Search Results (121)

In the heating, ventilation, and air conditioning (HVAC) systems of mushroom growing control rooms, traditional rule-based control methods are commonly adopted. However, these methods are characterized by response delays, leading to underutilization of energy-saving potential and energy costs that constitute a disproportionately high share of overall production costs. Therefore, minimizing the running time of the air conditioning system is crucial while maintaining the optimal growing environment for mushrooms. To address the aforementioned issues, this paper proposed a sensor optimization method based on the combination of principal component analysis (PCA) and information entropy. Furthermore, model predictive control (MPC) was implemented using a gated recurrent unit (GRU) neural network with an attention mechanism (GRU-Attention) as the prediction model to optimize the air conditioning system. First, a method combining PCA and information entropy was proposed to select the three most representative sensors from the 16 sensors in the mushroom room, thus eliminating redundant information and correlations. Then, a temperature prediction model based on GRU-Attention was adopted, with its hyperparameters optimized using the Optuna framework. Finally, an improved crayfish optimization algorithm (ICOA) was proposed as an optimizer for MPC. Its objective was to solve the control sequence with high accuracy and low energy consumption. The average energy consumption was reduced by approximately 11.2%, achieving a more stable temperature control effect. Full article

Utility tunnels concentrate various important urban engineering pipelines within a shared underground space, which poses significant fire risks, particularly from cable fires. In this study, a full-scale fire experiment was conducted to investigate the temperature distribution characteristics of cable fires in utility tunnels, along with the effects of spray intensity, cable fullness, and longitudinal ventilation on the extinguishing efficiency of a high-pressure water mist fire extinguishing system (HWMFES). The results show that the maximum heating area of a cable fire in a utility tunnel is localized to the three cable trays nearest to and directly above the fire source, with a peak temperature of 825 °C, while the impact on other areas is negligible. Increasing the spray intensity from 0.7 to 1.0 L/(min·m²) reduced the time required to lower temperatures to 50 °C by 40.8%, while reducing cable fullness from 12 to 6 cables per tray shortened extinguishing time by 22.5%. Additionally, applying a ventilation speed of 2 m/s enhanced cooling efficiency, reducing the time to reach 50 °C by 67.5% compared to still air conditions. These findings provide practical insights and data support for optimizing the design and application of HWMFES in enhancing fire safety in utility tunnels. Full article

Background: Acinetobacter baumannii is a highly concerning pathogen in hospital settings, responsible for severe infections such as ventilator-associated pneumonia, urinary tract infections, and meningitis. Its remarkable genetic plasticity facilitates the rapid acquisition of antibiotic resistance, significantly complicating treatment and increasing mortality rates. As multidrug-resistant (MDR) infections continue to rise, phage therapy emerges as a viable alternative. Methods: This study reports the isolation and characterization of Acinetobacter phage vB_AbaM_A72 from stagnant water in Jalisco, Mexico. Results: Transmission electron microscopy revealed a myovirus-like morphology with an icosahedral head (91.32 ± 0.12 nm) and a contractile tail (123.77 ± 0.19 nm). The phage exhibited high environmental resilience, tolerating temperatures up to 60 °C and pH ranging from 5 to 11. Notably, A72 demonstrated a narrow host range but effectively inhibited the growth of an MDR A. baumannii strain for at least 12 h across different multiplicities of infection. Whole-genome sequencing confirmed the absence of virulence, antibiotic resistance, or lysogeny-associated genes. Comparative genomic analysis identified A72 as the first member of a newly described Obolenskvirus species, sharing only 76.4% similarity with its closest relatives. Conclusions: These findings underscore the importance of fully characterizing novel bacteriophages to expand therapeutic libraries and reinforce the feasibility of phage therapy as a promising approach against MDR A. baumannii infections. Full article

This study evaluates the passive thermal resilience of two full-scale residential buildings during natural summer heatwaves and blackout-like conditions in a temperate European climate. The buildings share identical geometry and ventilation but differ in envelope mass and ground coupling. Building B1 is a masonry structure with a slab-on-ground floor, while B2 is a lightweight timber-frame house. In 2019, B1 underwent a retrofit in which floor insulation was removed to enable direct subsoil heat exchange. Three complementary frameworks were applied: model IOD, AWD, OEF, the indicators AF and αIOD, and the health-based scenario rating HE, HIHH, and WBGT. Across all metrics, B1 demonstrated superior resilience, with overheating fully eliminated after ground coupling was introduced. B2, in contrast, remained vulnerable under both moderate and extreme events. The findings highlight the critical role of thermal mass and soil buffering in maintaining safe indoor conditions without active systems. Under certain circumstances, omitting under-slab insulation can improve summer resilience without significantly compromising winter performance. A companion life-cycle analysis confirms lower cumulative carbon emissions for B1 under all SSP scenarios to 2100. Passive ground coupling thus emerges as a low-cost, maintenance-free adaptation strategy with co-benefits for mitigation and occupant safety. Full article

Acquired tracheoesophageal fistulas (TEF) are a rare but severe complication in post-coma neurorehabilitation patients, particularly those requiring long-term tracheostomy and enteral nutrition. Early recognition and proper surgical management are critical to prevent life-threatening outcomes and functional deterioration. However, variability in clinical presentation and the lack of standardized multidisciplinary pathways often delay referral to thoracic surgeons. We present the case of a young patient with severe traumatic brain injury, prolonged tracheostomy, and percutaneous endoscopic gastrostomy (PEG), who developed a TEF due to tracheal ischemic injury. Clinical suspicion arose from indirect signs—such as recurrent aspiration and air in the PEG system—the diagnosis was confirmed by bronchoscopy and sagittal CT imaging. Surgical planning was carried out in close collaboration between rehabilitation physicians and thoracic surgeons, based on shared criteria involving ventilator weaning, nutritional status, and clinical stability. This case highlights the importance of a multidisciplinary, protocol-driven approach in managing TEF. Current literature supports timely but carefully selected surgical intervention, particularly in patients who are no longer ventilator-dependent, significantly reducing perioperative mortality (reported up to 60% in ventilated patients). Recent reviews advocate for standardized surgical techniques—such as single-stage repair with muscle flap interposition—and emphasize the value of early diagnosis using a combination of bronchoscopy, videofluoroscopy, and sagittal CT. We propose a structured clinical pathway integrating neurorehabilitation and thoracic surgery, aimed at optimizing timing and surgical outcomes in patients with acquired TEF. This model may serve as a foundation for future guidelines, improving both safety and efficiency in the multidisciplinary management of this complex complication. Full article

Background: Pediatric tracheostomy decisions are challenging for clinicians and parents, especially when a child’s survival/neurodevelopmental outcome is uncertain. Better understanding of parents’ values over the decision period is crucial for clinical decision-making. Objective: To describe parents’ values during tracheostomy decision-making for their critically ill child and to identify opportunities to improve parent–clinician shared decision-making (SDM). Methods: We thematically analyzed 12 semi-structured interviews with parents who recently faced a tracheostomy decision for their critically ill child. Three study team members with qualitative expertise reviewed the transcripts, identifying key topics independently. A codebook was developed, and data were coded. Key research questions guided analysis, with findings iteratively reviewed by the study team. Results: We identified parents’ values at the three time points: when the decision was introduced, during their deliberations of it, and when the ultimate decision was made. Initially, parents resisted tracheostomy because it threatens normalcy. They valued proof of a need for tracheostomy and information with certainty. As certainty for tracheostomy increased over time, parents’ hope focused on reversibility of tracheostomy and improvement in normalcy compared to current status. They concurrently worried about practical issues such as emergencies, home care, and finances. Key considerations driving the final decision included best interest of the child, perceived benefits of tracheostomy compared to its downsides or other options, and potential for better quality of life and longer life. Conclusions: Parents’ dynamic values shifting with clinical uncertainty suggests opportunities to improve SDM by attending to parents’ individualized needs and managing expectations. Full article

Background: Myasthenia gravis (MG), a chronic autoimmune disorder with variable disease trajectories, presents considerable challenges for clinical stratification and acute care management. This systematic review evaluated machine learning models developed for prognostic assessment in patients with MG. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, and Scopus for relevant articles published from January 2010 to May 2025. Studies using machine learning techniques to predict MG-related outcomes based on structured or semi-structured clinical variables were included. We extracted data on model targets, algorithmic strategies, input features, validation design, performance metrics, and interpretability methods. The risk of bias was assessed using the Prediction Model Risk of Bias Assessment Tool. Results: Eleven studies were included, targeting ICU admission (n = 2), myasthenic crisis (n = 1), treatment response (n = 2), prolonged mechanical ventilation (n = 1), hospitalization duration (n = 1), symptom subtype clustering (n = 1), and artificial intelligence (AI)-assisted examination scoring (n = 3). Commonly used algorithms included extreme gradient boosting, random forests, decision trees, multivariate adaptive regression splines, and logistic regression. Reported AUC values ranged from 0.765 to 0.944. Only two studies employed external validation using independent cohorts; others relied on internal cross-validation or repeated holdout. Of the seven prognostic modeling studies, four were rated as having high risk of bias, primarily due to participant selection, predictor handling, and analytical design issues. The remaining four studies focused on unsupervised symptom clustering or AI-assisted examination scoring without predictive modeling components. Conclusions: Despite promising performance metrics, constraints in generalizability, validation rigor, and measurement consistency limited their clinical application. Future research should prioritize prospective multicenter studies, dynamic data sharing strategies, standardized outcome definitions, and real-time clinical workflow integration to advance machine learning-based prognostic tools for MG and support improved patient care in acute settings. Full article

Heating, ventilation, air conditioning, and refrigeration (HVAC&R) systems account for a significant share of global energy demand, prompting intensive research into advanced thermal enhancement techniques. Among these, nanofluids—colloidal suspensions of nanoparticles in base fluids—have shown promise in boosting heat transfer performance. This review provides a structured and critical evaluation of nanofluid applications in HVAC&R systems, synthesizing research published from 2015 to 2025. A total of 200 peer-reviewed articles were selected from an initial pool of over 900 through a systematic filtering process. The selected literature was thematically categorized into experimental, numerical, hybrid, and AI/ML-based studies, with further classification by fluid type, performance metrics, and system-level relevance. Unlike prior reviews focused narrowly on thermophysical properties or individual components, this work integrates recent advances in artificial intelligence and hybrid modeling to assess both localized and systemic enhancements. Notably, nanofluids have demonstrated up to a 45% improvement in heat transfer coefficients and up to a 51% increase in the coefficient of performance (COP). However, the review reveals persistent gaps, including limited full-system validation, underexplored real-world integration, and minimal use of AI for holistic optimization. By identifying these knowledge gaps and research imbalances, this review proposes a forward-looking, data-driven roadmap to guide future research and facilitate the scalable adoption of nanofluid-enhanced HVAC&R technologies. Full article

This study investigates indoor and outdoor air quality monitoring in a student dormitory located in northern Milan (Italy) using low-cost sensors. This research compares two monitoring periods in June and October 2024 to examine common PM_2.5 vertical patterns and differences at the building level, as well as their influence on the indoor spaces at the corresponding positions. In each period, around 30 sensors were installed at various heights and orientations across indoor and outdoor spots for 2 weeks to capture spatial variations around the building. Meanwhile, qualitative surveys on occupation presence, satisfaction, and well-being were distributed in selected rooms. The analysis of PM_2.5 data reveals that the building’s lower floors tended to have slightly higher outdoor PM_2.5 concentrations, while the upper floors generally had lower PM_2.5 indoor/outdoor (I/O) ratios, with the top-floor rooms often below 1. High outdoor humidity reduced PM infiltration, but when outdoor PM fell below 20 µg/m³ in these two periods, indoor sources became dominant, especially on the lower floors. Air pressure I/O differences had minimal impact on PM_2.5 I/O ratios, though slightly positive indoor pressure might help prevent indoor PM infiltration. Lower ventilation in Period-2 possibly contributed to more reported symptoms, especially in rooms with higher PM from shared kitchens. While outdoor air quality affects IAQ, occupant behavior—especially window opening and ventilation management—remains crucial in minimizing indoor pollutants. Users can also manage exposure by ventilating at night based on comfort and avoiding periods of high outdoor PM. Full article

The life-cycle carbon emissions (LCCE) assessment of dairy barns is crucial for identifying low-carbon transition pathways and promoting the sustainable development of the dairy industry. We applied a life cycle assessment approach integrated with building information modeling and EnergyPlus to establish a full life cycle inventory of the material quantities and energy consumption for dairy barns. The LCCE was quantified from the production to end-of-life stages using the carbon equivalent of dairy barns (CEDB) as the functional unit, expressed in kg CO₂e head⁻¹ year⁻¹. A carbon emission assessment model was developed based on the “building–process–energy” framework. The LCCE of the open barn and the lower profile cross-ventilated (LPCV) barn were 152 kg CO₂e head⁻¹ year⁻¹ and 229 kg CO₂e head⁻¹ year⁻¹, respectively. Operational carbon emissions (OCE) accounted for the largest share of LCCE, contributing 57% and 74%, respectively. For embodied carbon emissions (ECE), the production of building materials dominated, representing 91% and 87% of the ECE, respectively. Regarding carbon mitigation strategies, the use of extruded polystyrene boards reduced carbon emissions by 45.67% compared with stone wool boards and by 36% compared with polyurethane boards. Employing a manure pit emptying system reduced carbon emissions by 76% and 74% compared to manure scraping systems. Additionally, the adoption of clean electricity resulted in a 33% reduction in OCE, leading to an overall LCCE reduction of 22% for the open barn and 26% for the LPCV barn. This study introduces the CEDB to evaluate low-carbon design strategies for dairy barns, integrating building layout, ventilation systems, and energy sources in a unified assessment approach, providing valuable insights for the low-carbon transition of agricultural buildings. Full article

Improving the energy efficiency of residential buildings is essential for achieving global climate goals and reducing environmental impact. This study analyzes the Total Performance approach using the example of a modern semi-detached house built by a Polish developer, as an example. The building is designed with integrated systems that minimize energy consumption while maintaining resident comfort. The building is equipped with an air-to-water heat pump, underfloor heating, mechanical ventilation with heat recovery, and automatic temperature control systems. Energy efficiency was assessed using ArCADia–TERMOCAD 8.0 software in accordance with Polish Technical Specifications (TS) and verified by monitoring real-time electricity consumption during the heating season. The results show a PED from non-renewable sources of 54.05 kWh/(m²·year), representing a 23% reduction compared to the Polish regulatory limit of 70 kWh/(m²·year). Real-time monitoring conducted from December 2024 to April 2025 confirmed these results, indicating an actual energy demand of approximately 1771 kWh/year. Domestic hot water (DHW) preparation accounted for the largest share of energy consumption. Despite its dependence on grid electricity, the building has the infrastructure to enable future photovoltaic (PV) installation, offering further potential for emissions reduction. The results confirm that Total Performance strategies are not only compliant with applicable standards, but also economically and environmentally viable. They represent a scalable model for sustainable residential construction, in line with the European Union’s (EU’s) decarbonization policy and the goals of the European Green Deal. Full article

Heating, ventilation, and air-conditioning (HVAC) systems account for the largest share of energy consumption in European Union (EU) buildings, representing approximately 40% of the final energy use and contributing significantly to carbon emissions. Latent thermal energy storage (LTES) using phase change materials (PCMs) has emerged as a promising strategy to enhance HVAC efficiency. This review systematically examines the role of latent thermal energy storage using phase change materials (PCMs) in optimizing HVAC performance to align with EU climate targets, including the Energy Performance of Buildings Directive (EPBD) and the Energy Efficiency Directive (EED). By analyzing advancements in PCM-enhanced HVAC systems across residential and commercial sectors, this study identifies critical pathways for reducing energy demand, enhancing grid flexibility, and accelerating the transition to nearly zero-energy buildings (NZEBs). The review categorizes PCM technologies into organic, inorganic, and eutectic systems, evaluating their integration into thermal storage tanks, airside free cooling units, heat pumps, and building envelopes. Empirical data from case studies demonstrate consistent energy savings of 10–30% and peak load reductions of 20–50%, with Mediterranean climates achieving superior cooling load management through paraffin-based PCMs (melting range: 18–28 °C) compared to continental regions. Policy-driven initiatives, such as Germany’s renewable integration mandates for public buildings, are shown to amplify PCM adoption rates by 40% compared to regions lacking regulatory incentives. Despite these benefits, barriers persist, including fragmented EU standards, life cycle cost uncertainties, and insufficient training. This work bridges critical gaps between PCM research and EU policy implementation, offering a roadmap for scalable deployment. By contextualizing technical improvement within regulatory and economic landscapes, the review provides strategic recommendations to achieve the EU’s 2030 emissions reduction targets and 2050 climate neutrality goals. Full article

Background: Airway management in otolaryngology presents unique challenges due to shared airway access, altered anatomy, and specific procedural requirements. This article examines current techniques and oxygenation strategies across various ENT procedures to provide a guide for otolaryngologists. Methods: A narrative review was performed of the contemporary literature, focusing on airway techniques in ENT surgery, including laryngeal surgery, pediatric bronchoscopy, transoral surgery, and trauma and emergency scenarios. A systematic search for difficult airway guidelines was performed using the EMBASE, Pubmed, and Cochrane databases to examine where guidelines are published. Results: The key areas for specialist airway management included laryngeal surgery in the tubeless field and adjuncts for emergency situations. High-flow nasal oxygen (HFNO), jet ventilation, video laryngoscopy, and specialized tubes emerged as key technological advances, improving safety and outcomes. A systematic search identified 947 difficult airway articles across 82 publishers. These were predominantly in anesthetic journals (n = 301), with limited representation in the otolaryngology literature (n = 8) and limited guidance concerning awake surgical tracheostomies under local anesthetic. Awake tracheal intubation and emergency front-of-neck access were identified as key techniques across multiple publications. Conclusions: Modern ENT airway management requires multidisciplinary planning, advanced equipment familiarity, and procedure-specific techniques. Despite having the expertise to perform the gold standard, the limited otolaryngology literature on difficult airways suggests that guidelines are primarily developed by the anesthetic community. Full article

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder characterized by the progressive degeneration of upper and lower motor neurons, leading to muscle atrophy, paralysis, and respiratory failure. This comprehensive review synthesizes the current knowledge on ALS pathophysiology, clinical heterogeneity, diagnostic frameworks, and evolving therapeutic strategies. Mechanistically, ALS arises from complex interactions between genetic mutations (e.g., in C9orf72, SOD1, TARDBP (TDP-43), and FUS) and dysregulated cellular pathways, including impaired RNA metabolism, protein misfolding, nucleocytoplasmic transport defects, and prion-like propagation of toxic aggregates. Phenotypic heterogeneity, manifesting as bulbar-, spinal-, or respiratory-onset variants, complicates its early diagnosis, which thus necessitates the rigorous application of the revised El Escorial criteria and emerging biomarkers such as neurofilament light chain. Clinically, ALS intersects with frontotemporal dementia (FTD) in up to 50% of the cases, driven by shared TDP-43 pathology and C9orf72 hexanucleotide expansions. Epidemiological studies have revealed a lifetime risk of 1:350, with male predominance (1.5:1) and peak onset between 50 and 70 years. Disease progression varies widely, with a median survival of 2–4 years post-diagnosis, underscoring the urgency for early intervention. Approved therapies, including riluzole (glutamate modulation), edaravone (antioxidant), and tofersen (antisense oligonucleotide), offer modest survival benefits, while dextromethorphan/quinidine alleviates the pseudobulbar affect. Non-pharmacological treatment advances, such as non-invasive ventilation (NIV), prolong survival by 13 months and improve quality of life, particularly in bulb-involved patients. Multidisciplinary care—integrating physical therapy, respiratory support, nutritional management, and cognitive assessments—is critical to addressing motor and non-motor symptoms (e.g., dysphagia, spasticity, sleep disturbances). Emerging therapies show promise in preclinical models. However, challenges persist in translating genetic insights into universally effective treatments. Ethical considerations, including euthanasia and end-of-life decision-making, further highlight the need for patient-centered communication and palliative strategies. Full article

Background: Heart failure with reduced ejection fraction (HFrEF) frequently coexists with chronic obstructive pulmonary disease (COPD), and both conditions share symptoms such as exertional dyspnea. The cardiopulmonary exercise test (CPET) is an essential tool for assessing ventilatory and cardiovascular function and plays a key role in the differential diagnosis of dyspnea. However, the impact of exercise modality on the ventilatory and cardiovascular parameters obtained remains unclear in these groups. Our aim is to compare the oxygen consumption (V^·O₂) and breathing reserve (BR) values obtained from CPET on a treadmill and a cycle ergometer in patients with HFrEF-COPD and those with HFrEF alone. Methods: A prospective observational study included 65 patients with HFrEF (LVEF ≤ 40%), 18 of whom had COPD. Two CPETs were performed, the first on a treadmill and the second 48–72 h later on a cycle ergometer. Results: In the group with HFrEF-COPD, peak oxygen consumption (VO₂/kg) and maximum ventilation (VE) values were significantly higher on the treadmill (20 ± 5 vs. 17 ± 4 mL/kg/min, p < 0.001 and 55 ± 19 vs. 45 ± 11 L/min, p < 0.001, respectively), while breathing reserve (BR%) was lower on the treadmill (16 ± 21 vs. 33 ± 20, p < 0.001). Compared to the HFrEF group, patients with HFrEF-COPD had a lower BR in both exercise modalities (p = 0.01). Conclusions: Treadmill CPET demonstrates greater oxygen consumption and a more pronounced ventilatory response. BR is consolidated as a differential parameter in ventilatory limitation. The choice of exercise modality should be considered based on the underlying pathologies and the objective of the test. Full article