Search Results (5,986)

Hepatitis C virus (HCV) infection is still a major worldwide health concern. It is distinguished by a high degree of genetic variation that affects the course of the illness and the effectiveness of treatment. The epidemiological profile of HCV is prone to rapid change in areas where there is significant human migration, like Turkey. The purpose of this study was to evaluate the impact of long-term migration on local viral diversity by analyzing the distribution and temporal trends of HCV genotypes among Turkish citizens and asylum seekers in Kayseri, Turkey, over an eight-year period. From January 2014 to December 2021. 1173 HCV RNA-positive patients at Kayseri City Training and Research Hospital were the subject of a retrospective analysis. Genotypes were determined using the Abbott RealTime HCV Genotype II assay and Montania 4896 assay (Anatolia Geneworks, Türkiye). The most prevalent genotypes were Genotype 1b (48.3%, 95% CI: 45.5–51.2%), Genotype 4 (25.0%, 95% CI: 22.5–27.5%), and Genotype 1a (10.3%, 95% CI: 8.6–12.1%). Turkish patients exhibited the highest prevalence of Genotype 1b (98.2%), while asylum seekers demonstrated greater relative burdens of Genotype 4 (8.5% of total GT4) and Genotype 5 (83.3% of total GT5). Genotype 3a emerged in 2018, with a predominance in males (73.9%). The Cochran–Armitage trend test revealed statistically significant increasing trends for Genotype 3 (Z = 3.572, p = 0.0004) and Genotype 3a (Z = 2.600, p = 0.009). This eight-year retrospective study demonstrates that the HCV genotype distribution in Kayseri has undergone significant changes in the context of migration and demographic shifts. The statistically significant increasing trends of Genotypes 3 and 3a, particularly among younger male populations, suggest evolving transmission dynamics. These findings underscore the necessity of demographically targeted and culturally appropriate screening and treatment strategies for both resident and migrant populations to achieve HCV elimination goals. Full article

Boosting urban vitality (UV) in residential living spaces has become a core component of advancing the people-centered urbanization strategy. However, previous research has mainly focused on exploring UV at the scales of streets, blocks, and grids, with few nonlinear explorations conducted across different temporal dimensions at the scale of residents’ daily life. Therefore, this article adopts the XGBoost-SHAP model to explore the nonlinear and interaction effects of a built environment (BE) on UV across multi-scale community life circles (CLC), distinguishing between daytime and nighttime on weekdays and weekends. The results indicate that UV on weekends is higher than on weekdays, except for 5 min CLC (5MCLC). UV is highest in 10 min CLC (10MCLC) and lowest in 5MCLC. The mean building height (MBH) and Normalized Difference Vegetation Index (NDVI) have always been the most important indicators affecting UV. Unlike previous studies, the green view index (GVI) and sky view factor (SVF) are negatively associated with UV. The nonlinear relationship between BE and UV on weekdays exhibits greater regularity. The effects of other BE indicators on UV exhibits spatiotemporal heterogeneity, with the relative influence changes in commercial accessibility (CA), distance to metro (DSM) and distance to bus (DSB) being the most significant. The nonlinear and threshold effects of BE on UV show significant changes, except for GVI, SVF, and NDVI, at different times and scales. The threshold for cultural and leisure accessibility (CLA) is higher on weekdays than on weekends, whereas that for DSM is higher on weekends than on weekdays. The interaction effects between the building density (BD) and MBH, park and square accessibility (PSA), and DSM is significant at different scales. This study will provide a scientific basis for optimizing BE and differentiated planning of CLC, which further contributes to enhancing UV and promoting urban sustainable development. Full article

Plasma-assisted ammonia (NH₃) decomposition is a promising strategy for hydrogen production. However, reactor geometry remains a key factor limiting its hydrogen yield per energy input (${\mathrm{Y}}_{{\mathrm{H}}_2}$). This study systematically investigates H₂ production in outer-dielectric (OD), inner-dielectric (ID), and double-dielectric (DD) coaxial DBD reactors. The results show that the ammonia decomposition performance of OD- and ID-coaxial DBDs is significantly higher than that of the DD-coaxial DBD. OD- and ID-coaxial DBDs generate abundant micro-discharge pulses, enabling effective discharge energy deposition at lower peak voltages. Consequently, the reduced electric fields E/N are maintained within the optimal kinetic window for NH₃ dissociation and H₂ production. Moreover, by balancing residence time and energy density, the 8 cm length electrode achieves a peak ${\mathrm{Y}}_{{\mathrm{H}}_2}$ of 1.22–1.24 gH₂/kWh in the OD-coaxial DBD. For the ID-coaxial DBD, a 1 mm dielectric thickness yields a maximum capacitance of 86 pF, achieving a peak ${\mathrm{Y}}_{{\mathrm{H}}_2}$ of ~1.35 gH₂/kWh at the optimum E/N. In contrast, the DD-coaxial DBD exhibits the lowest ${\mathrm{Y}}_{{\mathrm{H}}_2}$ (≤0.82 gH₂/kWh) with minimal temperature rise. This is caused by the reduced current pulse numbers and the deviation of E/N from the optimal range with elevated operating voltages. This work provides guidance for the optimization of DBD reactors in plasma-assisted NH₃ decomposition for efficient H₂ production. Full article

GPU-accelerated quantum chemistry programs can dramatically reduce the time required for electronic structure calculations, yet most existing implementations either retrofit GPU kernels onto legacy CPU codebases or optimize individual kernels without addressing workflow-level integration overhead. We present GANSU (GPU Accelerated Numerical Simulation Utility), an open-source quantum chemistry framework written entirely in CUDA/C++ that integrates GPU-accelerated kernels for electron repulsion integrals, Fock matrix construction, and post-Hartree–Fock (post-HF) methods into a unified, GPU-resident execution pipeline. The key design principle is to eliminate host–device data transfers between computational stages by keeping all intermediate data, including density matrices, integral buffers, and Fock matrix replicas, on the GPU throughout the self-consistent field (SCF) iteration, combined with runtime-selectable integral strategies (stored ERI, resolution-of-the-identity, and Direct-SCF) that adapt to system size and available memory. On an NVIDIA H200 GPU, GANSU achieves end-to-end speedups of up to $52\times$ over PySCF for SCF, $45\times$ for MP2 on molecules with up to 470 basis functions, and $44\times$ for FCI, while outperforming GPU4PySCF by up to $34\times$ for FCI, across a range of molecular systems with up to 650 basis functions. The framework further provides analytical energy gradients and geometry optimization with nine algorithms, all operating within the same GPU-resident data flow. These results demonstrate that workflow-aware kernel integration, not just kernel-level optimization, is essential for realizing the full potential of GPU acceleration in scientific computing. GANSU is publicly available under the BSD-3-Clause license. Full article

Background: Understanding how demographic and clinical factors influence SARS-CoV-2 infection patterns, vaccination uptake and disease outcomes in community settings is essential for effective primary care-based public health planning. Objectives: This study aimed to investigate the distribution of SARS-CoV-2 infections among adults attending Primary Healthcare (PHC) facilities in Giannitsa, Greece, from 2020 to 2024, and to examine associations between demographic and clinical characteristics, vaccination category and disease outcomes. Methods: A retrospective analysis was conducted using data from the National Registry of Patients with COVID-19. The study included 1144 adults diagnosed with SARS-CoV-2 at PHC facilities from 19 November 2020 to 3 October 2024; all cases included in the present analysis had been confirmed by rapid antigen testing. Variables included age, gender, residence, registry-recorded underlying medical conditions, vaccination category, seasonality and clinical outcome. Results: Significant shifts in case distribution were observed across time, with younger adults predominating in 2020–2022 and older adults (61–90 years) in 2023–2024 (p < 0.001). Winter months showed higher case incidence overall (p < 0.001). Vaccination coverage increased annually, reaching 84.8% in 2024 (p < 0.001). Hospitalization/death occurred in 1.7% of patients and was strongly associated with age ≥61 years (6.0% vs. 0.3%), the presence of at least one registry-recorded underlying medical condition (9.2% vs. 0.9%) and vaccination category; specifically, hospitalization/death occurred in 10.4% of individuals diagnosed during the pre-vaccine period, 2.3% of unvaccinated individuals during the vaccination era and 0.9% of vaccinated individuals (all p < 0.001). Conclusions: Older age, underlying medical conditions and a lack of vaccination were key predictors of worse outcomes. The findings underscore the importance of strengthening vaccination outreach and targeted PHC interventions, particularly for high-risk and rural populations. Full article

Background: Older adults (aged 65 and older) faced a disproportionate burden of mortality during the COVID-19 pandemic, yet substantial geographical and sociodemographic disparities in vaccine uptake persisted within this vulnerable population. Objective: To examine the temporal dynamics of COVID-19 vaccination rates among older adults and investigate the association between vaccination uptake and neighborhood-level social determinants of health (SDOHs), including disability and poverty. Methods: COVID-19 vaccination data for older adult residents in Jefferson County, Kentucky, were obtained from the Kentucky Immunization Registry (KYIR). ZIP-code-level vaccination rates were calculated at three time points: 28 February 2021 (Q1), 31 May 2021 (Q2), and 31 May 2022 (Q6). The rates were linked to 2021 American Community Survey (ACS) ZIP code-level estimates of disability, poverty, and household composition. Two-dose COVID-19 vaccination rates stratified by race, ethnicity, and geographic region were used as outcome measures. Pearson correlation coefficients, bivariate, and multivariate linear models were used to estimate the association between COVID-19 vaccination rates and the SDOHs at the ZIP code level. Results: Among the estimated 139,222 older adults, overall two-dose vaccination rates rose from 22.4% in Q1 to 77.5% by Q6. Significant regional disparities were observed early in the campaign, with Q1 rates ranging from 12.6% in the Southwest to 35.4% in the Inner East county regions. Bivariate analyses showed ZIP-code-level disability and poverty rates were negatively associated with ZIP-code-level vaccination uptake in Q1 (disability slope: −0.38; 95% CI, −0.63 to −0.13; poverty slope: −0.36; 95% CI, −0.65 to −0.07). By Q6, the negative association between disability and vaccination had weakened significantly and was no longer statistically significant, while the negative association between poverty rate and vaccination rate remained persistent across all time points. Conclusions: The disability-associated gaps in older adults’ vaccination rates were dynamic and narrowed over time, whereas the poverty-associated gaps remained persistent and static. The low uptake observed among Black and Hispanic older adults in historically underserved areas suggests that understanding the specific factors that most negatively associate with vaccination rates in these populations, such as specific disabilities, may mitigate structural barriers. Future public health interventions should prioritize socioeconomically disadvantaged neighborhoods and account for the evolving association of functional impairments and healthcare access. Full article

Background/Objectives: Blood donation is a critical component of healthcare systems worldwide, yet donor recruitment remains challenging. This study evaluates the knowledge, attitudes, motivations, and practices (KAP) of blood donation among the general population in Saudi Arabia to identify key barriers and propose targeted interventions. Methods: A cross-sectional study was conducted using a structured, validated questionnaire distributed over five months (December 2022 to April 2023) via social media and in-person recruitment at the Central Blood Bank in Riyadh. A total of 1150 participants aged 18–60 years residing in Saudi Arabia were included in the final analysis. Statistical analysis was performed using SPSS version 22, with p < 0.05 considered significant. Results: Participants demonstrated moderate knowledge (mean score 5.43 ± 1.81 out of 9), with significantly higher scores among males, individuals aged 21–30 years, and those holding a bachelor’s degree. Attitudes toward donation were highly positive (mean score 15.46 ± 2.74 out of 20) and correlated with age, gender, marital status, and occupation. Despite this positive outlook, only 34.96% of participants had donated blood previously, although 95.25% expressed willingness to do so. Primary motivators included mobile donation units (89.22%) and paid leave (89.22%), whereas 51.22% of respondents considered current media campaigns ineffective. Common barriers to donation included health concerns (25.30%), time constraints (12.87%), and fear of needles (7.74%). Conclusions: This study reveals a critical disparity between positive public attitudes and actual donation practices in Saudi Arabia. To enhance donor participation, we recommend implementing convenient donation strategies such as mobile blood drives, workplace incentives, and more effective, culturally tailored educational campaigns. Addressing these factors could help Saudi Arabia improve its voluntary donation rates and ensure a sustainable, safe blood supply. Full article

China’s rapid economic growth is partly due to the productivity gains from agglomeration, whereby firms and workers in larger and denser cities benefit from proximity through knowledge spillovers, thicker labor markets, and shared infrastructure. This study examines the changing nature and location of agglomeration economies in China using resident-based measures of urban scale from the 2000, 2010, and 2020 population censuses. Chinese “cities” are administrative jurisdictions that contain both dense urban districts and lower-density counties, so the agglomeration elasticities are estimated separately for districts and counties for a balanced panel of 298 prefectural jurisdictions. Agglomeration economies occur only in urban districts, while coefficients on urban scale for counties and county-level cities are close to zero or significantly negative. Moreover, district-level elasticities decline over time, from 0.24 in 2000 to 0.15 in 2020, assuming no feedback from productivity to urban scale. Allowing for such feedback, the temporal decline is even greater, from 0.24 in 2000 to 0.08 in 2020. However, urban growth is shifting increasingly toward counties rather than districts, foregoing the potential agglomeration effects. Changes in location of construction workers also shows this dispersed urban growth. Hence, recent urban growth is increasingly in locations without agglomeration benefits. Full article

Bioaerosol emissions from biological treatment processes like composting, livestock operations, and wastewater plants pose notable occupational and environmental health risks. Biofiltration is a common mitigation measure for gaseous pollutants, but its effectiveness in controlling bioaerosols is less studied. This review synthesizes current evidence on biofiltration for the removal of bioaerosols. Findings indicate that biofiltration can significantly reduce emissions from waste-related biological processes, although results vary widely and depend heavily on design and operational factors. In composting, agricultural, and wastewater treatment contexts, fungal bioaerosols are consistently removed with high efficiency, often over 90%. Conversely, bacterial removal shows greater variability, from negligible to above 90%, influenced primarily by airflow rate, bed depth, and media stability. Systems with residence times of tens of seconds and bed depths of at least 1 m tend to reliably reduce bacterial counts, whereas undersized, high-flow systems experience marked efficiency losses. The choice of packing material is also crucial; mature, stable media maintain performance, whereas nutrient-rich or unstable substrates can lead to fungal emissions, turning the biofilter into a secondary source. Data on endotoxin removal are limited and remain insufficient for firm design recommendations. Overall, biofiltration’s effectiveness depends on complex interactions among physical retention, biological stability, and design. These insights emphasize the need for future research to focus on standardized, performance-based design criteria supported by consistent reporting and full-scale validation. Full article

This study reports on the design, construction, and operation of a laboratory-scale biomass gasification reactor, together with the procedures used to define and evaluate key operational and performance variables, including piston velocity, nominal biomass residence time, airflow rate, gas yield, lower heating value, and gasification efficiency. The unit is a moving-bed reactor operating in co-current gas–solid mode and reproducing key features of downdraft-like gasification, allowing the identification of the four main reaction zones: drying, pyrolysis, oxidation, and reduction. The reactor exhibits simple operation and handling and, notably, enables controlled axial displacement of the biomass bed through the reaction zone, allowing the nominal solid residence time in the heated zone to be adjusted through piston motion. In addition, the gasification of Spartina argentinensis was investigated in order to evaluate the functionality of the system and to assess reactor performance under selected operating conditions. At operating temperatures of 800–850 °C and an equivalence ratio of 0.2, gas yields exceeded 60 wt%, gasification efficiencies were above 50%, and the product gas reached heating values close to 1000 kcal Nm⁻³, indicating a favorable fuel quality of the product gas. These results confirm the potential of the proposed reactor as a useful experimental platform for the investigation of biomass gasification under controlled laboratory conditions. Full article

Hydrogen refueling stations (HRSs) are a critical enabling infrastructure for fuel cell electric vehicles (FCEVs), yet their deployment in dense metropolitan areas often faces a dual challenge: limited travel-time accessibility for users and low public acceptance driven by perceived safety risks. This study develops an integrated, city-scale framework to quantify HRS accessibility and resident acceptance and to identify expansion priorities for Seoul, South Korea. We combine (i) an online perception survey of 1000 adult residents (October 2024) capturing environmental awareness, perceived safety, siting preferences, and willingness-to-travel distance; (ii) spatial demand data on FCEV registrations by administrative dong (n = 2443 vehicles, 2022); and (iii) network-based travel-time analysis using the Seoul road network and the current HRS supply (n = 10, 2024). Accessibility is evaluated under three travel-time thresholds (10, 15, and 20 min), with service-area delineation and demand-weighted underserved-area diagnosis. Candidate expansion sites are generated and screened using operational and regulatory constraints (e.g., site area and proximity to protected facilities), followed by a p-median location-allocation optimization to select five additional sites that minimize demand-weighted travel impedance. Results indicate that, under the 20 min threshold (7.7 km at an average operating speed of 23.1 km/h), 50 of 425 dongs (11.8%) and 244 of 2443 FCEVs (10.0%) are outside the baseline service coverage. After adding five sites (total n = 15), underserved dongs decrease to 5 (1.2%) and underserved FCEVs to 26 (1.1%) for the 20 min threshold, with consistent improvements across shorter thresholds. Survey responses further reveal that only 12.5% of respondents perceive HRSs as safe, while 46.5% report a maximum willingness-to-travel distance of up to 5 km, underscoring the need for both accessibility enhancement and risk-aware communication. The proposed workflow offers a transparent, reproducible approach to support equitable and risk-informed HRS planning by jointly considering network accessibility, demand distribution, and social acceptance, thereby contributing to sustainable urban mobility, low-carbon transport transition, and socially acceptable hydrogen infrastructure deployment. Beyond local accessibility improvement, the study is framed in the broader context of sustainability, as equitable and socially acceptable hydrogen refueling infrastructure can support low-carbon urban transport transitions and more resilient metropolitan energy-mobility systems. Full article

We propose a dimensionally consistent fractional spatio-temporal PDE framework for modelling immune-mediated demyelination in multiple sclerosis (MS). The system couples effector and regulatory T cells, M1/M2 macrophage polarisation, pro- and anti-inflammatory cytokines, oligodendrocyte dynamics, and time-dependent therapeutic controls within a unified distributed-parameter structure. In contrast to ad hoc replacements of integerorder derivatives by Caputo fractional derivatives, the fractional extension proposed here is derived from an underlying continuous-time random walk (CTRW) process with Mittag–Leffler-distributed residence times. This stochastic derivation yields a governing system in which a single commensurate fractional order α ∈ (0, 1], together with a characteristic memory timescale τ0, ensures dimensional consistency and mass balance across all coupled components. The model is formulated as a system of nonlinear reaction–diffusion equations with cross-regulatory and multiplicative interaction terms governing immune amplification, cytokine feedback, and the demyelination–remyelination balance. Analytical interpretation shows how non-Markovian residence times induce Mittag–Leffler-type relaxation and thereby modify effective growth, decay, and stability properties. Numerical simulations compare classical and fractional dynamics, revealing that memory-driven kinetics prolong effector T-cell and M1-macrophage activity, attenuate reparative M2 and oligodendrocyte responses, and extend the effective action of bang–bang therapy inputs representing IFN-β and glatiramer acetate beyond their dosing windows. The results indicate that integer-order models may underestimate chronic inflammatory persistence and demyelination severity, while providing a mathematically and physically well-posed platform for memory-aware immune modelling and therapy evaluation in MS. Full article

Objectives: Inappropriate medication use is highly prevalent in nursing home residents and contributes to adverse drug events, falls, and increased healthcare utilization. The Turkish Inappropriate Medication use in oldEr adults (TIME) criteria provide a comprehensive framework for identifying both potentially inappropriate medications and prescribing omissions. We aimed to evaluate the outcomes of a Medication Therapy Management (MTM) intervention by use of TIME criteria among nursing home residents in Türkiye. Methods: This single-arm before–after observational study included 232 adults aged 60–110 years residing in the Bursa Metropolitan Municipality Nursing Home. Medication use patterns were evaluated using the TIME criteria and prescriptions were optimized through a Medication Therapy Management (MTM) intervention. Fall frequency and healthcare utilization outcomes were recorded during the 1 year before and after MTM implementation. Results: Following implementation of the Medication Therapy Management (MTM) approach based on TIME criteria, the median number of medications increased from 5 (IQR: 3–8) to 8 (IQR: 5–10) over one year (p < 0.001). During the post-implementation period, fall frequency, emergency department visits, family medicine visits, and non-geriatric specialist visits were lower compared with the pre-intervention year, whereas hospitalization rates did not significantly change. Conclusions: Among nursing home residents, the total number of medications was higher and fall frequency and selected healthcare utilization measures were lower during the year following implementation of MTM based on TIME criteria. These findings suggest that MTM-guided prescription optimization may be associated with changes in clinical and healthcare utilization outcomes; however, the absence of a control group precludes causal inference, and randomized controlled trials are required to confirm these associations. Full article

We develop a structural framework for the three-dimensional incompressible Navier–Stokes equations in which the nonlinear dynamics are reorganized in terms of triadic interactions, dyadic shells, and helical modes. Within this formulation, all interactions are classified into Low–Low, Low–High, and High–High channels, and it is shown that the Low–Low and Low–High contributions are perturbatively controlled through scale-localized estimates without introducing external assumptions. Consequently, potentially non-perturbative contributions are confined, within the present framework, to a class of same-scale High–High interactions. This class is further reduced, through geometric and dynamical constraints, to a coherent core characterized by amplitude activity and low phase drift. The resulting reduced dynamics is expressed in terms of family-level phase variables and associated curvature quantities. The main result establishes a quantitative residence-time compression principle for this coherent regime. Specifically, it is shown that intervals on which both amplitude activity and low phase drift persist must have small total measures, due to an absolute-value coercivity property of the curvature combined with bounded-variation control of the phase dynamics. This implies that coherent same-scale interactions cannot occupy a macroscopic portion of any bounded time interval, even though local re-entry into low-drift configurations is not excluded. Consequently, the nonlinear transfer associated with coherent triads becomes temporally localized and admits a shellwise compressed representation. These results provide a structurally reduced description of a candidate mechanism for cumulative same-scale amplification within the present dyadic–triadic framework. They do not claim a framework-level structural exclusion of the global regularity problem. Rather, they identify and analyze, within an explicit structural setting, a minimal mechanism for non-perturbative amplification, and establish a quantitative constraint on its temporal persistence. Full article

Urban residents require space-efficient interventions to mitigate chronic stress. While indoor digital nature shows promise, the precise impact of interactive design parameters remains unclear. This study investigated how interactive feedback intensity (none, slow, fast) and color hue (neutral, warm, cool) influence psychological and physiological restoration. Following negative emotion induction, healthy participants engaged in within-subject conditions evaluated via multimodal assessments, including EEG, HRV, and subjective scales (PANAS, PRS, SAM/PAD). Results identified interactive feedback intensity as the primary driver of restoration. Specifically, fast feedback improved positive affect by up to 20.4% and reduced negative affect by 20.8% compared to passive self-restoration. Neurologically, interactive engagement was associated with elevated EEG alpha-band activity by up to 97.8% relative to standing controls, a pattern consistent with cortical relaxation. Furthermore, while physical interaction was uniformly associated with physiological indices broadly consistent with recovery, color hue significantly moderated subjective outcomes. Neutral and warm hues generated significantly higher overall perceived restorativeness (M = 73.18 and M = 70.14, respectively) than the self-restoration control (M = 61.26). Notably, neutral tones were uniquely associated with modest changes in HRV time-domain indices suggestive of parasympathetic autonomic modulation. These findings provide actionable, empirically validated guidelines for deploying responsive digital interventions to support mental well-being in dense urban interiors. Full article