Search Results (32,458)

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

Gait refers to an individual’s unique walking pattern and is a promising biometric for age and gender estimation. Human gait exhibits inherent bilateral symmetry arising from the coordinated movement of the left and right sides of the body. However, occlusion remains a major challenge that disrupts the symmetric structure of gait patterns and degrades recognition performance. This paper investigates the impact of different occlusion types on gait-based age and gender estimation and proposes a Generative Adversarial Network (GAN)-based image restoration model to mitigate occlusion effects. Two occlusion types, namely block-wise and component-specific, are examined. A self-collected dataset of 715 side-walking gait energy images (GEIs) from 120 subjects was synthetically occluded to simulate real-life scenarios. Block-wise occlusion was applied both vertically and horizontally across GEI silhouettes, while component-specific occlusion targeted individual body parts. GAN-based restoration was subsequently applied to occluded images prior to model training. Experimental results confirm that occlusion significantly degrades recognition accuracy, with larger occluded regions causing greater performance drops. Shoulder occlusion most severely impacted age estimation, while head occlusion had the greatest effect on gender estimation. GAN-based restoration substantially recovered lost accuracy, demonstrating the potential of restoration techniques in compensating for missing body information. These findings highlight the importance of upper-body regions in gait-based soft biometrics and demonstrate the need to address occlusion in real-world gait recognition systems. Full article

The increasing adoption of virtual reality for industrial tasks such as virtual assembly, inspection, and operator training necessitates a standardized approach for evaluating and selecting appropriate hardware. This paper addresses this need by introducing a comprehensive methodology to assess the usability of commercially widespread virtual reality headsets specifically for industrial applications with hand-held controllers. We conducted a large-scale comparative study involving five leading headsets (HTC VIVE Pro 1 and 2, HTC VIVE XR Elite, Meta Quest Pro, and Meta Quest 3) and 60 demographically balanced participants. The evaluation was based on a protocol of 15 distinct tasks designed to measure performance in near and far-field object manipulation, interaction fidelity, visual clarity, ergonomics, and long-term comfort. By combining quantitative Key Performance Indicators with subjective user feedback and rigorous inferential statistical analysis, our findings reveal significant performance disparities among the devices. The results demonstrate that, while certain headsets excel in high-precision tracking for assembly tasks, others offer superior comfort, visual quality, and ease of use for inspection and prolonged sessions. Ultimately, this study concludes that no single headset is universally superior; the optimal choice is highly task-dependent. The proposed methodology provides a robust, evidence-based framework to guide industries in making informed virtual reality hardware selections tailored to their specific needs. Full article

Patients with cancer often experience intertwined symptom burden and functional decline that contribute to falls, unsafe transfers, uncontrolled symptoms, caregiver strain, and crisis-driven care. Physical medicine and rehabilitation (PM&R), also known as physiatry, and specialty PC both address suffering and quality of life through complementary clinical approaches; however, collaborative care with and between these two specialties is inconsistent in routine oncology practice. This paper presents a clinical implementation framework informed by targeted literature synthesis for bidirectional referral and co-management between PM&R and PC in oncology. The framework was informed by the PC referral criteria literature, cancer rehabilitation triage literature, trigger-based serious illness identification models, and implementation science. Four clinic-usable tools are proposed, including a scope and overlap map, a clinical-needs gradient, a referral trigger table linking common clinical signals to the reason for referral and expected clinical actions, and a primary-service triage workflow. This framework is intended to clarify which service is best positioned to be the primary supportive service according to the patient’s current needs, when rehabilitation therapy alone may be sufficient, and when co-management should be the default. This concept-to-practice model is designed to facilitate early, needs-based referrals and coordinated supportive care in oncology settings. Full article

Newborn screening initiatives have the potential to mitigate childhood morbidity in Africa, but they also have special ethical, legal, and social implications (ELSI) that are influenced by issues with the health system, cultural diversity, and limited resources. This scoping review explores the ELSI of newborn screening across Africa to identify key challenges, gaps, and future research needs. A systematic search identified 27 peer-reviewed studies published between 2008 and 2025, covering 12 African countries. Data were extracted on study characteristics, disease types, and ELSI dimensions from African Journals Online (AJOL), Scopus, PubMed, Web of Science, and BMJ Journals. Thematic analysis mapped recurring ethical, legal, and social concerns. Most studies examined ethical and social dimensions, while legal frameworks were rarely addressed. South Africa, Tanzania, and Ghana contributed the largest number of publications. Sickle cell disease (52%) and hearing screening (30%) were the dominant foci. Common ethical issues included informed consent, privacy, and justice; legal gaps centered on the absence of data protection and frameworks; and social concerns involved stigma, awareness, and cultural perceptions of hereditary disease. Ethical and social issues dominate NBS discourse in Africa, whereas legal oversight remains limited. To guarantee fair, reliable, and long-lasting newborn screening programs, national policy guidelines, community involvement, and context-specific ethical frameworks must be strengthened. Full article

With the rapid growth of urban motorization, personalized travel modes, including taxis and private cars, have expanded considerably. However, conventional public transportation systems, constrained by fixed routes and limited service flexibility, often struggle to satisfy residents’ increasingly diversified and high-quality commuting needs. To address this issue, this study proposes an integrated planning framework for customized bus services using taxi trajectory data. First, passenger origin–destination (OD) information is extracted by detecting changes in the taxi passenger-status field. The extracted OD records are then used to identify potential commuting demand by jointly considering peak-hour travel characteristics and regional OD stability. Second, the identified potential commuting demand is used to generate candidate boarding and alighting stops through an improved DBSCAN-based clustering method, namely IDK-SG. For route planning among the candidate stops, a bi-objective optimization model is developed to simultaneously account for passenger travel-time costs and bus operating costs, and the model is solved using a genetic algorithm. Finally, timetable optimization is formulated as a Markov decision process and solved using a Deep Q-Network (DQN) algorithm. Case studies using taxi GPS trajectory data from Chongqing demonstrate that the proposed framework can effectively identify stable commuting demand, optimize stop layouts and route schemes, and improve vehicle occupancy and service quality. These findings provide practical decision-making support for the operation and dynamic scheduling of customized bus services in urban peak-hour commuting corridors. Full article

Mesozooplankton were studied monthly (September 2023–August 2024, 12 months) at two coastal stations, at 35 and 90 m water depth, off Punta Blanca, SW Tenerife, Canary archipelago. Sample collection involved 250 and 500 μm bongo nets. This research focused on improving the description of plankton biodiversity and dynamics of the Canary archipelago (Macaronesia area), including its role in the transport of particulate carbon. A total of 156 taxa were identified. Copepoda dominated with 85 taxa, including 72 Calanoida species. They were numerically followed by Appendicularia, Chaetognatha, and Hydrozoa. Mesh sizes varied in collection efficiency, but with a similar pattern during the annual cycle: abundance peaks in early autumn (October–November) and late winter–spring (February–April). The 35 m depth station showed 57 to 3809 ind. m⁻³ (250 μm mesh size) and 10 to 1577 ind. m⁻³ (500 μm). The 90 m depth station showed 22 to 402 ind. m⁻³ (250 μm) and 11 to 170 ind. m⁻³ (500 μm). The present study enhances our understanding of Macaronesia’s mesozooplankton dynamics related to environmental variability, which is crucial for energy transfer assessments in pelagic food webs. It reports new species for the study area, Labidocera acutifrons (Dana, 1849–1852) and Undinula vulgaris (Dana, 1849–1852), highlighting the need for consistent zooplankton monitoring to properly inform conservation and sustainable management actions in the region. Full article

Non-suicidal self-injury (NSSI) is a significant public health concern, with disproportionately higher prevalence among sexual and gender minority (SGM) populations compared to cisgender heterosexual individuals. While prior research has examined NSSI and related outcomes in SGM groups, evidence on specific risk and protective factors remains limited. This scoping review aimed to systematically map and synthesize risk and protective factors associated with NSSI in SGM populations. A systematic search was conducted in PubMed, Scopus, and Web of Science up to 2 February 2026. A total of 43 studies were included, the majority of which were conducted in the United States and employed cross-sectional designs. Data were charted and synthesized using a minority stress-informed socioecological framework. Findings indicate that NSSI is consistently associated with the co-occurrence of minority stress processes and intrapersonal vulnerabilities. Additional risk factors were identified across family, peer, and community domains. Protective factors were less frequently examined but included social support, family connectedness, school safety, and adaptive coping strategies. Overall, the findings suggest that NSSI among SGM populations is best understood as the result of interacting risk processes across multiple ecological levels. These results support a minority stress-informed, multi-level conceptualization of NSSI in SGM individuals and highlight the need for longitudinal research and greater focus on protective factors. Full article

Porcine circovirus type 5 (PCV5) is a recently reported porcine-associated CRESS DNA virus, but information regarding its occurrence, genomic characteristics, and evolutionary relationship remains limited. In this study, a total of 100 diagnostic samples collected from clinically diseased pigs from 27 commercial swine farms in 16 cities across seven provinces of China during 2025 were screened for PCV5 using quantitative PCR. PCV5 was detected in 22% (22/100) of the tested samples, with positive samples identified in Henan and Fujian provinces among the sampled regions. PCV5-positive samples were mainly fecal samples and were obtained from pigs showing diarrhea, respiratory signs, wasting, or systemic disease. Co-detection analysis showed that most PCV5-positive samples were also positive for other swine viral pathogens, particularly PCV3, PCV2, and PEDV, indicating that the clinical significance of PCV5 should be interpreted cautiously. Complete genome amplification and sequencing yielded two identical PCV5 genomes from Henan and Fujian provinces. A representative strain, designated PCV5-Henan2025-ZJQ01, was further characterized and deposited in GenBank under accession number PZ496079. The complete genome was 2903 nt in length and contained a positive-sense ORF encoding Cap and a negative-sense ORF encoding Rep, showing a distinct genomic organization compared with classical porcine circoviruses. Phylogenetic analysis based on Rep and Cap amino acid sequences showed that PCV5-Henan2025-ZJQ01 was closely related to previously reported PCV5-related sequences but distinct from classical PCV1–PCV4. These findings provide additional molecular and genomic evidence for PCV5 in Chinese swine diagnostic samples and support the need for continued surveillance and further studies on its epidemiological and pathogenic significance. Full article

Coastal zones are facing rising exposure to climate-related hazards alongside intensifying human pressures, which highlights the need for robust tools to assess vulnerability. This study uses a GIS-based Coastal Vulnerability Index (CVI) to quantify and map relative vulnerability along ~13 km of shoreline in Al Hoceima Bay (northern Morocco). The proposed CVI integrates eight geological and physical indicators, including geomorphology, shoreline erosion and accretion rates, coastal slope, elevation, natural habitats, relative sea-level rise, significant wave height, and tidal range. Spatial analyses were performed using remote sensing data, historical records, field measurements, and Geographic Information Systems (GIS). The analysis reveals that 37% of the shoreline is categorized as high vulnerability, 44% is moderate, and 19% is low. Highly vulnerable sectors are primarily associated with low elevations, gentle coastal slopes, sandy beach systems, limited natural habitat protection, and proximity to river mouths. These findings demonstrate that the applied CVI provides a rapid and cost-effective framework for identifying priority areas for coastal management and climate adaptation. The proposed approach offers valuable decision-support insights for sustainable coastal planning in Al Hoceima Bay and other Mediterranean coastal environments characterized by limited data availability. Full article

Background/Objectives: Community-based drug rehabilitation is a key component of public health strategies in China, with anti-drug social workers playing a frontline role in relapse prevention, social reintegration, and long-term recovery. However, the sustainability and effectiveness of this workforce remain uncertain due to complex organisational and structural conditions. This study aims to examine the professional roles, work-related challenges, and coping strategies of anti-drug social workers within community-based rehabilitation systems. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and was registered in PROSPERO (Registration ID: 1381833). The literature published between 2009 and 2025 was identified through Google Scholar, PubMed, Web of Science, and the Electronic Library. A total of 35 Chinese and English-language studies met the inclusion criteria and were analysed to synthesise evidence on social work practice in drug rehabilitation contexts. Results: The findings identify three core professional roles: information provider, resource linker, and relationship repairer. These roles highlight the multifaceted contribution of social workers in bridging institutional systems and client needs. However, their effectiveness is constrained by fragmented governance structures, role conflict, professional identity ambiguity, administrative burden, limited training, and sustained emotional labour. These conditions contribute to occupational stress, burnout risk, and workforce instability, which weaken service continuity and client-centred care. Conclusions: Strengthening community-based drug rehabilitation requires addressing workforce and system-level constraints. Clearer role definition, targeted interdisciplinary training, reduced administrative demands, and structured organisational support are essential to enhance professional capacity, improve service delivery, and support long-term recovery outcomes. Full article

Landscape observatories have gained increasing relevance as socio-ecological observation systems aimed at monitoring, analysing and communicating landscape transformations and landscape evolution, although the field remains characterised by conceptual fragmentation and the absence of systematised international inventories. This study addresses this gap through the development and analysis of a curated inventory of 113 landscape observatories and related initiatives, constructed from a systematic web-based search and an explicit process of data screening and coding. The research examines the territorial distribution, temporal evolution, declared objectives, methodologies, operational scales and temporal continuity of the identified initiatives through descriptive and interpretative analyses supported by the existing literature, including the role of remote sensing, spatial analysis and repeat photography. The results reveal a strong European predominance, particularly in France, and a marked concentration of initiatives operating at regional scales, temporally associated with the implementation of the European Landscape Convention. The dated subset suggests a marked expansion after 2000, although many initiatives lack explicit chronological information. The analysis also highlights substantial heterogeneity in functional orientations, distinguishing between observatories with continuous photographic monitoring, temporally limited observation systems, landscape study centres, documentary repositories and other initiatives with non-systematic uses of photography. Furthermore, the study identifies a recurrent gap between declared objectives and the explicit articulation of methodologies and temporal monitoring schemes. Overall, the paper proposes a typological synthesis of landscape observatories and related initiatives and discusses their potential role as hybrid socio-ecological monitoring systems for adaptive territorial governance. The results also highlight the need for clearer analytical frameworks and greater methodological transparency to facilitate comparison and strengthen their contribution to territorial knowledge and governance. Full article

Background and Objectives: Low participation rates in exercise programs among older adults highlight the need for theory-driven, biopsychosocial interventions that enhance adherence, self-efficacy, and functional outcomes. Grounded in principles of motor learning and behavioral reinforcement within physiotherapy practice, this study aimed to examine the effect of periodic assessments combined with verbal feedback on functional and psychological outcomes in community-dwelling older adults. Methods: A pilot RCT was conducted involving 54 individuals aged ≥65 years (53 women and 1 man), recruited from senior community centers. Participants were randomly allocated to an intervention group (periodic assessment and verbal feedback; n = 27) or a control group (n = 27). Both groups participated in an identical 12-week structured exercise program, delivered twice weekly, focusing on balance, gait, and lower-limb functional training. An intention-to-treat approach was applied. Data were analyzed using Linear Mixed Models, with statistical significance set at p < 0.05. Results: Significant group × time interactions were observed in favor of the intervention group for key kinesiology-related functional outcomes, including the Short Physical Performance Battery (SPPB; p < 0.001), Timed Up and Go test (TUG; p = 0.011), and Activities-specific Balance Confidence Scale (ABC; p < 0.001). No statistically significant differences were identified between groups for the Behavioral Regulation in Exercise Questionnaire–2 (BREQ-2; p = 0.164) and the Self-Efficacy for Exercise Scale (ESE; p = 0.108), indicating that the primary psychological outcome (ESE) was not confirmed. However, both ESE and BREQ-2 demonstrated significant baseline differences favoring the intervention group, and, therefore, these findings should be interpreted with caution despite statistical adjustment. Conclusions: Periodic assessments followed by verbal feedback appear to selectively improve the functional effectiveness of structured exercise programs in older women, particularly physical performance, functional mobility, and balance confidence, with no significant differential effect on the primary psychological outcome (ESE; group × time interaction: p = 0.108). These findings support assessment-informed and feedback-driven physiotherapy strategies as a promising adjunct to exercise programs in older adults, with potential implications for optimizing functional outcomes within applied kinesiology and rehabilitation contexts. Full article

Background/Objectives: Inheritance classification in rare diseases remains challenging because curated knowledge is incomplete, heterogeneous, and imbalanced across inheritance categories. Disease-level inheritance modeling can support knowledge organization, annotation review, and hypothesis generation in rare-disease resources. This paper introduces RareFusion-Net, a multimodal benchmark framework for disease-level inheritance classification, and evaluates whether integrating ontology-enriched disease text, structured epidemiological metadata, and gene-association information improves prediction in curated rare-disease knowledge bases. RareFusion-Net is intended for knowledge modeling, not individual patient diagnosis. Methods: We developed RareFusionBalanced, a gated multimodal fusion model that combines biomedical disease descriptions, structured metadata, and gene-related information using auxiliary supervision. Ontology-enriched disease text was treated as the dominant semantic modality, while tabular and gene modalities were incorporated as complementary evidence when available. Robustness was improved using balanced regularization, selective transformer fine-tuning, dropout, weight decay, label smoothing, early stopping, and prediction aggregation across random seeds. Evaluation included accuracy, macro-F1, micro-F1, macro-AUC, mean average precision, calibration metrics, class-wise analysis, statistical testing, and ablation experiments. Results: RareFusionBalanced achieved 0.7382 test accuracy, 0.6284 macro-F1, 0.7382 micro-F1, 0.9183 macro-AUC, and 0.6686 mean average precision. Calibration was favorable, with an expected calibration error of 0.0395 and a Brier-OVR of 0.0528. The multimodal model slightly outperformed TextOnly-TransformerBalanced, but improvement over the best TF-IDF baseline was not statistically significant. Ablation showed ontology-enriched text as the strongest modality, with gene associations adding complementary value. Conclusions: RareFusion-Net provides a practical benchmark for ontology-aware rare-disease inheritance modeling. Results suggest selective multimodal benefit while highlighting minority-class difficulty, limited statistical superiority, need for external validation, and improved biological interpretability. Full article

Extreme heat poses health risks during pregnancy, but little is known about how pregnant individuals seek weather information to engage in heat-health protective actions. This study examined associations between routine and event-driven weather information seeking and both routine physiological heat-health protective actions (i.e., limiting sun exposure, staying hydrated, and spending time in air conditioning) and higher-threshold adaptive behaviors (i.e., changing plans due to heat). A cross-sectional survey of 195 pregnant individuals in Bexar County, TX, USA, was conducted during the summer and fall of 2024. Descriptive and nonparametric analyses explored relationships across trimesters. Participants demonstrated high routine weather information seeking and greater weather information needs since becoming pregnant. Over half (51.3%) reported increased weather information seeking during excessive heat, with lower increases during the first trimester. During extreme heat, most respondents increased heat-health protective actions. Increased information needs during pregnancy were significantly related to heat-health protective actions. Routine weather checking showed weak or inverse relationships with changing plans, suggesting that routine weather awareness alone may not prompt changing plans. Trimester patterns indicated heightened information seeking and protective actions later in pregnancy. Findings highlight the importance of pregnancy-specific heat risk communication with trimester-specific guidance provided in clinical counseling, public health messaging, and meteorological communication. Full article