Search Results (2,392)

The increasing integration of renewable energy sources increases the variability and uncertainty of power systems, requiring advanced prediction-based control strategies. This paper proposes an integrated AutoML–MPC framework for a hybrid renewable energy system (HRES) combining solar and wind generation, biomass, battery energy storage, and a hydrogen chain (electrolyzer and fuel cell). Short-term load and generation forecasts are made using H2O AutoML models, and the energy flow allocation is optimized using model-based control (MPC) formalized in the form of mixed-integer linear programming (MILP). The objective function minimizes electricity imports from the grid and the associated ${\mathrm{C}\mathrm{O}}_2$ emissions, subject to technological constraints. The results obtained showed a clear distribution of short-term (battery) and long-term (hydrogen) storage functions in time: during periods of excess generation, the electrolyzer operated close to nominal mode, and in the deficit phase, the fuel cell was activated, reducing the need for grid imports. The battery ensured fast short-term balancing, while the hydrogen system compensated for the longer-term energy shortage. The forecast models were characterized by high accuracy ($R^2>0.98$), which allowed for reliable planning of energy flows over the MPC horizon. The proposed methodology allows for effective coordination of storage technologies of different time scales, maximum use of renewable generation and reducing the system’s dependence on the external grid. Full article

Background: Guillain–Barré syndrome (GBS) is a rare, immune-mediated disorder affecting the peripheral nerves, often presenting with ascending muscle weakness and possible respiratory failure, usually following an infection. Borrelia burgdorferi, the causative agent of Lyme neuroborreliosis, is an uncommon trigger of GBS. Case presentation: We report the case of a 13-year-old girl with Lyme neuroborreliosis who developed sensorimotor GBS. She presented with progressive, symmetrical weakness, initially in the lower limbs and subsequently in the upper limbs, accompanied by absent deep tendon reflexes. Peripheral demyelination, confirmed in this case, is exceptionally rare. Results: Prompt diagnosis and appropriate treatment, together with rehabilitation measures, prevented further nerve damage. Seven months after onset, she was able to walk with support and had no sensory or cognitive deficits. Conclusions: Lyme neuroborreliosis can rarely trigger GBS with peripheral demyelination. Early recognition, timely intervention, and effective interprofessional collaboration limited the extent of nerve damage and promoted neurological recovery. Full article

Chronic d-galactose (d-gal) treatment is a model to induce accelerated aging-like phenotypes in rodents. However, the sex differences in behavioral and musculoskeletal manifestations of this model are not well understood. Heme oxygenase-1 (HO-1) is a cytoprotective protein that may have anti-aging properties. The goal of this study was to better understand the sex differences in the behavioral and musculoskeletal effects of chronic d-gal treatment in C57BL/6J mice, as well as the role of HO-1 induction or inhibition. Eight-week-old male and female mice received daily saline or d-gal injections (500 mg/kg, s.c.) for 12 weeks. After this time, mice in the d-gal group were randomized into three groups (n = 6/group/sex): d-gal, d-gal + cobalt protoporphyrin (CoPP) (5 mg/kg, s.c. weekly), and d-gal + zinc deutroporphyrin bisglycol (ZnBG) (42 mg/kg, i.p. triweekly) for a period of 4 weeks. Open-field, novel-object recognition, Barnes maze, grip strength, micro-computed tomography (µ-CT), histology, and protein analysis were performed. Chronic d-gal treatment resulted in a sexual dimorphic response, with female mice being more prone to develop deficits in both short- and long-term spatial memory as well as in non-spatial memory. Male mice exhibited deficits only in long-term spatial memory when treated chronically with d-gal. Inhibition of HO-1 was protective in both females and males. Chronic d-gal treatment did not accelerate the development of osteoporosis or sarcopenia in either males or females. Our results demonstrate a sexual dimorphic response to the chronic effects of d-gal treatment on aging, with greater effects in females than in males, which is dependent on HO-1. Full article

Polymer-based biosensors have evolved from passive supports into active functional elements that dictate analytical performance in complex real-world samples. This critical review with meta-trend analysis examines 96 original research articles published between 2015 and 2025, evaluating how four polymer classes (conductive polymers, redox-mediator polymers, hydrogels, and molecularly imprinted polymers) address matrix effects in food, beverage, environmental and clinical applications. Electrochemical detection dominates (79% of studies), with conductive polymers enabling low-potential operation that excludes electroactive interference. Hydrogels achieve superior precision (RSD below 3%) in protein-rich matrices through biocompatible microenvironments that preserve enzyme kinetics. Molecularly imprinted polymers provide unmatched stability in harsh environments for trace-level detection of heavy metals and toxins, though delayed response times from slow analyte diffusion persist. Critical evaluation exposes validation deficits: 91% of studies omit limits of quantification, while approximately one-third lack reproducibility (33%) and precision (30%). The multi-matrix challenge, maintaining calibration across different hostile environments, remains the primary barrier to commercial deployment. Advanced architectures, including nanocapsulation, hierarchical nanocomposites, and microneedle-integrated systems, offer pathways to overcome limitations in fouling resistance and operational stability. Full article

Non-organic (muscle) weakness (NOw) is proposed as a distinct pathological entity characterized by maladaptive neuroplasticity (learning) affecting motor control. Functional deficits are most directly revealed through the manual muscle testing (MMT) break test, which uniquely exposes a muscle’s ability to adapt to increasing external load, potentially serving as an index of motor control integrity. We advance the “muscle-motor-movement PTSD” (mPTSD) model in which learning during pain or stress (trauma) yields chronic avoidance (inhibition) of the associated muscles. In a second stage, compensatory synergies develop, overriding attempts at hypertrophy-oriented training. This non-systematic, integrative review synthesizes clinical reports, learning theories, motor control and pain literature, and objective tests of force and movement over time during MMT. Predictive processing and reinforcement learning offer complementary accounts of how hyper-precise priors and passive avoidance may maintain NOw beyond functional recovery. Unexplained muscle weakness is found in non-specific musculoskeletal disorders and functional motor disorder (functional weakness), but may also contribute to other conditions, such as kinesiophobia. Effective alternative treatments for NOw may act by updating or erasing maladaptive motor learning by disrupting memory reconsolidation, allowing immediate restoration of function. Analogous to psychoneuroimmunology’s role in immune function, we propose “psychoneurokinesiology”, the study of how maladaptive learning affects movement. Full article

Although chronic contamination by silver ions (Ag⁺) can persist in aquatic systems over long periods of time and can therefore have an impact on population developments, regulatory testing commonly relies on single-generation endpoints. Here, we used Daphnia magna to quantify long-term effects of pg/L to ng/L concentrations of Ag⁺ across generations and to test whether recovery depends on exposure history. Using 21 d life-cycle assays over up to seven consecutive generations, we quantified survival, key life-history traits, and population fitness (intrinsic rate of natural increase, r). In our study, low environmental concentrations of Ag⁺ caused minimal mortality, but sublethal effects persisted or multiplied over generations. Notably, continuous exposure led to significant reductions in body length and r at 50 pg/L (nominal LOEC) by the fourth generation exposed, representing population-relevant effects of Ag⁺ at very low concentrations which should be given consideration in the assessment of both water quality and the chemical itself. Recovery was concentration-dependent: low-concentration-exposed lineages recovered within a few generations, whereas 15 ng/L exposure resulted in persistent deficits even through the recovery period of three generations. Exposure-history patterns indicated that long-term outcomes were dominated by the cumulative number of exposed generations. These findings highlight the limitations of acute and single-generation assays and emphasize the importance of considering information on the effects of chemicals, including Ag⁺, across multiple generations in risk assessments. They also highlight the need to include expectations regarding recovery after the removal of pollutants in these assessments. Full article

Background: Surgical management of adult patients with post-dysplastic coxarthrosis using total hip arthroplasty is technically demanding and carries an increased risk of complications. In cases of high iliac dislocation classified as Crowe type IV, restoring the acetabular component to the anatomical hip centre often requires femoral shortening osteotomy to enable safe reduction in the prosthetic joint. Nevertheless, long-term evidence on functional outcomes and prosthesis survival with this approach is limited. Methods: A retrospective cohort study included 19 patients with 22 cases of Crowe type IV post-dysplastic hip osteoarthritis treated with uncemented total hip arthroplasty (Pinnacle/S-ROM, DePuy, Warsaw, IN, USA) combined with transverse subtrochanteric femoral shortening osteotomy. Patients underwent serial clinical follow-up, including assessment of range of motion, measurement of limb-length discrepancy, and functional evaluation using the Harris Hip Score and the WOMAC questionnaire. Radiological assessment included evaluation of osteotomy union, implant positioning, and osteolysis on standardized radiographs. Vertical distances of the centre of rotation (CR), the tip of the greater trochanter (GT), and the tip of the lesser trochanter (LT) from both reference lines were measured bilaterally, and inter-side differences were calculated. The reference lines consisted of the line connecting the inferior margins of the ischial bones and the teardrop (TD) line. Results: All osteotomies united at a mean of 5.57 months, with a mean follow-up of 129 months. Mean limb-length discrepancy decreased from 5.27 cm to 1.5 cm, and mean hip flexion improved from 82.9° to 106°. Functional outcomes improved significantly, with mean WOMAC increasing from 55.4 to 80.1 (p < 0.001) and mean Harris Hip Score from 49.8 to 84.66 at up to 3 years of follow-up (p < 0.001). Osteotomy length correlated strongly with lesser trochanter–teardrop distance (p = 0.00000048). Complications included distal femoral fissure (27.3%) and revision (18%), with no infection or permanent neurological deficit. Conclusions: Total hip arthroplasty combined with subtrochanteric femoral shortening osteotomy for Crowe type IV post-dysplastic hip osteoarthritis appears to be a feasible and effective procedure in an experienced centre, providing reliable osteotomy healing and significant early functional improvement that is sustained over time. Limb-length discrepancy was reduced and satisfactory biomechanical restoration was achieved, with an acceptable complication profile and implant survival of 81.3% at long-term follow-up. The LT–TD parameter was identified as a potential predictor of osteotomy length, enabling the proposal of a preoperative planning equation. However, given the limited sample size and lack of validation, these findings should be interpreted cautiously. Further studies are needed to confirm their broader applicability. Full article

This study explores the lived experiences of pregnant women in rural Nepal navigating maternal healthcare amidst intersecting structural barriers. Using the Social Determinants of Health framework and intersectionality, we examine how geographic isolation, inadequate infrastructure, and economic hardship compound risks to timely and safe maternal care. Twenty in-depth interviews were conducted at a district hospital in the eastern region of Koshi Province, Nepal. Four major themes were identified through inductive thematic analysis. These are: geographic vulnerability and transport challenges; gaps in rural maternal health provision; accommodation and institutional support deficits; and economic vulnerability and hidden costs of care. Findings reveal that poor road conditions, unreliable transport, and limited diagnostic services force women to undertake long, costly journeys, often requiring temporary relocation without institutional accommodation support. Despite policies such as the Safe Motherhood Programme, implementation gaps persist, leaving women to bear significant financial and emotional burdens. These experiences underscore systemic inequities in resource distribution and highlight the compounded disadvantage faced by women from rural and marginalised communities. To ensure equitable maternal healthcare, this study advocates for the decentralisation of health services and the implementation of inclusive financial protection policies tailored to the needs of women from rural and marginalised communities. To promote equitable maternal healthcare, we recommend strengthening rural health infrastructure, implementing maternity waiting homes, and expanding financial protection schemes tailored to vulnerable populations. This research offers critical insights for policymakers to address maternal health inequalities and advance Nepal’s progress toward Universal Health Coverage and Sustainable Development Goal 3 (Ensure healthy lives and promote well-being for all at all ages). Full article

Chronic kidney disease (CKD) is on the rise, with sarcopenia accompanying CKD in an estimated 25% of patients, featuring as a potentially debilitating issue that should not be overlooked. Sarcopenia, characterized by a loss of skeletal muscle mass and strength, is multifactorial. The aging process, uremic toxins, systemic inflammation, oxidative stress, gut dysbiosis, hormonal dysregulation, dietary deficits, and even air pollution are among the major parameters being implicated in sarcopenia among patients with CKD. Additionally, the existence of various comorbidities, such as type 2 diabetes mellitus (T2DM), depression, and cardiovascular diseases (CVD), also contribute to the chronic low-grade inflammation associated with skeletal muscle inflammation and atrophy. The purpose of this review is to delve into the complex interplay of multiple factors being involved in the pathogenesis of sarcopenia in patients with CKD. Moreover, we aim to shed light upon nutritional aspects that could delay the development and progression of sarcopenia among patients with CKD. To address vitamin D deficiency, micronutrients and macronutrients together with physical activity remain the cornerstone of delaying the progression of sarcopenia in this sub-population. Additionally, experimental drugs exhibiting therapeutic potential are also being discussed. As sarcopenia and quality of life are interconnected, the timely recognition of sarcopenia, together with nutritional and therapeutic interventions, is of the utmost importance in our crusade for a better quality of life (QoL) in patients with CKD. Full article

The COVID-19 pandemic represented a critical stress test for institutional trust and legitimacy, particularly in societies characterized by pre-existing deficits of confidence in public authorities. In Romania, the health crisis unfolded against a background of low institutional credibility and widespread skepticism toward political and administrative actors. This study examines how institutional authority was discursively evaluated, contested, and delegitimized through public online comments during the most severe phase of the pandemic. The analysis is based on a corpus of 457 comments collected from major Romanian news websites and YouTube channels between 20 and 26 October 2021, corresponding to the peak week in terms of infections and mortality. Drawing on Discourse Analysis and Discursive Psychology, the study combines quantitative coding with qualitative analysis to identify recurrent forms of moral and epistemic criticism, inflammatory discourse, and sarcasm, organized into interpretative repertoires. The findings show that online criticism is structured primarily around accusations of hypocrisy, incompetence, corruption, insensitivity, and authoritarianism. These discourses function not merely as expressions of dissatisfaction but as practices through which commenters articulate moral order, contest institutional legitimacy, and position themselves as morally vigilant and epistemically competent actors entitled to judge public decision-making. Online comment spaces thus emerge as arenas of discursive delegitimation in times of crisis, with important implications for democratic resilience and crisis governance. Full article

With the advancement of agricultural modernization, issues related to resource conservation, intensive utilization, and green, low-carbon development have become increasingly prominent. To enhance water and fertilizer use efficiency in Henan Province and promote green, low-carbon, and sustainable agricultural development, field experiments were conducted during 2023–2024. The experiment employed a randomized complete block design with three replications. Each plot measured 30 m² (5 m × 6 m), totaling 36 plots. An IoT-based real-time coordinated water-fertilizer regulation technology, driven by continuous WSH-TDR310S sensor monitoring of soil moisture and nitrogen status with automated threshold-based control logic, was implemented. By transforming the traditional static scheduling approach into a dynamic feedback mechanism driven by real-time sensor data, the synchronization between resource supply and crop demand was achieved. This study aimed to elucidate the response characteristics of summer maize growth dynamics and farmland N₂O emissions under the proposed regulation strategy. The experiment included three levels of water deficit (mild, moderate, and severe) and three fertilization levels (low, medium, and high), resulting in a total of nine real-time water–fertilizer coordinated regulation treatments, along with three local border irrigation control treatments. The results showed that under real-time water–fertilizer regulation, plant height, stem diameter, and leaf area index of summer maize exhibited unimodal variation patterns, with the medium irrigation–medium fertilization (B2) treatment performing optimally. Compared with the border-irrigation medium-fertilization control (D2), plant height and stem diameter under the B2 treatment increased significantly. Cumulative farmland N₂O emissions increased with higher irrigation and fertilization levels, with the border-irrigation high-fertilization treatment producing the highest emissions. Yield formation was mainly governed by structural growth traits, with plant height showing the strongest predictive ability, followed by stem diameter, whereas leaf area index showed weaker explanatory power. Summer maize yield exhibited a unimodal response to both irrigation and nitrogen input levels. Compared with the D2 treatment, the B2 treatment increased grain yield by 41.33%, while achieving water-saving and fertilizer-saving rates of 38.10% and 35.75%, respectively, thereby achieving an optimal balance between high yield and efficient water–fertilizer utilization. These findings provide theoretical support for summer maize production in the North China Plain and contribute to the promotion of green and sustainable agricultural development. Full article

Background/Objectives: Freezing of gait (FoG) is a disabling motor manifestation of Parkinson’s disease (PD) associated with impaired neural control of locomotion and increased gait variability. Quantitative characterization of gait kinematics may provide biomechanical insight into FoG-related instability, particularly under different dopaminergic states. Methods: This pilot study evaluated sagittal-plane knee kinematics in healthy individuals (n = 27) and patients with PD. (n = 8) under OFF and ON dopaminergic medication conditions using two-dimensional videogrammetry (Kinovea^®). Knee flexion–extension trajectories were time-normalized to 0–100% of the gait cycle, and group ensemble profiles (mean ± SD) were computed. Results: Phase-specific range of motion (ROM), within-subject variability, and interlimb coordination were quantified. Interlimb coordination was assessed using Pearson’s correlation coefficients (r) and cross-correlation lag analysis computed per subject and summarized statistically across groups. Compared with healthy participants, PD patients in the OFF state exhibited significantly reduced knee ROM during stance and swing (p < 0.05), accompanied by increased kinematic variability and disrupted temporal coordination. Interlimb correlation was significantly lower in PD OFF compared to healthy gait groups (p = 0.010), with larger temporal lags, indicating impaired bilateral synchronization. Following medication intake (ON state), knee excursion increased and interlimb coordination partially improved; however, correlation values and timing symmetry did not fully normalize to healthy levels. Conclusions: These findings demonstrate that sagittal-plane knee kinematics and interlimb coordination metrics derived from low-cost 2D videogrammetry are sensitive to the dopaminergic state and reveal persistent neuromotor deficits in PD. The proposed framework provides an interpretable and accessible approach for characterizing gait organization in Parkinson’s disease and supports future integration with clinical assessment and longitudinal monitoring. Full article

This manuscript presents an energy management strategy (EMS) for a commercial smart building participating in a tertiary frequency regulation market. The building integrates non-controllable components, such as loads and photovoltaic generation, and controllable resources such as a battery storage system and a set of electric vehicle (EV) chargers that are available for customers of the smart building. The EMS is based on model predictive control due to its innate ability to deal with operational constraints and different optimization criteria, which are critical for the operation of the EMS, and consists of two stages. The first iteratively optimizes energy costs and revenues from tertiary regulation reserves and activations in order to determine the optimal operation of the smart building and the regulation offers in nominal conditions. Then, a second problem determines the operation whenever an activation request is made. Simulation-based analyses are performed to study the performance of the EMS and its financial viability in diverse scenarios relevant to the smart commercial building. The results show that profits are greater if both upward and downward regulation can be provided, for a larger number of EVs and chargers and for longer connection times. Most notably, incomes from regulation almost match operation costs for a large number of chargers and EVs (240), obtaining a deficit of only EUR 39.12 for a day of operations. Full article

Background: Episodic ataxia type 2 (EA2) is the most common subtype of episodic ataxia and is primarily caused by pathogenic variants in the CACNA1A gene. Although classically characterized by paroxysmal ataxia, CACNA1A-related disorders are increasingly recognized as an age-dependent phenotypic continuum that extends beyond episodic cerebellar dysfunction to include fluctuating weakness, persistent neurological signs, and neurodevelopmental impairments. Case report: A 12-year-old boy presented with episodic vertigo. His medical history was notable for infantile paroxysmal tonic upward gaze beginning at 6 months of age. From the age of 7 years, he developed frequent episodes of vertigo and ataxia lasting 2 to 3 h. At 10 years of age, he experienced an episode of acute lower limb weakness with diminished deep tendon reflexes, without prominent ataxia. Guillain–Barré syndrome was initially suspected, and he received two courses of intravenous immunoglobulin, with only transient improvement. Neurophysiological studies were largely unremarkable, except for an isolated decremental response on repetitive nerve stimulation. In addition to paroxysmal events, he exhibited persistent interictal cerebellar signs, including dysmetria, dysdiadochokinesia, and downbeat nystagmus. Neuropsychological testing revealed mild intellectual disability with prominent visuospatial deficits. Trio-based whole-exome sequencing identified a de novo CACNA1A splice donor variant (c.978 + 1G > A), confirming the diagnosis of EA2. Treatment with acetazolamide resulted in marked improvement in episodic ataxic events. Conclusions: This case highlights EA2 as part of a broader CACNA1A-related phenotypic continuum rather than a purely paroxysmal disorder. Awareness of atypical and age-dependent manifestations is crucial to avoid diagnostic pitfalls and to facilitate the timely initiation of targeted therapy and appropriate developmental support. Full article

Background/Objectives: Avoidable mortality—deaths before age 75 from preventable or treatable causes—is a key indicator of health system performance. In Mexico, nearly two-thirds of municipalities lack hospital beds, yet no study has examined the municipal-level association between healthcare infrastructure and avoidable mortality. This study assessed whether healthcare desert status is independently associated with avoidable mortality after adjusting for social deprivation. Methods: This ecological study analyzed 1891 Mexican municipalities (population ≥ 1000) over 2015–2024. Avoidable deaths were classified per OECD/Eurostat criteria (January 2022 revision). Healthcare desert status was defined by municipal hospital bed availability from 2019 facility data. Negative binomial mixed-effects regression estimated incidence-rate ratios (IRRs) adjusted for social deprivation, age structure, and state-level heterogeneity. Interrupted time-series analysis quantified pandemic disruption. Results: Of 4,960,244 deaths under 75 years, 81.2% were avoidable. Of 1891 municipalities, 1187 (62.8%) lacked hospital beds (healthcare deserts). Desert municipalities had 42.5% higher avoidable mortality (IRR = 1.425; 95% CI: 1.370–1.482; pre-pandemic 2015–2019), which attenuated to 1.353 after age-structure adjustment. Each standard-deviation increase in hospital beds (1 SD ≈ 2.2 beds per 1000) was associated with 7.9% lower mortality (IRR = 0.921). Avoidable mortality exhibited strong spatial clustering (Moran’s I = 0.382) in southern Mexico. By 2024, the desert–adequate mortality gap had widened by approximately five fold (from $\sim$12 to 69 per 100,000 population). Conclusions: Healthcare deserts are independently associated with substantially higher avoidable mortality in Mexico. The COVID-19 pandemic durably amplified pre-existing disparities associated with healthcare infrastructure deficits. Targeted hospital expansion in underserved municipalities is urgently needed, alongside investment in social determinants of health. Full article