Search Results (849)

The Internet of Medical Things (IoMT) is the latest advancement in the Internet of Things (IoT). Researchers are increasingly drawn to its vast potential applications in secure healthcare systems. The growing use of internet-connected medical device sensors has significantly transformed healthcare, necessitating the development of robust methodologies to assess their integrity. As access to computer networks continues to expand, these sensors have become vulnerable to a wide range of security threats, thereby compromising their integrity. To prevent such lapses, it is essential to understand the complexities of the operational environment and to systematically identify technical vulnerabilities. This paper proposes a unified hesitant fuzzy-based healthcare system for assessing IoMT sensor integrity. The approach integrates the hesitant fuzzy Analytic Network Process (ANP) and the hesitant fuzzy Technique for Order Preference by Similarity to the Ideal Solution (TOPSIS). In this study, a hesitant fuzzy ANP is employed to construct a comprehensive network that illustrates the interrelationships among various integrity criteria. This network incorporates expert input and accounts for inherent uncertainties. The research also offers sensitivity analysis and comparative evaluations to show that the suggested method can analyse many medical device sensors. The unified hesitant fuzzy-based healthcare system presented here offers a systematic and valuable tool for informed decision-making in healthcare. It strengthens both the integrity and security of healthcare systems amid the rapidly evolving landscape of medical technology. Healthcare stakeholders and beyond can significantly benefit from adopting this integrated fuzzy-based approach as they navigate the challenges of modern healthcare. Full article

Background/Objectives: Multi-cancer detection (MCD) tests have emerged as a promising tool to redefine the landscape of early cancer detection. Implementation of this novel technology will likely fall to primary care clinicians (PCC). The purpose of this study is to characterize and explore differences in PCCs perceptions and preferences towards MCD testing. Methods: Between March and May of 2023, this cross-sectional survey was administered to 281 PCCs, including physicians and advanced care providers practicing within an integrated healthcare system spanning five states. The survey collected data on self-reported characteristics, perceptions of MCD testing, and preferences for learning about MCD testing. Analysis was limited to those with no prior experience with MCD testing (N = 181, response rate 22.8%). Descriptive statistics summarized key variables and chi-square tests assessed differences in perceptions and preferences by key characteristics. Results: Most PCCs were interested in MCD testing (66.3%), but limited knowledge/awareness of MCD testing and confidence to manage patients with a positive test were observed, along with concerns around cost (76.7%) and misuse/poor implementation. The primary preferences for learning about MCD testing were online courses or classroom instruction (64.5%). Significant differences in perceptions and preferences for learning were observed by location, degree, and years in practice. Conclusions: PCCs in our study held positive views towards MCD testing, but gaps and variation in knowledge and confidence towards MCD testing and concerns around the cost and misuse/poor implementation were observed. While efforts to train and educate all PCCs on MCD testing is a critical first step, more research is needed to understand how best to support implementation tailored to individual and system-level needs and characteristics. Full article

Background: Deficient mismatch repair rectal cancer represents approximately 10% of rectal malignancies and demonstrates exceptional responsiveness to immune checkpoint inhibitors, achieving unprecedented complete response rates approaching 100%. This creates a novel clinical dilemma: should patients achieving complete response undergo standard surgical resection or pursue organ preservation through watch-and-wait management? Methods: We conducted a comprehensive literature review of clinical trials and retrospective studies published through 2025, focusing on response assessment strategies, decision-making frameworks, oncological outcomes, and quality of life assessments. Results: Landmark studies demonstrated remarkable efficacy with dostarlimab achieving 100% clinical complete response, while surgical cohorts achieved 68–92% pathological complete response rates. Response assessment challenges included pseudoprogression and pseudoresidue phenomena that complicated conventional imaging interpretation and required specialised multimodal evaluation protocols. Comparative analyses suggest equivalent oncological outcomes between surgical and non-surgical approaches in complete responders, achieving 100% disease-free survival at 2–3 years across multiple studies. The watch-and-wait approach offered significant advantages by preserving organ integrity and avoiding surgical morbidity, including permanent colostomy (15.4%) and perioperative complications (19.3%). Conversely, surgical management provided distinct benefits through definitive tissue confirmation and anxiety relief from intensive surveillance requirements and potential recurrence concerns. Conclusions: The surgery versus watch-and-wait dilemma represents a choice between equally effective oncological approaches with different quality of life implications. Evidence supports individualised decision-making weighing functional preservation benefits against patient preferences and institutional capabilities in this evolving therapeutic landscape. Full article

This study presents the development and implementation of an integrated survey system designed to evaluate the impact of MaaS in the context of Cairo’s rapidly evolving urban landscape. The research employs a dual-survey methodology, combining an RP household travel survey with an innovative, context-aware SP experiment focused on MaaS. The system is tailored to address the complexities of Cairo’s formal and informal transport networks and the transformative potential of new public transit infrastructure associated with Cairo’s urban expansion and the introduction of the New Administrative Capital. The paper outlines the methodological framework, including the design of the survey instruments, drawing upon established guidelines and the integration of real-world transportation data for realistic scenario generation in the SP component. While this paper primarily focuses on the development of the survey system and its design principles, it also incorporates some preliminary findings from a 313-participant full-scale survey to illustrate the potential of this comprehensive approach for understanding current travel behaviour, socio-demographic determinants of mobility, and the prospects of context-aware SP data to assess user preferences for potential MaaS offerings. Results highlight the methodological advances in survey design for developing cities and aim to offer policy-relevant evidence for sustainable mobility interventions. Full article

Cellulose nanocrystals (CNCs), derived from renewable cellulose sources, have emerged as a versatile class of nanomaterial with exceptional mechanical strength, tuneable surface chemistry and inherent biocompatibility. In the scenario of contemporary commercial hydrogel products, which are expensive and rely on synthetic materials, the sustainable origin and unique physicochemical properties have positioned CNCs as promising sustainable functional building blocks for next-generation hydrogels in biomedical applications. Over the past decade, CNC-based hydrogels have gained momentum as soft biomaterials capable of interacting with diverse tissue types, predominantly demonstrated through in vitro cell line studies. This review critically examines the current landscape of research on biomedical applications of CNC-based hydrogels, focusing on their biomedical utility across 22 systematically screened studies. It revealed applications spanning around bone and cartilage tissue engineering, wound healing, medical implants and sensors, and drug delivery. We highlight the predominance of microcrystalline cellulose as the CNC source and sulfuric acid hydrolysis as the preferred extraction method, with several studies incorporating surface modifications to enhance functionality. Despite growing interest, there remains a lack of data for transitioning towards human clinical studies and commercialisation. Hence, this review highlights the pressing need for scalable, sustainable, and affordable CNC-based hydrogel systems that can democratise access to advanced biomedical technologies. Full article

Facing the severe challenge of global warming, the construction of photovoltaic (PV) power stations has been increasing annually both in China and worldwide, with mountainous areas gradually becoming preferred sites for such projects. Mountain landscapes are ecologically sensitive, and the large-scale installation of PV panels may lead to destruction of the mountain landscape ecological environment. In this study, soil physicochemical properties were measured in 160 soil test plots, and vegetation community conditions were assessed in 26 vegetation test plots at a mountain PV power station in Damiao Town, Chaoyang County, Liaoning Province, China, using a combination of field sampling and laboratory testing. Based on mean values of 15 soil and vegetation indicators under different PV panel coverage rates, calculated via ANOVA in SPSS 27.0 software with Bonferroni-corrected p-values, the effects of various coverage rates on the mountain landscape ecological environment were investigated through multiple comparisons of the mean values. Using the Euclidean distance principle, the similarity ranking between the ecological environment under different PV coverage intervals and the control point was determined as follows: 0% > 0–5% > 15–20% > 5–10% > 10–15% > over 20%. Ultimately, considering the power generation requirements of the PV power station, the 15–20% PV panel coverage rate was identified as the optimal range that minimizes impact on the mountain landscape ecological environment while meeting electricity production demands. Therefore, construction stakeholders should fully consider the influence of PV panel coverage rate on the mountain landscape ecological environment and control the coverage within the 15–20% range according to the power generation needs of mountain PV power stations, so as to mitigate the environmental impact of PV panel installation. Full article

Suillus flavidus is an ectomycorrhizal fungus associated with moist, nutrient-poor habitats, particularly peat bogs and transitional mires, where it forms symbiotic relationships with two-needle pines, especially Pinus sylvestris. This study presents an updated assessment of its distribution in Poland, identifies key ecological factors influencing its occurrence—such as habitat type and phenology—and evaluates its conservation status in the context of sustainability goals. Analysis of available data shows that over two-thirds of the known sites in Poland are located in peatland ecosystems, with more than half occurring within protected areas. Although S. flavidus is distinctly hygrophilous, it appears to prefer moderately wet habitats, particularly swamp forests. Despite an increase in recorded localities over the past five decades, S. flavidus remains an endangered species due to the ongoing degradation of peatland habitats, which are increasingly threatened by land-use change, drainage, and climate-related shifts in hydrology. The species’ long-term survival depends on sustainable landscape management, the preservation of suitable host tree populations, and the inclusion of fungi in conservation and restoration strategies. Thus, S. flavidus should be considered both an indicator species and a relevant element in meeting sustainability goals. Full article

Cultural ecosystem services are difficult to evaluate due to their subjective nature and the lack of indicators of the benefits they provide to people. This study applied an innovative methodology to assess the cultural landscape’s ecosystem services in the coastal countryside of La Janda in Cádiz, Spain, based on heritage assets situated outside urban centers. After identifying 700 cultural landmarks scattered throughout La Janda that represent the region’s cultural values and foster feelings of identity and belonging at a local level, public domain routes totaling 243.78 km have been selected to appreciate them. These routes have been incorporated into an Android application, enabling users to access a bibliographic summary of the landmarks and generate data on social preferences when contemplating cultural heritage. Integrated into a Public Participation Geographic Information System, these data serve as an indicator for evaluating cultural ecosystem services and support efforts to conserve and enhance the cultural capital spread across the territory. These data also allow for the identification of symbolic and emotional values linked to place identity, offering valuable inputs for sustainable place-branding strategies that promote the territory beyond conventional tourism models. Full article

This study investigates how traditional versus modern Chinese ink painting styles in tourism advertisements affect viewers’ visual attention, aesthetic evaluations, and tourism intentions. Using eye-tracking experiments combined with surveys and interviews, the researchers conducted a mixed-design experiment with 80 Chinese college students. Results indicate that traditional ink-style advertisements attracted longer total fixation durations, higher aesthetic evaluations, and stronger cultural resonance in natural landscape contexts, while modern ink-style advertisements captured initial attention more quickly and performed better aesthetically in urban settings. Qualitative analyses further revealed cultural familiarity and aesthetic resonance underpinning preferences for traditional style, whereas modern style mainly attracted attention through novelty and creativity. These findings expand Cultural Schema Theory and the aesthetic processing model within advertising research, suggesting practical strategies for tourism advertising to match visual styles appropriately with destination types and audience characteristics to enhance promotional effectiveness. Full article

Assessing the impact of land use and land cover (LULC) on water quality (WQ) is central to land-based environmental research. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this study analyses recent trends using LULC maps to assess stream WQ within buffers, focusing on papers published between 2020 and 2024. It identifies relevant remote sensing practices for LULC mapping, landscape metrics, WQ physicochemical parameters, statistical techniques for correlating LULC and WQ, and conventions for configuring buffers. Materials include Scopus, Web of Science, and Atlas.ti, which support both qualitative data analysis and Conversational Artificial Intelligence (CAI) tasks via its integration with OpenAI’s large language models. The methodology highlights creating a bibliographic database, coding, CAI, and validating prompts. Official maps and visual or digital interpretations of optical imagery provided inputs for LULC. Classifiers from earlier generations have shaped LULC cartography. The most employed WQ parameters were phosphorus, total nitrogen, and pH. The three most referenced landscape metrics were the Largest Patch Index, Patch Density, and Landscape Shape Index. The literature mainly relied on Redundancy Analysis, Principal Component Analysis, and alternative correlation approaches. Buffer configurations varied in size. CAI facilitated an agile systematic review; however, it encountered challenges related to a phenomenon known as hallucination, which hampers its optimal performance. Full article

The transport sector significantly contributes to global greenhouse gas emissions, making electromobility crucial in the race toward the United Nations Sustainable Development Goals. In recent years, the increasing competition among manufacturers, the development of cheaper batteries, the ongoing policy support, and people’s greater environmental awareness have consistently increased electric vehicles (EVs) adoption. Nevertheless, EVs charging needs—highly influenced by EV drivers’ behavior uncertainty—challenge their integration into the power grid on a massive scale, leading to potential issues, such as overloading and grid instability. Smart charging strategies can mitigate these adverse effects by using information and communication technologies to optimize EV charging schedules in terms of power systems’ constraints, electricity prices, and users’ preferences, benefiting stakeholders by minimizing network losses, maximizing aggregators’ profit, and reducing users’ driving range anxiety. To this end, accurately forecasting EV charging demand is paramount. Traditionally used forecasting methods, such as model-driven and statistical ones, often rely on complex mathematical models, simulated data, or simplifying assumptions, failing to accurately represent current real-world EV charging profiles. Machine learning (ML) methods, which leverage real-life historical data to model complex, nonlinear, high-dimensional problems, have demonstrated superiority in this domain, becoming a hot research topic. In a scenario where EV technologies, charging infrastructure, data acquisition, and ML techniques constantly evolve, this paper conducts a systematized literature review (SLR) to understand the current landscape of ML-based EV charging demand forecasting, its emerging trends, and its future perspectives. The proposed SLR provides a well-structured synthesis of a large body of literature, categorizing approaches not only based on their ML-based approach, but also on the EV charging application. In addition, we focus on the most recent technological advances, exploring deep-learning architectures, spatial-temporal challenges, and cross-domain learning strategies. This offers an integrative perspective. On the one hand, it maps the state of the art, identifying a notable shift toward deep-learning approaches and an increasing interest in public EV charging stations. On the other hand, it uncovers underexplored methodological intersections that can be further exploited and research gaps that remain underaddressed, such as real-time data integration, long-term forecasting, and the development of adaptable models to different charging behaviors and locations. In this line, emerging trends combining recurrent and convolutional neural networks, and using relatively new ML techniques, especially transformers, and ML paradigms, such as transfer-, federated-, and meta-learning, have shown promising results for addressing spatial-temporality, time-scalability, and geographical-generalizability issues, paving the path for future research directions. Full article

Historic districts are key urban spaces that convey cultural heritage and support tourism and social interaction. As the spatial interface shapes form and perception, this study explores youth-oriented visual behaviour and cognitive preferences regarding historic street interfaces. Using Kuan-Narrow Alley in Chengdu as a case study, we analysed eye-tracking data to assess visual engagement with interface elements. Architectural components received the highest attention for Total Fixation Duration, Fixation Count, and Visit Count, while commercial elements yielded a longer Average Fixation Duration. A multiple linear regression model identified Historical Linguistic Landscape (β = 1.088), Street Permeability (β = 0.401), and Street Width-to-Height Ratio (β = 0.178) as significant predictors of perceived usability, with Historical Linguistic Landscape proving most influential. These findings underscore the value of preserving cultural significance in streetscape morphology and provide theoretical and practical insights from a youth-centric perspective. By integrating eye-tracking with morphological analysis, the study offers a novel approach to understanding visual perceptions in historic districts. Despite limitations in sample size and scope, the study provides solid insights, with future research needed to broaden contexts for greater generalisability. Full article

Lawns have evolved from medieval European grasslands into globally accepted urban green surfaces, serving recreational, aesthetic and cultural purposes. Today lawn surfaces are essential components of public urban green space (PUGS), fulfilling ecosystem services such as urban heat mitigation, carbon sequestration and social well-being. However, their ecological and resource-intensive disservices, particularly in dry climates, have prompted growing concerns among environmental scientists, urban planners and landscape designers. In water-scarce regions like Perth, Western Australia, traditional lawns face increasing scrutiny due to their high irrigation demands and limited ecological diversity. This study contributed to the transdisciplinary LAWN as Cultural and Ecological Phenomenon project, focusing on the perspectives of professionals, landscape architects, park managers, turf producers and researchers responsible for the planning, design and management of urban lawn in PUGS. Using qualitative methods (semi-structured in-depth interviews), the research explores expert insights on the values, challenges and future trajectories of lawn use in a warming, drying climate. The interviews included 21 participants. Findings indicate that while professionals acknowledge lawns’ continued relevance for sports and active recreation, water scarcity is a major concern influencing design and species selection. Alternatives such as drought-tolerant plants, hard landscaping and multifunctional green spaces are increasingly considered for non-sporting areas. Despite growing concerns, the ideal lawn is still envisioned as an expansive, green, soft surface, mirroring entrenched public preferences. This study underscores the need to balance environmental sustainability with public preference and cultural expectations of green lawns. Balancing expert insights with public attitudes is vital for developing adaptive, water-conscious landscape design strategies suited to future urban planning and environmental conditions in Mediterranean climates. Full article

Scarturus williamsi (Williams’ jerboa) is a medium-sized, semi-fossorial rodent endemic to steppe ecosystems across Anatolia, Iran, and Azerbaijan, with specialized habitat requirements in semi-arid continental environments. This study integrates a mitochondrial DNA analysis with species distribution modeling to assess the species’ evolutionary structure and vulnerability to future climate change. The phylogeographic analysis and species distribution modeling reveal the evolutionary history and climate vulnerability of Scarturus williamsi across Anatolia and adjacent regions. The mitochondrial DNA analysis of 98 individuals demonstrates exceptional haplotype diversity (Hd = 0.9896), with 90 unique haplotypes and complete regional isolation, indicating pronounced population structuring across five evolutionary lineages: Central Anatolia, Eastern Anatolia, Aegean, Black Sea, and Azerbaijan–Iran. The Iran–Azerbaijan lineage exhibits the deepest evolutionary divergence, while Eastern Anatolia functions as the primary Anatolian refugium and Central Anatolia as the secondary refugial center. The strong isolation by distance (r = 0.735, p < 0.001) across ~2500 km explains 54.0% of the genetic variation, with the hierarchical structure reflecting greater Iran–Turkey isolation than intra-Turkish differentiation. The species distribution modeling identifies the Mean Temperature of Driest Quarter (bio9) and the Mean Diurnal Range (bio2) as primary habitat determinants, with bimodal preferences reflecting highland versus steppe adaptations. Climate projections reveal severe vulnerability with habitat losses of 63.69–98.41% by 2081–2100 across emission scenarios. SSP3-7.0 represents the most catastrophic scenario, with a severe habitat reduction (98.41% loss), while even optimistic scenarios (SSP1-2.6) project a 60–70% habitat loss. All scenarios show accelerating degradation through mid-century, with the steepest losses occurring between 2041 and 2080. Projected eastward shifts face constraints from the Anatolian Diagonal, limiting the climate tracking capacity. Despite occupying open landscapes, S. williamsi exhibits exceptional sensitivity to climate change, with Anatolian refugial areas representing critical diversity centers facing substantial degradation. Results provide baseline genetic structure and climate vulnerability information for understanding climate impacts on S. williamsi and Irano–Anatolian steppe fauna. Full article

In the face of the challenge of urban water resource degradation, green infrastructure construction has become a core strategy in modern urban water resource management. Urban aquatic horticulture (UAH), as an important component of this strategy, possesses the dual value of ecological purification and landscape aesthetics. However, its practical implementation is often constrained by public awareness and acceptance. This study aims to address the mismatch between the dual values of urban aquatic horticulture and public perception, and to develop an optimised plant selection strategy that integrates purification functions with public perception. Based on literature reviews, 18 images of aquatic plant landscapes showcasing different ornamental forms, species richness, and life types were created. A questionnaire survey was conducted on 320 participants to assess their perceptions of landscape aesthetic appeal and visual preferences, and a quantitative relationship model was established using multiple stepwise linear regression analysis. The public’s aesthetic perception of aquatic plant landscapes with different ornamental forms and species richness varies significantly, with flowering plant landscapes more likely to evoke aesthetic perception than non-flowering landscapes. The public’s visual preferences for landscape attributes significantly influence their aesthetic perception of aquatic plant landscapes. A multiple stepwise linear regression equation was established to model the relationship between the aesthetic perception of aquatic plant community landscapes and the public’s visual preferences for landscape attributes. There is no significant association between species richness and perceived landscape aesthetic appeal. The study developed an optimised selection strategy for aquatic plants that integrates purification functions with public perception, providing theoretical basis and practical guidance for the scientific configuration of aquatic horticultural systems in urban green infrastructure. In landscape design, flowering plants with ornamental value should be prioritised, with emphasis on landscape layers, colour, and spatial shaping to enhance public acceptance and promote the sustainable development of urban water resource management. Full article