Search Results (103)

Background/Objectives: Virtual reality has emerged as a promising intervention for pain management in individuals with cancer. Although its clinical effects have been explored, little is known about participant adherence and dropout behavior. This systematic review and meta-analysis aimed to estimate the pooled dropout rate in randomized controlled trials using virtual reality to treat cancer pain; assess whether dropout differs between groups; and explore potential predictors of attrition. Methods: We conducted a systematic search of PubMed, Web of Science, Scopus, and CINAHL up to April 2025. Eligible studies were randomized trials involving cancer patients or survivors that compared VR interventions for pain management with any non-VR control. Proportion meta-analyses and odds ratio meta-analyses were performed. Heterogeneity was assessed using the I² statistic, and meta-regression was conducted to explore potential predictors of dropout. The JBI appraisal tool was used to assess the methodological quality and GRADE system to determine the certainty of evidence. Results: Six randomized controlled trials were included (n = 569). The pooled dropout rate was 16% (95% CI: 8.2–28.7%). Dropout was slightly lower in VR groups (12.7%) than in controls (21.4%), but the difference was not statistically significant (OR = 0.94; 95% CI: 0.51–1.72; I² = 9%; GRADE: very low). No significant predictors of dropout were identified. Conclusions: VR interventions appear to have acceptable retention rates in oncology settings. The pooled dropout estimate may serve as a reference for sample size calculations. Future trials should improve reporting practices and investigate how VR modality and patient characteristics influence adherence. Full article

China’s accelerated urbanization has instigated construction land expansion and ecological land attrition, aggravating the carbon emission disequilibrium. Notably, the “land carbon emission elasticity coefficient” in urban agglomerations far exceeds international benchmarks, underscoring the contradiction between spatial expansion and low-carbon goals. Existing research predominantly centers on single-spatial-type or static-model analyses, lacking cross-scale mechanism exploration, policy heterogeneity consideration, and differentiated carbon metabolism assessment across functional spaces. This study takes Xiong’an New Area as a case, delineating the spatiotemporal evolution of land use and carbon emissions during 2017–2023. Construction land expanded by 26.8%, propelling an 11-fold escalation in carbon emissions, while emission intensity decreased by 11.4% due to energy efficiency improvements and renewable energy adoption. Cultivated land reduction (31.8%) caused a 73.4% decline in agricultural emissions, and ecological land network restructuring (65.3% forest expansion and wetland restoration) significantly enhanced carbon sequestration. This research validates a governance paradigm prioritizing “structural optimization” over “scale expansion”—synergizing construction land intensification with ecological restoration to decelerate emission growth and strengthen carbon sink systems. Full article

The processing of low-grade, lead-containing practical ores requires fine grinding to liberate galena and enhance flotation recovery. The ball mill is still one of the most common approaches used in industry for fine grinding. This study investigated the effect of the grinding parameters in a ball mill on the fine grinding product of galena and on flotation performance. The grinding product had a particle size below 30 μm, which was classified into +25 μm, −25 + 10 μm, and −10 μm fractions. Grinding experiments showed that modifications to the grinding concentration, media proportion, and filling ratio exerted significant effects on the yields of the +25 μm and −10 μm fractions. Flotation experiments showed that the yield of −10 μm particles negatively affected the flotation performance of galena. Discrete element method simulation results revealed that an increase in the motion velocity of the media group enhanced attrition effects during fine grinding, promoting the generation of −10 μm particles. The higher yield of −10 μm particles facilitated a smaller contact angle and smaller agglomerate size, resulting in lower recovery. To optimize the particle size distribution and improve fine-grained galena flotation recovery, it is essential to reduce the attrition of the grinding media on the mineral. Full article

Animal welfare is influenced by the cumulative life experiences of an individual. Among these, exposure to chronic stressors has a significant impact on both physical and mental health, contributing to premature aging—a process linked to telomere shortening. Conversely, positive experiences have been shown to mitigate, delay, and sometimes reverse telomere attrition. This suggests that telomere length could be a reliable indicator for assessing animal welfare. This study explored the association between telomere length and characteristics such as life history, environment, and health in domestic dogs. Buccal swabs collected DNA samples from 250 dogs, and telomere length was quantified via qPCR. Our findings revealed that environmental factors significantly influenced telomere length. Dogs housed in kennels or subjected to low physical activity levels exhibited shorter telomeres. Similarly, dogs living in groups of more than five dogs had shorter telomeres, and male dogs were found to have longer telomeres than females. Overall, these results highlight the importance of environmental conditions in influencing telomere length in dogs and the potential to use this biological indicator to evaluate animal welfare. Full article

(1) Background: University students’ mental health (MH) is in crisis due to academic stress, lack of physical activity (PA), and low self-esteem. This study evaluated a 12-week PA and meditation intervention to enhance psychological well-being in Spanish university students. (2) Methods: A quasi-experimental design was used, with a non-randomized control group and pretest-posttest assessments. The study lasted 14 weeks (12 weeks of intervention and two for evaluations). Initially, 149 students were recruited, but the final sample included 136 (82 intervention, 54 control) due to attrition. Participants were selected through convenience sampling, respecting university-established groups. The intervention consisted of six PA sessions (aerobic, cardiovascular, and strength exercises) and six meditation sessions (yoga and mindfulness). Validated questionnaires assessed resilience, psychological distress, self-esteem, mood, personality traits, sedentary behavior, PA levels, and sleep duration. (3) Results: Significant improvements were found in resilience (p < 0.001), depression (p < 0.01), and sleep duration (p < 0.05), with greater mood benefits in men. No major changes were observed in other variables. (4) Conclusions: PA- and meditation-based interventions can improve students’ MH, particularly in key psychological aspects. Further research should explore long-term effects and refine strategies by distinguishing between preventive and therapeutic approaches. Full article

The banking industry faces significant challenges, from high customer churn rates to threatening long-term revenue generation. Traditionally, churn models assess service quality using customer satisfaction metrics; however, these subjective variables often yield low predictive accuracy. This study examines the relationship between customer attrition and account balance using decision trees (DT), random forests (RF), and gradient-boosting machines (GBM). This research utilises a customer churn dataset and applies synthetic oversampling to balance class distribution during the preprocessing of financial variables. Account balance service is the primary factor in predicting customer churn, as it yields more accurate predictions compared to traditional subjective assessment methods. The tested model set achieved its highest predictive performance by applying boosting methods. The evaluation of research data highlights the critical role of financial indicators in shaping effective customer retention strategies. By leveraging machine learning intelligence, banks can make more informed decisions, attract new clients, and mitigate churn risk, ultimately enhancing long-term financial results. Full article

This paper explores the use of wearable technology (Garmin Fenix 7) to monitor physiological and psychological factors contributing to attrition during basic military training. Attrition, or the voluntary departure of recruits from the military, often results from physical and psychological challenges, such as fatigue, injury, and stress, which lead to significant costs for the military. To better understand and mitigate attrition, we designed and implemented a comprehensive and continuous data-capturing methodology to monitor 63 recruits during their basic infantry training. It’s optimized for military use by being minimally invasive (for both recruits and operators), preventing data leakage, and being built for scale. We analysed data collected from two test phases, focusing on seven key psychometric and physical features derived from baseline questionnaires and physiological measurements from wearable devices. The preliminary results revealed that recruits at risk of attrition tend to cluster in specific areas of the feature space in both Linear Discriminant Analysis (LDA) and Principal Component Analysis (PCA). Key indicators of attrition included low motivation, low resilience, and a stress mindset. Furthermore, we developed a predictive model using physiological data, such as sleep scores and step counts from Garmin devices, achieving a macro mean absolute error (MAE) of 0.74. This model suggests the potential to reduce the burden of daily wellness questionnaires by relying on continuous, unobtrusive monitoring. Full article

Due to its excellent specific strength, corrosion resistance, and biocompatibility, titanium alloy is often used as a biological implant material. In order to address the issues of low hardness and poor wear resistance of the Ti-25Nb-3Zr-2Sn-3Mo titanium alloy, a TiN/Sn coating with good biocompatibility was deposited on its surface using a new composite modification technology of surface mechanical strengthening + surface mechanical coating. By taking advantage of the wear resistance of TiN and the adhesiveness of Sn, a composite coating with corrosion–wear resistance was formed to improve its corrosion–wear resistance. Using TiN/Sn powders of different ratios (10% Sn, 20% Sn, 30% Sn, and 40% Sn) as media, the alloy was subjected to a combined strengthening treatment of surface mechanical attrition and solid-phase coating under a nitrogen atmosphere. The microstructure and mechanical properties of the composite-strengthened layer were tested by means of XRD, SEM-EDS, a nanoindentation tester, a white-light interferometer, and a reciprocating wear tester. Moreover, the corrosion–wear properties of the samples under different loads and electrochemical conditions were analyzed. The results show that the surface composite-strengthened layer of the alloy consisted of a TiN/Sn coating + a mechanical deformed layer. With an increase in the Sn content, the thickness of the TiN/Sn coating continuously increased, while the thickness of the mechanical deformed layer continuously decreased. The composite-strengthened layer had good comprehensive mechanical properties. In the SBF solution, the corrosion–wear resistance of the composite-strengthened samples improved; the degree of wear first decreased and then increased with the increase in the Sn content, and it reached the optimal value when the Sn content was 30%. Compared with the raw sample, the corrosion of the coating sample increased, but the wear significantly decreased. The corrosion–wear synergy factor κ value first increased and then decreased with the increase in the Sn content, reaching a maximum value at the 20% Sn content. This is the result of the combined effect of the corrosion resistance and wear resistance of the coating. Full article

Background/Objectives: Despite the effectiveness of exercise and nutritional interventions to improve aerobic capacity and quality of life in lung transplant (LT) recipients, their compliance is low. Strategies to reduce the high attrition rate (participants lost over time) is a major challenge. Artificial neural networks (ANN) may assist in the early identification of patients with high risk of attrition. The main objective of this study is to evaluate the usefulness of ANNs to identify prognostic factors for high attrition rate of a 10-week rehabilitation program after a LT. Methods: This prospective observational study included first-time LT recipients over 18 years of age. The main outcome for each patient was the attrition rate, which was estimated by the amount of missing data accumulated during the study. Clinical variables including malnutrition, sarcopenia, and their individual components were assessed at baseline. An ANN and regression analysis were used to identify the factors determining a high attrition rate. Results: Of the 41 participants, 17 (41.4%) had a high rate of attrition in the rehabilitation program. Only 23 baseline variables had no missing data and were included in the analysis, from which a low age-dependent body mass index (BMI) was the most important conditioning factor for a high attrition rate (p = 7.08 × 10⁻⁵), followed by end-stage respiratory disease requiring PT (p = 0.000111), low health-related quality-of-life (HRQoL) (p = 0.0009078), and low handgrip strength (p = 0.023). Conclusions: The prevalence of high attrition rate in LT recipients is high. The profile of patients with a high probability of attrition includes those with chronic obstructive pulmonary disease, low BMI and handgrip strength, and reduced HRQoL. Full article

This study investigated the efficiency of scale-propellers, typically used on small drones. A scale-propeller is accepted as having a diameter of 7 to 21 inches. Recent special operations has demonstrated the utility of relatively small, low-cost first-person view (FPV) drones, which are attritable. This investigation outlines the development of a MATLAB optimisation code, based on minimum induced loss propeller theory, which calculates the optimal chord and twist distribution for a chosen propeller operating in known flight conditions. The MATLAB code includes a minimum Reynolds number functionality, which provides the option to alter the chord distribution to ensure the entire propeller is operating above a set threshold value of Reynolds (>100,000), as this has been found to be a transition point between low and high section lift-to-drag ratios. Additional functions allow plotting of torque and thrust distributions along the blade. The results have been validated on experimental data taken from an APC ‘Thin Electric’ 10” × 7” propeller, where it was found that both the chord and twist distributions were accurately modelled. The MATLAB code resulted in a 16% increase in the maximum propulsive efficiency. Further work will investigate a direct interface to SolidWorks to aid rapid propeller manufacturing capability. Full article

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common side effects of chemotherapy, and effective treatments for CIPN are still lacking. For this reason, there is a growing interest in complementary and alternative medicine as a potential source of nonsurgical treatments for CIPN symptoms alongside pregabalin. One such option being explored is Chuna manual therapy (CMT), a traditional Korean manual therapy. Methods: This study compares the effectiveness and safety of using only pregabalin (PG) as a conventional method of treating breast and colorectal cancer patients with CIPN symptoms with a combination of both PG and electroacupuncture (EA) or CMT, while also assessing the feasibility of future large-scale clinical studies. Due to the COVID-19 pandemic, only 74 CIPN patients were recruited to this study. Twenty-five were assigned to the PG group, 26 to the PG + EA group, and 22 to the PG + CMT group for a five-week treatment and a four-week follow-up study. Results: For the primary outcome, we evaluated the mean differences in Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) compared to the baseline at week 5 (visit 4). Although we found that the PG + CMT group showed the biggest difference (−16.64 [95% CI: −25.16, −8.11]) compared to the PG group (−8.60 [95% CI: −14.93, −2.27]) and the PG + EA group (−6.73 [95% CI: −12.34, −1.13]), this finding lacked statistical significance (p = 0.2075). In terms of safety, two patients in the PG + CMT group reported side effects: one bruise and one headache. Conclusions: The low attrition and high adherence rates of all the groups, and the similar rates of side effects among them, support the feasibility of larger-scale follow-up studies. Full article

Binder selection is a crucial step in continuous twin-screw wet granulation (TSWG), as the material experiences a much shorter residence time (2–40 s) in the granulator barrel compared to batch-wise granulation processes. Polyvinyl alcohol (PVA) 4-88 was identified as an effective binder during TSWG, but the potential of other PVA grades—differing in polymerization and hydrolysis degree—has not yet been studied. Therefore, the aim of the current study was to evaluate the potential of different PVA grades as a binder during TSWG. The breakage and drying behavior during the fluidized bed drying of drug-loaded granules containing the PVA grades was also studied. Three PVA grades (4-88, 18-88, and 40-88) were characterized and their attributes were compared to previously investigated binders by Vandevivere et al. through principal component analysis. Three binder clusters could be distinguished according to their attributes, whereby each cluster contained a PVA grade and a previously investigated binder. PVA 4-88 was the most effective binder of the PVA grades for both a good water-soluble and water-insoluble formulation. This could be attributed to its high total surface energy, low viscosity, good wettability of hydrophilic and hydrophobic surfaces, and good wettability by water of the binder. Compared to the previously investigated binders, all PVA grades were more effective in the water-insoluble formulation, as they yielded strong granules (friability below 30%) at lower L/S-ratios. This was linked to the high dispersive surface energy of the high-energy sites on the surface of PVA grades and their low surface tension. During fluidized bed drying, PVA grades proved suitable binders, as the acetaminophen (APAP) granules were dried within a short time due to the low L/S-ratio, at which high-quality granules could be produced. In addition, no attrition occurred, and strong tablets were obtained. Based on this study, PVA could be the preferred binder during twin screw granulation due to its high binder effectiveness at a low L/S-ratio, allowing efficient downstream processing. However, process robustness must be controlled by the included excipients, as PVA grades are operating in a narrow L/S-ratio range. Full article

Background and Objectives: Telomere length (TL) undergoes attrition over time, indicating the process of aging, and is linked to a higher risk of diabetes mellitus type 2 (DM-2). This molecular epidemiological study investigated the correlation between leukocyte TL variations and determinants of molecular aging in 121 Pakistani DM-2 patients. Materials and Methods: The ratio of telomere repeats to the SCG copy number was calculated to estimate the TL in each sample through qPCR assays. Results: In this study, smaller mean TLs were observed in 48.8% of males (6.35 ± 0.82 kb), 3.3% of underweight patients (5.77 ± 1.14 kb), 61.2% of patients on regular medication (6.50 ± 0.79 kb), 9.1% with very high stress levels (5.94 ± 0.99 kb), 31.4% of smokers (5.83 ± 0.73 kb), 40.5% of patients with low physical activity (6.47 ± 0.69 kb), 47.9% of hypertensive patients (5.93 ± 0.64 kb), 10.7% of patients with DM-2 for more than 15 years, and 3.3% of patients with a delayed onset of DM-2 (6.00 ± 0.93 kb). Conclusion: This research indicated a significant negative correlation (R² = 0.143) between TL and the age of DM-2 patients. This study demonstrated that the correlation of telomere length with age in DM-2 patients was also influenced by various age-determining factors, including hypertension and smoking habits, with significant strong (R² = 0.526) and moderate (R² = 0.299) correlations, respectively; sex, obesity, the stress level and age at the onset of diabetes with significant weak correlations (R² = 0.043, 0.041, 0.037, and 0.065, respectively), and no significant correlations of medication routine, rate of physical activity, and the durations of DM-2 with age-adjusted telomere length. These results challenge TL as the sole marker of aging, thus highlighting the need for further research to understand underlying factors and mitigate the effect of aging or premature aging on diabetic patients. Full article

Two case studies of parenting programs for parents of children 0 to 36 months of age, developed and implemented by Save the Children/Ministry of Health/Khesar Gyalpo University in Bhutan and UNICEF Zambia, were conducted by an independent research group. The focus was on how program delivery and scale-up were revised on the basis of feedback from implementation research. Feedback on workforce delivery quality was based on observations of deliveries using a monitoring form, as well as survey and interview data collected from the workforce. In-depth interviews with the resource team during the fourth year of implementation revealed how the feedback was used to address horizontal and vertical scaling. Delivery quality was improved in some cases by revising the delivery manual, offering refresher courses, and instituting regular monitoring. Scaling challenges in Zambia included slow progress with regard to reaching families in the two districts, which they addressed by trialing group sessions, and stemming workforce attrition. The challenges in Bhutan were low attendance and reducing the workload of providers. Vertical scaling challenges for both countries concerned maintaining demand through continuous advocacy at community and government levels to sustain financing and to show effectiveness in outcomes. Full article

Despite data showing that nutritional interventions high in antioxidant/anti-inflammatory properties (anthocyanin-rich foods, such as blueberries/elderberries) may decrease risk of memory loss and cognitive decline, evidence for such effects in mild cognitive impairment (MCI) is limited. This study examined preliminary effects of American elderberry (Sambucus nigra subsp. canadensis) juice on cognition and inflammatory markers in patients with MCI. In a randomized, double-blind, placebo–controlled trial, patients with MCI (n = 24, M_age = 76.33 ± 6.95) received American elderberry (n = 11) or placebo (n = 13) juice (5 mL orally 3 times a day) for 6 months. At baseline, 3 months, and 6 months, patients completed tasks measuring global cognition, verbal memory, language, visuospatial cognitive flexibility/problem solving, and memory. A subsample (n = 12, 7 elderberry/5 placebo) provided blood samples to measure serum inflammatory markers. Multilevel models examined effects of the condition (elderberry/placebo), time (baseline/3 months/6 months), and condition by time interactions on cognition/inflammation outcomes. Attrition rates for elderberry (18%) and placebo (15%) conditions were fairly low. The dosage compliance (elderberry—97%; placebo—97%) and completion of cognitive (elderberry—88%; placebo—87%) and blood-based (elderberry—100%; placebo—100%) assessments was high. Elderberry (not placebo) trended (p = 0.09) towards faster visuospatial problem solving performance from baseline to 6 months. For the elderberry condition, there were significant or significantly trending decreases over time across several markers of low-grade peripheral inflammation, including vasorin, prenylcysteine oxidase 1, and complement Factor D. Only one inflammatory marker showed an increase over time (alpha-2-macroglobin). In contrast, for the placebo, several inflammatory marker levels increased across time (L-lactate dehydrogenase B chain, complement Factor D), with one showing deceased levels over time (L-lactate dehydrogenase A chain). Daily elderberry juice consumption in patients with MCI is feasible and well tolerated and may provide some benefit to visuospatial cognitive flexibility. Preliminary findings suggest elderberry juice may reduce low-grade inflammation compared to a placebo–control. These promising findings support the need for larger, more definitive prospective studies with longer follow-ups to better understand mechanisms of action and the clinical utility of elderberries for potentially mitigating cognitive decline. Full article