Search Results (196,755)

Croatian agricultural legislation acknowledges the significance of radionuclides as pollutants in agricultural lands; however, it lacks specific thresholds or reference values for contamination levels, in contrast to other contaminants. This absence highlights the necessity for a comprehensive assessment of radionuclides across various agricultural systems in Croatia. This study investigates the transfer of radionuclides ¹³⁷Cs and ⁴⁰K from soil to agricultural crops throughout Croatia and estimates the consequent annual ingestion dose for the population. The samples collected comprised food crops and animal feed, with corresponding soil samples analyzed to calculate transfer factors. Activity concentrations of ¹³⁷Cs exhibited regional and crop-type variability, reflecting the uneven distribution of fallout and differing soil properties. Transfer factors were found to range from 0.003 to 0.06 for ¹³⁷Cs and from 0.15 to 3.1 for ⁴⁰K, with the highest uptake occurring in kidney beans. The total estimated annual effective ingestion dose was calculated to be a maximum of 0.748 mSv/year for children aged 2–7, predominantly attributable to ⁴⁰K. Given the homeostatic regulation of potassium in the human body, the dose associated with ¹³⁷Cs poses a more significant radiological concern. These findings underscore the need for radionuclide-specific agricultural legislation in Croatia and offer a baseline for recommending reference values and informing future regulations regarding agricultural soil contamination. Full article

Leptospirosis is a globally significant zoonosis affecting animal health, productivity, and the environment. While typically associated with tropical climates, its persistence in semi-arid regions such as La Laguna, Mexico—characterized by low humidity, high temperatures, and limited water sources—remains poorly understood. Although these adverse environmental conditions theoretically limit the survival of Leptospira, high livestock density and synanthropic reservoirs (e.g., rodents) may compensate, facilitating transmission. In this cross-sectional study, blood sera from 445 dairy cows (28 herds: 12 intensive [MI], 16 semi-intensive [MSI] systems) were analyzed via microscopic agglutination testing (MAT) against 10 pathogenic serovars. Urine samples were cultured for active Leptospira detection. Risk factors were assessed through epidemiological surveys and multivariable analysis. This study revealed an overall apparent seroprevalence of 27.0% (95% CI: 22.8–31.1), with significantly higher rates in MSI (54.1%) versus MI (12.2%) herds (p < 0.001) and an estimated true seroprevalence of 56.3% (95% CI: 50.2–62.1) in MSI and 13.1% (95% CI: 8.5–18.7) in MI herds (p < 0.001). The Sejroe serogroup was isolated from urine in both systems, confirming active circulation. In MI herds, rodent presence (OR: 3.6; 95% CI: 1.6–7.9) was identified as a risk factor for Leptospira seropositivity, while first-trimester abortions (OR:10.1; 95% CI: 4.2–24.2) were significantly associated with infection. In MSI herds, risk factors associated with Leptospira seropositivity included co-occurrence with hens (OR: 2.8; 95% CI: 1.5–5.3) and natural breeding (OR: 2.0; 95% CI: 1.1–3.9), whereas mastitis/agalactiae (OR: 2.8; 95% CI: 1.5–5.2) represented a clinical outcome associated with seropositivity. Despite semi-arid conditions, Leptospira maintains transmission in La Laguna, particularly in semi-intensive systems. The coexistence of adapted (Sejroe) and incidental serogroups underscores the need for targeted interventions, such as rodent control in MI systems and poultry management in MSI systems, to mitigate both zoonotic and economic impacts. Full article

Glioblastoma (GBM) is the most aggressive primary brain tumor, characterized by rapid progression, profound heterogeneity, and resistance to conventional therapies. This review provides an integrated overview of GBM’s pathophysiology, highlighting key mechanisms such as neuroinflammation, genetic alterations (e.g., EGFR, PDGFRA), the tumor microenvironment, microbiome interactions, and molecular dysregulations involving gangliosides and sphingolipids. Current diagnostic strategies, including imaging, histopathology, immunohistochemistry, and emerging liquid biopsy techniques, are explored for their role in improving early detection and monitoring. Treatment remains challenging, with standard therapies—surgery, radiotherapy, and temozolomide—offering limited survival benefits. Innovative therapies are increasingly being explored and implemented, including immune checkpoint inhibitors, CAR-T cell therapy, dendritic and peptide vaccines, and oncolytic virotherapy. Advances in nanotechnology and personalized medicine, such as individualized multimodal immunotherapy and NanoTherm therapy, are also discussed as strategies to overcome the blood–brain barrier and tumor heterogeneity. Additionally, stem cell-based approaches show promise in targeted drug delivery and immune modulation. Non-conventional strategies such as ketogenic diets and palliative care are also evaluated for their adjunctive potential. While novel therapies hold promise, GBM’s complexity demands continued interdisciplinary research to improve prognosis, treatment response, and patient quality of life. This review underscores the urgent need for personalized, multimodal strategies in combating this devastating malignancy. Full article

Background/Objectives: Maternal overweight and obesity are critical factors increasing the risk of various pregnancy complications. Maternal obesity can lead to fetal macrosomia and a heightened risk of intrauterine death, with long-term implications for the child’s health. This study aimed to analyze the incidence of obesity and its impact on pregnancy outcomes in women who delivered by cesarean section at the University Hospital “St. George”, Plovdiv. Methods: A single-center retrospective cohort study was conducted. The documentary method was used for gathering data. Records were randomly selected. The statistical methods used included mean values, confidence intervals (of mean), frequency, and the Kolmogorov–Smirnov test for normality of distribution. Data comparisons were performed using the Mann–Whitney test. Mean values of numerical variables were compared using the independent samples t-test. Results: In total, 46.36% of women in this study were affected by obesity to varying degrees, and the proportion of women who were overweight at the end of their pregnancy was 37.85%. In the studied cohort, 15.99% of women were affected by hypertensive complications. This significant prevalence of obesity highlights concerns regarding body weight among women of reproductive age. This study emphasized a strong correlation between maternal obesity, particularly severe obesity, and the occurrence of preeclampsia. Conclusions: In this study among women who delivered by cesarean section, a significant proportion of them were affected by overweight and obesity. Data for our country are insufficient, and a more in-depth study of this problem is needed. Future research should explore the long-term impacts of maternal obesity on the health of the mother and the newborn. Full article

We need to educate students and the public about addressing natural resource challenges to maintain civilization moving into a sustainable future. Because US mineral and energy resources are found in its continental crust and sedimentary basins, introductory geology students need to be well-informed about US crust and basins. We think that creating effective videos about these topics is the best way to engage students to want to learn more. In preparation for making these videos, we researched what introductory geology students are taught and what they learn about these topics. Student interviews informed us about learned curriculum, and taught curriculum was analyzed using a novel keyword-counting method applied to textbook indices. We found that geophysics is stressed twice as much as geology, radiometric dating, and sedimentary basins. We expected that students would have learned more about geophysics and less about the other topics; however, this was not the case. Students knew more about geology, and less about geophysics, radiometric dating, and sedimentary basins. To make effective videos on these topics, we need to explain the following threshold concepts: seismic refraction to scaffold student understanding of crustal geophysics, as well as radiometric dating and deep time to understand crustal geology and the economic importance of sedimentary basins. Full article

Background: Aortic stenosis (AS) is the most common valvular heart disease, associated with poor outcomes if left untreated. Current guidelines recommend that transcatheter aortic valve implantation (TAVI) procedures be performed in hospitals with an on-site cardiac surgery unit due to potential complications requiring surgical intervention. Objective: Based on our experience, we evaluated the feasibility and outcomes of implementing a TAVI program in a cardiology department without an on-site cardiac surgery unit, in collaboration with a remote hospital for surgical backup. Methods: The TAVI program involved pre- and post-procedural evaluations conducted at Meir Medical Center (Kfar Saba, Israel) with a remote surgical team available. The study population included 149 consecutive patients with severe aortic stenosis treated at the Meir valve clinic between November 2019 and December 2023. Procedures were performed by the center’s interventional cardiology team. Results: The mean age of the 149 patients was 80 ± 6 years, and 75 (50%) were female. The average STS score was 4.3, and the EuroSCORE II was 3.1. Among the patients, 68 (45%) were classified as New York Heart Association (NYHA) class III-IV. The valve types used included ACURATE neo2 (57 patients, 38%), Edwards SAPIEN 3 (43 patients, 28%), Evolut-PRO (41 patients, 27%), and Navitor (7 patients, 4%). There were no cases of moderate to severe paravalvular leak and no elevated post-implantation gradients, and there was no need for urgent cardiac surgery. One case of valve embolization was successfully managed percutaneously during the procedure. In-hospital follow-up revealed no deaths and only one major vascular complication. At one-year follow-up, six patients had died, with only one death attributed to cardiac causes. Conclusions: Our findings support the safe and effective performance of transfemoral TAVI in cardiology departments without on-site cardiac surgery, in collaboration with a remote surgical team. Further prospective, multicenter studies are warranted to confirm these results and guide broader clinical implementation of this practice. Full article

Background/Objectives: Evidence-based nursing practice (EBNP) is essential in high-acuity settings such as intensive care units (ICUs) and emergency departments (EDs), where nurses are frequently required to make time-critical, high-stakes clinical decisions that directly influence patient safety and outcomes. Despite its recognized importance, the implementation of EBNP remains inconsistent, with frontline nurses often facing barriers to accessing and applying current evidence. Methods: This descriptive, cross-sectional study systematically mapped and prioritized clinical questions generated by ICU and ED nurses at a tertiary hospital in South Korea. Using open-ended questionnaires, 204 clinical questions were collected from 112 nurses. Each question was coded and classified according to the Nursing Interventions Classification (NIC) taxonomy (8th edition) through a structured cross-mapping methodology. Inter-rater reliability was assessed using Cohen’s kappa coefficient. Results: The majority of clinical questions (56.9%) were mapped to the Physiological: Complex domain, with infection control, ventilator management, and tissue perfusion management identified as the most frequent areas of inquiry. Patient safety was the second most common domain (21.6%). Notably, no clinical questions were mapped to the Family or Community domains, highlighting a gap in holistic and transitional care considerations. The mapping process demonstrated high inter-rater reliability (κ = 0.85, 95% CI: 0.80–0.89). Conclusions: Frontline nurses in high-acuity environments predominantly seek evidence related to complex physiological interventions and patient safety, while holistic and community-oriented care remain underrepresented in clinical inquiry. Utilizing the NIC taxonomy for systematic mapping establishes a reliable framework to identify evidence gaps and support targeted interventions in nursing practice. Regular protocol evaluation, alignment of continuing education with empirically identified priorities, and the integration of concise evidence summaries into clinical workflows are recommended to enhance EBNP implementation. Future research should expand to multicenter and interdisciplinary settings, incorporate advanced technologies such as artificial intelligence for automated mapping, and assess the long-term impact of evidence-based interventions on patient outcomes. Full article

Nanofluids are an innovative working medium in solar hot water installations (DHWs), thanks to their increased thermal conductivity and heat transfer coefficient. The aim of this work was to assess the effect of Al₂O₃ nanofluids in a water–ethylene glycol base (40:60%) and with the addition of Tween 80 surfactant (0.2 wt%) on thermal efficiency (ε) and exergy (η_ex) in a plate heat exchanger at DHW flows of 3 and 12 L/min. The numerical NTU–ε model was used with dynamic updating of thermophysical properties of nanofluids and the solution of the ODE system using the ode45 method, and the validation was carried out against the literature data. The results showed that the nanofluids achieved ε ≈ 0.85 (vs. ε ≈ 0.87 for the base fluid) and η_ex ≈ 0.72 (vs. η_ex ≈ 0.74), with higher entropy generation. The addition of Tween 80 reduced the viscosity by about 10–15%, resulting in a slight increase of Re and h-factor; however, the impact on ε and η_ex was marginal. The environmental analysis with an annual demand of Q = 3000 kWh/year and an emission factor of 0.2 kg CO₂/kWh showed that for ε < 0.87 the nanofluids increased the emissions by ≈16 kg CO₂/year, while at ε ≈ 0.92, a reduction of ≈5% was possible. This paper highlights the need to optimize nanofluid viscosity and exchanger geometry to maximize energy and environmental benefits. Nowadays, due to the growing problems of global warming, the analysis of energy efficiency and carbon footprint related to the functioning of a building seems to be crucial. Full article

Background/Objectives: In recent years, the discharge of antibiotics into rivers and irrigation canals has increased. However, few studies have addressed the impact of these compounds on agricultural fields that use such water to meet crop demands. Methods: In this study, the transport of two types of gentamicin (pure gentamicin and gentamicin sulfate) was modeled at concentrations of 150 and 300 μL/L, respectively, in a soil with more than 60 years of agricultural use. Infiltration tests under constant head conditions and gentamicin transport experiments were conducted in acrylic columns measuring 14 cm in length and 12.7 cm in diameter. The scaling parameters for the Richards equation were obtained from experimental data, while those for the advection–dispersion equation were estimated using inverse methods through a nonlinear optimization algorithm. In addition, a fractal-based model for saturated hydraulic conductivity was employed. Results: It was found that the dispersivity of gentamicin sulfate is 3.1 times higher than that of pure gentamicin. Based on the estimated parameters, two simulation scenarios were conducted: continuous application of gentamicin and soil flushing after antibiotic discharge. The results show that the transport velocity of gentamicin sulfate in the soil may have short-term consequences for the emergence of resistant microorganisms due to the destination of wastewater containing antibiotic residues. Conclusions: Finally, further research is needed to evaluate the impact of antibiotics on soil physical properties, as well as their effects on irrigated crops, animals that consume such water, and the soil microbiota. Full article

Background/Objectives: Targeting individuals with certain characteristics provides improved precision in many healthcare applications. An alert mechanism for COPD exacerbations has recently been validated. It has been argued that its efficacy improves considerably with stratification. This paper provides an in-depth analysis of the cough data of the stratified cohort to identify options for and the feasibility of improved precision in the alert mechanism for the intended patient group. Methods: The alert system was extended using a system complementary to the existing one to accommodate observed rapid changes in cough trends. The designed system was tested in a post hoc analysis of the data. The trend data were inspected to consider their meaningfulness for patients and caregivers. Results: While stratification was effective in reducing misses, the augmented alert system improved the sensitivity and number of early alerts for the acute exacerbation of COPD (AE-COPD). The combination of stratification and the augmented mechanism led to sensitivity of 86%, with a false alert rate in the order of 1.5 per year in the target group. The alert system is rule-based, operating on interpretable signals that may provide patients or their caregivers with better insights into the respiratory condition. Conclusions: The augmented alert system operating based on cough trends has the promise of increased precision in detecting AE-COPD in the target group. Since the design and testing of the augmented system were based on the same data, the system needs to be validated. Signals within the alert system are potentially useful for improved self-management in the target group. Full article

The response time of Artificial Neural Network (ANN) inference is critical in embedded systems processing sensor data close to the source. This is particularly important in applications such as predictive maintenance, which rely on timely state change predictions. This study enables estimation of model response times based on the underlying platform, highlighting the importance of benchmarking generic ANN applications on edge devices. We analyze the impact of network parameters, activation functions, and single- versus multi-threading on response times. Additionally, potential hardware-related influences, such as clock rate variances, are discussed. The results underline the complexity of task partitioning and scheduling strategies, stressing the need for precise parameter coordination to optimise performance across platforms. This study shows that cutting-edge frameworks do not necessarily perform the required operations automatically for all configurations, which may negatively impact performance. This paper further investigates the influence of network structure on model calibration, quantified using the Expected Calibration Error (ECE), and the limits of potential optimisation opportunities. It also examines the effects of model conversion to Tensorflow Lite (TFLite), highlighting the necessity of considering both performance and calibration when deploying models on embedded systems. Full article

Understanding the entrepreneurial profile is essential for developing effective regional policies that promote business growth. The path of an entrepreneur is shaped not only by individual decisions but also by the inherent risks of managing a business. This study aims to identify the characteristics of entrepreneurs at the regional level, specifically highlighting the impact of accumulated experience in their fields. Our central hypothesis asserts that entrepreneurial experience significantly influences how business owners perceive and respond to economic challenges. Utilizing survey data from 120 entrepreneurs in Romania’s Center Region (a NUTS 2 area), we reveal that entrepreneurial experience profoundly affects perceptions of key business challenges, such as legislative instability, taxation predictability, governmental support strategies, and access to SME financing. Importantly, our findings demonstrate that entrepreneurs with less than 10 years of experience express greater concerns about these challenges compared to their more seasoned peers. This novel insight highlights the need for tailored policy interventions aimed at enhancing regional economic resilience and fostering entrepreneurial sustainability. By addressing the specific needs of less experienced entrepreneurs, our study contributes to a deeper understanding of how experience shapes business dynamics in the region. Full article

Background: A detailed understanding of cardiac anatomy and physiology is crucial in cardiovascular medicine. However, traditional learning methods often fall short in addressing this complexity. Augmented reality (AR) offers a promising tool to enhance comprehension. To assess its potential integration into the Heidelberger Curriculum Medicinale (HeiCuMed), we conducted a needs assessment among medical students and lecturers at Heidelberg University Medical School. Methods: Our survey aimed to evaluate the perceived benefits of AR-based learning compared to conventional methods and to gather expectations regarding an AR course in cardiovascular medicine. Using LimeSurvey, we developed a questionnaire to assess participants’ prior AR experience, preferred learning methods, and interest in a proposed AR-based, 2 × 90-min in-person course. Results: A total of 101 students and 27 lecturers participated. Support for AR in small-group teaching was strong: 96.3% of students and 90.9% of lecturers saw value in a dedicated AR course. Both groups favored its application in anatomy, cardiac surgery, and internal medicine. Students prioritized congenital heart defects, coronary anomalies, and arrhythmias, while lecturers also emphasized invasive valve interventions. Conclusions: There is significant interest in AR-based teaching in cardiovascular education, suggesting its potential to complement and improve traditional methods in medical curricula. Further studies are needed to assess the potential benefits regarding learning outcomes. Full article

Prostate cancer accounts for approximately 1.5 million new diagnoses and 400,000 deaths every year worldwide, and demographic projections indicate a near-doubling of both figures by 2040. Despite existing treatments, 10–20% of patients eventually progress to metastatic castration-resistant disease (mCRPC). The median overall survival (OS) after progression to mCPRC drops to 24 months, and efficacy drops severely after each additional line of treatment. Omics platforms have reached advanced levels and enable the acquisition of high-resolution large datasets that can provide insights into the molecular mechanisms underlying PCa pathology. Genomics, especially DDR (DNA damage response) gene alterations, detected via tissue and/or circulating tumor DNA, efficiently guides therapy in advanced prostate cancer. Given recent developments, we have performed a comprehensive literature search to cover recent research and clinical trial reports (over the last five years) that integrate omics along three converging trajectories in therapeutic development: (i) predicting response to approved agents with demonstrated survival benefits, (ii) stratifying patients to receive therapies in clinical trials, (iii) guiding drug development as part of drug repurposing frameworks. Collectively, this review is intended to serve as a comprehensive resource of recent advancements in omics-guided therapies for advanced prostate cancer, a clinical setting with existing clinical needs and poor outcomes. Full article

The sugarcane industry plays a crucial economic role worldwide, with sucrose and ethanol as its main products. However, its processing generates large volumes of by-products—such as bagasse, molasses, vinasse, and straw—that contain valuable components for biotechnological valorization. This review integrates approximately 100 original research articles published in JCR-indexed journals between 2015 and 2025, of which over 50% focus specifically on sugarcane-derived agroindustrial residues. The biotechnological approaches discussed include submerged fermentation, solid-state fermentation, enzymatic biocatalysis, and anaerobic digestion, highlighting their potential for the production of biofuels, enzymes, and high-value bioproducts. In addition to identifying current advances, this review addresses key technical challenges such as (i) the need for efficient pretreatment to release fermentable sugars from lignocellulosic biomass; (ii) the compositional variability of by-products like vinasse and molasses; (iii) the generation of metabolic inhibitors—such as furfural and hydroxymethylfurfural—during thermochemical processes; and (iv) the high costs related to inputs like hydrolytic enzymes. Special attention is given to detoxification strategies for inhibitory compounds and to the integration of multifunctional processes to improve overall system efficiency. The final section outlines emerging trends (2024–2025) such as the use of CRISPR-engineered microbial consortia, advanced pretreatments, and immobilization systems to enhance the productivity and sustainability of bioprocesses. In conclusion, the valorization of sugarcane by-products through biotechnology not only contributes to waste reduction but also supports circular economy principles and the development of sustainable production models. Full article