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11 pages, 680 KB  
Proceeding Paper
Development and Evaluation of a Portable Sliding Sand Sieve for Construction and Civil Technology Laboratory Application
by Roy Vincent Perang, John Estillore, Maher Shalal Hash Baz Usa, Razen Purtado and Oliver Bernal
Eng. Proc. 2026, 143(1), 19; https://doi.org/10.3390/engproc2026143019 - 15 Jun 2026
Viewed by 156
Abstract
The study introduces a portable sliding sand sieve, transforming traditional stationary systems into an innovative solution for sand separation in the construction industry. This innovative tool offers improved mobility, durability, and operational efficiency, particularly for construction workers, civil technology students, and educators in [...] Read more.
The study introduces a portable sliding sand sieve, transforming traditional stationary systems into an innovative solution for sand separation in the construction industry. This innovative tool offers improved mobility, durability, and operational efficiency, particularly for construction workers, civil technology students, and educators in areas with limited access to advanced equipment. Utilizing a developmental research design, the study involved the conceptualization, fabrication, and evaluation of the prototype. The design incorporated locally available materials, including phenolic boards, mesh screens, steel tubing, and a sliding mechanism supported by bearings and brackets. The Input–Process–Output (IPO) model guided the development, ensuring focus on functionality, affordability, and user safety. To address this gap, the researchers aimed to design, develop, and evaluate a portable sliding sand sieve to enhance sand sieving in construction settings. Expert and student evaluators highly rated the portable sliding sand sieve for its design simplicity, functionality, durability, modularity, and ergonomics. It was praised for its ease of use, time-saving capability, and adaptability to various work environments. The sliding feature enabled continuous sand flow, enhancing productivity and reducing physical strain. Full article
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30 pages, 462 KB  
Article
Anti-Judaism and Typological Exegesis in Cyril of Alexandria’s Commentary on the Gospel of John
by Martin Micallef
Religions 2026, 17(6), 666; https://doi.org/10.3390/rel17060666 - 2 Jun 2026
Viewed by 471
Abstract
The biblical commentaries of Cyril of Alexandria (c. 376–444) represent a major contribution to the development of patristic exegesis. His Commentary on the Gospel of John demonstrates the close interaction between Christological theology, allegorical interpretation, and ecclesial polemic within late antique biblical interpretation. [...] Read more.
The biblical commentaries of Cyril of Alexandria (c. 376–444) represent a major contribution to the development of patristic exegesis. His Commentary on the Gospel of John demonstrates the close interaction between Christological theology, allegorical interpretation, and ecclesial polemic within late antique biblical interpretation. While Cyril’s exegesis has often been praised for its theological sophistication, modern scholarship increasingly recognizes that his interpretive framework also contains a pronounced anti-Judaic dimension. This study examines several key passages from Cyril’s Commentary on the Gospel of John in order to analyse how typology, supersessionist theology, and polemical rhetoric function together in his interpretation. Particular attention is given to Cyril’s portrayal of Jewish ignorance, his attribution of responsibility for the death of Christ, and his typological reinterpretation of Jewish law and history. The analysis demonstrates that Cyril integrates anti-Jewish rhetoric into a broader theological system in which the Mosaic law is presented as a provisional anticipation fulfilled in Christ and realized in the Christian Church. Full article
(This article belongs to the Special Issue Contemporary Johannine Scholarship: Texts, Contexts, and Trajectories)
33 pages, 588 KB  
Article
Shandao’s Construction and Innovation of the Pure Land Doctrinal System: A Study Centred on the Commentary on the Contemplation Sūtra
by Xiao Lin
Religions 2026, 17(6), 648; https://doi.org/10.3390/rel17060648 - 27 May 2026
Viewed by 264
Abstract
As a pivotal patriarch of the Pure Land school, Shandao 善導 (613–681) played a decisive role in shaping Pure Land Buddhism and the broader history of Chinese Buddhism. A direct disciple of Daochuo 道綽 (563–645), he championed the dual framework of Dingshan 定善 [...] Read more.
As a pivotal patriarch of the Pure Land school, Shandao 善導 (613–681) played a decisive role in shaping Pure Land Buddhism and the broader history of Chinese Buddhism. A direct disciple of Daochuo 道綽 (563–645), he championed the dual framework of Dingshan 定善 and Sanshan 散善 practices together with Nianfo 念佛 (Skt. buddhānusmṛti), especially Chiming nianfo 持名念佛 (vocal recitation of Amitābha’s name). Existing scholarship has already demonstrated that Shandao was not a master concerned exclusively with vocal recitation but also a systematic exegete of Guanfo 觀佛, visualisation, and samādhi. This article therefore does not present that recognition as its own innovation. Instead, it reconstructs the internal architecture by which Shandao’s Guanjing si tie shu 觀經四帖疏 (Commentary on the Contemplation Sūtra in Four Fascicles) integrates contemplative practice with three doctrinal commitments: the efficacy of ‘birth through ten recitations’ against the Yogācāra charge of Bieshi yi 別時意 (Skt. kālāntarābhiprāya, the identification of Amitābha’s land as a reward land, and the thesis that ordinary beings (Skt. pṛthagjana) may enter that land. Drawing also on the Guannian Amituo fo xianghai sanmei gongde famen 觀念阿彌陀佛相海三昧功德法門 (Method of Contemplating Amitābha Buddha’s Ocean-like Marks in Samādhi and Its Meritorious Virtues) and the Wangsheng lizan 往生禮讚 (Liturgy of Praise for Birth in the Pure Land), the article argues that Shandao’s originality lies less in any single doctrine than in the way these doctrines mutually support one another as a coherent programme of exegesis, practice, and Pure Land soteriology. Full article
12 pages, 448 KB  
Article
Parity-Based Level-Set Approach to the Collatz Conjecture
by Selcuk Koyuncu, Thevasha Sathiyakumar, Praise Alayode, Christopher Ellis and Peyton Thomas
Mathematics 2026, 14(10), 1763; https://doi.org/10.3390/math14101763 - 20 May 2026
Viewed by 259
Abstract
The Collatz conjecture concerns the iteration of the map f(n)=3n+1 for odd n and f(n)=n/2 for even n. In this paper, we study the level sets [...] Read more.
The Collatz conjecture concerns the iteration of the map f(n)=3n+1 for odd n and f(n)=n/2 for even n. In this paper, we study the level sets lx={nNL(n)=x}, where L(n) denotes the Collatz length. Using the parity representation of Collatz trajectories, we partition each lx according to the number of odd steps and analyze the corresponding means μx,k. Under a natural scaling assumption, these means satisfy an approximate geometric progression, so that logμx,k is approximately linear in k. Computations for n100,000 and 10x50 show highly stable regression parameters and near-perfect linear fits. Full article
(This article belongs to the Section E: Applied Mathematics)
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19 pages, 2714 KB  
Article
Social Marketing to Enhance Community Empowerment and Ownership for a Successful Implementation of the “Big Catch-Up” in Togo in 2025: A Mixed-Methods Study
by Soliou Badarou, Aimé Serge Dali, Kokou Herbert Gounon, Lorraine Shamalla-Hannah, Amevegbe Kodjo Boko, Xavier Richard Sire and Erinna Corinne Dia
Vaccines 2026, 14(5), 447; https://doi.org/10.3390/vaccines14050447 - 18 May 2026
Viewed by 289
Abstract
Introduction: The COVID-19 pandemic disrupted immunization services in Togo, resulting in 69,672 “zero-dose” and 24,846 “under-vaccinated” children by the end of 2023. This study assessed the effectiveness, acceptability, and feasibility of a social marketing approach deployed during the 2025 Big Catch-Up initiative in [...] Read more.
Introduction: The COVID-19 pandemic disrupted immunization services in Togo, resulting in 69,672 “zero-dose” and 24,846 “under-vaccinated” children by the end of 2023. This study assessed the effectiveness, acceptability, and feasibility of a social marketing approach deployed during the 2025 Big Catch-Up initiative in Togo. Methods: A convergent mixed-methods study was conducted in 17 priority health districts. The quantitative component compared vaccination coverage before and after the intervention using administrative data. Chi-squared test for linear trend compared district-level coverages, and statistical significance was set at p < 0.05 for all tests. The qualitative component used in-depth interviews with key informants to collect data, followed by thematic content analysis. The intervention was grounded on the social marketing framework with 4 pillars (4Ps): Product, Price, Place, and Promotion. Results: Coverage increased dramatically: Penta1 from 1% to 64%, Penta3 from 1% to 45%, MR1 from 4% to 50%, and MR2 from 6% to 49% (all p < 0.001). Togo ranked 3rd out of 24 African countries for Penta1 progress. The approach demonstrated high community acceptability, with Vaccination Monitoring Committees praised as being culturally appropriate. Key concerns included sustainability and resource constraints. Conclusions: Social marketing was associated with increased community adherence and immunization coverage improvement. However, long-term sustainability requires the institutionalization of community structures with domestic funding and continued health system strengthening. Full article
(This article belongs to the Section Epidemiology and Vaccination)
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26 pages, 11633 KB  
Article
From Sacred Voice to Wearable Form: Material Translation and the Kalavinka as Jewelry in the Song–Liao World
by Yunxin Xia
Religions 2026, 17(5), 572; https://doi.org/10.3390/rel17050572 - 10 May 2026
Viewed by 411
Abstract
This article examines the transcultural and transmedial transformation of the kalavinka motif along the Silk Road, situating its development within the interpretive framework of the Indian kinnara/kinnarītradition. It asks how a figure associated with wondrous sound and devotional praise in Buddhist cosmology came [...] Read more.
This article examines the transcultural and transmedial transformation of the kalavinka motif along the Silk Road, situating its development within the interpretive framework of the Indian kinnara/kinnarītradition. It asks how a figure associated with wondrous sound and devotional praise in Buddhist cosmology came to function as a wearable ornament without losing its religious identity. Through close formal analysis of Dunhuang murals from the Tang period (618–907 CE), the study identifies three interrelated visual processes that prepared the motif for mobility across media: the fusion of gendered pairs into an androgynous form, the progressive elongation and ornamental stylization of the tail, and the reorientation of bodily pose into compact, suspension-friendly configurations. These mechanisms are then examined in relation to eleventh-century painted and excavated materials, including donor adornment in Western Thousand Buddha Cave 16, a Khara Khoto scroll, a Liao (916–1125 CE) gold kalavinka earring, and a Western Xia linked-pearl headdress. Comparative visual and material analysis shows that kalavinka imagery circulated in parallel across mural, painted, and metal media, where scale, material, and bodily placement re-coded rather than erased its sacred associations. The study argues that this process is best understood as material translation, and it proposes a model for linking formal change, sensory affordance, and religious function in the arts of the Silk Road. Full article
(This article belongs to the Special Issue Buddhist Art Along the Silk Road and Its Cross-Cultural Interaction)
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11 pages, 286 KB  
Article
Arguing Against Death in Biblical Prayer
by Jonathan Yogev
Religions 2026, 17(5), 553; https://doi.org/10.3390/rel17050553 - 3 May 2026
Viewed by 428
Abstract
This article examines a recurring rhetorical strategy in biblical prayer in which the supplicant argues against death by presenting it as a loss not only for the self, but also for God. In several texts, the plea for deliverance is grounded in the [...] Read more.
This article examines a recurring rhetorical strategy in biblical prayer in which the supplicant argues against death by presenting it as a loss not only for the self, but also for God. In several texts, the plea for deliverance is grounded in the claim that the dead in Sheol can no longer praise, thank, remember, or call upon God. Death thus becomes rhetorically unacceptable not merely because it ends life, but because it silences worship. The study distinguishes between two biblical conceptions of the dead: one in which the dead retain awareness and communicative capacity, and another in which they are silent, cognitively diminished, and cut off from divine worship. It argues that the latter conception underlies a specific persuasive logic in prayers uttered under mortal threat. Through close readings of Isaiah 38, Psalms 6, 30, 88, and 115, the article shows that this argument functions as a recurring theological and rhetorical strategy within biblical prayer. Full article
27 pages, 1337 KB  
Article
Does Support in Organizations Inhibit Power Harassment? An Analysis Based on Self-Esteem and Types of Narcissism
by Ryoichi Semba
Soc. Sci. 2026, 15(4), 268; https://doi.org/10.3390/socsci15040268 - 20 Apr 2026
Viewed by 374
Abstract
In contemporary Japanese workplaces, interpersonal relationship problems have become increasingly serious, leading to heightened psychological stress and declining organizational functioning. One major contributing factor is power harassment (workplace bullying). This study surveyed 1621 Japanese workers to examine how support from supervisors and organizations [...] Read more.
In contemporary Japanese workplaces, interpersonal relationship problems have become increasingly serious, leading to heightened psychological stress and declining organizational functioning. One major contributing factor is power harassment (workplace bullying). This study surveyed 1621 Japanese workers to examine how support from supervisors and organizations influences power harassment, with particular attention to differences in self-esteem levels and narcissistic types. Hierarchical multiple regression analyses revealed that among individuals with high self-esteem, supervisor support tended to reduce power harassment in those characterized by the Need for Attention and Praise type, whereas organizational support tended to increase it. Additionally, for those classified as the Sense of Superiority and Competence type, the interaction between ego threat and both types of support showed a tendency to exacerbate power harassment. For individuals with low self-esteem, the interaction between ego threat and both types of support similarly tended to intensify power harassment in the Need for Attention and Praise type. These results suggest that the effects of support are not uniform; rather, they may inhibit or facilitate power harassment depending on individual psychological traits. Therefore, tailoring the method, timing, and source of support to workers’ psychological characteristics is essential for both preventing power harassment and promoting psychological adaptation. Full article
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22 pages, 5430 KB  
Article
A VVC Intra-Coding Acceleration Method Combining CNN Prediction and Adaptive Pruning
by Xiao Shi, Pinhan Lin and Geng Wei
Electronics 2026, 15(8), 1746; https://doi.org/10.3390/electronics15081746 - 20 Apr 2026
Cited by 1 | Viewed by 467
Abstract
The latest H266/VVC standard has received numerous praises for its excellent compression efficiency. However, its extremely high computational complexity has become a hindrance to the VVC adaptation industry ecosystem, while also increasing the difficulty of hardware design and application costs. To address this [...] Read more.
The latest H266/VVC standard has received numerous praises for its excellent compression efficiency. However, its extremely high computational complexity has become a hindrance to the VVC adaptation industry ecosystem, while also increasing the difficulty of hardware design and application costs. To address this issue, we designed an efficient intra-coding scheme based on neural networks, which consists of three parts: Firstly, we designed a neural network-based reverse prediction algorithm that uniquely utilizes the CNN’s prediction results for lower-level blocks to determine the QTMT partitioning of upper-level blocks, cleverly solving the adaptation problem of existing models to complex VVC partitioning patterns—a decision-making logic that has not been fully explored. Secondly, we designed a pruning algorithm, which is the first to dynamically couple the real-time RDO cost of BT segmentation with the TT segmentation direction, achieving adaptive decision-making. Finally, we designed a complexity pre-screening module. On the basis of analyzing whether the CU texture is smooth, this module designs four sets of adaptive thresholds for non-square CUs introduced in VVC. These thresholds can dynamically adjust local and global thresholds based on CU size, enabling size sensitive texture evaluation to determine whether the current block needs further partitioning. The experimental results show that, compared with traditional VTM4.0, our method reduces the average encoding time by 49.21%, while the BD-BR increase is 1.61%, and the BD-PSNR decreases by 0.06 dB, fully demonstrating its superiority and performance balance. Full article
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21 pages, 780 KB  
Article
When Support Backfires: Narcissistic Self-Regulatory Strategies, Ego Threat, and Workplace Aggression
by Ryoichi Semba
Behav. Sci. 2026, 16(4), 552; https://doi.org/10.3390/bs16040552 - 7 Apr 2026
Viewed by 435
Abstract
Although ego threat is known to influence workers’ aggressive behavior, little is understood about how support and narcissism shape this relationship. Accordingly, the present study conceptualized narcissistic traits as distinct self-regulatory strategies for maintaining self-worth and examined whether the meaning of support under [...] Read more.
Although ego threat is known to influence workers’ aggressive behavior, little is understood about how support and narcissism shape this relationship. Accordingly, the present study conceptualized narcissistic traits as distinct self-regulatory strategies for maintaining self-worth and examined whether the meaning of support under ego threat varies depending on these traits. An online survey was conducted with 1621 Japanese workers, and the participants were classified into three types—Self-Assertion, Need for Attention and Praise, and Sense of Superiority and Competence—based on the highest scores on the three factors of the Narcissistic Personality Inventory Short version. Hierarchical multiple regression analyses were then conducted separately for each type. The results showed that the behavioral consequences of ego threat varied substantially across narcissistic types and that support did not uniformly suppress power harassment. For the Self-Assertion type, perceived organizational support was positively associated with Invasion of Privacy. For the Need for Attention and Praise type, men and managers tended to choose Excessive Demands. For the Sense of Superiority and Competence type, supervisor support reduced harassment; however, under strong ego-threatening conditions, such support paradoxically amplified harassment. These findings suggest that support functions as a socially meaningful cue whose interpretation depends on narcissistic self-regulatory strategies. Full article
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25 pages, 7617 KB  
Article
Physically Validated Rainfall Thresholds for Roadside Landslides Using SMAP Soil Moisture and Antecedent Rainfall Models
by Suresh Neupane, Netra Prakash Bhandary and Dericks Praise Shukla
Geosciences 2026, 16(4), 150; https://doi.org/10.3390/geosciences16040150 - 7 Apr 2026
Viewed by 815
Abstract
Rain-induced shallow landslides persistently disrupt Nepal’s mountain roads, frequently leading to fatalities, transport disruptions, and economic losses. This study develops physically validated, site-specific rainfall thresholds for the landslide-prone Kanti National Roadway (H37) by integrating empirical intensity–duration (I-D) analysis, antecedent rainfall metrics, and satellite-derived [...] Read more.
Rain-induced shallow landslides persistently disrupt Nepal’s mountain roads, frequently leading to fatalities, transport disruptions, and economic losses. This study develops physically validated, site-specific rainfall thresholds for the landslide-prone Kanti National Roadway (H37) by integrating empirical intensity–duration (I-D) analysis, antecedent rainfall metrics, and satellite-derived soil moisture data. Using 35 years of rainfall records (1990–2024) and 59 field-verified landslides (2017–2024), we derived a localized I-D threshold: I = 19.37 × D−0.6215 (I: rainfall intensity in mm/h; D: duration in hours), effective for durations of 48–308 h, encompassing short intense storms and prolonged moderate rainfall. The Cumulative Antecedent Rainfall (CAR) method associated most failures with 3-day totals, while the Antecedent Precipitation Index (API) showed superior performance, with a 10-day threshold of 77 mm capturing all events. For physical validation, NASA’s SMAP Level-4 root-zone (0–100 cm) soil moisture data revealed a 1-day lag in response to rainfall; after adjustment, trends matched API saturation predictions and identified an inverse rainfall–moisture pattern before the 11 August 2019 landslide, indicating a potential instability precursor. This integration enhances predictive accuracy, bolsters mechanistic understanding of landslide hazards, and offers a scalable, cost-effective early-warning framework for data-scarce mountain regions, aiding climate-resilient infrastructure in regions with intensifying rainfall extremes. Full article
(This article belongs to the Section Natural Hazards)
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5 pages, 161 KB  
Editorial
Bearing Witness from Pentecost to the Eschaton: Introduction to “Multilingualism in Religious Musical Practice”
by Jeremy Perigo
Religions 2026, 17(4), 456; https://doi.org/10.3390/rel17040456 - 7 Apr 2026
Viewed by 683
Abstract
Through the Holy Spirit’s orchestration at Pentecost, the Church’s first public voice was multilingual praise [...] Full article
(This article belongs to the Special Issue Multilingualism in Religious Musical Practice)
24 pages, 7143 KB  
Article
Spectroscopic Insights into Nanodiamond–Doxorubicin Interactions in Drug Delivery Systems for Potential Cancer Treatment: “What Is Essential Is Invisible to the Eye”
by Danica Jović, Branislav Jović, Ivana Borišev, Višnja Bogdanović and Aleksandar Djordjevic
Pharmaceutics 2026, 18(4), 438; https://doi.org/10.3390/pharmaceutics18040438 - 1 Apr 2026
Cited by 1 | Viewed by 1235
Abstract
Background/Objectives: Non-covalent nanocarrier-based systems have become a promising platform as they offer a strategy to improve the efficacy-safety profile of doxorubicin (DOX) without altering its chemical structure. Praised for biocompatibility and rich surface chemistry, nanodiamonds (NDs) have launched as nanocarriers of choice [...] Read more.
Background/Objectives: Non-covalent nanocarrier-based systems have become a promising platform as they offer a strategy to improve the efficacy-safety profile of doxorubicin (DOX) without altering its chemical structure. Praised for biocompatibility and rich surface chemistry, nanodiamonds (NDs) have launched as nanocarriers of choice for advanced cancer therapy. By investigating DOX-ND physicochemical interactions, this work advances the structural understanding of a non-covalent potential anticancer system, which has not been quantitatively experimentally explored so far. Methods: To our knowledge, this is among the first studies combining ultraviolet–visible (UV–VIS) spectroscopy with spectral deconvolution to reveal the redistribution of different DOX species in the presence of NDs. Centrifugation-assisted analysis enabled differentiation between hypothetical labile and stable ND/DOX fractions. Adsorption kinetics was studied, and dynamic light scattering (DLS) measured particle size and zeta potential. In vitro screening was performed in non-malignant fibroblasts (MRC-5) and malignant melanoma (HS294T), glioblastoma (U251), and breast cancer (MCF-7) cells to evaluate ND/DOX combinations. Results: Centrifugation analysis revealed heterogeneous ND-DOX binding. Kinetic experiments showed fast multi-stage adsorption kinetics, best described by a bi-exponential decay function and the Weber–Morris model. DLS suggested stable systems with a particle size within 10–80 nm, predominantly around 20 nm, and positive zeta potential. Comparative in vitro screening demonstrated differential cellular responses across cell types, highlighting the relevance of ND/DOX interactions. Conclusions: The findings contribute to elucidating ND-DOX interactions relevant for the design and optimization of drug delivery systems, emphasizing the importance of spectroscopic insights for the design of nanodiamond-based drug delivery systems. Full article
(This article belongs to the Special Issue Carbon-Based Nanomaterials for Pharmaceutical Applications)
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21 pages, 340 KB  
Article
(Doing) Computational History: The Role of Data Work in Computational Approaches
by Sarah A. Lang
Histories 2026, 6(2), 26; https://doi.org/10.3390/histories6020026 - 27 Mar 2026
Viewed by 1543
Abstract
Computational methods have become increasingly prominent within the historical sciences, generating significant enthusiasm among some scholars. Yet their practical demands, epistemic limits, and ethical implications are less often critically examined than praised. This article explores what it means to do computational history today, [...] Read more.
Computational methods have become increasingly prominent within the historical sciences, generating significant enthusiasm among some scholars. Yet their practical demands, epistemic limits, and ethical implications are less often critically examined than praised. This article explores what it means to do computational history today, arguing that it is not primarily defined by algorithms but by datasets. It is methodologically specific, resource-intensive, selective in scope, labour-heavy, and dependent on pre-digitised sources, specialised infrastructure, and interdisciplinary collaboration. These dependencies limit the scope of research questions and can produce narrow outcomes despite substantial effort, lending some validity to the concern over whether the field yields sufficient historiographical return for the labour invested. Corpus construction and data work lie at the epistemic core of computational history. These often undervalued tasks are not merely technical precursors to analysis, but interpretive and epistemic acts. Data are shaped by digitisation politics, historical bias, and institutional power. They shape the questions asked, the answers produced, and the legitimacy of findings. Recognising and valuing data work is essential, both to embed critical perspectives into computational humanities and to counteract the privileging of certain forms of labour over others. Due to the association of quantification with rigour and scholarly prowess, algorithmic work receives more credit, creating a two-tier system in this division of labour in which those who develop algorithms are elevated above those who curate data, despite their symbiotic interdependence. Computational history, when done well, requires deep engagement with our sources, be they historical or data. For computational history to stabilise as a meaningful discipline, it must prioritise building better datasets over pursuing increasingly complex algorithms on an unstable basis of data. Full article
(This article belongs to the Section Digital and Computational History)
12 pages, 932 KB  
Article
Pilot and Feasibility Study of an Individualized Telehealth Exercise Program for People with Cystic Fibrosis
by Jordan Saag, Jonathan Bergeron, Julianna Bailey, Kathryn Monroe, Heather Hathorne, George M. Solomon, John D. Lowman, Surya P. Bhatt, Bryan Garcia and Stefanie Krick
J. Funct. Morphol. Kinesiol. 2026, 11(2), 136; https://doi.org/10.3390/jfmk11020136 - 26 Mar 2026
Viewed by 630
Abstract
Background: The Cystic Fibrosis Foundation (CFF) recognizes exercise as a critical part of managing cystic fibrosis (CF). This becomes even more important in the era of highly effective modulator therapy (HEMT) due to many people with cystic fibrosis (pwCF) having decreased symptom [...] Read more.
Background: The Cystic Fibrosis Foundation (CFF) recognizes exercise as a critical part of managing cystic fibrosis (CF). This becomes even more important in the era of highly effective modulator therapy (HEMT) due to many people with cystic fibrosis (pwCF) having decreased symptom burden and a newfound ability to tolerate exercise better. Our single-center pilot study was designed to assess the implementation of a remotely delivered, individualized, and comprehensive exercise program for pwCF. We aimed to determine the feasibility, safety and acceptance of this intervention. Methods: PwCF ≥ 18 years old were recruited and consented at the University of Alabama in Birmingham in 2022 and 2023. Basic fitness was assessed for each participant, and an individualized exercise prescription was prepared for each participant, who was expected to exercise three times weekly on a remote basis with the exercise physiologist for 12 consecutive weeks. Subjects were reassessed at 4 and 7 months for post-exercise evaluation. Patient demographics and clinical parameters, including exacerbation rate, FEV1 percent predicted, 6-min walk test (6MWT), and modified shuttle test (MST) were collected. Questionnaire data from the CFQ-R, PRAISE, and IPAQ were also recorded. The study was registered with ClinicalTrials.gov (NCT04680403) and was submitted on 17 December 2020. Results: Our goal was to enroll 12 participants over the 2-year study period. We were able to recruit nine people for the study, with four participants finishing the program. From the 36 sessions offered over the 12-week program, participants completed an average of 15 sessions. Clinical outcome data was observed, including lung function and exacerbation frequency, but not statistically analyzed due to the small sample size. Conclusions: Implementation of an individualized telehealth-based exercise program for pwCF was well received by participants, safe, and appreciated by the participants. Recruitment and adherence were challenging, which was partially due to the ongoing pandemic. Follow-up studies are needed to assess whether improvements in reducing the amount or supervision of weekly exercise sessions and/or extending the total time might help with adherence. Full article
(This article belongs to the Section Physical Exercise for Health Promotion)
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