Search Results (4,403)

This study presents a comprehensive analysis of the modeling and optimization of sensor installation nodes for weight measurement in the hoppers of a charging car utilized in coke production. The research highlights the critical role of precise load monitoring in preventing technological disruptions, minimizing equipment degradation, and optimizing energy consumption. Conventional sensor technologies, including capacitive, ultrasonic, and laser-based systems, are evaluated, with weight sensors mounted on hopper supports identified as the most robust solution for real-time mass determination under industrial conditions characterized by high dust levels, temperature fluctuations, and mechanical vibrations. A finite element analysis (FEA) was conducted to assess the structural behavior of sensor installation nodes under three distinct loading scenarios, corresponding to different operational conditions of the charging car. The four-point support structure of the hopper experienced the highest loads and non-uniformities. A stress–strain analysis of the sensor mounting assembly, performed using the Ansys software package, confirmed that both the sensor and its support structure maintain a sufficient safety margin (version 2024 R1, Ansys Inc., Canonsburg, PA, USA, the academic license provided to Wrocław University of Science and Technology). The findings validate the structural integrity and operational reliability of the proposed sensor configuration, contributing to the advancement of automated monitoring and control systems in coke production. Full article

The scheduling of crude oil operations in marine refineries is a complex combinatorial problem, exacerbated by stochastic disruptions like vessel delays and port congestion. Traditional deterministic and expected-value approaches fail to mitigate high-impact tail events, causing severe demurrage and production bottlenecks. To address this, we propose a novel CVaR-Driven Reactive GRASP Simheuristic. This framework hybridizes GRASP with Monte Carlo simulation, embedding Conditional Value-at-Risk (CVaR) into the adaptive memory to actively steer the search away from catastrophic logistical gridlocks. Overcoming standard “unlimited port capacity” assumptions, the model endogenously calculates demurrage dynamics and introduces an automated Failure Taxonomy for explainable insights. Evaluated on a 30-day industrial case study, representing a standard short-term operational scheduling horizon, under baseline conditions and severe dynamic disruptions (vessel delays, unit maintenance), the diagnostic reveals that over 80% of scheduling failures stem from endogenous port congestion rather than internal dead-ends. Furthermore, a comprehensive ablation study mathematically validates the superiority of the CVaR-driven memory over standard expected-cost optimization in preventing catastrophic tail-risk scenarios. Results demonstrate that this CVaR-driven approach effectively absorbs stochastic shocks, prevents stockouts, and minimizes worst-case costs, generating highly robust schedules in under three minutes. Ultimately, it provides a robust, risk-aware Decision Support System (DSS) for supply chain and operations managers. Full article

Background: Fear of malpractice and its potential legal, financial, and reputational consequences are associated with one of the most complex phenomena in the medical community: defensive medical practice (DMP). DMP is frequently analyzed in the specialized literature from the physician’s perspective; however, the patient’s role in triggering and maintaining defensive behaviors remains under-explored. Methods: This cross-sectional study examined contextual factors associated with fear of malpractice and the convergences between doctors’ and patients’ perspectives within a bilateral model (error–fear–perceived risk–prevention behaviors), without assuming direct causal relationship. Two questionnaires were administered in Romania to 240 dentists (March–June 2023) and 344 patients (June–December 2023). Associations were tested with chi-square and Fisher’s exact tests (reporting Cramér’s V and odds ratios), multivariate binary logistic regression, and post hoc power analysis. Results: Over half of dentists (53.3%) reported fear of malpractice despite minimal actual legal exposure (0.8%); this fear was associated with awareness of its potential consequences and perceiving patients as more demanding. In multivariate analysis, fear was the strongest independent predictor of perceiving patients as a threat (aOR = 3.98, 95% CI [1.67–9.48]). On the patient side, 57.9% would avoid a dentist with a known malpractice case and 34.0% had requested additional procedures for reassurance. Conclusions: The interaction between physician fear and patient pressure suggests the existence of a “reassurance loop”, in which the patient’s need for safety and the doctor’s fear can mutually reinforce each other, fostering defensive behaviors. We propose an exploratory typology of patient-induced DMP—direct induction (explicit requests for additional investigations/procedures) and indirect induction (relational pressure and reassurance seeking)—to guide future research. By integrating the dentist and patient perspectives within a bilateral model, the study provides a context-specific account of patient-induced defensive practice in Romanian dentistry and identifies dual-target educational interventions (addressing both clinician communication and patient health literacy) as a potential preventive direction. Full article

Failure Mode and Effect Analysis (FMEA) is a widely applied preventive risk assessment approach to enhance product reliability and safety, yet its structural validity is frequently questioned. Existing improvement models generally overlook the interrelationships among failure modes and suffer from high uncertainty and instability in opinion aggregation, risk factor weight allocation, and Risk Priority Number (RPN) computation. To bridge these gaps, this study proposes an integrated decision-making model. First, the Decision Making and Trial Evaluation Laboratory (DEMATEL) method is employed to analyze interactions among failure modes, constructing an influential network diagram to identify critical items. Second, a Rough Dombi Aggregator is applied for opinion aggregation, minimizing data loss and handling uncertainties from experts’ diverse backgrounds. Third, the Full Consistency Method (FUCOM) is utilized to determine the relative weights of risk factors. Finally, four weighted aggregation methods are developed to calculate RPNs, mitigating the instability common in traditional methods. This vehicle power system case study, alongside model comparison and sensitivity analysis, demonstrates the model’s effectiveness and robustness. The results indicate that across 9 different weight fluctuation scenarios, the core high-risk item “FM₇: Generator coil burned out due to short circuit” consistently ranks 1st. This highlights the exceptional stability of the proposed model in overcoming evaluation fluctuations. Ultimately, this integrated framework not only enhances the accuracy and robustness of failure mode prioritization but also serves as a valuable practical reference for engineers formulating preventive maintenance strategies under limited resources. Full article

Robust estimation of camera trajectories from unconstrained image sequences remains a fundamental problem in computer vision and robotics. Recently, a diffusion-based camera tracking network has shown strong performance in sparse-view and single-object-centric settings, where a consistent object is observed across frames. However, when multiple objects appear sequentially in a video, the initially observed object may disappear as the sequence progresses, which prevents maintaining the “single-object-centric” paradigm across all frames and degrades pose estimation when the conventional method is applied to the multi-object sequence. In this work, we propose an object-centric camera pose estimation framework that handles such sequences by partitioning a video into object-level sub-scenes. As a baseline network, Ray Diffusion is applied to single-object sub-scenes, while frame-to-frame camera motion in multi-object sub-scenes is estimated using monocular video depth, object masks, and point cloud alignment using Iterative Closest Point (ICP). Since the domain of pose estimation from different sub-scenes is inconsistent in terms of pose scale, it requires seamless concatenation of pose estimation results through all sub-scenes. In this regard, we introduce a scale alignment strategy based on reprojection error minimization. This enables the pose estimates from individual sub-scenes to be integrated into a single and seamless camera trajectory. We evaluate the proposed method on a newly collected indoor dataset consisting of 40 multi-object video sequences. Experimental results compare our camera trajectory estimation with both the diffusion-based method and the state-of-the-art visual SLAM methods. Full article

The aging of social infrastructure, intensively constructed during periods of rapid economic growth, is a pressing challenge facing modern society. Conventional infrastructure asset management has disproportionately emphasized a “managerial financial perspective,” aiming to maintain physical functions within limited budgets. However, the malfunction of road appurtenances such as tunnel lighting facilities induces severe traffic accidents and chronic congestion, resulting in public health risks for users (physical trauma, psychological stress, and the deterioration of Disability-Adjusted Life Years: DALYs) as well as massive socio-economic losses. The primary novelty of this study lies in bridging the gap between stochastic engineering deterioration models—specifically, discrete-time Markov chain models predicting physical degradation—and socio-economic stakeholder value chains. This study constructs a “Social Life Cycle Cost (LCC) Optimization Model” that directly incorporates these social losses and stakeholder risk disparities into the evaluation function, addressing the limitations of conventional financial-centric LCC models. By conducting robust uncertainty and global sensitivity analyses via large-scale Markov Chain Monte Carlo simulations (number of trials $N={10}^5$), we reveal that a corrective maintenance strategy inheres a critical “fat-tail risk” of stochastically incurring catastrophic social losses. Conversely, preventive intervention at State C minimizes the expected total cost with statistical significance ($p<0.001$) and drastically decouples engineering costs from social risks. This research provides quantitative evidence that early infrastructure intervention functions as an indispensable “social investment” for mitigating public health risks under the specific parameters of the proposed model. Full article

Pernicious anemia (PA) represents a significant diagnostic challenge in neuropsychiatric patients due to its subtle and variable presentation. While PA is traditionally associated with clinical and biochemical manifestations of anemia, many patients, particularly those with neuropsychiatric symptoms, may have normal hematologic parameters, delaying recognition and appropriate treatment. Neurological and psychiatric symptoms, ranging from cognitive impairment and mood disorders to subacute combined degeneration (SCD) of the spinal cord, can precede hematologic abnormalities, leading to misdiagnosis or inappropriate management. The lack of a definitive gold standard test for cobalamin deficiency (CD) further complicates identification. Commonly used biomarkers, such as serum cobalamin, methylmalonic acid (MMA), homocysteine (Hcy), intrinsic factor antibodies (IFAs), and parietal cell antibodies (PCAs), each have limitations in diagnosing PA, especially in the absence of overt anemia. The variability in diagnostic criteria and cutoff values across studies adds to the challenge of achieving early and accurate diagnosis. This article reviews the complexities of diagnosing PA in neuropsychiatric patients, evaluates the limitations of current diagnostic methods, and emphasizes the need for a more comprehensive, standardized approach to early detection and treatment. Combining clinical awareness with improved biomarker interpretation is essential for preventing irreversible neurological damage and improving patient outcomes. Improved diagnostic protocols and further research are essential to optimize detection and minimize the risk of long-term neurological damage. Full article

Objectives: The incidence of distal gastric cancer has declined worldwide owing to successful Helicobacter pylori eradication and improvements in environmental and dietary factors. In contrast, adenocarcinoma of the esophagogastric junction (AEG) and proximal gastric cancer have become increasingly prevalent, creating a growing need for function-preserving surgical approaches. Proximal gastrectomy has emerged as an attractive alternative to total gastrectomy because of its potential advantages in nutritional preservation and postoperative quality of life. However, concerns regarding postoperative reflux esophagitis have historically limited its widespread adoption. This review aimed to summarize the evolution of reconstruction after proximal gastrectomy and evaluate the advantages, limitations, and clinical outcomes of contemporary reconstruction techniques. Methods: A narrative review of the current literature was performed, focusing on reconstruction strategies following proximal gastrectomy. Major contemporary techniques, including double-tract reconstruction (DTR), double-flap reconstruction (DFT; Kamikawa method), side-overlap fundoplication by Yamashita (SOFY), and Toupet-like fundoplication reconstruction, were reviewed. Comparative evidence regarding reflux control, nutritional outcomes, operative complexity, anastomotic complications, and postoperative quality of life was examined. Results: Substantial advances in reconstructive techniques have significantly improved functional outcomes after proximal gastrectomy. DTR provides reliable reflux prevention, reproducibility, and broad applicability in minimally invasive surgery. DFT achieves excellent anti-reflux efficacy while preserving physiological food passage through the remnant stomach. SOFY offers favorable functional outcomes with reduced technical complexity and is particularly suited to laparoscopic and robotic surgery. Toupet-like reconstruction represents a promising alternative with encouraging early clinical results. Comparative studies indicate that all contemporary anti-reflux reconstruction methods substantially reduce reflux esophagitis compared with conventional esophagogastrostomy. Although each technique demonstrates specific advantages and limitations, no single reconstruction method has consistently shown superiority across all clinically relevant outcomes, including reflux prevention, nutritional preservation, operative complexity, and quality of life. Conclusions: Modern reconstruction techniques have expanded the role of proximal gastrectomy as a function-preserving alternative to total gastrectomy for proximal gastric cancer and AEG. Current evidence suggests that DTR, DFT, SOFY, and Toupet-like reconstruction can all achieve satisfactory oncological and functional outcomes when appropriately applied. Rather than identifying a universally superior procedure, contemporary practice should emphasize individualized reconstruction based on patient characteristics, surgeon expertise, and institutional experience. Future advances in robotic surgery, perioperative care, and standardized outcome assessment are expected to further optimize long-term outcomes following proximal gastrectomy. Full article

Odontogenic cutaneous sinus tracts represent an uncommon clinical manifestation of chronic dental infection and are frequently misdiagnosed due to the absence of dental symptoms and their resemblance to dermatologic lesions. This case report describes the nonsurgical endodontic management of a cutaneous sinus tract of dental origin in a 13-year-old patient. The patient presented with a persistent extraoral lesion in the mandibular region, initially evaluated by non-dental specialists. Clinical and radiographic examination revealed a necrotic mandibular first molar associated with a periapical radiolucency and intraoral sinus tract. Nonsurgical root canal treatment was performed using chemomechanical debridement with sodium hypochlorite irrigation and calcium hydroxide as an intracanal medicament. Complete obturation was achieved following resolution of intracanal exudation. No surgical intervention of the cutaneous lesion was undertaken. Progressive healing of the periapical lesion and spontaneous resolution of the extraoral sinus tract were observed over a 6-month follow-up period. This case is noteworthy because it combines a prolonged diagnostic delay, an atypical extraoral manifestation in a child, and successful resolution by nonsurgical endodontic therapy alone without surgical excision of the cutaneous lesion. The 6-month follow-up confirms sustained clinical and radiographic healing, underscoring the importance of early recognition and conservative management in pediatric patients. Early identification and elimination of the dental source can prevent unnecessary surgical procedures and minimize the risk of permanent scarring. Full article

Hydrophobic and superhydrophobic surfaces have emerged as key solutions for fluid transport, biofouling prevention, and energy efficiency, with market forecasts projecting a compound annual growth rate (CAGR) of over 15% through 2030 due to their broad range of applications. This review critically examines the principles of natural hydrophobicity, as exemplified by lotus leaves and shark skin, and their translation into engineered surfaces via micro/nanofabrication techniques, such as laser patterning, etching, and self-assembly. Recent advances in hybrid nanomaterials have demonstrated WCAs in the range of 140–160°, along with enhanced mechanical strength and chemical stability, enabling applications in self-cleaning, anti-corrosion, and oil–water separation technologies. Superhydrophobic coatings are particularly important for reducing ice adhesion by more than 80%, while drag reduction in pipelines can reach up to 30%, contributing to energy savings. Despite these advances, challenges remain in achieving long-term stability under harsh environmental conditions, minimizing environmental impact, and developing cost-effective, scalable fabrication techniques. Future directions focus on environmentally friendly, multifunctional nanocomposites with switchable wettability, including pH- and light-responsive coatings capable of reversibly transitioning between superhydrophilic (<5°) and superhydrophobic (>150°) states, paving the way for sustainable and adaptable surface technologies. Full article

Background and Objectives: This study aims to evaluate easily accessible clinical and laboratory parameters in older adults presenting with nontraumatic abdominal pain and to explore factors associated with significant findings on abdominal computed tomography (CT). The goal is to help prevent diagnostic delays and reduce emergency department (ED) length of stay by minimizing unnecessary testing. Materials and Methods: This retrospective cohort study evaluated patients aged 65 years and older presenting to a high-volume tertiary ED with acute nontraumatic abdominal pain who underwent abdominal CT between January 2020 and January 2022. To maintain data integrity in a crowded ED environment, only patients with complete medical documentation were enrolled. Based on objective radiological outcomes from official reports, patients were categorized into two groups: those with Acute Pathological CT Findings (acute intra-abdominal pathology explaining the presentation) and those with Non-Acute/Negative CT Findings (normal scans, chronic, incidental, or extra-abdominal findings). Multivariable logistic regression was performed to identify independent predictors of acute pathological findings. Results: A total of 503 patients were included, of whom 178 (35.3%) had Acute Pathological CT Findings. Univariable analyses showed that elevated Alanine Aminotransferase (ALT), total bilirubin, and Gamma-Glutamyl Transferase (GGT) were significantly associated with acute pathological findings, whereas higher levels of Blood Urea Nitrogen (BUN), creatinine, and troponin were more prevalent in the Non-Acute/Negative CT Findings group. Conclusions: Despite the identified associations, a reliable predictive model could not be established; therefore, CT is considered to remain a fundamental tool for accurate diagnosis in older adults. Full article

Background: Although pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, identifying individuals who may benefit from PrEP and delivering personalized prevention recommendations remain challenging in routine and digital health settings. Objective: This study aimed to develop and preliminarily evaluate an integrated artificial intelligence framework combining machine learning (ML) for HIV risk stratification and generative artificial intelligence (GenAI) for personalized PrEP recommendation support. Methods: A curated dataset of 2000 de-identified client profiles from Love2Test platform was used for proof-of-concept model development. Profiles were labeled as low or high HIV acquisition risk by domain experts based on structured behavioral information. Multiple ML classifiers were trained and compared using PyCaret. The selected model was integrated with a generative AI model through structured prompting to generate personalized PrEP recommendation content. The integrated framework was evaluated through structured physician assessment by four independent medical doctors. Results: The selected model showed strong internal discrimination for classifying high versus low HIV acquisition risk. The integrated framework also received favorable physician evaluation for clinical accuracy, explanation validity, contextual relevance, and error minimization across fixed and randomly selected profiles. However, because expert labeling was based on structured behavioral indicators closely related to the model inputs, the high internal performance should be interpreted within the context of this proof-of-concept study. Conclusions: The proposed framework provides a structured approach to support HIV risk stratification and personalized PrEP recommendations in a clinician-aligned manner. However, this study was an offline proof-of-concept and did not directly evaluate patient interaction, PrEP uptake, stigma, adherence, or clinical outcomes. Prospective studies using larger and more representative real-world datasets are needed to assess implementation, generalizability, and impact on service engagement and PrEP initiation. Full article

This study, based on phase equilibrium theory, uses reservoir crude oil systems as the research object and adopts the Perturbed Chain-Statistical Associating Fluid Theory (PC-SAFT) equation of state. By combining the Panuganti characterization method with the three-phase Rachford–Rice algorithm, an integrated RRPC-SAFT engineering workflow is established, which effectively addresses the drawbacks of traditional PC-SAFT models, including low computational efficiency and poor convergence under extreme working conditions. On this basis, systematic performance comparisons are conducted between the RRPC-SAFT workflow and classical cubic equations of state (PR and SRK). Furthermore, the asphaltene phase behavior under gas injection development conditions is simulated, and the quantitative effects of the four SARA fractions on the critical precipitation conditions and precipitation intensity of asphaltenes are determined, clarifying the evolution rules and main controlling factors of asphaltene phase instability under various development scenarios. The research results reveal that the average relative errors of bubble point pressure and asphaltene onset precipitation pressure (AOP) for the three crude oil samples are all less than or equal to 5%. Compared with the PR and SRK models, the average prediction errors are reduced by 1.27% and 2.01%, respectively. Gas injection simulation results demonstrate that nitrogen poses the highest risk of triggering asphaltene precipitation under equimolar injection, with the asphaltene onset precipitation pressure increasing up to 114.94%. Single-factor analysis of SARA fractions verifies that saturates and asphaltenes aggravate precipitation, while aromatics and resins suppress asphaltene destabilization. In terms of computational efficiency, the computational speed of the RRPC-SAFT algorithm is four times higher than that of the traditional Gibbs free energy minimization algorithm. This model can be applied to calculate the thermodynamic critical equilibrium conditions of asphaltene precipitation, providing a thermodynamic basis for early screening of asphaltene deposition risks, optimization of gas injection schemes, and design of deposition prevention and control technologies. Full article

Objectives: An ideal cardiotoxicity inhibitor targeting the angiotensin (Ang) II type 1 (AT₁) receptor would be a β-arrestin-biased orthostatic ligand, which inhibits the G protein pathway and activates the β-arrestin pathway. Therefore, this study examined seven Ang II mimetic peptides (MP1–7), Ang A and TRV027 as potential β-arrestin-biased AT₁ receptor ligands to prevent doxorubicin (Dox)-induced cardiotoxicity. Methods: Competition binding study, inositol phosphate (IP) production assay and extracellular signal-regulated kinase (ERK) 1/2 activation were performed using COS7 cells. Changes in phosphorylated Akt (Ser473), c-Jun N-terminal kinase (JNK) (Thr183/Tyr185), Bad (Ser112), Bcl-2 (Ser70), p53 (Ser46), active caspase-8 (Asp384) and active caspase-9 (Asp315) in cell lysates were measured using AT₁ receptor-transfected H9C2 cells. Results: Binding assays showed Ang II and Ang A had the highest affinity, with MP2 and MP7 similar to TRV027. IP production was strong for Ang II and Ang A, minimal for MP1 and MP7, and no stimulation for MP2 and TRV027. Ang II and Ang A significantly activated ERK1/2 in this cell system. MP2 and MP7 in addition to TRV027 also significantly activated ERK1/2, whereas MP1 did not activate it. Dox-activated JNK and Bad, while Ang A, TRV027, MP2, and MP7 inhibited JNK activation without affecting Bad or Akt. Conclusions: MP2, which is a candidate biased ligand for the AT₁ receptor and has similar amino acid sequence to TRV027, along with TRV027, attenuated Dox-induced JNK activation while avoiding excessive G protein-mediated activation. Interestingly, MP7, which showed minimal G protein-mediated activation with β-arrestin-mediated ERK activation, also attenuated Dox-induced JNK activation, a marker of pro-apoptotic stress signaling. Full article

Background/Objectives: Although contemporary preventive concepts are well established in dentistry, their consistent integration into routine clinical practice remains uncertain. This study aimed to assess how preventive strategies are understood and applied in daily dental practice, and to explore the relationship between clinicians’ level of familiarity with preventive concepts and their implementation in patient care. Materials and Methods: A cross-sectional survey was conducted among 202 practicing dentists between October 2024 and May 2025 using a structured, anonymous questionnaire comprising 34 items. The instrument explored professional characteristics, knowledge of preventive concepts, clinical decision-making, use of fluoride-based interventions and minimally invasive approaches, and familiarity with risk-based systems. Data were analyzed using descriptive statistics and chi-square and Fisher’s exact tests (p < 0.05). Results: Most respondents reported moderate to high familiarity with contemporary preventive concepts, particularly remineralization and fluoride-based prevention. Preventive measures were commonly used; however, their implementation was often not structured. Formal caries risk assessment was routinely or often performed by 69.3% of clinicians, yet structured systems such as CAMBRA were routinely or often used by only 19.8%. Continuing professional education was significantly associated with greater use of preventive technologies (p = 0.018), and the use of structured risk assessment was associated with risk-based restorative decision-making (p = 0.041). Conclusions: Respondents reported a high level of familiarity with preventive concepts, but their application appeared inconsistent and frequently unstructured. These findings highlight a persistent gap between familiarity and implementation and point toward the need for clinically feasible, structured approaches that can support preventive decision-making in routine care. Full article