Search Results (496)

Background: Type 1 diabetes (T1D) is associated with metabolic and neuromuscular impairments that may influence fatigue mechanisms and limit exercise tolerance. Although previous investigations have characterized muscle performance in T1D, the peripheral fatigue threshold, defined as the maximal sustainable level of peripheral fatigue, remains poorly understood in this population. This study aimed to compare the amplitude of the maximal peripheral fatigue threshold between individuals with T1D and healthy controls to elucidate the effects of T1D on neuromuscular function. Methods: Twenty-two participants (11 with T1D and 11 healthy controls) completed two randomized experimental sessions. In each session, 60 quadriceps maximal voluntary contractions (MVCs) were completed, performed for 3 s with 2 s of rest between contractions. One session was conducted under a non-fatigued control condition (CTRL), and the other followed a fatiguing neuromuscular electrical stimulation (FNMES) protocol. Central and peripheral fatigue were evaluated from the pre- to post-exercise changes in potentiated twitch force (ΔPtw) and voluntary activation (ΔVA), respectively. Critical torque (CT) was calculated as the average torque produced during the last 12 contractions, whereas the curvature constant of the torque–duration relationship (W′) was quantified as the area above CT. Results: Although both groups exhibited a decline in pre-exercise Ptw following the FNMES condition, no significant within-group differences in ΔPtw were observed between sessions (T1D: p = 0.34; controls: p = 0.23). Nevertheless, the extent of peripheral fatigue was significantly lower in participants with T1D than in controls (ΔPtw = −38 ± 11% vs. −52 ± 17%; p < 0.05). Additionally, W′ values were reduced by 24% in the T1D group relative to controls during the CTRL condition (p = 0.02), and CT was significantly lower in T1D participants (262 ± 49 N) compared to controls (353 ± 71 N; p < 0.01). A significant positive correlation was observed between ΔPtw and W′ across groups (r² = 0.62, p < 0.001), suggesting a mechanistic link between peripheral fatigue tolerance and work capacity. Conclusions: The present results indicate that, although individuals with T1D retain the capacity to develop peripheral fatigue, their fatigue threshold and critical torque are markedly attenuated relative to those of healthy individuals. This reduction reflects impaired neuromuscular efficiency and diminished tolerance to sustained contractile activity. The strong relationship between peripheral fatigue and work capacity underscores the contribution of peripheral mechanisms to exercise intolerance in T1D. These results enhance current understanding of fatigue physiology in diabetes and emphasize the need for tailored exercise and rehabilitation strategies to improve fatigue resistance and functional performance in this population. Full article

This paper investigates how external shocks propagate through fiscal transmission mechanisms in a commodity-dependent economy within a dynamic macroeconomic framework. The study contributes to the literature on macroeconomic fluctuations by examining the interaction between external revenue volatility, fiscal behavior, and institutional features in shaping short-run dynamics and medium-term outcomes. A Dynamic Stochastic General Equilibrium (DSGE) model is developed and calibrated to the Ecuadorian economy. The framework explicitly incorporates procyclical fiscal behavior, public capital accumulation, and endogenous spending efficiency, allowing for a structural analysis of fiscal transmission channels under external and productivity shocks. Counterfactual simulations are employed to assess the role of fiscal policy design and institutional constraints. The results show that while productivity shocks remain a key driver of output fluctuations, external revenue shocks significantly influence macroeconomic volatility through fiscal channels. Procyclical fiscal responses amplify fluctuations by reducing public investment and spending efficiency, slowing public capital accumulation and prolonging output contractions. Alternative fiscal configurations mitigate short-run volatility, although their effectiveness depends critically on institutional features governing spending efficiency. Overall, the analysis highlights that macroeconomic dynamics in resource-dependent economies are shaped not only by external shocks, but also by the interaction between fiscal policy design and institutional capacity. Integrating these elements into DSGE models provides a more comprehensive understanding of fiscal transmission mechanisms and macroeconomic volatility. Full article

Berries are an excellent source of bioactive compounds, particularly polyphenols, and have been widely used in folk medicine by the Mapuche people of southern Chile. In this study, a hydroalcoholic extract of Berberis congestiflora Gay (BE) was analyzed to determine its phytochemical composition and to evaluate its antioxidant capacity, vasorelaxant effects in rat aortas, and inhibitory activity on enzymes related to chronic non-communicable diseases, including exploration of a possible vasodilatory mechanism in isolated rat aortas. Antioxidant activity was assessed using Oxygen Radical Absorbance Capacity (ORAC), DPPH (2,2-diphenyl-1-picrylhydrazyl), and ABTS (2,2-azinobis-(3-ethylbenzothiazolin-6-sulfonic acid)) radical scavenging assays, as well as ferric reducing antioxidant power (FRAP). Vascular responses to the Berberis extract were studied using isometric tension recordings in an ex vivo rat thoracic aortic ring model, and the chemical constituents of BE were identified for the first time by HPLC-DAD-MS. The extract itself produced a dose-dependent contraction at 100 and 1000 µg/mL and induced relaxation in phenylephrine-precontracted aortas at the same concentrations, with a maximum contraction of 71% and maximum relaxation of 70% at 1000 µg/mL. Mechanistically, the extract triggered calcium-mediated contraction primarily through calcium release from the sarcoplasmic reticulum and, to a lesser degree, via extracellular Ca²⁺ influx, while its relaxant effect depended on an intact endothelium and activation of the NO/cGMP pathway. In addition, the extract showed inhibitory activity against cholinesterase, glucosidase, and amylase, with IC₅₀ values of 7.33 ± 0.32, 243.23 ± 0.3, and 27.21 ± 0.03 µg/mL, respectively, and docking studies were carried out for selected berry compounds. Overall, these findings indicate that these berries are a rich source of bioactive constituents with antioxidant properties and endothelium-dependent vasodilator effects, supporting their traditional use and highlighting their potential as enzyme inhibitors and as promising candidates for the development of phytotherapeutic products, particularly as supplements for chronic disease management. Full article

Objectives: The purpose of the present study was to investigate the acute effects of cold-water immersion (CWI), cryotherapy (CRT), and intermittent pneumatic compression (IPC) on lower-body neuromuscular performance in female basketball players. Methods: Eighteen athletes volunteered to participate (body mass = 63.0 ± 7.2 kg; height = 171.4 ± 6.5 cm; age = 16.4 ± 1.2 years), completing testing at three time points: (i) pre-practice, (ii) post-practice, and (iii) 45–60 min following a randomly assigned recovery intervention. At each time point, athletes performed three countermovement vertical jumps on a dual force plate system sampling at 1000 Hz (VALD Performance). To standardize external load across groups, all players wore inertial measurement units (Kinexon). Results: The two-way repeated measures ANOVA showed no statistically significant interaction (p > 0.05) between the three testing time points and recovery modalities for any of the analyzed variables. However, a significant main effect of time was observed, with 13 of 20 force-time metrics (65%), including jump height, reactive strength index-modified, contraction time, and concentric peak and mean force, declining post-recovery compared with pre-practice values, regardless of the recovery intervention applied. External load measures (e.g., total distance, number of jumps) remained consistent across groups. Conclusions: Overall, these findings suggest that CWI, CRT, and IPC were no more effective than passive recovery (i.e., control group) in mitigating post-practice declines in lower-body force and power-producing capacities. Full article

Road infrastructure underpins Nigeria’s economic competitiveness, yet Public–Private Partnership (PPP) performance is constrained not by inadequate legislation but by persistent weaknesses in enforcement and governance. Transparency deficits across procurement, design management, certification, and toll-revenue reporting have produced chronic delays, cost overruns, and declining public trust. This study offers the first empirical investigation of blockchain–Building Information Modelling (BIM) integration as a transparency-enhancing mechanism within Nigeria’s PPP road sector, focusing on Lagos State. Using a qualitative design, ten semi-structured interviews with stakeholders across the PPP lifecycle were thematically analysed to diagnose systemic governance weaknesses and assess the contextual feasibility of digital innovations. Findings reveal entrenched opacity rooted in weak enforcement, discretionary decision-making, and informal communication practices—including biased bidder evaluations, undocumented design alterations, manipulated certifications, and toll-revenue inconsistencies. While respondents recognised BIM’s potential to centralise project information and blockchain’s capacity for immutable records and smart-contract automation, they consistently emphasised that technological benefits cannot be realised absent credible institutional foundations. The study advances an original theoretical contribution: the Codify–Condition–Capacitate framework, which explains the institutional preconditions under which digital governance tools can improve transparency. This framework argues that effectiveness depends on: codifying digital standards and legal recognition; conditioning enforcement mechanisms to reduce discretionary authority; and capacitating institutions through targeted training and phased pilots. The research generates significant practical implications for policymakers in Nigeria and comparable developing contexts seeking institution-aligned digital transformation. Methodological rigour was ensured through purposive sampling, thematic saturation assessment, and documented analytical trails. Full article

This study addresses a pivotal strategic issue in hospitality e-commerce: how hotels can optimize cooperation with heterogeneous online travel agencies (OTAs). Moving beyond the conventional question of whether to cooperate, we investigate the interrelated decisions of which OTA type to partner with (quality-focused vs. price-focused) and which business model to adopt (merchant vs. agency). We develop a game-theoretic model that incorporates key e-commerce factors, including hotel capacity constraints, cross-channel spillover effects, and differential consumer acceptance of OTA types. Our analysis yields a contingent decision framework. We demonstrate that OTA cooperation becomes beneficial only when a hotel’s room capacity exceeds its direct-channel demand. The optimal strategy evolves with capacity: hotels with moderate capacity should partner with a single OTA type—predominantly the quality-focused one—while larger hotels should engage both types to maximize market coverage. In terms of business models, smaller hotels benefit from the risk-shifting merchant model, whereas larger hotels capture higher margins through the agency model. A key finding is the general superiority of a differentiated approach: applying the agency model to quality-focused OTAs and the merchant model to price-focused OTAs. This research provides a structured analytical framework to guide hotel managers in crafting e-commerce platform strategies and offers scholars a foundation for further inquiry into platform competition and contract design in digital marketplaces. Full article

Local scour around suction caisson foundations has emerged as a significant geotechnical hazard for offshore wind turbines as developments extend into deeper waters. This study quantitatively evaluates the scour-induced degradation of the bearing capacity of suction buckets in sand using a three-dimensional finite element model incorporating the Hardening Soil (HS) constitutive model. The HS framework enables realistic representation of stress-dependent stiffness, dilatancy, and plastic hardening, which are essential for simulating stress redistribution caused by scour. Parametric analyses covering a broad range of relative scour depths show that scour depth is the primary factor governing capacity loss. Increasing scour leads to systematic reductions in horizontal and moment capacities, evident stiffness softening, and a downward migration of plastic zones. A critical threshold is identified at S_d/L = 0.3, beyond which the rate of capacity deterioration increases significantly. The H–M failure envelopes contract progressively and exhibit increasing flattening with scour depth while maintaining nearly constant eccentricity. Empirical relationships between scour depth and key envelope parameters are further proposed to support engineering prediction. The results highlight the necessity of integrating scour effects into design and assessment procedures for suction bucket foundations to ensure the long-term performance and safety of offshore wind turbines. Full article

Aging induces sarcopenia and reduces bone mineral density, altering body composition. These modifications contribute to physical decline, increase non-communicable disease risk and increase the likelihood of hospitalization, thereby representing a substantial public health burden. In this study, we assessed the effects of isometric training with neuromuscular electrical stimulation conditioning contractions (ISO-NMES) and dynamic resistance training (DRT) on physical and functional capacities. Moreover, we investigated the impact of ISO-NMES training on the force and power of the trained and untrained leg. Eighteen sessions of ISO-NMES training for knee extensors were performed by 10 older adults (age: 70.1 ± 4.9 years; ISO-NMES group). The DRT group (n = 12; age: 70.5 ± 2.8 years) performed 18 sessions of dynamic resistance training at a local fitness center. Maximum voluntary contraction (MVC) and peak power (P) of lower limbs as well as functional capacities assessed with the 5 Sit to Stand, Timed Up and Go and 6 Minutes Walking Tests were examined in both groups before and after the related training protocols. At the end of the training period, only the ISO-NMES group had improved MVC (+30.4%, p < 0.001) and bilateral force (ISO-NMES: +6.3%, p = 0.032). Moreover, both groups had significantly improved functional capacities. Finally, in the ISO-NMES group, MVC, force and power significantly increased in both legs with a greater effect for MVC in the trained than untrained leg (+30.4 vs. +13.5%, p < 0.001). These findings suggest that ISO-NMES training was an effective strategy to improve physical and functional capacities in older adults. Thus, it could be considered as a potential intervention, particularly when the mobility to perform physical training is limited. Full article

A sharing framework based on Zero-Knowledge Proof (ZKP) and Proxy Re-encryption (PRE) technologies offers a promising solution for sharing Student Electronic Academic Records (SEARs). As core credentials in the education sector, student records are characterized by strong identity binding, the need for long-term retention, frequent cross-institutional verification, and sensitive information. Compared with electronic health records and government archives, they face more complex security, privacy protection, and storage scalability challenges during sharing. These records not only contain sensitive data such as personal identity and academic performance but also serve as crucial evidence in key scenarios such as further education, employment, and professional title evaluation. Leakage or tampering could have irreversible impacts on a student’s career development. Furthermore, traditional blockchain technology faces storage capacity limitations when storing massive academic records, and existing general electronic record sharing solutions struggle to meet the high-frequency verification demands of educational authorities, universities, and employers for academic data. This study proposes a dedicated sharing framework for students’ electronic academic records, leveraging PRE technology and the distributed ledger characteristics of blockchain to ensure transparency and immutability during sharing. By integrating the InterPlanetary File System (IPFS) with Ethereum Smart Contract (SC), it addresses blockchain storage bottlenecks, enabling secure storage and efficient sharing of academic records. Relying on optimized ZKP technology, it supports verifying the authenticity and integrity of records without revealing sensitive content. Furthermore, the introduction of gate circuit merging, constant folding techniques, Field-Programmable Gate Array (FPGA) hardware acceleration, and the efficient Bulletproofs algorithm alleviates the high computational complexity of ZKP, significantly reducing proof generation time. The experimental results demonstrate that the framework, while ensuring strong privacy protection, can meet the cross-scenario sharing needs of student records and significantly improve sharing efficiency and security. Therefore, this method exhibits superior security and performance in privacy-preserving scenarios. This framework can be applied to scenarios such as cross-institutional academic certification, employer background checks, and long-term management of academic records by educational authorities, providing secure and efficient technical support for the sharing of electronic academic credentials in the digital education ecosystem. Full article

In this study, using global liner shipping schedules, UNCTAD’s Port Liner Shipping Connectivity Index and Liner Shipping Bilateral Connectivity Index, together with bilateral trade-value data for 2022–2024, we construct a multilayer weighted port-to-port network that explicitly embeds port-level cargo-handling and service organisation capabilities, as well as demand-side routing pressure, into node and edge weights. Building on this network, we apply CONCOR-based structural-equivalence analysis to delineate functionally homogeneous port clusters, and adopt a structural role identification framework that combines multi-indicator connectivity metrics with Rank-Sum Ratio–entropy weighting and Probit-based binning to classify ports into high-efficiency core, bridge-control, and free-form bridge roles, thereby tracing the reconfiguration of cluster-level functional structures before and after the Red Sea crisis. Empirically, the clustering identifies four persistent communities—the Intertropical Maritime Hub Corridor (IMHC), Pacific Rim Mega-Port Agglomeration (PRMPA), Southern Commodity Export Gateway (SCEG), and Euro-Asian Intermodal Chokepoints (EAIC)—and reveals a marked spatial and functional reorganisation between 2022 and 2024. IMHC expands from 96 to 113 ports and SCEG from 33 to 56, whereas EAIC contracts from 27 to 10 nodes as gateway functions are reallocated across clusters, and the combined share of bridge-control and free-form bridge ports increases from 9.6% to 15.5% of all nodes, demonstrating a thicker functional backbone under rerouting pressures. Spatially, IMHC extends from a Mediterranean-centred configuration into tropical, trans-equatorial routes; PRMPA consolidates its role as the densest trans-Pacific belt; SCEG evolves from a commodity-based export gateway into a cross-regional Southern Hemisphere hub; and EAIC reorients from an Atlantic-dominated structure towards Eurasian corridors and emerging bypass routes. Functionally, Singapore, Rotterdam, and Shanghai remain dominant high-efficiency cores, while several Mediterranean and Red Sea ports (e.g., Jeddah, Alexandria) lose centrality as East and Southeast Asian nodes gain prominence; bridge-control functions are increasingly taken up by European and East Asian hubs (e.g., Antwerp, Hamburg, Busan, Kobe), acting as secondary transshipment buffers; and free-form bridge ports such as Manila, Haiphong, and Genoa strengthen their roles as elastic connectors that enhance intra-cluster cohesion and provide redundancy for inter-cluster rerouting. Overall, these patterns show that resilience under the Red Sea crisis is expressed through the cluster-level rebalancing of core–control–bridge roles, suggesting that port managers should prioritise parallel gateways, short-sea and coastal buffers, and sea–land intermodality within clusters when designing capacity expansion, hinterland access, and rerouting strategies. Full article

Background: The anterior cruciate ligament (ACL) and medial collateral ligament (MCL) display strikingly different healing behaviors, despite their similar structural roles within the knee. The epiligament (EL)—a vascular and cellular envelope surrounding each ligament—has emerged as a critical determinant of repair capacity. The aim of this study was to perform a region-specific, comparative analysis of EL molecular profiles in the ACL and MCL to elucidate the mechanisms underlying their contrasting reparative outcomes. Methods: Human ACL and MCL specimens were obtained from 12 fresh knee joints. Immunohistochemical labeling for CD34, α-smooth muscle actin (α-SMA), and vascular endothelial growth factor (VEGF) was performed across proximal, mid-substance, and distal EL regions. Quantitative image analysis using IHC Profiler for ImageJ generated semiquantitative (negative, low-positive, positive) distributions, and inter-ligament comparisons were quantified using t-tests (p  <  0.05). Results: Distinct, region-specific EL signatures were identified. The ACL EL exhibited strong proximal α-SMA expression (0% neg/66.8% low+/33.2%+) and notable distal CD34 positivity (0% neg/83.3% low+/16.7%+), while VEGF expression was confined to the mid-substance (≈55% low+/26%+). In contrast, the MCL EL was largely negative for CD34 and VEGF across all regions, showing a homogeneous but functionally oriented α-SMA profile: proximally negative, sparse mid positivity, and high distal low-positive staining (93.4% low+). Differences in proximal and distal CD34 and α-SMA expression between the ACL and MCL were highly significant (p  <  0.0001–0.001), confirming a mechanistic divergence in EL organization. Conclusions: The ACL EL is regionally heterogeneous, vascularly biased, and enriched in contractile α-SMA+ cells, suggesting localized but poorly coordinated reparative potential. In contrast, the MCL EL is structurally uniform, with distributed α-SMA activity supporting stable wound contraction and tissue continuity, despite limited angiogenic signaling. These findings indicate that the ACL’s failure to heal is not attributable to the absence of progenitor or angiogenic factors, but rather to its fragmented spatial organization and dominant contractile phenotype. Therapeutically, preserving and modulating the EL, particularly its CD34+ and α-SMA+ compartments, could be key to enhancing intrinsic ACL repair and improving outcomes in ligament reconstruction and regeneration. Full article

Against the backdrop of intensifying global climate change and expanding human encroachment into mountainous regions, landslides have increased markedly in both frequency and destructiveness, emerging as a key risk to socio-ecological security and development in mountain areas. Rigorous assessment and forward-looking prediction of landslide disaster vulnerability (LDV) are essential for targeted disaster risk reduction and regional sustainability. However, existing studies largely center on landslide susceptibility or risk, often overlooking the dynamic evolution of adaptive capacity within affected systems and its nonlinear responses across temporal and spatial scales, thereby obscuring the complex mechanisms underpinning LDV. To address this gap, we examine Yunnan Province, a landslide-prone region of China where intensified extreme rainfall and the expansion of human activities in recent years have exacerbated landslide risk. Drawing on the vulnerability scoping diagram (VSD), we construct an exposure–sensitivity–adaptive capacity assessment framework to characterize the spatiotemporal distribution of LDV during 2000–2020. We further develop a multi-model, multi-scale integrated prediction framework, benchmarking the predictive performance of four machine learning algorithms—backpropagation neural network (BPNN), support vector machine (SVM), random forest (RF), and XGBoost—across sample sizes ranging from 2500 to 360,000 to identify the optimal model–scale combination. From 2000 to 2020, LDV in Yunnan declined overall, exhibiting a spatial pattern of “higher in the northwest and lower in the southeast.” High-LDV areas decreased markedly, and sustained enhancement of adaptive capacity was the primary driver of the decline. At approximately the 90,000-cell grid scale, XGBoost performed best, robustly reproducing the observed spatiotemporal evolution and projecting continued declines in LDV during 2030–2050, albeit with decelerating improvement; low-LDV zones show phased fluctuations of “expansion followed by contraction”, whereas high-LDV zones continue to contract northwestward. The proposed multi-model, multi-scale fusion framework enhances the accuracy and robustness of LDV prediction, provides a scientific basis for precise disaster risk reduction strategies and resource optimization in Yunnan, and offers a quantitative reference for resilience building and policy design in analogous regions worldwide. Full article

Background/Objectives: Non-dilated left ventricular cardiomyopathy (NDLVC) is a recently defined clinical entity associated with increased risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD), despite preserved LV geometry. The role and temporal variability of noninvasive electrocardiographic (ECG) risk markers in this population remain insufficiently characterized. To assess the temporal variability of ECG-derived risk markers in patients with NDLVC and explore their association with major adverse cardiac events, including heart failure (HF) and VA hospitalization. Methods: We prospectively studied 55 patients with NDLVC who underwent cardiac magnetic resonance imaging and serial 24 h Holter monitoring, signal-averaged ECG, and standard 12-lead ECG over a one-year period. Patients were followed up for 39.5 ± 8.6 months. Nine ECG-based risk markers were analyzed, including premature ventricular contraction (PVC) burden, non-sustained ventricular tachycardia (NSVT) occurrence, its maximum rate and maximum beats, mean QTc interval, standard deviation of NN intervals (SDNN), deceleration capacity (DC), heart rate turbulence onset and slope (TO/TS), T-wave alternans (TWA), and late potentials. Clinical outcomes were HF and VA hospitalization. Logistic regression was used to evaluate associations between changes in ECG parameters and outcomes. Results: A change (from positive to negative and vice versa) in at least one ECG parameter was detected in 67.3% of patients, with the highest variability observed in TWA (34.5%), NSVT (23.6%), and PVC burden (23.6%). Despite this variability, only SDNN was significantly associated with increased risk of VA hospitalization during follow-up (OR = 0.98, 95% CI: 0.97–0.99, p = 0.006). No ECG changes were associated with HF hospitalization. Conclusions: Patients with NDLVC exhibit substantial temporal variability in noninvasive ECG risk markers. While most changes do not correlate with clinical events, an inverse association was found between SDNN and VA risk. These findings support the ongoing evaluation and the necessity to identify more effective risk stratification markers in this subgroup of patients. Full article

Under the dual pressures of global climate change and anthropogenic activities, enhancing the ecological functions of hydraulic structures has become a critical direction for sustainable watershed management. While traditional spur dike designs primarily focus on bank protection and flood control, current demands require additional consideration of river ecosystem restoration. Numerical simulations were performed using the RNG k-ε turbulence model to solve the three-dimensional Reynolds-averaged Navier–Stokes equations, a formulation that enhances prediction accuracy for complex flows in curved channels, including separation and reattachment. Following a grid independence study and the application of standard wall functions for near-wall treatment, a comparative analysis was conducted to examine the flow characteristics and ecological effects within a 180° channel bend under three configurations: no spur dikes, a single-side arrangement, and a staggered arrangement of non-submerged, flow-aligned, rectangular thin-walled spur dikes. The results demonstrate that staggered spur dikes significantly reduce the lateral water surface gradient by concentrating the main flow, thereby balancing water levels along the concave and convex banks and suppressing lateral channel migration. Their synergistic flow-contracting effect enhances the kinetic energy of the main flow and generates multi-scale turbulent vortices, which not only increase sediment transport capacity in the main channel but also create diverse habitat conditions. Specifically, the bed shear stress in the central channel region reached 2.3 times the natural level. Flow separation near the dike heads generated a high-velocity zone, elevating velocity and turbulent kinetic energy by factors of 2.3 and 6.8, respectively. This shift promoted bed sediment coarsening and consequently increased scour resistance. In contrast, the low-shear wake zones behind the dikes, with weakened hydrodynamic forces, facilitated fine-sediment deposition and the growth of point bars. Furthermore, this study identifies a critical interface (observed at approximately 60% of the water depth) that serves as a key interface for vertical energy conversion. Below this height, turbulence intensity intermittently increases, whereas above it, energy dissipates markedly. This critical elevation, controlled by both the spur dike configuration and flow conditions, embodies the transition mechanism of kinetic energy from the mean flow to turbulent motions. These findings provide a theoretical basis and engineering reference for optimizing eco-friendly spur dike designs in meandering rivers. Full article

Millions of healthcare workers experience percutaneous exposure to bloodborne communicable infectious disease pathogens annually, with the risk of contracting occupationally acquired infections. In this study, we aimed to assess the status of occupational safety and outbreak preparedness in Congolese nurses and laboratory technicians in Kongo central and the Katanga area, amidst multiple ongoing public health emergencies in the Democratic Republic of the Congo (DRC). This was a multicenter analytical cross-sectional study conducted in five referral hospitals located in Kongo central province and the Katanga area between 2019 and 2020 amidst Ebola, Yellow fever, Cholera and Chikungunya outbreaks. Participants were adult A0 grade nurses, A1 nurses, A2 nurses and medical laboratory technicians (N = 493). They answered a structured, self-administered questionnaire related to hospital hygiene and standard precautions for occupational infection prevention. The majority of the respondents were females (53.6%), and 30.1% of them have never participated in a training session on hospital infection prevention during their career. The proportions of those who have been immunized against hepatitis B virus (HBV) was markedly low, at 16.5%. Of the respondents, 75.3% have been using safety-engineered medical devices (SEDs), whereas 93.5% consistently disinfected medical devices after use. Moreover, 78% of the respondents used gloves during medical procedures and 92.2% wore masks consistently. A large majority of the respondents, 82.9%, have been recapping the needles after use. Regarding participation in outbreak response, 24.5% and 12.2% of the respondents were Chikungunya and Cholera epidemic responders, respectively; 1.8% have served in Ebola outbreak sites. The proportion of the respondents who sustained at least one percutaneous injury by needlestick or sharp device, blood/body fluid splash or both in the previous 12-month period was high, 89.3% (41.8% for injury, 59.2% for BBF event), and most of them (73%) reported over 11 events. Compared to laboratory technicians, nurses had higher odds for sustaining percutaneous injury and BBF events [OR = 1.38 (0.16); p < 0.01], whereas respondents with longer working experience were less likely to sustain those events [OR = 0.47 (0.11); p < 0.001]. Findings from this study suggest that Congolese nurses and laboratory technicians experience a high frequency of injury and BBF events at work, and remain at high risk for occupationally acquired infection. There is a need for periodic capacity-building training for the healthcare workforce to improve infection prevention in health settings, the provision of sufficient and appropriate PPE and SEDs, post-exposure follow-up and keeping records of occupational injuries in hospitals in Congolese healthcare settings. Full article