Search Results (1,709)

Understanding how pore-system geometry governs mechanical performance remains essential for designing slag-blended cementitious materials. This study investigates the time-dependent coupling between porosity P and fractal dimension D and its implications for strength development and brittleness evolution in cementitious materials with slag dosage variation (0–40%). Compressive strength (f_c), flexural strength (f_f), the compressive-to-flexural strength ratio (f_c/f_f, used as a practical brittleness proxy), porosity (%), fractal dimension, and low-field nuclear magnetic resonance (LF-NMR) permeability (k, mD) were evaluated at 3, 7, and 28 days. Results reveal a pronounced age dependence in microstructure–property relationships. At 28 days, increasing slag dosage led to monotonic pore refinement and geometric reorganization, evidenced by reduced porosity (4.84% → 3.88%), increased fractal dimension (2.754 → 2.820), and decreased permeability (0.00025 → 0.00011 mD), accompanied by enhanced mechanical performance (47.73 → 49.33 MPa in f_c; 6.34 → 7.11 MPa in f_f) and reduced brittleness (f_c/f_f: 7.53 → 6.94). In contrast, a critical 7-day decoupling was observed: slag mixtures exhibited substantially lower porosity (≈5.42–5.69% vs. 7.07% for the reference) yet lower compressive strength (≈34.81–35.29 MPa vs. 38.65 MPa), indicating that porosity alone is insufficient to interpret early-age compressive capacity. Across ages, permeability and fractal trends highlight the role of pore-network connectivity and geometric complexity in governing transport resistance and fracture-related behavior. Overall, the findings demonstrate that a time-dependent porosity–fractal coupling framework provides a coherent pathway “from pore geometry to strength,” particularly for brittleness-relevant indices where geometric effects are amplified. Full article

Camellia hakodae Ninh flowers are an endemic Vietnamese species with limited phytochemical and biological characterization. This study aimed to characterize the phytochemical profile and evaluate antioxidant and anti-inflammatory activities of the total flower extract. Ultrasonic-assisted extraction (UAE) and maceration with methanol and ethanol at different concentrations were carried out to evaluate the efficiency of extracting total phenolic content (TPC) and total flavonoid content (TFC), quantified by colorimetric assays, along with the antioxidant and anti-inflammatory activities of the resulting extracts. The highest TPC (94.9 ± 4.5 mg GAE/g) and TFC (3.1 ± 0.2 mg QE/g) were obtained using UAE with 70% methanol, while maceration with 70% ethanol showed comparable TPC values. The optimized extract exhibited strong antioxidant activity with an IC₅₀ of 29.06 µg/mL, close to that of ascorbic acid (28.16 µg/mL) and significant anti-inflammatory activity in the proteinase inhibition assay (IC₅₀ = 2.72 mg/mL) compared to acetylsalicylic acid (IC₅₀ = 3.16 mg/mL). GC-MS and LC-QTOF-MS/MS analyses revealed diverse metabolites, including phenolic acids, flavonoids, fatty acids, terpenoids, and nitrogen-containing compounds, with representative constituents, such as quinic acid, catechins, flavonol glycosides, and loliolide, providing strong chemical evidence for the observed bioactivities. This integrated study demonstrates that C. hakodae flower is a rich source of multifunctional bioactive compounds and highlights its strong potential for applications in nutraceuticals, functional foods, and cosmeceuticals. Full article

Background/Objectives: Despite extensive research on nurses’ knowledge and attitudes toward pain management globally, limited evidence exists regarding the actual implementation of multimodal pain management practices among Vietnamese nurses. This study aimed to (1) assess nurses’ implementation of pharmacological and non-pharmacological postoperative pain management interventions, (2) examine the relationships among knowledge, attitude, and practice (KAP), and (3) identify predictors of competent practice with attention to the relative contributions of formal training versus clinical experience. Methods: A cross-sectional survey was conducted among 230 nurses working in Urology Departments from two tertiary public hospitals in Ho Chi Minh City, Vietnam, between April and June 2024, focusing on postoperative pain management. Pain management knowledge, attitudes, and practices were assessed using validated instruments. Independent samples t-tests compared trained versus untrained nurses. Multiple linear regression identified predictors of practice competency. Effect sizes (Cohen’s d) quantified the magnitude of training effects. Results: Nurses demonstrated moderate-to-good competency, with pharmacological interventions (M = 3.74) implemented more consistently than non-pharmacological interventions (M = 3.48, p < 0.001). Trained nurses significantly outperformed untrained nurses across all domains with large effect sizes (Cohen’s d = 1.34–1.54). A clear hierarchy emerged in non-pharmacological practice: environmental (M = 4.01) > physical (M = 3.69) > cognitive–behavioral (M = 3.27) > spiritual (M = 2.60). Strong KAP correlations were observed (r = 0.70–0.85, p < 0.001). Prior training was the strongest predictor of both pharmacological (β = 1.31, p < 0.001) and non-pharmacological practice (β = 0.58, p < 0.001), while clinical experience showed no significant effect (p > 0.40). Conclusions: This study provides evidence that formal training—not clinical experience—is strongly associated with competent postoperative pain management practice among Vietnamese nurses, with large effect sizes demonstrating practical significance. The strong KAP relationships support targeted educational interventions addressing knowledge gaps to improve practice. These findings have implications for nursing education research in Vietnam and similar healthcare settings. Full article

In this work, a high-performance mid-wave infrared (MWIR) photodetector (PD) utilizing an InAs/GaSb Type-II superlattice absorber and a quaternary AlGaAsSb barrier is designed and analyzed based on numerical simulations aimed at determining an optimized detector structure. Through these simulations, the composition of the AlGaAsSb barrier is carefully designed to achieve lattice matching, high conduction band offset and zero valence band offset. By optimizing the barrier thickness and doping concentration, the depletion region is effectively shifted from the narrow-bandgap absorber to the wide-bandgap barrier; additionally, at 150 K and a reversed bias of 0.05 V, the dark current density in the PD with the barrier (pBn) is reduced to 1.83 × 10⁻⁵ A/cm², about two orders of magnitude lower than that of the PD without the barrier. Furthermore, the effect of the barrier on the generation–recombination (G-R) and the trap-assisted tunneling (TAT) currents are analyzed and compared in detail, and it is found that the barrier structure is much more effective in suppressing the TAT current at low reversed bias when the electric field is low in the absorber layer. These results demonstrate the efficacy of the proposed AlGaAsSb barrier design for realizing high-operating-temperature MWIR PDs. It also provides an insight into the physical mechanism that leads to the performance enhancement of InAs/GaSb PDs. Full article

Ovarian cancer (OC) is frequently diagnosed at an advanced stage and characterized by high rates of recurrence despite aggressive cytoreductive surgery and chemotherapy. Relapse is driven by microscopic residual tumors that are disseminated most often throughout the peritoneal cavity, posing significant challenges with conventional systemic therapy. Targeted alpha-particle therapy (TAT) combines molecular targeting with alpha-emitting radionuclides to deliver highly potent and localized cellular damage, uniquely suited for the eradication of small OC tumor clusters within the peritoneal cavity. We conducted an extensive literature search for clinical trials (clinicaltrials.gov) and pre-clinical studies (PubMed, Scopus, Google Scholar) between September 2025 and November 2025. Peer-reviewed articles published in English over the past 20 years that used OC mouse models with reported treatment data were included. Review articles without original data and clinical trials that have been terminated or withdrawn were excluded. In this review, we (1) summarize the biological and physical rationale supporting the use of TAT in OC, (2) discuss the relevant molecular and immunological anti-tumor mechanisms, and (3) critically evaluate early treatment outcomes of 19 pre-clinical and four clinical studies with respect to efficacy, safety, and feasibility. Despite the progress and promising survival outcomes, several challenges remain, including heterogeneous antigen expression, delivery and retention within the peritoneal cavity, off-target toxicity, radiation resistance, radionuclide availability, dosimetry uncertainties, and limitations in clinical trial design. We highlight future directions to overcome these barriers and the continued multidisciplinary efforts essential to translate TAT into effective clinical strategies to treat advanced stages of OC and other solid tumors resistant to conventional treatment. This work was supported with funding available to Kurt R. Zinn as the Hickman Family Endowed Chair in Oncology at Michigan State University. Full article

Forecasting monthly precipitation in mountainous terrain poses challenges that push conventional deep learning approaches to their limits: convective processes operate locally while orographic effects span entire drainage basins. We compare three architecture families on precipitation prediction across the Colombian Andes: ConvLSTM (convolutional recurrent), FNO-ConvLSTM (spectral–temporal), and GNN-TAT (graph attention LSTM). Using CHIRPS v2.0 and SRTM topography for Boyacá department (61 × 65 grid, 3965 nodes), we evaluate 39 configurations across feature bundles (BASIC, KCE elevation clusters, and PAFC autocorrelation lags) and horizons from 1 to 12 months. GNN-TAT matches ConvLSTM accuracy ($R^2$: 0.628 vs. 0.642; RMSE: 82.29 vs. 79.40 mm) with 95% fewer parameters (∼98K vs. 2.1M). Across configurations, GNN-TAT produces a lower mean RMSE (92.12 vs. 112.02 mm; $p=0.015$) and a 74.7% lower variance. The explicit graph structure, with edges weighted by elevation similarity, appears to reduce sensitivity to hyperparameter choices. Pure FNO struggles with precipitation’s spatial discontinuities ($R^2=0.206$), though adding a ConvLSTM decoder recovers much of the lost skill ($R^2=0.582$). Elevation clustering improves GNN-TAT significantly ($p=0.036$) but not ConvLSTM, suggesting that feature design should match the spatial encoding paradigm. ConvLSTM achieves peak accuracy on local patterns; GNN-TAT provides robust predictions with interpretable spatial reasoning. These complementary strengths motivate stacking ensembles that combine grid-based and graph-based representations. Full article

Pregnancy-associated plasma protein A (PAPPA) is a metalloproteinase that regulates insulin-like growth factor availability via cleavage of IGF-binding proteins, yet its role in cancer remains incompletely understood. Using integrated public datasets, we systematically examined PAPPA expression, prognostic relevance, cellular localization, and stromal associations across multiple tumor types. PAPPA was reduced in several cancers and primarily localized to stromal cells, whereas in cholangiocarcinoma and thyroid carcinoma it was elevated and also detected in malignant cells. High PAPPA expression was associated with poorer overall survival in bladder, cervical, lung squamous, mesothelioma, pancreatic, and gastric cancers, but exhibited a protective effect in lower-grade glioma. In tumors with adverse prognosis, PAPPA strongly correlated with cancer-associated fibroblast (CAF) infiltration and CAF marker genes; however, multivariable Cox analyses indicated that PAPPA generally retained an independent prognostic factor, whereas CAF infiltration was mostly not independently associated with overall survival. Interestingly, in LGG, despite negative PAPPA–CAF correlations, multivariable analysis showed that PAPPA remained protective while CAF infiltration was associated with worse survival. Pathway analyses linked PAPPA-associated genes to proteoglycans in cancer and PI3K–AKT and RAS signaling. Collectively, these findings establish PAPPA as an independent prognostic factor across most cancers, while its expression frequently coincides with high CAF infiltration in select tumor types, highlighting the need for further investigation. Full article

Objectives: This study evaluated the accuracy of an artificial intelligence (AI)-based cephalometric software (WebCeph version 2.0.0.) compared with manual tracing and determined whether stratifying patients by chronological age or dentition stage provides a more clinically relevant assessment of AI accuracy. Methods: Three hundred lateral cephalometric radiographs of Vietnamese patients were traced manually by an orthodontist (reference standard) and analyzed automatically by WebCeph. Intra-observer reliability was validated using ICC and Dahlberg’s error. We analyzed the data using three stratification strategies: (1) Overall; (2) Chronological age (<18, 18–25, >25 years); and (3) Dentition stage (<9 primary-early mixed, 9–12 late mixed, >12 permanent). The primary outcome was the absolute measurement difference (∣Δ∣), analyzed using the Kruskal–Wallis test and effect size (${\eta }^2$). Results: Overall, WebCeph showed high concordance with manual tracing (ICC > 0.80 for most parameters). Chronological age stratification showed weak associations with measurement error; differences between groups were largely non-significant ($p>0.05$) with a small effect size (${\eta }^2\approx 0.015$). In contrast, the dentition stage revealed significant performance disparities ($p<0.05$). Notably, accuracy for the Mandibular Arc (ICC = 0.349) and Mandibular Plane Angle ($p=0.048$) degraded significantly in the primary-early mixed group, a vulnerability obscured by chronological age-based stratification. Conclusions: Dentition stage is a more sensitive and biologically relevant predictor of AI accuracy than chronological age. While WebCeph is reliable for permanent dentition, accuracy degrades significantly in the primary-early mixed phase. Clinicians should prioritize manual verification of mandibular and incisor landmarks in mixed-dentition children. Full article

Background and Objectives: Burnout is highly prevalent among emergency and acute care healthcare workers (HCWs), yet biological correlates remain debated because candidate biomarkers are strongly shaped by circadian timing, shift work, sleep loss, and overlapping affective symptoms. We mapped post-2018 evidence of biological biomarkers assessed alongside validated burnout measures in emergency department (ED), emergency medical services (EMS), and related acute care settings. Specifically, we asked whether reproducible biological correlates of burnout can be identified in emergency and acute-care healthcare workers when biomarker endpoint class and sampling context are systematically considered. Materials and Methods: We conducted a systematic scoping review with evidence mapping (PRISMA-ScR). PubMed/MEDLINE and the MDPI platform were searched for English-language studies published from 2018 onward (through January 2026). Eligible quantitative studies enrolled ED/EMS or acute care HCWs, assessed burnout using validated instruments, and reported at least one biological biomarker. Evidence was charted by biomarker domain and endpoint class (basal measures, stress reactivity paradigms, and chronic indices such as hair-based markers). Results: Overall, 19 studies were included in mapping/synthesis. Biomarker selection clustered around the hypothalamic–pituitary–adrenal axis (cortisol; n = 10/19), with fewer studies focused on autonomic function (heart rate variability; n = 2/19) and immune–inflammatory markers (n = 2/19), and single-study coverage for oxidative stress (n = 1/19), cardiometabolic candidates (n = 1/19), cellular aging (n = 1/19), neuroglial/multi-system candidates (n = 1/19), and feasibility-oriented multi-marker designs (n = 1/19). Reported associations with burnout were heterogeneous in direction and magnitude, but were more interpretable when endpoint class, timing anchors, and shift/sleep-related covariates were explicitly reported. Rates of confounder adjustment were low across studies (e.g., only 3/19 reported multivariable adjustment, and none systematically measured sleep or circadian factors), substantially limiting interpretability. Conclusions: The 2018+ literature does not support a single reproducible biomarker for burnout in emergency and acute care workforces. Evidence instead suggests multi-system dysregulation that is highly sensitive to endpoint class, sampling timing, and contextual confounding. Future studies should prioritize timing-anchored repeated-measures protocols across shift and recovery windows, jointly model sleep/circadian factors and depressive symptoms, and evaluate multi-marker panels and intervention responsiveness. Full article

This study rethinks innovation diffusion in craft-based small and medium-sized enterprises (SMEs) by examining how cultural logics and collective governance shape selective digitalization. Drawing on a qualitative case of Ata handicraft SMEs in Bali, Indonesia, the study analyzes in-depth interviews with artisans through the lens of Innovation Diffusion Theory. The findings reveal that digital technologies are not rejected but adopted selectively, mediated by Balinese Hindu philosophies such as Tri Hita Karana, Tat Twam Asi, and Segilik Seguluk Selunglung Sebayantaka, which emphasize balance, relational ethics, and communal solidarity. Rather than pursuing efficiency-driven digital adoption, artisans prioritize collective control, cultural continuity, and equitable value distribution. Digital tools function primarily as complementary mechanisms—supporting coordination, documentation, and market interaction—rather than as transformative drivers of organizational change. This study contributes theoretically by extending Innovation Diffusion Theory beyond linear adoption models, demonstrating how culturally grounded governance structures recalibrate the meaning and trajectory of digital innovation. More broadly, it offers insights for inclusive innovation discourse by showing how collective institutions enable SMEs to engage with digitalization while safeguarding cultural integrity and social sustainability. Full article

The rapid advancement of automated essay scoring (AES) has been constrained by a representation bottleneck, where monolithic models collapse diverse facets of writing constructs into a single, uninterpretable signal, undermining the pedagogical value of multi-dimensional rating traits. To address this limitation, the RoBERTa-based Trait-Aware Transformer (RoBERTa-TAT) is introduced. This architectural reframing replaces unified pooling with parallel, trait-specific attention streams, preserving and disentangling critical features such as conceptual depth and mechanical precision. Tested on the ASAP Dataset-7, RoBERTa-TAT attains a new state-of-the-art Quadratic Weighted Kappa (QWK) of 0.936, outperforming sequential baselines and conventional Transformer variants. Beyond gains in accuracy, this trait-specialized architecture recasts scoring from a black-box prediction into a transparent diagnostic tool, enabling actionable, fine-grained feedback at different rating traits. High-resolution inspection reveals that the model’s internal representations correlate with specific linguistic markers—such as discourse connectives for organization—suggesting a degree of structural alignment with expert judgment. By aligning high-capacity representation learning with the granular demands of formative assessment, RoBERTa-TAT provides a practical, interpretable blueprint for deploying accountable AI in education and broadening access to expert diagnostic insight. Full article

Interleukin-37 (IL-37) is an anti-inflammatory cytokine with an undefined role in chronic endometritis (CE). This study aims to explore its therapeutic mechanism in CE, focusing on epithelial-mesenchymal transition (EMT) and macrophage polarization. A CE model was induced in Sprague-Dawley rats using lipopolysaccharide (LPS), followed by intervention with TAT-fused recombinant IL-37. Histological damage and fibrosis were evaluated through H&E and Masson staining. Immunofluorescence staining was performed to assess the expression of IL-37 and EMT markers (E-cadherin and vimentin) and macrophage phenotypes (M1: CD86⁺; M2: CD206⁺). In vitro, transwell, qPCR, Western blot, and flow cytometry analyses were performed to determine the effects of IL-37 on EMT and macrophage polarization. The activity of the STAT6 and Smad3 pathways was evaluated using Western blotting, dual-luciferase assays, and immunofluorescence staining. The results revealed that IL-37 accumulated in the injured uterus, alleviating inflammation, tissue damage, and collagen deposition. IL-37 reduced epithelial migration and reversed abnormal EMT by upregulating E-cadherin expression and downregulating vimentin expression. It also suppressed M1 macrophage infiltration and promoted M2 polarization. Mechanistically, IL-37 coactivated the STAT6 and Smad3 pathways, thereby increasing their phosphorylation and nuclear translocation and elevating ARG1 expression. In conclusion, IL-37 mitigates CE by suppressing EMT and promoting M2 macrophage polarization via coordinated STAT6/Smad3 activation, highlighting its therapeutic potential for CE. Full article

APETALA2/ethylene-responsive factor (AP2/ERF) transcription factors integrate phytohormone signalling with developmental programmes and specialised metabolism, yet their family-wide features and potential contributions to phenolic-acid biosynthesis remain to be systematically clarified in Salvia miltiorrhiza. In this study, we conducted a comprehensive genome-wide analysis and identified 169 SmAP2/ERF genes, which were classified into five subfamilies (AP2, ERF, DREB, RAV and Soloist). SmAP2/ERFs were unevenly distributed across chromosomes and expanded predominantly through tandem and segmental duplication, and Ka/Ks analysis indicated that tandem-duplicated pairs have mainly undergone purifying selection. Promoter analysis revealed abundant cis-acting elements related to light, phytohormones and stress responses, indicating extensive regulatory potential. Comparative phylogenetic analysis with Arabidopsis thaliana prioritised four candidates (SmAP2/ERF88, SmAP2/ERF110, SmAP2/ERF121 and SmAP2/ERF122) closely associated with specialised-metabolism regulators. These genes exhibited distinct tissue-preferential expression patterns and divergent hormone responsiveness: SmAP2/ERF88/110 were broadly inducible, whereas SmAP2/ERF121/122 responded mainly to abscisic acid and were repressed by brassinosteroids. Confocal imaging of GFP fusions confirmed nuclear localisation of all four proteins. Phytohormone treatments differentially regulated key phenolic-acid pathway genes (PAL, C4H, 4CL, TAT, HPPR, RAS and CYP98A14) and altered rosmarinic acid and salvianolic acid B accumulation. These results broaden the genome-wide understanding of the SmAP2/ERF family in Salvia miltiorrhiza. Hormone-responsive SmAP2/ERFs show expression patterns associated with hormone-dependent transcriptional changes in phenolic-acid pathway genes and with RA and SAB accumulation, providing candidates for future functional validation and metabolic engineering. Full article

Despite the widespread adoption of digital technologies in modern implant dentistry, a comprehensive synthesis of error propagation across the entire workflow of full-arch implant rehabilitation remains absent. This narrative review aimed to synthesize current evidence on cumulative error propagation throughout the digital workflow of full-arch implant rehabilitation. Rather than focusing on isolated accuracy metrics, this article proposes a conceptual “Error Control Framework” to elucidate how minor deviations introduced at different workflow stages interact and amplify. A comprehensive literature search (2015–2025) was conducted to analyze error generation across five interrelated phases: Planning, Acquisition, Processing, Output, and Feedback. The evidence indicates that inaccuracies in full-arch implant rehabilitation behave as a cascading system (snowball effect) rather than isolated events. Errors introduced during early stages establish an irreversible baseline that is magnified during digital processing and manufacturing. Consequently, reactive verification at delivery alone is insufficient. To address this, this article proposes a proactive Error Control Framework that integrates a “Front-End Loading” strategy (necessitating strict upstream standardization of scanning strategies and scan-body geometry), alongside “Critical Control Points” (enforcing mandatory physical verification prior to final manufacturing). Viewing digital full-arch rehabilitation as a cumulative error system allows clinicians to implement preventive strategies and verification checkpoints, improving passive fit and long-term mechanical and biological outcomes. Full article

Externalizing problems are influenced by family dynamics, yet the specific mechanisms linking parental control to distinct externalizing problem behaviors remain unclear. This study examined the effects of parental behavioral control on proactive aggression, reactive aggression, and delinquent behavior, focusing on the mediating role of child disclosure. Data were collected from 3818 adolescents (aged 10–18) and their parents in Hong Kong. Results revealed that child disclosure served as a robust mediator. For mothers, full mediation was observed across all three outcomes. For fathers, full mediation was found for both subtypes of aggression, whereas partial mediation was observed for delinquent behavior. The indirect pathways were invariant across gender, suggesting the mechanism is universal. Notably, the model significantly predicted reactive aggression through a full mediation model from both mother and father. The study highlights the unique dual-pathway role of fathers—combining structural deterrence for delinquent behavior with relational communication for aggression and supports the efficacy of trust-based interventions for diverse externalizing problems. These findings suggest that effective parenting operates primarily by fostering a disclosure-promoting context rather than mere surveillance. Full article