Search Results (434)

Invasive candidiasis (IC), characterized by the most common clinical manifestation of candidemia, is a fungal infection with a high mortality rate and a significant impact on global public health. It is estimated that each year there are between 227,000 and 250,000 hospitalizations related to IC, with more than 100,000 associated deaths. In Latin America and the Caribbean (LA&C), the absence of a standardized surveillance system has led to multicenter studies documenting incidences ranging from 0.74 to 6.0 cases per 1000 hospital admissions, equivalent to 50,000–60,000 hospitalizations annually, with mortality rates of up to 60% in certain high-risk groups. Armed conflicts and structural violence in LA&C cause forced displacement, the collapse of health systems, and poor living conditions—such as overcrowding, malnutrition, and lack of sanitation—which increase vulnerability to opportunistic infections, such as IC. Insufficient specialized laboratories, diagnostic technology, and trained personnel impede pathogen identification and delay timely initiation of antifungal therapy. Furthermore, the empirical use of broad-spectrum antibiotics and the limited availability of echinocandins and lipid formulations of amphotericin B have promoted the emergence of resistant non-albicans strains, such as Candida tropicalis, Candida parapsilosis, and, in recent outbreaks, Candidozyma auris. Full article

Background: Overcrowded emergency departments (EDs) create significant challenges for patient management and hospital efficiency. In response, Amiens Picardy University Hospital (APUH) developed the “Prediction of the Patient Pathway in the Emergency Department” (3P-U) model to enhance patient flow management. Objectives: To develop and clinically validate an explainable artificial intelligence (XAI) model for hospital admission predictions, using structured triage data, and demonstrate its real-world applicability in the ED setting. Methods: Our retrospective, single-center study involved 351,019 patients consulting in APUH’s EDs between 2015 and 2018. Various models (including a cross-validation artificial neural network (ANN), a k-nearest neighbors (KNN) model, a logistic regression (LR) model, and a random forest (RF) model) were trained and assessed for performance with regard to the area under the receiver operating characteristic curve (AUROC). The best model was validated internally with a test set, and the F1 score was used to determine the best threshold for recall, precision, and accuracy. XAI techniques, such as Shapley additive explanations (SHAP) and partial dependence plots (PDP) were employed, and the clinical explanations were evaluated by emergency physicians. Results: The ANN gave the best performance during the training stage, with an AUROC of 83.1% (SD: 0.2%) for the test set; it surpassed the RF (AUROC: 71.6%, SD: 0.1%), KNN (AUROC: 67.2%, SD: 0.2%), and LR (AUROC: 71.5%, SD: 0.2%) models. In an internal validation, the ANN’s AUROC was 83.2%. The best F1 score (0.67) determined that 0.35 was the optimal threshold; the corresponding recall, precision, and accuracy were 75.7%, 59.7%, and 75.3%, respectively. The SHAP and PDP XAI techniques (as assessed by emergency physicians) highlighted patient age, heart rate, and presentation with multiple injuries as the features that most specifically influenced the admission from the ED to a hospital ward. These insights are being used in bed allocation and patient prioritization, directly improving ED operations. Conclusions: The 3P-U model demonstrates practical utility by reducing ED crowding and enhancing decision-making processes at APUH. Its transparency and physician validation foster trust, facilitating its adoption in clinical practice and offering a replicable framework for other hospitals to optimize patient flow. Full article

Aquaculture is a crucial food-producing sector that can supply more essential nutrients to nourish the growing human population. However, it faces challenges, including limited water quality and space competition. These constraints have led to the intensification of culture systems for more efficient resource use while maintaining or increasing production levels. However, intensification introduces stress risks to cultured organisms by, for instance, overcrowding, waste accumulation, and water quality deterioration, which can negatively affect the growth, health, and immunity of animals and cause diseases. Additionally, environmental changes due to climate and anthropogenic activities further intensify the environmental stress for aquaculture organisms, including crustaceans. Shrimp are one of the most widely cultured and consumed farmed crustacea. Relative to aquatic vertebrates such as fish, the physiology of crustaceans has simpler physiological structures, as they lack a spinal cord. Consequently, their stress response mechanisms follow a single pathway, resulting in less complex responses to stress exposure compared to those of fish. While stress is considered a primary factor influencing the growth, health, and immunity of shrimp, comprehensive research on crustacean stress responses remains limited. Understanding the stress response at the organismal and cellular levels is essential to identify sensitive and effective stress biomarkers which can inform the development of targeted intervention strategies to mitigate stress. This review provides a comprehensive overview of the physiological changes that occur in crustaceans under stress, including hormonal, metabolic, hematological, hydromineral, and phenotypic alterations. By synthesizing current knowledge, this article aims to bridge existing gaps and provide insights into the stress response mechanisms, paving the way for advancements in crustacean health management. Full article

This study explores teachers’ understanding and implementation of inclusive education in a rural mainstream secondary school in Limpopo Province, South Africa. Grounded in the inclusive pedagogy framework, the research employed a qualitative approach, combining classroom observations and semi-structured interviews with three purposively selected teachers. Findings revealed a significant disconnect between teachers’ conceptual support for inclusion and their classroom practices, which remained largely traditional and undifferentiated. Teachers expressed narrow or fragmented understandings of inclusion, often equating it solely with disability integration, and cited systemic barriers such as overcrowding, rigid curricula, and inadequate training as key challenges. Despite emotional discomfort and pedagogical insecurity, participants demonstrated a willingness to adopt inclusive strategies if provided with contextualised professional development and systemic support. The study underscores the need for strengthened pre-service and in-service teacher training, curriculum flexibility, and resource provision to bridge the policy-practice gap in rural inclusive education. Recommendations include collaborative learning communities, stakeholder engagement, and further research to advance equitable implementation. Full article

The analysis of the spatial location of tourists is essential for effective tourism management. This study explores the potential effects of large language models (LLMs) on urban travel planning. Despite growing academic interest in LLMs, empirical research on their specific impact on urban tourist locations remains limited, even though these models may significantly affect tourist behavior and spatial dynamics. This article compares the location of heritage sites in the city of Barcelona that are traditionally visited by tourists (as identified through Instagram) with those recommended by ChatGPT. The results show that ChatGPT tends to recommend a much smaller and more spatially concentrated number of tourist attractions than those shared on Instagram. The findings indicate that ChatGPT reinforces mainstream representations of cities by prioritizing well-known landmarks, potentially overlooking emerging or local attractions. This simplification can lead to tourist overcrowding and the marginalization of less-visited areas. Likewise, it may entail new needs for the management of urban spaces. Urban planners and tourism managers may need to intervene to redistribute tourist flows in a context where various models of tourist behavior will coexist. Full article

Emergency department overcrowding disproportionately affects complex patients, such as older adults and those with comorbidities, who consume significant resources and experience prolonged delays. This study integrates process mining and predictive simulation to identify key factors influencing length of stay and to propose a data-driven solution: a tailored fast-track pathway for high-risk patients. Using data from 94,489 emergency episodes, a predictive formula was developed based on clinically relevant variables, including age (>65 years); triage levels (II and III); frequent emergency department visits; need for mobility aids; and specific reasons for consultation such as dyspnea, abdominal pain, and poor general condition. Simulation results demonstrated that implementing this fast-track pathway reduces length of stay by up to 21% and emergency department saturation by 35%, even with minimal resource allocation (five beds). The manual predictive formula showed comparable prediction performance to machine learning models while maintaining transparency and traceability, ensuring greater acceptability among healthcare professionals. This approach represents a paradigm shift in emergency department management, offering a scalable tool to optimise resource allocation, improve patient outcomes, and reduce operational inefficiencies. Future multicenter validations could establish this model as an essential component of emergency department management strategies. Full article

Background/Objectives: Missed outpatient appointments contribute to care discontinuity and emergency department (ED) overcrowding. This study investigated the association between missed appointments and ED visits, identifying predictors such as patient characteristics, distance from the hospital, and waiting time. Methods: A retrospective analysis was conducted using a dataset of 749,450 scheduled outpatient appointments from adult patients (aged ≥ 18 years). Patients under 18 were excluded. We identified missed appointments and assessed their association with ED visits occurring in the same period. Descriptive statistics, non-parametric tests, and logistic and linear regression models were applied to examine predictors such as age, sex, distance from the hospital, waiting time, the type of service, and medical specialty. Results: The overall no-show rate was 3.85%. Among patients with missed appointments, 37.3% also visited the ED. An older age (OR = 1.007; p = 0.006) and the male gender (OR = 1.498; p < 0.001) were significant predictors of having a scheduled appointment before an ED visit. No significant associations were found for distance or specialty branch. Conclusions: Missed appointments are associated with ED utilization. Predictive factors can inform targeted interventions, such as via improved scheduling systems and personalized reminders. Distance alone may not be a barrier, but system-level solutions are needed to address no-show rates and optimize healthcare resource use. Full article

The rapid shift to online education during the COVID-19 pandemic exacerbated mental health risks for students, particularly those experiencing multidimensional poverty—a potential contributor to psychological distress in digital learning environments. This study examines how poverty-driven techno-distress (technology-related stress) impacts university students’ mental health, focusing on 202 Chilean learners engaged in remote classes. Using partial least squares structural equation modeling (PLS-SEM), we analyzed multidimensional poverty and its association with techno-distress, measured through validated scales. The results suggest that poverty conditions are associated with 32.5% of technostress variance (R² = 0.325), while techno-distress may indirectly relate to 18.7% of students’ dissatisfaction with academic life—a proxy for emerging mental health risks. Importance–performance map analysis (IPMA) identified housing habitability (e.g., overcrowding, inadequate study spaces) and healthcare access as priority intervention targets, surpassing purely digital factors. These findings indicate that techno-distress in online education may function as a systemic stressor, potentially amplifying pre-existing inequities linked to poverty. For educators and policymakers, this highlights the urgency of early interventions addressing students’ physical environments alongside pedagogical strategies. By framing techno-distress as a public health challenge rooted in socioeconomic disparities, this work advances preventive approaches to safeguard student well-being in increasingly hybrid educational landscapes. Full article

This study examines culture-led urban regeneration as a strategy for revitalizing Meezan Chowk, a historically significant yet deteriorating public space in Quetta, Pakistan. Once a central site of social and commercial exchange, the area suffered from infrastructural decline, overcrowding, and the erosion of its architectural identity. The research proposes a design intervention to restore the site’s heritage value while enhancing its functional and social relevance. A qualitative approach is adopted, incorporating surveys, focus group discussions, and site observations to assess user needs and spatial dynamics. A SWOT analysis serves as the analytical framework to identify the site’s internal strengths and weaknesses, as well as external opportunities and threats. By utilizing the Geographic Information Systems (GIS) and OpenStreetMap data, further information can enhance understanding of the site’s urban morphology. The proposed design integrates vernacular elements, such as arched facades, shaded corridors, and communal courtyards, with contemporary features, including cafes, local artisan shops, and accessible public amenities. Full article

Mobile scaffolding is essential in construction but presents significant safety risks, particularly falls from height (FFH) due to improper use and insufficient monitoring. While prior research has identified hazards, it often lacks robust, actionable solutions, especially regarding the comprehensive analysis of worker behaviors and the spatial context. This study proposed a computer vision-based safety monitoring system that leverages depth cameras for accurate spatial assessments and incorporates temporal conditions to reduce false alarms. The proposed system extends object detection algorithms with mathematical logic derived from safety rules to classify four key unsafe conditions related to safety helmet use, guardrail and outrigger presence, and worker overcrowding on mobile scaffolds. A diverse dataset from multiple sources enhances the model’s applicability to real-world scenarios, while a status trigger module verifies worker behavior over a 3 s window, minimizing detection errors. The experimental results demonstrate high precision (0.95), recall (0.97), F1-score (0.96), and accuracy (0.95) for safe behaviors, with similarly strong metrics for unsafe behaviors. The qualitative analysis further confirms substantial improvements in worker position detection and safety compliance using 3D data over 2D approaches. These findings highlight the effectiveness of the proposed system in improving mobile scaffolding safety, addressing critical research gaps, and advancing construction industry safety standards. Full article

The present study explores residents’ perceptions of Stintino (Sardinia, Italy) as a tourist destination. The municipality is predominantly known for La Pelosa beach, widely regarded as one of the most attractive coastal sites in Europe. However, its popularity has raised critical issues related to carrying capacity and seasonal overcrowding, contributing to a tourism model centered almost exclusively on beach-related activities. This study aims to investigate how locals conceptualize their place beyond the dominant seaside narrative, particularly considering Stintino’s identity as a former fishing village with a strong maritime tradition. As part of Italy’s designated inner areas, Stintino also embodies a deep-rooted connection to cultural heritage, further reinforcing the need for its preservation. Adopting a photovoice-based participatory visual methodology, this study engaged 15 local stakeholders from key sectors (hospitality, fishing tourism, retail, gastronomy, and cultural institutions) who produced and discussed photographic representations of their lived experience of the territory. The visual material was thematically analyzed using a conceptual framework informed by theories of place perception and social representations. The findings suggested a multifaceted territorial storytelling rooted in local heritage, symbolic spaces, and everyday practices. Tourism governance strategies could incorporate community-based approaches, such as participatory mapping and inclusive narrative development, to foster more sustainable and place-sensitive promotion models. Full article

The literature shows greenspaces generally increase nearby property values, but in Riyadh, this relationship is complex and understudied. Existing studies lack sector-specific analyses across Riyadh’s neighborhoods, overlook the impact of the Green Riyadh Project launched in 2019, and fail to address negative externalities associated with large greenspaces in an arid, privacy-conscious context. Such paradoxical impact of larger greenspaces bordering major roads at the neighborhood edge, unexpectedly reduce property values by 2–4% due to petty crime, congestion, poor upkeep, and privacy concerns, contrasting with 10–18% premiums for properties abutting greenspaces with restricted access in affluent neighborhoods. Global studies typically report positive greenspace effects, so negative impacts in specific Riyadh sectors are surprising. This highlights the city’s unique arid, cultural, and urban dynamics in addressing this research gap. The research uses purposive quota sampling of Riyadh neighborhood greenspaces and a mixed-methods approach of quantitative hedonic pricing analysis combined with qualitative semi-structured interviews with real estate agents. Findings underscore the need for tailored urban planning (e.g., mitigating petty crime, overcrowding, poor maintenance). This suggests the importance of integrating green infrastructure into urban planning, not only for its ecological and social benefits but also for its tangible positive impact on property values. Poor greenspace upkeep and safety concerns can reduce price premiums of abutting properties. Full article

This study integrates socio-demographic factors and local sustainability indicators to assess their implications for public health and social vulnerability in the Henequén neighborhood of Cartagena, Colombia. This historically marginalized community, primarily composed of women and displaced families, faces chronic exposure to environmental contaminants due to its past as a municipal landfill. Poor housing conditions, overcrowding, and inadequate access to water and sanitation services exacerbate health risks. Additionally, low educational attainment and limited economic opportunities contribute to cycles of poverty and illicit activities, disproportionately affecting children’s development. Using a cross-sectional and correlational approach, the study identifies key variables, such as housing conditions, access to basic services, and marital status, that shape social vulnerability. The findings are analyzed in the context of the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 6 (Clean Water and Sanitation), and SDG 11 (Sustainable Cities and Communities). The study highlights critical gaps in sustainability efforts and provides a framework for assessing local progress toward achieving these global development objectives. Full article

An Abramson-type oblique-incident interferometer was used for the surface-form measurement of hand-scraped marks consisting of rough surfaces. Although the Abramson interferometer could measure the rough surface of hand-scraped marks under noncontact conditions, the inconsistency in the measurement results was caused by the differences in the incident direction of the measuring light. This study investigated the inconsistency in the measurement results of the Abramson interferometer caused by the oblique incidence of the measuring light. The reproducibility of inconsistencies due to the difference in the incident direction of the measuring light was confirmed, and the relationship between the inconsistency of the measurement results and the incident angle of the measuring light was investigated. Consequently, it was confirmed that the inconsistency of the measurement results due to the difference in the incident direction of the measuring light could be reduced by decreasing the incident angle of the measuring light. To avoid the overcrowding of the interference fringes caused by the reduction in the incident angle of the measuring light, an oblique-incident interferometer with a near-infrared laser was constructed. The validity of the developed oblique-incident interferometer was evaluated by comparison with a commercially available contour measurement instrument. The surface form obtained by the developed oblique-incident interferometer was confirmed to be consistent with the envelope of the cross-sectional profile measured by the contour measurement instrument. Full article

Pedestrian panic behavior is a primary cause of overcrowding and stampede accidents in public micro-road network areas with high pedestrian density. However, reliably detecting such behaviors remains challenging due to their inherent complexity, variability, and stochastic nature. Current detection models often rely on single-modality features, which limits their effectiveness in complex and dynamic crowd scenarios. To overcome these limitations, this study proposes a contour-driven multimodal framework that first employs a CNN (CDNet) to estimate density maps and, by analyzing steep contour gradients, automatically delineates a candidate panic zone. Within these potential panic zones, pedestrian trajectories are analyzed through LSTM networks to capture irregular movements, such as counterflow and nonlinear wandering behaviors. Concurrently, semantic recognition based on Transformer models is utilized to identify verbal distress cues extracted through Baidu AI’s real-time speech-to-text conversion. The three embeddings are fused through a lightweight attention-enhanced MLP, enabling end-to-end inference at 40 FPS on a single GPU. To evaluate branch robustness under streaming conditions, the UCF Crowd dataset (150 videos without panic labels) is processed frame-by-frame at 25 FPS solely for density assessment, whereas full panic detection is validated on 30 real Itaewon-Stampede videos and 160 SUMO/Unity simulated emergencies that include explicit panic annotations. The proposed system achieves 91.7% accuracy and 88.2% F1 on the Itaewon set, outperforming all single- or dual-modality baselines and offering a deployable solution for proactive crowd safety monitoring in transport hubs, festivals, and other high-risk venues. Full article