Search Results (2,290)

I argue that the universally accepted assumption that in realist fiction a character narrator’s narration contributes to their characterization needs to be complicated. Working with a conception of narrative as rhetoric that highlights readerly interest in the author’s handling of the mimetic, thematic, and synthetic components of narrative, I suggest that the question about narration as characterization is one about the relation between the mimetic (character as possible person) and synthetic (character as invented construct) components. In addition, understanding the mimetic-synthetic relation requires attention to issues at the macro and micro levels of such narratives. At the macro level, I note the importance of (1) the tacit knowledge, shared by both authors and audiences, of the fictionality of character narration, which means authors write and readers read with an interest in its payoffs; and of (2) the recognition that character narration functions simultaneously along two tracks of communication: that between the character narrator and their narratee, and that between the author and their audience. These macro level matters then provide a frame within which authors and readers understand what happens at the micro level. At that level, I identify seven features of a character’s telling that have the potential to be used for characterization—voice, occasion, un/reliability, authority, self-consciousness, narrative control, and aesthetics. I also note that these features have their counterparts in the author’s telling. Finally, I propose that characterization via narration results from the interaction between the salient features of the character’s telling and their counterparts in the author’s telling. I develop these points through the analysis of four diverse case studies: Mark Twain’s Huckleberry Finn, Robert Browning’s “My Last Duchess,” Nadine Gordimer’s “Homage,” and Ernest Hemingway’s A Farewell to Arms. Full article

The design of the suspension system affects handling and stability, vibrations of the steered wheels, vehicle ride comfort, and tyre tread wear. One of the most important vibration parameters is acceleration; high acceleration values can have an adverse effect on both the driver and passengers, as well as on the components of the vehicle’s suspension and handling. This paper presents the results of the effects of acceleration on the components of a front-independent MacPherson suspension system. Data on the accelerations were obtained from theoretical and experimental studies. A simulation study was conducted, taking into account the elastic and damping characteristics of the elastic components. The experimental study was conducted under laboratory conditions by using a suspension tester, BEISSBARTH, and a measuring system developed with LabVIEW 2021 SP1 and MATLAB R2022b software. The experiments were conducted with different tyre pressures and by using bushings made from different materials. The experimental tests were conducted with two rubber bushings within the mounting of the arm, as well as a rubber bushing and a polyurethane bushing. The experimental results were compared and analyzed. Two theoretical models were considered: one is a mathematical model, and the other is a simulation model which uses the finite element method. Numerical dynamic analysis of the suspension was performed using the SolidWorks 2023. Full article

Background: Immune checkpoint inhibitors (ICIs) have reshaped the treatment landscape of metastatic melanoma. While combination regimens often demonstrate improved response and survival compared to monotherapy, they are also associated with a higher incidence of immune-related adverse events (irAEs). Understanding the balance between benefit and risk is essential for making informed treatment decisions, especially given the variability in reported outcomes across clinical trials. Methods: We conducted a systematic review and meta-analysis of 14 clinical trials (comprising 22 treatment arms and >5000 patients) comparing ICI monotherapy (nivolumab, ipilimumab, or pembrolizumab) and combination therapy (nivolumab + ipilimumab) in advanced melanoma. Treatment-related outcomes were synthesized using fixed-effects, random-effects, or generalized linear mixed models (GLMMs), depending on study variability. Survival data were extracted from published Kaplan–Meier curves and analyzed using longitudinal GLMMs to capture trends over time. Results: Compared to monotherapy, combination immunotherapy achieved higher clinical benefit, with an overall response of 52.2% (vs. 31.6%), a five-year overall survival of 55.7% (vs. 34.3%), and a five-year progression-free survival of 39.0% (vs. 17.2%). However, this benefit came with a higher risk of toxicity: immune-related adverse events occurred in 93.2% of patients receiving combination therapy versus in 81.9% receiving monotherapy. Differences were consistent across all individual severe toxicities. Conclusions: Combination immunotherapy offers greater long-term clinical benefit than monotherapy in metastatic melanoma but at the cost of increased toxicity. By applying models adapted to study variability, we provide more reliable estimates of treatment efficacy and risk. GLMMs provide the most robust estimates and enable the modeling of survival dynamics over time. These findings support evidence-based decision-making and highlight the value of model-informed meta-analysis in oncology. Full article

Circulating current control is a critical part of the Modular Multilevel Converter (MMC) control system. Existing control methods rely on arm current information obtained from complex current measurement devices. However, these devices are susceptible to failures, which can lead to distorted arm currents, increased peak arm current values, and higher losses. In extreme cases, this can result in system instability. This paper first analyzes four typical arm current measurement faults, i.e., constant gain faults, amplitude deviation faults, phase shift faults, and stuck faults. Then, a Kalman Filter (KF)-based fault detection method is proposed, which allows for the simultaneous monitoring status of all six arm current measurements. Moreover, to facilitate fault detection, the Moving Root Mean Square (MRMS) value of the observation residual is defined, which effectively detects faults while suppressing noise. The entire fault detection process takes less than 20 ms. Finally, the feasibility and effectiveness of the proposed method are validated through MATLAB/Simulink simulations and experimental results. Full article

Chionea is classified within the Tipuloidea superfamily and predominantly inhabits cold regions. However, its phylogenetic relationships remain contentious. In this study, the first three mitogenomes of Chionea (Diptera: Limoniidae) sampled in northeastern China (Jilin region) were sequenced, and their phylogenetic relationships were reconstructed by integrating these sequences with 30 additional Tipuloidea mitogenomes retrieved from NCBI. Unlike other Tipuloidea species, which are predominantly distributed in relatively warmer regions, this research investigates whether positive selection has acted on the mitogenomes of these three Chionea species due to environmental pressures, thereby elucidating key evolutionary drivers for Chionea. The three mitogenomes of Chionea exhibit characteristic features typical of insect mitogenomes, comprising 13 protein-coding genes (PCGs), 2 ribosomal RNA genes (16S rRNA and 12S rRNA), 22 transfer RNA genes (tRNA), and a single non-coding control region (D-loop). Notably, the secondary structure of trnS1 lacks the DHU arm in all three samples, and UUA (Leu) emerges as the most frequently utilized codon. Furthermore, the COX2 and ND5 genes utilize incomplete stop codons “T”. Utilizing these 13 PCGs, we reconstructed the internal phylogenetic relationships within Tipuloidea, revealing that Chionea tianhuashana and C. sphaerae form sister branches, while (C. tianhuashana + C. sphaerae) constitutes a sister branch to C. crassipes. Moreover, our analysis confirms the monophyly of Tipulidae, Tipula, and Nephrotoma as well as the polyphyly of Tipulinae, Chioneinae, and Limoniidae. In the branch site model analysis, three positively selected sites were detected when Chionea was designated as the foreground branches: COX3 (at position 242), ND5 (at position 535), and ND6 (at position 138). Full article

In an era defined by rapid technological advancements, the intersection of artificial intelligence and industrial innovation has garnered significant attention from both academic and industry stakeholders. The emergence of Industry 4.0, characterized by the integration of cyber–physical systems, the Internet of Things, and smart manufacturing, demands the evolution of operational methodologies to ensure processes’ sustainability. One area of focus is the development of wearable systems that utilize artificial intelligence for the estimation of arm movements, which can enhance the ergonomics and efficiency of labor-intensive tasks. This study proposes a Random Forest-based regression model to estimate upper arm kinematics using only shoulder orientation data, reducing the need for multiple sensors and thereby lowering hardware complexity and energy demands. The model was trained on biomechanical data collected via a minimal three-IMU wearable configuration and demonstrated high predictive performance across all motion axes, achieving R² > 0.99 and low RMSE scores on training (1.14, 0.71, and 0.73), test (3.37, 1.97, and 2.04), and unseen datasets (2.77, 0.78, and 0.63). Statistical analysis confirmed strong biomechanical coupling between shoulder and upper arm motion, justifying the feasibility of a simplified sensor approach. The findings highlight the relevance of our method for sustainable wearable technology design and its potential applications in rehabilitation robotics, industrial exoskeletons, and human–robot collaboration systems. Full article

This study investigates how three technical factors—steering wheel tilt, torque, and cabin vibration frequency—affect driver posture. Heavy-truck drivers often suffer from musculoskeletal disorders (MSDs), mainly due to poor cabin ergonomics and prolonged postures during work. In countries like Ecuador, making major structural changes to cabin design is not feasible. These factors were identified through video analysis and surveys from drivers at two Ecuadorian trucking companies. An experimental system was developed using a simplified cabin to control these variables, while posture and muscle activity were recorded in 16 participants using motion capture, inertial sensors, and electromyography (EMG) on the upper trapezius, middle trapezius, triceps brachii, quadriceps muscle, and gastrocnemius muscle. The test protocol simulated key truck-driving tasks. Data were analyzed using ANOVA (${\displaystyle p<0.05}$), with technical factors and mass index as independent variables, and posture metrics as dependent variables. Results showed that head mass index significantly affected head abduction–adduction (${\displaystyle -}$8.12 to ${\displaystyle -}$2.18°), and spine mass index influenced spine flexion–extension (${\displaystyle -}$0.38 to 6.99°). Among technical factors, steering wheel tilt impacted trunk flexion–extension (${\displaystyle -}$13.56 to 16.99°) and arm rotation (${\displaystyle -}$31.1 to 19.7°). Steering wheel torque affected arm rotation (${\displaystyle -}$30.49 to ${\displaystyle -}$6.77°), while vibration frequency influenced forearm flexion–extension (3.76 to 16.51°). EMG signals showed little variation between muscles, likely due to the protocol’s short duration. These findings offer quantitative support for improving cabin ergonomics in low-resource settings through targeted, cost-effective design changes. Full article

Parkinson’s disease (PD) is a neurodegenerative disorder commonly marked by upper limb tremors that interfere with daily activities. Wearable devices, such as smartwatches, represent a promising solution for continuous and objective monitoring in PD. This study aimed to develop and validate a tremor-detection algorithm using smartwatch sensors. Data were collected from 21 individuals with PD and 27 healthy controls using both a commercial inertial measurement unit (G-Sensor, BTS Bioengineering, Italy) and a smartwatch (Apple Watch Series 3). Participants performed standardized arm movements while sensor signals were synchronized and processed to extract relevant features. Statistical analyses assessed discriminant and concurrent validity, reliability, and accuracy. The algorithm demonstrated moderate to strong correlations between smartwatch and commercial IMU data, effectively distinguishing individuals with PD from healthy controls showing associations with clinical measures, such as the MDS-UPDRS III. Reliability analysis demonstrated agreement between repeated measurements, although a proportional bias was noted. Power spectral density (PSD) analysis of accelerometer and gyroscope data along the x-axis successfully detected the presence of tremors. These findings support the use of smartwatches as a tool for detecting tremors in PD. However, further studies involving larger and more clinically impaired samples are needed to confirm the robustness and generalizability of these results. Full article

This study aims to evaluate the real-world efficacy and safety of aflibercept 8 mg intravitreal injections (IVTs) in pretreated patients with neovascular age-related macular degeneration (nAMD) throughout the first three IVTs. Background: Established anti-vascular-endothelial-growth-factor (anti-VEGF) therapies positively impact the progression of nAMD but require frequent administration, thus burdening patients and the healthcare system. Pivotal trials of the recently approved aflibercept 8 mg have demonstrated extended dosing intervals with comparable safety to standard treatments. However, real-world data is still scarce. Methods: A retrospective, single-center single-arm analysis was conducted on 22 eyes from 18 pretreated nAMD patients. Eyes were switched from other anti-VEGF agents to aflibercept 8 mg injections continuing a treat-and-extend regimen (no loading dose after switching). Treatment intervals and structural (central subfield thickness (CST); disease activity) and functional (best corrected visual acuity (BCVA)) outcomes were assessed at baseline (date of first aflibercept 8 mg injection) and at follow-up examinations until follow-up 3. Safety data, including intraocular pressure changes, were recorded. Results: Over a median follow-up of 16.6 weeks (IQR 15.1–27.0), patients switched to aflibercept 8 mg showed prolonged intervals between injections (5.5 weeks vs. 7 weeks, p < 0.001, Wilcoxon signed-rank test), reduced disease activity, stable CST, and stable BCVA. One patient experienced transient intraocular pressure elevation, which resolved without intervention. No other adverse events were observed. Conclusions: Treatment with aflibercept 8 mg appears to provide effective disease control with prolonged treatment intervals in switched nAMD patients in routine clinical practice. These findings further indicate the potential for reducing treatment burden. Full article

Background: This study aimed to develop a method to analyze the kinetic and kinematic characteristics of the traditional karate Gyaku Tsuki (reverse punch), focusing on the activation sequence of lower and upper extremities and trunk muscles during execution. Methods: An elite male (N = 1) karate athlete (in kata) performed 20 Gyaku Tsuki punches while equipped with 16 wireless surface EMG sensors integrated with 3-axis accelerometers. The five punches with the highest forearm acceleration were selected for analysis. EMG, accelerometer, and synchronized video data were recorded and processed. Results: A novel visualization technique was developed to represent muscle activation over time, distinguishing a spectrum of 0–25–50–75–100% activation levels. Muscle activation times for arm, leg, and trunk muscles ranged from −0.31 to −0.11 s relative to punch execution, indicating rapid, coordinated muscle engagement. Conclusions: This method enables detailed analysis of muscle activation patterns in karate punches. It offers valuable insights for biomechanics researchers and practical applications for coaches aiming to enhance performance and prevent injuries through better understanding of movement dynamics. Full article

Background: Prevention and clinical management of musculoskeletal injuries have historically focused on the assessment and training of modifiable physical factors, but perceptual decision-making has only recently been recognized as a potentially important capability. Immersive virtual reality (VR) systems can measure the speed, accuracy, and consistency of body movements corresponding to stimulus–response instructions for the completion of a forced-choice task. Methods: A cohort of 26 female college soccer players (age 19.5 ± 1.3 years) included 10 players who participated in a baseline assessment, 10 perceptual-response training (PRT) sessions, a post-training assessment that preceded the first soccer practice, and a post-season assessment. The remaining 16 players completed an assessment prior to the team’s first pre-season practice session, and a post-season assessment. The assessments and training sessions involved left- or right-directed neck rotation, arm reach, and step-lunge reactions to 40 presentations of different types of horizontally moving visual stimuli. The PRT program included 4 levels of difficulty created by changes in initial stimulus location, addition of distractor stimuli, and increased movement speed, with ≥90% response accuracy used as the criterion for training progression. Perceptual latency (PL) was defined as the time elapsed from stimulus appearance to initiation of neck rotation toward a peripheral virtual target. The speed–accuracy tradeoff was represented by Rate Correct per Second (RCS) of PL, and inconsistency across trials derived from their standard deviation for PL was represented by intra-individual variability (IIV). Perceptual Decision Efficiency (PDE) represented the ratio of RCS to IIV, which provided a single value representing speed, accuracy, and consistency. Statistical procedures included the bivariate correlation between RCS and IIV, dependent t-test comparisons of pre- and post-training metrics, repeated measures analysis of variance for group X session pre- to post-season comparisons, receiver operating characteristic analysis, and Kaplan–Meier time to injury event analysis. Results: Statistically significant (p < 0.05) results were found for pre- to post-training change, and pre-season to post-season group differences, for RCS, IIV, and PDE. An inverse logarithmic relationship was found between RCS and IIV (Spearman’s Rho = −0.795). The best discriminator between injured and non-injured statuses was PDE ≤ 21.6 (93% Sensitivity; 42% Specificity; OR = 9.29). Conclusions: The 10-session PRT program produced significant improvement in perceptual decision-making that appears to provide a transfer benefit, as the PDE metric provided good prospective prediction of musculoskeletal injury. Full article

This study introduces a data-driven framework for enhancing the sustainable management of fish species in Romania’s Natura 2000 protected areas through ecosystem modeling and association rule mining (ARM). Drawing on seven years of ecological monitoring data for 13 fish species of ecological and socio-economic importance, we apply the FP-Growth algorithm to extract high-confidence co-occurrence patterns among 19 codified conservation measures. By encoding expert habitat assessments into binary transactions, the analysis revealed 44 robust association rules, highlighting interdependent management actions that collectively improve species resilience and habitat conditions. These results provide actionable insights for integrated, evidence-based conservation planning. The approach demonstrates the interpretability, scalability, and practical relevance of ARM in biodiversity management, offering a replicable method for supporting adaptive ecological decision making across complex protected area networks. Full article

Background/Objective: Non-specific chronic neck pain (CNP) greatly affects the social dynamics, the work performance, and the personal independence of patients. Research emphasizes the significant role of sociological factors, psychological stress, and emotional conflicts in the development, regulation, and endurance of chronic pain. This study aims to explore the influence of emotional conflicts on pain experience among CNP patients, drawing from their experiences. Methods: A phenomenological investigation was conducted, grounded in Heideggerian philosophy, involving CNP patients and healthcare professionals in Madrid, Spain. Participants were recruited from Primary Health Care centers. Data collection methods included semi-structured in-depth interviews, focus groups with patients, focus groups with healthcare providers, participant observation, and reflective diaries. Hermeneutic phenomenology guided the data interpretation. Thematic analysis was applied to transcribed audio recordings. Results: This study included 12 patients with CNP who participated in two in-depth interviews conducted at different time points—before and after receiving physiotherapy treatment. Additionally, 23 CNP patients took part in four focus groups, and 46 healthcare professionals (including physicians, nurses, and physiotherapists) participated in three focus groups. A hermeneutic analysis revealed the following three main categories: “Self-concept and pain experience”, “Daily life obligations and pain perception”, and “Emotional conflicts related to CNP”. Patients described themselves as nervous, having communication difficulties, and often prioritizing family or work tasks, leading to stress. They indicated that their interpersonal conflicts with close relations intensified their perceived pain in the neck, head, shoulders, and arms. Conclusions: From the perspective of the participants in this study, interpersonal and emotional conflicts appear to influence their perception of CNP. Full article

Background: Hand–arm vibration syndrome (HAVS) is a well-recognized occupational condition resulting from prolonged exposure to hand-transmitted vibration (HTV), characterized by vascular, neurological, and musculoskeletal impairments. While vibration exposure is a known risk factor for HAVS, less is understood about the role of personal risk factors and, particularly regarding neurosensory dysfunction. This study aimed to examine the association between vibrotactile (VPT) and thermotactile perception thresholds (TPT) and individual risk factors and comorbidities in HTV-exposed workers. Methods: A total of 235 male HTV workers were evaluated between 1995 and 2005 at the University of Trieste’s Occupational Medicine Unit. Personal, occupational, and health-related data were collected, and sensory function was assessed in both hands. VPTs at 31.5 and 125 Hz and TPTs (for warm and cold) were measured on fingers innervated by the median and ulnar nerves. Results: Multivariable regression analysis revealed that impaired VPTs were significantly associated with age, higher daily vibration exposure (expressed as 8 h energy-equivalent A(8) values), BMI ≥ 25, smoking, vascular/metabolic disorders, and neurosensory symptoms. In contrast, TPTs showed weaker and less consistent associations, with some links to smoking and alcohol use. Conclusions: These findings suggest that, in addition to vibration exposure, individual factors such as aging, overweight, smoking, and underlying health conditions significantly contribute to neurosensory impairment and may exacerbate neurosensory dysfunction in a context of HAVS. The results underscore the importance of including personal health risk factors in both clinical assessment and preventive strategies for HAVS and may inform future research on its pathogenesis. Full article

Background: Scapular body fractures, when significantly displaced or malunited, can cause glenohumeral discomfort and functional disability. This study compares single- and dual-plating techniques in terms of pain, function, and active range of motion (aROM) in patients with scapular body fractures. Methods: Twenty-eight patients with scapular fractures were retrospectively analyzed, with sixteen undergoing single plating treatment and twelve dual plating treatment. The mean age was 44.9 years, and the mean follow-up was 14 months for single plating and 13.8 months for dual plating. Outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) scores, the Visual Analog Scale (VAS) for pain, aROM measurements, and the time to return to work. Functional outcomes were assessed using two-way ANOVA with Šidák’s multiple comparisons test at 2 weeks, 4 weeks, 3 months, 6 months, and 1 year. The time to return to work was analyzed with survival analysis and a log-rank test. Results: The single plating group had higher DASH scores than the dual plating group at 2 weeks (44.88 ± 10.81 vs. 32.75 ± 6.05, p = 0.005), 4 weeks (28.50 ± 5.91 vs. 22.83 ± 4.24, p = 0.033), and 3 months (19.63 ± 2.45 vs. 16.00 ± 2.45, p = 0.004), indicating greater disability. VAS scores were also higher in the single plating group at 2 weeks (4.00 ± 1.21 vs. 2.33 ± 0.88, p = 0.002) and 4 weeks (2.50 ± 1.03 vs. 1.17 ± 0.94, p = 0.008), suggesting faster pain relief in the dual plating group. However, differences were no longer significant after 3 months. At 1 year, the dual plating group demonstrated better external rotation (73 ± 3° vs. 63 ± 5°, p = 0.032), with no significant differences in internal rotation, abduction, or forward flexion. Dual plating patients returned to work earlier (Hazard Ratio = 3.346, 95% CI: 1.208 to 9.269, p = 0.020). Conclusions: In the current cohort, dual plating for scapular fractures offers superior early pain relief and functional outcomes compared to single plating, along with better external rotation at 1 year and an earlier return to work. These findings suggest that dual plating may facilitate faster recovery and enhanced active range of motion in selected patients, a hypothesis that warrants further investigation through future randomized trials. Full article