Search Results (19,432)

Existing studies on urban public space vitality predominantly focus on single temporal scales or macro-urban levels, lacking a systematic understanding of day–night and weekday–weekend differentiation patterns at the meso-scale. This study examines 149 public spaces in the Yuexiu District, Guangzhou, employing Baidu heatmap data and the geographically weighted random forest (GWRF) model to analyze built environment impacts across four temporal scenarios. The SHAP interaction analysis is incorporated to quantitatively evaluate factor interdependencies and their temporal variations. Findings reveal significant spatiotemporal heterogeneity. Building density shows greater night-time importance while residential density exhibits enhanced daytime importance, particularly on weekend. Weekday–weekend comparison demonstrates contrasting spatial reorganization patterns, with weekday showing divergence and weekend showing convergence in factor importance distributions. The factor interaction analysis highlights stable synergistic relationships between density and diversity, alongside temporal transitions in density–residential density interactions from competitive to synergistic during night-time. Low-vitality public spaces are concentrated in peripheral areas with high building density but insufficient commercial facilities and functional mix. These findings deepen our understanding of the spatiotemporal mechanisms underlying public space vitality generation and the interaction effects among built environment factors, thereby providing an empirical foundation for the formulation of temporally adaptive planning strategies. Full article

Obstructive sleep apnea (OSA) is a common disorder caused by recurrent upper airway obstruction during sleep, affecting individuals across the lifespan. In children, OSA commonly results from adenotonsillar hypertrophy and may resolve spontaneously or following surgical intervention. Among adolescents and adults, OSA is more frequently associated with modifiable lifestyle factors, particularly obesity. The natural history of OSA may evolve from intermittent snoring and mild disease to moderate or severe forms if left untreated, leading to reduced health-related quality of life and overall health deterioration. Early identification of OSA, especially in mild and moderate cases, allows timely interventions to improve OSA-associated indices and may prevent progression to severe disease. Continuous positive airway pressure therapy remains the treatment of choice for adults, providing effective symptom control and reducing long-term complications, although adherence rates vary. In obese patients, sustained weight reduction represents the most effective disease-modifying strategy: a ≥5% weight loss is associated with an approximately 80% reduction in progression risk, while bariatric surgery achieves remission in up to 60–65% of cases at one year. Emerging anti-obesity pharmacotherapies have also demonstrated clinically meaningful reductions in the apnea–hypopnea index. Comorbid conditions such as hypertension, type 2 diabetes, and depression exacerbate OSA severity, impair treatment response, and complicate overall disease management. This review uniquely integrates pediatric and adult longitudinal data, treatment-modified trajectories, and emerging therapeutic approaches to provide a life-course perspective on OSA natural history, highlighting opportunities for early, phenotype-directed intervention to possibly alter disease course and long-term outcomes. Full article

The growing miniaturization of electronic systems and the expansion of sustainable, autonomous IoT technologies emphasize the need for efficient, ultra-low-power energy harvesting devices. This study evaluates fifteen devices from five industry leaders for use in small-scale autonomous seed germination systems. Its novelty lies in applying a competitive profile matrix within a flexible multicriteria evaluation framework based on the simple additive weighting (SAW) method that uses a comprehensive set of competitive technology factors (CTFs). The results demonstrate that a transparent and structured methodology can generate prioritized lists of suitable energy harvesters while accounting for technical, economic, and environmental trade-offs. The study also shows that device rankings depend on the scope and objectives of the project. If these change, then the CTF selection, classification, and weighting adjust accordingly. Therefore, the relevance of this study lies in the adaptability, replicability, and audibility of the proposed framework, which supports the selection of informed technology for autonomous, IoT-based germination systems and other technological projects. Full article

Tantalum pentoxide (Ta₂O₅) films deposited on fused silica substrates are critical components of high-power laser systems. Ion-assisted electron beam evaporation (IAD-EBE) is the mainstream technique for fabricating Ta₂O₅ films. However, it commonly requires extensive experimental efforts for deposition quality optimization, while each coating cycle is extremely time-consuming. To solve this issue, this work establishes a dataset targeting the surface roughness (Rq) and refractive index (n) of Ta₂O₅ films using atomic force microscopy, as well as ellipsometer and deposition experiments. Influence of assisting ion source beam voltage (V)/current (I) and Ar (Q₁)/O₂ (Q₂) flow rate on the n and Rq of Ta₂O₅ films are analyzed. Combining energy-field mechanism analysis with a Bayesian optimization approach (PI-BO), both deposition quality prediction and feature analysis of process parameters are achieved. The determination coefficient/mean absolute error for the prediction models of n and Rq reach 0.927/0.013 nm and 0.821/0.049 nm, respectively. Based on sensitivity analysis, the weight factors of V, I, Q₁, and Q₂ affecting n/Rq of Ta₂O₅ films are determined to be 0.616/0.274, 0.199/0.144, 0.113/0.582, and 0.072/0.000. V and Q₂ are identified as the core factors for regulating deposition quality. The optimal ranges for V and Q₂ are 600~700 V and 70~80 sccm, respectively. This study proposes a PI-BO method for predicting Rq and n of Ta₂O₅ films under small-data conditions, while determining the preferred parameter ranges and their sensitivity weight factors. These findings provide effective theoretical support and technical guidance for IAD-EBE strategy design and optimization of optical films in high-power laser systems. Full article

Objectives: To explore if MRI can monitor treatment and predict outcome in patients with human epidermal growth factor 2 (HER2)-negative breast cancer receiving neoadjuvant chemotherapy (NACT) with or without bevacizumab. Methods: Multiparametric MRI was performed at baseline and after 12 and 25 weeks of NACT. MRI assessment included tumour size, apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI), and signal intensity–time curves and vascular volume transfer constant (K^TRANS) from dynamic contrast-enhanced MRI (DCE). The reference standards were pathological complete response (pCR) at the time of surgery, and 10-year recurrence-free survival. Receiver operating characteristics analyses were performed to assess the predictive value of the MRI parameters. MRI findings and outcomes were compared between the treatment groups. Results: Seventy women were included from November 2008 to July 2012, with a median age of 49.5 years and median tumour diameter of 47 mm. Fourteen patients (20.0%) achieved pCR, while eleven (15.7%) had recurrence during the 10-year follow-up. The treatment significantly reduced tumour size, increased ADC, decreased K^TRANS, and shifted the signal intensity–time curves towards more benign shapes. The DCE parameters changed significantly more in the bevacizumab group. In the bevacizumab group, baseline K^TRANS predicted pCR (Area under curve (AUC) = 0.73), but the difference in pCR-rates between the treatment groups was not significant (p = 0.07). Only tumour size and shrinkage at 12 weeks predicted pCR (AUC = 0.71–0.85) regardless of size measuring method. No MRI parameters predicted survival. Conclusions: All MRI parameters reflected treatment response, but no parameter predicted survival or benefit from adding bevacizumab to chemotherapy. Full article

Background/Objectives: Inflammation may play a critical role in the pathogenesis of gestational diabetes mellitus (GDM). However, evidence linking early-pregnancy cytokines to subsequent GDM risk remains inconsistent, with most prior research focusing only on CRP, IL6, and TNFα. In this study, we expand on prior work by evaluating a broader range of immune markers and assessing sociodemographic factors as potential moderators. Methods: Data from a prospective U.S. pregnancy cohort (n = 308) were analyzed. Twenty cytokines were quantified in maternal first-trimester plasma using the MILLIPLEX High-Sensitivity Human Cytokine Magnetic Bead Panel. One-hour oral glucose (50 g) tolerance test (OGTT) values assessed at an average gestational age of 27.7 weeks (SD = 2.9) and GDM diagnosis were abstracted from medical records. Multivariable linear and logistic regression models were used to examine associations between cytokines and 1 h 50 g OGTT levels or GDM diagnosis, adjusting for key sociodemographic factors. Interactions terms were included to evaluate whether sociodemographic factors moderated cytokine–GDM relationships. Results: Sixteen women (5.1%) were diagnosed with GDM. Higher first-trimester high-sensitivity-IL6 levels were significantly associated with increased 1 h 50 g OGTT values (b = 3.76; 95% CI: 0.21, 7.32; p = 0.04) and greater odds of GDM (OR = 2.36; 95% CI: 1.17, 4.77; p = 0.02). These associations were more pronounced among Non-Hispanic White women compared to Non-Hispanic Black women (p for interaction = 0.03) and potentially those with normal weight or underweight during early pregnancy compared to overweight or obese women (p for interaction = 0.08). Conclusions: Elevated inflammatory markers, particularly high-sensitivity IL6, in early pregnancy are linked to impaired glucose metabolism and increased GDM risk later in pregnancy. These relationships appeared stronger in Non-Hispanic White women and women with normal weight or underweight during early pregnancy, underscoring the potential to develop serology-based early identification and prevention strategies. Full article

Objective: This study assessed the efficacy of the cervical pessary combined with progesterone to prevent preterm birth in pregnant women with short cervix and previous preterm birth. Methods: This post hoc analysis of the randomized, multicenter P5 trial examined the efficacy of the cervical pessary associated with vaginal progesterone versus progesterone alone for preventing recurrent preterm birth in 155 pregnant women with cervical length ≤30 mm and prior spontaneous preterm birth (sPPTB) (main subgroup), and in 85 women with cervical length ≤25 mm and sPPTB (higher-risk population). The primary outcome was spontaneous preterm birth (sPTB) before 34 weeks; secondary outcomes included sPTB rates before 37, 32, and 28 weeks, analyzed using Odds Ratio (OR) and Kaplan–Meier curves. A secondary objective was to identify predictive factors for sPTB recurrence in the cohort with prior preterm birth (n = 479), irrespective of treatment allocation. Results: Demographic profiles were balanced between groups. The addition of a cervical pessary to progesterone did not result in a significant reduction in sPTB before 34 weeks: to cervix ≤30 mm, OR 1.169 (95% CI 0.524–2.609; p = 0.703) and 1.167 (95% CI 0.466–2.921; p = 0.742) for ≤25 mm; similar null findings were observed across all gestational age thresholds. Kaplan–Meier survival curves demonstrated no significant differences between groups (p > 0.05). Secondary analysis (n = 479) identified principal predictors of sPTB recurrence, regardless of the cervical length: higher education (OR 2.37; 95% CI 0.99–5.63; p = 0.024), previous cervical conization (OR 4.78; 95% CI 1.08–21.19; p = 0.039) previous low birth weight < 2.5 kg (OR 2.43; 95% CI 1.22–4.85; p = 0.051), prior miscarriages (OR 1.36; 95% CI 1.10–1.69; p = 0.005), current twin pregnancy (OR 14.86; 95% CI 4.35–50.68; p < 0.001) and cervical funneling (OR 3.60; 95% CI 1.79–7.24; p < 0.001). Predictive models achieved an AUC of 0.719, with 87.0% sensitivity and 58.8% specificity. Conclusions: These findings do not support the routine use of cervical pessary combined with progesterone in women with dual risk factors. In this Brazilian population, specific clinical and obstetric characteristics—including higher education, cervical funneling, prior low birth weight delivery, previous conization, current twin gestation, and prior miscarriage—could identify women at increased risk for recurrent preterm birth. Full article

In contemporary semiconductor manufacturing, wafer-handling robots are essential for achieving high-speed and high-precision wafer transportation. However, the demand for rapid motion and lightweight design introduces flexible transmission components that are prone to residual vibrations, which degrade positioning accuracy and system stability. To address this challenge, this paper proposes a vibration-suppression trajectory planning method based on the Gray Goose Optimization (GGO) algorithm. The proposed algorithm integrates grouped global search with local optimization capabilities, making it well suited for solving multi-objective optimization problems. Comparative tests conducted on eight randomly selected multimodal benchmark functions from the CEC2013 test suite verify the effectiveness and robustness of the GGO algorithm. Establishing a multi-objective function that considers both motion time and vibration energy enables the GGO algorithm to determine the switching time points of an S-shaped velocity profile, thereby generating smooth trajectories with continuous velocity and acceleration. By varying different initial conditions, the trade-off between motion time and vibration energy is systematically analyzed with respect to angular displacement, initial acceleration, and time-weighting factors. Simulation results indicate that the planned trajectories exhibit negligible displacement variation under zero-mean disturbances. The velocity error remains within 0.1 deg·s⁻¹, and the acceleration error is confined within 0.2 deg·s⁻². Consequently, Pareto-optimal solutions are successfully obtained with respect to both motion time and residual vibration energy. Full article

Cerebral palsy (CP) is a disorder frequently associated with respiratory and cardiac comorbidities, making the monitoring of heart rate (HR) and oxygen saturation (SpO₂) essential. This study examined the reliability and validity of Xiaomi Mi Band 6, compared with a clinical pulse oximeter, for measuring HR and SpO₂ in 35 children and adolescents with CP classified at GMFCS levels III–V. Mi Band 6 demonstrated good reliability for HR (ICC = 0.83), although the high measurement error (MDC₉₀ = 19.57 bpm) limits its usefulness for small physiological changes. SpO₂ results showed low reliability (ICC = 0.55) and substantial variability (MDC₉₀ = 18.85%), exceeding the clinically acceptable error margin of ±2–3%. Validity analyses revealed poor agreement between Mi Band 6 and clinical pulse oximeter for SpO₂, and moderate agreement for HR, with large variability in Bland–Altman analyses. Factors such involuntary movements, altered muscle tone, low body weight, and reflective sensors on the wrist may have affected the results. In conclusion, Xiaomi Mi Band 6 demonstrated good reliability and may be cautiously used for general HR monitoring, but it is not suitable for assessing SpO₂ in this pediatric population. Further research is needed to identify cost-effective and accurate wearable technologies. Full article

Coagulation is a physiological process necessary to achieve homeostasis. Many pathologies lead to spontaneous activation of the coagulation pathways and increase the risk of venous thrombosis (e.g., atrial fibrillation, orthopaedic surgery, cancer). Therefore, a lot of patients need anticoagulant drugs as preventive or curative treatment. In general, older molecules (unfractionated heparin, low-molecular-weight heparins, vitamin K antagonists) have good efficacy. Still, their adverse reactions, increased risk of bleeding, or difficult administration led to low adherence to treatment and had even limited their use. Recently, new molecules were authorised to improve patient adherence to treatment, mainly formulated for oral administration (e.g., dabigatran, rivaroxaban, apixaban, etc.). This therapeutic approach has a low risk of bleeding and does not require special monitoring by laboratory tests. Also, new anticoagulants for patients with heparin-induced thrombocytopenia (e.g., argatroban, lepirudin, bivalirudin, etc.) were obtained. Moreover, reversal agents for the new anticoagulant molecules used in overdoses or in situations where immediate cessation of the anticoagulant effect is required (e.g., emergency surgery) were studied, some of them being authorised on the pharmaceutical market. This narrative review aims to provide a pharmacological and therapeutic overview of anticoagulant drugs, underlining their implementation and limitations. Full article

Background: Overweight and metabolic disorders are strongly associated with gut microbiota dysbiosis. Probiotics represent a safe dietary strategy to improve metabolic health, although strain-specific effects remain unclear. This study evaluated the metabolic and gut microbiota-modulating effects of Lactobacillus helveticus (UA881) in overweight adults. Methods: In a randomized, double-blind, placebo-controlled trial, 50 overweight adults (Body mass index, BMI 25–27 kg/m²) were assigned to receive UA881 (5 × 10⁹ CFU/day) or placebo for 28 days. Anthropometric parameters, body composition, serum biochemical markers, inflammatory cytokines, fecal short-chain fatty acids (SCFAs), and gut microbiota composition (16S rRNA sequencing) were assessed at baseline and after 28 days. Statistical analyses included paired t-tests and ANCOVA adjusted for baseline values. Results: After 28 days of supplementation, UA881 significantly reduced body weight, BMI, and body fat mass. The primary endpoint, serum triglycerides, was significantly decreased, and the increases in uric acid, total cholesterol, and Low density lipoprotein-cholesterol (LDL-C) observed in the placebo group were attenuated. No significant changes were observed in interleukin-6 (IL-6) or tumor necrosis factor-α (TNF-α) levels. Fecal butanoic acid showed an increasing trend, and gut microbiota alpha diversity was significantly improved. At the genus level, Anaerostipes and Blautia were enriched, while Collinsella was reduced. Conclusions: A 28-day supplementation with L. helveticus UA881 (5 × 10⁹ CFU/day) improved body composition and lipid-related metabolic parameters and favorably modulated gut microbiota composition in overweight adults, supporting its potential as a probiotic candidate for metabolic health. Full article

In the era of growing demand for sustainable solutions in construction, increasing attention is being paid to the potential use of waste materials as components of building composites. This article presents the results of a study on the impact of ground polyurethane foam waste on the mechanical properties and durability of cement mortars. The waste, derived from industrial production processes, was used as a partial replacement for fine aggregates in various proportions. The analysis included bulk density, compressive and flexural strengths, water absorption, and resistance to freeze–thaw cycles. The results indicate that adding waste reduces the density of the mortar, which can be advantageous in applications requiring lightweight materials. The most favourable balance of strength retention, density reduction, and frost resistance was observed with a 1% addition, as the mortar maintained good mechanical performance and freeze–thaw durability while achieving reduced weight. Higher waste content (2–3%) led to significant deterioration of the mechanical properties due to increased porosity. All samples exhibited increased strength after 25 freeze–thaw cycles, possibly due to continued hydration under moist low-temperature conditions. The analysis of the microstructure of cement coatings with the addition of polyurethane foam enabled the explanation of the causes of the observed changes in physico-mechanical properties resulting from ageing factors. This study suggests that small amounts of waste can be effectively used to produce lightweight and environmentally friendly construction materials, supporting circular economy practices. Full article

Background: Human papillomavirus (HPV) infection is the necessary cause of almost all cervical cancers. HPV vaccination programs have been implemented worldwide, yet real-world evidence on vaccine effectiveness against invasive cervical cancer remains limited. Methods: We conducted a retrospective cohort study using synthetically generated data from a large health provider in Israel, including women who underwent a first Papanicolaou (Pap) test during 2014–2015. Their HPV-vaccination status before an index Pap test was obtained from computerized records. Incident cervical cancer and high-grade cervical pathology (cervical cancer, cervical intraepithelial neoplasia [CIN] 1–3, and carcinoma in situ) occurrence were examined through 2022. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models and fitted with propensity score weighting. Results: The cohort included 98,102 women, of whom 9198 (9.4%) were vaccinated against HPV before an index Pap test. While HPV-vaccinated women had a higher risk of cervical pathology compared with unvaccinated women, among women vaccinated before age 18, HPV vaccination was associated with a substantially lower, though not statistically significant, risk of cervical cancer (HR 0.28, 95% CI: 0.07–1.20, p = 0.087). Conclusions: In this large cohort, HPV vaccination was correlated with a higher risk of cervical pathology, likely reflecting residual confounding factors from sexual behavior and differential baseline risks of HPV infection. In contrast, vaccination during adolescence showed a marked trend toward a reduced risk of cervical cancer, consistent with international evidence that early vaccination, prior to HPV exposure, is the most effective preventative treatment. Full article

Urban vitality is a crucial indicator of a city’s sustainable development and the quality of life of its residents. Investigating the spatiotemporal patterns and influencing mechanisms of urban vitality is essential for optimizing the built-environment and improving governance. Using the central urban area of Guiyang, China, as a case study, this research integrates multi-source urban sensing data to investigate the spatiotemporal patterns of urban vitality and their driving factors. Geographically weighted regression (GWR) and machine learning combined with SHapley Additive exPlanations (SHAP) are applied to capture spatial heterogeneity, nonlinear relationships, and threshold effects among influencing variables. Results show that urban vitality exhibits a Y-shaped, single-core, multi-center, and clustered spatial configuration, with slightly higher intensity on weekdays and similar diurnal rhythms across weekdays and weekends. The effects of influencing factors display strong spatial non-stationarity, characterized by a concentric gradient radiating outward from the historic Laocheng core. Building density (BD), residential point density (RED), normalized difference vegetation index (NDVI), and road density (RD) emerge as the dominant contributors to urban vitality, while topographic conditions play a relatively minor role. The relationships between key landscape and built-environment variables and urban vitality are highly nonlinear, with distinct threshold effects. By integrating spatial econometric modeling and explainable machine learning, this study advances methodological approaches for urban vitality research and provides practical insights for landscape-oriented urban planning and human-centered spatial design. Full article

(1) Background: We aimed to determine rates of bacteremia and multidrug resistance (MDR) bacteremia and associated risk factors among neonates receiving parenteral nutrition (PN). (2) Methods: This is a multicenter study conducted in three neonatal intensive care units in Saudi Arabia, including 414 neonates who received PN. Associations were assessed using Chi-square or Fisher’s Exact tests when applicable and logistic regression analyses were conducted to determine factors predicting outcomes. Odds ratios with their 95% confidence intervals were computed, and a p value < 0.05 was considered statistically significant. (3) Results: PN was started within the first 10 days of life in 74.4% of cases. Fat emulsion was administered to 38.9% of the newborns. Blood cultures were positive in 24.9% of patients. Among the positive cultures, 4.9% were confirmed to have MDR bacteria. The mortality rate following bacteremia was 7.8%. The use of fat emulsion (p = 0.003), birth weight < 700 g (p < 0.001), and a gestational age within 27 weeks (p < 0.001) predicted bacteremia. (4) Conclusions: There was an association between the PN and bacteremia. Significant predictors of bacteremia were the use of fat emulsion, birth weight < 700 g, and a gestational age within 27 weeks. Full article