Search Results (19,579)

Pressure-controlled intermittent coronary sinus occlusion (PICSO) was initially developed to salvage ischemic myocardium. However, recent evidence suggests a more profound role: reawakening embryonic molecular pathways that facilitate myocardial regeneration. This review examines the paradigm shift in PICSO’s mechanism—from its traditional focus on infarct size reduction to its emerging role as a catalyst for myocardial repair through the reactivation of embryonic signaling. Findings suggested that myocardial decay could be ameliorated beyond salvage, revealing that PICSO enhances vascular activation in the coronary venous system, thereby influencing the fate of endothelial and myocardial cells. The theorem “embryonic recall” posits that PICSO induces molecular signals reminiscent of early cardiac development, offering a novel approach to cardiac repair in myocardial jeopardy. Noncoding RNA serves as a universal signaling event, thereby supporting the hypothesis. Yet, conflicting clinical outcomes highlight the need to redefine PICSO’s objectives, optimize device settings, and realize interventional strategies. The evolution of PICSO demands a radical shift in scientific perspective. Beyond ischemic salvage, its true potential may lie in harnessing regenerative mechanisms within the failing heart. Modern cardiology must adopt this dual role, bridging mechanical intervention with molecular rejuvenation to ensure its continued viability as a therapeutic option. PICSO, like the phoenix, may yet rise anew as a transformative force in cardiovascular medicine. Full article

Background: Static coronal alignment is considered a key of lower limb biomechanics after total knee replacement (TKR); however, its relationship with dynamic foot loading patterns and gait characteristics remains unclear. The primary objective of this prospective study was to investigate whether there is a correlation between dynamic plantar pressures and spatiotemporal parameters of gait and the coronal alignment of the lower limb after unilateral TKR for primary knee osteoarthritis (KOA). Methods: Thirty-two consecutive patients scheduled for TKR were evaluated preoperatively and at six months postoperatively. Changes in plantar pressure distribution and spatiotemporal gait parameters were collected using a multiplatform plantar pressure analysis system (PPAS), while coronal alignment was assessed using the femorotibial angle (FTA). Relationships with preoperative, postoperative, and correction-related alignment measures were examined using non-parametric statistical methods. Results: Dynamic plantar pressures and spatiotemporal gait parameters were not found to be consistently associated with pre- or postoperative values of FTA, respectively. Furthermore, the degree of correction did not appear to influence baropodometric outcomes. Conclusions: Static coronal alignment, as defined by the FTA, was not found to be consistently associated with dynamic plantar pressure patterns or spatiotemporal gait parameters at six months following unilateral TKR in our study population. These findings highlight the potential limitations of using solely static radiographic markers to evaluate complex functional outcomes such as gait. Full article

Water distribution pipe systems (WDPSs) are critical for delivering irrigation water in an irrigation district. Ensuring the WDPS operates with good operational performance has become a key focus for irrigation water management. Assessing the operational performance of WDPS from both water delivery capacity and pressure changes is compatible with the system, but such an approach has rare been proposed systematically. This paper establishes an integrated framework to assess the performance of WDPS by combining a performance indicator system with a simulation model. The performance indicator system encompasses Adequacy, Efficiency, Equity, and Pressure Reliability, capturing both water delivery capacity and pressure changes. The simulation model is established for providing required data for calculating the performance indicators. Applied to a case study, the framework demonstrates its applicability. Under the specified conditions of the case study, the overall assessment results of WDPS are Adequacy (0.99), Efficiency (0.993), Equity (0.0484), and Pressure Reliability (0.82). Meanwhile, the assessment results at different outlet nodes of the WDPS indicate that there may be insufficient pressure and excessive water supply at some outlet nodes of the WDPS. Further interpretation of the results indicates that the proposed method has the potential to be beneficial for irrigation water management, as it enables strategic assessment of the future operational performance of water distribution pipe systems (WDPSs) and provides effective management guidance for irrigation district managers. Full article

Under the pressing imperative of achieving “dual carbon” goals and advancing urban low-carbon transitions, understanding how neighborhood spatial environments influence carbon emissions has become a critical challenge for enabling refined governance and precise planning in urban carbon reduction. Taking the central urban area of Xining as a case study, this research establishes a high-precision estimation framework by integrating Semantic Segmentation of Street View Images and Point of Interest data. This study employs a Geographically Weighted XGBoost model to capture the spatial non-stationarity of emission drivers, achieving a median R² of 0.819. The results indicate the following: (1) Socioeconomic functional attributes, specifically POI Density and POI Mixture, exert a more dominant influence on carbon emissions than purely visual features. (2) Lane Marking General shows a strong positive correlation by reflecting traffic pressure, Sidewalks exhibit a clear negative correlation by promoting active travel, and Building features display a distinct asymmetric impact, where the driving effect of high density is notably less pronounced than the negative association observed in low-density areas. (3) The development of low-carbon neighborhoods should prioritize optimizing functional mixing and enhancing pedestrian systems to construct resilient and low-carbon urban spaces. This study reveals the non-linear relationship between street visual features and neighborhood carbon emissions, providing an empirical basis and strategic references for neighborhood planning and design oriented toward low-carbon goals, with valuable guidance for practices in urban planning, design, and management. Full article

Aviation hydrogen internal combustion engines represent a critical pathway for rapid decarbonization due to their reliability and compatibility with existing aircraft platforms. However, the significant reduction in air density at high altitudes causes severe power degradation in naturally aspirated port-fuel-injected hydrogen internal combustion engines, making turbocharging essential for maintaining propulsion capability. This study utilizes a combined experimental and simulation framework to investigate turbocharger matching for power recovery in a 1.4 L hydrogen engine. A simulation model was constructed and validated against experimental data within a 5% error margin to ensure technical accuracy. Theoretical compressor and turbine operating parameters were derived for altitudes ranging from 4 to 8 km, comparing two boost-pressure control strategies: variable geometry turbine and waste-gate turbine. The results demonstrate that both boosting strategies successfully restore sea-level power at altitudes up to 8 km, increasing high-altitude power output by approximately four-fold to five-fold compared to naturally aspirated conditions. Specifically, the variable of geometry turbine demonstrates superior overall performance, maintaining normalized turbine efficiencies between 78.4% and 96.3% while achieving lower pumping losses and improved brake thermal efficiency. These advantages arise from the variable geometry turbine’s ability to optimize exhaust-energy utilization across varying altitudes. This study establishes a quantitative methodology for turbocharger matching, providing essential guidance for developing efficient, high-altitude hydrogen propulsion systems. Full article

Education systems worldwide face a growing pressure to align with Sustainable Development Goal 4.7 by embedding Education for Sustainable Development (ESD) into school life. This study examines how primary school headteachers in Cyprus interpret and enact sustainable leadership to advance ESD within a small, highly centralised system. Drawing on sustainable and distributed leadership theories and a whole-school lens, the study employed semi-structured interviews with ten headteachers from diverse regions (urban, rural, and semi-rural). Reflective thematic analysis identified four patterns: (1) leaders sought a strategic integration of ESD into planning and culture; (2) empowerment and participation were pursued through teacher working groups, student eco-councils, and community partnerships; (3) systemic constraints, a rigid curriculum, limited autonomy, and scarce professional development produced a policy–practice gap; and (4) leaders relied on adaptive, collaborative micro-practices to sustain momentum. The findings suggest that, in Cyprus, sustainable leadership operates as a values-based stewardship enacted through ‘quiet activism’. The study highlights implications for leadership development, such as reflexivity, systems thinking, and ethical reasoning, as well as policy design, such as time, autonomy, and structured support for whole-school ESD, in small-state contexts. Full article

As critical platforms for long-endurance ocean exploration, unmanned underwater vehicles (AUVs) play an increasingly vital role in marine surveying and resident observation. However, in extreme deep-sea environments, their energy systems face severe constraints imposed by hydrostatic pressure and thermodynamic conflicts within confined spaces. Therefore, developing energy technologies with high energy density, intrinsic safety, and high-pressure adaptability is of paramount importance. This paper provides a comprehensive review of the multi-physics coupling issues in deep-sea energy systems and the research progress of current mainstream deep-sea energy technologies. Based on energy sources and conversion principles, existing technological paths are categorized into four classes, with a detailed assessment of their performance and bottlenecks in deep-sea environments. Finally, the paper outlines key future development directions for deep-sea energy systems to provide reference for subsequent research. Full article

Eutrophication remains a persistent challenge in the Romanian Black Sea coastal zone, driven by excess nutrient inputs from riverine and coastal sources and further intensified by climate change. This study assesses eutrophication dynamics and explores mitigation options using an integrated framework that combines in situ observations, satellite-derived chlorophyll a data, machine learning, and system dynamics modelling. Water samples collected during two field campaigns (2023–2024) were analyzed for nutrient concentrations and linked with chlorophyll a products from the Copernicus Marine Service. Random Forest analysis identified dissolved inorganic nitrogen, phosphate, salinity, and temperature as the most influential predictors of chlorophyll a distribution. A system dynamics model was subsequently used to explore relative ecosystem responses under multiple management scenarios, including nutrient reduction, enhanced zooplankton grazing, and combined interventions. Scenario-based simulations indicate that nutrient reduction alone produces a moderate decrease in chlorophyll a (45% relative to baseline conditions), while restoration of grazing pressure yields a comparable response. The strongest reduction is achieved under the combined scenario, which integrates nutrient reduction with biological control and lowers normalized chlorophyll a levels by approximately two thirds (71%) relative to baseline. In contrast, a bloom-favourable scenario results in a several-fold increase in chlorophyll a of 160%. Spatial analysis highlights persistent eutrophication hotspots near the Danube mouths and urban discharge areas. These results demonstrate that integrated strategies combining nutrient source control with ecological restoration are substantially more effective than single-measure interventions. The proposed framework provides a scenario-based decision-support tool for ecosystem-based management and supports progress toward achieving Good Environmental Status under the Marine Strategy Framework Directive. Full article

This paper presents an analytical model for one-dimensional consolidation analysis of multi-layered unsaturated soils under depth-dependent initial conditions. The general solutions are derived explicitly using the Laplace transform. By combining these general solutions with interfacial continuity conditions between layers and the boundary conditions, the reduced-order system is solved via the Euler method to obtain analytical solutions in the Laplace domain. Numerical inversion of the Laplace transform is then performed using Crump’s method to yield the final analytical solutions in the time domain. The model incorporates initial conditions that account for both uniform and linear distributions of initial excess pore pressure within the soil stratum. The proposed solution is verified by reducing it to degenerated cases (e.g., uniform initial pressure) and comparing it with existing analytical solutions, showing excellent agreement. This confirms the model’s correctness and demonstrates its generalization to multi-layered systems with depth-dependent initial conditions. Focusing on a double-layered unsaturated soil system, the one-dimensional consolidation characteristics under depth-dependent initial conditions are investigated by varying the physical parameters of individual layers. The proposed solution can serve as a theoretical reference for the consolidation analysis of multi-layered unsaturated soils with depth-dependent initial conditions. Full article

Background/Objectives: Optical coherence tomography angiography (OCTA) is a non-invasive imaging method that enables accurate in vivo visualisation and quantification of the macular and optic nerve head microvasculature, providing an indirect assessment of local retinal perfusion. This study aimed to evaluate the changes in OCTA perfusion parameters of macula and optic nerve head in healthy individuals following different isometric exercises and to determine their association with intraocular pressure alterations. Methods: Each subject performed four isometric exercises: elbow plank, reverse plank, right-side plank, and wall sit. Measurements of intraocular pressure, systemic blood pressure, heart rate, and OCT angiography of macula and optic nerve head were conducted before each exercise, immediately after its completion, and after a five-minute rest period. Intraocular pressure was measured using a Perkins applanation tonometer, and systemic blood pressure and heart rate were recorded using an automated sphygmomanometer. The relationship between changes in intraocular pressure and OCTA perfusion parameters was analysed. Results: A total of 12 eyes of 12 healthy subjects were included in the study, with a mean age of 28.67 ± 2.39 years. An immediate reduction in optic nerve head vessel density was observed after each exercise (elbow plank: p = 0.012; wall sit: p = 0.009; reverse plank: p < 0.001; right-side plank: p < 0.001), with a sustained decrease during the rest period following right-side plank. No significant changes in vessel density were observed in the macular region. Heart rate and systemic blood pressure increased after each exercise, while intraocular pressure increased following all exercises except the wall sit. Changes in intraocular pressure were significantly negatively associated with changes in optic nerve head vessel density in the post-rest period following elbow plank (inside disc sector: b = −1.153, p = 0.02, peripapillary sector: b = −0.369, p = 0.009) and reverse plank (whole image sector: b = −0.589, p = 0.031). Conclusions: The performance of isometric exercises induced an acute reduction in optic nerve head vessel density, and a significant association with intraocular pressure changes was observed. OCTA represents a promising research tool not only for the assessment of retinal microcirculation but also in the field of sports medicine. Full article

As a natural refrigerant, CO₂ shows significant potential in sustainable thermal engineering due to its environmental safety and economic viability. While the transcritical CO₂ cycle demonstrates strong performance in heating, low-temperature applications, and integration with renewable energy sources, its widespread adoption is hindered by key challenges at the application level. These include: high sensitivity of system efficiency to operating conditions, which creates an “efficiency hump” and narrows the optimal operating window; increased component costs and technical challenges for key devices such as multi-channel valves due to high-pressure requirements; and complex system control with limited intelligent solutions currently integrated. Despite these challenges, the transcritical CO₂ cycle holds unique value in enabling synergistic energy conversion. Its ability to efficiently match and cascade different energy grades makes it particularly suitable for data center cooling, industrial combined cooling and heating, and solar–thermal hybrid systems, positioning it as an indispensable technology in future low-carbon energy systems. To fully realize its potential, development efforts must focus on high-value applications and key technological breakthroughs. Priority should be given to demonstrating its use in fields where it holds a distinct advantage, such as low-temperature refrigeration and high-temperature industrial heat pumps, to establish commercially viable models. Concurrently, core technologies—including adaptive intelligent control algorithms, high-efficiency expanders, and cost-effective pressure-resistant components—must be advanced. Supportive policies, encompassing energy efficiency standards, safety regulations, and fiscal incentives, will be essential to facilitate the transition from demonstration projects to widespread industrial adoption. Full article

Hypertension remains a major public health concern globally. Accumulating evidence suggests that dietary phosphate (Pi) and fibroblast growth factor 23 (FGF23), a phosphaturic hormone, are involved in blood pressure regulation. Experimental studies have shown that excess Pi consumption, largely from inorganic Pi used as a preservative or flavor enhancer in processed foods, and increased FGF23 may contribute to vascular abnormalities, thereby promoting hypertension. Importantly, recent animal studies have demonstrated that peripheral FGF23 can cross the blood–brain barrier and stimulate FGF receptor 4 (FGFR4)-calcineurin signaling in the brain, contributing to sympathetic overactivation and hypertensive responses during high Pi loading. Additionally, dietary Pi loading leads to suppression of Klotho, which may further contribute to hypertension. Such mechanisms are potentially relevant to chronic kidney disease (CKD), a condition characterized by Pi retention, massively elevated FGF23, sympathetic overactivity, and hypertension. This review highlights current evidence linking Pi-induced FGF23 pathogenically to hypertension, with focus on FGF23 translocation to and FGFR4 signaling in the central nervous system as a potential mechanism and therapeutic target for hypertension associated with high Pi intake and CKD. Full article

The systems to manipulate a single particle in a microfluidic channel can be adopted to pharmacological and cytological experiments of single-cell observation. The common cell position systems use syringe pumps driven by piezoelectric devices, and these have a flow quantity limit. To achieve single-cell manipulation using actuators without limiting the flow quantity and with a low risk of contamination, we propose a particle control system that uses a sidewall-driven peristaltic micropump driven by pneumatic pressure. The adopted pump was integrated into a single-layer mold with a flow path and was simple to fabricate. Unlike syringe pumps, it not only pumps water forward, but also inhales from the back simultaneously, and can pump indefinitely. We developed a responsive and precise particle position control system using this pump in combination with a high-speed camera. In this system, the pumping pressure is operated by real-time adjustment of a pneumatic pressure supply to realize PID control. This approach moves the particle rapidly when it is far from a designated target position for a quick approach and slowly near the target position to position precisely. Full article

Background: Health care work contributes significantly to greenhouse gas emissions. Primary health care is community-based and focused on wellness and disease prevention. Within primary health care, pharmacists are most frequently the stewards of medicines, supplies, and other tangible products that contribute to carbon footprints. Pharmacists are in a unique position to help adapt to and mitigate climate change-related issues. Objective: To examine pharmacists’ perspectives on climate adaptation and mitigation strategies in primary health care delivery in interprofessional settings. Methods: Semi-structured qualitative interviews with primary care pharmacists were undertaken. Constant-comparative data analysis was used to code and categorize findings. The COREQ system was applied to ensure rigor and quality of research. Results: A total of 21 primary care pharmacists participated in this research. Several core themes emerged as follows: (a) universal agreement that climate change is real and primary health care needs to evolve rapidly to address it; (b) recognition that primary health care is time-pressured and resource constrained so successful solutions need to be pragmatic and work within realities of practice; (c) identification of actionable priorities with high potential for mitigation impact; and (d) mobilization of a coalition to develop system-wide initiatives that could be implemented in primary health care. Conclusions: Collaborative approaches and those that focus on the implementation of regulatory requirements were identified as being most productive in this setting. Full article

Water wastage management (WWM) in deep-level mines remains a critical challenge, as wastage increases operational costs and threatens sustainability. This study presents a systematic state-of-the-art review of WWM in deep-level mines. Relevant literature was critically assessed to establish current practices, identify limitations, and explore emerging solutions. Five principal approaches were identified: leak detection and repair, pressure control with fixed schedules, network optimisation, accountability measures, and smart management. While each provides benefits, significant challenges persist. Particularly, current pressure control techniques, essential for limiting leakage, rely on static demand profiles that cannot accommodate the stochastic nature of service water demand, often resulting in over- or under-supply. Smart management systems, which have proven effective for managing stochastic utilities in other industries, present a promising alternative. Enabling technologies such as sensors, automated valves, and tracking systems are already widely deployed in mining, underscoring the technical feasibility of such systems. However, no studies have yet examined their development for WWM in deep-level mines. This study recommends a framework for smart water management tailored to mining conditions and highlights three opportunities: developing real-time demand approximation methods, leveraging occupancy data for demand estimation, and integrating these models with mine water supply control infrastructure for implementation and evaluation. Full article