Search Results (89)

Background/Objectives: This study presents a survey-based evaluation of an explainable AI (Feature-Augmented) approach, which was designed to support the diagnosis of Alzheimer’s disease (AD) by integrating clinical data, MMSE scores, and MRI scans. The approach combines rule-based reasoning and example-based visualization to improve the explainability of AI-generated decisions. Methods: Five doctors participated in the survey: two with 6 to 10 years of experience and three with more than 10 years of experience in the medical field and expertise in AD. The participants evaluated different AI outputs, including clinical feature-based interpretations, MRI-based visual heat maps, and a combined interpretation approach. Results: The model achieved a 100% trust score, with 20% of the participants reporting full trust and 80% expressing conditional trust, understanding the diagnosis but seeking further clarification. Overall, the participants reported that the integrated explanation format improved their understanding of the model decisions and enhanced their confidence in using AI-assisted diagnosis. Conclusions: To our knowledge, this paper is the first to gather the views of medical experts to evaluate the explainability of an AI decision-making model when diagnosing AD. These preliminary findings suggest that explainability plays a key role in building trust and ease of use of AI tools in clinical settings, especially when used by experienced clinicians to support complex diagnoses, such as AD. Full article

Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disorder that progressively impairs motor and communication abilities. Globally, the prevalence of ALS was estimated at approximately 222,800 cases in 2015 and is projected to increase by nearly 70% to 376,700 cases by 2040, primarily driven by demographic shifts in aging populations, and the lifetime risk of developing ALS is 1 in 350–420. Despite international advancements in assistive technologies, a recent national survey in Saudi Arabia revealed that 100% of ALS care providers lack access to eye-tracking communication tools, and 92% reported communication aids as inconsistently available. While assistive technologies such as speech-generating devices and gaze-based control systems have made strides in recent decades, they primarily support English speakers, leaving Arabic-speaking ALS patients underserved. This paper presents SOUTY, a cost-effective, mobile-based application that empowers ALS patients to communicate using gaze-controlled interfaces combined with a text-to-speech (TTS) feature in Arabic language, which is one of the five most widely spoken languages in the world. SOUTY (i.e., “my voice”) utilizes a personalized, pre-recorded voice bank of the ALS patient and integrated eye-tracking technology to support the formation and vocalization of custom phrases in Arabic. This study describes the full development life cycle of SOUTY from conceptualization and requirements gathering to system architecture, implementation, evaluation, and refinement. Validation included expert interviews with Human–Computer Interaction (HCI) expertise and speech pathology specialty, as well as a public survey assessing awareness and technological readiness. The results support SOUTY as a culturally and linguistically relevant innovation that enhances autonomy and quality of life for Arabic-speaking ALS patients. This approach may serve as a replicable model for developing inclusive Augmentative and Alternative Communication (AAC) tools in other underrepresented languages. The system achieved 100% task completion during internal walkthroughs, with mean phrase selection times under 5 s and audio playback latency below 0.3 s. Full article

Background/Objectives: The development of hypophosphatemia has been associated with intravenous iron products, with the rate of hypophosphatemia found to be higher with ferric carboxymaltose. This consensus statement provides clinical guidance on the risk of hypophosphatemia development with ferric carboxymaltose and the approaches for management. To develop consensus recommendations regarding the clinical implications of hypophosphatemia after the administration of ferric carboxymaltose, the assessment of patient risk profile, and recommended approaches for risk reduction. Methods: Consensus statements were developed from an in-person meeting of specialists with expertise in iron pathophysiology and iron therapy and further supplemented with literature review. The multidisciplinary expert panel comprised global iron specialists spanning anesthesiology, cardiology, gastroenterology, obstetrics/gynecology, hematology, nephrology, and iron molecular biology. Structured discussions were held in an in-person meeting to gather expert opinion on the evidence base regarding intravenous iron and hypophosphatemia. Consolidated summary opinions underwent further iterations of panel review to form consensus recommendation statements. Results: The expert panel developed the following consensus statements: (1) Routine serum phosphate level measurement is not recommended for low-risk patients before or after treatment with ferric carboxymaltose, as most cases of hypophosphatemia that occur following the administration of ferric carboxymaltose are asymptomatic and transient; (2) patients receiving ferric carboxymaltose should be assessed for the degree of risk for developing symptomatic or severe hypophosphatemia prior to administration; (3) monitoring serum phosphate is recommended for patients at an increased risk for developing low serum phosphate or who require repeated courses of ferric carboxymaltose treatment at higher doses; (4) prophylactic oral phosphorus after ferric carboxymaltose is unlikely to effectively elevate phosphate and is not recommended for routine clinical practice; and (5) hypophosphatemic osteomalacia is rare and the risk of development after the administration of ferric carboxymaltose, in particular single infusion, is low. Conclusions: Hypophosphatemia following ferric carboxymaltose is predominantly asymptomatic and transient. Individuals at higher risk for developing hypophosphatemia with ferric carboxymaltose treatment include those who receive multiple infusions, higher cumulative doses, or long-term iron treatment or who have underlying clinical risk factors. These consensus statements provide structured guidance on the risk of hypophosphatemia with ferric carboxymaltose and the approaches to clinical management. Full article

This study examines the interplay of financial performance, corporate governance, and sustainability reporting quality (SRQ), addressing the need to enhance corporate transparency and accountability in an emerging market context. Guided by agency and stakeholder theories, this study investigated the effects of board size, independence, diversity, and experience on SRQ, along with the moderating role of governance in the financial performance–SRQ relationship. Using an explanatory research design and quantitative approach, data from 88 listed firms in premier markets from 2015 to 2024 were analyzed using ordered logistic regression. All data were gathered from the Refinitiv Eikon Platform (LSEG), annual reports. Panel GMM regression is used to estimate the relationship to deal with the endogeneity problem. The findings reveal that board size and experience positively influence SRQ, highlighting the role of diverse expertise and seasoned directors in fostering sustainability. Financial performance alone was not significantly associated with SRQ. However, robust governance structures enhanced the translation of financial resources into improved reporting quality. Firm size emerged as a key determinant, with larger firms exhibiting higher SRQ, while financial firms lagged compared to non-financial sectors. This study concludes that corporate governance is pivotal in shaping SRQ, particularly in resource-constrained environments. This study contributes to the literature by bridging governance, financial performance, and sustainability, offering practical insights for policymakers and corporate leaders to improve SRQ through regulatory frameworks and governance reforms. Full article

Background: Increasing evidence suggests that visiting the coast benefits mental health and that coastal prescribing is a promising societal endpoint. General practitioners (GPs) are the pivotal access point for patients to receive diagnosis and treatment, but little is known about their perspective on recommending patients to visit the coast. Methods: This study applied qualitative semi-structured interviews to explore GPs’ perspectives on coastal prescribing in Flanders. We interviewed eleven GPs (aged 32–69 years) and inspected their responses using inductive thematic analysis. Results: Results show that the interviewed GPs generally believed in the therapeutic benefits of the coast, but also acknowledged risks associated with crowding and patient-specific effects. Six barriers were identified for coastal prescribing: feasibility concerns, lack of awareness, prioritizing physical exercise or visiting nearby green nature, anticipating low motivation of the patient, feeling pressure to prescribe medication, and needing more scientific evidence. As solutions, they proposed gathering more scientific evidence and raising awareness. Finally, the GPs regarded their field expertise as valuable in helping to recruit patients for follow-up research on the health effects of the coast. Conclusions: Our findings highlight the importance of engaging GPs, patients, and other stakeholders to identify key knowledge gaps before co-creating coastal prescribing in healthcare. Full article

Background/Objectives: Focal therapy (FT) and technology are closely connected. Advanced imaging allows for precise identification of the index lesion, enabling the targeted use of various thermal and non-thermal energy sources through different approaches, with specific techniques tailored to lesion location and operator expertise. This personalized approach enhances both safety and effectiveness, facilitating customized treatment planning. Methods: The International Consultation on Urological Diseases formed a committee to review the current literature on FT for prostate cancer (PCa), focusing specifically on the technique. Following in-depth discussions, the committee chose a “by lesion” approach rather than the traditional “by energy” approach to structure the review. A comprehensive PubMed search was conducted to gather relevant articles on the various energy modalities and procedural approaches used in FT for PCa. Results: Lesions in the apex, anterior, and posterior regions of the prostate can be accessed through several FT approaches, each associated with specific energy modalities and techniques. The transrectal approach utilizes high-intensity focused ultrasound (HIFU) and focal laser ablation (FLA), while the transperineal approach is compatible with energy sources such as cryotherapy, irreversible electroporation (IRE), brachytherapy, and FLA. The transurethral approach supports methods such as transurethral ultrasound ablation (TULSA). Each approach offers distinct advantages based on lesion location, treatment area, and energy modality. The choice of technique evaluated the safety and efficacy of each energy source and approach based on specific treatment areas within the prostate, highlighting the need for robust research across lesion locations and modalities, rather than focusing solely on each modality for a specific region. Conclusions: FT is rapidly advancing with new energy sources, technological improvements, and increasing operator expertise. To further optimize FT, research should prioritize evaluating the safety and effectiveness of different energy sources for various lesion locations, focusing on the treatment area rather than the energy modality itself. Full article

Urban green spaces (UGSs) play a pivotal role in sustaining the livelihoods of urban dwellers. This study sought to explore the impact of UGSs on livelihoods in Bulawayo and Johannesburg cities. A mixed-methods approach was used to develop a nuanced understanding of the nexus between UGSs and the livelihoods of the residents. A questionnaire survey (n = 658) with 329 participants from each city and 20 interviews were used to gather and generate data. Twelve types of UGSs were identified, with a relatively large proportion of the participants recognizing informal recreational areas as the common type of urban green space (UGS) in both cities. Domestic gardens, cemeteries, parks, woodlands, institutional green spaces, street trees, wastelands, commonages, and green roofs were other green spaces in both cities. Economically, job opportunities emerged in areas such as selling wares, photography, and the collection of firewood and wild fruits for sale. Likewise, farming activities and property values increased. Socially, they were valuable recreation and leisure spots for picnicking, dog walking, dating escapades, mental and spiritual wellness as well as education. Environmentally, UGSs were special in terms of medicinal provisions and aesthetics. However, urbanization and encroachment are undermining the extent of livelihood benefits. Therefore, it is imperative to revitalize UGSs by instituting robust partnerships and collaboration between government agencies, mobilize resources and expertise, value addition to existing UGSs, rigorous education to promote better appreciation, inclusion of the locals in the design process so that green spaces meet their needs and priorities, and establishing effective maintenance and management systems that ensure sustainability of UGSs. Full article

Excessive nutrient loading in freshwater is a water quality and safety concern for Indigenous communities, especially those with inadequate water treatment. Continuous nutrient monitoring efforts in collaboration with community members require cost-effective but information-rich methods. Data gathered through community-science approaches could enhance source water protection programs and can provide first-hand knowledge and expertise through reciprocal information exchange with local community members. Yet, there are still misconceptions about the validity of data gathered by community scientists. This study validates the use of two inexpensive nutrient monitoring devices (YSI 9500 Photometer and the Nutrient Smartphone App) for community-based environmental research by testing the accuracy of each device, identifying nutrient hotspots, and determining if nutrient concentrations relate to precipitation patterns in a drought-prone region of Saskatchewan within the Lake Winnipeg Basin in Canada. We found that the measurement accuracy of these devices varied depending on the compound tested, with the poorest results for nitrate (r² = 0.07) and the best results for phosphate (r² = 0.89) when using the photometer. Seasonal nutrient concentration patterns differed between the years of moderate (2019) and low (2021) precipitation, but there was no correlation between rainfall amounts and nutrient concentrations, suggesting other drivers. This study identifies the strengths and weaknesses of cost-effective nutrient testing devices, guiding continuous monitoring efforts with communities. Full article

This paper empirically investigated the impact of climate governance on the relationship between ESG reporting and firm profitability. The collected sample is all the nonfinancial companies in Europe and Gulf countries during the period 2010–2023. All the data have been gathered from Refinitiv Eikon Platform (LSEG), annual reports, and the different stock exchanges. The panel GMM regression has been used to estimate the relationship to deal with the endogeneity problem. The findings revealed that ESG, board independence, growth, inflation, and GDP had a favorable impact on company performance in Europe and the Gulf Cooperation Council, but board meetings had a negative impact. The results indicate a notable difference in the influence of board size on companies’ performance. Within the GCC framework, an enlarged board size adversely impacts profitability, potentially attributable to inefficiencies or protracted decision-making. In Europe, a larger board size positively influences outcomes, possibly due to robust regulatory frameworks, more diversity of expertise, and improved strategic oversight. The findings demonstrate that company size positively influences performance in the GCC, indicating that larger firms gain advantages from economies of scale, enhanced market positioning, and improved access to resources in the area. In Europe, firm size adversely affects performance, likely due to increased operational difficulties, legal obligations, and potential inefficiencies linked to managing huge organizations. Based on the robust results reported, our results hold. Full article

The use of microfluidics for analysis of biological and chemical compounds is flourishing, with droplet microfluidics being well suited for high-throughput single substance analysis. Nowadays, many new experimental set-ups are reported that combine various fields and expertise, including, among others, microfluidics, optics, electronics, chemistry, biology, etc. This work aims to highlight the engineering effort that goes into the development and realization of experimental set-ups for obtaining ‘good’ scientific data. High quality research and results stand or fall with the quality of the set-ups that are used for obtaining said results. Unfortunately, replication of these custom-made set-ups (as well as reproducibility/gathering of data) may be hampered if not all parts are sufficiently/detailed documented in the (Electronic) Supplementary Information ((E)SI). In this work, we present detailed descriptions of the fluidic, electronic, and optical interfacings that are developed to make a microfluidic platform for the high-throughput, fluorescent-based screening of Fluidic Catalytic Cracking (FCC) catalyst particle acidity and the subsequent sorting of the most active catalyst particles. Full article

This research investigates the core competency indicators required for battery electric vehicle (BEV) sales personnel to effectively contribute to the growth of the BEV industry and the transition toward sustainable mobility. As global efforts to reduce carbon emissions intensify, this study identifies the necessary competencies to equip BEV sales teams in navigating the complexities of BEV adoption. This study employs a structured Delphi methodology, gathering insights from a panel of 15 industry professionals, to define and validate key competency dimensions. These competencies are categorized into four main dimensions—professional knowledge, professional ability, professional attitude, and personal traits—and further subdivided into 20 sub-dimensions and 58 specific indicators. Essential competencies include technical expertise in BEV technology, communication skills, customer relationship management, sales techniques, and proficiency in after-sales services. The findings emphasize the significant role of continuous learning, work attitude, and the integration of digital tools in driving sales effectiveness and customer trust. Furthermore, the competency framework developed in this study aligns with the United Nations Sustainable Development Goals (SDGs), particularly SDG 9 (industry, innovation, and infrastructure), SDG 11 (sustainable cities and communities), and SDG 4 (quality education). The framework offers practical insights for recruitment, training, and performance evaluation, ensuring that BEV sales personnel are well-prepared to foster the widespread adoption of electric vehicles, thereby contributing to a sustainable and low-carbon future. Full article

The growing use of mobile robots in unconventional environments demands new programming approaches to make them accessible to non-expert users. Indeed, traditional programming methods require specialized expertise in robotics and programming, limiting robots’ accessibility to a broader audience. End-user robot programming has emerged to overcome these limitations, aiming to simplify robot programming through intuitive methods. In this work, we propose a code-free approach for programming mobile robots to autonomously execute navigation tasks, i.e., reach a desired goal location from an arbitrary initial position. Our method relies on instructing the robot on new paths through demonstrations while creating and continuously updating a topometric map of the environment. Moreover, by leveraging the information gathered during the instruction phase, the robot can perceive slight environmental changes and autonomously make the best decision in response to unexpected situations (e.g., adjusting its path, stopping, or requesting user intervention). Experiments conducted in both simulated and real-world environments support the validity of our approach, as they show that the robot can successfully reach its assigned goal location in the vast majority of cases. Full article

Laboratory testing has played a pivotal role throughout the coronavirus disease 2019 (COVID-19) pandemic, exemplifying the importance of in vitro diagnostics in addressing public health threats posed by outbreaks of infectious diseases. This article aims to present key insights from our expertise, derived from evidence gathered during the COVID-19 pandemic, to inform strategies for managing future infectious challenges. Current scientific evidence underscores that patient sample testing not only allows to diagnose an acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but also supports outbreak prediction, improved control measures, anticipation of pressure on the healthcare system, mitigation of adverse clinical outcomes, and early detection of emerging SARS-CoV-2 variants. Additionally, wastewater monitoring has emerged as a powerful tool for forecasting disease burden, including both prevalence and severity. Collectively, these findings underscore the value of diagnostic testing and wastewater surveillance in guiding healthcare planning and optimizing resource allocation during the COVID-19 pandemic, offering a valid framework to be applied to future public health threats, especially to any potential outbreak of “Disease X” that may emerge in the future. Full article

Waste from electrical and electronic equipment (WEEE) is expected to reach 82 million metric tons by 2030, with a global average of 7.8 kg/cap/year. In 2022, the amount of WEEE generated in Laos was 3.6 kg/cap/year, with no formal collection or treatment facilities in place. An examination of WEEE management and repair practices in the capital of Laos, Vientiane, was conducted, involving a review of the relevant literature and data gathered from interviews and online surveys of a total of 82 families, 17 junkshops, and 16 repair shops. Additionally, the environmental impact of smartphone repair activities was determined by utilizing data from existing life cycle assessment studies. The findings highlight the challenges of WEEE management, including infrastructure deficit and policy gaps. The informal sector plays a significant role in WEEE collection and dismantling. Manual dismantling takes place in junkshops prior to exportation to Vietnam, Thailand, and China. Reuse and repair are common practices and are present in both formal and informal contexts. Smartphone repair is a prevalent service alongside cooling and freezing equipment repair. The primary obstacles of repair are linked to the quality and availability of spare parts, the absence of repair guidelines and technical expertise, complicated designs, and consumer awareness. Notwithstanding the challenges associated with repairs, this case study demonstrates the environmental benefits of smartphone repair, achieving a reduction of 44% in GHG emissions compared to the conventional replacement over a 7-year observation period. Recommendations are proposed to enhance WEEE management systems and advance the repair movement. Full article

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its global spread have left an indelible mark, disrupting multiple aspects of human life. It is therefore crucial to retrospectively analyze the factors that have contributed more to the initial inefficiency of the global response, thus enhancing preparedness and proactively addressing the risk of similar events occurring in the future. Critical areas were identified based on our expertise. Relevant bibliographic references were subsequently gathered through an open search of scientific databases to substantiate the concepts discussed in this article. The key issues that hindered an effective response to coronavirus disease 2019 (COVID-19) are numerous and multifaceted, and some of these will be critically examined in this article, including delayed identification of the pathogen, inadequate public health preparedness, inadequate therapeutic management, and deficiencies in laboratory diagnostics. From this analysis, key areas for improvement emerge to ensure more efficient responses to future health crises, including (i) enhancing and strengthening health information systems, (ii) improving pandemic preparedness and response planning, (iii) developing a resilient healthcare workforce, (iv) increasing investment in research and development, (v) expanding the use of telemedicine and digital health, (vi) ensuring universal access to healthcare, and (vii) improving public health communication and trust. Full article