Search Results (30,600)

The present study explores the application of RNNs for the prediction and propagation of flood waves along a section of the Bârsa River, Romania, as a fast alternative to classical hydraulic models, aiming to identify new ways to alert the population. Five neural architectures were analyzed as follows: S-RNN, LSTM, GRU, Bi-LSTM, and Bi-GRU. The input data for the neural networks were derived from 2D hydraulic simulations conducted using HEC-RAS software, which provided the necessary training data for the models. It should be mentioned that the input data for the hydraulic model are synthetic hydrographs, derived from the statistical processing of recorded floods. Performance evaluation was based on standard metrics such as NSE, $R^2$ MSE, and RMSE. The results indicate that all studied networks performed well, with NSE and $R^2$ values close to 1, thus validating their capacity to reproduce complex hydrological dynamics. Overall, all models yielded satisfactory results, making them useful tools particularly the GRU and Bi-GRU architectures, which showed the most balanced behavior, delivering low errors and high stability in predicting peak discharge, water level, and flood wave volume. The GRU and Bi-GRU networks yielded the best performance, with RMSE values below 1.45, MAE under 0.3, and volume errors typically under 3%. On the other hand, LSTM architecture exhibited the most significant instability and errors, especially in estimating the flood wave volume, often having errors exceeding 9% in some sections. The study concludes by identifying several limitations, including the heavy reliance on synthetic data and its local applicability, while also proposing solutions for future analyses, such as the integration of real-world data and the expansion of the methodology to diverse river basins thus providing greater significance to RNN models. The final conclusions highlight that RNNs are powerful tools in flood risk management, contributing to the development of fast and efficient early warning systems for extreme hydrological and meteorological events. Full article

Determining the transmission routes of pathogens in indoor environments is challenging, with most studies limited to specific case analyses and pilot experiments. When pathogens are instantaneously released by a patient in an indoor environment, the peak infection risk may not occur immediately but may instead appear at a specific moment during the pathogen’s spread. We developed a concise model to describe the temporal crest of infection risk. The model incorporates the transmission and degradation characteristics of aerosols and surface particles to predict infection risks via air and surface routes. Only four real-world outbreaks met the criteria for validating this phenomenon. Based on the available data, norovirus is likely to transmit primarily via surface touch (i.e., the fomite route). In contrast, crests of infection risk were not observed in outbreaks of respiratory diseases (e.g., SARS-CoV-2), suggesting a minimal probability of surface transmission in such cases. The new model can serve as a preliminary indicator for identifying different indoor pathogen transmission routes (e.g., food, air, or fomite). Further analyses of pathogens’ transmission routes require additional evidence. Full article

Peanut cultivation is widely practiced using plastic mulch film, resulting in the accumulation of microplastics/nanoplastics (MPs/NPs) in agricultural soils, potentially negatively affecting peanut growth. To investigate the effects of two polystyrene (PS) sizes (5 μm, 50 nm) and three concentrations (0, 10, and 100 mg L⁻¹) on peanut growth, photosynthetic efficiency, and physiological characteristics, a 15-day hydroponic experiment was conducted using peanut seedlings as the experimental material. The results indicated that PS-MPs/NPs inhibited peanut growth, reduced soil and plant analyzer development (SPAD) values (6.7%), and increased levels of malondialdehyde (MDA, 22.0%), superoxide anion (O₂⁻, 3.8%) superoxide dismutase (SOD, 16.1%) and catalase (CAT, 12.1%) activity, and ascorbic acid (ASA, 12.6%) and glutathione (GSH, 9.1%) contents compared to the control. Moreover, high concentrations (100 mg L⁻¹) of PS-MPs/NPs reduced the peanut shoot fresh weight (16.1%) and SPAD value (7.2%) and increased levels of MDA (17.1%), O₂⁻ (5.6%), SOD (10.6%), POD (27.2%), CAT (7.3%), ASA (12.3%), and GSH (6.8%) compared to low concentrations (10 mg L⁻¹) of PS-MPs/NPs. Notably, under the same concentration, the impact of 50 nm PS-NPs was stronger than that of 5 μm PS-MPs. The peanut shoot fresh weight of PS-NPs was lower than that of PS-MPs by an average of 7.9%. Additionally, we found that with an increasing exposure time of PS-MPs/NPs, the inhibitory effect of low concentrations of PS-MPs/NPs on the fresh weight was decreased by 2.5%/9.9% (5 d) and then increased by 7.7%/2.7% (15 d). Conversely, high concentrations of PS-MPs/NPs consistently reduced the fresh weight. Correlation analysis revealed a clear positive correlation between peanut biomass and both the SPAD values as well as Fv/Fm, and a negative correlation with MDA, SOD, CAT, ASA, and GSH. Furthermore, the presence of PS-MPs/NPs in roots, stems, and leaves was confirmed using a confocal laser scanning microscope. The internalization of PS-MPs/NPs within peanut tissues negatively impacted peanut growth by increasing the MDA and O₂⁻ levels, reducing the SPAD values, and inhibiting the photosynthetic capacity. In conclusion, the study demonstrated that the effects of PS on peanuts were correlated with the PS size, concentration, and exposure time, highlighting the potential risk of 50 nm to 5 μm PS being absorbed by peanuts. Full article

Background: In high-risk and frail patients with multivessel coronary artery disease (MV CAD), guidelines indicated complete revascularization with or without the use of cardiopulmonary bypass (CPB) bears a high morbidity and mortality risk. In cases where catheter interventions were deemed unsuitable and conventional coronary artery bypass grafting (CABG) posed an unacceptable perioperative risk, patients were scheduled for minimally invasive direct coronary artery bypass (MIDCAB) grafting or minimally invasive multivessel coronary artery bypass grafting (MICS-CABG). We called this approach “palliative revascularization.” This study assesses the safety and impact of palliative revascularization on clinical outcomes and overall survival. Methods: A consecutive series of 57 patients undergoing MIDCAB or MICS-CABG as a palliative surgery between 2008 and 2018 was included. The decision for palliative surgery was met in heart team after carefully assessing each case. The patients underwent single or double-vessel revascularization using the left internal thoracic artery and rarely radial artery/saphenous vein segments, both endoscopically harvested. Inpatient data could be completed for all 57 patients. The mean follow-up interval was 4.2 ± 3.7 years, with a follow-up rate of 91.2%. Results: Mean patient age was 79.7 ± 7.4 years. Overall, 46 patients (80.7%) were male, 26 (45.6%) had a history of atrial fibrillation and 25 (43.9%) of chronic kidney disease. In total, 13 patients exhibited a moderate EuroSCORE II, while 27 were classified as high risk, with a EuroSCORE II exceeding 5%. Additionally, 40 patients (70.2%) presented with three-vessel disease, 17 (29.8%) suffered an acute myocardial infarction within three weeks prior to surgery and 50.9% presented an impaired ejection fraction. There were 48 MIDCAB and nine MICS CABG with no conversions either to sternotomy or to CPB. Eight cases were planned as hybrid procedures and only 15 patients (26.3%) were completely revascularized. During the first 30 days, four patients (7%) died. A myocardial infarction occurred in only one case, no patient necessitated immediate reoperation. The one-, three- and five-year survival rates were 83%, 67% and 61%, respectively. Conclusions: MIDCAB and MICS CABG can be successfully conducted as less invasive palliative surgery in high-risk multimorbid patients with MV CAD. The early and mid-term results were better than predicted. A higher rate of hybrid procedures could improve long-term outcome in selected cases. Full article

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

Coal mining can cause the rupture of the overlying strata, and the energy released by large-scale fractures can therefore induce earthquake disasters, which in turn can cause more secondary disasters. In the past 50 years, countless earthquakes induced by coal mining have been reported. In this paper, the main factors relating to the mining-induced seismicity, including the mechanical properties, geometry of the space, excavation advance, and excavation rate, are investigated using both experimental and numerical methods. The sensitivity of these factors behaves differently with regard to the stress distribution and failure mode. Space geometry and excavation advances have the highest impact on the surface settlement and the failure, while the excavation rate in practical engineering projects has the least impact on the failure mode. The numerical study coincides well with the experimental observation. The result indicates that the mechanical properties given by the geological survey report can be effectively used to assess the risk of mining-induced seismicity, and the proper adjustment of the tunnel geometry can largely reduce the surface settlement and improve the safety of mining. Full article

Rabies remains a significant global public health concern, causing an estimated 59,000–69,000 human fatalities annually. Despite being entirely preventable through vaccination, rabies continues to impose substantial economic burdens worldwide. This study presents a scoping review of the economic research on rabies to determine overlaps and gaps in knowledge and inform future research strategies. We selected 150 studies (1973–2024) to analyze. The review categorizes the literature based on geographic distribution, species focus, and type of study. Findings indicate that economic studies are disproportionately concentrated in developed countries, such as the United States and parts of Europe, where rabies risk is low, while high-risk regions, particularly in Africa and Asia, remain underrepresented. Most studies focus on dog-mediated rabies, reflecting its dominant role in human transmission, while fewer studies assess the economic impacts of wildlife and livestock-mediated rabies. Case studies and modeling approaches dominate the literature, whereas cost–benefit and cost–effectiveness analyses—critical for informing resource allocation—are limited. The review highlights the need for more economic evaluations in rabies-endemic regions, expanded research on non-dog reservoirs, and broader use of economic methods. Addressing these gaps will be crucial for optimizing rabies control and supporting global initiatives to eliminate dog-mediated rabies by 2030. Full article

Acute kidney injury (AKI) is a serious clinical condition that is linked to markedly higher rates of morbidity and mortality in cirrhosis patients. Its diagnosis is challenging due to overlapping clinical and laboratory features among causes such as hepatorenal syndrome (HRS), acute tubular injury (ATI), and prerenal hypovolemia. In order to address the distinct pathophysiology and clinical context of cirrhosis, the definitions and classification of AKI have changed over time, moving from RIFLE and AKIN to KDIGO and ICA-AKI. Because cirrhosis patients have altered muscle mass and fluid retention, traditional markers like serum creatinine (sCr) and urine output have significant limitations. Neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and cystatin C (CysC) are some of the new biomarkers that have shown promise in early AKI detection and in differentiating structural from functional kidney injury. NGAL and KIM-1 are sensitive indicators of tubular damage with potential prognostic implications. IL-18 reflects inflammatory injury, and CysC offers a more reliable measure of glomerular filtration. Incorporating these markers may improve early diagnosis, risk stratification, and treatment decisions, representing a key direction for future research in managing AKI in cirrhosis. Full article

Background/Objectives: The aim of this study was to evaluate baseline health measurements among transitional housing residents (n = 29) participating in an 8-week pilot wellness intervention. Methods: Researchers measured anthropometrics, body composition, muscular strength, cardiovascular indicators, physical activity, diet quality, and health-related perceptions. Researchers analyzed data using descriptive statistics and conventional content analysis. Results: Most participants were male, White, and food insecure. Mean BMI (31.8 ± 8.6 kg/m²), waist-to-hip ratio (1.0 ± 0.1 males, 0.9 ± 0.1 females), body fat percentage (25.8 ± 6.1% males, 40.5 ± 9.4% females), blood pressure (131.8 ± 17.9/85.2 ± 13.3 mmHg), and daily step counts exceeded recommended levels. Absolute grip strength (77.1 ± 19.4 kg males, 53.0 ± 15.7 kg females) and perceived general health were below reference standards. The Healthy Eating Index-2020 score (39.7/100) indicated low diet quality. Common barriers to healthy eating were financial constraints (29.6%) and limited cooking/storage facilities (29.6%), as well as to exercise, physical impediments (14.8%). Conclusions: Residents living in transitional housing have less favorable body composition, diet, and grip strength measures, putting them at risk for negative health outcomes. Wellness interventions aimed at promoting improved health-related outcomes while addressing common barriers to proper diet and exercise among transitional housing residents are warranted. Full article

Background and Objectives: This study aimed to explore the risk factors of histopathological crescent formation in pediatric IgA vasculitis nephritis (IgAVN). Materials and Methods: Enrolled patients with biopsy-proven IgAVN from Zhejiang University’s hospital were split into two groups: 377 with no crescents on histopathology (Group 1) and 364 with crescentic nephritis (Group 2). Collected data included clinical features, lab indicators, histopathological grading, and factors causing glomerular sclerosis. Logistic regression was used to assess factors affecting crescent formation in IgAVN. Double-immunofluorescence assay was used to detect TGF-β1, MCP-1, α-SMA, Collagen I, and FN1 in kidney biopsy specimens. The relationship between kidney fibrosis factors and histopathological grade were analyzed using Chi-square and Pearson tests. Results: A total of 741 patients with IgAVN were included in the study. Univariate logistic regression identified potential factors related to crescent formation, including age, gender, clinical classification, hematuria grade, 24 h urine protein level, peripheral white blood cells (WBCs), serum albumin, Cystatin-C, APTT, and PT. Multivariate analysis revealed statistical significance for age, 24 h urine protein, and WBCs across pathological grades (p < 0.05). Mantel–Haenszel Chi-square tests indicated a linear relationship between IgAVN pathological grade and α-SMA, TGF-β1, MCP-1, and FN1. Pearson correlation analysis confirmed a positive correlation between pathological grade and these markers. Conclusions: Age, 24 h urinary protein, and blood WBCs are identified as risk factors for histopathological crescent formation in children with IgAVN. Additionally, a higher pathological grade is associated with more pronounced fibrosis indicators. Full article

To reveal the influence mechanisms of seasonal climatic factors (wind speed, wind direction, temperature) and leakage direction on hydrogen dispersion and explosion behavior from single-source leaks at typical risk locations (hydrogen storage tanks, compressors, dispensers) in hydrogen refueling stations (HRSs), this work established a full-scale 1:1 three-dimensional numerical model using the FLACS v22.2 software based on the actual layout of an HRS in Xichang, Sichuan Province. Through systematic simulations of 72 leakage scenarios (3 equipment types × 4 seasons × 6 leakage directions), the coupled effects of climatic conditions, equipment layout, and leakage direction on hydrogen dispersion patterns and explosion risks were quantitatively analyzed. The key findings indicate the following: (1) Downward leaks (−Z direction) from storage tanks tend to form large-area ground-hugging hydrogen clouds, representing the highest explosion risk (overpressure peak: 0.25 barg; flame temperature: >2500 K). Leakage from compressors (±X/−Z directions) readily affects adjacent equipment. Dispenser leaks pose relatively lower risks, but specific directions (−Y direction) coupled with wind fields may drive significant hydrogen dispersion toward station buildings. (2) Southeast/south winds during spring/summer promote outward migration of hydrogen clouds, reducing overall station risk but causing localized accumulation near storage tanks. Conversely, north/northwest winds in autumn/winter intensify hydrogen concentrations in compressor and station building areas. (3) An empirical formula integrating climatic parameters, leakage conditions, and spatial coordinates was proposed to predict hydrogen concentration (error < 20%). This model provides theoretical and data support for optimizing sensor placement, dynamically adjusting ventilation strategies, and enhancing safety design in HRSs. Full article

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

This study examined the distribution and disease associations of non-HLA-B*27 HLA-B alleles in Romanian spondyloarthritis (SpA) patients, aiming to address the underrepresentation of Eastern European populations in immunogenetic research. Methods: We analyzed 263 HLA-B*27-negative patients from Northeastern Romania fulfilling ASAS criteria. HLA-B genotyping was performed at two-digit resolution, and allele distributions were compared with two Romanian HLA-B*27-negative control groups (n = 335 and n = 1705 cases), using chi-square testing and logistic regression. Compared to controls, HLA-B*47 (p = 0.0007) and HLA-B*54 (p = 0.0013) were significantly enriched, while HLA-B*40 was underrepresented (p = 0.0287). Notably, HLA-B*54 was observed exclusively in axial SpA. Within the cohort, both HLA-B*13 and HLA-B*57 alleles were associated with psoriasis, while HLA-B*37 and HLA-B*41 alleles were clustered within the reactive arthritis group. The HLA-B*35 and HLA-B*18 alleles were the most frequently observed alleles across most clinical phenotypes. When comparing the frequency of HLA-B associations, the most common genotypes among SpA patients were B*08-B*18, B*13-B*35, and B*35-B*51. Notably, B*08-B*18 was more frequent in patients with radiographic sacroiliitis grade ≥ 2, while B*35-B*51 was more frequent in those with confirmed systemic inflammation, as indicated by elevated CRP or ESR levels. Analysis of peptide-binding patterns revealed a cluster of risk alleles, HLA-B*08, B*18, B*35, B*40, and B*54, sharing similar features, distinct from the canonical profile of B*27. These findings highlight the contribution of non-B*27 HLA-B alleles to SpA susceptibility in an Eastern European population and support the notion that HLA-B*27-negative SpA may represent a distinct clinical and immunological entity, driven by alternative pathogenic mechanisms. They also emphasize the importance of population-specific immunogenetic profiling and support expanding genetic characterization in HLA-B*27-negative patients. Full article

Background/Objectives: Mumps remains a relevant vaccine-preventable disease globally, especially in settings where immunization coverage fluctuates or vaccine-induced immunity wanes. This study aimed to assess long-term trends in mumps incidence, vaccination coverage, clinical outcomes, and demographic characteristics in the Autonomous Province of Vojvodina (AP Vojvodina), Serbia, over a 47-year period. Methods: We conducted a retrospective observational study using surveillance data from the Institute of Public Health of Vojvodina. Analyses included annual mumps incidence rates (1978–2024), coverage with mumps-containing vaccines (MuCVs; 1986–2024), monthly case counts, and individual-level case data for the 1997–2024 period. Variables analyzed included age, month of notification, gender, vaccination status, presence of clinical complications, and the method used for case confirmation. Results: Following the introduction of MuCV in 1986, the mumps incidence markedly declined, with limited resurgences in 2000, 2009, and 2012. Between 1997 and 2024, a total of 1358 cases were reported, with 62.7% occurring in males. Over time, the age distribution shifted, with adolescents and young adults being increasingly affected during the later (2011–2024) observed period. In 2012, the highest age-specific incidence was observed among individuals aged 10–19 and 20–39 years (49.1 and 45.5 per 100,000, respectively). Vaccination coverage for both MuCV doses was suboptimal in several years. The proportion of unvaccinated cases decreased over time, while the proportion with unknown vaccination status increased. Mumps-related complications—such as orchitis, pancreatitis, and meningitis—were rare and predominantly affected unvaccinated individuals: 84.2% of orchitis, 40.0% of pancreatitis, and all meningitis cases. Only two pancreatitis cases (40.0%) were reported after one MMR dose, while fully vaccinated individuals (two doses) had one orchitis case (5.3%) and no other complications. Laboratory confirmation was applied more consistently from 2009 onward, with 49.6% of cases confirmed that year (58 out of 117), and, in several years after 2020, only laboratory-confirmed cases were reported, indicating improved diagnostic capacity. Conclusions: Despite substantial progress in controlling mumps, gaps in vaccine coverage, waning immunity, and incomplete vaccination records continue to pose a risk for mumps transmission. Strengthening routine immunization, ensuring high two-dose MuCV coverage, improving vaccination record keeping, and enhancing laboratory-based case confirmation are critical. Consideration should be given to booster doses in high-risk populations and to conducting a seroepidemiological study to estimate the susceptible population for mumps in AP Vojvodina. Full article

Background/Objectives: Osteoporosis remains a leading cause of morbidity in postmenopausal women, yet many high-risk individuals remain undiagnosed or untreated. This study aimed to assess the prevalence of osteoporosis and osteopenia, treatment patterns, and skeletal fragility indicators in a large cohort of postmenopausal women undergoing DXA screening. Methods: We analyzed data from 1669 postmenopausal women aged 40–89 years who underwent DXA evaluation. BMD status was categorized as normal, osteopenia, or osteoporosis. Treatment status was classified based on active antiosteoporotic therapy, calcium/vitamin D supplementation, hormonal therapy (historical use), or no treatment. Logistic regression models were used to explore independent predictors of osteoporosis and treatment uptake. Results: A total of 45.0% of women had osteoporosis and 43.5% had osteopenia. Despite this, 58.5% of the population, over half of women with osteoporosis, were not receiving any active pharmacologic treatment. Bisphosphonates were the most prescribed therapy (17.9%), followed by calcium/vitamin D supplements (20.6%). A prior history of fragility fractures and radiological bone lesions were significantly associated with lower BMD (p < 0.05). Historical hormone replacement therapy (HRT) use was not associated with current BMD (p = 0.699), but women with HRT use reported significantly fewer fractures (p < 0.001). In multivariate analysis, later menopause age and low BMD status predicted higher odds of receiving active treatment. Conclusions: Our findings highlight a substantial care gap in osteoporosis management, with treatment primarily initiated reactively in more severe cases. Improved screening and earlier intervention strategies are urgently needed to prevent fractures and reduce the long-term burden of osteoporosis. Full article