oximetry and capnography, and built-in ventilator software. Different measures have been proposed to address the ineffectiveness of NIV, such as fitting the mask to reduce air leaks, increasing ventilatory support for residual hypoventilation, decreasing ventilatory support for hyperventilation, or a trial with a nasal mask to address oronasal interface effects. In the case of obstruction, the most common measure is to increase positive expiratory pressure during NIV. These measures enable NIV to be effective in 58% of cases, achieving a survival rate similar to that of patients who have effective NIV from the outset. Full article

Functional coatings on optical fibers enable selective detection of environmental and chemical parameters, but their use is typically limited to point or quasi-distributed sensing due to localized deposition techniques. In this work, we demonstrate a possible transition towards full-length functional coatings on optical fibers using a draw tower process, enabling their potential use in distributed sensor technology. An optical fiber with Pt:WO₃ nanocomposite polymer functional coating is employed as a proof of concept. The results demonstrate the successful application of this functional coating along hundreds of meters of fibers using a draw tower. When integrated into a distributed sensing configuration, the Pt:WO₃ fiber exhibited a clear change in response with varying hydrogen concentrations from 1% to 4% H₂, with a temperature increase of 2.5 °C at 4 vol.% indicating a promising performance for distributed hydrogen leak detection. This approach opens new opportunities for applying other functional coatings over extended fiber lengths using draw towers, which could be exploited for novel distributed sensing applications. Full article

Introduction: Chest drainage is central to thoracic surgery, pleural medicine, and emergency care, yet practice remains heterogeneous in tube caliber, access, suction, device selection, and removal thresholds. This narrative review aims to synthesize evidence and translate it into guidance. Materials and Methods: We performed a narrative review with PRISMA-modeled transparency. Using backward citation from recent comprehensive overviews, we included randomized trials, meta-analyses, guidelines/consensus statements, and high-quality observational studies. We extracted data on indications, technique, tube size, analog versus digital drainage, suction versus water-seal drainage, removal criteria, and key pleural conditions. Due to heterogeneity in device generations, suction targets, and outcomes, we synthesized the findings qualitatively according to converged evidence. Results: After lung resection, single-drain strategies, early use of water-seal, and standardized removal at ≤300–500 mL/day reduce pain and length of stay without increasing the need for reintervention; digital systems support objective removal using sustained low-flow thresholds (approximately 20–40 mL/min). Small-bore (≤14 Fr) Seldinger catheters perform comparably to larger tubes for secondary and primary pneumothorax and enable ambulatory pathways. In trauma, small-bore approaches can match large-bore drainage in stable patients when paired with surveillance and early escalation of care. For pleural infection, image-guided drainage, combined with fibrinolytics or surgery, is key. Indwelling pleural catheters provide relief comparable to talc in dyspnea associated with malignant effusions in patients with non-expandable lungs. Complications are mitigated by ultrasound guidance and avoiding abrupt high suction after chronic collapse; however, these strategies must be balanced against risks of malposition, occlusion or retained collections, prolonged air leaks, and device complexity, which demand protocolized escalation and team training. Conclusions: Practice coalesces around three pillars—right tube, right system, proper criteria. Adopt standardized pathways, device-agnostic thresholds, and volume or airflow criteria. Trials should harmonize “seal” definitions and validate telemetry-informed removal strategies. Full article

Background: Liver transplant recipients are highly susceptible to invasive fungal infections, particularly candidemia, due to intensive immunosuppressive therapy and postoperative complications. However, few studies have comprehensively examined postoperative antimicrobial and immunosuppressive factors in this context. Aim: This study aimed to identify perioperative and postoperative factors associated with the development of candidemia in living donor liver transplant (LDLT) recipients, with a particular focus on antimicrobial and immunosuppressive regimens during initial hospitalization. Methods: A retrospective case–control analysis was conducted involving 36 LDLT recipients who developed candidemia (candidemia group) and 72 matched controls without candidemia (non-candidemia group) between January 2019 and November 2023. Demographic and clinical variables were compared using univariate and multivariate logistic regression analyses to identify independent associations. A post hoc power analysis demonstrated a high statistical power (97.3%) to detect large effect sizes. Results: Univariate analysis revealed significant associations with prolonged intubation (p < 0.001), bile leaks (p < 0.001), relaparotomy (p < 0.001), chronic renal disease (p = 0.011), hepatocellular carcinoma (p = 0.011), and the use of antimicrobials including meropenem (p = 0.048), linezolid (p = 0.005), tigecycline (p = 0.045), third-generation cephalosporins (p = 0.003), anidulafungin (p < 0.001), fluconazole (p = 0.006), mycophenolate (p = 0.011), and total parenteral nutrition (TPN) (p = 0.049). CMV prophylaxis (p < 0.001) and CMV-PCR positivity (p = 0.015) were also significantly associated with candidemia. Multivariate logistic regression analysis identified prolonged intubation (OR = 1.07; p = 0.019), bile leaks (OR = 10.9; p = 0.002), anidulafungin use (OR = 4.70; p = 0.032), fluconazole use (OR = 35.8; p = 0.005), and absence of CMV prophylaxis (OR = 11.7; p = 0.021) as independent factors associated with increased odds of candidemia. Conclusions: Prolonged intubation, bile leaks, antifungal exposure, and lack of CMV prophylaxis are independently associated with higher odds of candidemia after LDLT. Targeted prophylaxis, prudent antimicrobial stewardship, and timely biliary intervention may reduce fungal morbidity and mortality in post-transplant patients. Full article

The global transition toward low-carbon energy and transportation systems positions hydrogen as a key clean and versatile energy carrier. However, ensuring the safe handling and storage of hydrogen—particularly in its liquid form LH₂)—remains a critical challenge to large-scale deployment. Accidental releases of LH₂ can lead to rapid dispersion, cryogenic hazards, and increased risks of ignition or detonation due to hydrogen’s low ignition energy and wide flammability limits. This review synthesizes recent advances in the understanding and modelling of LH₂ safety scenarios, emphasizing the complementary roles of Computational Fluid Dynamics (CFD) and Machine Learning (ML). The paper first outlines the fundamental physical processes governing cryogenic hydrogen leaks, spills, and jet releases, followed by an overview of current storage and sensing technologies. Special consideration is given to safety implications arising from the differences between open and enclosed environments and the fact that existent sensing technologies present deficiencies at low temperatures. CFD-based studies are reviewed to illustrate how these methods capture complex flow and dispersion dynamics under diverse operational and environmental conditions, supported by a summary of existing experimental investigations used for model validation. The emerging role of ML is then examined, focusing on its integration with CFD simulations and sensor networks for predictive risk assessment, real-time leak detection, and the development of digital twins. Finally, integrated CFD–ML-sensor systems are discussed as a pathway toward a physics-informed, data-driven framework for advancing hydrogen safety and reliability. Full article

Background/Objectives: Supraglottic airway devices are commonly used airway management tools, with various second-generation laryngeal masks available for patients undergoing general anesthesia. These devices offer improved sealing, gastric suction capabilities, and the potential for tracheal intubation. This study compared the recently introduced Singularity^TM Air laryngeal mask with two well-established devices, Ambu^® AuraGain^TM and i-GEL^®, under clinical conditions. Methods: We prospectively included 98 adult patients scheduled for elective surgery requiring general anesthesia. Patients were randomized to one of three laryngeal mask groups, and data on insertion success, ventilation efficiency, and postoperative complications, such as sore throat and dysesthesia, were collected. The primary endpoint was oropharyngeal sealing pressure, with additional assessments of insertion ease and bronchoscopic glottic visibility. Results: Median initial oropharyngeal leak pressure was lowest with i-GEL^® (22 cm H₂O) as opposed to Ambu^® AuraGain^TM (25 cm H₂O) and Singularity^TM Air (25 cm H₂O) [p = 0.0138], but this difference equalized after 15–30 min. I-GEL^® showed higher insertion success (88%, p = 0.001) and shorter time-to-first ventilation (29 s, p = 0.0106). Conversely, the gastric tube insertion rate was lower (70% versus >90% in the other masks). The Ambu^® AuraGain^TM and Singularity^TM Air performed similarly for most parameters. No significant differences were observed in tracheal intubation potential or postoperative adverse events among the three groups. Conclusions: The Singularity^TM Air performed comparably to Ambu^® AuraGain^TM and i-Gel laryngeal masks in oropharyngeal sealing pressure. I-Gel^® had the highest successful insertion rate. Most of the differences detected were not statistically significant, with all three masks providing effective airway management. Full article