Search Results (1,751)

Background: A 5–10% weight loss has shown significant clinical improvements in the overall well-being of people with obesity (PwO). This study investigated the characteristics of PwO, their interaction with healthcare providers (HCP), associated comorbid conditions, and how these factors influence greater weight loss. Methods: A cross-sectional analysis of PwO aged ≥ 18 years using data from the Saudi Arabia Awareness, Care and Treatment in Obesity Management (ACTION-IO) study. We evaluated the relationship between PwO who achieved 5 to <10% weight loss (LWL) and those who achieved ≥10% weight loss (HWL) during the preceding 3 years. Owing to the cross-sectional design, associations rather than causal relationships were evaluated between participant characteristics and clinically significant weight loss. Results: A total of 842 PwO were surveyed, 133 (15.8%) had HWL, and 709 (84.2%) had a weight loss of <10% within 3 years (LWL). HWL was observed in individuals with cardiovascular disease and depression/anxiety, as well as those who were motivated and committed to weight-loss interventions. PwO who had LWL had fewer interactions with their HCP and had a lack of support from friends and family. After adjustment for demographic factors, exercise, and weight-loss medication use, having discussed weight management with a healthcare provider within the previous 6 months (OR = 2.525, 95% CI = 1.692–3.768, p < 0.001), commitment to weight-loss action (OR = 1.572, 95% CI = 1.071–2.309, p = 0.021), cardiovascular disease (OR = 2.496, 95% CI = 1.175–5.300, p = 0.020), and depression/anxiety (OR = 2.734, 95% CI = 1.605–4.655, p < 0.001) were independently associated with achieving ≥10% weight loss. Conclusion: Greater weight loss was associated with more frequent discussions with healthcare providers, higher motivation and commitment to weight-loss efforts, and stronger family support. Cardiovascular disease and depression/anxiety were also independently associated with clinically significant weight loss. These findings identify factors associated with successful weight loss that warrant further investigation in longitudinal studies. Full article

Healthy and sustainable food consumption implies not only making conscious food choices but also limiting food waste. Interventions targeting choices are effective only if the healthier food selected is not wasted on the plate. The aims of the study were: to quantify plate and service waste in hospital canteens, characterize plate waste (PW), and compare PW before and after an intervention aimed at promoting healthy and sustainable food choices. A descriptive study was conducted in three Italian hospital canteens. Trays of users who gave consent were photographed (N = 1624). PW was quantified visually. Energy, nutrients, and environmental indicators were estimated using portion sizes, recipes provided by the canteens, food composition, and environmental databases. Both plate and service waste varied substantially across canteens. Post-intervention PW was 4.7% (C1: 6.1%, C2: 2.0%, C3: 2.6%) of the served food, corresponding on average to 33.1 g/tray, 43.6 kcal/tray, 69.6 g CO₂ eq./tray and 61.8 LH₂O/tray. Side dishes contributed most to the total PW. The canteen where PW decreased significantly compared to pre-intervention (C2: −48.9 g/tray in median among wasters) was the one with the least improvement in food choices. These findings highlight the importance of considering waste when implementing food choice interventions. Full article

Waveform agility improves anti-reconnaissance and anti-jamming capability in diverse inverse synthetic aperture radar (ISAR) scenarios, but it also breaks the phase variation assumptions used for conventional coherent processing. For cooperative bistatic ISAR radars, the problem is further complicated by the bistatic geometry and phase evolution induced by synchronization. This paper develops a joint coherent integration method for a cooperative bistatic radar with simultaneous pulse width (PW) and pulse repetition interval (PRI) agility. Firstly, we establish and analyze a bistatic geometric model to reveal key integration problems under agile waveforms, and then derive the coherent processing interval (CPI) local polynomial description for bistatic delay, Doppler and acceleration. On this basis, the matched filter response of each agile pulse is analyzed under the fixed-bandwidth assumption with linear frequency modulation (LFM), showing that PW agility produces a compressed peak displacement and an additional deterministic phase term, whereas PRI agility converts slow-time coherent integration into a nonuniformly sampled spectral estimation problem. To solve this problem, a joint fast and slow-time compensation route is derived, together with a bistatic-specific parameter design method that connects coherent integration tolerances with the bistatic angle and the observable projection vector. Finally, we test the performance of the proposed joint integration method in multiple scenarios and verify its effectiveness and robustness, which enhances detection performance and resolution for target localization. Full article

Traditional over-the-air (OTA) testing typically requires the device under test (DUT) to be positioned at the geometric center of the anechoic chamber, which limits the flexible evaluation of modern wireless terminals. Although the spherical vector wave (SVW) method provides a rigorous electromagnetic mode expansion, its direct use in eccentric testing scenarios is prone to coefficient-domain overfitting. In the conventional coefficient-domain formulation, the increased involvement of high-order evanescent modes can lead to overfitting of physically insignificant coefficients, resulting in unstable and oscillatory reconstruction. To explain this behavior, an analytical periodicity model is developed and validated by numerical simulations, showing good agreement across all tested configurations. To overcome this limitation, this paper develops a unified 3D eccentric spatial–spectral composite operator for eccentric field synthesis by directly incorporating the three-dimensional offset into the field evaluation process. The proposed operator maps probe excitation weights to the translated 3D local test-zone field samples, thereby reformulating the synthesis problem from coefficient-domain fitting to field-domain matching. This field-domain formulation naturally downweights high-order modal components with negligible local-field contributions, thereby improving numerical stability. Numerical simulations in a 3D multi-probe anechoic chamber (MPAC) demonstrate that, under significant eccentric conditions, the conventional SVW method essentially fails, while the plane wave synthesis (PWS) method achieves less accurate reconstruction than the proposed scheme. In contrast, the proposed scheme maintains stable, oscillation-free reconstruction and consistently outperforms PWS by 5 to 15 dB across all evaluated scenarios. This work provides a promising solution for flexible 3D OTA evaluation of large-scale wireless terminals. Full article

Background: The presence of left atrial fibrosis is a marker of advanced remodeling and is associated with a worse outcome after pulmonary vein isolation (PVI). Conventional fluoroscopy-only cryoballoon ablation (CBA) lacks this prognostic information. The addition of electroanatomical mapping (EAM) using the inner lumen spiral catheter allows accurate voltage assessment of the left atrial posterior wall. However, the value of the finding of posterior wall low-voltage zones (pwLVZs) is unknown. Purpose: To study the value of left atrial voltage maps during CBA by comparing clinical and procedural characteristics and clinical outcome between patients with and without pwLVZs. Methods: A cohort of 250 consecutive patients who underwent index CBA for atrial fibrillation was analyzed. All patients underwent pre- and post-procedural EAM using the Achieve^TM catheter and EnSite^TM mapping system. The presence of LVZs was evaluated at the postprocedural voltage map of the posterior wall. Clinical success was defined as freedom from documented AF or atrial tachycardia (AT) >30 s after 1 year. Results: PwLVZs were found in 41/250 (16.4%) of patients. Patients with pwLVZs were older (69.3 ± 8.5 vs. 64.2 ± 10.4; p = 0.003), more frequently female (63.4% vs. 32.5%; p < 0.001) and had higher CHA₂DS₂-VASc scores (3.0 ± 1.6 vs. 2.0 ± 1.5; p < 0.001). The incidence of obesity (31.7% vs. 25.8%; p = 0.048), structural heart disease (35.5% vs. 17.4%; p = 0.021) and persistent AF (68.3% vs. 43.8%; p = 0.004) was higher in the pwLVZs group. Kaplan–Meier analysis of clinical outcome showed a higher recurrence rate in the pwLVZs group. The finding of pwLVZs was a predictor of atrial arrhythmia recurrence during follow-up (HR 2.583; 95%CI: 1.334–5.002; p = 0.005). Conclusions: In CBA facilitated by integrated EAM, pwLVZ was associated with older age, female sex, higher CHADS-VASc scores, obesity, structural heart disease and persistent AF. The finding of pwLVZs is predictive of a worse clinical outcome. Full article

Existing AISI S100 provisions for cold-formed steel (CFS) screw connections lack codified strength equations for screw shear and net section fracture, and traditional machine learning (ML) models struggle to predict these minority failure modes due to imbalanced experimental datasets. This study proposes a cascaded ML framework that first classifies the failure mode and then predicts strength using mode-specific regressors. Two cascade strategies are evaluated: a Hard Classification Cascade (HC-C) and a novel Probability-Weighted Cascade (PW-C) that weights predictions by class probabilities to mitigate error propagation from misclassification. The predictive performance of the two cascaded models is benchmarked against a single regressor without classification. The superior PW-C model is then compared with AISI S100, and its resistance factor ϕ is subsequently calibrated in accordance with LRFD. Results show that the proposed cascaded models outperform the direct regression model, with PW-C improving the R² for minority-class screw shear from 0.765 to 0.933 and for net section fracture from 0.784 to 0.912. Compared with AISI S100 provisions, PW-C extends coverage to the currently unaddressed failure modes and effectively captures screw group effects on shear strength based on a database of 564 tests. Reliability analysis yields an overall ϕ_c of 0.64 for the PW-C model, with a recommended divisor of 1.15 for direct application within the AISI design framework. This work provides a practical, data-driven pathway for updating design codes to cover failure modes beyond current specification limits. Full article

Voltage-gated sodium channels are central to electrical excitability, and Nav1.7 is a major therapeutic target implicated in pain disorders and sensory signaling. Within the channel pore, permeating Na⁺ ions experience dynamically fluctuating hydration and coordination environments that may influence local ion–protein interactions. Identifying chemically distinct coordination states from molecular dynamics (MD) simulations is an important prerequisite for future higher-level electronic structure investigations. In this study, we present a reproducible workflow for identifying and classifying Na⁺ hydration–coordination microstates in the Nav1.7 pore using explicit-solvent molecular dynamics simulations. A geometrically defined pore region was used to quantify pore hydration and Na⁺ inner-shell coordination based on a 3.2 Å Na–O distance criterion. Na⁺ configurations were classified according to ligand identity into water-only (W), mixed protein–water (PW), and protein-only (P) microstates. Analysis of a 2 ns proof-of-principle simulation revealed a persistently hydrated pore environment, with Na⁺ coordination dominated by water-rich states and a smaller but distinct population of protein-contact configurations. These observations demonstrate that local coordination environments are chemically heterogeneous and cannot be fully described by hydration number alone. Representative structures from each microstate class were extracted to provide candidate configurations for future quantum mechanical, Quantum Mechanics/Molecular Mechanics (QM/MM), or density functional theory investigations of ion–ligand interactions in confined pore environments. The present work establishes a transparent and reproducible microstate-selection framework and does not report quantum mechanical energies, free-energy landscapes, or converged microstate populations. More broadly, the workflow provides a practical strategy for reducing complex MD ensembles into chemically interpretable coordination states suitable for subsequent higher-level analysis. Full article

Background: Respectful maternity care (RMC) prioritizes dignity, privacy, and autonomy during childbirth. In low-resource primary health centers (PHCs), the lack of delivery gown availability compromises these aspects, leading to discomfort and reduced patient satisfaction in PHCs. This study on Maathru Samman Pants (MSPs), a culturally sensitive garment designed with functional flaps, aims to enhance privacy, comfort, and dignity during labor, as well as assess the satisfaction, acceptability, and demand for MSPs among pregnant women and their birth companions in PHC settings across four Indian regions. Methods: A cross-sectional study was conducted across eight PHCs in North, South, East, and West India. A total of 80 pregnant women and 60 birth companions participated. Data were collected through structured questionnaires and in-depth interviews. The quantitative data covered satisfaction, acceptability, and demand using Likert scales, yes/no, and open-ended formats. The qualitative data were analyzed thematically. Results: Most PW (pregnant women) were aged 21–30 years, mainly Hindu, 34 (42.5%), or Christian, 27 (33.75%), with 71.25% homemakers. PW highly rated MSPs for covering the body, preventing cold, comfort, and ease of use. They felt cared for and respected, with a mean ± SD of 4.47 ± 0.57, and agreed that MSPs maintained privacy and cultural norms. Demand was strong, with 76 (95%) supporting the introduction of MSPs and 74 (92.5%) willing to use them again. Most PW, 66 (82.5%), and BCs (birth companions), 49 (81.67%), accepted MSPs positively, with a few reporting discomfort or changes. Conclusions: MSPs demonstrated high satisfaction, strong acceptability, and future demand among PW. This study addresses key gaps in respectful maternity care at the PHC level by enhancing privacy, preserving cultural norms, and improving comfort. Integrating MSPs into maternal health protocols could significantly improve birthing experiences in resource-limited settings. Full article

Background/Objectives: Krebs von den Lungen-6 (KL-6) is a mucin-like glycoprotein that is elevated in a variety of lung diseases and used as a diagnostic and prognostic biomarker in people with cystic fibrosis (pwCF). Single nucleotide polymorphisms (SNPs) in mucin-1 (MUC1) influence KL-6 serum concentration. This study investigated the relationship between serum KL-6 concentrations in pwCF and a MUC1 SNP and its longitudinal dynamics. Methods: The study included pwCF (n = 174) and healthy controls (n = 30). In pwCF, 365 samples were collected for longitudinal analyses; KL-6 levels were measured and the MUC1 SNP rs4072037 was genotyped in pwCF and controls. Cross-sectional and longitudinal associations between KL-6, genotype, and clinical parameters, such as infectious exacerbation, body mass index, inflammatory values and lung function, were analyzed using linear mixed-effects models. Results: Serum KL-6 was significantly elevated in pwCF compared with controls (458 ± 357 vs. 283 ± 103 U/mL; p < 0.001). Homozygous G/G carriers exhibited higher baseline KL-6 than A/A carriers (627 ± 673 vs. 397 ± 148 U/mL; p < 0.001), while heterozygous individuals showed intermediate levels. Longitudinally, the MUC1 SNP and interindividual differences in vital capacity (ppFVC) primarily determined baseline KL-6 levels, explaining 52.5% of variance. Short-term intraindividual fluctuations were largely driven by infectious exacerbations independent of genotype, accounting for ~10% of within-subject variance. Conclusions: PwCF generally showed elevated serum KL-6 levels and reflected both stable interindividual differences, mainly driven by the MUC1 SNP and ppFVC. Dynamic intraindividualchanges were associated with infectious exacerbations. Given the influence of MUC1 polymorphisms (e.g., rs4072037) on KL-6 concentration, personalized interpretation based on the genotype status may be informative in pwCF. Full article

Aligning plant breeders’ objectives with farmers’ preferences is essential for improving the adoption of new crop varieties. This study evaluated the effectiveness of a Participatory Weighted Selection (PWS) index, previously developed from a survey of 869 Moroccan farmers, by comparing it with biophysical Participatory Variety Selection (PVS) trials conducted on 19 farms across four agroecological zones in Morocco. Novel CWR-derived lines of durum wheat, barley, and lentil were assessed alongside commercial checks, and both male and female farmers were interviewed to gather PVS preferences. The results showed no significant gender differences for the top-ranked varieties across crops, with minor variations in some zones. Jabal emerged as the preferred durum wheat variety overall, while Zagharin2 was favored in favorable zones. Furat-3 was generally preferred for barley, except in certain mountain and favorable zones, and Bakria was the top lentil variety across most sites. Farmers’ PWS responses clustered into three groups, emphasizing consistent prioritization of high yield potential, abiotic stress tolerance, and good nutritional quality. Comparison of biophysical performance with PVS and PWS revealed strong alignment for durum wheat; however, the highest yielding genotypes for barley and lentil were not always the most preferred. Overall, these results demonstrate that the PWS approach effectively captures farmers’ preferences and provides a reliable tool for guiding breeding decisions. These findings reveal that integrating PWS with on-farm biophysical and PVS evaluations provides a robust, farmer-informed framework for prioritizing genotypes and improving the relevance of breeding decisions across diverse agroecological contexts. Full article

The selective conversion of high-molecular-weight paraffins (C₂₀–C₄₀) into linear alpha-olefins is often hindered by severe diffusion limitations and secondary over-cracking. This study addresses these challenges by transforming low-value natural minerals into sophisticated catalytic systems. We present a “top-down” engineering strategy for designing hierarchical catalysts based on natural Kazakhstani clinoptilolite. The multi-stage modification involves synergistic demineralization and precision chelation (EDTA, sulfosalicylic acid) to generate a tailored mesoporous architecture. This framework serves as a host for the sub-nanometric immobilization of Keggin-type heteropolyacids (PW₁₂, PMo₁₂), ensuring optimal active-phase dispersion. The innovative dual-step modification successfully bypassed the “micropore barrier”, creating a high-surface-area hierarchical network that facilitates the transport of bulky paraffinic molecules. Precise localization of heteropolyacid clusters within the created mesopores resulted in the formation of superstrong Lewis acid sites, as confirmed via temperature-programmed ammonia desorption. These sites triggered a highly efficient monomolecular beta-scission mechanism, suppressing undesirable hydrogen transfer reactions. The resulting catalysts achieved a breakthrough in technical paraffin cracking, delivering a 70% liquid product yield with an unprecedented >50% selectivity toward the C₇–C₁₄ α-olefin fraction. This work demonstrates a sustainable pathway for upgrading natural zeolites into high-performance, green catalysts that rival expensive analogs in precision and efficiency. Full article

In maritime electronic support measures (ESMS), multipath-scattered pulses are often suppressed during pulse sorting, although their delay, amplitude, and angular differences may provide information for passive scatterer localization. This paper investigates a front-end path-classification task positioned after emitter-level clustering and before multipath-assisted passive localization. Pulses produced by the same non-cooperative emitter but received through different propagation paths are classified as direct-path or multipath-scattered pulses. The task is formulated as supervised binary classification over PDW sequences. Five representative solution families are evaluated under a common protocol: FCM, DBSCAN, temporal sequence analysis (TSA), Single-LSTM, and a residual two-layer unidirectional LSTM with residual fusion. The input features are RF, PA, PW, PRI, TOA, DOA, and ΔTOA; the recurrent models use class-weighted training to address the direct/scattered class imbalance. Across 36 coupled scenarios with pulse-loss rates from 0% to 50% and parameter-jitter levels from 0.0 to 1.0, the residual LSTM obtains the highest average macro-F1 score (0.8717), compared with Single-LSTM (0.7726), DBSCAN (0.7686), TSA (0.6511), and FCM (0.5917). Repeated training over four random seeds yields a validation macro-F1 of 0.9821 ± 0.0007 on the original validation set. The ablation results indicate that ΔTOA is the principal temporal cue in this setting, while LayerNorm, residual fusion, class weighting, and augmentation mainly contribute to optimization stability and perturbation robustness. Measured-data verification suggests that the learned temporal representation can provide usable inputs for subsequent scatterer localization. The current validation is limited to a one-emitter simulation and rule-assisted measured-data annotation; mixed-emitter validation and quantitatively calibrated localization evaluation remain subjects for future study. Full article

Urban fire prevention is shifting from reactive response to proactive risk governance, yet current approaches often overlook risk-type heterogeneity, spatial dependencies, and underlying behavioral mechanisms, especially equitable risk distribution among vulnerable groups. To address this, this study integrates the Pressure–State–Response (PSR) model with environmental criminology theories (Routine Activity Theory (RAT) and Crime Pattern Theory (CPT)) to couple macro social causal chains with micro behavioral–spatial mechanisms. Using data from the digital urban management system of Shenzhen’s Guangming District in 2019, four fire risk event types are examined: electric bike charging violations (EB), unauthorized power wiring (PW), water heater misuse (WH), and aging gas pipelines (GP). Spatial error models explain 82–89% of the variance across fire risk event types, and spatial 5-fold cross-validation shows minimal performance decline (ΔR² = 0.03–0.08), confirming robust prediction without overfitting. Key findings include: (1) elderly proportion is significantly positively associated with WH and PW (coefficients = 2.64 and 3.06, p < 0.01); (2) restaurant density has a consistently positive association with all four risk types (coefficients = 0.24–0.60, p < 0.01); (3) functional diversity and connectivity exhibit dual patterns, showing negative associations with more visible, easily detectable violations (PW, GP) but positive relationships with relatively concealed behaviors (EB); (4) reported safety deficiencies display strong positive associations with all fire risk event types and can therefore serve as an effective early-warning indicator for broader fire risk. These results support risk-specific, equity-oriented prevention strategies that prioritize vulnerable groups and high-risk environments. The validated PSR–RAT/CPT framework provides a novel theoretical basis for targeted fire risk governance and advances safe, resilient, inclusive cities aligned with Sustainable Development Goal 11. Full article

Epilepsy is a heritable neurological disorder that is frequently comorbid with sleeping difficulties, including short/long sleep duration and insomnia. Although epidemiological studies have consistently reported the comorbidity between sleep disturbances and epilepsy, the shared genetic architecture and molecular mechanisms underlying this relationship remain poorly characterized, hindering therapeutic development. In this study, we integrated large-scale genome-wide association study (GWAS) summary statistics of European ancestry to dissect the genetic and molecular links between sleep traits and epilepsy. Using LDSC and GWAS-pw, we identified modest but statistically significant (Bonferroni-corrected) global and local genetic correlations between sleep behaviors and epilepsy. Subsequent CPASSOC cross-trait meta-analysis and transcriptome-wide association studies (TWAS) pinpointed specific pleiotropic loci and shared candidate genes, including SPAG7, VRK2, and LINC00925, which are functionally associated with neuroimmune signaling. While preliminary Phenome-Wide Association Study (PheWAS) profiling of these candidate targets did not identify major adverse associations in current databases, we emphasize that rigorous in vitro and in vivo experimental validations are required before considering them for therapeutic strategies. Finally, pleiotropy-robust bidirectional Mendelian Randomization (MR) analyses suggested unidirectional causal liability from epilepsy to short sleep duration. Although the estimated causal effect size was minimal, it reflects lifelong polygenic architecture rather than acute clinical magnitude. In conclusion, our multi-omics approach unveils the shared genetic architecture of the sleep-epilepsy axis and highlights potential biomarkers for future functional investigation. Full article

Urban–rural income inequality is a major challenge to social stability, inclusive growth, and sustainable modernization in developing and transition economies. Using panel data from 30 Chinese provinces from 2012 to 2020, this study examines how public service level (PWS) and marketization level (ML) affect urban–rural income inequality within a unified analytical framework. Urban–rural income inequality is measured by the Theil index, and entropy-weighted composite indices are constructed for PWS and ML. A panel fixed-effects model is employed to estimate the direct effects of PWS, ML, and their coupling coordination, while also testing the mediating roles of the growth rate of household income (GRHI) and the efficiency of human capital allocation (EHCA), as well as the threshold effect of the urbanization rate (Urb). The results show that both PWS and ML significantly reduce urban–rural income inequality and that stronger coupling coordination between them further narrows the income gap. PWS mainly works by promoting GRHI, whereas ML operates by improving EHCA. Moreover, the effects of both PWS and ML become stronger only when Urb exceeds a certain threshold. These findings provide insights for promoting inclusive and balanced development. Full article