Search Results (13,130)

Background/Objectives: Insomnia disorder is highly prevalent and disabling, yet access to cognitive behavioural therapy for insomnia (CBT-I), the recommended first-line treatment, remains limited. Digital CBT-I (dCBT-I) offers scalable alternative; however, treatment outcomes vary according to intervention format and delivery context. This study evaluated whether delivering dCBT-I within a structured, medically supervised crenotherapy context improved insomnia symptom severity compared with stand-alone dCBT-I. Methods: In this multicentre proof-of-concept randomised controlled trial, 66 adults with insomnia disorder were allocated to receive either stand-alone dCBT-I (n = 38) or dCBT-I delivered within a 3-week standardised crenotherapy programme (medically supervised thermal spa treatment; n = 28). The primary outcome was change in Insomnia Severity Index (ISI) scores from pre- to post-treatment. Secondary outcomes included subjective sleep parameters (e.g., sleep efficiency and sleep onset latency), sleep-related functioning, pre-sleep arousal, anxiety and depressive symptoms. Engagement and satisfaction were assessed as additional descriptive outcomes. Results: Both groups showed significant improvements in insomnia severity, sleep parameters, and psychological symptoms. However, the primary between-group comparison did not demonstrate a statistically significant additive effect of crenotherapy on insomnia severity. ISI outcomes did not differ between the crenotherapy-delivered and stand-alone dCBT-I groups. Nevertheless, post hoc exploratory subgroup analyses suggested that, among participants younger than 60, delivery of dCBT-I within a crenotherapy care setting was associated with greater improvements in insomnia symptoms compared with stand-alone dCBT-I (mean ISI change: 10.4 vs. 5.4, p = 0.030). In a separate subgroup analysis, among participants with baseline anxiety symptoms, dCBT-I delivered within a crenotherapy care setting was associated with a greater reduction in anxiety compared with stand-alone dCBT-I (p = 0.030). Engagement and satisfaction were high in both groups, with no significant differences. Conclusions: Delivering dCBT-I within a crenotherapy context appears feasible and may offer specific benefits for specific subpopulations, particularly younger individuals and those with comorbid anxiety. These findings support further investigation of context-sensitive digital models to improve personalisation and accessibility of insomnia treatment. Full article

Purpose: The paper deals with short-horizon foreign exchange (FX) predictability through predictive directional bias and how these are intertwined with the choice of features in weak-signal trading systems. Although FX markets are generally considered extremely efficient, temporal predictability at very short horizons might exist, but is exaggerated by feature selection, causing structural directional imbalance. This paper is intended to address the question of whether explicit bias-corrected feature selection can enhance tradable next-day FX performance under realistic cost constraints. Method: The approach of the study is the bias-corrected feature selection with Annealing (BFSA) and a fixed-penalty variant (BFSA-Fixed) built into a rolling walk-forward trading model. The process of feature selection and model estimation is repeated and re-estimated again in a time-respecting fashion, and forecasts are converted to directional trading decisions. The analysis takes into consideration transaction costs and puts emphasis on the net risk-adjusted performance, but not the sole predictive accuracy. Data: Daily information is provided in the empirical analysis of 14 liquid FX pairs, which include seven major and seven minor currencies. The motivation behind the choice of this universe is that it creates realistic conditions for execution, and it does not conflate the effects of extreme liquidity predictive performance with those of extreme liquidity. Results: Economic and statistically significant gains of performance with BFSA-Fixed at one day horizon (H = 1), as well as pair-level Sharpe ratios of 1 to 2 and above, annualized returns of 15 to 30, win rates of 55 to 60, and contained draws. These returns are constructively added together to a portfolio Sharpe of over 2. Conversely, performance reduces quickly in longer horizons (H = 2 and H = 3), with Sharpe ratios becoming negative and cumulative returns become flatten and negative, which are in line with rapid information decay and FX markets’ efficiency. Implications: The article shows that bias-corrected feature selection can significantly increase tradable next-day FX strategies with no leaning on persistent directional exposure or overfitting. Conclusion: The results justify the short-term use of bias-aware feature selection and highlight the inability of the FX to be predictable on a long-term basis. Full article

Background: Soft tissue sarcomas are rare and highly heterogeneous malignant tumors, often asymptomatic in the early stages. Accurate diagnosis and reliable assessment of the risk of metastasis, classified as low, intermediate, or high, are therefore essential for effective clinical decision-making. However, the application of Artificial Intelligence (AI) approaches to these diseases is often limited by the small size and quality of available datasets, which can compromise model robustness and reliability. Methods: The use of formal methods, based on mathematical modeling and logical verification, can be an alternative to AI techniques. When integrated with radiomics, formal methods provide a structured and interpretable approach to support disease diagnosis. Results: The proposed methodology yielded encouraging results, in line with those reported in the literature. A process was conducted to extract several first- and second-order radiomic classes, which were then selected based on their significance. The resulting models were evaluated using standard performance metrics and obtained 80% accuracy, 83% precision, and 83% recall. Conclusion: The transparency of formal methods improves the interpretability of models and radiomic features, allowing new links with clinical practice to be discovered. The proposed approach is presented as a feasibility and proof-of-concept framework aimed at improving interpretability. Given the very small cohort size, performance metrics should be considered preliminary and descriptive, as they require validation on larger external datasets before any clinical applicability can be claimed. Full article

Pennycress (Thlaspi arvense L.), a representative and economically valuable cover crop, supports and enhances key ecological processes throughout its life cycle via its root system. It is hypothesized that pennycress selectively modulates its rhizosphere microbial community through root-derived metabolites, which may influence both the crop’s growth and the subsequent crops in rotation. However, systematic investigations comparing the rhizosphere microbiomes and metabolomes among different pennycress lines remain limited. This study employed metagenomic and metabolomic approaches to examine the dynamic changes in the rhizosphere microbial community and metabolite profiles of three pennycress lines with significantly different total alkaloid contents. The goal was to elucidate the interactions between microbes and metabolites. Results indicated significant differences in microbial community structure across the cultivars. JiL67 maintained stable community diversity, while LiN54 (with the lowest alkaloid content) showed reduced diversity. HeL43 (with the highest alkaloid content) exhibited increased diversity but also potential community homogenization, accompanied by the significant enrichment of microbial taxa capable of alkaloid tolerance. Metabolomic analysis identified metabolites such as Portulacaxanthin II, Oleanolic acid, and Soraphen A as significantly enriched in the rhizosphere soil of pennycress. This study reveals the shifts in rhizosphere microbial communities and metabolites linked to different pennycress lines and uncovers their interactive mechanisms, providing a scientific foundation for developing more economically efficient pennycress cultivation strategies. Full article

Background/Objectives: The effective prevention and control of healthcare-associated infections (HAIs) require the active engagement of clinical staff, which depends on strong relationships between the Infection Prevention and Control Team (IPCT) and frontline healthcare personnel. The role of the Infection Control Physician (ICP) as a clinical leader is essential for supporting evidence-based practice and fostering collaboration. This study aimed to demonstrate the impact of leadership-oriented interventions—particularly the introduction of ICP consultations in hospital wards—on HAI surveillance quality. Methods: A retrospective observational quasi-experimental study was conducted in a single hospital in southern Poland between 2017 and 2024, excluding 2020–2021 due to the COVID-19 pandemic. HAI surveillance followed the ECDC HAI-Net methodology. The study included all hospitalized patients in wards where invasive medical devices or invasive procedures were used. The intervention consisted of expanding the IPCT, increasing managerial support, extending infection control nurses’ competencies, and implementing routine ICP medical consultations. Changes in HAI incidence rates between the pre-intervention (pre-IP) and post-intervention (post-IP) periods were analyzed for catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and central line-associated bloodstream infections (CLABSI), expressed per 1000 device-days. Results: The overall device utilization increased from 0.44 to 0.54 per 1000 patient-days in the post-IP period. The utilization of microbiological diagnostic tests more than doubled, with marked increases in blood cultures (6.4% vs. 15.5%) and urine cultures (7.7% vs. 11.0%). No IPCT consultations occurred in the pre-IP period, while 874 consultations were recorded in the post-IP period. Th incidence rates for CAUTI and VAP increased (1.4 to 3.1 and 11.7 to 24.6 per 1000 device-days, respectively). The CLABSI incidence showed no significant overall change. Conclusions: Structural and functional changes in the IPCT, combined with the introduction of ICP consultations, substantially enhanced the quality and completeness of HAI surveillance in the analyzed hospital. The findings highlight the importance of leadership-driven engagement in improving infection prevention and control systems. Full article

Optical remote sensing ship detection faces significant challenges in realistic maritime scenes due to strong background clutter (e.g., docks, shorelines, wake streaks), extreme scale variation, and the elongated geometry of ships with diverse orientations. These factors frequently lead to geometric misalignment, unstable localization, and false alarms, particularly in congested ports and complex sea states. To enhance robustness under clutter while retaining the set prediction efficiency of DETR, we propose the Directional Efficient Network (DENet), a structure-aware enhancement built upon RT-DETR. DENet introduces two complementary components. First, Directional Strip Convolution (DSConv) replaces the standard $3\times 3$ convolution for spatial mixing. By predicting offsets conditioned on input features, DSConv performs strip aggregation that aligns with slender hull structures, thereby suppressing interference from line-shaped background patterns. Second, Efficient Scale Fusion (ESF) augments the Hybrid Encoder as an additive residual correction. It combines multiple receptive field branches with lightweight differential compensation to balance low-frequency context and high-frequency structural transitions, ensuring stable multi-scale fusion in cluttered scenes. Extensive experiments demonstrate the effectiveness of DENet. On ShipRSImageNet, ${\mathrm{AP}}^{\mathrm{val}}$ improves from 58.8% to 63.2% and ${\mathrm{AP}}_{50}^{\mathrm{val}}$ increases from 68.5% to 73.6%. Consistent gains are also observed on NWPU VHR-10, where ${\mathrm{AP}}^{\mathrm{val}}$ reaches 63.0% and ${\mathrm{AP}}_{50}^{\mathrm{val}}$ reaches 94.6%, alongside improvements on the Infrared Ship Database and VisDrone2019-DET, validating the method’s generalization capabilities. Full article

Avian reticuloendotheliosis (RE) caused by reticuloendotheliosis virus (REV) is an important tumor and immunosuppressive disease posing a serious threat to poultry development. The REV envelope protein, glycoprotein (gp)-90, not only participates in cell receptor binding and viral assembly and release but also induces neutralizing antibody production. However, the antigenic epitope structure of gp90 has not yet been systematically understood. Therefore, in this study, the gp90 envelope protein of a predominant REV strain was prepared using a prokaryotic expression system, and a hybridoma cell line stably secreting the REV gp90 monoclonal antibody was developed via cell fusion and flow cytometry. Notably, a novel linear B-cell epitope, ¹⁹⁵REESVRERL²⁰³, was identified for the first time in the gp90 of REV using peptide scanning. This epitope was located on the outer side of the gp90 midpiece and was conserved across REV strains. Overall, this study is of great significance for the systematic understanding of REV antigen structure and the development of virus detection methods. Full article

Background: Floating barbed threads are commonly used for minimally invasive midface lifting and rely on mobile subcutaneous tissue for support, which may limit stability. Fixation is primarily achieved by barb engagement within the subcutaneous fat and fibrous septa of the retinacula cutis. Objectives: To describe an anatomically guided modification of the APTOS Excellence Visage Soft (PLLA/PCL) thread technique, positioning the terminal segment posterior to the zygomatic retaining ligament line with the aim to enhancing mechanical stability. This technical report presents the anatomical rationale, procedural steps, and illustrative clinical cases demonstrating feasibility. Methods: The modified technique uses a single-entry point at the superior zygomatic margin, with five threads per hemiface. After linear insertion, the cannula is rotated laterally and inferiorly to position the terminal barbs posterior to the zygomatic retaining ligament line, thereby transferring tensile load toward a more fixed anatomical structure. Representative cases were documented and are presented. Results: Illustrative cases showed immediate midface elevation with improved malar projection and softening of the nasolabial and mentolabial folds. Standardized 3D imaging and vector analysis demonstrated a superolateral pattern of soft tissue displacement along the intended vectors, consistent with the proposed fixed-anchorage concept. The procedure was well tolerated, with only mild and transient local effects observed. One illustrative case included photographic follow-up at 12 months, in which preservation of midface contour and malar projection was visually appreciable. Conclusions: Redirecting the terminal thread segment posterior to the zygomatic retaining ligament line is a feasible modification that may contribute to improved vector stability by engaging a fixed fascial structure. Observations—including one case with 12-month follow-up—support the anatomical plausibility of the approach, although controlled studies with objective endpoints are necessary to confirm long-term efficacy and reproducibility. Full article

Currently, one of the major trends in the construction industry is the creation of structures with increased strength and durability. The solution is the use of nanomaterials as modifiers for cementitious composites. The aim of this study is to produce concretes with a variable structure modified with a combination of aluminum oxide (NA) and titanium oxide (NT) nanoparticles with improved properties. A variatropic structure is characterized by differences in properties across the cross-section of the material. Concretes were produced using vibration (V), centrifugation (C), and vibrocentrifugation (VC) technologies. Modification was carried out with NA particles from 0% to 4.0% in increments of 1.0% and NT from 0% to 2.0% in increments of 0.5% of the binder mass. Through experimental study, the impact of combined nanomodification on the compressive strength, water absorption, and frost resistance of concrete created with different technologies was investigated. The most effective modification dosages with NA and NT particles were determined to be 2% and 1%. The determination of concrete properties and the statistical processing of experimental results were carried out in accordance with the requirements of standardized methods. Compared to control samples, the maximum compressive strengths for V, C, and VC concretes were 12.4%, 17.5%, and 20.3% higher, reaching 48.9 MPa, 58.4 MPa, and 62.9 MPa, respectively. The lowest water absorptions for V, C, and VC concretes were 5.21%, 4.24%, and 3.76%, which are 18.5%, 24.4%, and 29.2% lower than those of the control samples. After a series of freeze–thaw cycles—6 for V, 8 for C, and 10 for VC—the losses in compressive strength and mass of the nanomodified composites were less than those of the control samples, indicating an increase in the frost resistance of concrete. The influence of concrete production technology on the effect of nanomodification with NA and NT particles was proven. Nanomodified C and VC concretes have improved physical and mechanical properties compared to V concretes. Nanomodified concretes with a variable structure have a more organized microstructure with a greater number of clusters of calcium silicate hydroxides. The resulting variable-structure concrete has improved properties and can be used to manufacture columns, piles, and transmission line supports. Full article

Subsurface exploration of Mars is essential for understanding its geological evolution and potential water ice distribution. Subsurface radar sounding is an effective technique for detecting layered structure and physical parameters beneath the Martian surface. However, existing methods often neglect the influence of loss tangent and rely on data-driven approaches without physical constraints, limiting their accuracy in high-lossy environments and reducing their physical interpretability. To overcome these limitations, this paper proposes a dual-branch physics-informed network (DBPINet) for the joint inversion of layer thickness, permittivity, and loss tangent of Martian layered media. This method introduces a dual signal loss tangent branch (DSLT-Branch) to extract frequency-dependent attenuation features from dual-frequency radar signals and incorporates a physics-informed loss function based on the electromagnetic transmission-line model to embed physical laws into the learning process. Multiple numerical and measured experiments demonstrate the effectiveness of DBPINet. Compared with the MLP-based baseline and the more advanced LMPINet, DBPINet achieves significant improvements in different layered subsurface models. Specifically, on the three-layer models, the mean absolute percentage error (MAPE) for layer thickness, permittivity, and loss tangent is reduced by 4.793%, 3.600% and 4.559%, respectively. Meanwhile, DBPINet exhibits enhanced robustness under noisy conditions. When applied to real Mars Advanced Radar for Subsurface and Ionosphere Sounding (MARSIS) data acquired over the Medusae Fossae Formation (MFF) region, the inversion results reveal a three-layer subsurface structure (a volcanic ash surface layer, an ice-mixed basaltic middle layer, and a basaltic basement) that is consistent with existing geological interpretations. Full article

Background: Fluorescence-guided surgery based on near-infrared imaging, most often using indocyanine green (ICG), is increasingly used in colorectal cancer (CRC) surgery. This narrative review integrates current evidence across four clinically relevant domains-anastomotic perfusion, lymphatic mapping, tumor localization, and metastasis detection and emphasizes the technical and translational factors that will determine broader implementation. Methods: We performed a structured narrative review of clinical and translational studies identified through PubMed and citation tracking, with emphasis on ICG-based workflows and emerging targeted tracers. Because the literature spans heterogeneous interventions, imaging platforms, and endpoints, no de novo meta-analysis or formal risk-of-bias assessment was undertaken. Results: ICG fluorescence angiography is the most mature application and can refine transection-line selection, although its effect on anastomotic leak appears protocol dependent. In lymphatic mapping, ICG improves visualization of drainage pathways and nodal basins but does not reliably distinguish benign from metastatic nodes. For tumor localization, ICG supports lesion marking and dynamic tissue characterization, while targeted probes and contrast-free adjuncts may improve oncologic specificity. For metastatic disease, ICG is most useful for liver margin guidance and for excluding residual disease, whereas CEA-targeted and multimodal approaches appear particularly promising for peritoneal metastases. Conclusions: The added value of this review lies in linking current clinical maturity to the translational steps still required for routine adoption. In CRC surgery, fluorescence imaging is already useful in selected settings, but broader implementation will depend on standardized protocols, objective real-time quantification, and multicenter validation of targeted tracers against clinically meaningful outcomes. Full article

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Despite the availability of effective treatments and advances in diagnostic methods, TB remains the leading cause of death from infectious disease globally, with its incidence tending to increase. Pregnant women constitute a population group with particular characteristics, as the diagnosis and treatment of certain conditions can be challenging. Early diagnosis and monitoring of TB by a multidisciplinary team are crucial to guide treatment and reduce complications. Congenital TB, although uncommon, is a serious complication that should be assessed in neonates, especially when the mother has previously been diagnosed with the disease. First-line anti-TB drugs are considered safe during pregnancy and lactation. In contrast, second-line drugs have a less well-established safety profile during breastfeeding, and the available evidence regarding their excretion in breast milk remains limited; therefore, their use requires individualised risk-benefit assessment. Data on this specific population group are limited, as physiological changes during pregnancy alter the pharmacokinetics/pharmacodynamics (PK/PD) of drugs and the inclusion of pregnant women in clinical trials remains contentious. Routine TB screening in prenatal care, particularly in high-prevalence regions, is crucial to improving maternal and neonatal outcomes. This narrative review was based on a structured search of PubMed, Scopus, and Web of Science (January 2000–June 2025), using the keywords tuberculosis, Mycobacterium tuberculosis, pregnancy, and breastfeeding. Eligible articles included original studies, reviews, and international guidelines. Full article

Copper-based nanoparticles (Cu-based NPs) represent a major focus in nanomedicine due to their unique physicochemical properties and excellent biocompatibility. In this paper, we present an interdisciplinary study bridging engineering and biomedical sciences by employing a novel synthesis approach to produce highly stable and uniformly dispersed spherical copper nanoparticles (CuNPs), which were subsequently tested for their cytotoxic effects on SKBR3 and MSC human cells. The synthesis of CuNPs was performed in the presence of the complexing agent trisodium citrate (TSC), while starch was used for the chemical reduction step. Characterization of the Cu-based NPs via UV–Vis, FT-IR, Mie theory, DLS and SEM confirmed their nanoscale structure. The obtained CuNPs were subsequently assessed for their biological effects and cytotoxic responses induced in normal and SKBR3 cancer cell lines. The SKBR3 cell line showed a dose-dependent decrease in the cell index and a higher proportion of apoptotic cells compared to normal MSCs, with apoptosis representing the dominant mode of cell death. Although SKBR3 cells appeared to mount an antioxidant response against CuNP oxidative stress, the response was insufficient to counteract the apoptotic progression. In comparison, MSCs showed a greater resilience to CuNP-induced cellular stress. By promoting oxidative stress and disrupting the antioxidant defense system of cancer cells, CuNPs exhibit promising anti-cancer properties. Full article

Turkey, located on one of the world’s most active fault lines, frequently experiences major earthquakes. The 2023 Kahramanmaraş earthquakes (Mw 7.6 and 7.7) caused significant destruction and housing shortages. Post-disaster shelters are often provided using containers, which require flat and solid ground. This typically involves pouring concrete foundations, but high demand for materials and labor hinders rapid installation. This study investigates screw piles as an alternative foundation system for container settlements. Screw piles can eliminate the need for concrete, offering a faster, cost-effective, and environmentally friendly solution. Finite element analyses using Abaqus were conducted to assess the structural behavior of container foundations with screw piles under real earthquake records. Additionally, a decision-making analysis based on the Analytic Hierarchy Process compares screw piles and concrete foundations in terms of cost, time, sustainability, and safety. Results show that screw piles reduce structural responses and are a more feasible post-disaster foundation solution. Full article

Coherent-dispersion spectroscopy enables high-precision Doppler measurements of stellar spectral lines, which serves as a vital technique for the indirect detection of exoplanets. In this study, the post-dispersion system of a coherent-dispersion spectrometer (CODES) was designed and optimized using Zemax, with the detection spectral range of 656 nm–716 nm and a spectral resolution of 0.06 nm. The relay optical path adopted a combination of a cylindrical lens group and an image slicer, which reshaped the circular spot with a diameter of 630 μm into a linear spot of 27 μm × 2038.8 μm, effectively matching the slit size and improving the light throughput. A flat-field design was employed for the dispersion module, which adopted two structures: the Czerny–Turner spectrometer and the Dyson spectrometer. Both spectrometer structures were designed and optimized, and their aberrations and structural characteristics were comparatively analyzed. The on-axis Modulation Transfer Function (MTF) values at the central wavelength of the two spectrometers were 0.4@37 lp/mm and 0.8@37 lp/mm, respectively, and both the spectral resolution and imaging resolution could meet the design requirements. This work provides a feasible design idea for high-precision CODES for exoplanet detection as well as general medium-to-high resolution spectrometers. Full article