Search Results (4,959)

Medication errors pose a significant threat to patient safety. Although Bar-Code Medication Administration (BCMA) has reduced error rates, it is constrained by handheld devices, workflow interruptions, and incomplete safeguards against wrong patients, wrong doses, or drug incompatibility. In this study, we developed and evaluated a next-generation BCMA system by integrating artificial intelligence and mixed reality technologies for real-time safety checks: Optical Character Recognition verifies medication–label concordance, facial recognition confirms patient identity, and a rules engine evaluates drug–diluent compatibility. Computer vision models achieved high recognition accuracy for drug vials (100%), medication labels (90%), QR codes (90%), and patient faces (90%), with slightly lower performance for intravenous fluids (80%). A mixed-methods evaluation was conducted in a simulated environment using the System Usability Scale (SUS), Reduced Instructional Materials Motivation Survey (RIMMS), Virtual Reality Sickness Questionnaire (VRSQ), and NASA Task Load Index (NASA-TLX). The results indicated excellent usability (median SUS = 82.5/100), strong user motivation (RIMMS = 3.7/5), minimal cybersickness (VRSQ = 0.4/6), and manageable cognitive workload (NASA-TLX = 31.7/100). Qualitative analysis highlighted the system’s potential to streamline workflow and serve as a digital “second verifier.” These findings suggest strong potential for clinical integration, enhancing medication safety at the point of care. Full article

The present study examines the effect of work engagement (WENG) on task-related pro-environmental behavior (TPEB) and green creativity, with job crafting as a mediator. Based on data collected from 187 customer-contact hotel and restaurant employees in the United Kingdom, we employed structural equation modeling to test our hypotheses. The findings from a time-lagged survey study denote that WENG fosters employees’ job crafting, while job crafting boosts their TPEBs and green creativity. Our findings shed light on the relationship between WENG and green outcomes (TPEB and green creativity) through the mediating role of employees’ job crafting. The findings highlight that employees high in WENG use their job crafting behaviors that in turn enable them to display TPEBs and green creativity. This empirical piece contributes to the existing knowledge, since there is little research regarding the effects of non-green organizational factors on green work outcomes. The practical and theoretical implications of the findings are subsequently discussed. Full article

Acute inflammatory visceral pain (AIVP) is a prevalent yet challenging clinical condition associated with inflammatory diseases, characterized by diffuse pain that often escalates into nausea, vomiting, and systemic autonomic disturbances. The absence of effective and patient-centered therapies remains a significant clinical challenge. While dexmedetomidine (Dex) has demonstrated promising analgesic effects, its conventional intravenous administration involves slow infusion, heightening risks of infection and compromising patient comfort and compliance. Here, we present a breakthrough strategy using a hyaluronic acid (HA) hydrogel and microneedle-based transdermal system for Dex delivery to enhance clinical practicality. We successfully fabricated Dex-loaded HA hydrogel microneedles (MN/Dex), enabling efficient skin penetration and controlled drug release. Comprehensive biosafety evaluations, including skin irritation, cytotoxicity, and hemolysis assays, confirmed the excellent biocompatibility of the HA hydrogel microneedle system (HA-MN). In the acetic-acid-induced AIVP model, MN/Dex not only produced significant and sustained reduction in visceral and somatic hyperalgesia but also maintained normal physiological activity, avoiding sedation burden, preserving feeding behavior, and supporting natural mobility. MN/Dex offers a minimally invasive, easy-to-administer, and well-tolerated alternative to intravenous therapy, with the potential to transform outpatient management and improve quality of life for patients suffering from AIVP. This advanced delivery platform bridges a critical translational gap in pain management, combining efficacy with outstanding clinical adaptability. Full article

Arundo donax L. (common reed), a highly invasive species in Mediterranean wetlands such as the Albufera Natural Park, poses significant ecological and management challenges. Using Landsat-5 and Sentinel-2 NDVI data, this study quantified changes in its coverage between 1996 and 2024. The results reveal a significant expansion, showing a decreasing trend (91.4 ha in 1996 to 62.5 ha in 2011; −31.6%) followed by a clear rebound (83.5 ha in 2024; +33.6%), especially in the southern shrublands of the lagoon. A Mann–Kendall analysis confirmed a significant decreasing trend during 1996–2011 and an increasing trend during 2011–2024 (p < 0.05). The results indicate that previous control efforts reduced A. donax cover but that the species has recolonised after 2011, likely due to discontinuous management. These dynamics emphasise that long-term monitoring is required. Management strategies must focus on targeting the rhizome and implementing long-term monitoring programmes spanning three to five years. The utilisation of remote sensing methodologies proved effective in the monitoring of coverage, thereby facilitating the development of remediation strategies. It is imperative that actions accord primacy to critical areas such as the south and canals, complemented by native restoration and enhanced inter-administrative coordination, with the communication of benefits such as flood risk reduction. A balanced approach is required that considers ecological objectives, risks, and socio-political aspects. Full article

Background/Objectives: Marine-derived bioactive peptides have been reported to possess blood pressure-regulatory effects. However, most studies have focused on the antihypertensive effects after single-dose administration, and research on long-term administration and its protective effects against hypertension-induced tissue damage remains limited. Therefore, this study aimed to investigate the long-term antihypertensive efficacy of IGTGIPGIW, a bioactive peptide derived from Hippocampus abdominalis (H. abdominalis), and its protective effects on hypertension-related tissue damage. Methods: To evaluate the blood pressure-regulatory effects, spontaneously hypertensive rats (SHRs) were orally administered a high-dose (50 mg/kg) IGTGIPGIW peptide group (H-IGTGIPGIW) for 8 weeks. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were monitored weekly. Serum levels of angiotensin II (Ang II), angiotensin-converting enzyme (ACE), and angiotensin-converting enzyme 2 (ACE2) were measured to assess the peptide’s regulatory effects on the renin–angiotensin system. Histological analyses of the aorta and heart tissues were performed to evaluate the protective effects against hypertension-induced tissue damage. Results: After 8 weeks of treatment, H-IGTGIPGIW significantly reduced SBP, DBP, and MAP compared with SHRs. Serum Ang II and ACE levels were significantly decreased, while ACE2 levels were significantly increased. Histological analyses demonstrated that IGTGIPGIW alleviated aortic wall thickening and reduced renal and cardiac tissue damage in SHR. Conclusions: IGTGIPGIW, a bioactive peptide derived from H. abdominalis, effectively regulated blood pressure by modulating serum Ang II, ACE, and ACE2 levels. Moreover, it protected against hypertension-induced aortic, renal and cardiac tissue damage, suggesting its potential as a functional ingredient for managing hypertension. Full article

Background/Objectives: Advanced heart failure (AdvHF) characterizes patients with impaired functional capacity, severe systolic or diastolic cardiac function, unplanned visits or hospitalizations, raised natriuretic peptides, and increased mortality. Methods: Ninety-five consecutive AdvHF patients followed in a tertiary academic center in Northwestern Greece (2nd Department of Cardiology, University Hospital of Ioannina) were enrolled over a 30-month period. Three distinctive patterns of management were recognized and assessed: intermittent levosimendan administration to 33 patients, intermittent intravenous furosemide administration to 17 patients, and 45 patients were followed up exclusively on an outpatient basis with frequent visits. MAGGIC, SHFM, and BCN-Bio scores were assessed in all patients and mortality was also assessed. Results: Mean age was 73 (±10) years, and 38% were females, 41% had diabetes mellitus, 41% had chronic obstructive pulmonary disease, 59% had coronary artery disease (CAD), 73% had a history of atrial fibrillation, and 82.1% had a cardiac device implanted. The median duration of follow-up was 24 months (IQ range 14, 30). The 12-month and 30-month mortality rates were 19% and 49%, respectively. Higher rates of 1-year mortality were observed in the levosimendan group (30%). The median 12-month mortality of the three scores was comparable to the actual mortality, but their prognostic value was not satisfactory (AUC < 0.540 and p > 0.05 for all), while they performed better for 30-month mortality (AUC < 0.756 and p > 0.05 for all). In the current study, mortality at 12 months was associated with decreasing diastolic blood pressure (DBP) and sodium levels; the presence of CAD (p < 0.05 for all) and mortality at 30 months was associated with decreasing systolic blood pressure, as well as DBP and left ventricle ejection fraction, but also with the presence of CAD and the use of renin–angiotensin–aldosterone system blockers. Logistic regression-based models incorporating these factors have a greater diagnostic accuracy (AUC = 0.824 and 0.817 for 12 and 30 months, respectively; p < 0.001 for both). Conclusions: AdvHF patients represent a complex population requiring close follow-up and novel strategies to improve survival. Larger studies are needed to refine and update predictive scores in this population. Full article

This study conducts a systematic scoping review to explore how universities are integrating digital and emerging technologies into administrative processes. Following the PRISMA-ScR methodology, we systematically searched four major databases—Web of Science, Scopus, IEEE Xplore, and Google Scholar—for peer-reviewed publications between 2019 and 2024. Fifty-two studies met the inclusion criteria after rigorous screening and quality assessment using the CASP and JBI checklists. The originality of this review lies in synthesizing cross-disciplinary perspectives—encompassing digital marketing, artificial intelligence (AI), learning management systems (LMSs), open data, and collaborative digital tools—into a unified framework of administrative innovation. Findings reveal that digital marketing strategies enhance student engagement and institutional visibility, AI improves efficiency and decision-making, LMSs streamline academic and administrative coordination, and open data initiatives promote transparency but encounter legal and cultural resistance. Despite the potential of these technologies, persistent challenges include data privacy concerns, uneven digital infrastructure, and limited institutional readiness. This review contributes to the literature by mapping the intersection of technological innovation and university governance, identifying research gaps, and outlining directions for sustainable digital transformation in higher education. Full article

Traffic calming zones (TCZs) are increasingly being implemented in urban areas to enhance road safety, reduce vehicle speeds, and support sustainable mobility. However, their impact on public transport (PT) operations, particularly bus services, remains underexplored. This study examines the impact of classifying streets into TCZs on bus transport performance in Poland’s ten largest cities. Geospatial analysis and a custom R algorithm delineated areas suitable for TCZs based on road class and administrative category. GTFS data were analysed for almost 1000 bus lines to evaluate the overlap of their routes with TCZs. The findings reveal that in several cities, a significant portion of bus operations would run through TCZs, with the average route segment affected notably by city and zone classification methods. Differences in TCZ size and shape across cities were also statistically significant. This study concludes that although TCZs contribute to safer and more liveable urban environments, their influence on bus speeds, which can lead to changes in fuel or energy consumption, and route design must be carefully managed. Strategic planning is essential to find a balance between the benefits of traffic calming and the operational efficiency of PT. These insights offer valuable guidance for integrating TCZs into sustainable urban transport policy without compromising PT performance. Full article

The liver is the primary metabolic organ in the body, metabolizing nutrients and drugs. Advanced liver diseases result in compromised metabolic function of the liver. These diseases are often difficult to treat with drugs because of inability of the liver to generate effective drug metabolites and/or to properly inactivate the drugs resulting in high drug-induced toxicity with subsequent reduced patient compliance. Hepatocellular carcinoma (HCC) is a disease that develops on a fibrotic/cirrhotic liver and is mostly diagnosed at an advanced stage. Current protocol for treating advanced HCC includes a combination of immunotherapy or tyrosine kinase inhibitors (TKIs), which provides a survival benefit of only ~2 years. In addition, immunotherapy is effective in only 27% of HCC patients and patients treated with TKIs invariably develop drug resistance within 6 months. In this scenario gene therapy serves as an alternative approach that might bring significant benefits to HCC patients. Although gene therapy approaches for HCC or other liver diseases have yet to obtain approval from the Food and Drug Administration (FDA), a significant advancement has been made over the years in this field. In this review article, we highlight very recent literature showing the promise of gene therapy in managing HCC patients, extending survival benefits and providing improved quality of life. Full article

The construction industry faces significant payment processing challenges characterized by delays, disputes, and cash flow constraints affecting contractors. Traditional systems rely on fragmented, paper-based processes lacking transparency and real-time integration between project progress and financial transactions. This paper proposes a decentralized application that integrates BIM 5D capabilities with Solana blockchain technology for automated construction payment processing, called DB5D. The framework consists of several components: a web-based 3D viewer utilizing Autodesk Forge for BIM visualization, construction schedule integration from planning software, Solana blockchain programs using Program-Derived Address (PDA) and Cross-Program Invocation (CPI) for secure payment processing, and decentralized document management through InterPlanetary File System (IPFS) with Content Addressable Archives (CAR) compression. The system enables direct linkage between measurable project progress and automated payments by allowing stakeholders to extract quantities from BIM models, record construction task completion with supporting documentation, and trigger blockchain-based token transfers upon client approval. Comprehensive validation involving construction industry professionals confirms the framework’s practical viability. It demonstrates significant improvements in payment transparency, administrative efficiency, and scalability compared to existing blockchain implementations, while enabling economically feasible micro-payments throughout project lifecycles. Full article

Background/Objectives: Idiopathic pulmonary fibrosis (IPF) is a fibrotic interstitial lung disease (ILD) with a poor prognosis. The prognosis of ILDs showing progressive pulmonary fibrosis (PPF) is poor, similar to that of IPF. Diarrhea is the most frequently observed adverse event in ILDs treated with nintedanib. Managing diarrhea is important for maintaining nintedanib use and improving the prognosis of ILDs. Methods: Between October 2022 and March 2025, we enrolled patients with severe nintedanib-induced diarrhea that was uncontrolled by loperamide and/or probiotics. Other drugs were administered to control diarrhea, and the patients were prospectively observed to evaluate stool frequency, stool form score (scores 3, 2, and 1 for watery stool, soft stool without form, and soft stool with form, respectively), quality of life (QOL) using the Japanese version of the irritable bowel syndrome (IBS)-QOL questionnaire, adverse events, and laboratory findings. Results: Eleven patients (IPF, n = 5; PPF, n = 6) were enrolled, and all patients were treated with ramosetron, a 5-hydroxytryptamine type 3 receptor (5-HT₃) antagonist. Ramosetron was terminated within 3 weeks, before sufficient evaluation, because of insufficient efficacy (n = 1) and the discontinuation of nintedanib due to pneumothorax (n = 1). Stool frequency and stool form scores decreased significantly after the initiation of ramosetron therapy; however, IBS-QOL did not improve significantly. IBS-QOL correlated with shortness of breath scores but not with stool frequency. No prominent adverse events were associated with ramosetron administration. Conclusions: Ramosetron, a 5-HT₃ antagonist, improved stool frequency and stool form in patients with severe nintedanib-induced diarrhea. Full article

Access control schemes and models are essential tools for system administrators to protect the integrity of the information. However, they are frequently articulated in natural language, which is a powerful form that guarantees flexibility and expressiveness; however, their inherent ambiguity and unstructured nature pose significant challenges for automated enforcement and rigorous analysis. In this study, we evaluated several transformer-based models for the automated extraction of key components of Natural Language Access Control Policy (NLACP). To this end, we relied on a labeled dataset comprising software requirements specifications from different sectors, such as healthcare and conference management systems. We then conducted a fine-tuning phase, where the BERT model demonstrated optimal performance in extracting entities within a 3-entity paradigm, achieving an F-Measure value of 0.89. ModernBERT proved to be the most promising model in the more complex 5-entity extraction task, with a maximum F-Measure score of 0.84. Furthermore, we introduce an explainability step using layer-wise integrated gradients to gain insight into the decision-making process of these deep models, ensuring that the extracted policy components are both accurate and interpretable. Full article

Xanthoceras sorbifolium Bunge leaves (XBL), traditionally consumed as herbal tea, have attracted increasing attention as potential functional food ingredients for managing type 2 diabetes mellitus (T2DM). This study investigated the anti-diabetic effects of an aqueous XBL extract in T2DM rats induced with a high-fat, high-sucrose diet combined with streptozotocin. XBL administration significantly improved glycemic control, insulin sensitivity, lipid profiles, and pancreatic and renal histopathology. Integrated 16S rRNA sequencing and untargeted fecal metabolomics revealed the modulation of key metabolic pathways, including linoleic acid and histidine metabolism, and elevated production of short-chain fatty acids (SCFAs) such as acetate and propionate. XBL also enriched beneficial gut microbes including Prevotella, Lachnospiraceae_NK4A136_group, and [Eubacterium]_xylanophilum_group, whose abundance showed positive correlations with SCFA levels and metabolic improvements. These findings demonstrate that XBL ameliorates T2DM through gut microbiota–SCFA–metabolite interactions and suggest its potential as a natural, multi-target dietary strategy for metabolic health management. Full article

Accurate prediction of gas pipeline incidents through risk factor interdependencies is critical for proactive safety management. This study develops a hybrid SARIMA–association rule mining (ARM) framework integrating time-series forecasting with causal pattern decoding, using 60-month U.S. pipeline incident records (2010–2024) from the Pipeline and Hazardous Materials Safety Administration (PHMSA) database, covering leaks, mechanical punctures, and ruptures. Seasonal Autoregressive Integrated Moving Average (SARIMA) modeling with six-month rolling-window validation achieves precise leak forecasts (MAPE = 14.13%, MASE = 0.27) and reasonable mechanical damage predictions (MAPE = 31.21%, MASE = 1.15), while ruptures exhibit pronounced stochasticity. Crucially, SARIMA incident probabilities feed Apriori-based ARM, revealing three failure-specific mechanisms: (1) ruptures predominantly originate from natural force damage, with underground cases causing economic losses (lift = 3.70) and aboveground class 3 incidents exhibiting winter daytime ignition risks (lift = 2.37); (2) leaks correlate with equipment degradation, where outdoor meter assemblies account for 69.7% of fire-triggering cases (108/155 incidents) and corrosion dominates >50-year-old pipelines; (3) mechanical punctures cluster in pipelines <20 years during spring excavation, predominantly occurring in class 2 zones due to heightened construction activity. These findings necessitate cause-specific maintenance protocols that integrate material degradation laws and dynamic failure patterns, providing a decision framework for pipe replacement prioritization and seasonal monitoring in high-risk zones. Full article

Background: This study deploys the Lean Six Sigma DMAIC framework to achieve systemic optimization of the school subscription process in Tunisia’s public transport service, a critical administrative operation affecting efficiency and customer satisfaction across the urban mobility network. Methods: Beyond conventional applications, the research integrates advanced analytical and process engineering tools, including capability indices, measurement system analysis (MSA), variance decomposition, and root-cause prioritization through Pareto–ANOVA integration, supported by a structured control plan aligned with ISO 9001:2015 and ISO 31000:2018 risk-management standards. Results: Quantitative diagnosis revealed severe process instability and nonconformities in information flow, workload balancing, and suboptimal resource allocation that constrained effective capacity utilization. Corrective interventions were modeled and validated through statistical control and real-time performance dashboards to institutionalize improvements and sustain process stability. The implemented actions led to a 37.5% reduction in cycle time, an 80% decrease in process errors, a 38.5% increase in customer satisfaction, and a 38.9% improvement in throughput. Conclusions: This study contributes theoretically by positioning Lean Six Sigma as a data-centric governance framework for stochastic capacity optimization and process redesign in public service systems, and practically by providing a replicable, evidence-based roadmap for operational excellence in governmental organizations within developing economies. Full article