Search Results (15,349)

Background: Autologous bone graft is widely used for lumbar interbody fusion but may increase operative time and donor-site morbidity. Gene-activated grafts combining an osteoconductive scaffold with pro-angiogenic signaling may provide comparable fusion without graft harvesting. The aim of this paper is to compare radiographic fusion and health-related quality of life after single-level transforaminal lumbar interbody fusion (TLIF) using a gene-activated octacalcium phosphate graft containing plasmid DNA encoding vascular endothelial growth factor (OCP/VEGF) versus an autologous bone graft. Methods: 200 adults undergoing first-time single-level TLIF for degenerative lumbar stenosis were allocated 1:1 to OCP/VEGF (n = 100) or autograft (n = 100), prospectively. CT-based fusion assessment and SF-36 outcomes were evaluated at 6 and 12 months follow-up. Results: At 12 months after surgery, mean fusion-zone density was 617.6 ± 180.9 HU in the OCP/VEGF group versus 599.8 ± 181.9 HU in the autograft group (mean difference 17.8 HU; p = 0.484). Complete fusion on qualitative CT grading occurred in 77% versus 73%, respectively (risk difference 4%; p = 0.583). SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) improved significantly from baseline in both groups (p < 0.001), without clinically meaningful between-group differences at follow-up. Revision surgery occurred in 3% versus 5%. Conclusions: In single-level TLIF for degenerative lumbar stenosis, OCP/VEGF produced radiographic fusion and patient-reported outcomes comparable to autograft at 12 months, supporting its use as an autograft-sparing alternative. Full article

This paper presents an experimental comparison of the EMBA firmware security analysis framework deployed in cloud-based and standalone environments. Unlike prior studies that primarily focus on EMBA’s analytical capabilities, this work examines how deployment choices influence performance and execution time during IoT firmware analysis. Using identical EMBA configurations and analysis modules, firmware images of varying sizes were analyzed on a standalone personal computer and a Microsoft Azure cloud-based virtual machine. Execution time, detected vulnerabilities, and resource utilization were systematically recorded to evaluate the impact of the deployment environment. The results indicate that scan duration is affected by both firmware size and execution context. For example, using EMBA v1.5.0, a 25.5 MB firmware image required approximately 14 h on a standalone system and over 25 h in the cloud. In contrast, a 30.2 MB image was completed in approximately 18 h locally and 17 h in the cloud. Despite these differences in execution time, the type and number of identified vulnerabilities were largely consistent across both environments, suggesting comparable analytical coverage. Overall, this deployment-focused evaluation provides empirical insight into performance-related trade-offs relevant to practitioners selecting local or cloud-based environments for firmware security analysis. Full article

Background: Minimally invasive spinal stabilization (MISS) is increasingly used in metastatic spine surgery, but comparative evidence vs. open posterior stabilization (OPEN) remains limited. We compared perioperative outcomes, focusing on wound-related morbidity. Methods: This retrospective single-center cohort included 71 patients undergoing posterior stabilization for spinal metastases (MISS n = 45; OPEN n = 26). Wound-healing disorder was the primary endpoint. Groups were compared using nonparametric exact tests; adjusted and propensity score analyses were performed to assess robustness. Results: Baseline SINS, operated segment, and instrumented levels were comparable. BMI was higher in MISS (25.8 [24.0–29.7] vs. 22.1 [20.0–24.9] kg/m²; p = 0.001), and urgent admissions were more frequent in OPEN (42.3% vs. 11.1%; p = 0.006). Wound-healing disorders occurred in 6.7% (3/45) of the MISS group vs. 30.8% (8/26) of the OPEN group. (p = 0.014; crude RR 4.62, 95% CI 1.34–15.88). After adjustment for admission type, BMI, and ECOG (n = 65), the association was attenuated (adjusted RR 1.80, 95% CI 0.24–13.68; p = 0.572). SSI occurred in 1/45 (2.2%) MISS vs. 5/26 (19.2%) OPEN (p = 0.022). Estimated blood loss was similar between groups (MISS: 500 [350–800] vs. OPEN: 600 [500–700] mL; p = 0.357). The median length of stay was shorter in the MISS group, though this did not reach statistical significance. In trimmed IPTW (64 complete cases), OPEN remained associated with higher weighted risk (RR 1.91, 95% CI 0.42–8.65; p = 0.403). Conclusions: OPEN surgery was associated with higher unadjusted wound-related morbidity than MISS, while blood loss did not differ between approaches. Length of stay tended to be shorter after MISS, but analyses were underpowered. Full article

Objectives: This study examined whether 8 weeks of unilateral flywheel resistance training (FRT) enhances eccentric neuromuscular characteristics and change-of-direction (COD) performance in male soccer players, and whether these adaptations transfer to sport-specific dribbling and match-play demands. Methods: Twenty-four male soccer players were randomized to a unilateral flywheel training group (EXT, n = 12) or a traditional resistance training control group (CON, n = 12). Both groups completed unilateral lower-limb strength training twice weekly for 8 weeks. Eccentric knee extensor and flexor peak torque (60°·s⁻¹), eccentric-to-concentric (E:C) ratio, and inter-limb asymmetry were assessed using isokinetic testing. Performance measures included a 10 m sprint, modified 505, COD deficit, a dribbling-based COD test (AFL), and GPS-derived high-intensity acceleration and deceleration metrics during matches. Results: Compared with CON, the EXT group showed greater increases in knee extensor (+0.54 Nm·kg⁻¹) and flexor (+0.46 Nm·kg⁻¹) eccentric peak torque, a higher E:C ratio, and reduced inter-limb asymmetry (all p < 0.05). While 10 m sprint performance remained unchanged, EXT improved modified 505 performance and reduced COD deficits (up to −0.06 s). In addition, AFL completion time decreased and match-play high-intensity acceleration and deceleration events increased in EXT compared with CON (p < 0.05). Conclusions: Unilateral FRT effectively enhances eccentric braking-related capacity and COD efficiency, with clear transfer to soccer-specific technical performance and high-intensity match-play demands. Full article

Eating disorders among adolescents have emerged as a significant global public health concern, with attachment anxiety identified as a critical risk factor for anorexia nervosa (AN) symptoms. Individuals with attachment anxiety often exhibit heightened sensitivity to others’ perceptions and an intense fear of rejection, which may exacerbate their vulnerability to body image concerns. This study investigates the mediating role of appearance-based rejection sensitivity (ARS) and the moderating effect of sex in the relationship between attachment anxiety and AN symptoms among Chinese college students. A total of 826 participants aged 16–25 (M = 18.95, SD = 1.08, 60% females) completed online surveys using three validated scales: the Revised Adult Attachment Scale (RAAS) to assess attachment anxiety, the Appearance-based Rejection Sensitivity Scale (ARSS) to measure sensitivity to rejection related to physical appearance, and the Eating Disorders Inventory (EDI) to evaluate AN symptoms. The results reveal that there was no significant difference in attachment anxiety between males and females, while females experienced significantly higher levels of ARS and severity of AN symptoms than males. Attachment anxiety is positively correlated with AN symptoms, with ARS mediating this association. Sex further moderates the relationship between ARS and AN symptoms, with stronger effects observed in females. Current findings suggest that AN symptoms are closely associated with contemporaneous attachment anxiety, with passive sensitivity to potential rejection acting as a mediating factor. This underscores the importance of addressing attachment styles and communication patterns in interventions targeting adolescent AN symptoms, particularly in females. Full article

Hierarchical federated learning (HFL) combined with the Mobile Edge Computing (MEC) paradigm has attracted extensive research interest in the Industrial Internet of Things (IIoT) due to its ability to deploy computational resources near edge devices and effectively reduce communication overhead. However, in real-world applications, the dynamic participation of edge devices and their diverse training objectives can lead to instability in model convergence, affecting overall system performance. To address this challenge, this paper proposes a device selection strategy based on task completion probability to determine participating devices dynamically in each training round. Furthermore, to balance system resource consumption and model performance, we formulate an optimization objective to minimize the loss function under resource constraints. By leveraging theoretical analysis, we reformulate the objective as a loss upper bound minimization problem related to resource allocation, which is subsequently decomposed into multiple subproblems for iterative solving. Simulation results demonstrate that the proposed method achieves superior resource efficiency and training stability. Compared to the state-of-the-art HFL method, DSRA-HFL reduces the average training delay by approximately 18% and energy consumption by 22% under dynamic conditions, while maintaining a competitive model accuracy. This validates the effectiveness of our joint optimization strategy in practical IIoT scenarios. Full article

Oxidative alcohol metabolism in the liver relies on sequential enzymatic reactions involving alcohol dehydrogenase (ADH), cytochrome P450 2E1 (CYP2E1), and aldehyde dehydrogenase (ALDH) isozymes. However, the circadian regulation of these enzymes, their susceptibility to genetic, environmental, and metabolic disruption, and their functional implications toward alcohol-mediated tissue injury remain incompletely defined. To address this gap, we performed a comprehensive integrative analysis of the publicly available circadian transcriptome datasets spanning genetic clock disruption, acute sleep deprivation, chronic high-fat diet feeding, and occupational shift work to systematically characterize the temporal regulation and disruption vulnerability of the major alcohol-metabolizing enzymes. Mouse tissue-cycling analyses revealed pronounced gene- and tissue-specific diurnal regulation, with Adh1 oscillating primarily in adipose tissues; Cyp2e1 and mitochondrial Aldh2 cycling broadly across kidney, aorta, lung, adrenal gland, and liver; and cytosolic Aldh1b1 being uniformly arrhythmic. In the liver, Cyp2e1 and Aldh2 exhibited robust ~24 h oscillations that peaked during the light/resting phase, while Adh1 showed inconsistent rhythmicity and Aldh1b1 remained arrhythmic. Notably, Cyp2e1 and Aldh2 rhythms persisted in Bmal1 knockout and Clock mutant livers under light–dark conditions, despite complete loss of core clock gene oscillations, yet were abolished in constant darkness, revealing that systemic zeitgeber cues can mask the loss of intrinsic clock function to maintain apparent rhythmicity in these metabolic genes. Systematic cross-paradigm comparison established a novel gene-specific vulnerability hierarchy. Aldh2 was found to be most disrupted by environmental and metabolic perturbations, with acute sleep deprivation eliminating its rhythmicity and temporal expression pattern and a Western-style high-fat diet inducing pronounced phase delays and rhythm loss relative to low-fat diet controls. Both disruptions paralleled alterations in hepatocyte nuclear factor 4α (Hnf4a), newly implicating HNF4α as a potential mediator of ALDH2 circadian instability. In humans, ALDH2 and CYP2E1 exhibited conserved but phase-inverted circadian rhythms across multiple tissues relative to mice, and, importantly, night-shift workers showed markedly dampened and phase-shifted ALDH2 rhythms in peripheral blood mononuclear cells, providing the molecular link between occupational circadian misalignment and impaired acetaldehyde detoxification. Collectively, our detailed and innovative analytical approach reveals gene- and tissue-specific circadian regulation of alcohol-metabolizing enzymes, identifies ALDH2 as uniquely vulnerable to circadian misalignment, underscores the importance of circadian timing for optimal hepatic detoxification and resistance to tissue injury, and suggests that monitoring circadian rhythms could help tailor individualized advice on alcohol consumption for shift workers and populations with irregular sleep schedules, informing precision medicine approaches for alcohol-related disorders. Full article

Disputes over delay assessments are costly, persistent, prevalent worldwide, often funded by taxpayers, and negatively impact productivity in the construction sector. The identified academic literature argues that the main causes of the escalation of disagreements over delay assessments from contract claims into disputes (or factors) are objective factors, particularly unavailability and/or inadequacy of relevant project data. However, those findings are not based on comprehensive investigations of all factors involved, employing research methodologies that rely upon real-life project data. This article contributes to the fulfilment of the aforementioned knowledge gap. Published literature and twenty-one case studies were evaluated to identify the factors. The research findings revealed that although data-related issues were often important factors, they were not the main and/or most frequently identified ones. Subjective factors, including manipulation of programme activity completion dates, reliance on biased assumptions when data is unavailable, misinterpretation of material records, and self-serving delay analysis, were the main factors. The findings suggest that the root cause of this issue is the exploitation of systemic flaws, including the unavailability of good/best practice guidance on assessing the impact of delays, deficient contract provisions, inadequate impartiality, divergent priority of interests, unexploited technologies, and the confidential nature of dispute resolution methods. Full article

Does the completeness of actors’ knowledge affect the exercise of power in social structures? Exchange theories and the experiments used to test them vary in the level of information availability—ranging from fully transparent to sharply restricted. These paradigms implicitly assume that actors’ knowledge corresponds directly to the information provided. While previous experiments have compared exchange payoffs under complete and restricted information, no theory explains why differences in power outcomes should or should not emerge across exchange structures under differing informational conditions. This paper investigates how knowledge shapes the exercise of power in exchange networks, where power is operationalized as payoff differences between actors. Knowledge is defined as what an actor can infer from experimental information and within-structure interactions, rather than as information alone. The study first examines whether restricting information effectively limits actors’ knowledge and finds that it does. It then uses new and previously published experimental data to analyze how information conditions (complete versus restricted) and structure type (strong versus semi-strong) jointly affect actors’ ability to secure advantageous payoffs in exchange relations. The results resolve previously contradictory findings on the relationship between information availability and power exercise in exchange networks by demonstrating that the effects of knowledge depend on both network structure and the form of rationality actors can plausibly employ under given informational constraints. Full article

Background: Healthcare workers are at the forefront of the global battle against COVID-19. Their vaccination perspectives, particularly in regions like Sierra Leone that have faced health crises such as the Ebola outbreak, are essential for shaping public health strategies in low-income countries that routinely face infectious disease outbreaks. Objective: This research sought to understand the perceptions and experiences of Sierra Leone’s healthcare workers concerning COVID-19 vaccination and booster doses, set against the backdrop of global health resource disparities and regional vaccine distribution challenges. Methods: Utilizing a mixed-methods approach, the study analyzed data from an online survey, which saw 1001 complete responses from 2060 participants across six Ebola-impacted districts (October–November 2022), and in-depth interviews with 24 health workers from three of these districts (February–July 2022). Results: Approximately 80% of respondents reported having received a COVID-19 vaccine, predominantly Sinopharm and AstraZeneca, yet only 34% of vaccinated participants had received a booster dose. In multivariable analyses, personally knowing someone who experienced serious COVID-19 illness or death was associated with higher odds of both initial vaccination and booster uptake (p < 0.05). By contrast, prior Ebola-related experiences were not consistently associated with vaccination outcomes. Qualitative findings contextualized these patterns, highlighting the roles of professional exposure, limited booster-related information, and inequities in vaccine availability and distribution. Conclusion: These findings indicate that vaccination strategies must move beyond initial rollout to address barriers to sustained engagement, particularly for booster uptake among healthcare workers. They also emphasize the need for equitable vaccine access and transparent, locally tailored communication to mitigate structural and informational constraints in low-income settings. Full article

Notably, one of the key points to address low accuracy and delayed responsiveness of dam deformation prediction models lies in the timely detection of the outliers caused by environmental disturbances, sensor failures, or operational anomalies of dam monitoring sequences. Therefore, our work offers an unambiguous method for overcoming this challenge. In this paper, a robust prediction framework that integrates Complete Ensemble Empirical Mode Decomposition (CEEMD) and Isolation Forest (iForest) for effective outlier detection, followed by a Multi-Head Attention Bidirectional Gated Recurrent Unit (MHA-BiGRU) model for dam deformation prediction, is presented. The original deformation time series is first decomposed using CEEMD into a set of intrinsic mode functions (IMFs). This decomposition separates the series into trend-related components and noise components. Subsequently, the iForest algorithm is applied in outlier detection for noise components. Then, the BiGRU model is enhanced with an MHA mechanism to give more weight to the features that affect the sequences of monitoring dam deformation. By enabling the proposed model to focus on the key factors affecting dam deformation, the accuracy of the prediction results has been enhanced. Finally, a case study introducing monitoring data from a practical project in China demonstrates the performance of the proposed method. The proposed MHA-BiGRU model demonstrates superior performance across all tested scenarios. Notably, the coefficient of determination is consistently maintained above 0.98, peaking at 0.9880. In terms of error control, the model exhibits a maximum mean absolute error of 0.1789, thereby substantiating its exceptional prediction accuracy and robustness. In comparison with classical time series forecasting models, including LSTM, GRU and BiGRU, the proposed approach demonstrates enhanced robustness and delivers greater prediction accuracy. The findings provide a promising reference framework for dam structural characteristics prediction in similar projects. Full article

Introduction: Given the growing prevalence of eating-related health problems among children, it is essential to promote well-being and investigate the factors that may underlie these issues. Emotional intelligence has been identified in several studies as a protective factor for children’s psychosocial adjustment, yet its effects on eating habits remain largely underexplored. This cross-sectional correlational study aims to investigate the relationship between trait emotional intelligence, mindful eating, and emotional over-eating in children. Methods: In the present study, participants were 110 children aged between 8 and 12 years and their parents. Children completed the Trait Emotional Intelligence Questionnaire—Children short form (TEIQUE-CSF) and the Mindful Eating Questionnaire adapted for Children (MEQ-C). Parents completed the Emotional Over-eating subscale of Children’s Eating Behaviour Questionnaire (CEBQ). Results: A regression-based mediation model indicated that children’s trait emotional intelligence is positively related to mindful eating, which in turn is negatively related to emotional over-eating behaviors. The results further revealed that children with lower-than-average levels of emotional over-eating reported greater mindful eating than those with higher levels. Conclusions: These findings highlight trait emotional intelligence as a factor related to children’s eating behavior, suggesting that interventions aimed at enhancing emotional regulation skills and promoting mindful eating practices are particularly warranted in the context of heightened vulnerability to eating disorders among children. Full article

Background/Objectives: Dietary behaviors among young adults in Japan have become increasingly polarized, highlighting the limitations of traditional knowledge-based health education. Behavioral science-based approaches such as nudging and gamification may offer alternative strategies. This study aimed to develop and examine a Theory of Planned Behavior (TPB)-based path model of healthy dietary choice behavior among young Japanese adults and to examine patterns associated with a star-rating gamification feature embedded in a nutrition management mobile application. Methods: A total of 188 participants aged 18–39 years completed an online survey assessing TPB constructs and normative factors. Participants used either a star-rating or non-rating version of the FoodLog Athl application. Composite-score-based path analysis and conditional process analyses were conducted to examine relational patterns among constructs. Results: Intention and self-efficacy jointly explained 48% of the variance in dietary behavior, with self-efficacy emerging as the strongest predictor. Several moderation patterns were observed, including those of gender, university year, diet app use, awareness of consequences, and ascription of responsibility. Compared with users of the non-rating version, star-rating users were observed to show higher nutrient scores but lower self-efficacy and dietary behavior scores, along with greater awareness of dietary consequences. These post-intervention findings are exploratory. Conclusions: Self-efficacy plays a central role in healthy dietary choice behavior among young adults, and its association with behavior appears to be shaped by perceived consequences and responsibility. By applying a composite-score-based path analysis within an SEM framework, this study clarifies the structural relationships among TPB components in everyday dietary choice behavior among Japanese young adults. Star-rating feedback may enhance reflective awareness and shows potential as a gamified nudging tool but further research is needed to clarify its effects. Full article

Background and Objectives: Intra-articular injection of adipose-derived stromal vascular fraction (SVF) has emerged as a promising regenerative treatment for knee osteoarthritis (OA) because of its heterogeneous cellular composition and potent anti-inflammatory paracrine effects. Although SVF therapy has demonstrated clinical efficacy, the timing of pain relief and the influence of SVF cell dose on early clinical outcomes remain incompletely defined. Materials and Methods: This retrospective study included 146 patients (217 knees) with Kellgren–Lawrence (K–L) grade II–IV knee OA who underwent intra-articular injection of autologous adipose-derived SVF and completed a minimum follow-up of 1 year. Pain was assessed using the visual analog scale (VAS), and patients reported the time to perceived pain improvement after treatment. Radiographic severity was evaluated using the K–L grading system. Correlation analyses were performed to assess associations between pain-related outcomes, SVF cell number, and radiographic severity. Results: VAS scores improved significantly from baseline to the final follow-up (p < 0.01). Patients reported perceived pain improvement at a mean of 18.9 ± 14.5 days after SVF injection. The mean injected dose was 7.4 × 10⁷ total SVF cells per knee, including approximately 7.0 × 10⁶ stromal cells. Higher SVF cell numbers were significantly associated with greater pain improvement and lower VAS scores at final follow-up (p < 0.001 for both). Radiographic severity was not significantly correlated with pain at final follow-up, the magnitude of pain improvement, or the time to symptom relief. No clinically relevant adverse events were observed. Conclusions: Intra-articular injection of high-dose autologous SVF was associated with rapid and clinically meaningful pain relief, with symptom improvement occurring within approximately 3 weeks after treatment. The dose-dependent association and the lack of correlation with radiographic severity suggest that early pain relief is primarily mediated by the anti-inflammatory and paracrine effects of SVF rather than immediate structural cartilage regeneration. Full article

Coastal ecological restoration is a key approach to enhancing ecosystem resilience; however, the stage-wise evolution of restoration outcomes and the underlying driving mechanisms remain insufficiently quantified. Using Qingdao City as the study area, this research integrates remote sensing inversion, the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model, and time-series data from 2010 to 2020 to develop a comprehensive evaluation system for ecological restoration effectiveness, comprising 17 indicators across five dimensions: vegetation, biology, hydrology, economy, and climate. Based on this system, the entropy-weighted method is applied to conduct a dynamic assessment of restoration outcomes. The results indicate that (i) the composite evaluation score in the study area decreased from 0.36 in 2010 to 0.19 in 2015 and then increased to 0.74 in 2020, forming a “V-shaped” nonlinear trajectory with 2015 as a turning point, which is temporally consistent with a delayed response of ecological restoration outcomes following the implementation of major anthropogenic interventions. (ii) Dimension-specific analysis indicates that the decline in the composite score during 2010–2015 was mainly associated with the hydrological dimension, within which chemical oxygen demand (COD) and ammonia nitrogen emissions showed marked increases and were among the highest-weighted indicators. After 2015, following the intensive implementation of regional and system-oriented restoration projects such as the Blue Bay Initiative, pollutant emissions were observed to be effectively controlled, and Bare land area showed a continuous decline. These changes coincided with the rapid rebound of the composite score, within which Bare land area, as the highest-weighted indicator, played a prominent regulatory role. Marked differences were observed among dimensional responses: the biological and vegetation dimensions showed sustained improvement throughout the study period, whereas the hydrological dimension exhibited greater variability over time and stronger temporal alignment with policy-related phases. (iii) Robustness tests indicate that, after completely excluding climate-related variables, the composite score still increased from 0.36 and 0.24 to 0.77, with the “V-shaped” recovery pattern remaining unchanged. This result suggests that the observed improvement in restoration effectiveness in 2020 was more closely associated with systematic human interventions, rather than with short-term climatic fluctuations. This study provides a quantitative and transferable methodological framework for the dynamic evaluation and stage-oriented analysis of coastal ecological restoration effectiveness. Full article