Search Results (5,279)

Against the backdrop of high-quality urbanization in cities, the rapid expansion of metro networks has led to severe spatial mismatches in land use around station areas, which seriously restricts the full exertion of the comprehensive benefits of the transit-oriented development (TOD) model. Taking 139 operational metro stations in Xi’an in 2024 as the research sample, this study constructs a multi-objective land use optimization model with the richness of public services, transportation accessibility and population distribution balance as the three core maximization objectives. A hierarchically adaptive improved NSGA-III algorithm is proposed, with the following four key technical optimizations implemented: multi-dimensional adaptive reference point adjustment, design of real-integer hybrid coding genetic operators, construction of an enhanced multi-criteria environmental selection mechanism, and dynamic regulation of algorithm iteration. Experimental results show that the performance of the improved algorithm is significantly superior to that of the traditional NSGA-III algorithm: the values of the three core objectives are increased by 59.58%, 12.94% and 7.35% respectively compared with the original data; the algorithm achieves stable convergence after 25 iterations, with the convergence efficiency improved by 30%. The obtained Pareto optimal front features good uniformity (U = 0.92) and coverage (C = 0.95), and all the 80 non-dominated solutions meet all constraint conditions, with the solution set highly coupled with the urban functional zoning and spatial planning of Xi’an. This study proposes a zoned, prioritized and phased hierarchical land use optimization strategy for the areas around metro stations in Xi’an. The research findings provide a replicable research framework and methodological reference for the TOD practice and land use optimization of metro station areas in other rapidly urbanizing central cities in China and developing countries worldwide with the characteristic of rapid rail transit expansion. Full article

Background: Normal-weight obesity (NWO) is a nutritional status in which individuals have a normal body mass index (BMI) with a high percentage of body fat (%BF). However, the impact of elevated %BF on cardiometabolic risk remains unclear. This study aimed to evaluate whether NWO is associated with worse cardiometabolic risk markers and scores. Methods: We conducted a cross-sectional study using a convenience sample of employees from a public hospital. Participants aged ≥18 years with a BMI between 18.5–24.9 kg/m² were included in the study. %BF was categorized according to sex and age (InBody720). Normal weight and normal %BF (NWNB) and NWO were defined using cutoff points. Body composition, serum biochemical and inflammatory markers, hemodynamics, and autonomic function were considered cardiometabolic risk markers. The visceral fat area (VFA), atherogenic coefficient (AC), atherogenic index of plasma (AIP), body shape index (ABSI), and Framingham Risk (FR) score were considered cardiometabolic risk scores. Statistical significance was set at p < 0.05. Results: Of the 228 eligible participants, 52 met the inclusion criteria (NWNB, N = 29 and NWO, N = 23). Participants with NWO presented worse values of lipid profiles, anthropometric measurements, hemodynamic parameters, and autonomic function indices. After adjustment for age and sex, NWO remained associated with selected cardiometabolic markers, particularly LDL-c, triglycerides, and autonomic indices, whereas body composition findings should be interpreted as confirmatory of the phenotype. Conclusions: In this cross-sectional secondary analysis, NWO was associated with worse cardiometabolic markers and selected risk scores compared with NWNB. These findings support an unfavorable cardiometabolic profile in individuals with NWO, but do not allow inferences about future cardiometabolic events or causal relationships. Longitudinal studies are needed to clarify its prognostic significance. Full article

Health crises hinder the provision of intensive care for critical obstetric conditions such as preeclampsia and eclampsia, where timely decision making and system capacity directly impact maternal and fetal outcomes. This study compared the clinical and epidemiological profile and care processes in the ICU for cases of preeclampsia and eclampsia before and during the COVID-19 health crisis in Alto Amazonas, Loreto (Peru), using a comparative mixed-method approach. Quantitative data were obtained from ICU medical records for two periods (2015–2019 and 2020–2022). Categorical variables were compared using exact methods (Fisher’s exact test for 2 × 2 tables and exact procedures for scatter tables with multiple categories), and continuous variables were compared using nonparametric tests where appropriate. The most notable change was an increase in the frequency of cesarean sections during the health crisis, which should be interpreted with caution given the small sample size and potential changes in admission criteria and system limitations. Other clinical indicators and discharge status showed no clear evidence of substantial differences between the periods. Qualitative findings highlighted systemic limitations affecting continuity of care, particularly those related to timely access to safe blood products and referral pathways. These results align with SDG 3 (Good Health and Well-being) and support strengthening preparedness, referral coordination, and the availability of essential resources to protect maternal health during large-scale emergencies. Full article

Pyrolysis of refuse-derived fuel (RDF) is a promising waste-to-energy route, but its use in higher-value applications remains limited by tar carryover, benzene, toluene, ethylbenzene, and xylenes (BTEX), heteroatom-containing compounds, and pollutant accumulation in recirculated scrubber water. This study evaluated operating windows for RDF pyrolysis coupled with direct wet scrubbing and closed-loop water reuse, with the aim of identifying regimes suitable for different end-use tiers. A Taguchi L27 design of experiments (DOE), i.e., an orthogonal array comprising 27 experimental runs, was applied to evaluate the effects of pyrolysis temperature, residence time, scrubber liquid-to-gas ratio, and scrubber-water temperature, while sequential reuse of the same scrubber-water inventory was evaluated at 5, 10, and 15 cycles. Cleaned-gas pollutants were quantified by compound-resolved gas chromatography–mass spectrometry (GC–MS) after solid-phase adsorption (SPA) sampling, while phenolics and polycyclic aromatic hydrocarbons (PAHs) in scrubber water were determined by extraction followed by GC–MS. Feasibility within each end-use tier was defined as simultaneous satisfaction of tier-specific cleaned-gas thresholds (C_tar, C_BTEX, I_N, and I_S) and the corresponding water-loop hazard limit (I_tox), using literature-informed engineering screening criteria. The results showed that stronger scrubbing reduced gas-phase tar and BTEX burdens, whereas extended water reuse caused systematic accumulation of phenolics and PAHs and increased the composite water-loop hazard index. Boiler-grade operation remained feasible across a broad operating range, with 23 of the 27 tested conditions remaining robust, whereas internal combustion engine combined heat and power (ICE-CHP) feasibility was restricted to a narrow robust regime, and no robust microturbine-grade condition was identified. These findings show that operating windows for RDF pyrolysis must be defined jointly by gas cleanliness and water-loop management constraints. Full article

The durability of interior coatings is an important factor in the environmental performance of buildings, as the service life of the coatings directly determines the frequency of maintenance, material costs, and the overall life cycle impact. This study proposes the use of wet scrub resistance as a functional indicator of durability, providing an open dataset of commercial paints, analyzing their performance trends, and developing an integrated assessment framework. Data were collected through long-term tests according to EN ISO 11998 and EN 13300 standards from 2004 to 2025, ensuring the reliability and comparability of the results. The analysis shows that 56.8% of the tested paints met resistance class 1 and 31.5% met resistance class 2, meaning that these two classes account for almost 90% of all samples. Only around 10% of the paints were classified as class 3, while the share of the worst paints (classes 4–5) was only 1.6%. Long-term data show that class 1 has remained dominant for many years, exceeding 80% in some periods, but an increase in class 2 paints has been observed in recent years. The results of the study provide a quantitative basis for assessing the durability of coatings, allow for the prediction of maintenance intervals and analysis of technological advances, and facilitate data-driven decision-making, including the selection of sustainable building materials. The structured and standardized nature of the dataset also allows for its application in data-driven materials science, including the future development of machine learning models for predicting the durability of coatings and optimizing paint formulations based on sustainability criteria. Full article

Background: Migraine is a chronic illness that may impact the daily living and quality of life of affected individuals and might lead to excessive use of antimigraine medications. Quality of life in migraine patients is crucial, as it highlights the significant impact of migraines on daily activities, emotional well-being, and overall health. This study aims to assess the association between medication overuse headache and migraine-specific quality of life in migraine patients. Methods: A cross-sectional study was conducted at a neurology clinic in Riyadh, Saudi Arabia, from April 2025 to October 2025. Data about the quality of life were collected using the Migraine-Specific Quality of Life Questionnaire (MSQ). Medication overuse was identified using the International Classification of Headache Disorders, third edition (ICHD-3) criteria, and migraine severity was classified using the Migraine Symptom Severity Scale. Descriptive statistics were used to describe the study sample. Bivariate tests and multivariable linear regression were used to assess factors associated with MSQ. All statistical analyses were performed using SAS (ver. 9.4). Results: A total of 152 migraine patients were included, of whom 17.1% met the criteria for medication overuse headache (MOH). In bivariate analyses, MOH was significantly associated with lower Migraine-Specific Quality of Life (MSQ) scores across all domains (p < 0.001). Multiple adjusted linear regression confirmed MOH and migraine severity as the factors independently associated with reduced MSQ, with MOH associated with lower RR (β = –11.65), RP (β = –12.84), and EF (β = –16.23) scores (all p < 0.05). Conclusions: Medication overuse headache is common among migraine patients, affecting nearly one in six individuals in this study. It is strongly associated with increased migraine severity and a substantial reduction in quality of life across all domains. These findings highlight the critical need for early identification and appropriate management of medication overuse in clinical practice. Full article

Background: Ecuador is a genetically diverse population setting shaped by long-term interactions among Native American, European, and African populations across distinct ecological regions. Although multiple studies have examined ancestry patterns in Ecuadorian populations, the available evidence remains fragmented and methodologically heterogeneous. Objective: To systematically identify, critically appraise, and synthesize published studies on genetic ancestry and population structure in Ecuador. Methods: A systematic review was conducted in accordance with PRISMA 2020. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science Core Collection, SciELO, and Google Scholar through 31 January 2026. Eligible studies reported extractable ancestry-related data from Ecuadorian populations using autosomal, mitochondrial DNA, Y-chromosomal, or other ancestry-relevant genetic markers. Methodological quality was assessed using an adapted Joanna Briggs Institute framework. Owing to substantial heterogeneity across marker systems, sampling strategies, and ancestry inference methods, findings were synthesized qualitatively rather than by meta-analysis. Results: Of 1243 records identified, 12 studies met the inclusion criteria. Across marker systems, the evidence consistently supported a three-way admixture framework involving Native American, European, and African ancestry components, together with substantial regional and population-specific heterogeneity. Autosomal studies generally showed higher Native American ancestry in Highland and Native American populations, whereas African ancestry was more prominent in Afro-Ecuadorian and some Coastal populations. Uniparental markers further supported persistent sex-biased admixture, with predominant Native American maternal lineages and comparatively greater European or African paternal contributions depending on region and population history. Conclusions: Ecuadorian populations share a broad three-way admixture framework, but with marked internal heterogeneity across regions and population groups. These findings highlight the importance of geographic and demographic context in ancestry interpretation and the need for larger, more balanced, and methodologically standardized genomic studies in Ecuador. Full article

Archeological sites in humid regions are particularly susceptible to mechanical degradation induced by rainfall-driven wet–dry (W-D) cycles after excavation. In this study, representative archeological soils from the Suzhou region were investigated to quantify strength attenuation and pore structure evolution under cyclic moisture disturbance. Laboratory W-D cycling tests were conducted on samples prepared using static compaction and layered compaction methods, with cycle numbers up to nine and cycle amplitudes of 1–4 days. Unconfined compressive strength (UCS), direct shear strength, scanning electron microscopy, and mercury intrusion porosimetry were used for multiscale characterization. Results show that UCS decreases by approximately 40–50% after six to nine W-D cycles, accompanied by a porosity increase of 4.0–5.5% for statically compacted samples and 6.5–8.0% for layered-compacted samples. Layered-compacted specimens exhibit an average strength reduction of about 20% within the first three cycles, significantly higher than that of statically compacted soils. Microstructural observations reveal a progressive transformation from micropore-dominated structures (<10 μm, initially 70–80%) to interconnected meso- and macropores (>50 μm, up to 30–40%), leading to increased permeability (from ~10⁻⁸ to 10⁻⁶ cm/s). A semi-empirical model incorporating cycle number and amplitude successfully captures the non-linear evolution of porosity and strength degradation. These findings provide quantitative criteria for assessing excavation stability and long-term deterioration risks of archeological sites in humid environments. Full article

(1) Background: University food service establishments are complex environments, where high turnover and handling practices create conditions for microbial persistence. Food-contact surfaces (FCSs) and handlers’ hands (FHs) function as dynamic reservoirs, facilitating the circulation of contaminants within these institutional settings. This study aimed to characterise the microbiological contamination of FCSs and FHs in university food service establishments in Northern Portugal and to evaluate their role as interconnected environmental reservoirs within the indoor built environment. (2) Methods: A total of 590 samples were analysed from two universities in Northern Portugal (L1, L2), comprising 380 FCS and 210 FH samples. Aerobic colony counts (ACCs), Enterobacteriaceae, and Moulds and yeasts (MYs) were analysed according to ISO methods. FH samples were additionally screened for Escherichia coli and Staphylococcus spp. (3) Results: Overall, 35.5% of FCSs were classified as non-compliant, according to microbial criteria based on guideline values from the National Health Institute Dr. Ricardo-Jorge (INSA), with non-compliance primarily driven by elevated ACCs and MYs. Based on a Generalised Linear Model (GLM), establishment types (canteens vs. cafes) were associated with Enterobacteriaceae levels (p = 0.016), whereas ACCs and MYs were not significantly associated with district, establishment type, or functional surface category (p > 0.05). Differences between left and right hands showed small effect sizes, and location was a highly significant determinant of hand hygiene acceptability. (4) Conclusions: FCSs and FHs act as relevant contamination reservoirs in these settings. The results indicate that Enterobacteriaceae levels on FCSs differed between establishment types, while ACCs and MYs showed no significant variation across the evaluated environmental factors. Marked differences in hand hygiene acceptability between campuses support the implementation of targeted interventions, including the optimisation of cleaning and disinfection protocols, the structured training of food handlers, and the routine microbiological monitoring of surfaces and hands to improve institutional food safety. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is increasingly observed in patients undergoing supracricoid laryngeal surgery; however, the impact of postoperative anatomical changes on sleep-disordered breathing remains insufficiently characterized. This pilot study aimed to assess the incidence and severity of OSA after Open Partial Horizontal Laryngectomy type II (OPHL II) and to evaluate correlations between polysomnographic parameters and radiologic measurements of the neolarynx. Methods: A prospective observational cohort study was conducted on ten patients who underwent OPHL II between 2019 and 2024 and were evaluated at least one year postoperatively. The sample size was determined using a conservative estimate appropriate for a pilot prospective study, which required a long postoperative follow-up period of at least one year. All patients completed Stop-Bang, Berlin, and Epworth questionnaires and underwent overnight polysomnography. Cervical CT scans were used to measure airway length to the vocal cords (ALVC), supralaryngeal tract horizontal (SVTH) and vertical (SVTV) segments, and the base-of-tongue–to–cervical-body distance (BTCB). Results: OSA was detected in all patients: 40% mild, 30% moderate, and 30% severe. Mean AHI was 25.5 ± 18.9 events/h, and OSA severity strongly correlated with AHI (rho = 0.94; p < 0.0001). Among radiologic parameters, SVTV showed a positive correlation with OSA severity (rho = 0.82; p = 0.0035), while BTCB demonstrated a significant negative correlation (rho = −0.71; p = 0.0207). No significant associations were found for ALVC or SVTH. Conclusions: Supracricoid laryngectomy produces anatomical changes that predispose patients to OSA. Radiologic metrics—particularly SVTV and BTCB—appear to be meaningful predictors of OSA severity. A multidisciplinary approach is essential for early diagnosis and management. Due to the small number of patients enrolled larger multicenter studies are needed to confirm these findings and define radiologic criteria associated with postoperative OSA. Full article

Background/Objectives: Since non-invasive implants and invasive implants (metastases) are a key point of differentiation between serous borderline tumors (SBTs) and low-grade serous carcinoma (LGSC), the correct diagnosis of these two types of extraovarian lesions is crucial for patient treatment and prognosis. However, accurate diagnosis can be challenging even for experienced pathologists. The aim of this study was to evaluate interobserver agreement in the classification of these extraovarian lesions. Methods: Twenty-four cases of ovarian SBT and LGSC with 33 samples of non-invasive implants of SBT and metastasis of LGSC were independently reviewed by three gynecologic pathologists and three general pathologists. Diagnostic criteria included destructive invasion, micropapillary architecture, and retraction clefts. To measure interobserver agreement, Fleiss’ kappa and Cohen’s kappa were calculated, with consensus diagnoses determined by the majority of gynecologic pathologists. Results: According to the consensus, diagnosis 42.4% biopsies were classified as metastases of LGSC and 57.6% as non-invasive implants of SBT. Overall reproducibility was substantial (κ = 0.61). The agreement among gynecologic pathologists, as well as between gynecologic pathologists and the consensus (using leave-one-out reference), was substantial to near-perfect (κ = 0.745–0.821). General pathologists’ agreement with the consensus was moderate (κ = 0.467–0.698). Agreement between general pathologists was also moderate, with κ values ranging from 0.413 to 0.518. The difference in pairwise agreement between the two groups was statistically significant, confirming that gynecologic pathologists outperformed general pathologists in classifying extraovarian lesions. Conclusions: The results showed that current diagnostic reproducibility remains suboptimal, particularly among general pathologists, underscoring the need for improved training and standardized criteria. Ultimately, a multidisciplinary approach combining morphological expertise, immunohistochemical validation and molecular stratification will be essential for optimizing diagnosis and treatment. Full article

Sensory Architecture has been recognized as a relevant factor in the emotional experience of children and adolescents with autism spectrum disorder (ASD); however, a persistent gap remains in the systematic incorporation of empirical evidence into the architectural design process, particularly in Latin American urban contexts. Within this framework, the present study analyzed the relationship between Sensory Architecture and Emotional Well-Being in children and adolescents with ASD attending therapeutic centers in the district of San Juan de Lurigancho, Lima, with the aim of translating empirical findings into evidence-based architectural design criteria. A quantitative, non-experimental, cross-sectional, and correlational approach was adopted. The unit of analysis consisted of children and adolescents with ASD, whose emotional experience was assessed through proxy informants, specifically family members. The sample comprised 100 family informants selected using non-probabilistic convenience sampling. Data were collected through a structured questionnaire consisting of 25 items measured on a five-point Likert scale, which demonstrated high internal consistency (Cronbach’s alpha = 0.93). As the data did not follow a normal distribution (Kolmogorov–Smirnov, p < 0.05), Spearman’s Rho coefficient was applied. The results revealed positive and statistically significant associations between the dimensions of Sensory Architecture and Emotional Well-Being, with Spatial Configuration emerging as the dimension with the strongest associative weight ($\rho$ = 0.652; p < 0.001). Based on this empirical hierarchy, an evidence-based architectural design proposal for a therapeutic center was developed. Study limitations include the cross-sectional design and the absence of post-occupancy evaluation, which point to future research directions focused on longitudinal studies and empirical validation of architectural performance. Full article

Ceftobiprole is a fifth-generation beta-cephalosporin with high inter-individual pharmacokinetic variability in critically ill patients. However, data on its pharmacokinetics and central nervous system (CNS) penetration are limited. This study developed and validated a rapid LC-MS/MS method for quantifying ceftobiprole in human plasma and CSF. Sample preparation involved protein precipitation of 50 µL aliquots. Analysis used gradient elution on an ACQUITY UPLC^® HSS T3 column (2.1 × 100 mm, 1.8 µm) with 0.2% formic acid and acetonitrile and was detected by positive ion electrospray, achieving a 3.5 min run time. The method was linear from 0.100 to 25.0 mg/L in plasma and 0.0500 to 15.0 mg/L in CSF. Intra- and inter-run precision and accuracy were within ±15% at all quality control levels. All validation parameters, including selectivity, matrix effects, recovery, and stability under various conditions, met acceptance criteria. Potential interference from the prodrug ceftobiprole medocaril was evaluated and found to be negligible. The method was successfully applied to samples from three patients, revealing a CSF penetration range of 11.9% to 36.5%. This validated LC-MS/MS method enables simple and rapid quantification of ceftobiprole in plasma and cerebrospinal fluid, filling the gap in data on its CNS penetration and supporting routine drug concentration monitoring in critically ill patients. Full article

Using hedonic consumption theory (HCT) and a niche marketing strategy as analytical frameworks, our study examines consumer behavior in the luxury flower market, a swiftly growing segment of the global luxury goods industry. Adopting a nonexperimental, cross-sectional survey design, we collected primary data from 392 individuals from affluent households (defined as those with annual incomes exceeding $75,000, per standard demographic criteria) via purposive stratified sampling. Our questionnaire, which was reviewed by experts and tested in a pilot study, examined demographics, buying preferences, sustainability awareness, and hedonic motivations. The main findings show that most clients are well-educated women with substantial wealth. They care most about sensory, emotional, and symbolic qualities. Chi-square tests and logistic regressions robustly supported three hypotheses, gender disparities in appreciation, educational and sustainability awareness, and income influences on quality and variety emphasis, with descriptive evidence aligning with two further hypotheses regarding perceived supply shortages and sustainability preferences. The preferred places to buy include nurseries and high-end florists, suggesting opportunities for SMEs. Our study offers initial evidence supporting the application of HCT to perishable luxury floriculture among younger, educated, affluent consumers in North America. It underscores the hedonic appeal heightened by ephemerality and the potential influence of sustainability as a guilt-free enhancement, while indicating opportunities for niche marketing strategies through customization and sustainable sourcing. Our findings indicate opportunities for businesses aiming to reach comparable younger, educated, affluent demographics to fulfill unmet demand through sustainable sourcing, unique varieties, and customized experiences, which align with the SDGs. We conclude with a future research agenda. Full article

To address the issues of corn harvester field operations relying on driver visual guidance for row alignment, high labor intensity, and unstable operation accuracy, this study innovatively proposes a “vision-dominant, gateway-enhanced” dual-mode collaborative row-alignment assistance architecture, and independently develops the R²DC-Mask R-CNN instance segmentation network and MCC-KF robust filtering algorithm to form a deeply coupled hardware–software-assisted driving system. The R²DC-Mask R-CNN network is autonomously designed for corn row-detection scenarios, achieving accurate perception in complex field environments; the MCC-KF algorithm innovatively solves the state estimation divergence problem during transient vision failures through a multi-criteria constraint mechanism, ensuring continuous navigation capability; the intelligent gateway and vision system form a confidence-driven master–slave switching mechanism that adaptively enhances system robustness when vision is restricted. Field experiments demonstrate that within the speed range of 0.5–5.0 km/h, the average lateral deviation in the row alignment assisted by the system is 3.82–5.30 cm, the proportion of deviations less than 10 cm exceeds 96%, and all sample deviations remain within 20 cm; at a speed of 3.5 km/h, the system reduces the average grain loss rate from 3.76% under manual operation to 2.65%, a decrease of 29.5%. This system effectively improves row alignment accuracy and harvest quality, providing a practical human–machine collaborative solution for intelligent harvester operations. Full article