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Steps against the burden of Parkinson’s disease (StepuP): Protocol of a randomized controlled trial elucidating the biomechanical and neurophysiological mechanisms of a speed dependent treadmill training intervention
Objective Parkinson’s disease can impair gait and stability, leading to reduced independence and increased fall risk. While speed dependent treadmill training (SDTT) is clinically effective, the specific biomechanical and neurophysiological mechanisms driving these improvements remain unclear. The “StepuP” multicenter randomized controlled trial aims to elucidate these mechanisms and determine whether training enriched with virtual reality or mechanical perturbations (SDTT+) enhances gait efficacy and transfer to daily life. Methods We will recruit 126 individuals with Parkinson’s disease across four clinical sites and 21 healthy older adults as a reference group. Participants will be randomized to receive either standard SDTT or SDTT+ for 12 sessions. To capture the trajectory of recovery and retention, assessments will occur at three distinct timepoints: baseline, post-intervention, and a 12-week follow-up, each assessment including synchronized 64-channel electroencephalography (EEG), electromyography (EMG), and 3D kinematics. This multimodal setup allows for the quantification of cortical beta-band activity, corticomuscular coherence, and stability-related foot placement control. Furthermore, we will assess participant’s satisfaction, usability, and engagement through questionnaires and interviews to understand individual adherence and barriers to training. Significance The primary clinical endpoint is comfortable overground walking speed. We hypothesize that gait improvements are mediated by improved stability-related foot placement and cortical sensorimotor integration. By correlating lab-based mechanistic changes with real-world mobility patterns and participant experiences, this study seeks to identify specific pathophysiological mechanisms engaged during the treadmill training. These insights will help distinguish responders from non-responders, facilitating the development of personalized, acceptable, and effective rehabilitation strategies.
Intestinal lamina propria-type tumor stroma characterizes type 2 but not type 1 intraductal papillary neoplasm of the bile duct
Immunological mechanisms of mRNA vaccines for infectious diseases
Impact of long-term cryopreservation on serum proteome and metallome: Implications for Biobank quality control
Biobanks constitute a cornerstone of modern biomedical research, yet the effects of long-term storage on biospecimen integrity are not fully characterized. This study systematically evaluated the impact of prolonged cryopreservation on the metallomic and proteomic profiles of human serum. We analyzed 400 serum samples from the Shenzhen Chronic Disease Risk Factor Surveillance Project, including 200 long-term and 200 short-term cryopreserved specimens from healthy adults. Inductively coupled plasma mass spectrometry (ICP-MS) was used to quantify ten metals: vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), selenium (Se), rubidium (Rb), strontium (Sr), and cesium (Cs). Proteomic profiling was performed via liquid chromatography-tandem mass spectrometry (LC-MS/MS). The analysis quantified 682 proteins, with 242 showing significant abundance changes (fold change > 1.5, P < 0.05; 176 up-regulated, 66 down-regulated). Functional enrichment revealed these changes were linked to immune response, metabolic pathways, and antioxidant activity (P < 0.05). Concentrations of V, Mn, Fe, Zn, Rb, and Cs were significantly altered in long-term versus short-term stored samples ( P < 0.05). Moreover, long-term cryopreservation substantially reshaped the inter-element correlation networks. In summary, prolonged storage significantly modifies the serum metallome and proteome, potentially affecting the validity of research conclusions derived from biobanked materials. Consequently, storage duration must be rigorously considered and adjusted for in the design and interpretation of future large-scale retrospective studies utilizing archived specimens.
Laparoscopic fundoplication with or without intraoperative endoscopy for gastroesophageal reflux disease: a propensity score-matched cohort study
Demonstrating conservation impacts in California Marine Protected Areas using large-scale participatory science data
Measuring human interactions with protected areas is a key need in conservation social science, both to assess the potential for continuing negative impacts on sensitive resources and to support positive relationships with important places. Our paper investigates human activities in California Marine Protected Areas (MPAs) using an emerging approach of large-scale participatory data collection coupled with statistical analysis. Twelve organizations across the state developed, standardized, and implemented a data collection protocol for volunteers to record human activities, called “MPA Watch.” From 2012−2020, approximately 1,900 surveyors conducted more than 31,700 surveys, observing more than 1.2 million activities at 104 different sites across California’s coast, both inside and outside MPAs. We analyzed these data using generalized linear mixed models (GLMMs) with zero inflation to account for sampling bias associated with volunteer-driven data. We included covariates regarding weather and tides; time of day, week, and year; and beach type and amenities. We found statistically significantly lower consumptive activities inside MPAs with the strictest protections as compared with non-MPAs, and no significant difference between MPAs and non-MPAs for non-consumptive recreational activities. Some consumptive activities significantly declined over time. We also detected expected use patterns (e.g., for all activity categories, weekend counts were significantly higher than weekday counts). In addition, we noted patterns of interest for future study, including much higher incidence of non-consumptive activities than consumptive activities at a statewide level; higher popularity of some activities at certain individual sites; and the beginnings of the effects of the COVID-19 pandemic in 2020. Our analysis demonstrates that consumptive activities are lower inside California MPAs (indicating compliance with MPA rules), and results at particular sites can inform site-specific management strategies. Further, we show the potential of large-scale participatory science, coupled with appropriate statistical modeling, to monitor and inform conservation policy and management for protected areas.
Study on the interior ballistic characteristics of UAV ejection by CO2 phase transition catapult
Transformer-based advertisement image layout generation and object fidelity optimization
The layout of the image and the positional distribution of the objects directly affect the audience’s visual focus and the effect of the message conveyed. By setting up a specific layout structure, the viewer’s attention can be more focused on the product launched or the moral of the advertisement. Existing work related to position-controllable text-to-image generation has made great progress in generating results on simple images. However, when generating images of complex scenes, the quality is often poor. This can result in the model failing to accurately convey the message of the advertisement when used to generate advertisements. To address these limitations, we propose LAYOBJ-GAN, a novel two-stage framework for layout-controllable advertisement image synthesis. Unlike prior work, our method explicitly models background layouts jointly with object layouts during the text-to-layout generation stage, enabling comprehensive spatial planning of complex scenes. Technically, we introduce a Transformer-based sequence-to-sequence layout generator that learns long-range dependencies between textual descriptions and both background and object regions, which has not been explored in previous advertisement-oriented text-to-image frameworks. In the layout-to-image stage, we further propose a fine-grained text–layout interaction normalization module (TL-Norm) that enables object knowledge transfer from a pre-trained category-to-image model, allowing object appearance to be adaptively modulated by textual context and layout constraints. Extensive experiments on MS-COCO and a high-definition advertisement dataset (AsHQ-10K) demonstrate that LAYOBJ-GAN significantly outperforms seven state-of-the-art methods in image quality, layout controllability, and semantic object accuracy. These results confirm the effectiveness of explicitly modeling background layouts and transferring object-level generative knowledge for complex advertisement image synthesis.
Rheological and thermal degradation behavior of polypropylene/low-density polyethylene blends under successive multiple processing cycles
How a rush for minerals is causing deforestation in tropical regions
Medicaid expansion and inpatient hospital charges among women with major depressive disorders
Objective To examine the association between Medicaid expansion under the Affordable Care Act (ACA) and total inpatient hospital charges among women hospitalized with major depressive disorder (MDD), comparing Maryland and New Jersey, two Medicaid expansion states with distinct payment systems, to Florida, a non-expansion state. Methods We conducted a retrospective cohort study using data from the State Inpatient Databases for Maryland, New Jersey, and Florida from 2007 to 2020. The study population included women aged 18–64 years admitted with a primary diagnosis of MDD. The pre-ACA period was defined as 2007–2013, and the post-ACA period as 2014–2020. Difference-in-differences (DID) models with robust standard errors were used to estimate changes in total inpatient hospital charges, adjusting for demographic, socioeconomic, and clinical characteristics. Stratified analyses by race/ethnicity and insurance type were conducted to assess heterogeneity in policy effects. Results In adjusted analyses, Medicaid expansion was associated with divergent changes in hospital charges across expansion states. Compared with Florida, Maryland experienced a relative post-ACA reduction (DID estimate − $2,313; 95% CI: − $2,549 to −$2,078). In contrast, New Jersey had a post-ACA increase (+$3,366; 95% CI: $2,746 to $3,987). In Maryland, post-ACA reductions were observed across all racial and ethnic groups and insurance categories, with the largest decreases among uninsured and Medicaid-covered patients. New Jersey demonstrated heterogeneous patterns, including charge increases across most payer groups. Conclusion The effects of Medicaid expansion on inpatient charges among women with MDD differed across states, reflecting variations in payment regulation and hospital pricing. Maryland’s reductions suggest that coupling coverage expansion with cost‑containment mechanisms may help constrain hospital charge growth, with potential implications for the financial burden of mental health care.
Shifting responses of goose-beaked whales (Ziphius cavirostris) to long-standing naval sonar exposure opens new perspectives for research and mitigation
Abstract Predicting and mitigating the impacts of chronic noise on marine mammals is limited by sparse data on repeated disturbance. Naval sonar disrupts species behavior with lethal and sublethal risks, yet mitigation relies on short-term studies. We analyzed a decade of passive acoustic observational data to assess behavioral changes of goose-beaked whales ( Ziphius cavirostris ) at locations near and far from long-standing sonar operations. Whales remained present in impacted areas but exhibited patterns consistent with avoidance observed in exposure experiments. Interpreting these as responses, a 50% disturbance probability occurred at 122–132 dB pp re 1 µPa, below regulatory thresholds. With median 1.0–1.2 day intervals between exercises and 132–134 dB pp re 1 µPa daily received levels, disturbances imposed near-daily energetic and foraging costs. Differences in responses between areas with similar exposure suggest that ecological factors such as habitat quality may promote habitat persistence despite moderate disturbance. Over a decade, whales became more likely to be detected during shorter exercises and after exposure while maintaining sensitivity to moderate-to-high exposure levels. This suggests either reduced displacement responses over time or suitable prey conditions not found elsewhere as a result of changes in habitat conditions. These results suggest mitigation should prioritize sonar-free periods and limit exercise duration.
Association between unhealthy snack food and beverage consumption and the nutritional status of Nepalese children and adolescents: A systematic review
Introduction Eating habits have changed significantly over the past few decades, with consumers favoring unhealthy snack foods and beverages over traditional foods. This trend has shifted dietary patterns in developed and industrialized countries. However, this trend now also affects low- and middle-income countries, such as Nepal. Nepal is facing poverty, food insecurity, undernutrition like stunting and wasting, and also overweight and obesity during recent years among children and adolescents. The primary aim of this review is to assess the association between the consumption of unhealthy snack foods and beverages and the nutritional status of children and adolescents in urban, peri-urban, and rural Nepal. Materials and methods Electronic databases like PubMed, Google Scholar, Web of Science, and Scopus were used to undertake a thorough desk-based searching of the literature. The literature was chosen using a number of inclusion and exclusion criteria. The selected publications were gathered, appraised for quality assessment, and results synthesized from studies. Results Unhealthy snack food and beverages consumption is frequently reported to be high in urban areas and is significantly associated with higher odds of overweight or obesity. In sub-urban areas, the consumption is at a moderate level, exceeding that of rural areas, while generally lower than in urban settings and comparatively lower among rural youngsters, however, marketing initiatives and increased access are steadily raising the consumption. Although the majority of Nepalese children maintain a normal weight, underweight and stunting remain significant public health issues, and overweight and obesity are growing issues that require prompt action. Conclusions Children and adolescents in Nepal face two nutritional challenges: a growing prevalence of overweight and obesity and ongoing undernutrition. Undernutrition and stunting are major problems in rural Nepal, and the widespread consumption of unhealthy snack food and beverages in urban areas is strongly associated with the rising prevalence of overweight and obesity. These issues reflect the ongoing differences in food diversity, accessibility, and overall dietary quality between rural and urban settings.
Agronomic evaluation of microalgal extracts as seed bio stimulants for improving germination and early growth of common bean
Abstract Microalgal extracts are rich sources of diverse bioactive primary and secondary metabolites with potential bio stimulatory effects. This study comparatively evaluated extracts from Chlorella vulgaris , Nannochloropsis salina , and Arthrospira platensis as natural seed-priming agents, aiming to identify the most effective species and optimal concentration for enhancing seed germination and early seedling development of common bean ( Phaseolus vulgaris L.). Seeds were primed for 4 h in aerated algal extract solutions at concentrations of 0.0, 0.13, 0.25, 0.5, 1.0, 2.0, and 5.0%, followed by germination under controlled conditions (25–30 °C) for six days. Seed priming with algal extracts at concentrations up to 1.0% significantly improved germination percentage (GP), seedling vigor index (SVL), seedling length and biomass, and hydrolytic enzyme activities compared with untreated controls. The most pronounced stimulatory effects were observed at 0.5%, particularly with N. salina, which increased germination to 96% compared with 84% in the control, along with a ~ 130% increase in seedling vigor index. These enhancements were accompanied by elevated activities of hydrolytic enzymes and increased levels of total soluble sugars and proteins. Conversely, higher extract concentrations (2.0 and 5.0%) exerted inhibitory effects on germination and seedling growth, indicating a clear concentration-dependent response. Notably, S. platensis at 5.0% induced the largest decrease in GP (61%), along with a ~ 62.65% decrease in SVI.
Influence of environmental factors on the spat recruitment of the eastern oyster (Crassostrea virginica) along a subtropical river estuary in the Gulf of Mexico
Oyster spat recruitment is a key process controlling the persistence of natural populations. However, the relative influence of environmental gradients on spat recruitment remains poorly understood in estuaries of the Gulf of Mexico, especially along the Mexican coast. The aim of this study was to analyze the influence of some environmental factors on the spat recruitment of the eastern oyster ( Crassostrea virginica ) along the subtropical estuary of the Soto la Marina River, Gulf of Mexico. Six sampling sites were selected along the estuary, ranging from 1 km (Site 1) up to 22.8 km (Site 6) from the river mouth. Monthly, samples (April 2020–March 2021) of oyster spat ( C. virginica ) were collected from each site using an artificial spat collector. Water temperature, salinity, dissolved oxygen, pH, and Secchi depth were measured at the same time as oyster spat were collected for each site. Spatial and seasonal variations in the number of oyster spat were evaluated using a generalized linear mixed model (GLMM). Additionally, the relationship between spat recruitment and environmental variables was assessed using multiple linear regression analyses. Salinity was the unique environmental variable with significant differences between sites, showing a decreasing gradient from the river mouth to the upstream locations. The mean density of oyster spat decreased significantly from Site 1 to Site 5; however, they were absent at Site 6. Salinity and temperature were the environmental factors that explained the spatio-temporal variation of spat recruitment, showing a positive relationship with spat density on the collectors. Since temperature did not show significant differences between sampling sites, salinity is considered the primary environmental condition influencing the spat recruitment along the estuary. These findings provide a basis for identifying optimal areas and periods for oyster spat collection, supporting efforts in oyster reef restoration and the development of oyster aquaculture.
Pioneering detonation pressure in energetic materials
Patterns between evidence seeking behaviors, reasoning, and cognitive reflection: A supervised clustering approach
In the face of risk, decision-making can be driven by styles of evidence gathering and information processing. When studying how people navigate the complex landscapes of evidence, researchers face the analytical problem of an exponentially growing number of distinct evidence gathering styles, as the number of pieces of information increases. The existing solution is to chunk information into a manageable number of pre-defined categories. In this work, we propose to meet this analytical challenge with a two-pronged strategy. First, our observational setting offers more fine-grained pieces of evidence but masks the content of evidence behind a query (e.g., ’what does so-and-so say?’) to ensure that people only access what they deem as potentially relevant. Second, applying supervised clustering based on the SHapley Additive exPlanation (SHAP) methodology allows us to relate evidence from gathered patterns to final decision while significantly relaxing theoretical delineations of evidence types that would otherwise make analysis intractable. We argue that this two-pronged strategy approximately integrates the pathway from evidence seeking to information processing and decision-making. We applied this strategy to demonstrate the fruitfulness of bridging work on evidence gathering and information processing. For example, one mental shortcut (heuristic) to arrive at decisions when assessing a causal claim using a 2 × 2 contingency table is the ‘base rate neglect heuristic’ (considering only the treatment group, comparing the number of positive outcomes to the number of negative outcomes). While base rate neglect is a well-established heuristic in information processing research, there is not yet a clear equivalent picture regarding evidence gathering. We develop this picture by considering the assessment of the effectiveness of a hypothetical nasal spray based on queries that span gathering/processing evidence categories. Using a demographically diverse online sample collected during August 2024 in the United States, we establish that the base rate neglect heuristic from information processing research is also a heuristic when it comes to gathering first-order data. For example, we find that higher performance on the cognitive reflection test predicts selection of the full data of a 2 × 2 contingency table. But, the latter group is nevertheless similar to base rate neglecters in who they consider to be relevant outside sources (i.e., they have roughly the same “deference” behavior). So while evidential categories in information seeking research are well suited to track differences in deference behaviors, they are blind to the difference between these two groups. These findings are additionally important for designing tailored health communication so as to avoid fallacious inferences.