Search Results (1,836)

Background: Adaptive deep brain stimulation (aDBS) for Parkinson’s disease (PD) relies on accurate detection of beta oscillatory activity. However, electrocardiographic (ECG) artifacts frequently contaminate local field potentials (LFPs), compromising control algorithms. While offline cleaning methods exist, their feasibility for real-time operation within the strict timing constraints of current sensing-enabled devices remains unknown. Methods: We evaluated four ECG removal algorithms, template subtraction (TS), singular value decomposition (SVD), extended SVD (eSVD), and the Perceive toolbox (PR), on simulated datasets (contaminated at −30 to +20 dB) and clinical recordings from 20 PD patients. Algorithms were assessed for artifact removal quality (beta power preservation, signal-to-noise ratio) and real-time feasibility (99th percentile processing latency—P₉₉ < 50 ms). Results: Only TS and standard SVD met the real-time feasibility threshold, with TS achieving superior timing consistency (P₉₉ ≈ 10 ms). eSVD and PR proved incompatible with closed-loop requirements (P₉₉ > 90 ms). While eSVD yielded the highest artifact suppression at extreme contamination, it suffered from poor signal preservation at moderate levels. TS demonstrated the best balance, maintaining beta power accuracy within ±12% across clinically relevant contamination levels. Conclusions: TS is the recommended method for real-time aDBS applications, offering a safety-critical balance of computational efficiency and biomarker fidelity. Full article

Prolonged standing and repetitive lifting are routine occupational stressors that elevate plantar pressures across workers. In those with diabetes, these demands represent additional risk factors for diabetic foot pathology, highlighting the need for ergonomic interventions beyond standard safety footwear. This study evaluated the perceived ergonomic performance of the MoonWalking^® insole, a novel adaptive pneumatic system designed for real-time pressure stabilization and offloading when integrated into safety footwear. A comparative experimental protocol tested two conditions: safety footwear with the manufacturer’s original insole and the same footwear with the MoonWalking prototype. Twenty participants assessed perceived comfort using a VAS and binary ergonomic questionnaires. The results showed statistically significant improvements in perceived cushioning, foot fit, and overall comfort when using the MoonWalking insole. Participants consistently identified pressure-stabilizing and offloading functions across all plantar regions, indicating that adaptive pressure control was clearly perceptible. No pain or movement restrictions were reported. Although perceived fatigue did not reach statistical significance, a decreasing trend was observed. A slight reduction in intention to reuse the footwear occurred with the prototype, possibly due to its increased weight. These findings provide evidence that integrating an adaptive pneumatic insole into safety footwear may improve plantar pressure redistribution and user comfort. Full article

Empowered by nanotechnology, messenger RNA (mRNA) therapeutics have shown a rapid evolution post COVID-19 from a conceptual platform to a clinically validated modality, and they diversified into oncology, cardiovascular diseases, and rare disorders. As a template for in situ protein production, it offers several advantages over traditional proteins and DNA drugs. The intrinsic stability of mRNA and its sensitivity to innate immune sensing hinder its capacity for immediate cellular entry, necessitating its need for a delivery system to obtain optimal therapeutic potential. This review explores the innovations in nanocarrier engineering, design principles for lipid nanoparticles-mRNA (LNPs) platforms, and their clinical translation across the prominent indications. It also addresses their safety, immunogenicity, and scalability while addressing the key limitations and manufacturing scalability through comparative platform analysis. Although LNPs usually dominate their delivery through encapsulation and manufacturability, their limitations, like repeat dose reactogenicity and liver tropism, require next-generation designs like SORT lipids, stimuli-responsive hybrids for extrahepatic targeting. In oncology, LNP-mRNA drives the neoantigen vaccines, and rare diseases leverage the transient enzyme replacement. While the safety profiles highlight the innate immune tuning through nucleoside mods and lipid biodegradability, chronic administration risks are still persistent. While there are novel scalability options like microfluidic mixing to support the production gaps in organ selectivity and durability, their adoption is hindered. We outline the future directions to perceive mRNA’s full potential as a broader therapeutic class. Full article

Travel companion matching presents unique challenges compared with conventional recommendation domains, as it involves real-world interpersonal interaction, perceived safety risks, and limited historical user data under cold-start conditions. Existing platforms often lack structured multi-factor matching and transparent integration of trust and safety constraints. This study makes three contributions. First, it introduces a methodology for deriving interpretable compatibility weights from user preference data under cold-start conditions. Second, it presents a four-algorithm comparative evaluation framework that identifies user-preferred matching strategies through controlled real-user testing. Third, it proposes a safety-enhanced empirical hybrid algorithm that integrates a hard trust gate (T ≥ 0.7), safety-oriented components (51.3% normalised weight), and empirically derived preference personalisation (48.7%) within a single scoring framework. A three-phase empirical methodology is adopted: Phase 1 (n = 26 survey) derives compatibility weights, revealing safety (69.2%), travel pace (76.9%), and budget (73.1%) as dominant factors; Phase 2 (n = 15) compares four algorithms, with safety-first matching receiving the highest acceptance rate (60.0%, 95% Wilson CI: 35.7–80.2%); Phase 3 (n = 13 journeys) evaluates the hybrid algorithm, achieving an 84.6% selection rate with Precision@6 = 0.333, MRR@6 = 0.554, and NDCG@6 = 0.597. These results provide preliminary evidence that trust-aware constraints can be integrated with empirically derived preference modelling to produce actionable recommendations under cold-start conditions, offering a reproducible approach for peer-to-peer travel platforms prioritising user safety. Full article

Hydrogen refueling stations (HRSs) are a critical enabling infrastructure for fuel cell electric vehicles (FCEVs), yet their deployment in dense metropolitan areas often faces a dual challenge: limited travel-time accessibility for users and low public acceptance driven by perceived safety risks. This study develops an integrated, city-scale framework to quantify HRS accessibility and resident acceptance and to identify expansion priorities for Seoul, South Korea. We combine (i) an online perception survey of 1000 adult residents (October 2024) capturing environmental awareness, perceived safety, siting preferences, and willingness-to-travel distance; (ii) spatial demand data on FCEV registrations by administrative dong (n = 2443 vehicles, 2022); and (iii) network-based travel-time analysis using the Seoul road network and the current HRS supply (n = 10, 2024). Accessibility is evaluated under three travel-time thresholds (10, 15, and 20 min), with service-area delineation and demand-weighted underserved-area diagnosis. Candidate expansion sites are generated and screened using operational and regulatory constraints (e.g., site area and proximity to protected facilities), followed by a p-median location-allocation optimization to select five additional sites that minimize demand-weighted travel impedance. Results indicate that, under the 20 min threshold (7.7 km at an average operating speed of 23.1 km/h), 50 of 425 dongs (11.8%) and 244 of 2443 FCEVs (10.0%) are outside the baseline service coverage. After adding five sites (total n = 15), underserved dongs decrease to 5 (1.2%) and underserved FCEVs to 26 (1.1%) for the 20 min threshold, with consistent improvements across shorter thresholds. Survey responses further reveal that only 12.5% of respondents perceive HRSs as safe, while 46.5% report a maximum willingness-to-travel distance of up to 5 km, underscoring the need for both accessibility enhancement and risk-aware communication. The proposed workflow offers a transparent, reproducible approach to support equitable and risk-informed HRS planning by jointly considering network accessibility, demand distribution, and social acceptance, thereby contributing to sustainable urban mobility, low-carbon transport transition, and socially acceptable hydrogen infrastructure deployment. Beyond local accessibility improvement, the study is framed in the broader context of sustainability, as equitable and socially acceptable hydrogen refueling infrastructure can support low-carbon urban transport transitions and more resilient metropolitan energy-mobility systems. Full article

This cross-sectional study explored whether the relationship between adolescents’ physical activity and related factors (such as personal and social factors, and parental safety concern) differed according to adolescents’ levels of access to play spaces. Data from Wave 3 of the Growing Up in Ireland (GUI) national longitudinal study, a nationally representative sample of 5212 adolescents aged 17–18 years, was analyzed. Key study variables included adolescents’ physical activity, personal factors (gender, health status, parents’ education and physical activity levels, and active commuting), social factors (number of friends, family support), and parental safety concerns (perceived safety of walking/playing and neighborhood safety). Two structural equation models (SEMs) were employed to compare relationships among physical activity and related factors for adolescents with high and low access to play spaces. Results showed that adolescents living in areas with high access to play spaces reported significantly higher levels of physical activity. Parents’ levels of education and the number of friends available for play had significant impacts on adolescents’ physical activity, regardless of access to play spaces. However, parental perception of the safety of walking and playing was only significant for adolescents with low access to parks. The associations between related factors and adolescents’ levels of physical activity differed for those with high and low access to play spaces, suggesting that interventions promoting adolescents’ physical activity may not yield equal results across these groups. A key limitation of this study is its cross-sectional design and reliance on self-reported measures, which preclude causal inference. Full article

While polyurethane acoustic foam is widely used in entertainment settings for sound absorption, it poses a considerable fire risk when exposed to sparks from pyrotechnic devices. Even though fountain-type pyrotechnic devices are often perceived as producing “cold sparks”, the ignition potential of a single incandescent particle remains insufficiently quantified. This study experimentally investigates the ignition capacity of a fountain-type pyrotechnic article on pyramidal polyurethane acoustic foam under controlled conditions. Three dedicated experimental configurations were developed: (i) ignition probability tests at various distances, (ii) scaled configuration tests reproducing realistic installation geometry, and (iii) high-speed visualization of single incandescent particle interaction with the foam surface. For the first two configurations, ignition probabilities of 20% and 22.2% were obtained. High-speed recordings showed two distinct interaction mechanisms: particle fragmentation and ricochet, which did not result in ignition; partial penetration with localized melting, volatile release, and gas-phase ignition when residual thermal energy (about 0.5–1 J) was retained. The results demonstrate that even isolated single incandescent particles generated under realistic conditions can initiate the combustion of polyurethane acoustic foam. These findings challenge the “cold spark” safety perception and provide quantitative evidence that particle–induced ignition represents a significant fire hazard in enclosed environments where combustible acoustic materials and pyrotechnic effects coexist. The findings in this paper have direct implications for safety regulations in entertainment venues. Full article

Road accidents related to long-distance driving remain a major safety concern, primarily driven by fatigue and musculoskeletal discomfort. This study investigates the acceptance of driver assistance technologies, specifically seat adjustment and fatigue warning applications using the Technology Acceptance Model (TAM). Data were collected from 1600 drivers in Thailand. Participants were categorized into low-discomfort (n = 785) and high-discomfort (n = 815) groups based on the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Multi-group Structural Equation Modeling (SEM) demonstrated that the TAM framework adequately explains technology acceptance in both groups. However, significant differences in the underlying mechanisms were observed. For drivers with lower discomfort levels, attitude toward technology played a more prominent role in shaping usage intention. In contrast, perceived usefulness emerged as the dominant factor for drivers experiencing higher musculoskeletal discomfort. These findings indicate that physical discomfort functions as a critical moderator in technology acceptance. Practically, the results highlight the need for driver assistance systems that prioritize ergonomic effectiveness to enhance adoption among physically strained users. Full article

Campus streetscapes are a key part of universities’ everyday public realm, yet the same scene may be perceived positively in one dimension while negatively in another. To diagnose such multi-dimensional perceptual differences and translate them into actionable design evidence, this study develops an interpretable vision analytics framework for adaptive campus design. Using 72,733 Baidu Street View images collected from 41 campuses in mainland China, the study integrates ResNet-50-based perception prediction, spatial element extraction, XGBoost–SHAP-based mechanism interpretation, Kruskal–Wallis H testing, and GIS-based scene mapping. Supported by supplementary in situ validation, six types of multi-dimensional perceptual differences were identified. Sky, buildings, vegetation, hardscape, and terrain were found to be the five most important spatial elements overall, among which sky, buildings, and vegetation repeatedly emerged as the dominant core elements distinguishing different perceptual types. These elements do not act independently or linearly, but jointly shape different types of multi-dimensional perceptual differences through nonlinear threshold effects and interactions. These perceptual difference types were further found to cluster in recognizable campus scenes, including main roads, plazas, lawns, forest belts, and lakeside spaces. Based on these findings, scene-specific piecemeal optimization strategies were derived to support the coordinated enhancement of perceived safety, liveliness, and beauty. Overall, the study shows that campus perception is shaped by holistic spatial configurations rather than the simple accumulation of isolated elements, and provides a quantitative basis for iterative, feedback-oriented adaptive campus design. Full article

Inclusive education (IE) aims to promote meaningful participation and a sense of belonging for all learners. However, limited research has examined how students with learning difficulties (LDs) experience inclusion in everyday school life. This study explored how primary school students with mild LDs perceive their participation, relationships with teachers and peers, and the role of inclusive classes (ICs) within mainstream Greek primary education. A qualitative design was adopted, and data were collected through semi-structured interviews with ten Grade 6 students receiving support through ICs. Transcripts were analyzed using thematic analysis. Findings indicated that participation was associated with perceived competence in academic tasks, with language-based activities frequently described as cognitively demanding and stressful. Belonging was predominantly felt through peer acceptance and supportive teacher practices rather than solely through classroom placement. The ICs were perceived as providing individualized support and emotional safety, although some ambivalence regarding withdrawal from the mainstream classroom was reported. Students stressed the need for flexible assessment and clearer instructional guidance to enhance fairness and participation. Overall, the findings show that inclusion is experienced as a dynamic interaction between academic accessibility, interpersonal relationships, and supportive learning environments. They also underline the importance of incorporating student voice into inclusive practice. Full article

Background: The Democratic Republic of the Congo accounts for approximately 12–13% of the global malaria burden. While international guidelines oppose the use of Artemisia annua infusions due to risks of sub-therapeutic dosing and resistance selection, the plant remains widely used in resource-limited regions. This study evaluates the clinical acceptability and perceptions of healthcare providers regarding the integration of Artemisia annua tea into formal malaria control in the Maniema province. Methods: A cross-sectional survey was conducted among 337 healthcare professionals in the Kalima health district using the KoboCollect digital platform. Multivariate logistic regression was employed to identify the primary socio-professional determinants of clinical acceptability. Results: The overall clinical acceptability of Artemisia annua integration was 81.0%, with 82.8% of providers perceiving the preparation as effective. Rural residency was the strongest predictor of adherence (AOR = 6.847; p = 0.003), reflecting a pragmatic response to frequent ACT stockouts and high treatment costs. Despite high acceptability, 49.0% of providers identified the lack of clinical evidence as a major barrier, and 91.4% demanded formal training on standardized dosage and biological mechanisms. Conclusions: A significant “policy–practice gap” exists between international guidelines and field realities in the DRC. Healthcare providers demonstrate high readiness for integration but emphasize the absolute necessity of galenic standardization to mitigate resistance risks. To address these concerns, a complementary genomic investigation is currently underway in the same study area, comparing PfKelch13 mutation prevalence among Artemisia tea users versus ACT-treated patients. This molecular surveillance will provide essential evidence to define safety parameters for future phytopharmaceutical integration. Full article

Background and Objectives: Venous thromboembolic disease (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of morbidity and mortality worldwide and imposes a substantial financial burden on health systems due to both the direct and indirect costs of acute management and long-term complications. This systematic review aimed to assess patient satisfaction with anticoagulation therapy for VTE and to highlight potential differences according to the type of anticoagulant. The review focused on factors influencing the patient experience, such as perceived efficacy, ease of use, adverse effects, and health-related quality of life. Materials and Methods: A systematic review, without quantitative meta-analysis, was conducted in accordance with PRISMA 2020 guidelines. Articles were identified through searches in major databases (PubMed, Scopus, Cochrane Library and others) using keywords including “patient satisfaction”, “anticoagulation”, “venous thromboembolic disease”, and “quality of life”. In total, 21 studies published between 2009 and 2025 met the inclusion criteria. The studies assessed patient satisfaction with different types of anticoagulation, including vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs), and low-molecular-weight heparin (LMWH) injections. Results: Across the included studies, patients generally reported higher levels of treatment satisfaction with DOACs compared with VKAs, mainly due to the absence of routine laboratory monitoring and fewer dietary restrictions. However, satisfaction varied according to age, sex, and clinical status. In specific patient populations, such as those with cancer-associated thrombosis, factors including fewer drug–drug interactions and perceptions of safety with LMWH appeared to influence treatment choice and satisfaction. Adverse effects, particularly bleeding, were identified as major drivers of dissatisfaction. Several studies suggested that higher treatment satisfaction was associated with better adherence, while quality of life appeared to improve in patients treated with DOACs in comparison with VKAs. Conclusions: Patient satisfaction is a critical component of successful VTE management. Overall, DOACs appear to be associated with higher treatment satisfaction than traditional therapies such as VKAs, although further high-quality research is needed to individualise anticoagulation strategies. Systematic incorporation of patient-reported satisfaction into clinical decision-making and into international guidelines may improve adherence, enhance quality of life, and ultimately increase the effectiveness of anticoagulation therapy. Full article

To address the bottlenecks of low sample efficiency and poor control accuracy in traditional single-layer reinforcement learning during autonomous driving overtaking, this paper proposes an overtaking decision and control system based on hierarchical reinforcement learning to decouple complex tasks in spatial and temporal dimensions. A heterogeneous two-layer architecture is constructed, where the upper layer adopts the Proximal Policy Optimization algorithm to generate macroscopic discrete decisions, while the lower layer employs Twin Delayed Deep Deterministic Policy Gradient combined with Long Short-Term Memory to achieve smooth continuous control of steering and acceleration by perceiving temporal features of dynamic obstacles. A composite reward mechanism, integrating hard safety constraints and soft efficiency incentives, is designed to balance safety, efficiency, and comfort. Experimental results in complex scenarios with multiple interfering vehicles and random lane-changing behaviors demonstrate that the proposed system improves the training convergence speed by approximately 30% within 500,000 steps compared to single-layer algorithms. In tests across varying traffic densities, the system achieves a 98.3% success rate in medium-density scenarios with a collision rate of only 0.6%. In high-density challenges, the success rate remains above 95%, with the collision rate reduced by about 80% compared to baseline models. Furthermore, the lateral control deviation is strictly limited to within 0.2 m, and the longitudinal safety distance remains stable above 5 m. This system provides a robust, high-efficiency paradigm for autonomous overtaking. Full article

Background: Adults with disabilities living in low-resource communities experience persistent inequities in access to healthcare, mental health services, and community participation. However, qualitative data capturing lived experiences in the Deep South remain limited. This study aimed to identify priority needs among adults with mobility disabilities residing in economically distressed communities near Birmingham, Alabama, to inform future telehealth programming. Methods: Fifteen adults (mean age = 60 ± 10 years), predominantly African American and female, completed semi-structured phone interviews exploring basic needs, neighborhood accessibility, health priorities, and perceived supports. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s six-phase thematic analysis. Results: Five themes emerged: (1) seeking stability amid severe mental health strain and inadequate supports; (2) constrained food environments shaped by cost, location, and safety; (3) feeling forgotten: systemic neglect and restricted participation in community life; (4) physical health deprioritized by competing needs and structural barriers; and (5) remote support as a viable but unrealized option. Participants described how safety concerns, transportation barriers, and rising food costs constrained daily functioning, while unmet mental health needs compounded isolation. Despite widespread cardiometabolic disease, immediate needs related to mental health, food, and housing consistently superseded physical health. Mental health support was identified as the most feasible area for remote delivery, though poor awareness of available resources limited engagement with any service model. Conclusions: Findings demonstrate that disability-related disparities in low-resource communities are driven largely by structural and environmental factors rather than individual choice. Telehealth and mobile-based services may provide a feasible access strategy for mental health and supportive care in under-resourced settings, particularly when integrated with broader community supports. Addressing foundational needs is essential for advancing health equity among people with disabilities in the Southeast. Full article

Swimming and water safety education can reduce drowning risk, yet research among the Turkish population is limited. This study examined differences in water safety attitude and knowledge scores by self-reported participation in swimming and lifeguard education, including any differences seen by participant gender. A cross-sectional survey collected data on demographics, swimming experience, perceived ability, aquatic location use, swimming and lifeguard education participation, water safety knowledge and self-reported attitudes. Among 255 participants (51.4% female; mean age 22), 83.9% reported being able to swim. Females were significantly less likely than males to self-report swimming ability (χ² = 5.99; p = 0.018) or prior lessons with a qualified teacher (χ² = 4.10; p = 0.043). Swimming or lifeguard education did not significantly affect attitude scores overall or by gender. However, both forms of education were significantly associated with knowledge scores overall and by gender, with males showing significant differences in knowledge levels after swimming (χ² = 16.46; p < 0.001) and lifeguard education (χ² = 11.93; p = 0.003). Findings indicate that swimming and lifeguard education were significantly associated with greater water safety knowledge but not with positive attitudes. Gender disparities persist, with females reporting lower self-reported swimming ability and males showing higher water safety knowledge after education. Expanding swimming and lifeguard education in Türkiye could enhance water safety knowledge. Full article