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To hug or not to hug? Public and private displays of affection and relationship satisfaction among people from Indonesia, Nepal, and Poland
Displays of romantic affection, both public and private, contribute to improved well-being, reduced stress, greater life satisfaction, and enhanced relationship satisfaction. However, cultural norms significantly influence the expression of affection, particularly in public settings. This study aimed to compare individuals from Indonesia, Nepal, and Poland regarding their public and private displays of affection, negative attitudes, and behaviors towards other individuals engaging in public displays of affection. Additionally, we examined relationship satisfaction and its associations with the expression of affection. We collected data from 170 Indonesian participants (62 men and 108 women), 120 Nepali participants (56 men and 64 women), and 171 Polish participants (72 men and 99 women) aged 18 to 49. The results revealed cultural differences in public displays of affection: Polish participants reported the highest level, while Indonesian participants reported the lowest. Differences also emerged for private displays of affection: Polish participants scored higher than Nepali and Indonesian participants, while no differences were observed between participants from Nepal and Indonesia. Negative attitudes and behaviors towards displaying affection publicly were most prevalent in Indonesia and least prevalent in Poland. Nepali participants reported the highest level of relationship satisfaction, followed by Polish participants, with Indonesian participants reporting the lowest. Across all three countries, positive correlations were observed between displays of affection and relationship satisfaction, underscoring the importance of affectionate behaviors in romantic relationships. Moreover, our findings highlight the influence of cultural norms on the expression of romantic affection and suggest that relationship satisfaction is closely tied to affectionate behaviors, albeit with variations shaped by cultural context.
A comparison between Polovodova and Detinova methods for parity determination of field-collected <i>Aedes albopictus</i> and fluctuation of nulliparous and parous densities
RETRACTED: Edge computing based english translation model using fuzzy semantic optimal control technique
People’s need for English translation is gradually growing in the modern era of technological advancements, and a computer that can comprehend and interpret English is now more crucial than ever. Some issues, including ambiguity in English translation and improper word choice in translation techniques, must be addressed to enhance the quality of the English translation model and accuracy based on the corpus. Hence, an edge computing-based translation model (FSRL-P2O) is proposed to improve translation accuracy by using huge bilingual corpora, considering Fuzzy Semantic (FS) properties, and maximizing the translation output using optimal control techniques with the incorporation of Reinforcement Learning and Proximal Policy Optimisation (PPO) techniques. The corpus data is initially gathered, and necessary preprocessing and feature extraction techniques are made. The preprocessed sentences are given as input to the fuzzy semantic similarity phase, which aims to avoid uncertainties by measuring the semantic resemblance between two linguistic elements, such as phrases, words, or sentences involved in a translation using the Jaccard similarity coefficient. The fuzzy semantic resemblance component’s training estimates the degree of overlap or similarity between two sentences, such as calculating the percentage of characters and length of the longest matching sequence of characters. The suggested Reinforcement learning and PPO can address specific uncertainty causes in machine translation assessment, like out-of-domain data and low-quality references. In addition to simple word-level comparison, it permits a more complex grasp of the semantic link. Reinforcement Learning (RL) and Proximal Policy Optimisation (PPO) techniques are implemented as optimal control techniques to optimize the translation procedures and enhance the quality and precision of generated translations. RL and PPO aim to improve a machine translation system’s translation policy depending on a predetermined reward signal or quality parameter. The system’s effectiveness is evaluated by various metrics such as accuracy, Fuzzy semantic similarity, Bi-Lingual Evaluation Understudy (BLEU), and National Institute of Standards and Technology score (NIST). Thus, the proposed system achieves higher quality and translation accuracy of the text that has been translated and produces higher semantic similarity.
Evaluation of nerve function after Bell’s palsy based on different facial nerve assessment scales HBGS/SFGS/MPS: A comparative study
Background Studies have shown that approximately 30% of patients with Bell’s palsy may experience permanent disfigurement due to muscle weakness affecting facial expressions. The prognosis for Bell’s palsy is often correlated with the degree of impairment in facial nerve function observed in the early stages of the condition. Selecting appropriate assessment tools is essential for the effective treatment and prognosis of patients with Bell’s palsy. Objective Examine and compare three scales used to measure Bell’s palsy: the House-Brackmann Grading Scale (HBGS), the Sunnybrook Facial Grading System (SFGS), and the Modified Portmann Scale (MPS). Methods A retrospective study involved 97 patients with Bell’s palsy treated at the authors’ institution from 2021 to 2022. The authors accessed these data for research purposes in February 2025. The patient cohort underwent HBGS, SFGS, and MPS to assess facial nerve function before and after treatment. We compared the results of these three evaluation methods. Additionally, we performed correlation analyses and receiver operating characteristic (ROC) analyses of the post-treatment data to examine the relationships between HBGS and SFGS and between HBGS and MPS, using the internationally recognized and most widely utilized HBGS as the standard. Results The HBGS demonstrated moderate consistency with both the FSGS and MPS, revealing significant negative correlations (r = −0.876, P < 0.01; r = −0.860, P < 0.01). All three scales exhibited high reactivity and showed no ceiling/floor effect. The optimal cut-off values for the FSGS and MPS were determined to be ≤ 68 and ≤ 16 points, respectively, with AUC of 0.948 (95% CI: 0.910–0.984) and 0.931 (95% CI: 0.883–0.968). Conclusion HBGS, SFGS, and MPS are all appropriate tools for assessing Bell’s palsy. The severity of facial nerve palsy can be clinically classified using a transect score of 68 on the SFGS and 16 on the MPS. However, the results should be interpreted with caution, as objective indicators were not utilized as criteria.
Influence of mate and nest-site fidelity on a declining, urban avian population
As urbanization reduces species’ habitats and population sizes, managers need information on whether within-population processes, such as changes in mate and nest-site fidelity and dispersal distances, may be contributing to declines. Few avian studies have examined changes in these behaviors in declining populations or in urban settings. We investigated whether mate fidelity, nest-site fidelity or breeding dispersal distance changed over time in a population of burrowing owls (Athene cunicularia), a short-lived, socially-monogamous species. During the 18-year period of the study, the population declined by 69% in urban Santa Clara County, California, USA--a region of rapid urbanization. We assessed whether these behaviors were influenced by key factors including age, breeding success in the previous year, and years with the same mate, and examined the relationship between mate and nest-site fidelity over time and annual reproductive success. Our analyses showed no change over time in mate fidelity rates, nest-site fidelity rates, dispersal distances or annual reproductive success, indicating these behaviors remained stable even during a severe population decline. Although burrowing owls are a short-lived species, we found that increasing years with the same mate resulted in increased nest-site fidelity and annual reproductive success. To achieve increasing annual reproductive success in this species and others with similar fidelity behaviors, nest sites and pairs must be protected over many years allowing mates to stay together in the same nest territory. Since these fidelity behaviors were maintained during the population decline, other factors require investigation to determine the causes for decreases in this population. Burrowing owls are an urban-adaptable species that can maintain important fidelity behaviors in human-altered habitats. However, even such species are subject to population declines in urban settings.
Left ventricular segmentation method based on optimized UNet and improved CBAM: ESV and EDV tracking study
This paper introduces an optimized nested UNet model for automated left ventricular segmentation in cardiac function assessment. We utilize the EchoNet-Dynamic dataset, which contains both video data and expert annotations. Unlike conventional methods such as DeepLabv3 that struggle with large model sizes and imprecise segmentation, Our proposed model introduces a deeper feature extraction module to effectively capture multi-scale features and reduce computational overhead. By integrating the CBAM (Attention module) attention mechanism and a lightweight SimAM (Simple Attention Module) module, we enhance feature selectivity and minimize redundancy. To further stabilize training and address gradient issues, we combine binary cross-entropy and Dice loss functions. Experimental results reveal that our model significantly outperforms existing methods, achieving a 1.05% increase in the Dice coefficient and reducing model size to 15% of the original. These improvements not only enhance the accuracy of cardiac function assessments but also provide a more efficient solution for automated diagnosis in clinical practice.
Associations between genetic HPV 16 diversity and cervical cancer prognosis
Introduction Cervical cancer (CC) arises as a result of chronic and persistent female infection by different oncogenic human papillomaviruses (HPV). The incidence of this disease is still high in developing countries, such as Brazil, where diagnosis is often made in advanced stages. HPV 16 is the most common Papillomavirus genotype in CC worldwide. Studies regarding the association of different HPV 16 lineages with overall and disease-free CC survival rates can contribute to further understanding the behavior of different HPV 16 lineages concerning the prognosis of CC cases. Objective To assess the CC prognosis of patients treated in a Brazilian institution concerning HPV16 lineages. Methods Data were obtained from a prospective cohort of 334 patients with CC recruited between July 2011 and March 2014 and treated at the Brazilian National Cancer Institute (INCA), in Rio de Janeiro, Brazil. HPV 16 lineages were identified in tumor tissue samples. Genetic HPV 16 diversity comprised 218 cases of lineage A, 10 of lineage B, 10 of lineage C, and 96 of lineage D. In addition to HPV 16 lineages, age, histopathological type, staging, and treatment completion were evaluated as predictors of CC prognosis. Results The median patient age was 48 years. The most common histopathological type was squamous cell carcinoma (82.3%), followed by adenocarcinoma. Locally advanced disease staging was the most frequently detected, represented by similar stage II and III percentages (36.2% and 37.7%), followed by initial stage I (19.2%) and stage IV (6.9%). Two hundred two patients completed CC treatment. Age, histological type, staging, and treatment completion were associated with a higher risk of death, which was not observed for the HPV 16 lineage variable. With regard to age, an increase in each year of life led to approximately a 1% increase in the risk of death. Other histopathological types (poorly differentiated carcinoma, adenosquamous, neuroendocrine, and sarcoma) were associated with a higher risk of death compared with adenocarcinoma. Patients diagnosed in advanced stages exhibited a higher risk of death, and those who did not complete treatment exhibited an over 2-fold increased risk of death. Conclusion This study found no associations between HPV 16 lineages A, B, C, and D and CC prognosis.
Investigating the cardiorespiratory fitness gene COX7A2L in cardiomyocytes: Viability and mitochondrial function
Low cardiorespiratory fitness (CRF) is a well-established risk factor for cardiovascular disease (CVD) and all-cause mortality. Since CRF is largely genetically determined, understanding the genetic influences on CRF might reveal the protective mechanisms of high CRF. One gene found to be associated with CRF is COX7A2L. COX7A2L is a mitochondrial supercomplex assembly factor, but its role in cellular metabolism remains a topic of discussion. We hypothesized that COX7A2L could play a role in cellular respiration in cardiomyocytes, affecting cardiac function and CRF. To determine the effect of COX7A2L on cardiomyocyte function, we overexpressed and knocked down COX7A2L in human AC16 cardiomyocytes and performed MTT assays and Seahorse XF Cell Mito Stress Tests to assess cell viability and mitochondrial function. For the mitochondrial function measurements, we stimulated the cells with isoproterenol to investigate if the effect of altering COX7A2L levels would be larger under simulated increased energy demand. Overexpression and knockdown were validated using sandwich ELISA. Our findings showed that altering COX7A2L expression in human AC16 cardiomyocytes did not significantly affect cell viability or mitochondrial function. Further research is necessary to determine whether COX7A2L influences cardiomyocyte function and CRF.
Diagnostic accuracy of triglyceride to glucose index and triglyceride/high-density lipoprotein index for insulin resistance among children and adolescents: A systematic review
Introduction Insulin resistance (IR) is a common metabolic disorder associated with obesity, type 2 diabetes, and cardiovascular diseases. There is a need for simpler and more cost-effective indices to diagnose IR in pediatric populations. While the hyperinsulinemic-euglycemic clamp is the gold standard for diagnosing IR, it is costly and complex. Consequently, simpler indices like the triglyceride-to-glucose (TyG) and triglyceride/high-density lipoprotein (Tg/HDL) indices have been explored as alternative diagnostic tools for IR. Methods This systematic review adhered to PRISMA-DTA guidelines. Analytical studies evaluating the diagnostic accuracy of TyG and Tg/HDL indices for IR in children and adolescents were included. Eligibility criteria required studies to report sensitivity, specificity, or area under the curve (AUC) values compared against reference standards for IR. Excluded studies were those without reported diagnostic accuracy measures. Data were extracted from PubMed, Scopus, Web of Science, Embase, and SciELO Citation Index up to April 2024. Due to high heterogeneity, a narrative synthesis was performed. Results Twenty-one studies involving 28,768 participants were included. The TyG index showed sensitivities ranging from 60–92% and specificities of 54–100%, with AUCs between 0.610 and 0.960. For the Tg/HDL index, sensitivities varied from 14.8–85.7%, specificities from 60.9–97.6%, and AUCs from 0.687 to 0.809. These results suggest that the TyG index generally demonstrates higher diagnostic precision than the Tg/HDL index, but both exhibit moderate accuracy with considerable heterogeneity. Conclusion The TyG and Tg/HDL indices are promising tools for diagnosing IR in children and adolescents, but further studies with rigorous methodology are needed. Future research should focus on standardizing cut-off points and exploring their predictive value in diverse populations.
Social capital, digital economy and the entrepreneurship of the new generation of migrant youth: Empirical analysis based on CMDS data
In the era of digital economy, the form of digital production promotes the transformation of enterprise organization and business operation mechanism. It also affects the development of regional entrepreneurship and the choice of individual entrepreneurship. Youth is the future of the country and the hope of the nation, and youth employment is related to people’s well-being, economic development and the future of the country. From the perspective of social capital, this paper examines the entrepreneurship of the new generation of migrant youth by using the dynamic monitoring data of the floating population in 2018(CMDS). The empirical results show that the improvement of social capital can significantly promote the entrepreneurship of the new generation of migrant youth; From the perspective of social capital, social network, social trust and social status promote entrepreneurship significantly. However, the role of social participation is not obvious. From the perspective of different types of entrepreneurship, compared with survival entrepreneurship, social capital has a more significant impact on opportunity entrepreneurship. Heterogeneity analysis found that, Social capital has a significant impact on opportunistic entrepreneurship of groups with higher education level, higher family income and modern service industry; In the central cities and coastal areas, social capital can promote the opportunity entrepreneurship of the new generation of migrant youth. Expansion analysis further found that the digital economy can significantly promote the entrepreneurial effect of social capital.
Numerical simulation and parallel implementation of freight train air brake system
Numerical simulations of railway air brake systems are becoming increasingly computationally demanding due to the growing complexity and length of trains. This study introduces a parallel computing-enhanced model for simulating pressure dynamics in heavy-haul trains. The proposed approach assigns dedicated threads to each vehicle, with additional threads managing the interface fluxes of brake pipe connections, and is implemented in C# using the ThreadPool and Parallel libraries. A train configuration consisting of one locomotive and 116 vehicles was simulated under various brake pipe pressure reduction conditions. The validity of the air braking system simulation model was confirmed through comparisons with experimental data. Furthermore, the impact of parallel computing on simulation efficiency was investigated. The results indicate that the efficiency of serial computing is primarily influenced by the CPU Boost Clock frequency. Parallel computing consistently outperforms serial computing, with speedup ratios increasing as the number of CPU threads grows. Although the simulation partitions tasks by vehicle units, the computations remain sufficiently fine-grained that the ThreadPool implementation outperforms the Parallel library, as it eliminates the dynamic scheduling overhead inherent to Parallel’s workload distribution mechanism. Additionally, parallel computing efficiency improves as the number of vehicles increases; however, beyond a certain threshold, efficiency stabilizes as workload distribution becomes fully optimized.
The Human Exersome Initiative (HEI): Rationale, study design, and protocol
Habitual physical activity and exercise training (PA/EX) confers numerous health-benefits. Phenotypic adaptations and clinical health outcomes attributable to PA/EX are well-established, and molecular markers and mediators of the PA/EX response have been described. To date, the majority of prior work focused on the biochemical response to PA/EX has leveraged convenience samples of trained athletes participating in events, patients undergoing clinically indicated exercise stress testing, or laboratory protocols comprised of a single dose of exercise. Accordingly, the impact of “exercise dose”, defined by the product of intensity, duration, modality, and frequency, on the human biochemical response to PA/EX remains largely unexplored. The Human Exersome Initiative (HEI) was designed to fill this scientific knowledge gap. Specifically, the HEI will couple carefully controlled laboratory-based acute exercise testing with comprehensive systemic biochemical profiling to isolate the impact of PA/EX duration and intensity on human biochemistry. Herein, we describe the initial phase of the HEI which will aim to comprehensively define the impact of “exercise dose” on blood-based biochemistry in healthy young men and women. The overarching goal of the HEI is to elucidate how the human exercise response varies as a function of phenotypic variability. Using comparator data derived from young men and women, future iterations of this protocol will seek to determine how key sources of human variability (i.e., age, ethnicity, and the presence of comorbid disease) impact the biochemical response to PA/EX. We anticipate results from this work will facilitate biomarker discovery, the elucidation of molecular pathways and mechanisms associated with metabolic responses to exercise, and the identification of optimal exercise doses for future clinical interventions (i.e., tailoring preventive and therapeutic strategies).
The Wnt pathway induces a naïve-like subpopulation in primed stem cells, while NME7AB leads to a homogeneous naïve-like population
The literature is replete with conflicting reports as to whether the Wnt/β-catenin pathway induces human stem cell differentiation or pluripotency. Recently, scientists showed that human stem cells expressing low levels of active β-catenin preferentially differentiate down a neuroectoderm lineage, whereas cells expressing high levels favor mesendoderm. However, these results appear to contradict two other studies, where researchers improved differentiation to both neuroectoderm and mesoderm by increasing levels of active β-catenin at the start of differentiation. Here, we show that stem cells cultured with naïve growth factor, NME7AB, express the highest levels of active β-catenin, yet readily differentiate into neuroectoderm and mesendoderm, without lineage preference. This raised the interesting question of whether activation of the Wnt/β-catenin pathway could itself play a role in maintaining or inducing a naïve-like state. The β-catenin agonist WNT3A was added to stem cells in the absence of any other growth factors, which induced the concurrent emergence of two segregated populations: an OCT4+, XaXa naïve-like population and an OCT4- population. This finding could explain the apparently inconsistent reports as to whether β-catenin induces pluripotency or differentiation, while raising additional questions. Notably, does the naïve-like sub-population, devoid of cell fate decisions, contribute to an increased differentiation potential? Conversely, are the OCT4- cells predisposed to differentiate more efficiently? To address these questions, we compared the differentiation of primed state stem cells, with or without pre-treatment with WNT3A, to that of naïve state stem cells. WNT3A pre-treatment improved the differentiation potential of primed stem cells, while having no effect in naïve stem cells. Furthermore, differentiation of the homogeneous population of naïve cells was superior to the primed state cells, even after WNT3A pre-treatment. This result is consistent with the idea that the improved differentiation is due to the sub-population of the WNT3A induced naïve-like cells.
Mediating role of growth mindset between college life stress and adjustment to college life among nursing students: A-cross sectional study
Adjusting to college life is important for nursing students to achieve academic and work performance successfully. Growth mindset has been proposed as a mediating concept that can induce positive psychological outcomes in stressful life contexts, and may be a potential facilitating factor for adjustment to college life among nursing students experiencing stressful college life. This study aimed to examine the mediating effect of growth mindset in the relationship between college life stress and adjustment to college life in nursing students. This was a cross-sectional descriptive study. The study participants were 250 undergraduate nursing students recruited from three nursing colleges in Korea. Self-reported data on college life stress, growth mindset and adjustment to college life were collected using the online survey questionnaire. The data were analyzed using an independent t-test, one-way ANOVA, Kruskal-Wallis H test, Pearson’s correlation, and multiple regression analysis. The mediating effects were verified through the bootstrapping method using the PROCESS macro for SPSS. Higher levels of adjustment to college life were reported in nursing students who were in good health status and were satisfied with the nursing major. Nursing students’ adjustment to college life was negatively affected by college life stress and positively affected by growth mindset. Growth mindset mediated the link between college life stress and adjustment to college life of nursing students. Educators may be aware that growth mindset can transform stress into challenging opportunities for nursing students. As both types of growth mindset—intelligence and personality—mediated the relationship between college life stress and adjustment to college life, pedagogical strategies cultivating growth mindset in both domains should be developed and implemented to support nursing students’ adjustment.
A rubric for assessing conformance to the Ten Rules for credible practice of modeling and simulation in healthcare
The power of computational modeling and simulation (M&S) is realized when the results are credible, and the workflow generates evidence that supports credibility for the context of use. The Committee on Credible Practice of Modeling & Simulation in Healthcare was established to help address the need for processes and procedures to support the credible use of M&S in healthcare and biomedical research. Our community efforts have led to the Ten Rules (TR) for Credible Practice of M&S in life sciences and healthcare. This framework is an outcome of a multidisciplinary investigation from a wide range of stakeholders beginning in 2012. Here, we present a pragmatic rubric for assessing the conformance of an M&S activity to the TR. This rubric considers the ability of an M&S study to communicate how well the study conforms to the Ten Rules for credible practice and facilitate outreach to a wide range of stakeholders from context-specific M&S practitioners to policymakers. It uses an ordinal scale ranging from Insufficient (zero) to Comprehensive (four) that is applicable to each rule, providing a uniform approach for comparing assessments across different reviewers and different modeling studies. We used the rubric to evaluate the conformance of two computational modeling activities: 1. six viral disease (COVID-19) propagation models, and 2. a model of hepatic glycogenolysis with neural innervation and calcium signaling. These examples were used to evaluate the applicability of the rubric and illustrate rubric usage in real-world M&S scenarios including those that bridge scientific M&S with policymaking. The COVID-19 M&S studies were of particular interest because they needed to be quickly operationalized by government and private decision-makers early in the COVID-19 pandemic and were accessible as open-source tools. Our findings demonstrate that the TR rubric represents a systematic tool for assessing the conformance of an M&S activity to codified good practices and enhances the value of the TR for supporting real-world decision-making.
HMGB1-BoxA gene therapy in reversing cisplatin resistance in non-small cell lung cancer
Cisplatin is a widely used chemotherapy agent in the treatment of non-small cell lung cancer (NSCLC). However, its clinical efficacy is limited by the development of drug resistance in patients with NSCLC. Recently, we demonstrated that HMGB1-BoxA gene therapy (BoxA) is an ideal cancer treatment that revitalizes normal cells while promoting cancer cells’ DNA break cascade. Increasing cytoplasmic HMGB1 is a reason for cisplatin resistance (Cis-R); in this study, we investigated the potential of BoxA to reverse acquired cisplatin resistance in two NSCLC cell lines, A549/Cis-R, and H460/Cis-R. The growth capacity of these cancer cells was significantly impaired upon BoxA treatment, resulting in a notable reduction in cell viability, colony formation, cancer stemness, and self-renewal capacity. Significantly, BoxA enhanced cisplatin sensitivity and promoted apoptosis in cisplatin-treated Cis-R cells. Furthermore, BoxA altered the subcellular localization of the HMGB1 protein, decreasing its cytoplasmic localization. BoxA can potentially reverse cisplatin resistance by altering the translocation of HMGB1.
Understanding the audiological care of patients with co-existing dementia or mild cognitive impairment and hearing loss in the United Kingdom National Health Service: A qualitative study
Background Hearing loss is common among people living with dementia and can exacerbate the symptoms associated with dementia. The effective management of hearing loss can positively impact quality of life and help alleviate dementia-related symptoms. Little is known about current audiological pathways in the National Health Service (NHS) for adults living with dementia or mild cognitive impairment. Objectives To understand the current NHS audiological care pathways for adults living with dementia or mild cognitive impairment. Design Qualitative study Results Thirty-three NHS audiologists in the United Kingdom (UK) completed a qualitative survey about current adult audiological care pathways for people living with dementia or mild cognitive impairment, and 14 of those also participated in a follow-up interview. Data from the surveys and interviews were combined and analysed using reflexive thematic analysis. The key findings included the importance of person-centred care, the active involvement of carers, and the need for tailored approaches, including using adapted and additional tests to assess hearing loss while offering a variety of hearing interventions. Audiologists expressed a desire for more service integration, such as domiciliary visits, and emphasised the importance of adapting environments and practices, such as dementia-friendly spaces and routine dementia education for staff, to better support individuals living with these co-existing conditions, Conclusions These findings can help inform the development of formal clinical practice guidelines and evidence-based training to support audiological care for people living with dementia and mild cognitive impairment in the United Kingdom.
A framework for detecting and predicting highway traffic anomalies via multimodal fusion and heterogeneous graph neural networks
This paper presents a novel framework for detecting and predicting abnormal traffic events on highways. Current traffic monitoring systems often rely on single data sources, which limits their detection accuracy and robustness in complex environments. To address these limitations, we propose a framework based on multimodal deep fusion and heterogeneous graph neural networks (HGNNs), incorporating an Ensemble Contrastive Pessimistic Likelihood Estimation (CPLE) algorithm to optimize performance. The framework integrates static and dynamic traffic data, such as video images, traffic flow, vehicle speed, and tunnel weather conditions. Experimental results demonstrate that the model performs well in various scenarios, showing significant improvement in accuracy and stability over existing models like AGC-LSTM and AttentionDeepST. For instance, the proposed MHGNN-CPLE model achieves superior accuracy and F1 score in static detection tasks while maintaining high accuracy under different noise levels in dynamic detection scenarios. This study provides a significant advancement in traffic event analysis by effectively combining multimodal data and leveraging HGNNs to capture complex spatiotemporal dependencies.
Effect of telemedicine-supported structured exercise program in patients with chronic low back pain: a randomized controlled trial
Background Structured exercise programs delivered via telemedicine have the potential to benefit patients with chronic low back pain (CLBP). However, evidence-practice gaps exist, such as low exercise adherence and lack of attention to the mental health of CLBP, so further research is needed to investigate the impact of telemedicine-supported structured exercise program on patients with CLBP. Objectives To compare the clinical outcomes of patients with CLBP following a telemedicine intervention versus usual care therapy. Materials and methods An open label, randomized controlled trial (RCT) was conducted over eight weekly sessions. Participants with CLBP were randomly assigned to either the Experimental Group (EG) or the Control Group (CG) in a 1:1 ratio, using a randomized numeric table. The EG received an intervention consisting of patient education, health coaching, and structured exercise program delivered through mobile health (mHealth) apps. The CG received usual care therapy, including patient education and paper handouts describing home exercises. The outcome measures included disability, pain intensity, mental health status, quality of life, walking ability, and exercise adherence. These were evaluated using the Roland Morris Disability Questionnaire (RMDQ), the Numerical Rating Scale (NRS), Depression-Anxiety-Stress Scale (DASS21), 12-item Short Form Health Survey (SF-12), Time Up and Go (TUG), and Exercise Adherence Rating Scale (EARS), respectively. Linear mixed-effects model analysis was conducted at baseline, after 4 weeks (during treatment), and after 8 weeks (post-treatment), adhering to the principles of intention-to-treat (ITT) analysis. Results The study included a total of 78 participants, with 39 randomly assigned to each group. Changes were significantly different between groups at 8 weeks in disability (estimated value: −3.96, 95% CI: −5.45 to −2.47, P < 0.001), pain (estimated value: −1.69, 95% CI: −2.14 to −1.24, P < 0.001) and the physical health dimensions of quality of life (estimated value: 4.5, 95% CI: 1.29 to 7.71, P = 0.006). However, there were only within-group differences at 8 weeks in mental health status (estimated value: −3.81, 95% CI: −4.99 to −2.63, P < 0.001), mental health dimensions of quality of life (estimated value: 5.01, 95% CI: 2.9 to 7.13, P < 0.001), walking ability (estimated value: −0.92, 95% CI: −1.17 to −0.68, P < 0.001), and exercise adherence (Z: 1.91, P = 0.06) over time. Conclusion This study suggests that a telemedicine-based structured exercise program is more effective than usual care therapy in improving disability, pain, and physical health dimensions of quality of life in patients with CLBP. Furthermore, the telemedicine program is equally effective as usual care therapy in enhancing mental health status, mental health dimensions of quality of life, walking ability, and exercise adherence. These findings indicate that implementing such a program could reduce the burden on patients with CLBP. Trial registration This trial was registered at China Clinical Trial Registration Center with the identifier ChiCTR2300071560.