Search Results (2,996)

The rapid growth of e-commerce and advances in information and communication technologies have placed increasing pressure on last-mile delivery companies to enhance operational productivity. As investments in logistics infrastructure require long-term planning, maximizing the efficiency of existing terminal operations has become a critical priority. This study proposes a mathematical model for inbound truck scheduling that simultaneously minimizes truck waiting times and balances workload across temporary inventory storage located at outbound chutes in cross-docking terminals. The model incorporates a dynamic rescheduling strategy that updates the assignment of inbound trucks in real time, based on the latest terminal conditions. Numerical experiments, based on real operational data, demonstrate that the proposed approach significantly outperforms conventional strategies such as First-In First-Out (FIFO) and Random assignment in terms of both load balancing and truck turnaround efficiency. In particular, the proposed model improves workload balance by approximately 10% and 12% compared to the FIFO and Random strategies, respectively, and it reduces average truck waiting time by 17% and 18%, thereby contributing to more efficient workflow and alleviating bottlenecks. The findings highlight the practical potential of the proposed strategy for improving the responsiveness and efficiency of parcel distribution centers operating under fixed infrastructure constraints. Future research may extend the proposed approach by incorporating realistic operational factors, such as cargo heterogeneity, uncertain arrivals, and terminal shutdowns due to limited chute storage. Full article

Polyethylenimine (PEI) is a cationic polymer with a high density of amine groups suitable for strong electrostatic interactions with biological molecules to preserve their bioactivities during encapsulation and after delivery for biomedical applications. This review provides a comprehensive overview of PEI as a drug and gene carrier, describing its polymerization methods in both linear and branched forms while highlighting the processing methods to manufacture PEIs into drug carriers, such as nanoparticles, coatings, nanofibers, hydrogels, and films. These various PEI carriers enable applications in non-viral gene and small molecule drug deliveries. The structure–property relationships of PEI carriers are discussed with emphasis on how molecular weights, branching degrees, and surface modifications of PEI carriers impact biocompatibility, transfection efficiency, and cellular interactions. While PEI offers remarkable potential for drug and gene delivery, its clinical translation remains limited by challenges, including cytotoxicity, non-degradability, and serum instability. Our aim is to provide an understanding of PEI and the structure–property relationships of its carrier forms to inform future research directions that may enable safe and effective clinical use of PEI carriers for drug and gene delivery. Full article

Background and Clinical Significance: Brugada syndrome (BrS) is a rare inherited cardiac channelopathy, often associated with SCN5A loss-of-function mutations. Clinical presentations range from asymptomatic to malignant arrhythmias and sudden cardiac death. Physiological and pharmacological stressors affecting sodium channel function—such as pyrexia, certain medications, and possibly pregnancy—may unmask or exacerbate arrhythmic risk. However, there is limited information regarding pregnancy and obstetric outcomes. Obstetric management remains largely informed by isolated case reports and small case series. A literature review was conducted using OVID Medline and Embase, identifying case reports, case series, and one retrospective cohort study reporting clinical presentation, obstetric management, and outcomes in maternal BrS. A case is presented detailing coordinated multidisciplinary input, antenatal surveillance, and intrapartum and postpartum care to contribute to the growing evidence base guiding obstetric care in this complex setting. Case Presentation: A 30-year-old G2P0 woman with asymptomatic BrS (SCN5A-positive) was referred at 31 + 5 weeks’ gestation for multidisciplinary antenatal care. Regular review and collaborative planning involving cardiology, anaesthetics, maternal–fetal medicine, and obstetrics guided a plan for vaginal delivery with continuous cardiac and fetal monitoring. At 38 + 0 weeks, the woman presented with spontaneous rupture of membranes and underwent induction of labour. A normal vaginal delivery was achieved without arrhythmic events. Epidural block with ropivacaine and local anaesthesia with lignocaine were well tolerated, and 24 h postpartum monitoring revealed no abnormalities. Conclusions: This case adds to the limited but growing literature suggesting that with individualised planning and multidisciplinary care, pregnancies in women with BrS can proceed safely and without complication. Ongoing case reporting is essential to inform future guidelines and optimise maternal and fetal outcomes. Full article

CareCoach seeks to enhance self-efficacy in family caregivers of people living with dementia and has been feasibility tested in a multicentre randomised controlled trial. The intervention offers two face-to-face sessions with a trained coach and access to an online platform with nine modules. This paper reports findings from an embedded qualitative process evaluation assessing implementation from the implementer’s (‘coach’s’) (n = 8) perspective using individual interviews and implementer group discussions. Qualitative data were transcribed verbatim, inductively coded and analysed using Normalisation Process Theory. Implementers demonstrated (1) ‘Coherence’ by seeking to understand how CareCoach compared to current practice, highlighting the importance of supporting coaches to differentiate and identify boundaries between their new ‘coach role’ and usual practice; (2) ‘Cognitive Participation’ by reviewing training and resources to understand their role own responsibilities and facilitate delivery of coaching sessions; group supervision and peer support were also emphasised; (3) ‘Collective Action’ through interactions with carers to deliver key behavioural aspects such as goal setting, problem solving, and providing feedback; and (4) ‘Reflexive Monitoring’ by appraising the intervention to gain useful insights that could facilitate refinement of CareCoach training and delivery. This study provides a theoretically informed understanding of the implementation of CareCoach for caregivers of people living with dementia and provides recommendations to enhance training for coaches, intervention delivery and carer engagement. Full article

This paper presents the multi-triangular ring and self-routing protocol (MTRSRP), which is a new decentralized strategy designed to boost throughput and network efficiency in multiring scatternets. MTRSRP comprises two primary phases: leader election and scatternet formation, which collaborate to establish an effective multi-triangular ring topology. In the leader election phase, nodes exchange broadcast messages to gather neighbor information and elect coordinators through a competitive process. The scatternet formation phase determines the optimal number of rings based on the coordinator’s collected node information and predefined rules. The master nodes then send unicast connection requests to establish piconets within the scatternet, following a predefined role table. Intra- and inter-bridge nodes were activated to interconnect the piconets, creating a cohesive multi-triangular ring scatternet. Additionally, MTRSRP incorporates a self-routing addressing scheme within the triangular ring architecture, optimizing packet transmission paths and reducing overhead by utilizing master/slave relationships established during scatternet formation. Simulation results indicate that MTRSRP with dual-bridge connectivity outperforms the cluster-based on-demand routing protocol and Bluetooth low-energy mesh schemes in key network transmission performance metrics such as the transmission rate, packet delay, and delivery ratio. In summary, MTRSRP significantly enhances throughput, optimizes routing paths, and improves network efficiency in multi-ring scatternets through its multi-triangular ring topology and self-routing capabilities. Full article

Smart cities are technologically advanced urban environments where interconnected systems and data-driven technologies enhance public service delivery and quality of life. These cities rely on information and communication technologies, the Internet of Things, big data, cloud computing, and other Industry 4.0 tools to support efficient city management and foster citizen engagement. Often referred to as digital cities, they integrate intelligent infrastructures and real-time data analytics to improve mobility, security, and sustainability. Ubiquitous sensors, paired with Artificial Intelligence, enable cities to monitor infrastructure, respond to residents’ needs, and optimize urban conditions dynamically. Given the increasing significance of Industry 4.0 in urban development, this study adopts a bibliometric approach to systematically review the application of these technologies within smart cities. Utilizing major academic databases such as Scopus and Web of Science the research aims to identify the primary Industry 4.0 technologies implemented in smart cities, assess their impact on infrastructure, economic systems, and urban communities, and explore the challenges and benefits associated with their integration. The bibliometric analysis included publications from 2016 to 2023, since the emergence of urban researchers’ interest in the technologies of the new industrial revolution. The task is to contribute to a deeper understanding of how smart cities evolve through the adoption of advanced technological frameworks. Research indicates that IoT and AI are the most commonly used tools in urban spaces, particularly in smart mobility and smart environments. Full article

Person-centered navigation (PCN) in healthcare refers to a proactive collaboration among professionals, researchers, patients, and their families to guide individuals toward timely access to screening, treatment, follow-up, and psychosocial support. PCN—which includes professional, peer, and virtual guidance, is particularly crucial for rare cancers, where affected individuals face uncertainty, limited support, financial strain, and difficulties accessing relevant information, testing, and other services. The Canadian Cholangiocarcinoma Collaborative (C3) prioritizes PCN implementation to address these challenges in the context of Biliary Tract Cancers (BTCs). C3 uses a virtual PCN model and staffs a “C3 Research Navigator” who provides clinical and research navigation such as personalized guidance and support, facilitating access to molecular testing, clinical trials, and case reviews through national multidisciplinary rounds. C3 also supports a national network of BTC experts, a patient research registry, and advocacy activities. C3’s implementation strategies include co-design, timely delivery of support, and optimal outcomes across its many initiatives. Future priorities include expanding the C3 network, enhancing user engagement, and further integrating its innovative approach into routine care. Full article

The right to development, an inherent human right for all, emphasizes that all individuals and communities have the right to participate in, contribute to, and benefit from development that ensures the full realization of human rights. In Kenya, where a significant portion of the population faces poverty and vulnerability to climate change, access to rights-based needs such as clean water, healthcare, and education still remains a critical challenge. This study explored the implementation of a Human Rights-Based approach to community development through a Public–Private Development Partnership model (PPDP), with a focus on alleviating poverty and improving access to rights-based services at the community level in Narok and Nakuru counties. The research aimed to identify critical success factors for scaling the PPDP model and explore its effects on socio-economic empowerment. The study employed a mixed-methods approach for data collection, using questionnaires to obtain quantitative data, focus group discussions, and key informant interviews with community members, local leaders, and stakeholders to gather qualitative data. We cleaned and analyzed all our data in R (version 4.4.3) and used the chi-square to establish the significance of differences between areas where the PPDP model was implemented and control areas where it was not. Results reveal that communities with the PPDP model experienced statistically significant improvements in employment, income levels, and access to rights-based services compared to control areas. The outcomes underscore the potential of the PPDP model to address inclusive and sustainable development. This study therefore proposes a scalable pathway beginning with access to rights-based needs, followed by improved service delivery, and culminating in economic empowerment. These findings offer valuable insights for governments, development practitioners, investment agencies, and researchers seeking community-driven developments in similar socio-economic contexts across Africa. For the first time, it can be adopted in the design and implementation of development projects in rural and local communities across Africa bringing into focus the need to integrate rights-based needs at the core of the project. Full article

Super-resolution microscopy (SRM) has revolutionized our understanding of subcellular structures, including cell organelles and viruses. For human immunodeficiency virus (HIV), SRM has significantly advanced knowledge of viral structural biology and assembly dynamics. This review analyzes how SRM techniques (particularly PALM, STORM, STED, and SIM) have been applied over the past decade to study HIV structural components and assembly. By categorizing and comparing studies based on SRM methods, HIV components, and labeling strategies, we assess the strengths and limitations of each approach. Our analysis shows that PALM is most commonly used for live-cell imaging of HIV Gag, while STED is primarily used to study the viral envelope (Env). STORM and SIM have been applied to visualize various components, including Env, capsid, and matrix. Antibody labeling is prevalent in PALM and STORM studies, targeting Env and capsid, whereas fluorescent protein labeling is mainly associated with PALM and focused on Gag. A recent emphasis on Gag and Env points to deeper investigation into HIV assembly and viral membrane dynamics. Insights from SRM studies of HIV not only enhance virological understanding but also inform future research in therapeutic strategies and delivery systems, including extracellular vesicles. Full article

Background/Objectives: Neurodegenerative proteinopathies, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences for patients, caregivers, and healthcare systems. This review aims to synthesize evidence on the healthcare complexities of major neurodegenerative proteinopathies to highlight current knowledge gaps, and to inform future care models, policies, and research directions. Methods: We conducted a comprehensive literature search in PubMed/MEDLINE using combinations of MeSH terms and keywords related to neurodegenerative diseases, proteinopathies, diagnosis, sex, management, treatment, caregiver burden, and healthcare delivery. Studies were included if they addressed the clinical, pathophysiological, economic, or care-related complexities of aging-related neurodegenerative proteinopathies. Results: Key themes identified include the following: (1) multifactorial and unclear etiologies with frequent co-pathologies; (2) long prodromal phases with emerging biomarkers; (3) lack of effective disease-modifying therapies; (4) progressive nature requiring ongoing and individualized care; (5) high caregiver burden; (6) escalating healthcare and societal costs; and (7) the critical role of multidisciplinary and multi-domain care models involving specialists, primary care, and allied health professionals. Conclusions: The complexity and cost of neurodegenerative proteinopathies highlight the urgent need for prevention-focused strategies, innovative care models, early interventions, and integrated policies that support patients and caregivers. Prevention through the early identification of risk factors and prodromal signs is critical. Investing in research to develop effective disease-modifying therapies and improve early detection will be essential to reducing the long-term burden of these disorders. Full article

Background/Objective: Dry eye syndrome affects 16 million Americans with USD 52 billion in annual healthcare costs. With large language models (LLMs) increasingly used for healthcare information, understanding their performance in delivering equitable dry eye guidance across diverse populations is critical. This study aims to evaluate and compare five major LLMs (Grok, ChatGPT, Gemini, Claude.ai, and Meta AI) regarding dry eye syndrome information delivery across different demographic groups. Methods: LLMs were queried using standardized prompts simulating a 62-year-old patient with dry eye symptoms across four demographic categories (White, Black, East Asian, and Hispanic males and females). Responses were analyzed for word count, readability, cultural sensitivity scores (0–3 scale), keyword coverage, and response times. Results: Significant variations existed across LLMs. Word counts ranged from 32 to 346 words, with Gemini being the most comprehensive (653.8 ± 96.2 words) and Claude.ai being the most concise (207.6 ± 10.8 words). Cultural sensitivity scores revealed Grok demonstrated highest awareness for minority populations (scoring 3 for Black and Hispanic demographics), while Meta AI showed minimal cultural tailoring (0.5 ± 0.5). All models recommended specialist consultation, but medical term coverage varied significantly. Response times ranged from 7.41 s (Meta AI) to 25.32 s (Gemini). Conclusions: While all LLMs provided appropriate referral recommendations, substantial disparities exist in cultural sensitivity, content depth, and information delivery across demographic groups. No LLM consistently addressed the full spectrum of dry eye causes across all demographics. These findings underscore the importance for physician oversight and standardization in AI-generated healthcare information to ensure equitable access and prevent care delays. Full article

This concept paper outlines an implementation strategy for a mandatory training programme using the ADDIE instructional design model for delivery to nurses and other health professionals in an interprofessional education (IPE) environment). Background: Competence in Basic Life Support (BLS) is a lifesaving requirement for health professionals in clinical settings to ensure patient safety and accreditation outcomes. It is essential that health professionals are supported in attending mandatory training, including BLS. To inform learning and teaching strategies, it is useful to apply theoretical perspectives to the development of mandatory staff training methods. However, various training models exist, and few are grounded in instructional design theory to the unique environment for BLS in IPE. Method: A theory-based implementation strategy is outlined for a mandatory interprofessional training programme including BLS, using the ADDIE model to enhance patient outcomes. ADDIE is an instructional design framework comprising five elements: Assess, Design, Develop, Implement and Evaluate; describing a learning methodology that can be readily applied to mandatory training in IPE. Results: Through its iterative capability, the ADDIE model promotes learner needs and rapid acquisition of clinical skills that improve training accessibility. The strategy can equip educators with teaching skills based on a robust theoretical model, with potential to promote nursing and health professional attendance for mandatory training. Conclusions: Mandatory health professional training that addresses a theory informed strategy framed by the ADDIE model can support interprofessional collaboration and consistent competency across healthcare teams. This strategy has potential to contribute by demonstrating how instructional design can be operationalised to improve the effectiveness and engaging approach to BLS training and education to the unique dynamics of an interprofessional environment. Full article

Seafood processing byproducts (SB) such as bones and skin can be safely used as food ingredients to increase profitability for the seafood sector and provide nutritional value. An online survey of 716 US adult seafood consumers was conducted to explore SB trial intent, responsiveness to health and safety information, and associated elicited emotions (nine-point Likert scale). Consumers’ SB-elicited emotions were defined as those changing in reported intensity (from a baseline condition) after the delivery of SB-related information (dependent t-tests). As criteria for practical significance, a raw mean difference of >0.2 units was used, and Cohen’s d values were used to classify effect sizes as small, medium, or large. Differences in willingness-to-try, responsiveness to safety and health information, and SB-elicited emotions were found based on self-reported gender and race, with males and Hispanics expressing more openness to SB consumption. SB-elicited emotions were then used to model consumers’ willingness-to-try foods containing SB via logistic regression modeling. Traditional stepwise variable selection was compared to variable selection using raw mean difference > 0.2 units and Cohen’s d > 0.50 constraints for SB-elicited emotions. Resulting models indicated that extrinsic information considered at the point of decision-making determined which emotions were relevant to the response. These new approaches yielded models with increased Akaike Information Criterion (AIC) values (lower values indicate better model fit) but could provide simpler and more practically meaningful models for understanding which emotions drive consumption decisions. Full article

Background/Objectives: Respectful maternity care involves privacy, dignity, and informed choice within the process of delivery as stipulated by the World Health Organization (WHO). Informed consent is a cornerstone of patient-centered care, representing not just a formal document, but an ongoing ethical and clinical process through which women are offered objective, understandable information to support autonomous, informed decision-making. Methods: This narrative review critically examines the literature on informed consent in maternity care, with particular attention to both obstetric-led and midwifery-led models of care. In addition to identifying institutional, cultural, and systemic obstacles to its successful implementation, the review examines the definition and application of informed consent in perinatal settings and evaluates its effects on women’s autonomy and satisfaction with care. Results: Important conclusions emphasize that improving women’s experiences and minimizing needless interventions require active decision-making participation, a positive provider–patient relationship, and ongoing support from medical professionals. However, significant gaps persist between legal mandates and actual practice due to provider attitudes, systemic constraints, and sociocultural influences. Women’s experiences of consent can be more effectively understood through the use of instruments such as the Mothers’ Respect (MOR) Index and the Mothers’ Autonomy in Decision Making (MADM) Scale. Conclusions: To promote genuinely informed and considerate maternity care, this review emphasizes the necessity of legislative reform and improved provider education in order to close the gap between policy and practice. Full article

Entropy is a foundational concept across scientific domains, playing a role in understanding disorder, randomness, and uncertainty within systems. This study applies Shannon’s entropy in information theory to evaluate and manage complexity in industrial supply chain management. The purpose of the study is to propose a quantitative modeling method, employing Shannon’s entropy model as a proxy to assess the complexity in SCs. The underlying assumption is that information entropy serves as a proxy for the complexity of the SC. The research method is quantitative modeling, which is applied to four focal companies from the agrifood and metalworking industries in Southern Brazil. The results showed that companies prioritizing cost and quality exhibit lower complexity compared to those emphasizing flexibility and dependability. Additionally, information flows related to specially engineered products and deliveries show significant differences in average entropies, indicating that organizational complexities vary according to competitive priorities. The implications of this suggest that a focus on cost and quality in SCM may lead to lower complexity, in opposition to a focus on flexibility and dependability, influencing strategic decision making in industrial contexts. This research introduces the novel application of information entropy to assess and control complexity within industrial SCs. Future studies can explore and validate these insights, contributing to the evolving field of supply chain management. Full article