Search Results (655)

Reliable electricity supply is essential for healthcare institutions, particularly where grid instability can disrupt service continuity, compromise patient safety, and affect the operation of critical medical equipment. In this context, selecting an appropriate photovoltaic (PV) proposal is a complex decision problem that requires assessing technical, economic, environmental, and regulatory factors jointly. This study develops a hybrid multi-criteria decision-making framework that integrates the Fuzzy Analytic Hierarchy Process (FAHP), the Decision-Making Trial and Evaluation Laboratory (DEMATEL), and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) to support PV proposal selection in healthcare institutions. The framework was applied to four competing proposals for a hospital case study in Barranquilla, Colombia. After integrating FAHP and DEMATEL, the economic, technical, and environmental criteria received balanced interdependence-adjusted weights of 0.324, 0.337, and 0.338, respectively. At the same time, DEMATEL identified the technical dimension as the main net influencing dimension within the expert-elicited influence network. The final ranking placed Proposal 1 first, followed by Proposal 4, Proposal 2, and Proposal 3, with closeness coefficients of 0.530, 0.518, 0.498, and 0.492, respectively. Additional comparative analysis showed that omitting DEMATEL changed the winning alternative, whereas preserving the FAHP–DEMATEL weighting structure and replacing TOPSIS with MARCOS yielded the same ranking. Robustness analyses further showed that the ranking remained stable in most supplier-exclusion and leave-one-expert-out scenarios. In contrast, bootstrap-based probabilistic sensitivity analysis showed that Proposal 1 ranked first in 96.2% of the replications. These results support the practical usefulness of the proposed framework for decision-making in healthcare energy planning. Full article

Smart city mobility systems face a persistent gap between digital innovation and large-scale deployment. While Mobility-as-a-Service platforms and Mobility Living Labs have generated promising local solutions, transferring these solutions across cities remains constrained by data fragmentation, proprietary platforms, and divergent governance frameworks. This study proposes and operationalizes a policy-oriented framework for assessing the transferability of smart mobility solutions across urban contexts, drawing on the GEMINI project spanning seven European cities: Amsterdam, Copenhagen, Helsinki, Munich, Paris-Saclay, Porto, and Turin. A structured dataset covering application features, interoperability characteristics, technical specifications, and implementation challenges was developed and analysed using comparative indicators including Ease of integration, interoperability level, and replication potential. The results demonstrate that transferability depends on the interaction of technical, governance, and institutional conditions rather than technical compatibility alone. Applications built on open standards and modular architectures show significantly higher replication potential, while legacy systems, fragmented governance structures, and restrictive data-sharing arrangements remain the most persistent barriers. To operationalize the framework, a web-based Knowledge Hub was developed and deployed as a live decision-support platform, currently serving all seven Mobility Living Labs and openly accessible to cities across Europe. The framework offers a replicable model for smart city mobility governance. Full article

Metabolic dysfunction-associated steatohepatitis (MASH) progresses through macrophage activation and hepatic stellate cell (HSC)-driven fibrogenesis. As cell-level single-cell discoveries often suffer from pseudoreplication and fail to replicate across cohorts, in this study we critically re-evaluated human liver single-nucleus RNA-sequencing data using a rigorous per-donor statistical framework to dissociate invariant biological signals from technical artifacts. Macrophage and HSC compartments from dataset GSE202379 were profiled across clinical stages (healthy, metabolic dysfunction-associated steatotic liver disease, MASH). Cell-level statistics were aggregated into per-donor metrics, and continuous phenotypic shifts evaluated via the Jonckheere–Terpstra (JT) trend test. Key findings were tested for cross-cohort reproducibility in two independent cohorts (GSE136103 and GSE244832). A 249-gene scar-associated macrophage (SAMac) program showed reproducible, stage-dependent expansion in the discovery cohort (per-donor Jonckheere–Terpstra trend across the disease-only spectrum, MASLD to advanced MASH, z = 2.23, p = 0.026 [primary]; z = 2.74, p = 0.006 across all four stages including the healthy baseline) and directional replication in external data. Cell–cell communication analysis replicated the receptor-side topology of a conserved macrophage-to-HSC PDGF axis in both external cohorts and the ligand-driven PDGFC→PDGFRB edge in the external snRNA-seq cohort (GSE244832), with PDGFRB being a high-degree hub within the HSC fibrogenic interaction network. Importantly, a previously published global HSC activation module failed to validate (JT p = 0.77); however, its core extracellular matrix and RUNX1/2 sub-axis remained robust, whereas the widely claimed AP-1/JUNB regulatory driver was not supported at the transcript level in the single-nucleus RNA-seq cohort data. These findings are consistent with an isolation-associated immediate-early gene response in enzymatically dissociated scRNA-seq data, given the flat-to-downward transcript-level trend in cryopreserved-tissue cohorts; transcript-level data cannot, however, exclude protein- or phosphorylation-level AP-1 activity. Targetable downstream components within the validated core architecture were annotated. By implementing per-donor verification, we successfully separated robust pathological features of MASH from platform-dependent artifacts. The validated SAMac program and the macrophage–HSC PDGF axis, together with an associated RUNX subprogram, represent high-confidence, reproducibility-filtered candidate therapeutic nodes that require functional validation. These findings establish a reproducibility-first standard for single-cell translational research, and the validated programs are consistent with emerging models of inter-organ inflammatory circuitry in MASH. Full article

The increasing integration of AI in education imposes the need to examine the competencies of teachers for its pedagogically meaningful, safe, and responsible application. The goal of this research was to examine the self-assessments of teachers’ AI-related competencies, as well as to determine whether there were statistically significant differences regarding the subject area and years of teaching experience. The research was conducted on a sample of 165 primary and secondary school teachers in the Republic of Serbia. Data were collected using the Serbian-language version of the original Teacher Artificial Intelligence Competence Self-Efficacy (TAICS) Scale. The reliability and factor structure of the instrument were checked using Cronbach’s alpha coefficient, Kaiser–Meyer–Olkin (KMO) indicator, Bartlett’s test of sphericity, and exploratory factor analysis using principal axis factoring with Varimax rotation, while one-way analysis of variance (ANOVA) was used to examine differences. The results showed high internal consistency of the scale (Cronbach’s α = 0.972) and an interpretable three-factor solution explaining 71.202% of the total variance. The following factors were extracted: pedagogical–evaluative AI competencies, ethical–safety AI competencies, and operational–technical AI competencies. No statistically significant differences in pedagogical–evaluative or ethical–safety AI competencies were found according to subject area or years of teaching experience. For operational–technical AI competencies, an unadjusted difference was observed according to teaching experience; however, this finding did not remain statistically significant after the Bonferroni correction for multiple testing. These findings should be interpreted as preliminary and require replication in larger and more representative samples. The findings indicate that the competencies of teachers for artificial intelligence should be viewed as a multidimensional basis for further research, improvement of teaching practice, and planning of professional development in the field of application of AI in education. Full article

Distributed generation offers a critical pathway to sustainable urban energy; however, incomplete regulatory frameworks in emerging economies frequently force residential photovoltaic (PV) systems into export-restricted operation. This study quantifies the empirical performance and opportunity costs of a demand-matched, zero-export PV system paired with an Internet of Things (IoT)-managed backup tier. A 54-month longitudinal single-case evaluation was conducted in Arequipa, Peru, utilizing a 1.36 kWp grid-tied array and a 0.6 kWh/day decoupled backup subsystem. Performance was benchmarked against a fully metered pre-PV counterfactual. The zero-export constraint mandated a 96.3% self-consumption index (SCI), capping the self-sufficiency index (SSI) at 37.9% and yielding a utilization ratio (U) of only 24.1% against the site’s technical potential. Economically, a full lifecycle appraisal of the status quo produced a negative net present value (NPV) of −USD 1738. Scenario modeling reversed that outcome under net metering (+USD 862). Net billing at the generation price currently contemplated left the investment short of break-even (−USD 202): the break-even price is PEN 0.317/kWh, some 13% above that reference. The decisive variable is therefore not the remuneration mechanism alone but the price set within it. Furthermore, the decoupled backup architecture mitigated 97.7% of 43 recorded grid outages at a resilience cost of USD 3.2 per protected hour. The headline findings are therefore institutional, not technological: identical hardware shifts from value-destroying to value-creating through the regulatory treatment of surplus energy alone, provided that surplus is priced above the break-even threshold quantified here. We present two replicable sizing rules and propose the U metric to translate regulatory impasse into an internationally standardized reporting parameter, providing an evidence-based roadmap for accelerating decentralized renewable energy in resource-constrained grids (SDG 7, SDG 11). Full article

Despite the high global prevalence of depressive and anxiety disorders, access to early clinical assessment remains limited for many. Although this field has grown rapidly, existing reviews have focused primarily on technical performance, with limited systematic attention to whether current models meet the prerequisites for clinical implementation. This scoping review mapped methodological approaches across this domain and evaluated clinical readiness using five predefined indicators: sample size adequacy, external validation, prospective data collection, real-world evaluation, and model explainability. Searches of PubMed, Web of Science, and IEEE Xplore (March 2026) identified 2463 records; 34 studies (37 dataset evaluations) were included. The majority of studies (91%) were published from 2022 onwards. Depression was the primary target in 91% of studies, while only one study addressed anxiety. Hand-crafted acoustic features were the most frequent (57%), while classical machine learning was the most common model type (32%). External validation was conducted in only 32% of evaluations and real-world testing in 8%. Clinical readiness was classified as Low in 24%, Moderate in 65%, and High in 11% of evaluations. No evaluation met all five indicators simultaneously. These findings apply primarily to voice-based depression screening; 36 of 37 evaluations targeted depression, and the evidence base for anxiety disorders is limited to a single evaluation, precluding comparable characterisation for that condition. The principal challenges to clinical implementation are insufficient external validation, reliance on laboratory conditions, narrow linguistic coverage, and inconsistent metric reporting. The framework applied in this scoping review provides a replicable structure for assessing the clinical validity of AI-driven psychiatric screening tools. Full article

The licensing of trip-generating developments (TGDs) determines how mobility impacts are assessed and which mitigation measures are required, yet procedures remain heterogeneous and largely focused on roadway performance. No instrument was identified to assess their adherence to sustainable urban mobility (SUM) principles. This study proposes a maturity-based protocol for that assessment. It comprises four dimensions, sixteen components, and three maturity levels: N1 conventional, N2 in transition, and N3 SUM-oriented. It derives from an integrative review of the literature and technical and institutional documents. Expert content validation yielded item-level indices of 0.86–1.00 and a scale-level index of 0.94. Inter-rater assessment showed 81.3% exact agreement and an ordinal Krippendorff’s alpha of 0.83. Applied to Rio de Janeiro, it classified five components at N1, ten at N2, and one at N3. Sustainable mobility is reflected in the regulatory vocabulary, in the declared scope of the study, in measures for pedestrians and cyclists, and in the financial instrument, without reaching the metrics that structure the approval decision. By shifting the unit of analysis to the regulatory procedure and presenting a diagnostic profile rather than an aggregate score, the protocol provides a basis designed for replication and comparison across municipal licensing systems. Full article

Small-sided games (SSGs) are widely used in soccer training to replicate the technical, tactical, and physical demands of competition. However, their ability to reproduce the multidimensional distribution of accelerative and decelerative actions observed during official matches remains unclear. This study compared multidimensional locomotor distributions between SSGs and official match play in eleven professional soccer players monitored across more than 20 official matches and multiple SSG sessions during a competitive season. Locomotor data were obtained using validated tracking systems and analyzed by integrating speed, acceleration/deceleration magnitude, and metabolic power. The resulting multidimensional distributions were compared using Jensen–Shannon (JS) divergence to quantify distributional similarity. For accelerations, differences between SSGs and official matches were minimal at low metabolic power but increased progressively, reaching the greatest divergence above 60 W·kg⁻¹ (JS = 0.196). Decelerations showed a similar trend; however, no deceleration events above 30 W·kg⁻¹ were observed during SSGs, whereas official matches included exposure across higher metabolic power bands. These findings indicate that the SSG formats examined only partially reproduced the multidimensional locomotor demands of competition. Although accelerative actions remained represented across several metabolic power domains, exposure to high-intensity decelerations was absent during the SSG formats examined. From a practical perspective, these findings suggest that complementary training strategies may be considered when greater exposure to high-intensity deceleration demands is desired; however, the effectiveness of such strategies was not directly evaluated in the present study. Full article

The accelerating use of algorithmic systems in public administration exposes a standardization gap between technical AI assurance and institutional accountability. This article develops a tiered accountability and reporting standards framework for decisions made under public authority. A qualitative design science method combines comparative institutional analysis, structured absence analysis, and standards architecture design. The empirical basis comprises international standards, the United States Department of Government Efficiency (DOGE)–Treasury access episode as an institutional control precursor, Australia’s Robodebt scheme as an automated-decision failure, and public sector governance arrangements in Estonia, Singapore, Japan, South Korea, Canada, and the United States. A replicable coding protocol traces documented accountability gaps to five auditable primitives: provenance tracking, decision logging, role attribution, contestability, and post-deployment audit. The primitives are organized into minimum, heightened, and systemic/constitutional tiers according to material influence, rights and essential service effects, civil service integrity, institutional independence, and substitutive capacity. The article also specifies a Public Sector Algorithmic Accountability Statement (PAAS), crosswalks its ten disclosure fields to GRI 1, GRI 2, and GRI 3, and demonstrates its operation through a fully worked hypothetical benefits eligibility application. A tier assignment decision aid, an assurance cycle, and a cost–feasibility model support implementation, including in small institutions. The framework’s novelty lies not in claiming new lifecycle controls, but in consolidating those controls around the public decision configuration, escalating them according to public authority consequences, and joining internal evidence to comparable public reporting. The proposal shifts standardization from AI system certification alone toward auditable institutional answerability, governance sustainability, and constitutional integrity. Full article

Background: Retroviral vectors remain widely used for CAR T-cell manufacturing, including emerging multi-component engineering strategies that incorporate additional functional modules to enhance therapeutic performance. However, genome-wide profiling of integration patterns in CAR T cells subjected to multiplex retroviral engineering has not previously been reported. Methods: We performed genome-wide profiling of retroviral integration sites in CAR T-cell products derived from two targeting platforms (IL15-GPC3 and HER2). Each platform was evaluated under conditions with or without co-transduction of a retroviral vector encoding ADA1 and CD26. Experiments were conducted using cells obtained from a single donor with three technical replicates. Vector copy number (VCN), chromosomal distribution, genomic feature annotation, and integration hotspot analyses were conducted. Results: VCN levels were comparable across all CAR T-cell products and were not significantly affected by ADA1/CD26 co-expression. Integration events were broadly distributed across the genome with enrichment in gene-dense chromosomal regions. Chromosome 19 showed a prominent integration preference, with a secondary enrichment observed on chromosome 17. The majority of integration sites were located within intronic regions, with no enrichment observed in promoter regions. Recurrent integration hotspots were identified; however, no evidence of dominant clonal expansion was observed across conditions. Comparative analyses between ADA1/CD26 and control groups showed minimal differences in integration patterns. Conclusions: To our knowledge, this study provides the first comprehensive, genome-wide characterization of retroviral integration site profiles in CAR T-cell products manufactured by multi-vector co-transduction with an ADA1/CD26 module. By employing harmonized comparison with external reference datasets, we offer a directly benchmarked integration site characterization of multi-component CAR T-cell manufacturing. These findings establish a reference framework for integration site monitoring in next-generation CAR T-cell engineering systems and inform risk evaluation for emerging combinatorial vector strategies. Full article

This study presents a closed-loop digital–physical workflow for manufacturing patient-specific anatomical models and surgical guides for maxillofacial reconstruction. The workflow combines medical-image segmentation, additive manufacturing of anatomical models, surgeon-led physical simulation, re-digitization of the modified models, landmark-based and surface-based alignment with the original CT-derived anatomy, with FFD used as a limited supporting approach for localized geometry updating, CAD design, and fabrication of sterilizable guides. Technical feasibility was examined in two detailed mandibular reconstruction cases involving temporomandibular joint prosthesis implantation. The workflow was subsequently used in adapted forms in eight clinically heterogeneous mandibular reconstruction cases related to oncological treatment. These cases are reported as supplementary clinical implementations and were neither treated as direct replications of the complete closed-loop methodology nor pooled for quantitative comparison. In the two detailed cases, the guides were verified on the anatomical models, used intraoperatively, and followed by postoperative imaging providing qualitative clinical confirmation of implant positioning. The study did not include a direct CT-based control workflow or standardized geometric deviation analysis. Therefore, operating-time and cost effects are reported as case-specific observations and an illustrative scenario rather than comparative evidence. The main contribution is the physical-to-digital feedback step, which allows surgeon-introduced modifications of a printed model to be transferred back to the digital geometry before final guide design. The results support the technical feasibility and adaptability of the workflow, while prospective quantitative validation remains necessary. Full article

Ultrasound-guided hydrodissection and dextrose prolotherapy have evolved into anatomically explicit but mechanistically distinct strategies for musculoskeletal pain. This State-of-the-Art narrative review aimed to synthesize major recent clinical and technical developments and to interpret them within a target-based framework. PubMed and Embase via Ovid were searched for English-language publications from 1 January 2021 through 29 July 2026, supplemented by selected pre-2021 landmark studies identified through backward citation tracking. After initial deduplication, 1662 records entered Title/Abstract screening. The final narrative synthesis cited 67 publications, including selected landmark and methodological sources. One author performed screening, and a second author reviewed the final publication selection; study selection was purposive and designed for a narrative synthesis rather than exhaustive systematic inclusion. Four questions guided the review: recent refinements in hydrodissection technique and indications; increasing condition specificity of prolotherapy evidence; areas of overlap and distinction between the two procedures; and the evidentiary status of emerging applications. Hydrodissection research remains concentrated in carpal tunnel syndrome and increasingly addresses injectate, volume, tissue-plane spread, and procedural configuration, whereas evidence beyond the carpal tunnel remains incompletely replicated. Prolotherapy research has shifted from broad claims toward condition-specific studies in tendinopathy, plantar fasciopathy, knee osteoarthritis, periarticular disorders, and temporomandibular joint pathology. Across both fields, variations in concentration, volume, anatomical site, session number, comparator, rehabilitation, and procedural expertise limit generalization. Hydrodissection is defined by observable, fluid-mediated separation of a tissue interface, whereas prolotherapy involves dextrose delivery to a symptomatic connective-tissue target without requiring immediate tissue-plane separation. The proposed framework is intended to standardize terminology, organize evidence maturity, and guide future comparative research rather than prescribe a validated treatment algorithm. Full article

High-density valley residential areas face poor ventilation and heat island effects. Taking Lanzhou’s Xin’an Residential Area as a case, this study integrates land use and cover change (LUCC), circuit theory, and CFD to construct a resistance surface, identify corridors and key nodes, reveal coupling mechanisms and propose collaborative optimization strategies. Results show the following: (1) Ventilation resistance presents a pattern of “low in the north, high in the south, permeable at the periphery, obstructed in the interior”, with high-resistance zones accounting for 18% of the grid area; green plot ratio is the most sensitive regulatory factor (standardized regression coefficient = −0.679). (2) The fishbone-like ventilation network has primary hub nodes undertaking 80% of airflow transport, while tertiary terminal nodes (73% of total nodes) are the main ventilation bottlenecks. (3) Built-up land morphological indicators show strong spatial collinearity, and the positive effect of road plot ratio is masked in the regression model. The proposed hierarchical micro-renewal strategy provides an operable technical pathway for wind environment optimization, low-carbon renewal and climate-adaptive retrofitting of high-density valley residential areas. This study extends circuit theory to micro-scale ventilation analysis and establishes a replicable quantitative framework for ventilation diagnosis in analogous valley residential contexts. Full article

The formulation of organomineral composts can be used to modulate nutrient dynamics and improve the quality of fertilizers produced from agro-industrial residues. This study evaluated the effects of compost formulation, phosphorus source, and inoculation with phosphate-solubilizing bacteria on nutrient dynamics during the composting of sugarcane filter cake. Six formulations combining filter cake, poultry litter, and agricultural gypsum were evaluated: organic compost (T1); compost enriched with reactive phosphate rock (T2); reactive phosphate rock + phosphate-solubilizing bacteria (T3); triple superphosphate (T4); triple superphosphate with a modified filter cake-to-poultry litter ratio (T5); and compost without gypsum (T6). The experiment was conducted in a completely randomized design with five replicates, and composts were evaluated at 45, 65, and 115 days. Data were subjected to analysis of variance considering formulation, composting time, and their interaction. A significant interaction between compost formulation and composting time was observed for organic matter, organic carbon, P, K, Ca, Mg, and pH, whereas N and S were independently affected by these factors. Organic matter and organic carbon contents decreased by 18% and 19%, respectively, at 115 days compared with the earlier composting periods. P-enriched formulations had 52% higher P content than non-enriched composts, while T2 and T5 showed comparable P content. Inoculation with phosphate-solubilizing bacteria temporarily increased P content during the composting phase, whereas gypsum did not improve N conservation. These findings demonstrate that formulating composts with reactive phosphate rock is a technically feasible strategy for producing P-enriched organomineral fertilizers while promoting nutrient recycling and the valorization of agro-industrial residues. Full article

Translocations of endangered species are a common method of conserving wildlife; however, the release of dietary specialists pose unique challenges for conservationists. In preparation for future releases of the red panda (Ailurus fulgens styani), a bamboo specialist, a proof-of concept test was performed using the ‘Human-Assisted Soft Release’ (HASR) method previously used with giant pandas. Two red pandas (one male, one female) were trained using positive reinforcement to recall to a researcher and voluntary placement of GPS collars as well as physical examinations. Afterwards, to simulate a translocation, the individuals were ‘mock-released’ into a large public access red panda enclosure. Following the ‘mock-release’, the pandas were monitored for four weeks via GPS collars mounted with accelerometers as well as the HASR method. The protocol proved operationally successful: across eight scheduled sessions, both individuals met all four predefined criteria in every session attended (8/8 and 7/7, the latter shortened by injury), permitting recall, collar changes, body examinations and weighing inside a public enclosure without anesthesia or physical restraint, and allowing an injury to be detected from collar data and treated the following morning. Alongside this operational record, activity and space use were monitored descriptively. The odds of being active in the first week rose to 1.9 and 1.6 times each individual’s own pre-release baseline (+13.7 and +8.3 percentage points; p < 0.001) before returning to baseline across the month, and the two individuals differed in the reshaping of their daily rhythm and in their use of space. With the limitation of two individuals and an overlap with the breeding season, the behavioral observations reported here are descriptive and hypothesis-generating rather than hypothesis-confirming and require replication. The operational findings nonetheless demonstrate that the HASR method is technically feasible with red pandas and provides a basis for the pre-release preparation of this endangered species. Full article