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Background: Bariatric surgery (BS) is effective for achieving significant weight loss. However, weight regain (WR) is an emerging problem. Objective: To assess the prognostic value of morning serum cortisol, a 1 mg dexamethasone suppression test (DST), 24 h urinary free cortisol (UFC) and late-night salivary cortisol (LNSC) in a cohort of patients with severe obesity (pwSO) undergoing BS in terms of weight loss and WR. Methods: Patients scheduled for BS underwent the following procedures at baseline, 12 months and 24 months after BS: medical history, anthropometric data, blood analysis and cortisol tests. We evaluated total weight loss (TWL) ≥ 30% at 1 year and WR after 2 years as an increase of ≥10% of the maximum weight lost. Results: In total, 142 subjects were included; 101 (71.1%) were females and the mean age was 45.9 ± 9.2 years. Up to 76.8% of subjects achieved ≥30% TWL, without statistically significant differences in DST results or morning serum cortisol, UFC or LNSC levels. However, a higher pre-surgery morning serum cortisol level was a significant predictor of a WR ≥ 10% (cortisol 17.8 [IQR 13.1–18.5] vs. 12.0 [IQR 8.8–15.8] μg/dL; p < 0.01); OR of 1.216 (95% CI 1.069–1.384); AUC [0.761, CI: (0.616–0.906); p < 0.01]. A cut-off value of cortisol > 13.0 μg/dL was predictive of a WR ≥ 10% (sensitivity 0.71; specificity 0.63). Conclusions: No cortisol test was useful in predicting weight loss; however, the pre-surgery morning serum cortisol level was able to predict a WR ≥ 10% in a cohort of pwSO 2 years after BS. A cut-off value of cortisol > 13 μg/dL might be an easy tool to identify patients at higher risk of WR, enabling healthcare providers to implement tailored, long-term strategies to minimize this outcome. [ABSTRACT FROM AUTHOR]

The limitations of the existing Global Navigation Satellite Systems (GNSS) integrated with Inertial Measurement Units (IMU) have presented significant challenges in meeting the stringent demands of precision maneuvering. The identified constraints in terms of accuracy and availability have required the development of an alternative solution to enhance the performance of navigation systems in dynamic and diverse environments. This paper summarizes the research regarding the integration of ultra-wideband (UWB) technology as an augmentation of the conventional GNSS+IMU system; it proposes an approach that aims to overcome the limitations of conventional navigation systems. By making use of UWB technology, the proposed low-cost UWB-augmented GNSS+IMU system not only fulfils the required performance standards but also offers the unique capability to navigate seamlessly across indoor and outdoor environments. The developed system was validated through comprehensive testing and analysis in both the automotive and maritime sectors. The obtained results highlight the system's capacity as a dependable and resilient solution for precise navigation, and they promote its use within the domain of accurate maneuvering. [ABSTRACT FROM AUTHOR]

Background: Clinical reasoning (CR) is a holistic and recursive cognitive process. It allows nursing students to accurately perceive patients' situations and choose the best course of action among the available alternatives. This study aimed to identify the randomised controlled trials studies in the literature that concern clinical reasoning in the context of nursing students. Methods: A comprehensive search of PubMed, Scopus, Embase, and the Cochrane Controlled Register of Trials (CENTRAL) was performed to identify relevant studies published up to October 2023. The following inclusion criteria were examined: (a) clinical reasoning, clinical judgment, and critical thinking in nursing students as a primary study aim; (b) articles published for the last eleven years; (c) research conducted between January 2012 and September 2023; (d) articles published only in English and Spanish; and (e) Randomised Clinical Trials. The Critical Appraisal Skills Programme tool was utilised to appraise all included studies. Results: Fifteen papers were analysed. Based on the teaching strategies used in the articles, two groups have been identified: simulation methods and learning programs. The studies focus on comparing different teaching methodologies. Conclusions: This systematic review has detected different approaches to help nursing students improve their reasoning and decision-making skills. The use of mobile apps, digital simulations, and learning games has a positive impact on the clinical reasoning abilities of nursing students and their motivation. Incorporating new technologies into problem-solving-based learning and decision-making can also enhance nursing students' reasoning skills. Nursing schools should evaluate their current methods and consider integrating or modifying new technologies and methodologies that can help enhance students' learning and improve their clinical reasoning and cognitive skills. [ABSTRACT FROM AUTHOR]

Traditionally, freight wagon technology has lacked digitalization and advanced monitoring capabilities. This article presents recent advancements in freight wagon digitalization, covering the system's definition, development, and field tests on a commercial line in Sweden. A number of components and systems were installed on board on the freight wagon, leading to the intelligent freight wagon. The digitalization includes the integration of sensors for different functions such as train composition, train integrity, asset monitoring and continuous wagon positioning. Communication capabilities enable data exchange between components, securely stored and transferred to a remote server for access and visualization. Three digitalized freight wagons operated on the Nässjo–Falköping line, equipped with strategically placed monitoring sensors to collect valuable data on wagon performance and railway infrastructure. The field tests showcase the system's potential for detecting faults and anomalies, signifying a significant advancement in freight wagon technology, and contributing to an improvement in freight wagon digitalization and monitoring. The gathered insights demonstrate the system's effectiveness, setting the stage for a comprehensive monitoring solution for railway infrastructures. These advancements promise real-time analysis, anomaly detection, and proactive maintenance, fostering improved efficiency and safety in the domain of freight transportation, while contributing to the enhancement of freight wagon digitalization and supervision. [ABSTRACT FROM AUTHOR]

Due to their ability to provide a worldwide absolute outdoor positioning, Global Navigation Satellite Systems (GNSS) have become a reference technology in terms of navigation technologies. Transportation-related sectors make use of this technology in order to obtain a position, velocity, and time solution for different outdoor tasks and applications. However, the performance of GNSS-based navigation is degraded when employed in urban areas in which satellite visibility is not good enough or nonexistent, as the ranging signals become obstructed or reflected by any of the numerous surrounding objects. For these situations, Ultra-Wideband (UWB) technology is a perfect candidate to complement GNSS as a navigation solution, as its anchor trilateration-based radiofrequency positioning resembles GNSS's principle. Nevertheless, this fusion is vulnerable to interferences affecting both systems, since multiple signal-degrading error sources can be found in urban environments. Moreover, an inadequate location of the augmenting UWB transmitters can introduce additional errors to the system due to its vulnerability to the multipath effect. Therefore, the misbehavior of an augmentation system could lead to unexpected and critical faults instead of improving the performance of the standalone GNSS. Accordingly, this research work presents the performance improvement caused by the application of Fault Detection and Exclusion methods when applied to a UWB-augmented low-cost GNSS system in urban environments. [ABSTRACT FROM AUTHOR]

(1) Background: The current criteria for defining good or bad responders to bariatric surgery based on the percentage of weight loss do not properly reflect the therapeutic impact of the main bariatric techniques. At present there is an urgent need to fill this gap and provide scientific evidence that better define the success or failure of bariatric surgery in the long term. (2) Methods: This is a retrospective database study of a prospective cohort with 5-year follow-up. We established the success or failure of bariatric surgery in terms of weight loss according to a selected criterion: (1) Halverson and Koehler; (2) Reinhold modified by Christou; (3) Biron; (4) TWL > 20%; (5) percentage of changeable weight (AWL > 35%). We analyzed sensitivity and specificity for successful weight loss. (3) Results: 223 (38.7%) patients underwent sleeve gastrectomy (LSG) and 353 (61.2%) underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP). The success rates at 5 years are: EWL > 50% 464 (80%), Reinhold 436 (75.6%), Biron 530 (92%), TWL > 20% 493 (85.5%), AWL < 35% 419 (72.7); ≥50% EWL and alterable weight loss AWL > 35 were the most adequate criteria as their specificities and sensibility were far above >80%. (4) Conclusions: The present study shows how the different definitions of success or failure are inconsistent in relation to the outcomes of BS. However, there are some criteria that associate statistically significant differences for the resolution of comorbidities and show the highest sensitivity and specificity rates. [ABSTRACT FROM AUTHOR]

The main objectives of this work were to assess the efficiency, ease-of-use, and general performance of a novel osseoshaping tool based on first-user clinical experiences and to compare these observations with preclinical data generated in rodents using a miniaturized version of the instrument. All patients selected for the surgery presented challenging clinical conditions in terms of the quality and/or quantity of the available bone. The presented data were collected during the implant placement of 15 implants in 7 patients, and included implant recipient site (bone quality and quantity) and ridge evaluation, intra-operative handling of the novel instrument, and the evaluation of subsequent implant insertion. The instrument was easy to handle and was applied without any complications during the surgical procedure. Its use obviated the need for multiple drills and enabled adequate insertion torque in all cases. This biologically driven innovation in implant site preparation shows improvements in preserving vital anatomical and cellular structures as well as simplifying the surgical protocol with excellent ease-of-use and handling properties. [ABSTRACT FROM AUTHOR]

Aluminum-silicon-magnesium alloys are commonly used in the automotive industry to produce structural components. Among usual quality controls of produced castings, microstructure characterization and determination of mechanical properties are the most critical aspects. However, important problems can be found when measuring mechanical properties in those areas of castings with geometrical limitations. In this investigation, a set of A356 alloys have been prepared and then used to manufacture test castings and automotive castings in a laboratory and in industrial conditions, respectively, using Low Pressure Die Casting (LPDC) technology. Test castings were used to predict secondary dendritic arm spacing (SDAS) by using thermal parameters obtained from experimental cooling curves. The results have been then compared to the ones found in the literature and improved methods for estimating SDAS from cooling curves have been developed. In a subsequent step, these methodologies have been checked with different industrial castings by using simulated cooling curves and experimentally measured SDAS values. Finally, the calculated SDAS values together with the Mg contents present in A356 alloys and the temperature and aging time data have been used to develop new models so as to predict the tensile properties in different areas of a given casting prototype. These developed models allow casters and designers predicting tensile properties in selected areas of a given prototype casting even during design and simulation steps and considering the processing variables expected in a given foundry plant. The structures of these new models have been described and experimentally validated using different processing conditions. [ABSTRACT FROM AUTHOR]

The constantly changing process of caring for a person with dementia affects the informal caregivers' role due to its psychosocial impact. This cross-sectional study aimed to analyze the impact of the Person with Dementia informal caregiver's role caregiver to a person with dementia on the self-perceived quality of life (QoL) of the caregiver. In total, 160 informal caregivers were recruited between January and December 2019. Informal caregivers' quality of life was assessed using the European Quality of Life 5-Dimension scale, burden with the Zarit Burden Scale, emotional wellbeing using the General Health Questionnaire, and caregiver reactions using Caregiver Reaction Aspects. Patients' cognitive impairment was assessed with the Mini-Mental State Examination, their quality of life using Quality of Life in Alzheimer's Disease, and neuropsychiatric symptoms using the Neuropsychiatric Inventory. Outcomes were studied using the Pearson correlation coefficient and ANOVA test. Most informal caregivers' outcomes were significantly associated with their quality of life. Male informal caregivers have a slightly better quality of life than female caregivers (p < 0.001). Caregiver burden (p < 0.001), psychological wellbeing (p < 0.001) and negative aspects of caregiving on health (p < 0.001) correlated moderately with informal caregivers' quality of life. Factors associated with dementia, including the course of the illness and its severity with the presence of neuropsychiatric symptoms can negatively affect the informal caregiver's role and produce a low self-perception of quality of life; thus, social and professional support for informal caregivers is essential. [ABSTRACT FROM AUTHOR]

Preprocessing data in a reproducible and robust way is one of the current challenges in untargeted metabolomics workflows. Data curation in liquid chromatography–mass spectrometry (LC–MS) involves the removal of biologically non-relevant features (retention time, m/z pairs) to retain only high-quality data for subsequent analysis and interpretation. The present work introduces TidyMS, a package for the Python programming language for preprocessing LC–MS data for quality control (QC) procedures in untargeted metabolomics workflows. It is a versatile strategy that can be customized or fit for purpose according to the specific metabolomics application. It allows performing quality control procedures to ensure accuracy and reliability in LC–MS measurements, and it allows preprocessing metabolomics data to obtain cleaned matrices for subsequent statistical analysis. The capabilities of the package are shown with pipelines for an LC–MS system suitability check, system conditioning, signal drift evaluation, and data curation. These applications were implemented to preprocess data corresponding to a new suite of candidate plasma reference materials developed by the National Institute of Standards and Technology (NIST; hypertriglyceridemic, diabetic, and African-American plasma pools) to be used in untargeted metabolomics studies in addition to NIST SRM 1950 Metabolites in Frozen Human Plasma. The package offers a rapid and reproducible workflow that can be used in an automated or semi-automated fashion, and it is an open and free tool available to all users. [ABSTRACT FROM AUTHOR]