Search Results (5,637)

Narrative extraction algorithms construct storylines by finding coherent paths through document collections. The Narrative Trails algorithm frames this as maximum-capacity path optimization, where path quality depends on a coherence function measuring document relationships. We introduce quantum kernels as coherence functions for narrative extraction—to the best of our knowledge, the first systematic characterisation of quantum kernel methods for storyline extraction—and compare them against classical baselines on two corpora using a multi-seed protocol. The sweep covers 93 method evaluations (54 quantum kernels across three encoder families—R${}_Y$+CNOT-ring, IQP/ZZ-feature-map, and a projected quantum kernel—and 39 classical kernels—cosine, RBF, and the cluster-aware Narrative Trails baseline). On 11,215 human navigation paths from Wikispeedia, evaluation metrics divide into two clusters that disagree with each other: alignment-based metrics (length-normalised DTW and per-step DTW similarity) favour methods that produce long alignment-rich paths, while set-overlap metrics (Jaccard and F1) favour methods that produce shorter paths with higher article overlap. On LLM-judged coherence for Cuban news storylines, evaluated under a 12-method × 5-seed × 30-endpoint-pair × 2-judge design (Claude Sonnet 4.5 and GPT-4o, both at $T=0$ via structured tool calling), the cluster-aware classical baseline is the top method in terms of mean overall coherence; the 5-method quantum-kernel pool and the 7-method classical-kernel pool on matched projection input show no significant differences after Holm correction. Cross-task analysis reveals that LLM coherence rank correlates with alignment-cluster Wikispeedia metrics (Spearman $\rho \approx +0.70$) and anti-correlates with overlap-cluster metrics ($\rho \approx -0.62$). A closed-form theoretical analysis shows that the depth-1 R${}_Y$+CNOT-ring kernel reduces to a classical product-of-cosines kernel order equivalent to RBF, explaining the absence of empirical separation at low depth; deeper encoders break the cancellation but exponentially concentrate kernel values, eroding inter-pair distinguishability. Our results characterise quantum coherence kernels as competitive with classical kernels on the same projected input rather than decisively superior, with the cluster-aware classical baseline retaining a modest advantage attributable to its explicit topical structure. Full article

As large language models (LLMs) scale to cover more languages, their potential to support low-resource settings becomes increasingly promising. However, the mechanisms underlying cross-lingual transfer and the factors that facilitate it remain insufficiently understood. Prior work has highlighted the role of linguistic similarity—particularly syntactic structure—in enabling transfer across languages. In this study, we present a broad empirical analysis of how multilingual LLMs encode and relate structural information across languages with varying typological properties. We combine multiple complementary methods, including hidden-state similarity analysis, typological correlation, probing for syntactic features, and attention-based structural comparisons, across four multilingual models and thirteen languages. Our findings show consistent correlations between representational similarity and syntactic relatedness, suggesting that structural properties of language influence how information is organized and shared across languages. We further observe that attention-derived structures exhibit partial alignment with gold-standard syntax, though this alignment should be interpreted as heuristic rather than direct evidence of syntactic encoding. Overall, our results provide a comparative empirical perspective on cross-lingual structural bias in multilingual LLMs and highlight the importance of careful methodological interpretation when linking representation geometry to linguistic structure. Full article

(1) Background: Gait analysis technologies have advanced; however, traditional systems like optical motion capture are lab-bound and costly, limiting rehabilitation monitoring. This cross-sectional study evaluates self-powered triboelectric nanogenerator (TENG) insoles combined with IMU sensors to assess gait asymmetry, plantar pressure signatures, age effects and injury history in rehabilitation patients, aiming to enable portable, battery-free phenotyping. (2) Methods: Fifty-three patients (22 females, 31 males; age, 29 ± 26 years) from Astana clinics with trauma histories (e.g., spine, ankle, fractures) and 10 healthy references underwent a 2 min walk test (2MWT). TENG insoles captured plantar loading; ankle/knee IMUs measured spatiotemporal parameters (cadence, asymmetry). The data were normalized; the analyses used an ANOVA and correlations (Python 3.14.3). (3) Results: The TENG sensors showed force/frequency linearity (up to 10 V at 20 N). The cadence averaged 101 ± 10 steps/min, declining with age (r = −0.31, p = 0.03) and fractures (r = −0.23, p = 0.04). The asymmetry varied (−54% to +31%) without category differences. Flatfoot (55%) was linked to lateral loading shifts; condition-specific waveform signatures emerged (e.g., lateral heel in ankle issues). (4) TENG-IMU systems feasibly capture gait phenotypes in heterogeneous cohorts, supporting out-of-lab monitoring for personalized rehabilitation without batteries. Prospective validation is required for further practical implications. Full article

Auditory neurofeedback training (NFT) based on brain–computer interfaces (BCIs) has recently entered the precision motor domain as a task-embedded neural state regulation paradigm. Compared to traditional standalone NFT approaches (e.g., relaxation or attention training designed to enhance general cognitive abilities), task-embedded paradigms integrate feedback directly into the motor task execution process. However, this design inevitably creates a dual-task scenario, and the effects of such a scenario on neural activity and behavioral performance have received limited systematic investigation in the existing literature. This study designed and implemented a closed-loop BCI system employing five-level heartbeat sound feedback and used this system as a research platform to examine the immediate neural mechanism changes and potential dual-task interference effects induced by single-session auditory NFT in moderately skilled shooters. The system maps real-time EEG features onto graded auditory signals varying in playback rate and volume intensity, incorporating a dynamic threshold adjustment mechanism. Twenty-two moderately skilled shooters completed three within-subject conditions (no-sound baseline, SMR enhancement, and theta suppression) in a single session with 32-channel EEG and behavioral data recorded simultaneously. Analyses employed whole-brain cluster-based permutation tests, cross-frequency coupling analysis, and functional connectivity analysis. Cluster-based permutation tests revealed that theta feedback induced a significant frontal 4–7 Hz suppression cluster (cluster p = 0.004), whereas SMR feedback did not produce significant 12–15 Hz enhancement at the group level. Theta feedback elicited cross-frequency spillover as follows: sensorimotor SMR power decreased significantly in theta responders (d = −0.69), with frontal theta and sensorimotor SMR changes positively correlated (r = 0.67, p < 0.001). Functional connectivity analysis using debiased weighted phase lag index (dwPLI) further demonstrated significant theta-band network reorganization (cluster p = 0.034). At the neural level, clear modulation effects were observed, but shooting ring values did not improve significantly under feedback conditions, and aiming time was significantly prolonged—a behavioral pattern consistent with potential dual-task interference from task-embedded auditory feedback. Single-session auditory NFT can act on the prefrontal cognitive control network and induce cross-frequency network reorganization, but the feedback channel itself constitutes a parallel task that may limit the short-term transfer of induced neural states to behavioral performance. This study examined the neural mechanisms of task-embedded auditory NFT and reported the dual-task costs that have been less characterized in prior “task + feedback” research, providing design considerations and preliminary mechanistic evidence for future development of auditory NFT in precision motor skill training. Full article

Water scarcity and water quality degradation in river basins are critical issues addressed by water resources management authorities. Grey relational analysis is adopted to rank key factors affecting water resources in the Beijing-Tianjin-Hebei region. Bankruptcy theory is combined with an improved Nash bargaining game model, and spatiotemporal constraints of cross-regional water resources are incorporated to analyze water allocation under multiple water supply scenarios. Results indicate that the GM (1,1) model achieves Level II (good) prediction accuracy, with relative errors below 6% in most years. The cooperative game model (CGM) yields the highest correlation coefficient of 0.996, indicating the optimal allocation performance. The water demand satisfaction rate in Beijing is the highest among the three regions. An economic compensation range indicator (e) is established for water resource trading games. As the trading water volume increases from 0.01 to 20 billion m³, the feasible compensation range expands from 463.57 to 1,757,045.78 ten thousand yuan. These results provide a scientific basis for rational, stable, and sustainable water resources allocation in the Beijing-Tianjin-Hebei region. Full article

Introduction: Humanized care is a core indicator of nursing quality, yet its prevalence and determinants among Spanish undergraduates remain unclear. Methods: A cross-sectional survey was administered to fourth-year nursing students from public and private universities. Instruments included the Health Professional’s Humanization Scale (HUMAS), the Communication Styles Inventory-Revised (CSI-R) and a sociodemographic questionnaire that captured prior training: completion of ≥6 h role-playing seminars in patient–family communication. Results: Mean scores were 3.62 ± 0.48 for HUMAS and 2.50 ± 0.52 for CSI-R. Women exceeded men on HUMAS total (p = 0.025) and on Sociability, Emotional Understanding, Dispositional Optimism and Self-Efficacy (all p ≤ 0.013), but not on Affect-Regulation or CSI-R. Age correlated weakly with Optimism (r = 0.24) and Self-Efficacy (r = 0.21). Students who had completed the role-playing seminars recorded higher HUMAS totals (d = 0.50; p = 0.001) and sub-scores, with only a modest gain in Affect-Regulation, and showed a trend towards better CSI-R performance (p = 0.06). No differences emerged by university type. HUMAS and CSI-R correlated moderately (r = 0.32; p = 0.001). In multivariate analysis, training (β = 0.36; p = 0.001) and CSI-R (β = 0.26; p = 0.001) jointly explained 27.9% of humanization variance; male sex exerted a small negative effect (β = −0.19; p = 0.001), whereas age was nonsignificant. Conclusions: Structured communication seminars are a key factor associated with higher levels of humanization in senior nursing students, whereas sociodemographic influences are modest. Embedding longitudinal, simulation-rich modules in communication and emotional intelligence is therefore recommended to cultivate truly person-centered nurses and to narrow observed sex disparities. Full article

Water-quality degradation in semi-arid basins is strongly influenced by spatial heterogeneity and cumulative anthropogenic pressure. This study characterises spatial gradients, identifies contamination hotspots, and evaluates system behaviour in the Jipijapa River micro-basin, Ecuador, through an integrated analytical framework. A multi-year dataset (2023–2025; n = 27) from nine monitoring sites was analysed using non-parametric statistics, regulatory exceedance-based hotspot detection, the BMWP/Col index, Spearman correlations adjusted by false discovery rate, and exploratory machine-learning models (Random Forest and ε-SVR) with leave-one-out cross-validation. Results showed a significant longitudinal gradient, with dissolved oxygen decreasing from 6.1 to 2.1 mg L⁻¹ and BOD₅ increasing from 6.1 to 111.0 mg L⁻¹ downstream. Five hotspots were identified, mainly in the lower reach, while BMWP/Col values declined from 118.3 to 37.0, indicating ecological degradation. Correlation analysis revealed strong coupling between BOD₅ and dissolved oxygen (ρ = −0.916), modulated by altitude and vegetation cover. Machine-learning models showed high internal consistency, although their use was restricted to diagnostic pattern detection rather than operational prediction. Overall, the convergence of physicochemical, ecological, hotspot, and modelling evidence supports an inferred spatial resilience gradient and provides a locally adaptable framework for prioritising watershed interventions in data-limited semi-arid basins. Full article

Background/Objectives: This study aimed to examine whether psychological resilience mediates the relationship between religious coping behaviors and menopausal symptoms among postmenopausal women. Methods: A cross-sectional study was conducted in Türkiye between July 2024 and July 2025 with women aged 45–60 years in the natural menopausal period (n = 190). Data were collected using a sociodemographic questionnaire, the Menopause Rating Scale (MRS), the Religious Coping Styles Scale (RCSS), and the 10-item Connor–Davidson Resilience Scale (CD-RISC-10). Descriptive statistics, Spearman correlation analysis, and structural equation modeling (SEM) with robust estimation were performed. The potential mediating role of psychological resilience was examined using SEM. Results: Negative religious coping was significantly associated with lower psychological resilience (β = −0.17, p = 0.050). However, psychological resilience did not show a significant association with menopausal symptoms in the structural model (β = −0.11, p = 0.134). Positive religious coping was not significantly related to resilience (β = −0.04, p = 0.649). The overall model explained a low proportion of variance in menopausal symptoms (R² ≈ 0.05). No evidence of a mediating effect of psychological resilience was found. Bootstrapped indirect effects indicated that the mediating role of psychological resilience was not statistically significant, as the confidence interval included zero. Conclusions: Although psychological resilience and religious coping were associated at the correlational level, no evidence of a mediating effect was found. The low explanatory power of the model suggests that menopausal symptoms are influenced by broader biological and contextual factors. The findings should be interpreted cautiously, and further longitudinal research is needed. Full article

Background: The diffusing capacity of the lung for carbon monoxide (DLCO) is a key measure of alveolar–capillary gas exchange, but its clinical significance in chronic obstructive pulmonary disease (COPD) remains incompletely defined. This study aimed to characterize the demographic, clinical, functional, and comorbid profiles of COPD patients stratified by the degree of DLCO impairment, and to evaluate the potential value of DLCO as a marker for disease severity and clinical phenotyping in a Chinese cohort. Methods: This single-center retrospective cross-sectional study enrolled 650 patients diagnosed with COPD (according to GOLD 2025 criteria) who underwent pulmonary function tests between January 2024 and February 2025 at the university-town hospital of Chongqing Medical University. Patients were stratified by predicted DLCO% into four groups: normal (≥80%), mild impairment (60–79%), moderate impairment (40–59%), and severe impairment (<40%). Demographic, clinical, laboratory, pulmonary function, echocardiographic, and chest CT data were collected. Comparisons across groups were performed using ANOVA/Kruskal–Wallis tests, chi-square or Fisher’s exact tests, and Spearman correlation analysis (IBM SPSS Statistics 25.0). Due to the exploratory nature of the study, no adjustment for multiple comparisons was applied. Results: Progressive DLCO impairment was associated with a higher proportion of male patients (69.2% to 90.9%, p = 0.018), older age (67.3 ± 9.0 to 72.9 ± 6.7 years, p < 0.001), lower BMI (median from 23.9 to 20.0 kg/m², p < 0.001), and higher smoking prevalence (58.7% to 87.5%, p = 0.001). The prevalence of pulmonary tuberculosis rose markedly (0.58% to 9.09%, p = 0.037). All spirometric parameters declined (e.g., FEV1%pred from 67.3% to 32.6%, p < 0.001). Systemic inflammatory markers (NLR, SII) increased, while hemoglobin and albumin decreased (both p < 0.001). Respiratory failure occurred in 30.0% of the severe DLCO group (predominantly type I, p <0.001). Echocardiography revealed a decline in left ventricular ejection fraction (61.2 ± 5.0% to 59.1 ± 4.0%, p = 0.012) and a trend toward higher pulmonary hypertension risk (27.8%, p = 0.056). DLCO%pred correlated positively with FEV1%pred (r = 0.394, p < 0.001) and oxygen saturation (r = 0.151, p < 0.001), and negatively with NLR (r = −0.165, p < 0.001) and SII (r = −0.149, p < 0.001). Conclusions: In COPD, DLCO impairment is associated with distinct clinical phenotypes, including male sex, advanced age, malnutrition, increased tuberculosis risk, worse lung function, systemic inflammation, and respiratory/cardiac dysfunction. These findings support DLCO as a valuable complementary marker for disease severity characterization in COPD. Longitudinal studies are needed to confirm its prognostic value. Full article

Experiential avoidance, defined as unwillingness to deal with personal experiences such as thoughts, emotions, and memories, is closely related to difficulties in emotion regulation. This is because emotional awareness and acceptance are crucial for regulating distressing feelings. Somatic symptoms, referring to bodily sensations such as headaches, nausea, and fatigue with or without any underlying medical condition, are frequently reported among individuals with avoided or dysregulated emotional burden. This cross-sectional correlational study aimed to examine the mediating role of emotion regulation difficulties in the relationship between experiential avoidance and somatic symptoms; we used a sample size of 397 individuals recruited from a non-clinical population with the convenience sampling technique. The measurement instruments were the Brief Experiential Avoidance Questionnaire (BEAQ), Somatic Symptom Scale (SSS-8), and Difficulties in Emotion Regulation Scale (DERS-16). Statistical analysis was conducted using the IBM SPSS 29 statistical program and the SPSS Process Macro 4.2 extension. The results indicate that difficulties in emotion regulation mediated the relationship between experiential avoidance and somatic symptoms controlling for age, education, gender and perceived income and all variables were significantly correlated with each other, including subscales of difficulties in emotion regulation. Limited access to emotion regulation strategies was subscale with an indirect effect on the association between experiential avoidance and somatic symptoms. These findings are expected to guide mental health professionals in consulting clients with somatic symptoms and emotion regulation difficulties. Full article

Background/Objectives: In South Korea, physician assistant (PA) nurses—registered nurses performing physician-delegated advanced clinical tasks without a nationally standardized licensure system—are increasingly relied upon to address healthcare delivery gaps. This study examined the associations of organizational climate and role conflict with job esteem among PA nurses. Methods: A cross-sectional descriptive design was used. Data were collected from 145 PA nurses at four university hospitals (each ≥ 500 beds) in Daegu, South Korea, between March and April 2025, using validated instruments for organizational climate, role conflict, and job esteem. Multiple linear regression analysis was performed to identify factors associated with job esteem. Results: Organizational climate was positively correlated with job esteem, while role conflict showed a negative correlation. In the multiple linear regression model, organizational climate and pre-role training experience emerged as significant factors associated with job esteem, jointly explaining 23% of the variance, whereas role conflict did not show an independent association when organizational climate was included in the model. Conclusions: These findings suggest that supportive organizational climates and structured preparation may be important for sustaining job esteem among nurses working in expanded physician-delegated roles. In the broader context of physician shortages, which can compromise care quality and intensify nurses’ workload, strengthening organizational supports for PA nurses is also relevant to maintaining the quality and continuity of healthcare services. These findings may also be informative for other healthcare systems in which nursing role expansion is occurring faster than the development of supporting institutional structures. Full article

This study estimates daily nitrogen dioxide (NO₂) concentrations at ground level across the Marmara Region of Türkiye at 0.01° resolution. The framework integrates Sentinel-5P (S5P) TROPOspheric Monitoring Instrument (TROPOMI) and GEOS Composition Forecast (GEOS-CF) tropospheric NO₂ vertical column density (VCD) data with meteorological, topographic, land-use, socioeconomic, and temporal features through four tree-based ensemble algorithms trained on 74 ground station observations. Under a temporal split (2019–2022 training, 2023 validation, 2024 testing), S5P-Categorical Boosting (CatBoost) achieved the best performance (Pearson correlation coefficient (R) = 0.706, R² = 0.498, root mean square error (RMSE) = 14.31 µg/m³). Random splitting inflated R by +0.168 due to temporal autocorrelation, while leave-one-station-out and leave-one-province-out cross-validation reduced R to ~0.50 by removing spatial dependence, together revealing the combined effect of temporal and spatial autocorrelation. SHapley Additive exPlanations (SHAP) analysis identified TROPOMI NO₂ VCD, population density, road length, and nighttime light as dominant predictors; population density was the top predictor in the GEOS-CF model, followed by VCD. Concentration maps for 2024 showed that 95.9% of the region’s 26.74 million inhabitants were exposed above the WHO annual air quality guideline of 10 µg/m³, with a population-weighted mean of 21.08 µg/m³. Full article

Chronic kidney disease–mineral and bone disorder (CKD-MBD) is a major complication of end-stage renal disease and is associated with increased morbidity and mortality. Sclerostin, an osteocyte-derived glycoprotein that inhibits the Wnt/β-catenin signaling pathway, has been implicated in the dysregulation of bone metabolism in dialysis patients. However, comparative data on sclerostin levels and their clinical determinants between hemodialysis (HD) and peritoneal dialysis (PD) patients remain limited, particularly in Southeast Asian populations. This cross-sectional study was conducted at Hue Central Hospital, Vietnam, between June 2023 and January 2026. A total of 89 end-stage renal disease patients were consecutively enrolled (HD: n = 51; PD: n = 38). Median serum sclerostin levels were 584.21 (IQR: 301.18–1479.50) pg/mL in the HD group and 684.21 (IQR: 407.48–940.35) pg/mL in the PD group, with no significant difference between groups (p = 0.839). Serum sclerostin was inversely correlated with PTH in both HD (r = −0.444, p = 0.001) and PD patients (r = −0.341, p = 0.036). In the HD group, total femur BMD showed a significant inverse correlation with sclerostin (r = −0.304, p = 0.030). In multivariable analysis, Log_PTH remained an independent predictor of sclerostin across all three sequential models in the HD group (Model 1: B = −0.340, p = 0.001; Model 2: B = −0.270, p = 0.035; Model 3: B = −0.268, p = 0.039; adjusted R² range: 0.197–0.217) and in the combined HD + PD cohort (Model 1: B = −0.271, p < 0.001; Model 2: B = −0.263, p < 0.001; Model 3: B = −0.249, p = 0.003; adjusted R² range: 0.141–0.158). In the PD subgroup, Log_PTH was significant in Models 1 and 2 but not in Model 3; none of the models reached overall statistical significance (all p ≥ 0.081), and findings should be considered exploratory given the limited sample size. Serum sclerostin levels did not differ significantly between HD and PD patients. PTH was the most consistent independent predictor of sclerostin across dialysis modalities and analytical models, underscoring its central role in CKD-MBD pathophysiology. Larger prospective multicenter studies are warranted to validate these findings and further clarify the clinical utility of sclerostin in dialysis populations. Full article

(1) Background: Psoriasis is increasingly recognized as a systemic inflammatory disease associated with metabolic comorbidities. However, the hierarchical relationship between inflammatory activation and insulin resistance in driving metabolic syndrome (MetS) remains incompletely defined. This study aimed to characterize the integrated inflammatory–metabolic architecture of psoriasis using multivariate and latent domain modeling. (2) Methods: In this cross-sectional hospital-based study (2020–2022), 235 adult patients with psoriasis were evaluated. Systemic inflammatory markers (NLR, SII, CRP, ESR) and composite metabolic indices (TyG, AIP, METS-IR) were assessed. Correlation analysis, multivariable linear and logistic regression, interaction modeling, and principal component analysis (PCA) were performed to examine independent associations and underlying domain structure. (3) Results: Inflammatory and metabolic markers showed modest but significant correlations. In multivariable logistic regression, the TyG index was the strongest independent predictor of MetS (OR = 5.15, p < 0.001), whereas inflammatory markers did not retain independent significance. An interaction between adiposity and insulin resistance further improved model discrimination (AUC = 0.830). PCA identified two distinct latent domains explaining 69.9% of total variance: an immune–inflammatory domain (NLR, SII, ESR, CRP) and a metabolic–insulin resistance domain (TyG, AIP, METS-IR). Only the metabolic domain independently discriminated MetS. (4) Conclusions: Psoriasis exhibits a multidimensional systemic architecture characterized by partially independent inflammatory and metabolic domains. Although systemic inflammation and metabolic dysfunction coexist, insulin-resistance-related indices were more strongly associated with metabolic syndrome in this cohort. Full article

Background: Raised intracranial pressure in intracranial tumor surgery is driven by mass effect and edema, but invasive monitoring is selectively used, and imaging may not fully reflect contemporaneous pressure. We performed a pilot evaluation of preoperative optic nerve sheath diameter and CT mass effect in relation to pre-excision invasive intracranial pressure. Methods: This retrospective pilot study included adults with available preoperative optic nerve sheath diameter, CT mass effect graded by the Gordon–Firing score, and recorded pre-excision invasive intracranial pressure. The primary analysis assessed association with continuous pre-excision intracranial pressure using correlation and linear regression. Perioperative change in invasive intracranial pressure and serial optic nerve sheath diameter were also analyzed. Threshold analyses were exploratory. Results: In total, 45 patients were included. Mean pre-excision intracranial pressure was 29.40 mmHg, and 39/45 (86.7%) had intracranial pressure > 20 mmHg. Optic nerve sheath diameter showed a modest association with pre-excision intracranial pressure (r = 0.279, p = 0.064), whereas Gordon–Firing showed a stronger association (r = 0.522, p < 0.001). In the combined model, Gordon–Firing remained associated with intracranial pressure, whereas optic nerve sheath diameter did not. Mean intracranial pressure decreased by 12.24 mmHg after tumor excision, and optic nerve sheath diameter decreased at 1 h and 6 h postoperatively. Conclusions: CT mass effect graded by Gordon–Firing showed a stronger cross-sectional relationship with pre-excision invasive intracranial pressure than optic nerve sheath diameter, whereas serial optic nerve sheath diameter appeared more useful as a perioperative marker. Full article