Search Results (15,144)

Since its first appearance as a human pathogen in 1976, Legionella pneumophila has been identified as a causative agent of community-acquired pneumonia (CAP). It survives in rivers, bays, lakes, and water reservoirs, and it is categorized as the fourth most common causative agent of CAP leading to hospitalization. We aimed to investigate patterns in which environmental, seasonal and regional factors may affect the prevalence of Legionnaires’ disease in Crete during the last two decades (2000–2022).The data used originated from the national surveillance database and included any person reported with travel-associated Legionnaires’ disease (TALD) between January 2000 and December 2022. Meteorological data were collected from the National Weather Service. The meteorological variables included (max) temperature (in °C), cloudiness (in octas), wind speed (in knots), and relative humidity (RH) (%). The statistical analysis was based on a case-crossover design with 1:1 matching characteristic. We revealed both seasonal and regional effects on the incidence of Legionnaires’ disease. Cases are significantly more frequent in autumn, in comparison to the other three seasons, while Rethymnon is the prefecture with fewer cases in comparison to Chania or Heraklion. In addition, our research showed that the majority of cases occurred during the years 2017–2018. TALD in Crete is significantly associated with temperature in °C and wind speed in knots. Our research suggests that temporal and spatial factors significantly influence disease cases. These results are in line with studies from foreign countries. The study results aspire to expand our knowledge regarding the epidemiological characteristics of Legionnaires’ disease in relation to local, geographical and meteorological factors on the island of Crete. Full article

This paper presents a procedural method aimed at protecting maritime critical infrastructure, which is essential for the functioning of developed nations. A novel approach, developed by the authors, is introduced—focusing on the behavioral analysis of vessels to enable early identification of suspicious maritime activity and to prevent damage or destruction to key infrastructure elements. An integrated system is proposed, combining real-time electronic surveillance with continuous access to and analysis of data from both national and international databases. Drawing inspiration from medical sciences, a screening-based methodology has been developed. Data on vessels collected from various sources are processed according to the criteria adopted by the authors, using a multi-criteria decision analysis (MCDA) approach. MCDA is a decision-support method that considers multiple criteria simultaneously. It allows for the comparison and evaluation of different options, even when they are difficult to compare directly. This characteristic is used to select high-risk vessels for further monitoring. An initial classification of a vessel as suspicious does not constitute proof of criminal activity but rather serves as a trigger for further coordinated actions. Data on vessels is collected from the AIS (automatic identification system) and platforms that store vessel history. The AIS is a powerful tool that processes parameters such as a ship’s speed and course. This article presents sample results from surveillance and pre-selection analyses using the AIS, followed by a multi-criteria assessment of the behavior of vessels identified through this process. The results are presented both graphically and numerically. The authors conducted several scenarios, analyzing different groups of vessels. Based on this analysis, recommendations were developed for the interpretation of the findings. Full article

Anthracnose, a significant disease of aloe with characteristics of contact transmission, poses a considerable threat to the economic viability of aloe cultivation. To address the challenges of accurately detecting and classifying crop diseases in complex environments, this study proposes an enhanced algorithm, YOLOv11-seg-DEDB, based on the improved YOLOv11-seg model. This approach integrates multi-scale feature enhancement and a dynamic attention mechanism, aiming to achieve precise segmentation of aloe anthracnose lesions and effective disease level discrimination in complex scenarios. Specifically, a novel Disease Enhance attention mechanism is introduced, combining spatial attention and max pooling to improve the accuracy of lesion segmentation. Additionally, the DCNv2 is incorporated into the network neck to enhance the model’s ability to extract multi-scale features from targets in challenging environments. Furthermore, the Bidirectional Feature Pyramid Network structure, which includes an additional p2 detection head, replaces the original PANet network. A more lightweight detection head structure is designed, utilizing grouped convolutions and structural simplifications to reduce both the parameter count and computational load, thereby enhancing the model’s inference capability, particularly for small lesions. Experiments were conducted using a self-collected dataset of aloe anthracnose infected leaves. The results demonstrate that, compared to the original model, the improved YOLOv11-seg-DEDB model improves segmentation accuracy and mAP@50 for infected lesions by 5.3% and 3.4%, respectively. Moreover, the model size is reduced from 6.0 MB to 4.6 MB, and the number of parameters is decreased by 27.9%. YOLOv11-seg-DEDB outperforms other mainstream segmentation models, providing a more accurate solution for aloe disease segmentation and grading, thereby offering farmers and professionals more reliable disease detection outcomes. Full article

In this paper we aimed to compare seasonality, clinical characteristics, and outcomes of Influenza A and COVID-19 in the context of influenza reemergence and ongoing Omicron circulation. We performed a retrospective comparative analysis at the Teaching Hospital of Infectious Diseases in Cluj-Napoca, Romania. We included adult patients hospitalized with Influenza A or COVID-19 between 1 November 2022 and 31 March 2024. Data were collected on demographics, clinical presentation, complications, and in-hospital mortality. We included 899 COVID-19 and 423 Influenza A patients. The median age was 74 years for COVID-19 and 65 for Influenza A (p < 0.001). The age-adjusted Charlson comorbidity index was higher in COVID-19 patients (5 vs. 3, p < 0.001). Despite this age gap, acute respiratory failure was more common in Influenza A (62.8% vs. 55.7%, p = 0.014), but ventilation rates did not differ significantly. Multivariate models showed Influenza A was associated with increased risk of intensive-care unit (ICU) admission or ventilation, whereas older COVID-19 patients had higher in-hospital mortality (5.67% vs. 3.3%, p = 0.064). Omicron COVID-19 disproportionately affected older patients with comorbidities, contributing to higher in-hospital mortality. However, Influenza A remained a significant driver of respiratory failure and ICU admission, underscoring the importance of preventive measures in high-risk groups. Full article

As key components of the climate system, clouds exert a significant influence on the Earth’s radiation budget and hydrological cycle. However, studies focusing on cloud properties over Central Asia are still limited, and the impacts of cloud variability on regional temperature and precipitation remain poorly understood. This study uses reanalysis and multi-source remote sensing datasets to investigate the spatiotemporal characteristics of clouds and their influence on regional climate. The cloud cover increases from the southwest to the northeast, with mid and low-level clouds predominating in high-altitude regions. All clouds have shown a declining trend during 1981–2020. According to satellite data, the sharpest decline in total cloud cover occurs in summer, while reanalysis data show a more significant reduction in spring. In addition, cloud cover changes influence the local climate through radiative forcing mechanisms. Specifically, the weakening of shortwave reflective cooling and the enhancement of longwave heating of clouds collectively exacerbate surface warming. Meanwhile, precipitation is positively correlated with cloud cover, and its spatial distribution aligns with the cloud water path. The cloud phase composition in Central Asia is dominated by liquid water, accounting for over 40%, a microphysical characteristic that further impacts the regional hydrological cycle. Full article

We investigated the role of the intermediate-conductance, Ca²⁺-activated K⁺ channel K_Ca3.1 and volume-regulatory anion channel LRRC8A in regulating C-C motif chemokine ligand 2 (CCL2) expression in THP-1-differentiated M₂ macrophages (M₂-MACs), which serve as a useful model for studying tumor-associated macrophages (TAMs). CCL2 is a potent chemoattractant involved in the recruitment of immunosuppressive cells and its expression is regulated through intracellular signaling pathways such as ERK, JNK, and Nrf2 in various types of cells including macrophages. The transcriptional expression of CCL2 was suppressed in M₂-MACs following treatment with a K_Ca3.1 activator or an LRRC8A inhibitor via distinct signaling pathways: ERK–CREB2 and JNK–c-Jun pathways for K_Ca3.1, and the NOX2–Nrf2–CEBPB pathway for LRRC8A. Under in vitro conditions mimicking the elevated extracellular K⁺ concentration ([K⁺]_e) characteristic of the tumor microenvironment (TME), CCL2 expression was markedly upregulated, and this increase was reversed by treatment with them in M₂-MACs. Additionally, the WNK1–AMPK pathway was, at least in part, involved in the high [K⁺]_e-induced upregulation of CCL2. Collectively, modulating K_Ca3.1 and LRRC8A activities offers a promising strategy to suppress CCL2 secretion in TAMs, potentially limiting the CCL2-induced infiltration of immunosuppressive cells (TAMs, T_regs, and MDSCs) in the TME. Full article

The output of vehicle-integrated photovoltaics (VIPVs) varies due to complex surface interactions, shading, weather conditions, module temperature, and module configuration, making accurate predictions of power generation challenging. This study examines the characteristics of incident light on VIPVs, focusing on installations on automobile roofs and hoods. Surface element data were collected from areas near the target locations (hood and roof), with shading effects taken into account. The calculations evaluated how the angle of incoming light impacts the intensity on specific parts of the vehicle, identifying which surfaces are most likely to receive maximum illumination. For example, the hood exhibited the highest incident light intensity when sunlight approached directly from the front at a solar altitude of 71°, reaching approximately 98% of the light intensity. These calculations enable the assessment of incident light intensity characteristics for various vehicle parts, including the hood and roof. Additionally, by utilizing database information, it is possible to calculate the incident light on vehicle surfaces at any given time and location. Full article

Fan growth serves as a critical performance indicator for the sustainable development of livestreaming e-commerce (LSE). However, existing research has paid limited attention to this topic. This study investigates the unique interactive advantages of LSE over traditional e-commerce by examining how interactivity drives fan growth through the mediating role of user retention and the moderating role of anchors’ facial attractiveness. To conduct the analysis, real-time data were collected from 1472 livestreaming sessions on Douyin, China’s leading LSE platform, between January and March 2023, using Python-based (3.12.7) web scraping and third-party data sources. This study operationalizes key variables through text sentiment analysis and image recognition techniques. Empirical analyses are performed using ordinary least squares (OLS) regression with robust standard errors, propensity score matching (PSM), and sensitivity analysis to ensure robustness. The results reveal the following: (1) Interactivity has a significant positive effect on fan growth. (2) User retention partially mediates the relationship between interactivity and fan growth. (3) There is a substitution effect between anchors’ facial attractiveness and interactivity in enhancing user retention, highlighting the substitution relationship between anchors’ personal characteristics and livestreaming room attributes. This research advances the understanding of interactivity’s mechanisms in LSE and, notably, is among the first to explore the marketing implications of anchors’ facial attractiveness in this context. The findings offer valuable insights for both academic research and managerial practice in the evolving livestreaming commerce landscape. Full article

Background: Trichosporon spp. are opportunistic fungi, capable of causing infection, especially in critically ill individuals who often use broad-spectrum antibiotics, invasive devices, and have comorbidities. Objectives The aim of this study was to analyze individuals’ clinical characteristics, evaluate tolerance to biocides, as well as biofilm formation and efflux pump activity in isolates of Trichosporon asahii. Methods: Clinical isolates of T. asahii collected between 2020 and 2023 from both hospitalized and non-hospitalized individuals, of both sexes, regardless of age, were tested for tolerance to sodium hypochlorite, hydrogen peroxide, benzalkonium chloride, and ethyl alcohol. Efflux pump activity was also assessed using ethidium bromide, and biofilm formation was measured with the Safranin test. Clinical parameters such as outcomes, source, and length of hospitalization were analyzed through electronic medical records. Results: A total of 37 clinical isolates of T. asahii were identified. Thirty-three (83.8%) isolates were from hospitalized individuals, with 81.82% collected in ICUs, an average hospital stay of 35 days, and a mortality rate of 51.6%. The tested strains displayed the largest mean inhibition zone for 2% sodium hypochlorite, indicating lower tolerance. A high level of efflux pump expression was detected among clinical isolates. Biofilm formation was detected in 25/67.5% of the isolates. Conclusions: These findings highlight the clinical relevance of T. asahii, particularly in critically ill individuals, and underscore the pathogen’s ability to tolerate biocides, express efflux pumps, and form biofilms, all of which may contribute to its persistence and pathogenicity in hospital environments. Enhanced surveillance and effective microbial control measures are essential to mitigate the risks associated with T. asahii infections. Full article

Neuromuscular hip dysplasia (NHD) is a common deformity in children with cerebral palsy (CP). Although some predictive factors of NHD are known, the prediction of NHD is in its infancy. We present a Clinical Decision Support System (CDSS) designed to calculate the probability of developing NHD in children with CP. The system utilizes an ensemble of three machine learning (ML) algorithms: Neural Network (NN), Support Vector Machine (SVM), and Logistic Regression (LR). The development and evaluation of the CDSS followed the DECIDE-AI guidelines for AI-driven clinical decision support tools. The ensemble was trained on a data series from 182 subjects. Inclusion criteria were age between 12 and 18 years and diagnosis of CP from two specialized units. Clinical and functional data were collected prospectively between 2005 and 2023, and then analyzed in a cross-sectional study. Accuracy and area under the receiver operating characteristic (AUROC) were calculated for each method. Best logistic regression scores highlighted history of previous orthopedic surgery (p = 0.001), poor motor function (p = 0.004), truncal tone disorder (p = 0.008), scoliosis (p = 0.031), number of affected limbs (p = 0.05), and epilepsy (p = 0.05) as predictors of NHD. Both accuracy and AUROC were highest for NN, 83.7% and 0.92, respectively. The novelty of this study lies in the development of an efficient Clinical Decision Support System (CDSS) prototype, specifically designed to predict future outcomes of neuromuscular hip dysplasia (NHD) in patients with cerebral palsy (CP) using clinical data. The proposed system, PredictMed-CDSS, demonstrated strong predictive performance for estimating the probability of NHD development in children with CP, with the highest accuracy achieved using neural networks (NN). PredictMed-CDSS has the potential to assist clinicians in anticipating the need for early interventions and preventive strategies in the management of NHD among CP patients. Full article

With the advancement of low-carbon and sustainable development initiatives, electric scooters, recognized as essential transportation tools and leisure products, have gained significant popularity, particularly among young people. However, the current electric scooter market is plagued by severe product similarity. Once the initial novelty fades for users, the usage frequency declines, resulting in considerable resource wastage. This research collected user needs via surveys and employed the KJ method (affinity diagram) to synthesize fragmented insights into cohesive thematic clusters. Subsequently, a hierarchical needs model for electric scooters was constructed using analytical hierarchy process (AHP) principles, enabling systematic prioritization of user requirements through multi-criteria evaluation. By establishing a house of quality (HoQ), user needs were transformed into technical characteristics of electric scooter products, and the corresponding weights were calculated. After analyzing the positive and negative correlation degrees of the technical characteristic indicators, it was found that there are technical contradictions between functional zoning and compact size, lightweight design and material structure, and smart interaction and usability. Then, based on the theory of inventive problem solving (TRIZ), the contradictions were classified, and corresponding problem-solving principles were identified to achieve a multi-functional innovative design for electric scooters. This research, leveraging a systematic industrial design analysis framework, identified critical pain points among electric scooter users, established hierarchical user needs through priority ranking, and improved product lifecycle sustainability. It offers novel methodologies and perspectives for advancing theoretical research and design practices in the electric scooter domain. Full article

Background: HIV-associated neurocognitive disorders (HANDs) continue to be a significant concern, despite the advancements in prognosis achieved through Combination Antiretroviral Therapy (cART). Neuropsychological assessment, recommended by international guidelines for HANDs diagnosis, can be resource-intensive. Brief screening tools, like the International HIV Dementia Scale (IHDS) and the Montreal Cognitive Assessment (MoCA), are crucial in facilitating initial evaluations. This study aims to assess the Italian IHDS (IHDS-IT) and evaluate its sensitivity and specificity in detecting cognitive impairment in HIV patients. Methods: This cross-sectional study involved 294 patients aged ≥30 years, evaluated at the Immunology Unit of the University of Cagliari. Cognitive function was assessed using the MoCA and IHDS. Laboratory parameters, such as CD4 nadir, current CD4 count, and HIV-RNA levels, were also collected. Statistical analyses included Spearman’s correlation, Receiver Operating Characteristic analysis, and the Youden J statistic to identify the optimal IHDS-IT cut-off for cognitive impairment detection. Results: The IHDS and MoCA scores showed a moderate positive correlation (Spearman’s rho = 0.411, p < 0.0001). ROC analysis identified an IHDS-IT cut-off of ≤9, yielding an Area Under the Curve (AUC) of 0.76, sensitivity of 71.7%, and specificity of 67.2%. At this threshold, 73.1% of patients with MoCA scores below 23 also presented abnormal IHDS scores, highlighting the complementary utility of both cognitive assessment instruments. Conclusions: The IHDS-IT exhibited fair diagnostic accuracy for intercepting cognitive impairment, with a lower optimal cut-off than previously reported. The observed differences may reflect this study cohort’s demographic and clinical characteristics, including advanced age and long-lasting HIV infection. Further, longitudinal studies are necessary to validate these findings and to confirm the proposed IHDS cut-off over extended periods. Full article

Terahertz (THz) communication is regarded as a key technology for achieving high-speed data transmission and wireless communication due to its ultra-high frequency and large bandwidth characteristics. In this study, we focus on a single-carrier THz communication system and propose a two-stage deep learning-based time-domain equalization method, specifically designed to mitigate the nonlinear distortions in such systems, thereby enhancing communication reliability and performance. The method adopts a progressive learning strategy, whereby global characteristics are initially captured before progressing to local levels. This enables the effective identification and equalization of channel characteristics, particularly in the mitigation of nonlinear distortion and random interference, which can otherwise negatively impact communication quality. In an experimental setting at a frequency of 230 GHz and a channel distance of 2.1 m, this method demonstrated a substantial reduction in the system’s bit error rate (BER), exhibiting particularly noteworthy performance enhancements in comparison to before equalization. To validate the model’s generalization capability, data collection and testing were also conducted at a frequency of 310 GHz and a channel distance of 1.5 m. Experimental results show that the proposed time-domain equalizer, trained using the two-stage DL framework, achieved significant BER reductions of approximately 92.15% at 230 GHz (2.1 m) and 83.33% at 310 GHz (1.5 m), compared to the system’s performance prior to equalization. The method exhibits stable performance under varying conditions, supporting its use in future THz communication studies. Full article

Genu valgum (GV) is a common lower limb deformity that may increase the risk of anterior cruciate ligament (ACL) injury. This study used OpenSim musculoskeletal modeling and kinematic analysis to investigate the mechanical responses of the ACL under fatigue in females with GV. Eight females with GV and eight healthy controls completed a running-induced fatigue protocol. Lower limb kinematic and kinetic data were collected and used to simulate stress and strain in the anteromedial ACL (A–ACL) and posterolateral ACL (P–ACL) bundles, as well as peak joint angles and knee joint stiffness. The results showed a significant interaction effect between group and fatigue condition on A–ACL stress. In the GV group, A–ACL stress was significantly higher than in the healthy group both before and after fatigue (p < 0.001) and further increased following fatigue (p < 0.001). In the pre-fatigued state, A–ACL strain was significantly higher during the late stance phase in the GV group (p = 0.036), while P–ACL strain significantly decreased post-fatigue (p = 0.005). Additionally, post-fatigue peak hip extension and knee flexion angles, as well as pre-fatigue knee abduction angles, showed significant differences between groups. Fatigue also led to substantial changes in knee flexion, adduction, abduction, and hip/knee external rotation angles within the GV group. Notably, knee joint stiffness in this group was significantly lower than in controls and decreased further post-fatigue. These findings suggest that the structural characteristics of GV, combined with exercise-induced fatigue, exacerbate A–ACL loading and compromise knee joint stability, indicating a higher risk of ACL injury in fatigued females with GV. Full article

Wild edible mushrooms are increasingly recognised for their nutritional and therapeutic potential, owing to their richness in bioactive compounds and antioxidant properties. This study assessed the chemical composition, antioxidant capacity, and bioaccumulation of heavy metals (Cd, Pb, Ni) in Boletus edulis, Imleria badia, and Leccinum scabrum collected from two forested regions of north-western Poland differing in anthropogenic influence and soil characteristics. The analysis encompassed structural polysaccharides (β- and α-glucans, chitin), carotenoids, L-ascorbic acid, phenolic and organic acids. B. edulis exhibited the highest β-glucan and lycopene contents, but also the greatest cadmium accumulation. I. badia was distinguished by elevated ascorbic and citric acid levels and the strongest DPPH radical scavenging activity, while L. scabrum showed the highest ABTS and FRAP antioxidant capacities and accumulated quinic acid and catechin. Principal component analysis indicated strong correlations between antioxidant activity and phenolic acids, while cadmium levels were inversely associated with antioxidant potential and positively correlated with chitin. Although all metal concentrations remained within EU food safety limits, B. edulis showed consistent cadmium bioaccumulation. From a practical perspective, the results highlight the importance of species selection and sourcing location when considering wild mushrooms for consumption or processing, particularly in the context of nutritional value and contaminant load. Importantly, regular or excessive consumption of B. edulis may result in exceeding the tolerable weekly intake (TWI) levels for cadmium and nickel, which warrants particular attention from a food safety perspective. These findings underscore the influence of species-specific traits and environmental conditions on mushroom biochemical profiles and support their potential as functional foods, provided that metal contents are adequately monitored. Full article