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This paper addresses the problem of path planning and tracking control of the Unmanned Ground Vehicle (UGV) with a special focus on control tracking algorithms. The objectives of the research are the implementation, analysis, and comparison of different control strategies: PID, Stanley and Pure Pursuit. The implementation was carried out using the Robot Operating System (ROS) and the Gazebo simulator on the xMachines x100 UGV robot. Through a series of simulation experiments, the performance of the controllers was evaluated by employing a positioning error metrics, heading error and cross-track error. The obtained results indicated that the PID controller achieves the best performance regarding path tracking accuracy, while the Stanley and Pure Pursuit controllers obtain larger deviations, particularly pronounced in the final movement segment. Although the Stanley controller enabled faster task execution and the Pure Pursuit ensured smoother movement, the PID controller proved to be the most reliable solution. This paper provides a systematic insight into the practical application of these algorithms and guidelines for selecting an adequate controller depending on specific requirements.

Solid organ transplant recipients (SOTRs) have an increased risk of cutaneous malignancies due to long-term immunosuppressive therapy. To evaluate a risk stratification model for follow-up of SOTRs at Karolinska University Hospital, Sweden, in which SOTRs are categorized based on skin cancer risk (low, intermediate, high), 395 patients were followed from 2010 until 2023 in this retrospective, real-world cohort. Over a third of SOTRs (n=151, 38.23%) developed invasive skin cancer. High-risk SOTRs (n=30) displayed the shortest time to first post-transplant invasive skin cancer, followed by intermediate- (n=112) and low-risk SOTRs (n=253) (p<0.0001). In adjusted analyses, intermediate- and high-risk SOTRs had 5.98-fold (95% confidence intervals (CI): 4.05-8.34) and 11.90-fold (95% CI: 7.02-20.19) higher hazard of invasive skin cancer compared to low-risk SOTRs, respectively. Intermediate- and high-risk SOTRs had 1.53-fold (95% CI: 1.03-2.27) and 1.97-fold (95% CI: 1.10-3.54) higher hazard of death compared to low-risk SOTRs. Ten patients developed metastasis and four died of skin cancer. This model serves as a dynamic tool for follow-up and provides time-to-skin-cancer discrimination between intermediate- and low-risk SOTRs. The findings illustrate the potential utility of risk-based stratification of SOTR follow-up and secondary prevention of cutaneous malignancies, potentially improving survival outcomes in this patient group.

Background and Objectives: Myocardial protection during on-pump coronary artery bypass grafting (CABG) limits ischaemic injury, particularly in patients with left main coronary artery disease (LMCAD), in whom severe proximal stenosis may compromise antegrade cardioplegia delivery. We investigated whether combined antegrade–retrograde blood cardioplegia reduces postoperative high-sensitivity cardiac troponin I (hs-cTnI) concentrations, a marker of perioperative myocardial injury. Materials and Methods: We conducted a prospective, single-centre, randomised trial involving 60 adults undergoing elective isolated on-pump CABG for significant LMCAD. Patients were assigned (1:1) to antegrade-only or combined antegrade–retrograde blood cardioplegia. Cardiac biomarkers were measured after induction and at 4, 12, 24, and 48 h after ICU admission. The primary endpoint was peak hs-cTnI within 48 h; key secondary endpoints included the hs-cTnI area under the concentration–time curve, CK-MB, immediate myocardial electrical recovery and 30-day outcomes. Results: All patients received the assigned cardioplegia strategy, with no crossover. Peak hs-cTnI did not differ significantly between the antegrade-only and combined groups (median 529.1 [IQR 829.9] vs. 394.1 [503.4] ng/L; p = 0.21), nor did the hs-cTnI area under the concentration–time curve from 4 to 48 h (12,910.6 [23,127.4] vs. 8112.2 [11,686.2] ng·h/L; p = 0.16). Serial hs-cTnI, CK-MB, total creatine kinase, serum creatinine, immediate myocardial electrical recovery, and 30-day outcomes also did not differ significantly. No deaths, coronary sinus injuries, or other cardioplegia-related complications occurred. Conclusions: In patients undergoing isolated on-pump CABG for significant LMCAD, combined antegrade–retrograde blood cardioplegia did not significantly decrease peak hs-cTnI levels compared to the antegrade-only method. The combined approach was feasible with no cardioplegia-related complications, suggesting that an individualised strategy may be preferable to a routine one. Larger prospective studies are needed to determine whether higher-risk patients may derive greater benefit.

Background/Objectives: In heart failure with preserved ejection fraction (HFpEF), the gut–heart axis has emerged as a potential contributor to inflammation and cardiometabolic stress. We characterised gut microbiota composition, diversity, and predicted metabolic potential in HFpEF to assess their associations with disease status and clinical heterogeneity. Methods and Results: Faecal samples from 30 HFpEF patients and 28 healthy controls were profiled by means of bacterial ribosomal RNA gene sequencing. The groups were comparable in age (74 years in both groups) and sex (female: 60% vs. 60.7%). HFpEF patients exhibited lower community evenness (p = 0.04) and a trend toward lower diversity (p = 0.08), but no detectable shift in global community structure. The tested clinical and demographic variables explained only a modest proportion of the observed variation in community structure, with substantial residual variation across the beta-diversity analyses. No taxa were differentially abundant between groups at the predefined thresholds. Among clinical stratifications, New York Heart Association (NYHA) class showed the most consistent family-level associations, including stepwise depletion of Lachnospiraceae, Butyricicoccaceae, and Ruminococcaceae and enrichment of Akkermansiaceae; Enterobacteriaceae peaked in milder disease. These severity-associated taxonomic trajectories were accompanied by predicted functional shifts consistent with microbial adaptation to increasing metabolic constraints, including enrichment of stress-adaptation traits and, with increasing functional limitation, depletion of core metabolic and fermentative pathways and relative enrichment of oxidative stress-response pathways. Conclusions: HFpEF is associated with subtle gut microbiota alterations that appear to reflect severity- and context-dependent ecological reorganisation rather than uniform dysbiosis. These findings support severity-informed approaches targeting microbial metabolic function and ecological context rather than broad compositional changes.

ABSTRACT Background Climate change is intensifying public health risks and placing increasing pressure on disaster medicine systems. These challenges require adaptation strategies that incorporate climate justice principles and the One Health framework. Objective This scoping review aimed to examine how climate justice and One Health principles are incorporated into public health and disaster medicine adaptation policies. Methods A scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta‐analyses extension for Scoping Reviews (PRISMA‐ScR) guideline using major scientific databases (Scopus, PubMed and Web of Science) and global health organization resources published between 01 January 2005 and 31 October 2025. Critical appraisal of included evidence was assessed using design‑specific tools: the JBI Critical Appraisal Checklist for systematic reviews and the Mixed Methods Appraisal Tool (MMAT) for mixed‑methods studies. Data were synthesized to assess the degree of public health engagement in climate adaptation and the incorporation of climate justice and One Health principles. Results Out of a total of 19,835 records, eight eligible studies were included. The eight studies comprised six review articles and two mixed‑methods studies, with geographic coverage, including Pakistan, the United States, Greece and multi‑country or global analyses. Findings reveal persistent inequities in climate‐related health impacts, particularly among marginalized and resource‐limited populations. Health sector participation in national adaptation plans remains limited, with policies often fragmented, mitigation‐oriented or insufficiently aligned with One Health principles. Structural inequalities, weak governance, gender disparities and limited multisector coordination hinder equitable adaptation. Climate stressors, including extreme weather events, air pollution, vector‐borne diseases and environmental degradation, disproportionately affect communities with the lowest adaptive capacity. Conclusions There is an urgent need for standardized vulnerability assessment frameworks, stronger multisector collaboration, improved early‐warning systems and enhanced capacity building through international public health institutions.

ABSTRACT Introduction Visceral hypersensitivity (VHS) is considered a hallmark of irritable bowel syndrome (IBS) characterized by altered thresholds for rectal pain and discomfort during rectal distention. Rectal distention can also elicit the urge to defecate, a normal physical sensation that is, reported more often in IBS and may involve mechanisms distinct from pain and discomfort. This study investigates clinical, psychological, and physiological correlates of increased urge to defecate in IBS compared with healthy controls (HC), including sex‐based differences. Methods Patients with IBS (Rome III criteria) and HC underwent rectal balloon‐distension and completed questionnaires on demographics, lifestyle, gastrointestinal (GI) and psychological symptoms, and health‐related quality of life (HrQoL). Latent clusters were identified using finite‐mixture modeling, and associated determinants were evaluated using multivariable logistic regression analyses. Results Among 322 participants (220 IBS, 102 HC), the occurrence of the urge to defecate was more frequent in IBS than in HC (80.9% vs. 51.9%; p < 0.001) and often co‐occurred with rectal pain and discomfort, particularly in patients with VHS. Latent class analysis identified three clusters, primarily distinguished by rectal symptom‐distribution, with the most symptomatic cluster showing greater GI‐symptom severity, higher psychological burden, and lower HrQoL (all p < 0.001). Regression analyses confirmed associations of urge with GI symptom severity, depressive symptom scores, and co‐occurrence of pain/discomfort, but no association was found based on IBS subtype or sex. Conclusion Increased urge to defecate is highly prevalent in IBS, strongly associated with rectal pain, rectal discomfort, psychological burden, and reduced HrQoL, but not in the IBS subtype, suggesting shared or overlapping mechanisms, particularly in the context of VHS. These findings underscore its clinical and pathophysiological relevance, supporting its value for patient‐phenotyping and tailored management. Trial Registration The Maastricht Irritable Bowel Syndrome (MIBS) cohort study was registered under the registration number NCT00775060

Older adults represent a rapidly expanding subgroup of patients with inflammatory bowel disease, yet they remain markedly under-represented in pivotal clinical trials, limiting age-specific estimates of drug benefit and harm. This review synthesises the available evidence on the influence of ageing on the pharmacology, efficacy and safety of orally administered targeted inflammatory bowel disease therapies, focusing on registered Janus kinase inhibitors (tofacitinib, upadacitinib, filgotinib) and sphingosine-1-phosphate receptor modulators (ozanimod, etrasimod). Because the available age-stratified evidence is sparse and heterogeneous, a narrative review methodology was chosen to map the literature and identify knowledge gaps. We pragmatically report age-related findings using the age cut-offs applied in original studies and map outcomes including clinical and endoscopic response/remission, corticosteroid sparing and adverse drug events of special interest (serious/opportunistic infections, cardiovascular and thromboembolic events, malignancies and treatment discontinuation). Across the limited age-stratified datasets, efficacy appears largely maintained in older patients, but the evidence base is heterogeneous and frequently lacks dedicated analyses. Ageing-related physiological changes, comorbidity, frailty and polypharmacy are expected to modulate pharmacokinetic and pharmacodynamic variability and to amplify the clinical relevance of class-specific safety concerns, particularly infections, major adverse cardiovascular events and malignancy signals with Janus kinase inhibition and initiation-related cardiovascular/conduction considerations with sphingosine-1-phosphate modulation. There is, however, no clear consensus on how ageing-related vulnerability, including frailty and comorbidity burden, should be defined, measured, and reported across studies, which complicates the interpretation and comparison of outcomes. In the absence of robust outcome data for older adults with inflammatory bowel disease, treatment selection should be guided by biological vulnerability (frailty, organ function, comorbidity burden) and structured risk-mitigation strategies, while future research should prioritise age- and frailty-enriched prospective studies with geriatric-relevant outcomes and long-term pharmacovigilance.