Search Results (1,661)

Background and Aim: Passive smoking (PS) is a well-established risk factor associated with systemic and oral health impairments in children. However, its influence on perioperative physiological stability and recovery profiles during pediatric dental sedation remains insufficiently elucidated. This study investigated the association between PS exposure and perioperative vital parameters, recovery characteristics, and emergence behavioral outcomes in children undergoing dental extractions under sedation. Methods: This prospective cohort study (ClinicalTrials.gov: NCT06780189) included 100 ASA I children aged 4–6 years scheduled for primary molar extraction under midazolam-remifentanil-propofol sedation. Participants were stratified into three groups: no exposure, caregiver and household exposure, and household exposure only. An exposure-related relationship was evaluated based on daily household cigarette consumption. Perioperative vital signs (HR, blood pressure, and SpO₂) were continuously monitored. Postoperative recovery and emergence profiles were assessed using the Modified Aldrete Recovery Score (MASS), Richmond Agitation–Sedation Scale (RASS), and Pediatric Anesthesia Emergence Delirium (PAED) scale. Results: Children exposed to PS demonstrated significantly lower SpO₂ levels across all perioperative phases compared with non-exposed counterparts (p < 0.001), reflecting an exposure-related effect. In contrast, no statistically significant differences were observed in cardiovascular parameters (p > 0.05). Recovery time was significantly prolonged in PS-exposed children (p = 0.002). Furthermore, PS exposure was associated with significantly higher RASS and PAED scores, indicating increased agitation and emergence delirium (p < 0.001). Conclusions: Passive smoking adversely affects perioperative oxygenation, delays recovery, and exacerbates emergence neurobehavioral disturbances in children undergoing dental sedation. Environmental tobacco exposure must be integrated into preoperative risk assessments. Full article

This study examined whether barbell velocity measured under standardized loading conditions during routine resistance training may provide useful contextual information for athlete monitoring in elite track-and-field athletes. Although velocity-based training has been widely used for load prescription, its utility as contextual monitoring information under fixed external loads remains unclear. Eight national-level jump and throw athletes were observed over a six-week in-season period. Mean concentric velocity (MCV) was recorded during back squat exercises performed at a consistent external load (~60% 1RM) across 95 regularly scheduled training sessions. The overall mean MCV was 0.783 ± 0.057 m·s⁻¹ (range: 0.68–0.89 m·s⁻¹). Within-athlete session-to-session fluctuations ranged from 6.13% to 11.20%, exceeding both the coefficient of variation (2.06–3.80%) and the pooled typical error of measurement (0.019 m·s⁻¹), suggesting that the observed variability was unlikely to be explained solely by measurement noise. Distinct individual velocity trajectories were observed under fixed individualized loading conditions, reflecting notable intra- and inter-individual variability within an ecologically valid training environment. These findings suggest that barbell velocity may provide contextual information regarding session-to-session fluctuations relevant to athlete monitoring under standardized loading conditions. Collectively, the findings suggest that barbell velocity measured under standardized loading conditions may provide contextual information regarding day-to-day variability during routine elite training. Full article

Background/Objectives: Pharmaceutical formulation involves designing a drug product by combining the properties of an active pharmaceutical ingredient (API) with suitable excipients and processing strategies to produce a safe, effective, and manufacturable dosage form. However, data in formulation science are often limited, expensive to generate, and frequently restricted by proprietary and confidentiality constraints. Interactive digital tools can support formulators during early drug product development by improving the structure, transparency, and efficiency of formulation decision-making. While the current system focuses on structured decision support, future extensions may incorporate machine-learning methods for recommendation and knowledge extraction. Methods: In this work, we developed the Formulation tool, an interactive decision-support and visualization system for formulation development based on a hierarchical formulation-strategy framework commonly used in pharmaceutical practice. The tool is designed to prioritize suitable formulation principles and associated processing routes, with oral solid formulation as the initial application domain. The evaluated scenarios also include pathway regions relevant to oral liquid formulations. Its modular architecture also makes it adaptable to other formulation scenarios. To assess practical applicability, the tool was evaluated in a structured expert study involving five expert users across six predefined formulation scenarios (n = 30 runs) , covering three drugs under adult and pediatric conditions. Results: The tool showed agreement with the expected dosage-form families and overall formulation properties, with adult scenarios converging to oral solid regions and pediatric scenarios converging to oral liquid regions. At the downstream formulation-profile level, users converged either to the dominant expected pathway or to alternative feasible pathways within the same formulation region. Variability in full pathway completion was observed and was primarily associated with differences in user interaction behavior and exploratory usage patterns. The median task completion time was 113.5 s. Conclusions: In addition to organizing formulation knowledge, the Formulation tool records user interactions in a structured manner, which may support future learning from usage patterns. Because detailed downstream formulation constraints are often institution-specific and are typically not available in the public domain, the present evaluation focused on agreement at the dosage-form-family level and on overall formulation properties rather than on highly specialized constraint logic. The system is based on a constraint satisfaction problem (CSP) framework, which is well suited for modeling complex decision processes under explicit constraints. CSP has also been widely applied in intelligent scheduling systems, supporting its suitability for structured, constraint-rich decision-making tasks such as pharmaceutical formulation strategy development. Full article

Accurate traffic flow forecasting is essential for the stable operation and efficient scheduling of intelligent transportation systems. The key lies in identifying the complex spatio-temporal dependencies within the road network structure. In the real world, traffic data are often noisy and incomplete due to sensor failures, communication interruptions, and other unexpected disturbances. To overcome these challenges, this paper proposes an adaptive spatio-temporal self-supervised traffic flow forecasting method based on contrastive learning (ASTSS-CL). At the graph level, structural perturbations are generated by combining node centrality with nonlinear probabilities, while a learnable temporal-periodic parameter matrix and an attention-based fusion mechanism are introduced to adaptively optimize adjacency relationships. At the temporal level, complementary augmentations are designed in both the time and frequency domains. Dynamic interpolation captures continuous traffic variations, while wavelet decomposition and node-adaptive frequency masking balance low-frequency trends and high-frequency details; random masking further improves robustness to missing observations and disturbances. In addition, spatial heterogeneity learning and contrastive consistency learning are jointly employed to enhance representation quality. Experiments on the PeMS04 and PeMS08 datasets show that ASTSS-CL achieves MAE, RMSE, and MAPE values of 17.95, 28.86, and 12.07% on PeMS04, and 13.78, 22.05, and 9.46% on PeMS08, respectively, outperforming the best-performing baseline. These results validate the effectiveness of the proposed method and demonstrate its potential to support traffic management and the operation of intelligent transportation systems. Full article

Background: The erector spinae plane block (ESPB) is a commonly used interventional method in the treatment of post-herpetic neuralgia (PHN). ESPB can be performed under the guidance of ultrasound or fluoroscopy, and there are limited data in the literature regarding the effectiveness of ESPB using these two imaging modalities on pain. In this study, we aimed to compare the effectiveness of ESPB performed under the guidance of ultrasound and fluoroscopy on pain reduction in PHN. Methods: Patients between the ages of 18 and 90 years with thoracal pain related to PHN and scheduled to undergo the ESPB were enrolled in the prospective observational study. Patients were divided into two groups: those who underwent a single-shot fluoroscopy-guided (FS) or ultrasound-guided (USG) ESPB. The Numeric Rating Scale-NRS was used to assess pain intensity, and the DN-4 questionnaire was used to assess the presence of neuropathic pain (NP). Results: In the final analysis, data from a total of 48 patients, 24 from each group, were evaluated. No statistically significant difference was found between the two groups in terms of demographic data and initial clinical features. While a significant decrease in NRS scores was seen in both groups at the first and third months, no significant difference was seen between the two groups. There was no significant change in the number of patients with NP in either group compared to baseline. Conclusions: Both ultrasonography and fluoroscopy-guided ESPB appear to be effective in reducing pain in PHN. Further studies are needed for the efficacy of ESPB on NP. Full article

We present a novel framework for epidemiological disease spread modeling that combines agent-based simulation with Boolean state-space representations and optimal filtering for state estimation under noisy observations. Our approach models individual agents in discrete Susceptible-Exposed-Infected-Recovered (SEIR) states using a compact 2-bit Boolean representation, with agent interactions governed by scheduled contact patterns. To address the challenge of inferring latent infection states from limited and noisy testing data, we develop two complementary inference approaches: (1) a Boolean Kalman particle filter for small populations that tracks the full joint distribution over agent states, and (2) a mean-field approximation for large populations that factorizes the posterior into independent marginal distributions, enabling scalability to realistic population sizes. Unlike continuous-state Kalman filters, our methods naturally handle the discrete nature of epidemiological states while accommodating realistic observation models where only a subset of agents are tested at each time step, with test results subject to false positive and false negative errors. We demonstrate that this framework enables accurate reconstruction of population-level infection dynamics and individual agent states from sparse, noisy observations across populations from 100 to 50,000 agents, providing a computationally tractable approach for real-time epidemic monitoring. Full article

Cooperative multi-UAV path planning under dynamic and adversarial conditions demands simultaneous satisfaction of safety, efficiency, and coordination constraints, yet existing swarm-intelligence and RL–swarm hybrids rely on deterministic switching rules, tabular states, and ad hoc training schedules. This paper proposes RL-JSO, a hybrid framework in which a dueling double deep Q-network with prioritized experience replay adaptively selects among the drift, passive, and active phases of a jellyfish search optimizer, replacing the deterministic time-control rule with a learned policy. The framework integrates a five-layer hierarchical safety control mechanism, a mastery-gated nine-stage curriculum, and a shared reward module that architecturally enforces fairness between RL-JSO and a paired RL-PSO counterpart. Evaluation across four progressive campaigns with 160 independent runs per algorithm shows that, within the evaluated JSO/PSO family, RL-JSO is the only method that sustains a 100% collision-free rate across all four progressive difficulty campaigns, its Cliff’s delta over standard JSO grows monotonically with difficulty from medium to large, and under a composite cooperation metric its coordination score remains nearly invariant while comparators degrade by 17–23%. A paired inference-time ablation on the trained checkpoint provides controlled inference-time evidence that adaptive phase switching is a principal contributor to the observed test-time performance within the trained system, rather than the heuristic fallback layers. Full article

In molten salt reactors (MSRs), molten salt performs dual essential roles as fuel and coolant. The continuous circulation of the fuel salt in the primary loop inevitably leads to significant neutron activation of loop components, particularly the structural alloys of the heat exchanger (HX) and the coolant salt within the HX. This activation is strongly influenced by delayed neutron fluxes generated by the migration of delayed neutron precursors (DNPs) within the flowing fuel salt. Accurate quantification of the radioactivity of primary HX components is essential for establishing reliable modular replacement strategies, optimizing shutdown maintenance schedules, and ensuring operational safety. To address this requirement, a comprehensive simulation methodology has been developed to model the DNP transport through the primary HX in a small modular molten salt reactor (SM-MSR). It aims to quantitatively evaluate activation levels of HX structural alloys and circulating coolant salt within the HX. Comparative simulations were conducted to contrast scenarios with dynamic DNP migration and static-fuel scenarios excluding it. The results indicate that consideration of DNP migration increases the neutron flux at the top region of the HX by approximately three orders of magnitude compared with the static-fuel scenario. This elevates coolant salt radioactivity by over 50%. Significant increases in irradiation damage parameters (displacements per atom and helium production) are observed in the upper sections of HX structural alloys. These findings highlight the necessity of incorporating DNP migration effects for accurate prediction of primary loop component neutron activation. This provides a reference for future shielding design optimization, irradiation damage assessments, and shutdown dose rate calculations in the SM-MSR. Full article

Against the backdrop of the global advancement of carbon neutrality goals and the energy transition in the building sector, zero-carbon buildings have emerged as pivotal enablers for achieving carbon neutrality in the construction industry. The rule-based scheduling of energy storage systems (ESS) is critical to enhancing energy efficiency and economic performance of buildings. This study takes the Jinan Zero-Carbon Operation Center Project in Shandong Province as the research object, developing a comprehensive technical framework covering the entire process from design to operation, and investigates the rule-based design and ESS scheduling strategies in response to Shandong’s newly implemented seasonal time-of-use (TOU) electricity pricing policy. First, core performance indicators are defined in accordance with national evaluation standards for zero-carbon buildings. Hourly building energy loads and photovoltaic (PV) generation profiles are simulated over a full year, which serves as the basis for determining the optimal PV installed capacity and ESS sizing. Second, an ESS scheduling strategy integrating PV generation forecasting and the seasonal TOU electricity price structure is formulated, with clear charging and discharging logic defined. Finally, the operational and economic performance of different scheduling modes are evaluated and compared through case studies. The results show that the annual PV generation ratio reaches 101.38%, with a self-consumption rate of 73% and a self-sufficiency rate of 72%, all meeting the core requirements for zero-carbon buildings. Compared with the conventional real-time scheduling mode (Mode 1), the proposed optimized mode (Mode 2) that incorporates TOU pricing and PV forecasting achieves an annual operational cost saving of 367,349 CNY, corresponding to a reduction of 47.02%. Distinct seasonal variations in core indicators are also observed: the PV generation ratio is lower in summer and winter but the self-consumption rate is higher, with the opposite trend in spring and autumn. The proposed technical framework and scheduling strategy provide practical guidance for the design and operational optimization of zero-carbon buildings and offer decision-making support for ESS operation under TOU electricity pricing policies. Full article

Background/Objectives: Dance-based programs have been shown to support psychological well-being in later life, yet evidence remains limited for dance-mediated psychomotor interventions. This study examined the effects of a 12-week creative-dance-mediated psychomotor intervention on life satisfaction and positive and negative affect in community-dwelling older adults. Methods: This 12-week non-randomized controlled trial involved 34 participants (74.6 ± 6.6 years), allocated by convenience to an experimental group (EG) or control group (CG). The EG participated in a creative-dance-mediated psychomotor intervention (3×/week; 60 min/session; 36 sessions), while the CG maintained usual daily activities. Life satisfaction was assessed using the Satisfaction With Life Scale (SWLS), and affective experience was assessed using the Positive and Negative Affect Schedule (PANAS) at baseline and post-intervention. Results: No adverse events occurred; attendance was 89.8%. Within-group comparisons showed significant improvements in the EG for SWLS (20.4%), PANAS positive affect (14.3%), and PANAS negative affect (−13.9%), p < 0.05. In the CG, a significant improvement was observed only for PANAS negative affect (−11.5%), p < 0.05. Post-intervention comparisons between groups revealed significant differences favoring the EG for SWLS (p = 0.018) and PANAS positive affect (p < 0.001), with no significant between-group differences at baseline. Conclusions: Over 12 weeks, the intervention was associated with higher life satisfaction and positive affect in the EG compared with the CG. These findings suggest that this intervention format is safe and feasible and may support psychological well-being in community-dwelling older adults. Full article

Background/Objectives: Patients awaiting total hip arthroplasty (THA) may have a preoperative period for home-based exercise. However, the benefit of prehabilitation may depend on programme completion. This study assessed the association between compliance with home-based prehabilitation and postoperative course after THA, particularly hospital stay and self-assessed health status at discharge, and explored associations between compliance and changes in clinical and functional outcomes. Methods: In this prospective single-centre observational cohort pilot study, 40 adults scheduled for elective THA were included in a planned 60-day home-based prehabilitation programme as standard preoperative care. Assessments were performed before prehabilitation, preoperatively, and at discharge. Compliance was recorded using a daily checklist and expressed as a compliance index. Associations were analysed using non-parametric tests and Spearman correlation. Results: Median compliance index was 32.41%. Higher compliance was observed in participants reporting improvement or marked improvement at discharge than in those reporting slight improvement or no improvement (p = 0.0076). Compliance was inversely correlated with postoperative length of stay, median 6 days (rho = −0.593, p < 0.001). Compliance was lower in participants who reported pain during exercise (p = 0.0127). No significant associations were found between compliance and postoperative symptoms or changes in hip muscle strength, mechanical muscle properties, pain intensity, or functional test performance between baseline and preoperative assessments. Conclusions: Greater compliance with home-based prehabilitation was associated with shorter postoperative hospitalization and more favorable self-assessed health status at discharge. These findings support strategies to improve programme completion and minimize exercise-related pain. Full article

The objective of this study was to evaluate the efficacy of a novel digital platform (Visitrain VG, Alicante, Spain) as a visual rehabilitation tool for patients with convergence insufficiency (CI), in comparison with conventional in-office vision therapy (VT) supplemented with home reinforcement exercises. A retrospective comparative study was conducted comprising 33 patients diagnosed with CI, allocated into two groups: a digital group (DG; n = 16) receiving treatment with the aforementioned digital platform and a conventional group (CG; n = 17) undergoing conventional vision therapy. Binocular vision clinical parameters were assessed at baseline, one month, and three months of follow-up, including near point of convergence (NPC), positive fusional vergence (PFV), and binocular accommodative facility (BAF). Both groups demonstrated significant improvements following three months (p < 0.050). At the one-month evaluation, the CG showed a more rapid clinical response, with statistically significant between-group differences being observed in the NPC (p = 0.004) and near PFV (p = 0.040) compared with the DG. Nevertheless, at the three-month follow-up, no significant differences were found between the groups (p ≥ 0.060). The digital platform under investigation appears to constitute an effective therapeutic alternative to conventional vision therapy, albeit with a comparatively slower initial clinical response rate. It may be particularly indicated for patients requiring greater scheduling flexibility or those with limited access to in-office clinical care. Prospective controlled clinical trials are warranted to corroborate these preliminary outcomes. Full article

Background and Objectives: Elective electrical cardioversion (eECV) in patients with atrial fibrillation (AF) or atrial flutter is associated with a low risk of thromboembolic events (TEs) when adequate anticoagulation is provided. However, the role of routine transesophageal echocardiography (TEE) prior to eECV remains uncertain. This study aimed to assess thromboembolic outcomes in patients undergoing eECV with or without TEE guidance in a real-world clinical setting. Methods: A single-center, combined retrospective–prospective observational study including 296 adequately anticoagulated patients with AF or atrial flutter scheduled for eECV was conducted. The retrospective cohort (n = 220) underwent eECV without routine TEE, while the prospective cohort (n = 85) underwent TEE prior to eECV. The primary outcome was the occurrence of thromboembolic events (ischemic stroke or systemic embolism) within 30 days after eECV. Arrhythmia recurrence at 30 days was assessed as a secondary, exploratory outcome. Results: Among patients undergoing eECV, thromboembolic events were rare. In the retrospective cohort, 3/220 patients (1.36%) experienced a TE, whereas no events were observed in the prospective cohort (0/76). Due to the low number of events, the study was underpowered to detect meaningful differences between strategies (RR 2.44; 95% CI 0.13–46.7; p = 0.55). TEE identified left atrial appendage thrombus in 9/85 screened patients (10.6%), who were subsequently excluded from cardioversion. Arrhythmia recurrence at one month was more frequent in the prospective cohort (19.7% vs. 7.3%), likely reflecting differences in baseline clinical characteristics. Conclusions: Thromboembolic events after eECV in adequately anticoagulated patients were infrequent in this real-world cohort. While the study design limits direct comparison between strategies, the results indicate that a conventional anticoagulation-based approach without routine TEE is associated with a low risk of thromboembolic events in most patients. At the same time, the detection of left atrial appendage thrombus in a subset of patients underscores the importance of individualized risk assessment and supports the selective use of TEE in higher-risk clinical settings. Full article

The provision of power and grid services requires the co-ordination between Day-Ahead Market (DAM) and Ancillary Service Market (ASM) to attain reserve services and technically feasible operating conditions for market players and for the network. In this context, this work proposes a multi-stage approach to evaluate the dispatched power to balance the forecast updates of renewable energy sources and load from DAM to ASM, taking into account network and Unit Commitment (UC) constraints. The DAM is solved considering a zonal market framework and neglecting the UC constraints. Then, a mechanism to adjust the ASM bids is developed, defining time-varying costs for each regulation. Finally, the ASM is modelled as a network-constrained UC and economic redispatch (NCUCER) optimization problem, aiming at minimizing the overall cost, in order to procure secondary reserve requirement and to adjust the DAM schedules, taking into account network and UC constraints and balancing forecast updates. DC load flow sensitivity factors are exploited to evaluate the influence of redispatch actions and forecast updates on the observed power flow. This procedure is applied to NREL 118-Bus Test System assessing its performances throughout a yearly time horizon. Full article

Background/Objectives: This study assessed the diagnostic accuracy of two commonly used diagnostic instruments for autism spectrum disorder (ASD), the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R), in comparison to a best-estimate (BE) diagnosis made by a research psychologist. Methods: Two hundred and thirteen children aged 5 years 0 months to 7 years 11 months completed a comprehensive research assessment that included multiple diagnostic measures. Once each research assessment was complete, a research psychologist gave each participant an overall BE research diagnosis of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) ASD based on all available information from diagnostic testing and behavioral observations during testing. We assessed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of both the ADOS-2 and ADI-R separately and in combination and used receiver operating characteristic (ROC) curves to compare the areas under the curve (AUCs) of these instruments. Results: Both the ADOS-2 Spectrum Criterion scoring (sensitivity = 96.2%; specificity = 97.5%) and ADOS-2 Autism Criterion scoring (sensitivity = 82.0%; specificity = 100%) had excellent accuracy in comparison to the BE ASD diagnosis. The ADI-R had good accuracy (sensitivity = 78.6%; specificity = 83.5%) compared to BE ASD diagnosis. In receiver operating curve analyses, both scoring criteria for ADOS-2 were significantly more accurate than the ADI-R. Conclusions: Overall, both instruments provide good, if not excellent, classification accuracies when used individually, as well as in combination. Thus, when deciding which measures to use for ASD research, other factors should also be considered. Full article