Search Results (644)

Construction projects are inherently exposed to high levels of uncertainty due to technical complexity, multiple stakeholders, and dynamic operating environments. However, empirical evidence on the systematic implementation of risk management practices in developing construction contexts remains limited. Unlike studies that assess the effectiveness or outcomes of risk management, this study addresses the gap by examining perception-based evidence of its implementation at the project and organizational levels in Jordanian construction projects. The study focuses on planning, control and monitoring, perceived advantages, and implementation barriers. A quantitative, survey-based research design was employed using purposive sampling. The statistical population consisted of engineers, project managers, and contractors working in the Jordanian construction sector. Out of 280 distributed questionnaires, 232 valid responses were received (response rate: 82.9%). Data were analyzed using descriptive statistics and one-sample t-tests, with the neutral midpoint of the five-point Likert scale (3.00) used as the reference value. The reliability of the instrument was confirmed by Cronbach’s alpha coefficients ranging from 0.814 to 0.868. The findings indicate generally positive perceptions of risk management implementation, with mean values ranging from 3.84 to 4.13. Risk management planning achieved the highest mean score (4.13), whereas control and monitoring practices were comparatively weaker (3.84). Although 82.3% of respondents reported applying risk management techniques, experience levels remain low to moderate. Key barriers include the lack of structured programs, limited knowledge, and insufficient experience. The results highlight the need for institutionalized risk management frameworks and targeted professional training to enhance systematic implementation. Full article

Background/Objectives: To analyze the parent-perceived quality of life (QoL) in children with cerebral palsy (CP) and to study the relationship between sociodemographic and clinical factors and this perception, under the perspective of the International Classification of Functioning, Disability and Health (ICF). Methods: A cross-sectional study was conducted with 95 participants (ages 5–19 years) with CP. Participants’ parents were asked about sociodemographic and clinical characteristics and compiled Cerebral Palsy Quality of Life (CP-QoL) and Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT). Participants were assessed and classified into the following functional domains: gross motor function (GMFM-88, GMFCS), manual ability (MACS), eating and drinking abilities (EDACS), and communication function (CFCS). Correlations between CP-QoL domains and variables were investigated using Spearman’s correlation coefficient and multivariate predictive models were used to investigate the variables predicting CP-QoL scores for each domain. Results: A total of 95 children with a mean age of 12.4 ± 3.5 years (range 5–19 years) were included. Participants demonstrated moderate-high GMFM-88 level (228.8 ± 44.7) and high functional performance across PEDI-CAT domains: Activity (57.2 ± 5.1), Mobility (63.1 ± 5.6), and Social/Cognitive (70.2 ± 4.3). Parent-perceived QoL was significantly higher when children did not require AFOs, botulinum toxin, or recent hospitalizations, and lower among children who attended physical therapy >2 h/week. Moderate correlations were consistently found between the ‘Feelings about Functioning’ domain and functional variables, being positive for GMFM-88 and all PEDI-CAT domains, and negative for GMFCS, MACS, EDACS and CFCS. That domain of CP-QoL was best explained by the regression model (R² = 0.619, p < 0.001), with the combination of three variables: GMFM-88, PEDI-CAT Activity and PEDI-CAT Social/Cognitive. Among them, PEDI-CAT Activity was the strongest predictor (β = 0.1436). Conclusions: In children with CP, to enhance family well-being, interventions should prioritize social participation and carefully balance the intensity and frequency of therapy against family burden and daily life demands, as QoL is primarily driven by manual ability and functional performance. Full article

This study aimed to develop an immersive virtual reality (VR) program and conduct preliminary evaluation of its feasibility and learner perception for enhancing nursing students’ clinical practicum education. The VR program was designed using the ADDIE model (analysis, design, development, implementation, and evaluation) and implemented on the UNITY 3D platform. Expert evaluation was conducted through a VR application, and its effectiveness was further assessed among 25 fourth-year nursing students in terms of immersion, presence, and satisfaction. The expert evaluation yielded a mean score of 6.54 out of 7, indicating acceptable content validity. Among learners, evaluation demonstrated immersion at 42.28 ± 2.37 out of 50 (95% CI: 41.30–43.26), presence at 81.36 ± 7.32 out of 95 (95% CI: 78.34–84.38), and satisfaction at 13.48 ± 1.26 out of 15 (95% CI: 12.96–14.00). Overall, the developed VR program demonstrated acceptable expert validity and positive learner perceptions. These preliminary findings suggest feasibility as a supplementary practicum. However, the single-group design without control comparison and reliance on self-reported measures preclude conclusions about educational effectiveness. Full article

Background: Anorexia nervosa (AN) may require nasogastric tube (NGT) feeding when oral intake is insufficient. Evidence on the psychological impact and prognostic correlates of NGT use in adolescents affected with AN is limited. Methods: Fifty-seven adolescent inpatients (96.5% female; age range 12–18 years; and mean age 15.0 ± 1.51 years) affected with AN admitted in a child psychiatry ward and treated with NGT re-feeding in addition to oral nutrition were included in the study. A 21-item VAS questionnaire was administered at intake (T0), after NGT introduction (T1), after one week of NGT use (T2), and after NGT dismissal (T3) to assess the physical and psychological effects. Participants were also assessed with psychometric measures including personality (TCI), eating psychopathology (EDI-2), general psychopathology (BDI-II, SCL-90-R, and TAS), and family functioning (FAD). The measures were compared between each timepoint with paired t-tests and ANOVA for repeated measures. Pearson correlations were performed between the VAS scores and psychometric measures. Results: From admission to discharge, weight increased by +3.2 kg and BMI by +1.2 kg/m². Items 1, 3, 4, 6, 15, 18, and 20 of the VAS questionnaire items showed significant improvement over time. TCI personality traits, EDI-2 eating and BDI, SCL-90 and TAS general psychopathology, and FAD family functioning were related to NGT perception by the AN adolescents. Conclusions: NGT was helpful in weight progression during inpatient treatment. It was generally well tolerated, with progressive improvement in psychological and physical discomfort during treatment. The meaningful associations with specific psychometric features suggest the possibility to tailor the NGT use based on adolescent characteristics. Multidisciplinary care and tailored psychoeducation may enhance NGT acceptance. Full article

Background/Objectives: The growing integration of Artificial Intelligence (AI) and chatbots in health professional education offers innovative methods to enhance learning and clinical preparedness. This study aimed to evaluate the educational impact and perceptions in university students of Human Nutrition and Dietetics, regarding the utility, usability, and design of the E+DIEting_Lab chatbot platform when implemented in clinical nutrition training. Methods: The platform was piloted from December 2023 to April 2025 involving 475 students from multiple European universities. While all 475 students completed the initial survey, 305 finished the follow-up evaluation, representing a 36% attrition rate. Participants completed surveys before and after interacting with the chatbots, assessing prior experience, knowledge, skills, and attitudes. Data were analyzed using descriptive statistics and independent samples t-tests to compare pre- and post-intervention perceptions. Results: A total of 475 university students completed the initial survey and 305 the final evaluation. Most university students were females (75.4%), with representation from six languages and diverse institutions. Students reported clear perceived learning gains: 79.7% reported updated practical skills in clinical dietetics and communication were improved, 90% felt that new digital tools improved classroom practice, and 73.9% reported enhanced interpersonal skills. Self-rated competence in using chatbots as learning tools increased significantly, with mean knowledge scores rising from 2.32 to 2.66 and skills from 2.39 to 2.79 on a 0–5 Likert scale (p < 0.001 for both). Perceived effectiveness and usefulness of chatbots as self-learning tools remained positive but showed a small decline after use (effectiveness from 3.63 to 3.42; usefulness from 3.63 to 3.45), suggesting that hands-on experience refined, but did not diminish, students’ overall favorable views of the platform. Conclusions: The implementation and pilot evaluation of the E+DIEting_Lab self-learning virtual patient chatbot platform demonstrate that structured digital simulation tools can significantly improve perceived clinical nutrition competences. These findings support chatbot adoption in dietetics curricula and inform future digital education innovations. Full article

Air-conditioning systems are vital for indoor environmental quality. However, noise can offset its benefits, making acoustic monitoring important. Recent research revealed that sound quality perceptions can be described by three psychological dimensions: Evaluation, Potency, and Activity (EPA). This is the first study to develop psychoacoustic heatmap machine learning models (PHMLM) for predicting sound quality and the negative noise impacts (O1: Discomfortable, O2: Annoying, O3: Stressful, and O4: Unacceptable) of air conditioning sounds using a 227 × 227-pixel psychoacoustic heatmap as input for machine learning. A total of 1208 jury listening tests were conducted with 101 participants on 30 s soundtracks from air-conditioned environments. Psychoacoustic heatmaps were generated by converting time-varying psychoacoustic metrics (N, S, R, and FS) into intensity maps containing 51,529 pixels of multidimensional acoustic information. The PHMLMs achieved predictive performance with correlation coefficients of 0.79, 0.80, and 0.62 for E-, P-, and A-scores, respectively. Compared to traditional regression models (TRM), PHMLM-EPA demonstrated significantly better performance with 31% lower mean absolute error (4.4 vs. 6.4) and higher regression slope (0.798 vs. 0.587). Moreover, PHMLM-EPA demonstrated a higher goodness-of-fit than TRM (+55% to +95%) and traditional acoustic metric L_Aeq (+87% to +95%). The approach offers an advanced acoustic monitoring method for sustainable building designs. Full article

The deterioration of civil infrastructure poses a significant threat to public safety, yet conventional manual inspections remain subjective, labor-intensive, and constrained by accessibility. To address these challenges, this paper presents a real-time robotic inspection system that integrates deep learning perception and autonomous navigation. The proposed framework employs a two-stage neural network: a U-Net for initial segmentation followed by a Pix2Pix conditional generative adversarial network (GAN) that utilizes adversarial residual learning to refine boundary accuracy and suppress false positives. When deployed on an Unmanned Ground Vehicle (UGV) equipped with an RGB-D camera and LiDAR, this framework enables simultaneous automated crack detection and collision-free autonomous navigation. Evaluated on the CrackSeg9k dataset, the two-stage model achieved a mean Intersection over Union (mIoU) of 73.9 ± 0.6% and an F1-score of 76.4 ± 0.3%. Beyond benchmark testing, the robotic system was further validated through simulation, laboratory experiments, and real-world campus hallway tests, successfully detecting micro-cracks as narrow as 0.3 mm. Collectively, these results demonstrate the system’s potential for robust, autonomous, and field-deployable infrastructure inspection. Full article

Effective communication is essential for professional practice, yet medical curricula rarely incorporate systematic, performance-based training. The Sell Yourself!—Presentation Techniques course was developed to address this gap through a two-day, practice-oriented program integrating rhetorical training, evolutionary psychology, and structured peer feedback. We examined anonymized institutional evaluations from 450 medical students using descriptive statistics and combined inductive–deductive thematic and content coding to gauge the perceived educational utility of the course. The course received a mean satisfaction rating of 9.6/10, with approximately 74% of students assigning the maximum score. Inductive analysis identified interactivity (143 mentions), practical usefulness (76), feedback and improvement (75), positive atmosphere (51), instructor quality (47), and multimedia examples (37) as key strengths, while critiques primarily concerned breaks and scheduling (62), course length and intensity (59), and smaller concerns regarding feedback processes, content structure, and technical issues. Deductive coding indicated perceived improvements across five predefined dimensions: increased confidence, rhetorical fluency, feedback quality, peer recognition, and cultural inclusivity. Structured rhetorical training appears to be well received by learners and may provide a feasible model for embedding communication competence in medical education. These findings also offer a transferable template for integrating performance-based communication training into other programs. However, conclusions are limited by reliance on self-reported perceptions and the absence of a control group or direct assessment of applied communication outcomes. Full article

Background/Objectives: Recurrent oral ulcers (ROUs) are a common condition that significantly impacts patients’ quality of life. This pilot study was conducted to evaluate the feasibility and preliminary results of using non-thermal plasma (NTP) compared to low-level laser therapy (LLLT) and placebo to treat these ulcers. Methods: A prospective, controlled, randomised, parallel-group pilot study was conducted using a convenience sample of 50 patients with ROUs. Patients were randomly assigned (2:2:1) to one of three groups: NTP (n = 20), LLLT (n = 20), and placebo (n = 10). Feasibility and preliminary data acquisition were the primary goals. Exploratory outcomes included ulcer size reduction and safety profile. This was a single-blinded trial, where participants and outcome assessors were masked to group assignment. Ulcer size, pain perception, and time to complete healing were measured. For statistical analysis, ANOVA was used, with a p-value ≤ 0.05. Results: The groups were comparable at baseline. Exploratory results suggest that NTP demonstrated a promising trend in accelerating healing, with a mean healing time difference of 5.5 days compared to LLLT (2.5 ± 1.9 days vs. 8.0 ± 4.3 days) and 7.1 days compared to placebo (2.5 ± 1.9 days vs. 9.6 ± 5.3 days) (p < 0.001). Regarding pain, NTP provided significant and sustained relief. Patients in the NTP group were asymptomatic on day 2, unlike the LLLT and placebo groups, where pain persisted significantly (NTP VAS score at 1 h: 1.1 ± 2.1 vs. LLLT/Placebo VAS score at 1 h: 3.4 ± 2.4 and 7.3 ± 1.9, respectively) (p < 0.001). NTP was well tolerated, and no adverse events were reported. Conclusions: This pilot study suggests that NTP is a potentially safe and effective therapy for recurrent oral ulcers. Preliminary results indicate that it may accelerate healing and offer superior pain relief, warranting a large-scale clinical trial to confirm these findings. Full article

Background/Objectives: Healthcare workers (HCW) in primary care settings play a significant role in recommending vaccines to patients. We aimed to describe COVID-19 vaccination knowledge, attitudes, perception, and practices (KAPP) of HCWs in Tunisia and identify associated factors. Methods: We conducted a national cross-sectional survey (29 January to 3 February 2024) among HCWs in primary public healthcare centers using purposive sampling. Factors associated with good knowledge, positive attitude, and good practice, measured through Likert scales using face-to-face questionnaires, were identified using binary logistic regression. Results: We included 906 HCWs (mean age = 41.87 ± 8.89 years). In total, 37.75% (342/906) of HCWs had good knowledge and perception, 4.30% (39/906) had a positive attitude, and 24.9% (226/906) had good practices related to COVID-19 vaccination. Working in urban compared to rural areas was associated with good knowledge (aOR = 1.57, 95%CI = 1.12–2.21) and positive attitude (aOR = 4.94, 95%CI = 1.19–20.44) to COVID-19 vaccination. Physicians had better KAPP scores than other medical professionals. HCWs working in departments with high-risk patients were more likely to have good knowledge (aOR = 1.28, 95%CI = 1.00–1.72). Positive attitude was also associated with being male (aOR = 2.97, 95%CI = 1.75–5.07) and having at least one non-communicable disease (aOR = 1.92, 95%CI = 1.14–3.23). Being male (aOR = 1.97, 95%CI = 1.35–2.88) and having more years of professional experience (aOR = 1.81, 95%CI = 1.29–2.52) were associated with good practice. Conclusions: Just over a third of HCWs in primary healthcare clinics had good knowledge of COVID-19 vaccination, while positive attitudes and good practices were low. Targeted interventions, particularly for HCWs with less professional experience working in rural settings, are needed to increase good practices and improve COVID-19 vaccination coverage in Tunisia. Full article

This study develops an immersive marine Information and Communication Technology (ICT) convergence framework designed to enhance coastal climate resilience by improving accessibility, visualization, and communication of scientific research on Dokdo (Dok Island) in the East Sea. High-resolution spatial datasets, multi-source marine observations, underwater imagery, and validated research outputs were integrated into an interactive virtual-reality (VR) and web-based three-dimensional (3D) platform that translates complex geophysical and ecological information into intuitive experiential formats. A geospatially accurate 3D virtual model of Dokdo was constructed from maritime and underwater spatial data and coupled with immersive VR scenarios depicting sea-level variability, coastal morphology, wave exposure, and ecological characteristics. To evaluate practical usability and pro environmental public engagement, a three-phase field survey (n = 174) and a System Usability Scale (SUS) assessment (n = 42) were conducted. The results indicate high satisfaction (88.5%), strong willingness to re-engage (97.1%), and excellent usability (mean SUS score = 80.18), demonstrating the effectiveness of immersive content for environmental education and science communication crucial for achieving Sustainable Development Goal 14 targets. The proposed platform supports stakeholder engagement, affective learning, early climate risk perception, conservation planning, and multidisciplinary science–policy dialogue. In addition, it establishes a foundation for a digital twin system capable of integrating real-time ecological sensor data for environmental monitoring and scenario-based simulation. Overall, this integrated ICT-driven framework provides a transferable model for visualizing marine research outputs, enhancing public understanding of coastal change, and supporting sustainable and adaptive decision-making in small island and coastal regions. Full article

With the rapid evolution of cloud-native platforms, microservice-based systems have become increasingly large-scale and complex, making fast and accurate root cause localization and recovery a critical challenge. Runtime signals in such systems are inherently multimodal—combining metrics, logs, and traces—and are intertwined through deep, dynamic service dependencies, which often leads to noisy alerts, ambiguous fault propagation paths, and brittle, manually curated recovery playbooks. To address these issues, we propose GALR, a graph- and LLM-based framework for root cause localization and recovery in microservice-based business middle platforms. GALR first constructs a multimodal service call graph by fusing time-series metrics, structured logs, and trace-derived topology, and employs a GAT-based root cause analysis module with temporal-aware edge attention to model failure propagation. On top of this, an LLM-based node enhancement mechanism infers anomaly, normal, and uncertainty scores from log contexts and injects them into node representations and attention bias terms, improving robustness under noisy or incomplete signals. Finally, GALR integrates a retrieval-augmented LLM agent that retrieves similar historical cases and generates executable recovery strategies, with consistency checking against expert-standard playbooks to ensure safety and reproducibility. Extensive experiments on three representative microservice datasets demonstrate that GALR consistently achieves superior Top-k accuracy and mean reciprocal rank for root cause localization, while the retrieval-augmented agent yields substantially more accurate and actionable recovery plans compared with graph-only and LLM-only baselines, providing a practical closed-loop solution from anomaly perception to recovery execution. Full article

Background/Objectives: Mobile health (mHealth) technologies are increasingly used to support preventive oral care and patient self-management. CarieCheck is a Portuguese app intended to improve oral health literacy and support caries-risk self-assessment. This prospective pilot study focused on users’ perceived app quality and usability, assessed with uMARS-PT. Methods: Thirty participants from the academic community of Egas Moniz School of Health and Science used the app for 30 days and completed the uMARS-PT questionnaire. Descriptive statistics were used to calculate mean scores for Engagement, Functionality, Aesthetics, Information Quality, Subjective Quality, and Perceived Impact. Results: The overall mean uMARS-PT score was 4.22, indicating excellent perceived quality. The highest domain scores were Functionality (4.51), Aesthetics (4.45), and Information Quality (4.22). Engagement (3.71) and Subjective Quality (3.05) were moderate. Perceived Impact (3.85) reflected self-reported perception of increased awareness and motivation regarding oral health behaviors. Conclusions: CarieCheck was rated highly in usability, aesthetics, and information quality. These findings suggest that CarieCheck may be considered as a digital tool for preventive education and user-supported caries-risk self-assessment. Larger, longer-term studies in diverse populations using objective behavioral and clinical outcomes are warranted. Full article

Background/Objectives: Wearable fitness trackers (WFTs) are growing in popularity as tools to motivate physical activity and support healthier lifestyles. Evidence suggests that they can have both positive and negative effects on user behaviour and well-being. However, little is known about their impact in Saudi settings, considering its unique cultural context. This study aims to investigate the perceived positive and negative impacts of WFTs on adults’ health behaviours and well-being in Saudi Arabia. Methods: A cross-sectional survey was conducted among Saudi adults aged 18 years or older who currently use or have previously used WFTs, using an online questionnaire distributed via social media platforms in May 2025. The survey was developed based on evidence from the literature. It included demographic items, five-point Likert-scale questions assessing positive (9 items) and negative (10 items) effects of WFTs, and an open-ended question. Responses were analysed using descriptive statistics, independent samples t-tests, and one-way ANOVA. Results: A total of 154 adults participated. The mean composite score for positive effects was 3.26 (SD = 0.73), indicating general agreement on the benefits of WFTs, while the negative effects score was 2.15 (SD = 0.66), showing low endorsement of adverse outcomes. No significant differences appeared between gender (positive: p = 0.34; negative: p = 0.24) or age groups (positive: p = 0.56; negative: p = 0.19). However, users of over two months had higher positive scores (M = 3.43, SD = 0.66) than newer or former users (p = 0.01). Open responses showed 62% positive experiences; 27% reported stress, guilt, or obsessive monitoring. Conclusions: This study provides initial insights into WFT use and perceptions in Saudi Arabia. However, its cross-sectional nature limits the ability to draw causal conclusions. While most users experienced beneficial health outcomes, a significant proportion reported negative psychological experiences. These findings highlight WFT users’ dual experiences and the need for further longitudinal research and diverse recruitment strategies to better understand sustained engagement and psychological effects. Full article

Background/Objectives: This study aims to explore both the psychosocial outcomes of hearing aid use and the factors that differentiate users from non-users among older adults with sensorineural hearing loss (SNHL) in Romania. Methods: We conducted a cross-sectional, comparative study with follow-up, including 201 patients aged between 49 and 92 years (mean age 70.76 ± 11.86 years), diagnosed with moderate to severe SNHL, evaluated between 1 November 2023, and 30 November 2024, at the Municipal Clinical Hospital Orăștie, Romania. Audiological assessment involved pure-tone audiometry and speech testing. Outcome measures included the Word Recognition Score (WRS), International Outcome Inventory for Hearing Aids (IOI-HA), Hearing Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and the Self-Esteem Scale (SES). Results: Of the 201 patients, 105 (52.2%) accepted hearing aid (HA) fitting and 96 (47.8%) declined. No significant differences were found in age (p = 0.565) or sex (p = 0.476) between groups. HA users reported significantly lower perceived handicap (HHIA: 46.48 ± 24.83 vs. 77.74 ± 28.02, p = 0.015) and higher self-esteem scores (SES: 35.68 ± 4.88 vs. 23.03 ± 4.90, p < 0.001), while tinnitus-related distress (THI) did not differ significantly (p = 0.785). Word recognition scores improved significantly post-fitting across all degrees of hearing loss: moderate (48.52% → 86.13%), moderately severe (47.47% → 85.31%), and severe (47.55% → 85.46%), all p < 0.001. Conclusions: Hearing aid use in older adults with SNHL was associated with significant improvements in speech perception and reduced perceived hearing handicap. These benefits were consistent across all severity levels and were independent of unilateral or bilateral device use. The difference in self-esteem observed between users and non-users may reflect pre-existing psychological factors influencing HA adoption, underlining the importance of personalized counseling in hearing rehabilitation. Full article