Search Results (67)

As the Metaverse continues to evolve as a transformative digital ecosystem, its environmental implications remain insufficiently examined within academic discourse. Despite growing interest in its technological and societal impacts, there is a lack of comprehensive evaluations that synthesize existing knowledge on its sustainability potential. This interdisciplinary narrative review addresses this gap by critically exploring how Metaverse technologies intersect with environmental sustainability across key sectors, including education, healthcare, tourism, e-commerce, manufacturing, and urban development. Employing a narrative review methodology informed by a systematic selection of scholarly and industry sources, the study consolidates current practices, emerging opportunities, and notable trade-offs. While the Metaverse presents promising avenues for reducing material consumption, optimizing urban planning through digital twins, and lowering emissions via virtual alternatives to physical travel, it also raises pressing environmental concerns, particularly related to high energy consumption, short hardware lifespans, and the rebound effects of intensified digital engagement. The findings suggest that environmental sustainability within the Metaverse is not inherent to its virtual nature but hinges on deliberate design, regulatory foresight, and the broader energy systems it depends on. This review offers timely insights for policymakers, technology developers, and sustainability advocates seeking to align immersive digital innovation with ecological responsibility and long-term planetary health. Full article

With the arrival of an aging society and the continuous extension of the human lifespan, the quality of life has not improved in a corresponding manner. People’s demand for happiness and health is increasing. As a result, a model emerged that integrates tourism and medical services, which is health tourism. This growing demand has prompted many service providers to see it as a business opportunity and enter the market. Tourism can help travelers release work stress and restore physical and mental balance; meanwhile, health check-ups and disease treatment can help them regain health. Consumers have long favored health and medical tourism because it helps relieve stress and promotes overall well-being. As people age, some consumers experience a gradual decline in physical functions, making it difficult for them to participate in regular travel services provided by traditional travel agencies. Therefore, this study aims to explore the service needs of health and medical tourism customers (tourists/patients) and the interrelationships among these service needs, so that health and medical tourism service providers can develop more customized and diversified services. This study identifies four key drivers of medical tourism services: medical services, medical facilities, tour planning, and hospitality facilities. This study uses the APA (attention and performance analysis) method to assess each dimension and criterion and utilizes the DEMATEL method with the NRM (network relationship map) to identify network relationships. By combining APA and NRM techniques, this study develops the APA-NRM technique to evaluate adoption strategies and identify suitable paths for health tourism services, providing tailored development strategies and recommendations for service providers to enhance the service experience. Full article

This study examines whether regional infrastructure can predict economic resilience in European regions, focusing on resistance, recovery, and reorientation during the COVID-19 crisis. While infrastructure is widely recognized as a key factor influencing regional resilience, its explicit role has been underexplored in the European context. Using a comprehensive literature review and spatial econometric models applied to NUTS-2 level data from 2017 to 2024, we investigate the direct and spatial spillover effects of various infrastructure types—transportation, healthcare, tourism, education, and digital access—on regional resilience outcomes. We apply OLS and four spatial models (SEM, SLX, SDEM, SDM) under 29 spatial weighting matrices to account for spatial autocorrelation. Results show that motorway density, early school leaving, and healthcare infrastructure in neighbouring regions significantly affect resistance. For recovery, railway density and GDP per capita emerge as key predictors, with notable spatial spillovers. Reorientation is shaped by population structure, railway density, and tourism infrastructure, with both positive and negative spatial dynamics observed. The findings underscore the importance of infrastructure not only in isolation but also within regional systems, revealing complex interdependencies. We conclude that policymakers must consider spatial externalities and coordinate infrastructure investments to enhance regional economic resilience across interconnected Europe. Full article

Health tourism is an increasingly vital sector for both Kayseri and Türkiye, contributing significantly to exports and foreign currency inflows. Recent investments in health tourism infrastructure have positioned Kayseri as one of the leading cities in the country, particularly due to its strong healthcare facilities. This study explores Kayseri’s potential in health tourism, with a focus on bariatric surgery, by employing Multi-Criteria Decision Making (MCDM) and optimization methods. The study first provides an extensive literature review to identify the key factors influencing patients’ selection of health institutions for bariatric surgery. Subsequently, the Group Best-Worst Method (G-BWM) is applied using expert input from managers of bariatric surgery centers to determine the relative importance of these factors. Based on the G-BWM findings, nine health institutions in Kayseri offering obesity surgery services are evaluated and ranked using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), which generates institutional performance scores. Building on these results, a Goal Programming model is developed to assign patients to suitable health institutions while simultaneously considering the health institution’s revenue and patient satisfaction. This study offers several novel contributions. It integrates MCDM techniques with goal programming in the context of health tourism—a combination not widely explored in the literature. Additionally, it provides a comparative assessment of the factors influencing health tourists’ decision-making processes, offering policymakers a strategic framework for resource allocation. Lastly, by presenting a mathematical model for patient-institution assignment, the study offers practical guidance for health tourism organizations aiming to enhance both health institution revenue and patient satisfaction in the health tourism sector. Full article

With the rise in patients traveling worldwide for medical treatment in recent years, the importance of patient care continuum has become increasingly evident. We aimed to analyze the role of video consultations in facilitating medical care for patients traveling internationally for medical care in South Korea. In this retrospective study, data were gathered on video consultations for international medical travelers conducted between January 2021 and December 2023 at a single tertiary hospital. We analyzed information on patient demographics, the content of video consultation, and how these factors were associated with the patient’s decision to travel for treatment. A total of 16.5% of international medical travel patients who underwent video consultation subsequently traveled for treatment. Patients who engaged directly with the institution were more likely (aOR 5.74, [95% CI 1.20–27.33]) to travel for treatment compared to those who relied on domestic or international travel services. Additionally, patients who participated in follow-up video consultations were more likely (aOR 4.06, [95% CI 1.04–15.92]) to travel compared to those who underwent their first video consultation. International medical travel patients utilized video consultations for a range of medical conditions, with the likelihood of subsequent treatment travel being associated with both the medium through which consultations were initiated and prior experience with the institution. Full article

This study explores the intricate relationship between the growth of medical tourism in Malaysia and its impacts on the local community, particularly focusing on residents’ quality of life. Malaysia’s status as a competitive destination for affordable, high-quality healthcare services has led to significant economic growth, including increased healthcare revenue, job creation, and infrastructure improvements. However, the influx of foreign patients has raised concerns regarding healthcare accessibility for locals and the strain on local resources. Data from 361 respondents were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results indicate that medical tourism positively affects economic performance, with a significant path coefficient (β = 0.434, p < 0.01), showing a strong correlation between economic benefits and perceived improvement from medical tourism development. Similarly, personal benefits from the industry have a positive influence on quality of life (β = 0.202, p < 0.05). However, this study also reveals that attitudes towards medical tourism do not significantly impact residents’ perceptions of quality of life (β = 0.057, p > 0.05), highlighting social disparities in how different groups experience the effects of this industry. The findings suggest that while medical tourism offers economic advantages, challenges such as reduced healthcare access for locals and the growing commercialization of healthcare must be addressed. This study concludes with recommendations for sustainable policy interventions to balance the economic growth of medical tourism with the well-being of local communities. Full article

This study explores the spatial distribution of food services and their colocation with surrounding complementary services. It investigates these issues within the Guangdong–Hong Kong–Macao Greater Bay Area (GBA), utilizing point-of-interest (POI) data, spatial kernel density, the HDBSCAN clustering algorithm, and colocation quotients. The findings are as follows: (1) this research reveals a significant spatial agglomeration of food services near the Pearl River, with notable food clusters across administrative boundaries; (2) Guangzhou, Shenzhen, Foshan, and Dongguan provide a significant quantity of food services, while Hong Kong and Macao feature the highest percentages of foreign cuisine; (3) the colocation between food services and surrounding services is concentrated along the Pearl River; (4) leisure, education, and residential services are key factors attracting the proximity of food services; (5) leisure, education, retail, and tourism services exhibit the strongest attractiveness to Chinese food, while residential and healthcare services are closely linked to the distribution of snacks, and transportation services attract snacks and beverages. Full article

Background and Objectives: Chronic low back pain is a widespread condition, particularly in older populations, contributing to physical, mental, and social burdens. Traditional treatments, such as medications and surgery, carry long-term risks, including dependency, side-effects, and complications from invasive procedures. Additionally, healthcare accessibility is limited due to high costs, long waiting times, and geographic disparities in healthcare services, particularly in rural areas. For these reasons, non-pharmacological approaches that address both physical and psychological aspects are increasingly recognized as effective. This study aimed to evaluate the effectiveness of a marine resource-based healing program in Taean, South Korea, in improving pain, physical function, and mental health in patients with non-specific chronic low back pain. Materials and Methods: This randomized controlled trial involved 46 participants with non-specific chronic low back pain (mean age, 68.7 ± 5.1 years), randomly allocated to either an experimental group (marine healing program) or a control group (core exercises). The experimental group participated in a 4-night, 5-day intervention comprising heated peat pack therapy, mindfulness meditation, core exercises, and local tourism. The control group performed core exercises without additional interventions. Key outcomes included pain, muscle properties, functional disability, lower extremity function, balance, gait, and depression. Results: The experimental group demonstrated significant reductions in resting pain (p < 0.001), improved pressure pain threshold at L3 (p < 0.001), decreased L3 muscle tone (p = 0.015), and improved functional disability scores (p < 0.001). Functional gains were observed in lower extremity function scores (p < 0.001), balance (sway area: p = 0.046), gait velocity (p < 0.001), and depression levels (p < 0.001). Conclusions: The marine healing program significantly improved pain, functional abilities, and mental well-being in patients with non-specific chronic low back pain, highlighting its potential as an integrative approach to chronic low back pain management. Further studies are recommended to explore long-term and generalized effects. Full article

This study examined social determinants associated with Korean American immigrant women’s mammography use in Korea after immigration to the United States. Data from a cross-sectional survey were obtained from 187 women in Los Angeles County, California. More than one-quarter (28.3%) of the respondents reported returning to Korea for a mammogram after immigrating to the United States. Multivariable logistic regression revealed that compared to those who had their first mammogram in Korea, Korean American immigrant women who had their first mammogram in the United States were less likely to return to Korea for subsequent screenings (AOR = 0.02, 95% CI: <0.001, 0.05); also, those who had employer-based health insurance in the United States were less likely to get a mammogram in Korea after immigration (AOR = 0.01, 95% CI: <0.01, 0.18). Findings suggest that women familiar with the Korean healthcare system and who are uninsured or have inconsistent healthcare coverage in the United States may seek care in Korea. To promote adherence to breast cancer screening guidelines among Korean American immigrant women residing in the United States, greater access to free or low-cost screening services and breast cancer screening education is warranted to reduce the risk of later stage breast cancer detection resulting from medical tourism. Full article

This study evaluates the efficiency of public hospitals in Greece during the COVID-19 epidemic in 2020, using Data Envelopment Analysis (DEA) and the Analytical Hierarchy Process (AHP). Faced with unprecedented pressure from increased demand for medical services, these hospitals had to adapt quickly while playing a crucial role in supporting local economies, similar to the effect of tourism on rural economies. This study reveals that, despite average efficiency scores of 83% for result-oriented models (BCC) and 65% for constant return models (CCR), inefficiencies of scale emerged under the pressures of the pandemic. The AHP, by incorporating qualitative criteria and decision-makers’ preferences, offers a valuable perspective but shows little correlation with DEA’s quantitative results. This research emphasizes the importance of utilizing integrated methods to formulate a more comprehensive assessment, adapted to the complex challenges of the healthcare sector during crisis periods. Full article

Culture and tourism are crucial for economic growth and sustainable development, working together symbiotically. Culture boosts tourism by supporting heritage, production, and creativity, while cultural heritage, reflecting national identity and traditions, strengthens local economies. This study uses a panel data analysis to examine the impact of cultural factors on international tourist arrivals in 27 EU nations. The Driscoll–Kraay method reveals that UNESCO World Heritage Sites, government cultural expenditures, household recreation and cultural expenditures, real GDP per job, and bed capacity positively influence international tourist numbers. Regarding cultural factors, World Heritage Sites have the most significant influence, with each additional UNESCO site leading to a 0.22% rise in tourist numbers. The most crucial determinant of tourist arrivals is bed capacity, with a one percent increase leading to a 0.66% increase in tourist arrivals. Conversely, healthcare expenditures and political civil liberties have a negative impact on tourist arrivals. This study discusses managerial implications and offers recommendations for future research. Full article

Assistive robotic platforms have recently gained popularity in various healthcare applications, and their use has expanded to social settings such as education, tourism, and manufacturing. These social robots, often in the form of bio-inspired humanoid systems, provide significant psychological and physiological benefits through one-on-one interactions. To optimize the interaction between social robotic platforms and humans, it is crucial for these robots to identify and mimic human motions in real time. This research presents a motion prediction model developed using convolutional neural networks (CNNs) to efficiently determine the type of motions at the initial state. Once identified, the corresponding reactions of the robots are executed by moving their joints along specific trajectories derived through temporal alignment and stored in a pre-selected motion library. In this study, we developed a multi-axial robotic arm integrated with a motion identification model to interact with humans by emulating their movements. The robotic arm follows pre-selected trajectories for corresponding interactions, which are generated based on identified human motions. To address the nonlinearities and cross-coupled dynamics of the robotic system, we applied a control strategy for precise motion tracking. This integrated system ensures that the robotic arm can achieve adequate controlled outcomes, thus validating the feasibility of such an interactive robotic system in providing effective bio-inspired motion emulation. Full article

In the era of digitization and technical breakthroughs, artificial intelligence (AI) has progressively found its way into the field of customer relationship management (CRM), bringing benefits as well as difficulties to businesses. AI, particularly in the context of CRM, employs machine learning (ML) and deep learning (DL) techniques to extract knowledge from data, recognize trends, make decisions, and learn from mistakes with minimal human intervention. Successful firms have effectively integrated AI into CRM for predictive analytics, computer vision, sentiment analysis, personalized recommendations, chatbots and virtual assistants, and voice and speech recognition. AI-driven chatbots, one of the AI-powered CRM systems, arose as a disruptive approach to customer service, and as such, unfolded with economic and managerial ramifications in CRM. Given the literature’s focus on other AI-driven systems, there is an obvious need for an investigation of industry applications and the implications of AI-driven chatbots in CRM. The purpose of this study is to explore and elucidate the economic and managerial implications of AI-powered chatbots within CRM systems. This investigation aims to provide a comprehensive understanding of how these technologies can enhance customer interactions, streamline business processes, and impact organizational strategies. To reach this goal, this study conducts a comparative qualitative analysis based on many interviews with experts and contributors in the field. Interviews with CRM specialists yielded insights into the use of AI-driven chatbots in CRM and their impact on the industry. The primary advantages identified in this study were the impact of AI-powered chatbots on cost, efficiency, and human performance. In addition, AI chatbots have proven useful in a variety of industries, including retail and tourism. Nonetheless, there were limitations to its usage in the healthcare system, particularly in terms of ethical problems. Full article

Blockchain technology promises transformative potential across diverse sectors, facilitating innovations in areas ranging from finance to healthcare. Despite its many promising applications, several barriers—including scalability challenges, regulatory complexities, and technical hurdles—limit its widespread adoption. This systematic literature review delves into scalability enhancements and explores the legal and regulatory landscapes impacting blockchain deployment in ten key sectors: IoT, healthcare, finance, education, social media, genomics, supply chain, vehicular networks, e-voting, and tourism. These sectors were selected based on their significant engagement with blockchain technology and their prominence in the analyzed literature. We examine key technological advancements such as Layer-2 techniques, sharding, consensus algorithm optimization, and rollups, and discuss their implications for throughput, latency, and compliance with regulatory standards such as the General Data Protection Regulation (GDPR). The review details these technological and regulatory developments and discusses their broader implications for industry and academia, emphasizing the need for interdisciplinary research and innovation. By identifying gaps in current research and suggesting future directions, this study serves as a roadmap for researchers, practitioners, and policymakers to develop secure, scalable, and compliant blockchain systems. Our comprehensive examination provides valuable insights into enhancing the efficiency, security, and regulatory compliance of blockchain technology. Full article

Montenegro restored its national independence in 2006, and in the 17 years since then, the country has made significant progress in digital transformation, which is especially important for its accession to the European Union. In this paper, this period of 17 years of Montenegrin digital transformation is reviewed. The work aims to provide comprehensive coverage of the digitization processes across all relevant sectors, including healthcare, education, telecommunications and internet, personal and public transportation, tourism, agriculture, energy and sustainability, and public administration. The human-centric nature of digitization is emphasized where relevant, as well as related future trends. This paper also highlights barriers and limitations, such as the lack of consideration for cooperative intelligent transportation systems in national strategies, and user-related issues in digital public administration. Full article