Search Results (476,207)

Patients with cancer often experience intertwined symptom burden and functional decline that contribute to falls, unsafe transfers, uncontrolled symptoms, caregiver strain, and crisis-driven care. Physical medicine and rehabilitation (PM&R), also known as physiatry, and specialty PC both address suffering and quality of life through complementary clinical approaches; however, collaborative care with and between these two specialties is inconsistent in routine oncology practice. This paper presents a clinical implementation framework informed by targeted literature synthesis for bidirectional referral and co-management between PM&R and PC in oncology. The framework was informed by the PC referral criteria literature, cancer rehabilitation triage literature, trigger-based serious illness identification models, and implementation science. Four clinic-usable tools are proposed, including a scope and overlap map, a clinical-needs gradient, a referral trigger table linking common clinical signals to the reason for referral and expected clinical actions, and a primary-service triage workflow. This framework is intended to clarify which service is best positioned to be the primary supportive service according to the patient’s current needs, when rehabilitation therapy alone may be sufficient, and when co-management should be the default. This concept-to-practice model is designed to facilitate early, needs-based referrals and coordinated supportive care in oncology settings. Full article

This paper presents the structural characterization of zinc coatings on S235JR steel elements. The study offers a novel and comprehensive assessment of zinc coatings applied to profiled steel elements through hot-dip galvanizing. It examines coatings formed under real industrial production conditions, providing practical insight into their behavior on complex geometries. The characterization includes metallographic, mechanical, diffraction, and tribological tests. Metallographic observations revealed the layered structure of zinc coatings, consisting of the η, ζ, δ, and Γ phases, each with varying chemical compositions and microhardness. All coatings exhibited similar resistance to damage initiation; however, microscopic analysis revealed differences in their subsequent degradation. The thickest coating showed earlier formation of adhesive cracks, indicating increased stress concentration and a faster progression of damage. Full article

Metastasis, the primary cause of cancer mortality, relies on malignant cells acquiring extreme mobility and mechanical plasticity. We posit that this physical transition is driven not by de novo genetic innovations but by an atavistic reversion to highly conserved cytoskeletal blueprints, termed “Fungal Islands.” Through in silico sequence alignments and molecular docking, we investigated structural homology between human septin-9 (SEPT9) and its yeast ortholog, Cdc3. Our analysis reveals structural and thermodynamic parity within the G1/P-loop catalytic core across billions of years of eukaryotic divergence. This precise preservation of spatial configuration provides strong evidence against convergent evolution, demonstrating the core septin engine is constrained by intense purifying selection. Consequently, we argue that malignant cells exapt these functionally immutable ancestral nodes to drive a biomechanical shift, mirroring the invasive mechanics of fungal hyphal tips. This identifies a non-mutating structural template for next-generation ‘migrastatic’ therapies, offering a strategy to disable cancer’s migratory machinery while evading the mutational resistance typical of modern kinase inhibitors. Full article

Countermovement jump (CMJ) analysis is widely used to assess lower limb neuromuscular function, but commercial force plates often suffer from high cost, closed algorithms, and lack of bilateral independent measurement. This study developed and evaluated a dual channel strain gauge force plate system featuring open architecture and hardware-triggered video synchronization. The system consists of two physically isolated plates, each with four full bridge strain beams, a precision analog front end, and a 2000 Hz acquisition unit. A microcontroller-based hardware trigger synchronizes force data with video capture. Custom host software implements adaptive jump phase recognition and calculates peak force (PF), concentric impulse, jump height, rate of force development (RFD), and asymmetry index (ASI). Validation included static mass measurements in 14 participants, low-load static calibration (5.0–30.0 kg), free-fall impulse validation (7.00 to 31.32 N·s), 240 fps high-speed video cross validation of flight time, ecological-validity comparison with published AMTI-based force-plate data, and 48 h test–retest reliability assessment. Static mass measurement showed a mean absolute percentage error (MAPE) of 1.01% and a coefficient of determination (R²) of 0.9992, while low-load testing confirmed excellent linearity (R² > 0.996) and minimal absolute error (mean absolute error = 0.34 kg) at lighter weights. Dynamic impulse validation yielded R² > 0.997 and MAPE < 3%. Flight time agreement with high-speed video was within ±10 ms. Test–retest reliability was excellent for concentric impulse (intraclass correlation coefficient (ICC) = 0.997) and jump height (ICC = 0.987), and good for PF (ICC = 0.962) and rate of force development at 100 ms (RFD_100ms) (ICC = 0.883). The physically isolated dual-plate architecture effectively captured bilateral force differences, although the ASI demonstrated moderate reliability (ICC = 0.748), likely reflecting the inherent biological variability in bilateral coordination. The ecological-validity comparison further indicated that the macroscopic kinetic outputs of the proposed system fell within the expected physiological and biomechanical ranges reported for adult CMJ testing. Overall, these findings support the study hypothesis that the proposed dual-channel force plate system provides a valid, reliable, and cost-effective solution for synchronized bilateral CMJ kinetic assessment in sports performance monitoring and biomechanical research, while offering improved accessibility through an open-source and transparent analysis framework with a hardware cost below 500 USD. Full article

Flood susceptibility in Pakistan is strongly influenced by hydro-climatic variability, land-surface conditions, topography, and recurrent floodplain exposure; however, national-scale studies often lack a comprehensive assessment that captures both spatial patterns and temporal flood-risk dynamics within a single framework. This study is one of Pakistan’s first national efforts to address the gap between flood risk assessment and prioritization through a unified geospatial assessment. This study assesses flood susceptibility across Pakistan for 2002, 2012, and 2022 using a GIS-based AHP approach by integrating climatic, environmental, topographic, hydrological, soil, LULC, and anthropogenic indicators. The study results were further analyzed through district-level assessments, risk change analysis, persistence mapping, LULC exposure assessments, and the Comprehensive Flood Risk Priority Index (FRPI). The results show that high and very high flood susceptibility zones are primarily concentrated along the Indus River corridor, lower floodplains, and coastal Sindh, accounting for more than 7% of the total land area of Pakistan. Persistent flood hotspots are identified in Rann of Kutch (66.6%), Jacobabad (65.0%), and Jafarabad (61.1%), indicating strong temporal stability of flood-prone conditions. LULC exposure analysis reveals that cropland is the dominant exposed class, with the highest district-level exposure observed in Badin (17.1%) and Larkana (10.1%). The FRPI further identifies priority flood-risk zones where susceptibility, persistence, risk change, and exposure converge, with the highest FRPI values observed in Jacobabad (0.742), Rann of Kutch (0.738), and Badin (0.711). Model validation demonstrates strong predictive performance, with susceptibility ROC-AUC values ranging from 0.85 to 0.87 and FRPI AUC reaching 0.85. The proposed framework provides a robust decision-support tool for targeted flood-risk management and climate-resilient land-use planning in Pakistan. Full article

In this paper, we investigate a class of fractional functional differential systems with feedback control, in which the fractional derivatives are interpreted in the Caputo sense. By applying Schauder’s fixed point theorem with the Arzelà–Ascoli compactness criterion, we derive existence results for the solutions. Furthermore, specific hypotheses are introduced to establish uniqueness, continuous dependence of the unique solution, and Hyers–Ulam stability of the considered problem. The applicability and relevance of the theoretical results are further demonstrated through several special cases and illustrative examples. The main contribution of this study is to provide a qualitative analysis of a coupled Caputo fractional functional system involving nonlocal integral conditions and feedback control. Full article

Examining how artificial intelligence industry agglomeration (AIIA) affects carbon and pollution reduction is crucial for China’s agricultural sustainability. Existing research mainly examines the effect of artificial intelligence (AI) on the reduction of single pollutants while overlooking how industry agglomeration influences the marginal cost of coordinated abatement, a key issue for the agricultural resource–environment–economy system. Using panel data for 30 Chinese provinces from 2016 to 2024, this study constructs a marginal cost-based indicator of agricultural pollution–carbon reduction synergy (APCRS) and examines the effect of AIIA. The full-sample results reveal that AIIA has a U-shaped relationship with APCRS. Technological progress partially mediates this relationship. Agricultural socialized services and rural industrial integration buffer the initial negative association, whereas agricultural labor productivity strengthens the curvature of the estimated nonlinear pattern. The effect of AIIA also varies with external conditions and is more pronounced in regions with higher levels of marketization and industrialization while remaining significantly U-shaped across grain strategic zones. This dynamic process is more likely to emerge when public innovation investment and rural household income exceed critical thresholds. These findings provide new evidence for understanding how AI-driven agglomeration can support green agricultural transformation. Full article

Train-induced vibrations pose a significant threat to foundation pit slopes adjacent to railways during parallel construction or line renovation projects. To address this issue, this paper proposes a periodic steel-sheet pile barrier for vibration mitigation in narrow construction sites. Firstly, field tests were conducted along the Qinbei Railway in China. The acceleration time history and dominant frequency (27.6 Hz) of ground vibrations were obtained. Secondly, based on periodic structure theory, the dispersion relations and band-gap characteristics of periodic steel-sheet piles were analyzed using the finite element method. Parametric studies were then performed to investigate the effects of key factors, including periodic constants, pile spacing and pile count per unit cell, and construction deviations, on the band-gap boundaries and width. Subsequently, frequency-domain, time-domain, and slope stability analyses were carried out to evaluate the isolation performance. The results show that the optimized barrier, with parameters of a = 1.6 m, D = 0.1 m, n₁ = n₂ = 4, and L = 2S, reduced the peak acceleration by 70% and achieved a vibration reduction of up to 88% at the dominant frequency. Furthermore, slope stability analysis revealed that the barrier increased the factor of safety from 1.16 to 1.46, exceeding the code-required minimum of 1.2–1.3. This study provides a potentially cost-effective and construction-friendly solution for protecting temporary foundation pit slopes from train-induced vibrations in railway-adjacent areas. Full article

The Engineering-Procurement-Construction (EPC) general contracting model has emerged as the dominant delivery method for large-scale infrastructure and industrial projects in China. However, contemporary EPC project cost control remains plagued by critical industry challenges, including fragmented cross-stage coordination, pervasive data silos, and the shallow integration of digital technologies into core management processes. This study considers three key stakeholders—government regulators, project owners, and EPC general contractors—and develops a tripartite evolutionary game model to analyze the strategic interactions underlying intelligent cost control in EPC projects. We examine the evolutionary stability of each stakeholder’s strategy selection, explore how various factors influence tripartite strategic choices, and further investigate the stability of equilibrium points in the game system. The key findings are summarized as follows: (1) Strengthening government incentives and penalties simultaneously promotes owners’ investment in intelligent cost control systems and general contractors’ active collaborative cost management. However, excessive incentive intensity undermines the government’s regulatory effectiveness. (2) Establishing a revenue-sharing mechanism for excess cost savings fully stimulates the spontaneous cooperation willingness of owners and general contractors, serving as the cornerstone for market-oriented operation of intelligent cost control. (3) Reducing owners’ intelligent construction investment costs and general contractors’ collaborative control costs effectively addresses practical implementation barriers and accelerates the digital upgrading of engineering cost management. Finally, numerical simulations are performed using MATLAB R2020b to validate theoretical findings. Full article

Accurate extraction of transmission towers from Unmanned Aerial Vehicle (UAV) Light Detection and Ranging (LiDAR) point clouds is a prerequisite for overhead transmission line (OTL) acceptance. This task remains challenging because tower points are heavily entangled with ground, vegetation, conductors, and insulators, especially in complex terrain. To address this issue, we propose a shape prior-guided coarse-to-fine framework for tower extraction from UAV LiDAR point clouds. First, candidate tower regions are localized from the scene point cloud through preprocessing, near-ground suppression, and density-based clustering. Second, the least-disturbed central body of each candidate tower is identified in a slice-wise manner and used to estimate the tower orientation and four principal structural axes. Third, side-view and front-view structural envelopes are progressively inferred to suppress non-tower points around the tower body and tower head. Finally, a base-constrained filtering strategy is introduced to remove residual ground and low-vegetation points within the tower footprint. Experiments conducted on multiple OTL datasets acquired in different regions of China, including plains and mountainous areas, demonstrate that the proposed method achieves robust and efficient tower extraction across diverse scenarios. The results indicate that explicit structural priors offer a promising complement to feature-driven and data-intensive approaches, particularly in scenarios with limited annotated data and strict real-time requirements. The proposed method processes scene point clouds containing tens to hundreds of millions of points, with an average extraction time of approximately 100 to 300 s per tower depending on scene density. Full article

Introduction: Giant sinus of Valsalva aneurysms (SVA) represent a rare cardiovascular pathology that may remain asymptomatic for an extended period. However, they are associated with a high risk of life-threatening complications, including compression of adjacent structures and aneurysm rupture. Case presentation: We report a clinical case of a 71-year-old female patient with a long-standing history of arterial hypertension and cardiac arrhythmias, in which echocardiography revealed aneurysmal dilatation of the right coronary sinus. Cardiac computed tomography (CT) confirmed the presence of a giant aneurysm of the right sinus of Valsalva measuring 70 × 51 × 49 mm, compressing the outflow tracts of both ventricles (right—up to 7 mm, left—up to 8 mm) and the left inferior pulmonary vein (up to 3 mm), which clinically manifested as dyspnoea, lower-extremity oedema, and rhythm disturbances. The patient successfully underwent complex reconstructive surgery, including aortic root replacement and valve repair. Despite the technical success of the operation, the patient died from pneumonia three months postoperatively. Discussion: This observation underscores the critical role of imaging modalities (echocardiography and CT) in verifying this pathology. The use of multimodal imaging facilitated both a timely diagnosis and a detailed three-dimensional evaluation of the aneurysm’s relationship with adjacent structures. This information, in turn, guided personalised surgical planning. Conclusions: This case highlights the necessity of considering giant SVA in the differential diagnostic workup of patients who present with unexplained symptoms of heart failure. Full article

Cohabiting companion dogs establish hierarchy among themselves. It is hypothesized that the owner represents the main and undividable resource, thus primary access to this is a main organizing factor of rank-related behaviors of dogs. Here we tested high- and low-ranking cohabiting companion dogs’ (N = 70) reactions to their owner’s absence in a 3 min separation test. Rank scores have been assigned with a validated questionnaire (DRA-Q). We predicted that dominant dogs would show stronger reactions to being separated from their owner. Indeed, we found that higher-ranking dogs showed more intense activity and sooner arising attempts to leave the room (rearing at the wall, scratching the door, moving around, barking) than lower-ranking dogs did. These reactions may show also the intention to reestablish their connection with the absent owner. The associations between dogs’ rank and the behavioral responses were modified by the dogs’ age (negatively), the number of cohabiting dogs (positively), and we found that subcategories of the dog’s dominant status (such as ‘agonistic’ and ‘leadership’ subscales) were also associated with finer details of the outcome. These are the first results indicating that presence of the owner may provide more reassurance to higher-ranking dogs against stress than it does to lower-ranking dogs. Full article

Background: Clinical reasoning is a vital competency for safe nursing practice, yet no validated Arabic instrument exists to assess this skill among nursing students in Saudi Arabia. Aim: This study aimed to translate, culturally adapt, and psychometrically evaluate the Arabic version of the Clinical Reasoning Scale (CRS) and to investigate clinical reasoning among Saudi nursing students. Methods: This methodological instrument validation study with a cross-sectional survey component was conducted in Saudi Arabia between January 2024 and May 2025 among nursing students. The Arabic Clinical Reasoning Scale (CRS-A) was translated and culturally adapted in accordance with the WHOQOL Group guidelines for instrument translation. Content validity was assessed by 10 experts, and construct validity was evaluated using exploratory factor analysis (n = 365). The response rate was 98.65%. Internal consistency was evaluated using Cronbach’s alpha (n = 365), and test–retest reliability (n = 30) was measured with the Intraclass Correlation Coefficient (ICC) over a two-week period. Descriptive statistics, one-way analysis of variance (ANOVA), and independent sample t-tests were also performed. Results: The tool’s content validity (S-CVI = 0.98) was confirmed by a panel of experts. The CRS-A demonstrated excellent temporal stability (ICC = 0.95, p < 0.001) and internal consistency (Cronbach’s α = 0.935). The exploratory factor analysis showed that the 16 items’ factor loadings ranged from 0.542 to 0.807, and three factors accounted for 64.33% of the total variance. Students self-reported agreement with clinical reasoning abilities (mean scores: 3.81–4.18). No significant differences in clinical reasoning were found by age (p = 0.102) or gender (p = 0.226), but significant differences were found by Cumulative Grade Point Average (CGPA) (p < 0.001). Conclusions: The Arabic Clinical Reasoning Scale demonstrated preliminary psychometric performance for measuring clinical reasoning among Arabic-speaking student nurses. It provides educators with a valuable tool for identifying learning needs and evaluating educational interventions. Full article