Search Results (2,307)

Identifying habitat characteristics is essential for conserving critically endangered species. When quantifying species habitat characteristics, ignoring data types may lead to misunderstandings about species’ specific habitat requirements. This study focused on the critically endangered Chinese pangolin in Guangdong Province, China, and divided the study area into 600 m × 600 m grids based on its average home range. The burrow number within each grid was obtained through line transect surveys, with burrow numbers/line transect lengths used as direct indicators of habitat utilization intensity. The relationships with sixteen environmental variables, which could be divided into three categories, including topographic, human disturbance and land cover composition, were quantified using the GAM method. We also converted continuous data into binary data (0, 1), constructed GAMs and compared them with habitat utilization intensity models. Our results indicate that the habitat utilization intensity model identified profile curvature and slope as primary factors, showing a nonlinear response to profile curvature (Edf = 5.610, p = 0.014) and a positive relationship with slope (Edf = 1.000, p = 0.006). The presence–absence model emphasized distance to water (Edf = 1.000, p = 0.014), slope (Edf = 1.709, p = 0.043) and aspect (Edf = 2.000, p = 0.026). The intensity model explained significantly more deviance, captured complex nonlinear relationships and supported higher model complexity without overfitting. This study demonstrates that habitat utilization intensity data provides a more ecologically informative basis for in situ conservation (e.g., identifying core habitats), and the process from habitat selection to habitat utilization should be integrated to reveal species’ habitat characteristics. Full article

Background: This study aims to compare the logistical challenges of Home Health Care (HHC) services in Portugal and Brazil, highlighting the structural and operational differences between both systems. Methods: Guided by an abductive research approach, data were collected using a semi-structured survey with open-ended questions, applied to 13 HHC teams in Portugal and 18 in Brazil, selected based on national coordination recommendations. The data collection process was conducted in person, and responses were analyzed using descriptive statistics and qualitative content analysis. Results: The results reveal that Portugal demonstrates higher productivity, stronger territorial coverage, and a more integrated inventory management system, while Brazil presents greater multidisciplinary team integration, more flexible fleet logistics, and more advanced digital health records. Despite these strengths, both countries continue to address key logistical aspects, such as scheduling, supply distribution, and data management, largely through empirical strategies. Conclusions: This research contributes to the theoretical understanding of international HHC logistics by emphasizing strategic and systemic aspects often overlooked in operational studies. In practical terms, it offers insights for public health managers to improve resource allocation, fleet coordination, and digital integration in aging societies. Full article

Background: Delirium is a common, underdiagnosed neuropsychiatric syndrome in older adults, associated with high mortality and functional decline. Given its multifactorial nature and overlap with frailty, radiological markers may improve risk stratification in the emergency department (ED). Methods: We conducted a retrospective study on a small sample of 30 patients diagnosed with delirium in the emergency department who had recently undergone brain, thoracic, or abdominal CT scans for unrelated clinical indications. Using post-processing software, we analyzed radiological markers, including coronary artery calcifications (to estimate vascular age), cerebral atrophy (via the Global Cortical Atrophy scale), and cachexia (based on abdominal fat and psoas muscle volumetry). Results: Five domains were identified as significant predictors of 12-month mortality in univariate Cox regression: vascular age, delirium etiology, cerebral atrophy, delirium subtype (hyperactive vs. hypoactive), and cachexia. Based on these domains, we developed an exploratory 10-point delirium score. This score demonstrated acceptable diagnostic accuracy for mortality prediction (sensitivity 0.93, specificity 0.73, positive predictive value 0.77, negative predictive value 0.91) in this limited cohort. Conclusions: While preliminary and based on a small, retrospective sample of 30 patients, this multidimensional approach integrating clinical and radiological data may help improve risk stratification in elderly patients with delirium. Radiological phenotyping, particularly in terms of vascular aging and sarcopenia/cachexia, offers objective insights into patient frailty and could inform more personalized treatment pathways from the ED to safe discharge home, pending further validation. Full article

Background: Understanding the origin and natural organization of early infant vocalizations is important for predicting communication and language abilities in later years. The very frequent production of speech-like vocalizations (hereafter “protophones”), occurring largely independently of interaction, is part of this developmental process. Objectives: This study aims to investigate the gap durations (time intervals) between protophones, comparing typically developing (TD) infants and infants later diagnosed with autism spectrum disorder (ASD) in a naturalistic setting where endogenous protophones occur frequently. Additionally, we explore potential age-related variations and sex differences in gap durations. Methods: We analyzed ~1500 five min recording segments from longitudinal all-day home recordings of 147 infants (103 TD infants and 44 autistic infants) during their first year of life. The data included over 90,000 infant protophones. Human coding was employed to ensure maximally accurate timing data. This method included the human judgment of gap durations specified based on time-domain and spectrographic displays. Results and Conclusions: Short gap durations occurred between protophones produced by infants, with a mode between 301 and 400 ms, roughly the length of an infant syllable, across all diagnoses, sex, and age groups. However, we found significant differences in the gap duration distributions between ASD and TD groups when infant-directed speech (IDS) was relatively frequent, as well as across age groups and sexes. The Generalized Linear Modeling (GLM) results confirmed these findings and revealed longer gap durations associated with higher IDS, female sex, older age, and TD diagnosis. Age-related differences and sex differences were highly significant for both diagnosis groups. Full article

Japan’s 8.5 million vacant homes (Akiyas) represent a paradox of scarcity amid surplus: while rural depopulation leaves properties abandoned, housing shortages and bureaucratic inefficiencies hinder their reuse. This study proposes AKI2ALL, an AI-blockchain framework designed to automate the circular repurposing of Akiyas into ten high-value community assets—guesthouses, co-working spaces, pop-up retail and logistics hubs, urban farming hubs, disaster relief housing, parking lots, elderly daycare centers, exhibition spaces, places for food and beverages, and company offices—through smart contracts and data-driven workflows. By integrating circular economy principles with decentralized technology, AKI2ALL streamlines property transitions, tax validation, and administrative processes, reducing operational costs while preserving embodied carbon in existing structures. Municipalities list properties, owners select uses, and AI optimizes assignments based on real-time demand. This work bridges gaps in digital construction governance, proving that automating trust and accountability can transform systemic inefficiencies into opportunities for community-led, low-carbon regeneration, highlighting its potential as a scalable model for global vacant property reuse. Full article

Objective: Given the critical workforce challenges in home care settings and the limited understanding of empowerment mechanisms in isolated work environments, this study aimed to examine how structural empowerment influences psychological empowerment among home care workers in South Korea through the mediating pathways of thriving at work and caregiver reciprocity. Based on Kanter’s empowerment theory, we specifically investigated the serial mediation effects to understand the complex processes through which organizational support structures translate into enhanced worker empowerment. Methods: A cross-sectional survey was conducted with 192 home care workers. Data were analyzed using descriptive statistics, correlation analysis, and serial multiple mediation analysis using SPSS Process Macro Model 6. Results: Structural empowerment demonstrated significant positive correlations with thriving at work (r = 0.445, p < 0.001), caregiver reciprocity (r = 0.490, p < 0.001), and psychological empowerment (r = 0.337, p < 0.001). Thriving at work significantly influenced both caregiver reciprocity (β = 0.3968, p < 0.001) and psychological empowerment (β = 0.1685, p < 0.001). The serial mediation analysis revealed that the indirect effect of structural empowerment on psychological empowerment through thriving at work and caregiver reciprocity was statistically significant (indirect effect = 0.1327, 95% CI [0.0713, 0.1929]), with the model explaining 58% of the variance in psychological empowerment. Conclusions: Structural empowerment significantly enhances psychological empowerment among home care workers through the sequential mediation of thriving at work and caregiver reciprocity. Healthcare organizations should prioritize strengthening structural empowerment through comprehensive support systems and conducive work environments to optimize care quality and worker well-being. Full article

Data over sound (DoS) is an established technique that has experienced a resurgence in recent years, finding applications in areas such as contactless payments, device pairing, authentication, presence detection, toys, and offline data transfer. This study introduces CardiaWhisper, a system that extends the DoS concept to the medical domain by using a medical data-over-sound (MDoS) framework. CardiaWhisper integrates wearable biomedical sensors with home care systems, edge or IoT gateways, and telemedical networks or cloud platforms. Using a transmitter device, vital signs such as ECG (electrocardiogram) signals, PPG (photoplethysmogram) signals, RR (respiratory rate), and ACC (acceleration/movement) are sensed, conditioned, encoded, and acoustically transmitted to a nearby receiver—typically a smartphone, tablet, or other gadget—and can be further relayed to edge and cloud infrastructures. As a case study, this paper presents the real-time transmission and processing of ECG signals. The transmitter integrates an ECG sensing module, an encoder (either a PLL-based FM modulator chip or a microcontroller), and a sound emitter in the form of a standard piezoelectric speaker. The receiver, in the form of a mobile phone, tablet, or desktop computer, captures the acoustic signal via its built-in microphone and executes software routines to decode the data. It then enables a range of control and visualization functions for both local and remote users. Emphasis is placed on describing the system architecture and its key components, as well as the software methodologies used for signal decoding on the receiver side, where several algorithms are implemented using open-source, platform-independent technologies, such as JavaScript, HTML, and CSS. While the main focus is on the transmission of analog data, digital data transmission is also illustrated. The CardiaWhisper system is evaluated across several performance parameters, including functionality, complexity, speed, noise immunity, power consumption, range, and cost-efficiency. Quantitative measurements of the signal-to-noise ratio (SNR) were performed in various realistic indoor scenarios, including different distances, obstacles, and noise environments. Preliminary results are presented, along with a discussion of design challenges, limitations, and feasible applications. Our experience demonstrates that CardiaWhisper provides a low-power, eco-friendly alternative to traditional RF or Bluetooth-based medical wearables in various applications. Full article

Background/objective: Tailoring involves adapting research findings and evidence to suit specific contexts and audiences. This study examines how international stroke guidelines can be tailored to address gait issues after a stroke. Methods: A three-phase consensus method approach was used. A 10-member health experts panel extracted recommendations from three national clinical guidelines in the first phase. In the second phase, 362 physiotherapists completed an online questionnaire to assess the feasibility of adopting the extracted recommendations. In the third phase, a 15-physical therapist consensus workshop was convened to clarify factors that might affect the tailoring process of the extracted recommendations of gait disorder rehabilitation. Results: In phase one, 21 recommendations reached consensus. In the second phase, 362 stroke physiotherapists rated the applicability of these recommendations: 14 rated high, 7 rated low, and none were rejected. The third phase, a nominal group meeting (NGM), explored four themes related to tailoring. The first theme, “organizational factors”, includes elements such as clinical setting, culture, and regulations. The second theme, “individual clinician factors”, assesses aspects like clinical experience, expertise, abilities, knowledge, and attitudes toward tailoring. The third theme, “patient factors”, addresses issues related to multimorbidity, comorbidities, patient engagement, and shared decision-making. The final theme, “other factors”, examines the impact of research design on tailoring. Conclusions: Tailoring international clinical guidelines involves multiple factors. This situation brings home the importance of a systematic strategy for tailoring that incorporates various assessment criteria to enhance the use of clinical evidence. Future research should investigate additional implementation theories to enhance the translation of evidence into practice. Full article

A process evaluation was embedded in the multinational Music Interventions for Dementia and Depression in ELderly care (MIDDEL) trial to better understand barriers and facilitators for implementing music-based interventions (MBIs). Stakeholders from 66 care home units across 5 countries completed a survey at baseline (n = 229) and after a six-month intervention period (n = 101), comparing expectations and experiences between countries, intervention groups, and stakeholders. MBIs were evaluated and found to be relevant and feasible. Barriers include a lack of support, turnover among employees, and a lack of motivation. Facilitators include individual stakeholders who proactively facilitate and stimulate implementation, as well as the presence of stable, well-functioning teams, clear communication, and adhering to project plans. Fewer barriers than expected related to care staff workload and the time needed for implementing new MBIs in care homes. MBIs can be beneficial for people with dementia, yet implementation in care homes can be challenging due to contextual factors. Involving stakeholders in key positions is essential: care home managers are pivotal for policy-making and the sustainable adoption of MBIs, whereas the commitment and the involvement of care staff are needed for day-to-day implementation. Insight into these barriers to and facilitators of implementation can contribute to the interpretation of trial results. Full article

This article demonstrates how positioning residents as active co-designers fundamentally transforms both the process and outcomes of carbon-positive building development. Through structured collaborative workshops, shared decision-making protocols, and continuous partnership throughout the building lifecycle, the REN+HOMES Positive Carbon Building methodology challenges the conventional expert-driven approach to sustainable construction. Developed and validated through the H2020 REN+HOMES project, this resident-centered approach achieved remarkable technical performance—65.9% reduction in final energy demand—while simultaneously enhancing community ownership and long-term sustainability practices. By integrating participatory design with Zero Emissions Building (ZEB) criteria, renewable energy systems, and national carbon offset programs, the methodology proves that resident collaboration is not merely beneficial but essential for creating buildings that truly serve both environmental and human needs. This research establishes a new paradigm where technical excellence emerges from authentic partnership between residents and sustainability experts, offering a replicable framework for community-driven environmental regeneration. Full article

In the context of global demographic aging, falls among the elderly remain a major public health concern, often leading to injury, hospitalization, and loss of autonomy. This study proposes a real-time fall detection system that combines a modern computer vision model, YOLOv11 with integrated pose estimation, and an Artificial Intelligence (AI)-based voice assistant designed to reduce false alarms and improve intervention efficiency and reliability. The system continuously monitors human posture via video input, detects fall events based on body dynamics and keypoint analysis, and initiates a voice-based interaction to assess the user’s condition. Depending on the user’s verbal response or the absence thereof, the system determines whether to trigger an emergency alert to caregivers or family members. All processing, including speech recognition and response generation, is performed locally to preserve user privacy and ensure low-latency performance. The approach is designed to support independent living for older adults. Evaluation of 200 simulated video sequences acquired by the development team demonstrated high precision and recall, along with a decrease in false positives when incorporating voice-based confirmation. In addition, the system was also evaluated on an external dataset to assess its robustness. Our results highlight the system’s reliability and scalability for real-world in-home elderly monitoring applications. Full article

As the cradle of Jiangnan culture, Suzhou is home to a dense concentration of historical architectural heritage that is currently facing existential threats from rapid urbanization. This study aims to develop a spatial heritage corridor network for conservation and sustainable utilization. Using kernel density estimation, this study identifies 15 kernel density groups, along with the Analytic Hierarchy Process (AHP), to pinpoint clusters of historical architectural heritage and assess the involved resistance factors. Current Effective Conductance (CEC) theory is further applied to model spatial flow relationships among heritage nodes, leading to the delineation of 27 heritage corridors and revealing a spatial structure characterized by one primary core, one secondary core, and multiple peripheral zones. Based on 15 source points, six cultural relics-themed routes are proposed—three land-based and three waterfront routes—connecting historical sites, towns, and ecological areas. The study further recommends a resource management strategy centered on departmental collaboration, digital integration, and community co-governance. By integrating historical architectural types, settlement forms, and ecological patterns, the research builds a multi-scale narrative and experience system that addresses fragmentation while improving coordination and sustainability. This framework delivers practical advice on heritage conservation and cultural tourism development in Suzhou and the broader Jiangnan region. Full article

The insulin-like growth factor binding protein, acid-labile subunit (IGFALS), plays a crucial role in glucose metabolism and immune regulation, key processes in recovery from surgery. Here, we studied the perioperative serum IGFALS dynamics and explored potential clinical implications. A total of 79 patients undergoing elective cardiac surgery with implementation of cardiopulmonary bypass had their serum isolated at baseline, 24 h, seven days, and three months postoperatively to assess serum concentrations of IGFALS and insulin growth factor 1 (IGF-1). Markers of perioperative injury included troponin I (TnI), high-mobility group box 1 (HMGB-1), and heat shock protein 60 (Hsp-60). Inflammatory status was assessed via interleukin-6 (IL-6) and interleukin-8 (IL-8). Additionally, we measured in vitro cytokine production to viral stimulation of whole blood and monocytes. Surrogates of neuronal distress included neurofilament light chain (NF-L), total tau (τ), phosphorylated tau at threonine 181 (τp181), and amyloid β40 and β42. Renal impairment was defined by RIFLE criteria. Cardiac dysfunction was denoted by serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Serum IGFALS levels declined significantly after surgery and remained depressed even at 3 months. Administration of acetaminophen and acetylsalicylic acid differentiated IGFALS levels at the 24 h postoperatively. Serum IGFALS 24 h post-operatively correlated with production of cytokines by leukocytes after in vitro viral stimulation. Serum amyloid-β1-42 was significantly associated with IGFALS at baseline and 24 h post-surgery Patients discharged home had higher IGFALS levels at 28 days and 3 months than those discharged to healthcare facilities or who died. These findings suggest that IGFALS may serve as a prognostic biomarker for recovery trajectory and postoperative outcomes in cardiac surgery patients. Full article

This study provides a detailed dataset from two modern homes constructed inside an environmentally controlled chamber. These data are used to carefully calibrate a dynamic thermal simulation model of these homes. The calibrated models show good agreement with measurements taken under controlled conditions. The two case study homes, “The Future Home” and “eHome2”, were constructed within the University of Salford’s Energy House 2.0, and high-quality data were collected over eight days. The calibration process involved updating U-values, air permeability rates, and modelling refinements, such as roof ventilation, ground temperatures, and sub-floor void exchange rates, set as boundary conditions. Results demonstrated a high level of accuracy, with performance gaps in whole-house heat transfer coefficient reduced to 0.5% for “The Future Home” and 0.6% for “eHome2”, falling within aggregate heat loss test uncertainty ranges by a significant amount. The study highlights the improved accuracy of calibrated dynamic thermal simulation models, compared to results from the steady-state Standard Assessment Procedure model. By providing openly accessible calibrated models and a clearly defined methodology, this research presents valuable resources for future building performance modelling studies. The findings support the UK’s transition to dynamic modelling approaches proposed in the recently introduced Home Energy Model approach, contributing to improved prediction of energy efficiency and aligning with goals for zero carbon ready and sustainable housing development. Full article

Older people’s social participation is being shaped by the current context of “liquid modernity,” characterized by the erosion of traditional roles and identity, fragile social ties, individualism, economic precariousness, and uncertainty. The challenges entailed by these trends can be exacerbated when a circumstance, such as being the parent of an adult with a physical disability, is combined with old age. This study aimed to explore how this dual condition influences processes of aging and community participation. This work presents the findings of a phenomenological study conducted in 2025 through semi-structured interviews with a sample of 24 elderly people with children diagnosed with spina bifida. The results show that the children’s support needs, especially when they live with their parents, but also if they have become independent, impact the parents’ aging and social participation processes. Likewise, concern for the future is identified as a recurring aspect due to the children’s lack of support from a social network. It was concluded that public administrations and non-profit organizations should develop social intervention strategies aimed at promoting social participation, guaranteeing external assistance in the home, and providing coexistence resources. Full article