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Review
Engineering
Civil Engineering

Samira Mirzavand

,

Joaquim Tinoco

,

José C. Matos

,

Joao Amado

Abstract: Earth-retaining Structures are engineered systems designed to hold back soil, rock, or other materials and prevent landslides or the collapse of earth onto roadways. These structures are essential for stabilizing slopes and supporting excavations. They play an important role, especially in transportation infrastructure systems. One of the biggest challenges the asset holders are facing with, is the maintenance of these important as-sets. Several techniques have been used recently to monitor the health level of these geotechnical systems. Although there are some works reviewing these structural health monitoring techniques for civil structures, none of them specifically focused on earth-retaining structures which leads to an overall lack of knowledge in this field. Therefore, this survey aims to conduct a comprehensive review of health monitoring methods that are being used for the assessment of these important geotechnical assets to highlight the current state of research, identify gaps and limitations, and suggest fu-ture directions. In particular, this paper outlines the importance of timely maintenance for earth-retaining structures, presents the types of structural health monitoring meth-ods used for predictive or preventive maintenance of these assets, and finally, identi-fies the challenges and new solutions to help with a more efficient assessment and monitoring of these assets.

Article
Environmental and Earth Sciences
Water Science and Technology

Juan Franco-Quintero

,

Carlos Rizo-Maestre

,

María Dolores Andújar-Montoya

Abstract: The reuse of drinking water (direct and indirect; DPR/IPR) is increasingly being proposed as a strategy to strengthen urban water security in the face of climate variability and increasing demand. Although technological barriers have decreased considerably, many projects continue to face intense social and political conflicts. This article examines why technically viable reuse initiatives thrive in some contexts while failing in others, by developing a conceptual framework for analysing the conflicts associated with DPR/IPR. The study proposes three complementary typological matrices: Justification × Acceptance (J×A), Justification × Urgency (J×U) and Demands × Repertoires (D×R), which integrate the structural conditions of the projects with the strategic dynamics of the actors involved. The framework is illustrated by an empirical corpus of 25 global DPR/IPR cases, compiled through a realistic synthesis of academic literature, technical reports and contextual sources. The analysis shows that project trajectories do not depend solely on technological maturity or water scarcity, but on the interaction between technical justification, social acceptance, perceived urgency and, especially, the strategy and agency capacity of actors to mobilise demands, narratives and repertoires of action. Consequently, the advancement, transformation or blocking of potable reuse projects is mainly explained by how these strategies shape the legitimacy of water risk governance.

Communication
Public Health and Healthcare
Public Health and Health Services

Seshadri S. Vasan

,

Sudarshan Anand

,

Miae Lee

,

Nicholas C. Fluck

Abstract: Burden of diseases measured as disability-adjusted life years per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias amongst the highest contributors to the burden; that drug use disorders and colorectal cancer are showing worsening trends and require health promotion and disease prevention measures from ages 15 and 25 respectively, especially in Aberdeen City; and that males are more vulnerable to atrial fibrillation and flutter, diabetes mellitus and oesophageal cancer, while females are to cerebrovascular disease. We demonstrate the usefulness of our analysis and methodology for the wider health system, allowing targeted medical research investments and coordinated response from public health and health service delivery. We also show the need for up-to-date surveillance data, forecasts and evidence on the impact of interventions to be made available widely.

Article
Medicine and Pharmacology
Ophthalmology

Nik Krajnc

,

Martin Bertich

,

Fabian Föttinger

,

Stefan Macher

,

Felix Konstantin Schwarz

,

Christoph Stapf

,

Berthold Pemp

,

Gabriel Bsteh

Abstract: Objective. To assess whether modified OCT acquisition parameters improve GCIPL measurement reliability. Methods. Participants with multiple sclerosis (pwMS) and age- and sex-matched healthy controls (HC) underwent OCT (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany) at baseline and after two and four weeks. At each visit, five macular scan protocols were acquired: standard (49 lines, high-speed [HS], automated real-time tracking [ART]: 9), high-ART (49 lines, HS, ART: 50), high-lines (97 lines, HS, ART: 9), high-resolution (49 lines, high-resolution [HR], ART: 9), and maximum (97 lines, HR, ART: 50). Reliability was assessed using intraclass correlation coefficients (ICC). Absolute test-retest reproducibility was quantified using the mean absolute difference (MAD). Results. Thirty-eight eyes from nine pwMS (mean age 34.1±8.0 years, 44.4% female) and ten HC (31.7±11.1 years, 50.0% female) were included. At baseline, mean GCIPL thickness ranged from 70.8µm to 71.5µm across protocols, demonstrating excellent inter-protocol agreement (ICC 0.99; 95% confidence interval [CI]: 0.98-0.99; p< 0.001) and only marginally higher values with increased ART. Test-retest reliability was excellent for all protocols, demonstrating marginally lower absolute measurement variability of high-ART and high-lines protocols (MAD 0.26-0.27; 95% CI: 0.21-0.32), while temporal agreement remained excellent and comparable across acquisition settings. Mean acquisition time ranged from 10.6±1.6s for the standard protocol to 231.9±36.4s for the maximum protocol. Conclusions. All OCT acquisition protocols demonstrated excellent inter-protocol and test-retest reliability for GCIPL measurements. The high-lines protocol provides the most favourable balance between measurement reliability and acquisition time, supporting its potential utility for longitudinal GCIPL monitoring.

Article
Physical Sciences
Quantum Science and Technology

Smail Bougouffa

,

Kamal Berrada

Abstract: We investigate the non-Markovian dynamics of quantum steering in a tripartite photonic system subject to dephasing noise. By developing a theoretical framework based on the single-photon dephasing model extended to three independent photons, we analyze the temporal evolution of steering measures SA−BC and SAB−C for two distinct classes of initial states: W-type entangled states and GHZ-type mixed entangled states. The system is studied under various environmental configurations, ranging from fully Markovian to fully non-Markovian regimes, with asymmetric distributions of memory effects across the three photons. Our results reveal that the dynamics of Gaussian steering are highly sensitive to both the number of photons coupled to non-Markovian environments and the specific partition of the system being considered. For W-states, non-Markovian effects induce oscillatory behavior with death-revival cycles, where the intervals of sudden death and revival amplitudes depend critically on the distribution of memory effects. For GHZ-states, we observe multiple death-revival cycles in some configurations and prolonged preservation of steering without complete sudden death in others. Notably, we find that non-Markovian environments can either enhance steering through information backflow or prove detrimental depending on which subsystems they are coupled to relative to the steering and steered parties. These findings demonstrate that non-Markovianity can serve as a resource for protecting specific types of quantum steering, but its effects are highly configuration-dependent, offering insights for quantum information processing tasks requiring the preservation of directional quantum correlations in photonic networks.

Review
Public Health and Healthcare
Other

Hussein Abdullah Rajab

,

Mohammed A. Huneif

,

Ian F. Pryme

,

Ramadhan Oruch

Abstract: The incidence of insulin resistance and its complications is rising across societies worldwide, making its treatment a significant economic challenge. The disease is multifactorial, and its pathophysiology varies accordingly. Genetic factors, aging, and coexisting diseases are major contributors to its development. Among the coexisting conditions are autoimmune diseases and other conditions requiring treatment with therapeutic agents, some of which can induce insulin resistance. Research indicates that the free radical theory plays a significant role in initiating this complex cycle and in shaping the full clinical picture of diabetes syndrome. In this work, we discuss the pathophysiology of insulin resistance, the role of free radicals in its etiology, and drug treatments for diseases that may contribute to insulin resistance. We also explore the antioxidant effects of vitamin D and oral hypoglycemic agents, as well as their notable adverse effects, including cobalamin (vitamin B12) deficiency. A total of 147 scientific studies, including comprehensive meta-analyses, have been selected to address these questions and have been analyzed and discussed objectively to minimize scientific bias and confusion. This narrative work will help doctors and primary health caregivers envision the dimensions of diabetes syndrome from multiple perspectives and update their knowledge about the significance of vitamin D as an effective tool to combat insulin resistance

Article
Medicine and Pharmacology
Epidemiology and Infectious Diseases

José-Luis Pérez-Arellano

Abstract: Coxiella burnetii is an intracellular bacterium responsible for an anthropozoonosis that can be asymptomatic or manifest as acute or chronic Q fever . This extensive series of 588 patients represents one of the largest single-center studies on sporadic acute Q fever, highlighting the Canary Islands as a high-incidence region in Spain. Epi-demiologically, the domestic cycle is the primary driver of infection, with caprine livestock serving as the main reservoir, showing a local prevalence of 60.4%. Transmission is predominantly airborne via aerosols; the environmental resilience of C. burnetii facilitates its transport into urban areas, where the majority of patients reside despite lacking direct animal contact. While fever, headache, and sweating are hallmark symptoms, over 90% of patients exhibit transient urinalysis abnormalities, a finding that often leads to misdiagnosis and inappropriate antimicrobial use. Clinically, the non-specific (45.7%) and hepatic (44.1%) forms are most prevalent, whereas the pulmonary form (7.8%) is strongly associated with smoking and alcohol consumption. Although localized forms affecting the nervous system or skin (such as panniculitis) were observed, the overall prognosis remains excellent with no pro-gression to chronic Q fever in this series. In summary, the extensive series described characterizes acute Q fever patients in the Autonomous Community of the Canary Islands, with features that are similar in some cases but also show notable differences compared to other national and international series. Furthermore, depending on the patients' age, the time elapsed between the onset of clinical manifestations and hospital evaluation, and the clinical form, acute Q fever displays significant diffe-rences.

Article
Engineering
Civil Engineering

Thai Cuong Nguyen

,

Katharina Elert

,

Thomas Most

,

Katrin Linne

,

Carsten Koenke

Abstract: To reduce the significant environmental impact of the construction sector, developing renewable, load-bearing building materials is crucial. Straw, an abundant agricultural by-product, presents a promising resource for this purpose. This study focuses on a novel building material made from highly compressed straw, referred to as Straw-Brick, aiming to provide a reliable numerical model for predicting its complex mechanical behavior. To characterize the material, a series of uniaxial single-cycle and cyclic compression tests were conducted. Based on the experimental results, a one-dimensional, nonlinear rheological model was developed to capture the material’s key mechanical features. The model parameters were identified by fitting the simulation to the experimental data. The results show that the material behavior is characterized by strong nonlinearity, hysteresis, and stress relaxation. The proposed model is capable of capturing these main characteristics, showing good agreement with the experimental data. This work provides a validated material model that establishes a robust foundation for future numerical simulations of structural components made from this innovative and sustainable building material.

Article
Biology and Life Sciences
Biochemistry and Molecular Biology

Ichda Arini Dinana

,

Yukihiko Kubota

,

Masahiro Ito

Abstract: ATP-binding cassette (ABC) transporters constitute one of the largest membrane pro-tein superfamilies, yet the structural and evolutionary properties of their non-domain re-gions remain poorly characterized. To elucidate the diversity of these non-canonical re-gions across evolutionary lineages, we analyzed intrinsic disorder, site-specific selection, and predicted post-translational modification (PTM) sites across five architectural classes comprising 1,581 prokaryotic and eukaryotic sequences. Linker and flanking regions were consistently more disordered than transmembrane and nucleotide-binding domains across all architectures. Disorder fraction differed significantly among region types after phyloge-netic correction (Pagel's λ ≈ 0.97). Predicted PTM sites are enriched in disordered non-domain segments, with N-linked glycosylation and phosphoserine showing the strongest positive enrichment; 140 sites satisfied a tiered conservation criterion (Mu-siteDeep score ≥ 0.5; cross-species conservancy ≥ 30%), including 40 high-confidence or moderate-confidence sites (conservancy ≥ 50%) as well as novel phosphotyrosine candi-dates in half transporters and NBD-only proteins. Site-specific selection analyses indicated that episodic positive selection was concentrated at inter-domain boundaries, whereas NBD cores were subject to pervasive purifying selection. Together, these findings establish that non-canonical regions of ABC transporters are evolutionarily dynamic and harbor conserved predicted modification sites, supporting their roles as potential regulatory inter-faces rather than passive structural linkers.

Article
Medicine and Pharmacology
Dietetics and Nutrition

Dayanne da Silva Borges

,

Ricardo Fernandes

,

Barbara Beatriz Philippi Martins

,

Sheila Iria Kraus

,

Erasmo Benicio Santos de Moraes Trindade

,

Adair Roberto Soares Santos

Abstract: The role of the gut-brain axis is crucial in maintaining homeostasis and regulating neural, hormonal, and immunological activity. This study aimed to evaluate the effects of prebiotic or synbiotic on serum markers related to emotional disorders in individuals with morbid obesity in a triple-blind randomized trial. The sample consisted of 22 subjects, 16 women and 6 men, with a mean age of 41.8 ± 8.5 years and a mean BMI of 47.7 ± 6.8 kg/m2. Serum BDNF concentrations decreased significantly after 30 days of prebiotic supplementation (p=0.017), and when analyzing the difference between the evaluated moments, only this group showed a reduction in this parameter. Serum cortisol concentrations were increased in all groups between the moments evaluated, being statistically significant in the synbiotic supplemented group (p=0.028). Serum TNF-α concentrations increased significantly after 30 days of prebiotic supplementation when compared to the baseline of the group itself (p=0.035): however, this variation did not promote significant difference between the groups evaluated after 30 days of supplementation. The results suggest that low grade chronic inflammatory state may be related to neuroendocrine changes present in emotional disorders, but studies with greater sampling power and correlations with clinical findings are necessary to strengthen this evidence.

Review
Biology and Life Sciences
Immunology and Microbiology

Pierre Pontarotti

,

Vivek Keshri

Abstract: This article reviews current knowledge in comparative immunology and presents updated hypotheses on the evolution of the immune system in jawed vertebrates. It focuses on the co-option of the RAG transposon in the origin of the V(D)J recombination system, proposed to have occurred in two stages. Initially, the RAG transposon, along with other eukaryote-specific transposon such as HAT, interacted with host genes in early eukaryotes, leading to a new transposition mechanism. Subsequently, RAG and host genes were integrated into the V(D)J recombination system, representing a major evolutionary innovation. The broader implications of this events are also considered. Earlier hypothesis suggest that the establishment of the V(D)J recombination system contributed to MHC polymorphism. Phylogenomic evidence indicates that key immune components, including MHC, T-cell receptors (α,β and γ,δ), and immunoglobulins, existed in ancestors and later expanded through gene duplication, forming multigene families with diverse functions. Their proteins products interact with other immune molecules to regulate immune responses. While some retained original functions, others evolved new roles through neo-functionalization. Overall, the co-option of the RAG transposon played a critical role in shaping the immune system of jawed vertebrates by driving innovation in both adaptive and innate immunity.

Article
Computer Science and Mathematics
Artificial Intelligence and Machine Learning

Chaoyue He

,

Xin Zhou

,

Di Wang

,

Hong Xu

,

Wei Liu

,

Chunyan Miao

Abstract: ASI should be guided by open-world alignment. While human labels, preferences, and benchmarks remain indispensable, they are too narrow to serve as master objectives for frontier systems. The road to ASI is inherently a frontier supervision problem. As humans become structurally weak supervisors, the technical challenge shifts from imitating judgments to building evaluation loops answerable to reality, explicit constraints, and post-deployment evidence. We critique human-signal monism— the assumption that human-facing signals sufficiently proxy overall system quality—and diagnose its failure modes, including evaluator weakness and proxy over-optimization. As a constructive alternative, open-world alignment centers human intent while coupling it to verifier ecologies: layered task verifiers, hard constraints, uncertainty gates, and monitoring. This framework contributes an operational ASI definition, an actionable formalization, a coding agent case study, an analysis of open-world alignment’s own failure modes, and the Open-World Evaluation Card reporting artifact. Ultimately, ASI must be guided by objectives that remain answerable to the world.

Article
Medicine and Pharmacology
Other

Nguyen The Diep

,

Tien Van Nguyen

,

Nguyen Trong Duynh

Abstract: Objectives: Sarcopenia impairs physical function and increases healthcare burden among older adults with chronic musculoskeletal disorders. This study estimated the prevalence of sarcopenia and explored factors associated with sarcopenia among Vietnamese elderly outpatients. Methods: A hospital-based cross-sectional study was conducted among 88 outpatients aged 60 years or older with knee osteoarthritis and/or chronic spinal pain at a tertiary hospital in Northern Vietnam from May 2024 to October 2025. Sarcopenia and severe sarcopenia were defined according to the Asian Working Group for Sarcopenia 2019 criteria. Muscle mass, muscle strength, and physical performance were assessed using bioelectrical impedance analysis, handgrip dynamometry, and usual gait speed, respectively. Multivariable logistic regression and an exploratory chi-square automatic interaction detection decision tree were applied. Results: The prevalence of sarcopenia was 40.9%, including 23.9% with sarcopenia and 17.0% with severe sarcopenia. Age &gt;70 years (adjusted odds ratio [AOR] 9.00, 95% confidence interval [CI] 2.40-33.60), history of falls (AOR 6.33, 95% CI 2.77-14.45), low educational attainment (AOR 2.86, 95% CI 1.46-5.61), and poor sleep quality (AOR 1.16, 95% CI 1.02-1.32) were independently associated with sarcopenia. Conclusions: Sarcopenia was common in this outpatient population. Routine case-finding may be particularly relevant in older patients with falls, lower educational attainment, and poor sleep quality. The decision-tree findings should be interpreted as exploratory because of the cross-sectional, single-center design and modest sample size.

Article
Engineering
Textile Engineering

Hanaa Abouzaid

,

Ghada El-Sayad

,

Marwa Amin

,

Heba Abo El Naga

Abstract: The valorization of agricultural plant waste as a sustainable source of natural fibers has gained increasing attention due to environmental and economic concerns. This study investigates the feasibility of extracting bast fibers from Egyptian Corchorus olitorius L. (Molokhia) plant residues and evaluates the influence of different extraction methods on fiber properties. Fibers were extracted using biological retting, cold al-kaline chemical treatment (4% NaOH), and manual scraping, followed by comprehensive characterization of their morphological, chemical, crystalline, mechanical, thermal, and environmental properties. The results showed that the extraction method significantly affected fiber performance. Chemically extracted fibers exhibited the smallest average diameter (13.76 ± 0.44 μm), the highest cellulose content (72.23%), and the lowest lignin content (3.20%), indicating effective removal of amorphous components. XRD analysis revealed the highest crystallinity index for chemically extracted fibers (70.0%), compared to bi-ological (60.0%) and manual extraction (64.0%). These structural improvements resulted in superior mechanical properties, with tensile strength and Young’s modulus reaching 600.67 ± 11.73 MPa and 38.96 ± 0.64 GPa, respectively, compared to lower values for biologically and manually extracted fibers. Weight loss analysis indicated optimal extraction durations of 21 days for biological retting and 9 days for chemical treatment. ICP-MS analysis confirmed that heavy metal contents were well below Oeko-Tex® Standard 100 limits. Overall, the findings demonstrate that Molokhia plant waste is a promising and environmentally safe source of natural fibers, with cold chemical extraction offering the most effective route for producing high-quality fibers suitable for bio-based composite applications.

Article
Medicine and Pharmacology
Medicine and Pharmacology

Christopher L. Mendias

,

Tariq M. Awan

Abstract: Peptides are a rapidly expanding drug class with a parallel and largely unregulated gray market that sells preparations directly to consumers for self-administration. The use of gray market peptides has grown substantially, with patients self-administering these compounds for purported benefits including accelerated musculoskeletal injury recovery, muscle hypertrophy, fat loss, and athletic performance enhancement. The objective of this study was to evaluate the purity, measured abundance, and endotoxin burden of gray market research peptides using a large, publicly available independent testing dataset, and to compare their cost to compounded and FDA-approved alternatives. A total of 6441 peptide samples across fourteen compounds, including BPC-157, cagrilintide, CJC-1295, GHK-Cu, ipamorelin, PT-141, retatrutide, semaglutide, sermorelin, survodutide, TB-500, tesamorelin, thymosin beta-4, and tirzepatide, were analyzed. Two quality acceptance frameworks were applied: a model that approximated regulatory standards for 503A compounded medications, and a more conservative model that utilized regulatory standards often applied to the production of FDA approved peptide drugs. Between the two models, 41.6% to 71.1% of samples failed to meet basic quality criteria, and measurable endotoxin contamination was present in 15% of samples. Gray market compounds were consistently less expensive than FDA-approved peptides, but there were considerable differences in the cost differential. Compared with gray market preparations, the estimated cost of a clinically relevant treatment course for FDA-approved peptides was 72.8% higher for tirzepatide, and 3850% higher for PT-141. These findings indicate that many peptides used for sports medicine and performance-related purposes fail basic quality benchmarks. Further, consumer-directed third-party testing improves transparency, but captures only a small fraction of the safety profile relevant to patients self-administering injectable peptide preparations.

Article
Medicine and Pharmacology
Psychiatry and Mental Health

Giulio Perrotta

,

Stefano Eleuteri

,

Rukhsana Kausar

,

Rabia Iftikhar

,

Irene Petruccelli

Abstract: Introduction: The clinical relationship between sexual violence and paraphilia is complex, with research indicating several risk factors; however, having paraphilia does not automatically mean an individual will commit sexual violence. Children are considered more vulnerable than able-bodied adults. This is why investigating the subjective psychopathological profile of paraphilia is important, both for prevention and punishment. The use of the term "paraphilia" refers to an intense and persistent psychophysical state of sexual interest in activities or objects that by conventional nature do not have that specific connotation or use. In literature, there is a clear difference between paraphilia and paraphilic disorder. The current validation study aims to introduce the “Perrotta Paraphilic Global Spectrum of Gradation”, which is the basis of a questionnaire that considers both intensity and frequency of the symptoms described by the patient and therefore can distinguish between the functional condition and the disorder, distinguishing between paraphilic interest, paraphilia and paraphilic disorder, in particular for the protection of minors and vulnerable minorities. Method: A validation study with 198 participants was set up, with statistical analysis of the data relating to the population sample. Results: In the case of content validity, all items obtained a CVR score greater than the cut-off value, with a minimum score of 0.902. Therefore, all items of the scale were considered essential. Also, regarding the relevance of the items in exploring the constructs investigated, optimal values of I-CVI (1.000) and scale (0.918) were obtained. Cronbach's alpha is 0.901 and McDonald’s Omega is 0.871. Therefore, all items were rated as relevant. Using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) we achieve construct validity and therefore the validity of the 9 clinical elements. Conclusion: The paraphilic manifestation has clinical relevance and the instrumental proposal that distinguishes the high-functioning forms from the low-functioning ones is suggestive for use on a larger scale.

Article
Engineering
Bioengineering

Ligang Zhou

,

Yan Xu

,

Laishuan Wang

,

Wei Chen

,

Chen Chen

Abstract: Background: Accurate assessment of neonatal sleep is critical for monitoring brain development and identifying potential neurological disorders, yet manual scoring of multi-channel EEG recordings is labor-intensive and prone to variability. Methods: To address this, we propose a lightweight temporal-spatial feature fusion network for automatic neonatal sleep staging. The model employs a dual-branch architecture to separately capture temporal dependencies and spatial correlations in EEG signals, which are then integrated via an adaptive fusion module to obtain comprehensive feature representations while maintaining low computational complexity. Results: The framework was evaluated on a clinical neonatal dataset (CHFD) for tasks including sleep–wake classification, quiet sleep detection, and three-stage sleep staging, achieving superior performance compared with several state-of-the-art methods. Additional experiments on the MASS-S3 adult dataset demonstrate that the model retains competitive accuracy and F1-score, indicating strong generalization across populations. Conclusions: These results suggest that jointly modeling temporal and spatial features enables robust and efficient automatic sleep staging. The proposed approach offers a practical solution for clinical applications and edge deployment, providing reliable, multi-dimensional assessment of neonatal brain activity and laying the groundwork for future studies integrating larger datasets or multimodal physiological signals.

Article
Medicine and Pharmacology
Anesthesiology and Pain Medicine

Hwang-Ju You

,

Ji-Yoon Jung

,

Woojin Kwon

,

Sung-Ae Cho

,

Tae-Yun Sung

Abstract: Background and Objectives: Catheter-related bladder discomfort (CRBD) commonly arises as a direct consequence of perioperative urinary catheterization. A fixed dose combination of 1000mg acetaminophen and 300mg ibuprofen provides multimodal analgesia. Accordingly, we assessed the impact of this fixed dose combination on mitigating CRBD in patients undergoing urological procedures. Materials and Methods: In this prospective pilot study, 23 patients undergoing urological surgery requiring urinary catheterization were randomized into 2 groups; approximately 20 minutes before the anticipated end of surgery, patients were administered a combination of 1000 mg acetaminophen and 300 mg ibuprofen (maxigesic group, n = 11) or saline (control group, n = 12). The primary endpoint was the incidence of CRBD immediately after the patient arrived at the post-anesthetic care unit (PACU). The incidence of CRBD at 1,2,6 hours postoperatively, the severity of CRBD at each time point were also assessed. Results: The incidence of CRBD immediately after arrival at the PACU was significantly lower in the maxigesic group (54.5% vs. 100%, p = 0.014), whereas no significant differences were observed at later time points. The incidence of moderate PONV was significantly lower in the maxigesic group at 0 hour and 1hour (p = 0.036, 0.037, respectively). Conclusions: This pilot study indicates that intravenous acetaminophen and ibuprofen could be an effective, well-tolerated strategy for mitigating early postoperative CRBD in urological surgery. While these preliminary results are promising, larger randomized trials are warranted to validate the clinical efficacy of this multimodal regimen.

Article
Medicine and Pharmacology
Endocrinology and Metabolism

Maria Athanasopoulou

,

Maria Tsanti

,

Marios Papasotiriou

,

Alexandra Efthymiadou

,

Aristeidis Giannakopoulos

,

Dionisios Chrysis

,

Eirini Kostopoulou

Abstract: Background/Objectives: Advanced technologies in type 1 diabetes mellitus (T1DM) management have reshaped the strategies used to achieve optimal glucose control. Continuous Subcutaneous Insulin Infusion (CSII) and Automated Insulin Delivery (AID) systems are effective alternatives to multiple daily injections (MDI). This study aims to evaluate glycemic regulation in children and adolescents transitioning from MDI to in-sulin pumps and to raise awareness among patients and their families regarding the benefits of these systems. Methods: 50 pediatric patients with T1DM (24 males, 26 fe-males; mean age 10.76 ± 3.2 years) were evaluated. Cycle 1 established MDI metrics 3 months pre-transition. In cycle 2, patients transitioned either to an AID system (Medtronic MiniMed 780G, 78%), or a non-automated system (Omnipod DASH, 22%). Data were assessed at 3- and 6-months post-initiation. Parameters assessed were: Glycosylated hemoglobin (HbA1c), Time In Range (TIR), Time Above Range (TAR), Time Below Range (TBR), Glucose Management Indicator (GMI), Coefficient of Variation (CV). Results: The cohort exhibited a statistically significant increase in TIR (p=0.0038) with mean values of 70.9% at 3 months and 70.8% at 6 months. TAR significantly reduced (p=0.033) to 26.5% and 24.3% at 3 and 6 months, respectively. Sub-analysis in the AID group, revealed a marked increase in TIR (p=0.0001) alongside significant reductions in TAR (P=0.0009) and GMI (p=0.03). Conclusion: Transitioning from MDI to insulin pump therapy, particularly AID systems, is transforming the clinical landscape of T1DM management. The con-sistency of these results across age groups indicates that AID systems can successfully overcome pediatric and adolescent diabetes management challenges.

Article
Computer Science and Mathematics
Mathematics

Li-Hui Wang

,

Chen-Wei Liang

,

Mu-Jiang-Shan Wang

,

Qiu-Ju Bian

Abstract: Regular graphs are classical symmetric structures in graph theory, where each vertex has identical degree and the overall topology often exhibits strong automorphism properties. However, practical systems frequently require heterogeneous constraints, which can be modeled by introducing vertex colorings and non-uniform degree requirements, leading to controlled symmetry breaking. In this paper, we investigate two-tone factors in edge-connected regular graphs and claw-free cubic graphs under arbitrary red-blue vertex colorings. Using the framework of parity (g,f)-factors, we establish two main existence results. First, we prove that every λ-edge connected r-regular graph admits a two-tone ({k},{k,k+2})-factor for any coloring, provided that r/λ⩽k⩽r−r/λ, k⩽r−2, and k|G| is even. Second, we show that every 3-edge connected claw-free cubic graph admits a two-tone ({0,1},{2,3})-factor regardless of the coloring configuration. Beyond existence, we provide a constructive algorithm by reducing the parity factor problem to an exact f-factor problem and further to a perfect matching problem via vertex-splitting techniques. We rigorously justify the correctness of this reduction and show that the desired factor can be computed in polynomial time. From a structural perspective, our results reveal that edge-connectivity serves as a stabilizing mechanism that preserves parity feasibility under arbitrary color-induced perturbations, while claw-free constraints enforce local density that prevents parity imbalance. This provides a symmetry-based interpretation of two-tone factors as a balance between global regularity and local asymmetry. These findings contribute to both the theoretical development of factor theory and its algorithmic realization, with potential implications for deterministic network design and resource allocation in structured systems.

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