Search Results (2,727)

As an electric multiple unit (EMU) train passes through an extreme tunnel characterized by high altitude, steep gradient, and extended lengths, the pressure waves generated by the train–tunnel aerodynamic coupling combine with the baseline pressure variations within the tunnel. This interaction results in rapid fluctuations and extreme external pressure with higher amplitudes, which are transmitted into the carriage, causing pressure fluctuations that can adversely affect passenger comfort. These waves interact with multiple factors within the carriage, such as air ducts, airtight gaps, carbody deformation, oxygen supply systems, and temperature, creating a highly nonlinear internal pressure transmission system. This study first establishes a single-factor internal pressure fluctuation model. Subsequently, a multi-factor coupled internal pressure fluctuation model is constructed based on the ideal gas polytropic process assumption and the law of mass conservation. The model parameters are corrected and the model’s effectiveness and accuracy are validated using experimental data to predict and summarize the internal pressure variation patterns of the EMU train during dynamic operation in such tunnels, ensuring safe train operation and meeting the pressure comfort requirements of passengers. Finally, to address the challenges of maintaining and regulating multi-physical variable comfort under extreme tunnel conditions, this study investigates the impact of partial oxygen pressure and temperature on pressure fluctuations and comfort. The study finds that higher oxygen pressure and temperature significantly increase internal pressure fluctuation amplitude, with the oxygen supply system contributing 18.11% and temperature 5.74% of total variation. Thus, setting appropriate standards for oxygen supply, temperature, and valve operation is crucial for mitigating internal pressure fluctuations and enhancing safety and comfort. This research provides a theoretical foundation for developing a comprehensive comfort evaluation and regulation system under harsh environments. Full article

This study explores innovative methodologies for estimating the energy baseline (EnBL) of a university classroom building, emphasizing the critical roles of data quality and model selection in achieving accurate energy efficiency assessments. We compare time series models that are suitable for buildings with limited consumption data with univariate and multivariate regression models that incorporate additional variables, such as weather and occupancy. Furthermore, we investigate the advantages of dynamic simulation using the EnergyPlus engine (V5, USDOE United States) and Design Builder software v7, enabling scenario analysis for various operational conditions. Through a comprehensive case study at the UAO University Campus, we validate our models using daily monitoring data and statistical analysis in RStudio. Our findings reveal that model choice significantly influences energy consumption forecasts, leading to potential overestimations or underestimations of savings. By rigorously assessing statistical validation and error analysis results, we highlight the implications for decarbonization strategies in building design and operation. This research provides a valuable framework for selecting appropriate methodologies for energy baseline estimation, enhancing transparency and reliability in energy performance assessments. These contributions are particularly relevant for optimizing energy use and aligning with regulatory requirements in the pursuit of sustainable building practices. Full article

Background/Objectives: The objective of this study was to determine the results of fecal microbiota transplantation (FMT) from healthy lean subjects in patients with type 2 diabetes (T2D); Methods: We designed a phase II, randomized, single-blind, parallel-arm clinical trial. Twenty-one subjects (12 men [57.1%] and 9 women [42.9%]), who had previously signed an informed consent were randomized to FMT from lean donors, a probiotic (Lactobacillus delbrueckii spp. bulgaricus LB-14), or placebo. Mean age at baseline was 62.5 ± 5.8 years and mean body mass index (BMI) at baseline was approximately 32.4 ± 2.4 kg/m². Anthropometric measures, biochemical variables, oral glucose tolerance test (OGTT), and a stool microbiota analysis were performed (baseline, 4 and 12 weeks). The trial was conducted following the Declaration of Helsinki, Good Clinical Practice Guides (CPMP/ICH/135/95) and the current Spanish legislation regarding clinical trials (RD 223/2004).; Results: FMT changes occurred at the expense of the species found in the donor. No differences in weight, body mass index, HbA1c, or the results of the OGTT for glucose and insulin were found between groups after the intervention, although a decrease in uric acid was observed in the probiotic group (−0.5 mg/dL; p = 0.037) and a mild increase in HbA1c in the FMT group (+0.25%; p = 0.041); Conclusions: In our sample, neither FMT from healthy and lean donors nor a probiotic were effective in improving insulin sensitivity and HbA1c in patients with T2D. Full article

The sublethal toxic effects of pyriproxyfen, an insect juvenile hormone analog (JHA) insecticide, on the circulating metabolite balance in the Neotropical brown stink bug, Euschistus heros, one of the main agronomic pests in South America, were investigated. Our objectives were to evaluate changes in the baseline levels of lipids and carbohydrates, along with three selected micro-elements—nickel (Ni), copper (Cu), and zinc (Zn)—in the hemolymph of adult E. heros, following the application of a predetermined LC₃₀ of pyriproxyfen (single topical application) in fourth-instar nymphs (N4). Hemolymph was sampled using glass capillaries, with the resulting concentrations of lipids and carbohydrates determined through vanillin- and anthrone-positive reactions, respectively, and micro-element analysis was performed through total reflection X-ray fluorescence (TXRF) spectrometry. Lipids are the main and more stable energy metabolites for E. heros, with a proportion of 2:1 compared to carbohydrate levels. A remarkable sensitivity of carbohydrate levels to sublethal pyriproxyfen exposure, irrespective of sex, was observed. Baseline micro-element levels based on untreated control insects indicate sex-based differences in Ni and Zn, but not in Cu, concentrations. After insecticide exposure, the levels of these micro-elements were variable, with Ni and Zn generally decreasing and Cu decreasing in females but nearly doubling in males. The observed disproportion in lipids, carbohydrates, and inorganic micro-elements suggests potential physiological shifts triggered by pyriproxyfen activity in E. heros during late juvenile stages. Full article

Objectives: The aim of this research was to evaluate changes in body composition, adipokine levels, and dyslipidemia parameters in males with abdominal obesity following two distinct interventions: exercise alone and exercise combined with an ad libitum diet. Methods: This study included 44 males with abdominal obesity (mean age 34.7 ± 5.5 years, waist circumference [WC] 110.3 ± 8.5, BMI 32.0 ± 3.9), who were randomly assigned to three groups: an experimental group engaging in aerobic-resistance exercise (II, n = 16), an experimental group engaging in aerobic-resistance exercise combined with an ad libitum high-protein, low-glycemic index carbohydrate diet (III, n = 16), both interventions lasting 6 weeks, and a control group without interventions (I, n = 12). Body composition metrics (body mass index [BMI], waist circumference [WC], body fat [BF], abdominal fat [ABD]) and fat-free mass [FFM], along with biochemical blood analyses (irisin [IR], omentin [OMEN], glucose [GLU], insulin [INS], LDL- and HDL-cholesterol), were measured at baseline and after the 6-week intervention. The effects of the interventions on the analyzed variables across groups were assessed using mixed ANOVA tests with post-hoc comparisons. Effect size (ES) was also calculated using partial eta squared (ηp²). Results: The intervention in group III resulted in a significant decrease in IR (p < 0.01, ηp² = 0.03) by 41% and LDL-C (p < 0.01, ηp² = 0.02) by 14%. These effects were associated with a reduction in BF (p < 0.01, ηp² = 0.02) by 14%, ABD (p < 0.01, ηp² = 0.03) by 31%, and WC (p < 0.01, ηp² = 0.01) by 3%. In group II, decreases after 6 weeks of intervention were noted only in WC (p = 0.02, ηp² = 0.01) by 1% and in INS (p < 0.01, ηp² = 0.04) by 47%. No differences were found between groups. The use of low-glycemic index carbohydrates (p < 0.01, ηp² = 0.06) and increased protein intake (p < 0.01, ηp² = 0.30) led to changes in the fiber-to-energy value of the diet ratio (p < 0.01, ηp² = 0.18) and a reduction in dietary energy value (p < 0.01, ηp² = 0.13) by 23%, resulting in a greater energy deficit than in the II group. Conclusions: These findings highlight the effect of combining dietary and exercise interventions to achieve significant changes in body composition and metabolic parameters, even over a short period of intervention. Full article

Background/Objectives: Left ventricular diastolic dysfunction (LVDD) and elevated left ventricular filling pressure (LVFP) are strong predictors of clinical outcomes across various populations. However, their diagnostic utility in embolic stroke of undetermined source (ESUS) remains unclear. We hypothesized that LVDD with elevated LVFP (based on echocardiography) was more likely to be prevalent in ESUS compared to non-cardioembolic stroke (NCE) and to be associated with atrial fibrillation (AF) on follow-up monitoring. Methods: This is a single-center retrospective study that included adult patients with a diagnosis of acute ischemic stroke between January 2016 and June 2017. LV function was assessed by inpatient transthoracic echocardiogram (TTE), and stroke etiology was adjudicated by the neurologist per the consensus criteria. Patients with cardioembolic stroke and those with indeterminate diastolic function on TTE were excluded. Baseline patient characteristics and clinical variables were compared among patients with and without LVDD and elevated LVFP. Multivariable regression models were used to assess the associations between diastolic dysfunction, ESUS, and AF detection in ESUS patients. Results: We identified 509 patients with ESUS and NCE stroke who had reported diastolic function. The mean age was 64.19 years, 45.19% were female, and 146 had LVDD with available LVFP data. LVDD was not associated with ESUS (adjusted OR: 1.43, 95% CI: 0.90–2.27, p = 0.130) or atrial fibrillation (AF) detection on cardiac monitoring (adjusted OR: 1.88, 95% CI: 0.75–4.72, p = 0.179). However, LVDD with elevated LVFP was borderline associated with ESUS (adjusted OR: 2.17, 95% CI: 0.99–4.77, p = 0.054) and significantly associated with AF detection (adjusted OR: 3.59, 95% CI: 1.07–12.06, p = 0.038). Conclusions: Our data suggest that LVDD with elevated LVFP is borderline associated with ESUS and significantly associated with AF detection on follow-up cardiac monitoring. Therefore, the presence of LVDD with an increased probability of elevated LVFP may help identify a subset of stroke patients more likely to have ESUS, potentially due to atrial cardiopathy with underlying occult AF. Further studies are needed to confirm our findings and to evaluate the safety and efficacy of anticoagulation in patients with ESUS and LVDD with elevated LVFP. Full article

Digital gait monitoring is increasingly used to assess locomotion and fall risk. The aim of this work is to analyze the changes in the foot–floor contact sequences of Parkinson’s Disease (PD) patients in the year following the implantation of Deep Brain Stimulation (DBS). During their best-ON condition, 30 PD patients underwent gait analysis at baseline ($T_0$), at 3 months after subthalamic nucleus DBS neurosurgery ($T_1$), and at 12 months ($T_2$) after subthalamic nucleus DBS neurosurgery. Thirty age-matched controls underwent gait analysis once. Each subject was equipped with bilateral foot-switches and a 5 min walk was recorded, including both straight-line and turnings. The walking speed, turning time, stride time variability, percentage of atypical gait cycles, stance, swing, and double support duration were estimated. Overall, the gait performance of PD patients improved after DBS, as also confirmed by the decrease in their UPDRS-III scores from 19.4 ± 1.8 to 10.2 ± 1.0 ($T_0$ vs. $T_2$) (p < 0.001). In straight-line walking, the percentages of atypical cycles of PD on the more affected side were 11.1 ± 1.5% (at $T_0$), 3.1 ± 1.5% (at $T_1$), and 5.1 ± 2.4% (at $T_2$), while in controls it was 3.1 ± 1.3% (p < 0.0005). In turnings, this percentage was 13.7 ± 1.1% (at $T_0$), 7.8 ± 1.1% (at $T_1$), and 10.9 ± 1.8% (at $T_2$), while in controls it was 8.1 ± 1.0% (p < 0.001). Therefore, in straight-line walking, the atypical cycles decreased by 72% at $T_1$, and by 54% at $T_2$ (with respect to baseline), while, in turnings, atypical cycles decreased by 43% at $T_1$, and by 20% at $T_2$. The percentage of atypical gait cycles proved an informative digital biomarker for quantifying PD gait changes after DBS, both in straight-line paths and turnings. Full article

Background: Patients suffering from coronavirus disease-19 (COVID-19)-related interstitial pneumonia have variable outcomes, and the risk factors for a more severe course have yet to be comprehensively identified. Cohort studies have suggested that coronary artery calcium (CAC), as estimated at chest computed tomography (CT) scan, correlated with patient outcomes. However, given that the prevalence of CAC is gender- and age-dependent, the influence of baseline confounders cannot be completely excluded. Methods: We designed a retrospective, multicenter case-control study including patients with COVID-19, with severe course cases selected based on death within 30 days or requiring invasive ventilation, whereas controls were age- and sex-matched patients surviving up to 30 days without invasive ventilation. The primary outcome was the analysis of moderate-to-severe CAC prevalence between cases and controls. Results: A total of 65 cases and 130 controls were included in the study. Cases had a significantly higher median pulmonary severity score at chest CT scan compared to controls (10 vs. 8, respectively; p = 0.0001), as well as a higher CAC score (5 vs. 2; p = 0.009). The prevalence of moderate-to-severe CAC in cases was significantly greater (41.5% vs. 23.8%; p = 0.013), a difference mainly driven by a higher prevalence in those who died within 30 days (p = 0.000), rather than those requiring invasive ventilation (p = 0.847). White blood cell count, moderate-to-severe CAC, the need for antibiotic therapy, and severe pneumonia at CT scan were independent primary endpoint predictors. Conclusions: This case-control study demonstrated that the CAC burden was higher in COVID-19 patients who did not survive 30 days or who required mechanical ventilation, and CAC played an independent prognostic role. Full article

Background: Eosinophilic oesophagitis (EoE) is an immune-mediated oesophageal disorder causing dysphagia. Patients with EoE experience reduced QoL due to symptoms; however, this has not been assessed in the New Zealand population. The aim of this study was to assess QoL in patients with EoE in New Zealand. Methods: This observational study recruited participants from two New Zealand hospitals. Records were reviewed to confirm diagnoses, and consenting participants completed an electronic survey, consisting of the Dysphagia Symptom Questionnaire (DSQ) score and the QoL-specific EoE (EoE-QoL-A) questionnaire score. Correlation analysis examined the relationship between the DSQ and EoE-QoL-A scores. Differences in baseline variables were assessed. Univariate logistic regression assessed the association of variables with disease activity and QoL. Results: Fifty-four participants responded, and four were excluded due to incomplete surveys. The majority (76%) were male, and the median age was 47 years (IQR 42–58). The median DSQ was 49 (IQR 0–60), and the median EoE-QoL-A score was 68 (IQR 48–80). A reduced EoE-QoL-A score was associated with active disease (OR = 0.96,95% CI 0.926–0.995). Significant associations were found between disease activity and overall EoE-QoL-A score (r = −0.37, p < 0.01) as well as the sub-categories eating and diet (r = −0.54, p < 0.001), social (r = 0.30, p < 0.05), and emotional impact (r = −0.44, p < 0.01). The EOE-QoL-A score was higher in those on PPI (75 vs. 60, p = 0.02). Conclusion: This study identified a decreased quality of life (QoL) in individuals with EoE in New Zealand, aligning with international literature. The increased DSQ scores suggest a possible gap in current management approaches. The correlation between the DSQ and QoL highlights the need for improved care models of care for EoE. Full article

Investigating the spatial-temporal evolutionary trends of future temperature and precipitation considering various emission scenarios is crucial for developing effective responses to climate change. However, researchers in Iraq have not treated this issue under CMIP6 in much detail. This research aims to examine the spatiotemporal characteristics of temperature and rainfall in northern Iraq by applying LARS-WG (8) under CMIP6 general circulation models (GCMs). Five GCMs (ACCESS-ESM1-5, CNRM-CM6-1, MPI-ESM1-2-LR, HadGEM3-GC31-LL, and MRI-ESM2-0) and two emissions scenarios (SSP245 and SSP585) were applied to project the upcoming climate variables for the period from 2021 to 2040. The research relied on satellite data from fifteen weather sites spread over northern Iraq from 1985 to 2015 to calibrate and validate the LARS-WG model. Analysis of spatial-temporal evolutionary trends of future temperature and precipitation compared with the baseline period revealed that seasonal mean temperatures will increase throughout the year for both scenarios. However, the SSP585 scenario reveals the highest increase during autumn when the spatial coverage of class (15–20) °C increased from 27.7 to 96.29%. At the same time, the average seasonal rainfall will rise in all seasons for both scenarios except autumn for the SSP585 scenario. The highest rainfall increment percentage is obtained using the SSP585 for class (120–140) mm during winter. The spatial extent of the class increased from 25.49 to 50.19%. Full article

(1) Background: Does the variation in sequential development times of embryos, observed through time-lapse monitoring, between the two study groups play a role in predicting pregnancy success? (2) Methods: The prospective double-arm study was to identify the morphokinetic parameters specific to embryos that were capable of implanting and were conducted on 89 embryos cultured in the Esco Miri time-lapse incubator, divided into two groups: Lot A, consisting of 57 embryos that successfully implanted and resulted in life birth rate (LBR), and Lot B (NLB), comprising 32 embryos that did not implant, leading to a negative beta-hCG outcome. (3) Results: Baseline characteristics, including female age, were not found to be statistically significant (p > 0.01). In contrast, there is a highly statistically significant difference concerning oocytes (p = 0.0029). Morphokinetic variables represented by sequential culture times were not statistically significant (p > 0.01) when comparing the two groups. However, the negative mean differences between these parameters suggest that the times for Lot A are better (shorter) than those for Lot B. While not statistically significant, these differences may still have practical significance. In the case of grading, the difference is considered to be extremely statistically significant (p < 0.01). (4) Conclusions: Although there are no statistically significant differences in sequential timings (p > 0.01) between the two groups, there are parameters indicating predictive potential for exploring pregnancy in embryo morphokinetics. Full article

Demand and market value for pennywort largely depend on the quality of the leaves, which can be affected by various ambient environment or fertigation variables during cultivation. Although early detection of defects in pennywort leaves would enable growers to take quick action, conventional manual detection is laborious and time consuming as well as subjective. Therefore, the objective of this study was to develop an automatic leaf defect detection algorithm for pennywort plants grown under controlled environment conditions, using machine vision and deep learning techniques. Leaf images were captured from pennywort plants grown in an ebb-and-flow hydroponic system under fluorescent light conditions in a controlled plant factory environment. Physically or biologically damaged leaves (e.g., curled, creased, discolored, misshapen, or brown spotted) were classified as defective leaves. Images were annotated using an online tool, and Mask R-CNN models were implemented with the integrated attention mechanisms, convolutional block attention module (CBAM) and coordinate attention (CA) and compared for improved image feature extraction. Transfer learning was employed to train the model with a smaller dataset, effectively reducing processing time. The improved models demonstrated significant advancements in accuracy and precision, with the CA-augmented model achieving the highest metrics, including a mean average precision (mAP) of 0.931 and an accuracy of 0.937. These enhancements enabled more precise localization and classification of leaf defects, outperforming the baseline Mask R-CNN model in complex visual recognition tasks. The final model was robust, effectively distinguishing defective leaves in challenging scenarios, making it highly suitable for applications in precision agriculture. Future research can build on this modeling framework, exploring additional variables to identify specific leaf abnormalities at earlier growth stages, which is crucial for production quality assurance. Full article

Background: In response to the COVID-19 pandemic, the European Association of Urology (EAU) Guidelines defined priority groups to guide the prioritization of surgery for urological malignancies. The objective of this study was to evaluate the impact of the COVID-19 prioritization recommendations on tumor pathological characteristics in a real-world setting at our academic referral institution. Methods: We compared baseline and pathological tumor features of all patients with urological malignancies treated during the pandemic period (2020–2021) versus in the post-pandemic period (2022–2023). Our institution adhered to the international recommendations and prioritized those cases defined as “high-risk”. Results: Data from 9196 patients treated for urological malignancies were reviewed and grouped according to period of surgery (4401 in the pandemic period vs. 4785 in the post-pandemic period). The overall number of surgical procedures was comparable for all diseases except for the number of radical prostatectomies (1117 vs. 1405; p = 0.03) and partial nephrectomies (609 vs. 759; p = 0.02), which were significantly lower in the pandemic period. Regarding tumor pathological features, none of the recorded variables were found to differ according to period of surgery, including disease stage, tumor grading, presence of necrosis, lymphovascular invasion, and histological variants. Conclusions: A correct policy of prioritization of oncological pathologies during emergency periods and a centralization of oncological cases in reference centers reduce the possible risk of worsening cancer disease features related to the reorganization of healthcare resources. Full article

In the scenario of power system monitoring, detecting the operating status of circuit breakers is often inaccurate due to variable object scales and background interference. This paper introduces DLCH-YOLO, an object detection algorithm aimed at identifying the operating status of circuit breakers. Firstly, we propose a novel C2f_DLKA module based on Deformable Large Kernel Attention. This module adapts to objects of varying scales within a large receptive field, thereby more effectively extracting multi-scale features. Secondly, we propose a Semantic Screening Feature Pyramid Network designed to fuse multi-scale features. By filtering low-level semantic information, it effectively suppresses background interference to enhance localization accuracy. Finally, the feature extraction network incorporates Generalized-Sparse Convolution, which combines depth-wise separable convolution and channel mixing operations, reducing computational load. The DLCH-YOLO algorithm achieved a 91.8% mAP on our self-built power equipment dataset, representing a 4.7% improvement over the baseline network Yolov8. With its superior detection accuracy and real-time performance, DLCH-YOLO outperforms mainstream detection algorithms. This algorithm provides an efficient and viable solution for circuit breaker status detection. Full article

Background: Graft-versus-host disease (GvHD) is an overactive systemic inflammatory response that can arise following allogeneic hematopoietic stem cell transplantation (HSCT). This condition occurs when the transplanted donor immune cells recognize the recipient’s tissues as foreign and trigger an immune response against them. The ocular surface (eyelids, conjunctiva, meibomian glands, lacrimal glands, and cornea) is particularly involved in GvHD, and its response to existing treatments, including potent immunosuppressants and new targeted therapies, is undesirable, with such treatments often being ineffective. Human allogeneic umbilical cord blood platelet lysate stands out as a potent adjunct to conventional therapies for ocular surface disorders related to severe Dry Eye Disease. This study aimed to evaluate the safety and efficacy of umbilical cord blood platelet lysate eyedrops for the treatment of severe ocular surface disorders in graft-versus-host disease patients who have received previous unsuccessful treatments. Methods: This study was a prospective, non-comparative, interventional case series study involving 22 patients (10 females and 12 males) aged 25–46 years with severe ocular surface disorders that were unresponsive to standard treatments. The GvHD patients were categorized based on the severity of their ocular surface disorders into three groups: Group I: five patients with severe Dry Eye Disease and filamentary keratitis; Group II: eight patients suffering from severe blepharo-kerato-epitheliopathy; Group III: nine patients with corneal ulcers. Fresh umbilical cord blood (UCB) was obtained from healthy donors and subjected to centrifugation using a novel PRP preparation kit provided by Sciacca (AG) Cord blood bank, Italy in a one-step process. In all groups, the outcomes before and after treatment were evaluated by means of the OSDI (Ocular Surface Disease Index), SANDE (Symptom Assessment in Dry Eye) questionnaire, VAS (Visual Analogue Scale), slit lamp examination, Esthesiometry, Lissamine Green Staining, the NIBUT (Non-Invasive Break-Up Time) and BUT, fluorescein staining with digital photography and Oxford classification, the Schirmer Test, the Best Corrected Visual Acuity (BCVA), and Meibography. In Group III at each evaluation time, the size of the ulcer and its relative reduction compared to the baseline size were recorded. Clinical variables, such as corneal inflammation, conjunctivalization, corneal neovascularization, or pain, were also considered individually. Results: We observed a significant improvement in the SANDE, VAS, and OSDI scores; Schirmer Test; BUT; BCVA; and Oxford classification after treatment with allogeneic cord blood serum eyedrops. Nevertheless, pain and inflammation reduced markedly over time until complete healing in all cases. The mean reduction in the ulcer surface area (compared to baseline values) was significantly higher at all assessment points (p = 0.001 for day 7 and p < 0.001 for subsequent time points every 30 days for 90 days). At the last check-up (after 90 days of treatment), the number of ulcers (Group III, nine patients) with a reduction in size of greater than 50% was eight (88.8%), of which seven ulcers were completely healed. None of the patients experienced treatment-related local or systemic adverse events. In this study, using a relatively large number of cases, we demonstrated that the use of umbilical cord blood platelet lysate eyedrops is a safe, feasible, and effective curative approach for severe ocular surface disease in patients with GvHD. Conclusions: Our pilot study highlights the remarkable effectiveness of allogeneic cord blood serum eyedrops in patients with severe ocular surface disorders following GvHD who have shown an inadequate response to the usual treatments. It is mandatory to design future studies on the efficacy of this therapeutic approach for acute ocular, mucosal, and cutaneous GvHD. Full article