Search Results (2,190)

Background/Objectives: Sunk cost bias—continuing failing endeavours due to prior investments—is among the most studied decision-making biases. Despite decades of vignette-based research, these measures lack systematic psychometric validation. We examined whether widely-used sunk cost scenarios reliably measure the same psychological construct. Methods: Across two experiments (N = 395), we tested established sunk cost vignettes, including classic scenarios from Arkes and Blumer (1985). English-speaking participants from Prolific Academic completed vignettes alongside cognitive reflection and social desirability measures. We assessed internal consistency and intercorrelations between scenarios. Results: Internal consistency was consistently poor (ω = 0.14–0.57) with weak intercorrelations between scenarios. Even highly similar vignettes correlated only moderately. External validity was problematic, showing inconsistent relationships with cognitive reflection and social desirability across vignettes. Conclusions: These measurement failures have critical implications for neuroimaging research, where unreliable behavioural measures may be mistaken for genuine neural differences. The field needs systematic categorization of scenarios to identify which vignettes engage specific psychological processes and neural circuits, enabling more targeted theoretical development. Full article

The shear tests are conducted on six precast segmental concrete beams (PSCBs) in this paper. A new specimen design scheme is presented to compare the effects of segmental joints on the shear performance of PSCBs. The failure modes, shear strength, structural deflection, stirrup strain, and tendon stress are recorded. The factors of shear span ratio, the position of segmental joints, and hybrid tendon ratio are focused on, and their effects on the shear behaviors are compared. Based on the measured responses, the shear contribution proportions of concrete segments, prestressed tendons, and stirrups are decomposed and quantified. With the observed failure modes, the truss–arch model is employed to clarify the shear mechanism of PSCBs, and simplified equations are further developed for predicting the shear strength. Using the collected test results of 30 specimens, the validity of the proposed equations is verified with a mean ratio of calculated-to-test values of 0.96 and a standard deviation of 0.11. Furthermore, the influence mechanism of shear span ratio, segmental joints, prestressing force, and hybrid tendon ratio on the shear strength is clarified. The increasing shear span ratio decreases the inclined angle of the arch ribs, thereby reducing the shear resistance contribution of the arch action. The open joints reduce the number of stirrups passing through the diagonal cracks, lowering the shear contribution of the truss action. The prestressing force can reduce the inclination of diagonal cracks, improving the contribution of truss action. The external unbonded tendon will decrease the height of the arch rib due to the second-order effects, causing lower shear strength than PSCBs with internal tendons. Full article

Background: Implantation of modularly built-up stems with a tapered and fluted design is currently state of the art in revision total hip arthroplasty (RTHA). Nevertheless, implant-specific major complications like breakage of taper junctions as well as periprosthetic fractures (PPFs) may lead to failure of reconstruction during follow-up. Methods: A cohort of 117 cases receiving femoral RTHA by a modular stem was investigated retrospectively with a mean follow-up of 5.7 (0.5–13.7) years. Cumulative risk and potential factors affecting the occurrence of PPFs were calculated with the Kaplan–Meier method. In addition, cases were presented to discuss operative treatment options. Results: A cumulative risk of PPF of 12.1% (95% CI: 0–24.6%) was calculated at 13.7 years. Female patients had significantly higher risk compared to male patients (0% after 13.5 years for male patients vs. 20.8% (95% CI: 0.5–41.2%) after 13.7 years for female patients; log-rank p = 0.0438) as all five patients sustaining a PPF during follow-up were women. Four fractures were treated by open reduction and internal fixation. Non-union and collapse of the fracture occurred in one patient after closed reduction and internal fixation. Conclusions: Postoperative PPF after femoral revision with a modular stem has shown to be a frequent complication within this mid-term follow-up. Female patients were at a significantly higher risk in this aged cohort, indicating osteoporosis as a risk factor. The surgical treatment of PPF with an integrated long-stemmed prosthesis is challenging and thorough considerations of adequate operative treatment of PPFs are strongly advised in order to limit complication rates. Full article

Background: Pancreas and pancreas–kidney transplantation are well-established therapeutic options for patients with type 1 diabetes mellitus (T1DM) and end-stage kidney disease (ESKD), offering the potential to restore endogenous insulin production and kidney function. It improves metabolic control, quality of life, and long-term survival. While surgical techniques and immunosuppressive strategies have advanced considerably, graft rejection and limited long-term graft survival remain significant clinical challenges. Method: To better understand these risks, the genetic and immunological factors that influence transplant outcomes are examined. Beyond traditional human leukocyte antigen (HLA) matching, non-HLA genetic variants such as gene deletions and single-nucleotide polymorphisms (SNPs) have emerged as contributors to alloimmune activation and graft failure. Result: Polymorphisms in cytokine genes, minor histocompatibility antigens, and immune-regulatory pathways have been implicated in transplant outcomes. However, the integration of such genomic data into clinical practice remains limited due to underexplored gene targets, variability in study results, and the lack of large, diverse, and well-characterized patient cohorts. Initiatives like the International Genetics & Translational Research in Transplantation Network (iGeneTRAiN) are addressing these limitations by aggregating genome-wide data from thousands of transplant donors and recipients across multiple centers. These large-scale collaborative efforts aim to identify clinically actionable genetic markers and support the development of personalized immunosuppressive strategies. Conclusions: Overall, genetic testing and genomics hold great promise in advancing precision medicine in pancreas and pancreas–kidney transplantation. Full article

This study investigates the flow dynamics and local scour around a Reef Cube^® artificial reef deployed in Torbay, UK, using computational fluid dynamics. The flow is modelled using Reynolds-Averaged Navier–Stokes (RANS) equations with a k-ω SST turbulence model. A novel hydro-morphodynamic model employing the generalized internal boundary method in HELYX (OpenFOAM-based) is used to simulate scour development. Model performance was validated against experimental data for flow fields, bed shear stress, and local scour. Flow simulations across various scenarios demonstrated that parameters such as the orientation angle and arrangement of Reef Cubes significantly influence flow patterns, bed shear stress, and habitat suitability. The hydro-morphodynamic model was used to simulate scouring around a reef cube in the Torbay marine environment. Results indicate that typical tidal flow velocity flow in the region is barely sufficient to initiate sediment motion, whereas extreme flow events, represented by doubling the mean flow velocity, significantly accelerate scour development, producing holes up to ten times deeper. These findings underscore the importance of considering extreme flow conditions in scour analyses due to their potential impact on the stability and failure risk of AR projects. Full article

Background: Renal trauma accounts for approximately 3–5% of all trauma cases, predominantly affecting young males. The most common etiology is blunt trauma, particularly due to road traffic accidents, and it frequently occurs as part of polytrauma involving multiple organ systems. Management strategies are primarily dictated by hemodynamic stability, overall clinical condition, comorbidities, and injury severity graded according to the AAST classification. This study aimed to evaluate the effectiveness of non-operative management (NOM) in high-grade renal trauma (AAST grades III–V), beyond its established role in low-grade injuries (grades I–II). Secondary endpoints included the identification of independent prognostic factors for NOM failure and in-hospital mortality. Methods: We conducted a retrospective observational study including patients diagnosed with blunt renal trauma who presented to the Emergency Department of Policlinico Umberto I in Rome between 1 January 2013 and 30 April 2024. Collected data comprised demographics, trauma mechanism, vital signs, hemodynamic status (shock index), laboratory tests, blood gas analysis, hematuria, number of transfused RBC units in the first 24 h, AAST renal injury grade, ISS, associated injuries, treatment approach, hospital length of stay, and mortality. Statistical analyses, including multivariable logistic regression, were performed using SPSS v28.0. Results: A total of 244 patients were included. Low-grade injuries (AAST I–II) accounted for 43% (n = 105), while high-grade injuries (AAST III–V) represented 57% (n = 139). All patients with low-grade injuries were managed non-operatively. Among high-grade injuries, 124 patients (89%) were treated with NOM, including observation, angiography ± angioembolization, stenting, or nephrostomy. Only 15 patients (11%) required nephrectomy, primarily due to persistent hemodynamic instability. The overall mortality rate was 13.5% (33 patients) and was more closely associated with the overall injury burden than with renal injury severity. Multivariable analysis identified shock index and active bleeding on CT as independent predictors of NOM failure, whereas ISS and age were significant predictors of in-hospital mortality. Notably, AAST grade did not independently predict either outcome. Conclusions: In line with the current international literature, our study confirms that NOM is the treatment of choice not only for low-grade renal injuries but also for carefully selected hemodynamically stable patients with high-grade trauma. Our findings highlight the critical role of physiological parameters and overall ISS in guiding management decisions and underscore the need for individualized assessment to minimize unnecessary nephrectomies and optimize patient outcomes. Full article

Intelligent transport systems are revolutionising all aspects of modern life, increasing the efficiency of commerce, modern living, and international travel. Intelligent transport systems are systems of systems comprised of cyber, physical, and social nodes. They represent unique opportunities but also have potential threats to system operation and correctness. The emergent behaviour in Complex Cyber–Physical–Social Systems (C-CPSSs), caused by events such as cyber-attacks and network outages, have the potential to have devastating effects to critical services across society. It is therefore imperative that the risk of cascading failure is minimised through the fortifying of these systems of systems to achieve resilient mission assurance. This work designs and implements a programmatic model to validate the value of cascading failure simulation and analysis, which is then tested against a C-CPSS intelligent transport system scenario. Results from the model and its implementations highlight the value in identifying both critical nodes and percolation of consequences during a cyber failure, in addition to the importance of including social nodes in models for accurate simulation results. Understanding the relationships between cyber, physical, and social nodes is key to understanding systems’ failures that occur because of or that involve cyber systems, in order to achieve cyber and system resilience. Full article

This paper explores the complex power dynamics of UK social work higher education through an autoethnographic account of a Black woman course leader’s experiences over a period of two years, focusing on issues related to race, internalized oppression, and class. Drawing on Critical Race Theory (CRT), narrative analysis, and lived experience, it examines how systemic inequities manifest through three interlinked themes: (a) academic contrapower harassment (ACPH), (b) internalized oppression and toxic team dynamics, and (c) the interplay of harassment, institutional failure, managerial inaction, and the marginalization of social work as a discipline. This study illustrates how the intersectionality of multiple identities—namely, race, gender, and professional identity—impacts career progression, well-being, and institutional inclusion. This study examines the tensions between social work’s ethical foundations and performance-driven academic environments, advocating for systemic and policy interventions to stimulate institutional reform and cultivate a more equitable culture that enhances educational outcomes and, ultimately, improves social work practice. Full article

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems. Full article

In the context of globalization and the Belt and Road Initiative, maintaining the stability and security of the China Railway Express network (CRN) is critical for international logistics operations. However, unexpected events can lead to node and edge failures within the CRN, potentially triggering cascading failures that critically compromise network performance. This study introduces a Coupled Map Lattice model that incorporates cargo flow dynamics, distributing cargo based on distance and the residual capacity of neighboring nodes. We analyze cascading failures in the CRN under three scenarios, isolated node failure, isolated edge disruption, and simultaneous node and edge failure, to assess the network’s vulnerability during emergencies. Our findings show that deliberate attacks targeting cities with high node strength result in more significant damage than attacks on cities with a high node degree or betweenness. Additionally, when edges are disrupted by unexpected events, the impact of edge removals on cascading failures depends on their strategic position and connections within the network, not just their betweenness and weight. The study further reveals that removing collinear edges can effectively slow the propagation of cascading failures in response to deliberate attacks. Furthermore, a single-factor cargo flow allocation method significantly enhances the network’s resilience against edge failures compared to node failures. These insights provide practical guidance and strategic support for the CR Express in mitigating the effects of both unforeseen events and intentional attacks. Full article

River embankments are critical flood defense structures, stretching for thousands of kilometers across alluvial plains. They often originated as natural levees resulting from overbank flows and were later enlarged using locally available soils yet rarely designed according to modern engineering standards. Substantially under-characterized, their performance to extreme events provides an invaluable opportunity to highlight their vulnerability and then to improve monitoring, management, and reinforcement strategies. In May 2023, two extreme meteorological events hit the Emilia-Romagna region in rapid succession, causing numerous breaches along river embankments and therefore widespread flooding of cities and territories. These were followed by two additional intense events in September and October 2024, marking an unprecedented frequency of extreme precipitation episodes in the history of the region. This study presents the methodology adopted to create a regional database of 66 major breaches and damages that occurred during May 2023 extensive floods. The database integrates multi-source information, including field surveys; remote sensing data; and eyewitness documentation collected before, during, and after the events. Preliminary interpretation enabled the identification of the most likely failure mechanisms—primarily external erosion, internal erosion, and slope instability—often acting in combination. The database, unprecedented in Italy and with few parallels worldwide, also supported a statistical analysis of breach widths in relation to failure mechanisms, crucial for improving flood hazard models, which often rely on generalized assumptions about breach development. By offering insights into the real-scale behavior of a regional river defense system, the dataset provides an important tool to support river embankments risk assessment and future resilience strategies. Full article

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, progressive form of pre-capillary pulmonary hypertension characterized by persistent, organized thromboemboli in the pulmonary vasculature, leading to vascular remodeling, elevated pulmonary artery pressures, right heart failure, and significant morbidity and mortality if untreated. Despite advances, CTEPH remains underdiagnosed due to nonspecific symptoms and overlapping features with other forms of pulmonary hypertension. Basic Methodology: This review synthesizes data from large international registries, epidemiologic studies, translational research, and multicenter clinical trials. Key methodologies include analysis of registry data to assess incidence and risk factors, histopathological examination of lung specimens, and molecular studies investigating endothelial dysfunction and inflammatory pathways. Diagnostic modalities and treatment outcomes are evaluated through observational studies and randomized controlled trials. Recent Advances and Affected Population: Research has elucidated that CTEPH arises from incomplete resolution of pulmonary emboli, with subsequent fibrotic transformation mediated by dysregulated TGF-β/TGFBI signaling, endothelial dysfunction, and chronic inflammation. Affected populations are typically older adults, often with prior venous thromboembolism, splenectomy, or prothrombotic conditions, though up to 25% have no history of acute PE. The disease burden is substantial, with delayed diagnosis contributing to worse outcomes and higher societal costs. Microvascular arteriopathy and PAH-like lesions in non-occluded vessels further complicate the clinical picture. Conclusions: CTEPH is now recognized as a treatable disease, with multimodal therapies—surgical endarterectomy, balloon pulmonary angioplasty, and targeted pharmacotherapy—significantly improving survival and quality of life. Ongoing research into molecular mechanisms and biomarker-driven diagnostics promises earlier identification and more personalized management. Multidisciplinary care and continued translational investigation are essential to further reduce mortality and optimize outcomes for this complex patient population. Full article

As a novel prefabricated structural element, the pre-tensioned, prestressed concrete T-beam with polygonal tendons layout demonstrates advantages including reduced prestress loss, streamlined construction procedures, and stable manufacturing quality, showing promising applications in medium-span bridge engineering. This paper conducted a full-scale experiment and numerical simulation research on a 30 m pre-tensioned, prestressed concrete T-beam with polygonal tendons practically used in engineering. The full-scale experiment applied symmetrical four-point bending to create a pure bending region and used embedded strain gauges, surface sensors, and optical 3D motion capture systems to monitor the beam’s internal strain, surface strain distribution, and three-dimensional displacement patterns during loading. The experiment observed that the test beam underwent elastic, crack development, and failure phases. The design’s service-load bending moment induced a deflection of 18.67 mm (below the 47.13 mm limit). Visible cracking initiated under a bending moment of 7916.85 kN·m, which exceeded the theoretical cracking moment of 5928.81 kN·m calculated from the design parameters. Upon yielding of the bottom steel reinforcement, the maximum of the crack width reached 1.00 mm, the deflection in mid-span measured 148.61 mm, and the residual deflection after unloading was 10.68 mm. These results confirmed that the beam satisfied design code requirements for serviceability stiffness and crack control, exhibiting favorable elastic recovery characteristics. Numerical simulations using ABAQUS further verified the structural performance of the T-beam. The finite element model accurately captured the beam’s mechanical response and verified its satisfactory ductility, highlighting the applicability of this beam type in bridge engineering. Full article

Background: As intelligent systems increasingly operate in high-risk environments, understanding how they perceive and respond to hazards is critical for ensuring safety. Methods: In this study, we conduct a comparative analysis of 60 real-world accident reports, 30 from process control systems (PCSs) and 30 from autonomous vehicles (AVs), to examine differences in risk triggers, perception paradigms, and interaction failures between humans and artificial intelligence (AI). Results: Our findings reveal that PCS risks are predominantly internal to the system and detectable through deterministic, rule-based mechanisms, whereas AVs’ risks are externally driven and managed via probabilistic, multi-modal sensor fusion. More importantly, despite these architectural differences, both domains exhibit recurring human–AI interaction failures, including over-reliance on automation, mode confusion, and delayed intervention. In the case of PCSs, these failures are historically tied to human–automation interaction; this article extrapolates these patterns to anticipate potential human–AI interaction challenges as AI adaptation increases. Conclusions: This study highlights the need for a hybrid risk perception framework and improved human-centered design to enhance situational awareness and responsiveness. While AI has not yet been implemented in PCS incident studies, this work interprets human–automation failures in these cases as indicative of potential challenges in human–AI interaction that may arise in future AI-integrated process systems. Implications extend to developing safer intelligent systems across industrial and transportation sectors. Full article

Background/Objectives: Radicular pain is a frequent pathology, and disc herniation is the commonest aetiology. A meta-analysis summarising international guidelines for radicular pain, published in 2021, showed that lumbar traction’s place is still a topic of debate. In this study, our aim was to evaluate the effectiveness of lumbar tractions in treating radicular pain of discal origin in association with medical treatment versus medical treatment alone. We performed a randomised, controlled, interventional, prospective, superiority trial in Reims Hospital Rheumatology Unit. Methods: We included participants with radicular pain and concordant disc herniation with ambulatory treatment failure. Participants were randomised into two groups: medical group (analgesics, anti-inflammatories treatments, at least two epidural injections); tractions group with this medical treatment associated with lumbar tractions. The primary outcome was the difference in the proportion of participants experiencing a minimum of 25% improvement in radicular pain at one month follow-up between the two groups. Results: We included 424 participants: 211 in the tractions group and 213 in the medical group. We analysed 388 participants (194 in each group). We collected demographic and clinical data, lumbar and radicular Numeric Pain Scale at baseline, one and three months. A statistical difference was found for the primary outcome: 120/194 participants (62%) in tractions group and 98/194 participants (51%) in medical group (p = 0.024). Conclusions: To our knowledge, this is the first randomised and controlled study on this topic with these results. We can assert the superiority of lumbar tractions in association with medical treatment over medical treatment alone for radicular pain with concordant disc herniation. Full article