Search Results (34,757)

Background: Healthcare systems contribute significantly to environmental pollution, energy consumption, and resource depletion, making sustainability an increasingly important environmental and public health priority. Nurses, as frontline healthcare professionals, play a critical role in promoting environmentally responsible practices and advocating for sustainable healthcare within clinical settings. Objective: The study aimed to examine the associations between nurses’ sustainability consciousness, green advocacy, and work grit in hospital settings. Methods: A descriptive cross-sectional correlational study was conducted among 377 nurses working in two university-affiliated hospitals in Egypt. Data were collected using validated instruments assessing sustainability consciousness, green advocacy, and work grit. Descriptive statistics were calculated to summarize participant characteristics and study variables. Associations among sustainability consciousness, green advocacy, and work grit were examined using Pearson correlation analysis. Multiple linear regression analysis was conducted to identify significant predictors of green advocacy, while noting that the study design allows for identification of associations rather than causal relationships. Results: The findings indicated generally high levels of sustainability consciousness among nurses. Significant positive associations were observed between sustainability consciousness, green advocacy, and work grit (p < 0.01). Multiple linear regression analysis identified sustainability consciousness and work grit as significant predictors of green advocacy, explaining 34.2% of its variance. Conclusions: These findings highlight the interconnected roles of sustainability awareness, advocacy behaviors, and psychological resilience in promoting environmentally sustainable healthcare practices. Strengthening nurses’ sustainability consciousness and work grit may enhance green advocacy and contribute to the development of sustainable healthcare systems, supporting global environmental and public health goals aligned with the United Nations Sustainable Development Goals. Full article

Rising energy costs and strict CO₂ traceability regulations create demand for monitoring energy and CO₂ emissions in manufacturing. This paper presents a framework for modelling component-wise energy models with deployable accuracy. In many factories, power metres log data at a sampling rate of 1–2 Hz, so short start-up peaks of components are underestimated. Manufacturers want to exploit this information to support operational decisions, such as peak shaving and optimising energy contract costs. To enable data-driven decisions with limited measurement infrastructure, energy models must extrapolate component behaviour from sparse data. The framework is based on power measurements in accordance with ISO 14955-3, ensuring that the load characteristics required for subsequent modelling are known. The measurements are then segmented, and regressions are fitted for each segment. As a case study considering the mist extractors of two different machine tools, the proposed segmentation achieved determination coefficients (R²) of up to 0.94 in the complex ramp-up phase. The resulting models are compact, interpretable, and suited for energy monitoring on edge devices. The contribution is a reproducible framework for delivering peak-aware, component-level energy models from low-frequency industrial power metre data. Full article

The increasing penetration of wind generation requires performance evaluation methods that extend beyond average annual energy production. Temporal delivery characteristics, such as monthly dispersion and exposure to low-production periods, can influence both technical robustness and economic sensitivity. Building upon a previously developed probabilistic and entropy-based assessment framework, this study evaluates the robustness of delivery-oriented performance metrics for onshore and offshore wind units under parametric and economic uncertainty. Using high-resolution operational data from four wind units (three onshore and one offshore), the analysis incorporates percentile sensitivity, threshold variation in low-production exposure, bootstrap-based uncertainty intervals, and Monte Carlo simulation of economic inputs including CAPEX, operation and maintenance costs, and discount rate. The results indicate that variations in percentile definitions and stochastic economic assumptions modify absolute performance values but do not substantially alter the relative positioning between offshore and onshore units. Averaged over 2022–2024, the analyzed offshore unit exhibited a lower monthly energy dispersion coefficient ($C{V}_E=0.255$) [Reviewer2]than the analyzed onshore units ($C{V}_E=0.368$), [Reviewer2]corresponding to an approximate 30% reduction in relative variability. The offshore unit also showed lower mean low-production exposure ($LPE=0.526$ versus $0.581$ for onshore units) [Reviewer2]and consistently lower amplification of robustness-adjusted LCOE under conservative delivery assumptions. These results indicate that the analyzed offshore unit retains stronger delivery robustness and lower economic sensitivity across the tested parameter ranges. The proposed robustness-validation framework complements conventional yield-based assessments and provides additional insight for risk-aware evaluation of wind generation assets in renewable-dominated power systems. Full article

Large language model (LLM)-based document translation systems typically treat each segment independently, discarding terminology decisions, human corrections, and discourse cues after each generation step. This stateless approach causes terminology inconsistency across segments, failure to propagate approved post-edits downstream, and redundant prompt-token consumption. Existing solutions—document-level MT, retrieval-augmented generation, and computer-assisted translation (CAT) tools as a general category—address individual aspects but lack a unified, state-aware architecture with provenance, update rules, and rollback semantics. We propose Language Twin, a shared-state architecture that organizes translation projects into seven versioned layers (L0–L6), supporting selective context loading, scoped human-edit propagation, and reversible updates. A pilot study translated three curated English-to-Korean document bundles (17 segments) using GPT-4o with a temperature of 0.3. The Language Twin condition (P1) achieved numerically higher preferred-term accuracy than the strongest baseline (17/21 vs. 14/21; not statistically significant at this sample size) and showed no repeated downstream errors in the monitored set (0/5 vs. 5/5 against the propagation-disabled ablation; Fisher’s exact test: p = 0.008), while reducing prompt tokens by 39.2% relative to full-context loading (A4). In blinded human evaluation (quadratic-weighted κ = 0.71–0.78), P1 achieved the highest terminology rating (4.38/5 vs. 3.97/5) and lowest post-editing time (16.9 s vs. 19.1 s per segment). These pilot-scale results indicate that governed shared state can improve terminology consistency and editing efficiency. Full article

Forest structural complexity underpins habitat quality, microclimate buffering, and resilience, yet it remains poorly characterized across the Hindu Kush Himalaya (HKH) where field inventories and airborne LiDAR are difficult to scale across rugged terrain. Conservation planning and protected-area evaluation in the HKH therefore often rely on canopy height or cover proxies that do not directly represent vertical structural organization. Here we develop a repeatable, uncertainty-aware indicator of forest structural complexity from GEDI waveform LiDAR using the Waveform Structural Complexity Index (WSCI) and its prediction intervals. We first define a conservative analysis footprint (“trustable pixels”) by combining a woody-vegetation screen with minimum GEDI sampling support and canopy-stature plausibility, and by excluding the highest-uncertainty tail using a relative prediction-interval criterion. To separate complexity from canopy height, we model the HKH-wide expected WSCI–RH98 relationship and map height-normalized excess complexity (observed minus expected), identifying structural complexity hotspots and coldspots as the upper and lower tails of the excess distribution. Anomaly patterns are strongly organized along elevation and treeline-relevant belts and show coherent departures among ecoregions that persist after stratified adjustment for elevation and mean annual precipitation, indicating additional controls beyond broad environmental gradients. Protected areas exhibit systematically lower hotspot prevalence than surrounding landscapes, and within-elevation comparisons suggest this association is not explained by elevation alone, highlighting the need to interpret protected-area signals in the context of placement and land-use pressure. Overall, the anomaly atlas provides an operational indicator framework to stratify monitoring, prioritize field validation, and support the landscape-scale assessment of structural conditions beyond canopy height across one of the world’s most critical mountain forest systems. Full article

Background: Adults with disabilities living in low-resource communities experience persistent inequities in access to healthcare, mental health services, and community participation. However, qualitative data capturing lived experiences in the Deep South remain limited. This study aimed to identify priority needs among adults with mobility disabilities residing in economically distressed communities near Birmingham, Alabama, to inform future telehealth programming. Methods: Fifteen adults (mean age = 60 ± 10 years), predominantly African American and female, completed semi-structured phone interviews exploring basic needs, neighborhood accessibility, health priorities, and perceived supports. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s six-phase thematic analysis. Results: Five themes emerged: (1) seeking stability amid severe mental health strain and inadequate supports; (2) constrained food environments shaped by cost, location, and safety; (3) feeling forgotten: systemic neglect and restricted participation in community life; (4) physical health deprioritized by competing needs and structural barriers; and (5) remote support as a viable but unrealized option. Participants described how safety concerns, transportation barriers, and rising food costs constrained daily functioning, while unmet mental health needs compounded isolation. Despite widespread cardiometabolic disease, immediate needs related to mental health, food, and housing consistently superseded physical health. Mental health support was identified as the most feasible area for remote delivery, though poor awareness of available resources limited engagement with any service model. Conclusions: Findings demonstrate that disability-related disparities in low-resource communities are driven largely by structural and environmental factors rather than individual choice. Telehealth and mobile-based services may provide a feasible access strategy for mental health and supportive care in under-resourced settings, particularly when integrated with broader community supports. Addressing foundational needs is essential for advancing health equity among people with disabilities in the Southeast. Full article

Water surface object detection in shipborne remote sensing is challenged by unstable wave-induced backgrounds, illumination variations, extreme scale changes with tiny objects, and limited annotations. Multimodal RGB–infrared (RGB–IR) sensing leverages complementary visible and infrared cues to enhance robustness. However, most existing RGB–IR methods rely on backbones pretrained on limited-scale data, which constrain their performance for complex water surface scenes. In this work, we propose the WS-R-IR Adapter, a parameter-efficient vision foundation model (VFM)-based framework for shipborne RGB–IR object detection. Instead of full fine-tuning, it adapts frozen VFM representations via lightweight task-specific designs. the WS-R-IR Adapter includes (1) a water scene domain-aware modal adapter that progressively guides frozen backbone features with evolving semantic cues, (2) a parallel multi-scale structural perception module for fine-grained, scale-sensitive modeling, (3) an adaptive RGB–IR feature modulation fusion strategy, and (4) a resolution-aligned context semantic and structural detail fusion module. Moreover, we introduce an object-guided global-to-local registration framework to address dynamic cross-modal misalignment, and construct modality-aligned PoLaRIS-DET and ASV-RI-DET datasets that cover diverse water surface scenes. On the two datasets, the proposed method achieves mAP@0.5:0.95 scores of 74.2% and 50.2%, respectively, significantly outperforming existing methods with only 11.9M additional parameters. These results demonstrate the effectiveness of parameter-efficient VFM adaptation for multimodal water surface remote sensing. Full article

In millimeter wave V2I communication systems, accurate beam prediction is crucial for optimizing network performance and improving signal transmission efficiency. Traditional beam prediction methods mainly rely on single-modal data, which often fails to capture the comprehensive environmental information required for high accuracy prediction. In contrast, multi-modal approaches leverage complementary information from different data sources and offer a more promising solution. However, many existing fusion methods primarily depend on real-time sensory inputs and do not fully exploit stable environmental features in V2I scenarios, limiting the effective use of each modality. To address these limitations, this paper proposes a environment-aware proactive beam prediction method based on a multi-modal prior mask map (MMPMM), which integrates offline mapping with an online beam prediction network. Specifically, the method fuses information from images, point clouds, positions, and the MMPMM to predict the optimal beam index. The MMPMM provides channel-related prior information by extracting static V2I scene features offline without incurring any additional online measurement overhead. Experimental results on real-world datasets demonstrate that the proposed method achieves a Top-3 beam prediction accuracy of up to 71.23% while maintaining stable performance under the evaluated dynamic and degraded conditions, demonstrating its effectiveness in the considered scenarios. Full article

This study investigates the educational impact of an industrial field visit on the learning experience of second-year pharmacy students at Qatar University. The visit, integrated within the Pharmaceutics II course (PHAR 310), was designed to complement theoretical instruction by providing exposure to real-world pharmaceutical manufacturing and quality control processes, particularly for parenteral dosage forms. A mixed-methods approach was employed using quantitative and qualitative data derived from post-visit questionnaires. Findings indicated that students reported positive perceptions of the experience, with the majority indicating improved understanding of key pharmaceutical manufacturing concepts and strong support for the inclusion of similar activities within the curriculum. Qualitative analysis further suggested that the visit facilitated contextualization of theoretical knowledge, enhanced engagement, and supported early professional awareness. While these findings suggest that structured industrial visits may serve as a valuable complementary educational strategy in pharmacy training, the results should be interpreted with caution due to the small sample size and single-institution design. Further research incorporating larger cohorts, objective learning assessments, and longitudinal evaluation is underway to better establish the educational impact of these interventions. Full article

The DPF-DETR model has been designed to address the challenges encountered in object detection within drone imagery, particularly in scenarios involving significant target scale variations, dense targets, and complex backgrounds. To overcome the limitations of traditional object detection methods, the Density Sensing Mechanism (DSM) and Adaptive Density Map Loss (AdaptiveDM Loss) have been incorporated into the model to provide fine-grained supervision signals. The DSM optimizes the query selection mechanism by utilizing density maps, enabling the number of queries to be adaptively adjusted based on the distribution density of targets, thus improving detection accuracy in dense regions. Furthermore, the precision of the model in detecting dense targets is enhanced by AdaptiveDM Loss, which dynamically adjusts the weights for object localization and classification. Multi-scale feature fusion capabilities are also improved by the Multi-Scale Feature Fusion Network (MSFFN) and the Selective Feature Integration Module (SFIM). The MSFFN refines the fusion of features, which improves the detection of targets across various scales, particularly in complex scenes. Additionally, SFIM enhances the detection accuracy for small targets and complex backgrounds by integrating low-level spatial features with high-level semantic information. The Context-Sensitive Feature Interaction Module (CSFIM) further optimizes multi-scale feature fusion through context-guided interactions, bridging the semantic gap between features of different scales, thus improving the robustness of the model in dense scenarios. Experimental results have shown that DPF-DETR outperforms traditional models and state-of-the-art detection methods across multiple datasets, demonstrating superior robustness and accuracy, especially in dense target detection and complex background scenarios. Full article

Background/Objectives: This study proposes CMT-BUSNet, a hybrid architecture integrating CNN, Mamba, and Transformer branches for breast ultrasound tumor segmentation with built-in explainability. Methods: CMT-BUSNet employs a CNN-anchored hierarchical parallel encoder where Mamba and Transformer branches process CNN-derived features in parallel, fused through an Adaptive Feature Fusion Module (AFFM) with Dense Nested Decoder and Boundary-Aware Composite Loss. Five-fold cross-validation on BUS-BRA (N = 1875) compared nine architectures under identical protocols, plus nnU-Net v2 trained with its default self-configuring protocol as a benchmark. External evaluation used the BUSI dataset (N = 647). Results: CMT-BUSNet achieved DSC = 0.9037 ± 0.0047 on BUS-BRA with higher boundary delineation metrics than nnU-Net v2, which was trained under a different self-configuring protocol (B-IoU: 0.611 vs. 0.557; HD95: 10.07 vs. 13.54 pixels), despite nnU-Net’s marginally higher DSC (0.9108). On BUSI, CMT-BUSNet (DSC = 0.6709) yielded higher scores than nnU-Net (0.5579) across all metrics under zero-shot transfer, though the two methods were trained under different protocols. Training-based ablation confirmed each component’s contribution, and quantitative XAI validation demonstrated attribution faithfulness (nEAR = 2.82×) and uncertainty–error correlation (r = 0.39). Conclusions: CMT-BUSNet achieves competitive accuracy with higher boundary metrics, preliminary cross-dataset transferability, and built-in interpretability relative to nnU-Net (noting different training protocols). Internal validation folds are image-disjoint but not guaranteed to be patient-disjoint, which should be considered when interpreting the reported metrics. Multicenter validation is required before clinical deployment. Full article

Objectives: The objective of this study was to investigate metabolic dysfunction-associated steatotic liver disease (MASLD)-related awareness, health literacy (HL), and illness perception among patients at risk of MASLD in European primary care settings. Methods: Participants aged ≥50 years with either obesity, metabolic syndrome (MetS), or type 2 diabetes mellitus (T2DM), and attending general practices (GPs) in Greece, Spain, or The Netherlands were included in the study. The participants completed surveys to collect data on their socio-demographic characteristics and health habits, including the European Health Literacy Survey (HLS-E-Q16), the Brief Illness Perception Questionnaire [B-IPQ], and the Public Awareness of NAFLD Questionnaire. Results: Overall, 234 patients participated in the study (mean age: 66.5 ± 9.5 years; 45.7% were male). Among the participants, 64.5%, 66.2%, and 59.8% had a diagnosis of diabetes, obesity, and MetS, respectively. Almost one-third (27.9%) had never heard about MASLD or discussed MASLD with their GP. Twelve percent (12.1%) had never heard about cirrhosis, and 20.5% were unaware that liver disorders may cause serious health problems. Overall, 43.6% of the patients had a sufficient level of HL (score >13) with a mean score of 11.5 ± 3.3. Illness perception (B-IPQ score) was low at 41.6 ± 11.6. Significantly higher B-IPQ scores were documented for female compared to male respondents (43.1 vs. 39.8; p < 0.01). Multivariate analysis found that knowledge about MASLD was associated with higher HLS-E-Q16 (p = 0.017) and B-IPQ (p = 0.028) scores. Conclusions: Despite being at risk, a significant proportion of the study participants were unaware of MASLD, its risk factors, and their personal susceptibility. This study underscores the importance of enhancing patient HL and promoting prevention and risk reduction, particularly among high-risk patient populations. Full article

Heart rate variability (HRV) has emerged as a key biomarker for assessing autonomic nervous system activity, stress, fatigue, and emotional states. With the rapid development of wearable sensor technologies, HRV analysis has expanded from clinical environments to real-world, continuous monitoring. This review summarizes current applications of HRV metrics in wearable devices, including fitness tracking, mental stress assessment, sleep quality evaluation, and early detection of physiological or psychological disorders. Recent advances in photoplethysmography (PPG)-based HRV estimation have enabled noninvasive and user-friendly measurement, though challenges remain in accuracy under motion and variable environmental conditions. We also discuss methodological considerations, such as artifact correction, data segmentation, and the integration of HRV with other biosignals for multimodal analysis. Emerging research suggests that combining HRV with metrics such as respiration rate, skin conductance, and accelerometry can enhance robustness and interpretability in dynamic settings. Finally, future directions are proposed toward personalized health analytics, emotion-aware computing, and real-time adaptive feedback systems. This review highlights the growing potential of wearable HRV analysis as a foundation for preventive healthcare and human–machine symbiosis. Full article

In insurance portfolios, classifying customers without a prior history at a given company is particularly challenging due to the absence of historical behavior, extreme class imbalance, heavy-tailed loss distributions, and strict operational constraints. Traditional machine learning approaches, including the baseline methodology proposed in previous studies, typically optimize global predictive accuracy and therefore fail to capture business-critical outcomes, especially the identification of high-risk clients. This study extends the existing approach by evaluating two complementary business-aware classification strategies: (i) a balanced bagging ensemble specifically designed to handle class imbalance and maximize expected profit under explicit customer-omission constraints, and (ii) a lightweight Transformer-based architecture capable of learning richer feature representations. Both approaches incorporate the asymmetric financial cost structure of insurance and operate under operational selection limits. The empirical analysis is conducted on a proprietary large-scale auto insurance dataset comprising 51,618 customers and is complemented by validation on nine synthetic datasets to assess robustness. Model performance is evaluated using statistical tests (ANOVA, Friedman, and pair-wise comparisons) together with business-oriented metrics. The results show that both proposed approaches consistently outperform the baseline methodology (p < 0.001) in terms of profit, with the ensemble offering a better balance of performance and efficiency, while the Transformer shows stronger robustness and generalization under data perturbations. The balanced ensemble provides the most favourable trade-off between predictive performance, robustness, interpretability, and computational efficiency, making it suitable for deployment in regulated insurance environments, while the Transformer achieves competitive results and exhibits stronger generalization under data perturbations. The proposed approach aligns machine learning with actuarial portfolio optimization by explicitly integrating profit-driven objectives and operational constraints, offering two practical and scalable solutions for risk-based decision-making in real-world insurance settings. Full article

Reliable multi-sensor bearing fault diagnosis is challenged by temporal leakage caused by window-level random splitting, limited modeling of cross-sensor dependencies, and inadequate integration of raw temporal dynamics with time-frequency representations. To address these issues, this study proposes a leakage-resistant multi-sensor diagnosis framework that combines a partition-before-windowing evaluation protocol with adaptive time-frequency graph learning and reliability-aware fusion. Continuous vibration records are first divided into disjoint temporal regions with guard intervals and overlap auditing to suppress time-neighbor leakage. The model then extracts complementary features from a raw-signal branch and a dual-resolution log-STFT branch, while adaptive graph learning captures sample-dependent inter-sensor couplings and sensor reliability weighting highlights informative channels. A cross-gated fusion module further integrates temporal and graph-domain representations in a sample-adaptive manner for final classification. Experiments on a reconstructed nine-class benchmark derived from the HUSTbearing dataset show that the proposed method achieves a Macro-Accuracy of 0.973, a Macro-Recall of 0.964, and a Macro-F1 of 0.954, outperforming representative raw-signal and STFT-based baselines under the same leakage-resistant protocol. These results demonstrate that jointly modeling multi-scale time-frequency structure, dynamic sensor relationships, and reliable evaluation yields an effective and interpretable solution for intelligent bearing fault diagnosis under complex operating conditions. Full article