Search Results (8,435)

An assessment method for sustainability was developed by the authors in a previous article. Many social sustainability assessment methods rely on assessors’ subjective judgments, which can be problematic. This study aims to examine the level of consensus different assessors can achieve using various assessment methods and to compare their results with an assessment made by one of the authors, to reduce subjectivity. A selective sample of engineering students from Karlstad University were surveyed to test and compare three as-assessment methods against the initial assessment. The three methods are: Woxnerud’s (the authors’) method, Jan Gehl’s twelve quality criteria, and a structured survey. Seven student groups conducted the first assessment, followed by 12 individual students who performed the second and third assessments. The objectives were to determine whether multiple assessors could reach a consensus using each method, identify which method yielded the most consensus and was most effectively implemented, and measure each method’s consonance rate in relation to Woxnerud’s initial assessment. The first method achieved a 75.0% assessor consensus and 98.4% consonance. The second method achieved a 67.0% assessor consensus and 75.0% consonance. The third method achieved a 50% assessor consensus and 91.0% consonance. This limited study suggests that a subjective method, such as an assessment method for social sustainability, can yield somewhat similar results, and in addition, Woxnerud’s method is more objectively applicable than the two other methods tested in this article. Full article

Online social media (OSM) has revolutionized the manner in which communication unfolds, enabling users to spontaneously generate, disseminate, share, and aggregate multimedia data across the internet. Nevertheless, in this exchange of information, OSM platforms assume a dominant, central role, wielding excessive power. Blockchain online social media (BOSM) seeks to mitigate the drawbacks of traditional centralized OSM by leveraging the decentralized nature of blockchain technology, migrating the functionalities of social media into a decentralized realm, and positioning the users at the core of the OSM ecosystem. However, current BOSM models often rely on tokens for incentives and are hampered by the centralized, inefficient blockchain consensus mechanisms, alongside vulnerabilities such as collusion attacks. This paper introduces a novel blockchain system, NexoNet, tailored for decentralized social media, exploring the application of blockchain technology in the realm of online social media from both technical and economic perspectives. The NexoNet quantifies and evaluates user participation within the system, employing a multiple incentive mechanism to equitably distribute value created by users without the need for tokens. Furthermore, we propose the Proof-of-Active-Participation (PoAP) blockchain consensus mechanism, enabling all users to partake in the maintenance of the blockchain system, thus ensuring its security and efficiency. Theoretical analysis and simulations across various scenarios demonstrate that the NexoNet, with extensive user engagement, achieves equitable value distribution through its multiple incentive mechanism. It successfully safeguards against a spectrum of malicious attacks and attains high transaction processing efficiency. The simulation results show that NexoNet achieves an average transaction throughput of 2000 transactions per second (TPS) and a consensus delay of 2.385 s with 100 maintainers in the network. Furthermore, our tests demonstrated that even collusion with users comprising 75% of the total would only allow an additional 30 chances to propose a block. By deeply integrating user behavior with the underlying mechanisms of the blockchain system, the NexoNet fosters a user-centric blockchain social media ecosystem. Full article

(1) Background: Glioblastoma (GBM) is the most common malignant brain tumor in adults. Due to a lack of level 1 evidence, there is no clear consensus on the optimal extent of resection to improve overall survival. This umbrella review aggregates existing meta-analyses (MAs) to assess overall survival in patients undergoing subtotal resection (STR) versus gross total resection (GTR). (2) Methods: A systematic search of PubMed, Scopus, and Web of Science identified 441 studies, with four MAs meeting inclusion criteria. Data were analyzed using the metaumbrella R package, focusing on overall survival. Quality was assessed using AMSTAR2, with scores ranging from 0 to 11. The Ioannidis criteria were applied to evaluate the credibility of the evidence. (3) Results: The quality assessment rated all four studies highly, with a mean AMSTAR2 score of 10.25. The pooled analysis revealed a significant survival advantage for GTR over STR. However, the Ioannidis classification graded the evidence as Class III, indicating weak credibility. (4) Conclusions: GTR offers a slight survival benefit over STR in GBM patients, but the credibility of the evidence is weak, highlighting the need for further research. Full article

A distributed improved robust integral line-of-sight (RILOS) guidance-based sliding mode controller is designed for multiple underactuated autonomous surface vessels (ASVs) to perform cooperative maritime search operations. First, a parallel circle search pattern is designed based on the detection range of ASVs, which can provide the reference formation shape. Second, an improved RILOS method is presented by introducing an integral term into the improved robust LOS method, which can counteract the disadvantageous effect of the unknown sideslip angle and kinematic discrepancy simultaneously. Third, distributed improved RILOS guidance is presented by integrating the extended second-order consensus algorithm into the improved RILOS method; then, the desired heading angle and desired velocity are generated for the control system simultaneously. Finally, the fuzzy logic system is integrated into the sliding mode control (SMC) method to approximate the unknown nonlinear function; then, a distributed improved RILOS guidance-based SMC controller is presented for multiple ASVs. The close-loop signals are proved to be stable by the Lyapunov theory. The effectiveness of the presented method is verified by multiple simulations. Full article

Circulating tumor DNA (ctDNA) is a promising cancer biomarker, but accurately detecting tumor mutations in cell-free DNA (cfDNA) is challenging due to their low frequency and sequencing errors. Our study benchmarked Mutect2, VarScan2, shearwater, and DREAMS-vc using deep targeted sequencing of cfDNA with Unique Molecular Identifiers (UMIs) from 111 colorectal cancer patients. Performance was assessed at both the mutation level (distinguish tumor variants from errors) and the sample level (detect if an individual has cancer). Additionally, we investigated the effects of various UMI grouping and consensus strategies. The shearwater-AND variant calling method demonstrated the highest precision in detecting tumor-derived mutations from plasma, and reached the highest ROC-AUC of 0.984 for sample classification in tumor-informed cfDNA analyses. DREAMS-vc exhibited the highest ROC-AUC of 0.808 for sample classification in tumor-agnostic studies. We also found that sequencing depth differences in PBMCs could lead to false positives, particularly with VarScan2 and Mutect2, which was addressed by downsampling to equivalent mean depths. Additionally, network-based UMI grouping methods outperformed those using identical UMIs when all reads were retained. Our findings emphasize that the optimal variant caller depends on the study context—whether focused on mutation or sample classification, and whether conducted under tumor-informed or tumor-agnostic conditions. Full article

Residual rights are the right to choose asset uses not specified in the contract. They are essential in situations of uncertainty. The current energy transition presents a greater variety of assets. Moreover, it is impossible to anticipate all relevant states that the assets and the environment can embody, making it impossible to optimize them contractually. Furthermore, there is consensus that the transition must occur quickly, which means high levels of investment in new specific assets. How should we distribute property rights to maximize social benefits in a context with specific and dispersed assets? Because of the complementarity between network and distributed resources, this article questions the premise that deverticalization is invariably beneficial to consumers and argues for the need to revise the concept of network and develop the regulatory implications of such a reconceptualization. We defend the need to evaluate alternative network concepts considering the technological repertoire available to operationalize them. When considering the technological repertoire available today, characterized by the competitiveness of information and communications technology (ICT) and distributed resources, we should recognize the inherently incomplete nature of the contracts signed between network operators and users. Full article

Background: The surgical treatment of adolescent idiopathic scoliosis (AIS) is influenced by factors such as skeletal maturity, curve magnitude, progression, and spinal flexibility. The assessment of spinal flexibility is crucial for surgical planning; supine bending radiographs are commonly used but there is no consensus on the optimal technique. Fulcrum bending radiographs (FBRs) have shown better prediction of post-surgery correction compared to supine bending radiographs. New radiological techniques allow a significant reduction in radiation exposure. This study aims to compare spinal flexibility assessment and radiation exposure between FBRs and standing side-bending radiographs (SSRs) using biplanar stereoradiography. Materials and Methods: Twenty-five consecutive AIS patients scheduled for surgery were included in this prospective cohort study. Exclusion criteria were non-idiopathic etiology, age younger than 12 years, and older than 18 years. Pre-surgery FBRs and SSRs were performed, and the Cobb angles were measured. Flexibility and correction rates were calculated. Dose–area products (DAPs) were recorded. Statistical analysis was conducted using the Wilcoxon signed-rank test and Spearman correlation. Results: The mean pre-surgery Cobb angle of the thoracic curve was 66.3°. The FBR was superior to SSR for assessing flexibility for thoracic curves and provided a better prediction for post-surgery correction. There was no significant difference in lumbar curves between FBR and SSR. The mean DAP for SSRs was 0.81 Gy*cm² compared to 3.42 Gy*cm² for FBR, indicating a lower radiation exposure using SSRs. Conclusions: FBRs are superior for flexibility assessment of thoracic curves in AIS and offers a better prediction of post-surgery correction compared to SSRs. However, FBR is associated with a higher radiation exposure. Full article

Introduction: The assessment of bowel function in patients with Hirschsprung disease (HD) remains controversial, as several different bowel function scores are used in the literature and are therefore not suitable for reliable comparison. Conference Section: The OASIS-Holistic Care in Hirschsprung Disease Network Group addressed this issue and evaluated the most commonly used scores for their utility in HD patients. Scoping Review and Expert Group Consensus were performed. It was agreed that the ideal score for patients with Hirschsprung disease should be a comprehensive, validated score that allows reliable assessment of bowel function and continence, depicts changes according to management and natural history, and quantifies baseline parameters. This score should also enable comparisons of bowel function in patients born with HD worldwide. Concluding Remarks: The OASIS-Holistic Care in Hirschsprung Disease Network Group agreed that this ideal score does not yet exist and is therefore a future goal of the group. Meanwhile, clinicians should use a score for comparable, standardized, objective assessment, and the Rintala Score is suggested. Future developments may also lead to easily accessible patient-reported outcome measures and semi-automated dashboards that allow automated data extraction from electronic health records. Full article

This study presents an integrated system for object recognition, six-degrees-of-freedom pose estimation, and dexterous manipulation using a JACO robotic arm with an Intel RealSense D435 camera. This system is designed to automate the manipulation of industrial valves by capturing point clouds (PCs) from multiple perspectives to improve the accuracy of pose estimation. The object recognition module includes scene segmentation, geometric primitives recognition, model recognition, and a color-based clustering and integration approach enhanced by a dynamic cluster merging algorithm. Pose estimation is achieved using the random sample consensus algorithm, which predicts position and orientation. The system was tested within a 60° field of view, which extended in all directions in front of the object. The experimental results show that the system performs reliably within acceptable error thresholds for both position and orientation when the objects are within a ±15° range of the camera’s direct view. However, errors increased with more extreme object orientations and distances, particularly when estimating the orientation of ball valves. A zone-based dexterous manipulation strategy was developed to overcome these challenges, where the system adjusts the camera position for optimal conditions. This approach mitigates larger errors in difficult scenarios, enhancing overall system reliability. The key contributions of this research include a novel method for improving object recognition and pose estimation, a technique for increasing the accuracy of pose estimation, and the development of a robot motion model for dexterous manipulation in industrial settings. Full article

Local ecological knowledge has been shown to convey key information about elusive mammal species. Many of Africa’s nocturnal mammals are not yet considered globally threatened, yet behavioural ecology and population trends across their diverse ranges remain effectively unknown. We conducted semi-structured oral and visual interviews with eight groups of Ba’Aka in three villages (n = 53 males; n = 17 females) using trigger cards, to gain insights into beliefs about nocturnal mammals in the Central African Republic (CAR). We aimed to (1) explore the presence and local knowledge of nocturnal mammals; (2) determine cultural attitudes regarding nocturnal species; and (3) report on Traditional Ecological Knowledge (TEK) in the CAR. Using trigger cards, interviewees identified nine nocturnal mammals. Frequency of key words was measured and presented in word clouds, depicting that angwantibos (Arctocebus aureus) (n = 14), genets (Genetta spp.) (n = 11) and tree hyrax (Dendrohyrax dorsalis) (n = 6) were strongly associated with the supernatural (witchcraft; spiritual protection). The traditional uses of cryptic nocturnal mammals in Ba’Aka culture, including as meat and medicine, may affect the conservation of these species. We suggest a need to protect and include nocturnal mammals with unknown or decreasing populations in wildlife management strategies and community conservation programmes. Full article

Objective: We examined the effects of eight weeks of single-mode resistance, repeated sprint training, and the combination of the two programs on selected measures of physical fitness (muscle power, speed, and body composition), hematological parameters, and plasma volume variations in highly trained soccer players. Sixty male soccer players from the Tunisian national Ligue were randomly allocated to a resistance training group (RTG), a repeated sprint training group (RSTG), a combined resistance and repeated sprint training group (CTG), or an active control group (CG, soccer training only). The training volumes were similar between groups. Before and after training, we examined body composition, squat jump (SJ), countermovement jump (CMJ), sprint 30 m (S30), repeated-sprint sequences (RSSs), hematocrit, hemoglobin, mean hemoglobin concentration (MHC), and plasma volume. Significant group-by-time interactions were recorded for the RSS indices, SJ, and S30 (p < 0.039], 0.1< ηp² < 0.49]), as well as the hematological parameters (p = 0.0001–0.045, 0.11 < ηp² < 0.46). In terms of physical fitness, using post hoc tests, the CTG showed significantly greater gains compared to the RSTG, RTG, and the CG on the best time index of the RSSs (p = 0.008; d = 4.1), SJ (p = 0.004; d = 4.18) and 30 m linear sprint time (p = 0.008; d = 3.84). Body fat percentage also decreased significantly in the CTG compared to all other groups (p < 0.005, 0.21 < d< 0.35). Regarding hematological parameters (i.e., hemoglobin and hematocrit), the CTG, RSTG, and RTG showed significant decreases (p < 0.05) in their hemoglobin and hematocrit values compared to the CG (p < 0.05, 0.11 < d< 2.22]). Eight weeks of combined training compared to single-mode training was found to be more effective in improving fitness measures in highly trained soccer players. However, there appeared to be no consensus regarding the effect of single and combined repeated-sprint and resistance training on the hematological system. Full article

Human epidermal growth factor receptor 2-positive (HER2+) breast cancer is an aggressive subtype of breast cancer associated with a poor prognosis when sub-optimally treated. Recent advances include new and effective targeted therapies that have significantly improved outcomes for patients. Despite these advances, there are significant gaps across Canada, underscoring the need for evidence-based consensus guidance to inform treatment decisions. Addressing these gaps is crucial to ensuring that effective therapies are integrated into clinical practice, so as to improve the lives of patients affected by this aggressive form of breast cancer. The Research Excellence, Active Leadership (REAL) Canadian Breast Cancer Alliance is a standing nucleus committee of clinical-academic oncologists across Canada and Breast Cancer Canada, a patient organization. The mandate of this group is to provide evidence-based guidance on best practices in the management of patients with breast cancer. These consensus recommendations were developed using a modified Delphi process with up to three rounds of anonymous voting. Consensus was defined a priori as ≥75% of voters agreeing with the recommendation as written. There are 9 recommendations in the early setting; 7 recommendations in the metastatic setting; and 10 recommendations for patients with brain metastases. Full article

Unmanned aerial vehicles (UAVs) can collaborate as teams to accomplish diverse mission objectives, such as target search and tracking. This paper introduces a method that leverages accumulated target-density information over the course of a UAV mission to adapt path-planning rewards, guiding UAVs toward areas with a higher likelihood of target presence. The target density is modeled using a Gaussian process, which is iteratively updated as the UAVs search the environment. Unlike conventional search algorithms that prioritize unexplored regions, this approach incentivizes revisiting target-rich areas. The target-density information is shared across UAVs using decentralized consensus filters, enabling cooperative path selection that balances the exploration of uncertain regions with the exploitation of known high-density areas. The framework presented in this paper provides an adaptive cooperative search method that can quickly develop an understanding of the region’s target-dense areas, helping UAVs refine their search. Through Monte Carlo simulations, we demonstrate this method in both a 2D grid region and road networks, showing up to a 26% improvement in target density estimates. Full article

Background/Objectives: Gastrointestinal functional disorders (GFDs), including irritable bowel syndrome (IBS), are imbalances in the gut–brain axis characterized by persistence of symptoms in the abdominal area. Probiotics are live microorganisms that provide benefits to the health of their hosts when administered in adequate amounts, while prebiotics are a substrate that is selectively used by host microorganisms. This narrative review aimed to evaluate the effectiveness of prebiotics and probiotics mostly in irritable bowel syndrome, particularly on issues such as the interaction between these products and the gut microbiota, the duration of supplementation and long-term effects, the definition of ideal dosages, and the regulation and quality control of these products. Methods: A bibliographic search was carried out in indexed databases and articles published within 10 years before the beginning of the study and publications in English language, which investigated the specific theme of the study were considered. Papers dealing with topics not covered by the research questions, or presenting errors related with the wrong population or the wrong methods, as well as experimental studies and case reviews were excluded. Fifty-five articles were selected, initially in isolation by the authors and, afterward, under consensus. Results: It was possible to observe the effectiveness mainly of probiotics, in improving specific symptoms of the respective disorder; however, the available data remain unclear due to limitations concerning samples and methods of the studies evaluated. Conclusions: Despite evidence suggestive of therapeutic efficacy, additional multicenter randomized controlled trials (RCTs) with better defined protocols are still necessary to fill in the gaps in this subject, define measures to ensure the safe administration of these products, and confirm their therapeutic potential. Full article

Asymptomatic primary hyperparathyroidism (PHPT) involves 80–90% of the parathyroid tumor-associated cases of PHPT in the modern medical era, while normocalcemic PHPT (NPHPT) has a prevalence of 0.1–11%. We aimed to analyze the bone status and mineral metabolism in NPHPT amid conservative or surgical management. In this narrative review, we searched PubMed (between January 2020 and July 2024) via different keywords. Fourteen studies from the final analysis (388 patients with NPHPT; 1188 with PHPT; and 803 controls) showed that mean serum calcium levels varied between 2.57 and 2.26 mmol/L in NPHPT. Ten studies identified a similar 24 h urinary calcium in NPHPT versus hypercalcemic PHPT (HPHPT). Except for one study, a mandatory vitamin D analysis was performed, but the 25-hydroxyvitamin D cut-offs varied. Osteoporosis (n = 6 studies; N = 172 with NPHPT) was confirmed in 41.7–100% of NPHPT subjects. In surgery candidates, this rate might be overestimated. A DXA analysis was performed in eight studies (235 subjects with NPHPT, and 455 patients with HPHPT); two studies identified a lower BMD in HPHPT < NPHPT, but the results were not homogenous. A single study analyzed the TBS and found similar results in NPHPT. The prevalence of fractures (n = 9) varied between 7.4% and 42.8% in NPHPT. Bone turnover markers (N = 262 patients, n = 8 studies) showed lower bone formation markers in NPHPT versus PHPT (n = 3). Two studies analyzed the BMD and bone turnover markers following parathyroidectomy (161 patients, including 30 patients with NPHPT; mean ages over 60 years). To conclude, given the wide spectrum of complications associated with PHPT, an early diagnosis and proper management is essential. A more extensive screening in patients with osteoporosis and kidney stones might lead to the discovery of NPHPT, a more recently described form of PHPT. While it is still unclear whether NPHPT is an early stage of HPHPT or a separate entity, recent findings show similar osteoporosis and fracture occurrence, and an improvement in bone metabolism, following parathyroidectomy. More extensive prospective studies are crucial to understand the natural course of the disease, to reach a consensus regarding parathyroidectomy indications and surgery candidates’ selection, and to ensure proper personalized management for these patients. With the evolving diagnosis methods, PHPT has become a condition with a changing clinical presentation, which now requires modern evaluation and treatment approaches. Full article