Search Results (22,672)

Maritime Education and Training (MET) is undergoing rapid digital transformation, yet adoption of adaptive learning technologies (ALT) remains uneven, constrained by the Standards of Training, Certification and Watchkeeping (STCW) regime and by human and organizational barriers. A persistent question in the technology-acceptance literature is how individual acceptance becomes organizational readiness in safety-critical, regulated settings. This study models the translation from educator attitudes to perceived institutional readiness through the mediating role of perceived usefulness. Partial least squares structural equation modeling was applied to survey data from 104 maritime educators. The model explained 42.8% of the variance in perceived institutional readiness and 34.8% in perceived usefulness. Educator attitudes significantly predicted perceived institutional readiness (β = 0.298), and the relationship was partially mediated by perceived usefulness (indirect β = 0.202, 95% CI 0.12 to 0.35): educators must first be convinced of an ALT’s practical value before judging their institution ready to adopt it. A hypothesized moderation by professional experience was not supported and is reported as exploratory. Because predictor and outcome were self-reported by the same respondents, the outcome is interpreted as perceived readiness rather than a verified organizational state. The study contributes a validated model of the individual-to-organizational translation mechanism in MET and guidance for MET leaders integrating ALT under STCW. Full article

Bipolar disorder is characterized by marked circadian and metabolic vulnerability, but direct evidence linking the timing of food intake to its course remains sparse. This structured narrative review examines chrono-nutritional disruption, including irregular meal timing, nocturnal eating, prolonged or inconsistent fasting, eating-window variability, and eating jet lag, as a potential behavioral correlate and mechanistic contributor to bipolar instability. PubMed/MEDLINE, Scopus, and Web of Science were searched for literature published from January 2000 to 30 June 2026, supplemented by predefined foundational studies. Evidence was organized as direct bipolar-specific, indirect human, or translational/preclinical. The strongest direct findings are cross-sectional associations involving night eating, eveningness, sleep disturbance, and functioning; bipolar-specific longitudinal and completed interventional evidence remains insufficient. Indirect human and experimental studies suggest that biologically mistimed eating can alter peripheral-clock entrainment, glucose–insulin regulation, cortisol rhythmicity, mitochondrial function, inflammatory signaling, and gut microbial rhythms. On this basis, we propose a hypothesis-generating chrono-metabolic model in which food timing may interact bidirectionally with sleep, mood state, medication effects, and metabolic health. Routine attention to nutritionally adequate and feasible meal regularity may be considered within broader monitoring of social rhythms, but it has not been shown independently to prevent relapse or improve mood outcomes. Time-restricted eating is investigational in bipolar disorder and should be evaluated only in carefully monitored research or specialist contexts. Prospective within-person studies and adequately powered trials are required before chrono-nutritional strategies can be regarded as evidence-based bipolar interventions. Full article

Whole-life carbon (WLC) governance is increasingly important to the decarbonization of the built environment, yet its incorporation into building regulation differs across jurisdictions and instrument types. This study examines how WLC governance is represented in Türkiye’s building regulatory framework and in selected European governance models. It combines comparative document analysis with targeted Python-based text analysis of eleven regulatory, strategic, voluntary and methodological documents, focusing on terminology, life-cycle-stage visibility, normative language, document similarity and policy-instrument profiles. The findings show that Türkiye has an established binding framework for operational-energy performance, whereas embodied-carbon and WLC requirements remain less institutionalized within the binding regulatory core. Broader life-cycle, material, and circularity concepts are more visible in voluntary and strategic documents. The selected European cases illustrate distinct regulatory pathways: France’s RE2020 integrates operational-energy and life-cycle-carbon requirements within a single regulatory framework, while Sweden employs a specialized mandatory climate-declaration and calculation approach. At the EU level, the recast EPBD establishes a binding trajectory toward more explicit life-cycle GWP requirements, while RICS and Level(s) provide complementary methodological reference structures. The study contributes to building decarbonization research by treating regulatory and policy documents as primary governance objects and by providing a transparent and transferable framework for comparing how operational energy and WLC are positioned within regulatory hierarchies. Full article

Most research on sea buckthorn (Hippophae rhamnoides L.) has focused on the berries and oils. This structured narrative review examines the chemical profile of the leaves and evaluates cardiovascular and metabolic evidence from leaf preparations, isolated constituents, and other sea buckthorn materials. Two complementary PubMed searches yielded 3539 unique records. After screening in successive stages, 85 publications were included. A supplementary search in Scopus yielded no unique records. Leaves contain glycosides of isorhamnetin, quercetin, and kaempferol, together with ellagitannins, proanthocyanidins, phenolic acids, and triterpenoids. Their relative amounts vary between cultivars, harvest, processing, extraction, and the denominator used for reporting. Leaf preparations improved selected metabolic, vascular, or inflammatory outcomes in several animal and ex vivo models. Studies of isolated flavonols support biological plausibility but do not identify the compounds responsible for effects of complete leaf preparation. Human trials have examined berries, purée, juice and oils; effects on lipids, glucose regulation, blood pressure, and platelet activity were generally small or inconsistent. No controlled human trial or human pharmacokinetic study has evaluated a chemically characterized leaf preparation. This absence is the main obstacle to clinical translation. The next stage should compare one defined leaf preparation with appropriate controls in validated animal models, test fractions prepared from the same leaf batch, and require replication before human studies of pharmacokinetics, dose, safety, and efficacy. Current evidence supports this sequence but does not justify therapeutic use of sea buckthorn leaves. Full article

Osmotic energy conversion (blue energy), serving as a sustainable marine renewable energy source, converts Gibbs free energy originating from salt concentration differences into electric power by virtue of ion-selective nanofluidic membranes. Conventional commercial ion-exchange polymer membranes suffer from inherent limitations, including low transmembrane flux, insufficient ion permselectivity, severe interfacial concentration polarization, poor salt tolerance, and unsatisfactory long-term structural stability. These drawbacks greatly restrict the energy conversion efficiency and large-scale engineering application of reverse electrodialysis (RED). Conductive polymers (CPs), mainly including polypyrrole (PPy), polyaniline (PANI), polythiophene (PTh), and their derivatives, possess the distinctive merits of tunable surface charge density and polarity, outstanding electronic conductivity, facile nanochannel structural regulation, and reversible redox responsiveness, making them ideal building blocks for advanced nanofluidic membranes for high-efficiency osmotic energy conversion. This review summarizes recent progress in the fabrication of conductive polymer-based nanofluidic membranes, comprehensively compares the osmotic output performance of typical CP material systems, and discusses the core metrics of osmotic energy conversion output performance. By providing an overview of these developments, this review aims to offer insights into the future development of conductive polymer-based nanofluidic membranes for osmotic energy conversion. Full article

Young and novice drivers have the highest representation of driver injuries and fatalities. While driver education provides in-class and in-car exposure to the driving environment, the use of driving simulators can further expose challenging driving environments that are not typically provided as part of current driver education programs. The aim of this study was to examine and compare the delivery of a driver training program on simulated driving performance and confidence in young drivers. Sixty participants (aged 15–20; 66% male) completed cognitive and visual assessments, a driving comfort scale, and a pre-test simulated drive. Subsequently, participants were assigned to: (1) an intervention with feedback group (n = 20), (2) an intervention without feedback group (n = 20), or (3) control group (n = 20). Intervention group participants completed fifteen training scenarios, and all participants completed a post-test simulated drive and driving confidence scale. Outcome measures assessed on the simulator were driving errors (e.g., speed, vehicle position, braking distance) and the number of collisions. Across all groups, simulated crashes significantly decreased and driving confidence significantly increased post-test. Training with feedback produced the most consistent improvements, including improved speed regulation and safer following distances. All participants reported greater confidence in challenging conditions such as heavy rain, snow, icy roads, and night driving. Findings indicate that high-fidelity simulation, particularly when paired with structured feedback, can improve novice drivers’ skills and confidence, supporting simulation as a valuable complement to traditional driver education. Full article

In membrane-based reverse electrodialysis (RED), ion-selective membranes convert ionic concentration gradients directly into electrical output. Protons are often treated within the general framework of cation selectivity, while how membrane structure specifically regulates proton transport beyond conventional cation transport remains insufficiently understood. Here, freestanding aramid nanofiber (ANF)/Ti_0.87O₂ membranes approximately 3 μm thick are prepared by co-dispersion in trifluoromethanesulfonic acid (TfOH), spin coating, aqueous regeneration, and confined drying. X-ray diffraction and two-dimensional wide-angle X-ray scattering show that Ti_0.87O₂ incorporation is accompanied by enhanced ANF ordering and preferential orientation. After normalization to the bulk HCl/KCl conductivity ratio, the proton preference factor increases from approximately 1.0 for ANF to 1.67 at a Ti_0.87O₂ mass fraction of 0.5, while the apparent activation energy is lower for HCl than for KCl transport (0.18 versus 0.24 eV). Under a 1000-fold HCl concentration gradient (1 M/0.001 M), the membrane delivers 51.52 W m⁻² and retains 88.1% of its short-circuit current over approximately 33 h. Further integration into a 10-unit stack yields an open-circuit voltage of 1.77 V, demonstrating modular voltage scaling. Together, these results suggest that Ti_0.87O₂ nanosheets promote ANF ordering and contribute to proton-favorable transport behavior. Full article

Vitamin D is involved in endothelial regulation, inflammatory control, oxidative stress responses, angiogenesis, and neurovascular homeostasis, providing a biological basis for its potential involvement in the retinal and choroidal circulation. This narrative review synthesizes evidence from studies investigating associations between serum 25-hydroxyvitamin D [25(OH)D] concentrations and ocular vascular parameters assessed using optical coherence tomography (OCT), OCT angiography (OCTA), and retinal vascular imaging. Evidence from adult and pediatric populations generally associated vitamin D deficiency (VDD) with lower vessel density in the superficial and deep capillary plexuses, altered retinal vascular caliber and foveal avascular zone morphology, and reduced choroidal thickness or vascularity. However, the direction and magnitude of retinal OCTA findings were inconsistent, and conventional retinal structural measurements frequently remained unchanged. Supplementation studies reported relatively consistent increases in choroidal thickness and vascularity, whereas retinal perfusion responses were limited. Preliminary studies suggested that correction of VDD might support a more sustained response to bevacizumab in diabetic macular edema and central retinal vein occlusion, although this effect was not demonstrated consistently across retinal vascular diseases. Lower 25(OH)D concentrations were also more frequent among patients with retinal vascular occlusions, but residual systemic vascular confounding limits causal interpretation. Overall, current evidence supports a biologically plausible association between vitamin D status and ocular microvascular health but does not establish causality, functional visual benefit, or a specific therapeutic indication for supplementation. Longitudinal multicenter studies and randomized trials using standardized imaging protocols, functional outcomes, biochemical confirmation of vitamin D correction, and validated automated image analysis are required to determine the clinical relevance and reversibility of these findings. Full article

Background/Objectives: Although artificial intelligence (AI) has the potential to strengthen disease surveillance, predictive analytics, preventive interventions, and population-level decision-making, its successful integration requires health systems to be adequately prepared across technical, workforce, governance, and organizational dimensions. Saudi Arabia’s rapid digital health transformation provides a unique national context for exploring these readiness conditions. This study explored stakeholder perceptions of conditions relevant to health system readiness for integrating AI into public health in Saudi Arabia, including perceived challenges, implementation requirements, and strategic opportunities. Methods: A qualitative descriptive study was conducted using semi-structured interviews with 32 participants, including healthcare professionals, health informatics experts, and policymakers or healthcare planning stakeholders in Saudi Arabia. Participants were purposively selected based on their relevant professional experience. Data were analyzed using Braun and Clarke’s six-phase reflexive thematic analysis. Results: Four major themes were identified: (1) infrastructure readiness, reflecting progress in digital health platforms alongside persistent interoperability and data-integration challenges; (2) workforce capacity, highlighting limited AI literacy and the need for practical, role-specific training; (3) data governance and ethics, emphasizing privacy, accountability, algorithmic bias, and the need for greater regulatory clarity; and (4) perceived strategic opportunities, including preventive care, population health monitoring, disease surveillance, and decision support. The first three themes reflected conditions perceived as relevant to health system readiness, whereas the fourth captured anticipated applications and potential benefits rather than a dimension of current readiness. Overall, participants perceived substantial national strategic commitment and digital health development while identifying important implementation challenges related to interoperability, workforce capability, governance, and regulation. Conclusions: Participants’ accounts suggest that responsible AI integration into public health requires coordinated attention to interoperable infrastructure, workforce competencies, governance mechanisms, regulatory oversight, and human-centered implementation. A phased implementation approach, supported by role-specific AI training and clear governance and regulatory frameworks, may help translate national AI ambitions into safe and effective public health practice. These findings may inform policy development, workforce planning, and implementation strategies for responsible AI integration in Saudi Arabia and other regions whose health systems are undergoing rapid digital transformation. Full article

In battery energy storage systems (BESSs) in microgrids, traditional proportional–integral (PI) controllers remain a popular choice for management. The PI-based system often fails during sharp transients and under sudden shifts in solar irradiance or load demands. PI-based systems typically exhibit sluggish recovery times and pronounced voltage overshoots. To overcome these limitations, this article develops a flatness-based control (FBC) framework designed to optimize the dynamic response and stability of an islanded hybrid microgrid powered by photovoltaic (PV) arrays and wind turbines. The core mechanism directly regulates the battery charging and discharging currents. This mechanism ensures that the DC-bus voltage strictly tracks its reference command regardless of fluctuations in load or weather profiles. Crucially, the structural resilience of this control architecture was rigorously assessed, with the simulation model subjected to severe 20% mismatches in physical parameters, specifically the main DC-bus capacitance and battery inductance, alongside continuous high-frequency Gaussian white noise injected into the measurement feedback channels. Three scenarios have been implemented in MATLAB/Simulink: variable weather conditions, realistic weather conditions, and parameter uncertainties with measurement noise. The comparison shows that the new FBC controller cuts the settling time down from 0.47 s with the regular PI controller to just 0.02 s, which is a 95.7% decrease. In addition, the proposed controller substantially mitigates transient voltage deviations and eliminates the 2.6% voltage overshoot observed with the PI controller. The rise time is also reduced by approximately 35%. These results demonstrate that the proposed FBC provides faster, overshoot-free, and more stable DC-bus voltage regulation under the investigated operating conditions. Full article

Modern abdominal wall hernia surgery is centered on the biomechanics of the fascial-aponeurotic framework and on intra-abdominal pressure (IAP) control; neuromuscular regulation of the wall remains outside perioperative planning. This review reframes the abdominal wall as a coordinated neuromuscular system and outlines a framework in which ventral herniation is hypothesized to represent a compensatory response to altered regulation of elevated IAP, while discoordinated contraction of the muscular layers is proposed as a potential predisposing factor. A structured literature search was performed in PubMed/MEDLINE, Embase and the Cochrane Library from inception to March 2026 across four thematic blocks: basal tone and innervation, spinal pathology and coordination, skeletal muscle memory, and electromyographic and clinical models of denervation. Synthesis followed SANRA criteria. This is not a formal systematic review or meta-analysis. Basal tone of the abdominal muscles is individual and depends on spinal innervation, lifestyle, comorbidity, and hernia duration; obstructive pulmonary disease yields a hypertonic phenotype, and persistent meteorism a hypotonic one. In a patient predisposed to herniation, elevated IAP may be partially accommodated through redistribution of abdominal contents; within the proposed framework, herniation is hypothesized to function as a pressure-relief mechanism. Discoordination of the muscular layers may reduce the capacity of the abdominal wall to adapt to rapid or unfamiliar loading, potentially contributing to hernia formation in predisposed patients. Six meta-analyses of preoperative botulinum toxin type A confirm lateral muscle elongation; none assessed basal-tone recovery after toxin washout. Each hernia patient presents with an individual neuromuscular phenotype shaped by basal tone, intermuscular coordination and muscle memory. The proposed framework complements mechano-fascial concepts with a neurophysiological dimension and provides a hypothesis-generating rationale for investigating phenotype-tailored prehabilitation and postoperative rehabilitation. Prospective electromyographic mapping with functional maneuvers is the immediate research priority. Full article

The peripheral blood transcriptomic profile associated with clinically observed cutaneous radiation injury (CRI) during fractionated radiotherapy remains incompletely characterized. We analyzed blood transcriptomes from 22 adults receiving radiotherapy: 10 with CRI and 12 without radiation-related skin injury at blood collection. RNA was assayed using two-color Agilent microarrays. Variance filtering retained 12,251 probes that were evaluated using four complementary analyses: preranked Gene-Set Enrichment Analysis (GSEA) for ranked gene-set enrichment, Gene-Set Variation Analysis (GSVA) for sample-level gene-set scoring, weighted gene co-expression network analysis for co-expression structure, and differential expression analysis at the probe level. GSEA identified positive enrichment of interferon-γ response and E2F targets and negative enrichment of heme metabolism. Consistently, GSVA showed higher interferon-response, E2F-target, unfolded-protein-response, and cholesterol-homeostasis scores and lower angiogenesis, xenobiotic-metabolism, protein-secretion, hypoxia, and heme-metabolism scores in participants with CRI. Ten modular co-expression networks met the data-derived CRI-correlation prioritization criterion. Positively correlated networks were enriched for negative regulation of response to wounding and complement/coagulation cascades. Intramodular connectivity and sample-level expression analyses prioritized KDM4C and PARPBP as exploratory high-connectivity candidates, with both retaining top-10 connectivity in 95.5% of leave-one-out iterations. Exploratory differential expression analysis identified 1842 probes, comprising 585 upregulated and 1257 downregulated probes in CRI. Genes mapped from downregulated probes were significantly enriched for ribosome, spliceosome, and oxidative phosphorylation pathways. Across complementary analytical frameworks, CRI was associated with a coherent peripheral blood profile characterized by interferon and cell-cycle enrichment; altered wound-response and complement/coagulation processes; reduced heme-metabolism, angiogenesis, and xenobiotic-metabolism scores; and downregulated transcripts involved in ribosomal function, RNA processing, and mitochondrial energy metabolism. Although the cross-sectional design and later sampling of CRI participants precluded full separation of CRI-associated differences from treatment-time and cumulative-exposure effects, these findings extend the molecular characterization of CRI and identify pathways and high-connectivity candidates for longitudinal assessment of reproducibility, temporal dynamics, and potential diagnostic or predictive relevance. Full article

The Mediterranean Diet pattern is characterized by high intake of plant-based foods rich in bioactive nutrients, including carotenoids. This review examines the major dietary carotenoids and xanthophylls characteristic of the Mediterranean food matrix, focusing on their structural diversity, plant biosynthesis, release from the food matrix, bioavailability, and biological redox-modulating activities. The literature was collected from PubMed, Web of Science, and Scopus to trace the pathway of carotenoids from their accumulation in plant tissues to their potential effects on human health. Culinary processing and the concomitant intake of dietary lipids can enhance carotenoid bioaccessibility by promoting isomerization and facilitating the formation of mixed micelles during digestion. In addition to systemic absorption, noninvasive diagnostic tools, including skin carotenoid measurements by reflectance spectroscopy and macular pigment optical density, provide useful biomarkers of fruit and vegetable intake. Carotenoids may contribute to systemic antioxidant and redox regulation by quenching singlet oxygen, scavenging free radicals, and modulating redox-sensitive signaling pathways. Overall, their structural diversity, food-matrix interactions, bioaccessibility, and biological activities support continued investigation of carotenoid-rich foods within the Mediterranean dietary pattern and their associations with human health outcomes. Full article

Coal mine disaster emergency governance requires sustained coordination among regulators, mining enterprises, and professional rescue forces. This study develops a budget-closed tripartite evolutionary game in which subsidy/support outflows and penalty-revenue incidence are represented explicitly. Replicator dynamics is interpreted as a mean-field approximation of repeated organizational learning, and a cross-product extension is used to examine higher-order synergy. Dynamic stability is assessed as local asymptotic stability rather than classical evolutionary stability. Resilience is quantified using measure-conditioned basin stability P_H(ν), direction-conditioned critical disturbance magnitude Δ_crit(d), and conditional recovery time T_rec. The open form is retained only as a mechanism-isolation benchmark. Under full fiscal closure, the original high-incentive parameter set shifts the stable outcome to E₇ = (0, 1, 1), indicating that enterprise and rescue coordination may persist while strengthened regulation is not self-sustaining. An illustrative closure-consistent parameterization restores E₁/E₈ bistability and yields P_H(U([0, 1]³)) = 0.889, Δ_crit(1, 1, 1) = 0.738, and T_rec = 13.95 under the stated experiment. No locally asymptotically stable interior state arises in either the additive benchmark or the cross-product extension. Sensitivity checks further show that the numerical resilience values vary with the initial-state measure and disturbance direction. The findings suggest that collaborative resilience depends jointly on policy intensity, fiscal incidence, initial coordination conditions, and shock structure. Full article

Metazoan organisms employ an array of overlapping innate and adaptive immune mechanisms to defend against infection and prevent disease. Z-nucleic acid-binding protein (ZBP)1 (also denoted DAI or DLM1) has emerged as a key nucleic acid (NA) sensor within mammalian cells responding to stress, infection or inflammation. Once engaged and activated by Z-nucleic acid, ZBP1 recruits receptor-interacting protein (RIP) kinase (RIPK)3 through RIP homotypic interaction motif (RHIM)-mediated interactions to promote regulated cell death and inflammatory signaling, with necroptosis representing a particularly important antiviral defense mechanism. DNA viruses have coevolved with their hosts to encode diverse inhibitors that suppress ZBP1-RIPK3 signaling as well as other cell death pathways, highlighting the strong selective pressure imposed by necroptosis on viral replication. In contrast, RNA viruses lack inhibitors and activate multiple interconnected death pathways, including necroptosis, apoptosis, and pyroptosis. Increasing evidence indicates that both viral and cellular RNA transcripts adopt Z-conformation and activate ZBP1. Recent studies further implicate stress-induced transcriptional read-through, called disruption of transcription termination, of endogenous retroviral elements as important endogenous sources of Z-RNAs. These findings establish ZBP1 as a central sensor linking aberrant nucleic acid structures to RIPK3-dependent cell death and inflammation during viral infection and cellular stress of disease processes. Full article