Search Results (21,832)

Background and Objectives: Hyperphosphatemia is a key component of chronic kidney disease-mineral and bone disorder and is associated with higher rates of cardiovascular events and mortality in patients undergoing dialysis. Phosphate binders are essential for phosphorus reduction, and their evaluation relies on several factors, such as chemical composition, binding capacity, and safety profile. Unfortunately, long-term management is hindered by high pill burden and poor adherence. Magnesium phosphate binders have proven effectiveness in reducing phosphate levels. Nevertheless, despite their efficacy, they are not widely used in clinical settings because of concerns related to their use. This study assessed the efficacy of low-dose magnesium carbonate as a phosphate binder in patients undergoing chronic dialysis, focusing on its biochemical control, tolerability, and cost-effectiveness. Materials and Methods: A prospective observational study was conducted on 54 hemodialysis patients with end-stage renal disease at a single dialysis center. Patients were taking either 250 mg magnesium carbonate or 2400 mg sevelamer carbonate for 3 months. Results: Both groups showed decreased phosphorus levels, with a 14.2% significant reduction in the magnesium carbonate group (p < 0.001) and a 5.1% reduction in the sevelamer carbonate group. At the end of the study, no significant differences were observed between the groups (p = 0.682). In the magnesium carbonate group at month 3, compared to baseline, no significant differences were detected in other laboratory parameters reflecting calcium–phosphorus metabolism (Ca—p = 0.681, PTH—p = 0.126). Simultaneously, good compliance without clinically relevant gastrointestinal side effects was observed, including the absence of clinically significant hypermagnesemia. Conclusions: The phosphorus-lowering potential of low-dose magnesium carbonate is non-inferior to that of low-dose sevelamer carbonate. However, its favorable safety profile, low incidence of adverse effects, and cost-effectiveness make it a promising option in clinical practice, further highlighting the need for better recognition by physicians. Full article

Although radon measurements have been carried out in most countries for several decades, a rigorous methodology for assessing the reliability (as well as the effectiveness) of indoor radon testing between short-term and long-term measurements has not yet been established at either the national or international level. National regulators, lacking scientific justification, arbitrarily set the duration of indoor radon testing (from a few minutes to several months) preferring long-term measurements simply because it “seems more reliable”. To solve this fundamental regulation problem, an original (innovative) methodology is proposed based on the algorithms of the previously published Rational Method for indoor radon testing, which ensures 95% decision-making reliability within modern metrological concepts. A comparison of the reliability (and effectiveness) between short-term and long-term measurements can be made by taking into account the radon situation at both national and global levels. The obtained dependence of the mean (among 26 countries) percentage of definite (reliable) decisions vs. the duration of measurements indicates: (i) the greater effectiveness of using short-term measurements compared to long-term ones, as well as (ii) the excessive focus of national and international regulators only on instrumental uncertainty within QA/QC to the detriment of temporal (key) uncertainty in decision-making. Key conclusion: The established practice of radon regulation on both global and national levels contains a number of underlying myths, and therefore clearly needs to be rethought and updated within a rational (scientific) strategy. A vital necessity are specific experimental (field) studies to verify (clarify) the national values of the temporal (key) uncertainty of indoor radon (and thoron EEC), as well as the creation of simple and effective (inexpensive but reliable) IoT tools for large-scale measurements of indoor radon through the involvement (and at the expense) of the population. Full article

Background/Objectives: Functional secondary hypogonadism is frequent in men with obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM), but whether testosterone replacement therapy (TRT) produces clinically relevant metabolic benefits remains uncertain. This systematic review evaluated double-blind randomized placebo-controlled trials of TRT in obese men with functional secondary hypogonadism and either T2DM or metabolic syndrome. Methods: PubMed and Scopus were searched up to May 2026. Eligible studies enrolled adult men with biochemical hypogonadism and T2DM or metabolic syndrome, compared TRT with placebo, and reported metabolic outcomes. Open-label, single-blind, and non-randomized studies were excluded. Risk of bias was assessed with the Cochrane RoB 2 framework and certainty of evidence with GRADE. Results: Eight trials were included. The most consistent signal was improvement in body composition, mainly increased lean mass and reduced fat mass. Effects on insulin resistance were favorable in several trials but heterogeneous. GRADE certainty was low for fat mass, lean mass, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and it was very low for clamp-derived insulin sensitivity, HbA1c, fasting glucose, lipid outcomes, inflammatory and vascular surrogate markers, and long-term safety. Conclusions: Low-certainty evidence suggests that TRT may improve body composition and HOMA-IR in carefully selected men with functional secondary hypogonadism and metabolic disease, whereas effects on glycemic and lipid outcomes remain very uncertain. TRT should not be regarded as an antidiabetic or lipid-lowering intervention. Larger phenotype-specific trials with longer follow-up are needed. Full article

Coastal and offshore steel infrastructures such as transmission towers and wind turbine towers are prone to coating degradation after long-term exposure to salt fog, high humidity, and ultraviolet radiation. The subsequent uniform corrosion significantly reduces the cross-sectional load-carrying capacity and threatens structural safety. This paper presents a numerical parametric analysis on the compression behavior of circular steel tube (CST) members subjected to uniform corrosion induced by coating failure, based on 18 accelerated corrosion tests. The effectiveness of the wall thickness reduction method for simulating uniform corrosion after coating degradation is verified, and the influence of key parameters on load-carrying capacity degradation is systematically investigated. A simplified formula for elastic local buckling of corroded CSTs is derived, and a direct strength method (DSM) calculation framework considering both global buckling and local–global interactive buckling is established. The results show that the uniform corrosion ratio is the dominant factor affecting load-carrying capacity degradation, while sectional dimension, slenderness ratio, and eccentricity have negligible influence. The proposed DSM method achieves a prediction error within 5% compared with test and numerical results. It is primarily applicable to uniformly corroded steel tubes represented by equivalent wall thickness loss, and its applicability to scenarios with localized corrosion, pitting corrosion, weld-zone corrosion, or non-uniform wall thickness reduction requires further validation. This method provides a rapid and accurate tool for residual load-carrying capacity assessment and life cycle management of coastal steel infrastructures after coating failure. Full article

The paper presents a certification-oriented methodology for requirements management and model verification in the design of unmanned aerial vehicle (UAV) systems. The proposed approach addresses challenges in certifying safety-critical UAV platforms whose architectures include custom-developed hardware and software components. The methodology integrates requirements engineering, functional hazard analysis (FHA), and formal model verification into a unified design and validation workflow. Methods for categorizing, prioritizing, and decomposing system requirements are presented to support the development of reliable UAV software and operational procedures. A systematic approach for mapping certification requirements and FHA safety functions to UAV operational scenarios and system use cases is introduced, enabling traceability between safety requirements, system behavior, and verification artifacts. The proposed framework employs Unified Modeling Language (UML) state-machine models, validated using linear temporal logic (LTL) and computation tree logic (CTL). Model verification is performed using the NuSMV symbolic model checker to assess the correctness, completeness, consistency, and safety properties of operational scenarios. A practical case study concerning UAV handover between ground control stations (GCSs) demonstrates the applicability of the proposed method. The analysis identifies inconsistencies in the operational model and shows how formal verification supports the early detection of unsafe or incomplete system behaviors. The presented approach supports the development of certification-ready UAV systems by improving requirements traceability, reducing verification ambiguities, and facilitating the validation of safety-critical flight-control procedures. Full article

The rapid adoption of electric vehicles (EVs) has intensified the demand for advanced energy storage technologies capable of delivering high energy density, high power density, enhanced safety, and extended service life. Although lithium-ion batteries remain the dominant energy storage technology for EVs, their limited power capability, thermal degradation, and accelerated aging under high transient loads constrain vehicle performance. Battery–supercapacitor hybrid energy storage systems (HESSs) have emerged as a promising solution by combining the high energy density of batteries with the high-power density and rapid charge–discharge capability of supercapacitors. However, the increasing complexity of HESS architecture requires intelligent energy management strategies to optimize power allocation, battery protection, thermal regulation, and overall system efficiency. Existing review papers primarily address individual aspects of HESS architecture, battery management, or artificial intelligence (AI)-based control, leaving a lack of a unified review integrating these topics. This paper addresses this gap by reviewing 181 publications published between 2020 and 2026, covering HESS architectures, conventional and AI-driven energy management strategies, machine learning, deep learning, reinforcement learning, battery state estimation, diagnostics, prognostics, thermal management, and fault diagnosis. The reviewed studies are critically analyzed to assess the impact of AI on battery lifetime, regenerative braking, charging performance, thermal behavior, and energy efficiency. The review further identifies emerging research directions, including explainable AI, digital twins, federated learning, edge intelligence, vehicle-to-grid integration, and cybersecurity-aware energy management. The findings indicate that AI-based approaches generally demonstrate greater adaptability, predictive capability, and battery protection than conventional methods under dynamic operating conditions, although challenges related to computational complexity, real-time implementation, data availability, explainability, cybersecurity, and standardization remain significant barriers to large-scale deployment. Full article

Hydrogen (H₂) has emerged as a promising sustainable energy vector due to its scalability, high energy density, and its ability to enable sector coupling across electricity, heating, transportation, and industry. There remains a huge technical challenge to overcome. The economic implications of low round-trip efficiency, high capital costs, the limited lifespan of fuel cells and electrolyzers, and infrastructure constraints on H₂’s relative competitiveness have not been comprehensively studied. In a comparative assessment against other storage options such as batteries, pumped hydro, and compressed air energy storage (CAES), we highlight the potential of H₂ as a grid-scale storage solution. The novelty of this paper is that it compares H₂ as a competing option with other storage technologies and highlights its unique suitability for seasonal and grid-scale applications where others fall short. The paper also discusses the technological opportunities for AI and other digital technologies in the H₂ grid. Unlike general reviews, this work emphasizes the engineering performance of H₂’s production cost and economic viability, electrolyzer technology maturity, infrastructure readiness, safety and lifecycle considerations, and provides critical synthesis and implications. With this, the paper extends beyond the theoretical capacity for H₂ and gives an engineering-focused analysis that informs the drive toward sustainable and resilient power grids. Full article

This paper proposes a norm-based admissibility criterion formulated in the frequency domain for evaluating whether translational and rotational motion amplitudes of a ship moored at a quay remain within operational limits prescribed by port authorities. The approach is built on a linear six-degree-of-freedom model that includes hydrodynamic added-mass and radiation-damping effects, wave excitation forces, and aerodynamic wind loads, as well as linearized reactions of mooring lines and quay fenders, including an equivalent viscous representation of hull–fender friction. Instead of explicitly inverting the full system matrix to compute the complete response, the admissibility assessment is derived from row-wise norm bounds of the frequency-domain system, yielding a computationally efficient admissibility criterion for compliance with motion limits. The criterion naturally enables a port-oriented decision index and an operational safety margin that can be evaluated for each degree of freedom and used to compare alternative mooring arrangements. Numerical verification is performed for a bulk carrier under storm wave excitation and different loading conditions, demonstrating the sensitivity of admissibility to mooring geometry and pretension. The results confirm that the proposed criterion provides a practical engineering tool for rapid go/no-go decisions regarding cargo operations and supports the selection of mooring arrangements that improve operational robustness under adverse environmental loading conditions. In addition, a Monte Carlo-based uncertainty analysis is performed to evaluate the robustness of the proposed admissibility criterion with variable mooring stiffness and damping parameters. The proposed criterion is intended as a rapid engineering screening tool to complement conventional frequency-domain response analysis. Full article

Background: Family-based interventions are effective in mitigating the risk for relapse of schizophrenia. However, the accessibility of these interventions is scarce in many clinical settings. A group-based brief cognitive behavioural intervention facilitated by a therapist using videoconferencing may help address this practice gap and improve the high treatment disengagement that occurs in interventions delivered in self-paced web-based forums or mobile applications. Objective: To examine the feasibility, acceptability, and safety of an online group-based cognitive behavioural family intervention for dyads of individuals with schizophrenia-spectrum disorders and caregivers. Methods: This feasibility study adopted a parallel-group, assessor-blind randomised controlled trial with a twelve-week post-intervention follow-up as well as individual semi-structured interviews. Participants were randomly assigned to the intervention group [i.e., tele-group cognitive behavioural family intervention (tgCBFI) group] and the treatment-as-usual group. Both groups also received biweekly brief telephone support. The feasibility and acceptability were assessed by the recruitment rate, intervention completion rate, retention rate and participants’ service satisfaction. Safety was measured by the number of adverse events. Results: Most intervention group participants (85.7%) attended all six online group sessions (six service user-caregiver dyads, corresponding to 12 participants), while 100% of participants attended the per-protocol number of sessions (≥four sessions). The study recruitment rate was 16.4%, while the study retention rate for follow-up assessments was 95.8%. No adverse events were reported throughout the study. Five themes were generated to illustrate the benefits of and recommendations for the tgCBFI programme to complement the quantitative findings. Conclusions: The preliminary results suggested that the use of videoconferencing to deliver group-based cognitive behavioural intervention was partially feasible and provided exploratory estimates suggesting possible improvement in psychiatric symptoms for individuals with schizophrenia-spectrum disorders, warranting a fully powered trial. Trial Registration: prospectively registered at ClinicalTrials.gov NCT05808244. Full article

Traditional wet markets are critical components of Indonesia’s urban food system, yet remain largely unexamined from an occupational health and safety (OHS) perspective. This study identified and prioritized OHS risks among vendors and visitors at Nanggalo Market, a high-density traditional market in Padang, West Sumatra. This was an exclusively qualitative, descriptive, non-probability (purposive) study; no actual occupational accidents, injuries, or exposure incidents were evaluated, and risk levels reflect participants’ perceptions together with researchers’ triangulated observations rather than objective incident records. An observational qualitative design combined elicitation surveys with 45 participants (20 vendors, 20 visitors, 5 market managers), direct observation, and in-depth interviews with 7 key informants. Risk assessment followed the AS/NZS 4360:2004 matrix, classifying risks by likelihood and consequence severity based on participant- and researcher-perceived evidence rather than recorded incident data. Ten potential hazards were identified across six activity zones: traffic and parking; buying and selling; culinary activities; building structures and floor conditions; security and stray animals; and emergency access. Seven risks were classified as high-level, including slipping on wet floors, lack of evacuation routes, lack of fire extinguishers, narrow circulation paths, poor toilet conditions, crowding, and traffic injuries, while three were moderate. All high-level risks lacked adequate controls. Recommended interventions span the full hierarchy of controls, prioritizing engineering and administrative measures, and propose community-based occupational health posts as a sustainable mechanism. These findings provide an evidence base for strengthening OHS governance in traditional wet markets across Indonesia and comparable low- and middle-income country settings. Full article

Bridge health assessment and deterioration prediction are essential for traffic safety and maintenance planning. However, conventional bridge evaluation still relies heavily on expert judgment and heuristic rules, limiting objectivity and long-term forecasting capability. This study proposes a physics-constrained multi-task learning–semi-Markov framework for bridge condition assessment, multi-year deterioration forecasting, and risk-aware maintenance prioritization. Guided by the Highway Bridge Technical Condition Rating Code, the proposed model jointly predicts health grade, defect type, and severity from inspection item/defect entry records, improving assessment robustness through cross-task information sharing. The predicted health states are then incorporated into a physics-constrained semi-Markov model to forecast bridge deterioration over a three-year horizon, and the current and predicted states are further used for maintenance prioritization. Experiments on real bridge inspection data show that the proposed model achieves test accuracies of 95.20%, 99.67%, and 99.72% for health grade, defect type, and severity, respectively, with a Cohen’s kappa of 0.872, while the proposed semi-Markov model achieves a three-year prediction accuracy of 95.4% and a weighted accuracy of 99.1%. Comparative and ablation studies further demonstrate the effectiveness of the proposed framework for bridge lifecycle management. Full article

Human skin is continuously exposed to microbial invasion and oxidative stress, highlighting the need for safe and effective natural skin-protective agents. This study aims to investigate the antibacterial, antioxidant, and anti-tyrosinase activities of methanolic leaf extracts of Syzygium nervosum collected from Chiang Mai (SNLM-CM) and Phayao (SNLM-PY), Thailand. LC–QTOF–MS analysis revealed distinct phytochemical profiles between the extracts, suggesting that geographical origin influenced their biological activities. Antibacterial activity against Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli was evaluated, together with studies of bacterial membrane integrity. Antioxidant capacity was assessed using ABTS, DPPH, FRAP, and ORAC assays, while anti-tyrosinase activity and cytotoxicity toward normal human dermal fibroblasts (NHDF) were determined by MTT assay. Both extracts exhibited potent antibacterial activity, particularly against Gram-positive bacteria (S. aureus and S. epidermidis) likely through membrane disruption, as evidenced by propidium iodide uptake, intracellular DNA and protein leakage, and scanning electron microscopy observations. SNLM-CM showed stronger antioxidant activity, whereas SNLM-PY demonstrated greater anti-tyrosinase activity. The extracts maintained high NHDF viability at concentrations below 100 µg/mL and retained antibacterial efficacy when incorporated into a cleansing gel formulation. Overall, S. nervosum leaf extracts exhibit promising antibacterial, antioxidant, and anti-tyrosinase activities, warranting further investigation to optimize their safety and efficacy for dermatological and cosmetic use. Full article

Background/Objectives: Children with cancer admitted to the pediatric intensive care unit (PICU) are at increased risk for post-intensive care syndrome (PICS-p) due to prolonged immobility, deep sedation, and severe illness. The ABCDEF bundle offers a framework for enhancing ICU care and patient recovery, but implementing all components in pediatric oncology patients is challenging. This study assesses the development and implementation of the BRAVE (Beginning Restorative Activities Very Early) initiative, specifically BRAVE2, to integrate the comprehensive ABCDEF bundle and a nurse-led mobility program, in collaboration with rehabilitation specialists, within a pediatric oncology intensive care unit. Methods: BRAVE2 was a quality improvement project conducted in a single pediatric ICU from 2022 to 2023. We analyzed ICU data to assess patient demographics, frequency of physical and occupational therapy (PT/OT) consultations, time to initial mobilization, and delirium screening rates (CAPD score of 9 or higher) for patients with ICU stays over 48 h. BRAVE2 addressed all elements of the ABCDEF bundle, including regular pain assessments, evaluation of spontaneous breathing readiness, sedation adjustments, delirium screening, early mobilization, and family engagement. Outcomes were monitored using statistical process control methods. Results: Of 140 patients, 117 (84%) remained in the ICU for more than 48 h. The delirium screening rate was 15.5%, consistently below the target of 30%. PT/OT consultations within 72 h occurred in 80.7% of patients, and early mobilization in 49.7% of patients, both below the 80% goal. However, 90.4% of patients with tracked mobility were able to ambulate during their ICU stay. No mobility-related safety incidents were reported. Conclusions: Rolling out a full ICU liberation plan in a pediatric oncology ICU is possible, and implementing a comprehensive one is feasible and sustainable despite challenges. Although therapist-led early mobilization did not meet targets, incorporating nurse-led mobility strategies and routine delirium screening has established a scalable model to enhance ICU care and support long-term recovery for these patients. Full article

Resource-based cities in Northwest China face increasing ecological, geotechnical, and socio-economic challenges caused by long-term mining, including subsidence, slope instability, waste rock accumulation, soil erosion, industrial decline, and settlement deterioration. Post-mining land reuse is constrained by geological safety, foundation stability, slope safety, drainage capacity, erosion risk, and waste rock dump stability, yet existing restoration studies often separate engineering remediation from landscape reuse, industrial pathway selection, and long-term governance. Taking a mining area in City A, Gansu Province, as a case study, this paper develops a geotechnical constraint-based ecology–landscape–economy framework for post-mining land reuse and sustainable human settlement improvement. Unlike conventional reclamation approaches that mainly emphasize engineering remediation, vegetation recovery, or single-function land reuse, this study integrates geotechnical constraints, land-unit classification, pathway-specific compatibility assessment, and capital–space coupling into a planning-scale decision-support framework. Post-mining land was classified into five units, and their compatibility with three restoration plus industrial pathways was assessed using five indicators: geological safety, ecological sensitivity, land-use availability, landscape and cultural value, and industrial operation potential. The results indicate that backfilled mining voids and reclaimed platforms are most suitable for modern agriculture, tailings ponds and subsidence waterbodies for cultural tourism and wellness, and waste rock dump platforms and other stable, low-sensitivity open land for new energy development. A capital–space coupling mechanism is further proposed to link restoration, support, and development zones with government funds, corporate capital, social capital, green finance, and industrial income. This framework provides a planning-scale engineering-suitability screening tool for sustainable post-mining land transformation. Full article

Over the past decade, the incidence of infectious syphilis has been on the rise in the general Chinese population. Consequently, Treponema Pallidum (TP) testing has been proposed as a surrogate marker for sexually transmitted pathogens and for monitoring risky sexual behaviors among blood donors globally. In addition, sexual contact with individuals chronically infected with hepatitis B virus (HBV) is recognized as one of the primary routes of HBV transmission. Blood donors may acquire HBV infection through sexual contact with chronically infected partners, particularly with occult hepatitis B infections (OBIs), which are characterized by intermittent and extremely low viral loads. Therefore, the prevalence of OBIs among syphilis-positive blood donations and the corresponding risks to blood safety require further investigation. This study aimed to investigate the prevalence of OBIs among syphilis-positive blood donors and assess the surrogate value of TP testing for evaluating OBI-related risks to blood supply. After routine screening using serological assays and nucleic acid testing (NAT), blood donation samples with positive anti-TP enzyme-linked immunosorbent assay (ELISA) results were collected and further confirmed by the Treponema Pallidum Particle Agglutination Assay (TPPA). For blood donations confirmed positive for syphilis, further tests were performed to characterize whether the donations had HBV co-infection, including electrochemiluminescence immunoassay (ECLI) for the detection of hepatitis B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), anti-hepatitis B e antibody (anti-HBe), and anti-hepatitis B core antibody (anti-HBc). Additionally, quantitative real-time polymerase chain reaction (qPCR) was used for HBV DNA quantification, and nested PCRs for the S and basal core promoter/precore (BCP/PC) region were conducted in combination with high-volume nucleic acid extraction. Subsequently, molecular characterization of HBV DNA in these co-infected samples was carried out by DNA sequencing to analyze the viral genetic features. Of 252 anti-TP ELISA+ donations screened from 64,871 blood samples, 138 (138/250, 55.2%) donations were confirmed syphilis-positive but NAT−, among which 78 (78/138, 56.5%) were anti-HBc-positive, and 88 (88/138, 63.7%) had anti-HBs. Notably, seven donations (7/138, 5.1%) were diagnosed as OBI co-infections, and available sequence analysis revealed that three cases were genotype B and one case was genotype C. In addition, several mutations in the S region of the HBV genome were identified, including Q101R, K122R, Q129H, T131N, M133T, G145R, and Y161F mutations. Furthermore, nucleotide mutations such as T1719G, A1752T, G1896A, and A1762T/G1764A in the BCP/PC regions were also detected in these OBI donations. These mutations may contribute to the extremely low HBV viral loads and/or failure in HBsAg detection, collectively leading to OBIs. These data indicate that syphilis screening of blood donors has potential to serve as an additional safeguard measure for excluding donations co-infected with OBIs. The high prevalence of undetected OBIs in syphilis-positive blood donors further supports that syphilis screening has the potential to serve as a surrogate marker for HBV-related risks in the blood supply. Full article