Search Results (12,788)

Frailty, cognitive impairment, depression, functional dependency, low physical performance, and undernutrition are highly prevalent in older adults referred for cancer treatment, cardiovascular interventions, neurological therapies, and orthopaedic surgery, and each independently predicts treatment toxicity, post-procedural complications, and mortality. Comprehensive Geriatric Assessment (CGA) is the most accurate predictor of treatment outcomes in older patients, yet it remains structurally absent from most speciality pathways, contributing to overtreatment of biologically frail patients and undertreatment of biologically robust ones. In this Viewpoint, we propose and operationalise the FIT–FRAIL–DISABLE multidimensional geriatric stratification model as a conceptual framework for translating CGA findings into proportional, speciality-specific treatment recommendations across oncology, cardiology, neurogeriatrics, and orthogeriatrics. The model integrates six validated CGA instruments—the Mini-Mental State Examination (MMSE), the 15-item Geriatric Depression Scale (GDS-15), basic and instrumental Activities of Daily Living (ADL, IADL), the Short Physical Performance Battery (SPPB), and the Mini Nutritional Assessment Short Form (MNA-SF)—into three actionable categories (FIT, FRAIL, DISABLE) aligned with full-intensity, risk-adapted, and symptom-focused care, and is explicitly positioned in relation to the deficit-based frailty paradigm and the WHO Intrinsic Capacity (ICOPE) framework, which it complements rather than replaces. We specify a provisional, a priori decision rule for combining domain scores and describe how each stratification category should inform—but not dictate—goal-concordant treatment intensity within a shared decision-making process. FIT–FRAIL–DISABLE is presented as a proposed, hypothesis-generating framework: its composite thresholds and domain weighting have not yet been empirically derived, and the model has not undergone prospective validation. Retrospective calibration on existing CGA cohorts and prospective multicentre validation are being designed within the GERIA-NET research consortium. If validated, the framework has the potential to reduce both overtreatment-related harm and undertreatment-related therapeutic deprivation in older adults undergoing active treatment. Full article

Video anomaly detection has two very different answers to the question of how a detector should acquire its notion of “normal” for a given camera: adapt its parameters to hours of normal footage recorded by that exact camera, or perform no target-scene adaptation at all and rely on frozen, heavily pretrained backbones—a vision-language image–text model and a large language model applied to text descriptions of frames. We call the second setting target-scene-training-free: the backbones themselves are trained on very large general-purpose corpora, but no parameter is updated, fine-tuned, or transfer-learned on the target scene. That setting is far more convenient to deploy, but how much accuracy does it give up, and can any of that gap be closed without target-scene adaptation? We define an anomaly operationally, as a frame whose score under a scoring function $s(·)\in [0,1]$ exceeds a threshold, and evaluate every system with one metric definition and one implementation: frame-level area under the ROC curve (AUC) and equal error rate (EER), computed over all ground-truth-labeled test frames of each benchmark. We train a simplified future-frame-prediction network—a U-Net optimized with an intensity and gradient-difference loss, with the optical-flow and adversarial terms of the original design removed—on the normal-only training split of UCSD Ped1, UCSD Ped2, and CUHK Avenue, reaching a mean AUC of 0.848. A target-scene-training-free system starts far behind at 0.567, because its semantic signal is dropped in practice: the vision-language model that would produce it is too slow to run over a full test set. We close this gap in three ways, all evaluated on full test sets: CLIP-Guided Semantic Grounding (CSG), Vision-Language Reasoning (VLR), and Statistically-Calibrated Semantic Grounding (SCSG). Our best method raises mean AUC to 0.653, closing roughly a third of the gap with no target-scene adaptation. The trained model nonetheless leads on every benchmark, and because it is deliberately simplified, the gap we report is a conservative lower bound on the gap a fully engineered trained model would show. We report every result honestly, including a prompt-sensitivity analysis showing how much of the training-free result depends on prompt wording, cases where a more sophisticated method did not beat a simpler one, and a measured explanation of why UCSD Ped1 is the weakest benchmark for the trained model. Full article

Lead-free palladium halides containing square-planar coordination units provide a distinctive platform for investigating light-matter interactions, yet their spectroscopic behavior and thin-film photoresponse remain largely unexplored. Herein, we report a systematic investigation of Cs₂PdCl₄·H₂O, synthesized as both nanorods and single crystals, covering its structural, spectroscopic, electronic, and photoresponsive properties. Single-crystal X-ray diffraction confirms that the monohydrate crystallizes in the orthorhombic Cmcm space group with discrete square-planar [PdCl₄]²⁻ units. Powder X-ray diffraction verifies that the nanorods adopt the same crystalline phase and retain their principal diffraction features after two months of ambient storage. X-ray photoelectron spectroscopy confirms the Pd(II) valence state, and optical measurements determine a direct bandgap of 2.32 eV. Temperature-dependent and time-resolved photoluminescence reveal a low-temperature emission blueshift, enhanced emission intensity, and prolonged carrier decay, attributable to suppressed non-radiative relaxation and contributions from multiple emissive states. Density functional theory calculations based on the experimentally determined monohydrate structure show that the band-edge states are dominated by Cl 3p and Pd 4d orbitals. Thermally deposited Cs₂PdCl₄·H₂O-derived films deliver reproducible visible-light photocurrent switching across 397–564 nm and retain 71% of their initial response after 504 h under nitrogen. These findings establish Cs₂PdCl₄·H₂O as a visible-light-responsive lead-free palladium halide and provide a basis for future exploration in optoelectronic sensing. Full article

We investigate the optical and electronic properties of a spherical AlSb/InAs/AlSb core/shell/shell quantum dot (QD) under the combined effects of size confinement and an external magnetic field. The system contains a centrally located hydrogenic donor impurity whose attractive Coulomb interaction affects the distribution of electronic energy levels, their corresponding wavefunctions, and their optical responses. The total optical absorption coefficients and refractive index changes are analyzed as functions of incident photon energy by systematically varying the core radius and the applied magnetic field. The results reveal a tunable optical absorption resonance associated with the E_{1 →} E₂ intersubband transition, whose spectral position and amplitude are strongly modified by the core radius, magnetic-field strength, and presence of the hydrogenic impurity. Increasing the magnetic field intensity from 0 to 30 T redshifts the optical absorption and refractive index peaks by 20–60 meV, reflecting the predominance of magnetic effects in the total confining potential. In contrast, expanding the internal quantum dot radius (core radius) also leads to a redshift, but in a lower-energy range of incident photons (0–20 meV), governed primarily by the quantum-size confinement effect. This net distinction in energy-shift ranges indicates that applying a magnetic field offers a broader tuning mechanism than quantum-size effects in the proposed core/shell/shell QDs. Furthermore, the coexistence of two distinct absorption ranges underscores the potential of AlSb/InAs/AlSb spherical QDs for various technological applications, including multi-band, magnetically tunable infrared and THz-infrared optical photodetectors. Full article

Intensive poultry farming produces substantial volumes of chicken manure that require effective and hygienic management. This study investigated a composite inoculant formulated with four microorganisms: Kocuria rosea  ACCC 10488, Bacillus subtilis ACCC 60364, Trichoderma longibrachiatum ACCC 32584, and Lactobacillus plantarum ACCC 11118. This study investigated a composite inoculant formulated with four microorganisms obtained from the Agricultural Culture Collection of China (ACCC): Kocuria rosea ACCC 10488, Bacillus subtilis ACCC 60364, Trichoderma longibrachiatum ACCC 32584, and Lactobacillus plantarum ACCC 11118. Its performance was examined both without amendment and after addition of plant-derived bulking materials. The experiment included five treatments: untreated chicken manure (T1), the bulking-agent mixture without microbial addition (T2), a commercial inoculant combined with the same bulking materials (T3), the newly prepared inoculant without bulking agents (T4), and the newly prepared inoculant combined with the bulking mixture (T5). Three independent 50-kg piles were prepared for every treatment. Temperature was recorded for 45 days; physicochemical characteristics, odor indicators, nutrient concentrations, enzyme activities, seed-bioassay responses, and Ascaris egg mortality were evaluated over the initial 15 days. T5 reached 74 °C on days 5 and 10 and remained above 50 °C through day 30 at the plotted observation points. On day 15, this treatment had lower measured levels of odorous compounds, greater concentrations of available phosphorus and potassium, a 99% germination index, and complete mortality of the assayed Ascaris eggs. Collectively, T5 showed favorable changes across several indicators of early composting performance under the conditions tested. The study did not examine microbial community structure, persistence of the introduced strains, functional genes, whole-pile nutrient mass balances, or longer-term agronomic performance. Consequently, the data neither establish synergistic interactions among the component strains nor identify specific nutrient-transformation pathways. Full article

Coworking spaces have become an increasingly important component of contemporary urban economies, yet their spatial organisation remains poorly understood in rapidly developing Gulf cities. This study examines the spatial clustering and urban correlates of coworking space locations in Jeddah, Saudi Arabia. A dataset of 53 coworking spaces was integrated with points of interest, built-up land, and road-network data within a GIS framework. Spatial pattern was evaluated using Monte Carlo nearest-neighbour analysis, kernel density estimation, and Ripley’s L-function. A 1 km grid was subsequently used to model coworking space presence through binary logistic generalised linear regression, with a 2 km grid used for sensitivity analysis. Coworking spaces exhibited pronounced spatial clustering: the observed mean nearest-neighbour distance was 1023 m compared with 2667 m under complete spatial randomness (nearest-neighbour ratio = 0.384, Monte Carlo p = 0.001). The observed centred Ripley’s L-function exceeded the upper pointwise 95% CSR simulation envelope throughout the evaluated 0.25–10 km range, indicating multiscale spatial concentration. In the final 1 km model, business density (OR = 2.13, p < 0.001), built-up proportion (OR = 1.042 per percentage point, p < 0.001), and road density (OR = 1.075, p = 0.008) were positively associated with coworking space presence. Business density and built-up proportion remained significant at the 2 km scale, whereas the road-density association weakened. These findings suggest that coworking spaces in Jeddah are primarily embedded within business-intensive, highly urbanised, and accessible parts of the metropolitan area while also demonstrating sensitivity to spatial analytical scale. Full article

Remote sensing ship detection is of great significance in marine traffic monitoring, port management, national defense security and other fields. Due to the small target scale, complex backgrounds and sparse distribution of ships in remote sensing images, existing real-time detectors still face challenges in localization accuracy and feature utilization efficiency. Taking RT-DETR-s as the baseline, this paper proposes two encoder-level improvements to boost the performance of ship detection in remote sensing imagery. On the attention mechanism side, an Edge-Aware Self-Attention (EASA) module is proposed as the principal methodological contribution. The Scharr edge map is injected into the attention matrix before softmax with a learnable intensity, providing a structural prior that enhances attention interactions between positions with strong edge responses, including ship contours, coastlines, and wake boundaries. The semantic distinction between ship-relevant and irrelevant edges is learned through the query-key projections in the attention mechanism itself, rather than through the edge bias. In terms of feature fusion, a Shallow-Guided Deep Fusion (SGDF) module is designed as an efficient integration strategy of existing techniques (CBAM attention and cross-scale fusion), with its novelty in the attention-first, downsampling-later pipeline that preserves fine-grained spatial details for small-object detection. It injects high-resolution small-object context from the backbone’s shallow layers into deep features, effectively mitigating the loss of spatial information of small ships in deep feature maps via spatial-channel attention. Finally, the existing WIoUv3 loss function is adopted and systematically compared with six other IoU variants to identify the most suitable regression loss for remote sensing ship detection. Experiments demonstrate that compared with RT-DETR-s, the proposed method achieves 2.8% higher mAP50–95 and 3.2% higher APsmall (APs) while maintaining real-time inference speed (37.6 FPS). Full article

Background/Objectives: Management of locally advanced laryngeal squamous cell carcinoma remains controversial. This study compared definitive chemoradiotherapy (CRT) with total laryngectomy followed by postoperative radiotherapy with or without chemotherapy (TL + PORT/CRT) in T3–T4aN0–N1 disease. Methods: This multicenter retrospective cohort included 311 patients treated between 2008 and 2025 at two centers: 160 received definitive CRT and 151 underwent TL + PORT/CRT. Survival was estimated using Kaplan–Meier and Cox regression analyses. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used as adjusted analyses. The primary endpoint was disease-specific survival (DSS). Results: Median follow-up was 98 months. In the unmatched cohort, 5- and 10-year DSS rates were 92.1% and 92.1% after CRT versus 93.7% and 83.5% after TL + PORT/CRT (p = 0.351), while 5-year local control favored TL + PORT/CRT (98% vs. 79%; p < 0.001). After PSM (59 patients per group), cluster-robust Cox analysis showed inferior overall survival (OS) after CRT (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.12–3.86; p = 0.021) and inferior local control (HR, 12.83; 95% CI, 3.75–43.87; p < 0.001). In the 2015–2025 intensity–modulated radiotherapy (IMRT)-restricted analysis, OS also favored TL + PORT/CRT (HR, 3.64; 95% CI, 1.09–12.22; p = 0.036), whereas full-cohort IPTW showed no significant OS difference (HR, 0.93; 95% CI, 0.64–1.36; p = 0.715). Functional laryngeal preservation was achieved in 126/160 patients (78.8%) after CRT. Conclusions: Definitive CRT was associated with inferior local control, while DSS remained comparable. OS estimates varied across adjusted analyses and did not support a stable treatment-specific survival effect. Definitive CRT remains an organ-preservation option in appropriately selected patients. Full article

Background/Objectives: Fibromyalgia (FM) is a nociplastic pain syndrome characterized by chronic widespread pain, fatigue, sleep disturbance, cognitive dysfunction, and heightened sensitivity to somatic and environmental stimuli. Depressive symptoms and major depressive disorder (MDD) frequently co-occur with FM and are associated with greater disability, pain catastrophizing, sleep disruption, and poorer treatment response. Although pharmacological treatments can reduce symptoms in some patients, many individuals experience persistent functional and affective burden, highlighting the need for mechanism-based adjunctive strategies. Mindfulness-based interventions (MBIs), particularly mindfulness-based stress reduction (MBSR), have shown promise for improving functional impact, pain catastrophizing, perceived stress, depressive symptoms, sleep-related burden, and quality of life in FM. However, the effects of MBIs on pain intensity and biomarkers are less consistent. Methods: This narrative mechanistic review develops a hypothesis-generating multisystem neurobehavioral framework to explain how MBIs may influence pain–mood coupling in FM with depressive symptom burden. We define pain–mood recalibration as a reduction in the extent to which pain intensity, bodily vigilance, and interoceptive threat appraisal automatically drive depressive symptoms, rumination, avoidance, and functional disengagement. Results: Fibromyalgia-specific evidence most strongly supports cognitive–emotional mechanisms, including reduced catastrophizing, psychological inflexibility, rumination, perceived stress, and avoidance. Interoceptive, neural-network, autonomic, immune-inflammatory, and sleep-fatigue-behavioral pathways remain exploratory and require prospective mediation and moderation testing. Conclusions: Future trials should prioritize active controls, ecological momentary assessment, longitudinal biomarkers, neuroimaging, interoceptive tasks, and formal mediation/moderation models to determine which patients benefit, through which mechanisms, and under what biological and psychological conditions. Full article

Against the backdrop of industrialization and urbanization, China’s cropland resource utilization has changed significantly, yet existing research lacks integrated zoning and formation mechanisms. Taking the Huang–Huai–Hai region as a case, this study constructed an indicator system covering quantitative endowment, landscape morphology, natural background, and production functions from the perspective of dominant and recessive land-use transitions. Based on the general characteristics and spatiotemporal evolution of different cropland resource utilization forms, we used 3S technology and the CART algorithm to classify the 52 cities in the Huang–Huai–Hai region into five cropland resource utilization patterns. From 2000 to 2020, these patterns evolved from fragmented and extensive to large-scale, intensive, and functional. Market reforms and land tenure interventions were closely associated with this evolution, as they affected labor allocation, property rights, farming practices, technology, and farmers’ risk aversion. This study enriches cropland resource utilization theory and supports territorial optimization for high-quality agriculture in the region. Full article

Population ageing challenges the social sustainability of high-density cities, where equitable eldercare access underpins SDG 3, SDG 10 and SDG 11. In China, rapid expansion of community-based eldercare facilities (CEFs) under the “90-7-3” framework has produced a tripartite system of government, operating enterprises and older adult users whose spatial priorities conflict, threatening both distributive equity and long-term operational viability. Existing single-dimensional evaluations inadequately capture this complexity. This study develops an integrated four-dimensional spatial evaluation framework—supply–demand accessibility, spatial equity, functional diversity and market competition—applying the Gaussian two-step floating catchment area method, isochrone-based service-area analysis and a preference-weighted Shannon index to 697 CEFs across 130 sub-districts in Beijing’s central urban area. Results reveal a pronounced core–periphery divide. For service-type CEFs, 90.17% of communities (87.95% of older adults) lie within a 15-min walking catchment, yet service-area overlap reaches 199.32%, indicating redundant resource deployment and intense localised competition in core districts. For residential-type CEFs, only 53.91% of communities are within walkable reach and total coverage drops to 15.84%, exposing care blind spots and spatial inequity in outer districts. Functional diversity, by contrast, is evenly distributed and micro-environmentally shaped. The framework offers replicable diagnostics for sustainable ageing-in-place provision in rapidly ageing high-density cities. Full article

Selenium (Se) biofortification of microalgae is a promising strategy for producing functional biomass with enhanced nutritional value. This study evaluates the effect of sodium selenite (Na₂SeO₃) supplementation to the culture medium on the biochemical profile of Limnospira platensis cultivated under intensive growth conditions with an elevated CO₂ concentration (3 vol.%). Two consecutive cultivation experiments were conducted using Na₂SeO₃ supplementations of 10, 20, 40, and 80 mg/L along with a control (0 mg/L). In the second experiment, biomass previously cultivated at 20 mg/L served as the inoculum to evaluate the response of a pre-adapted culture. Biomass productivity, protein, carbohydrate, lipid, pigment, CHNS composition, Se accumulation, and macro- and microelement contents were determined. Maximum biomass productivity (0.369 g·L⁻¹·day⁻¹) was obtained at 10 mg/L. The most severe disruptions to biochemical and elemental parameters occur at 80 mg/L. This concentration triggers a statistically significant reduction in protein content (down to 46.98% in the first experiment), an accumulation of mercury, an elevation in carbohydrates, and a corresponding shift in the C/N ratio. The second experiment demonstrated enhanced metabolic stability of the pre-adapted culture, including preservation of protein content under high selenium stress and normalization of copper accumulation, indicating the adaptive capacity of L. platensis to prolonged selenium exposure. The concentration of Se in the biomass grown under 0 (control), 10, 20 and 80 mg/L of Na₂SeO₃ was 0.5, 88.7, 394.0 and 762.0 mg/kg, respectively. Overall, a method for producing L. platensis biomass with a controlled Se content has been demonstrated. Based on these findings, Na₂SeO₃ concentrations of 10–40 mg/L are recommended for producing Se-enriched biomass, balancing productivity, nutritional quality, and elemental safety. The nutritional efficacy of the biomass obtained using this method should be the subject of future research. Full article

Equitable access to health-promoting public services is an important component of socially sustainable urban development, yet fitness-facility accessibility is often assessed under homogeneous demand assumptions. This study develops an age-differentiated framework for central Harbin, China, integrating 100 m age-stratified population data, facility functional area, pedestrian-network travel costs, and physical-activity participation rates within an MGH-3SFCA model. Accessibility was evaluated for four age groups at 15 min, with shorter-threshold comparisons, population exposure analysis, bivariate LISA, and sensitivity tests. Adults and students generally formed the relatively higher-accessibility pair, whereas children and seniors remained more disadvantaged. More than 91% of each age group was located in zero, very low, or low accessibility classes. High-intensity ball-sports facilities were dominated by geographic non-coverage, while resistance-training facilities were more widely reachable but mostly at very low levels. The adult–senior zero-accessibility population gap widened from 3.52 percentage points at 15 min to 13.66 at 5 min. High–Low clusters occupied only 5.90–7.39% of land grids but contained 11.77–13.25% of corresponding populations. Broad spatial patterns were stable to alternative composite weighting, while some age contrasts were specification-dependent. The framework supports age-responsive and socially sustainable neighbourhood planning by distinguishing spatial coverage, population exposure, and potential local mismatch. Full article

Psychological research has long conceptualized guilt as a moral-relational regulatory emotion, yet its functioning in digital communication environments has received little systematic theoretical attention. This article proposes a theoretical model to understand the conditions created by the digital medium for the emergence, intensity, and moral-relational regulatory functioning of guilt. Conceptualizing guilt as a communicatively embedded regulatory process, the model integrates four theoretical approaches: the theory of mediatization, the psychology of moral and self-conscious emotions, narrative identity theory, and the distinction between intrinsic and extrinsic religious orientation. The model describes guilt as a process comprising five interrelated moments. Its central thesis is that four structural characteristics of the digital medium—partial anonymity and increased social distance, temporal asynchronicity, mass publicity, and the unpredictability of the normative framework—influence all moments of the process in a similar direction, thereby weakening or destabilizing the moral-relational regulatory role of guilt. Using intrinsic and extrinsic religious orientations as examples, the model also shows that these effects may operate differently depending on the type of orientation. The proposed framework may contribute to the dialogue among psychology, media studies, and the study of religion by interpreting the functioning of guilt under the specific conditions of the digital communication environment. Full article

The retinal pigment epithelium (RPE) is a monolayer of cells located between retinal photoreceptors and the choroid, playing a critical role in maintaining visual function by protecting the retina and supporting photoreceptor metabolism. Damage to RPE cells can lead to visual disorders, including macular degeneration. Chronic exposure to high-energy blue light has been shown to elevate intracellular reactive oxygen species (ROS) in RPE cells, causing oxidative stress and cellular damage. In this study, a microfluidic platform incorporating a gradient-generating structure was developed to establish controllable and stable gradients of blue light intensity and chemical concentrations. This platform was used to investigate the effects of varying blue light intensities and antioxidant concentrations on oxidative stress in human RPE cells ARPE-19. Cells cultured within the microfluidic channels were exposed to different blue light intensities in combination with chemical treatments. Results demonstrated that ROS production increased with higher blue light intensity, whereas higher antioxidant concentrations effectively reduced ROS accumulation, supporting the ability of these antioxidants to attenuate blue-light-induced intracellular oxidative stress. The present microfluidic device enables simultaneous evaluation of multiple conditions within a single experiment, reducing reagent consumption and enhancing experimental efficiency. This in vitro microfluidic platform integrates chemical and light gradients to assess retinal oxidative damage and antioxidant effects, offering significant potential for ophthalmic drug screening and investigations of retinal protective mechanisms. Full article