Search Results (9,433)

Wettability determination is of crucial importance for multiphase flow in porous media. Currently available methods are either applied to simplified geometries (sessile drop) or are time-consuming (Amott, USBM) and cost-intensive (micro-CT scanning). The purpose of this study is to systematically test the streaming potential method as a fast, cheap, and in situ applicable method for surface probing and determination of the wetting state of soda lime glass beads through zeta potential. Different wetting states are achieved by means of silanization and are characterized by an average contact angle. Comparison of contact angles measured by sessile drop on plate geometries and contact angles derived from bead pack micro-CT images confirmed that the treatment is transferable to the bead packs. The correlation between the zeta potential of the single bead size packing with a single wetting state and the contact angle is non-unique over the entire range of tested treatment volume ratios. The contact angle plateaus at higher degrees of silanization, while the zeta potential values still change. Before the plateau, a correlation between contact angle and zeta potential is present. Zeta potential measurements on the mixtures of the same-sized beads with two different wetting states confirm the existing theory that the apparent zeta potential is a surface area-weighted average of constituents. For a mixture where the zeta potential is size dependent, a new correlation for a dual bead system was derived. The non-unique correlation between zeta potential and contact angle, combined with a bead size-dependent zeta potential, will limit the use of zeta potential for contact angle derivation for the system of soda lime glass beads with various silanization coatings used here. Monitoring relative changes of wetting conditions might still be possible. Full article

Background: The protracted Syrian conflict has severely disrupted healthcare services, compromising the continuity and quality of care for individuals with type 2 diabetes mellitus (T2DM). This study evaluated diabetes-related quality of life, treatment satisfaction, and perceived stress among adults with T2DM receiving care in selected clinics within conflict-affected Syrian regions and examined predictors of these outcomes. Methods: A cross-sectional survey was conducted in July 2024 among 200 adults with T2DM recruited from outpatient clinics, primary healthcare centers, and diagnostic laboratories in Homs and Damascus. Participants completed validated Arabic versions of the Audit of Diabetes-Dependent Quality of Life (ADDQoL), Diabetes Treatment Satisfaction Questionnaire (DTSQs), and Perceived Stress Scale (PSS-10), alongside the collection of sociodemographic and clinical data. Descriptive statistics, univariate analyses, and multivariable linear regression models were applied. As this study used a facility-based purposive sample, its findings may not be generalizable to all individuals with diabetes in Syria. Results: Participants had a mean age of 57.6 ± 11.8 years, and 59.5% were male. Hypertension (70.5%) and obesity (35.5%) were the most common comorbidities, while retinopathy (21.5%), nephropathy (23.5%), and neuropathy (19.5%) were the most frequent complications. The mean ADDQoL Average Weighted Impact score was −3.1 ± 1.3, indicating substantial quality-of-life impairment. The mean DTSQs total score was 30.4 ± 5.6, suggesting moderate satisfaction with treatment despite frequent perceived hyperglycemia. The mean PSS-10 score was 18.8 ± 3.4, with 92.5% of respondents experiencing moderate stress. In multivariable models, poorer quality of life was predicted by older age, rural residence, higher BMI, and depression. Lower treatment satisfaction was associated with rural residence and retinopathy, while higher perceived stress was linked to lower education, obesity, and obstructive sleep apnea. Conclusions: Adults with T2DM attending selected healthcare facilities in conflict-affected Syria experience marked reductions in quality of life, moderate treatment satisfaction, and elevated psychosocial stress. These findings highlight the need for strengthened medication supply chains, improved rural service coverage, and integration of psychosocial support within diabetes care in fragile health systems. Full article

This article presents the results of research into the operation of retractable-type fall arresters used for fall protection in conjunction with flexible anchor points. The purpose of these devices is to enable the user to move freely in the vertical direction and safely arrest any fall from the workstation. Reports from users of such protective equipment and previous studies have indicated the occurrence of specific situations in which retractable-type fall arresters did not work properly. It was manifested by the sudden locking and unlocking of the device’s retractable lanyard, which means that the falling person was not stopped at the required distance. This is a highly dangerous phenomenon known as “jump action” that can cause serious injury or even death. Therefore, three different designs of retractable-type fall arresters and three loading conditions were investigated to analyze the jump action phenomenon. Based on the experimental results, a modification of the retractable type fall arresters was proposed in the form of an added electronic control. The proposed programmable control system will make it possible to eliminate the risks associated with “jump action” and expand the functionality of the studied fall arresters. Full article

Background and Purpose: Progressive multiple sclerosis impairs cognitive and motor functions and reduces quality of life. Complex goal-directed movements are challenging due to cognitive deficits, whereas in-phase bilateral exercises require less attentional demand and cognitive effort. This type of exercise may therefore improve both cognitive and motor functions. Previous studies in people with progressive multiple sclerosis suggested a strong association between cognitive and upper limb functions; however, the effects of in-phase bilateral exercises remain unclear. Objectives: To evaluate the effects of in-phase bilateral upper limb exercise on cognitive processing, motor functions, and quality of life in people with progressive multiple sclerosis. Methods: Twenty participants (11 females, mean age = 55.8 years) were randomized (1:1) to an experimental or active control group for a 12-week intervention. The experimental group performed in-phase bilateral upper limb exercises while the active control group performed conventional exercises. ANOVA was conducted to determine the effect of intervention on information processing speed, motor function, fatigue, and quality of life. Results: Post hoc analyses revealed that the experimental group demonstrated significantly greater improvements than the active control group in information processing speed (t(18) = 8.6, p < 0.05), as well as across all exploratory secondary outcome measures (all p < 0.05). Conclusions: This pilot randomized controlled trial suggests that in-phase bilateral exercises, which demand less cognitive effort than other forms of bilateral coordination, are associated with improvements in information processing speed, motor functions, fatigue, and quality of life in people with progressive multiple sclerosis. Full article

Modified Spitzy shelf acetabuloplasty is a joint-preserving surgical procedure for acetabular dysplasia that aims to enhance bony coverage of the hip joint. Although prior studies have primarily relied on two-dimensional (2D) radiographic evaluations, comprehensive three-dimensional (3D) assessments remain limited. The purpose of this retrospective study was to evaluate changes quantitatively in acetabular coverage following modified Spitzy shelf acetabuloplasty using 3D models reconstructed from computed tomography (CT) images. We retrospectively analyzed 11 hips in 11 patients who underwent staged bilateral modified Spitzy shelf acetabuloplasty. Preoperative and postoperative CT data were used to construct 3D pelvic models, which were registered using anatomical landmarks. Bone graft dimensions, insertion angle, and placement location were evaluated. Acetabular sector angles (ASA), representing circumferential coverage of the femoral head, were measured at 15° intervals on the functional pelvic plane and the anterior pelvic plane. The mean bone graft dimensions were 26.3 ± 3 mm (anteroposterior length) and 12.7 ± 2.7 mm (mediolateral length), providing coverage of 49.5° ± 9.1°. Postoperative ASA increased significantly from 34.5° to 60° on the functional pelvic plane and from 0° to 45° on the anterior pelvic plane (both p < 0.05). 3D analysis demonstrated that modified Spitzy shelf acetabuloplasty effectively enhanced anterosuperior acetabular bony coverage. Although this is a report of a few cases (11 hips), the above findings highlight the value of 3D evaluation in identifying postoperative changes that may not be detected using conventional 2D assessments. Also, further research analyzing the three-dimensional bone graft model revealed in this study may help inform the development of a more ideal biomimetic approach, not only in terms of shape but also function. Full article

Nowadays, river systems exhibit significant geomorphic changes that primarily reflect their response to the climate signal, driven by ongoing climate change. In this context, detecting future trends in riverbed dynamics is crucial, especially from a river management perspective. The purpose of the study is to identify long-term trends in riverbed evolution at the Băleni gauging station on the Ialomița River, based on the channel-forming discharge concept, through the end of the 21st century. To achieve this, a comprehensive methodology was developed that primarily focuses on calculating the effective discharge (Qe) as a key driver of riverbed dynamics, using discharges simulated by the E–HYPE hydrological model forced by eight EURO–CORDEX EUR–11 ensemble climate projections under the RCP 4.5 and RCP 8.5 scenarios up to 2100. The results of the study indicate Qe values ranging between 7.49 m³/s and 12.79 m³/s for RCP 4.5, and between 5.66 m³/s and 13.94 m³/s for RCP 8.5. Based on the ensemble mean of Qe, different riverbed evolution trends and are identified: a state of dynamic equilibrium under RCP 4.5, suggesting that the riverbed is probable to maintain its geomorphological state similar to the present; and pronounced variability under RCP 8.5, indicating intense erosion processes until mid-century, followed by a slight aggradation trend that may intensify at the end of the century, with Qe being 23.27% lower than the reference period. Overall, the Qe_8.5 evolution suggests a potential future alteration of the Ialomița riverbed. Beyond its main findings, this study provides a methodological framework for assessing future effective discharge and may support river management and restoration planning in the study area. Full article

The performance of Gas Metal Arc-Directed Energy Deposition (GMA-DED) strongly depends on efficient path-planning strategies that balance trajectory quality and computational cost. With the purpose of developing a computationally faster and more scalable path-planning approach, this study introduces the Fast Advanced-Pixel strategy by integrating the K-means clustering algorithm into to the Advanced Pixel strategy version to reduce the dimensionality of an optimization problem. Computational validation was conducted on four geometrically distinct parts using different clustering configurations. Statistical analysis (ANOVA) was applied to assess the significance of the results. The findings revealed that by increasing the number of clusters, computational time is substantially reduced, achieving up to a twenty-fold improvement compared with the former strategy, while maintaining consistent trajectory quality. Experimental validation using complex parts, such as a “Jaw Gripper” and a “C-frame” of a resistance spot welding gun, confirmed defect-free deposition and dimensional agreement with the CAD models. Accordingly, within the scope of GMA-DED technology and pixel-based path-planning strategies, the Fast Advanced-Pixel approach demonstrates a significant improvement in computational efficiency while preserving trajectory quality, enabling the accurate and reliable fabrication of geometrically complex metallic parts. Full article

This study examined how resilience-based interventions enable rural older women living with HIV in Zimbabwe to confront stigma and sustain their quality of life. Guided by the 4S framework of resilience resources planning (social support, coping strategies, sagacity, and solution-seeking), the research explored how women apply these dimensions to navigate challenging life events. A purposive sample of 17 women (those not living with a spouse or in a socially sanctioned relationship), aged 40–65, all on antiretroviral therapy and drawn from rural Matabeleland South Province, participated through in-depth interviews. Using Interpretive Phenomenological Analysis, four themes emerged: (1) Social Support and Social Networks as Foundations of Resilience, (2) Self-Efficacy and Coping Strategies in Managing Emotional Distress, (3) Spirituality and Sagacity as Sources of Strength and Meaning, and (4) Sense of Purpose and Solution-Seeking Behaviours. The findings highlight that resilience is actively mobilised through family ties, peer groups, and community initiatives, enabling women to adapt to socio-economic hardship and health-related barriers. This study concludes that empowerment strategies, especially community-based programmes focused on skills development and economic opportunities, are essential for enhancing resilience, reducing vulnerability, and improving health outcomes. Strengthening these resources not only equips women to manage HIV-related challenges but also contributes to sustainable development within their communities. Full article

Background: The purpose of this study was to evaluate the 2-year postoperative outcomes of iStent inject W implantation combined with phacoemulsification, with a specific focus on comparing results between high myopia (HM) and non-high myopia (non-HM) eyes. Methods: In this retrospective study, subjects were divided into HM and non-HM groups using an axial length cut-off of 26.0 mm. The main outcome measures were intraocular pressure (IOP), number of glaucoma medications, surgical success rates, and postoperative complications. Surgical success was defined as a decrease in glaucoma medical therapy of ≥1 medication without an increase in IOP, or a postoperative IOP ≤ 21 mmHg with a ≥20% reduction. Changes from baseline were analyzed up to 24 months postoperatively. Results: The non-HM group achieved a significant IOP reduction at all postoperative time points. The HM group showed no significant postoperative IOP reduction except at 3 months. The mean number of medications significantly decreased from baseline to 24 months in two groups. The cumulative surgical success rate at 24 months was 48.6% in the non-HM group, whereas it was significantly lower at 19.4% in the HM group (p = 0.038). No significant difference in the incidence of postoperative complications was observed between the groups. Conclusions: The IOP-lowering efficacy of iStent inject W implantation combined with phacoemulsification appeared limited in eyes with HM. These results may suggest the need for careful patient selection and clinical judgment when considering iStent inject W implantation in this population. Full article

Background and Objectives: Total vaginal hysterectomy (TVH) has been performed quite often for a uterus with prolapse, although less used than total abdominal hysterectomy (TAH). The purpose of this study was to compare the perioperative outcomes of patients who underwent either TVH or TAH for a uterus with a weight between 250 and 300 g and uterine prolapse (UP). Materials and Methods: In this retrospective study, 180 hysterectomies were planned for women with UP between 2020 and 2024 in a tertiary center in Romania. Patients were diagnosed based on clinical symptomatology and transabdominal ultrasound. All hysterectomies were performed by the same surgeon and were divided into two groups: TVH group (n = 90) and TAH group (n = 90). Patients' characteristics like age, uterine weight, body mass index (BMI), parity, operative time, intra-operative blood loss, hospital stay, medical history, surgical history, intra- and post-operative complications, and adhesions were evaluated. Results: No significant differences were found between groups in terms of mean age, uterine weight, BMI, or parity. TVH was associated with significantly shorter operative time, lower intra-operative blood loss, and reduced hospital stay compared to TAH (p < 0.001). Both medical and surgical histories were more common in the TAH group compared with the TVH group. However, post-operative complications were slightly more frequent in the TAH group (9.99% vs. 3.33%), as were adhesions (33.33% vs. 13.33%). Uterine hemisection, tactical myomectomy, or morcellation were used in most cases to obtain a reduction in uterine size for the TVH group (81.11%). Conclusions: Our results showed that shorter operating time, lower intra-operative blood loss, and reduced hospital stay support the use of TVH in the case of an enlarged uterus with UP. The present study showed that all patients requiring hysterectomy for such conditions can be offered TVH, which could represent a better therapy option. Full article

This study explores the concept of spiritual intelligence from an evolutionary perspective, providing a comprehensive and updated definition. A concept analysis was conducted following Rodgers’ Evolutionary Method, supported by a scoping review in accordance with the Joanna Briggs Institute methodology. Studies explicitly addressing spiritual intelligence, regardless of population, setting, or discipline, were included across quantitative, qualitative, mixed-methods, and review designs. Four databases—PsycINFO, PubMed Central, Scopus, and Web of Science—were searched for publications up to 15 December 2025, using the term “spiritual intelligence.” One-hundred-twelve articles met inclusion criteria and were analyzed through narrative synthesis and inductive analytical processing. Spiritual intelligence emerged as a construct encompassing adaptive cognition, higher consciousness, problem management, and personal growth, often referred to as Spiritual Quotient or Existential Intelligence. Antecedents included self and transcendental awareness, existential questioning, and search for meaning and purpose, while consequents comprised enhanced health, performance, self-awareness, and humanitarian orientation. Defining attributes were equanimity, life-wisdom, transcendental awareness, spiritual consciousness, meaning and purpose creation, and existential questioning. This evolutionary analysis traced the concept from theory to application, revealing its positive influence in daily life. Equanimity and life-wisdom were identified as core attributes, highlighting implications for training and integration of spiritual care in professional practice. Full article

Background: Older adult falls during step negotiation result in higher injury rates compared to level ground falls. Previous research on discrete events during step negotiations may not capture important age-related changes. Curve analysis techniques enable assessment of an entire time series and may further advance the understanding of older adult falls during step negotiation. The purpose of the current study was to investigate lower extremity kinematics during transition step negotiation in older women with fall history compared to young women using statistical parametric mapping (SPM). Methods: 15 older female adults with a fall history and 15 young female adults participated in the study. Participants performed walking trials along a 5.5 m raised walkway, descended a 17 cm step and continued walking 3 m. Data was processed from lead limb toe-off prior to the step, through lead limb weight acceptance of the transition step. SPM was used to perform independent t-test analysis of the three-dimensional lower extremity time series. Results: The older faller group showed significantly decreased lead hip abduction (9–19% of step negotiation, mean difference: 3.74°, p = 0.045), increased lead knee flexion (65–80% of step negotiation, mean difference: 5.8°, p = 0.012), and increased trail limb hip adduction (91–100% of step negotiation, mean difference: 3.92°, p = 0.046). Conclusions: The older faller group showed altered hip joint angles in the frontal plane and knee joint angles in the sagittal plane during early swing and late weight acceptance phases, which may reflect compensatory strategies for reduced strength and/or balance. Curve analysis provides additional insight into age-related kinematic changes during step negotiation that may be related to older adult fall risk. Full article

Teacher well-being is increasingly shaped by rapid technological change in education. As digital innovation accelerates, teachers’ well-being is closely linked to technological self-efficacy, understood as confidence in using digital tools alongside a sense of professional meaning, agency, and control. This qualitative study explores the relationship between teacher well-being and technological self-efficacy through an examination of teachers’ experiences in the “Artificial Intelligence for Beginners” professional development program. Reflective narratives from 18 participating teachers were analyzed to examine how engagement in the program was experienced as supporting the development of techno-pedagogical self-efficacy, professional learning, and well-being. Thematic analysis revealed several interconnected themes, including increased technological confidence and reduced anxiety toward digital innovation, the development of practical applications for personalized learning, heightened awareness of ethical and privacy considerations, and the emergence of a collaborative professional learning community. Participants also reported developing strategies for coping with digital complexity and experiencing a renewed sense of professional identity. Overall, the findings suggest that structured professional development in artificial intelligence may contribute to teachers’ perceived competence, autonomy, and sense of purpose. Strengthening technological self-efficacy through such programs may support individual teacher well-being and the collective professional climate within schools in AI-enhanced educational contexts. Full article

Medication adherence following myocardial infarction (MI) is essential for effective secondary prevention, yet adherence rates remain suboptimal. Healthcare professionals (HCPs) are central to promoting adherence through clinical decision-making, patient education, and ongoing behavioural support. Understanding how HCPs perceive and experience the factors’ influencing adherence is key to developing effective, context-specific interventions. This study explored HCPs’ perspectives on medication adherence post-MI and identified behavioural determinants influencing medication management across the care pathway. A qualitative descriptive study was conducted using semi-structured interviews with HCPs in the southwest of Ireland. Participants included hospital pharmacists, community pharmacists, general practitioners (GPs), cardiologists, and nurses, recruited through purposive, convenience, and snowball sampling. Interviews were recorded, transcribed verbatim, and analysed using directed content analysis guided by the Theoretical Domains Framework (TDF). Twelve HCPs (eight female) were interviewed between December 2024 and May 2025, including four pharmacists, two GPs, three cardiologists and three nurses. Interviews lasted 30–50 min (mean 41 min). Analysis identified 15 facilitators, 13 barriers, and 7 dual-role determinants across 10 TDF domains. Novel contributions include demonstrating how HCPs’ real-world experiences contextualise adherence issues in the distinct post-MI setting characterised by abrupt care transitions, polypharmacy, and emotional vulnerability and identifying where HCPs feel most constrained and where their expertise could directly inform targeted intervention design. HCPs’ insights reveal complex, context-specific behavioural determinants influencing post-MI medication adherence and highlight the need for multidisciplinary, tailored, and system-level solutions. Enhancing collaboration, supporting patient-centred communication, and addressing resource barriers could empower HCPs to deliver more effective, personalised adherence support and inform the development of targeted intervention strategies. Full article

Background/Objectives: Noncontact knee ligament injuries, including anterior cruciate ligament (ACL) ruptures and medial collateral ligament (MCL) sprains, are prevalent in sports that involve frequent cutting and pivoting. Conventional rigid knee braces can offer stability but often compromise comfort and performance, whereas soft sleeve-type supports provide minimal mechanical protection. The purpose of this study was to evaluate the acute biomechanical effects of a tensioned cable knee bracing system on peak knee valgus angle and external knee abduction moment during a controlled lateral shuffle task. Methods: Ten physically active adults (mean age 21.7 ± 3.8 years) performed submaximal lateral shuffle movements under three conditions: unbraced, sleeve-only (zero-tension), and a novel tensioned cable brace. Three-dimensional knee kinematics and ground reaction forces were collected, and peak knee valgus angle and external abduction moment were calculated during the eccentric phase of each movement. Results: Wearing the knee brace under tension significantly reduced knee valgus angle (4.5° vs. 7.9°) and peak external knee abduction moment (1.6 vs. 2.0–2.1 Nm/kg) compared to the unbraced condition. Conclusions: These findings indicate that the tensioned cable brace effectively reduced frontal plane knee loading during a lateral shuffle task, indicating its potential as an effective bracing approach. Full article