This article presents a multimodal behavioral protocol for examining observable correlates of cognitive effort and strategic revision during English-Chinese written translation and sight interpreting. Keystroke logs and screen recordings are synchronized for written translation, whereas audio recordings and verbatim transcripts are used for sight interpreting. Revision and self-repair episodes are coded by type and by functional outcome (effective, neutral, or detrimental) independently of holistic output-quality ratings. In a demonstration with 62 participants assigned to novice and trained groups, both groups completed the two task conditions in counterbalanced order. Trained participants had higher mean output-quality scores in written translation (20.1 ± 2.1 vs. 16.8 ± 2.3) and sight interpreting (18.9 ± 2.4 vs. 15.4 ± 2.6), and a larger proportion of effective revisions or self-repairs. Because pauses, deletions, onset latency, and revision density are indirect and task-sensitive, they are interpreted as behavioral correlates that require triangulation rather than as direct measures of a unitary construct. The protocol is intended for controlled expository texts and can be adapted to other language pairs after recalibrating input-method handling, pause thresholds, text comparability, and scoring procedures.
Lumbar degenerative disease is highly prevalent among older adults, and posterior lumbar fusion is a common surgical treatment. However, chronic postoperative pain, paraspinal muscle atrophy, and related complications frequently impair functional recovery and long-term outcomes. Conventional continuing rehabilitation often relies on delayed responses and standardized management, limiting its ability to address individual recovery needs during home-based rehabilitation. This single-center retrospective comparative cohort study included 117 patients aged ≥60 years who underwent single- or two-level posterior lumbar interbody fusion at the Fourth Affiliated Hospital of Soochow University between January 1, 2024, and January 31, 2025. All patients received standardized perioperative care and baseline rehabilitation guidance before discharge. Post-discharge rehabilitation consisted of either a smart nursing-enabled individualized rehabilitation model delivered through a wearable smart nursing terminal (n = 54) or conventional continuing rehabilitation comprising routine telephone follow-up, outpatient review, and a fixed home rehabilitation program (n = 63). The smart nursing model incorporated standardized stepwise rehabilitation with individualized adjustments, real-time monitoring, graded alert-triggered interventions, and continuous supervision throughout the 12-month recovery period. The primary outcome was the between-group difference in the change in activity-related Numerical Rating Scale (NRS) pain score from baseline to 12 months. Group-by-time analysis showed a greater reduction in activity-related NRS scores in the smart nursing group than in the control group (interaction estimate: -1.10 points; 95% CI: -1.50 to -0.69; P < 0.001). At 12 months, the smart nursing group also demonstrated lower resting NRS scores (1.87 ± 0.80 vs 2.87 ± 0.77), greater erector spinae cross-sectional area (14.20 cm2 ± 1.13 cm2 vs 12.19 cm2 ± 0.56 cm2), higher maximum isometric paraspinal torque (82.84 Nm ± 7.58 Nm vs 66.75 Nm ± 4.57 Nm), and a lower incidence of chronic postsurgical pain (16.67% vs 63.49%) (all q < 0.001). Differences in fusion and complication outcomes were examined in an exploratory manner. Smart nursing-enabled individualized rehabilitation was associated with improved 12-month outcomes, although the retrospective, nonrandomized design precludes causal inference.
Internet use is deeply embedded in university life, but problematic internet use cannot be evaluated adequately by exposure time alone. Evidence suggests that maladaptive or compulsive patterns of internet use are associated with difficulty in emotion regulation, yet inconsistencies in questionnaire order, eligibility criteria, screening thresholds, scoring procedures, and analytic reporting continue to limit comparability across studies. This method's article presents a standardized questionnaire protocol for behavioral-science and psychological-assessment studies examining internet addiction and emotion-regulation difficulty among university students. The workflow includes a fixed questionnaire sequence, prespecified eligibility criteria, mandatory-response settings, pilot-based completion-time thresholds, sequential data-quality screening, standardized scoring of the Internet addiction test and the 16-item difficulties in emotion regulation scale, and reproducible descriptive, correlational, and multivariable regression analyses. The protocol also specifies archiving of raw returns, screening logs, README/codebook files, and the final analysis-ready dataset. A representative implementation is reported to demonstrate execution of the protocol rather than to validate the instruments or establish prevalence. In that implementation, 520 students were invited, and 480 questionnaires were returned. After sequential exclusion of duplicate submissions, speeded responses, failed attention checks, patterned responding, logical inconsistency, and missing core data, 452 valid questionnaires were retained. The predefined analytic demonstration examined the association between the Internet addiction test total score and the difficulties in emotion regulation scale total score. The retained sample showed a mean Internet addiction test total score of 51.94 and a mean Difficulties in emotion regulation scale total score of 35.95. Emotion-regulation difficulty increased across internet-addiction severity groups, and the association remained evident after adjustment for demographic and behavioral covariates. This protocol provides a transparent workflow that can be repeated, audited, and adapted for future cross-sectional, repeated-measure, or longitudinal studies in university populations.
University teachers participate in professional development under different institutional, disciplinary, and motivational conditions. Participation records alone cannot explain whether professional development translates into meaningful professional learning. This article presents a reproducible, anonymous, cross-sectional survey protocol for assessing psychological need satisfaction, autonomous and controlled motivation, teaching self-efficacy, professional development engagement, and reflective practice from a self-determination theory perspective. The protocol specifies eligibility screening, stratified convenience sampling, questionnaire construction, expert review, pilot testing, online administration, anonymization, response-quality screening, scale scoring, reliability estimation, correlation analysis, hierarchical regression, and sensitivity analyses. It also clarifies scale adaptation, permission verification, construct scoring, and the interpretation of highly reliable scales as potential indicators of item redundancy. Representative results were obtained from one completed implementation of the protocol, in which 326 submitted records were exported and 313 valid responses were retained after prespecified screening. The results showed that autonomy, competence, and relatedness need satisfaction were positively associated with autonomous motivation, and that autonomous motivation and teaching self-efficacy were associated with professional development engagement. The protocol is suitable for standardized, multi-institutional, survey-based studies of the motivational and professional belief correlates of professional development engagement. It is less suitable for causal inference, longitudinal change estimation, direct behavioral outcomes, or institution-level program evaluation unless repeated measurements, observation, qualitative inquiry, or administrative data are added.
Esophageal squamous cell carcinoma remains difficult to diagnose early and to stratify accurately before treatment. Conventional tumor-node-metastasis staging provides essential anatomical information but does not fully reflect circulating biological heterogeneity. This two-center ambispective observational study developed and externally validated a combined serum biomarker panel incorporating carcinoembryonic antigen, squamous cell carcinoma antigen, and carbohydrate antigen 125 for diagnostic discrimination and prognostic risk assessment in esophageal squamous cell carcinoma. A total of 277 participants were enrolled from a tertiary hospital and a community healthcare center, including 167 patients with esophageal squamous cell carcinoma, 55 patients with benign esophageal disease, and 55 healthy controls. The tertiary hospital cohort was used for model development and internal validation, and the community center cohort was used for external validation. Pretreatment serum biomarkers were measured before initial treatment, logarithmically transformed, standardized using training-cohort parameters, and entered into diagnostic logistic regression and prognostic Cox proportional hazards models. The combined panel showed higher diagnostic discrimination than any individual marker, with an area under the receiver operating characteristic curve of 0.869 in the training cohort and 0.842 in the external validation cohort. A higher combined biomarker burden was associated with tumor length of at least 5 cm, pT3-4 disease, lymph node metastasis, and tumor-node-metastasis stage III-IV disease. In survival analysis, high combined biomarker burden independently predicted poorer overall survival and progression-free survival after adjustment for major clinicopathological factors. The integrated prognostic model, combining biomarker burden with clinicopathological variables, outperformed the tumor-node-metastasis stage alone, with a training-cohort C-index of 0.792 and an external-validation C-index of 0.761. These findings support the use of the serum carcinoembryonic antigen, squamous cell carcinoma antigen, and carbohydrate antigen 125 panel as a practical, noninvasive adjunct for pretreatment assessment and individualized risk stratification in esophageal squamous cell carcinoma.
