Search Results (77,880)

Introduction: Neisseria gonorrhoeae, a bacterium responsible for gonorrhea, can spread through oral sex, causing pharyngeal gonorrhea, which is also a leading cause of urethritis in outpatient clinics. This study investigated whether tea tree oil (TTO) alone or in combination with other natural products could serve as an effective alternative to chlorhexidine in preventing the spread of oral gonorrhea. Methods: An in vitro model was developed using T84 epithelial cells as a mucosal layer and Neisseria gonorrhoeae strain MS11. The study assessed the minimal inhibitory concentration (MIC), bacterial adherence, invasion, and transmigration across the mucosal barrier. Berberine (BB), a major and bioactive alkaloid derived from Coptis chinensis, was tested with and without TTO in MIC assays and epithelial cell viability tests. Ceftriaxone was used as a positive control. Results: The MIC values for TTO, BB, and ceftriaxone against the MS11 strain were determined to be 0.2%, 5 μg/mL, and 0.0125 μg/mL, respectively. Notably, the combination of TTO with BB demonstrated a synergistic effect, reducing the MIC to 0.000625% TTO + 1.25 μg/mL BB. This combination provided the strongest protective effect. No cytotoxicity was observed in the epithelial cell viability tests for 0.2% diluted TTO, 5 μg/mL BB, or the combination of 0.000625% TTO + 1.25 μg/mL BB. Conclusions: BB, when combined with TTO, exhibited a synergistic antimicrobial effect against Neisseria gonorrhoeae strain MS11 in the T84 mucosal model. These findings highlight the potential of this combination as a natural alternative to chlorhexidine gluconate for managing oral gonorrhea. Full article

Background: Epidural motor cortex stimulation (MCS) is an established neuromodulatory option for refractory neuropathic pain; however, structured data on long-term outcomes, stimulation dependency, and real-world device management remain limited, particularly in chronic neuropathic orofacial pain. Methods: This retrospective single-center cohort study included patients with refractory neuropathic orofacial pain treated with epidural MCS at a tertiary neurosurgical center. Clinical data were extracted from medical records and longitudinal follow-up documentation. Pain intensity was assessed using a unified 0–10 numerical rating scale (NRS/VAS) at baseline, best achieved response, and last follow-up. Responder status was defined at the last follow-up (≥50% pain reduction from baseline). Secondary outcomes included stimulation dependency during OFF periods, reprogramming burden, device-related events, and safety. Results: Ten patients (6 women, 4 men; mean age 61.5 ± 8.6 years) were followed for a mean of 7.6 ± 6.3 years (range 2–22 years), with 70% exceeding five years of follow-up. Baseline pain intensity (8.8 ± 0.4) decreased to 4.6 ± 0.8 at the best achieved response and remained lower at last follow-up (5.6 ± 0.9). At the last follow-up, eight patients (80%) were classified as partial responders (30–49% pain reduction), while two (20%) were classified as non-responders. Clinically relevant worsening during stimulator OFF periods occurred in 70% of patients. Reprogramming was required in all patients, and 60% underwent battery replacement. No clinically significant stimulation-related adverse effects were observed. Conclusions: Epidural MCS was associated with sustained pain reduction over extended follow-up. These findings support the interpretation of MCS as a chronic neuromodulatory therapy requiring ongoing stimulation, individualized programming, and long-term device management, contributing clinically relevant long-term evidence to the evolving role of neuromodulation in refractory chronic neuropathic pain. Full article

Diabetes mellitus (DM) is a complex metabolic disorder associated with a heightened risk of cardiovascular events, largely driven by a hypercoagulable and hypofibrinolytic state. The pathophysiological interplay between chronic hyperglycemia, oxidative stress, insulin resistance, and systemic inflammation fosters profound alterations in the coagulation cascade, endothelial function, and platelet activity. This narrative review synthesizes evidence from studies published between 2008 and 2026, focusing on coagulation and platelet-related biomarkers selected based on their biological relevance to thrombosis, endothelial dysfunction, and inflammation, as well as the availability of clinical and interventional data across different forms of DM. Although there are numerous biomarkers involved in the pathogenesis of various forms of diabetes, this narrative review critically examines key coagulation biomarkers—including D-dimer, fibrinogen, prothrombin, tissue thromboplastin or tissue factor, P-selectin, soluble urokinase plasminogen activator receptor, thrombomodulin, plasminogen activator inhibitor-1, von Willebrand factor, and β-thromboglobulin—across distinct diabetes subtypes, including type 1, type 2, gestational, and secondary forms linked to endocrinopathies and pancreatic diseases. The literature reveals substantial subtype-specific heterogeneity in hemostatic alterations. For instance, Type 1 DM is characterized by early endothelial dysfunction and platelet activation, while Type 2 DM presents with elevated coagulation factors, impaired fibrinolysis, and a proinflammatory milieu. Gestational DM exhibits pregnancy-specific changes in coagulation, yet distinguishing them from obesity-related effects remains challenging. Secondary diabetes forms, such as those associated with Cushing’s syndrome or pancreatitis, further underscore the diversity in thrombotic risk profiles. Among the coagulation and platelet activation biomarkers reviewed, fibrinogen, P-selectin, and plasminogen activator inhibitor-1 demonstrate the most consistent associations with glycemic control, vascular dysfunction, and therapeutic modulation, particularly in type 2 diabetes, suggesting greater potential for clinical translation. In contrast, evidence for markers such as D-dimer, tissue factor or tissue thromboplastin, and soluble urokinase plasminogen activator receptor remains heterogeneous and insufficient for routine clinical application. By synthesizing mechanistic insights and clinical data, this review highlights the urgent need for subtype-tailored coagulation assessment in diabetes management. A better understanding of the dynamic alterations in coagulation pathways may facilitate earlier detection of vascular complications and inform personalized antithrombotic strategies. Full article

Flexible automated assembly lines (FAALs) in Industry 4.0 require robust quality management that integrates operational data with systematic risk analysis. However, Process Failure Mode and Effects Analysis (PFMEA) documents are often developed during the design phase and not systematically updated with actual production data, leading to a gap between formal risk assessment and operational reality. This study addresses this gap by developing and validating an integrated data-driven framework that combines classical quality tools (process flow charts, check sheets, cause-and-effect diagrams, and Pareto analysis) with data-driven PFMEA, creating traceable links from operational logs to risk ratings. While individual quality tools are well-established, the core contribution of this work is a structured data transformation pipeline that creates traceable, auditable linkages from raw operational event logs to calibrated PFMEA ratings with quantified uncertainty—a combination not previously demonstrated for flexible assembly systems. The framework was applied to FMS-200, a modular FAAL for bearing units, consisting of eight stations and a common transfer system. Analysis of 186 failure events across 2743 assembly cycles, including 18 product configurations, identified 40 distinct failure modes with risk priority number (RPN) values ranging from 60 to 378, revealing that approximately 90% of the aggregated risk is associated with pneumatic systems. Monte Carlo uncertainty analysis (10,000 iterations) demonstrated robust rank stability, with the top five failure modes maintaining their relative ordering in over 90% of simulations. The framework provides production and quality managers with a systematic methodology to maintain PFMEA relevance through continuous data integration, enabling evidence-based prioritization of improvement actions. Full article

Optimizing nitrogen (N) management is crucial for high-quality rice (Oryza sativa L.) production. However, how N affects grain quality at different positions within a panicle remains unclear. This study evaluated the effects of different N application regimes on the milling, appearance, eating, and nutritional quality of grains at varying panicle positions. We used a japonica cultivar Wuyunjing 31 in a controlled pot experiment with three N treatments: N32:0 (early heavy N), N16:16 (split application with late N topdressing), and N16:0 (low-N control). Results showed that late N topdressing (N16:16) significantly improved head rice yield across all grain positions, which was linked to higher storage protein accumulation (especially glutelin) and larger length-to-width ratio. Conversely, late N application deteriorated appearance quality by increasing the chalky grain rate and chalkiness. This negative effect was most pronounced in superior grains on upper and middle branches. Furthermore, the N16:16 treatment consistently decreased amylose content while increasing albumin, prolamin, and glutelin levels, demonstrating a clear trade-off between carbon (C) and N sinks. We speculated that these intra-panicle differences result from increased competition for carbon resources between starch and protein synthesis pathways. Overall, precision N management should account for spatial differences in grain development to effectively balance rice yield and quality. Full article

The accurate and rapid prediction of hazard gas dispersion fields in urban environments is essential for guiding emergency sensor deployment and enabling real-time risk assessment. However, the computational cost associated with Computational Fluid Dynamics (CFD) simulations hinders their use as real-time forward models, while simplified Gaussian plume models lack the fidelity to resolve building obstruction effects. This study proposes a morphology-guided conditional Generative Adversarial Network (cGAN) framework designed to achieve real-time gas dispersion field modeling in urban environments with complex building configurations. The urban area is discretized into 50 × 50 m grid cells, each characterized by six morphological parameters describing building geometry. K-means clustering categorizes these cells into distinct morphological types. High-fidelity dispersion datasets are then generated for each type using Lattice Boltzmann Method (LBM) simulations. Each sample encodes building geometry, release location, wind speed, and time as multi-channel input images, with the corresponding gas dispersion concentration field is recorded as the output. Two cGAN architectures, Image-to-Image Translation (Pix2Pix) and its high-resolution variant (Pix2PixHD), are employed to learn the mapping from input features to dispersion fields. Model performance is evaluated using four complementary metrics: Fraction within a Factor of Two (FAC2) for prediction accuracy, Normalized Root Mean Square Error (NRMSE) for precision, Fractional Bias (FB) for systematic error, and Structural Similarity Index (SSIM) for spatial pattern fidelity. A case study is conducted across a 1176 km² urban district in China. The results demonstrate that under varying wind speeds (0.5–1.5 m/s) and temporal scales (5–60 s), and across five morphological categories, the Pix2PixHD-based model achieves 92.5% prediction accuracy and reproduces 97.6% of the spatial patterns. The proposed framework accelerates computation by approximately 18,000 times compared to traditional CFD, reducing inference time to under 0.1 s per scenario. This sub-second capability enables real-time concentration field estimation for emergency management, and provides a physically informed, computationally feasible forward model that can potentially support sensor-based gas source localization and detection network planning in complex urban environments. Full article

Corporate financial policy requires managers to balance financing, investment, and payout decisions while maintaining sufficient financial flexibility to respond to unexpected shocks and investment opportunities. Despite the importance of financial flexibility, limited empirical evidence exists on its determinants in African capital markets. Using panel data from 106 non-financial firms listed on the Johannesburg Stock Exchange over the period 2000–2019, this study examines the determinants of financial flexibility. Financial flexibility is identified by comparing actual and predicted leverage and classifying firms with persistent spare debt capacity as financially flexible. The main empirical model is estimated as a random-effects linear probability model with heteroscedasticity-robust standard errors. The results show that financial flexibility is significantly negatively associated with leverage and Tobin’s Q, indicating that firms with higher debt levels and stronger growth opportunities are less likely to preserve borrowing capacity. Retained earnings and financing cost show weak negative associations at the 10% significance level, while dividend payout, profitability, cash holdings, and tangibility are statistically insignificant. The study contributes to the corporate finance literature by providing new evidence from an African emerging market context, incorporating payout policy into the financial flexibility framework, and showing how leverage discipline and growth-related financing demands shape firms’ financial flexibility. Full article

Precision soil management is fundamental to the sustainable production of high-quality tea, yet the spatial integration of fertility and heavy metal safety remains a significant challenge. This study aimed to delineate multi-dimensional management zones (MZs) in the tea plantations of Tianmuhu, Jiangsu Province, by evaluating three clustering algorithms: K-means (KM), Fuzzy C-means (FCM), and Iterative Self-Organizing Data Analysis Technique (ISODATA). A total of 70 representative soil samples were analyzed for 10 properties. Descriptive statistics revealed pronounced spatial heterogeneity, particularly for Hg (CV = 71.04%) and P (CV = 61.83%). Pearson correlation and Principal Component Analysis (PCA) demonstrated strong synergistic relationships among organic matter (OM), nitrogen (N), and potassium (K) (r = 0.49–0.69, p < 0.01), which formed a distinct Fertility Factor on PC1. Conversely, PCA identified divergent sources for heavy metals, with Cr primarily governed by pedogenic processes (PC2), while Cd were associated with anthropogenic inputs. Guided by these distinct spatial drivers, this study separately delineated fertility and heavy metal safety MZs. The optimal number of clusters was determined by balancing statistical validity with spatial operationality via the Silhouette Coefficient (SC) and Smoothness Index (SI), with results indicating that a 2–3 zone scheme yielded the most favorable scores. Comparative analysis showed that for soil fertility, ISODATA outperformed KM and FCM by effectively capturing the high variability of P and producing statistically distinct zones (p < 0.05). For heavy metal pollution, FCM provided better partitioning by reflecting the continuous gradients of composite contaminants. Validation results showed that while 61% of the area was classified as high-fertility (ISODATA), approximately 63–75% fell into relatively higher heavy metal accumulation categories. This dual-objective zoning framework provides a scientific basis for site-specific fertilization and targeted environmental monitoring in the regional tea industry. Full article

Intensive ornamental planting is increasingly prevalent in urban green spaces, yet its effects on soil microbial community assembly and interaction networks remain poorly understood. Here, we examined shifts in soil properties, microbial diversity, community composition, and interaction networks across successive planting cycles. Bacterial alpha-diversity remained relatively stable, whereas fungal communities showed pronounced sensitivity to early planting stages. Beta-diversity analyses revealed that bacterial community composition was jointly influenced by planting stage and site type, while fungal communities were primarily structured by site characteristics. Co-occurrence network analysis revealed contrasting reassembly trajectories between microbial groups. Bacterial networks exhibited increasing complexity and modularity, indicating enhanced interaction intensity and competitive structuring under intensive management. In contrast, fungal networks displayed reduced connectivity but maintained or recovered modular organization, suggesting structural buffering. Notably, keystone taxa remained taxonomically conserved, indicating that network reorganization was driven by interaction rewiring rather than species turnover. We propose a dual-speed reassembly framework in which bacteria function as fast-responding components with dynamic interaction networks, whereas fungi act as slow-buffering, structurally persistent elements. This decoupling of short-term functional responsiveness and long-term stability provides new insights into how intensive management reshapes soil microbiomes in botanical garden ecosystems. Full article

The management of waste bentonite slurry (WBS) produced during slurry shield TBM excavation involves environmental and operational challenges from the perspective of developing a more sustainable tunnelling construction process. In this study, the potential reuse of WBS as a complete replacement for bentonite in two-component grout formulations used for TBM backfilling is explored. A comprehensive laboratory testing program is conducted, in which the effects of WBS on the properties of two-component grout (unit weight, viscosity, bleeding, gel time, and mechanical strength) are assessed after various curing times, and the outcomes are compared with standard values commonly given in technical specifications. WBS produced from two different commercial bentonites is investigated. The results show that while the first formulation exhibits rapid setting and irregular gelation, the mix derived from the second bentonite demonstrates superior mechanical performance, increasing compressive strength by up to 40%. This enhancement is primarily governed by a physical filler effect, where fine soil particles optimize packing density and refine the microstructure. Consequently, the incorporation of selected types of WBS into a two-component grout could be a practicable approach, since it offers benefits in terms of mechanical performance, although careful mix design would be required to manage workability. This study shows how tunnelling can become more sustainable by reusing excavation waste and transforming it into a useful by-product. Full article

Background: The antibiotic ibezapolstat and the live biotherapeutic product live-JSLM are promising future approaches for treating Clostridioides difficile infection. Ibezapostat is a highly specific antibiotic for Clostridioides difficile, with minimal impact on the intestinal flora. Live-JSLM is designed to restore healthy intestinal microbiota, thus preventing recurrence of Clostridioides difficile infection. In this narrative review, we reviewed available data on ibezapostat and live-JSLM, considering that they are prototypes of two distinct, unique mechanisms of action against Clostridioides difficile. Methods: Data sources: PubMed and SCOPUS databases were searched from 1 January 2012 to 15 November 2025. Original articles reporting data on ibezapolstat and live-JSLM were included. Results: 31 studies were included. When compared to conventional anti-Clostridioides difficile antibiotics, ibezapolstat had a similar level of effectiveness and minimal impact on the gut microbiota. The available data confirm live-JSLM safety and efficacy in restoring the gut microbiota following the conclusion of the standard anti-Clostridioides difficile antibiotic regimen. Conclusions: The results on ibezapolstat efficacy are promising, but require confirmation in larger patient populations through double-blind, randomised phase III trials. In the near future, an integrated approach may enhance the management of Clostridioides difficile infection: starting with highly specific antibiotics, i.e., ibezapolstat, followed by microbiome-based therapies such as live-JSLM. Full article

Pyrolysis of refuse-derived fuel (RDF) is a promising waste-to-energy route, but its use in higher-value applications remains limited by tar carryover, benzene, toluene, ethylbenzene, and xylenes (BTEX), heteroatom-containing compounds, and pollutant accumulation in recirculated scrubber water. This study evaluated operating windows for RDF pyrolysis coupled with direct wet scrubbing and closed-loop water reuse, with the aim of identifying regimes suitable for different end-use tiers. A Taguchi L27 design of experiments (DOE), i.e., an orthogonal array comprising 27 experimental runs, was applied to evaluate the effects of pyrolysis temperature, residence time, scrubber liquid-to-gas ratio, and scrubber-water temperature, while sequential reuse of the same scrubber-water inventory was evaluated at 5, 10, and 15 cycles. Cleaned-gas pollutants were quantified by compound-resolved gas chromatography–mass spectrometry (GC–MS) after solid-phase adsorption (SPA) sampling, while phenolics and polycyclic aromatic hydrocarbons (PAHs) in scrubber water were determined by extraction followed by GC–MS. Feasibility within each end-use tier was defined as simultaneous satisfaction of tier-specific cleaned-gas thresholds (C_tar, C_BTEX, I_N, and I_S) and the corresponding water-loop hazard limit (I_tox), using literature-informed engineering screening criteria. The results showed that stronger scrubbing reduced gas-phase tar and BTEX burdens, whereas extended water reuse caused systematic accumulation of phenolics and PAHs and increased the composite water-loop hazard index. Boiler-grade operation remained feasible across a broad operating range, with 23 of the 27 tested conditions remaining robust, whereas internal combustion engine combined heat and power (ICE-CHP) feasibility was restricted to a narrow robust regime, and no robust microturbine-grade condition was identified. These findings show that operating windows for RDF pyrolysis must be defined jointly by gas cleanliness and water-loop management constraints. Full article