Search Results (101,686)

Background/Objectives: Spinal cord injury (SCI) leads to long-term changes in mobility, bodily function, and everyday participation, extending beyond physical impairment to affect autonomy, identity, and social inclusion. In Greece, limited community-based rehabilitation services, environmental inaccessibility, and fragmented follow-up care further shape the lived experience of individuals with SCI. This study aimed to explore the lived experiences and perceived rehabilitation needs of people with paraplegia living in the community, adopting a phenomenological approach to understand rehabilitation as an ongoing process of reclaiming autonomy, dignity, and participation. Methods: A qualitative phenomenological design was employed. In-depth semi-structured interviews were conducted with fourteen individuals with paraplegia following SCI. Data were analyzed using Braun and Clarke’s reflexive thematic analysis, supported by ATLAS.ti software. Results: Participants described living with SCI as a ‘Socially lived disability: a daily confrontation with an inadequate system and the ongoing struggle for accessibility, autonomy, and dignity’ (Overarching Theme). Participants’ experiences were organized into six themes: (A) facing the new reality, (B) barriers and facilitators of independent living, (C) role and importance of rehabilitation, (D) me and others around me, my difference, (E) the need for adequately trained and informed health professionals and caregivers, (F) ageing as an additional challenge. Conclusions: Living with SCI is experienced as an ongoing process of embodied and social reorientation, in which autonomy, participation, and dignity are continuously negotiated rather than restored once and for all. Rehabilitation emerges as a lifelong, person-centered process that extends beyond functional recovery to support bodily confidence, accessibility, social inclusion, and quality of life across the life course. These findings highlight the need for coordinated, community-based rehabilitation systems, accessible environments, and adequately trained health professionals capable of addressing the evolving functional, social, and existential realities of individuals living with SCI. Full article

This study explains how strategy–execution gaps become self-reinforcing during digital process transformation in layered manufacturing organizations. Drawing on an embedded qualitative process study of a large Chinese brewery’s transformation (2020–2024), we triangulate 10 semi-structured interviews across hierarchical levels with longitudinal public disclosures to reconstruct the initiative timeline and trace mechanisms across change phases. The analysis shows that platform-based process governance can scale faster than shared meaning and dialog, producing frontline sensemaking gaps and formalistic, top-down communication. These conditions thin employee voice and weaken feedback closure, which in turn erodes the legitimacy of organizational diagnosis and fragments implementation support. As interface problems are handled through local workarounds, management intensifies visibility-based monitoring, further suppressing voice and reinforcing the execution gap. We develop an organizational development process model that centers feedback closure and diagnosis legitimacy as bridging mechanisms linking soft change dynamics (meaning, trust, voice) with hard digital governance (process standards, data infrastructures, monitoring). The model offers actionable implications for leaders to build closure and legitimate diagnosis as operational capabilities throughout transformation. Full article

As a highly integrated and increasingly complex high-risk process industry, the petrochemical sector plays a critical role in industrial continuity and social stability, yet faces significant governance adaptability challenges under normalized public health emergencies. Taking a Chinese petrochemical enterprise as a case study, this paper develops an integrated framework combining STAMP/STPA, complex network analysis, and robustness analysis. Based on a reconstructed four-level hierarchical control and feedback structure, STPA was applied to identify 20 unsafe control actions (UCAs). These UCAs and their precursor factors were further abstracted into a relational network of control deficiencies for topological analysis and Monte Carlo-based robustness testing under random failure and targeted attack. The results show pronounced small-world and core–periphery structural characteristics, with vulnerability concentrated in a limited number of high-centrality source and hub nodes. Systemic resilience constraints mainly arise from governmental deficiencies in response experience and training, enterprise-level amplification at hub nodes, and pressure accumulation at frontline execution nodes. Accordingly, three resilience protocols are proposed: distributed authorization for source nodes; digitized dual-channel feedback for hub nodes; and minimum operational redundancy with cross-replacement for terminal nodes. This study provides theoretical basis and strategies for high-risk industrial systems to enhance resilience and sustainable development in uncertain environments. Full article

Forest Rights Mortgage Loans (FRMLs) have grown quickly in China’s collective forest areas, even though the basic conditions for this type of lending remain far from ideal. In many places, forest holdings are small and scattered, property rights are complex and not fully consolidated, and channels for disposing of collateral are limited. Under these circumstances, the Fulin Loan Model (FLM) in Fujian provides a useful case for understanding how forest-rights lending can still function in practice. Drawing on fieldwork, semi-structured interviews, and process tracing, this study explores both how the model was established and how it has been sustained over time. The analysis suggests that the FLM is neither a straightforward market-based lending tool nor merely a top-down policy arrangement. Rather, it relies on a more mixed form of governance in which local government support, banking procedures, and village-level social relations are brought together through specific organizational arrangements. These arrangements help lower the costs of early institutional experimentation, distribute and manage lending risks, and translate locally rooted trust into a form of credit support that formal financial institutions can recognize. As a single-case study, the FLM points to one possible way in which rural finance can be made workable under conditions of incomplete markets and strong social embeddedness. Full article

In general, condition monitoring (CM) and noise, vibration and harshness (NVH) are often treated as separate disciplines, despite the fact that both rely on vibration measurements. CM relies on broadband statistical metrics such as RMS, kurtosis, and envelope analysis to detect faults. Meanwhile, NVH investigates tonal excitation mechanisms related to gear mesh frequency (GMF) and its modulation components. In this study, we investigate whether a numerical relationship can be established between classical CM indicators and physically based tonal excitation indicators derived from frequency–domain analysis. Using healthy and damaged benchmark gearbox recordings, Spearman correlation analysis was performed between broadband metrics and GMF-related tonal features, including GMF-band energy and absolute sideband energy. Results show moderate but statistically significant correlations between RMS, envelope peak amplitude, and tonal indicators, whereas kurtosis exhibits no meaningful association. Additionally, tonal response amplification in the damaged gearbox is shown to be non-uniformly distributed across sensor locations, indicating sensor-dependent structural sensitivity rather than uniform response growth. These findings demonstrate that broadband CM indicators partially encode changes in tonal excitation-related response, establishing a reproducible data-driven bridge between diagnostic condition monitoring and NVH excitation analysis. Full article

Electrochemical chlorine production is of considerable industrial importance in areas such as water treatment, chemical manufacturing, and disinfection. However, conventional precious metal-based dimensionally stable anodes (DSAs), such as RuO₂- and IrO₂-based systems, are limited by high cost and resource constraints, motivating the development of low-cost alternative catalysts. In this study, Mn₃O₄ electrodes with controllable defect characteristics were fabricated by electrochemical deposition under various processing conditions. The effects of defect modulation and surface modification on the structural, electronic, and electrochemical properties of the electrodes were systematically evaluated. X-ray diffraction analysis confirmed that all deposited films retained a stable tetragonal Mn₃O₄ crystal structure, indicating that the deposition parameters primarily influenced defect states rather than the bulk phase. Mott–Schottky measurements revealed that the Mn₃O₄ electrodes exhibited p-type semiconducting behavior, with charge carrier densities on the order of 10¹⁴ cm⁻³, suggesting that oxygen vacancy-related defect states may contribute to the observed electronic properties of the electrodes. To further enhance anodic performance, Pt was introduced onto the Mn₃O₄ surface via sputtering, resulting in significantly improved charge transfer characteristics. Electrochemical measurements demonstrated that the best performing Pt/Mn₃O₄ electrodes delivered a current density exceeding 100 mA cm⁻² at an applied potential of 1.5 V versus Ag/AgCl. More importantly, defect-enriched Pt/Mn₃O₄ electrodes exhibited markedly enhanced chlorine evolution activity, with the chlorine production rate increasing from approximately 14 µmol cm⁻² to 29 µmol cm⁻², corresponding to an enhancement of about 2.07-fold. Faradaic efficiency analysis further showed that sample (g) and sample (n) achieved chlorine evolution efficiencies of 59.2% and 74.6%, respectively, indicating a higher tendency toward chlorine evolution for the Pt-modified electrodes under the tested conditions. These findings suggest that the synergistic combination of defect engineering and surface modification effectively modulates the electronic structure of Mn₃O₄, providing a viable strategy for improving chlorine evolution performance. Full article

Individuals with serious mental illness (SMI) face profound and largely preventable physical health inequities shaped by social and structural conditions, representing a major public health concern related to avoidable health inequalities. Because many receive everyday support in community mental health (CMH) systems, these services represent a crucial arena for understanding how such inequities are encountered and made sense of in practice. The study examines how physical health is understood within German CMH practice. Five group discussions with 30 CMH workers were analysed using an interpretive qualitative approach. The analysis identified five professional logics through which physical health becomes part of CMH support: trusting relationships that both enable and limit action; psychological stability as a core mandate; physical health positioned between recognition and delegation; fragile motivation combined with an ethics of restraint; and health promotion situated between aspiration and structural constraint. The findings show that helping relationships, everyday environments, and organisational structures create specific conditions for health-related support. Strengthening these interconnected levels may enable CMH to integrate physical health more systematically, offering insights relevant to international CMH contexts facing similar relational and structural challenges. Full article

Background/Objectives: Type 2 Diabetes Mellitus (T2DM) is a prevalent metabolic disorder associated with major cardiovascular and metabolic complications. Regular physical activity is recommended for glycaemic management, but barriers such as obesity, joint pain, and impaired mobility may limit participation in land-based exercise. Aquatic exercise may provide a feasible alternative as water buoyancy reduces joint loading while allowing aerobic and resistance training. This systematic review and meta-analysis evaluated the effects of aquatic exercise interventions on glycaemic control in adults with T2DM. Methods: The review followed the PRISMA 2020 guidelines. MEDLINE, Cochrane CENTRAL, Scopus, Web of Science, and IEEE Xplore databases were searched. Randomised and non-randomised longitudinal studies involving adults aged ≥35 years with T2DM participating in structured aquatic exercise programmes were eligible. The primary outcome was glycated haemoglobin (HbA1c). Risk of bias was assessed using RoB 2 and RoBANS 2, and certainty of evidence was evaluated using GRADE. Random-effects meta-analysis calculated mean differences (MDs) with 95% confidence intervals. Results: Eleven randomised controlled trials involving 335 participants were included. Aquatic exercise significantly reduced HbA1c compared with passive control conditions (MD = −0.76%; 95% CI −1.21 to −0.32), although heterogeneity was high. No significant differences were observed between aquatic and land-based exercise interventions. Eight studies used wearable heart-rate monitors to regulate exercise intensity. Conclusions: Aquatic exercise may improve glycaemic control compared with sedentary conditions and yields effects comparable to those of land-based exercise in adults with T2DM. Further high-quality trials are needed to clarify optimal exercise dose–response and evaluate more advanced wearable technologies. Full article

Understanding the depth and severity of corrosion is vital for evaluating the long-term durability and economic performance of Zn-based structures. In this study, a machine learning (ML) framework was applied to forecast the corrosion depth of zinc under varying environmental circumstances. A dataset consisting of 300 samples compiled from previously published atmospheric corrosion studies under various environmental conditions was used to develop and evaluate the machine learning models. Seven ML algorithms were developed by integrating different environmental constraints such as temperature, time of wetness (TOW), SO₂ concentration, Cl⁻ concentration, and exposure time as input parameters. The models were trained using cross-validation and hyperparameter optimization to ensure robust predictive performance and minimize overfitting. The Random Forest (RF) model confirmed superior predictive performance with an R² of 96.4% and RMSE of 0.642 µm among all used models. The predictive ability of the optimized RF model was further confirmed using five new environmental systems, attaining excellent agreement with predicted values (R² = 97.9%, RMSE = 0.87 µm). Model interpretability analysis using SHAP (SHapley Additive exPlanations) discovered that exposure time and SO₂ concentration are the most significant parameters leading zinc corrosion behaviour. The developed ML framework provides interpretable insights into the influence of environmental parameters on atmospheric zinc corrosion behaviour and provides a reliable tool for forecasting corrosion depth. These findings highlight the potential of ML approaches to support corrosion mitigation strategies and accelerate materials design by reducing reliance on conventional trial-and-error experimentation. Full article

Building world-class ports requires not only scale expansion but also sustainable structural capability. However, the concept of port “hardcore strength” remains insufficiently clarified and operationalized in existing sustainability and port evaluation research. In this study, port hardcore strength is understood as an integrated capability framework covering infrastructure efficiency and logistics capability, connectivity and regional integration, maritime services and industrial clustering, strategic leadership and innovation capability, and sustainable governance and green port development. This study proposes a sustainability-oriented evaluation framework for assessing the “hardcore strength” of world-class ports through a multi-dimensional indicator system. Methodologically, the study integrates the EWM and CRITIC, and introduces Bland–Altman analysis to examine whether the EWM and CRITIC weight vectors exhibit an obvious systematic bias prior to game-theoretic integration. Using 18 representative global ports from 2019 to 2023 as a case study, the results show that the overall ranking structure remains broadly stable, with Singapore Port and Shanghai Port consistently ranking first and second, respectively, while some middle-ranked ports exhibit moderate positional changes. The findings suggest that differences in world-class port development are rooted not only in operational scale, but also in the coordination of multiple capability dimensions. The study enriches the understanding of world-class port evaluation from a sustainability-oriented perspective. Full article

The new compound Cs₂Cu₂[V₄O₁₂]Br₂ was synthesized by the chemical vapor transport reaction method. Structural data obtained by single-crystal X-ray diffraction in the temperature range 100–700 K revealed three successive (with decreasing temperature) structural phase transitions: from the high-temperature aristotype structure I4/mmm (>550 K) to the polymorph P4/mnc (550–340 K), then to P4/m (340–300 K), and finally to the low-temperature phase I4/m (<300 K). The crystal structure of the new compound is based upon the Cu₂[V₄O₁₂]⁰ layers, consisting of four-membered rings of corner-sharing vanadate tetrahedra linked by CuO₄ squares. Analysis of the structural evolution with increasing temperature shows that the entire sequence of phase transitions is governed by the rotation of the [V₄O₁₂]⁴⁻ rings about the z axis. Full article

Background/Objectives: Diabetic small fiber neuropathy and related sensory and epidermal problems affect up to 70% of all patients with diabetes. Long-term hyperglycemia disrupts cytoskeletal organization and axonal transport; however, molecular changes within human diabetic epidermis remain understudied. Diaph1 and its cytoskeletal ligands, including β-Actin and Profilin, are key regulators of cytoskeletal dynamics and may be associated with diabetes-related alterations in skin structure and innervation. Methods: Sixteen patients with type 2 diabetes, aged 43.3 ± 9.6 years (disease duration 18.9 ± 8.7 years), and twelve non-diabetic controls, aged 43.9 ± 8.9 years, were enrolled in the study. All participants provided informed consent. Skin punch biopsies were obtained under local anesthesia and processed for staining of PGP 9.5, Diaph1, β-Actin, and Profilin. Quantitative image analysis was performed to assess stained area fraction, signal intensity, and intraepidermal nerve fiber density. Statistical comparisons and Spearman’s rank correlation analyses were used to evaluate group differences and associations between staining parameters. Results: Diabetic skin samples exhibited a significant reduction in PGP 9.5-positive intraepidermal nerve fibers, indicating reduced cutaneous innervation. In contrast, Diaph1 and Profilin showed broader and more diffuse epidermal staining, while β-Actin displayed altered staining patterns and intensity. Significant correlations between Diaph1- and β-Actin-related staining measures indicated an association consistent with altered cytoskeletal organization under chronic hyperglycemic conditions. Conclusions: Long-standing type 2 diabetes was associated with reduced PGP 9.5-positive intraepidermal nerve fibers, together with altered epidermal staining patterns of Diaph1, Profilin and β-Actin. These findings indicate coexisting cutaneous denervation and cytoskeletal alterations in diabetic skin. Full article

Background: Patients with type 2 diabetes mellitus (T2DM) undergoing cardiac surgery represent a high-risk population characterized by substantial cardiometabolic stress and increased susceptibility to postoperative heart failure, renal dysfunction, and unplanned rehospitalization. Although sodium-glucose cotransporter 2 (SGLT2) inhibitors provide established cardiorenal protection in ambulatory populations, their perioperative impact in cardiac surgery cohorts remains insufficiently defined. Methods: In a single-center retrospective cohort of 620 T2DM patients, inverse probability of treatment weighting and time-dependent Cox regression were applied to account for perioperative treatment interruption and delayed postoperative reinitiation when evaluating the association between chronic SGLT2 inhibitor therapy and 12-month rehospitalization risk. To provide biological context for the observed clinical associations, target-driven systems pharmacology, molecular docking against SGLT2, NHE1, AMPK, and NLRP3, and protein–protein interaction (PPI) network analysis were performed. Hub proteins were identified using Maximal Clique Centrality, followed by functional enrichment (GO/KEGG) analysis. Results: Chronic SGLT2 inhibitor therapy was associated with reduced first rehospitalization (HR 0.64; 95% CI 0.48–0.85; p = 0.002) and a lower cumulative rehospitalization burden (IRR 0.61; 95% CI 0.46–0.82; p = 0.001), primarily driven by heart failure-related and metabolic phenotypes. Molecular docking analyses identified favorable binding with SGLT2 and additional cardiometabolic and inflammatory targets, including NHE1, AMPK, NLRP3, IKKβ, IL-6Rα, and PPAR isoforms, suggesting modulation of myocardial ion homeostasis, metabolic resilience, and inflammatory signaling. PPI analysis identified eight hub proteins (AKT1, MTOR, STAT3, EGFR, PIK3CA, SRC, MAPK1, and MAPK3) significantly enriched in PI3K/AKT, MAPK/ERK, and ErbB signaling pathways. Conclusions: Chronic SGLT2 inhibitor therapy was independently associated with reduced postoperative rehospitalization and cumulative event burden in T2DM patients undergoing cardiac surgery. Integrated in silico analyses offer mechanistic hypotheses consistent with the observed clinical associations. These findings suggest that structured perioperative SGLT2 inhibitor management may contribute to improved postoperative outcomes, while prospective validation in future studies would strengthen these findings. However, given the retrospective observational design, these findings should be interpreted as associative rather than causal. Full article

The paper analyzes the structural transformations in tourism using the network input–output (IO) model. The study is based on IO tables for two years (2013 and 2023). This allows a comparative analysis of changes in the structure of technical coefficients and in multipliers associated with production and tax revenues. The approach enables the identification of changes in tourism’s position within the economic network. Tourism is also analyzed in terms of the degree of integration, dependence on intermediate inputs, and the capacity to spread the economic effects. The results show few upstream linkages for tourism. There is a low level of spillovers. To make it more resilient and generate more spillovers, it is important to build relationships with sectors such as agriculture, creative industries, and business services. The reliance on outsourced services could affect relationships with productive industries. Full article

Coal is the primary energy source in China and has long dominated energy consumption, serving as both the cornerstone for safeguarding national energy security and the backbone of stable energy supply. Despite the gradual improvement in the level of fully mechanized and intelligent mining in recent years, as well as the remarkable progress achieved in safe and efficient mining technologies, significant challenges are still encountered in the horizontal slicing mining of steeply inclined coal seams. This study was conducted against the engineering backdrop of the steeply inclined extra-thick coal seam in the Yimen Coal Mine, Sichuan Province. A combination of theoretical analysis, FLAC3D numerical simulation, and on-site monitoring was employed to investigate the support technology for mining roadways. Considering the geological occurrence conditions, roadway dimensions, and service life, the bolt (cable) + steel strip + metal mesh system was selected as the basic support method, with shed supports supplemented for reinforcement in areas with special geological structures or fractured surrounding rock. A non-uniform roadway support technology for horizontal slicing mining of steeply inclined extra-thick coal seams was proposed. The optimal support parameters of the roadways were determined through numerical simulation, and favorable support effects were verified by field measurements. Full article