Search Results (5,069)

Background/Objectives: Sphingosine-1-phosphate (S1P) is implicated in glycemic control. However, its circulating levels and clinical significance in type 2 diabetes mellitus (T2DM) remain controversial. We assessed plasma S1P levels in T2DM patients, its associations with metabolic parameters and complications, and explored its biomarker potential and non-linear (U-/J-shaped) relationships. Methods: This cross-sectional study enrolled 140 patients with T2DM and 63 matching healthy controls. Plasma S1P was measured by competitive ELISA. Statistical analyses included comparisons, correlation, ROC analysis, multivariable logistic regression, and quadratic/spline regression for U-shaped relationships. Results: Plasma S1P was significantly elevated in T2DM patients [1256.7 (149.4–1510.0) ng/mL] compared to controls [1075.1 (202.0–1510.0) ng/mL; p < 0.001]. S1P correlated positively with age, disease duration, HbA1c, insulin resistance, TyG index, triglycerides, systolic blood pressure, and negatively with HDL-C. Patients with complications had higher S1P than those without (p = 0.001), with progressive increases from retinopathy to nephropathy to mixed complications. Insulin-treated patients exhibited the highest S1P levels (p < 0.001). ROC analysis showed moderate diagnostic accuracy (AUC = 0.724). S1P is an independent associated factor with complications (OR = 1.18 per 100 ng/mL, p = 0.003). Non-linear analysis revealed a U-shaped relationship with HDL-C (optimal S1P: 1100–1350 ng/mL) and a J-shaped relationship with complication risk (threshold ~1250 ng/mL). Conclusions: Plasma S1P is elevated in T2DM and correlates with disease severity, glycemic control, insulin resistance, and complications. S1P demonstrates moderate biomarker potential and exhibits non-linear U-/J-shaped relationships with metabolic parameters, suggesting an optimal therapeutic window of 1100–1280 ng/mL. These findings support S1P as a marker of cumulative disease burden and a potential therapeutic target. Full article

To investigate the mitigation of high-pressure CO₂-induced degradation of wellbore cement sheath in Carbon Capture, Utilization, and Storage–Enhanced Oil Recovery applications (CCUS-EOR), conventional Class G oil well cement and modified cement systems incorporating graphene, waterborne epoxy resin, and a composite of waterborne epoxy resin with graphene were formulated. This study presents the original comparative investigation on the long-term carbonation resistance of graphene-modified, waterborne-epoxy-modified, and their composite-modified oil well cements under 130 °C and 7 MPa CO₂ partial pressure, filling the research gap of unclear synergistic effects of the two modifiers in high-temperature CCUS environments. The specimens were subjected to simulated downhole conditions, and key properties, including compressive strength and permeability, were evaluated. The underlying mechanisms were elucidated through material characterization techniques such as X-ray diffraction, X-ray computed tomography, and scanning electron microscopy. Results indicated that the waterborne epoxy resin–modified cement system exhibited superior long-term carbonation resistance, achieving a 90 d compressive strength retention rate of 84%. The graphene-modified cement showed a 90 d compressive strength retention rate of 65%, while the waterborne epoxy–graphene composite system only retained 39.7% of its compressive strength at 90 d due to negative synergistic effects. The enhanced durability of the waterborne-epoxy-modified cement is attributed to the formation of a continuous polymeric film, which acts as a protective barrier against CO₂ penetration. This study provides valuable insights for the design of CO₂-resistant cement systems in CCUS-EOR environments. Full article

Background: Cultural competence is essential in nursing, enabling the delivery of ethical, patient-centered, and respectful care that respects diverse cultural backgrounds in an increasingly diverse healthcare setting. Improving cultural competence can substantially reduce stereotyping, time pressure, and distress among nurses. Objective: This study aimed to examine the relationship between cultural competence and loneliness among nurses working at a university medical city in Saudi Arabia and to identify associated demographic and psychological factors. Methods: A descriptive cross-sectional study was conducted using a convenience sample of 184 nurses. Data were collected via an online questionnaire that included the Cultural Capacity Scale, the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire-4 between April and May 2024. Descriptive statistics, Spearman’s correlation, and multiple linear regression were used in the data analysis. Result: Findings indicate high cultural competence (mean score: 78.82) but moderate loneliness (mean score: 11.9). Notably, a strong negative correlation exists between cultural competence and feelings of loneliness (r = −0.777) and anxiety/depression (r = −0.818), suggesting that increased cultural competence is associated with lower loneliness and mental health issues. Conclusions: Both cultural knowledge and sensitivity emerged as significant predictors of lower anxiety and depression levels. These findings highlight the association between cultural competence and reduced loneliness and psychological distress among nurses, suggesting the need for targeted training interventions to improve nurses’ well-being and the quality of patient-centered care in culturally diverse healthcare settings. Full article

Coalbed methane (CBM) development is strongly controlled by pore structure evolution in deformed coals and its influence on hydraulic fracturing behavior. To clarify the multifractal characteristics of cross-scale pores and their control on fracturing effectiveness, this study investigated eight different deformation coals from the Ordos Basin using low-temperature CO₂/N₂ adsorption (LT-CO₂A/LT-N₂A) and high-pressure mercury intrusion porosimetry (HMIP). Micropores (<2 nm), mesopores (2–50 nm), and macropores (>50 nm) were systematically characterized, and their pore size distributions (PSDs) were quantitatively analyzed using the Coal Structure Index (CSI) and multifractal theory. The results indicate that the multifractal parameters of macropores are significantly distinct from those of mesopores and micropores, exhibiting lower H (0.824–0.893) and D₁ (0.766–0.853), and higher α₀ (1.422–1.541), ΔD (1.230–1.408), and Δα (1.459–1.642). Macropores controlled by tectonic deformation exhibit stronger heterogeneity compared to mesopores and micropores in local parts of the coal mass; PSD varies significantly with deformation rising, derived from the differential pore structure evolution during brittle–ductile transition and the multi-scale synergistic effects including maturity and composition. Combined with field fracturing curves, the results further indicate that the α₀, ΔD, and Δα of macropores are negatively correlated with breakdown pressure, with correlation coefficients of 0.51, 0.61, and 0.59, respectively, and that strong local heterogeneity of macropores favors fracture initiation and propagation and reduces breakdown pressure. Cataclastic coal is the most favorable for hydraulic fracturing, followed by undeformed coal, whereas granulated coal shows the poorest fracturing performance. Full article

Evaluating whether zoning-based management is associated with measurable ecosystem function benefits is crucial for China’s national park system reform, yet most existing assessments emphasize greening or productivity alone. Here, we evaluate zoning-associated patterns in the Three-River Headwaters Region by combining MODIS-derived carbon use efficiency (CUE = NPP/GPP; 2001–2024), a boundary–buffer comparison with environmental matching, and an explainable machine learning attribution framework. NPP increased across all zones, whereas CUE remained stable to slightly declining, indicating a productivity–efficiency decoupling in the remote sensing record. Core and Buffer zones maintained higher long-term median CUE than the Outside zone, but matched boundary contrasts were heterogeneous, and the Experimental–Outside CUE contrast, although robust in sign, was small in magnitude. Zone–year attribution (2002–2020) suggests that interannual CUE variability is dominated by climate and land surface structure/change, while human pressure shows a smaller negative association; these grouped SHAP contributions should be interpreted as indicative rather than precise estimates. Post-2020 climate baseline residuals show persistent negative CUE anomalies in Buffer and Experimental zones, suggesting additional non-climatic influences but not demonstrating causality. Given the temperature-sensitive structure of MOD17 and the representativeness limits of QC-filtered 500 m observations, we interpret these results as management-consistent patterns rather than stand-alone causal proof. The findings support incorporating carbon use efficiency into zonal monitoring and may inform differentiated, efficiency-oriented management review. Full article

Under long-term cyclic loading, the cumulative plastic deformation of unsaturated sandy subgrade is a key control factor for the pavement’s service performance. However, its evolution mechanism and quantitative characterization still lack a universal model. In this study, based on the GDS dynamic triaxial system, a series of cyclic tests were conducted under different conditions: matric suction from 0 to 90 kPa, net confining pressure from 30 to 120 kPa, dynamic stress amplitude from 60 to 240 kPa, and compaction degrees of 87–96%, reaching a total of 10,000 cycles. The results reveal that the permanent deformation of unsaturated sandy subgrade material evolves through three stages: fast, slow, and stable. The deformation is exponentially negatively correlated with matric suction, net confining pressure, and compaction degree, and exponentially positively correlated with dynamic stress amplitude. A coupling prediction model was developed by embedding matric suction and compaction degree factors into the Karg model. This model incorporates net confining pressure, dynamic stress amplitude, matric suction, and compaction degree. By using a normalized master curve method, the permanent deformation curves under different working conditions were compressed into a unique dimensionless function. The parameters have clear physical significance and allow for a unified description across stress, suction, state, and soil types. Experimental data, along with data from the literature, were used to validate the model, showing prediction errors of less than 10% and R² > 0.95. The model provides a simple, high-precision, and transferable theoretical tool for long-service-life subgrade deformation control. Full article

Methods examining eyewitness testimony and its identification of suspects have not received sufficient analysis internationally. In the face of growing empirical evidence of methodologic and judicial errors, Greece’s judicial process nonetheless prioritizes eyewitness testimony in gathering evidence and preparing cases for trial. Due to its pluralistic geographical and cultural position uniting European, Balkan, and Mediterranean influences, and its alignment with non-Napoleonic code nations, Greece is a useful example for studying witness interviewing in evolving judicial systems. Drawing on 87 semi-structured interviews with Greek legal professionals, this study identifies systemic variables affecting eyewitness interviews and suspect identification. Prominent barriers to robust witness interviewing included inappropriate questioning techniques and wording, frequent interruptions, scripted questions, and failure to develop a sense of trust. In identifying suspects, participants highlighted inadequate compliance with defined protocols, inadequate management of negative emotions, pressure on witnesses to make positive identifications, and introduction of improper guidance about the alleged perpetrator. Lengthy delays before the eyewitness interview and a lack of infrastructure were core influences alongside a lack of familiarity with best practices. The findings signal the need for authorities to adopt reliable methods and specific guidance for utilizing eyewitness testimony. Full article

This study evaluates the effect of loading size on the longitudinal warping of beech wood containing reaction wood. Reaction wood in hardwood species has properties that negatively affect not only the usability of wood products but also the processing of the wood in which it is found. To investigate these effects, steam pressure treatment and three levels of mechanical loading (700, 2000, 4000 kg·m⁻²) were used, along with the effect of the proportion of reaction wood. Steam pressure treatment generally caused greater warping, particularly in unloaded specimens, due to increased release of internal growth stresses. Mechanical loading effectively reduced deformation, with the most pronounced effects observed at 700 and 2000 kg·m⁻²; further increases in loading did not provide any significant additional benefits. Although the proportion of reaction wood ranged from 14% to 56%, there was no obvious statistical correlation with deformation, suggesting that the distribution and degree of development of reaction wood have a greater impact than its total content. Overall, hydrothermal treatment induces the release of internal stress, leading to warping, while moderate mechanical loading can successfully limit warping. Understanding these interactions is key to processing beech wood with reaction wood and to improving the quality of finished products. Full article

Rapid urbanization has led to a significant increase in land use carbon emission (LCE), putting great pressure on ecological security. The coupling relationship between LCE and the ecological security index (ESI) is the key to sustainable development. Based on land use/cover change (LUCC) and Open-Data Inventory for Anthropogenic Carbon dioxide (ODIAC) data, the LCE of the Jilin Border Cities (JLBCs) from 2013 to 2023 was estimated. Twenty-seven indicators were selected from both natural and socioeconomic aspects to evaluate the ESI using the Driving forces–Pressure–State–Impact–Response–Management (DPSIRM) model. The spatial interaction between LCE and ESI was analyzed using the coupling degree model and spatial autocorrelation. The results show that from 2013 to 2023, the main LCE areas in the JLBCs were concentrated in central urban districts, while the total LCE remained negative but exhibited a clear upward trend. The ESIs in Tonghua City and Baishan City have continued to improve, but those in Yanbian Autonomous Prefecture have gradually deteriorated, with ecological security warnings intensifying progressively toward the east. The spatial variation in the LCE–ESI coupling degree is significant, predominantly exhibiting low coupling with differences across scales. Within the study area, coupling degree shows a strong positive correlation, revealing distinct spatial clustering patterns dominated by low clusters and cold spots. Future efforts should focus on promoting low-carbon development models, strengthening protection and restoration, while implementing targeted measures to enhance the overall ecology of JLBCs. Full article

Continuous greenhouse watermelon cultivation is widely constrained by declining soil function, impaired nutrient cycling, and increasing soil-borne disease pressure. Developing biologically driven strategies to restore soil–crop coupling is therefore critical for sustainable protected horticulture. Here, we conducted a two-year field experiment (2024–2025) using a randomized block design with three treatments (CK, ST, and STE), three replicates per treatment, and a plot area of 22.5 m² to evaluate how straw application alone and in combination with earthworms regulate soil processes and crop performance in a continuous greenhouse watermelon system. Compared with CK and ST, earthworm–straw co-application (STE) exerted stronger effects, particularly during the mid-to-late growth stages. In 2024, STE increased soil organic matter by 25.34% and 30.28% relative to CK at the fruiting and harvest stages, respectively; in 2025, the corresponding increases were 25.22% and 27.62%. STE also significantly increased total nitrogen at nearly all growth stages, with the maximum increase reaching 67.23% relative to CK at harvest. In 2025, total phosphorus under STE was significantly higher than under CK and ST across all growth stages, with increases of 75.82% and 79.63%, respectively, at the fruiting stage. Neutral phosphatase activity was markedly enhanced, increasing by 292.24% at the fruiting stage in 2025. These improvements were accompanied by higher plot yield and lower wilt disease incidence, with yield increasing by 34.00% in 2024 and 21.29% in 2025 relative to CK, while disease incidence decreased by 41.46% and 56.06%, respectively. Integrative Mantel tests showed that total nitrogen was the factor most strongly associated with watermelon yield, with the correlation coefficient increasing from r = 0.490 (p = 0.001) in 2024 to r = 0.662 (p = 0.001) in 2025. Co-occurrence network analysis further revealed a strong positive correlation between yield and total nitrogen (r = 0.848 in 2024; r = 0.673 in 2025) and a negative correlation between disease incidence and total nitrogen (r = −0.661 in 2024; r = −0.822 in 2025), indicating progressively strengthened soil–plant functional coupling over time. Our findings demonstrate that earthworm–straw co-application strengthened soil nutrient transformation capacity and enhanced soil suppressiveness against wilt disease, thereby providing an effective ecology-based strategy for alleviating continuous-cropping constraints in greenhouse watermelon systems. Full article

Background: Psychological distress, autonomic dysregulation, and unhealthy lifestyle behaviors are common after myocardial infarction (MI) and negatively affect cardiovascular outcomes. In recent years, integrative mind–body interventions, such as yoga and mindfulness-based approaches, have gained increasing attention as adjuncts to conventional cardiac rehabilitation (CR) programs. However, evidence regarding their effectiveness in post-MI populations remains fragmented. Objective: This systematic review aimed to synthesize the available evidence on the effects of yoga- and mindfulness-based interventions in patients following myocardial infarction. Methods: A systematic literature search was conducted across major electronic databases to identify randomized controlled trials and observational studies evaluating yoga- or mindfulness-based interventions in post-MI patients. Eligible studies included adult MI populations. Study selection and quality assessment were performed according to predefined criteria. Results: The 10 included studies suggest that yoga-based cardiac rehabilitation programs may provide benefits beyond standard care, particularly in terms of self-rated health, psychological well-being, and return to pre-infarction daily activities. Mindfulness-based interventions were associated with reductions in anxiety and perceived stress, improvements in blood pressure control, enhanced social support, and better health-related quality of life. Several studies also reported favorable effects on autonomic balance and stress-related physiological markers. Finally, a study reported benefits in terms of MACE (p = 0.032). However, heterogeneity in intervention protocols, outcome measures, and study designs limited direct comparisons across studies. Conclusions: Yoga and mindfulness-based interventions appear to be promising complementary strategies in post-MI care. Full article

Rapid global urbanization has exacerbated the conflict between land expansion and ecosystem carrying capacity, making the enhancement of urban land use efficiency (ULUE), a critical pathway for sustainable development. While the digital economy offers a new engine for green transition, its spatiotemporal mechanisms remain underexplored. Taking China, a representative emerging economy, as a case study, this paper investigates the impact of digital transformation on ULUE from 2013 to 2020. By integrating the Super-EBM model with GTWR, we reveal a dynamic evolution where national efficiency improves while regional polarization intensifies. A key finding challenges traditional agglomeration theory, that population density increasingly exerts a negative impact on ULUE, suggesting that congestion costs and ecological pressures are outweighing agglomeration benefits in the digital era. Furthermore, digital infrastructure demonstrates a consistent positive effect by overcoming geographical barriers, whereas environmental regulation exhibits a J-curve effect that is initially constraining but eventually boosts efficiency. These insights provide a roadmap for developing nations to leverage digital tools for balancing economic growth with ecological sustainability, emphasizing the need for spatially differentiated strategies to manage the digital divide and urban congestion. Full article

The corporate social responsibility (CSR) approach from a managerial point of view has become a topic of interest especially in the European ex-Communist countries. This paper explores the intentions of Romanian managers of small and medium-sized enterprises and multinational corporations operating in Romania to implement corporate socially responsible practices (CSRPs). To this end, a quantitative research methodology based on an online survey was employed, and partial least squares structural equation modeling was used to analyze the data. The results show that the research model based on the Theory of Planned Behavior (TPB) has been validated. The values of composite reliability and Cronbach’s alpha exceed 0.7, the value of average variance extracted exceeds 0.5, while the values of average block variance inflation factor and average full collinearity are below 3.3. The findings also indicate that the intention of managers to integrate CSRP within their business organizations is mostly influenced by the stakeholder pressure, suggesting that the attainment of social approval is a crucial driver of responsible behavior, rather than other constructs related to the TPB. The study concludes that while negative attitudes towards CSR do not significantly affect managers’ intentions to engage in CSRP, positive attitudes exert a favorable influence. Full article

Saskatoon berry (SB), a traditional food of Indigenous people, has been associated with cardiometabolic benefits in animal models; however, its effects on humans remain unclear. This study investigated the effects of dried SB consumption on cardiometabolic outcomes, gut microbiota, and short-chain fatty acids (SCFAs) profiles in healthy adults. In a 10-week, single-arm, and open-label trial, 20 healthy adults consumed 40 g/day of freeze-dried whole SB. Biochemical measures, physical exams, dietary records, participant feedback, and fecal samples were collected before and after the intervention. Gut microbiota composition and fecal SCFAs were profiled using 16S-rRNA sequencing and gas chromatography–mass spectrometry, respectively. SB intake significantly reduced fasting plasma glucose, total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), non-high-density lipoprotein-cholesterol (non-HDL-c), systolic blood pressure, and high-sensitivity C-reactive protein, while increasing dietary fiber intake. Fiber intake was negatively correlated with TC, LDL-c and non-HDL-c (p < 0.05). The relative abundance of fecal Prevotellaceae increased after SB consumption and was positively correlated with multiple fecal SCFAs (p < 0.05–0.0001), while being negatively associated with lipid profiles and blood pressure. No adverse cardiovascular, hepatic, or renal dysfunction were observed; however, the significant increase in sugar intake may pose a risk for elevated blood glucose. Therefore, limiting other high-sugar foods during SB supplementation may be advisable for individuals with glucose intolerance. Overall, SB intake improved glucose and lipid metabolism and lowered blood pressure and inflammatory markers in healthy adults. These cardiometabolic benefits may be mediated by fiber and anthocyanins in SB and through modulation of gut microbiota and SCFA production; however, further confirmation is needed in subsequent randomized controlled trials. Full article