Search Results (29)

Due to the rapid proliferation and evolution of the Internet of Things (IoT) in industrial and smart city applications, concerns over sensitive data security have become increasingly prominent. This is especially true in resource-constrained “cloud–terminal” centralized architectures, where ensuring privacy protection for downlink data and implementing fine-grained access control have become critical. Ciphertext-Policy Attribute-Based Encryption (CP-ABE) serves as an effective solution due to its fine-grained access control capability. Nevertheless, conventional CP-ABE approaches face notable limitations when deployed in these practical settings, including the lack of an efficient and lightweight client-side revocation mechanism, excessive decryption overhead on terminal devices, and the practical difficulty in balancing security with performance. To address these issues, this paper proposes LOR-A2ABE, a Lightweight, Outsourced, and Revocable Anonymous Attribute-Based Encryption scheme. The scheme achieves lightweight client-side revocation through partial updates by embedding version numbers and timestamps into keys and ciphertexts via hash mapping. Furthermore, it employs outsourcing to offload the majority of computations to the cloud, allowing client-side decryption with only constant, low-complexity operations, thereby significantly reducing the computational burden on resource-constrained terminals. Considering the practical context where client devices are typically resource-limited sensors or microcontrollers and downlink data often require real-time processing, our scheme adopts a practical security model optimized for IoT constraints. This model prioritizes forward security and efficient revocation—the most critical requirements for operational IoT systems—while maintaining provable security under the Decisional Linear (DLIN) assumption within a bounded collusion model, achieving IND-CPA security and anonymity. Theoretical analysis and experimental simulations show that LOR-A2ABE incurs acceptable and controllable overhead in the key issuance and encryption phases, while outperforming most existing schemes in decryption and revocation efficiency, making it particularly suitable for “cloud–terminal” centralized IoT environments where terminal devices are resource-constrained and require frequent decryption operations. Full article

Open partial horizontal laryngectomy (OPHL) is a key conservative option for laryngeal cancer, with established oncological outcomes but limited data on functional results and patient perspectives. Voice preservation is mainly associated with type I OPHL, whereas types II–III often result in significant but broadly comparable impairments, making vocal decline the main limitation of OPHL. Patient-reported outcomes (PROs) help clarify the balance between treatment efficacy and side effects. This single-institution study analyzed 70 consecutive OPHL patients (12 women, 17.1%; 58 men, 82.9%), mean age 65.9 years (SD 8.96), with a median follow-up of 52.5 months (range 2–218). PROs were assessed using the Priority Scale, the V-RQOL, the MDADI, the Decisional Conflict Scale, the Decisional Regret Scale, and the Brief Pain Inventory. The Priority Scale showed that curing cancer (98.6%) and prolonging life (82.9%) were top concerns, while only 34.3% prioritized natural voice preservation. V-RQOL averaged 77.4/100, indicating limited impact of voice on quality of life; MDADI was 78.5/100, reflecting minimal swallowing difficulties. Decisional Conflict averaged 34.3/100, with 30% reporting no difficulty; Decisional Regret was low (13.0/100), with only 1.4% expressing moderate regret. Most patients (78.6%) reported no pain. Overall, OPHL provided satisfactory functional and decisional outcomes, with high patient satisfaction despite the complexity of treatment. Full article

Background: Chinese adolescents face a dual burden of malnutrition, yet the weight-status-specific mechanisms underlying physical activity (PA) participation remain underexplored. Methods: We conducted a cross-sectional study among 1573 adolescents (aged 9–15 years) in Shangrao City, China. Validated scales measured social-ecological factors (family/peer support, physical environment), psychological factors (stage of change, self-efficacy, decisional balance), and PA participation. Data preprocessing utilized full information maximum likelihood to handle missing values. Confirmatory factor analysis was performed to validate the measurement model, followed by multi-group structural equation modeling to analyze pathway configurations across underweight (n = 187), normal-weight (n = 1070), and overweight/obese (n = 316) groups. Mediation effects were tested using bootstrapping with 5000 resamples. Results: Clear weight-specific patterns emerged. Normal-weight adolescents presented a fully functional comprehensive model where PA was predicted by the stage of change (β = 0.211, p < 0.001), friend support (β = 0.120, p < 0.001), self-efficacy (β = 0.092, p < 0.05), and perceived benefits (β = 0.095, p < 0.01). Underweight adolescents primarily relied on internal readiness driven by stage of change (β = 0.270, p < 0.001) and self-efficacy (β = 0.164, p < 0.05), with family support only indirectly influencing participation via psychological mediators. In contrast, overweight/obese adolescents showed a “socially dependent” pattern: friend support directly predicted PA levels (β = 0.136, p < 0.05), significantly enhanced self-efficacy (β = 0.370, p < 0.01), and effectively lowered perceived barriers (β = −0.165, p < 0.05). Additionally, the physical environment strongly impacted perceived benefits (β = 0.471, p < 0.01) but did not translate into action. Conclusions: These findings underscore the significant differences in PA determinants across the spectrum of malnutrition, necessitating targeted public health interventions to support the Healthy China 2030 initiative. Full article

Frequent data sharing in Vehicular Ad Hoc Networks (VANETs) necessitates a robust foundation of secure access control to ensure data security. Existing ciphertext-policy attribute-based encryption schemes are constrained by the performance bottleneck of a single attribute authority. Furthermore, although many schemes adopt outsourced decryption, the verifiability of the decryption results is not guaranteed. Therefore, this paper proposes a Symmetrically Verifiable Outsourced Decryption Data Sharing Scheme with Privacy-Preserving for VANETs (VODDS). To balance the computational overhead across multiple authorities, VODDS introduces a distributed key distribution mechanism that organizes them into groups. Within each group, the key distribution credential is generated through a Group Key Agreement, with each round secured by a Byzantine consensus mechanism to achieve a balance between security and efficiency. User identities are converted into anonymous representations via hashing for embedding into the attribute keys. Furthermore, blockchain technology is used to record a hash commitment for the verification ciphertext. This enables the user to verify the outsourced result through a smart contract, which performs a symmetrical verification by matching the user’s locally computed hash against the on-chain record. Moreover, VODDS employs a linear secret sharing scheme to achieve policy hiding. We provide security analysis under the q-parallel Bilinear Diffie–Hellman Exponent and Decisional Diffie–Hellman assumptions, which proves the security of VODDS. In addition, VODDS exhibits higher efficiency compared to related schemes in the performance evaluation. Full article

Background/Objectives: Sustainable nutrition is essential for human and planetary health. The Transtheoretical Model-based Sustainable Nutrition Behavior Scale (TTM-SNBS) was developed to assess sustainable nutrition behaviors and the dynamic processes of behavior change in adolescents. Methods: The item pool was generated through literature review and expert consultation using the Delphi technique (10 experts, three rounds). Construct validity was assessed using exploratory and confirmatory factor analyses. Reliability was evaluated through Cronbach’s alpha and test–retest methods. External validity was examined through correlations with the Sustainable and Healthy Eating Behaviors Scale (SHEBS), following COSMIN standards. The study included 512 adolescents aged 14–18 years (54% female) from public high schools in Ankara, Türkiye. Results: Initially, 75 items were developed through expert evaluation. After preliminary testing, two items with low and negative correlations were removed; 73 were retained for validation. Factor analyses and refinement produced a 45-item final validated scale comprising one stage of change item and five subscales: cognitive processes (14 items), behavioral processes (18 items), decisional balance—pros (4 items), decisional balance—cons (4 items), and self-efficacy (4 items). Items showed good discrimination (>0.27). Cronbach’s alpha values ranged from 0.67 to 0.93, and fit indices were acceptable (χ²/df = 2.8–4.2; RMSEA = 0.045–0.065). External validity was supported by significant positive correlations with the SHEBS. Conclusions: The TTM-SNBS is the first psychometrically validated, theory-based instrument to assess sustainable nutrition behaviors in adolescents. It offers a reliable and valid instrument to support future research and interventions promoting sustainable dietary practices. Full article

Background: Tobacco use remains a major public health concern among young adults and is often complicated by co-occurring addictive behaviors. Objective: This study analyzed motivation for change, assessed with the decisional balance framework, in relation to multiple addictions among young smokers seeking treatment. Methods: Ninety-eight participants from the University of Granada enrolled in either an app-based cognitive–behavioral therapy (CBT) program (n = 35) or a traditional face-to-face CBT program (n = 63). Recruitment relied on self-identification and voluntary participation. Standardized instruments were applied to measure nicotine dependence (FTND), behavioral and substance-related addictions (MULTICAGE CAD-4), cannabis dependence (SDS), and motivation for change (DBQ). Logistic and stepwise regression analyses were conducted to identify predictors of treatment choice and motivational outcomes. Results: Younger participants and students were more likely to choose the app-based program. Compulsive buying was linked to perceiving more disadvantages of smoking, whereas sex addiction, cannabis dependence, and other substance addictions were associated with perceiving fewer disadvantages. Conclusions: Treatment preferences and motivational profiles differ according to age, academic status, and co-occurring addictions. These findings highlight the need to tailor smoking cessation strategies to individual profiles and support the role of mobile health tools in engaging digitally oriented populations. Full article

Background: Smoking is a major public health concern in Saudi Arabia, with significant gender differences influencing smoking behavior and cessation. Aim: This study aimed to investigate smoking abstinence self-efficacy (ASE), decisional balance (DB), quitting desire, and their predictors among adult male and female smokers in Saudi Arabia. Methods: A cross-sectional study was conducted using a convenience sample of 375 male and 220 female adult smokers recruited via social media. Data were collected through an online survey assessing personal health, smoking behavior, desire to quit, ASE, and DB. Logistic regression was used to identify predictors of earnest quitting desire, high ASE, and negative DB. Results: Males were more likely to smoke for 10 or more years (70.7% vs. 29.1%), maintain regular smoking patterns (86.9% vs. 54.1%), and exhibit high nicotine dependence (29.3% vs. 6.4%) compared to females. A higher proportion of females (76.8%) than males (66.9%) expressed a strong desire to quit. ASE was generally higher in males, with 49.6% showing average levels, while 46.4% of females had low ASE, particularly in social and positive mood contexts. Females displayed a higher prevalence of negative DB (73.6% vs. 58.1%), indicating greater awareness of smoking’s drawbacks. Both genders acknowledged the cons of smoking, though males perceived fewer pros. Conclusions: A complex interplay of factors influences smoking behavior and cessation among adult smokers. Gender differences also play a crucial role in smoking cessation factors among Saudi adults. Tailored cessation strategies addressing self-efficacy and motivation are recommended to enhance quitting success. Full article

Transforming the course of protracted and bloody conflicts requires changing the behaviors and minds of society members who take part in these conflicts. While studies examining the psychology of such societies point to the barriers that conflict-supporting narratives create for changing minds and behavior, a novel psychological intervention offers a new direction to facilitate openness for attitude change based on the Information Process Model (IPM). Previous studies indicated the effectiveness of this intervention in creating an unfreezing of conflict attitudes and increasing support for peace negotiation in different conflict areas. However, since the psychological process underlying its effectiveness remains underexplored, the aim of the current research is to examine the experiences of participants exposed to IPM-based messages and the role of cognitive and emotional ambivalence in facilitating the unfreezing of conflict-supporting narrative and contemplating alternative beliefs. The first study (n = 234) examines how IPM (vs. control) videos increase engagement with and ambivalence towards conflict-supporting narratives using quantitative and qualitative analysis of written Decisional Balance responses. The second study (n = 24) delves into the expressions of cognitive and emotional ambivalence following exposure to different segments of an IPM video using semi-structured interviews, and further assesses their potential influence on facilitating contemplation with newly provided information. Full article

Background: Smoking is a detrimental health behavior that can be addressed by designing stage-matched interventions with evidence-based behavioral change models such as the transtheoretical model (TTM). This study applied the TTM to predict smoking cessation stages among adults in Saudi Arabia. Methods: This social media-based cross-sectional study in Saudi Arabia used a convenient sample of 491 adult smokers (men and women). A digital questionnaire containing basic and smoking-related data and smoking scales (stages of change, cessation readiness, decisional balance, and self-efficacy) was used for data collection. The data were collected from 1 July to 30 October 2023 and were investigated using an ordinal regression analysis. The results illustrate that among the studied smokers, cigarette smoking was the prevalent method of smoking, especially among men (71.7%) compared to women (27.8%). Regarding stages of smoking, the pre-contemplation (35.8%) and contemplation (30.1%) stages were the highest, where men were more represented in both stages (37.9% and 40.8%, respectively). In comparison, women represented a higher percentage in the action (23.9%) and maintenance (21.1%) stages. The ordinal regression showed that increasing age (adjusted odds ratio; AOR = 1.045, p = 0.044), high quitting readiness (AOR = 1.134, p < 0.001), self-efficacy (AOR = 1.965, p = 0.028), decisional balance (AOR = 1.870, p < 0.001), and absence of psychological problems (AOR = 2.047, p < 0.001) increased the likelihood of being at higher smoking cessation stages. However, increased smoking duration (AOR = 0.756, p = 0.010), male gender (AOR = 0.340, p < 0.001), not working (AOR = 0.364, p = 0.013), adequate income (AOR = 0.535, p = 0.032), no chronic diseases (AOR = 0.430, p < 0.001), regular smoking (AOR = 0.052, p < 0.001), high smoking dependency (AOR = 0.775, p = 0.038), and hookah smoking (AOR = 0.032, p < 0.001) decreased the likelihood of being at higher smoking cessation stages. Conclusions: Cigarette smoking is a prevalent problem among Saudi adults, especially men, with the highest percentage of these being at lower smoking cessation stages. Thus, this study recommends the development of stage-matched interventions to facilitate the move towards higher smoking cessation stages through efforts by, and collaboration between, community sectors to face this rising issue. Full article

This paper focuses on the acceptance of ADASs in the traffic safety and human factor domain. More specifically, it examines the predictive validity of the Unified Model of Driver Acceptance (UMDA) for an ADAS bundle that includes forward collision warning, headway monitoring and warning, and lane-keeping assistance in Belgium and Vietnam, two substantially different geographical, socio-cultural, and macroeconomic settings. All systems in the studied ADAS bundle are located at the Society of Automotive Engineer (SAE)-level 0 of automation. We found moderate acceptance towards such an ADAS bundle in both countries, and respondents held rather positive opinions about system-specific characteristics. In terms of predictive validity, the UMDA scored quite well in both countries, though better in Belgium than in Vietnam. Macroeconomic factors and socio-cultural characteristics could explain these differences between the two countries. Policymakers are encouraged to prioritise initiatives that stimulate the purchase and use of the ADAS, rather than on measures meant to influence the underlying decisional balance. Full article

Humanitarian logistics face significant challenges during natural disasters due to operational uncertainties. Humanitarian logistics networks such as food banks must manage both regular operations and disaster-induced supply and demand. The study aims to develop and assess two-stage stochastic models that support decision-making under these dual operations. We evaluate various decisional strategies through extensive numerical experiments inspired in the operation of the food bank network Bancos de Alimentos de México (BAMX), highlighting the importance of suitable timeframes for reactive and anticipative decisions. The findings offer valuable insights for managers in balancing routine and emergency responses efficiently. Full article

Regular physical activity (PA) improves the psychological well-being of those who practice it. However, female university students are a risk group due to their low level of PA. Based on the transtheoretical model of behavioural change, the main aim of this study was to examine whether the relationship between PA and subjective vitality was mediated by cognitive-emotional variables such as decisional balance (perceived benefits and barriers) and enjoyment associated with PA in a group of female university students. Participants were asked to complete self-administered questionnaires, which were available for one month via a Google Form. The results showed the existence of a statistically significant, relative, and indirect effect between the stage of change and subjective vitality via both mediating variables. Compared to females in the pre-contemplation stage, those in the action and maintenance stages achieved higher subjective vitality scores as a result of the effect of being in a more advanced stage on decisional balance and enjoyment of PA. It is concluded that female university students who reported regular PA found the activity to be more revitalising, stimulating, and exciting; all positive feelings and cognitions that translated into a more energetic and vital perception of themselves. Full article

In the contemporary tramp shipping industry, route optimization and scheduling are directly linked to enhancements in operations, economics, and the environment, making them key factors for the effective management of maritime transportation. To enhance effective ship-to-cargo matching and the refinement of maritime transportation itineraries, this paper introduces a time efficiency and carbon dioxide emission multi-objective optimization algorithm named ETE-SRSP (efficiency–time–emission multi-optimization algorithm). ETE-SRSP incorporates several factors, including the initial positions of ships, time windows for loading and unloading operations, and varying sailing speeds. Within the ETE-SRSP framework, pioneering an approach that integrates ballast and laden sailing velocities as decisional parameters, it employs a multi-objective optimization technique to investigate the intricate interplay between temporal efficiency and carbon dioxide emissions. Additionally, the model’s proficiency in mitigating emissions and managing costs is clearly demonstrated through the optimization of these objectives, thereby offering a robust framework for decision support. The experimental results show that the optimal sailing speeds derived from the ETE-SRSP, under typical time-weight scenarios, can achieve an optimal balance between emission reduction and cost control. In summary, this study underscores the optimization strategy’s potential to effectively address the maritime sector’s need for economic growth and ecological conservation, showcasing its practical value in the industry. Full article

The use and promotion of active transportation has been scientifically proven to play a fundamental role in influencing global sustainable development goals. Despite increased recognition, there is a notable gap in understanding how to effectively transition the general population from convenience-oriented transport to embracing active modes. The application of the Transtheoretical Model (TTM) in understanding the utilization of active transport modes is currently constrained. The first aim is to include measuring the readiness to change in the use of active transport modes to increase physical activity (PA) using a continuous measure (i.e., University of Rhode Island Change Assessment, URICA). A second aim is to determine whether the decisional balance (perception of pros and cons) and self-efficacy increase as respondents progress through the stages of change as well as with the increase in self-reported active transport use. In total, 260 university students and staff filled out an online survey containing self-reported use of active transport modes and TTM constructs. The results suggest that URICA successfully identifies five stages of change. The decision balance and self-efficacy of the behaviour increase as individuals progress through the stages. The same is also true for the use of active transport modes. Full article

Nurses are frontline care providers whose health is vital to providing good quality of care to patients. The purpose of this study was to develop an exercise program for high-risk metabolic syndrome nurses based on the transtheoretical model. The transtheoretical model was used in this study due to its popular use in exercise behavior change and it can clearly identify the stage of exercise so as to plan an effective program to promote health. This was a quasi-experimental pilot study with a total of 40 participants who met the inclusion criteria. Exercise programs were developed for three groups distinguished by their commitment to exercising for health. Sixteen (40%) nurses moved one step forward, six (15%) nurses moved backward, and eighteen (45%) nurses maintained at the same stage over time (stable sedentary, 40%; stable active, 5%). Bowker’s test of symmetry, χ2 = 14.00 (p < 0.01), revealed that the population exercising increased significantly after the intervention. After the program, the perceived benefits from exercise in the decisional balance significantly increased to 1.53 (t = 2.223, p < 0.05), perceived exercise barriers significantly decreased to 3.10 (t = −3.075, p < 0.05), and self-efficacy significantly increased to 2.90 (t = 3.251, p < 0.01), respectively. Applying the transtheoretical model to health behavior enables significant change. The benefits of applying the transtheoretical model for promoting exercise include increasing perceived exercise benefits and self-efficacy, decreasing perceived exercise barriers, and increasing physical activity levels. Full article