Search Results (19,359)

This study examines the diversity of terminologies associated with assistive technology (AT), a crucial field that promotes autonomy and inclusion for people with disabilities. Although the wide use of assistive technology is observed in the literature, a variety of terms are often used interchangeably, which hinders research, technological development, and the formulation of public policies. In this sense, this systematic review aimed to identify, categorise, and analyse the diversity of terms used to describe AT in the scientific literature, contributing to greater conceptual clarity and supporting structured and interdisciplinary development in the field. A comprehensive search was conducted in July 2024 across the Scopus, Web of Science, and PubMed databases, covering publications from 1989 to 2024. Eligible studies were peer-reviewed journal articles in English that conceptually defined at least one AT-related term. The selection process followed the PRISMA 2020 guidelines and included studies from Q1 and Q2 journals to ensure academic rigour. A total of 117 studies were included out of 11,941 initial records. Sixteen distinct terms were identified and grouped into five clusters based on semantic and functional similarities: Cluster 1—Technologies for assistance and inclusion. Cluster 2—Functional assistive devices. Cluster 3—Assistive interaction interfaces. Cluster 4—Assistive environmental technologies. Cluster 5—Assistive systems. A complementary meta-analysis revealed geographic and temporal trends, indicating that terms such as “assistive technology” and “assistive device” are globally dominant. In contrast, others, like “enabling technology,” are more context-specific and emerging. The findings contribute theoretically by providing a structured framework for understanding AT terminology and practically by supporting the design of public policy and interdisciplinary communication. Full article

The literature has shown extensive interest in exploring the factors of subjective well-being (SWB). However, most research has conducted cross-sectional analysis of the built environment (BE), commute, and SWB, and little is known about gender differences in their connections. Based on two periods of survey data of 4297 respondents from China, the study performs a cross-sectional and longitudinal examination of whether the BE and commute have effects on SWB, and how the effects differ between men and women. The results reveal that BE features, including destination accessibility and residential density, significantly affect SWB, with stronger impacts observed among men. Men benefit more from greater accessibility and are more negatively affected by higher residential density than women. In contrast, commute mode and duration influence SWB in similar ways for both genders. A shift from nonactive to active commuting improves well-being for men and women alike. Furthermore, certain life events produce gender-specific effects. For instance, childbirth increases SWB for men but decreases it for women. These findings highlight the importance of gender-sensitive planning in building inclusive urban and transportation environments that enhance population well-being. Full article

Endotoxins, lipopolysaccharides released from the outer membrane of Gram-negative bacteria, pose a significant risk in healthcare environments, particularly in Central Sterile Supply Departments (CSSDs), where the delivery of sterile pyrogen-free medical devices is critical for patient safety. Traditional methods for controlling endotoxins in water systems, such as ultraviolet (UV) disinfection, have proven ineffective at reducing endotoxin concentrations to comply with regulatory standards (<0.25 EU/mL). This limitation presents a significant challenge, especially in the context of reverse osmosis (RO) permeate used in CSSDs, where water typically has very low conductivity. Despite the established importance of endotoxin removal, a gap in the literature exists regarding effective chemical-free methods that can meet the stringent endotoxin limits in such low-conductivity environments. This study addresses this gap by evaluating the effectiveness of the eBooster™ electrochemical technology—featuring proprietary electrode materials and a reactor design optimized for potable water—for endotoxin removal from water, specifically under the low-conductivity conditions typical of RO permeate. Laboratory experiments using the B250 reactor achieved >90% endotoxin reduction (from 1.2 EU/mL to <0.1 EU/mL) at flow rates ≤5 L/min and current densities of 0.45–2.7 mA/cm². Additional real-world testing at three hospitals showed that the eBooster™ unit, when installed in the RO tank recirculation loop, consistently reduced endotoxin levels from 0.76 EU/mL (with UV) to <0.05 EU/mL over 24 months of operation, while heterotrophic plate counts dropped from 190 to <1 CFU/100 mL. Statistical analysis confirmed the reproducibility and flow-rate dependence of the removal efficiency. Limitations observed included reduced efficacy at higher flow rates, the need for sufficient residence time, and a temporary performance decline after two years due to a power fault, which was promptly corrected. Compared to earlier approaches, eBooster™ demonstrated superior performance in low-conductivity environments without added chemicals or significant maintenance. These findings highlight the strength and novelty of eBooster™ as a reliable, chemical-free, and maintenance-friendly alternative to traditional UV disinfection systems, offering a promising solution for critical water treatment applications in healthcare environments. Full article

Background: Plant-based protein supplementation in supporting muscle recovery following resistance exercise remains an area of growing interest, particularly among vegan athletes, as a potential alternative to animal-based proteins. This systematic review aimed to evaluate the effectiveness of plant-based proteins on recovery from resistance exercise-induced muscle damage in healthy young adults. Methods: A systematic and comprehensive search was administered in eight databases up to 1 May 2025, identifying 1407 articles. Following deduplication and screening, 24 studies met the eligibility criteria, including 22 randomized controlled trials and 2 non-randomized studies, with the majority from high income western countries. Results: Interventions primarily involved soy, pea, rice, hemp, potato, and blended plant protein sources, with doses ranging from 15 to 50 g, typically administered post resistance exercise. Outcomes assessed included muscle protein synthesis (MPS), delayed-onset muscle soreness (DOMS), inflammatory biomarkers, muscle function, and fatigue. The review findings reaffirm that single-source plant proteins generally offer limited benefits compared to animal proteins such as whey, particularly in acute recovery settings, a limitation well-documented consistently in the literature. However, our synthesis highlights that well-formulated plant protein blends (e.g., combinations of pea, rice, and canola) can stimulate MPS at levels comparable to whey when consumed at adequate doses (≥30 g with ~2.5 g leucine). Some studies also reported improvements in subjective recovery outcomes and reductions in muscle damage biomarkers with soy or pea protein. However, overall evidence remains limited by small sample sizes, moderate to high risk of bias, and heterogeneity in intervention protocols, protein formulations, and outcome measures. Risk of bias assessments revealed concerns related to detection and reporting bias in nearly half the studies. Due to clinical and methodological variability, a meta-analysis was not conducted. Conclusion: plant-based proteins particularly in the form of protein blends and when dosed appropriately, may support muscle recovery in resistance-trained individuals and offer a viable alternative to animal-based proteins. However, further high-quality, long-term trials in vegan populations are needed to establish definitive recommendations for plant protein use in sports nutrition. Full article

Background and Objectives: Breast reconstruction after mastectomy has been shown to significantly improve psychosocial wellbeing and quality of life. Enhanced Recovery After Surgery (ERAS) protocols, especially those tailored to breast reconstruction, have revolutionized recovery by reducing complications, pain, opioid use, and hospital stay while improving patient satisfaction. The purpose of this narrative review was to present existing practices and supporting evidence within current ERAS protocols, as well as propose a modern ERAS framework centered around enhancing the patient experience following breast reconstruction. Methods: A focused literature search was conducted to identify studies investigating emerging approaches to patient care and surgical techniques adopted as part of a broader ERAS workflow Results: Some recent innovations include digital ERAS tracking, robot-assisted techniques, neurotization, and closed incision negative pressure therapy (ciNPT). These innovations show promise in reducing morbidity following reconstruction and may greatly improve sensory and functional outcomes. These advancements also reflect a shift toward more holistic, patient-centered care, extending beyond immediate clinical needs to address long-term wellbeing through psychosocial support and patient-reported outcome measures. Incorporating tools that validate patient perspectives helps guide interventions to optimize satisfaction and recovery. Conclusions: Future research should aim to standardize ERAS protocols by incorporating evidence-based practices, reinforcing breast reconstruction as a patient-centered, evidence-driven process that is focused on comprehensive recovery and improved quality of life. Full article

Background: The aim of this study was to conduct a systematic review of the research literature on the prevalence of psychiatric comorbidities in patients with hyperacusis and misophonia. Method: Four databases were searched: PubMed, PsycINFO, Scopus, and Web of Science (Wis)—last search conducted on the 16th of April 2024 to identify relevant studies. The methodological quality of each study was independently assessed using the JBI Critical Appraisal Checklist. Results: Five studies were included for the prevalence of psychiatric comorbidities in hyperacusis, and seventeen studies for misophonia. Among patients with hyperacusis, between 8% and 80% had depression, and between 39% and 61% had any anxiety disorder as measured via a diagnostic interview and/or self-report questionnaires. For misophonia, nine studies provided data on various forms of mood and anxiety disorders, with prevalences ranging from 1.1% to 37.3% and 0.2% to 69%, respectively. Conclusions: Although the 22 included studies varied considerably in design and scope, some recurring patterns of comorbidity were noted. However, apparent trends—such as the higher prevalence of mood and anxiety disorders compared to other psychiatric conditions—should be interpreted with caution, as most studies did not comprehensively assess a full range of psychiatric disorders. This likely skews prevalence estimates toward the conditions that were specifically investigated. Full article

Background: Midwifery’s Intangible Heritage was officially recognized by the United Nations Educational, Scientific and Cultural Organization on 6 December 2023, highlighting that elements of midwifery knowledge and practice, shaped over generations, constitute cultural heritage worth safeguarding. While previous studies have investigated midwives’ perceptions of professional identity, none have done so within the explicit framework of MIH. Objective: this study explored how midwives and student midwives in Cyprus perceive the intangible heritage of their profession and how it relates to their shared professional identity. Methods: A qualitative descriptive study was conducted between April and July 2023. Three focus groups were held, involving 22 participants: 15 registered midwives and 7 student midwives. A semi-structured interview guide consisting of 10 questions was used, developed by the lead author (M.P.) based on the literature and improvisation and finalized with the research team (E.H., S.V., N.M.) after expert input. Thematic analysis was performed inductively to identify recurrent themes. Results: Four major themes emerged: (1) key elements of Midwifery’s Intangible Heritage and their transmission across generations; (2) a sense of shared professional identity; (3) perceived threats to the midwifery profession; and (4) midwives’ expectations for the future of the profession. Conclusions: The findings reflect the historical background of midwifery in Cyprus and its contrast with contemporary practice, particularly within the context of the overmedicalization of birth and societal perceptions of midwifery in the socio-cultural setting. Safeguarding Midwifery’s Intangible Heritage requires both empowering women to seek midwifery-led care and enabling midwives to practice autonomously within their full professional scope. In addition, policymakers and educational bodies must support the preservation of midwives’ core skills through targeted educational curricula, structured mentorship, and continuous professional development. Full article

Background: Cerebral palsy (CP) is a lifelong neurodevelopmental disorder characterised by motor impairment and commonly associated with comorbidities such as cognitive, communicative, and behavioural difficulties. While the physical and functional aspects of CP have been extensively studied, the mental health needs of this population remain largely underexplored, particularly concerning suicidal ideation and self-injurious behaviours. The purpose of this review is to synthesise the existing literature on suicidality in individuals with CP, explore theoretical and clinical risk factors, and identify key gaps in the current evidence base. Methods: A narrative literature review was conducted focusing on studies addressing suicidal ideation, self-harm, or related psychiatric outcomes in individuals with CP. Additional literature on risks and protective factors was included to support theoretical inferences and clinical interpretations. Results: Only a limited number of studies addressed suicidality directly in CP populations. However, several reports document elevated rates of depression, anxiety, and emotional distress, particularly among adults and individuals with higher levels of functioning. Communication barriers, chronic pain, social exclusion, and lack of accessible mental health services emerged as critical risk factors. Protective elements included strong family support, inclusive environments, and access to augmentative communication. Conclusions: Suicidality in individuals with CP is a neglected yet potentially serious concern. Evidence suggests underdiagnosis due to factors such as communication barriers and diagnostic overshadowing. Future research should prioritise disability-informed methodologies and validated tools for suicidal ideation, while clinicians should incorporate routine, adapted mental health screening in CP care to ensure early detection and person-centred management. Full article

Ice energy storage systems have gained significant attention as sustainable solutions for energy management, particularly in applications with fluctuating energy demands. This study aims to compare two different designs, a triple-tube heat exchanger (TTHE) and spherical ice balls, the latter being the most widely used traditional design in the industry. The TTHE design was first analyzed theoretically, then optimized using Computational Fluid Dynamics (CFD) simulations, and validated by the literature. Finally, it was compared with spherical ice balls under identical conditions. The analyses were conducted for an ice storage volume of 1000 kg, with the complete solidification process designed to occur within 8 h. The results indicate that the TTHE reduced solidification time by 25% while simultaneously increasing energy storage by 8%. This study contributes to the advancement of sustainable energy technologies by providing a comparative analysis of spherical ice balls and triple-tube heat exchangers for optimizing ice storage systems. The implementation of a TTHE for thermal storage can lower energy costs, mitigate peak demand, and address the intermittency challenges associated with renewable energy sources. Full article

Intraosseous hemangiomas (IH) are rare intrabony lesions that represent less than 1% of intraosseous tumors. IH are mostly seen in the axial skeleton and skull. Most commonly, the frontal bone, zygomatic, sphenoid, maxilla, ethmoid, and lacrimal bone can manifest IH. Currently, IH is classified as a developmental condition of endothelial origin. According to WHO, the five histological types of IH are cavernous, capillary, epithelioid, histiocytoid, and sclerosing. IH of the zygoma is an extremely rare condition with female predominance. A systematic review recently estimated that there were 78 cases published in the literature until 2023. The lesion is usually asymptomatic and presents with a gradually deteriorating deformity of the malar area, and the patient might be able to recall a history of trauma. Numbness due to involvement of the infraorbital nerve might also be present; however, atypical skin and bone sensations might also occur. Other symptoms include painful swelling, bone asymmetry, skin irritation, sinus pressure, paresthesia, diplopia, enophthalmos, or atypical neuralgia. A bony lesion with a trabecular pattern in a radiating formation (sunburst pattern) or a multilocal lytic lesion pattern created by the multiple cavernous spaces (honeycomb pattern) is commonly observed during radiologic evaluation. We present a rare case of IH of the zygoma in a 65-year-old generally healthy woman. A cyst-like bone tumor was revealed from the CT scan, which made preoperative biopsy of the lesion problematic. A careful radiological diagnostic differentiation of the lesion should always be conducted in such cases to outline a safe surgical plan and possible alternatives if needed. The patient underwent total tumor resection in the operating room, and the defect was reconstructed with the use of a titanium mesh and a synthetic hydroxyapatite bone graft based on a 3D surgical guide printed model. Full article

Under a 2021 amendment to German law, the KelRide project became the first public on-demand service operating electric autonomous vehicles (AVs) without fixed routes on public roads. This paper addresses two notable gaps in the literature by (1) conducting an ex post evaluation of demand predictions for a non-infrastructure (Mobility-on-Demand (MoD)) project and (2) using real-world data to analyze how demand responds to key Autonomous Mobility-on-Demand (AMoD) system parameters in a rural context. Earlier simulation-based demand forecasts are compared to observed booking data, and the recalibrated model is used to investigate the sensitivity of passenger numbers to vehicle speed, fleet size, service area, operating hours, and idle vehicle positioning. Results show that increasing vehicle speed leads to a superlinear rise in passenger numbers—especially at small fleet sizes—while demand saturates at large fleet sizes. A linear increase in demand is observed with expanding service areas, provided fleet size is sufficient. Extending operating hours from 9 a.m.–4 p.m. to full-day service increases demand by a factor of two to four. Passengers numbers also vary notably depending on the positioning of idle vehicles. Consistent with empirical findings, the analysis underscores that raising AV speed is essential for ensuring the long-term viability of autonomous mobility services. Full article

The scope and scale of commercial captive lion breeding (CLB) in South Africa have rapidly increased since the 1990s. We conducted a qualitative systematic review using the PRISMA protocol to determine whether CLB provides a sustainable supply side intervention to reduce pressure on wild lion populations. A search was performed using three academic databases for sources published between 2008 and 2023. We collated and reviewed the data using an evaluation framework to determine the potential benefits and threats of CLB in the context of conservation. Among the 126 peer-reviewed and 37 grey literature articles identified, we found evidence suggesting that the framework’s criteria were not fully met, raising concerns that CLB may facilitate the demand for lions, their parts, and derivatives. Our findings further indicate a reasonable cause to doubt that the CLB provides a sustainable supply side intervention to meet the commercial demand for lions, their parts, and derivatives. This could adversely impact conservation of wild lion populations. We conclude that further research is required to effectively evaluate the purported conservation benefits of CLB. These insights may also have implications for the policy and governance of commercial predator breeding operations in South Africa and globally. Full article

Background: Neuropathic pain (NP), resulting from damage to the somatosensory nervous system, affects 7–10% of the global population and remains poorly managed despite available therapies. Smoking has been associated with increased pain severity and disease burden, yet its role in neuropathy/NP has not been systematically reviewed. This systematic review synthesizes the existing literature on smoking status and its relationship with neuropathy/NP incidence, prevalence, and severity. Methods: The review was conducted in accordance with PRISMA guidelines and included studies that assessed smoking consumption, dependency, quantity, and cessation in individuals with neuropathy/NP. Summary estimates were stratified by exposure type, and pooled odds ratios and relative risks were calculated. Results: Across 62 studies comprising cohort, case–control, and cross-sectional designs, smoking was consistently associated with greater NP prevalence and pain severity. Smoking dependency was linked to increased incidence, while cessation was associated with reduced risk of NP. Despite considerable heterogeneity and risk of bias, particularly from subjective exposure measurement and inconsistent classification, this relationship remained statistically significant. Conclusions: Findings support the role of smoking as a modifiable risk factor in various etiologies of neuropathy/NP. Cessation may represent a low-cost, low-risk, low-tech adjunctive therapy; however, further robust cessation interventional trials are needed, particularly for less common infectious causes of chronic NP such as leprosy. Full article

Industries 4.0 and 5.0 are based on technological advances, notably large language models (LLMs), which are making a significant contribution to the transition to smart factories. Although considerable research has explored this phenomenon, the literature remains fragmented and lacks an integrative framework that highlights the multifaceted implications of using LLMs in the context of digital manufacturing. To address this limitation, we conducted a systematic literature review, analyzing 53 papers selected according to predefined inclusion and exclusion criteria. Our descriptive and thematic analyses, respectively, mapped new trends and identified emerging themes, classified into three axes: (1) manufacturing process optimization, (2) data structuring and innovation, and (3) human–machine interaction and ethical challenges. Our results revealed that LLMs can enhance operational performance and foster innovation while redistributing human roles. Our research offers an in-depth understanding of the implications of LLMs. Finally, we propose a future research agenda to guide future studies. Full article

(1) Background: Dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) are persistent organic pollutants (POPs), characterized by high toxicity and strong lipophilicity, which promote their bioaccumulation in human tissues. Their detection in breast milk raises concerns about early-life exposure during lactation. Although dietary intake is the primary route of maternal exposure, environmental pathways—including inhalation, dermal absorption, and residential proximity to contaminated sites—may also significantly contribute to the maternal body burden. (2) Methods: This narrative review examined peer-reviewed studies investigating maternal and environmental determinants of dioxin and dl-PCB concentrations in human breast milk. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science (2000–2024), identifying a total of 325 records. Following eligibility screening and full-text assessment, 20 studies met the inclusion criteria. (3) Results: The included studies consistently identified key exposure determinants, such as high consumption of animal-based foods (e.g., meat, fish, dairy), living near industrial facilities or waste sites, and maternal characteristics including age, parity, and body mass index (BMI). Substantial geographic variability was observed, with higher concentrations reported in regions affected by industrial activity, military pollution, or inadequate waste management. One longitudinal study from Japan demonstrated a declining trend in dioxin levels in breast milk, suggesting the potential effectiveness of regulatory interventions. (4) Conclusions: These findings highlight that maternal exposure to dioxins is influenced by identifiable environmental and behavioral factors, which can be mitigated through public health policies, targeted dietary guidance, and environmental remediation. Breast milk remains a critical bioindicator of human exposure. Harmonized, long-term research is needed to clarify health implications and minimize contaminant transfer to infants, particularly among vulnerable populations. Full article