Search Results (866)

Osteoarthritis (OA) is a highly prevalent musculoskeletal disorder and a major cause of disability, posing growing challenges for healthcare systems worldwide. Conventional supervised clinical assessments provide valuable insights but are largely limited to cross-sectional snapshots and often fail to reflect the variability of real-world functioning, physical activity patterns, and symptom fluctuations experienced by individuals with OA, especially those with knee OA. This perspective introduces a multisensor digital phenotyping framework for smart knee OA assessment, integrating supervised laboratory evaluations with unsupervised continuous monitoring in daily living environments using wearable sensors, smart insoles, activity trackers, and mobile devices. Feasibility was tested in 40 participants (20 knee OA patients, 20 controls). Raw data from questionnaires, electronic goniometry, dynamometry, force plate, connected insoles, and seven-day home monitoring were harmonized via a standardized pipeline aligned with the ICF framework. The pipeline employed anomaly detection, missing data imputation, z-score normalization, and cloud-based storage. This framework is envisioned to facilitate advanced data integration and machine-learning-ready analytics, enabling longitudinal monitoring, pattern recognition, and individualized health profiling. By conceptually bridging cross-sectional and continuous sensing modalities, this approach has the potential to enhance ecological validity, support earlier identification of functional decline, and inform data-driven clinical decision-making. Key methodological, technological, and ethical challenges—including data quality, interpretability, privacy, digital literacy, and clinical adoption—are also highlighted. Overall, this paper underscores the promise of AI-enabled multisensor digital phenotyping to advance smart, personalized, and precision healthcare for individuals with knee OA. Full article

Counterfeit and unsafe medicines pose significant risks to patient safety and undermine trust in healthcare systems. This paper presents ACTMeds, a blockchain-supported pharmaceutical traceability and recall platform that considers pharmaceutical supply chain requirements and public health operational needs relevant to the Australian Capital Territory (ACT). The system integrates Ethereum smart contracts, developed using Ganache, with a React-based web application providing regulator, operator, pharmacy, and auditor interfaces, alongside a public verification portal leveraging QR and GS1 barcodes. In addition, role-based access control is enforced across the medicine lifecycle, including manufacture, custody transfer, dispensing, and recall, with immutable on-chain events generated to support auditability and accountability. To balance transparency with confidentiality, the platform prototypes a zero-knowledge (ZK) recall mechanism in which regulators can cryptographically prove that recall conditions meet predefined policy requirements without disclosing sensitive incident details. Threat modeling was conducted using the STRIDE framework, and security evaluation combined static application security testing (Solhint and ESLint) and dynamic testing. The paper further discusses deployment options, cost considerations, ZK recall performance analysis, ethical implications, and future enhancements. Security testing validated the platform’s resilience, with no high-severity vulnerabilities identified and medium-severity issues related to HTTP security headers addressed. The results indicate that a regulator-led, privacy-preserving, tamper-evident ledger can improve medicine authenticity verification and recall responsiveness while maintaining compliance and data protection obligations. Full article

By allowing continuous connectivity, automation, and data-driven decision-making across these areas, Internet of Things (IoT) has transformed certain facets of daily life, including home automation and healthcare, as well as business operations like supply chain management and smart manufacturing. IoT systems are susceptible to different cyberattacks, though, because of different designs, lack of funds, and inadequate security policies, which creates major security issues given their fast growth. Covering important topics including protocols, architectures, attack classification, detection methods, countermeasures, and research issues, this paper offers a thorough study of IoT security. Emphasizing their relevance in enhancing the security of IoTs, the article offers a thorough analysis of machine and deep learning-based detection techniques. It also offers recommendations for future paths to handle changing risks by means of particular proposals and provides tools and datasets required for IoT security studies. When considering recent progress, however, there are still some major limitations in scaling, real-time detection, dataset availability, and versatility of current solutions. We identified these issues and provided guidance on future research; we also offered a selected set of tools and datasets for further research. Additionally, this paper provides an overview of the most important issues related to IoT security as documented in the current literature, providing a framework for developing resilient and adaptable IoT security solutions in the future. Full article

Background/Objectives: The global health landscape is currently confronted with dual challenges from both infectious diseases and chronic conditions. Medical–preventive integration has emerged as a pivotal strategy to address these issues, aiming to create a comprehensive, closed-loop framework that spans disease prevention, treatment, rehabilitation, and healthcare, ultimately improving population health outcomes. In the Chinese context, existing policies remain fragmented, scattered across various healthcare-related regulations, and lack systematic and comprehensive analysis. This policy fragmentation may impede the creation of synergistic effects essential for the effective implementation of integrated healthcare strategies. Methods: This study adopted a mixed-methods approach to analyze 85 national policies: a three-stage coding process identified 1088 policy nodes, and a three-dimensional framework (policy instruments (X) × full-cycle health service (Y) × integration stages (Z)) was applied to uncover systemic imbalances. Social network analysis and Latent Dirichlet Allocation (LDA) topic modeling were utilized to map interagency collaboration patterns and thematic shifts, which were visualized using Gephi and Sankey. Results: The analysis revealed that policy instruments are predominantly supply-side (45.04%) and environmental-side (40.35%), with demand-side instruments (14.61%) being notably underutilized, particularly in health financing. Rehabilitation services, representing just 8.27% of the policy focus, were identified as a significant gap in the comprehensive health service cycle. While 44.58% of the instruments facilitated collaboration of medical and preventive services, integration of medical–preventive management stagnated at 25.28%, reflecting institutional inertia that impedes the redistribution of cross-sector resources. Agency collaboration evolved from a siloed approach (2015–2018) to a networked structure (2019–2021) and transitioned to centralized governance post-2022. Thematic shifts in policy discourse moved from a “Healthy China” focus toward pandemic-driven disease surveillance, culminating in the recent development of smart health ecosystems. Conclusions: China’s policies for medical–preventive integration demonstrate notable structural imbalances, particularly in the economic instruments related to health financing and the private-sector participation in healthcare. These imbalances may impede the effective allocation of healthcare resources and hinder the seamless transition toward integrated care. Future policy efforts should focus on optimizing the structure of policy instruments, addressing gaps in the full lifecycle of health services, advancing integration reforms, and promoting the transformation of the healthcare system through enhanced collaborative governance among key stakeholders. Full article

Background: Healthcare chatbots have emerged as a promising application of artificial intelligence in healthcare, offering potential benefits in accessibility, efficiency, and patient engagement. However, despite their growing adoption, limited research has examined the factors that determine their success from the user’s perspective. Objective: This study aimed to evaluate the success of a health chatbot service by applying the updated DeLone and McLean Information Systems Success Model augmented with a trust construct, examining the effects of information quality, system quality, service quality, and trust on intention to use, user satisfaction, and net benefits. Methods: An online survey design was employed, utilizing a structured questionnaire with 28 items measuring seven constructs on a seven-point Likert scale. Data were collected electronically from residents of Saudi Arabia between July and September 2024 using convenience sampling. Eligible participants were adults aged 18 years or older who had previously used the health chatbot service. A total of 321 valid responses were obtained. Partial Least Squares Structural Equation (PLS-SEM) was conducted using SmartPLS 3.3 software for measurement and structural model analysis. Results: The measurement model demonstrated acceptable reliability and validity, with composite reliability values exceeding 0.90 and average variance extracted values above 0.70 for all constructs. Structural model analysis supported eight of ten hypotheses. Trust exhibited the strongest effect on intention to use (β = 0.359, p < 0.001), followed by system quality (β = 0.234, p < 0.001) and information quality (β = 0.147, p < 0.01). Intention to use significantly predicted user satisfaction (β = 0.620, p < 0.001) and net benefits (β = 0.278, p < 0.001). User satisfaction demonstrated a strong positive effect on net benefits (β = 0.610, p < 0.001). The model explained 67.6% of the variance in intention to use, 72.7% in user satisfaction, and 71.4% in net benefits. Conclusions: Trust emerged as the most influential factor affecting intention to use the healthcare chatbot service, underscoring its critical role in user acceptance of health chatbot services. Information quality, system quality, and service quality exerted small to moderate effects on behavioral outcomes. These findings suggest that healthcare organizations deploying chatbot services should prioritize building user trust alongside ensuring high system and information quality to maximize user satisfaction and realized net benefits. Full article

The explosive growth of the Internet of Things (IoT) has expanded the attack surface across industrial systems, smart cities, healthcare, and homes, motivating a synthesis of recent advances in machine learning for IoT security and a clear statement of remaining gaps. This review conducted a systematic search of MDPI, IEEE Xplore, Nature, ScienceDirect, and SpringerLink for publications from 2023 to 2025, screening them for domain relevance and organizing findings into a taxonomy of ML methods, threat types, and deployment contexts, with particular attention to datasets, edge constraints, and privacy considerations. We find that the field is shifting from signature-based detection to supervised and deep learning approaches that report high accuracy on benchmark traffic, while federated learning enables privacy-preserving, distributed intrusion detection with near-real-time edge performance. Across domains, prevalent threats include DDoS, unauthorized access, and malware; persistent challenges include device heterogeneity, rapid exploit weaponization, nonstandardized evaluation, concept drift, adversarial/poisoning risks, and governance and privacy constraints that hinder real world rollouts. We conclude that ML materially strengthens IoT resilience but requires rigorous, industry-scale validation, lightweight and explainable models, protocol-aware designs, robust federated aggregation, and SDN/NFV orchestration; we outline benchmark and deployment priorities to translate laboratory gains into operational security. Full article

A clustering analysis was conducted to identify distinct patient subgroups with White Blood Cells (WBC) count alongside Age and Total Immunoglobulin E (IgE) biomarkers. All data were obtained from a coordinated primary care network operating in Apulia (Southern Italy). We analyzed 300 patient records, performed preprocessing and exploratory data analysis, and then applied unsupervised clustering directly to the standardized three-variable feature space (Age, WBC, and Total IgE), followed by supervised validation steps. Several algorithms were applied for clustering. Among the evaluated methods, K-means and Spectral Clustering showed the most favorable internal validation profiles, based on Silhouette Score (SS), Calinski–Harabasz Index (CH), and Davies–Bouldin Index (DB). K-means achieved the best scores (SS = 0.406, CH = 190.00, DB = 0.900), closely followed by Spectral Clustering (SS = 0.398, CH = 182.57, DB = 0.936), outperforming Agglomerative Clustering (SS = 0.361, CH = 160.41, DB = 1.016) and Gaussian Mixture Models (SS = 0.233, CH = 103.89, DB = 1.289). Post-clustering ANOVA analyses indicated significant differences in WBC, age, and total IgE across the five consensus clusters. An evaluation of cluster internal separability occurred through the training of a Random Forest classifier to predict cluster membership. The results indicate internal cluster separability within the analyzed dataset, but more external verification and clinical evidence are necessary for validation. The research group established clinical descriptions along with suggested treatment plans and detected co-existing diseases to help validate model-based findings. A simplified cluster-informed clinical summary based on biomarker ranges was derived to support interpretation of the identified patient profiles. This integrated method preliminarily suggests that patient strata may be identified from routine clinical variables, while highlighting the importance of internal validation and clinical interpretability in clustering research. Full article

The rapid evolution of smart cities demands a transition from reactive healthcare systems to proactive, data-driven health management paradigms that support long-term urban sustainability. Predicting population health status based on lifestyle-related behavioral and physiological factors is critical for enabling early intervention, personalized healthcare, and efficient resource allocation directly contributing to the United Nations Sustainable Development Goals (SDG 3: Good Health and Well-being; SDG 11: Sustainable Cities and Communities). This study proposes an IoT-enabled Explainable Artificial Intelligence (XAI) framework for predictive health scoring as part of sustainable population health management, integrating real-time data acquisition, cloud-based analytics, and interpretable machine learning. To address the limitations of conventional ensemble models particularly the black-box nature and hyperparameter sensitivity of Extreme Gradient Boosting (XGBoost) a Bayesian optimization strategy is employed to automatically fine-tune model parameters, thereby enhancing predictive accuracy and generalization performance. Furthermore, Shapley Additive Explanations (SHAP) are incorporated to provide transparent, interpretable insights into model predictions by quantifying the contribution of individual lifestyle features. Using a publicly available Kaggle dataset (“Health and Lifestyle Data for Regression”), experimental evaluation demonstrates that the proposed Bayesian-Optimized XGBoost model achieves superior performance (Test R² = 0.878, RMSE = 4.983), outperforming ten benchmark models, including standard XGBoost, which exhibits signs of overfitting (Test R² = 0.832). The results further reveal that Body Mass Index (BMI) and diet quality are the most influential factors affecting health scores, providing actionable insights for urban health policymakers. The proposed framework highlights the synergy between IoT, optimization techniques, and explainable AI to develop transparent, reliable, and scalable predictive health systems. This work provides a practical foundation for next-generation smart healthcare applications and decision-support systems, advancing the vision of sustainable, data-driven, and human-centric smart cities. Full article

Accurate multi-step building load forecasting is critical for optimizing energy management in smart grids and reducing operational costs. However, existing forecasting methods struggle with complex temporal dependencies, seasonal variations, and robust performance under noisy conditions. This paper proposes R-SATNet (Robust Self-Attention Transformer Network), a novel deep learning architecture that integrates multi-head self-attention mechanisms with robust optimization techniques for enhanced building load prediction. The proposed framework incorporates temporal feature extraction modules, adaptive noise suppression layers, and multi-scale attention blocks to capture both short-term fluctuations and long-term seasonal patterns. Extensive experiments on real-world building load datasets demonstrate that R-SATNet achieves superior forecasting accuracy with 15.7% lower RMSE and 12.3% improved MAPE compared to state-of-the-art methods. The model maintains robust performance under various noise conditions and provides reliable multi-step predictions up to 24 h ahead, making it highly suitable for practical smart energy system deployments. The proposed framework is validated across six diverse building datasets spanning commercial, residential, industrial, campus, mixed-use, and healthcare facilities, confirming its generalizability and practical applicability in heterogeneous smart energy environments. Full article

Over the past 200 years (1820–2020), global life expectancy has nearly tripled, increasing from 26 to 72.91 years, due to factors such as poverty reduction and public health initiatives. Today, society faces different challenges than it did centuries ago. In patient care and healthcare system priorities, the goal is to develop smart, feasible, long-lasting, cost-effective, readily available, adverse-reaction-free, adaptable, and personalized solutions that minimize patient discomfort, reduce caregiver effort, and decrease hospitalization duration and costs. In this context, biomaterials serve as versatile tools capable of performing a wide range of diagnostic, therapeutic, and theragnostic functions. Thanks to their biocompatibility, biodegradability, surface chemistry, and responsiveness, biomaterials are currently addressing issues such as patient compliance (through controlled drug-delivery systems and smart wound dressings), long transplant waiting lists, transplant rejection, non-adaptable prosthetics (artificial organs), oncology treatment efficacy (nano-formulations for theragnostics and multiple tumor targeting), and inconsistent in vitro drug-testing models (organs-on-a-chip). In this review, we focus on biomaterials’ smartness, then explore databases for efficient product design, and finally highlight their applications in the biomedical field, especially in drug delivery, tissue engineering, and regenerative medicine. Full article

The growing prevalence of chronic diseases, population aging, and the shift toward preventive and personalized care under Healthcare 5.0 have increased the need for continuous health monitoring beyond clinical settings. While wearable devices enable remote monitoring, their long-term use is often limited by user compliance, comfort issues, battery dependence, and disruption of daily routines. To address these limitations, unobtrusive home-based health monitoring systems have emerged, integrating sensing technologies into domestic environments and everyday objects. This review provides a system-level analysis of unobtrusive health monitoring technologies for smart homes. It examines seven major sensing approaches, including camera-, laser-, radar-, infrared-, mechanical-, bioelectrical-, and optical-based sensors, and their integration into four home environments: living areas, bathrooms, bedrooms, and home offices. For each sensing modality, the operating principles, monitored physiological parameters, representative applications, and key advantages and limitations are discussed. Overall, existing solutions reveal trade-offs among measurement accuracy, robustness in real home conditions, energy autonomy, privacy preservation, and user acceptance. Heart rate and respiratory rate are the most commonly monitored parameters, while multimodal and clinically validated systems remain limited. Although unobtrusive sensing technologies show strong potential for proactive and personalized healthcare, challenges related to accuracy, interoperability, privacy, and cost continue to hinder large-scale adoption. Full article

Ensuring data security and privacy has emerged as a serious concern in the realm of blood supply chain. This is mainly because of sensitivity of donor information, the involvement of multiple stakeholders, and the need for transparent traceability. This paper proposes a novel privacy-preserving, permissioned blockchain framework for blood supply chain management that integrates Hyperledger Fabric, the InterPlanetary File System (IPFS), and a Zero-Knowledge Proof (ZKP)-based authentication protocol. The framework introduces a Pseudonymous Role-Bound Zero-Knowledge Authentication (PRZKA) mechanism that enables donors to authenticate and authorize access to their medical data without revealing their real identities. Context-specific pseudonyms derived through cryptographic hash-to-curve operations ensure unlinkability across different healthcare interactions, while Schnorr-style challenge–response proofs prevent replay attacks and credential misuse. Sensitive donor information is protected using Fabric Private Data Collections, whereas encrypted medical records are stored off-chain in IPFS, with only secure content identifiers recorded on the blockchain. Smart contracts enforce fine-grained, consent-aware access control policies and maintain immutable audit logs of all access events. The proposed system architecture combines an off-chain ZKP gateway with on-chain authorization logic to minimize blockchain overhead while preserving strong security guarantees. Furthermore, a performance evaluation framework is defined, including metrics, workload scenarios, and system configurations, to support future empirical validation. Security analysis indicates that the proposed framework enhances privacy, prevents identity linkage, and enables auditable, consent-driven data sharing compared with existing blockchain-based healthcare solutions. Full article

Digital twins (DTs) enable innovation across industries. While business discourse promotes DTs as catalysts for new business models, the academic literature lacks a cohesive understanding of how DTs enable different types of business innovation and what distinguishes cross-organizational innovation from firm-level innovation. This paper conducts a systematic literature review of 60 articles, analyzing 25 business innovation cases through a typology derived from established frameworks extended to address cross-organizational innovation. Process innovation appeared in nearly all the cases (24 of 25), confirming DTs’ fundamental role as operational technology. Product innovation manifests in two patterns: the twin as offering and the twin enabling offerings. paradigm innovation appeared in over half of cases, taking context-specific forms including business model transformation, governance mechanisms, and organizational restructuring. Beyond-firm innovation clusters in healthcare, smart cities, sustainability transitions, and energy systems where cross-organizational coordination is required. Beyond-firm cases consistently co-occur with paradigm innovation and exhibit higher innovation type diversity than single-firm cases, suggesting that cross-boundary coordination requires accompanying organizational restructuring. The study contributes a Digital Twin Innovation Typology extending established frameworks to capture innovation no single firm can achieve alone. Practical implications address how domain context shapes innovation potential and coordination mechanisms required for beyond-firm innovation. Full article

Renewable energy technologies are becoming more and more relevant in a variety of engineering fields as a result of the move toward low-carbon, sustainable energy systems. Although research has historically concentrated on power generation, it now covers a broad range of applications, including precision agriculture, smart grids, energy storage, healthcare devices, and sustainable buildings. However, existing review studies are often limited to single disciplines or specific technologies, lacking a unified cross-disciplinary perspective that captures the interconnected nature of modern renewable energy systems. This gap motivates the need for a comprehensive review that bridges multiple engineering domains. This review provides a comprehensive synthesis of literature on renewable energy applications in electrical and electronics, computer, environmental, biomedical, architectural, and agricultural engineering. In electrical and electronics engineering, the use of renewable energy sources is largely based on the efficient generation of electricity from natural resources such as solar, wind, and ocean energy. Computer engineering contributes through artificial intelligence (AI), Internet of Things (IoT) architectures, digital twins, and cybersecurity solutions, optimizing energy management. Environmental engineering emphasizes life cycle assessment, carbon footprint reduction, and circular economy strategies. In biomedical engineering, energy harvesting and self-powered devices illustrate micro-scale applications of renewable energy. Architectural engineering integrates renewable systems through building-integrated photovoltaics, net-zero energy designs, and smart building management, while agricultural engineering uses solar-powered irrigation, biomass utilization, agrivoltaic systems, and other sustainable practices. To support a low-carbon future with integrated and sustainable engineering solutions, this study not only highlights innovations within individual fields but also showcases how different disciplines can connect and work together. Overall, the review offers a novel cross-disciplinary framework that advances the understanding of renewable energy systems beyond isolated applications and provides direction for future integrative research. Full article

Equitable prioritization of public investments is increasingly critical as municipalities face constrained budgets, heterogeneous neighborhood needs, and demands for transparent decisions. This paper proposes a fairness-aware group multi-criteria decision-making (MCDM) framework for ranking municipal infrastructure investments when budgets are constrained, and neighborhood needs differ. Six alternatives are assessed in the Istanbul case study: flood risk mitigation, inclusive public realm and cooling, smart and energy-efficient municipal assets, walking and cycling infrastructure, healthcare access improvements, and seismic retrofitting of public buildings. The criteria system combines efficiency, implementability, socio-environmental performance, and equity-oriented priorities through five main dimensions and 23 sub-criteria. In addition to cost, feasibility, and service effectiveness, the framework incorporates fairness-related criteria such as baseline need and deficit severity, vulnerability-targeting effectiveness, minimum service guarantee for the worst-off, and priority for low-accessibility centers. Public acceptance and environmental performance are also included. Stakeholder panels provide expert judgments using intuitionistic fuzzy sets, capturing membership, non-membership, and hesitation to reflect uncertainty. Criteria weights are derived with Intuitionistic Fuzzy Step-wise Weight Assessment Ratio Analysis (IF-SWARA), enabling importance elicitation and group aggregation without forcing crisp consensus. Alternatives are then ranked using Intuitionistic Fuzzy Combined Compromise Solution (IF-CoCoSo), which blends additive and multiplicative compromise solutions to balance overall performance with equity objectives. Robustness is assessed through sensitivity analysis by varying the γ parameter within the IF-CoCoSo procedure. A municipal case study demonstrates that healthcare access improvements achieve the highest compromise performance, followed by flood risk mitigation and seismic retrofitting of public buildings, while smart and energy-efficient municipal assets rank last. The findings confirm that explicitly embedding fairness criteria can shift municipal priorities toward alternatives that more directly reduce deprivation, risk, and spatial inequality. The main contribution of this study is not merely empirical application, but the development of a fairness-aware group MCDM framework that operationalizes distributive justice in municipal investment prioritization through a structured set of criteria. Full article