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Keywords = external environmental stimulus

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21 pages, 770 KiB  
Article
Unraveling Tourist Behavioral Intentions in Historic Urban Built Environment: The Mediating Role of Perceived Value via SOR Model in Macau’s Heritage Sites
by Jiaxing Liu, Yongchao Zhu, Jing Liu and Pohsun Wang
Buildings 2025, 15(13), 2316; https://doi.org/10.3390/buildings15132316 - 1 Jul 2025
Viewed by 510
Abstract
In response to growing concerns about overtourism and the need for sustainable heritage tourism, this study investigates how external environmental stimuli affect tourists’ perceived value and behavioral intentions in historic urban environments. Using the Stimulus–Organism–Response (SOR) model as the theoretical framework, and based [...] Read more.
In response to growing concerns about overtourism and the need for sustainable heritage tourism, this study investigates how external environmental stimuli affect tourists’ perceived value and behavioral intentions in historic urban environments. Using the Stimulus–Organism–Response (SOR) model as the theoretical framework, and based on 275 valid questionnaires collected from five major sites in the Historic Center of Macau, this study explores the direct and indirect relationships among four types of environmental stimuli (physical factors, social activities, environmental atmosphere, and information and services), perceived value, and behavioral intentions. The results of structural equation modeling (SEM) indicate that all four stimuli significantly influence perceived value and behavioral intentions. Among them, physical factors exert the strongest influence on perceived value (β = 0.291, p < 0.001), while social activities are the most influential predictor of behavioral intentions (β = 0.225, p < 0.01). Perceived value plays a significant mediating role in all relationships, with the largest mediation effect found in the path from physical factors to behavioral intentions (27.99%), followed by environmental atmosphere (24.80%), information and services (22.62%), and social activities (11.66%). These findings validate the applicability of the SOR model in heritage tourism contexts and highlight the central role of perceived value in shaping tourist behavior. Theoretically, this study advances our understanding of how multidimensional environmental stimuli contribute to value-based decision-making in tourism. Practically, it provides actionable insights for urban planners and heritage managers to design environments that promote deeper engagement and foster sustainable tourist behavior in high-density historic destinations like Macau. Full article
(This article belongs to the Special Issue New Trends in Built Environment and Mobility)
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22 pages, 1793 KiB  
Article
The Impact of Green Perception on Pro-Greenspace Behavior of Urban Residents in Megacities: Shaped by “Good Citizen” Image
by Yige Ju, Tianyu Chen, Guohua Hu and Feng Mi
Forests 2025, 16(6), 1014; https://doi.org/10.3390/f16061014 - 17 Jun 2025
Viewed by 346
Abstract
Green perception underlies pro-greenspace behavior, but external stimuli and behavior are not always aligned. Understanding how residents’ perceived external green stimuli influence pro-greenspace behavior, and how the “good citizen” image (face) shapes this relationship, is essential. The study aims to deepen the understanding [...] Read more.
Green perception underlies pro-greenspace behavior, but external stimuli and behavior are not always aligned. Understanding how residents’ perceived external green stimuli influence pro-greenspace behavior, and how the “good citizen” image (face) shapes this relationship, is essential. The study aims to deepen the understanding of the complex mechanisms driving urban residents’ pro-greenspace behavior by constructing an extended Stimulus-Organism-Response theoretical framework (C-SOR) that includes contextual factors. Using data from a 2024 field survey of 959 residents from Shanghai, China, this study employs Ordinary Least Squares (OLS) regression to examine the main effect of green perception on pro-greenspace behavior. A mediation model is employed to analyze the mediating role of nature connectedness, while a moderation model tests the moderating effect of “good citizen” image (face) on the stimulus–behavior relationship. The results show that green perception significantly promotes pro-greenspace behavior, positively influencing it through nature connectedness. However, the “good citizen” image (face) exerts a motivational crowding-out effect on green perception. Further analysis reveals individual heterogeneity in the expression of these effects across different types of pro-greenspace behavior. The findings highlight the importance of green space experience and the activation of environmental wisdom in traditional culture, offering new perspectives for developing strategies to guide pro-greenspace behavior. Full article
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24 pages, 44857 KiB  
Article
Analysis of Green Travel Choice Behavior of Residents in Central Urban Areas: Applying the Theory of Planned Behavior and Stimulus–Organism–Response Model
by Chunyao Deng, Zhenwu Shi, Yanli Zhang and Jinru Wang
Sustainability 2025, 17(5), 2208; https://doi.org/10.3390/su17052208 - 3 Mar 2025
Viewed by 1494
Abstract
The potential benefits of green travel in achieving dual-carbon goals and promoting sustainable urban development have been widely recognized. However, the various factors influencing green travel behavior in small- and medium-sized central urban areas have not been adequately explored. This study developed a [...] Read more.
The potential benefits of green travel in achieving dual-carbon goals and promoting sustainable urban development have been widely recognized. However, the various factors influencing green travel behavior in small- and medium-sized central urban areas have not been adequately explored. This study developed a theoretical model to analyze residents’ green travel decision-making, integrating the theory of planned behavior and the stimulus–organism–response model. The model was validated through qualitative and quantitative analyses, revealing key findings. (1) Residents’ green travel awareness and intentions are influenced by personal characteristics, internal psychological factors, and external environmental factors, each with varying degrees of impact. (2) Psychological demand for travel and extreme weather conditions significantly impact green travel awareness. (3) Green travel awareness positively affects actual green travel behavior, with other factors indirectly influencing behavioral intention through awareness. (4) Subjective norms and policy support directly influence green travel choices. Based on these findings, the study suggests policy recommendations to enhance residents’ green travel awareness, promoting sustainable urban development. Full article
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13 pages, 5858 KiB  
Article
Temperature Sensing in Agarose/Silk Fibroin Translucent Hydrogels: Preparation of an Environment for Long-Term Observation
by Maria Micheva, Stanislav Baluschev and Katharina Landfester
Nanomaterials 2025, 15(2), 123; https://doi.org/10.3390/nano15020123 - 16 Jan 2025
Viewed by 3428
Abstract
Environmental changes, such as applied medication, nutrient depletion, and accumulation of metabolic residues, affect cell culture activity. The combination of these factors reflects on the local temperature distribution and local oxygen concentration towards the cell culture scaffold. However, determining the temporal variation of [...] Read more.
Environmental changes, such as applied medication, nutrient depletion, and accumulation of metabolic residues, affect cell culture activity. The combination of these factors reflects on the local temperature distribution and local oxygen concentration towards the cell culture scaffold. However, determining the temporal variation of local temperature, independent of local oxygen concentration changes in biological specimens, remains a significant technological challenge. The process of triplet–triplet annihilation upconversion (TTA-UC), performed in a nanoconfined environment with a continuous aqueous phase, appears to be a possible solution to these severe sensing problems. This process generates two optical signals (delayed emitter fluorescence (dF) and residual sensitizer phosphorescence (rPh)) in response to a single external stimulus (local temperature), allowing the application of the ratiometric-type sensing procedure. The ability to incorporate large amounts of sacrificial singlet oxygen scavenging materials, without altering the temperature sensitivity, allows long-term protection against photo-oxidative damage to the sensing moieties. Translucent agarose/silk fibroin hydrogels embedding non-ionic micellar systems containing energetically optimized annihilation couples simultaneously fulfill two critical functions: first, to serve as mechanical support (for further application as a cell culture scaffold); second, to allow tuning of the material response window to achieve a maximum temperature sensitivity better than 0.5 K for the physiologically important region around 36 °C. Full article
(This article belongs to the Section Nanoelectronics, Nanosensors and Devices)
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22 pages, 1103 KiB  
Article
Mechanism by Which Environmental Education Influences Pro-Environmental Behavior in Wuyishan National Park, China
by Xinyi Wu, Weiguo Jia and Tianyu Wu
Sustainability 2025, 17(1), 43; https://doi.org/10.3390/su17010043 - 25 Dec 2024
Cited by 2 | Viewed by 1177
Abstract
Environmental education is one of the main functions of China’s national parks, and it also plays a crucial role in the construction of an ecological civilization. Compared with the rest of Asia, the inception of national parks in China occurred relatively late, and [...] Read more.
Environmental education is one of the main functions of China’s national parks, and it also plays a crucial role in the construction of an ecological civilization. Compared with the rest of Asia, the inception of national parks in China occurred relatively late, and fostering tourists’ pro-environmental behavior is a challenging endeavor. According to the theoretical paradigm of stimulus–organism–response (SOR), in this study, we selected place attachment, environmental attitude, and environmental quality to construct a theoretical model of the relationship between the perception of environmental education and pro-environmental behavior. We conducted a sample survey of 728 tourists who had been to Wuyishan National Park and constructed a structural equation model. Our findings indicate the following: (1) pro-environmental behavior is directly and significantly promoted by one’s perception of environmental education, place attachment, and environmental attitude; (2) place attachment and environmental attitude play an intermediary role between one’s perception of environmental education and pro-environmental behavior; and (3) the quality of the external environment positively influences the correlation between one’s perception of environmental education and place attachment. This study provides solutions and suggestions for Wuyishan National Park to improve the effectiveness of environmental education regarding tourists’ pro-environmental behavior. Full article
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63 pages, 14545 KiB  
Review
Sum-Frequency Generation Spectroscopy at Aqueous Electrochemical Interfaces
by Ba Lich Pham, Alireza Ranjbari, Abderrahmane Tadjeddine, Laetitia Dalstein and Christophe Humbert
Symmetry 2024, 16(12), 1699; https://doi.org/10.3390/sym16121699 - 21 Dec 2024
Cited by 1 | Viewed by 2872
Abstract
The electrochemical interface (EI) is the determining factor in the yield and mechanism of sustainable energy storage and conversion systems due to its intrinsic functionality as a dynamic junction with the symmetry breaking of the molecular arrangement for complex reaction fields of mass [...] Read more.
The electrochemical interface (EI) is the determining factor in the yield and mechanism of sustainable energy storage and conversion systems due to its intrinsic functionality as a dynamic junction with the symmetry breaking of the molecular arrangement for complex reaction fields of mass transport and heterogeneous electron transfer. At the EI, the externally applied potential stimulus drives the formation of the electrical double layer (EDL) and governs the adsorption of interfacial adsorbate species in aqueous electrolyte solutions. Water and its aqueous electrolyte systems are integral and quintessential elements in the technological innovation of various fields such as environmental sciences, electrocatalysis, photocatalysis, and biochemistry. Although deciphering the structure and orientation of water molecules at the electrode–electrolyte interface in a quantitative analysis is of utmost importance, assessing chemical phenomena at the buried EI was rather challenging due to the intricacy of selecting interface-specific methodologies. Based on the non-centrosymmetry of the interfaces’ electronic properties, sum-frequency generation (SFG) spectroscopy has been manifested to be specifically well suited for probing the EI with detailed and comprehensive characteristics of adsorbates’ chemical structures and electrochemical events. In this review, we holistically engage in a methodical and scrupulous assessment of the fundamental EDL models and navigate towards the connection of the renowned Stark effect and potential dependence of SFG spectra at heterogeneous electrode–electrolyte interfaces. We dissect the development, advantages, and available geometrical configurations of in situ SFG spectroscopy in harnessing the EI. A broad spectrum of applications in unraveling the water orientations and rationalizing the convoluted mechanism of fuel-generated electrocatalytic reactions with particular encumbrances and potential resolutions is underscored by leveraging SFG spectroscopy. Full article
(This article belongs to the Special Issue Chemistry: Symmetry/Asymmetry—Feature Papers and Reviews)
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22 pages, 9930 KiB  
Review
Research Progress and Emerging Directions in Stimulus Electro-Responsive Polymer Materials
by Zifeng Jin, Xiaoyan Wei, Xiaojun He, Zhenglin Wang, Zhibo Zhao, Huan He, Ya’nan Yang and Nan Chen
Materials 2024, 17(17), 4204; https://doi.org/10.3390/ma17174204 - 25 Aug 2024
Cited by 1 | Viewed by 2313
Abstract
Stimulus electro-responsive polymer materials can reversibly change their physical or chemical properties under various external stimuli such as temperature, light, force, humidity, pH, and magnetic fields. This review introduces typical conventional stimulus electro-responsive polymer materials and extensively explores novel directions in the field, [...] Read more.
Stimulus electro-responsive polymer materials can reversibly change their physical or chemical properties under various external stimuli such as temperature, light, force, humidity, pH, and magnetic fields. This review introduces typical conventional stimulus electro-responsive polymer materials and extensively explores novel directions in the field, including multi-stimuli electro-responsive polymer materials and humidity electro-responsive polymer materials pioneered by our research group. Despite significant advancements in stimulus electro-responsive polymer materials, ongoing research focuses on enhancing their efficiency, lifespan, and production costs. Interdisciplinary collaboration and advanced technologies promise to broaden the application scope of these materials, particularly in medical and environmental protection fields, ultimately benefiting society. Full article
(This article belongs to the Section Smart Materials)
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17 pages, 739 KiB  
Article
Investigating the Determinants of Construction Stakeholders’ Intention to Use Construction and Demolition Waste Recycling Products Based on the S-O-R Model in China
by Zhikun Ding, Xinyue Huang, Xinrui Wang, Qiaohui Chen, Jiasheng Zhang and Zezhou Wu
Sustainability 2024, 16(6), 2262; https://doi.org/10.3390/su16062262 - 8 Mar 2024
Cited by 1 | Viewed by 1575
Abstract
In China, the annual generation of construction and demolition waste (CDW) has been steadily increasing, accompanied by a generally low recycling rate. To promote sustainable development, there is an urgent need to enhance the recycling of CDW. This paper aims to investigate the [...] Read more.
In China, the annual generation of construction and demolition waste (CDW) has been steadily increasing, accompanied by a generally low recycling rate. To promote sustainable development, there is an urgent need to enhance the recycling of CDW. This paper aims to investigate the determinants of construction stakeholders’ intention to use CDW recycling products in China. The stimulus–organism–response (S-O-R) model, integrating the technological–organizational–environmental (TOE) framework, personal perceptions, personal traits, and the intention to use, was chosen as our theoretical model. Through an analysis of 272 valid questionnaires, the partial least squares structural equation modeling (PLS-SEM) was utilized to evaluate the model and test the proposed hypotheses. The results indicated that personal traits are the most influential factor shaping construction stakeholders’ intention to use, followed by personal perceptions, while external stimuli exert no direct significant impact on the intention to use. Nevertheless, personal traits and personal perceptions play a significant mediating role in the relationship between external stimuli and the intention to use, forming a noteworthy serial chain mediation. The research findings imply that in China, bolstering personal traits plays a critical role in guiding and promoting the intention to use CDW recycling products. Full article
(This article belongs to the Section Waste and Recycling)
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59 pages, 7841 KiB  
Review
Preparation, Stimulus–Response Mechanisms and Applications of Micro/Nanorobots
by Tao He, Yonghui Yang and Xue-Bo Chen
Micromachines 2023, 14(12), 2253; https://doi.org/10.3390/mi14122253 - 17 Dec 2023
Cited by 9 | Viewed by 3493
Abstract
Micro- and nanorobots are highly intelligent and efficient. They can perform various complex tasks as per the external stimuli. These robots can adapt to the required functional form, depending on the different stimuli, thus being able to meet the requirements of various application [...] Read more.
Micro- and nanorobots are highly intelligent and efficient. They can perform various complex tasks as per the external stimuli. These robots can adapt to the required functional form, depending on the different stimuli, thus being able to meet the requirements of various application scenarios. So far, microrobots have been widely used in the fields of targeted therapy, drug delivery, tissue engineering, environmental remediation and so on. Although microbots are promising in some fields, few reviews have yet focused on them. It is therefore necessary to outline the current status of these microbots’ development to provide some new insights into the further evolution of this field. This paper critically assesses the research progress of microbots with respect to their preparation methods, stimulus–response mechanisms and applications. It highlights the suitability of different preparation methods and stimulus types, while outlining the challenges experienced by microbots. Viable solutions are also proposed for the promotion of their practical use. Full article
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18 pages, 8356 KiB  
Review
4D Printing Shape-Morphing Hybrid Biomaterials for Advanced Bioengineering Applications
by Irene Chiesa, Maria Rachele Ceccarini, Silvia Bittolo Bon, Michela Codini, Tommaso Beccari, Luca Valentini and Carmelo De Maria
Materials 2023, 16(20), 6661; https://doi.org/10.3390/ma16206661 - 12 Oct 2023
Cited by 8 | Viewed by 2406
Abstract
Four-dimensional (4D) printing is an innovative additive manufacturing technology used to fabricate structures that can evolve over time when exposed to a predefined environmental stimulus. 4D printed objects are no longer static objects but programmable active structures that accomplish their functions thanks to [...] Read more.
Four-dimensional (4D) printing is an innovative additive manufacturing technology used to fabricate structures that can evolve over time when exposed to a predefined environmental stimulus. 4D printed objects are no longer static objects but programmable active structures that accomplish their functions thanks to a change over time in their physical/chemical properties that usually displays macroscopically as a shapeshifting in response to an external stimulus. 4D printing is characterized by several entangled features (e.g., involved material(s), structure geometry, and applied stimulus entities) that need to be carefully coupled to obtain a favorable fabrication and a functioning structure. Overall, the integration of micro-/nanofabrication methods of biomaterials with nanomaterials represents a promising approach for the development of advanced materials. The ability to construct complex and multifunctional triggerable structures capable of being activated allows for the control of biomedical device activity, reducing the need for invasive interventions. Such advancements provide new tools to biomedical engineers and clinicians to design dynamically actuated implantable devices. In this context, the aim of this review is to demonstrate the potential of 4D printing as an enabling manufacturing technology to code the environmentally triggered physical evolution of structures and devices of biomedical interest. Full article
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21 pages, 508 KiB  
Article
Unveiling the Soaring Trend of Fashion Rental Services: A U.S. Consumer Perspective
by Ting Chi, Victoria Gonzalez, Justin Janke, Mya Phan and Weronika Wojdyla
Sustainability 2023, 15(19), 14338; https://doi.org/10.3390/su151914338 - 28 Sep 2023
Cited by 5 | Viewed by 7473
Abstract
Fashion rental services have become increasingly popular due to their provision of sustainable and environmentally friendly ways of consuming fashion products. This research aimed to investigate the effects of various stimuli offered by these services, such as product variety, information quality, style conformity, [...] Read more.
Fashion rental services have become increasingly popular due to their provision of sustainable and environmentally friendly ways of consuming fashion products. This research aimed to investigate the effects of various stimuli offered by these services, such as product variety, information quality, style conformity, and service quality, on consumer internal states (perceived performance risk, perceived financial risk, perceived social risk, perceived utilitarian value, and perceived hedonic value) and consequently their external responses (purchase intention and word of mouth). The SOR (stimulus—organism–response) model was applied, with consumer knowledge acting as a moderating variable between the stimuli and organism constructs. To examine and analyze the proposed hypotheses, an online survey was administered, resulting in 379 eligible survey responses. The findings reveal that stimuli offered by fashion rental services (product variety, information quality, style conformity, and service quality) show more significant impact on consumer perceived utilitarian value and hedonic value than perceived performance risk, financial risk, and social risk. Consequently, consumer perceived utilitarian value and hedonic value play a more influential role than perceived risks in forming the positive behavioral responses (use intention and word of mouth). No demographic variables were found to have any significant impact on the purchase intentions or word of mouth regarding fashion rental services. The proposed model shows a high explanatory power, collectively accounting for 60.1% of variance in U.S. consumers’ intention to use fashion rental services and 63.5% of variance in U.S. consumers’ WOM on fashion rental services. Full article
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19 pages, 1936 KiB  
Article
Can Airport and Social Waste Reduction Measures Have a Synergistic Impact on Passenger Behavior?
by Xinrui Guo, Yifan Gu, Yufeng Wu, Chunhua Kang, Yingjia Wang and Tieyong Zuo
Sustainability 2023, 15(18), 13859; https://doi.org/10.3390/su151813859 - 18 Sep 2023
Cited by 2 | Viewed by 1676
Abstract
As an integral part of urban functions, waste reduction behaviors inside the airport and outside in society form a linkage mechanism that influences each other, but the coupling mechanism between the two is not clear. In this study, we constructed a model of [...] Read more.
As an integral part of urban functions, waste reduction behaviors inside the airport and outside in society form a linkage mechanism that influences each other, but the coupling mechanism between the two is not clear. In this study, we constructed a model of the interaction between airport and social waste reduction behaviors and explored the effects of internal airport factors and external social factors on airport waste reduction behaviors. The results show that both internal and external factors have a significant positive effect on passengers’ behavior, with publicity and education, social norms, and laws and regulations having a greater effect. Airport internal factors (such as internal facilities, publicity and education and environmental stimulus) and social external factors (such as social norms and laws and regulations) can form a better positive feedback mechanism for waste reduction, and path coefficients for both interactions exceed 0.7. Airport publicity and education can directly improve passengers’ waste reduction behaviors, and better promote the continuation of these behaviors in society. It is recommended connecting the publicity and education activities between airports and society. The social external factors are more likely to affect the behavior of airport management, and it is recommended that the design of airport management should be made more effective in developing countries that have weaker awareness of and worse social attitudes towards for waste reduction. Full article
(This article belongs to the Section Environmental Sustainability and Applications)
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21 pages, 4778 KiB  
Article
Dynamic Response Threshold Model for Self-Organized Task Allocation in a Swarm of Foraging Robots
by Bao Pang, Ziqi Zhang, Yong Song, Xianfeng Yuan and Qingyang Xu
Appl. Sci. 2023, 13(16), 9107; https://doi.org/10.3390/app13169107 - 10 Aug 2023
Cited by 1 | Viewed by 1895
Abstract
In swarm-robotics foraging, the purpose of task allocation is to adjust the number of active foraging robots dynamically based on the task demands and changing environment. It is a difficult challenge to generate self-organized foraging behavior in which each robot can adapt to [...] Read more.
In swarm-robotics foraging, the purpose of task allocation is to adjust the number of active foraging robots dynamically based on the task demands and changing environment. It is a difficult challenge to generate self-organized foraging behavior in which each robot can adapt to environmental changes. To complete the foraging task efficiently, this paper presents a novel self-organized task allocation strategy known as the dynamic response threshold model (DRTM). To adjust the behavior of the active foraging robots, the proposed DRTM newly introduces the traffic flow density, which can be used to evaluate the robot density. Firstly, the traffic flow density and the amount of obstacle avoidance are used to adjust the threshold which determines the tendency of a robot to respond to a stimulus in the environment. Then, each individual robot uses the threshold and external stimulus to calculate the foraging probability that determines whether or not to go foraging. This paper completes the simulation and physical experiments, respectively, and the performance of the proposed method is evaluated using three commonly used performance indexes: the average deviation of food, the energy efficiency, and the number of obstacle avoidance events. The experimental results show that the DRTM is superior to and more efficient than the adaptive response threshold model (ARTM) in all three indexes. Full article
(This article belongs to the Special Issue AI Technology and Application in Various Industries)
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30 pages, 18238 KiB  
Review
Accelerating the Gas–Solid Interactions for Conductometric Gas Sensors: Impacting Factors and Improvement Strategies
by Hongchao Zhao, Yanjie Wang and Yong Zhou
Materials 2023, 16(8), 3249; https://doi.org/10.3390/ma16083249 - 20 Apr 2023
Cited by 16 | Viewed by 4404
Abstract
Metal oxide-based conductometric gas sensors (CGS) have showcased a vast application potential in the fields of environmental protection and medical diagnosis due to their unique advantages of high cost-effectiveness, expedient miniaturization, and noninvasive and convenient operation. Of multiple parameters to assess the sensor [...] Read more.
Metal oxide-based conductometric gas sensors (CGS) have showcased a vast application potential in the fields of environmental protection and medical diagnosis due to their unique advantages of high cost-effectiveness, expedient miniaturization, and noninvasive and convenient operation. Of multiple parameters to assess the sensor performance, the reaction speeds, including response and recovery times during the gas–solid interactions, are directly correlated to a timely recognition of the target molecule prior to scheduling the relevant processing solutions and an instant restoration aimed for subsequent repeated exposure tests. In this review, we first take metal oxide semiconductors (MOSs) as the case study and conclude the impact of the semiconducting type as well as the grain size and morphology of MOSs on the reaction speeds of related gas sensors. Second, various improvement strategies, primarily including external stimulus (heat and photons), morphological and structural regulation, element doping, and composite engineering, are successively introduced in detail. Finally, challenges and perspectives are proposed so as to provide the design references for future high-performance CGS featuring swift detection and regeneration. Full article
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11 pages, 266 KiB  
Review
Cold-Stimulus Headache in Children and Adolescents
by Ilaria Bonemazzi, Maria Federica Pelizza, Giulia Berti, Claudio Ancona, Margherita Nosadini, Stefano Sartori and Irene Toldo
Life 2023, 13(4), 973; https://doi.org/10.3390/life13040973 - 9 Apr 2023
Cited by 3 | Viewed by 3233
Abstract
The literature on cold-stimulus headache (CSH) is relatively sparse compared to other primary headache disorders and the studies on the pediatric population are very limited. This systematic review aims to analyze the evidence on CSH in children and adolescents focusing on epidemiology, clinical [...] Read more.
The literature on cold-stimulus headache (CSH) is relatively sparse compared to other primary headache disorders and the studies on the pediatric population are very limited. This systematic review aims to analyze the evidence on CSH in children and adolescents focusing on epidemiology, clinical features, pathogenic mechanisms, and treatments. Our review included 25 studies, among which 9 papers include pediatric cases (4 pediatric samples, 5 mixed samples of children and adults). The aim of this work is to highlight the features of CSH in children and adolescents. In children, the prevalence of CSH is higher than in adults and it is not gender-specific. There is a relevant family history for CSH and the comorbidity with migraine is significant. The triggers and clinical features of CSH due to ingesting a cold stimulus in children overlap with those in adults. CSH due to external application of a cold stimulus (or to environmentally low temperatures) is not studied in children and adolescents. We describe in detail a new pediatric case of CSH triggered by low ambient temperatures; to the best of our knowledge, this represents the first description in the literature. In conclusion, CSH in children is probably underestimated and has peculiar features compared to adults; further studies are needed to better understand its clinical features and pathophysiology. Full article
(This article belongs to the Special Issue The Other Pediatric Primary Headaches)
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