Search Results (4,920)

Compared to non-smart communities, smart communities expand the boundaries of community management and provide a platform for the deep integration of fitness and health. However, a single-entity governance model reduces the management efficiency of smart communities and hinders the realization of fitness-health integration within them. A collaborative governance model involving governments, businesses, social organizations, and residents replaces the traditional linear governance model that relies on a single entity through resource integration. This study, based on collaborative governance theory, employs three scenario-based experimental designs and quantitative analysis, with Xiamen’s smart city community and non-smart urban village community as research subjects. It explores the multistakeholder collaborative governance model for the deep integration of fitness and health, compares the differences in fitness-health integration between smart communities and non-smart communities, and measures the effectiveness differences between multistakeholder collaborative governance and single-entity governance models. The findings indicate: (1) Residents in smart communities have higher satisfaction with comprehensive fitness-health services; (2) Residents in smart communities perceive shorter psychological distances when engaging in fitness-health activities compared to non-smart environments; (3) The governance model moderates the impact of psychological distance on service satisfaction. Compared to the single-actor model, multiactor collaborative governance more effectively enhances perceived psychological proximity and improves satisfaction. The research findings contribute theoretically to advancing understanding of collaborative governance theory while expanding the application of the technology acceptance model (TAM) and the construal level theory in the context of community governance. Practically, they offer insights for public policymakers to optimize resource allocation and for community managers to strengthen digital governance. Full article

For monitoring animal adaptation when facing environmental challenges, and more specifically when addressing the impacts of global warming—particularly responses to heat stress and short-term fluctuations in osmotic regulations in the different organs influencing animal physiology—there is an increasing demand for digital tools to understand and monitor a range of biomarkers. Microneedle arrays (MNAs) have recently emerged as promising devices minimally invasively penetrating human skin to access dermal interstitial fluid (ISF) to monitor deviations in physiology and consequences on health. The ISF is a blood filtrate where the concentrations of ions, low molecular weight metabolites (<70 kDa), hormones, and drugs, often closely correlate with those in blood. However, anatomical skin differences between human and farm animals, especially large animals, as well as divergent tolerances of such devices among species with behavior specificities, motivate new MNA designs. We addressed technological challenges to design higher microneedles for farm animal (pigs and cattle) measurements. We designed microneedle arrays composed of 37 microneedles, each 2.8 mm in height, using dextran-methacrylate, a photo-crosslinked biocompatible biopolymer-based hydrogel. The arrays were characterized geometrically and mechanically. Their abilities to perforate pig and cow skin were demonstrated through histological analysis. The MNAs successfully absorbed approximately 10 µL of fluid within 3 h of application. Full article

The assessment of microplastics (MPs) in terrestrial ecosystems has garnered increasing global attention due to their accumulation and migration in soils, which may have potential impacts on soil health, biodiversity, and agricultural productivity. However, research on their distribution and interactions in soil remains limited, especially in tropical regions. This study aimed to characterize MPs extracted from tropical soil samples and relate their abundance to soil and terrain attributes under different land uses (forest, grassland, and agriculture). Soil samples were collected from an experimental farm in Lavras, Minas Gerais, Southeastern Brazil, to determine soil physical and chemical attributes and MP abundance in a micro-watershed. These locations were also used to obtain terrain attributes from a digital elevation model and the normalized difference vegetation index (NDVI). The majority of microplastics found in all samples were identified as polypropylene (PP), polyethylene (PE), polyethylene terephthalate (PET), and vinyl polychloride (PVC). The spatial distribution of MP was rather heterogeneous, with average abundances of 3826, 2553, and 3406 pieces kg⁻¹ under forest, grassland, and agriculture, respectively. MP abundance was positively related to macroporosity and sand content and negatively related to clay content and most chemical attributes. Regarding terrain attributes, MP abundance was negatively correlated with plan curvature, convergence index, and vertical distance to channel network, and positively related to topographic wetness index. These findings indicate that continuous water fluxes at both the landscape and soil surface scales play a key role, suggesting a tendency for higher MP accumulation in lower-lying areas and soils with greater porosity. These conditions promote MP transport and accumulation through surface runoff and facilitate their entry into the soil. Full article

Background/Objectives: Survey administration mode may significantly influence responses on polarizing health topics, yet this methodological factor remains understudied in vaccine hesitancy research. Understanding how data collection methods affect parental attitudes toward childhood vaccination is crucial for accurate public health surveillance and intervention design. Methods: This comparative cross-sectional study examined parental attitudes toward childhood vaccination using both paper-based (n = 487) and online (n = 386) survey administration among 873 parents. This study employed multivariate logistic regression analysis to assess differences between survey modes while controlling for demographic variables. Results: Key outcomes included general vaccination support, belief in vaccine–autism links, preference for natural immunity, and communication comfort with healthcare providers. Substantial differences emerged between survey modes. Online respondents showed significantly lower vaccination support (61.92% vs. 88.48%, p < 0.001), higher belief in the vaccine–autism link (37.31% vs. 16.77%, p < 0.001), and greater endorsement of natural immunity over vaccination (38.08% vs. 12.50%, p < 0.001). After adjusting for demographics, online respondents had 5 times lower odds of supporting childhood vaccination (OR = 0.20, 95% CI: 0.13–0.30) and nearly 5 times higher odds of preferring natural immunity (OR = 4.67, 95% CI: 3.19–6.95). Online respondents were also less likely to feel comfortable discussing vaccines with healthcare providers (51.0% vs. 72.7%, p < 0.001). Conclusions: Survey administration mode substantially influences measured parental vaccine attitudes, with online platforms capturing more vaccine-skeptical responses. These findings have critical implications for public health research methodology and suggest that mixed-mode survey designs or statistical adjustments may be necessary to obtain representative population estimates of vaccine hesitancy. Full article

The pandemic spared most children and adolescents in Ghana from severe clinical disease, but it exposed long-standing gaps in services and protection methods. Methods: We conducted a desk-based narrative review of peer-reviewed studies, national and international reports, and grey literature from January 2020 to May 2025. The evidence was organised across eight domains of child and adolescent well-being. Across mental health, gambling and other risky behaviours, access to health services, economic hardship and child labour, nutrition, education, early childhood development, and WASH, the pandemic disrupted essential services and social safety nets. Examples include declines in routine care and immunisation, wider digital exclusion during remote learning, a rise in child labour linked to income loss, and persistent hygiene constraints. Preparedness in Ghana should focus on mental health, digital inclusion, early childhood services, and strong social protection. Ghana’s specific empirical data are uneven, so we triangulate peer-reviewed evidence with official reports, appraised the grey literature, and calibrated claims to the strength of sources. Full article

Background: Artificial Intelligence (AI)-driven Decision Support Systems (DSSs) promise improvements in diagnostic accuracy and clinical workflow efficiency, but their adoption is hindered by inadequate confidence calibration, limited transparency, and poor alignment with real-world decision processes, which limit clinician trust and lead to high override rates. Methods: We developed and validated a dynamic scoring framework to enhance trust in AI-generated diagnoses by integrating AI confidence scores, semantic similarity measures, and transparency weighting into the override decision process using 6689 cardiovascular cases from the MIMIC-III dataset. Override thresholds were calibrated and validated across varying transparency and confidence levels, with override rate as the primary acceptance measure. Results: The implementation of this framework reduced the override rate to 33.29%, with high-confidence predictions (90–99%) overridden at a rate of only 1.7%, and low-confidence predictions (70–79%) at a rate of 99.3%. Minimal transparency diagnoses had a 73.9% override rate compared to 49.3% for moderate transparency. Statistical analyses confirmed significant associations between confidence, transparency, and override rates (p < 0.001). Conclusions: These findings suggest that enhanced transparency and confidence calibration can substantially reduce override rates and promote clinician acceptance of AI diagnostics. Future work should focus on clinical validation to optimize patient safety, diagnostic accuracy, and efficiency. Full article

(1) Background: Mobile populations living in disadvantaged circumstances often face disrupted continuity of care due to incomplete or inaccessible health records. This feasibility study explored the perceived usefulness of Electronic Personal Health Records (EPHRs) in enhancing access to and continuity of care for mobile populations across Denmark, Ghana, Kenya, and The Netherlands. (2) Methods: A qualitative study using ninety semi-structured interviews, with multi-level stakeholders ranging from policymakers to mobile individuals, recruited through purposive and convenience sampling. Interview guides and analysis were informed by the Technology Acceptance Model (TAM), and analysis by the Unified Theory of Acceptance and Use of Technology (UTAUT). (3) Results: Stakeholders highlighted the value of improved medical data sharing and ownership and considered EPHRs promising for enhancing care continuity and efficiency. Key concerns included limited digital and health literacy, and data security and privacy, underscoring the need for education and safeguards against inappropriate data sharing. Due to differences in digital readiness and privacy guidelines, a one-size-fits-all EPHR is unlikely to succeed. (4) Conclusions: EPHRs are considered valuable tools to enhance care continuity and increase patient ownership, but they face technical, structural, and social challenges, including data security and varying levels of digital (health) literacy. Successful implementation requires context-sensitive, co-created solutions supported by strong policy frameworks. Full article

The role of nitric oxide (NO) in the onset and pathogenesis of hearing loss remains a matter of debate. To address this, we conducted a narrative review of the literature on the subject. We performed a literature search of SCOPUS, PubMed, Cochrane Library, EMBASE, and Google Scholar databases on the production and role of NO in hearing loss using the search terms/strategy “nitric oxide” AND “hearing loss” to ensure a comprehensive review of available studies. Results: Of 186 papers initially retrieved, 166 were unrelated to hearing loss and NO and were excluded. Of the 23 papers ultimately reviewed, 58% (12 articles) reported that NO caused or worsened hearing loss, 26% (5 articles) reported a beneficial effect of NO in the treatment of and/or defense against hearing loss, and 16% (3 articles) reached no firm conclusion on whether NO played a positive or negative role. This review highlights the dual role of NO in auditory health, where it is essential for normal cochlear function through regulation of blood flow and neurotransmission. However, excessive or dysregulated NO production, particularly via inducible nitric oxide synthase (iNOS), can lead to oxidative stress and hearing loss. Conversely, NO also exhibits protective effects in certain contexts, such as reducing noise-induced hearing damage through its antioxidant properties. These findings underscore the potential of NO modulation as a therapeutic strategy for hearing loss, emphasizing the need for further research to optimize its application and understand the conditions under which it is beneficial or harmful. Full article

Background/Objectives: Mental health and emotional well-being are critical yet often overlooked in older adults. Immersive virtual reality (VR) may offer novel strategies for promoting relaxation in this population, but the diversity of intervention designs and underlying mechanisms remains insufficiently mapped. This scoping review aimed to systematically examine head-mounted display (HMD) VR interventions for relaxation in older adults, focusing on core scenarios, mechanisms, and conceptual paradigms. Methods: Following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines, comprehensive searches of MEDLINE, Cochrane Library, Web of Science, and Scopus were conducted for empirical studies of HMD-based VR relaxation interventions in adults aged 60 and older. Data on study characteristics, hardware, intervention scenarios, and reported physiological and psychological mechanisms were extracted and categorized into conceptual paradigms. Results: Twenty-four studies were included, covering diverse clinical and community samples. Four main VR relaxation paradigms emerged: environmental relaxation, guided meditation, psychotherapy integration, and interactive gamified relaxation. Reported mechanisms included parasympathetic activation, multisensory immersion, attentional distraction, positive affect induction, mindfulness, cognitive engagement, and reminiscence activation. Considerable heterogeneity was found in intervention design and outcomes, with mechanisms often inferred rather than directly described. Conclusions: Similar relaxation mechanisms were engaged across paradigms, including hybrid interventions combining multiple approaches, highlighting the adaptability of VR to meet diverse needs. Identifying these four paradigms provides a foundation for future research and development of targeted VR-based relaxation for older adults. Further studies should clarify mechanisms, use standardized physiological outcome measures, and assess long-term benefits of VR relaxation interventions in geriatric populations. Full article

(1) Background: Chronic pulmonary diseases (CPDs), such as COPD, asthma, and interstitial lung disease, are often accompanied by psychological distress and reduced quality of life. Mindfulness-Based Interventions (MBIs), including digital and virtual reality (VR) formats, have emerged as promising non-pharmacological approaches to improve symptom management and well-being. This systematic review aimed to evaluate the effectiveness of MBIs—delivered in-person or digitally—on anxiety, depression, disease-related stress, dyspnea, and health-related quality of life in individuals with CPDs. (2) Methods: A systematic review was conducted following PRISMA guidelines across PubMed, Scopus, and Web of Science (2005–2025). Thirteen studies (8 randomized controlled trials, 5 non-randomized) met inclusion criteria. Outcomes assessed included psychological distress, physical symptoms, and health-related quality of life (HRQoL). Risk of bias was evaluated using RoB 2 and ROBINS-I tools. (3) Results: MBIs were associated with improvements in anxiety, depression, stress, and HRQoL in several studies. Interventions were generally well-tolerated and effective across various delivery methods, including digital and VR-based formats. Improvements were especially notable when interventions were tailored and sustained. (4) Conclusions: MBIs, including digital and VR-delivered formats, show promise in supporting psychological and physical outcomes in CPD populations. They represent a feasible and complementary tool in modern respiratory care. Full article

Background and Objectives: Early ambulation and timely detection of postoperative complications are cornerstones of colorectal Enhanced Recovery After Surgery (ERAS) programmes, yet the traditional bedside checks performed every 4–8 h may miss clinically relevant deterioration. The consumer wearables boom has spawned a new generation of wrist- or waistband-mounted sensors that stream step count, heart-rate and temperature data continuously, creating an opportunity for data-driven early-warning strategies. No previous systematic review has focused exclusively on colorectal surgery. Methods: Three databases (PubMed, Embase, and Scopus) were searched (inception—1 May 2025) for prospective or retrospective studies that used a consumer-grade or medical-grade wearable to collect objective physical-activity or vital-sign data during the peri-operative period of elective colorectal resection. Primary outcomes were postoperative complication rates, length-of-stay (LOS) and 30-day readmission. Two reviewers screened records, extracted data and performed risk-of-bias appraisals with ROBINS-I or RoB 2. Narrative synthesis was adopted because of the heterogeneity in devices, recording windows and outcome definitions. Results: Nine studies (n = 778 patients) met eligibility: one randomised controlled trial (RCT), seven prospective cohort studies and one retrospective analysis. Five studies relied on step-count metrics alone; four combined step-count with heart-rate or skin-temperature streams. Median wear time was 6 d (range 2–30). Higher day-1 step count (≥1000 steps) was associated with shorter LOS (odds ratio 0.63; 95% CI 0.45–0.84). Smart-band–augmented ERAS pathways shortened protocol-defined LOS by 1.1 d. Pre-operative inactivity (<5000 steps·day⁻¹) and low “return-to-baseline” activity on the day before discharge independently predicted any complication (OR 0.39) and 30-day readmission (OR 0.60 per 10% increment). A prospective 101-patient study that paired pedometer-recorded ambulation with daily lung-ultrasound scores found fewer pulmonary complications when patients walked further (Spearman r = –0.36, p < 0.05). Conclusions: Continuous, patient-worn sensors are feasible and yield clinically meaningful data after colorectal surgery. Early postoperative step-count trajectories and activity-derived recovery indices correlate with LOS, complications and readmission, supporting their incorporation into digital ERAS dashboards. Standardised outcome definitions, open algorithms for signal processing and multicentre validation are now required. Full article

Digital Twins (DTs) have become central to intelligent asset management within Industry 4.0, enabling real-time monitoring, diagnostics, and predictive maintenance. However, implementing Prognostics and Health Management (PHM) strategies within DT frameworks remains a significant challenge, particularly in systems experiencing multi-component degradation (MCD). MCD occurs when several components degrade simultaneously or in interaction, complicating detection and isolation processes. Traditional data-driven fault detection models often require extensive historical degradation data, which is costly, time-consuming, or difficult to obtain in many real-world scenarios. This paper proposes a model-based, control-driven approach to MCD detection, which reduces the need for large training datasets by leveraging reference tracking performance in closed-loop control systems. We benchmark the accuracy of four control strategies—Proportional-Integral (PI), Linear Quadratic Regulator (LQR), Model Predictive Control (MPC), and a hybrid model—within a Digital Twin-enabled hydraulic system testbed comprising multiple components, including pumps, valves, nozzles, and filters. The control strategies are evaluated under various MCD scenarios for their ability to accurately detect and isolate degradation events. Simulation results indicate that the hybrid model consistently outperforms the individual control strategies, achieving an average accuracy of 95.76% under simultaneous pump and nozzle degradation scenarios. The LQR model also demonstrated strong predictive performance, especially in identifying degradation in components such as nozzles and pumps. Also, the sequence and interaction of faults were found to influence detection accuracy, highlighting how the complexities of fault sequences affect the performance of diagnostic strategies. This work contributes to PHM and DT research by introducing a scalable, data-efficient methodology for MCD detection that integrates seamlessly into existing DT architectures using containerized RESTful APIs. By shifting from data-dependent to model-informed diagnostics, the proposed approach enhances early fault detection capabilities and reduces deployment timelines for real-world DT-enabled PHM applications. Full article

Background: Telepsychiatry expanded rapidly during the COVID-19 pandemic, yet patient experience data from mixed urban and rural areas in Saudi Arabia remain scarce. Objective: We aimed to quantify the perception of telepsychiatry among adults with major depressive disorder [MDD] in Madinah City, the KSA, and to identify associated demographic and clinical factors. Methods: A cross-sectional survey was conducted at Madinah Mental Health Hospital between December 2024 and March 2025. Eligible participants were Arabic-speaking adults [≥18 years] with a clinician-confirmed diagnosis of major depressive disorder [MDD] according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5], following a scheduled video- or audio-based telepsychiatry consultation. Perception of telepsychiatry was assessed using the validated 10-item Arabic version of the Telehealth Satisfaction Scale [TeSS], which evaluates audiovisual quality, communication, and support. Variables associated with perception at p < 0.20 in the bivariable analyses were entered into a multiple linear regression model to identify independent predictors. Results: Of the 218 eligible patients, 207 participated [response rate = 95%], with similarly high participation rates being reported in comparable telepsychiatry surveys [e.g., 90–91%]. The majority were male [59%], with a mean [SD] age of 38.4 [11.2] years. The mean satisfaction score was 32.3 ± 6.3, and 36% of participants were classified as highly satisfied. In the multivariable analysis, higher satisfaction was independently associated with male gender [B = 3.0, 95% CI: 1.3–4.7], intermediate versus elementary education [B = 4.3, 95% CI: 1.1–7.6], and the presence of a chronic illness [B = 2.1, 95% CI: 0.3–3.8]. Conclusions: Telepsychiatry is generally well-accepted among adults with depression in Madinah. However, women and individuals with lower educational attainment report lower satisfaction. Targeted interventions such as improving privacy, offering digital literacy support, and tailoring communication may help improve the telepsychiatry experience for underserved groups. Full article

Background/Objectives: While dentistry plays a critical role in promoting oral health, it also contributes significantly to environmental degradation through high energy consumption, water usage, and reliance on disposable, non-recyclable materials. Periodontology, in particular, involves resource-intensive procedures such as full-mouth disinfection, frequent surgical interventions, and aerosol-generating instrumentation. The aim of the present narrative review is to synthesize current knowledge and delineate feasible, evidence-informed strategies to operationalize sustainability across the full spectrum of periodontal treatment settings. Methods: The electronic search of the present narrative review was performed across PubMed/MEDLINE, Web of Science, BioMed Central, Scopus, CINAHL, and Cochrane Library databases. Results: The review identified actionable sustainability strategies across pre-workplace (e.g., eco-conscious procurement and transport reduction), workplace (e.g., energy- and water-saving technologies, digital workflows, and pollution control), and waste management (e.g., reuse protocols, recycling, and sustainable material selection). Particular emphasis was placed on the role of dental education, life cycle assessments, and digital innovations. Conclusions: The transition toward sustainable periodontology requires the adoption of evidence-based practices and leveraging digital innovation to reduce the environmental impact while maintaining high standards of care. Full article

Objective: Although information technology’s impact on social inequality has attracted widespread attention, existing research remains divided on whether technology generates “digital dividends” or exacerbates the “digital divide”. Most studies assume uniform effects across all life domains; yet, the mechanisms through which technology affects different aspects of social stratification may vary substantially. Method: Using data from the 2023 Chinese General Social Survey (CGSS) covering 5332 respondents, we examine information technology’s differential effects on economic income and health outcomes between urban and rural residents through multiple regression, interaction analysis and Blinder–Oaxaca decomposition. Result: Our findings reveal that information technology significantly enhances both income and health status, validating the digital dividend hypothesis. However, technology effects exhibit domain-specific patterns: urban–rural differences are modest in economic domains but pronounced in health domains, where rural residents benefit significantly more than urban counterparts. Information technology contributes 10.8% to urban–rural income gaps but plays larger roles in health disparities. Conclusion: We propose a digital dividend differentiation theory, whereby technology effects tend toward homogenization in standardized economic domains governed by market logic while exhibiting compensatory functions in health domains dependent on geographic proximity. These findings challenge the assumptions of technological uniformity and provide foundations for differentiated digital development policies. Moreover, by revealing how digital technologies can reduce structural inequalities in income and health, this study advances the understanding of digital inclusion as a core driver of sustainable urban–rural development, offering both academic contributions to sustainability scholarship and practical guidance for achieving inclusive development goals. Full article