Search Results (399)

The growing need for efficient battery reuse and recycling requires rapid, reliable methods to assess the state of health (SoH) of lithium-ion cells. Conventional SoH estimation based on full charge–discharge cycling is slow, energy-intensive, and unsuitable for dismantled cells with unknown histories. This work presents an automated diagnostic approach using Electrochemical Impedance Spectroscopy (EIS) combined with Electrical Equivalent Circuit (EEC) modeling for fast, non-invasive SoH estimation. A correlation between fitted EIS parameters and cell degradation stages was established through controlled aging tests on NMC-based lithium-ion cells. The methodology was implemented in custom software (BaterurgIA) integrated into a robotic testing bench, enabling automatic EIS acquisition, data fitting, and SoH determination. The system achieves SoH estimation with 5–10% accuracy for cells in intermediate and advanced degradation stages, while additional parameters improve sensitivity during early aging. Compared to conventional cycling methods, the proposed approach reduces diagnostic time from hours to minutes, minimizes energy consumption, and offers predictive insights into internal degradation mechanisms. This enables fast and reliable cell grading for reuse, reconditioning, or recycling, supporting the development of scalable solutions for battery second-life applications and circular economy initiatives. Full article

The study evaluates the efficacy of an image-guided CAP treatment method with a plasma device capable of rapid biofilm removal from chicken tissue. The plasma treatment operating configuration includes a gas mixture of Argon and H₂O at a flowrate of 1.5 lpm. An X-Y stage was used to move the chicken sample below the stationary plasma scalpel at a speed of 0.1 mm/s. The discharge voltage and current were maintained between 3.2 and 3.7 kV (AC 20 kHz), and at 3 mA, respectively. The electrode gap and sample distance were set to 0.6 mm and 4 mm. This configuration facilitated effective biofilm removal, as confirmed by CFU analysis and 3D microscopic analysis showing a >99% reduction in biofilm post treatment with an etch rate of 2.2–5.8 µm/s and an impact width of up to 300 µm. The plasma scalpel electrode temperature reached 94.7 °C, while the targeted biofilm area was heated to 36.3 °C, suggesting non-thermal biofilm disruption. Three-dimensional microscopic analysis revealed biofilm thickness on chicken tissues ranging from 20 to 180 µm, comparable to biofilm loads on mammalian tissues. In conclusion, the study highlights the potential of CAP devices as a promising solution for biofilm debridement. Full article

This paper aims to explore Virtual Power Plants (VPPs) in combination with Demand Response (DR) concepts, integrating solar power generation, Electric Vehicle (EV) charging and discharging, and user loads to establish an optimal energy management scheduling system. Willingness curves for load curtailment are derived based on the consumption patterns of industrial, commercial, and residential users, enabling VPPs to design DR mechanisms under Time-of-Use (TOU), two-stage, and critical peak pricing periods. An energy management model for a VPP is developed by integrating DR, EV charging and discharging, and user loads. To solve this model and optimize economic benefits, this paper proposes an Improved Wolf Pack Search Algorithm (IWPSA). Based on the original Wolf Pack Search Algorithm (WPSA), the Improved Wolf Pack Search Algorithm (IWPSA) enhances the key behaviors of detection and encirclement. By reinforcing the attack strategy, the algorithm achieves better search performance and improved stability. IWPSA provides a parameter optimization mechanism with global search capability, enhancing searching efficiency and increasing the likelihood of finding optimal solutions. It is used to simulate and analyze the maximum profit of the VPP under various scenarios, such as different seasons, incentive prices, and DR periods. The verification analysis in this paper demonstrates that the proposed method can not only assist decision makers in improving the operation and scheduling of VPPs, but also serve as a valuable reference for system architecture planning and more effectively evaluating the performance of VPP operation management. Full article

Background/Objectives: Elderly patients who require aftercare in an intramural care (IMC) facility may contribute to “bed blocking,” which occurs when patients who are ready for discharge remain hospitalized longer than medically necessary. While most bed-blocking studies focus on capacity issues, this study also investigates the coordination process. In a regional hospital in the Netherlands, we examine the extent to which bed blocking occurs due to patients awaiting IMC, and how this issue can be characterized in terms of capacity and coordination challenges. Methods: The case study employs a mixed-methods approach, analyzing system data, documents, and interviews from the hospital, IMC organizations, and a health insurance provider. The location of each patient (organization and department) was collected and reconstructed to a patient path. All patient paths together formed a network enabling data analysis both on the level of patient paths as well as on the level of the networks as they developed through time. This gave insight into the complexity of the total network that has to be coordinated. Results: In 2023, 6% of the hospital capacity was occupied by patients awaiting IMC. Delays were observed at various coordination stages. Due to a lack of data on IMC bed capacity, we were unable to establish whether capacity limitations also contributed to bed blocking. Conclusions: The coordination system is complex and includes waiting times at each coordination stage, resulting in bed blocking. The absence of a centralized capacity overview, coupled with limited data, prevents decision-makers from identifying bed blocking arising from capacity shortages. Greater insight is needed to coordinate patient flow and determine the required slack capacity. Full article

Introduction: Heart failure (HF) remains a leading cause of morbidity and hospitalization among elderly patients. Therefore, identifying reliable prognostic indicators is crucial for improving clinical outcomes in this population. The aim of this study was to evaluate the association between the Model for End-stage Liver Disease excluding INR (MELD-XI) and clinical outcomes in elderly patients hospitalized for decompensated HF. Material and methods: This was a single-center observational study involving 242 elderly patients with end-stage HF who were hospitalized for decompensation at our institution between 2019 and 2023. Upon hospital admission and discharge, MELD-XI scores were calculated using serum bilirubin and creatinine levels. The primary endpoint of the study was all-cause mortality during the follow-up period. Results: The median age of the patients was 68 years (66–74.6), and 78.9% were men. The median (Q1–Q3) follow-up time was 1.47 (0.78–2.31) years. During the follow-up period, 47.1% of the patients died. Independent predictors of mortality were diabetes mellitus [HR 1.656 (1.113–2.463), p = 0.013] and MELD-XI at discharge [OR 1.267 (1.210–1.327), p < 0.001]. The area under the receiver operating characteristic curves (AUC) for MELD-XI at discharge was 0.827 (95% CI: 0.776–0.878). The cut-off value for MELD-XI at discharge (>11.7 points) had a sensitivity of 97% and a specificity of 59%. Conclusions: Independent predictors of death in the analyzed population of elderly patients with decompensated HF were diabetes mellitus and MELD-XI at discharge. Full article

This paper presents the results of a survey of the designed biological wastewater treatment facilities of an enterprise specializing in the production of rubber products. The aim of the study was to assess the efficiency of wastewater treatment systems under the conditions of a salvo discharge of industrial effluents that differ in composition from domestic wastewater. The analysis covered the parameters of water supply, water disposal, and wastewater characteristics at various stages of treatment. Three samples were taken: after washing the premises (WW1), at the inlet to the treatment facility (WW2), and at the outlet after treatment (WW3). Experimental assessment of the purification efficiency for key pollutants showed a high degree of removal of surfactants (91.2%), oil products (84.4%), and COD (63.4%). However, phosphorus–phosphate turned out to be significantly higher than the norm—2.32 mg/L with an acceptable level of 0.2 mg/L—which corresponds to an excess of 11.6 times. A low degree of ammonium nitrogen removal was also revealed—62%. Calculations showed a critically high ratio of COD/BOD5 = 5.1 with the recommended <2.6, which indicates a small share of biodegradable substances and the need to implement physical and chemical treatment methods. The absence of the characteristic smell of household wastewater and the presence of black inorganic sediment confirm the toxicity of emerging pollutants for activated sludge. It is concluded that the installed biological treatment system cannot cope with the salvo loads of industrial wastewater. Optimization measures are proposed: preliminary local treatment, dosed feed, and a separate treatment system. Full article

Background/Objectives: Colorectal cancer (CRC) ranks third in the Western world in cancer incidence and second as the cause of cancer-related deaths. Despite advances in perioperative care, minimizing postoperative morbidity is crucial in clinical practice. Digitalization of the healthcare process plays a key role in genuinely and effectively engaging patients. Our aim was to evaluate a digital solution for remote monitoring of patients with CRC, from surgery indication to postoperative discharge. Methods: We developed a digital solution using Value Stream Mapping (VSM) to identify patient care flow and Lean Sigma for optimization and efficiency. We incorporated the Enhanced Recovery After Surgery (ERAS)/RICA pentamodal recommendations to create a program with an individualized schedule for each patient, who received tailored educational, medical, and practical information at every stage of the process. Results: A total of 193 patients used the digital solution, with >75% adhering to ERAS recommendations. The median length of hospital stay was 5 days, with low adherence leading to 3.4 (p = 0.628) or 3.27 (p = 0.642) extra days in the hospital compared to patients with intermediate and high adherence, respectively. The mean comprehensive complication index (CCI) was 9.1/100, which was higher in patients with low adherence (15) versus intermediate (8.17; p = 0.027) and high (7.42; p = 0.011) adherence. An increase in self-perception of quality of life by 9.2% was identified at the end of the process compared to the outcome at the beginning (p = 0.09), and 80% rated their overall satisfaction with the care process as 8 or higher out of 10. Conclusions: The digital solution facilitates the monitoring of CRC care and implementation and adherence to ERAS recommendations, improving patient engagement and satisfaction. Full article

Background: Patients presented for complicated redo surgery after previous aortic valve replacement with the indication for aortic root repair due to dilatation or aneurysm. In those cases where the prosthetic aortic valve is in good condition, a valve-sparing procedure might simplify the complicated surgery. The aim of this case series paper is to describe a technique and to show the results of repairing the aortic root without compromising the previously inserted, well-functioning mechanical aortic valve. Methods: Between March 2017 and May 2017, 11 patients underwent re-sternotomy with placement on cardiopulmonary bypass with cardiac arrest and exposure of the aortic root. After the aortotomy, the aortic valve was inspected. Subsequently, the aortic sinuses were resected, sparing the coronary ostia buttons. A prosthetic tube was implanted above the preexisting valve. Finally, the coronary ostia were reattached to the tube, turning this procedure into a complete Bentall. Results: Echocardiography demonstrated fully functional valves and well-implanted aortic prosthesis. All patients were discharged within ten days post-surgery without any adverse events. Conclusions: The delayed two-stage Bentall procedure is a feasible and safe technique that preserves pre-implanted valves and does not cause any distortion of the aortic annulus. Full article

Background/Objectives: Heart transplantation is a life-saving procedure for patients with end-stage heart failure, yet it involves significant psychological and emotional challenges throughout its various stages. International guidelines recommend a multi-professional approach to the care of these patients and a psycho-social assessment for listing. The recommendations focus on content aspects, but not on the psychometric measure to be administered to patients as part of the assessment. Therefore, the purpose of this study is to provide the preliminary results of administering the protocol used by our center, measuring coping strategies, cognitive functioning, quality of life, and psychological distress in a sample of patients who are candidates for and undergo cardiac transplantation, and to observe any variations after the procedure. Methods: We conducted a comprehensive psychological-clinical assessment involving 40 patients, focusing on psychosocial functioning, cognitive reserves, mental health, and coping strategies. Tools such as the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Beck Depression Inventory-II (BDI-II), Montreal Cognitive Assessment (MoCA), General Anxiety Disorder 7 (GAD-7), and Medical Outcomes Survey Short Form 36 (SF-36) were employed to evaluate readiness for transplantation and post-transplant adaptation. Results: Results showed high levels of clinical anxiety (52.5%) and low perceived physical health (98%) before the transplant, while post-operative evaluations indicated reduced anxiety (13.51%) and depressive symptoms (10.81%), along with improved psychological well-being and reintegration into daily life. Conclusions: These results show improvement in physical and cognitive levels, accompanied by a state of enhanced psychological well-being after transplantation. A longitudinal psychological approach, from pre-transplant screening to post-discharge follow-up, is needed to address distress, improve coping mechanisms, and promote treatment adherence. This integrative strategy is critical to improving the quality of life and long-term outcomes for heart transplant recipients. Full article

Asynchrony between the movement of water and sediment in a reservoir will affect long-term maintenance of the reservoir’s capacity to a certain extent. Based on water and sediment data on the Three Gorges Reservoir (TGR) measured over the years and a river network model, optimization of the dispatching mode of the reservoir’s sand peak process was studied, and the corresponding water and sediment dispatching indicators were provided. The results show that (1) sand peak discharge dispatching of the TGR can be divided roughly into three stages, namely the flood detention period, the sediment transport period, and the sediment discharge period. (2) According to the process of the flood peak and the sand peak, a division method for each period is proposed. (3) A corresponding scheduling index is proposed according to the characteristics of the sand peak process and the needs of flood control scheduling. This research can provide operational indicators for the operation and management of the sediment load in the TGR and also provide technical support for sustainable reservoirs similar to TGR. Full article

The large-scale utilization of hydrogen energy is currently hindered by challenges in low-cost production, storage, and transportation. This study focused on investigating the impact of the diaphragm cavity profile on the movement behavior and stress distribution of a dual-stage diaphragm compressor. Firstly, an experimental platform was established to test the gas mass flowrate and fluid pressures under various preset conditions. Secondly, a simulation path integrating the finite element method simulation, theoretical stress model, and movement model was developed and experimentally validated to analyze the diaphragm stress distribution and deformation characteristics. Finally, comparative optimization analyses were conducted on different types of diaphragm cavity profiles. The results indicated that the driving pressure differences at the top dead center position reached 85.58 kPa for the first-stage diaphragm and 75.49 kPa for the second-stage diaphragm. Under experimental conditions of 1.6 MPa suction pressure, 8 MPa second-stage discharge pressure, and 200 rpm rotational speed, the first-stage and second-stage diaphragms reached the maximum center deflections of 4.14 mm and 2.53 mm, respectively, at the bottom dead center position. Moreover, the cavity profile optimization analysis indicated that the double-arc profile (DAP) achieved better cavity volume and diaphragm stress characteristics. The first-stage diaphragm within the optimized DAP-type cavity exhibited 173.95 MPa maximum principal stress with a swept volume of 0.001129 m³, whereas the second-stage optimized configuration reached 172.57 MPa stress with a swept volume of 0.0003835 m³. This research offers valuable insights for enhancing the reliability and performance of diaphragm compressors. Full article

Background: Recurrent apical pelvic organ prolapse (POP) presents significant management challenges, with limited evidence on optimal surgical approaches. This study evaluated the safety and long-term effectiveness of minimally invasive sacrospinous ligament (SSL) fixation using the EnPlace^® device for treating recurrent apical POP. Methods: A cohort analysis was performed on 82 consecutive patients (mean age 65.9 ± 8.6 years) with stage III or IV recurrent symptomatic apical POP. All patients underwent transvaginal SSL fixation using the EnPlace^® device between January 2021 and July 2023. Primary outcomes included anatomical cure rates, patient satisfaction, and complications. Long-term follow-up was conducted via a structured telephone survey in December 2024. Results: The mean interval between primary and recurrent repair was 3.2 ± 2.6 years. Most patients (64.6%) underwent surgery under regional anesthesia with a mean operative time of 24.1 ± 7.1 min and minimal blood loss (23.8 ± 6.5 mL). No intraoperative complications occurred, and 98.8% of patients were discharged the same day. Two early postoperative complications occurred, neither requiring surgical intervention. At six-month follow-up, significant improvements were observed in POP-Q measurements for apical prolapse, cystocele, and rectocele. Long-term follow-up (mean 31.6 ± 8.3 months) revealed that only 11 patients (13.4%) reported mild POP symptoms. Patient satisfaction scores averaged 90.8 ± 17.1, with only 8.5% reporting low satisfaction. Only two patients (2.4%) required additional intervention for recurrent apical POP. Conclusions: Minimally invasive SSL fixation using the EnPlace^® device demonstrates favorable safety and efficacy for recurrent apical POP, offering a viable alternative to more invasive procedures with high patient satisfaction and low recurrence rates. Full article

In this study, the process of electrolytic–plasma nitrocarburizing (EPNC) of 20-grade steel was investigated using various electrolytes and temperature regimes. At the first stage, optical spectral analysis of plasma emission during EPNC was carried out with spectral registration in the range of 275–850 nm, which allowed the identification of active components (Hα, CN, Fe I, O I lines, etc.) and the calculation of electron density. Additionally, the EPNC process was recorded using a high-speed camera (1500 frames per second), which made it possible to visually evaluate the dynamics of arc and glow discharges under varying electrolyte compositions. At the next stage, the influence of temperature regimes (650 °C, 750 °C, and 850 °C) on the formation of the hardened layer was studied. Using SEM and EDS methods, the morphology, phase zones, and the distribution of chemical elements were determined. Microhardness measurements along the depth and friction tests were carried out. It was found that a temperature of 750 °C provides the best balance between the uniformity of chemical composition, high microhardness (~800 HV), and a minimal coefficient of friction (~0.48). The obtained results confirm the potential of the selected EPNC regime for improving the performance characteristics of 20-grade steel. Full article

Background/Objectives: Anatomical and functional damage of the mitral valve (MV) apparatus in patients with dilated cardiomyopathy (DCM) is secondary to left ventricular (LV) injury, leading to functional mitral regurgitation (FMR). Real-time four-dimensional echocardiography (RT 4DE) is a useful imaging technique in different pathologies, including DCM. Left atrial (LA) strain, as measured by left atrium quantification software, is an accurate technique for evaluating increased filling pressure. The MV has a complex three-dimensional morphology and motion. Four-dimensional echocardiography (4DE) has revolutionized clinical imaging of the mitral valve apparatus. This study aims (1) to characterize the mitral annulus (MA) parameters in patients with DCM and advanced-stage heart failure (HF) according to etiology and (2) to find correlations between left atrial function and MA remodeling in this group of patients, using 4DE quantification software. Methods: A total of 82 patients with DCM and an LV ejection fraction ≤ 40% were recruited. Conventional 2DE and RT 4DE were conducted in DCM patients with a compensated phase of HF before discharge. The measured parameters were left atrial reservoir strain (LASr), annular area (AA), annular perimeter (AP), anteroposterior diameter (A-Pd), posteromedial to anterolateral diameter (PM-ALd), commissural distance (CD), interregional distance (ITD), annular height (AH), nonplanar angle (NPA), tenting height (TH), tenting area (TA), and tenting volume (TV). Results: Measured parameters revealed more advanced damage of LA and MA parameters in ischemic compared to nonischemic etiology. Univariate analysis identified AA, AP, A-Pd, PM-ALd, CD, ITD, TH, TA, and TV (p < 0.0001) as determinants of LASr. Including these parameters in a stepwise multivariate logistic regression, PM-ALd (p = 0.03), TH (p = 0.043), and TV (p = 0.0001) were the best predictors of LAsr in these patients. Conclusions: The results of this study revealed the correlation between LA function depression and MA remodeling in patients with DCM. Full article

The co-disposal of municipal solid waste incineration fly ash (MSWI-FA) in cement kilns is an effective method for managing incineration by-products in China. However, the presence of heavy metals in MSWI-FA raises environmental concerns. This study analyzed the Cu, Zn, Cd, Pb, Cr, and Ni concentrations in MSWI-FA from 11 representative facilities across China and assessed the efficacy of a three-stage water washing process for Cl and heavy metal removal. The results revealed significant regional variations in heavy metal content that were strongly correlated with surface soil levels, with Zn, Pb, and Cu exhibiting the highest concentrations. Elemental correlations, such as Cu-Pb and Zn-Cd synergies and Cd-Ni antagonism, suggest common waste sources and temperature-dependent volatilization during incineration. The washing process (solid–liquid ratio = 1:10) achieved 97.1 ± 2.0% Cl removal, reducing residual Cl to 0.45 ± 0.32%, but demonstrated limited heavy metal elimination (10.28–19.38% efficiency), resulting in elevated concentrations (32.5–60.8% increase) due to 43.4 ± 9.2% mass loss. Notably, the washing effluents exceeded municipal wastewater discharge limits by up to 52-fold for Pb and 38-fold for Cd, underscoring the need for advanced effluent treatment. To mitigate environmental risks, the addition of washed MSWI-FA in cement kilns should be restricted to ≤0.5%, with Cd content prioritized in pre-disposal assessments. This study provides actionable insights for optimizing MSWI-FA co-processing while ensuring compliance with ecological safety standards. Full article