Search Results (825)

Background and Objectives: Healthcare-associated infections (HAIs) remain a major challenge in emergency hospital settings, where high patient turnover and empirical antibiotic use may contribute to the emergence and spread of multidrug-resistant organisms. Monitoring antibiotic consumption is essential for antimicrobial stewardship and infection prevention. This study evaluated antibiotic consumption patterns across multiple hospital units and explored their ecological relationship with HAI rates. Materials and Methods: A retrospective observational study was conducted in a tertiary-level emergency hospital in Romania between 1 January 2021 and 31 October 2025. Antibiotic consumption was quantified using Defined Daily Dose per 100 bed-days (DDD/100 bed-days) according to World Health Organization (WHO) methodology and categorized using the WHO Access, Watch, and Reserve (AWaRe) classification. HAI data were collected using standardized surveillance definitions. Statistical analyses were primarily descriptive and exploratory and included graphical trend assessment, simple linear regression for temporal trend description, and Spearman correlation analysis for exploratory ecological co-variation assessment. Results: Antibiotic consumption showed substantial variability across hospital units, without a consistent temporal trend over the study period. The Watch group predominated over the Access group from 2023 onward, while Access antibiotics remained below the WHO-recommended 60% threshold. The highest antibiotic consumption was observed in the Medical Wards, followed by Surgical Wards and the Intensive Care Unit. A total of 27 HAIs were identified (0.27 per 1000 patient-days), with the highest incidence observed in the ICU. The most frequent infections were Clostridioides difficile infections (33.3%) and catheter-associated urinary tract infections (29.6%). Exploratory ecological analyses did not identify robust associations between total antibiotic consumption and HAI rates across hospital units. A numerically elevated co-variation was observed between fluoroquinolone consumption and Clostridioides difficile infection incidence; however, this finding should be interpreted strictly as exploratory and hypothesis-generating. Conclusions: Antibiotic use varied across hospital units, with predominance of broad-spectrum agents and suboptimal adherence to WHO AWaRe targets. Reported HAI incidence remained low and should be interpreted within the limitations of routine surveillance systems and potential under-ascertainment. These findings support the value of continuous institutional surveillance of antibiotic use and HAIs while highlighting the limitations of aggregated ecological analyses. Full article

Against the backdrop of intensifying global climate change, climate policy uncertainty (CPU) and investor sentiment have become critical factors influencing the stability of financial markets. In this study, a quantitative index of investor sentiment is constructed using stock trading volume, turnover rate, price-to-earnings ratio, circulating market value, and the consumer confidence index. The QVAR-DY model is employed to analyze the risk contagion mechanisms among CPU, investor sentiment, and China’s financial sub-markets across different quantiles. Furthermore, five machine learning models—LSTM, BiLSTM, CNN, XGBoost, and LightGBM—are used to forecast risk spillover indices, and their performance is compared with three benchmark models (ARIMA, Persistence, and HistMean) to systematically evaluate the advantages of machine learning models in capturing tail risk spillover effects. The findings reveal significant cross-market risk contagion in financial markets, characterized by asymmetry. The level of risk spillover under extreme conditions is substantially higher than under normal conditions, indicating high sensitivity to extreme events and major policies. CPU exhibits the most pronounced spillover effect on the money market, while investor sentiment has the greatest impact on the stock market. The stock, real estate, and commodity markets act simultaneously as sources of risk and receivers of shocks. In terms of forecasting performance, LightGBM performs best under normal conditions, whereas LSTM achieves the highest prediction accuracy under extreme conditions. Full article

Tumor metastasis constitutes a frequent contributor to high mortality rates, with EMT intimately implicated in this disseminative process. Accumulating evidence in recent years indicates that neoplastic cells undergoing EMT frequently exhibit concurrent metabolic reprogramming. Multiple modalities—including glycolysis, mitochondrial oxidative phosphorylation, lipid metabolism, as well as amino acid metabolism—cooperatively supply energy, facilitate membrane remodeling, and sustain redox homeostasis. Specifically, glycolytic flux, oxidative phosphorylation, lipid turnover, and amino acid catabolism/anabolism function in a concerted manner to meet the bioenergetic demands, support biogenesis of cellular membranes, and preserve the intracellular redox equilibrium during phenotypic conversion. Notably, intermediate metabolites can in turn modulate the trajectory of EMT through signal transduction cascades or epigenetic modifications. This review systematically delineates the bidirectional regulatory circuitry interconnecting EMT and metabolic reprogramming; furthermore, it examines the implications of this crosstalk for neoplastic disease progression. Finally, therapeutic strategies targeting the nexus of metabolic reprogramming and EMT are summarized. Full article

Background: Nursing faculty shortages, burnout, and high turnover represent an escalating workforce crisis in Saudi governmental colleges of nursing. The Job Demands–Resources (JD-R) model offers a theoretically grounded framework for examining how occupational demands are associated with reduced well-being and how resources moderate these effects. Objective: This study aimed to examine the direct associations between job demands and stress outcomes and the moderating roles of job and personal resources among nursing faculty in Saudi Arabia, accounting for gender and nationality as structural covariates. Methods: A quantitative cross-sectional survey was conducted with 268 nursing faculty members from five governmental colleges using a voluntary survey of all eligible faculty (response rate: 51.1%). Theory-driven hierarchical regression analyses examined direct and moderating effects within the health-impairment pathway of the JD-R model. Results: Job demands significantly predicted all three burnout dimensions, reduced mental well-being, and job dissatisfaction. Trait emotional intelligence moderated the demand–exhaustion (delta-R² = 0.031, p = 0.006) and demand–job satisfaction (delta-R² = 0.028, p = 0.009) relationships. Job resources moderated the demand–mental well-being (delta-R² = 0.024, p = 0.018) and demand–professional efficacy links (delta-R² = 0.021, p = 0.029). Conclusions: Job demands are the primary predictor of burnout and occupational stress. Gender and nationality were associated with systematic differences in stress outcomes, suggesting that interventions should be culturally responsive and account for structural inequities. Full article

A previous analysis of diversity within the Monomorium nigrius Forel group, formally recognized as a single species, concluded that >200 species may occur in the Australian monsoonal tropics (AMT). Here, we test this conclusion by incorporating CO1 data from an additional 223 M. nigrius group specimens collected from the monsoonal tropics of the Northern Territory (NT). By integrating morphological variation, CO1 structure and divergence, and geographic distribution, we recognized 85 species from monsoonal NT. PTP and bPTP analyses, which consider CO1 structure and divergence alone, recognized 107 and 136 species, respectively. Using a distance-based clustering approach, the number of OTUs defined by a CO1 divergence threshold of 1–6% ranged from 163 to 37. Given that sampling remains highly patchy, many more than the 85 species recognized here are likely to occur in monsoonal NT. Only four of the 85 species are known from elsewhere in the AMT. Given such high rates of species turnover, our findings support the conclusion that the total number of AMT species in the M. nigrius group likely exceeds 200. Remarkable levels of unrecognized hyperdiversity occur in many ant species groups in the AMT, challenging the traditional understanding that peak ant diversity occurs in tropical rainforest biomes. Full article

(1) Background: The rapid spatial expansion of the ruderal weed Chenopodium hybridum L. poses a potential challenge to agricultural production and regional ecosystems in China. However, the spatial evolution characteristics of its potential geographic distribution remain unclear under the compound scenarios of global warming and intensified human activities. (2) Methods: Utilizing an optimized MaxEnt model (regularization multiplier (RM) = 0.5, feature combination (FC) = LQ), this study integrated bioclimatic, topographic, soil, and Human Footprint (Hfp) data to predict the potential suitable habitats of C. hybridum in China under current conditions and four future Shared Socioeconomic Pathways (SSPs) emission scenarios (SSP126, SSP245, SSP370, and SSP585) for the 2050s and 2070s. Additionally, spatial turnover rate and centroid migration analyses were incorporated to elucidate its spatiotemporal dynamics. (3) Results: The results indicate that the optimized model exhibited robust predictive performance (Area Under the Curve (AUC) = 0.928). The Human Footprint (Hfp) was the environmental factor most prominently associated with the macro-spatial distribution of C. hybridum, with a relative contribution of 58.4%—significantly higher than any single natural geographic factor. Currently, potential suitable habitats are primarily concentrated in North, Central, and Southwest China, totaling approximately 205.59 × 10⁴ km². Under future climate scenarios, the highly suitable core habitats exhibit a consistent contraction trend, whereas the marginal suitable habitats shift spatially toward the arid inland regions of the northwest and the high-altitude areas of the southwest. By the 2070s under the higher-emission scenario (SSP585), the spatial turnover rate reaches a peak value (16.23%), and the distributional centroids of the potential suitable habitats exhibit localized directional shifts. (4) Conclusions: The spatial expansion trajectory of C. hybridum exhibits a high degree of spatial congruence with human activity corridors, reflecting a distinct macro-ecological niche spatial response characterized by shifts toward higher latitudes and elevations. It must be emphasized that the projections of this study reflect potential habitat suitability rather than definitive future actual distributions. The three-tier spatial management framework proposed herein—encompassing transport regulation, ecological management in core areas, and early warning in marginal zones—can serve as a scientific basis for the early monitoring and spatial management of this species under climate change. Full article

The most widely used bankruptcy predictor, Altman’s Z-Score, assigns a positive coefficient to asset turnover; faster firms are rated safer. Under crisis conditions, that assumption reverses. We introduce the Solvency Margin (SM), a diagnostic calculable from standard financial statements that measures, in dollars, how far an organization is from the threshold where operations become impossible. Unlike static liquidity ratios, the SM yields a concrete speed limit: the maximum operating velocity at which an organization can survive a defined shock. We validated the SM against pre-crisis financial data across three crises in two domains. Regarding the automotive sector, SM computed from FY2019 filings showed directional predictive power among ten major automakers in both the 2021 semiconductor shortage (ρ = 0.50, p = 0.14) and the 2020 COVID-19 pandemic (ρ = 0.53, p = 0.12; ρ = 0.70, p = 0.036 excluding one governance-driven outlier). With reference to the 2023 U.S. banking crisis, SM augmented with a Deposit Stability Factor predicted crisis outcomes among eighteen regional banks (Spearman ρ = 0.62, p = 0.006), correctly ranking three of four failed institutions in the bottom three positions. Monte Carlo simulation (450,000+ runs) confirmed threshold behavior. We present a five-step calculation method and a three-lever decision framework for practitioners. Full article

Urban streams typically exhibit altered hydromorphology and large fluctuations in water quality variables, creating stressful conditions for biota. In this study, we investigated periphyton along two urban streams (Bliznec, B, and Veliki Potok, VP) in Zagreb (the Croatian capital) over one year. Both streams were sampled in an upstream pristine reach within Medvednica Nature Park, a middle reach influenced by either agriculture or low-density residential areas (houses with gardens) and affected by channelization, and a lower reach, also channelized, impacted by a mix of agricultural influence and more intensive residential development with higher population density. Nutrient concentration, conductivity, COD, and chlorophyll a showed an increasing trend from upper to lower sites, reflecting the influence of urbanization. The number of periphytic taxa and their abundance correlated positively with the increasing urbanization, probably due to increased food sources. Periphyton consisted mainly of ubiquitous taxa, with 55 phagotrophic protist and 10 micro-metazoan taxa. Ciliates dominated both in diversity (44 taxa) and abundance (over 90% of mean abundance), mainly comprising bacterivorous taxa. Periphyton exhibited pronounced seasonal dynamics, with occasional high similarity between the two urban streams studied and high turnover rates of assemblages between samplings. This pattern indicates that urban streams support highly dynamic periphytic communities, strongly shaped by environmental disturbance and that these assemblages have the capacity to withstand frequent environmental variability in urbanization-influenced reaches. Full article

Developing low-cost, non-noble-metal electrocatalysts to replace platinum-based benchmarks for the alkaline hydrogen evolution reaction (HER) remains a critical challenge. Using density functional theory (DFT) calculations combined with the computational hydrogen electrode (CHE) model, we systematically investigate the thermodynamics, kinetics, and intrinsic reaction mechanism of HER on a TiO₂-supported Ni₃ trimer (Ni₃/TiO₂) in alkaline media. We find that the Ni₃ trimer, rather than the TiO₂ support, provides multiple active sites for intermediate adsorption. The trimeric Ni₃ motif generates delocalized electronic states, leading to electron-rich active sites that significantly lower the barrier for water dissociation, facilitate intermediate desorption, and sustain catalytic turnover. The reaction proceeds predominantly via the Volmer–Heyrovsky pathway, where either water dissociation or H₂ desorption can be the rate-determining step, depending on the applied potential. Crucially, the significantly reduced reaction barrier heights demonstrate that the alkaline HER activity of Ni₃/TiO₂ is comparable to that of benchmark Pt₁/TiO₂ single-atom catalysts (SACs). This work establishes a promising design strategy for constructing high-performance non-noble metal few-atom catalysts (FACs) to replace noble metal SACs for multi-step electrocatalytic reactions. Full article

Understanding how P availability affects root turnover and P redistribution within plants is essential for optimizing fertilization strategies and sustaining forest growth under low-P soils. This study evaluated the effects of P fertilization on root system dynamics, plant growth, and P nutrition of Handroanthus heptaphyllus, a flowering landscape tree, cultivated in a subtropical climate. Plants were grown under two soil P levels (low and high). Plant height, stem diameter, leaf P concentration, soil P availability, total numbers of living and dead fine roots, total fine root surface area, and fine root production rate were measured at 18, 24, 30, and 36 months after planting. Phosphate fertilization increased soil P availability during the first 24 months and resulted in significant gains in plant height, stem diameter, fine root production, total surface area, and the ratio between living and dead fine roots, indicating a higher proportion of living roots relative to dead ones. Under high P availability, the greatest fine root production and surface area of living fine roots occurred in the 0–20 cm soil layer, reflecting localized P application near the plants. High P availability enhanced root system development, promoted greater soil exploration, and improved P uptake. These results indicate that under P supplementation, plants strategically invest in root growth, improving nutrient acquisition efficiency and reducing dependence on external inputs. Increased phosphorus availability enhances root growth and increases fine root production and turnover. Minirhizotron monitoring effectively captured shifts in root system dynamics driven by P availability, including enhanced root growth, increased fine root production and turnover, and improved nutrient uptake under high P, as well as limited root activity under low P conditions, indicating a more conservative strategy with reduced investment in root production. Full article

Modern electric vehicle (EV) charging stations must increase their adaptability to dynamic demand patterns driven by users’ heterogeneous charging behaviors, which often result in high spatial–temporal fluctuations. This study develops an agent-based model to accurately evaluate the potential of partial-charging strategy in addressing this issue, taking into account the influence of drivers’ heterogeneous waiting patience. The simulating results indicate that the operational efficiency of the charging station and the level of crowding are most sensitive to changes in vehicle arrival rates and the total number of charging stations. However, individual-level heterogeneity in waiting patience emerges as the core factor preventing limitless queuing increase. Compared with other strategies, the partial-charging strategy improves the turnover of charging stations by reducing per-vehicle charging duration, allowing stations to adapt to varying charging demand conditions without capacity expansions. Setting the charging threshold at 80% state of charge allows the stations to efficiently serve twice the demand level as under full-charging strategy, while a 70% threshold may increase this adaptability by approximately 2.5 times. This study provides structured recommendations for the strategic and adaptive deployment of the partial-charging strategy in alleviating queue-related inefficiencies of charging stations. Full article

This study examines how catalysts and operating conditions enhance the pyrolysis of textile wastes, supporting their use as a viable feedstock for waste-to-energy recycling. Pyrolysis of three common textile wastes—cotton, polyester, and nylon—was studied using thermogravimetric analysis (TGA). Experiments were conducted at heating rates of 5, 10, 15, and 20 °C/min, both with and without catalysts, including K₂CO₃, ZnO, KOH, CaO, and natural zeolite. The results showed that cotton decomposes at significantly lower temperatures than polyester and nylon, with a peak decomposition rate at 361.7 °C compared to 437.9 °C for polyester and 459.8 °C for nylon. Reaction kinetics were analyzed using three established models: Kissinger–Akahira–Sunose (KAS), Flynn–Wall–Ozawa (FWO), and Kissinger. Among the materials studied, polyester exhibited the lowest activation energy (184.8 kJ/mol), while cotton and nylon showed higher values (241.1 and 236.2 kJ/mol, respectively). Catalyst performance varied by material. Potassium carbonate was particularly effective for cotton, increasing the weight loss rate and reaction rate constant. ZnO significantly reduced the activation energy for nylon. Although catalysts generally enhanced reaction rates, many also increased activation energy. This increase in activation energy and collision frequency suggests that catalytic pyrolysis becomes more temperature-sensitive while achieving higher reaction turnover frequencies. Full article

This study investigates the key determinants of firm profitability in the global automotive sector, examining whether superior returns on assets (ROA) stem from operational efficiency, strategic leverage, or innovation intensity, and highlighting the potential trade-off between efficiency and investment in capital-intensive industries. Analysing a global panel dataset of 192 automotive firms from 38 countries/regions over 2010–2024, a fixed effects regression model with Driscoll–Kraay standard errors was applied to control for unobserved heterogeneity, heteroskedasticity, and cross-sectional dependence across 11 financial and strategic variables. The findings reveal that firm size and inventory turnover are significant positive drivers of profitability, while research and development (R&D) intensity exerts a strong negative impact. The positive association with the effective tax rate reflects reverse causality, where more profitable firms incur higher tax burdens, rather than a causal effect of taxation on performance. Notably, working capital management, leverage, sales growth, and capital expenditure showed no statistically significant effects after controlling for firm and time effects. Temporal fluctuations, including a marked profitability decline in 2024, underscore the sector’s sensitivity to macroeconomic shocks. This study contributes robust, large-scale empirical evidence on the short-term profitability trade-off associated with R&D intensity in a globally integrated industry, addressing cross-sectional dependence through its methodological approach. Full article

Background/Objectives: Reconstruction of complex lower extremity soft tissue defects remains challenging, particularly in the proximal and middle tibial regions, including the knee, where suitable recipient vessels are often limited due to prior trauma, infection, or surgical intervention. This study aimed to evaluate the feasibility and clinical applicability of anterior tibial vessel turnover as an alternative recipient vessel strategy in free flap reconstruction. Methods: A retrospective review was conducted of seven patients who underwent free flap reconstruction using anterior tibial vessel turnover as the recipient vessel between 2019 and 2024. Preoperative imaging was performed to assess vascular status and collateral circulation. Clinical data, including patient demographics, defect characteristics, flap parameters, and postoperative outcomes, were analyzed. Results: The mean patient age was 62.7 years (range, 38–86 years). Defects were primarily located in the proximal and middle tibial regions and were associated with trauma, postoperative infection, chronic osteomyelitis, or burn injury. The mean flap size was 137.4 cm² (range, 49.5–280 cm²). All flaps survived, resulting in a flap survival rate of 100%, with no cases of total flap loss or re-exploration due to vascular compromise. One patient experienced partial flap loss, while no other flap-related complications were observed. Most patients achieved stable wound coverage and favorable functional recovery. Conclusions: Anterior tibial vessel turnover may serve as an alternative recipient vessel strategy for selected cases of complex lower extremity free flap reconstruction. This technique enables microvascular anastomosis in a more superficial and accessible field and expands reconstructive options in cases with compromised recipient vessels. Full article

A novel citric acid-assisted in situ reduction method has been developed for the synthesis of bimetallic AuPd alloy nanoparticles supported on amine–phosphate-functionalized carbon nanotubes (AuPd/NH₂-P-CNTs). In this strategy, formic acid acts not only as the reducing agent for reducing metal precursors, but also as the hydrogen source for the subsequent catalytic dehydrogenation. The introduction of citric acid significantly accelerates the reduction kinetics and promotes the uniform formation of ultrafine AuPd nanoparticles (∼1.8 nm). As a result, the optimized Au_0.5Pd_0.5/NH₂-P-CNTs exhibit an extraordinary catalytic activity and 100% H₂ selectivity during hydrogen generation from FA with sodium formate as an additive, affording a remarkable initial turnover frequency of 5663.94 mol H₂ mol Pd⁻¹ h⁻¹ at 303 K. The experimental results reveal that the -NH₂ and -P functional groups on the support are crucial for stabilizing and uniformly dispersing the alloy nanoparticles. Furthermore, the enhanced reaction rate can be attributed to the strong metal–support interaction established between AuPd nanoparticles and -NH₂-P-CNT supports. This work provides a new perspective on the design of highly efficient Pd-based catalysts for hydrogen production from formic acid. Full article