Search Results (16,303)

Patients with cancer often experience intertwined symptom burden and functional decline that contribute to falls, unsafe transfers, uncontrolled symptoms, caregiver strain, and crisis-driven care. Physical medicine and rehabilitation (PM&R), also known as physiatry, and specialty PC both address suffering and quality of life through complementary clinical approaches; however, collaborative care with and between these two specialties is inconsistent in routine oncology practice. This paper presents a clinical implementation framework informed by targeted literature synthesis for bidirectional referral and co-management between PM&R and PC in oncology. The framework was informed by the PC referral criteria literature, cancer rehabilitation triage literature, trigger-based serious illness identification models, and implementation science. Four clinic-usable tools are proposed, including a scope and overlap map, a clinical-needs gradient, a referral trigger table linking common clinical signals to the reason for referral and expected clinical actions, and a primary-service triage workflow. This framework is intended to clarify which service is best positioned to be the primary supportive service according to the patient’s current needs, when rehabilitation therapy alone may be sufficient, and when co-management should be the default. This concept-to-practice model is designed to facilitate early, needs-based referrals and coordinated supportive care in oncology settings. Full article

Natural lacquer, a bio-based polymer derived from Toxicodendron vernicifluum, has attracted renewed scientific interest as a sustainable coating material with exceptional mechanical durability, chemical resistance, and aesthetic qualities. This review synthesizes current knowledge on the chemical composition, enzymatic curing mechanisms, and structure–property relationships of lacquer-based polymer systems, with particular focus on recent advances in functional modification and processing technology. Key findings indicate that laccase-catalyzed oxidative polymerization, operating optimally at pH 6.0–7.5 and 20–30 °C, governs the formation of a highly cross-linked urushiol network whose properties are fundamentally determined by side-chain unsaturation and emulsion stability. Mechanistic analysis reveals that polyurethane hybridization improves weathering resistance by introducing flexible aliphatic segments and additional hydrogen-bonding cross-links, while graphene oxide incorporation enhances anticorrosion performance through a physical barrier mechanism that prolongs ionic diffusion pathways. UV-curable LPEA derivatives achieve an 83% reduction in curing time relative to ambient-cured lacquer, enabling integration with industrial spray-coating lines. Despite these advances, several critical limitations remain inadequately resolved. Allergen reduction strategies have not yet achieved sufficient quantitative efficiency for large-scale commercial deployment, and the long-term stability of nanocomposite lacquer films under sustained UV exposure and hydrothermal conditions is not well established. Furthermore, most high-performance modification systems reported in the literature are demonstrated only on laboratory scale, with scalability, substrate compatibility, and lifecycle performance remaining largely unvalidated. The review identifies the absence of standardized performance evaluation protocols and the fragmentation of structure–property data across studies as key barriers to systematic progress, and proposes that future work prioritize the development of integrated processing–modification–performance frameworks to guide the rational design of next-generation lacquer-based functional materials. Full article

The impact of the built environment on physical and mental health and wellbeing has been evidenced worldwide. Quality and design affect residents’ wellbeing and physical and mental health outcomes. A local authority planning team in London introduced new guidance to improve the quality of amenity space within residential developments. This paper aims to evaluate the early implementation of this guidance using Normalisation Process Theory. A qualitative design was employed using semi-structured interviews (n = 34), with a purposive sample of planning staff, applicants, review panel members and organisers and elected officials. Framework analysis was undertaken. All stakeholders perceived the introduction of the new amenity space guidance positively, but views of the planning officer training that accompanied it were more nuanced. Key factors influencing implementation included attitude towards and understanding of the new guidance, use of common language, workload, number of policy and guidance documents and a lack of a guidance template from the beginning. Further contextual barriers included the need for economic viability for developers and affordable housing in the area. To further embed and sustain implementation, it is recommended that the guidance continues to be used in a flexible manner with ongoing training and focused support for both planning officers and planning applicants. Full article

Population aging demands accessible interventions for psychological well-being in later life. This work evaluated the feasibility and acceptability of an 8-week mindful walking program in community-dwelling older adults and generated exploratory estimates of within-person change across emotional, psychosomatic, and psychological outcomes. Thirteen community-dwelling older adults participated in a pilot human trial with assessments at baseline, post-intervention, and one-month follow-up. Measures included depression, anxiety, somatic symptoms, mindfulness, mind wandering, alexithymia, quality of life, and attachment style. Primary feasibility outcomes indicated high acceptability and participant satisfaction, good physiological tolerance and full adherence. Secondary exploratory analyses suggested within-person reductions in depressive symptoms and alexithymia, while somatic symptoms decreased notably by follow-up. Mindfulness increased and was maintained over time, while mind wandering displayed a probable long-term decrease. Psychological quality of life improved and remained elevated, whereas physical, social, and environmental quality-of-life domains showed uncertain trends. Trait anxiety decreased post-intervention but returned toward baseline at follow-up, while state anxiety and attachment styles remained stable. Within pilot design limits, mindful walking may be a feasible intervention for older adults, associated with exploratory within-person patterns suggesting possible improvements in certain psychological outcomes, which should be interpreted as preliminary and descriptive signals pending confirmation in controlled trials. These preliminary findings support further investigation in controlled trials to determine effectiveness and to formally test hypothesized mechanisms. Full article

Robust perception in adverse weather conditions remains a significant challenge for autonomous vehicles. Short-wave infrared (SWIR) sensors offer specific physical properties that enable them to penetrate atmospheric disturbances like fog, rain, and snow. However, effectively combining this robustness with the textural and colour information of visible (VIS) cameras is difficult due to signal decorrelation and the limitations of static fusion schemes. To address this, we present VISWIR (Visible and SWIR Weighted Image Reconstruction), a pixel-level fusion method based on a multi-scale pyramid architecture. We introduce an automated strategy for scheduling parameters based on weather conditions using an optimisation framework. Rather than relying on static weights, our method applies offline parameter scheduling to adjust fusion hyperparameters based on the meteorological context. We focus on a multi-objective optimisation approach that maximises perceptual image quality via No-Reference Image Quality Assessment (NR-IQA) metrics. Validated in controlled environment scenarios with varying weather severities, our results confirm the potential of VISWIR as a robust, lightweight algorithmic baseline to enhance the perception capabilities of autonomous vehicles in adverse weather conditions. Full article

Background/Objectives: Work-related musculoskeletal disorders (WMSDs) and occupational stress substantially affect workforce health and productivity. This systematic review aimed to synthesize evidence regarding the effectiveness of the Pilates method as a biopsychosocial intervention for employees, examining its impact on physical, psychological, and occupational outcomes. Methods: A systematic search was conducted across major electronic databases and search engines (PubMed, Scopus, Web of Science, PEDro, and Google Scholar) following PRISMA 2020 guidelines. The review protocol was prospectively registered in PROSPERO (CRD420261390771). Eligible studies included randomized controlled trials, quasi-experimental, and observational designs involving employees participating in Pilates programs. Outcomes were categorized into three domains: physical health, mental well-being, and occupational performance. Results: Twenty-three studies (n = 1179 participants) met the inclusion criteria. The evidence indicates that Pilates may reduce pain intensity and disability in workers with chronic low back or neck pain, with moderate certainty based on randomized controlled trials. Improvements in psychological outcomes, including anxiety and job-related stress, were also reported, although the certainty of evidence was lower. Occupational benefits included enhanced job satisfaction and, in limited cases, favorable cost-utility findings. Conclusions: Pilates appears to be a feasible multidimensional intervention for workplace health, with potential benefits across physical and psychosocial domains. Further high-quality trials are needed to clarify long-term effects, economic impact, and optimal implementation strategies within occupational settings. Full article

Machine learning has become a field of growing interest in asphalt pavement engineering, spanning mix design, material characterization, performance prediction, distress detection, sustainability, quality control, and maintenance planning. However, a lack of transparency can undermine engineering trust, defensibility, and field implementation. This systematic scoping review aims to synthesize explainable artificial intelligence (XAI) and interpretable machine-learning applications for asphalt pavement materials and systems, following the PRISMA-ScR guidelines. Major scientific databases were used to identify relevant peer-reviewed studies, which were screened against a set of inclusion and exclusion criteria and categorized into seven research dimensions. A final library of 163 publications was compiled, comprising 73 core evidence studies and 90 supporting references. The review covers techniques such as SHAP, LIME, partial-dependence analysis, attention mechanisms, surrogate models, sensitivity analysis, symbolic modeling, and physically informed interpretation. The use of XAI in performance prediction, material-property interpretation, and modeling for mix design is well developed, while distress/damage analysis, life cycle sustainability, field validation, uncertainty-aware explanation, maintenance decision support, and human-centered evaluation are still relatively underdeveloped. The main contribution is a five-layer framework linking data provenance, model performance, explanation quality, physical plausibility, and decision utility. The review proposes moving from post hoc feature ranking to validated, physically centered, uncertainty-aware, and engineer-in-the-loop decision support for asphalt XAI. Full article

Background/Objectives: Depression is a mood disorder characterized by persistent sadness and loss of interest. Pharmacy students exhibit a relatively high prevalence of depressive symptoms, which may negatively impact quality of life, academic performance, and, in severe cases, lead to suicidal ideation. Given the increasing trend of medication use among young adults, we hypothesized that this behavior may be associated with depressive symptoms, potentially reflecting attempts to manage concurrent physical symptoms or reduced psychological well-being. Therefore, the objective of this study was to assess the association between depressive symptoms and medication use among pharmacy students. Methods: A cross-sectional study was conducted among students enrolled in pharmacy-related programs from University Center for Exact Sciences and Engineering (CUCEI), University of Guadalajara. Participants completed a personalized questionnaire assessing sociodemographic variables, medication use, comorbid conditions, and depressive symptoms using the Patient Health Questionnaire-9. Descriptive statistics were used to summarize participant characteristics. Categorical variables were reported as frequencies and percentages and compared using the chi-square test. Continuous variables were summarized as means and standard deviations and compared using Student t-test. To evaluate factors associated with moderate-to-severe depressive symptoms, logistic regression and multivariable linear regression analyses were performed. Results: A total of 365 students completed our personalized questionnaire; nearly half of the sample (47.3%) presented moderate-to-severe depressive symptoms. Multivariable analyses showed that insufficient sleep, academic stress, psychological support, and the number of medications used simultaneously were significantly associated with depressive symptoms. Logistic regression identified being in a relationship and receiving psychological support for at least one year as protective factors, while employment, insufficient sleep, academic stress, and a greater number of concomitant medications were associated with increased odds of moderate-to-severe depressive symptoms. Conclusions: A modest association was observed between self-reported medication use and moderate-to-severe depressive symptoms among pharmacy students. These findings suggest that medication use patterns may warrant further investigation as a potential marker of depressive symptoms in pharmacy students. Future longitudinal studies are needed to clarify the nature and direction of this association and to determine whether medication use could contribute to the identification of students at increased risk of depression. Full article

This paper presents a physics-informed Deep Q-Network (DQN) framework for optimizing the deployment of 100 vortex bladeless turbines (VBTs) in a Saharan microgrid. The proposed approach integrates wake interaction modeling, land-use constraints, techno-economic factors, and power quality (PQ) indicators at the point of common coupling. The novelty lies in coupling aerodynamic modeling with reinforcement learning and grid constraints. Results show that dense layouts (≤400 m²) yield up to 41% gains but degrade PQ (Pst > 1.0, THD > 5%). An optimal range of 500–800 m² achieves stable performance with moderate gains (6–9%) and acceptable PQ. Larger surfaces (>1000 m²) show limited benefits (<4%). The framework supports efficient and sustainable wind deployment in constrained environments. Full article

Background/Objectives: Major Depressive Disorder (MDD) is a leading cause of disability, yet physical therapy (PT) is underrepresented in hospital-based psychiatric care. While exercise is a known adjunctive treatment, specific evidence on functional, task-oriented interventions in acute settings remains scarce. This study explored changes in quality of life, depressive symptoms, pain, and self-efficacy in patients with MDD following a specialized hospital-based PT program focused on functional movement and autonomy. Methods: We conducted a prospective pre–post case series in the Short-Stay Psychiatric Unit of the Royo Villanova University Hospital (Zaragoza, Spain). We recruited seven adult patients with MDD via convenience sampling. The intervention consisted of a group-based PT program (two 45 min sessions/week during the hospital stay) utilizing task-oriented functional exercises targeting progressive strength, balance, and motor control designed to enhance self-efficacy through activities of daily living (ADLs), combined with health education. Outcomes included the EQ-5D-3L (quality of life), MADRS (depression), NRS (pain), GSE (self-efficacy), and GCPC-UN-ESU (satisfaction). Results: All seven participants (100%) exhibited a positive upward trend in self-perceived health status via the EQ-VAS (mean increase of 35 points). Six cases (85.7%) showed preliminary positive trends in the anxiety/depression dimension of the EQ-5D-3L, with the mean Single Index Value increasing from 0.310 to 0.683. Reductions in depressive symptom severity were observed in six participants, with several transitioning toward moderate or mild levels. Additionally, four patients reported descriptive reductions in pain intensity and showed favorable shifts in self-efficacy scores. Six participants expressed high satisfaction with the intervention. Conclusions: Integrating a hospital-based functional PT program with standard care may offer preliminary benefits for quality of life and reduce depressive symptoms in MDD patients. These findings suggest that task-oriented PT presents a feasible complementary approach for acute psychiatric admissions, although larger controlled trials are needed to confirm these exploratory results. Full article

Background: Nutritional deterioration and systemic inflammation are prevalent in cancer patients undergoing chemotherapy and may independently impair health-related quality of life (QoL). Yet their simultaneous, domain-specific contributions to QoL remain poorly characterized, particularly in Middle Eastern populations. Methods: This cross-sectional study included adult cancer patients receiving chemotherapy. Medical records were used to collect clinical and laboratory data. Structured interviews were conducted to assess nutritional status using the Malnutrition Universal Screening Tool (MUST) and quality of life using the EORTC QLQ-C30 questionnaire. The NLR was calculated as an indicator of systemic inflammation. Multiple linear regression models, adjusted for age, sex, cancer site, stage, and treatment cycle, were used to examine independent associations with QoL domains. Results: Nearly 60% of patients were at a medium-to-high malnutrition risk and 27.1% exhibited high systemic inflammation (NLR > 3). The NLR was significantly associated with greater dyspnea (B = 28.4, p = 0.001), and the MUST was significantly associated with greater appetite loss (B = 17.0, p = 0.001). Additional significant associations included the NLR with poorer physical functioning (p = 0.009) and role functioning (p = 0.012), and the MUST with nausea and vomiting (p = 0.039). In the multivariate analysis, the NLR showed a statistically significant overall effect on the QoL profile (p = 0.007), while the MUST did not (p = 0.281), consistent with its more domain-specific pattern. Conclusions: This cross-sectional study suggests that systemic inflammation and nutritional risk are associated with domain-specific quality of life among cancer patients receiving chemotherapy. The NLR and MUST may represent accessible, complementary indicators of patient vulnerability and supportive care needs. Prospective multi-center studies are warranted to validate these associations and determine their clinical utility in supportive oncology practice. Full article

Haze commonly degrades visible-spectrum remote sensing (RS) images by reducing contrast and distorting colors. Existing RS dehazing methods still face two limitations. Prior-driven methods rely on handcrafted assumptions that may become unreliable in complex wide-area scenes without explicit sky regions. Learning-based methods require paired training data, yet real aligned hazy/haze-free RS image pairs are difficult to collect, which limits their real-world generalization. To address these limitations, we propose a method called Remote Sensing Image Dehazing via RGB-Space Physical Constraints (RDPC). The new method revisits the atmospheric scattering model (ASM) from the perspective of RS imaging and builds the restoration process on several physical properties of hazy image formation. For atmospheric light estimation, the RGB-space line-convergence behavior of local regions with similar reflectance and slight depth variations is exploited, allowing atmospheric light to be estimated without explicit sky areas. For transmission estimation, the geometric relation between observed pixels and atmospheric light is used in RGB space, where local perpendicularity provides physically plausible haze-removal guidance and global compensation helps avoid excessive darkening and color degradation. The estimated transmission and albedo guidance are further refined by enforcing ASM consistency and variation sparsity through joint optimization. Experiments on synthetic and real-world RS image dehazing benchmarks demonstrate that RDPC achieves competitive performance against representative prior-based and learning-based methods, including Image Dehazing and Exposure (IDE), Iterative Predictor-Critic (IPC), Curvature-to-Plane Prior (C2P), Adaptive Structure-Texture Awareness (ASTA), Asymmetric U-Net (AU-Net), Efficient Multi-scale Prior Fusion (EMPF), and Lightweight Feature Dehazing (LFD), in terms of peak signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), learned perceptual image patch similarity (LPIPS), Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE), neural image assessment (NIMA), and processing time. Full article

Genetic cardiomyopathies (GCMs) are chronic heart muscle disorders requiring lifelong monitoring and treatment. Although quality of life (QoL) and health-related quality of life (HRQoL) are increasingly recognized as important outcomes in cardiomyopathy care, their conceptualization and measurement remain inconsistent. This scoping review aims to (a) identify the tools most commonly used to assess QoL and HRQoL in adults with genetic cardiomyopathies and (b) map the thematic areas of existing studies, including symptom burden, psychological distress, diagnostic challenges, and the impact of medical and psychological interventions. PubMed, Scopus, and PsycINFO were systematically searched, and the final search was completed in November 2025. Seventeen peer-reviewed studies met the inclusion criteria and were included in this scoping review. The review followed the PRISMA extension for Scoping Reviews and included both quantitative, qualitative and mixed-methods designs. Most studies employed standardized tools such as EQ-5D (N = 5), SF-36/SF36v2 (N = 5), and the Kansas City Cardiomyopathy Questionnaire (N = 3), while others included the Minnesota Living with Heart Failure Questionnaire (N = 2) and disease-specific or ad hoc measures. The most frequently investigated themes included impairments in physical functioning, emotional well-being, symptom burden, psychological distress, and social participation. Several studies showed that patients’ perceived QoL was more closely associated with symptom burden and psychological adjustment than with objective clinical indicators alone. Clinical interventions showed mixed or limited effects on QoL and HRQoL outcomes, even when clinical parameters improved. Qualitative research further emphasized the lived experiences of patients and families, highlighting unmet needs in care. Less commonly addressed findings concerned caregiver perspectives, patient–provider communication, treatment adherence, socioeconomic disadvantage, healthcare costs, productivity loss, and the experiences of patients with rarer cardiomyopathy-related conditions. The results highlight how QoL and HRQoL are central but still inconsistently assessed outcomes in cardiomyopathy research. This review calls for greater conceptual clarity between QoL and HRQoL, greater standardization in measurement tools, broader inclusion of psychosocial variables, and more patient-centred research approaches to better support individuals living with cardiomyopathies. Full article

Background: Menopause represents a critical physiological transition associated with hormonal changes that influence both metabolic health and quality of life (QoL). Metabolic dysfunction-associated steatotic liver disease (MASLD), a common metabolic condition, is closely linked to menopause; however, its independent contribution to QoL impairment remains unclear. This study aimed to investigate the interplay between menopausal status, metabolic dysfunction, MASLD, and QoL in midlife women. Methods: A cross-sectional observational study was conducted including 80 women aged 45–55 years, comprising both premenopausal and menopausal participants. Clinical, anthropometric, biochemical, and imaging data were collected. MASLD was diagnosed using magnetic resonance imaging in the presence of metabolic dysfunction. Metabolic assessment included glucose, insulin, liver enzymes, C-reactive protein, and indices of insulin resistance (HOMA-IR) and sensitivity (QUICKI). QoL was evaluated using the Utian Quality of Life (UQOL) scale. Associations were examined using univariate and multivariable linear regression models. Results: MASLD prevalence was significantly higher in menopausal women compared with non-menopausal women (61.9% vs. 15.8%, p < 0.001). Metabolic parameters, particularly insulin resistance and body mass index, were strongly associated with MASLD. The mean total UQOL score indicated moderate QoL. In multivariable analysis, menopausal status was the only independent predictor of reduced total QoL (b = −4.93, p = 0.01) and occupational health domain (b = −4.60, p = 0.001). MASLD and metabolic parameters were not independently associated with overall QoL. Correlation analyses revealed modest associations between metabolic markers and specific QoL domains, particularly occupational and physical health. Conclusions: Menopause is the primary determinant of reduced QoL in midlife women, particularly affecting functional domains, while MASLD does not independently impact QoL despite its strong association with metabolic dysfunction. These findings suggest that menopausal status may play a more prominent role in quality-of-life outcomes than MASLD in women undergoing the menopausal transition. However, the cross-sectional design does not allow conclusions regarding causal or mechanistic relationships. Full article

Remote sensing change detection (RSCD) aims to produce pixel-accurate change maps from bi-temporal images yet is fundamentally challenged by radiometric pseudo-changes (season, illumination, and atmosphere) that cause structure–environment entanglement in deep features. We propose CSD-Net, a framework centered on content–style decoupling (CSD): a physics-inspired feature decomposition mechanism that encourages separation between intrinsic geometric content and extrinsic environmental style. In the CSD module, learnable pseudo-change tokens estimate a spatially invariant global style proxy through cross-attention and broadcast, and subtraction performs feature-level radiometric-bias compensation, yielding pseudo-change-robust content features for change prediction. CSD-Net (Base) alone achieves state-of-the-art performance across four benchmarks (LEVIR-CD, LEVIR-CD+, CDD, and WHU) with favorable accuracy–efficiency trade-off (14.49M parameters and 15.26G FLOPs). We further explore an optional extension, CSD-Net⁺, that employs an MLLM (Qwen2.5-3B, LoRA-tuned) as a semantic refiner and SAM for instance mask refinement, coupled with uncertainty-aware three-way softmax fusion. This exploratory Stage 2 brings modest but consistent IoU improvements of 0.45–2.20% at the cost of significant computational overhead and is designed for offline, quality-critical scenarios. We provide a comprehensive account of both the effectiveness and the limitations of the proposed approach, including the marginal benefit–cost ratio of foundation model integration. Full article