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Types of decorations, their social meaning and influence on moral injury: A mixed methods approach
Research on moral injury has thus far paid little attention to social factors and cultural elements. This study addresses this gap by examining the effects of one particular cultural artefact on moral injury that is typical of armed forces, (military) decorations, including awards and medals. Through a preregistered experiment involving two scenarios—omission of helping behavior and commission of mortar fire—resulting in civilian deaths, we manipulated the factors self-attribution versus attribution of blame to others/the system and the presence or absence of a decoration. Moreover, we conducted seven qualitative interviews. Contrary to our expectations, none of the experimental conditions within the scenarios yielded significant differences. However, the scenarios themselves differed significantly from each other, indicating that wrongful inaction may have a stronger effect on moral injury than wrongful action. The subsequent qualitative interviews ( N = 7) revealed nuanced insights, suggesting that the effects of decorations on moral injury may vary. Cases were discerned in which military decorations demonstrated the potential to either alleviate or exacerbate moral injury. This dynamic depended on factors such as an individual’s assessment of the justifiability of the act for which they received the decoration, and the perceived authenticity of the decoration’s bestowal – whether it was experienced as a genuine acknowledgment or merely a superficial gesture. These findings indicate a possibly complex interplay of cultural artifacts and moral injury within military contexts.
Experimental study on creep mechanical properties and failure modes of anthracite in dry and saturated states
Relationship between the asymmetry of the resting scapular position and the prevalence of latent myofascial trigger points in the trapezius muscle in asymptomatic adults
Myofascial trigger points (MTrPs) and body postural misalignment, including the position of the scapula, can contribute to the onset and persistence of musculoskeletal pain. However, the relationship in asymptomatic cases remains unclear. Therefore, this study aimed to investigate the relationship between the asymmetry of the resting scapular position and latent MTrPs in the upper trapezius muscle (UTM) in asymptomatic adults. A total of 32 asymptomatic adult men (mean age, 26.28 ± 1.1 years) were included in this study. Full-body photographs were taken from the posterior view, with the participants resting in a standing position. To determine the degree of asymmetry of the resting scapular position, the horizontal scapular alignment angle (HSAA) was analyzed from the photographs. The assessor identified the presence of latent MTrPs in the right and left UTMs. The HSAA was significantly lower in the group with latent MTrPs in the right UTM than in those without latent MTrPs. The results showed that the right scapula was more depressed than the left scapula in the group with latent MTrPs in the right UTM. Furthermore, multiple regression analysis indicated that the dominant arm and presence of latent MTrPs in the right UTM significantly contributed to the prediction of the HSAA. The results of this study demonstrated a close relationship between the asymmetry of the resting scapular position and latent MTrPs in the UTM in asymptomatic adults, which may contribute to the onset and persistence of musculoskeletal pain.
Analysis of risk factors for Takotsubo cardiomyopathy in older patients using large-scale medical reimbursement data
Validation of the Keen Eye computer-based method for diagnosing visual neglect using a dual-task paradigm
Visual neglect is a common and disabling consequence of right hemisphere damage. Standard paper-and-pencil assessments may fail to detect subtle or well-compensated cases of neglect, especially under low attentional demands. This study presents and validates the Keen Eye computer-based method for diagnosing neglect using a dual-task paradigm. The method involves the simultaneous detection of lateralized visual targets and identification of centrally presented digits, increasing attentional load and sensitivity to spatial biases. We tested 102 patients with right hemisphere damage (38 with neglect, 64 without) using a predefined set of target positions that systematically varied across the visual field. Classification models based on error patterns and asymmetry coefficients demonstrated high sensitivity and specificity in distinguishing patients with neglect. The method also revealed quadrant-specific and vertically biased omissions. The findings support the utility of attention-demanding computer-based tasks for improving diagnostic precision in visual neglect and suggest potential for identifying subclinical or hidden neglect profiles.
Exploring usage and perceived effectiveness of fitness trackers and mobile health applications among university students in Saudi Arabia
Abstract The integration of technology into health and wellness has been gaining momentum. Wearable technology and mobile health applications (Apps) have become increasingly popular for tracking health-related behaviors. This study explores the usage, perceived impact, and tracking capabilities of fitness trackers (FTs) and mobile health Apps among university students in Riyadh, Saudi Arabia, over a 4-month period in 2024. A cross-sectional, web-based study was conducted in the Riyadh, region of Saudi Arabia, between March and June 2024. The target population was undergraduate healthcare students enrolled in the faculties of nursing, pharmacy, and EMS at a public university in Riyadh for the academic year 2024. The questionnaires collected information on demographics and FT usage, perceptions. The other sections focused on Mobile Health App usage, reasons for not using, the most commonly utilized feature, source of FTs. The last section assessed the impact of mobile apps and FTs on health. A total of 523 healthcare students responded to the study by giving a response rate of 95.1%. However, the analysis included on 357 undergraduate students who used FTs and mobile health apps. The prevalence of use of FTs and mobile health apps was 68.3%, among those 40.1%( n = 143) of them were belongs to pharmacy, 30.3% ( n = 108) of them were EMS and 29.7% ( n = 106) of them were nursing. Among the users, the most popular FT was wristband 43.7% ( n = 156) smart watches 35.9% ( n = 128). In addition, 52.1% ( n = 186) of the healthcare students reported using mobile health Apps. Healthcare students used FTs to increase physical activity 24.4%, improving workouts 21.6%, monitoring heart rate, and losing weight. In addition, 48.1% of the healthcare students agreed that FTs increases their physical activity. This study revealed fourth-year students were more likely to wear FTs every day compared to their peers, ( p = 0.022; χ² =29.223), and athletes used FTs significantly more frequently than non-athletes ( p = 0.022; χ² = 11.447) suggesting significant association between year of study and student’s athlete’s status and FTs use. Our findings emphasize the importance of technology in promoting health and wellness, especially through the use of FTs and mobile health apps. Significantly, the use of this technology was linked to higher levels of physical activity and increased confidence, illustrating the necessity for raising awareness among students and individuals regarding the advantages of FTs and mobile health apps. Additional research is needed to investigate the reasons behind utilizing technology for health enhancement, ultimately guiding efforts to maximize its benefits.
Leveraging spatial data infrastructure for machine learning based building energy performance prediction
The calculation, management and maintenance of energy performance of buildings (EPBs) are significant in increasing energy efficiency in buildings and reducing greenhouse gas emissions since it is estimated that approximately one third of energy consumption is associated with buildings, and furthermore, three-quarters of the existing building stock is characterized by energy inefficiency. However, in many cases, EPBs are either not calculated or not integrated in a register within national spatial data infrastructure (NSDI). This complicates policy development and planning for both local and national governments, which may result in numerous complications. The objective of this paper is twofold: firstly, to design a building energy data model as an extension of NSDI in Türkiye and then implementing and populating it with real data taken from energy performance certificates from the Tuzla District in Istanbul; and secondly, to develop energy performance prediction models with Machine Learning (ML) algorithms (i.e., Random Forest (RF), Gradient Boosting Machine (GBM), Light Gradient Boosting Machine (LightGBM) and Extreme Gradient Boosting (XGBoost) in order to estimate the overall performance scores of the buildings. The model’s findings demonstrated robust predictive accuracy, achieving an R² of 0.818 (XGBoost) and performance metrics of RMSE = 5.153, MAE = 2.886, and MAPE = 3.369. These results substantiate the model’s reliability in estimating targeted building energy performance scores. These predictions can be used to provide a comprehensive overview of districts in terms of EPB and inform the development of road maps at the district, city, or national level. Furthermore, the predictions can support the development of EPB-related legislation, facilitate the design of incentive and sanction mechanisms, and promote broader sustainability and climate mitigation goals in a practical manner. Nevertheless, as a limitation of this study, the model has only been tested in a single district, which restricts its generalizability; it should therefore be evaluated in other areas to confirm its applicability.
Novel anti-LAG-3 antibody LBL-007 with anti-PD-1 blockade enhances antitumor immunity by promoting T cell-induced apoptosis
Unveiling the dynamic coupling and driving mechanisms among digital infrastructure, economic resilience and carbon productivity
Investigating the coupled and coordinated relationship among digital infrastructure (DI), economic resilience (ER) and carbon productivity (CP) is pivotal for advancing sustainable development in China. This study employs multiple approaches, including the coupling coordination model, kernel density estimation, Markov chain, and spatial Durbin model, to analyze the spatiotemporal evolution and driving factors of the coupling coordination degree (CCD) from 2013 to 2021. The findings are as follows. First, the average levels of DI, ER and CP show a consistent upward trajectory. Second, the CCD among the three systems exhibits steady growth, transitioning from a state of “general out of balance” to “barely coupling coordination”. Spatially, the CCD demonstrates a characteristic pattern of decreasing from east to west. Overall, achieving a “cross-level transition” in CCD is challenging, and the neighboring provinces significantly influence the enhancement of local CCD. Third, the CCD demonstrates a positive spatial agglomeration effect, with stable hotspots concentrated in regions such as Hubei, Anhui, Zhejiang, and Shanghai. Fourth, strategic emerging industries, population density, human capital, and environmental regulation intensity positively contribute to the local CCD, whereas financial development exerts a negative impact. Regarding spatial spillover effects, strategic emerging industries and environmental regulation intensity exert positive influences, while population density shows a negative effect. Meanwhile, the spatial spillover effects of human capital and financial development are not significant.
Impact of symptom burden clusters on self-efficacy and quality of life in hemodialysis patients: a multicenter cross-sectional study
Correction: ‘I cannot be what I don’t see’: an evaluation of Academic Intersectionality Mentoring in medical schools (AIMMS Mentoring)
Coupling coordination and driving mechanism between tourism development, ecological conservation and digital economy: insights from Chinese 278 cities
Machine learning reveals distinct T-cell receptor clusters in plasma cell dyscrasias compared to healthy controls
T-cell receptor (TCR) repertoire diversity has been implicated in the progression and prognosis of multiple myeloma (MM). This study aimed to evaluate the association between T-cell clonality, immune response, and clinical outcomes in patients with plasma cell dyscrasias using next-generation sequencing of the TCR β chain (TCRB). TCRB sequencing was performed on peripheral blood samples from patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and newly diagnosed multiple myeloma (MM). Healthy individuals served as controls. No significant differences in TCR repertoire diversity were observed between healthy individuals and those with MGUS, SMM or MM after adjusting for age. Furthermore, TCR diversity did not correlate with treatment response in newly diagnosed MM or SMM patients. However, machine learning analysis revealed distinct TCR clusters differentially abundant between healthy individuals and those with plasma cell dyscrasias, exhibiting different amino acid properties. These findings suggest that shared T-cell receptor specificities among patients with plasma cell dyscrasias reflect underlying differences in antigen recognition and underscore the need for further studies to unravel the functional and clinical significance of these distinct immune signatures.
Correlation of three wear testing methods and surface roughness analysis in 3D-printed crown materials
Analyzing the adoption of AIGC tools in fashion design: An S-O-R framework integrating task–technology fit
AI-Generated Content (AIGC) tools have rapidly emerged in the field of apparel design in recent years, but how designers adopt these tools and the psychological mechanisms behind them are unclear. This study constructs a model based on the stimulus-organism-response (S-O-R) theory, aiming to reveal how external stimulus variables (perceived content quality (PCQ), personalized fit (PF), industry pressure (IP), perceived technological risk (PTR)) are adopted through psychological state variables (self-efficacy (SE), innovativeness (INN), and task technology fit (TTF)) influence apparel designers’ AIGC adoption intentions. Based on the questionnaire data of 267 Chinese fashion designers, partial least squares structural equation modeling (PLS-SEM) was used for empirical analysis. The results showed that: PCQ and PF significantly enhanced SE and TTF, while PTR significantly inhibited the above psychological mechanisms; SE, INN, and TTF positively influenced adoption intention, with TTF having the most significant effect, and IP did not show a significant effect. The findings not only validate the applicability of the S-O-R theory in creative technology adoption, but also emphasize the key role of TTF matching and psychological-cognitive factors in promoting the application of AIGC tools, providing theoretical support and practical insights for subsequent tool optimization and user guidance.
Perceptions of air pollution from stubble burning and its health risks in Punjab, India
Abstract In the state of Punjab, India, where a rice-wheat double cropping system is prevalent, smoke from paddy stubble burning deteriorates air quality in the area and downwind regions. To assess citizens’ perception about air pollution, its health risks, and attitude toward stubble burning, a semi-structured interview was conducted with 2202 households in 22 districts of Punjab between August 2020 and January 2021. We explored household- and district-specific factors affecting each dimension of health risk perception using the random-intercept logistic regression model. Among all households, 46% of respondents perceived air pollution in Delhi as “severe” while only 25% perceived that in Punjab areas as “severe”. Although 60% of respondents noted that smoke from stubble burning did not affect their health or that of their families, more than 65% considered stubble burning to be a major issue. Respondents whose family members have health issues or who are aware of the health risks of air pollution were more likely to perceive smoke from stubble burning is harmful to health. Our findings suggest that while households are aware of the poor air quality in Delhi, they did not recognize stubble burning to be the main cause – in part due to lack of observational evidence.
Symptomatic dry eye disease (DED) in cohort of contact lens wearers in Jordan
Understanding the symptomatic dry eye disease (DED) and its associated risk factors among contact lens wearers is crucial for clinicians to tailor effective interventions, enhance patient care, and prevent contact lens dropout. This study investigated symptomatic DED and its associated risk factors among a sample of contact lens wearers in Jordan. This cross-sectional study assessed symptomatic DED in a cohort of contact lens wearers in Jordan using an online survey distributed across various social media platforms. A total of 301 participants completed the survey, which included demographic and contact lens profile questions and the Arabic version of the Ocular Surface Disease Index (ARB-OSDI) questionnaire. Statistical analyses explored the associations between OSDI scores, demographics, symptoms, visual-related functions affected by dryness, and triggers of dryness. Among the study population, 77.1% were females, 48.2% were aged 18–24 years old, and 24.87% were soft contact lens wearers. The mean OSDI score was 22.9 ± 17, with 70% showing mild-to-severe dry symptoms and 25% showing severe symptomatic DED. The ANOVA revealed a significant association between symptomatic DED, wearing face masks, longer contact lens age, and poor cleaning habits. The use of lubricant eye drops significantly reduced symptomatic DED with a mean OSDI score of 8.79. The most prevalent dryness symptoms were pain and blurred vision, affecting reading and TV watching in 50% of the population. Wind and air conditioning were the most common environmental triggers, reported by 67.8% and 66.4% of participants, respectively. A high proportion of symptomatic DED was reported in this study population. Wearing face masks, a longer contact lens age, and poor contact lens hygiene were correlated with exaggerated DED symptoms. Conversely, the use of lubricated eye drops reduces the symptoms of DED.
The initiation mechanism of gravel-type debris flow based on laboratory simulation experiments
Regional differences in prevalence, awareness, treatment and control of hypertension in Poland - comparison of two national multi-center health surveys: WOBASZ and WOBASZ II
Introduction Data on regional differences in the current prevalence of hypertension in Poland remain limited. Objectives This study aimed to assess the prevalence, awareness, treatment, and control of hypertension among Polish adults in 2013–2014 (WOBASZ II study) and to compare these parameters with data from 2003–2005 (WOBASZ study). Patients and Methods The study was conducted in two independent, representative samples. The WOBASZ II study included 3,406 women and 2,757 men, while the WOBASZ study examined 7,783 women and 6,972 men. Results The greatest increase in hypertension prevalence over 10 years was observed among men from Świętokrzyskie Voivodeship (39.7% vs. 51.8%) and women from Łódzkie Voivodeship (32.7% vs. 44%). Increases in hypertension awareness were noted in men from Wielkopolskie Voivodeship (50.8% vs. 59.5%) and women from Świętokrzyskie Voivodeship (65.7% vs. 77%). Treatment rates rose in men from Warmińsko-Mazurskie Voivodeship (16.8% vs. 40.3%) and women from Opolskie Voivodeship (24.7% vs. 44.4%). Improvements in hypertension control were seen in men from Wielkopolskie Voivodeship (3.5% vs. 13.3%) and women from Lubuskie Voivodeship (5.6% vs. 27.4%). Conclusions Pronounced differences were observed in the prevalence, awareness, treatment, and control of arterial hypertension among voivodeships, highlighting the necessity of region-specific public health interventions and resource allocation to effectively manage hypertension. Additionally, changes observed over the decade from 2003/04–2013/14 highlight evolving epidemiological trends and demonstrate the impact of such interventions on hypertension management.