Search Results (4,460)

Background: The benefits of metabolic bariatric surgery (MBS) in people with a body mass index (BMI) ≥ 50 kg/m² are not well-established, with concerns of increased risk and poorer weight loss. The optimal surgical type (gastric bypass [GB] versus sleeve gastrectomy [SG]) is unclear, with studies comparing complication rates, weight loss, and glycaemic outcomes reporting mixed results. Methods: Participants with a BMI ≥ 50 kg/m² undergoing MBS (SG or GB) from 2008 to 2022 were recruited. Demographics, anthropometrics, biochemistry, and diabetes status were analysed at baseline, 12 months, and 24 months post-operatively. Surgical outcomes and complications were analysed. Results: The study included n = 184, with BMI ≥ 50 kg/m² (57.6% female, age 38.6 ± 10.5 years, and BMI 55.3 ± 6.0 kg/m²). Pre-operatively, 21.1% had pre-diabetes, and 33.2% had diabetes (mean HbA1c 8.0 ± 1.7%). Most subjects (89.1%) underwent SG. The overall 30-day adverse event rate was 4.9%, with a higher, but not statistically significant, rate in the GB group (15.0% vs 3.7%, p = 0.061). The GB group had a longer length of stay (GB =4.5 ± 0.6 days, SG = 3.1 ± 0.2, and p = 0.023). The rate of revisional surgery was 2.7%, with no significant difference between groups. The follow-up rate was 67.9% at 12 months and 51.1% at 24 months. The average %total weight loss (%TWL) at 12 months (27.4 ± 9.0%, SG = 27.6 ± 9.0%, GB = 26.0 ± 9.4%, and p = 0.481) and 24 months (27.1 ± 10.9%, SG = 27.4 ± 11.1%, GB = 24.9 ± 8.9%, and p = 0.495) were similar between groups. The GB group had a larger HbA1c reduction (3.2 ± 1.1%) than SG (1.9 ±1.3%, p = 0.030) but no difference in diabetes remission rates (69.2% at 12 months, 76.7% at 24 months). Conclusions: MBS is safe and effective for individuals with a BMI ≥ 50 kg/m², with low complication rates and good weight loss and glycaemic outcomes at 2 years. No statistically significant differences in %TWL, diabetes remission, or complication rates were noted between SG and GB groups, though results are limited by the small number of participants who underwent GB. Full article

Botnet architectures are evolving rapidly, creating significant threats to global network security. This paper presents a homogeneous Radial Basis Function Neural Network (RBFNN) approach for botnet detection that employs a single, uniform RBFNN architecture with identical basis kernel types across all network components. Utilizing the CTU-13 dataset to extract flow-level packet length distribution features. These features are critical for identifying the distinct signatures of the 30 botnet types in the dataset, thereby enhancing the detection capabilities of our uniform RBF framework. The proposed model was designed to address the challenge of achieving high discriminative capability between Normal and Botnet activities while preserving the low latency needed for real-time deployment. Extensive experiments, including cross-validation and Operating Characteristic (ROC) analysis, show the model is effective, achieving a top classification accuracy of 98.31% and distinguishing well between Botnet and normal activities, with an Area Under the Curve )AUC( of 0.997. Furthermore, Training behavior analysis demonstrated stable convergence across different batch size configurations, highlighting trade-offs between accuracy and computational cost. A batch size of 64 provides an optimal balance between convergence speed and accuracy, with a total training time of 29.62 minutes. Crucially, the assessment of processing speed revealed a latency of 1.0118 microseconds. Such minimal delay validates the architecture’s suitability for high-speed network environments where real-time traffic analysis is imperative. Moreover, confusion matrix analysis further confirmed the reliability of the detection, with a low false-positive rate of nearly 0.018. Overall, the empirical results demonstrate that the homogeneous RBFNN offers an advanced solution for complex botnet detection. Full article

Rock fracture mechanics and the associated energy-release behavior play a key role in ensuring safe extraction in underground coal mining. Hydraulic fracturing generates prefabricated fracture networks in competent rock strata, thereby modifying fracture propagation patterns and reducing the failure resistance of the strata. In this study, standardized three-point bending tests were conducted to investigate the fracture behavior of pre-cracked sandstone specimens with different crack morphologies, quantities, and spacings. New crack initiation occurred mainly at the midspan in specimens containing horizontal prefabricated cracks, whereas inclined prefabricated cracks promoted crack initiation from the crack tips. Although horizontal crack length did not exhibit a clear monotonic effect on load-bearing capacity, the overall capacity decreased with increasing crack density or decreasing crack spacing. Vertical cracks further reduced load-bearing performance, particularly at relatively small crack spacings. The strain response exhibited a non-monotonic relationship with horizontal crack parameters, increasing first and then decreasing with increasing crack length and spacing, while showing a positive correlation with vertical crack spacing. Dissipated energy was negatively correlated with prefabricated crack angle, accounting for 92.65%, 89.10%, and 94.03% of the total input energy. With increasing crack length, the proportion of dissipated energy first increased and then decreased, with values of 92.65%, 90.77%, 92.52%, and 96.13%. Energy dissipation decreased with increasing horizontal crack spacing but increased with vertical crack spacing. Numerical simulations further showed that both horizontal and vertical fractures generated by ground fracturing promoted timely strata failure, while vertical fractures were more effective in facilitating overburden fracture propagation and reducing the bearing capacity of the rock strata and advance coal body by more than 13%. These findings provide a mechanistic basis for the control of thick and competent hard-roof strata. Full article

Mobile robot path planning in complex environments remains challenging due to obstacle constraints, high-dimensional search space, and the need to balance path optimality and safety. To address these challenges, this paper proposes an improved Red-Billed Blue Magpie Optimizer (IRBMO) with multi-strategy cooperation. Specifically, a territorial awareness mechanism enhances global exploration to avoid premature path convergence, a representative individual learning strategy improves exploitation to refine path quality, and a random subpopulation diffusion strategy helps escape local optima in complex obstacle environments. The proposed method is applied to grid-based path planning problems with different map sizes and obstacle densities. Experimental results show that IRBMO significantly reduces path length compared with other algorithms, while achieving faster convergence and better stability. Parameter sensitivity analysis, ablation study, and convergence analysis further verify the effectiveness of the proposed strategies. In addition, benchmark tests on CEC2017 and CEC2022 functions against 19 competitors further confirm its optimization capability. Overall, IRBMO provides an effective and robust solution for robot path planning problems. Full article

Introduction: Distress during pediatric magnetic resonance imaging (MRI) neuroimaging can compromise scan quality and negatively impact children’s experiences. This review aimed to systematically synthesize biomarkers and psychological factors associated with distress in children, adolescents, and young adults undergoing neuroimaging. Methods: This systematic review was conducted according to PRISMA and AMSTAR-2 guidelines and preregistered in OSF. A systematic search was performed in six electronic databases, including observational articles published between 2000 and 2025 that assessed distress during MRI and functional MRI (fMRI). Data extraction and risk of bias assessment (QUIPS tool) were performed independently by two reviewers. Results: Ten studies (n = 558) examining distress during neuroimaging were included in this review. Distress was assessed through subjective self- and parent-reports, objective physiological measures, and qualitative interviews. Overall, distress levels were low to moderate; most participants tolerated scans well, though younger age, male sex, parental anxiety, procedure length, and chronic illness were associated with greater discomfort. Noise, immobility, and boredom emerged as the most frequent triggers, while strategies such as distraction, age-appropriate information, and reducing waiting times were perceived as helpful. Among participants with cancer, scan-related anxiety was closely linked to fear of recurrence and perceived stress. Risk of bias across studies was moderate to high, particularly in domains of attrition and statistical reporting. Conclusions: Distress during scanning is driven by anticipatory and parental anxiety, procedure length, and chronic illness. Biomarkers (e.g., cortisol, blood pressure) showed inconsistent links with subjective distress, highlighting the need for integrated measures. Full article

The electrification of floating production, storage, and offloading (FPSO) units has emerged as a strategic solution to meet the growing demand for increased oil production while reducing carbon emissions associated with onboard gas turbine generation. Power-from-shore (PFS) systems represent a promising approach to achieving this goal, with transmission technologies based on high-voltage direct current (HVDC) and high-voltage alternating current (HVAC) solutions. Although HVDC is more suitable for long-distance and high-power applications, HVAC systems offer advantages in terms of robustness, simplicity, and operational maturity. Nevertheless, the reactive power compensation requirements arising from the high capacitance of submarine cables remain a major technical challenge. This study investigates and compares several reactive power compensation topologies applied to three distinct PFS systems. The proposed methodology enables a comprehensive evaluation of both onshore and subsea reactor placement strategies under technically and technologically feasible conditions. The results demonstrate that long-distance transmission of 75 MW over 250 km was achieved exclusively through subsea compensation configurations, which maintained efficiencies above 90% and voltage and current profiles within operational limits. Conversely, onshore-only compensation proved to be the most efficient solution for shorter transmission distances. The results demonstrate that the full electrification of an FPSO is technically feasible, with voltage and current profiles remaining within acceptable operational limits. The findings also indicate that mid-cable reactor placement (at 50%) is not the most effective configuration, with superior results observed for placements at 20–80% and 40–70% of the cable length. Overall, the outcomes confirm that subsea reactor placement enables higher power transfer over longer distances, significantly extending the technical boundaries traditionally separating HVDC and HVAC solutions. These results emphasize the need for continued technological development to make subsea shunt reactor installation a viable and reliable option for future FPSO electrification projects. Full article

The Timed Up and Go (TUG) test is a clinical gold standard for assessing elderly mobility, yet its automated deployment in home-monitoring and resource-limited areas is hindered by high hardware costs and expert calibration requirements. This study introduces a Physics–Data Hybrid framework specifically designed for uncalibrated consumer-grade CMOS cameras, enabling a “plug-and-play” solution for early Parkinson’s disease (PD) risk screening. The proposed pipeline integrates learning-based pose perception with a self-evolving physics model to recover absolute metric-scale motion without manual checkerboard calibration. A noise-adaptive fusion strategy is implemented to reconcile 2D pixel dynamics with 3D kinematic consistency, overcoming the inherent scale ambiguity of monocular vision. Crucially, this framework enables the extraction of high-dimensional spatiotemporal parameters—such as stride length coefficient of variation and mean gait velocity—which provide a finer diagnostic resolution for capturing subtle motor fluctuations than conventional timing-only systems. Results from our pilot study with a cohort of 10 subjects demonstrate that these extracted metric features serve as decisive markers for risk staging simulated by dual-task-induced cognitive-motor-interference, achieving 98% screening accuracy and an overall classification accuracy of 87.32%. This framework provides a robust, low-cost tool for ubiquitous telehealth, potentially supporting early PD risk assessment in underserved populations. Full article

This study aimed to enhance the accuracy and interpretability of erosion gully classification within black soil regions by focusing on Changxing Township, Xinxing District, Qitaihe City, Heilongjiang Province as the research site. Utilizing RTK (Real-Time Kinematic) surveying technology, three-dimensional topographic data were collected for 139 actively developing erosion gullies. Key morphological parameters—including gully length, depth, gradient, average top width, average bottom width, and slope gradients on both sides—were extracted to construct interactive features. The variable set was refined through correlation analysis and variance inflation factor (VIF) diagnostics to mitigate multicollinearity. A random forest model was employed as the primary classification approach and benchmarked against logistic regression, support vector machines (SVM), decision trees, and backpropagation neural networks. To address class imbalance, a combination of class weighting, Synthetic Minority Over-sampling Technique (SMOTE), and undersampling methods was implemented. Model tuning and interpretability assessments were performed using cross-validation, grid search optimization, and SHapley Additive exPlanations (SHAP) analysis. The findings demonstrate that the random forest model achieved superior overall performance, with test set accuracy, macro-averaged F1 score, and balanced accuracy values of 0.9143, 0.8087, and 0.8427, respectively. Among imbalance handling techniques, class weighting yielded better results compared to oversampling and undersampling. Feature importance and SHAP analyses identified gully length, average crest width, and their interaction with gully depth as the principal determinants influencing gully grade classification. These results elucidate the synergistic developmental dynamics of gully longitudinal extension, vertical deepening, and lateral widening. The proposed methodology offers valuable technical support for the rapid surveying, classification, and management decision-making processes related to black soil erosion gullies. Full article

Some actinobacterial species have been reported to improve plant growth due to their roles as biostimulants and biological control agents. In this study, the effect of actinobacterial isolate 27, obtained from the rhizospheric soil of melon plants and identified as Streptomyces calvus, was evaluated on the growth of Arabidopsis thaliana and tomato plants. In Arabidopsis, in vitro assays showed that after seven days of interaction, isolate 27 increased fresh weight by 1.4-, 1.5-, and 2.3-fold and lateral root number by 1.7-, 1.3-, and 2.5-fold under physical contact and split-plate systems (MS and ISP2 media), respectively, compared with non-inoculated plants. An increased β-glucuronidase (GUS, encoded by the uidA gene) signal was observed in primary and lateral roots of the Arabidopsis DR5::uidA reporter line during both interaction types, suggesting the activation of auxin-responsive pathways. In addition, isolate 27 rescued the rhd6 (root hair defective 6) mutant phenotype, restoring root hair formation. Gas chromatography-mass spectrometry (GC-MS) analysis revealed that isolate 27 emitted volatile organic compounds (VOCs), including an alcohol and several sesquiterpenes, and that this profile changed during interaction with Arabidopsis plantlets. In soil-based pot assays, inoculation with isolate 27 significantly enhanced the development of Arabidopsis plants after 23 days, both when applied alone and in co-inoculation with Trichoderma atroviride. Furthermore, isolate 27 stimulated tomato plant growth, leading to significant increases in fresh and dry biomass, as well as shoot and root lengths after 28 days. Overall, these results demonstrate that S. calvus isolate 27 promotes plant growth and development through the production of bioactive compounds that modulate plant growth pathways, including hormonal responses, highlighting its potential as a bioinoculant for sustainable and productive agricultural systems. Full article

Marine bacteria are increasingly explored as alternative microbial platforms for the production of high-value biopharmaceuticals. In this study, we investigate the Antarctic marine bacterium Pseudoalteromonas haloplanktis TAC125 (PhTAC125), an unconventional host capable of yielding soluble and biologically active human cyclin-dependent kinase-like 5 (hCDKL5). This serine/threonine kinase plays a crucial role in neuronal development, and its deficiency causes CDKL5 Deficiency Disorder, a severe and currently untreatable neurodevelopmental disease. Recombinant production of hCDKL5 is a prerequisite for the development of enzyme replacement therapy; however, current manufacturing processes remain insufficient for industrial translation, particularly in terms of product quality and functional consistency. To address these limitations, we developed dedicated analytical strategies: protein accumulation was quantified using a customised sandwich Enzyme-Linked Immunosorbent Assay (ELISA) designed to selectively detect full-length hCDKL5, while protein functionality was assessed by mass spectrometry-based quantification of autophosphorylation, a critical determinant of kinase activation. These complementary tools were applied to characterise hCDKL5 production under different growth conditions. Overall, this work establishes an integrated analytical framework aligned with a Quality by Design approach, enabling the simultaneous assessment of yield, structural integrity, and functional activation, and providing a robust basis for rational process optimisation towards scalable hCDKL5 manufacturing. Full article

Mosquito-borne infectious diseases remain a major challenge to public health, highlighting the need for efficient and accessible gene editing approaches. Receptor-mediated ovary transduction of cargo (ReMOT) offers an alternative to embryonic microinjection, in which P2C, an ovary-targeting peptide, enables ovarian delivery of the editing components. However, key design parameters and operational boundaries of the P2C-based ReMOT system have not been clearly defined. Here, we performed a methodological evaluation of the P2C-mediated ReMOT CRISPR/Cas9 system in Aedes aegypti. Cas9-P2C fusion proteins with different configurations were constructed and assessed through ovarian targeting assays, in vitro cleavage analyses, and in vivo gene editing experiments. Our results show that full-length Cas9-P2C fusion proteins exhibit nuclease activity and enable effective ovarian delivery. In contrast, linear truncation of the P2C peptide markedly reduced ovarian targeting, indicating a dependence on structural integrity. Using this delivery strategy, we generated kynurenine monooxygenase (KMO) edited mosquitoes, demonstrating feasibility under the conditions tested. In addition, protein injection was also associated with reduced reproductive performance, providing physiological reference for ReMOT applications. Overall, this study defines the key design parameters and operational boundaries of the P2C-based ReMOT system, providing methodological guidance for its application and optimization in future mosquito genetic studies. Full article

Review text in recommender systems provides rich insights into user preferences and experiences that cannot be fully captured by numerical ratings alone. While recent studies have increasingly leveraged review text to enhance recommendation accuracy, most have primarily focused on improving model performance, with limited attention to quantitatively examining how specific textual elements influence rating prediction. To address this gap, this study empirically investigates the impact of review text characteristics on prediction performance in review-based recommender systems. Specifically, we employ the Unstructured Context-Aware Model (UCAM), where contextual information is replaced with review text embedded using a pre-trained BERT model. Three key textual factors are examined: review length, aspect, and emotion type. Review length is divided into quartiles, and results show that removing shorter reviews significantly degrades performance, indicating their critical role. For analysis, reviews are categorized into food, service, price, atmosphere, and location, with service and food contributing most to performance improvements, while location shows relatively low influence. Emotion types are classified based on Plutchik’s framework, revealing that removing joy, trust, and anticipation reduces performance, whereas excluding sadness slightly improves it. Overall, this study highlights the differential importance of textual features and demonstrates their potential for enhancing recommender system design. Full article

Jasmonates (JAs) are a diverse group of jasmonic acid (JA)-linked metabolites, including the biosynthetic intermediate 12-oxophytodienoic acid (OPDA). Although changes in JAs have been associated with plant responses to abiotic stress, the involvement and kinetics of specific forms such as JA, JA-Ile and OPDA require further clarification. This study analyzed jasmonate profiles in roots and leaves of two oat genotypes differing in drought tolerance. Jasmonates were quantified using UPLC-MS/MS, expression of key biosynthetic genes was assessed by qRT-PCR, and JA/OPDA treatments were applied to evaluate their effects on physiological and morphological responses to drought. Drought induced contrasting jasmonate dynamics in roots and leaves, with overall JA levels increasing in leaves and decreasing in roots, with genotype- and compound-specific differences. JA and JA-Ile ((+)-7-iso-jasmonoyl-L-isoleucine) showed similar trends, whereas OPDA displayed a distinct pattern. The tolerant genotype exhibited an early and marked reduction in root OPDA, while the susceptible one showed minimal change. Exogenous OPDA increased drought symptoms, reduced leaf relative water content and strongly decreased root length by limiting the formation of new thin roots. In contrast, JA application alleviated drought symptoms, reflected in a lower area under the drought progress curve, without affecting root length. Results suggest that under water deficit, reduced OPDA, likely due to its conversion into JA and JA-Ile, is associated with the development of small-diameter roots essential for maintaining water status in oat. Together, these results highlight tissue-specific differences in jasmonate dynamics during drought and show that OPDA and JA treatments lead to distinct drought-related responses in both leaves and roots. Full article

Background/Objectives: Fenestrated and branched endovascular aortic repair (F/BEVAR) is increasingly used for the treatment of complex aortic aneurysms, and is traditionally performed under general anesthesia (GA). Data on the use of local anesthesia (LA) for F/BEVAR remain limited. This study aimed to report early outcomes of F/BEVAR performed under LA versus GA, with a focus on feasibility and perioperative complications in a high-risk patient population. Methods: This single-center retrospective analysis included patients undergoing F/BEVAR under LA or GA. Primary outcomes were in-hospital mortality and in-hospital complications. Secondary outcomes included early reintervention, intensive care unit and hospital length of stay, blood transfusion requirements, and technical success. Results: A total of 359 patients were included, of whom 25 (7.0%) were treated under LA and 334 (93.0%) under GA. Conversion from LA to GA occurred in 6 patients (24%). Patients in the LA group represented a higher-risk cohort, with advanced age, higher ASA class, larger aneurysm diameters, and a greater proportion of emergency and ruptured repairs. Technical success was high, and procedural metrics were within expected ranges. In-hospital mortality was numerically higher in the LA group (12.0% vs. 2.9%, p = 0.05). Overall, in-hospital complications were more frequent in the LA group (68.0% vs. 41.3%, p = 0.009), including a higher rate of spinal cord ischemia (24.0% vs. 8.5%, p = 0.02). Blood transfusion requirements were also greater in patients treated under LA (p = 0.004), while blood loss, ICU stay, and hospital length of stay were comparable. Early reintervention occurred more frequently in the LA group (31.8% vs. 10.4%, p = 0.009). Conclusions: LA appears feasible in selected high-risk patients undergoing complex F/BEVAR. However, given substantial baseline differences between groups, no conclusions can be drawn regarding comparative safety or efficacy relative to GA. These findings should be considered preliminary. Full article

Background and Objectives: The epidemiological characteristics of Candida species have changed worldwide, with an increasing number of reports on co-infections with non-albicans Candida species (NACs) and multidrug-resistant bacteria. A longer length of hospital stay, more severely ill patients, and empirical antimicrobial use in intensive care units (ICUs) increased the prevalence of Candida healthcare-associated infections (HAIs). If the diagnosis or treatment of invasive candidiasis is delayed, the morbidity and mortality of patients will significantly increase. Materials and Methods: We conducted a nationwide surveillance study to analyze data on HAIs in the ICUs of medical centers and regional hospitals between 2018 and 2023. We assessed the temporal trends of Candida species (including Candida albicans and NACs) across all HAIs, bloodstream infections (BSIs), and urinary tract infections (UTIs), and simultaneously assessed the corresponding trends of Enterococcus faecium (Efm). A linear trend for the proportions of microorganisms from 2018 to 2023 was noted according to the Mantel–Haenszel chi-square test. Spearman’s rank correlation coefficients were used to analyze the correlations between pathogen proportions, systemic antimicrobial agent consumption, and length of ICU stay. Results: The overall proportion of all Candida species in HAIs in the ICUs increased significantly from 15.13% to 16.74% (p < 0.001); this increase was driven mainly by NACs (increasing from 6.84% to 7.91%, p < 0.001) from 2018 to 2023. The proportion of Efm increased significantly, from 7.7% to 11.11% (p < 0.001). The proportions of all Candida species significantly increased in UTIs (from 24.63% to 28.13%, p < 0.001), especially NACs, while the proportion of Efm also increased significantly in UTIs (from 9.47% to 15.32%, p < 0.001). With respect to the UTIs, the proportion of all the Candida species, C.albicans, and NACs were positively correlated with the amount of systemic antibiotics used. A longer hospital stay was strongly correlated with all Candida HAIs and UTIs, especially NACs. Significantly ecological associations between all the Candida strains and Efm were observed for UTIs. Conclusions: This study revealed that a persistent expansion of NAC infections was associated with increased Efm infections and rising antibiotic consumption. The changes in the proportions of different Candida species in UTIs were most pronounced. These findings support an ecological model in which antibiotic stress and chronic critical illness contribute to the expansion of fungal–bacterial co-infections in the ICU setting and underscore the need for integrated antibiotic management and multi-infection surveillance. Full article