Search Results (1,868)

Background: Plant-rich dietary patterns are widely associated with metabolic and gastrointestinal health benefits. However, individuals consuming predominantly plant-based foods may also experience chronic low-dose exposure to dietary pesticide residues. At the same time, physical activity is recognized as an important lifestyle factor influencing metabolic health and gut microbiome composition. How microbiome features and microbiome-related metabolic profiles vary according to physical activity level in adults consuming plant-rich diets and reporting gastrointestinal symptoms remains insufficiently characterized. Objective: To explore associations between physical activity level, gut microbiome characteristics, and urinary organic acid patterns in adults consuming predominantly plant-rich diets and experiencing gastrointestinal symptoms, within a cohort characterized by comparable estimated dietary pesticide exposure used as a contextual dietary background variable. Methods: This cross-sectional observational study included 93 adults consuming ≥50% plant-based foods for at least six months and reporting persistent gastrointestinal symptoms. Participants were stratified according to physical activity level using WHO-based thresholds (<150 vs. ≥150 min/week of moderate-intensity activity). Stool microbiota were assessed using a targeted quantitative PCR panel, and microbial diversity was summarized using a laboratory-derived Shannon index. A voluntary subgroup (n = 50) underwent targeted urinary organic acid analysis (LC–MS/MS). Dietary pesticide exposure was indirectly estimated using national surveillance data combined with individual dietary records and was applied uniformly across groups. Analyses were primarily descriptive and exploratory; results are presented as associations. Results: Estimated dietary pesticide exposure did not differ between physical activity groups. Participants with lower physical activity were older and exhibited lower microbial diversity and a higher prevalence of reduced abundance in selected commensal taxa. Differences were observed in selected intermediary organic acid markers, while no statistically significant difference was found for the bile acid-related indicator. Several cross-domain correlations were identified between microbial features and metabolite patterns. However, given the cross-sectional design, age imbalance between groups, and subgroup-based metabolomic analyses, the findings should be interpreted as hypothesis-generating rather than indicative of independent effects of physical activity. Conclusions: In adults consuming plant-rich diets and reporting gastrointestinal symptoms, physical activity level was associated with distinct microbiome and microbiome-related metabolic patterns under comparable estimated dietary pesticide exposure. These findings highlight the potential contribution of lifestyle factors to interindividual variability in gut microbial and metabolic profiles, while underscoring the need for age-adjusted, longitudinal, and biomarker-based studies to clarify directionality and mechanisms. Full article

Background: Turner syndrome is a genotypic disorder in females characterized by the total or partial absence of an X chromosome. While cardiovascular issues and sensorineural hearing loss are well-documented, vestibular system involvement remains understudied. This study aims to examine vestibular system involvement in patients with Turner syndrome and assess if they exhibit a higher prevalence of peripheral vestibular pathology compared to the general population. Methods: A retrospective longitudinal study was conducted with 21 Turner syndrome patients and 21 age-matched controls. Evaluations included clinical history, otoscopy, pure tone audiometry, the Video Head Impulse Test (vHIT) to measure vestibulo-ocular reflex gain, and computerized dynamic posturography, specifically the Sensory Organization Test (SOT) and Stability Limits Analysis. Results: Turner syndrome patients showed significantly higher hearing thresholds across all frequencies compared to controls (p < 0.001). In the vHIT, 30% of the Turner group presented pathological results, with significant gain reductions in the right horizontal and left posterior semicircular canals. Posturography revealed a significant reduction in overall stability (p = 0.006) and a significantly lower vestibular index (p = 0.011) in the Turner group. Additionally, patients with Turner syndrome demonstrated significant impairments in directional control, reaction time, and excursion points during Stability Limits Analysis. Conclusions: Patients with Turner syndrome are more likely to experience vestibular disorders, a finding likely associated with estrogen deficiency and the loss of its protective effect on the inner ear. These results highlight the necessity of including vestibular and posturographic assessments in the routine clinical follow-up of these patients to facilitate early detection and rehabilitation, even in the absence of overt symptoms like vertigo. Full article

To address the problems of high digging resistance, elevated energy consumption, and severe soil adhesion encountered during mechanized potato harvesting, a bionic potato digging shovel inspired by the corrugated dorsal structure of the white grub was developed. Based on reverse-engineered geometric curves, two longitudinally corrugated shovel models (L-S-1 and L-S-2) were constructed, and a coupled soil–potato–shovel model was established using the Discrete Element Method (DEM) to evaluate soil disturbance characteristics and digging resistance at a forward speed of 0.5 m/s and an entry angle of 35°. The simulation results indicated that the longitudinally corrugated shovel L-S-2 exhibited the best overall performance, reducing digging resistance by 13.87% and increasing the soil fragmentation rate by 20.67% compared with a conventional flat shovel (P-S). Using L-S-2 as the baseline design, additional DEM simulations were conducted at forward speeds ranging from 0.4 to 0.6 m/s to systematically investigate the influence of operating speed on digging performance. To further enhance anti-adhesion performance, a composite bionic shovel (H-L-S-2) was developed by embedding polytetrafluoroethylene (PTFE) hydrophobic material into the surface of L-S-2 and reinforcing the shovel tip using laser cladding. Soil-bin experiments were then performed under controlled conditions with forward speeds of 0.4–0.6 m/s and soil moisture contents of 15–20% at an entry angle of 35°, and the results showed an average resistance reduction rate of 17.46%, with a maximum reduction of 18.02%. Both DEM simulations and soil-bin tests confirmed the effectiveness of the composite bionic shovel in reducing soil adhesion, with the number of adhered soil particles decreasing by 41.2% in simulations and the mass of adhered soil reduced by 37.5% in physical tests. These results demonstrate that coupling a bionic corrugated structure with surface material modification can effectively reduce digging resistance, enhance soil fragmentation, and mitigate soil adhesion, providing a practical approach for optimizing the design of potato digging shovels. Full article

Background: Traumatic spinal injuries (TSI) are often associated with substantial physical burden and potential psychological consequences. Early detection of depressive symptoms may be important for improving quality of life during recovery. Despite the high prevalence of injury, unique sociocultural factors affecting mental health, and the need to optimize long-term rehabilitation outcomes, there is a lack of longitudinal assessments of depression in TSI patients in this region of the MENA (Middle East and North Africa). This study aimed to examine the occurrence of depressive symptoms following TSI over a 3-month period. Methods: A prospective cohort study was conducted to assess the occurrence of depression in TSI patients admitted between 2019 and 2022 at the Hamad Trauma Center. Conscious patients aged 18–65 years diagnosed with TSI were included. Perceived social support was assessed using the RAND Social Support Survey (Medical Outcomes Study Social Support Survey), a validated instrument measuring multiple dimensions of social support. Patient Health Questionnaire-9 (PHQ-9), a widely validated self-administered screening tool for depressive symptoms, was utilized twice: at 2 weeks and at 3 months post-trauma to evaluate early-onset depressive symptoms and their persistence or resolution over time. Results: A total of 189 TSI were included. The cohort was predominantly young individuals. The most common mechanisms of injury included falls (42.1%) and motor vehicle crashes (31.1%). The mean Injury Severity Score was 16.5 ± 8.2 and the spine Abbreviated Injury Scale score was 2.4 ± 0.7. Injuries involved cervical (32.8%), thoracic (38.1%), and lumbo-sacral (6.9%) regions. A total of 32.6% underwent spinal surgery, and 9.0% experienced neurological deficits. Most patients reported emotional and informational support (69%), and 62% reported caregiving support. At 2 weeks post-trauma, patients demonstrated mild depressive symptoms, with a mean PHQ-9 score of 4.6 ± 5.1, which decreased to 2.5 ± 4.2 at 3 months. The proportion of patients screening positive for depressive symptoms (PHQ-9 ≥ 5) decreased from 39.1% (52/133) at 2 weeks to 19.5% (26/133) at 3 months, corresponding to a 19.6% absolute reduction over the follow-up period. A subset of patients reported increased feelings of depression or hopelessness and sleep disturbances at three months compared with two weeks post-trauma. Conclusions: Patients with TSIs experience psychological distress in the early post-injury period, with a subset screening positive for depressive symptoms. Although depressive symptom scores declined over 3 months, continued psychological screening and follow-up care remain important components of comprehensive TSI management during recovery and rehabilitation. Our results should be considered cautiously because of gender-biased findings, single center data and potential attrition bias. Full article

Potholes are typical negative road obstacles that can significantly compromise vehicle safety and ride comfort when traversed at inappropriate speeds. To address this issue, this paper proposes a pothole-detection-based, comfort-oriented pothole traversal algorithm that integrates multi-sensor fusion perception, comfort-constrained speed planning, and fuzzy control. A camera and a single-point ranging LiDAR are first fused to extract key geometric features of potholes, including contour, area, and depth. Based on these features, a vehicle–pothole dynamic model is developed in ADAMS to quantify the influence of pothole area and depth on vehicle vertical vibration. The vertical frequency-weighted root-mean-square (RMS) acceleration is adopted as the ride comfort indicator, based on which the maximum allowable traversal speed under different pothole geometries is determined. Furthermore, a longitudinal pothole traversal control strategy based on fuzzy theory is designed to regulate vehicle acceleration, enabling the vehicle to reach the comfort-constrained limiting speed within a finite preview distance while ensuring braking safety. The proposed method is validated through multi-scenario co-simulations using MATLAB/Simulink and CarSim, as well as real-vehicle experiments. Results demonstrate that the proposed strategy can effectively adjust vehicle speed before pothole traversal, satisfying comfort constraints and improving ride comfort without sacrificing driving safety. Full article

Background: Posterior decompression with instrumented fusion (PDF) is a conventional surgical procedure performed in patients with massive ossification of the posterior longitudinal ligament (OPLL); however, it is invasive to the posterior cervical tissues. In this report, we introduce a novel PDF technique, exoscopic minimally invasive open-door laminoplasty with pedicle screw fixation (exLAPPS), to treat cervical OPLL, while minimizing posterior tissue damage. Methods: ExLAPPS was indicated for patients with K-line (−) OPLL or a canal occupying a ratio of ≥50%, allowing decompression from C3 to C7. A small midline incision was used for the navigation reference placement and exoscopic minimally invasive open-door laminoplasty, whereas bilateral lateral incisions were utilized for posterior fixation, including pedicle screw insertion, based on the minimally invasive cervical pedicle screw technique. Results: A total of 7 patients with K-line (-) or a canal occupancy ≥50% underwent exLAPPS for cervical OPLL. The mean operative time was 248 min (range, 165–342 min) and the mean blood loss was 320 mL (range, 50–740 mL). Postoperative imaging demonstrated adequate spinal cord decompression in all patients. A total of 52 pedicle screws were inserted, with a pedicle screw deviation rate of 1.9%. Conclusions: ExLAPPS is a minimally invasive surgical technique designed for posterior decompression and fixation in patients with cervical OPLL. In this preliminary case series, the procedure was successfully performed with acceptable operative time, blood loss, and screw placement accuracy. Although the present study did not include a direct comparison with conventional procedures, these preliminary observations suggest that ExLAPPS is a feasible surgical option for selected patients with cervical OPLL. Full article

Background: This longitudinal study examined the clinical outcomes of physiotherapy interventions in patients with chronic low back pain, specifically observing the interactions between demographic characteristics, physical metrics, and psychological variables. Methods: A cohort of n = 150 patients, Final n = 123 (18% attrition rate), was assessed using a one-group pre-test/post-test design, with primary outcome measures including Health-Related Quality of Life, the Perceived Stress Scale, and the Numerical Pain Rating Scale. Participants received eight standardized sessions over 4 weeks, including electro-physical agents combined with individualized kinesiotherapy. Data analysis/synthesis was performed via Multiple Correspondence Analysis (MCA) to map associations between categorical variables and treatment responses. Results: The predominant clinical profile found was a middle-aged female with moderate educational attainment, presenting with a Body Mass Index in the overweight range and moderate-to-high baseline pain intensity. MCA revealed distinct phenotypic trends: longer Work Experience was associated with lower baseline Quality of Life (QoL) and heightened stress/pain levels. In contrast, patients characterized by higher education and significant Work Experience demonstrated notable post-intervention QoL gains. High baseline QoL served as a predictor for sustained improvement and pain attenuation, while elevated pre-intervention pain scores were consistently linked to perceived unmet clinical needs and exacerbated stress. Conclusions: MCA successfully mapped non-linear clusters—such as the “Socio-Psychological Barrier” profile—that traditional univariate methods fail to visualize, suggesting that “individualized care” must prioritize health literacy among patients experiencing extensive work-related strain. Full article

The use of resource-saving technology in road construction material production is a current problem, the solution of which will allow us to increase the environmental and economic efficiency of the road construction industry. Nowadays, secondary raw materials are widely used in highway construction, obtained both from the waste of old road construction materials and collected from other industries. During asphalt production, up to 90% of raw materials can be replaced by reclaimed asphalt pavement (RAP). This technology requires residual binder modification to reduce the negative impact on the technological and operational asphalt concrete properties. On the other hand, the use of rubber crumbs or granules obtained from the disposal of old car tires in asphalt–concrete mixtures is widespread. However, some types of car tires cannot be used as raw materials to produce an effective modifier. Truck tires and tires from special vehicles are suitable for use as a modifier for asphalt–concrete mixtures. Tires designed for passenger cars do not contain enough polymer. As an experiment on asphalt–concrete mixture production using secondary resources only, a testing facility was developed. The testing facility uses hot gas obtained by burning automobile tires in a special oven as a heat source. Rubber residues from the recycling of automobile tires are used as fuel, which cannot be used to produce rubber powder or granules. RAP obtained by cold milling of the pavements of city and public roads was used as the object of the research. When studying the characteristics of the asphalt–concrete-mixture-based binder, it was found that the sulfur compounds present in the composition of hot gases change the properties of the binder, leading to a serious deterioration in the technological characteristics of asphalt–concrete mixtures. The asphalt–concrete mixture obtained during RAP processing is characterized by a narrow temperature range in which it can be laid and compacted to the required density values. After laying the pavement, quality control revealed a significant variation (the number of air voids ranged from 0.8 to 5.5%) in the average density of samples taken from the compacted layer. In addition, there were significant violations of the longitudinal evenness of the finished coating. Experiments were carried out to extract the binder from asphalt–concrete mixtures before and after regeneration. The physico-mechanical and rheological characteristics were studied and qualitative analysis of the binder was realized by IR spectroscopy. The data obtained allow us to establish the mechanism of how sulfur-containing gases influence the bitumen binder’s properties in asphalt mixtures. Additionally, the features of thermo-oxidative degradation occurring during the hot recycling of asphalt–concrete mixtures were established. A justification is also given for the need to use anti-aging modifiers to restore the properties of the residual binder. Full article

The parafoil is highly susceptible to deviations from its reference trajectory under wind disturbances. Given its constrained longitudinal control authority, it has limited capability to correct these deviations and regain the intended glide path. To overcome this limitation, we propose a dynamic planning framework based on a layered homing strategy. The airdrop mission trajectory is initially designed as a traditional multi-segment path. To approximate non-uniform glide characteristics under wind disturbances, this planning problem incorporates a predicted wind model as an external input. Node parameters of the segmented trajectory are then solved using an improved grey wolf optimizer (IGWO). By tracking this reference trajectory, the parafoil is guided into the proximity of the target. To ensure landing precision, the terminal phase is formulated and discretized using an adaptive pseudo-spectral method (APSM). The online planner computes a real-time trajectory to account for actual motion characteristics. This dynamic replanning (DRP) compensates for deviations caused by model mismatches and external disturbances. The proposed homing method is statistically verified via extensive Monte Carlo simulations under different wind conditions. Finally, the airdrop experiment is conducted to validate the DRP method. Full article

Prior research on tour guides’ influence on tourists’ pro-environmental behavior has largely emphasized informational content (e.g., interpretation) and communication tactics (e.g., humor), while leaving the social-influence role of guides’ emotional displays underexamined, especially with respect to simultaneous affective and cognitive mechanisms. Drawing on Emotions-as-Social-Information (EASI) theory, we develop a dual-path model in which tour guides’ environmental passion affects tourists’ pro-environmental behavior via an affective-reaction pathway (positive emotions) and an inferential pathway (self-protection motivation), with tourists’ self-construal moderating the first-stage effects. Using a seven-day experience sampling (intensive longitudinal) survey (873 day-level observations nested within 159 tourists) and estimating a 1-1-1 multilevel structural equation model with Monte Carlo confidence intervals, we find that guides’ environmental passion predicts tourists’ pro-environmental behavior both directly and indirectly through the two mediators, and these indirect effects are stronger among tourists with a more interdependent self-construal. The study extends EASI theory to guide–tourist interactions and advances tourism sustainability research by clarifying how emotional displays operate as social information in shaping tourists’ daily pro-environmental responses. Full article

Background: Elderly patients with heart failure with reduced ejection fraction (HFrEF) who experience worsening heart failure (wHF) remain at high residual risk despite optimal medical therapy (OMT), and data on cognitive function and comprehensive geriatric assessment (CGA) in this setting are lacking. This study evaluated the association between 12-month treatment with vericiguat and changes in cardiac, functional and geriatric parameters in elderly patients with recent wHF. Methods and results: In this single-center prospective observational study, 55 patients (45 men, mean age 76.4 ± 5.1 years) with HFrEF on OMT and a recent episode of wHF were treated with vericiguat and followed for 12 months. Clinical assessment, CGA and echocardiography including speckle-tracking were performed at baseline, 6, and 12 months. At 12 months, the mean vericiguat dose was 5.5 ± 2.9 mg/day. NT-proBNP levels decreased from 980 (467–2106) to 654 (274–1762) pg/mL (p < 0.0001), while left ventricular ejection fraction increased from 36.8 ± 3.1% to 43.4 ± 5.7% (p < 0.0001). Global longitudinal strain improved from −9.2 ± 1.7% to −11.5 ± 2.1% (p = 0.008), with parallel improvements in right ventricular function and pulmonary pressures. Cognitive performance improved (MMSE 25.1 ± 1.7 to 26.2 ± 2.1 points, p < 0.0001), as did depressive symptoms (GDS 7.8 ± 2.0 to 5.4 ± 1.6 points, p < 0.0001), physical performance (SPPB 6.7 ± 1.1 to 8.4 ± 0.9 points, p < 0.0001), and gait speed (0.70 ± 0.10 to 0.83 ± 0.06 m/s, p < 0.0001). Conley score decreased from 5.2 ± 2.3 to 2.4 ± 1.8 points (p < 0.0001), suggesting a lower risk of falls. Loop diuretic and MRA use were significantly reduced during follow-up. Conclusions: In this elderly HFrEF cohort with recent wHF on contemporary OMT, 12-month treatment with vericiguat was associated with consistent improvements in cardiac structure and function, biomarkers, and multidimensional geriatric status. These hypothesis-generating findings support the integration of CGA into future controlled studies of vericiguat in frail older patients with HFrEF. Given the observational design and lack of a control group, causal inference is not possible. Full article

A mesoscale model for chloride diffusion in reinforced concrete was established by considering the blocking effect of reinforcing steel. This model improved the accuracy of chloride concentration prediction and enhanced the reliability of durability-based service-life assessment. First, a series of chloride transport experiments under wetting–drying cycles was carried out on reinforced concrete specimens. These experiments were used to evaluate the effects of exposure condition, rebar blocking, and concrete compressive strength on chloride transport. Then, a mesoscale chloride diffusion model including the rebar-induced blocking effect was developed and validated. Finally, a sensitivity analysis of the key parameters was conducted. The results showed that, compared with concrete without longitudinal reinforcement, wetting–drying cycles had a stronger influence on reinforced concrete with longitudinal bars. The enhancing effect of wetting–drying cycles on chloride ingress was the strongest, followed by compressive strength and then the rebar-induced blocking effect, although the latter was still non-negligible. As the rebar diameter increased, the peak chloride concentration increased, and the chloride concentration around the aggregates also increased more rapidly. Full article

Ensuring the safety of Autonomous Driving Systems (ADS) at urban intersections remains challenging due to complex interactions between vehicles and traffic management infrastructure. This study validates an ADS equipped with connected perception using Infrastructure-to-Vehicle (I2V) communication within a combined virtual and hybrid testing approach. The validation follows the overall structure and methodology of the SUNRISE Safety Assurance Framework (SAF), which is applied in detail where required by the scope of the study. Five representative urban intersection scenarios, covering both nominal driving conditions and safety-critical edge cases, are evaluated using virtual simulations in MATLAB/Simulink (2014b) and hybrid experiments integrating OMNeT++ (5.7.1)/Veins (5.2)/SUMO (1.12.0) with real-world components. Key Performance Indicators (KPIs) related to safety, decision-making, longitudinal control, passenger comfort, and V2X communication performance are analyzed. The results show strong consistency between virtual and hybrid testing, with ego vehicle speed deviations below 2 km/h and trigger distance differences under 3 m. V2X communication achieves a near-perfect Cooperative Awareness Message (CAM) delivery ratio, with an average latency of approximately 142 ms. While this latency remains within the tolerance of the deployed ADS, the overall end-to-end delay highlights opportunities for further optimization. The study demonstrates how the SUNRISE SAF can effectively structure ADS validation, identifies critical scenarios such as right-of-way violations by non-priority obstacles, and provides insights into improving connectivity handling and low-speed braking behavior for Cooperative, Connected, and Automated Mobility (CCAM) systems in urban environments. Full article

This study experimentally investigates the thermal–hydraulic performance of heat exchanger tubes fitted with wired twisted tapes, with particular emphasis on the effects of the hole spacing-to-width ratio (s/W) and edge margin-to-width ratio (e/W). Experiments were conducted over a Reynolds number range of 6000–20,000, and the results were compared with those of plain tubes and tubes equipped with conventional twisted tapes. The findings revealed that the incorporation of wires significantly enhanced heat transfer due to the combined action of longitudinal eddies generated by wire protrusions and swirling flow induced by the twisted tape. At identical Reynolds numbers, tubes with a smaller hole spacing (s/W = 0.16) exhibited superior heat transfer performance, achieving Nusselt number enhancements of up to 107.7% relative to plain tubes and 51.6% relative to conventional twisted tapes. Similarly, reducing the edge margin ratio intensified near-wall eddies and further disrupted the boundary layer. The friction factor was found to increase with decreasing hole spacing and edge margin, primarily due to additional flow obstructions and enhanced near-wall shear stresses. For wired twisted tapes with s/W = 0.16, the friction factor reached nearly six times that of a plain tube. Despite this penalty, the thermal performance factor (TPF) remained favorable, with values of up to 1.2, indicating that the heat transfer benefits outweighed the corresponding pressure losses. Full article

Patients with end-stage liver disease (ESLD) and their caregivers experience extensive physical, psychological, and social burdens and needs for resources. However, empirical evidence on patients’ and caregivers’ specific reported use of resources to help manage ESLD is lacking. Understanding the type and helpfulness of resources used could strengthen clinical care to address individual needs for resources. Aim: To examine and compare resources patients and caregivers identified as being most helpful in managing ESLD in relation to resources they felt would be helpful. Methods: Patients with ESLD and their caregivers responded in writing to two open-ended questions as part of a survey: (1) What resources have you found most helpful in dealing with patient’s liver disease? and (2) What resources would be helpful in dealing with patient’s liver disease? Conventional content analysis was used to identify resource categories. Results: A total of 192 patients and 198 caregivers completed surveys. We identified two major resource domains—medical and non-medical—and five categories within each. Analysis revealed participant group- and disease severity-based differences in helpful resources. Conclusions: Proactively engaging patients and caregivers early in the course of illness to identify relevant resources that might facilitate ability to manage ESLD. An interprofessional care approach would facilitate efforts supporting financial, social, spiritual, emotional, and mental health needs. Future longitudinal research of unique resource needs along the disease trajectory may help to develop effective interventions. Full article