Search Results (2,702)

Background/Objectives: This study aimed to create a ‘carbapenem resistance score’ with the risk factors of carbapenem-resistant Gram-negative bacterial infections (GNBIs) in patients with hematological malignancies. Methods: Patients with carbapenem-resistant and susceptible GNBIs were included in this study and compared in terms of risk factors. Three models of “carbapenem resistance risk scores” were created with statistically significant variables. Results: The study included 154 patients with hospital-acquired GNBIs, of whom 64 had carbapenem-resistant GNBIs and 90 had carbapenem-susceptible GNBIs. Univariate and multivariate analyses identified several statistically significant risk factors for carbapenem resistance, including transfer from another hospital or clinic (p = 0.038), prior use of antibiotics like fluoroquinolones (p = 0.009) and carbapenems (p = 0.001), a history of carbapenem-resistant infection in the last six months (p < 0.001), rectal Klebsiella pneumoniae colonization (p < 0.001), hospitalization for ≥30 days (p = 0.001), and the presence of a urinary catheter (p = 0.002). Notably, the 14-day mortality rate was significantly higher in the carbapenem-resistant group (p < 0.001). Based on these findings, three risk-scoring models were developed. Common factors in all three models were fluoroquinolone use in the last six months, rectal K. pneumoniae colonization, and the presence of a urinary catheter. The fourth variable was transfer from another hospital (Model 1), a history of carbapenem-resistant infection (Model 2), or hospitalization for ≥30 days (Model 3). All models demonstrated strong discriminative power (AUC for Model 1: 0.830, Model 2: 0.826, Model 3: 0.831). For all three models, a cutoff value of >2.5 was adopted as the threshold to identify patients at high risk for carbapenem resistance, a value which yielded high positive and negative predictive values. Conclusions: This study successfully developed three practical risk-scoring models to predict carbapenem resistance in patients with hematological malignancies using common clinical risk factors. A cutoff score of >2.5 proved to be a reliable threshold for identifying high-risk patients across all models, providing clinicians with a valuable tool to guide appropriate empirical antibiotic therapy. Full article

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, with hypercholesterolemia identified as a major, but modifiable risk factor. This review serves as the second part of a comprehensive analysis of dyslipidemia management. The first installment laid the groundwork by detailing the key pathophysiological mechanisms of lipid metabolism, the development of atherosclerosis, major complications of hyperlipidemia, and the importance of cardiovascular risk assessment in therapeutic decision-making. It also examined non-pharmacological interventions and conventional therapies, with a detailed focus on statins and ezetimibe. Building upon that foundation, the present article focuses exclusively on emerging pharmacological therapies designed to overcome limitations of standard treatment. It explores the mechanisms, clinical applications, safety profiles, and pharmacogenetic aspects of novel agents such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (alirocumab, evolocumab), small interfering RNA (siRNA) therapy (inclisiran), adenosine triphosphate–citrate lyase (ACL) inhibitor (bempedoic acid), microsomal triglyceride transfer protein (MTP) inhibitor (lomitapide), and angiopoietin-like protein 3 (ANGPTL3) inhibitor (evinacumab). These agents offer targeted strategies for patients with high residual cardiovascular risk, familial hypercholesterolemia (FH), or statin intolerance. By integrating the latest advances in precision medicine, this review underscores the expanding therapeutic landscape in dyslipidemia management and the evolving potential for individualized care. Full article

High-performance hydrogen gas sensors have gained considerable interest for their crucial function in reducing H₂ explosion risk. Although MoS₂ has good potential for chemical sensing, its application in hydrogen detection at room temperature is limited by slow response and incomplete recovery. In this work, Pd-doped MoS₂ thin films are deposited on a Si substrate, forming Pd-doped MoS₂/Si heterojunctions via magnetron co-sputtering. The incorporation of Pd nanoparticles significantly enhances the catalytic activity for hydrogen adsorption and facilitates more efficient electron transfer. Owing to its distinct structural characteristics and sharp interface properties, the fabricated Pd-doped MoS₂/Si heterojunction device exhibits excellent H₂ sensing performance under room temperature conditions. The gas sensor device achieves an impressive sensing response of ~6.4 × 10³% under 10,000 ppm H₂ concentration, representing a 110% improvement compared to pristine MoS₂. Furthermore, the fabricated heterojunction device demonstrates rapid response and recovery times (24.6/12.2 s), excellent repeatability, strong humidity resistance, and a ppb-level detection limit. These results demonstrate the promising application prospects of Pd-doped MoS₂/Si heterojunctions in the development of advanced gas sensing devices. Full article

Proteus mirabilis is a zoonotic pathogen that poses a growing threat to both animal and human health due to rising antimicrobial resistance (AMR). It is widely found in animals, including China’s nationally protected captive giant and red pandas. This study isolated Proteus mirabilis from panda feces to assess AMR and virulence traits, and used whole-genome sequencing (WGS) to evaluate the spread of resistance genes (ARGs) and virulence genes (VAGs). In this study, 37 isolates were obtained, 20 from red pandas and 17 from giant pandas. Multidrug-resistant (MDR) strains were present in both hosts. Giant panda isolates showed the highest resistance to ampicillin and cefazolin (58.8%), while red panda isolates were most resistant to trimethoprim/sulfamethoxazole (65%) and imipenem (55%). Giant panda-derived strains also exhibited stronger biofilm formation and swarming motility. WGS identified 31 ARGs and 73 VAGs, many linked to mobile genetic elements (MGEs) such as plasmids, integrons, and ICEs. In addition, we found frequent co-localization of drug resistance genes/VAGs with MGEs, indicating a high possibility of horizontal gene transfer (HGT). This study provides crucial insights into AMR and virulence risks in P. mirabilis from captive pandas, supporting targeted surveillance and control strategies. Full article

This article provides an overview of the current state-of-the-art in cyber risk and cyber risk management, focusing on the mathematical models that have been created to help with risk quantification and insurance pricing. We discuss the main ways that cyber risk is measured, starting with vulnerability functions that show how systems react to threats and going all the way up to more complex stochastic and dynamic models that show how cyber attacks change over time. Next, we examine cyber insurance, including the structure and main features of the cyber insurance market, as well as the growing role of cyber reinsurance in strategies for transferring risk. Finally, we review the mathematical models that have been proposed in the literature for setting the prices of cyber insurance premiums and structuring reinsurance contracts, analysing their advantages, limitations, and potential applications for more effective risk management. The aim of this article is to provide researchers and professionals with a clear picture of the main quantitative tools available and to point out areas that need further research by summarising these contributions. Full article

Background/Objectives: Melanoma is an aggressive type of skin cancer that poses serious health risks if not detected in its early stages. Although early diagnosis enables effective treatment, delays can result in life-threatening consequences. Traditional diagnostic processes predominantly rely on the subjective expertise of dermatologists, which can lead to variability and time inefficiencies. Consequently, there is an increasing demand for automated systems that can accurately classify melanoma lesions and retrieve visually similar cases to support clinical decision-making. Methods: This study proposes a transfer learning (TL)-based deep learning (DL) framework for the classification of melanoma images and the enhancement of content-based image retrieval (CBIR) systems. Pre-trained models including DenseNet121, InceptionV3, Vision Transformer (ViT), and Xception were employed to extract deep feature representations. These features were integrated using a weighted fusion strategy and classified through an Ensemble learning approach designed to capitalize on the complementary strengths of the individual models. The performance of the proposed system was evaluated using classification accuracy and mean Average Precision (mAP) metrics. Results: Experimental evaluations demonstrated that the proposed Ensemble model significantly outperformed each standalone model in both classification and retrieval tasks. The Ensemble approach achieved a classification accuracy of 95.25%. In the CBIR task, the system attained a mean Average Precision (mAP) score of 0.9538, indicating high retrieval effectiveness. The performance gains were attributed to the synergistic integration of features from diverse model architectures through the ensemble and fusion strategies. Conclusions: The findings underscore the effectiveness of TL-based DL models in automating melanoma image classification and enhancing CBIR systems. The integration of deep features from multiple pre-trained models using an Ensemble approach not only improved accuracy but also demonstrated robustness in feature generalization. This approach holds promise for integration into clinical workflows, offering improved diagnostic accuracy and efficiency in the early detection of melanoma. Full article

Evaluating risk in complex systems relies heavily on human auditors whose subjective assessments can be compromised by knowledge gaps and varying interpretations. This subjectivity often results in inconsistent risk evaluations, even among auditors examining identical systems, owing to differing pattern recognition processes. In this study, we propose a causality model that can improve the comprehension of risk levels by breaking down the risk factors and creating a layout of risk events and consequences in the system. To do so, the initial step is to define the risk event blocks, each comprising two distinct components: the agent and transfer mechanism. Next, we construct a causal map that outlines all risk event blocks and their logical connections, leading to the final consequential risk. Finally, we assess the overall risk based on the cause-and-effect structure. We conducted real-world illustrative examples comparing risk-level assessments with traditional experience-based auditor judgments to evaluate our proposed model. This new methodology offers several key benefits: it clarifies complex risk factors, reduces reliance on subjective judgment, and helps bridge the gap between subjective and objective uncertainty. The illustrative examples demonstrate the potential value of the model by revealing discrepancies in risk levels compared to traditional assessments. Full article

Grains and their derivatives play a crucial role as staple foods for the global population. Identifying grains in the food chain that are free from mycotoxin contamination is essential. Researchers have explored various traditional detection methods to address this concern. However, as grain consumption becomes increasingly time-sensitive and dynamic, traditional approaches face growing limitations. In recent years, emerging techniques—particularly molecular-based vibrational spectroscopy methods such as visible–near-infrared (Vis–NIR), near-infrared (NIR), Raman, mid-infrared (MIR) spectroscopy, and hyperspectral imaging (HSI)—have been applied to assess fungal contamination in grains and their products. This review summarizes research advances and applications of vibrational spectroscopy in detecting mycotoxins in grains from 2019 to 2025. The fundamentals of their work, information acquisition characteristics and their applicability in food matrices were outlined. The findings indicate that vibrational spectroscopy techniques can serve as valuable tools for identifying fungal contamination risks during the production, transportation, and storage of grains and related products, with each technique suited to specific applications. Given the close link between grain-based foods and humans, future efforts should further enhance the practicality of vibrational spectroscopy by simultaneously optimizing spectral analysis strategies across multiple aspects, including chemometrics, model transfer, and data-driven artificial intelligence. Full article

We adapt previously developed conceptual and numerical models of ciguateric food chains on the Great Barrier Reef, Australia, to model the bioaccumulation of ciguatoxins (CTXs) in parrotfish, the simplest food chain with only two trophic levels. Our model indicates that relatively low (1 cell/cm²) densities of Gambierdiscus/Fukuyoa species (hereafter collectively referred to as Gambierdiscus) producing known concentrations of CTX are unlikely to be a risk of producing ciguateric fishes on the Great Barrier Reef unless CTX can accumulate and be retained in parrotfish over many months. Cell densities on turf algae equivalent to 10 Gambierdiscus/cm² producing known maximum concentrations of Pacific-CTX-4 (0.6 pg P-CTX-4/cell) are more difficult to assess but could be a risk. This cell density may be a higher risk for parrotfish than we previously suggested for production of ciguateric groupers (third-trophic-level predators) since second-trophic-level fishes can accumulate CTX loads without the subsequent losses that occur between trophic levels. Our analysis suggests that the ratios of parrotfish length-to-area grazed and weight-to-area grazed scale differently (allometrically), where the area grazed is a proxy for the number of Gambierdiscus consumed and hence proportional to toxin accumulation. Such scaling can help explain fish size–toxicity relationships within and between trophic levels for ciguateric fishes. Our modelling reveals that CTX bioaccumulates but does not necessarily biomagnify in food chains, with the relative enrichment and depletion rates of CTX varying with fish size and/or trophic level through an interplay of local and regional food chain influences. Our numerical model for the bioaccumulation and transfer of CTX across food chains helps conceptualize the development of ciguateric fishes by comparing scenarios that reveal limiting steps in producing ciguateric fish and focuses attention on the relative contributions from each part of the food chain rather than only on single components, such as CTX production. Full article

Background: BDE-47, a pervasive environmental pollutant detected in >90% of human serum samples, is increasingly linked to metabolic disorders. This study investigates the specific impact of BDE-47 exposure on the gut microbiota in prediabetic mice and evaluates the efficacy of therapeutic interventions in mitigating these effects. Objectives: To determine whether BDE-47 exposure induces diabetogenic dysbiosis in prediabetic mice and to assess whether dietary interventions, such as grape exosomes and an antioxidant cocktail, can restore a healthy microbiota composition and mitigate diabetes risk. Methods: In this study, a prediabetic mouse model was established in 54 male SPF-grade C57BL/6J mice through a combination of high-sugar and high-fat diet feeding with streptozotocin injection. Oral glucose tolerance tests (OGTT) were conducted on day 7 and day 21 post-modeling to assess the establishment of the model. The criteria for successful model induction were defined as fasting blood glucose levels below 7.8 mmol/L and 2 h postprandial glucose levels between 7.8 and 11.1 mmol/L. Following confirmation of model success, a 3 × 3 factorial design was applied to allocate the experimental animals into groups based on two independent factors: BDE-47 exposure and exosome intervention. The BDE-47 exposure factor consisted of three dose levels—none, high-dose, and medium-dose—while the exosome intervention factor included three modalities—none, Antioxidant Nutrients Intervention, and Grape Exosomes Intervention. Fresh fecal samples were collected from mice two days prior to sacrifice. Cecal contents and segments of the small intestine were collected and transferred into 1.5 mL cryotubes. All sequences were clustered into operational taxonomic units (OTUs) based on defined similarity thresholds. To compare means across multiple groups, a two-way analysis of variance (ANOVA) was employed. The significance level was predefined at α = 0.05, and p-values < 0.05 were considered statistically significant. Bar charts and line graphs were generated using GraphPad Prism version 9.0 software, while statistical analyses were performed using SPSS version 20.0 software. Results: The results of 16S rDNA sequencing analysis of the microbiome showed that there was no difference in the α diversity of the intestinal microbiota in each group of mice (p > 0.05), but there was a difference in the Beta diversity (p < 0.05). At the gate level, the abundances of Proteobacteria, Campylobacterota, Desulfobacterota, and Fusobacteriota in the medium-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Patellar bacteria was lower than that of the model control group (p < 0.05). The abundances of Proteobacteria and Campylobacterota in the high-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Planctomycetota and Patescibacteria was lower than that of the model control group (p < 0.05), while the abundance of Campylobacterota in the grape exosome group was higher than that of the model control group (p < 0.05). The abundance of Patescibacteria was lower than that of the model control group (p < 0.05), while the abundance of Firmicutes and Fusobacteriota in the antioxidant nutrient group was higher than that of the model control group (p < 0.05). However, the abundance of Verrucomicrobiota and Patescibacteria was lower than that of the model control group (p < 0.05). At the genus level, the abundances of Bacteroides and unclassified Lachnospiraceae in the high-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Lachnospiraceae NK4A136_group and Lactobacillus was lower than that of the model control group (p < 0.05). The abundance of Veillonella and Helicobacter in the medium-dose BDE-7 group was higher than that in the model control group (p < 0.05), while the abundance of Lactobacillus was lower (p < 0.05). The abundance of genera such as Lentilactobacillus and Faecalibacterium in the grape exosome group was higher than that in the model control group (p < 0.05). The abundance of Alloprevotella and Bacteroides was lower than that of the model control group (p < 0.05). In the antioxidant nutrient group, the abundance of Lachnospiraceae and Hydrogenophaga was higher than that in the model control group (p < 0.05). However, the abundance of Akkermansia and Coriobacteriaceae UCG-002 was significantly lower than that of the model control group (p < 0.05). Conclusions: BDE-47 induces diabetogenic dysbiosis in prediabetic mice, which is reversible by dietary interventions. These findings suggest that microbiota-targeted strategies may effectively mitigate the diabetes risk associated with environmental pollutant exposure. Future studies should further explore the mechanisms underlying these microbiota changes and the long-term health benefits of such interventions. Full article

Global antibiotic use saturates ecosystems with selective pressure, driving mobile genetic element (MGE)-mediated antibiotic resistance gene (ARG) dissemination that destabilizes ecological integrity and breaches public health defenses. This review synthesizes the sources, environmental distribution, and ecological risks of antibiotics and ARGs, emphasizing the mechanisms of horizontal gene transfer (HGT) driven by MGEs such as plasmids, transposons, and integrons. We further conduct a comparative critical analysis of the effectiveness and limitations of antibiotics and ARGs remediation strategies for adsorption (biochar, activated carbon, carbon nanotubes), chemical degradation (advanced oxidation processes, Fenton-based systems), and biological treatment (microbial degradation, constructed wetlands). To effectively curb the spread of antimicrobial resistance and safeguard the sustainability of ecosystems, we propose an integrated “One Health” framework encompassing enhanced global surveillance (antibiotic residues and ARGs dissemination) as well as public education. Full article

Early evacuation during bushfires remains the safest strategy; however, in many realistic scenarios, timely evacuation is challenging, making safe sheltering a last-resort option to reduce risk compared to late evacuation attempts. However, most Australian homes in bushfire-prone areas are neither designed nor retrofitted to provide adequate protection against extreme bushfires, raising safety concerns. This study addresses this gap by investigating the concept of retrofitting a part of the residential buildings as attached safe rooms for sheltering and protection of valuables, providing a potential last-resort solution for bushfire-prone communities. Numerical simulations were conducted using the Fire Dynamics Simulator to assess heat transfer and internal temperature conditions in a representative residential building under bushfire exposure conditions. The study investigated the impact of the placement of the safe room relative to the fire front direction, failure of vulnerable building components, and the effectiveness of steel shutters in response to internal temperatures. The results showed that the strategic placement of safe rooms inside the building, along with adequate protective measures for windows, can substantially reduce internal temperatures. The findings emphasised the importance of maintaining the integrity of openings and the external building envelope, demonstrating the potential of retrofitted attached safe rooms as a last-resort solution for existing residential buildings in bushfire-prone areas where the entire building was not constructed to withstand bushfire conditions. Full article

This study intends to portray how varying degrees of environmental policy stringency and the growing pressure of global competition reflect on high-tech (HT) sectors’ cost rationalization strategies and lead to environmental consequences in 15 G20 countries (1992–2019). Moreover, we center the pattern of cost rationalization management regarding the opportunity cost of ecosystem service consumption and propose to test the fundamental hypothesis stating the possible transmission of competition-induced technological innovations to green economic transformation. Our new methodology estimates quantile-specific effects with MM-QR, while identifying the main interaction effects between regulatory pressure and trade competition uses an extended STIRPAT model. The results reveal a paradoxical finding: despite higher environmental policy stringency and opportunity costs of ecosystem services, HT sectors persistently adopt environmentally detrimental cost-reduction approaches. These findings carry important policy implications: (1) environmental regulations for HT sectors require complementary innovation subsidies, (2) trade agreements should incorporate clean technology transfer clauses, and (3) governments must monitor sectoral emission leakage risks. Our dual machine learning–econometric approach provides policymakers with targeted insights for different emission scenarios, highlighting the need for differentiated strategies across clean and polluting HT subsectors. Full article

Accurate and spatially consistent rainfall estimation is essential for hydrological modeling and flood risk mitigation, especially in mountainous tropical regions with sparse observational networks and highly heterogeneous rainfall. This study presents a comparative analysis of six radar–gauge merging methods, including three statistical approaches—Quantile Adaptive Gaussian (QAG), Empirical Quantile Mapping (EQM), and radial basis function (RBF)—and three geostatistical approaches—external drift kriging (EDK), Bayesian Kriging (BAK), and Residual Kriging (REK). The evaluation was conducted over the Huong River Basin in Central Vietnam, a region characterized by steep terrain, monsoonal climate, and frequent hydrometeorological extremes. Two observational scenarios were established: Scenario S1 utilized 13 gauges for merging and 7 for independent validation, while Scenario S2 employed all 20 stations. Hourly radar and gauge data from peak rainy months were used for the evaluation. Each method was assessed using continuous metrics (RMSE, MAE, CC, NSE, and KGE), categorical metrics (POD and CSI), and spatial consistency indicators. Results indicate that all merging methods significantly improved the accuracy of rainfall estimates compared to raw radar data. Among them, RBF consistently achieved the highest accuracy, with the lowest RMSE (1.24 mm/h), highest NSE (0.954), and strongest spatial correlation (CC = 0.978) in Scenario S2. RBF also maintained high classification skills across all rainfall categories, including very heavy rain. EDK and BAK performed better with denser gauge input but required recalibration of variogram parameters. EQM and REK yielded moderate performance and had limitations near basin boundaries where gauge coverage was sparse. The results highlight trade-offs between method complexity, spatial accuracy, and robustness. While complex methods like EDK and BAK offer detailed spatial outputs, they require more calibration. Simpler methods are easier to apply across different conditions. RBF emerged as the most practical and transferable option, offering strong generalization, minimal calibration needs, and computational efficiency. These findings provide useful guidance for integrating radar and gauge data in flood-prone, data-scarce regions. Full article

A systems-oriented review of machine learning (ML) over the entire flood management spectrum, encompassing fluvial flood control, pluvial flood management, and resiliency-risk characterization was undertaken. Deep learners like long short-term memory (LSTM) networks perform well in predicting reservoir inflows and outflows. Convolution neural networks (CNNs) and other object identification algorithms are being explored in assessing levee and flood wall failures. The use of ML methods in pump station operations is limited due to lack of public-domain datasets. Reinforcement learning (RL) has shown promise in controlling low-impact development (LID) systems for pluvial flood management. Resiliency is defined in terms of the vulnerability of a community to floods. Multi-criteria decision making (MCDM) and unsupervised ML methods are used to capture vulnerability. Supervised learning is used to model flooding hazards. Conventional approaches perform better than deep learners and ensemble methods for modeling flood hazards due to paucity of data and large inter-model predictive variability. Advances in satellite-based, drone-facilitated data collection and Internet of Things (IoT)-based low-cost sensors offer new research avenues to explore. Transfer learning at ungauged basins holds promise but is largely unexplored. Explainable artificial intelligence (XAI) is seeing increased use and helps the transition of ML models from black-box forecasters to knowledge-enhancing predictors. Full article