Search Results (31,890)

An administrator-assisted CLP-SEIRS-T${}^{+}$ framework is developed to model malware propagation and urban cyber-resilience in clustered temporal communication networks. The model extends CLP-SEIRS-T by integrating community structure, predicted links, asynchronous node activation, and an endogenous defense layer in which administrator nodes remain infectable, recover faster than ordinary nodes, and trigger local patch diffusion when community-level prevalence exceeds a risk threshold. Unlike formulations that treat defense as an external or perfectly reliable safeguard, the proposed framework embeds administrator intervention directly within the epidemic state space and couples propagation dynamics with resilience-oriented performance measures, including safe functionality, absorptive capacity, spillover attenuation, recovery time, and service continuity. To keep experimental evidence scale-explicit, the validation is organized as a tiered protocol: a 48-node isolated virtual-machine cyber-range verifies safe mechanism realization; emulation-calibrated logical traces and pilot repeated comparisons examine trajectory behavior, pathway composition, and defense-component effects; and expanded numerical sweeps assess scalability, threshold sensitivity, alternative link-prediction scores, and adaptive-stress assumptions. The results show that direct links dominate local amplification, whereas predicted links contribute disproportionately to cross-community spillover. In the pilot comparison, the full CLP-SEIRS-T${}^{+}$ configuration achieves the best observed balance, reducing mean peak burden by 56.9%, shortening mean recovery time by 86.7%, increasing absorptive capacity by 37.1%, and improving service continuity by 12.0% relative to the no-intervention baseline. Larger-network sweeps over $N=48,100,150,200,$ and 500 logical hosts preserve the same qualitative mechanism ordering while keeping functionality error below 0.02. Threshold analysis indicates that intermediate trigger values provide a better burden–cost balance than either overly aggressive or delayed patching. Link-score comparisons show that local-neighborhood predictors yield consistent spillover interpretations, whereas degree-driven prediction can increase bridge exposure. Parameterized adaptive-stress tests further indicate that the mechanism remains beneficial under moderate stress but degrades under severe patch suppression, false telemetry, or intensified bridge seeking. These findings suggest that urban cyber-resilience depends jointly on network modularity, temporal availability, structurally likely bridge formation, state-dependent local defense, and the integrity of administrative response. Full article

Artificial intelligence (AI) is increasingly embedded in marketing work, yet employees who use AI tools may not always disclose AI’s role in producing their outputs. This study examines AI disclosure silence, defined as employees’ intentional withholding of information about the use, role, or contribution of AI tools in work-related outputs after AI has already been used. Unlike AI avoidance or resistance, this construct concerns post-adoption concealment; unlike general employee silence, it focuses on the hidden technological contribution behind visible work. Drawing on Conservation of Resources Theory and Psychological Safety Theory, the study investigates how threat-based conditions, safety and governance conditions, and AI-related capability are associated with AI disclosure silence. Data were collected through a two-wave survey of 635 marketing employees who actively used AI tools at work. The analysis combined measurement validation, Necessary Condition Analysis (NCA), fuzzy-set Qualitative Comparative Analysis (fsQCA), and explainable machine learning. The findings show that no single condition operated as a strong necessary bottleneck. Instead, AI disclosure silence appeared through multiple pathways involving AI anxiety, fear of negative evaluation, perceived creativity threat, perceived job insecurity, low trust in management, weak psychological safety, and unclear AI policy. SHapley Additive exPlanations (SHAP)-based interpretation further indicated that fear of negative evaluation, AI anxiety, perceived creativity threat, and trust in management had the strongest model-based predictive relevance. The study contributes to workplace AI and employee silence research by positioning AI disclosure silence as an emerging post-adoption disclosure construct. It also highlights the need for clear AI disclosure norms, non-punitive managerial responses, AI-assisted authorship guidelines, and psychologically safe AI-governance practices. The findings should be interpreted as configurational and predictive evidence rather than causal effects, and further scale validation across sectors and cultures is encouraged. Full article

Introduction. Chronic non-cancer pain is highly prevalent and profoundly diminishes quality of life. While pharmacological and interventional treatments are central, its psychosocial and spiritual dimensions remain under-addressed. This pilot study assessed the feasibility of a therapist-led support group intervention for patients with chronic non-cancer pain and explored preliminary psychospiritual outcomes. Methods. A two-arm, non-randomized pilot feasibility study was conducted among 58 outpatients of a university pain management clinic in Poland. Feasibility was assessed through recruitment, retention, attendance, and safety, while preliminary psychological and spiritual outcomes were evaluated using validated self-report instruments. The intervention group (n = 29) participated in eight group sessions combining psychoeducation, mindfulness-based techniques, and supportive dialogue inspired by the Simonton Method. The control group (n = 29) received standard care. Participants completed the Numeric Rating Scale to measure pain intensity, the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, the WHOQOL-BREF, the Spiritual Well-Being Scale, the Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire-9. Results. The intervention was feasible in terms of physician workload; however, patients adherence varied significantly. At baseline, the control group showed a significantly higher positive affect and existential well-being than did the intervention group. In exploratory within-group analyses, participants in the intervention group showed improved positive affect and reduced anxiety (p < 0.05), whereas existential well-being showed a trend toward improvement (p < 0.06). However, the self-selection design limits causal inferences. Nevertheless, participants reported social connectedness, meaning-making, and enhanced vitality. Discussion. This pilot feasibility study provides preliminary evidence that a therapist-led support group intervention integrating psychoeducation, mindfulness, and supportive components is practicable within multidisciplinary pain management. Further research in a larger, randomized trial is needed to evaluate adherence and safety, as well as clinical effects, more rigorously. Full article

Food waste research often applies the Motivation–Opportunity–Ability (MOA) framework, yet conventional aggregate measures may obscure the distinct roles of physical context and cognition-related capacity. Using a macro-contextual, micro-primary dual-layer design, this study first uses World Bank data from 176 countries to provide structural context; this macro layer is not statistically linked to the student-level model. The main behavioral inference comes from matched plate-weighing and questionnaire data from 170 students across two purposively selected ordinary higher education institutions in northern and southern China. Within this exploratory and context-specific micro-level sample, the baseline three-dimensional MOA model explains only 4.1% of variance in log-transformed plate waste, whereas decomposing Opportunity into social and physical components and representing the Ability extension through behavioral ability and a two-item cognitive-capacity proxy improves model fit. The five-dimensional model explains 44.1% of variance ($F=26.2$, $p<0.001$). Johnson relative weight analysis indicates that Physical Opportunity (51.1%) and the two-item cognitive-capacity proxy (46.3%) account for most explained MOA variance in this sample. Item-level sensitivity checks further suggest that portion estimation and nutrition knowledge should be interpreted as distinct cognition-related indicators rather than as a validated latent scale. Robustness checks across raw, log-transformed, winsorized, logistic, and quantile specifications indicate consistent positive associations for Physical Opportunity and consistent negative associations for cognition-related indicators. Because the design is cross-sectional, these findings identify associations rather than causal effects; physical-environment redesign and cognitive-capacity support should therefore be treated as candidate directions for future intervention testing rather than as confirmed intervention effects. By linking objectively measured plate waste to institutional dining conditions, the study contributes to sustainability research on responsible consumption, resource efficiency, low-carbon campus operations, and practical pathways for reducing avoidable food-related environmental burdens in university settings. Full article

Introduction: Sediment flushing is widely used to recover storage capacity and maintain outlet functionality in Mediterranean reservoirs, but it can also generate short downstream pulses of suspended sediment, oxygen depletion, and ammonia that may threaten fish and fish habitats. Despite this, operation-specific environmental criteria explicitly oriented to reducing acute fish risk during flushing remain poorly defined. Objective: This study aimed to develop and validate a practical operational protocol for sediment flushing in southern Spain, with emphasis on reducing acute downstream risk to fish through field-applicable thresholds, decision rules, and stop criteria. We also evaluated whether water density could serve as a rapid surrogate for total suspended matter (TSM) during operations. Methodology: The protocol was applied to 14 flushing events conducted at seven reservoirs and weirs in Andalusia, southern Spain. Monitoring included upstream and downstream stations, pre-operation baseline surveys, 15-minute measurements during flushing, and post-operation recovery checks. Operational control was based on pre-alert and alert thresholds for dissolved oxygen, ammonium/ammonia, conductivity, suspended matter, and a density-based surrogate for TSM. Protocol validation considered operational safety during flushing, the relationship between field density and laboratory-measured TSM, and before–after multivariate changes in downstream environmental conditions. Results: Threshold exceedances occurred in 5 of the 14 events, comprising 4 pre-alerts and 1 alert. Pre-alerts were mainly driven by ammonium/ammonia or dissolved oxygen, and exceedance durations were generally short (30–120 min). The only alert-level event combined severe oxygen depletion with high sediment concentrations and triggered suspension of the operation, showing the usefulness of the stop rule. Density was significantly related to laboratory TSM in all reservoirs retained for calibration (R² = 0.365–0.934), supporting its use as a rapid field proxy when calibrated at the reservoir scale. Before–after multivariate analysis detected no consistent overall downstream shift, although event-level responses were heterogeneous. Conclusions: The protocol proved operationally feasible as a science-based framework for managing sediment flushing while reducing acute risk to downstream fish in Mediterranean reservoirs. Its combination of fish-relevant thresholds, real-time monitoring, site-specific density calibration, and explicit stop rules can support safer operations, improve transparency, and strengthen environmental permitting. Full article

Research on post-COVID tourism behaviour has expanded rapidly, yet inland UNESCO World Heritage cities remain underexamined, particularly in Mediterranean contexts. This study examines whether the pandemic produced durable changes in tourist behaviour and in willingness to pay for sustainable services in Cáceres, Spain. A structured face-to-face survey was administered to 421 visitors in March 2023, after public-health restrictions had been lifted. The analysis covered self-reported behavioural change, perceived impacts on different destination types, perceived effects on local sustainability objectives and changes in willingness to pay (WTP) for sustainable services. Descriptive statistics were complemented by an exploratory binary logistic regression predicting increased WTP. Because the model includes only sociodemographic predictors and shows modest fit, it is used to describe associations rather than to predict. Reported behavioural change was limited: mean scores for crowd avoidance, health–safety preferences, shorter stays and substitution towards rural and nature tourism ranged from 1.73 to 1.91 on a five-point scale. Respondents nevertheless perceived substantial spatial effects of the pandemic, particularly on natural parks (92.6%) and rural destinations (84.1%). Most believed that the pandemic had accelerated sustainability efforts mainly through greater institutional and business awareness (54.9%). WTP proved relatively stable, with 62.7% reporting no change and 26.1% an increase. Women and respondents with university education showed higher odds of reporting increased WTP. Because constructs such as institutional trust and pro-environmental values were not measured directly, these attitudes are interpreted—rather than demonstrated—as reflecting governance-related confidence and value orientations more than lingering health concerns. This governance-and-values reading is the study’s main interpretive contribution and requires confirmation with direct measures of the underlying constructs. Full article

Background/Objectives: Despite the availability of free national mammography services, participation in breast cancer screening remains suboptimal in Kuwait. This study aimed to assess breast cancer screening beliefs and barriers among women in Kuwait using the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) and to examine their associations with sociodemographic characteristics. Methods: This study is a secondary analysis of a cross-sectional dataset collected among 458 women aged ≥20 years across all six governorates of Kuwait. Data were collected using a structured questionnaire including the BCSBQ, breast cancer knowledge measures, and a general help-seeking barrier scale. Internal consistency was assessed using Cronbach’s alpha, and exploratory factor analysis was performed to evaluate construct validity. Group differences were examined using t-tests and one-way analysis of variance with post hoc correction, while adjusted associations were assessed using general linear models and linear regression. Results: The BCSBQ demonstrated good internal consistency (Cronbach’s α = 0.808) and a clear three-factor structure (Kaiser–Meyer–Olkin = 0.790; Bartlett’s test p < 0.001), explaining 50.26% of the total variance. Nearly half of participants (48.7%) reported positive attitudes toward screening, while 16.4% exhibited firmer fatalistic beliefs and 18.8% reported elevated mammography-related barriers. A substantial proportion believed that screening is only necessary when symptoms are present (57.2%). Lower education and younger age were significantly associated with higher barriers and less favorable screening beliefs (p < 0.05). In regression analysis, higher mammography-related barriers were associated with greater general help-seeking barriers, whereas more positive attitudes were associated with lower barriers, explaining 11.5% of the variance (R² = 0.115, p < 0.001). Conclusions: Breast cancer screening beliefs among women in Kuwait are shaped by sociodemographic factors, particularly education level and age, with persistent misconceptions and perceived barriers influencing screening perceptions. Targeted, culturally appropriate interventions are needed to address these gaps and promote participation in Kuwait’s free-access screening program. Full article

Background: Diabetes-related stigma is an underrecognized psychosocial factor that may contribute to emotional burden among individuals with diabetes. In Saudi Arabia, where the prevalence of diabetes is among the highest globally, limited evidence exists on how stigma across different social contexts influences interpersonal diabetes distress. We aimed to assess the association between diabetes-related stigma and interpersonal diabetes distress and to determine whether these associations differed across family, workplace, and healthcare stigma domains among adults with diabetes in Saudi Arabia. Methods: This cross-sectional study analyzed survey data collected from 438 patients with diabetes. Diabetes-related stigma was measured using an adapted 12-item diabetes stigma scale covering family, workplace, and healthcare domains, while interpersonal diabetes distress was assessed using the Interpersonal Distress subscale of the Diabetes Distress Scale (DDS). The relationships between stigma and distress were estimated using multiple linear regression analysis adjusted for age, gender, education level, years since diagnosis, and presence of complications. Results: Participants reported moderate levels of stigma (mean: 2.50, SD: 1.08) and interpersonal distress (mean: 2.31, SD: 1.23). Higher stigma scores were strongly associated with greater interpersonal distress (β = 0.57, 95% CI: 0.48 to 0.66). Domain-specific analysis showed that workplace (β = 0.26, 95% CI: 0.10 to 0.42) and healthcare stigma (β = 0.23, 95% CI: 0.07 to 0.38) were significantly associated with distress, while family stigma was not. Individuals with diabetes complications had higher distress (β = 0.49, 95% CI: 0.25 to 0.73). No evidence of effect modification by gender or education was observed. Spline models confirmed a positive and strengthening association at higher levels of stigma. Conclusions: Diabetes-related stigma is a strong and consistent factor associated with interpersonal diabetes distress in Saudi Arabia, with workplace and healthcare stigma demonstrating the strongest associations. These findings highlight the importance of addressing stigma within both social and healthcare environments and suggest that stigma reduction strategies may help alleviate the psychosocial burden associated with diabetes. Full article

Objective: Traumatic brain injury (TBI) is disproportionately prevalent in incarcerated populations, yet the potential impact on cognitive functioning remains underexplored. This study examined the relationship between TBI history and cognitive performance in a male prison population. Method: Sixty-three participants from Tongariro Prison completed a comprehensive neuropsychological assessment including measures of executive function, memory, processing speed, and perceptual reasoning, with embedded performance validity metrics. TBI history was assessed using the Ohio State University TBI Identification Method (OSU-TBI ID), premorbid function was assessed using the Speed and Capacity of Language Processing (SCOLP) Spot-the-Word task, mood was assessed using the Depression, Anxiety and Stress Scales (DASS-21), and alcohol and substance use were measured using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Regression analyses explored the relationship between TBI history and cognitive functioning, controlling for premorbid function, mood, alcohol and substance use, and ethnicity. Results: Contrary to hypotheses, TBI frequency and severity were not associated with poorer cognitive performance in this population. However, a self-reported history of pervasive TBI—defined as repeated head impacts over a narrow time frame—was significantly associated with reduced performance on the Color–Word Interference Test (CWIT) inhibition task, indicating links to greater cognitive disinhibition. Conclusions: Findings suggest that experiencing at least one period of pervasive TBI may be associated with an impact on inhibition (but not other aspects of executive functioning) in men in prison. These results underscore the importance of nuanced TBI history assessment and highlight inhibition as a potential target for rehabilitation in incarcerated individuals exposed to repetitive head trauma. Full article

Obsessive–compulsive disorder (OCD) is a chronic and disabling psychiatric condition whose neurobiological underpinnings remain incompletely characterized. A growing body of evidence suggests that vitamin D, through its modulatory actions on neuroinflammation, serotonin synthesis, and cortico-striato-thalamo-cortical circuitry, may be implicated in its clinical expression. The present cross-sectional study examined the association between serum 25-hydroxyvitamin D levels and OCD severity in 306 adult outpatients with a diagnosis of OCD, of whom 173 had vitamin D measurements available. Symptom severity was assessed through the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), and associations were examined using non-parametric tests, partial correlations and multivariable linear regression adjusted for age, gender, age at onset, and bipolar comorbidity. Mean vitamin D was 20.0 ± 13.1 ng/mL, with 60.1% of patients meeting criteria for deficiency. Lower vitamin D levels correlated inversely with Y-BOCS total score (ρ = −0.26, p = 0.001) and with both subscales, and deficient patients showed a mean Y-BOCS total approximately 5.5 points higher than non-deficient ones. In multivariable models, lower vitamin D (β = −0.253, p = 0.001) and earlier age at onset (β = −0.278, p = 0.001) independently predicted greater severity (R² = 0.133), while a history of suicide attempts neither predicted severity nor moderated the vitamin D association. These findings support vitamin D status as a biological correlate of OCD severity and warrant longitudinal and interventional investigation. Full article

Background and Objectives: Non-invasive biomarkers reflecting neurodegeneration are increasingly important in multiple sclerosis (MS). Optical coherence tomography (OCT) provides quantitative measures of retinal structure, most commonly peripapillary retinal nerve fiber layer (pRNFL) thickness. However, the potential clinical relevance of optic nerve head morphology, including cup-to-disc ratio (CDR), remains insufficiently explored. We investigated associations between OCT-derived parameters, subjective visual vertical (SVV), and disability in MS. Materials and Methods: In this retrospective study, 100 patients with MS were included. OCT parameters (pRNFL thickness and area-based CDR) were analyzed at baseline and follow-up. Clinical disability was assessed using the Expanded Disability Status Scale (EDSS). Detailed optic neuritis history was not consistently available in the retrospective clinical records and therefore could not be systematically accounted for in the analyses. SVV was evaluated in 37 patients using a virtual reality–based protocol. Associations were assessed using Spearman correlation and linear regression analyses. Multivariable regression models were adjusted for age, sex, and follow-up duration. Results: pRNFL thickness was not associated with baseline EDSS (rho = −0.06, p = 0.55) or annualized EDSS change. Baseline CDR correlated with both baseline EDSS (rho = 0.30, p = 0.0065) and follow-up EDSS (rho = 0.46, p < 0.0001). In univariable regression analysis, baseline CDR was associated with follow-up EDSS (B = 3.33, R² = 0.23, p < 0.0001), remaining significant after adjustment for age, sex, and follow-up duration (B = 2.59, 95% CI 1.26–3.92, p = 0.0002). No significant associations were observed between OCT parameters and SVV measures. Conclusions: Higher CDR values, but not pRNFL thickness, were associated with disability measures in this exploratory MS cohort. However, these findings should be interpreted cautiously because optic neuritis history could not be systematically accounted for and physiological optic disc variability may substantially influence CDR measurements. Full article

Remote patient monitoring (RPM) is widely framed as a foundational technology for the next generation of chronic-disease care. Specific applications—pacemaker follow-up, hypertension cohorts, structured heart-failure programmes, post-surgical biosensor protocols, and virtual wards—now generate measurable clinical and economic value. Yet a decade of evaluations and implementation studies suggests that the surrounding ecosystem has matured unevenly: working applications coexist with persistent cross-cutting fragility. In this Perspective we argue that four structural gaps continue to constrain RPM’s promise at scale: (i) economic models that do not credibly compensate the asynchronous clinical work that RPM generates; (ii) ambiguous frameworks for professional liability and accountability for continuous data streams, intensified by artificial-intelligence (AI)-mediated decision support; (iii) privacy, equity, and benefit-sharing arrangements that do not yet make patients unambiguous net beneficiaries—a gap visible across very different health systems internationally; and (iv) engagement and adherence dynamics that determine whether programmes deliver value at all, but are still treated as secondary outcomes. The COVID-19 emergency briefly suspended much of the friction in this ecosystem and produced a useful natural experiment: what scaled rapidly under emergency conditions, and what subsequently atrophied, illuminates which gaps are technical, which are economic, and which are institutional. We close with a six-point research and policy agenda intended to move RPM from localised successes to a trustworthy, generalisable standard of care. Full article

Structures are continuously subjected to the combined effects of temperature variations and other environmental factors during service, leading to changes in their structural responses and severely compromising the accuracy of damage identification. To address this temperature-induced interference, this study proposes a damage identification method that jointly identifies damage and temperature parameters. Temperature variations are treated as unknown parameters and identified simultaneously with the damage parameters. The inverse problem is defined by an objective function that quantifies the discrepancy between measured and analytical strains. To enable the analysis of large-scale structures, a stiffness separation method accounting for temperature variation is introduced, which divides the structure into substructures for damage identification. This method is numerically demonstrated through a case study of a steel truss bridge, and the applicability of the combined temperature identification and stiffness separation method is evaluated under different temperature conditions. Full article

Wildfires can threaten the safety of transmission towers by degrading galvanized coatings and reducing the load-bearing capacity of steel members exposed to elevated temperatures. This study investigates the thermal damage evolution and structural response of transmission tower legs under localized wood-crib fire exposure through a combined experimental and numerical approach. A 1:4 scale tower-leg model was subjected to a single wood-crib fire exposure for approximately 20 min, during which temperature histories, surface damage patterns, and deformation of the fire-exposed members were recorded. The results show that the maximum measured temperature reached 803 °C and decreased approximately linearly with height, leading to distinct damage zones along the tower leg. The galvanized coating exhibited progressive degradation, including oxidation, melting, cracking, and local peeling, while the surface appearance changed from bright silver to black and finally to gray-white with reddish-brown areas in severely heated regions. A temperature-informed elastic–plastic finite element model was then used to interpret the global structural response. The analysis indicates that elevated temperature reduced the stiffness and load-bearing capacity of the fire-exposed side, causing deformation concentration and torsional distortion in diagonal members. The proposed framework provides a practical basis for post-fire damage identification and rapid structural assessment of transmission towers in wildfire-prone regions. Full article

Objectives: This paper presents a principle and framework for generating social trust in AI outputs as an institutional structure rather than an ethical declaration. Sound technical design alone does not guarantee the institutional trust required to establish social measurement. What is needed is not a declaration of trust but the construction of an infrastructure that supports it. Methods: First, the Extended Kelvin Principle is derived by prepending to Kelvin’s measurement–understanding–control chain the links “no social trust without trust infrastructure; no legitimate social measurement without social trust.” Infrastructure-scale trust requires not declarations but verifiability, recordability, and auditability. Just as GUM and calibration infrastructure underpin trust in measured values, AI output governance requires GLO, a common language for expressing output legitimacy, implemented by a VRAIO-type infrastructure. GLO treats an output candidate as a “claim” and declares the rule-conformity of its purpose and content as a legitimacy confidence L, derived from a fact-based argument accompanied by a legitimacy budget. Results: VRAIO integrates declaration, rule verification, tamper-resistant recording, and independent auditing. A sealed, deterministic verifier makes L reproducible: computational falsity is caught by re-computation, factual falsity by checking authoritative records, and severe sanctions render false declaration irrational. Conclusions: GLO is not a mere AI version of GUM but a common language for an underdeveloped domain, whose effectiveness depends on connection to an enforceable output-governance infrastructure. Full article