Search Results (30,187)

Rural communities face persistent challenges in accessing timely, culturally relevant, and trustworthy health information due to inadequate communication infrastructures, workforce shortages, and infrastructural constraints. As generative artificial intelligence (GenAI) tools become increasingly accessible, rural serving organizations are often pushed to explore their use to expand communication reach and reduce staff burden through funding incentives, vendor offerings, and policy signals, even when adoption is misaligned with local capacity or priorities. However, guidance is lacking on how rural systems should approach GenAI adoption in ways that strengthen, rather than undermine, trust and equity. This Opinion offers a systems-oriented and community-centered perspective on rural GenAI readiness by distinguishing between non-agentic applications that support human communicators and agentic systems that introduce varying degrees of autonomy. We propose a staged maturity framework tailored to rural health communication ecosystems, outlining opportunities, risks, and governance needs at each stage of adoption. By centering on rural context, communication trust, and system readiness, this Opinion aims to support the intentional, ethical, and sustainable integration of GenAI into rural health communication systems. Full article

The Wadi Al-Ahsaba watershed is an arid to semi-arid catchment situated in southwestern Saudi Arabia, characterized by intermittent surface flow, high evaporation and low rainfall, and a dam reservoir built for flood control. The work aims to assess hydrological and anthropogenic controls on surface and groundwater quality, pollution status, and human health risks using an integrated approach of hydrogeochemical analysis, multivariable statistics, and water quality and contamination indices. A total of 21 water samples (15 surface water, 6 groundwater) were analyzed for general chemistry, major ions, and trace elements. Hydrogeochemical analysis and principal component analysis (PCA) were implemented to differentiate the geogenic from anthropogenic control on water quality. The pollution status and associated risk were evaluated using water quality index (WQI), contamination degree (Cd), Hazard Quotient (HQ), and Hazard Index (HI). Results suggest limited surface–groundwater interaction, with surface water dominated by Ca–Mg–HCO₃ facies, indicating recent recharge and limited water–rock interaction, whereas groundwater exhibits mixed Ca–Mg–Cl and Ca–Na–Cl–SO₄ types, revealing longer residence time and water–rock interaction. Nitrate (9.5–109 mg/L) and TDS (522–1003 mg/L) exceeded drinking water standards in 90% and 95% of tested samples, respectively, and WQI ranged from 43 to 134, reflecting excellent to poor water. High non-carcinogenic risk from nitrate was observed, especially for infants. The study concluded that the geogenic processes (water–rock interaction, evaporation, and mineral dissolution) control the general chemistry of tested water, while anthropogenic input from wastewater and agriculture input are likely contributors to nitrate contamination. The study contributes to the understanding of arid wadi-dam systems by revealing how limited recharge, hydrological connectivity, and episodic flow control contaminant transport and persistence, underscoring the critical role of integrated hydrological analysis and land use management in safeguarding freshwater resources in arid environments. Full article

Recent developments and trends in power systems have increased the importance of dynamic modeling and monitoring of system components. Increased penetration of renewable energy sources and battery storage systems makes grid operation challenging. Being environment-friendly and fast-responding, hydroelectric power plants will participate in the generation as a balancing factor while introducing inertia. They will operate dynamically—as a reserve in frequency regulation and load-generation balancing— due to the intermittent characteristics of wind and photovoltaics (PVs). Therefore, their condition monitoring and health assessment should be performed regularly or in real time to ensure that the plant is ready whenever needed. In this research, a data-driven condition monitoring method is introduced in which the health status of the water conduit system is assessed from the turbine’s startup process. The proposed “PbyGate Analysis” method briefly obtains the expected behavior and healthy/anomalous operation regions from the historical data. Then the unit is monitored in real time with the online SCADA measurements. The method is developed and tested on three different hydroelectric turbine data. Startups are tagged as healthy or anomalous with 84.5% accuracy. Full article

Adolescents growing up in multilingual regions experience diverse educational contexts that may shape their daily routines and psychosocial environments, but their independent relevance for mental health remains unclear. South Tyrol, with its parallel German-, Italian-, and Ladin-language school systems, provides a unique setting to examine these associations. This study assessed whether school language and home–school language mismatch are associated with mental health, psychosomatic symptoms, and health-related behaviors among adolescents. We analyzed data from a population-based survey of 2005 adolescents aged 11–19 years who provided self-reported information on mental health, psychosomatic complaints, school stress, social support, digital behaviors, lifestyle, and sleep. Multivariable regression analyses examined the independent association of home–school language mismatch with mental health outcomes, adjusting for sociodemographic and educational factors and further incorporating sleep-related behaviors. Mental health outcomes, psychosomatic symptoms, and most health-related behaviors showed little variation by school language, with generally small effect sizes. Home–school language mismatch was associated with slightly higher depressive symptom scores in unadjusted analyses but was not independently associated with mental health outcomes after adjustment. In contrast, weekly sleep problems emerged as the strongest correlate of depressive symptoms, accounting for a substantial proportion of explained variance. These findings indicate that adolescent mental health in this multilingual context is associated less with the language of schooling itself than with broader behavioral and developmental factors, highlighting sleep-related behaviors as a central and modifiable target for prevention. Full article

Background/Objectives: Small-scale workplaces often have limited access to occupational health services, despite potential exposure to hazardous solvents. Biological monitoring can provide worker-level evidence of internal exposure when routine environmental monitoring is limited. This study evaluated urinary biomarkers of benzene and toluene exposure among workers in small-scale printing workplaces in South Korea and examined whether self-reported chemical handling corresponded with biomarker patterns. Methods: In this cross-sectional field biomonitoring study, 21 workers from eight printing companies provided end-of-shift urine samples. Creatinine-adjusted urinary concentrations of trans,trans-muconic acid (t,t-MA), S-phenylmercapturic acid (SPMA), phenol, and o-cresol were analyzed and compared with applicable biological reference values. Associations between reported chemical handling and elevated biomarker levels were estimated using Firth’s penalized logistic regression, and correlations among log-transformed biomarkers were explored. Results: Nine workers (42.9%) had urinary o-cresol concentrations at or above the American Conference of Governmental Industrial Hygienists (ACGIH) biological exposure index of 300 μg/g creatinine. Workers reporting benzol handling, a local term for petroleum-based cleaning products, had higher odds of elevated SPMA, although the estimate was imprecise and hypothesis-generating (age-adjusted OR 6.04, 95% CI 0.75–104.90, p = 0.093). The correlation between SPMA and t,t-MA was stronger among workers reporting benzol handling (r = 0.94) than among those reporting toluene handling (r = −0.01). Conclusions: These exploratory findings indicate that toluene-related internal exposure is a relevant occupational health concern in small-scale printing workplaces, while reported benzol handling may indicate possible low-level benzene-related exposure. Urinary biomonitoring may support exposure surveillance and preventive occupational healthcare in small enterprises when interpreted alongside workplace observations, product information, ventilation, protective equipment use, and worker education. Full article

Lead (Pb²⁺) and cadmium (Cd²⁺) are among the most hazardous heavy metal pollutants in wastewater owing to their high toxicity, environmental persistence, and detrimental impacts on human health and aquatic ecosystems. In this study, a novel ternary magnetic composite, SnFe₂O₄/activated carbon/polypyrrole (SnFe₂O₄/AC/PPy), was effectively synthesized and tested as an effective adsorbent in the removal of Pb²⁺ and Cd²⁺ from aqueous water. The composite was prepared by depositing spinel SnFe₂O₄ nanoparticles on activated carbon, followed by in situ polymerization of polypyrrole to enhance surface functionality and adsorption affinity. The successful fabrication of the porous SnFe₂O₄/AC/PPy hybrid composite was confirmed through FTIR, XRD, SEM–EDS, BET, XPS, and VSM characterization. The composite demonstrated a relatively high surface area (352.3 m²/g) and adequate magnetic responsiveness (12.33 emu/g), ensuring facile magnetic separation following wastewater treatment. Batch adsorption experiments showed great removal efficiency of 95.02 and 92.48% for Pb²⁺ and Cd²⁺ ions, respectively, at optimum conditions. The adsorption equilibrium data followed the Langmuir isotherm model with maximum adsorption capacities of 187.07 mg/g for Pb²⁺ and 96.45 mg/g for Cd²⁺ ions, which were attributed to monolayer adsorption on homogenous active sites. The kinetic and isothermal model indicated that the adsorption process was controlled by the combination of physical and chemical interactions. Thermodynamic parameters showed negative Gibbs free energy and enthalpy changes (ΔH° = −49.74 kJ/mol for Pb²⁺ and −38.82 kJ/mol for Cd²⁺ ions), confirming the spontaneous and exothermic nature of adsorption. Furthermore, the increasingly negative ΔG° values at lower temperatures indicated that the adsorption was thermodynamically more favorable under cooler conditions. According to the regeneration studies, the composite maintained a high removal efficiency after five consecutive cycles. In general, SnFe₂O₄/AC/PPy composite has good potential as a stable, reusable, and high-performance adsorbent to treat heavy metal wastewater. Full article

Objectives: Depressive symptoms are common among middle-aged and older adults. This study examined the associations of family structure and its transitions with depressive symptoms, and the mediating role of intergenerational support. Methods: Participants were drawn from the first five waves of CHARLS. Family structure and transitions were assessed at baseline (Wave 1) and Wave 2. Outcome was defined as new-onset depressive symptoms occurring after Wave 2 among participants who were free of depressive symptoms at both Wave 1 and Wave 2. A Cox proportional hazards model was used to examine the association between family structure/transitions and incident depressive symptoms. Parallel mediation analysis was conducted to examine the potential mediating effects of intergenerational support. Results: Compared with two-generation households, skipped-generation households were associated with a higher risk of depressive symptoms in older adults (HR = 1.30, 95% CI: 1.04–1.63), and transitions from two-generation to skipped-generation households were also associated with a higher risk (HR = 1.54, 95% CI: 1.06–2.23). Emotional support partially mediated this association. Conclusions: Older adults living in or transitioning to skipped-generation households are associated with a higher risk of depressive symptoms, suggesting that public health efforts should prioritize skipped-generation households and the processes leading to their formation. Full article

Background/Objectives: Retention of healthcare professionals in the workforce, their employment, and the improvement of working conditions largely depend on identifying the factors that influence their departure and their health. The study was conducted during the period from January to June 2021. This study aimed to examine the association between specific work-related stressors and work ability. The initial hypothesis was that general and specific occupational stressors negatively associate with work ability among healthcare professionals in emergency medical intervention teams. Methods: The study was designed as a cross-sectional comparative study. It was conducted among nurses and physicians in pre-hospital emergency medical services, employed full-time in intervention teams, while the control group consisted of employees from dispatch and call-receiving units. The study was conducted on the 840 participants, representing 43.3% of all healthcare professionals employed in pre-hospital emergency medical services in the Republic of Croatia. In addition to questions on participants’ personal characteristics, the following instruments were used: 1. a validated Questionnaire on Workplace Stressors among hospital healthcare professionals; and 2. the international standardized Work Ability Index (WAI) questionnaire for assessing work ability. Participants completed the questionnaires in paper form. Results: On average, the participants demonstrated lower levels of stress compared to reference values, both for overall stress and for individual stress factors, while their work ability, assessed using the Work Ability Index (WAI), ranged from very good to excellent. The control group showed higher levels of stress across all factors and lower work ability. However, the control group was older on average, generally had lower levels of education, and consisted more often of women—personal characteristics that may influence the examined variables. Lower stress levels and better work ability were associated with job satisfaction, ambition, and the fact that participants were working in their desired profession. Frequent sick leave (absenteeism) was highly correlating with both higher stress levels and poorer work ability. Conclusions: Greater job satisfaction and higher motivation have a positive impact on stress levels and employees’ work ability. The study results can serve as a starting point for institutional management in designing feasible decisions aimed at improving satisfaction, health, the work environment, and the work ability of emergency medical service personnel, as well as making these institutions more attractive for recruitment and retention of employees both in their positions and within the profession. Full article

Background/Objectives: Emerging viral zoonoses represent a growing threat to global public health, with most newly emerging infectious diseases originating from animal reservoirs. Recent outbreaks of monkeypox, Ebola virus disease, Marburg virus disease, Rift Valley fever, and avian influenza highlight the capacity of zoonotic viruses to cross species barriers, spread internationally, and generate substantial health, social, and economic consequences. This review examines the ecological, epidemiological, and biological determinants of viral zoonotic emergence and transmission, with particular emphasis on vaccination and outbreak prevention strategies. Methods: A structured narrative review was conducted using a predefined literature search strategy across major scientific databases. Peer-reviewed epidemiological, clinical, and public health publications published between January 2000 and February 2026 were screened and selected according to predefined relevance criteria. Results: The emergence of viral zoonoses is driven by complex interactions among animal reservoirs, environmental and climatic changes, human behavior, and viral adaptation. Although transmission pathways and clinical outcomes differ among pathogens, common determinants of spillover and outbreak amplification were identified. Current evidence supports the importance of integrated surveillance, genomic monitoring, vaccination strategies, and community engagement as key components of preparedness and response. Emerging preventive approaches targeting pathogen transmission, including transmission-blocking strategies and vector-associated microbiota interventions, may provide additional opportunities for disease control. Conclusions: Strengthening preparedness for emerging viral zoonoses requires coordinated One Health approaches integrating human, animal, and environmental health. Future priorities include the development of next-generation vaccines, expansion of digital and genomic surveillance systems, improved equitable access to vaccines, and innovative interventions aimed at reducing zoonotic spillover and interrupting pathogen transmission. Full article

The Yellow River Delta (YRD), a crucial ecotone, is becoming increasingly polluted by antibiotics, posing serious threats to aquatic ecosystems and human health. In this study, comprehensive investigations were conducted to explore the regional distribution, environmental risks, and source apportionment of antibiotics, with the aim of facilitating precise management and control of antibiotic pollution. The results show that the surge in runoff during the water–sediment regulation period (June and August) of the Yellow River drove a sharp rise in antibiotic concentrations in the surface water, peaking at 135.0 ng/L, whereas antibiotics were rarely detected in the sediments after multiple rounds of intense hydraulic scouring (0.2~12.6 ng/g in October). Furthermore, seven antibiotics (sulfadiazine, sulfamethoxazole, flumequine, ofloxacin, tetracycline, doxycycline, and lincomycin) in surface water and six antibiotics (norfloxacin, enrofloxacin, ofloxacin, doxycycline, oxytetracycline, and florfenicol) in sediments were identified as representative compounds according to the antibiotic pollution profiles. Environmental risk assessment coupled with spatial autocorrelation analysis revealed that sulfamethoxazole generally posed medium to high risk (0.12~1.27) in surface water. Sediments posed more serious ecological risks, with universally high risk levels (ranging from 1.11 to 280.00). More importantly, in both surface water and sediment, four core antibiotic sources—namely, human sewage, livestock farming, agricultural and aquaculture inputs, and hydrodynamic-driven resuspension processes—were consistently identified through the Positive Matrix Factorization model and Kriging interpolation. These findings provide crucial insights for establishing targeted antibiotic pollution control strategies in the YRD and advance the understanding of antibiotic fate in sediment-laden rivers. Full article

Schools in Sweden support multilingual students’ language and knowledge development in various ways, including through pedagogical collaboration among multiple professionals. Despite the recognized benefits, however, little is known about how such pedagogical collaboration is understood and practiced by classroom teachers in Sweden. The purpose of the present study is to deepen the understanding of how teachers in the early years of schooling collaborate with heritage language teachers, Swedish as a second language teachers, and special educational needs teachers, in order to support language and knowledge development in second language learners. Individual semi-structured interviews were conducted with 15 Swedish teachers working in the early years of schooling, i.e., from reception year to Grade 3. The interviews were analyzed thematically. Results showed that teachers generally perceive collaboration with other professionals as beneficial. They conceptualized varying forms of pedagogical collaboration, encompassing frequent and flexible collaboration with close colleagues, interdependent collaboration with heritage language teachers (often complicated by structural constraints), and regular, structured collaboration within the student health team. Identified opportunities associated with pedagogical collaboration included the provision of holistic support for second language learners, as well as opportunities for professional development and collegial support. At the same time, several challenges were highlighted, including time-related and structural constraints that hinder collaboration, as well as language barriers and the influence of individual characteristics. Student health teams were highlighted as important for integrating expertise; however, limited teacher insight and the infrequent inclusion of Swedish as a second language teachers were reported to result in multilingual perspectives being overlooked. This study therefore recommends greater consideration of multilingual expertise in assessments of special educational needs and calls for further research on the role of student health teams in supporting second language learners. Full article

Formaldehyde (HCHO), a prevalent indoor air pollutant released from furniture and building materials, poses significant health risks due to its carcinogenic nature. In this study, a binary cuprous oxide–titanium dioxide (Cu₂O–TiO₂) composite photocatalyst was synthesized via a hydrothermal method to enable efficient visible-light-driven degradation of gaseous formaldehyde at ambient temperature. The structural, morphological, and optical properties of the as-prepared catalysts were characterized using XRD, SEM, TEM, EDX, and UV-Vis spectroscopy. While pristine Cu₂O exhibited a formaldehyde degradation efficiency of approximately 68% under white light illumination, the incorporation of TiO₂ markedly enhanced the photocatalytic performance. Among the different mass ratios tested, the Cu₂O–TiO₂ (1:1) composite demonstrated the highest activity, achieving 83% degradation of formaldehyde within 240 min under white light. Enhanced performance is attributed to the formation of a heterojunction that reduces the effective bandgap, promotes charge separation, and suppresses electron–hole recombination. Additionally, the generation of carbon dioxide and water as end products confirmed complete mineralization. The catalyst also showed good reusability, retaining over 81% efficiency after five cycles. This work presents a cost-effective, stable, and visible-light-active Cu₂O–TiO₂ heterojunction photocatalyst with strong potential for indoor air purification applications. Full article

The Arabian honeybee, Apis mellifera jemenitica, is well adapted to the arid and semi-arid conditions of the Arabian Peninsula. However, little is known about the interactions among climatic conditions, Varroa mite, and honeybee viruses affecting A. m. jemenitica colonies. This study investigated the prevalence of Varroa destructor and major honey bee viruses (DWV, BQCV, SBV, CBPV, ABPV, KBV, IAPV and AIV) in A. m. jemenitica colonies located across arid and semi-arid regions of Saudi Arabia. The results revealed a high prevalence of Varroa infestation and DWV in both climatic zones. The other viruses (BQCV, SBV, CBPV, ABPV, KBV, IAPV and AIV) showed significant spatial variation in prevalence across the surveyed regions. Varroa infestation levels were generally low and significantly higher in semi-arid environments compared to arid regions (p < 0.001). Mean regional DWV loads (copies/bee) were consistently low across all A. m. jemenitica colonies (6.8 × 10² to 4.4 × 10³ copies/bee), were positively linked with Varroa infestation levels (R² = 0.63), and demonstrated significant variation among climatic zones (p < 0.001). Virus co-occurrence analysis using Phi (ϕ) coefficients revealed structured viral communities, with several virus pairs exhibiting moderate to strong positive associations. Overall, this study highlights the low DWV loads in A. m. jemenitica colonies, and the impact of climate conditions on Varroa mite–virus interactions in shaping honeybee health under arid and semi-arid conditions. Full article

Objectives: Dyslipidemia is a major driver of cardiovascular disease (CVD), causing a global economic burden. Statins are the mainstay for reducing LDL-C, with pitavastatin (PIT) being the newest-generation statin, showing non-inferior efficacy compared with potent statins. This study aims to assess the cost-effectiveness of pitavastatin in comparison with atorvastatin (ATOR) and rosuvastatin (ROS). Method: The PubMed, Cochrane, and Embase databases were searched to identify full or partial economic evaluations through 19 November 2025. Our primary outcome is the incremental cost-effectiveness ratio (ICER), with health outcomes measured by quality-adjusted life years (QALYs) or percentage reduction in LDL-C. Regarding quality assessment, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 tool was applied. The Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB 2) checklist and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) were performed for RCTs and non-RCT risk assessments, respectively. Result: Five studies were synthesized. One model-based analysis over a lifetime revealed that PIT was less expensive but generated slightly fewer QALYs than ATOR and was dominated by ROS. Four within-trial CEAs with follow-up ≤12 months found that for each 1% reduction in LDL-C, PIT was generally more economical than low-dose ATOR but consistently more costly than ROS. Conclusions: Because of the small number and heterogeneity of studies, it is not possible to draw firm conclusions about the cost-effectiveness of PIT. Further model-based analyses with an adequate sample size and comprehensive costing are needed to clarify the economic role of PIT. Full article

The stroboscopic effect and phantom array effect caused by temporal light modulation (TLM) in light-emitting diode (LED) lighting are important temporal light artifacts (TLAs) that can influence visual perception, task performance, and visual comfort. This review systematically analyzes 40 studies published between 1998 and 2024 to provide a comprehensive overview of the current understanding of both effects. The reviewed literature covers visibility thresholds, influencing parameters, experimental methodologies, and assessment metrics. The analysis shows that reported visibility thresholds for the stroboscopic effect typically range from 550 to 1000 Hz, whereas thresholds for the phantom array effect may extend to 10–15 kHz, suggesting substantial differences in the underlying perceptual mechanisms. In addition to modulation frequency, modulation depth, waveform, duty cycle, luminance, retinal image motion, and observer factors have been identified as important determinants of visibility. The review further highlights significant methodological differences among studies, including variations in experimental design, stimulus generation, participant characteristics, and psychophysical procedures. Although the stroboscopic visibility measure (SVM) provides a standardized framework for evaluating the stroboscopic effect, no comparably validated metric is currently available for the phantom array effect. The review identifies major knowledge gaps regarding the interaction of influencing parameters and the lack of standardized assessment methods. Future research should focus on establishing unified experimental protocols and developing robust metrics for the phantom array effect to support comprehensive lighting standards that protect visual comfort, well-being, and consumer health. Full article