Search Results (2,917)

Background: Diabetic foot ulcers recur frequently after healing. The first three months carry the highest risk. Remission is a vulnerable phase that demands precise self-care and timely feedback. Evidence supports thermometry and protective footwear with gradual return to activity, yet adherence at home is inconsistent. Objective: To describe the design and planned evaluation of a conversational agent (chatbot) that guides patients through the remission phase following diabetic limb reconstruction. Methods: This protocol describes a conversational agent (chatbot) that turns remission guidance into daily actions, grounded in clinical expertise and established care guidelines. Walking is dosed like a drug, with careful titration based on tissue response. The agent integrates automatic data capture (smartphone step counts, skin temperature, shoe step streams, smartwatch step streams, Bluetooth thermometry when available, and app session timestamps) with manual patient entries (shoe wear time, skin redness persistence, and symptom checks). It doses walking activity, guides footwear break-in, prompts photo-confirmed concerns, following clinician-informed rules and escalation pathways. We define data quality checks for missingness and physiologic plausibility, and the agent reinforces reducing weight-bearing activity when risk signals appear. We outline device drift. The study is designed as a single-arm feasibility pilot (n = 30) to assess engagement, safety, and implementation fidelity. Results: No clinical outcome results are reported because this is a protocol study and enrollment has not yet begun. This study presents the prespecified sensing-to-decision workflow, escalation logic, and pilot endpoints, along with internal technical verification procedures (e.g., message delivery reliability, data completeness checks, and rule-engine consistency testing). Conclusions: A remission chatbot is a plausible method to extend specialist support into the home, reflecting integration of clinical expertise with digital health tools. This protocol defines how feasibility, safety, and usability will be evaluated. Clinical efficacy should be confirmed in future studies. Full article

On the basis of data from ten semi-structured interviews and selected secondary data from surveys conducted by the Office for National Statistics in Great Britain, this paper explores how young men and women articulate attitudes and experiences related to sustainable transport, using gender as an analytical lens. The study is exploratory and qualitative. Both traffic safety and personal safety appear to have a much more limiting influence on women’s travel mode choices than on men’s. Perceptions of safety, comfort, distance, convenience and accessibility are defined and shaped by the surrounding urban environment and transport infrastructure, and emerge as important considerations in the narratives of the study participants. The use of the car by men and women is somewhat linked to barriers to sustainable transport, such as infrequent and unreliable public transport, and, in the case of women, safety concerns. Concern for the environment is largely similar across male and female participants. Full article

This research investigates novel polymeric composite materials made from recycled polyolefin and waste plant biomass (poplar seeds and vegetable peels), which have potential applications in the relatively unexplored field of electrical insulation. For composites made from poplar seeds with low density polyethylene matrix, the structure appears more uniform, even with increased biomass content, in contrast to those utilizing high density polyethylene matrix, which displays notable heterogeneous areas where the polymer appears separated from the fibrous network at higher biomass levels. Concerning the composites of vegetable peels with high density polyethylene matrix, the fragments of vegetable peels are clearly recognizable, and their bond to the polymer matrix appears weaker. When incorporating vegetable peels into the polypropylene matrix, it results in a better distribution of the vegetable peel fragments within the polymer matrix, as well as enhanced structural homogeneity. Overall, the incorporation of biomass reduces the Shore hardness measurement for every polymer matrix. Regarding tear resistance, the inclusion of biomass reduces the values only for low density polyethylene with poplar seeds. For both high density polyethylene and polypropylene, regardless of the biomass type, the property seems to enhance marginally with the addition of biomass. The primary advantage of utilizing these composites is that their water absorption rate is at least twice as low as that of transformer board, while still offering a similar capacity for absorbing transformer oil. All composite types exceeded the minimum required threshold of 70 °C for service exposure, and adhered to insulation class A, similar to cellulose-based insulations. The addition of cellulose to polyolefin composites appears to slightly improve their breakdown strength. The conductivity for this type of composite is at least three times lower than that of cellulose insulation materials, rendering them beneficial for applications in electrical engineering as potential substitutes for cellulose-based materials in multiple electrical insulation uses, e.g., for insulating low voltage electrical machines, as well as serving as a substitute for pressboard in transformers. Additionally, their thermoplastic properties offer enhanced processing versatility, opening up new opportunities for electrical engineering technology, especially with regard to electrical insulation recyclability in the context of a circular economy. Full article

Electric vehicles (EVs) are promoted to decarbonise road transport, yet uptake remains slow in many emerging markets. This study examines consumer resistance to EV adoption in Sri Lanka by modelling status quo bias (SQB) using a Prospect Theory lens. An online survey of urban vehicle owners and near-term buyers yielded 157 responses; after screening and removing influential outliers, 151 cases were analysed using partial least squares structural equation modelling (PLS-SEM). The model tests five Prospect Theory-aligned antecedents, namely, loss aversion, reference dependence, risk perception, framing effects, and uncertainty aversion, and evaluates environmental concern as a moderator. Results indicate that loss aversion has a significant positive effect on SQB (β = 0.216, p = 0.005) and uncertainty aversion is the strongest predictor (β = 0.453, p < 0.001), while reference dependence, risk perception, and framing effects show positive but statistically non-significant direct effects. Moderation tests show that environmental concern significantly moderates the effects of reference dependence (β = 0.181, p = 0.039) and framing effects (β = 0.179, p = 0.037) on SQB, but does not significantly moderate the loss aversion, risk perception, or uncertainty aversion paths. Overall, perceived losses and—especially—ambiguity surrounding EV ownership appear to sustain reliance on internal combustion vehicles in this developing-country context, underscoring the need for interventions that reduce uncertainty (credible infrastructure signals, stable policy, service capability) and mitigate perceived losses (warranties, resale assurances) alongside carefully framed communications. Full article

Background: Venous thromboembolism (VTE) is a common and serious complication in patients with advanced non-small-cell lung cancer (NSCLC). While guidelines recommend prophylactic anticoagulation for cancer outpatients at high risk, its clinical implementation remains conservative in China. Objectives: This study aimed to investigate the current use of prophylactic anticoagulation for advanced NSCLC outpatients at high risk of VTE in China and explore factors influencing physicians’ decision-making. Methods: A descriptive cross-sectional survey using a convenience sampling approach was conducted from May to June 2025 among physicians from multiple top-tier tertiary hospitals across China. The survey assessed physicians’ knowledge, practices, and concerns regarding VTE risk assessment and prophylactic anticoagulation. Descriptive statistics and multiple response analyses were performed using SPSS 25.0. Results: A total of 235 valid responses were collected. Although 84.7% of physicians reported receiving anticoagulation training, only 57.8% routinely used the Khorana score for risk assessment. After excluding six physicians (2.7%) who reported never assessing VTE risk, 59.4% reported initiating prophylactic anticoagulation for patients with a Khorana score ≥ 2. Direct oral anticoagulants were preferred by 75.6% of physicians. Key concerns included management of bleeding events (78.6%) and adverse reactions monitoring (61.1%). Notably, only 49.4% of physicians reported being familiar with the Khorana score. Conclusions: Prophylactic anticoagulation for advanced NSCLC outpatients appears to remain underutilized in China. Limited familiarity with VTE risk assessment tools and concerns regarding bleeding risk may influence physicians’ clinical decisions. Educational initiatives and prospective studies may help improve guideline adherence. Full article

There are concerns that high-dose and/or long-term creatine monohydrate supplementation (CrM) leads to greater side effects (SEs) compared to placebo. This analysis investigated whether the dose or duration of CrM was associated with SEs. Data from trials involving more than 12,800 participants within CrM and placebo study arms of 684 randomized clinical trials were analyzed. SEs were combined into categories and total absolute dose and CrM duration were grouped into tertiles (low, moderate, and high). Crosstabs with chi-square tests were used to compare the prevalence of SEs across CrM dose and duration tertiles. Logistic regression models, adjusted for biological sex, age, and population categories, were used to test dose and duration as continuous predictors. Across 684 randomized controlled trials, reported SEs were infrequent. Although dose and duration tertiles were statistically associated with study-level side effect reporting, the effect sizes were uniformly small, events were infrequent, and the reported symptoms were primarily mild and nonspecific. No consistent exposure–response pattern indicative of clinically meaningful risk was observed. Adjusted logistic regression and frequency-based analyses showed no consistent dose- or duration-dependent increase in SE risk, with placebo groups often reporting similar or greater SE frequencies at the study-reporting level. CrM appears to be well-tolerated and, at the study-level, does not increase the risk of gastrointestinal, renal, liver, musculoskeletal, or other SEs compared to placebo, even at high doses or longer durations. Full article

Remote photoplethysmography (rPPG) extracts physiological signals from facial videos by analyzing subtle skin color variations caused by blood flow. While this technology enables contactless health monitoring, it also raises privacy concerns because facial videos reveal both identity and sensitive biometric information. Existing privacy-preserving techniques, such as blurring or pixelation, degrade visual quality and are unsuitable for practical rPPG applications. This paper presents rePPG, a framework that inserts a desired rPPG signal into facial videos while preserving the original facial appearance. The proposed method disentangles facial appearance and physiological features, enabling replacement of the physiological signal without altering facial identity or visual quality. Skin segmentation restricts modifications to skin regions, and a cycle-consistency mechanism ensures that the injected rPPG signal can be reliably recovered from the generated video. Importantly, the extracted rPPG signals are evaluated against the injected target physiological signals rather than the subject’s original physiological state, ensuring that the evaluation measures signal rewriting accuracy. Experiments on the PURE and UBFC datasets show that rePPG successfully embeds target PPG signals, achieving 1.10 BPM MAE and 95.00% PTE6 on PURE while preserving visual quality (PSNR 24.61 dB, SSIM 0.638). Heart rate metrics are computed using a 5-second temporal window to ensure a consistent evaluation protocol. Full article

Aquaponic systems are increasingly recognized as sustainable technologies for integrated fish and vegetable production. However, concerns remain regarding the potential internalization of human pathogens into vegetables grown in these systems. This study assessed the risk of pathogen internalization in lettuce leaves grown in aquaponic systems with Nile tilapia challenged with Escherichia coli or Vibrio cholerae. The system comprised nine fish tanks, eighteen hydroponic pipes, and eighty-one lettuce plants, with tanks assigned to three treatments. Samples of water, fish gut, fish blood, and lettuce leaves were collected. Microbiological analyses included selective culture, biochemical assays, and molecular identification. Although colonies consistent with E. coli and V. cholerae were recovered on selective media, molecular sequencing identified other bacterial species, including Aeromonas sp., Aeromonas caviae, Aeromonas veronii, Enterobacter hormaechei, and Citrobacter freundii. The findings indicate that conventional culture-based methods may produce false-positive results and highlight the importance of molecular confirmation. Notably, pathogenic bacteria associated with tilapia were detected and appeared capable of disseminating through the system and internalizing into lettuce tissues. This result highlights the need for biosecurity measures, contamination monitoring, and the combined use of conventional and molecular diagnostic tools to ensure accurate pathogen detection and compliance with international food safety standards. Full article

Background: The widespread use of Social Networks (SNS), particularly among youths, could promote Feeding and Eating Disorders (FEDs), but could also be a tool for implementing FED prevention strategies. This study aimed to identify which SNS could be most effective for implementing primary and secondary FED prevention. Methodology: A cross-sectional study was conducted via an Italian population-based survey, distributed using a snowball sampling strategy. The survey included 283 participants aged 18–35 by using the Bergen Social Media Addiction Scale (BSMAS), the SCOFF screening tool for FEDs, items from the Body Uneasiness Test (BUT), and the Mukbang Addiction Scale (MAS). Results: The sample was predominantly female (69.3%). Participants screening positive on the SCOFF were more frequently TikTok users. Stepwise logistic regression analysis showed that TikTok use was associated with SCOFF positivity (OR = 1.9) and body image concerns (e.g., spending a lot of time in front of the mirror; OR = 1.9). Instagram use was associated with body image dissatisfaction (OR = 3.9). In the overall sample, the likelihood of screening positive on the SCOFF was associated with TikTok use (OR = 1.7), higher BSMAS scores (OR = 1.1), exposure to body positivity/neutrality content (OR = 1.9), and watching Mukbang videos (OR = 1.8). Conclusions: TikTok and, to a lesser extent, Instagram appear to be widely used by young individuals vulnerable to FEDs and body image dissatisfaction. These platforms may therefore represent strategic channels for delivering educational and preventive interventions targeting eating behaviors and body image among young people. Further longitudinal research is needed to clarify causal relationships and evaluate the effectiveness of SNS-based prevention strategies. Full article

Italy and the surrounding seas are recognised as one of the European hotspots for tornadoes and waterspouts. In recent years, the town of Rosignano Solvay (on the Northern Tyrrhenian coast) experienced repeated waterspouts affecting the same areas, raising local concern about the possible influence of heated wastewater discharged into the sea by a nearby industrial site. We reconstruct the mesoscale meteorological conditions of four intense waterspouts near Rosignano Solvay using a limited-area weather model at a high-to-very-high resolution (inner domain grid spacing of 500 m; sensitivity tests at 100 m). At the reported event times, the intensity of key mesoscale precursors (low-level wind shear, 1 km storm-relative helicity, maximum updraft intensity, and lifting condensation level) is consistent with the values typically associated with EF1 (or stronger) tornadoes and waterspouts. The model systematically predicts the peak of instability indices 2–3 h earlier than the reported event times. For one case study, we conduct two sea surface temperature sensitivity experiments to assess the potential atmospheric impact of heated wastewater discharge (temperature increases of +1.5 K and +5 K over a 10 km² area). The resulting changes in instability indices are marginal, with differences of at most 3% relative to the control run. A simple mass-balance estimate for the modified sea patch suggests that, given the reported discharge rates, a plausible impact of the warm water released from the industrial site could lead to an increase in the local sea surface temperature of approximately +0.7 °C over two months. We conclude that synoptic and mesoscale conditions primarily govern waterspout initiation in this region, while the direct effect of the small warm coastal plume from the industrial discharge appears to be minor. Full article

Background/Objectives: Excessive smartphone use has emerged as an important behavioral health concern during adolescence, a developmental period characterized by heightened psychosocial vulnerability. This study aimed to identify psychosocial and behavioral factors associated with excessive smartphone use among Korean adolescents using nationally representative data. Methods: Data were obtained from the 2024 Korean Youth Risk Behavior Web-based Survey (KYRBS), including 54,653 adolescents. Excessive smartphone use was operationally defined as average daily smartphone use of ≥300 min. Multivariable logistic regression was conducted to examine associated factors. An exploratory machine learning analysis using a Light Gradient Boosting Machine included 52,450 participants with complete predictor data. Results: Female sex, higher grade level, lower perceived socioeconomic status, higher perceived daily stress, higher anxiety symptoms, poorer sleep-related recovery, suicidal ideation, and more frequent vigorous physical activity were associated with higher odds of excessive smartphone use. The supplementary modeling approach showed patterns consistent with the regression findings, with grade level, socioeconomic status, and sex contributing prominently. Vigorous physical activity demonstrated a nonlinear association with predicted risk. Conclusions: Excessive smartphone use among adolescents appears to be shaped by developmental stage, socioeconomic context, and psychological vulnerability. These findings support prevention strategies that address emotional well-being and sleep health alongside broader structural and school-based approaches. Full article

A rare clinical condition associated with numerous diagnostic and treatment challenges, pregnancy-associated melanoma (PAM), is defined as melanoma diagnosed either during pregnancy or within the first year postpartum. The physiological changes in pregnancy (hormonal changes and immune modulation), along with the normal changes in the pregnant woman’s skin (skin color changes, etc.), may all hinder early detection of this disease and create concerns regarding the advancement of melanoma and the well-being of both the mother and her fetus. The purpose of this review article was to summarize the current literature on the incidence, biology, diagnostic methods and treatments of PAM, with an emphasis on comparison between the two forms of melanoma. More recent research indicates that pregnancy itself is not typically associated with decreased melanoma-specific survival rates. However, when worse results are reported, it appears that this may be more due to delays in initial diagnoses (diagnosis of cancer after delivery) or detection of cancer postpartum, as well as the increased number of stages of melanoma at which women were diagnosed at the time of their first evaluation compared to non-pregnant controls, rather than being a result of enhanced biologic aggressiveness in melanoma driven by pregnancy itself. The preclinical and translational models have suggested that pregnancy may influence melanoma biology through the mechanisms of hormonal signaling, immune system modulation and vascular remodeling; however, these mechanisms remain hypothesis-generating, and current clinical evidence does not indicate that changes in hormone levels during pregnancy negatively affect melanoma survival. Surgical excision is the mainstay of treatment and can be performed safely during pregnancy. In select patients, a sentinel lymph node biopsy may also be performed. Due to the risk of fetal harm, systemic therapy (targeted agents and/or immune checkpoint inhibitors) cannot be used for the treatment of PAM during pregnancy. Post-pregnancy treatment of PAM will follow standard melanoma treatment guidelines; however, the treatment options will need to take into consideration whether or not the patient is breastfeeding and if she desires to become pregnant again in the future. In summary, PAM will require a multidisciplinary, individualized approach to maximize oncologic outcomes while protecting the health of both the mother and her fetus. Awareness of this disease and timely diagnosis are critical to maximizing the prognosis. Full article

HIV-associated neurocognitive disorders (HAND) persist despite combination antiretroviral therapy (cART) and can be exacerbated by repeated cocaine (COC) exposure. Because COC, HAND, and cART independently disrupt medial prefrontal cortex (mPFC) function, their combined neurotoxic impact is a critical clinical concern. Using patch-clamp electrophysiology in HIV-1 transgenic (Tg) and non-Tg rats, we examined mPFC pyramidal neuron activity following repeated exposure to COC and/or cART. In non-Tg rats, COC and cART independently increased neuronal firing, trending toward an additive hyperactive effect when combined. Conversely, HIV-1 Tg rat neurons exhibited plateaued excitability, with no further firing elevations induced by COC or cART. Under intense depolarizing stimuli, treated neurons displayed overactivation-induced firing declines. These findings indicate that while COC and cART additively disrupt mPFC function in non-Tg rats, excitability mechanisms appear saturated in the HIV-1 Tg model. This restricted experimental context highlights the overlapping neurobiological impacts of cART and stimulant use, providing foundational insights into the comorbidity of COC use disorder and HAND. Full article

Background: Urticaria, particularly chronic urticaria (CU), is a highly prevalent inflammatory skin disorder characterized by recurrent wheals and/or angioedema with a fluctuating and unpredictable course that significantly impairs quality of life and requires long-term monitoring. Despite established therapeutic guidelines, disease control remains suboptimal in a considerable proportion of patients. Telemedicine has emerged as a promising adjunctive strategy for chronic disease management. This review aims to critically evaluate the role, applications, benefits, and limitations of telemedicine and digital health interventions in urticaria management. Methods: A scoping review of the literature was conducted focusing on studies addressing telemedicine, digital patient-reported outcomes, mobile health applications, and remote monitoring strategies in urticaria. Evidence from pandemic and post-pandemic telemedicine models was also analyzed to identify transferable approaches. Results: Telemedicine demonstrates significant potential in urticaria management by enabling structured symptom monitoring, facilitating remote follow-up during therapeutic escalation (including biologic therapies), improving patient empowerment and adherence, and reducing healthcare utilization and indirect costs. Digital tools such as electronic diaries and validated PRO-based applications support continuous disease assessment. However, telemedicine cannot replace direct clinical examination, and limitations include diagnostic uncertainty, digital inequalities, data privacy concerns, and lack of large disease specific trials. Conclusions: Telemedicine represents a valuable complementary and integrative model for urticaria care, particularly suited for chronic disease monitoring. Hybrid care pathways combining remote and in-person management appear to be the most effective and sustainable strategy. Further high-quality urticaria-specific studies and standardized digital frameworks are required to optimize its clinical implementation. Full article

Personality recognition and emotion recognition, two core tasks within affective computing, are fundamentally constrained by data scarcity as collecting and annotating human behavioral data is expensive and restricted by privacy concerns. Under these limited data conditions, existing models tend to rely on superficial shortcut features such as background appearance, lighting conditions, or color variations, rather than behavior-relevant cues including facial expressions, posture, and motion dynamics. To address this issue, we propose Style-Abstraction-based Data Augmentation, a style transfer-based augmentation strategy that reduces dependency on low-level appearance information while preserving high-level semantic cues. Specifically, we employ cartoonization to generate stylized variants of training videos that retain expressive characteristics but remove stylistic bias. We validate our approach on three diverse personality benchmarks (First Impression v2, UDIVA v0.5, and KETI) and emotion benchmark(Emotion Dataset) using state-of-the-art models including ViViT (Video Vision Transformer), TimeSformer, and VST (Video Swin Transformer). Our experiments indicate that increasing the proportion of style-abstracted data in the training set can improve performance on the evaluated datasets. Notably, our method yields consistent gains across all benchmarks: a 0.0893 reduction in MSE on UDIVA v0.5 (with VST), a 0.0023 improvement in 1-MAE on KETI (with TimeSformer), and a 0.0051 improvement on First Impression v2 (with TimeSformer). Furthermore, extending style-abstraction-based data augmentation to a four-class categorical emotion recognition task demonstrates similar performance gains, achieving up to a 3.44% accuracy increase with the TimeSformer backbone. These findings verify that our style-abstraction-based data augmentation facilitates learning of behavior-relevant features by reducing reliance on superficial shortcuts. Overall, cartoonization-based style abstraction for data augmentation functions as both an effective augmentation strategy and a regularization mechanism, encouraging the model to learn more stable and generalizable representations for affective computing applications. Full article