Abstract: Near-seabed contact operations with underwater hexapod robots can require one leg to execute a contact task, which reduces the stability of the remaining asymmetric five-legged support. To address this problem, this study proposes a five-legged asymmetric coordinated stability control method that integrates gait rhythm planning with attitude feedback. The method decouples the left middle leg from support, propulsion and CPG phase evolution to form a “5+1” asymmetric support base. This configuration reduces the periodic influence of task-induced disturbances on body balance. Meanwhile, a five-legged Hopf-CPG rhythm maintains continuous gait under asymmetric support. Low-bandwidth attitude feedback modulation is introduced between the CPG-generated foot trajectory and the inverse-kinematics input to balance attitude correction with foot-contact continuity. Full-degree-of-freedom underwater simulations in Webots show that, at a flow speed of 0.8 m/s, the method reduces combined attitude RMS by 41.52% relative to the no-feedback strategy. Relative to high-gain PD control, it reduces the RMS rate of change of the control output by 71.32%. These results indicate that the method improves input smoothness and compatibility with five-legged gait rhythms, with a moderate trade-off in transient attitude suppression. It therefore offers a coordinated approach to balancing attitude stability and gait continuity under asymmetric operation.

Abstract: The glymphatic system is a brain-wide perivascular network that facilitates cerebrospinal fluid-interstitial fluid exchange and the clearance of metabolic waste. Growing experimental and clinical evidence suggests that glymphatic dysfunction may represent a convergent upstream mechanism linking aging, neuroinflammation, and neurodegeneration. In this narrative review, we synthesize human imaging, clinical, and translational evidence implicating glymphatic dysfunction across major neurodegenerative diseases and integrate these findings with emerging data supporting its role in chronic low-grade inflammation associated with aging (inflammaging). We further discuss how alterations in the gut microenvironment may remotely influence glymphatic function and contribute to neurodegeneration through the gut–brain axis. Although supported by extensive preclinical evidence, studies in humans increasingly demonstrate impaired glymphatic function in several neurodegenerative disorders, most assessed using diffusion tensor imaging along the perivascular space (DTI-ALPS) index. Glymphatic dysfunction is associated with cognitive decline, motor impairment, and disease progression. Aging-related alterations in astrocytic function, aquaporin-4 polarization, blood-brain barrier integrity, and perivascular fluid dynamics provide mechanistic links between inflammaging and glymphatic failure. Gut dysbiosis may further exacerbate these processes by promoting central nervous system inflammation and vascular dysfunction. Together, these findings identify the glymphatic system as a clinically relevant pathway in neurodegeneration that may be regulated by aging-associated neuroinflammatory mechanisms involving the gut-brain axis. Finally, we discuss lifestyle factors that influence glymphatic function and propose a unified framework positioning glymphatic dysfunction as a central integrator of impaired brain clearance, with potential implications for biomarker development, clinical assessment, and disease-modifying therapeutic strategies in neurodegenerative disorders.

Abstract: Objectives: The study determined antibiotic resistance profiles of surgical wound’ multidrug-resistant (MDR) isolates belonging to the ESKAPE group and evaluated antibacterial and antibiofilm activities of geraniol (G), carvacrol (C), and eugenol (E), individually and in the selected binary mixtures against them. The cytotoxicity of monoterpenes and their combinations was also assessed. Methods: The antibacterial activity against E. faecium, S. aureus MRSA, K. pneumoniae, A. baumannii, P. aeruginosa and Enterobacter spp. was assessed in microdilution assay. Antibiofilm activity was tested in crystal violet assay. Cytotoxicity of the tested monoterpenes was estimated in XTT assay. Results: C proved the strongest antimicrobial activity (MIC 0.32±0.24 mg mL-1). Antibacterial checkerboard assay, used to study interactions, showed synergism between all monoterpenes. Significant biofilm inhibition (in crystal violet assay) was found for sole monoterpenes, with the most pronounced inhibition for G (38.78–84.72%, p< 0.05). The most significant biofilm eradication was demonstrated for C (25.21-61.34%, p< 0.05), while the G (28.83-55.26%) and E (21.74-52.83%) exhibited a weaker effect. G-C mixtures were further studied for the antibiofilm effect, showing notable inhibition of biofilm formation on all isolates except P. aeruginosa. However, the G-C mixtures exhibited biofilm eradication activity solely against P. aeruginosa. Cytotoxicity tested on normal human MRC-5 fibroblasts showed no cytotoxicity at tested doses of G, E and C, while G-C mixtures were less cytotoxic than povidone-iodine (p< 0.05), used as control. Conclusions: All monoterpenes and G-C mixture proved significant antibacterial and antibiofilm potential against ESKAPE isolates, and acceptable impact on cell viability.

Abstract: The Molten Salt Fast Reactor (MSFR) concept, integrated into the iMAGINE framework, offers a transformative approach to nuclear waste management and fuel cycle closure. However, industrial deployment requires small-scale demonstrators like DEMO (demonstration fusion power plant) to validate reactor physics and safety under realistic conditions. This study investigates the central challenge of sustaining criticality in a 50 MWth demonstrator over a 20-year lifespan, with the innovative challenge to operate without employing a traditional mechanical control system. Using the HELIOS code package, simulations reveal that a reference burner core with 19.9% enrichment experiences a significant criticality loss of over 2600 pcm during reactor lifetime. Several non-mechanical compensation strategies were evaluated against operational goals. Over-feeding fissile material can stabilize criticality but risks deviating from the salt’s ideal eutectic composition. Relying on negative thermal feedback requires temperature adjustments of approximately 130 K, which may be "too challenging" for a first-of-a-kind system due to increased corrosion risks and narrow safety margins. Furthermore, while online salt clean-up of noble metals is vital for chemical validation, its direct contribution to reactivity is marginal. A central novel insight is the identification of a "design dilemma": although increasing core size (reducing enrichment to 14%) sustains criticality through enhanced breeding, it increases fuel costs by 2.5 times and extends the time to target burnup from 20 to about 60 years. Since the primary mission of a demonstrator is to produce high-burnup fuel for analysis quickly, larger cores are counterproductive. results of this study shows that no single method is ideal; instead, either a hybrid approach combining several of the investigated approaches or a future disruptive innovation, such as moderator control for HTGR, is essential to balance reactor physics with practical experimental objectives.

Abstract: The circular economy (CE) decreases food waste, enhances food security and maintains food. This study assesses the acceptance of CE in the Eastern Province of Saudi Arabia and identifies its factors. Primary data were collected from 384 Saudi citizens aged 18 years and above through a structured questionnaire using a cross-sectional technique. Data analysis comprised descriptive statistics and OLRM. The CE level was calculated based on 40 questions asked to the participants on recyclable bread, dates, cooked rice, cooked pasta, stewed veggies, stewed meat and fruit. Cronbach’s alpha was 0.931 for all queries. Adult CE adoption is low (3.1 %), mid (34.4 %), and high (62.5 %). OLRM studies demonstrate that CE applications and platforms improve CE levels. Participants who disagreed that not retaining leftover food wastes food had 7.89 times increased probability of having high CE levels. CE levels are 4.94 times higher when food purchases are not out of boredom. The results support the development of food recycling apps and platforms, educational and awareness efforts, and regulatory frameworks and regulations. They support change in behavior, food security, reduction in food waste and sustainable food systems.

Abstract: Energy-autonomous Internet of Things (IoT) nodes are becoming important components of distributed wireless networks used in building automation, industrial monitoring and wider smart systems. Their operation is constrained not only by the amount of harvested and stored energy, but also by sensing activity, communication cost, computational workload and required service quality. This review analyzes these dependencies from a cross-layer perspective linking energy harvesting and power management, field-level IoT nodes, wireless communication technologies, and edge–fog–cloud computing. The main original contribution is a decision-oriented framework for energy-autonomous distributed intelligence, supporting adaptive placement of sensing, processing, inference and coordination functions across field, edge, fog and cloud resources. The analysis shows that energy autonomy cannot be achieved by optimizing individual nodes only. Wireless connectivity, network topology and communication overhead directly affect the feasibility of higher-level processing, while edge and fog resources can reduce field-node load and improve local service continuity. The proposed framework therefore combines energy feasibility, communication conditions, service requirements and coordination scope. The resulting guidelines are particularly relevant to building automation and smart IoT systems, supporting interoperable, adaptive and energy-efficient distributed wireless architectures.

Abstract: Accurate multi-step traffic flow forecasting requires dynamic spatial modeling and adaptation to heterogeneous temporal and node-level patterns. This study proposes FAMoE-ST, a hierarchically frozen attention network with a hybrid-memory mixture of experts. Historical flow and temporal and node context are encoded as sensor tokens and processed by a six-layer Transformer initialized from GPT-2. To remove dependence on arbitrary sensor indexing, causal masking is replaced by all-to-all bidirectional spatial attention, and all nodes share the zero GPT position ID. The lower four blocks are frozen, whereas the upper two blocks are adapted and their feed-forward networks are replaced by four-expert modules. A linear router is fused with a 32-slot memory router; each token retrieves four slots and activates two experts. With 12 observations predicting the next 12 steps, FAMoE-ST achieves MAE/RMSE/MAPE values of 18.55/30.35/12.91% on PEMS04 and 14.57/24.08/9.71% on PEMS08. Relative to ST-LLM, MAE decreases by 6.97% and 7.39%, respectively. Ablations show complementary benefits from restricted adaptation, sparse experts, and memory routing. A parameter-matched control further indicates that the gains are not attributable solely to stored capacity, although the experiments do not isolate the effect of GPT-2 pretraining.

Abstract: The options for controlling agricultural plant-pathogenic bacterial diseases with antibiotics are rather limited. Applications of naturally derived antimicrobial peptides may provide an alternative. Background/Objectives: The cell-free conditioned media (CFCM) of Xenorhabdus budapestensis (EMA) and X. szentirmaii (EMC) bacteria inactivate Erwinia amylovora, the causative agent of fire blight disease in Rosaceae both in vitro and in planta. We suppose that the active ingredient compounds are fabclavines. Testing the hypothesis, inducible fabclavine-producing strains were constructed in regulatory gene (hfq) deleted mutant strains of both Xenorhabdus species. Anti-Erwinia potentials of non-induced and induced fabclavine-producing cultures were compared in vitro and in planta. Methods: To obtain the appropriate fabclavine-producing mutants, we applied the easyPACId method with minor modifications. Fabclavine production was confirmed by LC-HRMS and in vitro bioassays. The in planta experiments were designed and carried out as follows: apple blossoms in an incubator were subjected to antimicrobial and control treatments before artificial inoculations of the buds with Erwinia amylovora Ea1. Results: Cell-free medium of both induced fabclavine-producing Xenorhabdus species exerted strong antagonistic effects on Ea1 in vitro, while the non-induced ones showed substantially reduced antibacterial activity. Similarly, both induced culture media prevented fireblight symptoms in artificially infected flowers in a dose-dependent manner. The non-induced EMC was completely inactive in planta, whereas EMA exhibited some protective activity. Conclusions: The results support the hypothesis that inducible Xenorhabdus mutants producing only fabclavines can be used for protection against E. amylovora. Application perspectives are discussed from the aspects of resistance, side effects, and costs based on parallel in planta experiments with streptomycin and kasugamycin.

Abstract: Non-destructive in-situ tests, such as the plate bearing (plate load) test, are widely used to estimate the equivalent deformation modulus (e.g., E_v2) of existing road embankments. However, the depth of influence sampled by such a test is governed by the loading plate diameter, so a single test yields only an average, diameter-dependent modulus rather than the actual variation of stiffness with depth. This study investigates whether systematically varying the plate diameter, and inverting the resulting settlement–diameter (dispersion) curves, can recover the full depth-dependent stiffness profile, E(z). Synthetic settlement–diameter curves were generated using a Boussinesq-based forward model for four families of reference stiffness profiles, representing normal (stiffness increasing with depth) and reverse (stiffness decreasing with depth) linear and exponential trends, combined with six Poisson’s ratios and five profile slopes/exponents (30 cases per profile family, 120 cases in total). Two inversion strategies were applied to back-calculate E(z) from each dispersion curve: a classical Occam-type, smoothness-constrained (Tikhonov-regularized) nonlinear inversion, and a direct, closed-form Simplified Inversion Method (SIM) based on differencing the apparent-modulus-versus-diameter curve. Results were benchmarked against the known reference profiles. Once calibrated so that its governing parameters depend only on Poisson’s ratio and the shape of the measured dispersion curve, SIM could be applied blindly, without prior knowledge of the true profile, and recovered E(z) with markedly lower error than Occam’s inversion (WAD = 2.2–4.7% and RMSPE = 2.6–5.8%, versus 7.4–19.1% and 9.4–28.3%, respectively, across the four profile families). For the Poisson’s ratio most typical of earth materials, ν = 0.3, the calibration further collapses to a universal parameter set (I = 0.66; c = 1.3 for stiffness increasing with depth, c = 2.5 for stiffness decreasing with depth), which attains WAD ≤ 4.2% across all four families with no calibration equation at all. Notably, Occam’s inversion reproduced the settlement–diameter curve itself with good accuracy in most cases, yet this close data fit did not guarantee an accurate stiffness profile—a direct manifestation of the intrinsic non-uniqueness of the settlement-based inverse problem. These findings support the use of a Poisson ratio-calibrated direct inversion method as a practical, robust alternative to generic regularized inversion for recovering stiffness profiles from multi-diameter plate loading data.

Abstract: As emerging persistent contaminants, microplastics (MPs) are ubiquitous in aquatic environments. Wastewater treatment plants (WWTPs) act as critical sinks and sources of MPs, and their MPs removal efficiency can strongly influence aquatic ecological safety. To investigate how different process configurations affect MPs occurrence and removal performance, four municipal WWTPs equipped with diverse biological and advanced treatment processes were sampled and analyzed. MPs were extracted via density flotation combined with H₂O₂ digestion, and their morphological and polymeric features were identified using stereomicroscopy and Fourier-transform infrared (FTIR) spectroscopy. The results revealed that MPs removal efficiencies differed significantly across treatment processes, which were primarily governed by biological adsorption and advanced filtration units. MPs removal rates rose with increasing particle size, and MPs sized 0–0.5 mm were most likely to penetrate the treatment system. Fragmented and pellet MPs showed higher removal efficiencies than fibrous and film-shaped MPs. Polymers including PVC, PS, PTFE and PP, as well as dark-colored MPs, were more resistant to removal. Longer hydraulic retention time (HRT) and a stable and sufficiently long sludge retention time (SRT) promoted the association of MPs with activated sludge, whereas excessive aeration induced MPs fragmentation and resuspension. Optimizing operational parameters and upgrading advanced filtration facilities could enable targeted MPs control. This study provide a theoretical basis for mitigating MPs emissions from municipal WWTPs.

Abstract: Space travel is hazardous because its environment contains higher amounts of radiation compared to the Earth. For this reason, materials must be optimized for radiation shielding to protect organic life forms and electrical equipment. This project focuses on creating effective shielding for protection against space radiation. The Stopping Range of Ions in Matter (SRIM) is a software used to simulate the electronic stopping power of protons in materials and can assist in optimizing them for shielding. SRIM was used to simulate diamond (D), graphite (G), carbon nanotubes (CNT) and combinations of material layer ordering consisting of the three allotropes with 145 MeV Protons. Results showed that diamond, graphite and carbon nanotube (D_G_CNT) were the optimal order of layering for minimum penetration depth amongst these multi-layered materials. The multi-layered material CNT_G_D having the least effective stopping power reordered to D_G_CNT, the travel depth reduces by 28.14%, showing how layer ordering effects the stopping power of a material.

Abstract: Solid waste management (SWM) is an important public health and environmental problem in the cities of developing countries. This is a systematic literature review (SLR) that synthesizes evidence of health and environment effects from the improper waste disposal with particular reference to Gaborone City, Botswana. Scopus, Web of Science, Google Scholar and PubMed were searched, resulting in 2,978 records that were subjected to PRISMA-guided screening and quality assessment, leading to 60 key studies. Although there is a known lack of Botswana specific data, there is also evidence that open dumping and open burning along with poor collection services result in respiratory disease, gastrointestinal infections, vector borne disease and multi-compartmental environmental contamination. Electronic waste is particularly dangerous and represents a fast-growing waste stream which globally has 75-78% that is inadequately managed. In Gaborone, risks are exacerbated by policy gaps, institutional fragmentation, and poor implementation of laws. This paper provides evidence-based recommendations that align with Botswana Vision 2036, the African Union Agenda 2063, and the UN Sustainable Development Goals (SDGs), specifically aimed at the Ministry of Health, the Ministry of Environmental Protection and Gaborone City Council for consideration in the context of the municipal SWM scoping review of Botswana. Finally, the study highlights the pressing need for enhanced solid waste organization and health-oriented policies in Sub-Saharan Africa (SSA).

Abstract: The design of unsymmetrical N-heterocyclic carbene (uNHC) ligands represents an effective strategy for tuning the catalytic performance of ruthenium olefin metathesis catalysts. In this work, two second-generation Hoveyda–Grubbs-type complexes bearing unsymmetrical NHC ligands with N-benzyl and N′-2-isopropylphenyl substituents and anti or syn backbone configurations were synthesized and fully characterized. Their catalytic performance was evaluated in representative olefin metathesis reactions, including cross metathesis, ethenolysis of ethyl oleate, and ring-closing metathesis of substrates with increasing steric demand, and compared with that of the corresponding N-cyclohexyl analogues and the commercial second-generation Hoveyda–Grubbs catalyst. Replacing the N-cyclohexyl substituent with the more flexible N-benzyl group significantly influences catalyst performance, although this depends on both the backbone configuration and the type of metathesis transformation. Overall, catalysts featuring an anti phenyl-substituted NHC backbone exhibited superior performance, particularly in the ethenolysis of ethyl oleate and in the sterically demanding ring-closing metathesis of linalool. The introduction of the benzyl substituent reduced the differences in catalytic behavior between the anti and syn isomers in RCM reactions compared with the corresponding cyclohexyl derivatives. Finally, the chiral anti catalyst was evaluated in a model asymmetric ring-opening cross-metathesis reaction, affording only low enantioselectivity.

Abstract: Diabetes mellitus affects over 537 million adults worldwide, yet the impact of hyperglycemia on absorbable suture degradation remains poorly understood. This study evaluated the in vitro degradation of polyglycolic acid (PGA) and PGLA 910 copolymer sutures under glucose concentrations of 0, 300, and 600 mg/dL over 28 days. A total of 120 sutures (60 per material) were incubated at 37°C in phosphate-buffered saline with different glucose concentrations. Mechanical properties were assessed at baseline and at 7, 14, 21, and 28 days via tensile testing. Medium pH was monitored weekly, and surface morphology was characterized by scanning electron microscopy. PGLA 910 demonstrated higher baseline strength than PGA (14.56 ± 1.11 N vs. 13.37 ± 1.00 N; p < 0.001). Both materials maintained strength during the first 7 days (p = 0.080), but progressive loss occurred from day 14 onward. At day 28 under normoglycemic conditions (0 mg/dL glucose) , PGA retained only 1.12 N (8.4% of initial strength), while PGLA 910 retained 3.81 N (26.2%; p < 0.001). Glucose concentration did not significantly affect degradation (p = 0.153). Medium pH correlated strongly with residual strength (ρ = 0.86–0.89; p < 0.001). SEM revealed more severe surface degradation in PGA than in PGLA 910. We conclude that PGLA 910 offers superior resistance to hydrolytic degradation, making it a more suitable choice for diabetic patients when extended mechanical integrity is required. However, both materials degrade extensively within 4 weeks and are unsuitable for applications requiring support beyond 3 weeks. The strong pH–strength correlation confirms the autocatalytic nature of the degradation mechanism.

Abstract: Effective mass reflects the body mass mechanically coupled during impact. Acceleration-based effective-mass estimates require noise-sensitive differentiation of segment kinematics. This study introduced an impulse-based estimate (M_e,imp = J/v_pre) and evaluated its reliability, agreement with an acceleration-based estimate (M_e,acc), and sensitivity to a carried-load condition. Forty male military cadets performed five maximal front kicks onto a force plate synchronized with three-dimensional motion capture under two fixed-order conditions: barefoot without load (NL) and with 30 kg of carried equipment (WL). Reliability was assessed using intraclass correlation coefficients; condition differences using paired tests with effect sizes and FDR correction; method agreement using correlations, ICCs, and Bland–Altman analysis; and isokinetic strength interactions using body-mass-adjusted mixed-effects models. M_e,imp showed poor-to-moderate single-kick reliability but good reliability for the five-kick mean (ICC = 0.84–0.87). It was higher in WL than NL (25.95 ± 5.44 vs. 21.89 ± 5.14 kg; p < 0.001; d_z = 0.92), reflecting a 21% greater net impulse, while pre-impact foot velocity (v_pre) remained unchanged. Contact duration increased and the force–time profile became more push-like under WL. In a subsample with usable impact-phase marker trajectories (n = 20), M_e,imp and Me,acc were not significantly correlated (r = 0.10, p = 0.54) and showed negligible agreement (ICC = 0.02; Bland–Altman bias = −21.5 kg). Stronger concentric hip rotators were associated with a smaller WL–NL increase in M_e,imp (Bonferroni-adjusted p = 0.044–0.050). M_e,imp should be interpreted as a contact-integrated index of impulse-transfer capacity, reliable when averaged across repeated kicks, rather than as true inertial mass or an interchangeable substitute for Me,acc.

Abstract: Listeria monocytogenes is one of the leading foodborne pathogens and an increasing public health concern because of the emergence of antimicrobial-resistant strains. This scoping review aimed to synthesize the available evidence on the prevalence and phenotypic antimicrobial resistance profiles of L. monocytogenes in animal-derived foods. The review was conducted following the Joanna Briggs Institute methodology and the PRISMA-ScR guidelines through systematic searches of PubMed/MEDLINE, Scopus, Web of Science, and Embase. Of the 711 records identified, 11 studies met the eligibility criteria. The included studies reported the occurrence of L. monocytogenes in meat and meat products, milk and dairy products, and ready-to-eat foods, with prevalence ranging from 0.1% to 60.0% across different food matrices. Resistance was most frequently reported to β-lactams and tetracyclines, whereas several studies identified multidrug-resistant isolates. In contrast, most isolates remained susceptible to ampicillin, amoxicillin, vancomycin, linezolid, and gentamicin. This scoping review provides an updated synthesis of the available evidence on the prevalence and phenotypic antimicrobial resistance profiles of Listeria monocytogenes in animal-derived foods and summarizes the phenotypic antimicrobial resistance patterns reported across the included food matrices.

Abstract: FEFLOW is used to provide a design stage analysis of seepage flow through a tailings storage facility constructed by on-dam cycloning, including phreatic surface level, drain flows, and water balance. Significant differences between simulation results and measurements of dam crest piezometer data and foundation flows highlight possible structural issues with hydraulic conductivity gradient of the tailings beaches, hydraulic conductivity of the downstream shells, and internal erosion. Partial saturation of tailings beach material is accounted for by solving Richards’ transient flow equation throughout facility staged construction, using MATLAB seepage analysis of an idealized 1D staged construction processes as an initial benchmark for setting FEFLOW time stepping and mesh size parameters. Seepage analysis of an idealized 2D staged construction process is used to clarify the importance of solving Richards’ transient flow equation for accurate tailings dam phreatic surface location.

Abstract: Background/Objectives: Post-traumatic nasal pyramid reconstruction is challenging in patients with severe deformity and exhausted autologous graft options, particularly after multiple failed surgeries. Custom-made titanium implants may offer precise structural support, but data on their mucosal integration and ultrastructural tissue response in nasal reconstruction are lacking. The aim of this study is to describe the first case of nasal pyramid reconstruction using an IPS (Individual Patient Solutions) custom-made titanium implant and to evaluate peri-implant tissue response with transmission electron microscopy (TEM). Methods: A 50-year-old male military personnel with long-standing saddle-nose deformity, nasal obstruction, and prior failed graft-based reconstructions underwent open rhinoplasty with placement of a patient-specific titanium implant designed with three-dimensional virtual surgical planning. The implant reconstructed the nasal dorsum from nasion to tip and was stabilized with cortical screws; an additional thin titanium plate was used for tip support. Intraoperative biopsies of nasal mucosa and adjacent connective tissue were processed for TEM to assess epithelial, stromal, vascular, and implant–tissue interface characteristics. Results: Clinically, nasal airway patency improved immediately after packing removal, with restoration of nasal contour and stable functional and aesthetic outcomes at 24-month follow-up without complications. Ultra-structurally, the respiratory epithelium showed preserved stratification, intact basal and ciliated cells, normal nuclei and mitochondria, and organized extracellular matrix closely opposed to discrete titanium particles, without granulomatous foreign-body reaction, dense inflammatory infiltrate, or fibrotic encapsulation. Focal ciliary damage, cytoplasmic vacuolization, lamina propria thickening, and vascular elastic lamina remodeling were interpreted as adaptive or transient stress-related changes rather than chronic implant toxicity. Conclusions: Custom-made IPS titanium implants can provide stable structural support, satisfactory functional and aesthetic outcomes, and a well-tolerated mucosal interface in complex post-traumatic nasal pyramid reconstruction after failed graft-based surgeries. Ultrastructural analysis with TEM supports their biocompatibility, showing predominantly preserved epithelial and stromal architecture with only focal, adaptive stress-related changes rather than chronic implant-related toxicity.

Abstract: A 4-year-old nonverbal boy with level 3 autism spectrum disorder and Duchenne muscular dystrophy (DMD) who was receiving chronic prednisone therapy presented to the emergency room with acute appendicitis. The diagnosis was significantly delayed due to atypical pain presentation, a potentially blunted inflammatory response from chronic steroid use, and the absence of classic abdominal examination findings due to DMD. The patient presented with five days of fever, poor oral intake, decreased stool output and behavioral changes. Initial physical examination and evaluation over two emergency department visits failed to establish the diagnosis. By the third visit, the patient exhibited abdominal distension, hypoactive bowel sounds, and bandemia. Computed tomography demonstrated perforated appendicitis with a walled-off abscess. Nonoperative management was unsuccessful, resulting in the development of multiple intra-abdominal abscesses that required percutaneous drainage. Following a 10-day hospitalization, the patient improved and was discharged. He subsequently underwent a scheduled laparoscopic appendectomy two months later, with pathology demonstrating persistent inflammation. This case raises awareness of the atypical presentation of pain in children with autism and the potential for DMD and chronic steroid therapy to mask expected examination findings. These factors should prompt clinicians to maintain a low threshold for advanced imaging when clinical concern is present. It also illustrates that non operative management of perforated appendicitis in immunosuppressed children may have an increased risk of failure.

Abstract: Running a vocational training program requires connected decisions, not merely a published course. This conceptual framework article combines design-science research with a tutorial format to show how AI-supported decisions can be linked without confusing model advice with organizational authority. Nine decision models (M1–M9) support program features, price and class size, demand, learner journeys, partners, service coverage, three resource types, cohort economics, and the next permitted action. Across them, four shared mechanisms clarify decision objects, put required conditions before preference, reconstruct realistic action spaces, and permit abstention. An optional tenth model (M10) reviews whether the model set should continue, change, simplify, pause, or stop. Each model has a stated basis, input–output contract, procedure, adaptation, checkable design property, and stop condition. The models sit within a nine-stage service journey, while people and authorized bodies retain responsibility for approval, examination, and certification. Evidence consists of a directed narrative review, a design-conformance check, and researcher-generated synthetic mechanism checks. The findings are intentionally mixed: some prototypes enforce stated conditions at an economic cost; the demand model improves only half of the synthetic paths; joint price–capacity planning loses profit after conditions change; and model-set review fails when assumptions about corrective action are wrong. These illustrations reveal rule behavior, trade-offs, and failure modes, not field performance or universal superiority. The contribution is an adaptable decision framework and tutorial that organizations can examine, simplify, and later test with their own evidence.