Search Results (16,584)

Background/Objectives: Cognitive impairment is one of the most common and debilitating clinical features of Multiple Sclerosis (MS). Neuropsychological assessment, however, is time-consuming and requires personal resources, so, due to limited resources in daily clinical practice, information on cognitive profiles is often lacking, despite its high prognostic relevance. Time-saving and effective tools are required to bridge this gap. This study evaluates the sensitivity and specificity of a revised version of TRACK-MS (TRACK-MS-R), a recently published screening tool to identify cognitive impairment in MS in a fast and reliable way, offering a balance between efficiency and diagnostic yield for the individual patient. Methods: In this prospective cross-sectional study, 102 MS patients and 94 age-, sex-, and education-matched healthy controls (HC) completed an extensive neuropsychological assessment, including TRACK-MS-R, to test for cognitive processing speed (Symbol Digit Modalities Test, SDMT) and verbal fluency (Regensburger Word Fluency Test, RWT). Sensitivity of TRACK-MS-R was assessed by using the BICAMS-M battery as a reference, and specificity was determined by comparing MS patients to HC. Results: TRACK-MS-R demonstrated high sensitivity (97.44%) when compared to the gold standard as represented by BICAMS-M for early and accurately detecting cognitive impairment in MS patients. Additionally, as a potential cognitive marker, TRACK-MS-R showed a specificity of 82.98% in distinguishing MS patients from healthy controls. Conclusions: TRACK-MS-R proves to be a highly sensitive and time-efficient screening tool for detecting cognitive impairment in patients with MS, while demonstrating good specificity compared to HC. Whereas high sensitivity is a prerequisite for a valid screening tool, its relatively modest specificity compared to BICAMS-M (62.9%) calls for caution in interpreting standalone results but instead indicates more extensive neuropsychological testing. Its briefness and diagnostic accuracy support its implementation in routine clinical practice, particularly in time-constrained settings. Full article

The global spread of Mpox virus (MPXV) underscores the urgent need for rapid, field-deployable diagnostic tools, especially in low-resource settings. We evaluated a loop-mediated isothermal amplification (LAMP) assay, termed LAMPOX, developed by Coris BioConcept. The assay was tested in three formats—two liquid versions and a dried, ready-to-use version—targeting only the ORF F3L (Liquid V1) or both the ORF F3L and N4R (Liquid V2 and dried) genomic regions. Analytical sensitivity and specificity were assessed using 60 clinical samples from confirmed MPXV-positive patients. Sensitivity on clinical samples was 81.7% for Liquid V1 and 88.3% for Liquid V2. The dried LAMPOX assay demonstrated a sensitivity of 88.3% and a specificity of 100% in a panel of 112 negative controls, with most positive samples detected in under 7 min. Additionally, a simplified sample lysis protocol was developed to facilitate point-of-care use. While this method showed slightly reduced sensitivity compared to standard DNA extraction, it proved effective for samples with higher viral loads. The dried format offers key advantages, including ambient-temperature stability and minimal equipment needs, making it suitable for point-of-care testing. These findings support LAMPOX as a promising tool for rapid MPXV detection during outbreaks, especially in resource-limited settings where traditional PCR is impractical. Full article

Contamination of food with heavy metals is an important factor leading to serious health concerns. Rapid identification of these heavy metals is of utmost priority. There are several methods to identify traces of heavy metals in food. Conventional methods for the detection of heavy metal residues have their limitations in terms of cost, analysis time, and complexity. In the last decade, voltammetric analysis has emerged as the most prominent electrochemical determination method for heavy metals. Voltammetry is a reliable, cost-effective, and rapid determination method. This review provides a detailed primer on recent advances in the development and application of graphene-based electrochemical sensors for heavy metal monitoring over the last decade. We critically examine aspects of graphene modification (fabrication process, stability, cost, reproducibility) and analytical properties (sensitivity, selectivity, rapid detection, lower detection, and matrix effects) of these sensors. Furthermore, to our knowledge, meta-analyses were performed for the first time for all investigated parameters, categorized based on graphene materials and heavy metal types. We also examined the pass–fail criteria according to the WHO drinking water guidelines. In addition, the effects of heavy metal toxicity on human health and the environment are discussed. Finally, the contribution of heavy metal contamination to the seventeen Sustainable Development Goals (SDGs) stated by the United Nations in 2015 is discussed in detail. The results confirm the significant impact of heavy metal contamination across twelve SDGs. This review critically examines the existing knowledge in this field and highlights significant research gaps and future opportunities. It is intended as a resource for researchers working on graphene-based electrochemical sensors for the detection of heavy metals in food safety, with the ultimate goal of improving consumer health protection. Full article

Efficient planning of train crew rosters is a key factor in ensuring operational reliability and promoting long-term sustainability in railway transport, both economically and socially. This article presents a systematic approach to developing a crew rostering model in passenger rail transport, with a focus on the operational setting of the train crew depot in Česká Třebová, a city in the Czech Republic. The seven-step methodology includes identifying available train shifts, defining scheduling constraints, creating roster variants, and calculating personnel and time requirements for each option. The proposed roster reduced staffing needs by two employees, increased the average shift duration to 9 h and 42 min, and decreased non-productive time by 384 h annually. These improvements enhance sustainability by optimizing human resource use, lowering unnecessary energy consumption, and improving employees’ work–life balance. The model also provides a quantitative assessment of operational feasibility and economic efficiency. Compared to existing rosters, the proposed model offers clear advantages and remains applicable even in settings with limited technological support. The findings show that a well-designed rostering system can contribute not only to cost savings and personnel stabilization, but also to broader objectives in sustainable public transport, supporting resilient and resource-efficient rail operations. Full article

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

This study examines how Ontario’s Health and Physical Education curriculum addresses the needs of young adults with disabilities. A total of 54 individuals aged 18–35 years old with developmental, learning, or physical disabilities who had completed secondary school in Ontario participated in a cross-sectional mixed-methods survey. Participants were recruited through disability-focused community networks and a university psychology participant pool. They completed the Sex Education subscale of the Sexual Knowledge, Experience, Feelings and Needs Scale, a 35-item sexual knowledge questionnaire, and open-ended questions. Quantitative data were analyzed using descriptive statistics and independent samples t-tests; qualitative responses were examined using thematic analysis. Participants reported limited factual knowledge, minimal classroom representation, and heavy reliance on independent learning. Barriers included inaccessible materials, teacher discomfort, and the absence of disability narratives in sexuality units. Findings point to three priorities: revising curriculum content, expanding educator training, and creating disability-affirming resources. These measures will help ensure comprehensive and rights-based sexuality education that supports the autonomy and well-being of students with disabilities. Full article

Target detection is essential in intelligent transportation and autonomous control of unmanned aerial vehicles (UAVs), with single-stage detection algorithms used widely due to their speed. However, these algorithms face limitations in detecting small targets, especially in aerial photography from unmanned aerial vehicles (UAVs), where small targets are often occluded, multi-scale semantic information is easily lost, and there is a trade-off between real-time processing and computational resources. Existing algorithms struggle to effectively extract multi-dimensional features and deep semantic information from images and to balance detection accuracy with model complexity. To address these limitations, we developed FFG-YOLO, a lightweight small-target detection method for UAVs based on YOLOv8. FFG-YOLO incorporates three modules: a feature enhancement block (FEB), a feature concat block (FCB), and a global context awareness block (GCAB). These modules strengthen feature extraction from small targets, resolve semantic bias in multi-scale feature fusion, and help differentiate small targets from complex backgrounds. We also improved the positioning accuracy of small targets using the Wasserstein distance loss function. Experiments showed that FFG-YOLO outperformed other algorithms, including YOLOv8n, in small-target detection due to its lightweight nature, meeting the stringent real-time performance and deployment requirements of UAVs. Full article

This study presents an extended approach to compartmental modeling of infectious disease spread, focusing on regional heterogeneity within affected areas. Using classical SIS, SIR, and SEIR frameworks, we simulate the dynamics of COVID-19 across two major regions of Ukraine—Dnipropetrovsk and Kharkiv—during the period 2020–2024. The proposed mathematical model incorporates regionally distributed subpopulations and applies a system of differential equations solved using the classical fourth-order Runge–Kutta method. The simulations are validated against real-world epidemiological data from national and international sources. The SEIR model demonstrated superior performance, achieving maximum relative errors of 4.81% and 5.60% in the Kharkiv and Dnipropetrovsk regions, respectively, outperforming the SIS and SIR models. Despite limited mobility and social contact data, the regionally adapted models achieved acceptable accuracy for medium-term forecasting. This validates the practical applicability of extended compartmental models in public health planning, particularly in settings with constrained data availability. The results further support the use of these models for estimating critical epidemiological indicators such as infection peaks and hospital resource demands. The proposed framework offers a scalable and computationally efficient tool for regional epidemic forecasting, with potential applications to future outbreaks in geographically heterogeneous environments. Full article

Malignant gastric outlet obstruction (MGOO) is a serious complication arising from advanced gastric or pancreatic head cancer, significantly impairing patients’ quality of life by disrupting oral intake and inducing severe gastrointestinal symptoms. With benign causes such as peptic ulcer disease on the decline, malignancies now account for 50–80% of gastric outlet obstruction (GOO) cases globally. This review outlines the pathophysiology, evolving epidemiology, and treatment modalities for MGOO. Therapeutic approaches include conservative management, endoscopic stenting, surgical gastrojejunostomy (GJ), stomach partitioning gastrojejunostomy (SPGJ), and endoscopic ultrasound-guided gastroenterostomy (EUS-GE). While endoscopic stenting offers rapid symptom relief with minimal invasiveness, it has higher rates of re-obstruction. Surgical options like GJ and SPGJ provide more durable palliation, especially for patients with longer expected survival. SPGJ, a modified surgical technique, demonstrates reduced incidence of delayed gastric emptying and may improve postoperative oral intake and survival compared to conventional GJ. EUS-GE represents a promising, minimally invasive alternative that combines surgical durability with endoscopic efficiency, although long-term data remain limited. Treatment selection should consider patient performance status, tumor characteristics, prognosis, and institutional resources. This comprehensive review underscores the need for individualized, multidisciplinary decision-making to optimize symptom relief, nutritional status, and overall outcomes in patients with MGOO. Full article

Grid-forming (GFM) inverters have recently seen wider adoption in microgrids and inverter-based-resource (IBR)-penetrated grids, and are primarily used to establish grid voltage under a wide array of conditions. In the existing literature, GFM control is almost exclusively applied using voltage-source inverters (VSIs). However, due to the inherent limitations of available semiconductor devices’ current ratings, inverter-side current must be limited in VSIs, particularly during grid-fault conditions. These limitations complicate the real-world application of GFM functionality in VSIs, and complex control methodologies and tuning parameters are required as a result. In the following study, GFM control is instead applied to a buck-type current-source inverter (CSI) using a combination of linear droop-control and finite-control-set (FCS) mode-predictive control (MPC) that will be referred to herein as hybrid model-predictive control (HMPC). The resulting inverter features a simple topology, inherent current limiting capabilities, and a relatively simple and intuitive control structure. Verification was performed on a 1MVA/630V system via MATLAB/Simulink, and the simulation results demonstrate strong performance in voltage establishment, power regulation, and low-voltage ride through under-grid-fault conditions, highlighting its potential as a competent alternative to VSIs in GFM applications, and lacking the inherent limitations and/or complexity of existing GFM control methodologies. Full article

Asphalt plant reclaimed powder is a common solid waste in road engineering. Reusing reclaimed powder as filler holds significant importance for environmental protection and resource conservation. The key factors affecting the feasibility of reclaimed powder reuse are its acidity/alkalinity and cleanliness. Traditional evaluation methods, such as the methylene blue test and plasticity index, can assess reclaimed powder properties to guide its recycling. However, these methods suffer from inefficiency, strong empirical dependence, and high variability. To address these limitations, this study proposes a rapid and precise evaluation method for reclaimed powder properties based on Fourier transform infrared spectroscopy (FTIR). To do so, five field-collected reclaimed powder samples and four artificial samples were evaluated. Scanning electron microscopy (SEM), X-ray fluorescence spectroscopy (XRF), and X-ray diffraction (XRD) were employed to characterize their microphase morphology, chemical composition, and crystal structure, respectively. Subsequently, FTIR was used to establish correlations between key acidity/alkalinity, cleanliness, and multiple characteristic peak intensities. Representative infrared characteristic peaks were selected, and a quantitative functional group index (Is) was proposed to simultaneously evaluate acidity/alkalinity and cleanliness. The results indicate that reclaimed powder primarily consists of tiny, crushed stone particles and dust, with significant variations in crystal structure and chemical composition, including calcium carbonate, silicon oxide, iron oxide, and aluminum oxide. Some samples also contained clay, which critically influenced the reclaimed powder properties. Since both filler acidity/alkalinity and cleanliness are affected by clay (silicon/carbon ratio determining acidity/alkalinity and aluminosilicate content affecting cleanliness), this study calculated four functional group indices based on FTIR absorption peaks, namely the Si-O-Si stretching vibration (1000 cm⁻¹) and the CO₃²⁻ asymmetric stretching vibration (1400 cm⁻¹). These indices were correlated with conventional testing results (XRF for acidity/alkalinity, methylene blue value, and pull-off strength for cleanliness). The results show that the Is index exhibited strong correlations (R² = 0.89 with XRF, R² = 0.80 with methylene blue value, and R² = 0.96 with pull-off strength), demonstrating its effectiveness in predicting both acidity/alkalinity and cleanliness. The developed method enhances reclaimed powder detection efficiency and facilitates high-value recycling in road engineering applications. Full article

Introduction and Objectives: Risk-sharing agreements (RSAs) have emerged as a key strategy for financing high-cost medical technologies while ensuring financial sustainability. These payment mechanisms mitigate clinical and financial uncertainties, optimizing pricing and reimbursement decisions. Despite their widespread adoption globally, Latin America has reported limited implementation, particularly for high-cost medical devices. This study aims to share insights from designing RSAs in the form of Outcome Protection Programs (OPPs) for medical devices in Latin America from the perspective of a medical devices company. Methods: The report follows a structured approach, defining key OPP dimensions: payment base, access criteria, pricing schemes, risk assessment, and performance incentives. Risks were categorized as financial, clinical, and operational. The framework applied principles from prior models, emphasizing negotiation, program design, implementation, and evaluation. A multidisciplinary task force analyzed patient needs, provider motivations, and payer constraints to ensure alignment with health system priorities. Results: Over two semesters, a panel of seven experts from the manufacturer designed n = 105 innovative payment programs implemented in Argentina (n = 7), Brazil (n = 7), Colombia (n = 75), Mexico (n = 9), Panama (n = 4), and Puerto Rico (n = 3). The programs targeted eight high-burden conditions, including Coronary Artery Disease, atrial fibrillation, Heart Failure, and post-implantation arrhythmias, among others. Private providers accounted for 80% of experiences. Challenges include clinical inertia and operational complexities, necessitating structured training and monitoring mechanisms. Conclusions: Outcome Protection Programs offer a viable and practical risk-sharing approach to financing high-cost medical devices in Latin America. Their implementation requires careful stakeholder alignment, clear eligibility criteria and endpoints, and robust monitoring frameworks. These findings contribute to the ongoing dialogue on sustainable healthcare financing, emphasizing the need for tailored approaches in resource-constrained settings. Full article

The highway and bridge industry is facing persistent challenges related to the high turnover of technical personnel, which poses risks to the continuity and sustainability of infrastructure development. Although Geographic Information System (GIS) training has increasingly been advocated as a strategy to stabilize the workforce, its practical application remains relatively limited across China. Drawing on the Conservation of Resources (COR) theory, this study examines whether GIS training is associated with lower turnover intention among technical staff, potentially through enhanced perceptions of career growth and reduced work-related anxiety. Based on 412 valid responses—primarily from technical personnel employed by major infrastructure enterprises such as regional subsidiaries of the China Communications Construction Group (CCCG) and China State Construction Engineering Corporation (CSCEC)—the study employs Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess the proposed relationships. The findings indicate that GIS training is negatively associated with turnover intention, with career growth partially mediating this association. Additionally, work anxiety moderates the relationship, such that the link between GIS training and turnover intention appears weaker under higher levels of anxiety. This research contributes to bridging the gap between training practices and theoretical understanding, offering insights to inform workforce retention strategies in technology-intensive industries. Full article

Nudibranchs have garnered increasing interest in biomedical research due to their complex chemical defense mechanisms, many of which are derived from their diet, including sponges, cnidarians, tunicates, and algae. Their remarkable ability to sequester dietary toxins and synthesize secondary metabolites positions them as a promising source of biologically active compounds with potential therapeutic applications, particularly in oncology. This study aimed to review and summarize the available literature on the bioactive potential of nudibranch-derived compounds, focusing mainly on their antitumor properties. Although research in this area is still limited, recent studies have identified alkaloids and terpenoids isolated from species such as Dolabella auricularia, Jorunna funebris, Dendrodoris fumata, and members of the genus Phyllidia. These compounds exhibit notable cytotoxic activity against human cancer cell lines, including those from colon (HCT-116, HT-29, SW-480), lung (A549), and breast (MCF7) cancer. These findings suggest that compounds derived from nudibranchs could serve as scaffolds for the development of more effective and selective anticancer therapies. In conclusion, nudibranchs represent a valuable yet underexplored resource for antitumor drug discovery, with significant potential to contribute to the development of novel cancer treatments. Full article

This research presents the development of a novel object detection algorithm designed to identify humans in natural outdoor environments using minimal computational resources. The proposed system, SARGAS, combines a custom convolutional neural network (CNN) classifier with MOG2 background subtraction and partial affine transformations for camera stabilization. A secondary CNN refines detections and reduces false positives. Unlike conventional supervised models, SARGAS is trained in a partially unsupervised manner, learning to recognize feature patterns without requiring labeled data. The algorithm achieved a recall of 93%, demonstrating strong detection capability even under challenging conditions. However, the overall accuracy reached 65%, due to a higher rate of false positives—an expected trade-off when maximizing recall. This bias is intentional, as missing a human target in search and rescue applications carries a higher cost than producing additional false detections. While supervised models, such as YOLOv5, perform well on data resembling their training sets, they exhibit significant performance degradation on previously unseen footage. In contrast, SARGAS generalizes more effectively, making it a promising candidate for real-world deployment in environments where labeled training data is limited or unavailable. The results establish a solid foundation for further improvements and suggest that unsupervised CNN-based approaches hold strong potential in object detection tasks. Full article