Search Results (210)

This study synthesizes novel photosensitizer calcination betaine hydrochloride carbon dots (CBCDs) to address the critical challenge of Enterococcus faecalis (E. faecalis) biofilms, a major cause of root canal treatment failure. To this end, this study investigates the effective elimination via reactive oxygen species (ROS) mediated by these CBCDs. CBCDs were prepared by calcining betaine hydrochloride and rigorously characterized for their structural and chemical properties using transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS). Their optical characteristics were also thoroughly analyzed through UV-Vis and fluorescence spectroscopy. The RNO-ID assay was performed to explicitly confirm ROS production, particularly verifying significant singlet oxygen (¹O₂) generation. Bactericidal efficacy of the CBCDs was comprehensively evaluated against planktonic E. faecalis and its formed biofilms. Live/dead staining was subsequently performed to observe their state after treatment. As a result, TEM confirmed nanosized CBCDs, and FTIR/XPS analyses identified crucial functional groups. Colony Forming Unit (CFU) assays revealed a dose-dependent reduction in E. faecalis viability, achieving complete eradication at 200 mg/L under light irradiation. Complete cell death and inactivation of the formed biofilms with increasing CBCD concentrations were also strongly evidenced by red fluorescence. The obtained results underscore CBCDs as highly effective photodynamic agents for the robust elimination of E. faecalis biofilms, offering a promising new strategy to combat persistent oral infections. Full article

This study examined the efficacy of pediatric Produce Prescription Programs (PPP) on food security status, dietary intake, and health outcomes among children, and aimed to determine the optimal prescription dosage and exposure duration required to promote beneficial outcomes. A systematic review of studies published within the past 10 years, reporting on discrete food security status, dietary quality, and health outcomes among children was conducted. Studies not reporting child-specific data or not published in the English language were excluded. Three databases were searched (PubMed, CINAHL Complete, and EBSCO), data was narratively compiled, and the Newcastle-Ottawa Quality Assessment was employed to assess risk of bias. Prescription monetary amounts (dosages) were standardized, facilitating comparison between programs and outcomes. Nine studies (n = 3808 at-risk children) conducted at 52 sites were retrieved. Program protocols varied. Participation improved food security and fruit/vegetable intake; some beneficial changes were similar regardless of produce dosage and exposure. Data suggest conjecturally that a minimum dosage of $70/month adjusted for locality, cost-of-living and implementation year and exposure of ≥6 months might promote achievement of FV recommended guidelines. The value of educational components emerged in the studies. The findings of this study are limited by the high risk of bias embedded in the included interventions, as well as high heterogeneity amongst the programs. More research on program designs, the impact of PPPs on health outcomes, and cost-benefit analyses are warranted. Rigorous study designs are needed to assess the health impacts and long-term efficacy of pediatric PPPs. Full article

Background: Humanitarian surgical missions play a critical role in addressing health disparities, particularly in low-resource settings where conditions such as cleft lip and palate (CL/P) are prevalent. The success of these missions relies heavily on the commitment of volunteers, including healthcare professionals and logistical personnel. While their contributions are widely acknowledged, the psychological and emotional impact of participating in such missions remains underexplored. Objective: This study protocol aims to explore the lived experience of volunteers involved in humanitarian surgical missions. Materials and Methods: A qualitative study, using Interpretative Phenomenological Analysis (IPA), will be conducted. Semi-structured interviews will be carried out with volunteers who have participated in at least one humanitarian surgical mission. Interviews will be audio-recorded, transcribed verbatim, and analyzed to identify emerging themes. Data collection will continue until saturation is reached. The reporting of this study will follow the COREQ guidelines. Expected Results: This study is expected to provide a deeper understanding of the emotional and professional experiences of volunteers in surgical missions. Expected results include identifying key themes related to motivation and preparation, on-site engagement, field experience, interpersonal relationships and group dynamics, and personal reflections. These results will inform strategies to enhance the effectiveness of missions, improve volunteer support, and ensure the sustainability of humanitarian interventions. Additionally, these findings will contribute to the broader field of international health volunteering and support future program development. Conclusions: This protocol outlines a rigorous qualitative approach to investigating the lived experience of volunteers in humanitarian surgical missions. The anticipated findings are expected to inform targeted training, psychological support, and organizational strategies, ultimately improving the effectiveness and sustainability of future missions and the well-being of volunteers. Full article

Blockchain networks face a critical but understudied threat: wave attacks that exploit difficulty adjustment algorithms through strategic mining participation. Adversaries cyclically withdraw and re-enter mining to create oscillations that degrade network liveness and destabilize honest miners’ revenue. We present the first production-ready framework that maintains network responsiveness while enabling robust, post hoc threat detection. The framework employs a statistically rigorous pipeline featuring controller-aligned anomaly detection, transitive collusion grouping via union-find, and Benjamini–Hochberg False Discovery Rate control. We formally prove the economic viability of this architecture: when penalties on unvested rewards are enabled by governance, wave attacks become asymptotically unprofitable for rational adversaries. Evaluated on a 128-node distributed testbed simulating Bitcoin, Ethereum Classic, and Monacoin networks over 30 independent runs, our framework achieves 92.7% F1-score in detecting attacks, significantly outperforming baseline methods (74.7%). This work provides a complete, theoretically-grounded solution for securing proof-of-work blockchains against difficulty manipulation, forming the foundation for the adaptive AI-driven enhancements presented in our companion paper (Part II). Full article

The generation and stability of foam are critical attributes influencing the perceived efficacy and sensory experience of cleansing products like face cleansers and hair shampoos. This study rigorously investigated the influence of water hardness on the foam characteristics of a face cleanser and hair shampoo through integrated macroscopic, microscopic, and rheological analyses. Hard water consistently induced severe foam destabilization, evidenced by significantly increased foam decay and shortened drainage half-lives. Microstructural analysis revealed pronounced bubble coalescence, manifested as reduced bubble counts and elevated mean bubble areas. Rheologically, hard water compromised foam viscoelasticity, leading to diminished complex moduli (G*), earlier G″/G′ crossovers, and heightened phase angles (δ), signifying a rapid transition to a predominantly viscous, unstable state. Conversely, soft water consistently yielded highly elastic foams with robust G* values, maintained G′ dominance, and low δ, indicative of superior structural integrity and temporal stability. Notably, controlled rate viscosity profiles remained unaffected by water hardness. These findings collectively demonstrate that divalent cations fundamentally undermine foam lamellar film stability, inducing profound structural and mechanical degradation. Concurrently, tribological measurements revealed that the face cleanser consistently exhibited higher coefficients of friction in hard water across varying sliding speeds, whereas the hair shampoo displayed a more complex, speed-dependent frictional profile that was comparatively less sensitive to water hardness. This underscores the critical necessity for formulation chemists to mitigate water hardness effects to ensure consistent product performance and sensory attributes. Full article

Background/Objectives: Myasthenia gravis (MG) is a rare autoimmune neuromuscular disease. Clinical trials with rigorously collected data provide valuable opportunities for mathematical modeling of patient outcomes over time. However, for rare diseases such as MG, combining data across multiple trials presents challenges due to heterogeneity in outcome measures. This study aims to address these challenges by investigating relationships among commonly used MG outcome measures to support the development of a standardized “Myasthenia Gravis Portrait.” Methods: We integrated three primary data types from multiple clinical studies: (i) laboratory and medication data, (ii) Electronic Health Record (EHR) data (e.g., age, sex, years since diagnosis, BMI), and (iii) disease severity scores. We examined the relationships among several MG-specific scoring systems, including Activities of Daily Living (MG-ADL), Quantitative Myasthenia Gravis (QMG), MG Composite (MG-CE), and MG Quality of Life-15 (MGQOL-15), to evaluate consistency and comparability across studies. Results: Preliminary analyses revealed variable correlations among the different scoring systems, indicating that, while some measures capture overlapping aspects of disease progression, others reflect distinct patient- or clinician-centered perspectives. These findings highlight the need for a harmonized framework that captures both functional and clinical dimensions of MG severity. Conclusions: The proposed “Myasthenia Gravis Portrait” provides a standardized approach for representing patient outcomes across diverse clinical datasets. This framework will facilitate the creation of virtual populations of digital twins, enabling a machine-learning-based modeling of MG progression and prediction of individualized disease trajectories. Full article

With the increasing adoption of virtual reality (VR) in research and training applications, reliable stress detection in naturalistic settings remains challenging, particularly when hardware complexity must be minimized. This study presents an enhanced framework for real-time stress recognition in VR environments that integrates behavioral interactions with selectively derived physiological signals. Building upon previous architectures, the proposed framework incorporates pre-task baseline measurements to account for subject-specific and session-initial variability. While the comprehensive analysis employs a three-class affective framework, the practical implementation focuses on binary stress detection for real-world VR applications. Stress detection is achieved through VR-based behavioral signals, complemented by minimal input from a Galvanic Skin Response (GSR) sensor. The experimental evaluation demonstrates that baseline calibration improves separation across stress conditions. Quantitatively, the proposed Weighted Baseline Detector (WBD) achieved a classification accuracy of 94.17% and an Area Under the Curve (AUC) of 0.9993, outperforming the fixed global baseline approach (85.0% accuracy, AUC 0.9067), which demonstrates the effectiveness of the proposed calibration method. Rigorous cross-validation confirms that the approach achieves stable performance with statistical significance across stress conditions. These findings highlight the potential of combining behavioral analysis with physiological support to develop practical, low-hardware VR platforms for live stress recognition. Full article

Social media has become a central element in the daily lives of adolescents, shaping not only their communication patterns but also their self-perception, identity construction, and relationships with others. While these platforms provide opportunities for connection and self-expression, they also entail significant risks. This paper presents a scoping review of the literature, following principles of transparency and rigor inspired by the PRISMA framework, on the impact of social media on adolescent identity, with particular attention to self-concept, self-esteem, and body image. It also examines cyberbullying as a prevalent form of digital violence during adolescence, analyzing its causes, consequences, and variations according to gender, age, and social context. The findings indicate that adolescents build their identities both offline and online, where constant comparison, the use of filters, and the pursuit of social validation can generate emotional distress, insecurity, humiliation, and even social exclusion. Gender differences are also observed: girls are more exposed to aesthetic pressure, whereas boys tend to reproduce ideals of strength and leadership. Finally, the review highlights the importance of social work interventions focused on prevention, digital education, and emotional support in order to foster safe online environments and promote the development of authentic, stereotype-free identities. Full article

Background/Objectives: Interdisciplinary research teams that include critical disability studies (CDS) scholars and Healthcare and Medical Researchers have the potential to investigate complex lived experiences and explore new opportunities to best serve disabled communities. However, individuals in these fields typically approach disability research in different ways. Throughout this manuscript, we refer to a hypothetical interdisciplinary research team as an example of how to integrate the questions, challenges, and possibilities into practice when joining CDS and Healthcare and Medical Research. Discussion: First, we raise three large and complex questions that researchers must address (and discuss) when conducting disability research: (a) what is (a) disability, (b) what does it mean to live with a disability, and (c) who is included in research samples/as research participants for disability research? Then, we discuss the colliding and harmful relationship history between CDS and Healthcare and Medical Research fields, and the continued oppositional training of professionals in both fields. Finally, we offer insights into how collaborative efforts and methods of interdisciplinary research teams can optimize success when tackling complex research questions to serve disabled communities. Conclusions: We suggest approaches for projects at the intersection of CDS and Healthcare and Medical Research: holistic, person-centered research, treating individuals in the disability community as experts, and collaborating with the community while conducting research. This manuscript serves as a starting point for researcher teams looking to conduct ethical, rigorous, and trustworthy research at the intersection of health, medicine, and disability. Full article

Background/Objectives: This study explored the lived experiences of nursing students in South Korea who participated in clinical practice at Community Treatment Centers (CTCs) during the COVID-19 pandemic. Methods: This study was designed as a qualitative study and applied Colaizzi’s descriptive phenomenology. Semi-structured interviews were conducted with ten nursing students who practiced at CTCs for three to four weeks. Data were analyzed through Colaizzi’s seven procedural steps to derive the essential structure of their experience. Data saturation was achieved, and methodological rigor criteria were applied. Results: Four overarching themes emerged: (1) transformative growth through immersive clinical practice in quarantine; (2) enduring and adapting to uncertainty and emotional turmoil; (3) reconciling vulnerability and responsibility as future professionals; and (4) validation and pride in becoming visible during a national crisis. Conclusions: The study revealed that CTC practice constituted a transformative learning experience that enhanced students’ professional identity and resilience in disaster situations. Findings highlight the need to integrate disaster ethics and psychosocial preparedness into undergraduate nursing curricula. Full article

Improving living conditions, public services, and social safety nets in the aging residential areas is a core component of community renewal. Age-friendly development calls for integrated improvements in accessibility, safety, comfort, and aesthetics, which are essential for meeting the mobility needs of older adults and people with disabilities. Vertical transportation upgrades, especially elevators and barrier-free design, are critical interventions, yet the lack of a systematic evaluation framework has limited a comprehensive assessment of their effectiveness. This study aims to establish a comprehensive evaluation framework that tightly integrates age-friendly development with vertical transportation improvements, providing detailed guidance to support the renewal of aging residential communities. Methods: We adopted the PRISMA 2020 systematic review methodology, performing a structured search of the Web of Science Core Collection from 2014 to 2024. After applying rigorous inclusion and exclusion criteria, 61 studies were selected for in-depth analysis. Results: The review identifies four core dimensions—accessibility, safety, comfort, and aesthetics—that directly influence vertical transportation renovation outcomes. Key factors include step-free access such as ramps and slope compliance; elevator availability and reliability; lighting and anti-slip safety; waiting and riding comfort; and clear wayfinding through signage legibility. Innovation: Based on these findings, we propose an operational framework that not only defines these dimensions but also links them to measurable evaluation indicators and provides a step-by-step usage protocol. This framework enables policymakers and practitioners to design evidence-based renewal strategies, ensure equitable mobility for vulnerable groups, and promote sustainable, inclusive communities. The findings of this study can serve as a reference for future policy formulation, design practices, and empirical research on sustainable and age-friendly community renewal. Full article

Rural areas across Europe, particularly in the Balkans, are confronting a challenging and uneven negative transformation, marked by depopulation, economic stagnation and the degradation of their vernacular heritage. Assessing the unique dynamics and historical reality of these settlements proves difficult because conventional sustainability assessment systems are typically urban-focused and static. To address the methodological shortfall, this research introduces the Living Palimpsest Profile (LPP), a novel framework that conceptualizes rural settlements as layered landscapes in which time is treated as an endogenous variable in the sustainability equation. Employing the palimpsest metaphor, the LPP integrates a rigorous qualitative assessment, validated through convergent verification, with a hierarchical Framework of Visions. The framework was applied successfully to two Balkan case studies, demonstrating capacity to capture local specificity and inform contextual policy segmentation in line with the Sustainable Development Goals (SDGs). Given its significant transferability to other heritage-rich regions, the LPP is positioned as an essential methodological solution for the sustainable development of vernacular settlements worldwide. Full article

Background: Recurrent pregnancy loss (RPL) and recurrent implantation failure (RIF) are significant challenges in reproductive medicine. For both, embryonic aneuploidy is the leading etiological factor. Preimplantation genetic testing for aneuploidy (PGT-A) via trophectoderm biopsy is the current standard for embryo selection. However, it is limited by its invasiveness, potential for embryo damage, and diagnostic errors due to mosaicism. Rationale/Objectives: This review critically evaluates the emerging role of noninvasive PGT (niPGT). NiPGT analyzes cell-free DNA from spent blastocyst culture media, thus, it is a potential alternative for managing RPL and RIF. Hence, the primary objective is to determine whether current evidence supports niPGT as a reliable replacement for conventional biopsy-based PGT-A in these high-risk populations. Outcomes: The analysis reveals that niPGT offers significant theoretical advantages. These include complete non-invasiveness, enhanced embryo preservation, and high patient acceptability. However, its clinical application is hampered by substantial limitations. Key amongst them is the inconsistent and often suboptimal diagnostic accuracy (sensitivity 70–85%, specificity 88–92%) compared to biopsy. Other significant factors include the high rates of amplification failure (10–50%), vulnerability to maternal DNA contamination, as well as low DNA yield. Crucially, there is a definitive lack of robust, prospective randomized controlled trial (RCT) data demonstrating improved live birth rates or reduced miscarriage rates specifically in RPL and RIF cohorts. As such, niPGT is not yet ready to be a standalone clinical adoption in RPL and RIF cases. However, it may serve as a valuable adjunct for rescue scenarios following biopsy failure or for ethical reasons. Wider Implications: The integration of niPGT with artificial intelligence, time-lapse imaging, and multi-omics profiling underlies a promising future. However, its transition from a predominantly research tool to a clinical standard necessitates various critical undertakings. These include rigorous multicenter RCTs, standardizing international protocol, and tailoring validation for the RPL and RIF subgroups. This review highlights the need for cautious optimism, positing that evidence-based integration, rather than premature adoption, is essential to realizing niPGT’s full potential without compromising patient care in these complex fertility scenarios. Full article

Background: Chronic pain affects nearly one in five adults worldwide and is increasingly recognized not only as a disease but as a potential risk factor for neurocognitive decline and dementia. While some evidence supports this association, existing systematic reviews are static and rapidly outdated, and none have leveraged advanced methods for continuous updating and robust uncertainty modeling. Objective: This protocol describes a living systematic review with dose–response Bayesian meta-analysis, enhanced by artificial intelligence (AI) tools, to synthesize and maintain up-to-date evidence on the prospective association between any type of chronic pain and subsequent cognitive decline. Methods: We will systematically search PubMed, Embase, Web of Science, and preprint servers for prospective cohort studies evaluating chronic pain as an exposure and cognitive decline as an outcome. Screening will be semi-automated using natural language processing models (ASReview), with human oversight for quality control. Bayesian hierarchical meta-analysis will estimate pooled effect sizes and accommodate between-study heterogeneity. Meta-regression will explore study-level moderators such as pain type, severity, and cognitive domain assessed. If data permit, a dose–response meta-analysis will be conducted. Living updates will occur biannually using AI-enhanced workflows, with results transparently disseminated through preprints and peer-reviewed updates. Results: This is a protocol; results will be disseminated in future reports. Conclusions: This living Bayesian systematic review aims to provide continuously updated, methodologically rigorous evidence on the link between chronic pain and cognitive decline. The approach integrates innovative AI tools and advanced meta-analytic methods, offering a template for future living evidence syntheses in neurology and pain research. Full article

This empirical investigation explores the complex interdependencies between the concept of the Smart University Campus and the broader ecosystem of Smart City policies, with a particular focus on the New European Bauhaus initiative as a catalyst for educational transformation. The study examines how university campuses can evolve into paradigmatic models of innovation, sustainability, and inclusion through the strategic integration of emerging technologies, circular bioeconomy principles, and holistic ecological strategies. A comprehensive case study, grounded in rigorous quantitative analysis, including Principal Component Analysis (PCA), Importance-Performance Analysis (IPA), and Cluster Analysis (CA), based on questionnaires administered to a sample of 245 high school and university students—primarily from the academic community of the “King Mihai I” University of Life Sciences in Timișoara (USVT)—provides empirical insights into perceptions and expectations regarding the Smart Campus ecosystem and its core components: Smart Learning, Smart Living, Smart Safety and Security, Smart Socialization and Smart Health. The distinctive contribution of this research lies in its empirical demonstration that the strategic alignment between university campuses and Smart City initiatives, guided by the principles of the New European Bauhaus, can enhance educational efficiency by creating integrated learning ecosystems that simultaneously address academic needs, sustainability imperatives, and goals of sustainable urban development. Full article