Search Results (3,767)

The scope of actual pro-environmental initiatives, programs, interventions, and campaigns is limited. Therefore, spillover effects from these activities to other domains of economy, the private sphere, and society are crucial to achieve a transformation of society towards sustainability. Starting from the known literature and using Google Scholar as a platform for searching additional studies, this explorative, traditional narrative review analyses behavioural spillover effects, where either one behaviour influences the likelihood of another behaviour, or an intervention shows an impact on an environmentally significant behaviour, which it did not primarily address. In the scientific literature, spillover is classified by direction (environmentally positive versus negative), involved behaviours (similar or cross-behavioural), timing (short or long term), context (e.g., work to private life), and social scope (personal, interpersonal, intra- and inter-organisational, intergroup, or international). Positive spillover can result from cognitive dissonance reduction, consistent self-perception, pro-environmental values, norms, self-identity, action-based learning, and habit formation. Negative spillover emerges through rebound effects, moral licensing, and psychological reactance. Stronger spillover is observed between similar behaviours, while cross-domain spillover is generally weaker. According to previous research, a facilitated participatory approach with strong pro-environmental orientation appears recommendable for practitioners to foster the value change required for effective and sustained positive spillover. Full article

Purpose: This study provides a critical examination of the literature on applying artificial intelligence (AI) and Extended Reality (XR) in restaurant settings and related foodservice operations. It focuses on how AI and XE influence consumer nutrition awareness and decision-making about food choices, and their implications for customer satisfaction, loyalty, and service delivery in foodservice environments. Design/methodology/approach: The study adopts a systematic literature review (SLR) approach following the PRISMA method. An initial search identified over 3900 academic papers published between 2016 and 2025. Studies were selected on the basis of predetermined inclusion and exclusion criteria, and 26 peer-reviewed articles were analyzed. The review provides a conceptual synthesis and develops propositions for practical applications and future research directions. Findings: The review reveals a shift from static systems that rely on optimization, toward adaptive and user-centered solutions that are behavior-oriented. AI applications predominate in the case of calorie tracking, personalized recommendations, and menu planning. Though deployment of XR technologies (e.g., AR and VR) is less prevalent, they offer potential for immersive, and real-time interventions. A key distinction emerges between studies demonstrating empirical effectiveness (e.g., improved understanding and healthier choices) and those focused on technical and/or conceptual developments. To date, there has been limited validation of behavioral impacts in foodservice settings. Originality: This study offers a theory-informed conceptualization of AI and XR applications in restaurant and foodservice contexts by integrating three perspectives: hospitality (menus and dining experience), nutrition (dietary awareness and healthier choices), and human–technology interaction (technology acceptance and user engagement). The study reconceptualizes AI- and XR-enabled systems as behavioral intervention tools and outlines a focused research agenda for advancing nutritional communication in foodservice environments. Full article

Background: Intrahepatic cholangiocarcinoma (ihCC) is a rare aggressive liver malignancy with rising incidence. For resectable cases, surgery is the only curative approach, but recurrence rates remain high. These challenges highlight the need for personalized, evidence-based clinical decision-making to improve patient outcomes. To address this, we developed the Multiphasic Evidential Decision-making Matrix (MedMax) to support systematic, individualized therapeutic strategies for ihCC. Methods: In this retrospective single-center study, between 2010 and 2020, we assessed the ability of the MedMax matrix to make treatment decisions in 489 consecutive patients with ihCC or suspected ihCC. Patients were divided into two cohorts depending on whether their tumor was operable (surgical cohort, n = 335) or non-operable (non-surgical cohort, n = 154). We assessed the accuracy of diagnostic confirmation and treatment allocation by MedMax and evaluated how the model’s recommendations corresponded to those made by the tumor board. Results: In the surgical cohort, MedMax achieved 100% accuracy in diagnostic confirmation and 97.9% accuracy in treatment allocation. There was 74.3% concordance between the resection type proposed by MedMax and actual extent of resection. This discrepancy was caused by deviations from the preoperative plan based on intraoperative findings, which could not have been predicted preoperatively. In the non-surgical cohort, MedMax again achieved 100% accuracy in diagnostic confirmation and 98.7% accuracy in treatment allocation. All discrepancies between the decisions made by MedMax and those made by the tumor board were attributed complex, high-risk patient profiles. MedMax reliably identified risk factors (such as advanced comorbidities and multifocal disease) in both cohorts. Conclusions: The MedMax matrix can make accurate, reliable and transparent decisions about the diagnosis and treatment of patients with ihCC thanks to its modular, evidence-based approach. It can also stratify and document risks in both surgical and non-surgical settings. Full article

Background/Objectives: Blood donation is a critical component of healthcare systems worldwide, yet donor recruitment remains challenging. This study evaluates the knowledge, attitudes, motivations, and practices (KAP) of blood donation among the general population in Saudi Arabia to identify key barriers and propose targeted interventions. Methods: A cross-sectional study was conducted using a structured, validated questionnaire distributed over five months (December 2022 to April 2023) via social media and in-person recruitment at the Central Blood Bank in Riyadh. A total of 1150 participants aged 18–60 years residing in Saudi Arabia were included in the final analysis. Statistical analysis was performed using SPSS version 22, with p < 0.05 considered significant. Results: Participants demonstrated moderate knowledge (mean score 5.43 ± 1.81 out of 9), with significantly higher scores among males, individuals aged 21–30 years, and those holding a bachelor’s degree. Attitudes toward donation were highly positive (mean score 15.46 ± 2.74 out of 20) and correlated with age, gender, marital status, and occupation. Despite this positive outlook, only 34.96% of participants had donated blood previously, although 95.25% expressed willingness to do so. Primary motivators included mobile donation units (89.22%) and paid leave (89.22%), whereas 51.22% of respondents considered current media campaigns ineffective. Common barriers to donation included health concerns (25.30%), time constraints (12.87%), and fear of needles (7.74%). Conclusions: This study reveals a critical disparity between positive public attitudes and actual donation practices in Saudi Arabia. To enhance donor participation, we recommend implementing convenient donation strategies such as mobile blood drives, workplace incentives, and more effective, culturally tailored educational campaigns. Addressing these factors could help Saudi Arabia improve its voluntary donation rates and ensure a sustainable, safe blood supply. Full article

The literature emphasizes the importance of perceived social media marketing activities (SMMAs) in shaping various brand-related outcomes. However, their importance in brand attachment formation remains underexplored. Grounded in the Stimulus–Organism–Response (S-O-R) framework and Attachment Theory, this study examines the relationship between SMMAs and brand attachment, and the impact of brand attachment on brand loyalty and consumer engagement with brand social media (CEBSM). A questionnaire survey was conducted with 502 consumers of outdoor and sports brands in Algeria. Data analysis was performed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The findings unveil that SMMAs, including interactivity, informativeness, personalization, trendiness, and WOM, are positively associated with brand attachment. Furthermore, brand attachment is significantly associated with both brand loyalty and CEBSM. This study makes several theoretical contributions by being among the early studies to examine the individual effects of social media marketing dimensions, the role of SMMA in brand attachment formation, and brand-related outcomes alongside in-platform outcomes. This study offers recommendations to guide community managers and brand managers in clarifying the roles and capabilities of social media marketing in evoking and reinforcing brand attachment. Full article

Artificial Intelligence (AI) is transforming the food industry by enhancing food safety (contamination detection, traceability), optimizing supply chains (demand forecasting, waste reduction, logistics), personalizing nutrition (customized recommendations), and driving product innovation (new flavor creation, formulation) through data analysis, machine vision, and predictive analytics, leading to greater efficiency, sustainability, and consumer satisfaction from farm to fork [...] Full article

Perinatal mood disorders (PMDs) affect approximately 15% of birthing persons during the pregnancy or postpartum (up to one year after birth) time period. People who recently gave birth and are of diverse backgrounds and identities, especially those who are oppressed, are disproportionately affected by PMDs and may experience these conditions differently. One such group is low-income birthing persons living in urban areas. This article will summarize PMDs, including their prevalence rates and how they are disproportionately experienced among low-income birthing persons living in urban areas. The factors to be reviewed include racism, cultural stigma, community stressors, issues with access to services, lack of resources, socioeconomic concerns, and healthcare system problems. Additionally, how PMDs among low-income birthing persons living in urban areas can be prevented, identified, and treated will be discussed. Strategies include practicing cultural humility and promoting anti-oppressive practice, building positive relationships with birthing persons, utilizing formal and informal social supports, promoting community engagement, sharing resources and tangible supports, following universal screening recommendations, addressing barriers to care, and advocating for effective policies. Full article

Driven by the global agenda of low-carbon urban development, local governments in China have implemented targeted policies requiring new energy vehicle adoption in the ride-hailing industry. This study focuses on a key issue in the development of sustainable smart public transportation systems: the factors affecting the acceptance of electric vehicles (EVs) in ride-hailing services among full-time and part-time drivers. Using 432 valid samples of ride-hailing drivers from Zhangzhou, a third-tier city in China, we compared the basic personal attributes of full-time and part-time drivers. Ordered logit models were developed to explore differences in factors influencing their acceptance of electric ride hailing (ER). Findings reveal: (1) Drivers’ perceived significance of EVs in green transportation is positively associated with their acceptance of ER. (2) Endurance mileage and charging efficiency have no significant effect on acceptance among drivers in underdeveloped cities. (3) Full-time drivers exhibit relatively low concern for subsidy policies, whereas part-time drivers express a pressing need for vehicle purchase subsidies and operational subsidies. (4) Overall, part-time drivers demonstrate higher acceptance of ER than full-time drivers. Based on these findings, this paper offers policy recommendations for governments to enhance ER acceptance among both driver groups. It is important to note that the present study utilizes survey data collected from Zhangzhou. The research conclusions should be treated with caution when applied to other cities, and further studies can be conducted in different regions to verify the results. Full article

Platformized markets increasingly organize consumer encounters through adaptive ranking and personalization systems that learn from behavioral traces and reorder what consumers see over time. Although consumer identity theory explains how consumers use marketplace resources to express and negotiate the self, it does not fully explain how recursive ranked exposure shapes identity trajectories. This article develops Algorithmic Consumer Identity Theory (ACIT) to address that gap. ACIT proposes that identity formation in platformized markets is conditioned by three interrelated mechanisms: algorithmic mirroring, through which consumers interpret personalized outputs as self-diagnostic signals; algorithmic steering, through which ranking and recommendation systems structure future exposure; and reinforcement-loop strength, which captures the inertia generated by recursive feedback among behavior, inference, and exposure. Together, these mechanisms produce the steered self, an emergent identity configuration shaped through repeated interaction with curated exposure environments. The theory specifies how adaptive personalization can increase identity salience, strengthen or fragment coherence, intensify dissonance under conditions of misrecognition, and reduce perceived data agency when contestability is weak. By distinguishing representational feedback from directional exposure governance, ACIT offers a mechanism-based and empirically falsifiable framework for understanding identity in AI-mediated markets. The article contributes to consumer identity theory, platformization research, and AI-in-marketing scholarship, and identifies implications for platform governance and identity-safe personalization design. Full article

Background: Persons with intellectual disability have a significantly higher prevalence of diabetes than the general population. Special Olympics Fit Feet, a major screening process for evaluating foot health in persons with intellectual disability, has not included an assessment for the risk of diabetic foot ulcers thus far. A probable reason for this may be that clinicians in the past have felt that persons with intellectual disability were not capable of understanding how to complete the Semmes-Weinstein test for lack of protective sensation. A study was designed to assess whether the Special Olympics athletes could complete the Semmes-Weinstein test for lack of protective sensation. Methods: 31 Special Olympics athletes with intellectual disability participating in a Fit Feet foot screening underwent a Semmes-Weinstein test for lack of protective sensation (LOPS). An assessment was completed using predetermined criteria to establish whether the subject understood what was required and could satisfactorily complete the test. Likewise, it was also determined if the Special Olympics athletes believed they understood the test. Results: Study findings determined that approximately 67% of the athletes in the study were able to successfully complete the test and 90% of the Special Olympics athletes reported they completely understood the test. These results do not apply to the intellectual disability population at large. Conclusion: A significant percentage of the test population appeared able to successfully undergo the Semmes-Weinstein test for lack of protective sensation (LOPS). Therefore, it is recommended that any foot screening process for Special Olympics athletes should include an assessment for loss of protective sensation including use of monofilament testing. Full article

Background: Pilon fractures refer to distal tibial fractures that may involve extra-articular, partial articular, or complete intra-articular components, most commonly caused by high-energy trauma. The choice between early (<72 hours) and delayed (>7 days) surgical fixation significantly impacts clinical outcomes. This study aimed to compare the effects of early vs. delayed plate fixation on fracture healing time, functional outcomes, and complication rates. Materials and Methods: This retrospective study analyzed 80 patients who underwent surgical treatment for pilon fractures between 2018 and 2023. Patients were divided into two groups: Early surgery (<72 hours, n=40); Delayed surgery (>7 days, n=40). Additionally, patients were categorized based on the fixation method: Single plate fixation (n=40); Double plate fixation (n=40). Outcome Measures: Fracture healing time (weeks) - Defined as cortical continuity on radiographs; Functional outcomes (AOFAS score); Complication rates (infection, malunion, implant failure). Results: Shorter healing time was observed in the early surgery group (14.2 vs. 16.8 weeks, p<0.05). Better functional outcomes were recorded in the early surgery group (AOFAS score: 82.3±6.5 vs. 78.1±7.2, p<0.05). Lower infection rates were noted in the delayed surgery group (7.5% vs. 12.5%, p<0.05). Double plate fixation provided better mechanical stability but resulted in higher soft tissue complication rates. Single plate fixation preserved soft tissue integrity but had higher malunion and implant failure rates. Conclusion: Early surgery is associated with shorter healing time and better functional outcomes, but increased soft tissue complications require careful management. Delayed surgery offers a safer approach for soft tissue healing but may prolong functional recovery. While double plate fixation ensures greater stability, it may increase soft tissue morbidity, whereas single plate fixation reduces soft tissue complications but may compromise stability. A personalized surgical approach is recommended for optimal outcomes in pilon fracture management. Full article

Understanding user behavior on the web is considered essential for personalization, recommendation, and anomaly detection. Centralized analytics approaches raise significant privacy risks and regulatory concerns, particularly when large volumes of interaction data are collected in the cloud. Federated learning offers a decentralized alternative but faces challenges in handling heterogeneous, Non-Independently and Identically Distributed (non-IID) web interaction data. This paper presents FogLearn-Web, a fog computing-based federated learning framework for privacy-preserving web user behavior analytics. The architecture employs hierarchical aggregation in which browser-embedded models train locally, fog nodes perform behavior-aware regional aggregation, and the cloud maintains a global model with formal differential privacy guarantees. A key contribution is the behavioral sketch, a compact representation of local interaction distributions that enables attention-weighted federated averaging without exposing raw data. Experiments on benchmark and real-world datasets show that FogLearn-Web achieves within 2.3% of centralized accuracy while reducing data transmission by 89% and improving convergence under non-IID settings by 34% over standard FedAvg. Full article

Non-small cell lung cancer (NSCLC) accounts for nearly 85% of lung cancer cases and remains a leading cause of cancer-related mortality worldwide. Advances in molecular diagnostics and targeted therapies have transformed treatment paradigms, yet the integration of molecular testing into routine care for resected NSCLC specimens continues to face significant challenges. This review outlines the technical, clinical, and systemic barriers that limit the effectiveness of molecular testing. Key considerations include tissue quality, the limitations of formalin-fixed paraffin-embedded (FFPE) samples, and the comparative roles of conventional methods—such as immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and reverse transcription polymerase chain reaction (RT-PCR)—versus next-generation sequencing (NGS). We also discuss the prevalence and clinical relevance of common genomic alterations, including TP53, KRAS, EGFR, and ALK, as well as their impact on prognosis and treatment selection. Real-world obstacles such as accessibility, reimbursement, delays in testing, interdisciplinary coordination, and sample adequacy are critically examined. Emerging innovations—including multi-omics integration, spatial profiling, liquid biopsy, artificial intelligence, and novel targeted therapies—offer opportunities to overcome current limitations and improve patient outcomes. Finally, practical recommendations are proposed to optimize tissue handling, testing algorithms, and access to precision-guided therapies. By addressing these challenges, molecular testing in NSCLC can be more effectively leveraged to personalize treatment strategies and enhance survival outcomes. Full article

Background: During the flu season, there is an increase in absenteeism due to illness, a drop in productivity, and a greater risk of the virus spreading among workers. Thus, the Italian Ministry of Health recommends vaccination for essential service workers. The University of Salerno, in collaboration with the local health authority of Salerno, offers free vaccination to its employees. Methods: A public health methodology for seasonal influenza vaccination in the workplace is presented—specifically in the university setting—with the aim of identifying individual, contextual, and organizational elements of the model that have promoted vaccination uptake. An ad hoc questionnaire was used (October–December 2025) to survey 399 academic employees, investigating seasonal influenza vaccination in the following aspects: recent personal experiences, motivations, vaccination experiences at university, sources of information, considerations regarding national and local vaccination campaigns, and level of vaccine confidence (VCI). Results: Seasonal influenza vaccination at the University is appreciated for its compatibility with working hours (66.1%), the availability of a platform that allows flexible booking (56.9%), the perception of safety in the environment (31.6%), the fact that the vaccine is free (17.4%), and the involvement of office/laboratory colleagues (5%). Participants appreciate the model and would apply it to other vaccinations at the University and in other institutional settings. A significant relationship (F = 7.24; df = 1; p < 0.05) exists between confidence in the vaccine and the sense of security experienced when receiving the vaccine in the workplace. Data analysis was performed using the IBM SPSS v.28 software. Conclusions: The model proposed can be applied to other institutional contexts, simplifying and facilitating access to vaccines by implementing vaccination campaigns tailored to specific work environments. Full article

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, compounded by difficulties in emotional regulation, which have sparked growing interest due to their relationship with emotional intelligence (EI). Background/Objectives: The objective of this study was to analyze the effectiveness and characteristics of interventions aimed at developing EI in people diagnosed with ADHD. Methods: A systematic review was conducted following PRISMA 2020 in the Web of Science, Scopus, PubMed, Dialnet, ERIC, and SpringerLink databases. After applying inclusion and exclusion criteria and evaluating methodological quality, 31 studies were selected. Results: The evidence shows that children and adolescents with ADHD have lower levels of EI than the typically developing population, especially in emotional regulation, stress management, adaptability, and interpersonal skills. Interventions focused on emotional training have demonstrated improvements in emotional competencies, self-control, ADHD symptoms, and social functioning. However, variations are observed according to age, clinical subtype, the presence of comorbidities, and the type of informant, as well as heterogeneity in the assessment instruments used. Conclusions: Strengthening EI emerges as a promising complementary strategy for improving the emotional and social adaptation of people with ADHD. It is recommended to move toward longitudinal studies and more personalized interventions tailored to the clinical and developmental characteristics of the disorder. Full article