Search Results (407)

Objectives: This study aims to explore the facilitators and barriers in the process of using AI agents for disease management in older COPD patients. Methods: Based on the normalization process theory, a descriptive qualitative study was used to conduct semi-structured interviews with 28 older patients with COPD recruited from June to August 2025 in a Class A tertiary hospital in Wuxi, Jiangsu Province. Results: A total of 28 interviews were conducted. Four themes (Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring), nine subthemes (recognition of intelligent technology;supported by policy discourse and the background of national-level projects; the creation of a family atmosphere; recommendations from HCPs; relief and social connection; new “doctor”–patient relationship and communication; eliminate the burden and return to life; benefit and value perception; right self-decision by AI) in facilitators and nine subthemes (privacy conflicts and trust deficiency; blurred boundaries of human–machine responsibility and authority; non-high-quality services are chosen reluctantly; technical anxiety; lack of motivation for continued engagement; extra burden; limitations of the physical environment; human–machine dialogue frustration; a sense of uncertainty about the future of AI) in barriers were extracted. Conclusions: This study identified key factors influencing the use of AI agents in chronic disease management in older patients with COPD. The results provide directions for improving the implementation and sustainable use of AI health technologies. Full article

This article presents the Intelligent Monitoring System (IMS), an AI-assisted, low-latency surveillance platform designed for defense environments. The study addresses the need for real-time autonomous situational awareness by integrating high-speed video transmission with advanced computer vision analytics in constrained network settings. The IMS employs a hybrid transmission architecture based on RTSP for ingestion and WHEP/WebRTC for distribution, orchestrated via MediaMTX, with the objective of achieving end-to-end latencies below one second. The methodology includes a comparative evaluation of video streaming protocols (JPEG-over-WebSocket, HLS, WebRTC, etc.) and AI frameworks, alongside the modular architectural design and prolonged experimental validation. The detection module integrates YOLOv11 models fine-tuned on the VisDrone dataset to optimize performance for small objects, aerial views, and dense scenes. Experimental results, obtained through over 300 h of operational tests using IP cameras and aerial platforms, confirmed the stability and performance of the chosen architecture, maintaining latencies close to 500 ms. The YOLOv11 family was adopted as the primary detection framework, providing an effective trade-off between accuracy and inference performance in real-time scenarios. The YOLOv11n model was trained and validated on a Tesla T4 GPU, and YOLOv11m will be validated on the target platform in subsequent experiments. The findings demonstrate the technical viability and operational relevance of the IMS as a core component for autonomous surveillance systems in defense, satisfying strict requirements for speed, stability, and robust detection of vehicles and pedestrians. Full article

This article examines the relationship between the Indonesian Ulama Council (MUI), a Muslim umbrella organisation, and the Indonesian state. It focuses on the dynamic role that MUI has played in public health issues and the national lottery. The two topics were chosen to focus on MUI’s partly contradictory role in its relationship with the state of Indonesia. While MUI has largely played along with the state on issues of public health and family planning, it has stood in opposition to and provided moral resistance to the state on issues of gambling and the national lottery. The analysis uses the theories of Bourdieu on symbolic capital and power, and the resource dependence theory as analytical tools. The article discusses how the state depends on the MUI’s religious legitimacy regarding policies like family planning and COVID vaccination. It has used its symbolic capital to mediate between divine revelation, public morality, and state authority. The MUI has played a paradoxical role through the dual processes of halalisation and haramisation. In contrast to halalisation in areas such as commerce, the MUI has stipulated the haramisation of gambling executed through a national lottery. Full article

Background/Objectives: Changes in the physiological activity of transforming growth factor-beta (TGF-β) family caused by genetic variability may significantly affect the phenotype of the musculoskeletal system and, consequently, the risk of sports injuries. This study aimed to investigate whether the TGFBI (rs1442), TGFBR3 (rs1805113 and rs1805117), and MSTN (rs11333758) polymorphisms, either individually or in combination, were associated with susceptibility to muscle injury, anterior cruciate ligament (ACL) rupture, and other injuries. Methods: The study group included 202 physically active Caucasians with reported sport injuries and 133 healthy controls. All the samples were genotyped using real-time polymerase chain reaction (real-time PCR). Results: The results revealed that (1) the TGFBR3 rs1805117 TC genotype was nominally associated with increased ACL injury risk; (2) the MSTN rs11333758 heterozygotes was more frequent in the one injury group (vs controls) and in the ACL group, whereas in the multiple vs. one comparison the over-dominant model suggested lower odds for heterozygotes; and (3) the TGFBI rs1442 CG genotype was nominally associated with lower odds of fractures, dislocations or sprains. In addition, simultaneous analysis of chosen SNPs revealed interactions between TGFBR3 rs1805117 and rs1805113, with a nominal association of the rs1805113 G allele with increased injury risk, as did rs11333758 and rs1805113, with a potential effect of rs11333758 on injury status. However, haplotype analysis of the TGFBR3 SNPs revealed no significant associations. After Bonferroni correction, none of the associations remained statistically significant. Conclusions: The results suggested that carrying specific TGFBI, TGFBR3, and MSTN genotypes may be potentially associated with susceptibility to musculoskeletal injuries in a physically active Caucasians. Full article

The first (main) aim of the article is to define and practically apply the parameterized Kolmogorov–Smirnov (PKS) goodness-of-fit test for normality. The second contribution is to expand the family of empirical distribution functions with four new proposals. The third contribution is to construct a family of alternative distributions that includes both older and newer distributions. The fourth contribution is to calculate the power of the analyzed tests under alternative distributions with parameters chosen to be similar to the normal distribution in various ways. The new proposal is distinguished for left-skewed alternative distributions and symmetric distributions characterizing by negative excess kurtosis. The effectiveness of the PKS test is also illustrated by the analysis of thirty real data sets. Full article

Improved maternal experiences and outcomes have been widely linked to the presence of birth companions. However, cultural norms, institutional constraints, and privacy concerns frequently restrict women’s choice of birth companions in many Middle Eastern countries, including Jordan. This study investigated Jordanian women’s beliefs and barriers about the presence of companions in the labour room. A qualitative descriptive study design was conducted using Braun and Clarke’s framework for thematic analysis. Thirteen women (ages 21 to 38 years) with prior pregnancy and childbirth experience were chosen from a free health awareness event in Irbid, Northern Jordan in July 2025, to participate in semi-structured interviews. The responses were recorded on audio tapes and subsequently stored in their original format. Data were coded, transcribed, and then thematically analyzed to identify beliefs and perceived barriers. The most significant beliefs were: (i) emotional and psychological support, wherein companionship was thought to alleviate fear and provide reassurance; (ii) strengthening family ties, as women saw shared childbirth experiences as improving family bonds; and (iii) cultural and religious interpretations, wherein female relatives were frequently seen as more acceptable than husbands. Women reported two barriers to allowing companions in the labour room: (i) privacy and modesty issues, where they feared embarrassment, exposure, and judgment, and (ii) institutional and policy restrictions, such as restrictive hospital regulations. Although Jordanian women recognized the emotional and interpersonal benefits of having company during childbirth, they encountered numerous substantial institutional, cultural, and privacy-related barriers. Improving women’s birth experiences and promoting respectful maternity care may be achieved by addressing these issues through culturally sensitive education, privacy-enhancing infrastructure, and regulatory reform. Full article

Many familial diseases are caused by genetic accidents, which affect the genome and its epigenetic environment, summarized as an interaction network between genes. We wish to study the existence or absence of robustness for such genetic interaction networks centered on the gene SP1 and involved in three familial diseases: familial angioedema, osteogenesis imperfecta, and biliary atresia. The updating of gene states at the vertices of the interaction graph of the genetic network (1 if a gene is activated, 0 if it is inhibited) can be performed in multiple ways that have been well-studied over the last 20 years: parallel, block-parallel, sequential, block-sequential, random, etc. We add to these classic updating modes two new ones, the intricate and the state-dependent. We have studied the robustness of three particular interaction graphs related to the familial diseases chosen as examples. The comparison of the interaction graphs and dynamics of the chosen familial diseases of different etiology shows common points in their interaction graphs and similarities in their dynamics according to their expression clock. Full article

With support from European funding, a digital picture book library was developed to assist families with limited access to age-appropriate books in a familiar language. This study examines how a multilingual group of families engaged with the library. Specifically, it investigates the frequency of visits, the range of titles accessed, the extent of rereading, the navigational strategies used to support comprehension, and the languages chosen during reading. Log data were collected over approximately four months in two kindergarten groups (28 users) and one childcare center serving 3-year-old children (48 users). About one-third of participants read at least one complete book, although most did so only once or a few times. Among families who used the library more consistently, all titles were accessed, and many were reread. Some users showed remarkable navigation patterns: they repeatedly revisited early scenes, suggesting a self-guided strategy for building familiarity before progressing through the story. Despite the multilingual backgrounds of the families, books were read predominantly in the societal language. Overall, the findings suggest that the digital library is appealing to families and, when implemented on a broader scale, has the potential to support the language development of a substantial number of children. Full article

Background/Objectives: Although the relationship between prolonged breastfeeding and early childhood caries remains unclear, dentists must manage children’s oral health while respecting mothers’ chosen feeding practices and providing information on maintaining oral health as long as possible. This longitudinal study was performed to investigate the occurrence of dental caries and identify associated factors, with particular attention to maternal condition and oral-health-related support in long-term breastfed children. Methods: Of 6746 children aged 42 months in Toyonaka City, Japan, 1210 who had been breastfed for at least the first 18 months were enrolled. Participants underwent oral examinations and anthropometric measurements at 18 and 42 months of age. In addition, a self-administered questionnaire was distributed to families when the child was 18 months old. Logistic regression analysis was used to evaluate risk factors for dental caries, with caries occurrence at 42 months as the dependent variable. Results: Overall, 24.3% of the children had experienced dental caries at 42 months. Logistic regression analysis identified several significant factors associated with caries occurrence: birth order (p < 0.001), snacking frequency (p = 0.038), Cariostat^® caries-risk test results (p < 0.001), and wake-up time (p = 0.015) among child factors, and parental exhaustion (p = 0.041) and participation in postnatal oral health classes (p = 0.005) among maternal factors. Conclusions: Waking habits in early childhood, maternal psychological condition, and participation in postnatal oral health instruction were significantly associated with dental caries occurrence over time among long-term breastfed children. Full article

Acyl-CoA-binding proteins (ACBPs) are essential lipid carrier proteins involved in plant lipid metabolism. However, the systematic identification and expression profiles of the ACBP gene family in citrus species remain poorly understood. Here, Citrus sinensis and Poncirus trifoliata were chosen as model species to examine the biological properties of citrus ACBPs. Using bioinformatics methods, five ACBP gene members were found in each species and named CsACBPs and PtrACBPs, respectively. All obtained ACBP members were divided into four subfamilies based on conserved domains and amino acid sequences. CsACBP and PtrACBP genes exhibited structural variation in motifs and exons. The predicted protein structures of CsACBPs and PtrACBPs exhibited conservation between the two species while displaying distinct variation within each species. Collinearity analysis showed one intraspecific pairing relationship in each of the two citrus species. Furthermore, there were more collinear couplings between citrus species and Arabidopsis thaliana but none between citrus species and Oryza sativa (rice). Notably, the analysis of cis-acting elements in ACBP gene promoters identified a number of motifs associated with light, abiotic stresses, and phytohormones. Expression profiling confirmed tissue-specific expression patterns of CsACBP1~5 and PtrACBP1~5. RT-qPCR analysis revealed that all CsACBP and PtrACBP genes responded to cold and salt stresses, though the magnitude of their responses varied significantly. Specially, although PtrACBP5 did not respond to low temperatures as rapidly as other members, its expression level increased significantly after 24 h of low-temperature treatment. Protein–protein interaction (PPI) network predictions indicated tight associations among four of the five CsACBPs, with CsACBP5 excluded from these interactions. Moreover, CsACBP1, CsACBP2, and CsACBP3 were predicted to be potential targets of csi-miR3952, csi-miR396a, and csi-miR477b, respectively. Overall, our research provides a solid foundation for further investigations into the biological functions and regulatory mechanisms of ACBP genes in citrus growth, development, and stress adaptation. Full article

Diurnal enuresis can significantly affect a child’s biopsychosocial well-being; however, there is a lack of diagnostic and management algorithms on the diagnosis. The purpose of this literature review is to dissect the development of the evaluation and management of diurnal enuresis. A total of 44 articles published from January 1900 to December 2024 were chosen through literature searches in PubMed, Science Direct, Embase, and Google scholar. Search terms were “Diurnal Enuresis” or “Daytime Incontinence” as Mesh terms, and subsequent terms included “pediatrics”, “urinary bladder, overactive”, and “therapeutics”. Inclusion criteria included studies involving pediatric study subjects aged 5–18 years old with a specific diagnosis of diurnal enuresis, exclusion criteria were studies before 1900 and involving night-time wetting diagnoses. A consensus among the literature and the American Academy of Family Physicians recommends a stepwise diagnostic evaluation, including history taking followed by a focused physical exam, for diurnal enuresis has proven to be the most effective. Regarding treatment, biofeedback was shown to improve symptoms in 74% of cases in one study by Wiener, while pharmacological treatment via Mirabegron (beta 3 agonist) showed a 70% improvement in one study by Fryer, but older drugs such as oxybutynin (anticholinergics) are still preferred. A multidisciplinary approach with TENS therapy, behavioral modification, biofeedback, and pharmacology can enhance effectiveness, improve reliability, and provide more successful results while minimizing the impact of diurnal enuresis on a child’s well-being. Further research is needed to optimize pharmacologic management strategies and improve adherence to increase the likelihood of reaching treatment goals. Full article

Background/Objectives: As population aging garners attention worldwide, there is great significance in communicating information on such measures to countries outside of Japan, which is considered unique in its position as a “super-aging society.” This study objectives to investigate public health measures linked to daily life by clarifying how the role transitions of local residents in their 60s, such as seeking re-employment, looking after grandchildren, and caring for family, affect their health status. Methods: We conducted focus group interviews with 26 residents and analyzed them qualitatively and inductively. Result: The findings suggested that, in predicted role transitions voluntarily chosen by participants, they tended to experience positive changes in health through the transition, although temporary feelings of fatigue were also described in relation to re-employment and grandchild care. Even in anticipated role changes, some participants expressed reluctance to engage in health-promoting activities within the local community. In cases of unavoidable role transition to family caregiving, participants described difficulties in maintaining self-care and feelings of caregiving fatigue that were challenging to manage through personal effort alone. These findings suggest that health support during role transitions in one’s 60s may benefit from including information about community activities and opportunities to build connections with local residents. In addition, support for those transitioning into caregiving roles could focus on facilitating access to social resources and tailoring assistance to individual needs. Conclusions: This study confirmed to specifically target health support for people in their 60s based on the results of this study, the focus on the transition needs to include not only role transition to re-employment but also unavoidable transition to caregiving. Full article

Adverse childhood experiences (ACEs) are recognized risk factors for later substance use. Yet, data remain scarce—particularly regarding the differentiated effects of specific types of ACEs and their distinct associations with various psychoactive substances. The current study is one of the first in Lithuania to explore the associations between specific ACEs and psychoactive substance use in young adulthood (ages 18–29). This cross-sectional study included a total of 709 participants who completed an online survey. ACEs were measured using a combination of adapted ACEs items and the MACE questionnaire. Substance use was assessed using self-reported instruments: CUDIT-R (cannabis), AUDIT (alcohol), ASSIST (heavy psychoactive substances), and nicotine use. Structural equation modeling (SEM) was chosen to examine predictive relationships. Results revealed that experiences of sexual abuse and physical maltreatment in childhood predicted higher levels of alcohol use in young adulthood. Sexual abuse was positively associated with nicotine, cannabis, and heavy psychoactive substance use, while witnessing interpersonal violence was only associated with higher nicotine use. However, verbal abuse showed significant negative associations across several substance categories. No significant associations were found between family addiction history and substance use. The absence of an important relationship between family history of addiction and substance use indicates that genetic factors may be less decisive than environmental or psychosocial conditions. The main findings of this study are that ACEs are not qualitatively equivalent to one another, so it is worth examining them separately, rather than summing them. Furthermore, based on the negative associations with verbal abuse and the generally statistically negative associations, we can assume that ACEs may not be the most important factors increasing substance use. Further studies should look for other factors that influence substance use. Full article

Microwave devices based on microstrip resonators are widely used today in communication, radar, and navigation systems. The requirements to these devices may include specific frequency-selective properties, as well as size and production costs. The design of resonators and filters are mostly performed manually, as the process requires expert knowledge and computationally expensive modeling, so practitioners are usually limited to tuning a chosen example from a set of known, typical topologies. However, the set of possible topologies remains unexplored and may contain specific constructions, which have not been discovered yet. In this study we propose an approach to automatically search the space multimode resonator topologies using a zero-order optimization algorithm and numerous computational experiments. In particular, a family of symmetrical resonators constructed out of four rectangles is considered, and the parameters are tuned by the recently proposed L-SRTDE algorithm. We state the problem of building the topology of a microwave device conductor with specified frequency-selective characteristics as an optimization problem, and the minimized function (target function) in this problem is based on the evaluation of the deviation between the specified frequency-selective characteristics and their values obtained via electrodynamic modeling. The experiments with two target function formulations have shown that the proposed approach allows finding novel topologies and automatically tune them according to the required frequency-selective properties. It is shown that some of the topologies are different from the known ones but still demonstrate high-quality properties. Full article

In this paper, we present selected findings from a 2024/2025 study on the reading habits of students from two major Slovenian universities enrolled in teacher education programs and compare them with data from a similar study conducted in 2017/2018. Understanding the reading practices of future educators is essential for improving reading engagement in schools and society as a whole. The data obtained from a selected student sample corroborate previous research indicating that early reading socialization—particularly childhood reading within the family, maternal education, and attendance in preschool—are factors positively associated with the number of books read in adulthood. The findings also highlight the important compensatory role of preschools and schools in fostering adult readers, especially in cases where family support for reading is lacking. In certain respects, the reading habits of students have deteriorated compared to the initial study: the time devoted to reading has decreased, and students more frequently choose less demanding texts. Female students read a greater number of books than male students, though their chosen texts tend to be less demanding, while male students more often select more challenging texts. Reading for pleasure and intrinsic motivation to read significantly influence the number of books read. Full article