Search Results (620)

This study applies a dynamic strategic foresight to examine how Unmanned Aerial Systems (UAS)-based Advanced Air Mobility (AAM), supported by Advanced Communication Systems (ACS), can be integrated into a coherent System of Systems (SoS) for sustainable and effective Disaster Management (DM). These three domains (AAM, ACS, and DM) form a strongly coupled Internet of Things (IoT) triad within an integrated SoS. Using lessons learned from previous or running research projects of the contributing authors, i.e., SUDEM, REGUAS, 5G!Drones, and ETHER, the foresight identifies key enablers—including resilient 5G/6G communication architectures, interoperable data fusion frameworks, and UAS-supported situational awareness. It highlights structural challenges such as fragmented standards, limited cross-agency data integration, and gaps in ACS redundancy for emergency operations. The resulting roadmap outlines development priorities for ACS-enabled AAM, from unified communication protocols and hybrid TN-NTN architectures to education and capacity-building for digital-centric DM. Practically, the findings suggest that policymakers should prioritise harmonised regulatory frameworks for AAM-ACS interoperability and invest in global data exchange standards, while system designers should incorporate redundant communication layers and modular SoS architectures to ensure operational continuity under extreme conditions. Full article

Background: Mental healthcare has emerged as a major public health issue in the aftermath of COVID-19 worldwide due to global health system challenges which hinder effective healthcare. In this, there is a knowledge gap on research exploring the perceived quality of mental healthcare amongst hospital-based health workers with a particular focus on knowledge and practice, organization and system, and job satisfaction factors for an insight towards strengthening ongoing effort for the realization of the universal health coverage goal of the comprehensive global mental health action plans. The aim of this study was to assess health workers’ perceptions of quality in mental healthcare at three district hospitals in Johannesburg, South Africa. Methods: An exploratory cross-sectional research design was used on a stratified random sample of 160 health workers recruited as participants at the three selected hospitals in Johannesburg. Data were collected using a self-administered questionnaire and then subjected to descriptive statistical analysis using SPSS Version 29. Results: It was established that healthcare workers’ at the three district hospitals in Johannesburg were generally familiar with mental health guidelines and mental disorders which resulted in better patient engagement and prioritisation of mental health as being important as physical health. However the majority of these healthcare workers perceived the quality of mental healthcare at the three hospitals was low. Further assessment however revealed that these perceptions may have emanated from organizational and system incapacity, and limited satisfaction with compensation and benefits, recognition for work done and limited training. Conclusions: Health worker perceptions of quality in mental healthcare help provide an insight into what health systems may need to address mental health service delivery. The study of the three hospitals in Johannesburg, South Africa underscore the need to reinforce knowledge sharing through healthcare worker training, strengthen organisational and system capacity, provide adequate remuneration and benefits, and reinforce clear referral pathways and collaboration with specialists for the realisation of quality improvement and sustenance in pursuing the universal health coverage goal of the WHO Comprehensive Mental Health Action Plans and the Sustainable development Agenda on health of 2030 and beyond. Full article

Background: Blood flow restriction training (BFRT) is a low-load resistance training modality capable of inducing muscle hypertrophy and strength adaptations that are comparable to traditional high-load resistance training. Beyond athletic performance settings, BFRT has growing relevance for musculoskeletal health, rehabilitation and populations unable to tolerate high mechanical loads. However, substantial inter-individual variability in adaptive responses has been reported. Genetic and molecular factors may partly contribute to this variability and inform more individualised exercise strategies. Other intrinsic and extrinsic factors, including age, sex, training status, nutrition, and protocol-related differences, may also influence adaptive responses. Objective: This scoping review aimed to map available evidence on molecular modulators of adaptation to BFRT and to identify gaps in the literature regarding genetic influences on BFRT responses. Methods: A structured search of PubMed, Web of Science and Google Scholar was conducted till 1 February 2026. Experimental and quasi-experimental studies examining BFRT in relation to genetic polymorphisms, gene expression, and molecular signalling pathways associated with strength and hypertrophy outcomes were included. Primary outcomes were genetic and molecular factors relevant to BFRT adaptation, including genetic polymorphisms, gene expression, and molecular signalling markers. Secondary outcomes included muscle strength, hypertrophy, vascular responses, and related functional outcomes where reported. Study selection and data extraction were conducted according to PRISMA-ScR guidelines. The methodological quality of randomised controlled trials was assessed using the PEDro scale. This scoping review was registered retrospectively in the Open Science Framework on 17 March 2026, after completion of the literature search. Results: From an initial 47 records, only three studies (n = 3) met the inclusion criteria. The included studies reported molecular responses associated with BFRT, including downregulation of proteolytic genes, suppression of myostatin expression, and upregulation of angiogenic markers. Notably, no studies directly examined genetic polymorphism or genotype–BFRT interactions, highlighting a clear need for these studies in this field. Conclusions: This scoping review therefore identifies a critical evidence gap, with genotype-informed BFRT prescription remaining unsupported by the current literature. Limited evidence supports the possible role of BFRT in molecular responses associated with muscle adaptation. Future research should prioritise well-designed studies integrating both genetic and molecular analyses to better understand inter-individual variability in BFRT adaptations. Full article

Background/Objectives: Physical restraints and seclusion remain ethically contested interventions in psychiatric care, raising significant concerns regarding patient safety, dignity, and therapeutic impact. Despite growing international momentum towards restraint-reduction strategies, their use persists across the Eastern Mediterranean Region (EMR), an area that has been the subject of limited systematic attention. This review synthesises evidence on the knowledge, attitudes, and experiences of nurses and individuals with mental illness regarding these practices in EMR psychiatric settings. Methods: Following PRISMA 2020 guidelines (PROSPERO: CRD42023383751), we systematically searched nine electronic databases for studies published up to June 2023, supplemented by backward and forward citation searching. Multiple reviewers independently screened records against predefined eligibility criteria, with disagreements resolved through consensus. Methodological quality was assessed using Joanna Briggs Institute (JBI) Critical Appraisal tools, and reporting quality was evaluated using an adapted CROSS checklist; these two appraisal dimensions were conducted and reported independently. Findings were integrated through narrative synthesis. Results: From 4634 identified records, 19 studies conducted across 11 EMR countries met the inclusion criteria. Nursing knowledge deficits were identified across multiple settings, and attitudes towards restraint practices were predominantly negative. Individuals with mental illness consistently described restraint as humiliating, punitive, and physically distressing. Recurrent challenges identified across studies included inadequate staff training, chronic understaffing, and limited access to restraint-reduction alternatives. Conclusions: Substantial gaps in nursing knowledge and training persist across the EMR. The findings of this review, while derived predominantly from cross-sectional studies with convenience samples, suggest that evidence-based education programmes, standardised restraint-reduction policies, and patient-centred care frameworks warrant prioritisation to safeguard the rights, safety, and dignity of individuals with mental illness in this region. Longitudinal and experimental research is needed to confirm these directions and establish their effectiveness within EMR contexts. Full article

Background/Objectives: Financial toxicity (FT) is increasingly recognised as a critical dimension of the cancer care continuum, reflecting both objective financial burden and subjective financial distress arising from cancer-related care. Head and neck cancers (HNC) may be particularly vulnerable to FT because treatment often involves multimodal care, functional morbidity, prolonged rehabilitation, and disruption to employment. This scoping review mapped and synthesised the literature on FT in a focused subset of head and neck cancers (HNC), namely malignancies of the oral cavity, oropharynx, nasopharynx, sinonasal tract, and major and minor salivary glands. Methods: A scoping review was conducted in accordance with the methodological guidance of the Joanna Briggs Institute for scoping reviews to identify and synthesise studies addressing FT in the selected HNC subsites. Searches were undertaken in MEDLINE, Embase, Scopus, Web of Science, CINAHL, EconLit, and Global Index Medicus for English-language studies published between 1 January 2015 and 1 January 2025. The search window was restricted to this period to capture the more contemporary evolution of FT as a distinct research construct in oncology. Eligible studies included adult patients and reported patient-level FT outcomes, including direct costs, indirect costs, out-of-pocket expenditure, financial hardship, financial distress, employment disruption, or related economic strain. Findings were synthesised narratively and organised thematically. Results: Twenty-five studies published between 2015 and 2025 were included. The evidence base was dominated by cross-sectional and retrospective designs, with limited prospective follow-up and very little intervention-focused research. FT was conceptualised heterogeneously across studies, spanning direct expenditure, indirect and non-medical costs, subjective financial distress, and coping-related consequences. Questionnaire-based approaches were used in 13 studies, but only a smaller subset employed FT-specific instruments such as COST. Across the literature, FT was most commonly associated with lower income, weaker financial protection, employment disruption, rural residence in some settings, and more intensive treatment. Reported downstream associations included poorer quality of life, psychological distress, care alteration, and work-related burden, although evidence for treatment delay or survival effects was more limited and should be interpreted cautiously. Conclusions: In this focused HNC subset, FT appears multidimensional, socially patterned, and clinically relevant. However, the literature remains methodologically fragmented, with inconsistent measurement and sparse longitudinal evidence. Future work should prioritise validated and tumour-specific assessment strategies, prospective study designs, and evaluation of mitigation interventions that address both direct and indirect burden across the cancer continuum. Full article

Culturally unsafe mental health services contribute to persistent inequities for Aboriginal and Torres Strait Islander peoples, yet existing cultural safety frameworks lack clear, prioritised, community-endorsed implementation guidance. This study aimed to establish Aboriginal consensus on cultural safety principles, implementation priorities and practical actions for culturally safe mental health services. A three-round modified Delphi study was conducted with 37 Aboriginal participants from Western Australia with expertise in mental health, social and emotional wellbeing and lived experience. In Round 1, participants completed an online survey rating the importance of cultural safety principles and identifying those requiring urgent action. In Rounds 2 and 3, facilitated yarning sessions reviewed findings, refined principles, grouped them into implementation domains, and identified priority actions. Aboriginal Participatory Action Research ensured Aboriginal leadership and governance throughout. All principles achieved strong consensus for importance. The most urgent priorities were trustworthiness, Aboriginal governance, trauma-informed care, addressing racism and strengthening the Aboriginal workforce. Participants organised the refined principles into six implementation domains, with Leadership and Governance identified as foundational to reform. Trustworthiness was reframed as an aspirational outcome requiring structural change. This study provides a community-endorsed, prioritised framework for translating cultural safety principles into mental health service practice and policy. Full article

Object detection in optical remote sensing imagery has emerged as a crucial task in computer vision, with applications ranging between environmental monitoring to disaster management, precision agriculture, and urban planning. This review systematically examines current methodologies, categorising them into four principal approaches: (1) template matching-based methods, which leverage predefined patterns for object identification; (2) knowledge-based methods, which incorporate geometric and contextual information to enhance detection accuracy; (3) object-based image analysis (OBIA), which segments images into meaningful objects using spectral and spatial properties; (4) machine learning-based methods, particularly deep convolutional neural networks (CNNs), which have revolutionised the field through automatic feature learning. Each methodology’s performance characteristics, computational requirements, and suitability for different remote sensing applications are analysed. Our systematic review, following PRISMA guidelines, analysed 189 studies published from 2010 to 2025, of which 73 provided quantitative results on standard benchmarks. The three most critical challenges identified are as follows: (1) annotation bottleneck, as dense bounding box labelling of remote sensing imagery remains highly labour-intensive for deep learning approaches, (2) extreme scale variation spanning 2–3 orders of magnitude within single scenes, and (3) domain adaptation failures when models encounter new geographic regions or sensor characteristics. This review identifies critical research gaps and proposes prioritised future directions, emphasising foundation models for zero-shot detection, efficient architectures for resource-constrained deployment, and standardised benchmarks with size-specific metrics. The analysis provides practitioners with evidence-based decision frameworks for method selection and researchers with a roadmap for advancing object detection in remote sensing applications. Full article

Protecting and preserving the agricultural heritage, folk culture and ecological environment of traditional villages is a key element in advancing the strategy for comprehensive rural revitalisation. This paper constructs a theoretical framework for tourism symbiosis, examines the level of tourism symbiosis in the 13 national-level traditional villages of Jia County, and proposes strategies for tourism development. This study employs the Analytic Hierarchy Process (AHP) and Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method, alongside spatial analysis techniques such as the Hotspot Analysis, to reveal the levels of tourism symbiosis in traditional villages and their spatial distribution. The results indicate that traditional villages are distributed along the Yellow River, with a linear clustering pattern particularly evident in the central region of Jia County; the overall level of symbiosis exhibits a spatial pattern of higher levels in the north and lower levels in the south, with uneven levels across various dimensions; The traditional villages are categorised into four symbiotic models: comprehensive advantage-led, cultural corridor-dependent, ecological and cultural tourism potential, and low-development conservation. Based on these categories, strategies are proposed to deepen the exploration of local culture, promote industrial integration and regional collaboration, prioritise ecological conservation and environmental restoration, and establish distinctive brands through the rational utilisation of surrounding resources. The research framework and conclusions of this paper provide methodological references and practical insights for the concentrated and contiguous protection of traditional villages, as well as for research on rural revitalisation and sustainable development. Full article

Artificial intelligence (AI) is increasingly being applied in breast cancer care, yet its use across the post-diagnosis phase remains poorly mapped. This scoping review aimed to identify and categorise AI applications in post-diagnosis breast cancer care, encompassing treatment planning, treatment delivery, follow-up and surveillance, survivorship, and palliative care. Following JBI methodology and PRISMA-ScR reporting guidelines, four databases (MEDLINE, EMBASE, CINAHL, and Web of Science) were searched, identifying 3784 records. After screening and full-text assessment, 54 studies published between 2016 and 2024 were included. Machine learning was the predominant technology (81%), followed by generative AI (7%), conversational agents (6%), traditional natural language processing (4%), and data mining (2%). Follow-up and surveillance were the most represented care stage (48%), driven primarily by recurrence prediction models. Most applications were provider-focused (83%), while patient-facing tools accounted for 17% of studies and relied on either conversational agents or generative AI. No studies addressed palliative care. The evidence base was predominantly retrospective (70%) and concentrated in high-income countries (74%). Future research should prioritise prospective evaluation in clinical workflows, address unsupervised patient use of generative AI, and ensure equitable development across diverse populations and care settings. Full article

The progression of chronic bone diseases is intricately linked to dysregulated macrophage polarisation. However, a comprehensive understanding of the complex interplay between macrophage polarisation and metabolic reprogramming in the context of bone disorders remains elusive. Thus, this review conducted a systematic search of major databases, including PubMed, using combinations of keywords such as “macrophage polarisation,” “immunometabolism,” “metabolic reprogramming,” and “chronic bone diseases” (including “osteoporosis,” “osteoarthritis,” and “periodontitis”). Inclusion criteria prioritised original research published within the last five years to capture recent advances. Diverging from previous reviews constrained by the classical M1/M2 dichotomy, this article aims to delineate the heterogeneity and functional plasticity of macrophages within the bone microenvironment, emphasising metabolic reprogramming as a central mechanism driving the dynamic behaviour of macrophages across various skeletal pathologies. Furthermore, this review highlights the pivotal roles of specific metabolites—such as succinate, itaconate, and citrate—within the osseous microenvironment, underscoring their influence on macrophage phenotypic transitions and the regulation of bone metabolic homeostasis. Finally, this article envisages innovative therapeutic strategies targeting the “metabolism–immunity axis,” encompassing the design of nano-delivery systems to modulate macrophage metabolism, the utilisation of engineered extracellular vesicles, the development of immunometabolism-modulating biomaterials, and the exploration of naturally occurring bioactive molecules. Based on these findings, the present work proposes the “metabolism–immunity–skeleton” axis as a theoretical framework, thereby establishing a robust foundation for the development of precision metabolic immunotherapy tailored to a spectrum of chronic bone diseases. Full article

This interdisciplinary study integrates criminological theory with geospatial methods to analyse large, multi-format datasets using geostatistical techniques. The aim is to predict where Child Criminal Exploitation (CCE) is likely to cluster, based on the spatial convergence of contextual risk factors. Drawing on insights from General Strain Theory (GST) and prior research on CCE, this study integrated seven open-source datasets capturing educational attainment, age demographics, violent crime, deprivation, and paramilitary-related violence. These variables were operationalised to construct a proxy measure for strain. Spatial analysis was conducted using ArcGIS Pro, including the Data Interoperability extension, to enable efficient integration and interrogation of multi-format geospatial data. Geospatial analysis demonstrated that contextual risk factors for CCE are spatially clustered. Using four search parameters, a small subset of wards with elevated risk were identified. This resulted in a reduction in ward locations by 85–99%, land area under investigation from 14.45% to 0.84%, and affected population from 17.91% to 1.41%, enabling more targeted and efficient resource allocation. As understanding of the contextual factors contributing to CCE improves, this methodological approach offers scalable and data-driven means of identifying high-risk areas. By integrating geospatial analysis with criminological theory, the model supports more effective safeguarding strategies and prioritisation of limited public resources. This study is limited by the absence of multi-agency datasets, which were beyond its scope. Future research aims to incorporate cross-sector data to validate and refine the model through ground-truthing, enhancing its predictive accuracy and practical applicability. Full article

Aviation safety depends critically on pilots’ mental and cognitive states, particularly in high-stakes and complex operational environments where human errors cause most safety events today. This paper reviews current advances in real-time monitoring of commercial pilots’ cognitive states through physiological and neurophysiological signals and identifies methods applicable to enhance aviation safety and efficiency. In an increasingly complex and congested system, it is essential to investigate the relationships between pilots’ mental workload, stress, startle effect, and physiological parameters to highlight cognitive overload or deficiencies in real time. This systematic literature review was conducted according to PRISMA 2020 guidelines, using Google Scholar, Scopus, and PubMed, and identified 26 eligible studies. A targeted backward citation search screened 17 additional records, and two studies were added to the initial set. Twenty-eight records were therefore included and the review highlights a range of biometric indicators of pilots’ mental states with varying degrees of validity and operational applicability. Collectively, these studies offer a clear overview of state-of-the-art approaches, while also evidencing constraints related to intrusiveness and real-world feasibility. Physiological monitoring holds strong promise for enhancing pilot performance and safety by detecting early signs of overload and stress. However, its integration into operational aviation remains limited. Future research should prioritise longitudinal, in situ evaluations, multimodal data fusion, and pilot-centred design to ensure practical applicability, non-intrusiveness, and regulatory compliance, ultimately bridging the gap between academic research and cockpit reality. Full article

This narrative review examines topical anti-inflammatory therapies in veterinary medicine through the lens of the One Health framework, integrating pharmacology, dermatology, ecotoxicology, food safety, and regulatory science. It discusses the interconnected roles of veterinarians, pharmacists, environmental scientists, public health authorities, and regulatory bodies in addressing antimicrobial resistance, environmental contamination, zoonotic transmission, and drug residues in food-producing animals. By emphasising cross-sector collaboration, the review highlights how coordinated strategies can enhance animal welfare, safeguard human health, and reduce ecological burden. The article analyses inflammatory conditions in companion and farm animals and compares systemic versus topical anti-inflammatory approaches. Particular attention is given to corticosteroids, NSAIDs, immunomodulators, pro-resolving lipid mediators, and plant-derived bioactives, alongside advances in vehicles such as lipid nanocarriers and biodegradable film-forming systems designed to minimise systemic absorption and environmental dispersion. Regulatory considerations, residue control, pharmacovigilance gaps, and sustainability-oriented formulation strategies are critically addressed. Topical anti-inflammatory therapies, when rationally designed and monitored under One Health principles, represent a strategic opportunity to improve therapeutic precision while limiting systemic toxicity and ecological impact. Future directions should prioritise translational research, eco-compatible formulation design, and harmonised regulatory frameworks. Full article

Adaptive reuse of industrial heritage from a tourism perspective presents a complex design challenge requiring a balance between heritage preservation, functional innovation, and diverse stakeholder expectations. However, current practices often face issues such as ambiguous demand interpretation and a disconnect between design generation and systematic evaluation. Addressing these limitations, this paper proposes and illustrates a human–machine collaborative design paradigm that integrates generative AI into a closed-loop process of “demand analysis–intelligent generation–comprehensive evaluation.” The method first employs Kansei Engineering and the KANO model to qualitatively extract and quantitatively prioritise heterogeneous user needs, translating subjective perceptions into structured design constraints and optimisation objectives. Next, these needs are encoded as text prompts to drive targeted spatial exploration by the generative AI tool Nano Banana AI. Finally, the TOPSIS method is applied for multi-criteria performance evaluation and solution selection. A case study of Shanghai Libo Brewery suggests that this paradigm can enhance design efficiency and show potential to outperform traditional methods across dimensions such as historical preservation, public accessibility, ecological integration, social inclusivity, and formal innovation. The research offers a quantifiable and systematically documented intelligent design methodology for industrial heritage renewal, while acknowledging the exploratory nature of the generative phase. Furthermore, it provides a visitor-demand-driven innovation pathway for developing industrial heritage tourism destinations, thereby potentially enhancing cultural experiences and tourism appeal at heritage sites. This research illustrates a move from an experience-driven paradigm toward a data- and value-driven approach, contributing theoretical methodologies to the intersection of cultural tourism and artificial intelligence. Full article

Background/Objectives: Mild cognitive impairment (MCI), the prodromal stage of Alzheimer’s disease, may be influenced by nutritional status and genetic susceptibility. This systematic review synthesised evidence on how nutritional biomarkers interact with genetic variants, particularly APOE ε4, to influence cognitive outcomes in individuals with MCI. Methods: Following PRISMA 2020 guidelines, seven studies were included (three longitudinal, two randomised controlled trials, and two cross-sectional) involving adults aged ≥55 years with MCI. Nutritional exposures comprised plasma or serum concentrations of vitamins A, D, E, the vitamin B group, lipids, selenium, and ketogenic medium-chain triglycerides. Genetic risk was assessed primarily through APOE ε4 status. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using GRADE. Due to heterogeneity in biomarkers, cognitive tools, and study designs, findings were synthesised narratively. Results: Across nutrient categories, higher concentrations of vitamin D, selenium, and antioxidants were associated with better cognitive outcomes. kMCT supplementation improved episodic memory and brain energy metabolism. Evidence for nutrient–gene interactions was mixed: APOE ε4 modified responses to vitamin B group and selenium but showed limited influence on vitamin D, lipids, or kMCT effects. Heterogeneity in biomarker assays, cognitive tools, and genetic stratification limited comparability across studies. Conclusions: Nutritional biomarkers appear to influence cognitive trajectories in MCI, and some associations may differ by APOE ε4 status. However, small samples and limited genetic stratification constrain interpretation. Future research should prioritise standardised biomarker measurement, genetically stratified cohorts, and individual participant data meta-analyses to clarify nutrient–gene interactions in MCI. Full article