Search Results (2,193)

Objective: There is scarce reporting of radial head fracture epidemiology and patient characteristics beyond age and sex. This study aimed to describe demographic, socioeconomic, and injury pattern characteristics for people sustaining a radial head fracture admitted to trauma centers over a 15-year period. Methods: Analysis of Victorian Orthopaedic Trauma Outcomes Registry data was conducted to describe the demographic and case characteristics of patients with radial head fractures admitted to collaborating hospitals. Cohort and case characteristics were compared by center type (Level 1 vs. other trauma centers). Results: A total of 991 cases with a unilateral radial head fracture were recorded over 15 years, with 827 admitted to Level 1 trauma centers and 164 admitted to other centers. The mean age at time of injury was 48.7 years (SD 19.7), with male predominance (n = 621, 62.7%). Most patients resided in major cities (n = 824, 85.2%), were treated under the universal healthcare system (n = 546, 56.1%), and had no Charlson Comorbidity Index conditions (n = 738, 74.5%). A higher proportion of patients managed at Level 1 centers were male (65.7% vs. 47.6%), younger (mean 47.7 vs. 53.7 years), living in major cities (86.6% vs. 78.5%), and working prior to injury (71.3% vs. 57.1%). Over 85% of the cohort sustained concomitant injuries, with Level 1 centers receiving a higher proportion of multiple injury cases (87.8% vs. 73.2%). Elbow dislocations constituted the largest proportion of concomitant injuries (n = 257, 25.9%). Conclusions: This study has provided new insights into the demographic characteristics, comorbidity status, and associated injuries of radial head fracture populations admitted to Level 1 and other trauma centers, using long-established registry data. Full article

People with disabilities often face challenges like moving around independently and depending on personal caregivers for daily life activities. Traditional assistive devices are universally accepted by these communities, but they are designed with one-size-fits-all approaches that cannot adjust to individual human sizes, are not easily customized, and are made from rigid materials that do not adapt as a person’s condition changes over time. This systematic review examines the integration of smart materials, sensors, actuators, and 3D/4D printing technologies in advancing assistive devices, with a particular emphasis on mobility aids. In this work, the authors conducted a comparative analysis of traditional devices with commercially available innovative prototypes and research stage assistive devices by focusing on smart adaptable materials and sustainable additive manufacturing techniques. The results demonstrate how artificial intelligence drives smart assistive devices in hospital decentralized additive manufacturing, and policy frameworks agree with the Sustainable Development Goals, representing the future direction for adaptive assistive technology. Also, by combining 3D/4D printing and AI, it is possible to produce adaptive, affordable, and patient centered rehabilitation with feedback and can also provide predictive and preventive healthcare strategies. The successful commercialization of adaptive assistive devices relies on cost effective manufacturing techniques clinically aligned development supported by cross disciplinary collaboration to ensure scalable, sustainable, and universally accessible smart solutions. Ultimately, it paves the way for smart, sustainable, and clinically viable assistive devices that outperform conventional solutions and promote equitable access for all users. Full article

Children’s neighborhood mobility has been widely examined through either independent movement or psychological autonomy, yet few studies consider how these dimensions intersect in the lived realities of low-income, high-density environments. This study explores how neighborhood conditions simultaneously constrain and enable children’s experiences of mobility and autonomy, focusing on People’s Housing Project (PPR) estates in Kuala Lumpur, Malaysia. Using a qualitative, child-centered approach, data were collected through child-led walks and mental mapping with 23 children aged 7–12. The child-led walks revealed everyday hazards that restricted children’s freedom of movement and heightened concerns for safety. Conversely, the mental maps highlighted intangible but significant attachments that fostered a sense of belonging, pride, and autonomy despite material deprivation. Together, these findings illustrate that children’s well-being depends not only on opportunities for independent mobility but also on affective and symbolic dimensions of autonomy embedded in their neighborhood environments. The study concludes that planning and housing policies must move beyond efficiency and density to address children’s rights to safe, supportive, and meaningful spaces that nurture both freedom of movement and autonomy in everyday life. Full article

In this study, I expand on the Black feminist tradition of rethinking Black women’s activism by examining how Black queer women’s fashion shows challenge traditional definitions and sites of activism. I present BlaQueer Style as an interpretive framework that largely draws on the wisdom and theories of Black feminism to undercover how these productions and the politics that shape them are not only sites of activism because they challenge the conventions of mainstream cultural institutions, but because they make space for the social and personal transformation of the communities they center. In this analysis of two public LGBTQ+ fashion shows, I argue that intention aside, the Black queer women founders and fashion workers and their practices and performances of centering marginalized communities, using the body to signal and subvert controlling images, and building coalition among these communities, highlight the liberatory potential of their fashion work. In a time when Black queer and trans people are experiencing misrepresentation and other forms of violence globally, BlaQueer Style is what I name the politics that presents a deep commitment to both the aesthetics and the liberation of these communities in Black queer women’s fashion work. Full article

Europe has experienced a growing divergence in trends of population change across the urban hierarchy. A key driver of this divergence is internal migration, which underpins the efficient functioning of the economy by enhancing labor market flexibility and allowing people to choose the most desired locations. Internal migration in Latvia is of increasing importance, as the propensity to change residence within national borders has become the primary mechanism of demographic change, shaping population redistribution across regions and the urban hierarchy. We used Latvia as a case study, exemplified by the monocentric urban system with Riga City at its center, as well as a relatively dense network of small towns spread across all regions. Small towns in Latvia, although not characterized by high levels of internal migration, exhibit notable changes in their demographic and socioeconomic composition. Our analysis uses administrative data on registered migration for each year from 2011 to 2021 to characterize migration patterns, as well as data from the 2011 and 2021 census rounds on 1-year migration to analyze the composition of the migrant population. The results showed sociodemographic variations in the characteristics of individuals migrating to small towns. Understanding the temporal and spatial dynamics of internal migration patterns and compositional effects is vital for effective local and regional development policies to plan essential services and infrastructure. Full article

Since the 1960s, theories on the relationship between people and their environment have explored how elements of the built environment may directly or indirectly influence human behavior. In this context, neuroarchitecture is emerging as an interdisciplinary field that integrates neuroscience, architecture, environmental psychology, and cognitive science, with the aim of providing empirical evidence on how architectural spaces affect the human brain. This study investigates the potential of neuroarchitecture to inform environmental design by clarifying its current conceptual framework, examining its practical applications, and identifying the context in which it is being implemented. Beginning with an in-depth analysis of the definition of neuroarchitecture, its theoretical foundations, and the range of interpretations within the academic community, the study then offers a critical review of its practical applications across various design fields. By presenting a comprehensive overview of this emerging discipline, the study also summarizes the measurement techniques commonly employed in related research and critically evaluates design criteria based on observed human responses. Ultimately, neuroarchitecture represents a promising avenue for creating environments that deliberately enhance psychological and physiological well-being, paving the way toward truly human-centered design. Nevertheless, neuroarchitecture is still an emerging experimental field, which entails significant limitations. The experiments conducted are still limited to virtual reality and controlled experimental contexts. In addition, small and heterogeneous population samples have been tested, without considering human variability. Full article

Background: Treatment failure continues to play a role in HIV-related morbidity in Mozambique. Antiretroviral therapy (ART) regimen switches are decided empirically, as HIV genotypic resistance testing (HIV-GT) is unavailable in Mozambique’s public health system. Since 2016, Médecins Sans Frontières (MSF) and I-TECH have provided access to HIV-GT at Alto Maé Health Center, Maputo. We describe the cohort of people with virologic failure (VF) that underwent HIV-GT and analyze dolutegravir (DTG) resistance (R) patterns. Methods: This cross-sectional assessment of routine programmatic data between July 2020 and February 2024 was conducted to guide future program enhancements. People living with HIV (PLWH) receiving ART beyond the first line with confirmed VF were included. Mutations were interpreted according to the Stanford HIVdb algorithm. We applied Bayesian bootstrapping for analysis, and the threshold for significance of effects was defined as a probability of 95%. Results: A total of 106 persons underwent HIV-GT following a structured adherence strategy, 62 (58.5%) of whom were on a DTG-based regimen. Fifty-seven of the 62 samples from persons on a DTG-based regimen were sequenced, and 51 (89.5% [95% CrI: 80.7, 96.2]) had confirmed resistance to DTG; the mean DTG-R score was 70.2 (95% CrI: 62.2, 78). Samples with DTG-R had a median of three INSTI mutations (IQR 1–4). Major DTG-associated mutations were found in 46 out of 57 samples: G118R (n = 28), R263K (n = 15), and Q148RK (n = 7). None of the people on the protease inhibitor regimen had an INSTI mutation. Conclusions: In contexts with limited access to resistance testing, the introduction of algorithms to identify PLWH at risk of developing drug resistance is strongly recommended. The proposed algorithm incorporates adherence reinforcement strategies, as recommended in national policies, followed by a short, supervised antiretroviral therapy (ART) support strategy. This approach has shown a high predictive value for identifying PLWH with resistance mutations to dolutegravir (DTG), thereby allowing the continuation of the effective DTG regimen without unnecessary regimen switches. Full article

Parkinson’s disease (PD), a progressive neurodegenerative disorder affecting over 10 million people worldwide, necessitates continuous symptom monitoring to optimize treatment and enhance quality of life. Effective communication between patients and healthcare providers (HCPs) is vital but often hindered by fragmented data and cognitive impairments. PARKA AI, a novel iOS application, leverages Apple Watch HealthKit data (e.g., tremor detection, mobility metrics, heart rate, and sleep patterns) and integrates it with self-reported logs (e.g., mood, medication adherence) to empower PD self-management and improve patient–HCP interactions. Employing a human-centered design approach, we developed a high-fidelity prototype using a large language model (LLM)— Google Gemini 1.5 Flash—to process and analyze self-reports and objective sensor-derived data from Apple Healthkit to generate patient-friendly summaries and concise HCP reports. PARKA AI provides accessible data visualizations, personalized self-management tools, and streamlined HCP reports to foster engagement and communication. This paper outlines the derived design requirements, prototype features, and illustrative use cases to show how LLMs can be used in digital health tools. Future work will focus on real-world usability testing to validate the application’s efficacy and accessibility. Full article

Effective and fair governance of protected areas (PAs) is essential for their ecological and social sustainability, particularly in contexts of high biodiversity and sociopolitical tensions. This study assessed the governance system of the Serranía del Perijá Regional Natural Park (SPRNP) in Colombia using criteria of effectiveness and justice, through a qualitative methodology grounded in thematic analysis. The research was based on semi-structured interviews and a focus group, with intentional coding supported by artificial intelligence using ATLAS.ti 25 software, which enhanced efficiency and pattern recognition in the construction of a semantic network. This AI-assisted coding approach represents an innovative methodological contribution to the qualitative assessment of PA governance. The findings highlight centralized governance, weak community participation, limited institutional presence, and power asymmetries that undermine equity in decision-making. The exclusion of the Yukpa people from the PA declaration process illustrates broader challenges of Indigenous recognition in Latin American governance contexts. Based on these findings, the study proposes three prospective governance scenarios—community-centered, inter-institutional coordination, and public–private articulation—which offer practical pathways for transforming governance. The study concludes that achieving more equitable and inclusive governance requires institutional strengthening, power redistribution, and the recognition of local knowledge. A viable solution may emerge from an adaptive combination of the proposed scenarios. Full article

This paper presents the design, development, and experimental evaluation of a hybrid wheel–leg guide robot intended to assist blind and elderly people with mobility tasks indoors and outdoors. The design requirements are derived from an analysis of safety, usability, and affordability needs for assisting devices. The resulting design consists of a compact platform with two front leg–wheel assemblies and three additional wheels, two of which are motorized, arranged in a triangular configuration that provides stable support and reliable traction. The proposed locomotion system is innovative because existing guide robots typically rely exclusively on either wheels or legs. In contrast, this hybrid configuration combines the energy efficiency of wheeled locomotion with the capability of leg-assisted stepping, enabling improved terrain adaptability. Experiments with a prototype were carried out in indoor environments, including straight-line motion, turning, and obstacle-overcoming tests. The prototype, with a total weight of 1.9 kg and a material cost of 255 euros, maintained stable movement and achieved a 100% success rate for obstacles up to 30 mm, with partial success up to 40 mm. Additional test results indicate an average cruising speed of 0.1 m/s, and a practical endurance of 4.5–5 h. The proposed design aims to contribute to the development of more inclusive, efficient, and user-centered robotic solutions, promoting greater autonomy and quality of life for blind and elderly people. Full article

Cystic fibrosis (CF) newborn screening (NBS) aims to improve outcomes through early diagnosis, yet disparities in time to diagnosis remain. This study examines CFTR allele frequencies and variant panel performance among a diverse CF population in Georgia to inform recommendations for updating the NBS algorithm and improving equity. This cross-sectional study includes 969 people with CF (PwCF) from Georgia’s accredited CF centers. CFTR variant frequencies were calculated according to race and ethnicity. Panel performance was evaluated for Georgia’s current Luminex-39 variant test and three expanded panels. Statistical analyses compared detection rates across panels and demographic groups. Georgia’s diverse CF population demonstrates a unique CFTR allelic variability compared to national data. Increasing panel size enhances case identification. A panel including 719 CF-causing variants from the CFTR2 database significantly improves case detection from 93% to 97% (p = 0.002), as well as two-variant detection from 69% to 86% (p < 0.001). Detection of minoritized PwCF also improves with increasing panel size. However, even using the 719-variant panel, detection of non-Hispanic Black PwCF remains significantly lower compared to non-Hispanic White PwCF (case detection: p = 0.003; two-variant detection: p < 0.001). In conclusion, the use of expanded CFTR panels for NBS in Georgia would enhance timely diagnosis and improve equity. Full article

The global textile industry has a significant environmental impact, driven by fast fashion and rising consumption, which leads to large amounts of waste. In Chile, this problem is especially visible, with thousands of tons of discarded clothing accumulating in open areas and landfills. This study explores how to design a practical textile revalorization system grounded in local reality. We used a qualitative mixed-methods approach, combining semi-structured interviews with six experts in textile circularity and an online survey completed by 328 people. Thematic analysis revealed low public awareness of textile recycling, limited consumer participation, and major structural barriers, including scarce infrastructure and unclear regulations. Experts emphasized the importance of coordinated action among government, industry, and grassroots recyclers, while survey respondents highlighted the need for education and easier recycling options. Based on these insights, we propose an integrated framework that combines education campaigns, better recycling systems, and formal recognition of informal recyclers’ work. While centered on Chile, the study offers ideas that could support textile circularity efforts in other countries facing similar challenges. By merging expert knowledge with everyday public perspectives, the approach helps design more realistic and socially grounded solutions for textile waste management. As with many exploratory frameworks, external validation remains a necessary step for future research to strengthen its robustness and applicability. Full article

Extreme climate events such as heatwaves are becoming more frequent and pose serious challenges in cities. Urban areas are particularly vulnerable because built surfaces absorb and release heat, while human activities generate additional greenhouse gases. This increases health risks, making it crucial to study population exposure to heat stress. This research focuses on Naples, Italy’s most densely populated city, where intense human activity and unique geomorphological conditions influence local temperatures. The presence of a Surface Urban Heat Island (SUHI) is assessed by deriving high-resolution Land Surface Temperature (LST) in a time series ranging from 2013 to 2023, processed with the Statistical Mono Window (SMW) algorithm in the Google Earth Engine (GEE) environment. SMW needs brightness temperature (Tb) extracted from a Landsat 8 (L8) Thermal InfraRed Sensor (TIRS), emissivity from Advanced Spaceborne and Thermal Emission Radiometer Global Emissivity Database (ASTERGED), and atmospheric correction coefficients from the National Center for Environmental Prediction and Atmospheric Research (NCEP/NCAR). A total of 64 nighttime images were processed and analyzed to assess long-term trends and identify the main heat islands in Naples. The hottest image was compared with population data, including demographic categories such as children, elderly people, and pregnant women. A risk index was calculated by combining temperature values, exposure levels, and the vulnerability of each group. Results identified three major heat islands, showing that risk is strongly linked to both population density and heat island distribution. Incorporating Local Climate Zone (LCZ) classification further highlighted the urban areas most prone to extreme heat based on morphology. Full article

Pneumocystis jirovecii pneumonia (PCP) remains a frequent cause of intensive care unit (ICU) admission among people living with HIV (PLWH), despite widespread antiretroviral therapy (ART) use. We conducted a retrospective cohort study of 39 PLWH with PCP admitted to the ICU at the Croatian national HIV referral center between 2002 and 2023. Patients were grouped by calendar period (pre-2015 vs. post-2015, reflecting the adoption of the “test and treat” strategy in 2015). Primary outcomes included ICU, 30-day, and 1-year mortality. We also evaluated the association between in-ICU ART initiation and survival. There were 37 (94.9%) males with a median age of 49 years (Q1–Q3, 37.5–54.5). Thirty-three (84.6%) were newly diagnosed with HIV. There were no differences between the observed periods regarding demographic characteristics. ART was initiated in the ICU in 21 (53.8%) patients, more frequently after 2015 (p < 0.001). ICU, 30-day, and 1-year mortality rates were 53.9% (n = 21), 51.3% (n = 20), and 66.7% (n = 26), respectively. Survival significantly improved in the later period, with 1-year survival reaching 54.5% (12/22). In-ICU ART initiation was associated with improved survival in univariable analysis, but this effect attenuated after adjusting for APACHE II or calendar year. Early ART may offer benefit but remains confounded by disease severity and evolving care standards. Full article

Urban regeneration has increasingly become a global strategy for promoting sustainable urban development, with the renewal of deteriorating residential communities serving as a key dimension of this process. Within the framework of a people-centered development paradigm, growing attention has been directed toward the necessity of securing residents’ satisfaction in community renewal initiatives. This study employs advanced textual analysis of resident submissions collected from government–citizen interaction platforms to investigate the determinants of satisfaction with renewal projects. Leveraging the semantic comprehension capabilities of large language models (LLMs), we identify both salient keywords and sentiment orientations embedded in residents’ narratives. Guided by the theoretical framework of resident satisfaction, the extracted keywords are organized into seven thematic domains: basic infrastructure improvement, quality-enhancement renovation, solicitation of residents’ preferences, residents’ decision-making power, policy transparency, construction governance, and community-level communication. Regression modeling is subsequently applied to assess the relative influence of these thematic domains on residents’ satisfaction. The findings suggest that insufficient integration of residents’ preferences at the preliminary stages of participation constitutes a principal source of dissatisfaction during the implementation of renewal projects. Furthermore, the study compares Latent Dirichlet Allocation (LDA) topic modeling with LLMs-based topic clustering, revealing the latter’s superior capacity to capture thematic structures in complex, long-form textual data. These results underscore the potential of LLMs to enhance the analytical rigor of research on urban regeneration and citizen participation. Full article