Search Results (184)

The endangered plant Hopea hainanensis serves as both an indicator and keystone species in tropical rainforests, and its survival status is influenced by the interspecific relationships among coexisting tree species within the community. To explore these relationships, species resource utilization patterns, and community succession dynamics within the endangered plant community, this study utilized survey data from the Hopea hainanensis community in the Bawangling and Jianfengling branches of the National Park of Hainan Tropical Rainforest. Various analytical methods were employed, including the Variance Ratio (VR) method, test statistic (W), χ² test, Spearman’s rank correlation, and M. Godron’s stability analysis, to examine the interspecific associations among dominant tree species at different structural levels in the two regions and their effects on community stability. The results indicate that: (1) Hopea hainanensis is the dominant species in the medium tree layer in both study areas, while it functions as an associated species in other structural layers. (2) In communities where Hopea hainanensis is present in both Bawangling and Jianfengling, the dominant tree species across various structural layers generally show a non-significant positive association. (3) The results of the χ² test and Spearman’s rank correlation test reveal that the interspecific associations across different structural layers of the Hopea hainanensis communities in both regions are predominantly non-significant. This suggests weak interspecific relationships and a high degree of species independence. The communities at different structural levels in both Bawangling and Jianfengling are in an unstable state, with ongoing dynamic adjustments to their internal tree species composition and structure. In terms of stability, the community stability across structural levels in these two regions follows the order: middle shrub layer > middle arbor layer > small arbor layer > large shrub layer. This study reveals the interspecific relationships, community succession status, and stability of dominant tree species at different structural levels in slope barrier communities across regions. These findings provide a theoretical basis for developing scientifically sound and reasonable protection strategies for slope barrier populations, as well as for the restoration and sustainable development of tropical rainforest vegetation. Full article

Background: The U.S. Medicare Annual Wellness Visit (AWV) offers a structured opportunity for cognitive screening and personalized prevention planning among older adults. Yet, implementation of AWVs, particularly for individuals with cognitive impairment, remains inconsistent across primary care or other diverse care settings. Methods: We conducted a scoping review using the Consolidated Framework for Implementation Research (CFIR) to explore multilevel factors influencing the implementation of the Medicare AWV’s cognitive screening component, with a focus on how these processes support the detection and management of cognitive impairment among older adults. We searched four databases and screened peer-reviewed studies published between 2011 and March 2025. Searches were conducted in Ovid MEDLINE, PubMed, EBSCOhost, and CINAHL databases. The initial search was completed on 3 January 2024 and updated monthly through 30 March 2025. All retrieved citations were imported into EndNote 21, where duplicates were removed. We screened titles and abstracts for relevance using the predefined inclusion criteria. Full-text articles were then reviewed and scored as either relevant (1) or not relevant (0). Discrepancies were resolved through consensus discussions. To assess the methodological quality of the included studies, we used the Joanna Briggs Institute critical appraisal tools appropriate to each study design. These tools evaluate rigor, trustworthiness, relevance, and risk of bias. We extracted the following data from each included study: Author(s), year, title, and journal; Study type and design; Data collection methods and setting; Sample size and population characteristics; Outcome measures; Intervention details (AWV delivery context); and Reported facilitators, barriers, and outcomes related to AWV implementation. The first two authors independently coded and synthesized all relevant data using a table created in Microsoft Excel. The CFIR guided our data analysis, thematizing our findings into facilitators and barriers across its five domains, viz: (1) Intervention Characteristics, (2) Outer Setting, (3) Inner Setting, (4) Characteristics of Individuals, and (5) Implementation Process. Results: Among 19 included studies, most used quantitative designs and secondary data. Our CFIR-based synthesis revealed that AWV implementation is shaped by interdependent factors across five domains. Key facilitators included AWV adaptability, Electronic Health Record (EHR) integration, team-based workflows, policy alignment (e.g., Accountable Care Organization participation), and provider confidence. Barriers included vague Centers for Medicare and Medicaid Services (CMS) guidance, limited reimbursement, staffing shortages, workflow misalignment, and provider discomfort with cognitive screening. Implementation strategies were often poorly defined or inconsistently applied. Conclusions: Effective AWV delivery for older adults with cognitive impairment requires more than sound policy and intervention design; it demands organizational readiness, structured implementation, and engaged providers. Tailored training, leadership support, and integrated infrastructure are essential. These insights are relevant not only for U.S. Medicare but also for global efforts to integrate dementia-sensitive care into primary health systems. Our study has a few limitations that should be acknowledged. First, our scoping review synthesized findings predominantly from quantitative studies, with only two mixed-method studies and no studies using strictly qualitative methodologies. Second, few studies disaggregated findings by race, ethnicity, or geography, reducing our ability to assess equity-related outcomes. Moreover, few studies provided sufficient detail on the specific cognitive screening instruments used or on the scope and delivery of educational materials for patients and caregivers, limiting generalizability and implementation insights. Third, grey literature and non-peer-reviewed sources were not included. Fourth, although CFIR provided a comprehensive analytic structure, some studies did not explicitly fit in with our implementation frameworks, which required subjective mapping of findings to CFIR domains and may have introduced classification bias. Additionally, although our review did not quantitatively stratify findings by year, we observed that studies from more recent years were more likely to emphasize implementation facilitators (e.g., use of templates, workflow integration), whereas earlier studies often highlighted systemic barriers such as time constraints and provider unfamiliarity with AWV components. Finally, while our review focused specifically on AWV implementation in the United States, we recognize the value of comparative analysis with international contexts. This work was supported by a grant from the National Institute on Aging, National Institutes of Health (Grant No. 1R01AG083102-01; PIs: Tzeng, Kuo, & Raji). Full article

Background/Objectives: Capnography monitoring in the Post-Anesthesia Care Unit (PACU) plays a crucial role in the early detection of respiratory complications, being fundamental for patient safety. It provides objective and continuous data on ventilation, enabling timely interventions to optimize health outcomes. This scoping review aims to map the available evidence regarding barriers and facilitators to the use of capnography for respiratory monitoring by nurses in the Phase I PACU. Methods: A scoping review was conducted following the methodology proposed by the Joanna Briggs Institute (JBI). The search was performed in the MEDLINE and CINAHL Complete databases and the Portuguese Open Access Scientific Repository (RCAAP). Studies in Portuguese, English, and Spanish were included, with no time restrictions. The search strategy combined indexing terms and natural language, adapted to each database. Results: Seven studies were included in the sample. The main identified barriers were a high workload, perceived lack of patient adherence, and lack of knowledge. Key facilitators included the alarm sound, patient education, anticipating patient clinical instability, increased nurse confidence, perception of enhanced safety, targeted training for nurses, continuous improvement in care delivery, effective communication and feedback, promotion of sustainable care practices, and prior knowledge and exposure. Conclusions: The use of capnography in the PACU allows for respiratory function assessment and the early detection of clinical events. Its implementation should be based on current scientific evidence, promoting a culture of safety and quality improvement in patient care. Full article

Background: Early language development, a key predictor of later academic achievement, arises out of social interactions and communication. High-quality social and emotional interactions in early child care and education (ECCE) programs may therefore promote language-rich environments for young children. While culturally and linguistically minoritized communities face systemic barriers that limit equitable access to high-quality ECCE including social and emotional learning (SEL) programs, access to evidence-based SEL programs remains inequitable, disproportionately benefiting White, English-speaking, and higher-income ECCE providers. The current study aims to examine how I-T CHILD, a program designed to foster a climate that supports mental health and SEL in ECCE, improves the quality of the language environment using LENA technology. Methods: Implemented at the height of the COVID-19 pandemic, 38 family child care providers located in an urban setting (63.2% Hispanic/Latine; 40% living in poverty) were randomly assigned to the 12-week I-T CHILD program or to the waitlist-control group. Data were analyzed using hierarchical linear modeling procedures. Results: Infants and toddlers cared for by I-T CHILD providers produced significantly more vocalizations (p = 0.002; ES = 1.50) and were exposed to significantly less media and electronic sounds (p = 0.032; ES = −0.97) than infants and toddlers in the waitlist-control condition. Conclusions: Our findings reinforce the importance of the mental health climate in ECCE and its circular effect on early language development. We offer key insights into how mental health climate interventions in ECCE settings can enhance language interactions, center the child, and foster foundational skills linked to long-term academic success for historically underserved populations. Full article

Histotripsy is a novel, noninvasive, non-thermal technology invented in 2004 for the precise destruction of biologic tissue. It offers a powerful alternative to more conventional thermal or surgical interventions. Using short-pulse, low-duty cycle ultrasonic waves, histotripsy creates cavitation bubble clouds that selectively and precisely destroy targeted tissue in a predefined volume while sparing critical structures like bile ducts, ureters, and blood vessels. Such precision is of value when treating tumors near vital structures. The FDA has cleared histotripsy for the treatment of all liver tumors. Major medical centers are currently spearheading clinical trials, and some institutions have already integrated the technology into patient care. Histotripsy is now being studied for a host of other cancers, including primary kidney and pancreatic tumors. Preclinical murine and porcine models have already revealed promising outcomes. One of histotripsy’s primary advantages is its non-thermal mechanical actuation. This feature allows it to circumvent the limitations of heat-based techniques, including the heat sink effect and unpredictable treatment margins near sensitive tissues. In addition to its non-invasive ablative capacities, it is being preliminarily explored for its potential to induce immunomodulation and promote abscopal inhibition of distant, untreated tumors through CD8+ T cell responses. Thus, it may provide a multilayered therapeutic effect in the treatment of cancer. Histotripsy has the potential to improve precision and outcomes across a multitude of specialties, from oncology to cardiovascular medicine. Continued trials are crucial to further expand its applications and validate its long-term efficacy. Due to the speed of recent developments, the goal of this review is to provide a comprehensive and updated overview of histotripsy. It will explore its physics-based mechanisms, differentiating it from similar technologies, discuss its clinical applications, and examine its advantages, limitations, and future. Full article

The escalating environmental noise pollution along urban rail transit corridors, exacerbated by rapid urbanization, necessitates innovative and efficient noise control measures. A comprehensive investigation was conducted that utilized field measurements of train passing-by noise to establish a statistical energy analysis model for evaluating the acoustic performance of both vertical (VB) and fully enclosed (FB) barrier configurations. The study incorporated Maa’s theory of micro-perforated plate (MPP) parameter optimization and developed a neural network surrogate model focused on insertion loss maximization for barrier geometric design. Key findings revealed significant barrier-induced near-track noise amplification, with peak effects observed at the point located 1 m from the barrier and 2 m above the rail. Frequency-dependent analysis demonstrated a characteristic rise-and-fall reflection pattern, showing maximum amplifications of 1.47 dB for VB and 4.13 dB for FB within the 400–2000 Hz range. The implementation of optimized MPPs was found to effectively eliminate the near-field noise amplification effects, achieving sound pressure level reductions of 4–8 dB at acoustically sensitive locations. Furthermore, the high-precision surrogate model (R² = 0.9094, MSE = 0.8711) facilitated optimal geometric design solutions. The synergistic combination of MPP absorption characteristics and geometric optimization resulted in substantially enhanced barrier performance, offering practical solutions for urban rail noise mitigation strategies. Full article

The current focus of urban environmental governance is on the traffic noise pollution caused by road transportation. Elevated complex roads, defined as transportation systems comprising elevated roads and underlying ground-level roads, exhibit unique traffic noise distribution characteristics due to the presence of double-decked roads and viaducts. This study conducted noise measurements at two sections of elevated complex roads in Guangzhou, including assessing noise levels at the road boundaries and examining noise distribution at different distances from roads and building heights. The results show that the horizontal distance attenuation of noise in adjacent areas exhibits no significant difference from that of ground-level roads, but substantial discrepancies exist in vertical height distribution. The under-viaduct space experiences more severe noise pollution than areas above the viaduct height, and the installation of sound barriers alters the spatial distribution trend of traffic noise. Given that installing sound barriers solely on elevated roads is insufficient to improve the acoustic environment, systematic noise mitigation strategies should be developed for elevated composite road systems. Additionally, the study reveals that nighttime noise fluctuations are significantly greater than those during the day, further exacerbating residents’ noise annoyance. Full article

The rapid expansion of deep-sea sensing networks underscores the critical need for accurate underwater positioning of observation base stations. However, achieving precise acoustic localization, particularly at depths exceeding 4 km, remains a significant challenge due to systematic ranging errors, clock drift, and inaccuracies in sound speed modeling. This study proposes and validates a three-tier calibration framework consisting of a Dynamic Single-Difference (DSD) solver, a geometrically optimized reference buoy selection algorithm, and a Virtual Beacon (VB) depth inversion method based on sound speed profiles. Through simulations under varying noise conditions, the DSD method effectively mitigates common ranging and clock errors. The geometric reference optimization algorithm enhances the selection of optimal buoy layouts and reference points. At a depth of 4 km, the VB method improves vertical positioning accuracy by 15% compared to the DSD method alone, and nearly doubles vertical accuracy compared to traditional non-differential approaches. This research demonstrates that deep-sea underwater target calibration can be achieved without high-precision time synchronization and in the presence of fixed ranging errors. The proposed framework has the potential to lower technological barriers for large-scale deep-sea network deployments and provides a robust foundation for autonomous deep-sea exploration. Full article

Background: Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease and a major cause of morbidity and mortality among preterm infants. Traditional diagnostic methods such as abdominal radiography have limited sensitivity in early disease stages, prompting interest in bowel ultrasound (BUS) as a complementary imaging modality. Objective: This scoping review aims to synthesize existing literature on the role of ultra sound in the early detection, diagnosis, and management of NEC, with emphasis on its diagnostic performance, integration into clinical care, and technological innovations. Methods: Following PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Embase, Cochrane Library, and Google Scholar for studies published between January 2000 and December 2025. Inclusion criteria encompassed original research, reviews, and clinical studies evaluating the use of bowel, intestinal, or Doppler ultrasound in neonates with suspected or confirmed NEC. Data were extracted, categorized by study design, population characteristics, ultrasound features, and diagnostic outcomes, and qualitatively synthesized. Results: A total of 101 studies were included. BUS demonstrated superior sensitivity over radiography in detecting early features of NEC, including bowel wall thickening, portal venous gas, and altered peristalsis. Doppler ultrasound, both antenatal and postnatal, was effective in identifying perfusion deficits predictive of NEC onset. Neonatologist-performed ultrasound (NEOBUS) showed high interobserver agreement when standardized protocols were used. Emerging tools such as ultra-high-frequency ultrasound (UHFUS) and artificial intelligence (AI)-enhanced analysis hold potential to improve diagnostic precision. Point-of-care ultrasound (POCUS) appears feasible in resource-limited settings, though implementation barriers remain. Conclusions: Bowel ultrasound is a valuable adjunct to conventional imaging in NEC diagnosis. Standardized protocols, validation of advanced technologies, and out come-based studies are essential to guide its broader clinical adoption. Full article

Background/Objectives: We address the ongoing under-representation of ethnic minority groups in cardiovascular research in this opinion paper—a challenge that limits both scientific validity and equitable healthcare outcomes. We aim to outline the underlying causes of this issue and propose concrete strategies to address it. Methods: To engage ethnic minorities in cardiovascular research, we thoroughly studied the existing literature and gathered expert opinions to identify barriers and formulate practical solutions. Results: Our findings highlight the need for a multifaceted approach, including culturally appropriate educational outreach, interactive multimedia information, community ambassador programs, and improved, but ethically sound, ethnicity registration practices. Conclusions: To promote ethnic minority participation in cardiovascular research, a thorough improvement plan is required. Our proposed solutions, which align with insights from the current literature, suggest that addressing cultural, structural, and informational barriers can help achieve a more representative and inclusive participant population. This is an essential step towards improving cardiovascular outcomes for all. Full article

Environmental noise, a significant public health concern, is associated with adverse health effects, including cardiovascular diseases, cognitive impairments, and psychological distress. Noise reduction strategies are essential for mitigating these effects. Despite evidence of their health benefits, limited information exists on the cost-effectiveness of such strategies to guide resource allocation. This study systematically reviewed economic evaluation studies of interventions aimed at reducing environmental noise to assess their cost-effectiveness and inform policymaking. A systematic review following PRISMA 2020 guidelines was conducted across MEDLINE, EMBASE, and Web of Science. Eligible studies were full economic evaluations addressing environmental noise reduction strategies, assessing both costs and health effects. Screening and data extraction were performed independently by two reviewers. Quality appraisal employed the CHEERS 2022 checklist. Narrative synthesis was used to analyze findings due to heterogeneity in study designs, methodologies, and outcomes. Costs were standardized to 2024 euros. From 2906 identified records, five studies met the inclusion criteria, primarily focused on traffic-related noise. Three studies conducted cost-utility analyses, and two employed cost–benefit analyses. Reported interventions included sound insulation, take-off trajectory adjustments, and noise barriers. Economic evaluations varied significantly in methodologies, cost categories, and health outcomes. The health economic studies yielded mixed results, ranging from findings that demonstrated cost-effectiveness to those where the costs exceeded the benefits. There are currently too few health economic evaluations to draw robust conclusions about the cost-effectiveness of environmental noise mitigation strategies. Future research should adopt standardized approaches and robust sensitivity analyses to enhance evidence quality, enabling informed policy and resource allocation decisions. Full article

Vestibular atelectasis (VA) is a rare clinical entity characterized by a collapse of the endolymphatic space resulting in vestibular loss with the possible onset of positional and/or sound/pressure-induced vertigo. It could be idiopathic or secondary to other inner-ear diseases including Meniere’s disease (MD). A collapse of the membranous labyrinth involving the semicircular canals (SCs) and the utricle represents its distinctive histopathological feature. While specific radiological patterns consistent with VA have been described on contrast-enhanced MRI with delayed acquisitions, an impairment of the blood–labyrinthine barrier (BLB) could be detected in several disorders leading to vestibular loss. We conducted a narrative review of the literature on VA focusing on the putative pathomechanisms accounting for positional and sound/pressure-induced nystagmus despite unilateral vestibular loss (UVL) in this condition, providing two novel cases of VA. Both patients presented with a clinical picture consistent with unilateral MD that rapidly turned into progressive UVL and positional and/or sound/pressure-induced vertigo. In both cases, the posterior SC was initially impaired at the video-head impulse test (vHIT) and both cervical and ocular VEMPs were initially reduced. Progressively, they developed unsteadiness with paretic spontaneous nystagmus, an impairment also for the lateral and anterior SCs, caloric hypo/areflexia and VEMPs areflexia. They both exhibited ipsilesional nystagmus to sound/pressure stimuli and in one case a persistent geotropic direction-changing positional nystagmus consistent with a “light cupula” mechanism involving the lateral SC of the affected side. A collapse of the membranous labyrinthine walls resulting in contact between the vestibular sensors and the stapes footplate could explain the onset of nystagmus to loud sounds and/or pressure changes despite no responses to high- and low-frequency inputs as detected by caloric irrigations, vHIT and VEMPs. On the other hand, the onset of positional nystagmus despite UVL could be explained with the theory of the “floating labyrinth”. Both patients received contrast-enhanced brain MRI with delayed acquisition exhibiting increased contrast uptake in the pars superior of the labyrinth, suggesting an impairment of the BLB likely resulting in secondary VA. A small intralabyrinthine schwannoma was detected in one case. VA should always be considered in case of positional and/or sound/pressure-induced vertigo despite UVL. Full article

Psychology is a core discipline in understanding why and how individuals choose to engage in sustainable action. This paper uses social representations theory to explore the rising use of eco/green prefixes for psychology concepts through a critical analysis of the concept of eco/green fatigue. It argues that this term, which originated in the world of popular online news media, has typically been treated in academic psychology discussions using existing psychology concepts in the same way as eco-anxiety and eco-grief, which hides important features of the phenomenon that need to be better understood. The paper presents an analysis of eco-fatigue based on a critical review of the existing psychology literature, qualitative online archival analyses, and an exploratory quantitative survey study. The survey study was conducted with a sample of 182 students and non-students and analysed using principal components and cluster analysis. The paper provides evidence that simply adding an eco/green prefix to an existing psychology concept without a systematic empirical investigation into the phenomenon can result in overly simplistic conceptual frameworks that do not lead to sound practical conclusions. A preliminary empirical examination of the social representation of eco-fatigue in the public arena suggested that inappropriate sustainability messaging and bad business behaviour may be more of a barrier to sustainability action than the beliefs or attitudes held by individuals. Full article

With the large-scale construction of rail transit in mainland China, the noise problem caused by passing trains has become increasingly prominent. The vertical sound barrier is currently the most effective noise control measure for rail transit. However, the noise reduction performance of the vertical sound barrier at different train speeds remains unclear. This study focuses on the box-girder cross-sections of an elevated urban rail transit line with and without vertical sound barriers, conducting field tests during train passages. Based on the test results, the influence of train speed on noise levels at both cross-sections was investigated, the sound source characteristics were analyzed, and the noise reduction performance of the vertical sound barriers at different speeds was explored. The findings indicate the following: Regardless of the presence of sound barriers, within the speed range of 20 to 80 km/h, the linear sound pressure levels at the track-side and beam-side measurement points exhibit a strong linear correlation with speed, while the correlation is weaker at the beam-bottom measurement points. As speed increases, the wheel–rail noise increases by approximately 1.5 dB compared to the structural noise at the same speed. Vertical sound barriers significantly reduce mid-to-high-frequency noise, but in the low frequency band between 20 and 63 Hz, the noise increases, likely due to secondary structural noise radiated by the self-vibration of the barriers when trains pass. At speeds of 20, 40, 60, and 80 km/h, the insertion loss at measurement points located 7.5 m from the track centerline ranges from 6.5 to 9.0, 8.5 to 10.5, 7.5 to 9.5, and 7.5 to 10.2 dB, respectively. At 25 m from the track centerline, the insertion loss ranges from 1.5 to 2.5, 6.0 to 6.5, 5.5 to 6.0, and 5.0 to 6.0 dB, respectively. The noise reduction capability of the vertical sound barrier initially increases and then decreases with higher speeds, and the rate of reduction slows as speed increases. This research will provide a reference and basis for determining speed limits in the rail transit sections equipped with sound barriers. Full article

This study examines the rapid degradation of oak mooring piles caused by shipworms in Venice, Italy. In the last few decades, this problem has raised significant safety and environmental concerns, as the piles often need to be replaced every 18–24 months. The sound basic density and diameter of 22 oak piles were analysed after being exposed to shipworm attacks for 18–240 months to determine whether denser piles or larger diameters influence the rate of decay. This was performed to assess whether larger cross sections or higher densities of the piles could imply an increased durability against marine borers. The impact of environmental factors such as temperature, salinity, pH, and dissolved oxygen levels was also assessed. The results highlighted that pile density and diameter do not significantly influence the resistance against shipworms, while rising temperatures (+2 °C in the past two decades) may contribute to accelerating shipworm activity. These phenomena are worsened by the arrival of warm-water shipworms since 2013, exhibiting greater aggressiveness in wood degradation. Furthermore, the potential impact of storm surge barriers on shipworm activity remains an open research topic. Alternative materials and protection techniques introduced since 2015, such as polyurethane piles or metal stapling, face environmental and logistical challenges. Despite these alternatives, many new oak mooring piles are still installed in Venice without protection and are vulnerable to rapid deterioration. Addressing these issues requires multidisciplinary research to develop sustainable materials and preservation techniques for maintaining infrastructure in Venice. Full article