Search Results (22,168)

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing oral care. Methods: A convergent mixed-methods design was applied, involving 115 residents aged ≥60 years and 16 caregivers in a public facility. The residents’ oral health was assessed using interviewer-assisted questionnaires (demography, dependency level, Oral Frailty Five-item Checklist), clinical examinations (dental caries status, number of remaining teeth, oral and denture hygiene), and the Decayed, Missing, and Filled Teeth (DMFT) index. Focus group discussions with caregivers were conducted, transcribed, and thematically analyzed. Quantitative data were descriptively analyzed using SPSS version 29.0. Results: Over one-third of the residents (39%) were moderately to highly dependent on caregivers. All had experienced dental caries, with most having fewer than 20 teeth (92.9%) and requiring dentures (81.7%). Overall, both oral and denture hygiene were poor. Assessment of oral frailty indicated that the majority of residents (94.8%) were at risk of impaired oral function. A thematic analysis identified four key themes influencing oral health: (1) health and oral health conditions of residents; (2) variety in oral care practices; (3) older adults’ attitudes and behaviors; and (4) system factors. These themes were mapped in a conceptual framework demonstrating multilevel influences on oral care. Conclusions: Despite the single-center design, these findings provide actionable insights for improving geriatric oral health policies in Malaysia. Practical recommendations include integrating oral health into aged-care standards, expanding mobile dental services, and establishing oral care champions within facilities. Addressing these challenges is critical to improving quality of life and aligning long-term care practices with the WHO’s healthy aging priorities. Full article

Family caregivers provide most daily care for people living with chronic illness or frailty, yet they remain under-recognized in health and social care systems. To address this gap, we co-designed the Caregiver-Centered Care Champions Education Program, which equips frontline providers with the competencies needed to lead caregiver-inclusive change. Guided by the Kirkpatrick-Barr Health Workforce Education Framework, we conducted a mixed methods interpretive description evaluation of learner satisfaction, knowledge and confidence gains, and self-reported behaviour change. Sixty-seven interdisciplinary participants completed three online modules. Quantitative results from pre/post surveys (Wilcoxon signed rank tests) showed significant improvements across all competencies (p < 0.001; large effect sizes) alongside high satisfaction (means 6.56–6.96/7). Qualitative findings revealed that 94% of participants applied program content within three months, and 61% implemented five or more distinct behaviour changes (e.g., collaborative care planning, system navigation support). The analysis illuminated how learners integrated caregiver-centred principles with change leadership strategies. Time constraints and staffing shortages emerged as key barriers. Our co-designed, theory-informed approach effectively bridged individual learning and system change, demonstrating the potential to transform caregiver inclusion practices when supported by organizational policies. Full article

Mixed eccentricity faults in squirrel cage induction motors (SCIMs) are challenging to diagnose due to their subtle influence on the stator-current signal. Several research gaps remain in this field, including the limited investigation of fault severity levels and the scarcity of studies addressing fault detection under full-load conditions. Motivated by these gaps, this study proposes a diagnostic approach based on the variational mode decomposition (VMD) of the stator current. This paper proposes a diagnostic approach based on VMD of the stator current. The current signal is decomposed into intrinsic mode components, which are further separated into approximated and detailed signals. By focusing on the detailed signals and removing the fundamental frequency, the proposed algorithm highlights the spectral components associated with the mixed eccentricity. Experimental validation was carried out on a 1.5 kW SCIM connected directly to the power grid and tested under three loading levels (12.5%, 50%, and 100% of the rated load). In all nine experimental scenarios, the method successfully distinguished the healthy motor from faulty conditions with 20% and 30% mixed eccentricity severities. These results demonstrate that the proposed VMD-based method provides a reliable and quantitative tool for rotor fault diagnosis under varying load conditions. Full article

This study serves as a proof of concept for the evaluation of two membrane technologies, reverse osmosis combined with membrane distillation, for the recovery of N-methylmorpholine N-oxide (NMMO) and water from generated wastewater by the textile manufacturing “Lyocell process”. This method utilizes NMMO to dissolve cellulose for the production of cellulosic yarn, resulting in wastewater that contains 1–2 %w/w NMMO. After an initial pretreatment to remove suspended solids, followed by a mixed ion-exchange resin, the stream was fed into a reverse osmosis membrane unit, concentrating the solution to approximately 10 %w/w NMMO. Following this step, the RO concentrate was introduced to a DCMD setup equipped with a PTFE microporous membrane, achieving a final concentration of a 70.5 %w/w NMMO aqueous solution, which is considered suitable for reuse. The main contribution of the present study is to establish, in principle, that the newly proposed method can be a modular and scalable alternative to the dominant multi-stage evaporation technologies. Full article

Background/Objective: Tear hyperosmolarity is the main triggering factor in the immunopathogenesis of dry eye disease (DED). Tear osmolarity is known as the relevant metric to evaluate DED severity; however, measuring tear osmolarity after slit lamp examination (SLE) is known as a contraindication due to variability. In this study, we investigated the effects of SLE and fluorescein staining (FS) on the variabilities of tear osmolarity. Methods: In this prospective observational study sixty-five patients were enrolled in the study, comprising 31 healthy controls and 34 DED patients. The tear osmolarity was measured in the right eye using the TearLab^® system. The initial measurements were performed to establish baseline values before SLE, and additional measurements were performed after 20 s of SLE and followed by 20 s of SLE+FS. There were five-minute intervals between measurements. A correlation analysis was performed between OSDI score, tear film break-up time (TBUT), and tear osmolarity. A linear mixed-effects model was also applied to account for repeated measures and inter-subject variability. Results: The mean ages of the control and DED group were 31.3 ± 11.5 and 50.5 ± 15.5 years. Increased tear osmolarity was significantly associated with greater OSDI score and lower TBUT only in DED patients, but not in normal controls (OSDI:R = 0.378/p = 0.030, TBUT:R = −0.543/p = 0.011). The mean tear osmolarities in the normal controls were 298.3 ± 11.3, 299.1 ± 13.3, and 297.0 ± 12.6 mOsm/L at baseline (group 1), after SLE (group 2), and after SLE+FS (group 3), respectively, with no significant difference (p = 0.379). However, there was a significant difference in the tear osmolarities of the three groups in the DED patients (296.1 ± 11.5, 296.5 ± 11.0, and 291.2 ± 11.3 mOsm/L for groups 1–3, respectively/p < 0.001). The tear osmolarity of group 3 was significantly lower than those of groups 1 and 2 in the DED patients (p = 0.010/0.016). After FS, the mean tear osmolarity decreased by 4.9 ± 9.2 mOsm compared to the baseline in DED group. Conclusions: Tear osmolarity was only decreased in DED patients after SLE+FS, whereas it was unaffected in normal control subjects. Increased tear osmolarity in only DED patients correlated with increased symptom scores and decreased TBUT. These fluctuations in tear osmolarity reflect compromised tear film homeostasis in DED, highlighting the need to contextualize osmolarity data with clinical DED parameters. Full article

Residential buildings, the bastions of shelter and protection, are facing an escalating threat from climate change. The need to bolster the resilience of UK residential buildings is becoming more urgent, given the nature and frequency of the impact of climate change. This study employed a sequential explanatory mixed-method approach. The first phase involved surveying 313 households, revealing that Climate Change on Buildings (CCB) and Climate Change Measures (CCM) significantly influenced Climate Change on Occupants (CCO). Moreover, climate-positive measures were found to have a significant impact on building occupants. The second phase involved semi-structured interviews with ten UK construction experts to gather insights into the effects of climate change on residential buildings and strategies for mitigation. The findings from both phases underscore the need for government incentives, green loans, and increased stakeholder awareness to mitigate the impacts of climate change. To fully address climate change and improve the quality of life for residents, all stakeholders, including policy makers, construction professionals, and the community, must participate actively in these efforts. Consequently, a framework was developed to minimise the impacts of climate change on UK residential buildings. Full article

This paper conducts a multi-objective comparative study on various ventilation–radiant coupled heating systems that combine mixing ventilation (MV) and displacement ventilation (DV) with ceiling, side wall, and floor radiant heating. The aim is to explore the differences in indoor environmental quality (IEQ) and human thermal comfort under different system configurations, as well as the impact of the radiant temperature in the radiant modules and the supply air temperature in the ventilation module on system performance. The research results show that the combination of displacement ventilation and floor radiant heating (DV-F) performs the best in terms of thermal comfort and energy efficiency. In this configuration, the Predicted Mean Vote (PMV) for the indoor environment and human thermal comfort is close to neutral (−0.15 to 0.35), the Draught Rate (DR) is significantly lower than in other systems (3.7% to 4.4%), and the ventilation efficiency is relatively high. In addition, a comprehensive evaluation of different system configurations using the CRITIC weight method further verified that the DV-F configuration with a radiant temperature of 26.2 °C to 28.2 °C and a supply air temperature of 26 °C to 28 °C is superior. This study provides theoretical guidance for the design and optimization of heating systems. Full article

The protection and dissemination of cultural heritage in the digital age are confronted with dual problems of fragmented cultural narratives and insufficient public participation, which have now become a major bottleneck in realizing the value of cultural heritage. The rise of artificial intelligence technology nowadays offers an unprecedented opportunity to address this challenge. This study proposes a framework that combines artificial intelligence to tackle this issue, using the UNESCO World Heritage site, Kaiping Diaolou, as a case study. The methodology integrates AIGC tools such as Stable Diffusion and GPT-4 with traditional 3D modeling and digital twin technologies, aiming to go beyond traditional “photorealistic” replication by creating ink-wash stylized models with cultural resonance and artistic expressiveness, while providing immersive gamified experiences in virtual and augmented reality environments. A mixed-methods evaluation combining ratings from 6 experts and surveys from 122 participants confirms that the framework significantly improves work efficiency—modeling time is reduced from several hours to an average of 48 min, with a 60% increase in efficiency. More importantly, the gamified narrative generated by AI received a high engagement score of 4.2 (out of 5.0) among the 18 to 25 age group. The study also reveals a significant digital divide: users over 36 years old rated usability 35% lower than younger participants. The framework effectively lowers the technological threshold, allowing non-expert users to meet 70% of usability standards after brief training. This study ultimately validates an innovative framework that combines scalability and efficiency, offering an empirically tested practical solution for the deep, sustainable revitalization and public engagement of cultural heritage. Full article

Background/Objectives: Acute leukemias (AL) in children under 1-year-old are combined under the term “infant leukemia” and are a very rare malignancies, accounting for up to 5% of all childhood AL cases. The predominance of unfavorable clinical and laboratory characteristics leads to unsatisfactory treatment results, even with the use of modern treatment protocols. Patients/Methods: A comprehensive search through MEDLINE, PubMed, Scopus, and ScienceDirect using infant leukemia-related keywords was performed and included a final set of 52 academic articles. Our own experience included 11 patients with infant leukemia underwent allo-HSCT (allogeneic hematopoietic stem cell transplantation) at the NN Blokhin National Medical Research Center of Oncology in 2021–2023. Types of leukemia included acute myeloid leukemia, lymphoblastic leukemia, and mixed-phenotype acute leukemia. The most frequent cytogenetic aberration was KMT2A. All patients were in clinical and hematological remission, but four had positive MRD status (minimal residual disease). Donors: haploidentical—5 (45.4%), matched unrelated donor—5 (45.4%), and matched related donor—1 (9.2%). Graft manipulations: post-transplant cyclophosphamide was given to three patients with haplo-HSCT, and TCRαβ/CD19 depletion was performed in two patients. The type of immunosuppressive therapy (IST) varied based on the donor. Conditioning regimens were myeloablative. Results: Median follow-up was 23.5 months. Acute GVHD grade I–II developed in two patients (18%) and grade III–IV in three patients (27%). The overall survival rate was 54.5% (n = 6). The relapse rate after allo-HSCT was 18% (n = 2). The most common cause of treatment failure was infectious complications in the early post-transplant period (70%). Conclusions: Our center’s experience demonstrated acceptable transplant-related mortality and satisfactory relapse rates after allo-HSCT in patients with infant leukemia. The treatment of acute leukemia in infants is challenging, and optimal protocols are being developed around the world specifically for these patients. Taking into account the characteristics of this age group, the choice of chemotherapy drug doses should be carefully considered, and the indications for allo-HSCT should be balanced. Full article

Peri-urban forests are increasingly threatened by urbanization, fragmented governance, and limited land-use regulation, especially in Lebanon, where these landscapes play crucial ecological and cultural roles. Reliable sustainability assessment tools are needed to capture their multidimensional value and guide conservation strategies. This study applies the Landscape Sustainability Assessment (LSA) tool to Baabda Forest, a peri-urban green space of high ecological and cultural importance on the edge of Beirut, and compares the outcomes both with the LandScale framework and with results previously obtained from the Tannourine Cedar Forest Nature Reserve, a protected site in North Lebanon. Through a mixed-methods approach integrating spatial analysis, ecological fieldwork, socio-perceptual surveys, and institutional review, the research assessed ecological integrity, social functions, economic potential, and perceptual values. Findings show that Baabda Forest demonstrates significant ecological richness, cultural symbolism, and community engagement, but suffers from weak governance, lack of economic mechanisms, and absence of formal legal protection. In contrast, Tannourine benefits from structured management and national recognition, which strengthen its sustainability profile. The comparison between LSA and LandScale further reveals how international tools highlight governance and production issues but overlook cultural and perceptual dimensions that are critical in peri-urban contexts. This study demonstrates the added value of LSA as a holistic framework and emphasizes the need for participatory governance, sustainable economic activation, and legal designation to ensure Baabda Forest’s long-term sustainability, while providing insights transferable to similar landscapes globally. Full article

Background: Prefabricated functional appliances (PFAs) are widely used for interceptive orthodontic treatment in children, delivering intermittent forces with potential advantages for oral function. This study evaluated the effects of PFA treatment on the root development of maxillary central incisors in children during the mixed dentition stage using panoramic radiographs. Methods: A retrospective review was conducted on 77 children in the mixed dentition phase (2020–2025). These were divided into three groups: untreated controls (n = 33); skeletal Class II malocclusion group, treated with the Pre-Ortho^® Type 1 appliance (Group 1, n = 25); and functional anterior crossbite group treated with a Type 3 appliance (Group 2, n = 19). All participants underwent at least two panoramic radiographs; treatment was initiated when the maxillary central incisors were at Nolla stages 8 or 9. Following root completion, panoramic images were analyzed using the modified Lind method to measure crown length, root length, and root-to-crown ratio. Results: Mean final root lengths of the maxillary central incisors were 14.11 ± 1.40 mm (controls), 14.46 ± 1.42 mm (Group 1), and 13.89 ± 1.04 mm (Group 2) (p > 0.05). The mean root–crown ratios showed no significant variation (p > 0.05). Root development was unaffected by wear duration, with limited sex differences. Conclusions: PFA treatment may not adversely affect the root development of maxillary central incisors and indicates a safe intervention in children. Full article

Against the backdrop of global energy transition, geothermal energy has emerged as a critical renewable resource, yet its exploration remains challenging due to uneven subsurface distribution and complex surface conditions. This study pioneers a novel framework integrating the Normalized Shaded Vegetation Index (NSVI) with radiative transfer-based land surface temperature inversion to detect geothermal anomalies in the Gonghe Basin, Qinghai Province. Using multi-source remote sensing data (GF5 B AHSI, ZY1–02D/E AHSI, and Landsat 9 TIRS), we first constructed NSVI, achieving 97.74% classification accuracy for shadowed vegetation/water bodies (Kappa = 0.9656). This effectively resolved spectral mixing issues in oblique terrain, enhancing emissivity calculations for land surface temperature retrieval. The radiative transfer equation method combined with NSVI-derived parameters yielded high-precision land surface temperature estimates (RMSE = 2.91 °C; R² = 0.963 against Landsat 9 products), revealing distinct thermal stratification: bright vegetation (41.31 °C) > shadowed vegetation (38.43 °C) > water (33.56 °C). Geothermal anomalies were identified by integrating temperature thresholds (>45.80 °C), 7 km fault buffers, and concealed Triassic granite constraints, pinpointing high-potential zones covering 0.12% of the basin. These zones are concentrated in central Gonghe, northern Guinan, and central-northern Guide counties. The framework provides a replicable solution for geothermal prospecting in topographically complex regions, with implications for optimizing exploration across the Gonghe Basin. Full article

Background: Previous research showed that the majority of the variation in providers’ practice patterns is unexplained by patient, physician, and primary care practice characteristics. This study assessed physicians’ personal behavioral characteristics as explanatory components of medical practice variation (MPV). Methods: In this cross-sectional study, primary care physicians from Clalit Health Services in southern Israel were interviewed using validated surveys assessing risk-taking, tolerance for ambiguity, stress due to uncertainty, fear of malpractice, and empathy. We analyzed how much these traits explained MPV compared to patient, physician demographic, occupational, and practice characteristics using generalized linear mixed models and Nakagawa’s R². Results: Of the 160 physicians approached, 146 (91.3%) participated. The median practicing time was 22 years; 48% were male, with a median age of 49. The median number of patients per practice was 1135. Overall, 40.4% of MPV was explained, mostly by patient characteristics (18.9%), practice characteristics (10.2%), and physician demographics (8.3%). Physician behavioral traits explained only 2.3%. Conclusions: Personal behavior characteristics explain a minority of MPV, leaving 60% of the MPV unexplained. This suggests either limitations in survey assessments or that these traits are not key drivers of MPV. Full article

Objectives: Prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease COVID-19 is a public health priority. The efficacy of non-pharmaceutical interventions such as wearing face masks to prevent SARS-CoV-2 infection has been well established in controlled settings. However, evidence for the effectiveness of face masks in preventing SARS-CoV-2 transmission within real-world settings is limited and mixed. The present systematic review evaluated the effectiveness of face mask policies and mask wearing to prevent SARS-CoV-2 transmission and COVID-19 in real-world settings. Methods: Following PRISMA guidelines, scientific databases, and gray literature, were searched through June 2023. Inclusion criteria were as follows: (1) studies/reports written in or translated to English; (2) prospectively assessed incidence of SARS-CoV-2 or COVID-19; (3) assessed the behavior and/or policy of mask-wearing; and (4) conducted in community/public settings (i.e., not laboratory). Studies were excluded if they did not parse out data specific to the effect of mask wearing (behavior and/or policy) and subsequent SARS-CoV-2 transmission or COVID-19 disease or if they relied solely on statistical models to estimate the effects of mask wearing on transmission. A total of 2616 studies were initially identified, and 470 met inclusion and exclusion criteria for full-text review. The vote counting method was used to evaluate effectiveness, and risk of bias was assessed using JBI critical appraisal tools. Results: A total of 79 unique studies met the final inclusion criteria, and their data were abstracted and evaluated. Study settings included community/neighborhood settings (n = 34, 43%), healthcare settings (n = 30, 38%), and school/universities (n = 15, 19%). A majority of studies (n = 61, 77%) provided evidence to support the effectiveness of wearing face masks and/or face mask policies to reduce the transmission of SARS-CoV-2 and/or prevention of COVID-19. Effectiveness of mask wearing did not vary substantially by study design (67–100%), type of mask (77–100%), or setting (80–91%), while 85% of masking policies specifically reported a benefit. Conclusions: This systematic literature review supports public health recommendations and policies that encourage the public to wear face masks to reduce the risk of SARS-CoV-2 infection and COVID-19 in multiple real-world settings. Effective communication strategies are needed to encourage and support the use of face masks by the general public, particularly during peak infection cycles. Full article

Leveraging ubiquitous wireless signals for environmental sensing provides a highly promising pathway toward constructing low-cost and high-density flood monitoring systems. However, in real-world flood scenarios, the wireless channel is simultaneously affected by rainfall-induced signal attenuation and complex multipath effects caused by surface runoff (water accumulation). These two physical phenomena become intertwined in the received signals, resulting in severe feature ambiguity. This not only greatly limits the accuracy of environmental sensing but also hinders communication systems from performing effective channel compensation. How to disentangle these combined effects from a single wireless link represents a fundamental scientific challenge for achieving high-precision wireless environmental sensing and ensuring communication reliability under harsh conditions. To address this challenge, we propose a novel signal processing framework that aims to effectively decouple the effects of rainfall and surface runoff from Channel State Information (CSI) collected using commercial Wi-Fi devices. The core idea of our method lies in first constructing a two-dimensional CSI spatiotemporal spectrogram from continuously captured multicarrier CSI data. This spectrogram enables high-resolution visualization of the unique “fingerprints” of different physical effects—rainfall manifests as smooth background attenuation, whereas surface runoff appears as sparse high-frequency textures. Building upon this representation, we design and implement a Dual-Decoder Convolutional Autoencoder deep learning model. The model employs a shared encoder to learn the mixed CSI features, while two distinct decoder branches are responsible for reconstructing the global background component attributed to rainfall and the local texture component associated with surface runoff, respectively. Based on the decoupled signal components, we achieve simultaneous and highly accurate estimation of rainfall intensity (mean absolute error below 1.5 mm/h) and surface water accumulation (detection accuracy of 98%). Furthermore, when the decoupled and refined channel estimates are applied to a communication receiver for channel equalization, the Bit Error Rate (BER) is reduced by more than one order of magnitude compared to conventional equalization methods. Full article