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Digital technology adoption and clean energy transition among rural households in China
Adaptive fuzzy-reinforcement framework for real-time task scheduling and resource optimization in medical edge computing
Abstract This paper proposes a hybrid fuzzy-reinforcement learning framework for real-time task scheduling and resource optimization in medical edge computing. The proposed framework introduces a direct mathematical coupling between fuzzy inference and reinforcement learning rather than a simple hybrid combination. By integrating fuzzy logic to evaluate task urgency, bandwidth congestion, and battery constraints with a reinforcement learning agent, the framework dynamically refines offloading strategies. Simulation results in Internet of Medical Things (IoMT) environments demonstrate the framework’s superiority over existing benchmarks, achieving up to 42% lower average latency, 31% greater energy efficiency, and up to 20% improvement over Dynamic Priority-Based Task Scheduling and Adaptive Resource Allocation (DPTARA) under the evaluated benchmark settings in the completion rate of critical tasks. Operating with a linear time complexity of $$O\left(N\cdot M\right),$$ the proposed system guarantees scalable and robust performance for delay-sensitive healthcare applications. Experimental results across four benchmark IIoT healthcare datasets demonstrate the effectiveness of the proposed framework. Specifically, the model achieves average accuracy improvements of 2.8–4.6% over state-of-the-art baselines, while reducing false negative rates by up to 35.4%. In addition, the proposed fuzzy–reinforcement learning scheduler decreases average task latency by 23.7%, improves resource utilization by 18.9%, and enhances system adaptability under dynamic workload conditions. These results confirm the framework’s robustness, scalability, and suitability for real-time medical edge computing environments.
Study on abrasive water jet machining of compacted graphite iron on Taguchi method
Abstract In this study, the influence of abrasive flow rate (AFR), stand-off distance (SOD), and traverse speed (TS) on surface roughness (SR), kerf width (KW), and kerf taper angle (KTA) during the abrasive water jet machining (AWJM) of 10 mm thick compacted graphite iron (CGI) was investigated. A full-factorial Taguchi L27 orthogonal array was employed to optimize the response parameters in terms of the SR, KW, and KTA. Analysis of variance (ANOVA) was performed to evaluate the statistical significance and contribution ratios of each parameter. The results revealed that AFR was the most dominant factor affecting SR and KTA, whereas TS had the greatest influence on KW. In contrast, SOD had only a minor impact on all the response variables. The optimized machining conditions for CGI were determined as 325 g/min AFR, 1.5 mm SOD, and 20 mm/min TS for the minimum SR. The findings highlight that the AWJM process can effectively machine CGI with high precision and minimal thermal damage, offering a viable alternative to conventional methods for difficult-to-machine materials.
Music–taste interactions enhance gustatory and sensorimotor brain activity
Prevalence of non-communicable diseases among people living with HIV at HIV Clinic of Kigali University Teaching hospital (CHUK), a cross-sectional study
The impact of large language models on collaborative learning processes and outcomes in higher education for English translation
Hidden diversity and chemical variation within Parmelia saxatilis group (Lecanorales, lichenized Ascomycota) and description of a new species P. tobolewskiana
Multi-scenario simulation of land use change and its effects on ecosystem service value: a case study of the three provinces in the middle reaches of the Yangtze River, China
Development and validation of the Life after Stroke questionnaire as a patient-reported outcome measure for stroke survivors living at home
Science sleuths uncover more than 100 suspicious images in Thermo Fisher antibody catalogue
Risk factors associated with gestational diabetes mellitus in Ghana: a prospective cohort study
Synergistic effects of alumina and graphite reinforcement on microstructural evolution and tribological performance of friction stir processed copper based composites
Integration of stepped care for perinatal mood and anxiety disorders among women attending maternal and child health clinics in Kenya: Protocol for a cluster randomized controlled trial
Background Perinatal mood and anxiety disorders (PMAD) cause substantial morbidity and mortality globally. Kenya, like many low- and middle-income countries, experiences severe shortage of specialized mental healthcare workers and poor coverage of screening and management for PMAD. Provision of screening and treatment by lay and non-specialist providers in the context of routine maternal child health services may enhance access to mental health services and improve outcomes. Methods and analysis In a hybrid type II cluster randomized clinical trial in 20 facilities in Western Kenya, we will evaluate the clinical, service delivery, and implementation outcomes of a stepped-care model integrating: 1) screening of all pregnant women for depression and anxiety symptoms, 2) Problem Management Plus (PM+) counseling delivered by trained lay providers, and 3) telepsychiatry for women with severe symptoms, suicidality, or inadequate response to PM + . The intervention package also includes a bundle of implementation strategies such as audit and feedback, process mapping, health educational health talks, and procurement of antidepressants for all sites. In addition, intervention sites will receive provider training, structured supervision and financial compensation for providers. Facilities will be randomized 1:1 to intervention and enhanced standard of care (basic screening and referral to specialist care), using restricted randomization. We will enroll a total of 2,970 women. Women will be eligible if they are pregnant and ≥20 weeks’ gestation, attending antenatal care at the facility, ≥ 14 years old, and screen positive for PMAD symptoms (Patient Health Questionnaire [PHQ]-2 ≥ 3 and/or Generalized Anxiety Disorder-[GAD]-2 ≥ 3). Assessments will be conducted at enrollment (pregnancy), 6 weeks, 14 weeks, and 6 months postpartum among participants in both study arms to align with routine well-baby visits. Primary outcomes are PMAD symptoms (PHQ-9 and GAD-7 score) change at 14 weeks postpartum using an intent-to-treat analysis. Secondary outcomes include quality of life at 14 weeks postpartum, PM+ mechanism of action, and adverse pregnancy outcomes at 6 weeks postpartum. Using mixed methods, we will evaluate acceptability and fidelity of the intervention and compare service delivery and other implementation outcomes (penetration, efficiency, equity, cost) across arms and alongside multilevel drivers of implementation success. Ethics and dissemination The study protocol was approved by Kenyatta National Hospital/University of Nairobi (P425/04/2023) and the University of Washington (STUDY00017933). All participants will provide written informed consent. Findings will be published in peer-reviewed journals and international conferences. Trial registration Trial registration number NCT06456307 .
Experimental and numerical simulation assessment of fracture evolution and tensile strength recovery in Grout-reinforced fractured surrounding rocks
Dressing-induced hemodynamic instability in patients with heart failure: Implications for nursing care
Background Heart failure (HF) restricts activities of daily living, impacting prognosis and quality of life. Dressing requires sustained upper-limb movements, postural transitions, and fine-motor tasks that may impose cardiovascular and autonomic demands, potentially informing on physiological tolerance during daily activities. Objective This observational study compared hemodynamic, autonomic, subjective, and upper-limb sensor count (ULSC) responses during dressing across HF clinical courses to characterize recovery dynamics during daily activities and identify nursing support requirements. Methods We compared healthy controls (HCs; n = 15), de novo HF (NO-HF; n = 12), and recurrent HF (R-HF; n = 12) groups. Heart rate (HR), systolic blood pressure (SBP), peripheral oxygen saturation, HR variability, Borg scale score, ULSC, dressing duration, and HR recovery (HRR) were measured at rest, during dressing, and after 20 min of recovery. Linear mixed-effects models tested group, time, and interaction. Pairwise comparisons were performed via Bonferroni adjustment. Results HR increased during and immediately post-dressing across groups, with NO-HF exhibiting higher HR than R-HF. HRR varied among groups (HC vs. NO-HF: P = 0.108; HC vs. R-HF: P < 0.0001; NO-HF vs. R-HF: P = 0.026). SBP displayed a group effect (P = 0.034). Peak HR responses tended to occur immediately post-dressing in HC and NO-HF, whereas R-HF descriptively showed a delayed peak around 5 min. No significant group × time interaction was observed. ULSC showed no group differences after dressing time and body size adjustments. Patients with HF had higher Borg scores than did HCs (NO-HF, P < 0.001; R-HF, P = 0.028). Conclusions Despite being low-intensity, dressing was associated with measurable physiological and subjective HF responses. R-HF trended toward slower HR recovery; NO-HF demonstrated consistently higher HR levels and perceived exertion. Monitoring recovery responses and supporting pacing and symptom self-monitoring during daily activities may be important in HF nursing care.
Structure of the mouse cytoplasmic lattice
Expression of progranulin (GP88) protein appears as an independent prognostic factor for clinical progression in high-risk prostate cancer patients
Abstract Prostate cancer (PCa), the second most common cancer, is still a major cause of morbidity and mortality among men worldwide. A particularly aggressive group of PCa, where prognostic biomarkers are still needed, are clinically defined high-risk PCa. We had previously shown that the survival and proliferation factor progranulin (GP88) is a prognostic marker for primary PCa. We aimed in this study to characterize GP88 protein expression in high-risk PCa by immunohistochemistry and to examine its association with prognosis. Immunohistochemical staining for GP88 was performed with TMA of samples from 94 high-risk PCa patients using an H-score. GP88 staining was in a range of 3.69 to 252.51 (median: 109.28). The association of GP88 staining with prognosis was examined by survival analyses (Kaplan–Meier, multivariate Cox’s regression analysis). Elevated GP88 expression was associated with a shorter clinical progression-free survival (CPFS) in all PCa patients ( P = 0.043), and in the following patient subgroups: Elder PCa patients (> 67 years; P = 0.020), patients with pT3 tumors ( P = 0.008), with Gleason scores GS5 and GS6 ( P = 0.033 and P = 0.030), and patients without radiation therapy ( P = 0.009) at considering that only four patients received an adjuvant radiation therapy. In a multivariate Cox’s regression analysis, increased GP88 protein expression (RR = 2.98; P = 0.049) and the preoperative PSA level (RR = 5.29; P = 0.030) appeared as independent prognostic factors for clinical progression. Interestingly, lower GP88 staining in corresponding low Gleason lesions was correlated with the presence of immune cells, suggesting an immune cell suppressive effect of GP88. Altogether, Progranulin (GP88) protein positivity appears very likely to be an independent prognostic factor for clinical progression in high-risk PCa patients.
The effect of food sensory experience on tourist engagement behavior: A study based on mental imagery theory
Research on the effect of food tourism on tourist engagement behavior is an important gap in tourism research. Based on mental imagery theory, this study constructed a theoretical model to explore how food sensory experience influences tourist engagement behavior, with food memory (stored multisensory experiences of food) and mental imagery (active cognitive reconstruction of sensory information) as parallel mediating variables. This is the first study to integrate mental imagery theory into food tourism research, focusing on the core role of multisensory experience. A cross-sectional online survey was conducted targeting tourists who participated in Zibo’s food tourism (Shandong, China)—a typical case of post-epidemic tourism recovery driven by food—and 447 valid questionnaires were collected. Structural equation modeling (SEM) with bootstrapped indirect effects (sample size = 5000, 95% confidence interval) was used for data analysis. Results show that: (1) Food sensory experience (encompassing sight, smell, taste, and touch) exerts a significant positive effect on tourist engagement behavior, with the strongest impacts on feedback intention (β = 0.480, p < 0.001) and revisit intention (β = 0.411, p < 0.001); (2) Food memory and mental imagery play significant parallel mediating roles—sensory experience independently activates both constructs, which in turn drive engagement; (3) Mental imagery has a stronger mediating effect on recommendation intention than food memory, while food memory is more impactful on revisit intention. Theoretically, this study clarifies the sensory-cognitive-behavioral mechanism underlying tourist engagement, filling the gap of how multisensory experiences shape engagement behavior. Practically, it provides actionable strategies for tourism destinations to enhance tourist engagement. In addition, the implications and suggestions for future research are discussed and meaningful implications for relevant tourism destinations are provided.