Search Results (894)

The rapid diffusion of generative AI is profoundly transforming knowledge-intensive work and reshaping how employees innovate. Although prior research has highlighted the positive role of generative AI in improving work efficiency and performance, the underlying mechanisms through which it promotes employee creative behavior remain insufficiently understood. Drawing on Social Cognitive Theory and Psychological Safety Theory, this study develops a moderated dual-path model to examine how generative AI use influences employee creative behavior through creative self-efficacy and psychological safety. Using a three-wave time-lagged survey design, data were collected from 297 employees in highly digitalized industries. The results indicate that generative AI use is positively associated with subsequent self-reported employee creative behavior. Both creative self-efficacy and psychological safety significantly mediate this relationship. Furthermore, digital leadership strengthens the positive effects of generative AI use on creative self-efficacy and psychological safety, thereby further enhancing its indirect effects on employee creative behavior. The findings not only extend the literature on generative AI and employee creative behavior but also deepen the theoretical understanding of AI empowerment mechanisms by identifying two critical pathways: a capability-enhancement pathway and a risk-reduction pathway. This study provides important theoretical insights and practical implications for organizations seeking to effectively leverage generative AI to foster employee creative behavior in the context of digital transformation. Full article

Deep visual recognition has achieved remarkable success across various domains, including medical imaging, autonomous vehicles, and security systems. However, the black-box nature of deep learning models poses challenges in terms of transparency and trust, especially in critical applications where human understanding is essential. Explainable AI (XAI) seeks to address these concerns by providing human-interpretable explanations for model predictions. This review explores the key techniques for explainability in deep visual recognition, including model-agnostic methods such as LIME and SHAP, model-specific approaches like saliency maps and feature visualization, and intrinsically interpretable models like decision trees and rule-based systems. We also discuss the evaluation of explainability through metrics like fidelity, consistency, and stability, and explore the challenges of balancing model performance with interpretability. Furthermore, we examine applications of XAI in medical imaging, autonomous driving, security and surveillance, agriculture, satellite imagery and remote sensing, industrial inspection, and visual forensics, highlighting how domain-specific data and operational constraints affect the required form and validation of explanations. Finally, we address current research gaps and propose future directions for enhancing the robustness and human–AI interaction in explainable visual recognition systems. As AI continues to be integrated into safety-critical domains, the development of explainable, transparent, and trustworthy AI systems will be crucial for their widespread adoption and ethical use. Full article

Background/Objectives: Methamphetamine (meth) use disorder (MUD) continues to pose a significant public health challenge, and there are currently no FDA-approved pharmacological treatments available. Compounds that simultaneously activate nociceptin opioid peptide (NOP) and mu opioid receptors offer a promising therapeutic approach for substance use disorders, including psychostimulant addiction. Methods: We evaluated two mixed NOP/mu receptor agonists for their ability to reduce meth intake using a translational drug-versus-food choice self-administration paradigm in male and female Sprague–Dawley rats. In addition, both compounds were tested in female rats for their effects on cue- and priming-induced reinstatement of meth-seeking behavior, established preclinical models of relapse. Results: PPL-138 and PPL-143 are structurally related bifunctional NOP/mu partial agonists that exhibit greater efficacy at NOP than at mu receptors, with PPL-143 showing the highest NOP efficacy. In behavioral assays, both compounds significantly reduced meth self-administration in male rats and exhibited comparable potency in this effect. In female rats, however, PPL-143 was less effective than PPL-138 in reducing meth intake. In reinstatement models, PPL-138, but not PPL-143, attenuated prime-induced reinstatement of meth seeking, whereas both compounds produced comparable increases in meth seeking in the cue-induced reinstatement paradigm. Additional findings indicated that PPL-138 enhanced meth-induced locomotor activation. Conclusions: The findings support mixed mu/NOP partial agonists as a promising pharmacological strategy for treating MUD, while also indicating a potential for increased drug seeking under certain conditions. Notably, enhancing the NOP component does not appear to meaningfully improve either the safety profile or the anti-meth efficacy of these bifunctional ligands. Full article

Background: Robotic platforms expand minimally invasive options in colorectal surgery but raise concerns about training and patient safety. Dual-console systems may enable real-time coaching while preserving outcomes. Methods: We implemented a structured framework for safe implementation of robotic colorectal surgery that balances trainee autonomy with patient safety using a dual-console model. Early cases emphasized low-complexity pathology with escalation by predefined benchmarks. We prospectively gathered data and evaluated early program outcomes with primary endpoints including intraoperative adverse events, conversion to open surgery, 30-day morbidity, anastomotic integrity, and oncologic quality metrics. Secondary endpoints included operative time. Results: We included the analysis of 17 patients operated by one surgeon under supervision and compared the results to other senior colorectal surgeons. Out of the 17 patients, there were no conversions or anastomotic leaks. Overall complications were comparable to baseline robotic cases. Resection margins and lymph node yields met oncologic standards. Operative times were longer during early adoption but approached baseline with progression. Operative times were significantly reduced after eight cases and approached the times of senior surgeons after 13 cases. Conclusions: A dual-console strategy enables safe, scalable training in robotic colorectal surgery without compromising short-term patient outcomes or oncologic quality. Key elements include rigorous case selection, proficiency-based progression, real-time coaching, standardized protocols, and continuous data surveillance. This framework can guide institutions seeking to expand robotic colorectal programs while safeguarding patients and accelerating the learning curve. Full article

The attribution of anomalous vessel behaviors is crucial for maritime traffic supervision and safety decision-making. However, existing approaches often lack the capability to systematically interpret multidimensional anomaly features and reveal their underlying behavioral mechanisms, limiting the transparency and practical value of anomaly attribution. To address these challenges, we propose a multidimensional anomalous vessel behavior attribution and decision-support framework based on large language models (LLMs). Specifically, the framework first employs Behavioral Anomaly Semantic Mapping (BASM) to transform multidimensional anomaly features into structured semantic units governed by logical constraints; it then leverages knowledge-guided reasoning (KGRP-PCoT) with LLMs to perform multi-step inference, enabling systematic attribution from low-level anomaly observations to high-level behavioral mechanisms. Experiments conducted on AIS data from the Wusongkou waters demonstrate that the proposed framework significantly outperforms traditional methods. Quantitative evaluations show that the framework achieves a BLEU-4 score of 0.91 and a BERTScore of 0.98 when integrated with advanced LLMs like DeepSeek. Furthermore, the ablation study confirms that the proposed BASM and KGRP-PCoT mechanisms improve the BERTScore from approximately 0.86 to 0.98. It not only reveals the causal mechanisms underlying anomalous behaviors more accurately but also improves logical consistency and regulatory compliance, confirming its practical utility and decision-support value. Full article

Background: Artificial intelligence (AI) is increasingly proposed to augment early-stage assistance for survivors of sexual and gender-based violence (GBV), including intimate partner and domestic violence, across crisis hotlines, specialist services, digital reporting channels, legal support tools and healthcare pathways. However, the scope, maturity and evaluative strength of the peer-reviewed evidence remain uncertain. We aimed to map the application domains, evaluative maturity, and implementation and safety gaps of this evidence base. Methods: We conducted a scoping review reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR), using a Population–Concept–Context framework focused on AI-enabled first-response and early support. Searches in Scopus, Web of Science Core Collection and PubMed were supplemented by targeted searches of IEEE Xplore and ACM Digital Library. Records were screened against predefined criteria, charted using a structured form and synthesised descriptively. Results: Original searches yielded 187 records and 21 included sources of evidence. The supplementary search identified 539 records/candidates; 27 full texts were assessed and 6 additional sources met eligibility criteria, yielding 27 included sources of evidence. Evidence covered survivor-facing conversational support; screening and triage in emergency and specialist services; social-triage and online disclosure models; survivor-informed help-seeking and chatbot design; legal/support routing; and enabling modalities such as speech-based approaches. Most sources reported technical performance, usability, acceptability or systems-audit findings, while no workflow-integrated evaluation was identified and survivor-centred effectiveness outcomes, service uptake and adverse-event monitoring were rarely reported. Conclusions: The evidence remains heterogeneous and early-stage, with limited support for service-integrated effectiveness or safety. Included sources more often assessed models, interfaces or prototypes than downstream pathway outcomes. The findings support cautious, pathway-aware interpretation and identify recurring concerns regarding escalation, accountability, equity, digital trace safety and human handover. The proposed practice considerations and outcome domains are author-informed priorities for future pilot and implementation studies, not validated guidelines. Full article

Post cancer treatment, many young people often live with ongoing emotional, social, and physical difficulties, but support is not always accessed when it is needed. This study aimed to co-produce a conceptual model of support-seeking after cancer treatment with young people with lived experience of cancer, to better understand the triggers, timing, and pathways influencing engagement with support. This co-design work, informed by Bird et al.’s generative framework for co-production, built upon a prior study involving interviews and co-design workshops with young people and healthcare/allied health professionals, and informed a preliminary model of support-seeking. The current work involved two further co-production stages through an online survey and workshop to refine this model. Data were analysed using a thematic approach to support conceptual model development. Four interconnected themes shaped support-seeking: (1) readiness to engage: recognition, emotional readiness, and relational safety; (2) access and appraisal of support: visibility, fit, feasibility, and burden; (3) pathways to support: multi-modal, layered, and non-linear engagement; and (4) support trajectory: changing needs and recurrent engagement. Engagement in support-seeking depended on the alignment of readiness, recognition of need, and relational safety. This model offers a framework to improve how post-treatment support is designed and delivered in practice. Full article

Background/Objectives: Secondary victimization (SV) following sexual assault (SA) is known to compound negative health outcomes for survivors seeking help within formal systems, such as healthcare. While there have been advances in preventing SV and support for SA survivors seeking help within healthcare, experiences of SV persist alongside worsening health disparities, particularly among disenfranchised populations of women. This literature review aims to examine the literature on HCP approaches to practices that may contribute to the SV of SA survivors. Methods: Following the PRISMA 2020 guidelines, the literature from three databases (PubMed, CINAHL Plus, and PsycINFO) was collected, followed by the screening of the titles, abstracts, and full texts of primary data sources available in full text and published in English between 2009 and 2022. The articles included for synthesis were appraised using the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP), and the data extracted were analyzed using thematic analysis. Results: Four HCP approaches to practice were found to potentially contribute to the SV of SA survivors: (1) incomprehensive care in clinical practice; (2) a lack of collaboration between inter-agencies, healthcare organizations, interdisciplinary teams, and HCPs with SA survivors; (3) barriers to HCP training and preparedness to respond to SA; and (4) failures to implement trauma-informed care (TIC) frameworks. Conclusions: Based on these findings, we provide recommendations for the prevention and mitigation of the SV of SA survivors by integrating philosophical frameworks to guide healthcare practice, including person-centered care, trauma- and violence-informed care (TVIC), and cultural safety. We reflect on the current gaps identified from this systematic review and the need for future research to operationalize and measure SV after SA in healthcare. Full article

Possessing a high nitrogen content, low cost and stable supply, urea serves as a critical non-protein nitrogen (NPN) source that represents a promising alternative to conventional protein feedstocks for reducing production costs in microbial protein (MP) synthesis. This article systematically discusses the application potential of urea in MP production, the metabolic pathways governing microbial urea utilization, and the key factors influencing the conversion efficiency of urea to microbial protein. Herein, we summarize recent progress in urea modification technologies covering slow-release urea, extruded urea, and urea-based composite preparations and elucidate the complete metabolic mechanisms of urea assimilation in both rumen fermentation and in vitro cultivation, including transmembrane transport, urease-catalyzed hydrolysis, ammonia assimilation, and MP synthesis. Furthermore, we analyze the regulatory effects of dietary energy level, carbohydrate structure, protein concentration, forage quality, urea formulation type, and functional additives on nitrogen utilization efficiency. Current evidence indicates substantial knowledge gaps regarding urea transporter functionality, the coordinated regulation of UC and nitrogen assimilation pathways, microbial community interactions, and the stability control of industrial-scale production. The development of high-efficiency utilization technologies, feed safety evaluation systems, and precision feeding models for industrial applications remains incomplete. This article seeks to provide a thorough theoretical reference for the efficient utilization, mechanistic elucidation, and industrial promotion of urea-based nitrogen sources within MP production systems. Full article

Background: Mental health services face significant challenges in providing equitable care to ethnic minority and migrant populations. Despite the right to healthcare, disparities in service use among minority communities reflect not only practical barriers but also deeper issues of cultural compatibility between patients and health systems. Aim: This study aimed to provide a systematic overview of the main difficulties encountered by ethnic minority and migrant people when seeking psychological support from mental health services, with a specific focus on linguistic and communicative barriers and organisational and economic barriers. Methods: A scoping review was conducted using the SCOPUS database, searching for peer-reviewed studies focused on the European context. Studies were included if they addressed ethnic minorities’ experiences with mental health services from a user perspective and included primary research of any design. Studies focused exclusively on staff perspectives or not specifically addressing ethnic minorities’ help-seeking were excluded. Twenty studies met the inclusion criteria. A qualitative narrative synthesis was adopted, following PRISMA-ScR guidelines. Results: People with an ethnic or migrant background face specific and compounded barriers when seeking mental health support. Two main categories were identified: linguistic and communicative difficulties, including language distance, limited interpreter availability, and the gap between Western biomedical models and cultural frameworks of distress; and organisational and economic obstacles, including poor knowledge of available services, socioeconomic disadvantage, stigma, and institutional distrust. Discussion: These barriers are deeply structural and cannot be addressed through awareness campaigns alone. Increased access to services is not inherently beneficial unless accompanied by a fundamental transformation ensuring that care is culturally appropriate, safe, and genuinely responsive to minority communities’ needs. Distrust of mental health services may in part reflect a historically grounded and legitimate response to institutions whose practices have not always served the interests of minority groups. Conclusions: Reducing disparities in mental health care requires multi-level intervention, including inclusive policies, training of culturally competent professionals, and a critical rethinking of the models underpinning mental healthcare care. Future research should attend not only to the quantity of service use among minority populations but to the quality, cultural legitimacy, and safety of the care provided. Full article

Patients with thoracic aortic disease (TAD) frequently seek advice on the safety of commercial air travel. Despite the clinical relevance of this question, robust evidence is virtually absent, and current recommendations rely largely on expert opinion. This Viewpoint discusses the physiological effects of flights, reviews the limited available evidence, and proposes a pragmatic, risk-based approach for clinicians counselling patients with TAD. Full article

Introduction: Pain is one of the most common reasons why patients seek medical care, and chronic pain is now recognized as a major health problem worldwide. Better understanding of pain mechanisms has shown the importance of distinguishing nociceptive, neuropathic, and nociplastic pain in order to choose the most effective treatment. In recent years, topical analgesics have gained increasing attention because they can provide pain relief directly at the site of application while reducing systemic exposure and the risk of adverse effects. This is especially important in older adults, patients with multiple diseases, and those exposed to polypharmacy. Methods: This narrative review presents the current knowledge on the pharmacology, efficacy, and safety of topical drugs used in pain treatment. Particular attention is given to topical non-steroidal anti-inflammatory drugs (NSAIDs), lidocaine, capsaicin, menthol, and camphor. The review also discusses newer and less established therapies used mainly in neuropathic pain, including topical ketamine, amitriptyline, phenytoin, gabapentin, and clonidine. A structured, non-systematic literature search was conducted using the PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar databases to identify studies evaluating the efficacy and safety of topical analgesic therapies. Results: Current evidence supports topical NSAIDs as first-line therapy for localized musculoskeletal pain and osteoarthritis, while lidocaine and high-concentration capsaicin patches are effective options in focal neuropathic pain. Although several newer topical therapies show promising results, more high-quality clinical studies are still needed. Overall, topical analgesia is an important part of multimodal pain management because it combines analgesic efficacy with a better safety profile compared with many systemic therapies. Conclusions: Taking the aspects discussed in this paper into account, it seems justified to search for new drug combinations that would contribute to effective pain therapy with topical agents. It is recognized that a multimodal approach to pain management, which utilizes drugs with different mechanisms of action, can increase efficacy and reduce the systemic adverse events of the drugs used. The effective and safe treatment of patients with pain, especially neuropathic pain, despite emerging new clinical trials, remains a challenge for clinicians. Full article

Community-based oyster reef restoration historically involved deploying plastic-based restoration units. However, many practitioners now seek to eliminate plastic usage due to environmental concerns. Scientific investigation into the efficacy and environmental safety of novel, non-plastic restoration products is limited. Four non-plastic shell bag materials (three biopolymers, one basalt fiber) were tested in field and laboratory studies, using plastic controls. In Mosquito Lagoon, FL, USA, a subtropical estuary, units at four restored reefs were monitored quarterly for one year. A 12-month laboratory study examined these same materials and their potential to shed microparticles. In the field, all biopolymers exhibited low persistence (≤17% remaining after 12 months). Basalt had high persistence (96%), but developed large rips by the end of the study. Oyster recruitment was negatively associated with damage to shell bags due to substrate loss. In the laboratory, basalt fiber shed high numbers of thin, rod-like microparticles (1987.4 microparticles/year ± 256.4 SE). Other materials shed <5 microparticles/year on average. Low durability of experimental materials emphasizes the need for more resilient restoration products that can withstand conditions in subtropical marine ecosystems. It is unknown if basalt microparticles impact marine environments, but further study is imperative given the high volume that was shed. Full article

Background: Fear of malpractice and its potential legal, financial, and reputational consequences are associated with one of the most complex phenomena in the medical community: defensive medical practice (DMP). DMP is frequently analyzed in the specialized literature from the physician’s perspective; however, the patient’s role in triggering and maintaining defensive behaviors remains under-explored. Methods: This cross-sectional study examined contextual factors associated with fear of malpractice and the convergences between doctors’ and patients’ perspectives within a bilateral model (error–fear–perceived risk–prevention behaviors), without assuming direct causal relationship. Two questionnaires were administered in Romania to 240 dentists (March–June 2023) and 344 patients (June–December 2023). Associations were tested with chi-square and Fisher’s exact tests (reporting Cramér’s V and odds ratios), multivariate binary logistic regression, and post hoc power analysis. Results: Over half of dentists (53.3%) reported fear of malpractice despite minimal actual legal exposure (0.8%); this fear was associated with awareness of its potential consequences and perceiving patients as more demanding. In multivariate analysis, fear was the strongest independent predictor of perceiving patients as a threat (aOR = 3.98, 95% CI [1.67–9.48]). On the patient side, 57.9% would avoid a dentist with a known malpractice case and 34.0% had requested additional procedures for reassurance. Conclusions: The interaction between physician fear and patient pressure suggests the existence of a “reassurance loop”, in which the patient’s need for safety and the doctor’s fear can mutually reinforce each other, fostering defensive behaviors. We propose an exploratory typology of patient-induced DMP—direct induction (explicit requests for additional investigations/procedures) and indirect induction (relational pressure and reassurance seeking)—to guide future research. By integrating the dentist and patient perspectives within a bilateral model, the study provides a context-specific account of patient-induced defensive practice in Romanian dentistry and identifies dual-target educational interventions (addressing both clinician communication and patient health literacy) as a potential preventive direction. Full article

Autonomous haulage systems (AHSs) have become increasingly important as mining operations seek to improve productivity and remove workers from hazardous environments. The systematic integration of this technology requires not only operational change management but also a deeper understanding of mine planning implications. The existing literature describes AHSs and implementation guidelines with a focus on operational safety and autonomous system architecture, but it does not systematically address required planning-level adaptations. This study aims to identify how surface mine planning frameworks must evolve to accommodate autonomy in open-pit metal mining operations. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, with emphasis on identifying the principal aspects of AHSs that must be considered in mine planning strategies. Findings reveal major shifts in workforce dynamics, communication infrastructure, and haul-road geometry, and show that road-width and load-channelization questions remain site-specific research needs rather than settled design rules. This study highlights the need for (i) mine planning frameworks that treat AHSs as a constraint on pit geometry, haul-road structural and functional design, fleet selection, production scheduling, road-maintenance strategy, and economic and social evaluation; (ii) human–systems integration and improved human-autonomous collaboration; and (iii) empirical validation of workforce transition strategies for more effective and safe deployment. Full article