Search Results (10,548)

Land use/land cover (LULC) change constitutes a critical driver influencing regional carbon cycling processes. Optimizing LULC structures represents a significant pathway toward the realization of carbon neutrality. This study takes Liaoning Province as a case area to analyze LULC changes from 2000 to 2020 and to assess their impacts on land use carbon emissions (LUCE) and ecosystem carbon storage (ECS). To accelerate the achievement of carbon neutrality, four development scenarios are established: natural development (ND), low-carbon emission (LCE), high-carbon storage (HCS), and carbon neutrality (CN). For each scenario, corresponding optimization objectives and constraint conditions are defined, and a multi-objective LULC optimization coupling model is formulated to optimize both the quantity structure and spatial pattern of LULC. On this basis, the model quantifies ECS and LUCE under the four scenarios and evaluates the economic value of each scenario and its contribution to the carbon neutrality target. Results indicate the following: (1) From 2000 to 2020, the extensive expansion of construction land resulted in a reduction in ECS by 12.72 × 10⁶ t and an increase in LUCE by 150.44 × 10⁶ t; (2) Compared to the ND scenario, the LCE scenario exhibited the most significant performance in controlling carbon emissions, while the HCS scenario achieved the highest increase in carbon sequestration. The CN scenario showed significant advantages in reducing LUCE, enhancing ECS, and promoting economic growth, achieving a reduction of 0.18 × 10⁶ t in LUCE, an increase of 118.84 × 10⁶ t in ECS, and an economic value gain of 3386.21 × 10⁶ yuan. This study optimizes the LULC structure from the perspective of balancing economic development, LUCE reduction, and ECS enhancement. It addresses the inherent conflict between regional economic growth and ecological conservation, providing scientific evidence and policy insights for promoting LULC optimization and advancing carbon neutrality in similar regions. Full article

Background/Objectives: While ART effectively suppresses HIV viremia, many PLWH exhibit persistent immune dysfunction. This study aimed to assess immune recovery and immune exhaustion (PD-1/PD-L1 expression) in newly diagnosed versus long-term ART-treated individuals. Methods: We analyzed 79 PLWH: 52 newly diagnosed individuals (12-month follow-up) and 27 long-term-treated patients (Ukrainian refugees). Flow cytometry was used to evaluate CD4+ and CD8+ counts, the CD4+/CD8+ ratio, and PD-1/PD-L1 expression on CD3+, CD4+, and CD19+ lymphocytes. ART regimen and HIV subtype were included as covariates in linear regression models. Results: At 12 months, CD4+ counts were similar between groups (median 596.5 vs. 621 cells/μL, p = 0.22), but newly diagnosed patients had higher CD8+ counts (872 vs. 620 cells/μL, p = 0.028) and a lower CD4+/CD8+ ratio (0.57 vs. 1.05, p = 0.0027). Immune exhaustion markers were significantly elevated in newly diagnosed individuals: CD4+ PD-1+ T cells (24.4% vs. 3.85%, p = 0.0002) and CD3+ PD-1+ T cells (27.3% vs. 12.35%, p < 0.0001). Linear regression confirmed group membership independently predicted higher CD3+ (β = +21.92, p < 0.001), CD4+ (β = +28.87, p < 0.0001), and CD19+ (β = +8.73, p = 0.002) percentages. Lipid parameters and SCORE2 did not differ significantly. Conclusions: Despite virologic suppression and CD4+ recovery, immune exhaustion markers remain elevated in newly diagnosed PLWH, suggesting incomplete immune normalization. Traditional parameters (CD4+ count and CD4+/CD8+ ratio) may not fully capture immune status, warranting broader immunologic profiling in HIV care. Full article

Objectives: The aim of this study was to evaluate the impact of four working heights on lumbar biomechanics during wall construction tasks, focusing on work-related musculoskeletal disorders (WMSDs). Methods: Fifteen young male participants performed simulated mortar-spreading and bricklaying tasks while actual body movements were recorded using Inertial Measurement Unit (IMU) sensors. Muscle activities of the lumbar erector spinae (ES), quadratus lumborum (QL), multifidus (MF), gluteus maximus (GM), and iliopsoas (IL) were estimated using a 3D musculoskeletal (MSK) model and measured via surface electromyography (sEMG). The analysis of variance (ANOVA) test was conducted to identify the significant differences in muscle activities across four working heights (i.e., foot, knee, waist, and shoulder). Results: Findings showed that working at foot-level height resulted in the highest muscle activity (7.6% to 40.6% increase), particularly in the ES and QL muscles, indicating an increased risk of WMSDs. The activities of the ES, MF, and GM muscles were statistically significant across both tasks and all working heights (p < 0.01). Conclusions: Both MSK and sEMG analyses indicated significantly lower muscle activities at knee and waist heights, suggesting these as the best working positions (47 cm to 107 cm) for minimizing the risk of WMSDs. Conversely, working at foot and shoulder heights was identified as a significant risk factor for WMSDs. Additionally, the similar trends observed between MSK simulations and sEMG data suggest that MSK modeling can effectively substitute for sEMG in future studies. These findings provide valuable insights into ergonomic work positioning to reduce WMSD risks among wall construction workers. Full article

Background/Objectives: This study investigated the association between cochlear implant (CI) users’ assessed perception of musical sound quality and their subjective music perception and music-related quality of life (QoL). The aim was to provide a comprehensive evaluation by integrating a relatively objective Turkish Multiple Stimulus with Hidden Reference and Anchor (TR-MUSHRA) test and a subjective music questionnaire. Methods: Thirty CI users and thirty normal-hearing (NH) adults were assessed. Perception of sound quality was measured using the TR-MUSHRA test. Subjective assessments were conducted with the Music-Related Quality of Life Questionnaire (MuRQoL). Results: TR-MUSHRA results showed that while NH participants rated all filtered stimuli as perceptually different from the original, CI users provided similar ratings for stimuli with adjacent high-pass filter settings, indicating less differentiation in perceived sound quality. On the MuRQoL, groups differed on the Frequency subscale but not the Importance subscale. Critically, no significant correlation was found between the TR-MUSHRA scores and the MuRQoL subscale scores in either group. Conclusions: The findings demonstrate that TR-MUSHRA is an effective tool for assessing perceived sound quality relatively objectively, but there is no relationship between perceiving sound quality differences and measures of self-reported musical engagement and its importance. Subjective music experience may represent different domains beyond the perception of sound quality. Therefore, successful auditory rehabilitation requires personalized strategies that consider the multifaceted nature of music perception beyond simple perceptual judgments. Full article

This study investigated the influence of curing temperature and time on both the mechanical properties and cytotoxicity of stereolithographic polymethyl methacrylate (PMMA) resin. After printing using stereolithographic equipment, the resin was cured at 45 °C, 60 °C, and 75 °C for up to 120 min. Our results reveal that the mechanical properties achieved a peak after approximately 30 min of curing at the two highest temperatures, followed by a subsequent decrease, while curing at 45 °C resulted in a constant increase in mechanical properties up to 120 min. Testing with S. epidermidis and E. coli exhibited a bland antibacterial effect, with the number of living bacteria increasing with both the time and temperature of curing. To assess potential cytotoxicity, the materials were also tested with human fibroblasts, and the trends observed were similar to what was previously seen for both bacteria strains. Interestingly, an association was observed between the intensity ratio of two Raman bands (around 2920 and 2945 cm⁻¹), indicative of long-PMMA-chain formation and cytotoxicity. This finding suggests that Raman spectroscopy has the potential to serve as a viable method for estimating the cytotoxicity of 3D printed PMMA objects. Full article

Objective: This study aimed to develop a performance evaluation index system for a district-level public hospital in Chongqing, China, based on Diagnosis-Related Groups (DRGs), to provide a benchmark for performance assessment in similar hospitals. The system was constructed using a literature analysis, the Delphi method, and the Analytic Hierarchy Process (AHP) to identify and weight relevant indicators. Results: The evaluation system consists of three primary indicators and eighteen secondary indicators. Key secondary indicators include the Case Mix Index (CMI), cost consumption index, low-risk group mortality rate, the proportion of patients with three- or four-level surgeries at discharge, and the proportion of medical service revenue to medical income. In 2020, significant improvements were observed in several indicators, such as a decrease in the low-risk group mortality rate to 0% and increases in the proportion of patients with three- or four-level surgeries and CMI by nearly 10% and 13%, respectively. Conclusions: This study successfully developed a comprehensive and scientifically sound performance evaluation index system for a district-level public hospital in Chongqing. The system has proven effective in objectively assessing inpatient medical care performance and providing valuable guidance for improving healthcare services in similar settings. Full article

Our study was conducted in the Valle Nuevo National Park and included four habitat classes: tussock grass (Sabapa), pine forest (Pinoc), broadleaf forest (Boslat), and agricultural ecosystem (Ecoag). We had two main objectives: to comparatively describe millipede communities and to determine the relationships between population density/diversity and soil physicochemical variables. The research was cross-sectional and non-manipulative, with a descriptive and correlational scope; sampling followed a stratified systematic design, with eight transects and 32 quadrats of 1 m², covering 21.7 km. We found a sandy loam soil with an extremely acidic pH. The highest population density of millipedes was recorded in Sabapa, and the lowest in Ecoag. The highest alpha diversity was shared between Boslat (Margalef = 1.72) and Pinoc (Shannon = 2.53); Sabapa and Boslat showed the highest Jaccard similarity (0.56). The null hypothesis test using the weighted Shannon index revealed a statistically significant difference in diversity between the Boslat–Sabapa and Pinoc–Sabapa pairs. Two of the species recorded highly significant indicator values (IndVal) for two habitat classes. We found significant correlations (p < 0.05) between various soil physicochemical variables and millipede density and diversity. Full article

Background/Objectives: Although numerous prognostic biomarkers have been proposed for colorectal cancer (CRC), their longitudinal evaluation remains limited. The aim of this study was to investigate longitudinal changes in biomarkers calculated from routinely used laboratory markers and their relationships to common chronic diseases (comorbidities). Methods: A retrospective longitudinal observational study was completed with the inclusion of 817 CRC patients and a total of 4542 measurement points. Pan-immune inflammation value (PIV), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) were calculated based on complete blood count and albumin measurement data. Results: Longitudinal data analyses confirmed the different values and slopes of the parameters tested at the different endpoints. Survivors had the lowest and most constant PIVs and SII values, and the highest and most slowly decreasing PNI values. Those patients with non-cancerous death had similar values to the previous cohort, but an increase/decrease occurred towards the death event. Patients with CRC-related death had significantly higher PIVs and SII values and significantly lower PNI values (p < 0.0001), and a significant increase/decrease was observed at the early observational periods. The presence of lymph node and/or distant metastases, adjuvant chemotherapy, and hypertension significantly affected PIVs and SII and/or PNI values. The changes in PIVs and SII and PNI values toward pathological values are poor prognostic signs (p < 0.0001). Conclusions: Each of the three calculated markers demonstrates suitability for longitudinal patient follow-up, and their pathological alterations over time serve as valuable prognostic indicators. They may also be useful to detect certain clinicopathological parameters early. Full article

Background/objectives: This was a post hoc analysis of safety data across the bivalent respiratory syncytial virus prefusion F (RSVpreF) vaccine clinical trial development program. Methods: Data from eight clinical trials in 46,913 immunocompetent adults who received RSVpreF or placebo were analyzed. Local reactions and systemic events were assessed among non-pregnant ≥18-year-olds (n = 9517); adverse events (AEs) among pregnant and non-pregnant 18–59-year-olds (n = 9238); and vaccine-related AEs among non-pregnant ≥18-year-olds (n = 39,314). Post-marketing data in non-pregnant adults were considered. Results: Local reactions and systemic events were reported more frequently in RSVpreF versus placebo recipients; injection site pain was the most common local reaction (RSVpreF, 18.9%; placebo, 7.4%), and fatigue (23.5%; 18.4%) and headache (19.5%; 15.0%) were the most common systemic events. Percentages of AEs within 1 month after vaccination were similar across groups (RSVpreF, 12.8%; placebo, 13.1%); severe AEs were reported in ≤1.5% of participants. Differences in percentages of individuals reporting vaccine-related AEs between the RSVpreF and placebo groups were <0.2% for all related AEs. Serious AEs throughout the study were reported in ≤14.0% (RSVpreF, 12.6%; placebo, 14.0%). No atrial fibrillation, Guillain-Barré syndrome, or acute polyneuropathy cases were reported. The AE data from post-marketing data sources were consistent with the safety profile from the clinical trial program, with no new safety concerns. Conclusions: Integrated data demonstrated that RSVpreF was well tolerated with a favorable safety profile in non-pregnant and pregnant adults. Ongoing surveillance through real-world use and clinical trial experience continue to support the safety profile of RSVpreF. ClinicalTrials.gov: CT03529773/NCT04071158/NCT04785612/NCT05035212/NCT05096208/NCT05842967/NCT04032093/NCT04424316. Full article

Background/Objectives: Cannabidiol (CBD) is a non-intoxicating cannabinoid touted for a variety of medical benefits, including alleviation of anxiety. While legalization of hemp-derived products in the United States (containing ≤0.3% delta-9-tetrahydrocannabinol [d9-THC] by weight) has led to a rapid increase in the commercialization of hemp-derived CBD products, most therapeutic claims have not been substantiated using clinical trials. This trial aimed to assess the impact of 6 weeks of treatment with a proprietary hemp-derived, full-spectrum, high-CBD sublingual solution similar to those available in the marketplace in patients with anxiety. Methods: An open-label pilot clinical trial (NCT04286594) was conducted in 12 patients with at least moderate levels of anxiety. Patients self-administered a hemp-derived, high-CBD sublingual solution twice daily during the 6-week trial (target daily dose: 30 mg/day CBD). Clinical change over time relative to baseline was assessed for anxiety, mood, sleep, and quality of life, as well as changes in cognitive performance on measures of executive function and memory. Safety and tolerability of the study product were also evaluated. Results: Patients reported significant reductions in anxiety symptoms over time. Concurrent improvements in mood, sleep, and relevant quality of life domains were also observed, along with stable or improved performance on all neurocognitive measures. Few side effects were reported, and no serious adverse events occurred. Conclusions: These pilot findings provide initial support for the efficacy and tolerability of the hemp-derived, high-CBD product in patients with moderate-to-severe levels of anxiety. Double-blind, placebo-controlled studies are indicated to obtain robust data regarding efficacy and tolerability of these types of products for anxiety. Full article

The difficulty and manual nature of procuring human evaluators for ranking the quality of images affected by various types of degradations, and of those cleaned up by developed algorithms, has lead to the widespread adoption of automated metrics, like the Peak Signal-to-Noise Ratio (PSNR) and the Structural Similarity Index Metric (SSIM). However, disparities between rankings given by these metrics and those given by human evaluators have encouraged the development of improved image quality assessment (IQA) metrics that are a better fit for this purpose. These methods have been previously used solely for quality assessments and not as objectives in the training of neural networks for high-level vision tasks, despite the potential improvements that may come about by directly optimizing for desired metrics. This paper examines the adequacy of ten recent IQA metrics, compared with standard loss functions, within two trained dehazing neural networks, with observed broad improvement in their performance. Full article

Background and Objectives: The long-term renal and cardiovascular effects of neonatal acute kidney injury (AKI) in preterm infants remain unclear. This study investigated whether neonatal AKI leads to persistent subclinical kidney injury and blood pressure changes in school-aged children born preterm. Methods: In this prospective cohort, preterm-born children (≤35 weeks’ gestation) with (n = 19) and without (n = 38) neonatal AKI were evaluated at 7–12 years. A term-born control group (n = 44) was included for biomarker comparison. Assessments included perinatal data, anthropometry, office and ambulatory blood pressure monitoring (ABPM), and renal ultrasonography. Kidney function was evaluated using serum creatinine (sCr), cystatin C, and estimated glomerular filtration rate (eGFR). Tubular injury was assessed using urinary kidney injury molecule-1/Cr (KIM-1/Cr), neutrophil gelatinase-associated lipocalin/Cr (NGAL/Cr), and trefoil factor 3/Cr (TFF3/Cr) ratios, as well as serum TFF3. Results: Conventional kidney function markers were similar among groups. However, the AKI group had higher serum cystatin C, lower cystatin C–based eGFR, and elevated urinary KIM-1/Cr and NGAL/Cr compared to no-AKI and term controls. Serum TFF3 was also higher in the AKI group. ABPM revealed higher nocturnal systolic blood pressure and blood pressure load in the AKI group. Kidney size did not differ between preterm subgroups. Conclusions: Neonatal AKI in preterm infants is associated with subtle alterations and potential renal stress or injury at school age, detectable only with sensitive biomarkers and ABPM. Further prospective studies are needed to validate these biomarkers and determine their role in predicting long-term outcomes in preterm infants with neonatal AKI. Full article

Strawberries are highly perishable fruits prone to postharvest losses due to defects, diseases, and uneven ripening. This study proposes a deep learning-based approach for automated quality assessment using the YOLOv8n object detection model. A custom dataset of 5663 annotated strawberry images was compiled, covering eight quality categories, including anthracnose, gray mold, powdery mildew, uneven ripening, and physical defects. Data augmentation techniques, such as rotation and Gaussian blur, were applied to enhance model generalization and robustness. The model was trained over 100 and 200 epochs, and its performance was evaluated using standard metrics: Precision, Recall, and mean Average Precision (mAP). The 200-epoch model achieved the best results, with a mAP50 of 0.79 and an inference time of 1 ms per image, demonstrating suitability for real-time applications. Classes with distinct visual features, such as anthracnose and gray mold, were accurately classified. In contrast, visually similar categories, such as ‘Good Quality’ and ‘Unripe’ strawberries, presented classification challenges. Full article

The main objective of this study was to compare the long-term outcomes of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis, focusing on differences between self-expanding valve (SEV) versus balloon-expandable valve (BEV) prostheses and the influence of balloon pre- and post-dilatation on clinical results. The secondary objective was to report the long-term outcomes after TAVI in Romania. All patients who underwent a TAVI procedure for severe AS between November 2016 and May 2025 at a tertiary center in Romania were included in the present study. A total of 702 patients were included, of which 455 (64.8%) and 247 (35.1%) patients received a BEV (Sapien3 platform) and a SEV (Accurate, Boston, Portico, Evolut, or Navitor platforms), respectively. Pre-dilatation was performed in 514 (73.2%) cases, and post-dilatation was performed in 189 (26.9%) cases. There were 10.5 and 7.8 all-cause and cardiovascular-cause mortality event rates per 100 patient years, respectively. In regard to the univariable Cox regression, a BEV has significantly lower mortality than an SEV (HR = 0.67[0.46–0.96], p = 0.03), pre-dilatation did not influence mortality (HR = 0.71[0.48–1.04], p = 0.08), and post-dilatation significantly increased mortality (HR = 1.51[1.05–2.19], p = 0.03). In regard to the multivariable Cox regression, survival was not influenced by pre-dilatation or the valve platform, while post-dilatation had a trend towards higher mortality (p = 0.06). The BEV and SEV have similar survival rates, with no heterogeneity among a large number of TAVI platforms. While pre-dilatation had no impact on mortality, post-dilatation was associated with a trend towards increased mortality (p = 0.06), which was independent of the transprosthetic gradient. Survival after TAVI in Romania is comparable to that reported in Western registries. Full article

Background/Objectives: Perceived physical literacy (PPL) appears to be a relevant strategy for combating the prevalent sedentary lifestyle among young people. Therefore, understanding their PPL levels will facilitate the implementation of appropriate strategies for this purpose. Therefore, this study aimed to analyze the differences in PPL considering the sex dimension (i.e., males and females) and the age-group (i.e., early compulsory secondary education, late compulsory secondary education and baccalaureate). Methods: Seven-hundred-and-four Spanish students (age = 14.3 ± 1.6 years old) belonging to three different Spanish secondary schools voluntarily participated in this study. To assess adolescents’ perceptions of their physical literacy, the Spanish Adolescents’ Perceived Physical Literacy Assessment (S-PPLI) was used. This instrument consists of nine items equally distributed across three categories: self-perception and self-confidence, self-expression and communication with others, and knowledge and understanding. Results: Males obtained higher scores in all the indicators of PPL, except for items 1, 8 and 9, compared to their female counterparts (p < 0.05), while the oldest age-group reported higher scores in the indicators of knowledge and understanding category compared to students in the early years of compulsory secondary education (p < 0.01). Conclusions: Programs based on increasing the PPL should be implemented specifically for females. Also, similar programs must be included into scholar curriculums from the beginning of secondary education, with the aim of promoting improvements in the health and physical condition of Spanish adolescents. Full article