Search Results (956)

As a high-performance lightweight structural material with superior strength, Ti55531 titanium alloy has been widely adopted in critical load-bearing components such as landing gears and airframe frames in the aerospace sector to achieve significant weight reduction. However, when the tensile strength of Ti55531 exceeds 1250 MPa, the fracture toughness typically falls below 50 MPa·m^1/2. In this study, we addressed this challenge by precisely controlling the cooling rate during β annealing heat treatment. Through careful regulation of the cooling rate from the high-temperature β phase region to the aging temperature region, the Widmanstätten structure was successfully introduced into the Ti55531 titanium alloy. The experimental results demonstrate that this microstructure achieves a high tensile strength of 1252 MPa at a cooling rate of 2.5 °C/min, while simultaneously improving the elongation and fracture toughness to 9% and 84 MPa·m^1/2, respectively. Microstructural analysis reveals that the basket-weave structure plays a crucial role in maintaining high strength. Meanwhile, the Widmanstätten structure effectively increases the energy required for crack extension by resisting crack propagation and altering the crack propagation path, thus significantly enhancing fracture toughness. These findings offer a promising pathway for overcoming the traditional trade-off between strength and toughness in high-performance titanium alloys. Full article

Background/Objectives: Tablet development requires simultaneous optimization of multiple quality attributes under limited experimental budgets, yet formulation–property relationships are highly nonlinear in mixture systems. To support pre-formulation decision-making prior to extensive tablet prototyping, this study proposes an AI framework that organizes formulation and process data together with raw-material property records into a reusable database, and enriches conventional composition/process features with physically motivated mixture descriptors derived from raw-material properties and formulation/process settings. Methods: Mixture-level scalar descriptors are constructed by composition-weighted aggregation of material properties, and particle size distribution (PSD) is incorporated via a compact set of summary statistics computed from composition-weighted mixture PSDs. Three feature sets are compared: (i) Materials + Processes (MP), (ii) MP with scalar Descriptors (MPD), and (iii) MPD with PSD summaries (MPDD). Five target properties are modeled: hardness, disintegration time, flow function, cohesion, and thickness. We train and evaluate Random Forest, Extra Trees Regressor, Lasso, Partial Least Squares, Support Vector Regression, and a multi-branch neural network that processes the three feature blocks separately and concatenates them for prediction. For interpolation assessment, repeated Train/Dev/Test splitting (5:3:2) across multiple random seeds is used, and the effect of feature augmentation is quantified by paired RMSE improvements with bootstrap confidence intervals and paired Wilcoxon signed-rank tests. To assess robustness under practical formulation updates, rolling-origin time-series splits are employed and Applicability Domain indicators are computed to characterize out-of-distribution coverage. Results: Across interpolation evaluations, mixture-descriptor augmentation (MPD/MPDD) improves hardness and disintegration time in most settings, whereas gains for flow function are smaller and cohesion/thickness show mixed effects under limited sample sizes. Conclusions: Under extrapolation-oriented evaluation, the descriptors can improve hardness but may degrade disintegration-time prediction under covariate shift, emphasizing the need for careful descriptor selection and dimensionality control when deploying pre-formulation predictors. Full article

Digital transformation has profoundly reshaped caregiving practices, yet its influence on family cohesion within disability contexts remains underexplored, particularly in Arab societies. This qualitative phenomenological study examines how digital technologies shape family cohesion among Jordanian caregivers of children with disabilities. In-depth, semi-structured interviews were conducted with 22 primary caregivers, and data were analyzed using reflexive thematic analysis. The findings reveal a central tension of being “between connectivity and care,” articulated through four interrelated themes: (1) a digital double-bind in which online support networks function as a vital “virtual village” while simultaneously contributing to intra-familial fragmentation; (2) the reconfiguration of care labor, whereby digital management emerges as an invisible and gendered form of caregiving work, often positioning mothers as primary digital coordinators; (3) the translation of traditional social capital (wasta) into digital spaces to navigate systemic resource constraints, producing new moral and emotional burdens; and (4) the strategic use of digital platforms to preserve cultural, religious, and familial identity in the face of stigma, thereby reinforcing internal cohesion. These findings suggest that digital technologies do not merely facilitate connection but actively reconfigure family dynamics through ongoing negotiation between support and strain. The study underscores the need for family-centered digital inclusion policies and support interventions that mitigate digital burdens while harnessing technology’s potential to strengthen culturally grounded resilience among families of children with disabilities. Full article

Background: Neonatal and infant aortic arch reconstruction remains a high-risk cardiovascular procedure requiring effective cerebral and myocardial protection. Variability in perfusion strategies may influence early hemodynamic stability and postoperative recovery. This study aimed to evaluate the early and short-term cardiovascular outcomes of a standardized beating-heart aortic arch reconstruction strategy incorporating simultaneous antegrade selective cerebral and continuous coronary perfusion. Methods: In this retrospective single-center cohort study, 31 consecutive neonates and infants undergoing aortic arch reconstruction between November 2022 and December 2025 were analyzed. A standardized surgical protocol was applied, consisting of extensive ductal tissue resection, interdigitating posterior end-to-end anastomosis, anterior autologous pericardial patch augmentation, and moderate hypothermic antegrade selective cerebral perfusion combined with continuous coronary perfusion via innominate artery cannulation. Early postoperative outcomes and short-term echocardiographic follow-up results were assessed. Results: The cohort included 31 patients, 22.6% of whom had complex associated cardiac anomalies requiring concomitant procedures. Median cardiopulmonary bypass and aortic cross-clamp times were 119 and 64 min, respectively. There was no in-hospital mortality. Major complications were infrequent, and median intensive care unit stay was 5 days. During a median follow-up of 6.8 months, one patient (3.2%) developed recoarctation requiring reintervention. No late mortality was observed. Conclusions: A fully standardized beating-heart aortic arch reconstruction strategy incorporating simultaneous cerebral and coronary perfusion demonstrated favorable early cardiovascular and short-term outcomes, even in anatomically complex cases. Preservation of continuous coronary perfusion may be associated with improved myocardial stability and early postoperative recovery; however, these findings should be interpreted as observational and hypothesis-generating given the absence of a control group. Larger multicenter studies with longer follow-up are warranted to confirm these findings. Full article

Background and Clinical Significance: Vascular lesions of the face, particularly arteriovenous malformations (AVM) and mixed hemangiomas (MH), pose significant diagnostic and therapeutic challenges because of their complex anatomy, unpredictable behavior, and high risk of bleeding. Surgical planning should be individualized and often requires a staged approach with meticulous interdisciplinary coordination to ensure patient safety. The presence of a concomitant odontogenic infection further complicates management, as local inflammation may exacerbate vascular instability and increase the risk of life-threatening complications. Local inflammation and infection might cause some life-threatening conditions, especially when an abscess occurs in the area of any vascular lesion. Ensuring that the oral cavity is free from potential odontogenic infections is a particularly important issue in many complex cases, especially in patients treated for oral, head, and neck cancer or in those with other coexisting morbidities affecting the oral and facial regions. Case Presentation: A 72-year-old man was referred for management of a severe odontogenic infection associated with an extensive facial vascular lesion. The patient’s medical history was significant for arterial hypertension and chronic liver dysfunction (CLD) of unclear etiology. Complete blood testing, including coagulation assessment and liver ultrasonography, was performed, with no contraindication to surgery identified. The scope of odontogenic-related infections was scheduled for simultaneous removal during initial surgery. Preparation for surgery included the local application of sclerotherapy agents. Conclusions: Quite often, a routine panoramic radiograph can help in assessing the status of bone and dentition to undertake all necessary treatment. Severe odontogenic disease, including multiple retained roots, periapical infections, and odontogenic cystic lesions in the context of poor oral hygiene, may lead to the occurrence of possible inflammation. In case of any vascular lesion, a careful diagnostic and therapeutic strategy is needed. This case report highlights that maintaining an infection-free oral environment is a critical component of care in patients with complex facial MH and should be regarded as an essential element of overall treatment planning. Full article

Understanding how environmental enrichment influences behavioural time allocation is particularly important for threatened primate species maintained under human care. Accordingly, we investigated whether environmental enrichment (EE) influences behavioural time allocation in yellow-breasted capuchin monkeys (Sapajus xanthosternos), aiming to inform evidence-based husbandry practices in zoological settings. Employing the standard ethological approach of behavioural coding, we observed 20 capuchins housed in three groups comprising adult and juvenile males and females. We recorded behavioural categories including: aggressive, exploratory, affiliative/play, general activity, alert, inactivity, and abnormal behaviour. To evaluate individual engagement with EE, we applied the ABA paradigm, wherein phases A1 and A2 (controls) represented standard zoo conditions, while phase B corresponded to the implementation of an EE programme. Each phase spanned 10 days, and behavioural data were collected via focal animal sampling (2 × 10 min focal sessions per animal per day), resulting in a total of 1200 focal sessions. Behavioural time allocation was analysed using a multivariate generalized linear mixed modelling approach that accounted for the interdependence among behavioural categories. Based on previous studies, we predicted that environmental enrichment may promote higher levels of play and exploration and lower aggression and inactivity. However, despite by-eye suggestions of increases in play and decreases in activity during enrichment, when behavioural categories were analysed simultaneously within the multivariate framework, overall behaviour time budgets and behavioural diversity were found not to change significantly across experimental phases. There were also no sex or age effects on behaviour. This indicates that for S. xanthosternos, the enrichment protocol used here did not provide sufficient novelty or complexity to alter established activity patterns. Integrated analytical approaches are needed to further evaluate the effectiveness of enrichment strategies to ensure they are tailored to specific cognitive and social needs of complex species; future studies could explore how social dynamics, enclosure design, and environmental complexity interact to shape behavioural responses to enrichment. Full article

Background/Objectives: Prognostication in traumatic brain injury (TBI) remains challenging. The urine-to-serum osmolality (U/S) ratio may reflect hypothalamic–pituitary axis integrity, a critical but underexplored prognostic domain. We investigated whether the U/S ratio provides early prognostic value and enhances prediction when combined with conventional severity markers. Methods: This retrospective study included 128 adult TBI patients admitted to a neurosurgical intensive care unit (ICU) with simultaneous osmolality measurements within 6 h of admission. The primary outcome was ICU mortality; the secondary outcome was poor neurological outcomes (Glasgow Outcome Scale 1–3). Results: ICU mortality was 14.1% (18/128), and poor neurological outcome occurred in 41.8% (46/110). Non-survivors had significantly lower U/S ratios than survivors (1.09 ± 0.58 vs. 1.70 ± 0.68, p < 0.001). For ICU mortality, U/S ratios (AUC = 0.803) showed similar discriminative ability to GCS (AUC = 0.806). For poor neurological outcomes, the U/S ratio (AUC = 0.768) significantly outperformed both GCS (AUC = 0.641, p = 0.038) and the Acute Physiology and Chronic Health Evaluation (APACHE) II score (AUC = 0.553, p < 0.001). Combining the U/S ratio with GCS improved mortality prediction (AUC = 0.890), as did combinations with the APACHE II score (AUC = 0.847). The U/S ratio remained independently associated with ICU mortality and poor neurological outcomes after adjusting for GCS or APACHE II scores. Quartile analyses revealed a dose–response relationship, with ICU mortality of 34.4% in Q1 versus 3.1% in Q4 (p for trend < 0.001). Prognostic value was preserved in patients receiving osmotic therapy (n = 86). Conclusions: The U/S ratio is a simple, readily available biomarker that independently predicts mortality and poor neurological outcomes in TBI patients. Particularly for neurological outcome predictions, it outperforms GCS or the APACHE II score alone. Combined with established severity scores, it may serve as a practical bedside tool reflecting hypothalamic–pituitary function in neurocritical care. Full article

Background/Objectives: Contemporary healthcare systems are characterised by rapid change, high workload, and staff shortages, creating conditions that may compromise care quality and generate turbulence in nursing. Turbulence has been discussed in nursing research. However, greater conceptual clarity is needed regarding its underlying factors and implications for nursing work. The aim of this study was to explore and analyse the concept of turbulence in nursing and its related factors. Methods: The study was conducted using the Simultaneous Concept Analysis Method involving a consensus group and a nursing care, expert group and included content validity index ratings as a validation technique. Results: Eight factors related to turbulence in nursing were identified. A conceptual model was developed to illustrate the interrelationships among these factors and their role within the turbulence concept. Based on this model and the demonstrated contextual interconnections, a comprehensive definition of turbulence in nursing was formulated. Conclusions: The study has achieved a deeper understanding of the concept “turbulence in nursing” through the identification of eight different, generally valid turbulence-related factors and their presumed impact on nursing care. A conceptual model of interacting forces in turbulence in nursing has been presented as both a detector and a compass for mapping and counteracting future tendencies toward turbulence in the work environment. The study enables healthcare professionals and leaders to detect and address emerging turbulence in nursing practice and education. By clarifying its underlying major related sources, the model serves as a practical guide for improving the work environment, strengthening team resilience, and ultimately enhancing patient safety and quality of care. Full article

Disruption of the intestinal barrier is a hallmark of inflammatory bowel disease (IBD) and drives both epithelial injury and neutrophil-mediated inflammation, yet rapid, multiplexed assessment of these processes remains an unmet clinical need. Intestinal fatty acid binding protein (iFABP) and fecal calprotectin (FC) provide complementary insights into barrier integrity and mucosal inflammation, but conventional ELISA-based assays are time-consuming, low-throughput, and require large sample volumes. Here, we introduce a dual electrochemical sandwich immunosensor enabling simultaneous quantification of iFABP and FC on screen-printed dual carbon electrodes (SPdCEs). Capture antibodies were immobilized via electrografting of p-aminobenzoic acid diazonium salt, while a V₂O₅/MWCNTs-HRP–streptavidin nanocomposite amplified the electrocatalytic reduction in hydrogen peroxide, enhancing sensitivity. The platform achieved detection limits of 0.01 pg mL⁻¹ (iFABP) and 1 pg mL⁻¹ (FC) with a total assay time of 1 h 20 min and sample volume of just 5 μL, outperforming conventional ELISA in speed and efficiency. High repeatability, reproducibility, and accurate recovery in enriched fecal samples confirmed analytical robustness. By integrating multiplexed detection, nanostructured signal amplification, and robust electrode engineering, this immunosensor provides a rapid, sensitive, and low-volume platform for point-of-care and decentralized monitoring of IBD, enabling timely clinical decision-making and longitudinal patient management. Full article

Background: Lifestyle behaviours and medication adherence are interrelated components of cardiovascular secondary prevention, yet their co-occurrence in Middle Eastern post-percutaneous coronary intervention (PCI) populations remains poorly characterised. This study described smoking status and physical activity patterns, assessed antiplatelet medication adherence, and explored associations between lifestyle factors and adherence among Saudi patients following PCI. Methods: A cross-sectional survey was conducted among 236 Saudi adults who had undergone PCI within the preceding 12 months at two tertiary cardiac centres in Riyadh, Saudi Arabia. Data were collected on smoking status, cigarette consumption, self-reported physical activity frequency (defined as the frequency of engagement in regular exercise such as walking, swimming, or other structured physical activity), and self-reported medication adherence measured via the Morisky Medication Adherence Scale-8 (MMAS-8). Descriptive statistics characterised lifestyle and adherence patterns. Bivariate analyses (chi-square tests) and multivariate binary logistic regression were used to explore associations between lifestyle factors and adherence, adjusting for comorbidities including hypertension, diabetes mellitus, arthritis, and heart disease. Results: Participants were predominantly male (73.7%) and older adults (83.9% aged >50 years). Smoking prevalence was 23.3% (n = 55 of 236 participants), and physical inactivity was highly prevalent, with 57.2% of the sample (n = 135) reporting never engaging in regular exercise. Adherence was suboptimal, with 55.4% of participants (n = 129) classified as having low adherence (self-reported, measured via the MMAS-8). In multivariate analysis, arthritis was the only statistically significant predictor of adherence (adjusted odds ratio [AOR] = 2.81, 95% confidence interval [CI]: 1.01–7.84, p = 0.048; note, however, that this finding does not survive Bonferroni correction for multiple comparisons and should be interpreted as hypothesis-generating). Smoking (AOR = 0.52, 95% CI: 0.19–1.45, p = 0.213) and physical inactivity (AOR = 0.45, 95% CI: 0.09–2.25, p = 0.332) showed inverse but statistically non-significant trends with adherence. Conclusions: Unhealthy lifestyle behaviours and low medication adherence were each highly prevalent and co-occurred in this post-PCI population, though associations between lifestyle factors and adherence were not statistically confirmed except for arthritis. These descriptive findings are hypothesis-generating and provide a rationale for future adequately powered prospective studies and trials evaluating integrated nursing interventions that simultaneously address smoking, physical inactivity, and medication non-adherence in Saudi cardiac care settings. Full article

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a high-burden, under-researched condition characterized by heterogeneous and fluctuating symptoms, including cognitive dysfunction commonly described by patients as “brain fog”. Despite growing interest in digital health technologies for symptom monitoring and personalized care, their application to the assessment and management of cognitive dysfunction in ME/CFS remains unclear. This descriptive review aimed to examine the current scientific evidence on digital approaches related to brain fog in ME/CFS. A structured literature search following PRISMA guidance was conducted to identify relevant studies. The available literature remains limited in scope and methodological maturity. During synthesizing across studies, three main functional domains of digital application become apparent: (1) digital tools for cognitive assessment, which have the strongest evidence base; (2) digital platforms for longitudinal monitoring; and (3) digitally mediated interventions or rehabilitation approaches, both of which are less well studied. Simultaneously, the findings suggest that patient-reported brain fog may represent a visible component of the broader ME/CFS disease spectrum and could serve as an early clinical indicator guiding diagnosis and management. Interpreting these symptoms within a biopsychosocial framework may facilitate understanding of the complex nature of the disease and optimize the use of digital technologies for monitoring cognitive dysfunction and supporting patient-centered care in ME/CFS. Full article

Pharmaceuticals and personal care products (PPCPs), as persistent organic pollutants, are widely present in various aquatic environments. Their long-term presence in aquatic environments poses a potential threat to ecosystems and human health. This study established an efficient, green, and cost-effective photocatalytic method using P25 titanium dioxide (P25TiO₂) to simultaneously degrade five representative PPCPs (methyl paraben (MeP), carbamazepine (CBZ), bisphenol A (BPA), diclofenac (DFC), and triclosan (TCS), while elucidating the reaction mechanisms. Under sunlight irradiation, degradation rates for all five PPCPs reached 100%, achieving near-complete mineralization with total organic carbon (TOC) removal rates exceeding 95%. This demonstrates the system’s exceptional capability to not only degrade the parent compounds but to thoroughly convert them into benign inorganic substances. We systematically investigated the effects of catalyst concentration, initial pollutant concentration, light intensity, pH, and various common inorganic anions (chloride, sulfate, bicarbonate, phosphate) and humic acid (HA) on the degradation process. Additionally, mechanistic studies indicated that hydroxyl radicals (·OH) are the primary active species in the system. The degradation rate differences among various persistent organic pollutants (DFC > BPA > TCS > CBZ > MeP) primarily stem from variations in the reactivity of different functional groups within their molecular structures toward ·OH. In summary, this study provides a promising and practical solution for treating complex medical wastewater containing five typical PPCPs. Full article

Chronic wound infections are a major clinical challenge due to biofilm formation and increasing antimicrobial resistance, which compromise the effectiveness of conventional treatments. This review provides a focused and critical evaluation of biomaterial-based strategies designed to simultaneously control infection and promote tissue regeneration. Four principal antimicrobial platforms are comparatively analyzed: drug-loaded biomaterials, antimicrobial peptide-functionalized systems, metal-based nanomaterials, and bacteriophage-integrated materials. Their mechanisms of action, effectiveness against biofilms, and capacity to modulate the wound microenvironment are systematically examined. A key contribution of this work is the integration of these strategies within a translational framework, highlighting trade-offs between clinical maturity, antimicrobial performance, resistance mitigation, and regulatory complexity. In contrast to conventional reviews that primarily catalogue materials, this manuscript positions biomaterial approaches along a continuum from clinically established to emerging technologies, providing insight into why certain strategies (e.g., antibiotic-loaded dressings) dominate current practice, while others (e.g., phage-based and smart responsive systems) remain high-impact but underdeveloped. Furthermore, recent advances in stimuli-responsive (“smart”) biomaterials, multifunctional composites, and bioinspired platforms are critically evaluated as next-generation tools capable of dynamically responding to infection-specific cues. Key barriers, including cytotoxicity, manufacturing scalability, and regulatory constraints, are discussed to identify priorities for clinical translation. This perspective provides a structured roadmap for the development of effective biomaterial-based interventions in chronic wound care. Full article

Background: Breast cancer poses not only a physical health threat but also significant emotional and identity challenges for women, particularly regarding femininity and body image. Understanding how patients adapt psychologically can guide effective psychosocial interventions. Objective: This study aimed to evaluate psychological adaptation, coping strategies, illness acceptance, and body image in women with breast cancer and identify factors associated with better adjustment. Methods: A cross-sectional study was conducted among 30 women aged 22–66 undergoing treatment at the Wielkopolskie Centrum Onkologii, Poland. Standardized tools included the Mini-MAC scale (coping strategies), Acceptance of Illness Scale (AIS), and Body Image Scale (BIS). Descriptive statistics and correlations were analyzed. Results: Most participants exhibited a constructive coping style, with positive redefinition and fighting spirit being predominant. Some women simultaneously showed elements of a destructive coping style, including helplessness and hopelessness, indicating complex emotional reactions. Overall, participants demonstrated high illness acceptance, despite notable body image-related discomfort, particularly shame, reduced perceived attractiveness, and appearance-related anxiety. While age did not correlate significantly with coping or body image, a significant negative association was found between age and illness acceptance, with younger women showing better adjustment. Conclusions: Psychological adaptation to breast cancer is multidimensional and individualized, dependent on personality traits, internal resources, and social support. Findings highlight the need for holistic, patient-centered psychosocial care, addressing both emotional adaptation and body image-related distress, including support for intimacy and prosthetic interventions. Individualized strategies can improve quality of life and functional outcomes during and after cancer treatment. Full article

(1) Background: Colombia hosts one of the world’s largest mixed-displacement crises, combining longstanding internal displacement with the influx of Venezuelan migrants. This case study examines how the Emergency Medical Team (EMT) Hospital Barco San Raffaele (HBSR) adapted its service-delivery model to respond simultaneously to internal displacement in the Colombian Pacific region and the Venezuelan refugee influx. Using the WHO EMT Surge Capacity Framework, the study analyses how health services were adapted across two concurrent displacement contexts. (2) Methods: A mixed-methods comparative case study was conducted using mission reports, epidemiological surveillance data, policy reports and institutional documents collected between November 2020 and May 2021. Data were analyzed through a thematic analysis structured around the four domains of the WHO EMT Surge Capacity Framework (Staff, Structure, Supplies and Systems), to examine how service adaptation was operationalized across different geographic, sociocultural and legal environments; (3) Results: EMT HBSR adapted staffing composition, supply chains, infrastructure, and operational systems across both settings. Its hybrid model, combining a hospital boat platform with mobile outreach teams, enabled continuity of primary care, mental, maternal and child health, and community-based services in geographically isolated and culturally diverse communities; (4) Conclusions: The findings illustrate how flexible EMT operational models can support the adaptation of health services, and reduce health access inequalities in displacement contexts characterized by high mobility, confinement and limited health system capacity. Mobile platforms, such as hospital boats, appear to be a viable strategy for ensuring continuity of care along migratory routes and in geographically isolated areas affected by protracted instability. Full article