Search Results (501)

Haemophilic arthropathy is caused by repeated joint bleeding episodes, primarily affecting knees, ankles and elbows. Conservative options should be considered prior to surgery, as well as postural evaluation, since any functional overload promotes the development of new bleeding. The aim of this study is to verify the use of foot orthoses in combination with postural rehabilitation, assessing the incidence of spontaneous haemarthroses and haematomas. In total, 15 patients were enrolled and randomly divided into two groups: 8 in group A, composed of patients who were prescribed foot orthoses and a 20-session rehabilitation program, and 7 in group B, composed of patients who were instructed to use foot orthoses only. All patients were evaluated at baseline (T0), at 3 months (T1—end of the rehabilitation program), and at 12 months (T2), using the following scales: Functional Independence Score in Haemophilia (FISH), Haemophilia Joint Health Score (HJHS) and Numerical Rating Scale (NRS). During the 12 months between the first and the last assessment, no patient in group A developed hemarthroses or hematomas, while one case of hemarthrosis was recorded in group B. The HJHS improved significantly (≤0.05) in group A at both T1 and T2, while in group B it improved significantly only in T2. As for FISH, it showed significant improvements in both groups at T1 and T2. NRS showed a significant reduction only at T2 in both groups (p-value T0–T1 0.3 in group A e 0.8 in group B). No patient reported any adverse effects from the use of orthotic insoles. The combination of postural rehabilitation, the use of foot orthoses and pharmacological prophylaxis could improve functioning and joint status in patients affected by haemophilic arthopathy, delaying or preventing new hemarthroses by improving the distribution of joint loads and the modification of musculoskeletal system’s characteristics. Full article

News recommendation systems must simultaneously address multiple challenges, including dynamic user interest modeling, nonlinear popularity patterns, and diversity recommendation in cold-start scenarios. We present a Popularity-Aware Dynamic Multi-Perspective Fusion Network (PAD-MPFN) that innovatively integrates three key components: adaptive subspace projection for multi-source interest fusion, logarithmic time-decay factors for popularity bias mitigation, and dynamic gating mechanisms for personalized recommendation weighting. The framework uniquely combines sequential behavior analysis, social graph propagation, and temporal popularity modeling through a unified architecture. Experimental results on the MIND dataset, an open-source version of MSN News, demonstrate that PAD-MPFN outperforms existing methods in terms of recommendation performance and cold-start scenarios while effectively alleviating information overload. This study offers a new solution for dynamic interest modeling and diverse recommendation. Full article

The evolution of 3GPP non-terrestrial networks (NTNs) is enabling new avenues for broadband connectivity via satellite, especially within the scope of 5G. The parallel rise in satellite mega-constellations has further fueled efforts toward ubiquitous global Internet access. This convergence has fostered collaboration between mobile network operators and satellite providers, allowing the former to leverage mature space infrastructure and the latter to integrate with terrestrial mobile standards. However, integrating these technologies presents significant architectural challenges. This study investigates 5G NTN architectures using satellite mega-constellations, focusing on transparent architectures where Starlink is employed to relay the backhaul, midhaul, and new radio (NR) links. The performance of these architectures is assessed through a testbed utilizing OpenAirInterface (OAI) and Open5GS, which collects key user-experience metrics such as round-trip time (RTT) and jitter when pinging the User Plane Function (UPF) in the 5G core (5GC). Results show that backhaul and midhaul relays maintain delays of 50–60 ms, while NR relays incur delays exceeding one second due to traffic overload introduced by the RFSimulator tool, which is indispensable to transmit the NR signal over Starlink. These findings suggest that while transparent architectures provide valuable insights and utility, regenerative architectures are essential for addressing current time issues and fully realizing the capabilities of space-based broadband services. Full article

Increasing climate change requires cities to adapt to changing weather conditions. New elements for decentralized stormwater management must be installed to protect the sewer system from overloading during heavy rainfall events and to keep water in the city for irrigation use. A pilot project was implemented in Leipzig in 2020, in which infiltration tree trench systems with three different designs were installed and equipped with measuring technology during a road renovation project. The catchment areas of these three tree trenches are between 215 and 300 m² each. In two of the systems, water retention was included to supply the tree with water during drought periods. The retention elements are sealed with clay in tree trench TT1 and bentonite in tree trench TT3. For tree trench TT2, no retention capacity was provided. This article presents the design, construction, and scientific monitoring of the three tree infiltration trenches. The conclusions after four years of operation from the perspective of two departments of the City of Leipzig are summarized. The tree trench TT1 with the clay pan for water storage shows the best performance in terms of water retention and tree fitness. For the next generation of such infiltration systems, improvements in the design of the street runoff inlets and the surface of the tree trench system’s interior are discussed. Full article

Motorbike taxis are widely used in Yaoundé and Douala, despite their association with heightened accident risks and relatively high fares. This research combines qualitative methods, including 38 semi-structured interviews and direct field observations, with a quantitative survey of 280 motorbike taxi passengers (customers). It employs a dynamic risk approach to analyse both the factors motivating individuals to choose motorbike taxis and the strategies adopted by drivers and passengers to mitigate and prevent accidents. The findings reveal that speed, cost-effectiveness, and the limited accessibility of certain neighbourhoods to other transport options are key factors driving regular motorbike taxi use. Moreover, strategies for managing accident risks include regulating passenger positions based on gender, perceived age, or physical stature; invoking deities for protection; and passengers’ verbal interactions with drivers to ensure safer behaviour. This research also explores how overloading, a collectively tolerated deviance, is managed to avoid or minimize the impact of accidents. By addressing both risk acceptance and prevention strategies, this study provides new insights into passengers’ social perceptions, which are often overlooked in motorbike taxi research. It expands the understanding of motorbike taxi use in urban Global South transport contexts, particularly in terms of users’ risk management behaviours. Full article

Overload detection is crucial in nuclear fusion experiments to prevent damage to plasma-facing components (PFCs) and ensure the safe operation of the reactor. At Wendelstein 7-X (W7-X), real-time monitoring and prediction of thermal events are essential for maintaining the integrity of PFCs. This paper proposes a machine learning approach for developing a real-time overload detector, trained and tested on OP1.2a experimental data. The analysis showed that Self-Organizing Maps (SOMs) are efficient in detecting the overload risk starting from a set of plasma parameters that describe the magnetic configuration, the energy behavior, and the power balance. This study aims to thoroughly evaluate the capabilities of the SOM in recognizing overload risk levels, defined by quantizing the maximum criticality across different IR cameras. The goal is to enable detailed monitoring for overload prevention while maintaining high-performance plasmas and sustaining long pulse operations. The SOM proves to be a highly effective overload risk detector. It correctly identifies the assigned overload risk level in 87.52% of the samples. The most frequent error in the test set, occurring in 10.46% of cases, involves assigning a risk level to each sample adjacent to the target one. The analysis of the results highlights the advantages and drawbacks of criticality discretization and opens new solutions to improve the SOM potential in this field. Full article

Zinc-alpha2-glycoprotein (ZAG) is a soluble glycoprotein primarily produced in adipocytes and the liver, with key roles in lipid metabolism, including lipolysis and the browning of adipose tissue. Despite extensive studies on its role in rodents, the relationship between ZAG and insulin in humans remains unclear. Given the emerging interest in ZAG’s involvement in metabolic diseases such as metabolic-dysfunction-associated steatotic liver disease, this study aimed to investigate the acute effects of insulin on ZAG levels both in vivo and in vitro. We recruited 24 healthy, individuals who were non-obese and assessed the impact of oral glucose overload, a standardized liquid nutritional supplement, and intravenous glucagon on circulating ZAG levels. In parallel, we explored the effects of insulin on ZAG production in cultured HepG2 cells. Our findings revealed a consistent acute reduction in serum ZAG levels following all in vivo tests, coinciding with increased insulin levels. In vitro, insulin rapidly downregulated ZAG protein and mRNA levels in HepG2 cells, with significant reductions observed within 15 min, followed by partial recovery after 2 h. These results suggest a potential acute inhibitory effect of insulin on ZAG production, supporting its role in promoting energy storage by suppressing lipolysis postprandially. This study provides new insights into the complex interplay between insulin and ZAG in regulating energy balance and highlights the potential of ZAG as a therapeutic target in metabolic diseases. Full article

Background/Objectives: To review the problem of diagnostic delay in soft tissue sarcomas with the aim of identifying its causes and consequences, understanding how to clinically suspect and refer them, and evaluating the main limitations of the referral guidelines already in use. Methods: A systematic review of the available literature was performed, focusing on the theoretical framework, the elements and time intervals to be considered, causes and consequences, “red flag” symptoms/signs, the main referral guidelines in use, their results, and the methods used to avoid excessive referrals. Results: Diagnostic delay in soft tissue sarcomas is a frequent event that is poorly characterized and has important consequences, including prognostic, medico-legal and psycho-social effects. The common denominator is the lack of knowledge and awareness. Several referral guidelines have been described, and most of them are based on clinical data. Their results have been disappointing. Thus, it is necessary to implement new methods to improve their results and avoid the overload of pre-referral imaging systems, sarcoma diagnostic triage meetings, and telemedicine systems. Conclusions: Sarcoma units and health system leaders need to study this issue to determine the extent of the problem and its causes. Without this information, it is almost impossible to properly address the problem and take corrective actions. Early referral of suspected soft tissue sarcoma lesions, although desirable, is a complex issue due to the non-specificity of the symptoms. Existing clinical referral guidelines need to be modified to improve detection and conversion rates. Full article

The emergence of Flexible Manufacturing Systems (FMS) presents new challenges in Industrial IoT (IIoT) environments. Unlike traditional real-time systems, FMS must accommodate task set variability driven by human–machine interaction. As such variations can lead to abrupt resource overload or idleness, a dynamic scheduling mechanism is required. Although prior studies have explored dynamic scheduling, they often relax deadlines for lower-criticality tasks, which is not well suited to IIoT systems with strict deadline constraints. In this paper, instead of treating dynamic scheduling as a prediction problem, we model it as deterministic planning in response to explicit, observable user input. To this end, we precompute feasible resource plans for anticipated task set variations through offline optimization and switch to the appropriate plan at runtime. During this process, our approach jointly optimizes processor speeds, memory allocations, and edge/cloud offloading decisions, which are mutually interdependent. Simulation results show that the proposed framework achieves up to 73.1% energy savings compared to a baseline system, 100% deadline compliance for real-time production tasks, and low-latency responsiveness for user-interaction tasks. We anticipate that the proposed framework will contribute to the design of efficient, adaptive, and sustainable manufacturing systems. Full article

Psoriasis, a chronic inflammatory skin disorder, is driven by dysregulated immune responses and keratinocyte dysfunction. Here, we explore the therapeutic potential of Astilbin (AST), a flavonoid with potent anti-inflammatory properties, in modulating ferroptosis and the cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway in IL-17-stimulated HaCaT keratinocytes. Our psoriatic cell model recapitulated key pathological features, including hyperproliferation, membrane integrity loss, mitochondrial dysfunction, and heightened oxidative stress, alongside elevated proinflammatory cytokine levels. Ferroptosis-related biomarkers were significantly altered, with increased malondialdehyde (MDA) accumulation, reduced glutathione (GSH) levels, iron overload (Fe²⁺), and enhanced lipid peroxidation (detected via C11-BODIPY). Mechanistically, mitochondrial damage triggered cytoplasmic leakage of mitochondrial DNA (mtDNA), activating the cGAS-STING pathway, as evidenced by upregulated pathway-associated protein expression. AST intervention effectively mitigated these pathological changes by suppressing ferroptosis and modulating cGAS-STING signaling. These findings reveal a dual-pathway regulatory mechanism, positioning AST as a promising therapeutic candidate for psoriasis. By elucidating the interplay between ferroptosis and the cGAS-STING pathway, this study provides new insights into psoriatic inflammation and offers a rationale for targeting these pathways in therapeutic strategies. Full article

The integration of Distributed Energy Resources (DERs) such as photovoltaic (PV) systems, battery energy storage systems (BESSs), and electric vehicles (EVs) introduces new challenges to distribution networks despite offering opportunities for decarbonization and grid flexibility. This paper proposes a scalable simulation-based framework that combines deterministic nodal hosting capacity analysis with probabilistic Monte Carlo simulations to evaluate and optimize DER integration in diverse feeder types. The methodology is demonstrated using the IEEE 13-bus and 123-bus test systems under full-year time-series simulations. Deterministic hosting capacity analysis shows that individual nodes can accommodate up to 76% of base load from PV sources, while Monte Carlo analysis reveals a network-wide average hosting capacity of 62%. Uncoordinated DER deployment leads to increased system losses, overvoltages, and thermal overloads. In contrast, coordinated integration achieves up to 38.7% reduction in power losses, 25% peak demand shaving, and voltage improvements from 0.928 p.u. to 0.971 p.u. Additionally, congestion-centric optimization reduces thermal overload indices by up to 65%. This framework aids utilities and policymakers in making informed decisions on DER planning by capturing both spatial and stochastic constraints. Its modular design allows for flexible adaptation across feeder scales and configurations. The results highlight the need for node-specific deployment strategies and probabilistic validation to ensure reliable, efficient DER integration. Future work will incorporate optimization-driven control and hardware-in-the-loop testing to support real-time implementation. Full article

Communicating the science behind food production to consumers is increasingly complex due to the proliferation of food innovations, information overload, and the presence of misinformation. Trust plays a pivotal role in consumer perceptions of food safety and acceptance of new food technologies. This study explores consumers’ trust in food by segmenting audiences based on cognitive trust in science, affective trust in new foods, and dispositional trust in sources of food information. Using a survey of 1011 United States consumer respondents, cluster analysis identified five distinct trust segments: Lack Trust, Trusting, On the Fence, Trust New Food Not Science or Sources, and Trust Science not New Food. Results revealed significant demographic differences among the five segments, with age, education, political ideology, and dietary preferences influencing trust levels. Findings contribute to audience segmentation theory by demonstrating the coexistence of multiple trust dimensions and their impact on food-related decision-making. Practically, this study provides a framework for science communicators and policymakers to tailor messaging strategies that align with consumer trust profiles, ultimately fostering informed decision-making in the food system. Full article

Background/Objectives: The surveillance of patients with incidental pulmonary nodules overloads existing respiratory and lung cancer clinics, as well as multidisciplinary team meetings. In our clinical setting, until 2018, we had numerous patients with incidental pulmonary nodules inundating our outpatient clinics; therefore, the need to develop a novel service and dedicated clinical pathway arose. The aims of this study are to 1. provide (a) a model of setting up a novel pulmonary nodule service, and (b) a pragmatic clinical pathway to address the increasing need for surveillance of patients with incidental pulmonary nodules. 2. share real-world data from a dedicated pulmonary nodule service running in a tertiary setting with existing resources. Methods: A retrospective review of established processes and referral mechanisms to our tertiary pulmonary nodule service was conducted. We have also performed a retrospective collection and review of data for patients reviewed and discussed in our tertiary pulmonary nodule service between April 2018 and April 2024. Results: Our tertiary pulmonary nodule service (PNS) comprises a dedicated pulmonary nodule clinic, a nodule multidisciplinary team (MDT) meeting and a dedicated proforma referral system. Due to the current national health system legislation and relevant processes, patients are required to physically attend clinic appointments. There are various sources of referral, including other departments within the hospital, other hospitals, various specialties in primary care and self-referrals. Between 15 April 2018 and 15 April 2024, 2203 patients were reviewed in the pulmonary nodule clinic (903 females, 1300 males, mean age 64 ± 19 years). Of those patients, 65% (1432/2203) were current smokers. A total of 1365 new patients and 838 follow-up patients were reviewed in total. Emphysema was radiologically present in 72% of patients, and 75% of those (1189/1586) already had a confirmed diagnosis of chronic obstructive pulmonary disease (COPD). Coronary calcification was identified in 32% (705/2203), and 78% of those (550/705) were already known to cardiology services. Interestingly, 27% (368/1365) of the new patients were discharged following their first MDT meeting discussion, and 67% of these were discharged as the reason for their referral was an intrapulmonary lymph node which did not warrant any further action. Among all patients, 11% (246/2203) were referred to the multidisciplinary thoracic oncology service (MTOS) due to suspicious appearances/changes in their nodules that warranted further investigation, and from those, 37% were discharged (92/246) from the MTOS. The lung cancer diagnosis rate was 7% (154/2203). Conclusions: The applied pathway offers a pragmatic approach in setting up a service that addresses an increasing patient need. Its application is feasible in a tertiary care setting, and admin support is of vital importance to ensure patients are appropriately tracked and not lost to follow-up. Real-world data from pulmonary nodules services provide a clear overview and contribute to understanding patients’ characteristics and improving service provision. Full article

Background: Acute heart failure (AHF) is a complex syndrome associated with high mortality and hospital readmissions, characterized by volume overload and inflammation. Soluble ST2 (sST2) and antigen carbohydrate 125 (CA125) are emerging biomarkers that reflect these processes and may interact to influence long-term outcomes in AHF patients. This study aims to examine the prognostic relationship between sST2 and CA125 in predicting mortality and heart failure (HF)-related hospitalizations in patients with decompensated heart failure. Methods: In a cohort of 635 patients with AHF, we investigated whether the prognostic value of sST2 varies according to CA125 levels (≤35 vs. >35 U/mL). The endpoints were: (a) time to all-cause death, and (b) the combination of time to death or new HF admission. Results: This study of EAHFE registry data shows that the association between sST2 and long-term adverse outcomes (mortality and HF hospitalizations) in patients with AHF was differentially influenced by CA125 concentrations (p-value for interactions = 0.031 and 0.029, respectively). Higher sST2 was associated with the risk of death and the combined risk of death/HF readmission when CA125 was >35 U/mL [HR = 1.02 (CI 95%: 1.01–1.04), p = 0.006 and 1.02 (CI 95%: 1.01–1.03); p = 0.013 per increase in 10 ng/mL, respectively], but not when CA125 was ≤35 U/mL. Conclusions: This study highlights the prognostic interaction between sST2 and CA125 in AHF. Elevated sST2 predicts poor outcomes mainly in patients with high CA125 levels (>35 U/mL), suggesting CA125’s role in modulating inflammatory activity in HF. Further research is needed. Full article

The arrival of 5G technology is transforming the creation of smart cities by delivering unmatched speed, extremely low latency, and broad device connectivity. These developments allow for the effortless integration of IoT devices, live monitoring systems, and cutting-edge urban applications. This paper examines the impact of 5G in tackling significant urban challenges, including network overload, energy efficacy, and data security, while highlighting its revolutionary potential in improving smart city frameworks. An important emphasis is the fusion of 5G with real-time digital twins, which link physical and digital realms to enhance urban systems, refine resource management, and strengthen public safety. Even with its potential, the rollout of 5G encounters challenges such as expensive infrastructure, significant energy requirements, and limited signal reach. This research explores the present trends, current applications, and new challenges related to 5G in smart cities, providing insights into its constraints and approaches to address them. It summarizes the necessity of cooperation among stakeholders to realize 5G’s complete capabilities and to create scalable, secure, and sustainable solutions for smart cities. Full article