Search Results (978)

A cross-sectional correlational research design was used to investigate the relationship between organizational safety climate, supervisor safety climate, compliance, safety citizenship behaviors and safety self-efficacy. A sample of 728 workers located in a single Eastern European manufacturing plant completed self-report questionnaires regarding the aforementioned constructs. A path analysis revealed that supervisor safety climate partially mediated the relationship between organizational safety climate and the outcome variables, compliance and safety citizenship behaviors. Additionally, safety self-efficacy was found to be positively related to compliance and safety citizenship behaviors. Safety self-efficacy also moderated the relationship between supervisor safety climate and safety citizenship behaviors, such that a stronger positive correlation between safety citizenship behaviors and supervisor safety climate was present when safety self-efficacy was high. The findings suggest safety self-efficacy may be useful in predicting compliance and organizational citizenship behaviors. Further, it is likely that the presence of safety self-efficacy may serve as an enabling factor, which empowers employees who have been motivated by the supervisor safety climate to actually engage in safety citizenship behaviors. Organizations could aim to increase employee safety self-efficacy by encouraging supervisors to role model appropriate safety behaviors, by implementing adequate safety training programs and ensuring information about safety hazards and previous safety incidents is disseminated. Full article

A difficult NP-hard optimization problem, designing cryptographically robust substitution-boxes (S-boxes) necessitates a careful balancing act between several conflicting properties, such as differential uniformity and nonlinearity. Genetic Algorithms (GAs) have been widely used for this task; however, their performance is often limited by premature convergence and insufficient diversity during crossover operations. This primarily occurs because genetic algorithms commence with limited a priori knowledge. This sort of “blindness” and failure to utilize local knowledge results in diminished performance. In GA, the crossover operations facilitate the dissemination of robust candidates within the population. Conventionally, GA implements crossover for each pair of parents for diversity and a robust solution. However, this is not invariably the situation. To enhance children’s candidacy, parental diversity is quite crucial. This paper proposes a similarity-aware crossover strategy, integrated with a Siamese learning framework, to guide the genetic algorithm for improved S-box optimization with better diversity and faster convergence by utilizing parental local information. The proposed model is similarity-aware to guarantee that the GA improves parental diversity. When the parents exhibit excessive similarity, a “regressive” crossover is opted, which ensures the propagation of a parental couple with sufficient diversity to produce superior offspring. The proposed similarity-aware GA model is applied and evaluated to generate cryptographically robust and optimized S-boxes. To verify the robustness in terms of diversity, the model has been tested using three different loss functions: contrastive loss, KL divergence loss, and the suggested method of combining both loss functions to form a hybrid loss function. The effectiveness of the proposed approach is demonstrated through the generation of high-quality S-boxes with strong cryptographic properties. Full article

Picky eating is one of the most frequent feeding problems in childhood and is often dismissed as a normal developmental phase. Despite a steadily expanding body of research, uncertainty persists regarding its clinical relevance, assessment, and management. This review synthesizes recent evidence on picky eating in children, with a specific focus on definitions, epidemiology, developmental trajectories, underlying mechanisms, clinical impact, and interventions. Reliance on broad definitions and prevalence estimates has obscured clinically meaningful distinctions between transient, developmentally typical food selectivity and persistent patterns associated with nutritional risk, functional impairment, and family stress. Drawing on contemporary data, we propose a continuum-based, phenotype-oriented framework that emphasizes persistence, severity, and functional impact rather than food refusal alone. Advances in understanding picky eating have not consistently translated into improved clinical care, highlighting persistent gaps in implementation, access, and dissemination of evidence-based feeding guidance. Finally, we outline priorities for future research and practice aimed at improving outcomes for children with clinically relevant picky eating. Full article

This systematic literature review (SLR) evaluates the existing literature on the benefits, implementation challenges, and ethical concerns associated with Artificial Intelligence (AI)-driven Knowledge Management Systems (KMS) across industries. The SLR followed PRISMA guidelines to identify studies from Scopus, Web of Science, JSTOR, and Google Scholar, using inclusion and exclusion criteria. Critical Appraisal Skills Programme (CASP) checklists were used to assess methodological quality and risk of bias in the included studies, and a structured narrative synthesis was employed to synthesize the findings. The review of 21 articles reveals benefits like improved knowledge capture and creation, storage, retrieval, personalization, and efficient dissemination, which lead to effective decision-making and performance improvements. The implementation barriers are categorized as organizational, technological, ethical, and financial, which generate a lack of trust, inability to manage, lack of interoperability, and monetary constraints. These barriers can be overcome by adopting Kotters’ Eight Stage Change Model, developing interoperability frameworks, evolving ethics benchmarks and standard guidelines for governance, and using viability analyses that incorporate both financial and non-financial considerations. In addition to bridging the gap between AI and KMS theories, the paper also provides practical and actionable insights about managing implementation and governance challenges. Full article

Introduction: Early warning systems reduce losses when risk knowledge, forecasting, communication, and response planning operate as an end-to-end chain, yet Gulf Coast warning practice often treats hazard dynamics, ecosystem change, and social vulnerability as separate domains. This study mapped operational early warning systems for climate-relevant hazards across Louisiana, Texas, Mississippi, Alabama, and Florida and examined whether ecosystem protective functions and social vulnerability were integrated into warning thresholds, dissemination design, and preparedness planning. Methods: I conducted a scoping review using the Web of Science Core Collection and Scopus for publications from 2020 through 18 January 2026 and targeted searches of NOAA/NWS/NHC, FEMA IPAWS, CDC/ATSDR SVI, IOOS/GCOOS, USGS, and state coastal agency portals between 15 September 2025 and 18 January 2026. Of 861 identified records, 440 duplicates were removed, 421 titles and abstracts were screened, 121 full texts were assessed, and 25 sources were included in the final charting and synthesis. Results: The review identified 11 operational systems and related platforms spanning the four early warning pillars, but routine socio-ecological integration remained limited. Louisiana showed the strongest documentation of ecosystem monitoring through CPRA and CRMS, while Florida and Texas showed more developed evacuation and dissemination interfaces. Mississippi and Alabama were represented by thinner monitoring and implementation records in the included sample. Across states, ecosystem loss and social vulnerability were used more often as planning context than as repeatable inputs to thresholds, message tailoring, or assistance triggers. Discussion: Gulf Coast practices can be strengthened through formal protocols that connect ecosystem condition and vulnerability indicators to impact-based briefings, multilingual and accessible alert workflows, and tract-sensitive preparedness actions. The findings indicate that implementation can advance by linking existing datasets to defined operational decisions and by evaluating warning performance through reach, accessibility, comprehension, and action feasibility, as well as technical accuracy. Full article

This study explores health and care workers’ perceptions of the longer-term influence of a rapidly developed digital support package designed to promote psychological wellbeing during the COVID-19 pandemic. A qualitative design was used, involving semi-structured interviews with 20 health and care professionals, including frontline clinicians and senior leaders, who had used and disseminated a theory-informed digital wellbeing package, accessed globally by 82,425 users within its first year. Interviews conducted in 2025 examined participants’ accounts of perceived effects at individual, professional, and organisational levels. Data were analysed using reflexive thematic analysis informed by public mental health, organisational resilience, and implementation science perspectives. Four themes were identified: enhanced psychological wellbeing and coping; changes to professional practice and fatigue management; reframing resilience as a collective and organisational responsibility; and the sustainability and ongoing relevance of the resource beyond the pandemic. Participants described experiences such as reduced stress and anxiety, improved sleep and emotional regulation, sustained use of cognitive–behavioural strategies, and perceived improvements in functioning at work. Some participants also reported that the resource informed their thinking about leadership, psychological safety, and wellbeing practices, and described its continued relevance five years post-release. These qualitative findings illustrate how the digital wellbeing intervention was experienced by participants and how they interpreted its relevance over time. The study suggests that digitally delivered, theory-informed resources may have perceived value for individual capacity building, professional practice, and organisational approaches to resilience within health systems facing ongoing structural pressures. Full article

The literature on the Commercial Determinants of Health has primarily focused on the political power and interventions of corporations versus countermeasures by civil society. However, there is a gap in the discourse concerning industry use of legal threats and actions to silence public health organizations and their public health communication campaigns (PHCCs). This legal review aims to understand legal challenges brought against PHCCs and provide best practices for effective campaigns while minimizing legal risk. We used jurisprudence in Mexico and the United States as proxies for civil and common law countries, supplemented by international law and principles to identify the best defenses and mitigation strategies against defamation and trademark infringement actions. Legal frameworks in these countries demonstrate the ability of aggressive evidence-based public health campaigns to withstand these legal challenges. Based on these legal protections, we recommend that advocates implement PHCCs that (1) contain facts that are true and substantiated with evidence, (2) frame messaging as opinion or satire, (3) highlight the non-commercial purpose of informing people about the impact of their consumption choices on health and well-being and (4) explain how the messaging advances the rights to health and access to information. A PHCC’s success in court can also set important precedents regarding the right of advocates to disseminate and the right of populations to receive important health messages. Following these recommendations and best practices, health advocates can minimize legal risk and continue to provide effective evidence-based PHCCs that promote and protect public health. Full article

Background: Blockchain is increasingly proposed to strengthen pharmaceutical traceability, anti-counterfeiting, and chain of custody in multi-actor supply chains, but the evidence base remains heterogeneous in technical rigor and operational clarity. Methods: We conducted a mapping review of Scopus and Web of Science to map publication patterns, identify dominant thematic configurations, and compare citation-salient studies across recurring solution profiles and operational design dimensions. The final corpus comprised 103 records. Results: The literature expanded rapidly from 2019 to 2025, with notable geographic concentration and dissemination mainly through technically focused outlets. Keyword analysis identified a core traceability theme, an implementation stream centered on smart contracts, Ethereum, and security, and additional streams involving vaccines and regulatory or credentialing concerns. Citation-salient studies clustered into implemented systems and prototypes, architecture or framework proposals, and contextual maturity or decision-layer evidence. Across these profiles, transferability depended less on platform choice than on governance and access-control assumptions, modular smart contract roles, and verifiable on-chain/off-chain data placement. Conclusions: Chain-of-custody semantics and evaluation methods remain inconsistently formalized, limiting cross-study comparability and the interpretability of operational claims. Benchmark-oriented assessments and minimal reporting standards specifying governance parameters, logistics scope and checkpoints, workload, measurement conditions, and concrete evidence artifacts are needed. Full article

The dissemination of sustainable knowledge within the domain of higher education has grown exponentially since the implementation of the UN’s SDGs; however, the body of evidence is currently fragmented across various institutional and educational sectors. This research synthesizes review-level evidence on how institutions of higher education provide for the dissemination of sustainable knowledge and develop the competencies necessary to support it, through a narrative literature review with a supporting structured Web of Science search, transparent narrowing, and interpretive thematic synthesis. An evidence set of focused relevance (2015–2025) was established from an initial total of 6604 records and through the subsequent full-text analysis yielded a final corpus of 63 review articles. Two dominant theme categories were identified: (i) Institutional Embedding and Governance Level Integration and (ii) Educational Level Implementation. A third area of investigation mapped the development of the discipline through both bibliometric and narrative reviews. A common cross-cutting constraint is that specific links between mechanisms/outcomes, as well as comparative analyses of student outcome metrics across studies, are not uniformly documented, which limits cumulative inferences about effective practices. Thus, greater clarity is needed regarding linkages between competence objectives, curriculum, pedagogy, assessment, and measurable outcomes. Additionally, the governance conditions are frequently referenced as enabling factors. Full article

Background/Objectives: Oral health is an essential component of general health, particularly in hospitalized pediatric patients undergoing surgery. Hospitalization may disrupt oral hygiene routines and dietary habits, increasing the risk of oral health deterioration. This prospective observational study aims to develop a standardized oral care protocol for pediatric patients hospitalized for surgical procedures by evaluating changes in oral health status, oral hygiene practices, and dietary habits between hospital admission and discharge. Methods: Children aged 0–17 years undergoing surgery and hospitalized for at least three nights were enrolled. Clinical oral examinations and caregiver-administered questionnaires were performed at admission and at discharge. Oral health status, plaque accumulation, gingival condition, oral pain, hygiene behaviors, and dietary habits were assessed. Results: In total, 118 patients were included. During hospitalization, plaque accumulation significantly increased and oral hygiene practices worsened. Dietary habits changed, with fewer daily meals and a slight reduction in cariogenic food and beverage intake. Oral hygiene instructions or dental examinations were documented in only 2.5% of patients. Based on these observations, a protocol was developed targeting hospitalized patients, their families, and healthcare staff, with the aim of improving oral health conditions during hospitalization. Conclusions: Pediatric surgical hospitalization is associated with a deterioration in oral hygiene behaviors and increased plaque accumulation. The implementation of standardized protocols and the dissemination of preventive oral health knowledge may transform hospitalization into an opportunity to improve oral health in children and adolescents. Full article

Equity in precision cancer health, defined here as equitable access to inclusive cancer risk assessment, cancer risk reduction/management, and risk-appropriate cancer healthcare from prevention through survivorship, is critical for addressing broader population cancer disparities. Specifically, we describe the impact of the Illinois Cancer Health Equity Research (I-CHER) Center on precision cancer health equity, including how the Center cumulatively served >10,000 residents from under-resourced communities; disseminated findings to >300 members of the local cancer health disparities workforce; and translated scientific solutions into sustained clinical practice and two state laws. The objective of this case report is to describe the I-CHER Center’s multisectoral structure; participatory administrative processes for research; early implementation challenges and tensions across sectors; and solutions that contributed to early center-wide successes. This case report offers one example of the administrative infrastructure needed for advancing scientific solutions in precision cancer health equity within a Minority Serving Institution (MSI) and its internal federally qualified health center (FQHC). Full article

This study proposes a GTS-PF (Gradient-based Time-Sequential Potential Field)-based path generation method for real-time reference-path planning at infrastructure-based RSUs in cooperative driving automation environments. Conventional path planning approaches exhibit limitations in computational lightweight characteristics or responsiveness to dynamic environments, which restrict their suitability for negotiation-oriented reference-path generation and dissemination. To address these limitations, the proposed GTS-PF framework interprets the prediction time horizon as a sequence of updated temporal layers, enabling adaptive responses to dynamic obstacle variations. The method is formulated based on potential field principles to allow efficient computation while incorporating diverse interaction effects. A key feature of the proposed approach is the separation of direction planning and speed planning for obstacle avoidance, wherein a candidate acceleration set is generated based on future risk evaluation. Simulation results in an overtaking scenario involving a low-speed preceding vehicle demonstrate that the proposed method satisfies predefined safety and path-quality criteria. Moreover, the computation time was reduced by 81% compared to the baseline method, confirming computational lightweight feasibility for RSU-level implementation and demonstrating applicability in infrastructure-led cooperative driving automation. Full article

Campylobacter spp. constitutes a significant global public health hazard as it is a leading cause of reported foodborne diseases. Human infection is predominantly acquired through the ingestion of contaminated food, unpasteurized milk and untreated water, prompting the widespread implementation of chemical disinfection across several sectors, from healthcare, domestic environments, and food-processing to animal husbandry. While these biocidal agents encompass multiples classes with different modes of action and efficacy, growing evidence suggests that their extensive and repeated use may unintentionally promote bacterial persistence, tolerance and adaptive responses. Although biocide resistance has been documented in several foodborne pathogens, data on biocide tolerance in Campylobacter spp. remain limited. Available studies report variable degrees of reduced susceptibility to commonly used biocides among isolates originating from poultry production, food-processing environments, and water systems. Importantly, while biocide-induced adaptive responses in Campylobacter spp. may potentially overlap with antimicrobial resistance mechanisms, the extent to which these agents drive co-selection, persistence, or dissemination requires further elucidation. Evidence remains limited on the effects of long-term and repeated exposure under realistic processing conditions, the interplay between stress-induced gene regulation and stable genetic changes, and the contribution of mobile genetic elements, biofilm formation, and microbial communities in shaping antimicrobial resistance evolution. In light of the global health burden imposed by campylobacteriosis and the rising challenge of antimicrobial-resistant Campylobacter, this review brings together current evidence on the role of biocides in shaping bacterial survival, adaptation, and resistance mechanisms. Full article

Monkeypox (Mpox) disease, caused by the Monkeypox virus (Mpox virus), emerged as a significant global health threat during the 2022 outbreak, prompting the World Health Organisation (WHO) to declare it a Public Health Emergency of International Concern (PHEIC). Rapid evolution through genomic modifications enhanced its outbreak potential. Zoonotic transmission occurs through close contact with infected rodents or primates; human-to-human transmission occurs via close contact or homosexual intercourse. The virus disseminates via the lymphatic system, causing symptoms ranging from mild skin lesions to severe multi-system complications or even death. Diagnosis incorporates clinical symptoms as well as advanced molecular and immunological methods. Currently, no specific antiviral medications or vaccines are available for Mpox, necessitating reliance on conventional therapeutic supports and treatments developed for smallpox. Raising awareness, promoting protective practices, implementing surveillance, enabling rapid diagnosis, ensuring timely treatment, and promoting mass vaccination are crucial to curb Mpox transmission. This narrative review provides a comprehensive overview of the current knowledge on epidemiology, evolution, transmission, pathogenesis, clinical signs, diagnosis, treatment, vaccination, and prevention strategies for Mpox. Full article

Objective: This exploratory study presents an international, multi-stakeholder snapshot of perceptions regarding real-world data and real-world evidence in health technology assessment. The aim is to identify perceived opportunities, barriers, and enabling conditions rather than to generate generalizable conclusions. Methods: A 21-item, expert-validated questionnaire was distributed via LimeSurvey to diverse health technology assessment stakeholders, including academia, industry, health technology assessment agencies, healthcare providers, policymakers, patients, and payers. The survey explored perceptions of value, methodological and regulatory challenges, and future outlooks for RWD/RWE use in HTA. Ethical approval was obtained by the University of West Attica Ethics Committee, and pilot testing was conducted prior to dissemination. Data were analyzed using descriptive statistics, consistent with the study’s exploratory intent and acknowledging that results are preliminary and not statistically generalizable. Results: Thirty-two completed responses demonstrated preliminary stakeholder support for integrating real-world data and real-world evidence into health technology assessment. Respondents represented academia, industry, HTA agencies, healthcare providers, policymakers, and patient/advocacy groups; however, no payer responses were obtained. Respondents emphasized the value of real-world data in complementing clinical trials by capturing real-world effectiveness, patient diversity, and long-term outcomes, especially in rare diseases and cancer. Key challenges included poor data quality, confounding biases, and regulatory barriers. Stakeholders highlighted the importance of standardization, transparency, and international collaboration. Opportunities included better decision-making, personalized healthcare, and improved post-market monitoring, with strong calls for robust infrastructure, clear methodologies, patient involvement, and supportive health policy frameworks. Conclusions: Real-world data and evidence enhance health technology assessment by supporting better decisions and personalized care. However, issues like data quality, methods, and trust must be addressed through standardization, strong infrastructure, and collaboration to ensure effective and impactful implementation in healthcare, while acknowledging these insights are based on a small exploratory sample. Full article