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The stability of critical distance theory model for high cycle fatigue limit prediction of foreign object damaged blade samples

An analysis of pediatric retinoblastoma medical malpractice litigation

Background Retinoblastoma is a cancer of the retina that is most commonly diagnosed in the pediatric population. Unfortunately, this cancer can spread, leading to poor outcomes such as enucleation. The purpose of this study was to determine the characteristics of medical malpractice litigation associated with a diagnosis of retinoblastoma in the pediatric population. Methods A search for all available cases associated with “retinoblastoma” in the Westlaw Campus Research Legal Database was conducted. This spanned from database inception to August 2023. Cases were included if there was a complaint of medical malpractice related to retinoblastoma present in a pediatric patient. Demographic information for each patient was collected. The specialty of the defendant(s), state where the case took place, and case outcomes were also determined. Results Thirteen cases with a total of 14 patients were analyzed. One case included two siblings who were both diagnosed with retinoblastoma. The majority of the patients were female (N = 10, 71.4%) and all patients were alive at the time of trial. Three of the cases were initiated because an obstetrician-gynecologist/reproductive endocrinologist or ophthalmologist failed to tell a parent about the genetic risks associated with a family history of retinoblastoma. Specialties of the defendant(s) most frequently involved pediatrics (N = 5, 38.4%) and family medicine (N = 4, 30.8%). Conclusion Failure to diagnose retinoblastoma represents the most common context in which malpractice litigation arises in pediatric patients. However, few cases were identified in this study, which may be due to the settlement of these cases out of court. Although retinoblastoma is a condition primarily diagnosed in the pediatric population, our analysis shows that many different specialties are potentially involved during litigation. This highlights the importance of retinoblastoma education and screening across multiple specialties.

Understanding farmers’ participation in agricultural marketing networks through an exploratory sequential mixed-methods study integrating qualitative barrier identification and structural equation modeling

Cross-context qualitative synthesis of a mobile obstetric referral emergency system (MORES) in Ghana and Liberia

Background To address the delayed provision of obstetric emergency care in Ghana and Liberia, our team previously implemented a mobile obstetric emergency referral system (MORES) connecting rural health facilities (RHFs) and district hospitals through a South-South-North triangular collaboration. This secondary qualitative data analysis aimed to synthesize the perceived barriers and benefits associated with the adoption of MORES in Ghana and Liberia. To guide this cross-context synthesis, we utilized Rogers’ Diffusion of Innovation Theory. Methods The analysis included individual interviews conducted among 29 district hospital providers and 33 rural health facility (RHF) workers in Liberia. In Ghana, 11 midwives at a district hospital participated in a focus group discussion. The codes were developed utilizing an inductive process. Thematic analysis was utilized to compare adoption across countries through the Diffusion of Innovation Theory. Findings Four themes were identified from the healthcare workers in Ghana and Liberia: compatibility, relative advantage, resource barriers, and limited implementation. According to healthcare workers, MORES was compatible with everyday workflow and had significant relative advantage, contributing positively to adoption. Healthcare workers were able to prioritize patient conditions upon presentation with increased referral information. Resource barriers and the limited implementation across districts restricted widespread adoption of MORES. Healthcare workers in both countries cited inconsistent access to ambulances as a barrier to complete obstetric referrals and in Liberia, the need for financial support for data and network connectivity was referenced. There were nuances by country, within the four themes. In Ghana, providers used MORES to facilitate follow-up on patients who did not complete referrals, contributing to MORES’ relative advantage. Conclusions MORES has the potential to reduce obstetric emergency referral delays in Ghana and Liberia. If the resource barriers and limited implementation of MORES are addressed, healthcare workers may continue to adopt and use the MORES system. Policy makers can address referral delays through the scale up of MORES, a compatible intervention with great relative advantage.

Evaluation of the predictive accuracy of nine staging systems in patients with hepatocellular carcinoma: a multicenter, retrospective study in China

Abstract There are several staging systems for hepatocellular carcinoma (HCC); however, the best prognostic system for Chinese patients has not been established. The aim of this study was to evaluate nine staging systems and identify the best prognostic staging system for Chinese patients with HCC. This retrospective study included 1,495 patients with HCC from 2012 to 2022 in 17 hospitals in China. The predictive ability of nine HCC staging systems was evaluated based on homogeneity, monotonicity of gradients, Akaike’s information criterion, and area under the receiver operating characteristic curve. Overall survival at 1, 3 and 5 years was 59.90%, 40.34%, and 34.83%, respectively. Multivariable Cox analysis identified older age, multiple tumor nodules, maximum tumor size > 5 cm, macrovascular invasion, distant metastases, treatment modalities, worse performance status, low protein, high bilirubin, and high alpha-fetoprotein as independent prognostic factors. The Hong Kong Liver Cancer (HKLC) system showed the highest predictive accuracy for Chinese patients in hepatitis B virus-infected populations and in those undergoing non-curative treatment. The Cancer of the Liver Italian Program showed the best predictive ability in patients with hepatitis C virus infection or in the curative treatment subgroup. HKLC may be the most consistent and reliable prognostic model for patients with HCC in the Chinese population.

Comparison of fish biomass and fish carbon content associated with reef sites at the Rio Grande Valley artificial reef in the Gulf of Mexico

As global fisheries stocks have decreased due to overfishing and climate change, artificial reefs have gained significant attention. In addition to providing or restoring habitat, artificial reefs may serve as carbon capture sinks and potential climate mitigation strategies. The Rio Grande Valley (RGV) Reef is an artificial reef located in the northwestern Gulf of Mexico off the coast of Texas. The RGV Reef area spans 1,650 acres and is comprised of hundreds of groupings of recycled and pre-formed materials ranging from low relief (1–2 ft) to high relief (8–30 ft) reef structures. This reef provides a variety of novel habitat stepping-stones for multiple fish species at different life stages and supports local fisheries. Since the deployment of reef structures, fish biomass and abundance are substantially higher than expected for unconsolidated soft-bottom habitats; however, quantifying fish biomass is necessary to evaluate the relative effectiveness of different structural types. For this study, a Simrad EK80 split-beam sonar was used to estimate fish biomass at the reef sites. Biomass was calculated using fish echo returns and length-weight relationships. The standing stock of fish carbon contained within the fish populations associated with the RGV Reef was assessed using literature-derived measurements. The total fish biomass within the RGV Reef area was estimated at 24.4 tons, equating to 2.81 metric tons of carbon within the fish population. This study provides important information on the factors influencing fish biomass in this reef and the amount of carbon held in fish biomass within a previously overlooked potential blue carbon ecosystem.

Numerical investigation of the composite mechanical behavior of grouted rock members with rough fractures

Effectiveness of a fully immersive virtual reality-based therapeutic exercise programme with altered visual feedback in patients with fibromyalgia: A study protocol for a randomised controlled trial

Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, and diverse physical and psychological symptoms that significantly impair daily functioning. Latest guidelines advocate for a comprehensive approach to FM management, emphasizing patient education, therapeutic exercise, pharmacological treatments, and psychotherapy. Although exercise remains the primary non-pharmacological strategy supported by robust evidence, its clinical implementation faces several limitations, including poor adherence, fear of movement, pain catastrophizing and proprioceptive deficits. Immersive virtual reality (IVR) has recently emerged as a promising adjunctive tool that not only addresses these limitations but also provides additional therapeutic benefits. Specifically, preliminary studies suggest that incorporating visual feedback manipulation through IVR can effectively modify movement perception, potentially enhancing clinical outcomes. This randomised controlled trial aims to assess the efficacy of a fully immersive virtual reality (FIVR)-based therapeutic exercise programme designed to induce implicit visual illusions, making participants perceive less movement than is performed during structured resistance exercises. Eighty participants diagnosed with FM will be recruited and randomly allocated to either the experimental group, which will engage in a structured resistance exercise regimen combined with FIVR, or the control group, performing identical exercises without FIVR. The primary measure will be the impact of FM on daily life, evaluated using the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes include fatigue, sleep quality, FM symptom severity, health-related quality of life, psychological factors, central sensitization, body perception distortion, lower limb strength and handgrip strength, functional mobility, lumbar range of motion, influence of modified visual feedback, behavioural regulation during exercise and overall physical activity levels. This study aims to provide robust evidence regarding the potential benefits of integrating FIVR with therapeutic exercise. Findings could support FIVR as a valuable clinical innovation, potentially yielding superior improvements in daily functioning, physiological outcomes, and psychological well-being compared to traditional exercise interventions alone. ClinicalTrials.gov (NCT06948500). URL: https://clinicaltrials.gov/ct2/show/NCT06948500 .

Copper coating of magnesium alloy AZ31 using conventional electrode EDM for enhanced corrosion resistance

Analysis of leaf morphology development-related genes and photosynthetic metabolic pathways in the transcriptomes of new leaves of Tea-Oil tree (Camellia oleifera ‘changlin53’)

Camellia oleifera is a distinctive woody oilseed species endemic to southern China and is considered one of the world’s four major woody oil plants alongside oil palm, olive, and coconut. Its oil is renowned for its high content of unsaturated fatty acids, earning it the title “Oriental Olive Oil.” However, the conventional C. oleifera industry faces challenges such as substantial yield fluctuations and poorly understood regulatory mechanisms of oil metabolism. There is an urgent need to elucidate the synergistic mechanisms between photosynthetic efficiency and metabolic networks at the molecular level during leaf development to establish a theoretical foundation for high-yield, high-quality breeding. In this study, we systematically analyzed the developmental dynamics of new leaves at the spreading, growth, and maturity stages in the high-yield variety ‘Changlin 53’. By integrating morphological and anatomical observations with multi-period transcriptome sequencing, we investigated the key regulatory networks underlying leaf functional maturation. The results showed that as leaves developed, chlorophyll *a* content increased significantly, the expression of photosynthesis-related genes (e.g., chlorophyll *a*-binding protein Lhca1, photosystem II reaction center protein PsbA) was upregulated, photosynthetic capacity was gradually enhanced, and leaf functional maturation was promoted through the regulation of carbon assimilation and energy metabolism pathways. To validate these findings, 12 randomly selected differentially expressed genes (DEGs) were analyzed using qRT-PCR. The expression patterns were highly consistent with the RNA-Seq data. This study reveals, for the first time, the potential synergistic mechanism involving photosynthesis, metabolism, and hormones during leaf development in ‘Changlin 53’, providing a key theoretical basis for selecting and breeding C. oleifera varieties with high light-use efficiency.

A hierarchical multi‑timescale reinforcement learning framework for hybrid energy storage management with aging‑aware constraint adaptation

Miniaturized shared aperture multiband antenna for wireless biomedical applications

This study presents a compact, folded dipole multiband shared-aperture antenna that operates effectively across both sub-1 and sub-6 GHz frequency bands using a single radiating structure—constructed on an FR-4 substrate. Design measures 16.40 × 10.50 × 1.52mm 3 ( 0.0386 λ × 0.0247 λ × 0.0036 λ ), ( 0.431 λ × 0.276 λ × 0.040 λ ), ( 0.512 λ × 0.328 λ × 0.048 λ ), resonates at the bands of 0.431-0.435 GHz, 4.75-4.96 GHz, and 5.64-5.88 GHz, thus having a flexibility to a wide range of applications. The proposed antenna is a folded dipole built on the upper layer, and the coaxial feeds run to horizontally and vertically oriented strips on the backside layer. This arrangement enables simultaneous use along with various frequency bands in a single physical structure by taking advantage of shared-aperture concept thereby achieving space economy and operational efficiency. By applying a miniaturization plan based on lumped element integration, the radiating system guarantees a reduction of 80% in the dimensionality, and remains functionally intact. Besides, the integrated measurement subsystem incorporates a cancer-related analyte which mimics the electromagnetic nature of cancerous cellular organisms and thus a detectable spectral change at 5.7 GHz. The implication of this phenomenon is the initiation of an oncogenic presence diagnostic indicator. The concomitant capability of operating in multiple bands and smaller footprint make the antenna especially favourable to use in the context of operating in healthcare infrastructures for biomedical platforms along with wireless communication applications.

Lappaconitine protects SH-SY5Y cells from TNF-α-induced mitochondrial apoptosis by blocking the Bax-dependent Caspase-3 signaling pathway

Dengue severity and profiles of complement activation and immune mediators: A multicenter cohort study in Indonesia

Background Dengue virus (DENV) infection can manifest as dengue fever (DF) or dengue hemorrhagic fever (DHF), although DHF often becomes clinically apparent around defervescence. How complement components and other immune responses evolve over the course of illness from the febrile to recovery phase remains incompletely defined. This study characterized circulating complement activation and immune mediators in DF and DHF using paired febrile and early-recovery samples. Methods We conducted a multicenter prospective cohort study at five hospitals in Indonesia between November 2024 and October 2025. Patients with laboratory-confirmed dengue were classified as DF or DHF. Plasma concentrations of PTX3, C5a, IL-6, IL-10, IL-8, and CXCL10 were quantified in paired febrile and early recovery phase samples. Between-group differences, within-patient changes between the two time points, and correlations among immune mediators were assessed using appropriate statistical methods. Results We included 110 confirmed dengue cases in the analysis. PTX3 and IL-10 levels were significantly higher in DHF than in DF during early recovery, whereas no mediator differed significantly between severity groups during the febrile phase. Across phases, C5a increased significantly from febrile to early recovery in DHF but not in DF, whereas PTX3 decreased significantly in DF but not in DHF. Correlations among mediators were generally weak to moderate, with a reproducible PTX3–IL-10–CXCL10 module observed across both phases. Conclusion The measured mediators did not distinguish DF from DHF during the febrile phase, but differences emerged in early recovery, with higher PTX3 and IL-10 in DHF. Across phases, C5a increased significantly from febrile to early recovery in DHF, whereas PTX3 decreased significantly only in DF. A PTX3–IL-10–CXCL10 module was observed at both time points. Together, these patterns suggest that within-patient changes around defervescence or in the early recovery may be informative and warrant evaluation in larger, prospectively timed cohorts.

Paclitaxel-coated balloon treatment is associated with sympathetic coronary denervation in a porcine model

Abstract Drug-coated balloon (DCB) therapy promotes beneficial vascular remodeling after percutaneous coronary intervention. However, its mechanisms remain elusive. Given paclitaxel’s neurotoxicity, the effects of paclitaxel (PTX)-DCB treatment on periarterial innervation are unknown. This study assessed the impact of PTX-DCB on periarterial innervation in porcine coronary arteries. Coronary arteries from twelve pigs were treated with balloon catheters across four groups: (1) uncoated balloon (POBA), (2) balloon with 3 µg PTX/mm 2 (1 × 3), (3) balloon with 6 µg PTX/mm 2 (1 × 6) and (4) two balloons each with 6 µg PTX/mm 2 (2 × 6). Quantitative coronary angiography was performed before, during, and after balloon angioplasty, and at day 28 prior to sacrifice. Following sacrifice, tissue samples were taken for histological examination of periarterial nerve fibres. High-dose PTX treatment resulted in late lumen enlargement (+ 0.29 ± 0.60 mm) in the control angiography after 28d compared to POBA treatment (POBA vs. 2 × 6-PTX group ( p  = 0.0236). Sympathetic nerve fiber density did not differ between the untreated and balloon-treated segments in the POBA group (untreated: 386.5 ± 169.1 nerves/cm 2 , balloon: 328.5 ± 289.9 nerves/cm 2 , p  = 0.6439) but was significantly reduced in the PTX-treated animals (1 × 3-PTX: untreated: 540.9 ± 216.2 nerves/cm 2 , balloon: 177.0 ± 130.5 nerves/cm 2 , p  = 0.0020; 1 × 6-PTX: untreated: 546.5 ± 226.8 nerves/cm 2 , balloon: 142.4 ± 61.7 nerves/cm 2 , p  = 0.0003; 2 × 6-PTX: untreated: 498.6 ± 404.0 nerves/cm 2 , balloon: 176.5 ± 103.4 nerves/cm 2 , p  = 0.0478). PTX-DCB treatment significantly reduced the proportion of periarterial nerve fibers < 500 µm 2 in the balloon-treated segment ( p vs. untreated segment: POBA = 0.0267; 1 × 3-PTX = 0.0680; 1 × 6-PTX = 0.0028; 2 × 6-PTX = 0.0391). PTX-DCB therapy exerts previously unrecognized pleiotropic effects by reducing perivascular nerve fiber density, resulting in coronary denervation that may contribute to the luminal gain beyond antiproliferative effects.

Getting over the hurdles to save lives: Incorporating perceived barriers into theory of planned behaviour (TPB) model to predict stated intention among Hong Kong trained laymen

Background The ‘Intention-focused model’ is advocated for educating bystanders in Basic Life Support (BLS), consisting of cardiopulmonary resuscitation and automated external defibrillation. Although previous International Consensus on Cardiopulmonary Resuscitation statements have summarised barriers at the scene of out-of-hospital cardiac arrest, few studies have investigated how barriers perceived by trained laypeople affect their intention to deliver BLS (BLS intention) and the underlying mechanisms, especially during the COVID-19 pandemic when global fear of infection was persistently heightened. This study examines the relationship between perceived barriers (PB) and the Theory of Planned Behaviour (TPB) constructs, i.e., attitude, subjective norms (SN), perceived behavioural control (PBC) and BLS intention, as well as the role of concern about infection. Methods A cross-sectional online survey of 678 trained adult laypeople was conducted in 2022 using convenience sampling. Structural equation modelling was used to analyze the relationship between PB subscales, BLS intention, attitude, SN and PBC. Multigroup analysis was used to examine the potential moderating effect of concern about infection. Results A split-construct model consisting of two barrier subscales showed better model fit (χ2/df = 3.224, CFI = 0.966, RMSEA = 0.057) than the lumped-construct model (χ2/df = 3.732, CFI = 0.953, RMSEA = 0.064). Performance-related barriers had a strong significant association with PBC (β = −0.74, P < 0.001), while cultural barriers were significantly associated with attitude (β = −0.34, P < 0.001), and SN ( β  = −0.16, P  < 0.001) were significant, but not for PBC ( β  = 0.01, P  = 0.905). Attitude, SN, and PBC had significant effects on BLS intention ( β  = 0.14–0.56, Ps  < 0.001). Multigroup analysis showed that concern about infection significantly moderated the relationship between cultural barriers and attitude (Low concern: β  = −0.474, P  < 0.001; High concern: β  = −0.326, P  < 0.001; Δχ 2 (1)=6.319, P  = 0.012). Conclusions This study offers empirical evidence for integrating perceived barriers into an intention-focused model to predict laypersons’ willingness to perform resuscitation. Future research should focus on addressing priority concerns and transforming them into heightened willingness through enhancing positive attitudes, SN and PBC.

Three-dimensional inversion of gravity data using implicit neural representations and scientific machine learning

Abstract Inversion of gravity data is an important method for investigating subsurface density variations relevant to mineral exploration, geothermal assessment, carbon storage, natural hydrogen, groundwater resources, and tectonic evolution. Here we present a scientific machine-learning approach for three-dimensional gravity inversion that represents subsurface density as a continuous field using an implicit neural representation (INR). The method trains a deep neural network directly through a physics-based forward-model loss, mapping spatial coordinates to a continuous density field without predefined meshes or discretisation. Spatial encoding enhances the network’s capacity to capture sharp contrasts and short-wavelength features that conventional coordinate-based networks tend to oversmooth due to spectral bias. We demonstrate the approach on synthetic examples including smooth models, representing realistic geological complexity, and a dipping block model to assess recovery of structures at different depths. The INR framework reconstructs detailed structure and geologically plausible boundaries without explicit regularisation or depth weighting, while reducing the number of inversion parameters as the problem size grows bigger. These results highlight the potential of implicit representations to enable scalable, flexible, and interpretable large-scale geophysical inversion. This framework could generalise to other geophysical methods and for joint/multiphysics inversion.

Students’ engagement with AI-supported learning and its association with academic interest and career intentions in business analytics education

Artificial intelligence (AI) tools are increasingly embedded in higher education, yet limited research has examined how sustained AI usage intentions in AI-supported learning environments are associated with learning motivation and longer-term educational development. Treating AI use as a course-embedded learning experience rather than a discrete adoption decision, this study investigates how students’ perceptions of AI-supported learning are associated with continued usage intentions and how such intentions subsequently relate to academic interest and career-related intentions. Grounded in post-adoption technology continuance research, motivation theory, and Social Cognitive Career Theory, we develop and test a structural model linking perceived AI enhancement, interactivity, fun, and coolness to continued AI usage intentions, academic interest, and career-choice intentions. Survey data were collected from undergraduate students enrolled in business analytics courses and analyzed using structural equation modeling. The results show that perceived enhancement, interaction, fun, and coolness are each significantly associated with continued AI usage intentions in coursework. Continued AI usage intentions, in turn, are positively related to academic interest in business analytics, and academic interest statistically mediates the relationship between continued AI usage intentions and career-choice intentions. However, indirect effects from these antecedent variables to academic interest through continued AI usage intentions were not statistically significant. By conceptualizing continued AI usage intentions as an ongoing learning process that is linked to how students engage with disciplinary knowledge over time, this study advances understanding of the developmental role of AI-supported instruction in higher education. The findings contribute to research on technology, knowledge, and learning, and offer practical implications for designing AI-supported learning environments that foster sustained usage intentions, interest development, and future-oriented educational pathways.

Age-related differences in circadian timing system and sleep quality in young and older lifelong endurance runners

Readability, quality, and reliability of AI-generated ınformation on myofascial pain syndrome: A comparative analysis of ChatGPT, Gemini, and Perplexity

Patients seeking information about Myofascial Pain Syndrome (MPS), which affects a large segment of the population, are increasingly turning to AI-based chatbots as an alternative to traditional methods. However, the medical accuracy of the content offered by these digital platforms, as well as its suitability to the “grade 6 reading level” standard, which determines its comprehensibility by patients, is a critical point of uncertainty. This study aims to fill this significant gap in the literature by systematically comparing MPS content generated by different AI models using readability indices, reliability, and quality metrics. The 18 most relevant keywords, derived from 25 keywords identified via Google Trends data, were queried using ChatGPT (GPT-5.2), Gemini 3 Flash, and Perplexity (Sonar-4 Large) models. The readability of the generated responses was analyzed using six different indices (FRES, FKGL, GFOG, CLI, ARI, SMOG), while content quality was assessed using GQS and EQIP scales, and reliability using DISCERN and JAMA scales by two independent observers. The responses generated by all AI models examined were found to be statistically significantly more complex than the suggested 6th-grade reading level (p < 0.001). In inter-model comparisons, ChatGPT exhibited the easiest readability [lowest linguistic difficulty] scores, while Perplexity scored significantly higher than both ChatGPT and Gemini in content quality and reliability metrics (JAMA, DISCERN, GQS, EQIP) (p < 0.05). Correlation analysis revealed a strong and positive relationship between quality and reliability parameters. Artificial intelligence platforms have been observed to exhibit high potential in the production of medical information. However, linguistic barriers exceeding sixth-grade reading comprehension, along with reliability limitations of current models, prevent them from replacing professional medical consultation. Perplexity has been found superior in terms of academic quality, while ChatGPT has been found superior in terms of readability. Nevertheless, positioning these systems as complementary “secondary consultation mechanisms” supporting physician oversight in clinical decision-making processes is critically important for patient safety.