Search Results (17,957)

Point-of-care ultrasound (POCUS) is now part of everyday work in neonatal intensive care, supporting diagnosis, procedures, and decisions in acutely unwell infants. Its spread has outpaced the development of training, credentialing, and quality assurance structures, and the neonatal literature rarely describes how and why the technique fails. In this perspective, we focus on non-cardiac neonatal POCUS (lung, cranial, and abdominal). We adapt existing frameworks into four error domains: indication, image acquisition, image interpretation, and clinical integration. We also separate errors that can occur in any ultrasound examination from those tied to the point-of-care setting, including confirmation, anchoring, and availability bias, time pressure, and fatigue. Using illustrative cases and comparative tables, we describe common look-alike findings, summarize thermal and mechanical bioeffects by organ, and discuss probe and gel hygiene in the neonatal unit. We then outline a stepwise pathway for training, supervision, credentialing, and quality assurance, and suggest practical safeguards: structured protocols and reports, simple debiasing habits, image archiving with periodic expert review, and close collaboration with radiology and cardiology. Seen in this way, investment in safety is part of the value of neonatal POCUS rather than an added cost. Full article

Atmospheric particulate-matter variability reflects the combined effects of emissions, meteorology, and regional transport, and its interpretation benefits from the integration of complementary observations. This study combines two years (2023–2024) of aerosol light absorption at 880 nm (Abs880), PM2.5, PM10, and meteorological observations from ACTRIS/EBAS and ARPA Puglia to characterize the urban-scale covariation in Lecce, southern Italy. Since the aerosol-absorption and ARPA measurements were obtained at sites separated by approximately 6.3 km, the resulting relationships are interpreted as urban-scale associations rather than as co-located source-attribution measurements. After quality assurance/quality control, UTC time normalization, daily aggregation (>75% completeness), temporal alignment, and z-score standardization for PCA, the integrated observations were examined using seasonal comparisons, linear regression, principal component analysis, and HYSPLIT backward trajectories. PM2.5/PM10 ratio showed seasonal variability in both study years, with higher mean values during the winter. The PM2.5 was positively associated with the Abs880 (R² = 0.68 in 2023 and 0.59 in 2024), and the season-stratified regressions remained positive in all the seasonal subsets, although their strength varied. The meteorology-adjusted sensitivity models also retained a positive Abs880 coefficient after an HAC correction for serial dependence. The wind speed showed a weaker inverse association with PM2.5, whereas the temperature and the relative humidity showed weak pairwise associations. A PCA identified a common covariance direction among PM2.5, PM10, and Abs880, with additional meteorological structure in the six-variable sensitivity analysis. Two representative episodes contrasted an enhanced Abs880 under low-wind conditions with a spring Saharan-dust intrusion. Overall, this study characterizes the relationships among particulate matter, aerosol light absorption, meteorology, and regional transport over the 2023–2024 observation period. FAIR-oriented data practices and interoperable monitoring infrastructures provide the methodological framework that enables the integration, traceability, and reproducibility of these analyses. Full article

Advanced coupled resonance sensors (ACRS), built by integrating micropillar arrays onto quartz crystal microbalance (QCM) substrates, have emerged as a powerful platform for high-sensitivity measurement of viscosity, water contamination, temperature, and purification in liquid environments. Despite their demonstrated performance, the systematic role of pillar geometry, material properties, and fabrication tolerances on device behavior has not been investigated. This work presents a three-dimensional finite element digital twin of an ACRS device operating in air and liquid, in which pillar height, cross-sectional shape, elastic modulus, density, and internal loss factor are treated as independent input parameters. The model resolves the full coupled fluid–structure interaction using the linearized Navier–Stokes equations in the liquid domain, viscoelastic damping inside the pillar, and the periodic acoustic loading imposed by the QCM substrate. The framework was validated against pillar-height-dependent response in air and in deionized water for square (critical height 15 µm in air, 13 µm in water) and circular (11 µm in air, 9.5 µm in water) cross-sections, and against bulk-liquid viscosity loading across a sucrose–water series spanning approximately 1–15 cP, in which the model reproduced frequency shifts up to 85 kHz. Sensitivity enhancement exceeded a factor of 22 for both geometries near their critical heights, and the normalized peak shear displacement peaked at the critical height for both cross-sections in air and in water, exceeding the substrate amplitude by more than an order of magnitude. A Monte Carlo uncertainty propagation analysis demonstrated that operation at the critical height amplifies the standard uncertainty in resonance frequency by more than an order of magnitude relative to sub-critical operation, with geometric tolerances dominating over material property variability by a factor of two to four. The analysis recommends sub-critical operation for quantitative measurement, where the fabrication-driven combined coefficient of variation stays below 0.2% under realistic fabrication conditions. The model is validated for Newtonian liquids under fully wetted conditions and against the frequency response only. The viscosity response is validated over approximately 1–15 cP, and use outside this interval is an extrapolation of the calibration. The digital twin provides a metrologically grounded basis for ACRS design and material selection. Full article

Reliable assessment of crop water stress is essential for improving irrigation efficiency for upland crop and orchard fruit production. Thermal sensing combined with the crop water stress index (CWSI) provides a non-destructive approach for characterizing plant water status; however, its performance depends strongly on baseline determination, sensing platform, canopy architecture, environmental conditions, image-processing procedures, and validation strategy. This paper aimed to review thermal imaging and point-based infrared thermometry (IRT) approaches for CWSI measurement and mapping, with particular emphasis on sensing requirements of upland field crops and orchard fruit tree canopies. A PRISMA-aligned literature search was conducted using major scientific databases and complementary citation tracking, resulting in 68 primary studies included in the structured thematic synthesis. Empirical, theoretical, and artificial-reference CWSI formulations were compared together with handheld, ground-based, unmanned aerial vehicle (UAV)-mounted, fixed camera, and point-based IRT sensing configurations. Radiometric calibration, canopy segmentation, temperature extraction, spatial interpolation, and physiological validation methods were critically evaluated. The reviewed evidence indicates that image-based approaches provide valuable spatial information but remain sensitive to radiometric drift, mixed canopy–background pixels, shadowing, and baseline uncertainty, whereas point-based IRT offers high temporal resolution but depends strongly on representative sensor placement and field-of-view geometry. These limitations differed according to canopy architecture, with soil–background contamination being particularly important in incomplete field canopies and radiation-driven within-canopy heterogeneity being more important in orchards. Combining periodic spatial thermal mapping with continuous point-based monitoring provided a promising framework for precision irrigation. Future research should prioritize transferable baseline parameterization, standardized uncertainty reporting, multi-season commercial validation, benchmark datasets, and crop-specific irrigation thresholds. Full article

Skeleton-based human action recognition is attractive for practical vision systems because it represents motion compactly, but occlusion and pose-estimation failures can remove spatially adjacent joints for extended periods and degrade graph-based recognition. We propose a Topology-Aware Graph Learning (TAGL) framework that couples three mechanisms: Neighborhood Expansion Masking generates spatially correlated, sequence-level joint loss during training; Adaptive Multi-Hop Graph Learning reweights information from different graph distances when local neighborhoods become unreliable; and Holistic Topological Mapping provides complementary global structural cues through persistent topology. TAGL achieves 93.3%/97.9% top-1 accuracy on NTU RGB+D 60, 90.4%/91.6% on NTU RGB+D 120, 97.0% on Northwestern-UCLA, and 47.2% on UAV-Human. Across six heterogeneous skeleton corruptions, its average accuracy reaches 85.8%, compared with 79.3% without NEM and 84.5% with random masking, while requiring 1.78 M parameters and 2.58 GFLOPs. These results show that TAGL improves tolerance to incomplete and structurally degraded skeleton observations without excessive computational overhead. Its compact and corruption-aware design is therefore promising for skeleton-based monitoring systems operating under imperfect pose observations, including safety surveillance, human–robot interaction, and rehabilitation-oriented motion analysis. Full article

The standard Grey Wolf Optimizer (GWO) suffers from rapid population diversity loss when solving the Traveling Salesman Problem (TSP), leading to premature convergence. This paper proposes the Closed-Loop Adaptive Grey Wolf Optimizer (CLA-GWO), which constructs a five-layer closed-loop adaptive framework comprising: (i) discrete GWO evolution, (ii) dual-threshold diversity detection, (iii) three-level adaptive catastrophe, (iv) two-phase recovery, and (v) self-learning feedback control. The algorithm autonomously perceives population homogenization and restores diversity through scale-adaptive intervention. A two-stage parameter optimization strategy, combining the tree-structured Parzen estimator (TPE) with one-factor-at-a-time (OAT) sensitivity analysis, identified the optimal configuration. Component ablation on seven variants revealed that performance is principally driven by 2-opt local search and nearest-neighbor (NN) initialization, while the catastrophe lockout period (CLP) and multi-level catastrophe mechanisms safeguard diversity. Benchmark comparison on 20 TSPLIB instances demonstrated that CLA-GWO achieves competitive or superior performance under the adopted benchmark protocol against eight state-of-the-art algorithms across primary and secondary comparison groups. A Friedman test confirmed that the overall performance difference among the three independent baselines and CLA-GWO is statistically significant. The framework’s perceive–decide–intervene–recover–learn principle suggests a candidate transferable design pattern for other population-based metaheuristics; its current validation is limited to symmetric TSP, and asymmetric or non-Euclidean variants remain to be examined. Full article

Since 1999, Kosovo has depended on an extremely close partnership with the United States for state-building, security guarantees, diplomatic recognition and Euro-Atlantic momentum. Yet, under Prime Minister Albin Kurti, bilateral relations have hit their most sour point in a quarter century. This article examines whether Kurti’s foreign policy marks a structural change from Washington, or a continuation of long-standing Kosovo strategic goals carried out by new domestically motivated means. Drawing on insights from neoclassical realism and small-state behaviors of both the past and present, as well as from process-tracing during events taking place over the period of 2019 to 2025, the research assesses the inter-relationship among domestic nationalism, elite competition, and the identity politics of Vetëvendosje versus international pressure from the United States, the EU and Serbia. The findings suggest that, although Kosovo’s grand strategy formally still depends on Euro-Atlantic integration as a preferred choice, Kurti’s leadership style, typified by unilateral decisions and choices of security and confrontation rhetoric and deflationary opposition to externally sponsored house compromises, materially damages U.S-Kosovo trust. Consequences include that Washington would suspend the Strategic Dialogue with Kosovo in 2025 and the fact that there has also been increased diplomatic criticism of policies in the Serb-majority north. These developments are in contrast with Kosovo’s dependence on American sponsorship after 1999 and show that domestic political incentives have won over strategic caution. The article concludes that Kurti’s approach is one of partial continuity in the goals but a rupture in the behavior: Kosovo continues to seek alignment with the States of the West (NATO, EU and U.S.) but through foreign policy strategies that are detrimental to them, and so weaken Kosovo’s negotiating leverage—with the risk of a long-term diplomatic isolation. Full article

This paper introduces a unified analytical framework for solving a broad class of nonlinear partial differential equations by mapping them onto a fundamental second-order nonlinear template equation. While various direct methods such as the $G^{\prime }/G$-expansion , Kudryashov, and Jacobi elliptic function methods are widely used, we demonstrate that their underlying mechanism relies on reducing nonlinear partial differential equations to ordinary differential equations via traveling-wave transformations. By identifying a central prototype equation, $y^{\prime \prime }\left(\xi \right)=A{y}^2\left(\xi \right)+By\left(\xi \right)$, we provide a systematic approach to extract exact solutions for ten renowned nonlinear equations from diverse physical domains. Beyond algebraic derivations, the study investigates the structural and dynamical properties of the template equation, including phase-plane geometry, stability analysis, and a Poincaré-map and Lyapunov-exponent-verified route to deterministic chaos under periodic perturbations. The results confirm that the proposed template not only simplifies the solution-finding process but also serves as a robust tool for predicting complex transitions and stability regimes in nonlinear dispersive media. Full article

The human auditory system can selectively prioritize a target speaker in the presence of competing speech, providing a biological model for the design of interpretable auditory systems. In this study, we present a biomimetic computational auditory framework that translates temporal-processing principles of human hearing into an engineering mechanism for target-speech enhancement. Motivated by the distinct temporal characteristics of transient and quasi-periodic speech components, the proposed framework employs two complementary processing pathways. A first-order differential pathway emphasizes transient consonant cues, whereas a delay-superposition pathway exploits the quasi-periodicity of vowel signals to reinforce target-related periodic structures. The enhanced components are subsequently screened through an enhancement-based criterion and selectively reconstructed using zero-crossing-based signal replacement. Experiments on CRM two-talker speech mixtures demonstrated effective target-speech enhancement across multiple speaker-pair conditions, including both same- and cross-gender mixtures. The proposed method consistently improved target selectivity and preserved the principal spectral characteristics of the designated speaker. Psychoacoustic experiments were further used to examine the perceptual relevance of differentiated consonant-vowel processing and selective auditory attention. Rather than reproducing auditory neural circuitry directly, the proposed model provides an interpretable engineering abstraction of biological temporal-selection principles. These findings demonstrate how auditory mechanisms can be translated into a transparent biomimetic signal-processing architecture and provide a basis for future bio-inspired and neuromorphic auditory systems. Full article

Taiwan’s central role in global semiconductor manufacturing exposes Taiwan-related ETFs to technology concentration, geopolitical uncertainty, and supply-chain disruptions, resulting in return distributions characterized by heavy tails, volatility clustering, and asymmetric responses to negative shocks. This study analyzed thirty U.S.-listed ETFs with Taiwan exposure from February 2015 to February 2025 using tail-risk diagnostics, asymmetric volatility modeling, and portfolio optimization under mean–variance and conditional value-at-risk (CVaR) criteria. Hill tail-index estimates documented heavy-tailed behavior across the ETF universe. Although the ETFs exhibited broadly similar asymptotic tail-decay behavior, semiconductor-focused ETFs produced substantially larger VaR and CVaR estimates than diversified benchmarks, indicating that cross-sectional differences in extreme downside risk were driven primarily by differences in return scale rather than tail-index estimates. GJR–GARCH estimates revealed persistent and asymmetric volatility. The apparent long memory in squared returns may therefore largely reflect conditional heteroskedasticity rather than genuine fractional integration, as GJR–GARCH filtering substantially reduced the evidence of long-range dependence. This result was robust across bandwidth choices for EWT, although some bandwidth sensitivity remained for EWP. CVaR optimization produced substantially more concentrated allocations than mean–variance optimization, with the CVaR tangent portfolio allocating a large weight to SMH; this concentration was most pronounced during the post-COVID, AI-driven semiconductor boom and should be interpreted as a feature of this sample period rather than a persistent structural property of semiconductor ETFs. Portfolio rankings depended on the performance measure: the Sharpe ratio and STARR measure favored the equally weighted portfolio, whereas the Rachev ratio favored CVaR-based portfolios. Overall, the results suggested that variance-based frameworks alone provided an incomplete characterization of risk in technology-concentrated investment environments and that variance-based and tail-sensitive performance measures could favor different portfolios over the same sample period. Full article

Background/Objectives: Structured perioperative checklists may standardize bariatric surgical care, but their association with early clinical outcomes remains uncertain. This study compared 30-day postoperative outcomes before and after implementation of a structured perioperative checklist and characterized complications by type and Clavien–Dindo severity. Methods: This single-center retrospective pre–post cohort study included patients undergoing primary bariatric surgery from June 2024 through December 2025. The checklist was prospectively introduced on 29 July 2024. Cohort identification, data extraction, outcome classification, and comparative analyses were performed retrospectively. Forty patients were included in each cohort. The primary outcome was any 30-day postoperative complication; secondary outcomes included complication severity, intensive care unit admission, and length of hospital stay. Checklist implementation was assessed on the basis of documented completion; item-level adherence to individual perioperative measures and corrective actions prompted by checklist responses were not assessed. Accordingly, the intervention evaluated in this study represents implementation of a structured checklist-based documentation and care-standardization process rather than verified adherence to individual checklist components. Results: Complications occurred in 4 of 40 patients (10.0%) in the checklist group and 9 of 40 (22.5%) in the non-checklist group (relative risk, 0.44; 95% confidence interval, 0.15–1.33; p = 0.13). Minor complications occurred in 7.5% and 15.0%, respectively, and major complications in 2.5% and 7.5%, respectively. The study was underpowered to reliably detect a between-group difference in the observed magnitude in 30-day complication rates; therefore, this comparison should be interpreted as exploratory. Median hospital stay was shorter in the checklist group (3 days; interquartile range, 2.5–4.0) than in the non-checklist group (4 days; interquartile range, 3.0–6.0; Mann–Whitney U = 398; p < 0.001). Intensive care unit admission occurred in 7.5% and 17.5%, respectively (p = 0.31). Given the sequential, non-overlapping study periods, the observed difference in length of stay cannot be separated from secular changes in clinical practice, discharge processes, institutional factors, or surgical-team experience. Conclusions: Checklist implementation was temporally associated with a shorter postoperative length of stay, whereas the observed reduction in 30-day complications did not reach statistical significance. Because the cohorts were treated during sequential, non-overlapping periods, these differences cannot be attributed independently to checklist implementation. The findings should therefore be considered exploratory and hypothesis-generating. Full article

Background: Fever and its related symptoms are common reasons for pediatric emergency department (ED) visits. Parents are often concerned about fever in children, and a frequent reason for ED visits is the persistence of fever despite the administration of antipyretics at home. It is hypothesized that caregivers often administer incorrect doses of acetaminophen and ibuprofen. Objective: To assess caregivers’ dosing practices in children with fever by evaluating the accuracy of acetaminophen and ibuprofen dosing and to identify factors associated with inaccurate dosing in Saudi Arabia. Methodology: A cross-sectional survey was conducted over a six-month period from 1 January 2022 to 30 June 2022 in the emergency department. We included caregivers of children under 14 who received a quantifiable dose of acetaminophen or ibuprofen for fever. Data were collected using a structured questionnaire. Multivariable regression analysis was utilized to identify factors associated with inaccurate dosing. Results: A total of 330 caregivers of children were included in the study. The caregivers’ ages ranged from 18 to 60 years, with a mean age of 32.3 ± 6.4. Of these, 148 (44.8%) had university-level education or higher, while 33 (10%) had education below high school level. Only 81 caregivers (24.5%) administered the correct dose of medication. In contrast, 118 (35.8%) gave subtherapeutic doses, 40 (12.1%) administered higher-than-recommended doses, and 91 (27.6%) were unsure about the correct dose. Multivariable regression indicated that caregivers with education below high school (aOR = 2.65; 95% CI: 1.30–5.40 for low dose) and those making self-directed dosing decisions (aOR = 2.10; 95% CI: 1.15–3.85 for low dose) were significantly associated with incorrect dosing. Conclusions: The study indicates that approximately three-quarters of caregivers either administered incorrect doses of acetaminophen or ibuprofen or were unsure of the correct dose. Given that 93% of caregivers were unaware of medication concentrations, targeted educational interventions are required to improve dosing accuracy. Full article

Public expenditure is central to human development, but higher spending does not necessarily produce better outcomes. This study examines fiscal commitment, institutional conditions, and health and education trajectories in Canada, Malaysia, and South Africa in relation to Sustainable Development Goals 3, 4, 8, and 16. Using indicator-specific longitudinal data covering 1990–2024, including health expenditure for 2000–2023, it applies a comparative trajectory-based design combining descriptive statistics, period changes, indexed trajectories, bilateral gap analysis, averaged-endpoint robustness tests, and expenditure–outcome co-movements. The findings reveal multidimensional, indicator-specific trajectories. Canada retained the strongest institutional and developmental levels, although gains were generally modest from high initial conditions. Malaysia converged across several outcomes despite comparatively low health expenditure and declining education expenditure shares. South Africa increased expenditure and improved infant mortality and schooling but continued to diverge in life expectancy, unemployment, and selected governance indicators. HDI trajectories synthesize these previously examined health, education, and income dimensions rather than provide independent confirmation. The study contributes an integrated longitudinal comparison that distinguishes fiscal commitment, absolute progress, and bilateral convergence. Although non-causal, the analysis shows how expenditure and outcomes evolved differently across institutional and structural contexts over more than three decades, supporting context-sensitive, outcome-focused public management. Full article

Background: The government’s health expenditure in the European Union is determined by a number of factors, including economic capacity, financing arrangements, demographic pressures, health needs, environmental exposure, and labour-market conditions. The EU-27 provides a significant comparative context, given that Member States share a broad institutional framework while exhibiting considerable variation in fiscal capacity, population structure, and health-system financing. Methodology: This study analyses a balanced EU-27 panel for the years 2000–2023. The econometric approach addresses such phenomena as cross-sectional dependence, mixed integration orders, endogenous structural breaks, uncertain panel cointegration, and non-standard residual dependence. The primary stationary specification uses country and year fixed effects with Driscoll–Kraay standard errors. Supplementary robustness checks encompass alternative and predetermined financing measures, common-correlated-effects estimators, and finite-T dynamic sensitivity analysis. Results: Nine of the thirteen analysed series are I(1), while the remaining four are I(0). Bootstrap Westerlund tests do not provide evidence of robust multivariate panel cointegration. In the primary specification, GDP growth is positively associated with the annual log change in government health expenditure per capita, measured in current-PPP international dollars (β = 0.412, p < 0.001). Unemployment is negatively associated with expenditure change. Conversely, old-age dependency is positively associated with expenditure change, although this association is more sensitive to model specification. The strong contemporaneous coefficients on private health-expenditure share and government health budget share become negligible and statistically insignificant when one-period-lagged changes are employed. This finding suggests that these are contemporary financing-composition co-movements rather than prospective effects. Under pooled and heterogeneous common-correlated-effects estimators, the GDP coefficient remains positive but is substantially attenuated and loses conventional statistical significance. A finite-T sensitivity analysis reveals a weak positive short-run persistence; however, this is insufficient to substitute for the parsimonious static specification. Conclusions: Economic capacity is the most stable positive correlate across the financing-robustness exercises. However, common-factor adjustment reduces both its magnitude and statistical significance. The findings support cautious interpretation of the financing and demographic associations and demonstrate that estimator choice matters in EU health-expenditure panels. Full article

The diffraction properties of a 2D grating realized with heliconical cholesteric liquid crystal (ChOH) have been studied by extended computer simulation using the finite element method. In particular, the dependence of the diffraction efficiency and the positions of various reflection orders arising in a 2D ChOH on its geometric parameters—such as the transverse period, sample thickness, and the types of polarization of the incident radiation—has been investigated in detail. The structure is made by a periodic alternation of stripes with different pitches producing the transversal grating, while the longitudinal grating is given by the heliconical order of the material. It is shown that a double Bragg diffraction originates from the 2D grating with maximum efficiency for circularly polarized light with the same handedness as the liquid crystal helix. Unique optical properties of this structure have been highlighted. Spectral and angular symmetry of plus/minus orders of diffraction is broken by a small increase in the angle of incidence, while mutual tunability of the double diffraction is achieved through the applied electric field. We also highlight a peculiar feature of this structure: by varying the applied field, it is possible to tune one diffraction resonance with respect to the other one and to switch off the double diffraction. Full article