Search Results (697)

Background/Objectives: While elevated Lp(a) levels are associated with incident heart failure development, the role of Lp(a) in established heart failure with reduced ejection fraction (HFrEF) versus heart failure with preserved ejection fraction (HFpEF) remains unexplored. Methods: We conducted a retrospective analysis of 387 heart failure patients from our institutional database (January 2018–June 2024). Patients were categorized as HFrEF (n = 201) or HFpEF (n = 186) using ICD-10 codes. Categorical variables were compared between heart failure types using the Chi-square test or Fisher’s Exact test, and continuous variables were compared using the two-sample t-test or Wilcoxon rank-sum test, as appropriate. Logistic regression was utilized to assess heart failure type as a function of Lp(a) levels, adjusting for covariates. Spearman correlation assessed relationships between Lp(a) and pro-BNP levels. Results: Despite significant demographic and clinical differences between HFrEF and HFpEF patients, Lp(a) concentrations showed no significant variation between groups. Median Lp(a) levels were 60.9 nmol/dL (IQR: 21.9–136.7) in HFrEF versus 45.0 nmol/dL (IQR: 20.1–109.9) in HFpEF (p = 0.19). After adjusting for demographic and clinical covariates, Lp(a) showed no association with heart failure subtype (OR: 1.001, 95% CI: 0.99–1.004; p = 0.59). Conclusions: Lp(a) levels do not differ significantly between HFrEF and HFpEF phenotypes, suggesting possible shared pathophysiological mechanisms rather than phenotype-specific biomarker properties. These preliminary findings may support unified screening and treatment strategies for elevated Lp(a) across heart failure, pending confirmation in larger studies. Full article

This study proposes a novel metaheuristic algorithm, Cosmic Evolution Optimization (CEO), for numerical optimization and engineering design. Inspired by the cosmic evolution process, CEO simulates physical phenomena including cosmic expansion, universal gravitation, stellar system interactions, and celestial orbital resonance.The algorithm introduces a multi-stellar framework system, which incorporates search agents into distinct subsystems to perform simultaneous exploration or exploitation behaviors, thereby enhancing diversity and parallel exploration capabilities. Specifically, the CEO algorithm was compared against ten state-of-the-art metaheuristic algorithms on 29 typical unconstrained benchmark problems from CEC2017 across different dimensions and 13 constrained real-world optimization problems from CEC2020. Statistical validations through the Friedman test, the Wilcoxon rank-sum test, and other statistical methods have confirmed the competitiveness and effectiveness of the CEO algorithm. Notably, it achieved a comprehensive Friedman rank of 1.28/11, and the winning rate in the Wilcoxon rank-sum tests exceeded 80% in CEC2017. Furthermore, CEO demonstrated outstanding performance in practical engineering applications such as robot path planning and photovoltaic system parameter extraction, further verifying its efficiency and broad application potential in solving real-world engineering challenges. Full article

The Slime Mould Algorithm (SMA) is a widely used swarm intelligence algorithm. Encouraged by the theory of no free lunch and the inherent shortcomings of the SMA, this work proposes a new variant of the SMA, called the BWSMA, in which three improvement mechanisms are integrated. The adaptive greedy mechanism is used to accelerate the convergence of the algorithm and avoid ineffective updates. The best–worst management strategy improves the quality of the population and increases its search capability. The stagnant replacement mechanism prevents the algorithm from falling into a local optimum by replacing stalled individuals. In order to verify the effectiveness of the proposed method, this paper conducts a full range of experiments on the CEC2018 test suite and the CEC2022 test suite and compares BWSMA with three derived algorithms, eight SMA variants, and eight other improved algorithms. The experimental results are analyzed using the Wilcoxon rank-sum test, the Friedman test, and the Nemenyi test. The results indicate that the BWSMA significantly outperforms these compared algorithms. In the comparison with the SMA variants, the BWSMA obtained average rankings of 1.414, 1.138, 1.069, and 1.414. In comparison with other improved algorithms, the BWSMA obtained average rankings of 2.583 and 1.833. Finally, the applicability of the BWSMA is further validated through two structural optimization problems. In conclusion, the proposed BWSMA is a promising algorithm with excellent search accuracy and robustness. Full article

Introduction: Haglund’s deformity, characterized by bony enlargement at the back of the heel, often coincides with Achilles tendon pathology due to impingement on the retrocalcaneal bursa and tendon insertion. Surgical management of Haglund’s deformity with a preexisting Achilles tendon rupture is complex, and understanding the outcomes of this subset of patients is essential for optimizing treatment strategies. Methods: This retrospective study reviewed patients undergoing open surgical management for Haglund’s syndrome between January 2015 and December 2023. Patients with chronic degenerative changes secondary to Haglund’s deformity and a preoperative Achilles tendon rupture were compared to those without. Data on demographics, surgical techniques, weightbearing protocols, and complications were collected. Univariate analysis was performed using χ² or Fisher’s exact test for categorical variables, and the T-test or Wilcoxon rank-sum test for continuous and ordinal variables, with normality assessed via the Shapiro–Wilk test. Results: Four hundred and three patients were included, with 13 having a preoperative Achilles tendon rupture. There was a higher incidence of preoperative ruptures among males. Surgical repair techniques and postoperative weightbearing protocols varied, though were not randomized. Complications included persistent pain, wound breakdown, infection, plantar flexion weakness, and revision surgery. While patients with Haglund’s deformity and a preoperative Achilles tendon rupture demonstrated a trend toward higher complication rates, including postoperative rupture and wound breakdown, these differences were not statistically significant in our analysis. Conclusions: A cautious approach is warranted in managing these patients, with careful consideration of surgical planning and postoperative rehabilitation. While our findings provide valuable insights into managing patients with Haglund’s deformity and preoperative Achilles tendon rupture, the retrospective design, limited sample size of the rupture group, and short duration of follow-up restrict generalizability and the strength of the conclusions by limiting the power of the analysis and underestimating the incidence of long-term complications. Therefore, the results of this study should be interpreted with caution. Further studies with larger patient cohorts, validated functional outcome measures, and comparable follow-up durations between groups are needed to confirm these results and optimize treatment approaches. Full article

Currently, most studies evaluating storm surges are conducted at the provincial level, and there is a lack of detailed research focusing on cities. This paper focuses on the urban scale, using some fine-scale data of coastal areas obtained through remote sensing images. This research is based on the Hazard–Exposure–Vulnerability (H-E-V) framework and PPRR (Prevention, Preparedness, Response, and Recovery) crisis management theory. It focuses on 52 Chinese coastal cities as the research subject. The evaluation system for the disaster response capabilities of Chinese coastal cities was constructed based on three aspects: the stability of the disaster-incubating environment (S), the risk of disaster-causing factors (R), and the vulnerability of disaster-bearing bodies (V). The significance of this study is that the storm surge capability of China’s coastal cities can be analyzed based on the results of the evaluation, and the evaluation model can be used to identify its deficiencies. In this paper, these storm surge disaster response capabilities of coastal cities were scored using the entropy weighted TOPSIS method and the weight rank sum ratio (WRSR), and the results were also analyzed. The results indicate that Wenzhou has the best comprehensive disaster response capability, while Yancheng has the worst. Moreover, Tianjin, Ningde, and Shenzhen performed well in the three aspects of vulnerability of disaster-bearing bodies, risk of disaster-causing factors, and stability of disaster-incubating environment separately. On the contrary, Dandong (tied with Qinzhou), Jiaxing, and Chaozhou performed poorly in the above three areas. Full article

The safety associated with the bearing capacity of pile foundations is intrinsically linked to the overall safety, stability, and economic viability of structural systems. In response to the need for rapid and precise predictions of pile bearing capacity, this study introduces a kernel extreme learning machine (KELM) prediction model optimized through a multi-strategy improved beetle optimization algorithm (IDBO), referred to as the IDBO-KELM model. The model utilizes the pile length, pile diameter, average effective vertical stress, and undrained shear strength as input variables, with the bearing capacity serving as the output variable. Initially, experimental data on pile bearing capacity was gathered from the existing literature and subsequently normalized to facilitate effective integration into the model training process. A detailed introduction of the multi-strategy improved beetle optimization algorithm (IDBO) is provided, with its superior performance validated through 23 benchmark functions. Furthermore, the Wilcoxon rank sum test was employed to statistically assess the experimental outcomes, confirming the IDBO algorithm’s superiority over other prevalent metaheuristic algorithms. The IDBO algorithm was then utilized to optimize the hyperparameters of the KELM model for predicting pile bearing capacity. In conclusion, the statistical metrics for the IDBO-KELM model demonstrated a root mean square error (RMSE) of 4.7875, a coefficient of determination (R²) of 0.9313, and a mean absolute percentage error (MAPE) of 10.71%. In comparison, the baseline KELM model exhibited an RMSE of 6.7357, an R² of 0.8639, and an MAPE of 18.47%. This represents an improvement exceeding 35%. These findings suggest that the IDBO-KELM model surpasses the KELM model across all evaluation metrics, thereby confirming its superior accuracy in predicting pile bearing capacity. Full article

Measurable changes in electrophysiology have been documented in spaceflight, creating a pathway for disease genesis and progression in astronauts. These electrophysiology changes can be measured using potential difference (PD). A probe to measure PD was developed and is used clinically on Earth; this probe relies on fluid perfusion to establish an electrical connection to make PD measurements. The changes to fluid behavior in microgravity and partial gravity (including lunar and Martian gravity) drives the need to test this probe in a spaceflight environment. Here, we test the PD probe in a novel nasal cavity phantom in parabolic flight, simulating microgravity, lunar gravity, Martian gravity, and hypergravity conditions across 37 parabolas. The results are evaluated across gravity conditions using the Wilcoxon Rank Sum test. We record no statistically significant difference in probe PD measurements in 1 g, microgravity, lunar gravity, and hypergravity (approximately 1.8 g) conditions, reaching a NASA Technology Readiness Level 6. Martian gravity findings are inconclusive. Perfusion-based PD probes are therefore successfully demonstrated for use in spaceflight operation in microgravity, lunar gravity, and hypergravity environments; this establishes a foundation for moving towards the in-space testing of perfusion-based probes in astronauts. Full article

Post-tensioned (PT) reinforced concrete bridges are particularly vulnerable structures, as the deterioration of internal tendons is often difficult to detect using conventional inspection methods or visual assessments. This paper introduces a practical framework for ranking non-destructive testing (NDT) techniques employed to assess PT systems. The ranking is based on four performance categories: measurement accuracy, ease of use, cost, and impact of disruption to bridge operations on traffic. For each NDT technique, a score is assigned for each evaluation category, and the final ranking is determined using the weighted sum model (WSM). This approach enables the final assessment to reflect the priorities of different decision-making contexts defined by the end-user such as accuracy-oriented, cost-oriented, and impact-oriented scenarios. The proposed method is then applied to an existing bridge in order to practically demonstrate its effectiveness and the flexibility of the proposed criteria. Full article

In this paper, we aim to develop an efficient algorithm for the solving Tensor Robust Principal Component Analysis (TRPCA) problem, which focuses on obtaining a low-rank approximation of a tensor by separating sparse and impulse noise. A common approach is to minimize the convex surrogate of the tensor rank by shrinking its singular values. Due to the existence of various definitions of tensor ranks and their corresponding convex surrogates, numerous studies have explored optimal solutions under different formulations. However, many of these approaches suffer from computational inefficiency primarily due to the repeated use of tensor singular value decomposition in each iteration. To address this issue, we propose a novel TRPCA algorithm that introduces a new convex relaxation for the tensor norm and computes low-rank approximation more efficiently. Specifically, we adopt the tensor average rank and tensor nuclear norm, and further relax the tensor nuclear norm into a sum of the tensor Frobenius norms of the factor tensors. By alternating updates of the truncated factor tensors, our algorithm achieves efficient use of computational resources. Experimental results demonstrate that our algorithm achieves significantly faster performance than existing reference methods known for efficient computation while maintaining high accuracy in recovering low-rank tensors for applications such as color image recovery and background subtraction. Full article

Background and Objective: Large language model (LLM)–based chatbots are increasingly utilized by postpartum individuals seeking guidance on breastfeeding. However, the chatbots’ content quality, readability, and alignment with clinical guidelines remain uncertain. This study was conducted to evaluate and compare the quality, readability, and factual accuracy of responses generated by three publicly accessible AI chatbots—ChatGPT-4o Pro, Gemini 2.5 Pro, and Copilot Pro—when prompted with common maternal questions related to breast-milk supply. Methods: Twenty frequently asked breastfeeding-related questions were submitted to each chatbot in separate sessions. The responses were paraphrased to enable standardized scoring and were then evaluated using three validated tools: ensuring quality information for patients (EQIP), the simple measure of gobbledygook (SMOG), and the global quality scale (GQS). Factual accuracy was benchmarked against WHO, ACOG, CDC, and NICE guidelines using a three-point rubric. Additional user experience metrics included response time, character count, content density, and structural formatting. Statistical comparisons were performed using the Kruskal–Wallis and Wilcoxon rank-sum tests with Bonferroni correction. Results: ChatGPT-4o Pro achieved the highest overall performance across all primary outcomes: EQIP score (85.7 ± 2.4%), SMOG score (9.78 ± 0.22), and GQS rating (4.55 ± 0.50), followed by Gemini 2.5 Pro and Copilot Pro (p < 0.001 for all comparisons). ChatGPT-4o Pro also demonstrated the highest factual alignment with clinical guidelines (95%), while Copilot showed more frequent omissions or simplifications. Differences in response time and formatting quality were statistically significant, although not always clinically meaningful. Conclusions: ChatGPT-4o Pro outperforms other chatbots in delivering structured, readable, and guideline-concordant breastfeeding information. However, substantial variability persists across the platforms, and none should be considered a substitute for professional guidance. Importantly, the phenomenon of AI hallucinations—where chatbots may generate factually incorrect or fabricated information—remains a critical risk that must be addressed to ensure safe integration into maternal health communication. Future efforts should focus on improving the transparency, accuracy, and multilingual reliability of AI chatbots to ensure their safe integration into maternal health communications. Full article

Hilbert proved in 1888 that a positive semi-definite (PSD) homogeneous quartic polynomial of three variables always can be expressed as the sum of squares (SOS) of three quadratic polynomials, and a psd homogeneous quartic polynomial of four variables may not be sos. Only after 87 years, in 1975, Choi gave the explicit expression of such a psd-not-sos (PNS) homogeneous quartic polynomial of four variables. An $m\times n$ biquadratic polynomial is a homogeneous quartic polynomial of $m+n$ variables. In this paper, we show that an $m\times n$ biquadratic polynomial can be expressed as a tripartite homogeneous quartic polynomial of $m+n-1$ variables. Therefore, by Hilbert’s theorem, a $2\times 2$ PSD biquadratic polynomial can be expressed as the sum of squares of three quadratic polynomials. This improves the result of Calderón in 1973, who proved that a $2\times 2$ biquadratic polynomial can be expressed as the sum of squares of nine quadratic polynomials. Furthermore, we present a necessary and sufficient condition for an $m\times n$ psd biquadratic polynomial to be sos, and show that if such a polynomial is sos, then its sos rank is at most $mn$. Then we give a constructive proof of the sos form of a $2\times 2$ psd biquadratic polynomial in three cases. Full article

Background/Objectives: The relationship between OSA and adult hypertension has been extensively studied; however, it remains understudied in pediatric patients without OSA. The aim of this study is to identify factors associated with pediatric hypertension without OSA, through an IRB-approved retrospective chart review of patients who underwent polysomnography at Nemours Children’s Hospital, DE/NJ between January 2020 and July 2023. Methods: Eligibility criteria included children 8–17 years, completed PSG, and clinic visit blood pressure (BP). Anthropometrics, demographics, social determinants, and medical history were obtained from electronic medical records. Hypertension was defined as the average systolic and/or diastolic BP that is ≥95th percentile for gender, age, and height based on AAP Clinical Practice Guidelines. All variables were checked for normality. Chi-square tests for categorical data and Wilcoxon rank sum tests for continuous data were used to test significance between non-OSA non-hypertensives (NH) and hypertensives (H). p < 0.05 is considered significant. Results: Of 285 charts evaluated, 137 were classified as non-OSA. Patient information, including parents in household, smoking exposure, and food allergies, were statistically significant (p < 0.05) in hypertensive pediatric patients without OSA. Hypertension was significantly correlated (p < 0.05) with birth weight, BMI, daytime heart rate, systolic BP, and diastolic BP. Statistically significant differences (p < 0.05) were found in mental illnesses, neurological disease, and respiratory disease. Among polysomnography parameters, only nighttime heart rate was found to be statistically significant. Conclusions: The data suggests that in pediatric patients without OSA, there are multiple factors and co-morbidities associated with hypertension. These factors and co-morbidities warrant additional follow up in clinical practice to mitigate the risks of hypertension in pediatric patients. Full article

Background: Most of the existing hyperpolarized (HP) ¹³C MRI analyses use univariate rate maps of pyruvate-to-lactate conversion (k_PL), and radiomic-style multiparametric models extracting complex, higher-order features remain unexplored. Purpose: To establish a multivariate framework based on whole abdomen/pelvis HP ¹³C-pyruvate MRI and evaluate the association between multiparametric features of metabolism (MFM) and clinical outcome measures in advanced and metastatic prostate cancer. Methods: Retrospective statistical analysis was performed on 16 participants with metastatic or local-regionally advanced prostate cancer prospectively enrolled in a tertiary center who underwent HP-pyruvate MRI of abdomen or pelvis between November 2020 and May 2023. Five patients were hormone-sensitive and eleven were castration-resistant. GMP-grade [1-¹³C]pyruvate was polarized using a 5T clinical-research DNP polarizer, and HP MRI used a set of flexible vest-transmit, array-receive coils, and echo-planar imaging sequences. Three basic metabolic maps (k_PL, pyruvate summed-over-time, and mean pyruvate time) were created by semi-automatic segmentation, from which 316 MFMs were extracted using an open-source, radiomic-compliant software package. Univariate risk classifier was constructed using a biologically meaningful feature (k_PL,median), and the multivariate classifier used a two-step feature selection process (ranking and clustering). Both were correlated with progression-free survival (PFS) and overall survival (OS) (median follow-up = 22.0 months) using Cox proportional hazards model. Results: In the univariate analysis, patients harboring tumors with lower-k_PL,median had longer PFS (11.2 vs. 0.5 months, p < 0.01) and OS (NR vs. 18.4 months, p < 0.05) than their higher-k_PL,median counterparts. Using a hypothesis-generating, age-adjusted multivariate risk classifier, the lower-risk subgroup also had longer PFS (NR vs. 2.4 months, p < 0.002) and OS (NR vs. 18.4 months, p < 0.05). By contrast, established laboratory markers, including PSA, lactate dehydrogenase, and alkaline phosphatase, were not significantly associated with PFS or OS (p > 0.05). Key limitations of this study include small sample size, retrospective study design, and referral bias. Conclusions: Risk classifiers derived from select multiparametric HP features were significantly associated with clinically meaningful outcome measures in this small, heterogeneous patient cohort, strongly supporting further investigation into their prognostic values. Full article

The quality of water in the Red River is a complex interplay between human-induced changes and inherent natural variables. This research utilized the snapshot sampling approach, garnering water quality data from 45 sampling sites in the Red River and crafting 24 environmental indicators related to land use and inherent natural determinants at the catchment scale. Through Spearman rank correlation and redundancy analyses, relationships among land use, natural variables, and water quality were elucidated. Our variance partitioning revealed differentiated impacts of land use and natural factors on water quality. Pivotal findings indicated superior water quality in the Red River, driven mainly by land use dynamics, which showed a distinct geomorphic gradient. Specific land use attributes, like cropland patch density, grassland’s largest patch index, and urban metrics, were pivotal in explaining variations in parameters such as total nitrogen, ammonia, and temperature. Notably, the configuration of land use had a more profound influence on water quality than merely its components. In terms of natural influences, while topography played a dominant role in shaping water quality, other factors like soil and weather had marginal impacts. Elevation was notably linked with metrics like total phosphorus and suspended solids, whereas precipitation and slope significantly determined electrical conductivity and chlorophyll-a models. In sum, incorporating both land use configurations and natural determinants offers a more comprehensive understanding of water quality disparities in the Red River’s ecosystem. For holistic water quality management, the focus should not only be on the major contributors like croplands and urban areas but also on underemphasized areas like grasslands. Tweaking cropland distribution, recognizing the intertwined nature of land use and natural elements, and tailoring land management based on topographical variations are essential strategies moving forward. Full article

This study exploited the skin temperature signal derived from a wrist-worn wearable device to define potential digital biomarkers for glycemia levels. Characterization of the skin temperature signal measured through the Empatica E4 device was obtained in 16 subjects (data taken from a dataset freely available on PhysioNet) by deriving standard metrics and a set of novel metrics describing both the current and the retrospective behavior of the signal. For each subject and for each metric, values that correspond to when glycemia was inside the tight range (70–140 mg/dL) were compared through the Wilcoxon rank-sum test against those above or below the range. For hypoglycemia characterization (below range), retrospective behavior of skin temperature described by the metric CV_{T SD} (standard deviation of the series of coefficient of variation) proved to be the most effective both in daytime and nighttime (100% and 50% of the analyzed subjects, respectively). On the other side, for hyperglycemia characterization (above range), differences were observed between daytime and nighttime, with current behavior of skin temperature, described by M2_T (deviation from the reference value of 32 °C), being the most informative during daytime, whereas retrospective behavior, described by SD_{T hhmm} (standard deviation of the series of means), showed the highest effectiveness during nighttime. Proposed variability features outperformed standard metrics, and in future studies, their integration with other digital biomarkers of glycemia could improve the performance of applications devoted to non-invasive detection of glycemic events. Full article