Search Results (9,773)

Aiming at the multi-objective solution problem of the deployment optimization of the hybrid communication network based on PLC, wireless and dual-mode collaborative networking, this paper proposes an algorithm design based on comprehensive performance optimization with business benefits as the orientation. Firstly, according to the non-ideal channel conditions and the low latency service requirements, the cross-layer modeling of the physical layer and MAC layer is adopted. Then, a dynamic weighting mechanism based on different service levels is defined, and a hybrid communication network adaptive access model considering the constraints of business benefits, network performance, and networking costs is designed. The hybrid communication network deployment and access algorithm design based on K-mean clustering and the improved NSGA-II are realized. Finally, the algorithm performance simulation and comparative analysis are carried out. The simulation results show that the proposed algorithm design can effectively balance the two objectives of network benefits and deployment costs under various network constraints and provide diversified deployment strategies in a targeted manner. Full article

Cities face the need to implement urban planning solutions that support sustainable development; however, this is not fully possible due to inadequate legal regulations. This development can be understood as increasing the environmental and economic resilience of urban areas and improving the quality of life for city residents. A noticeable trend in urban development plans is the implementation of the “15 min city”, “20 min city”, or similar concepts, which aim to enhance walkability by ensuring access to basic urban services and functions within walking distance. The aim of this article is to evaluate accessibility to green areas and selected educational services in cities (named in the article as MSAS–Municipal Standards for Accessibility of Social Infrastructure), and then to compare the results with proposed legal regulations in Poland that set minimum distances between social infrastructure zones and residential areas. The study will be conducted using selected urban centers: in Poland as a case study and in Belgium as verification. The use of spatial analysis methods (GIS) and a method transferability test enables the assessment of accessibility zones, as well as the identification of potential discrepancies between legal standards and actual accessibility conditions. In this context, this article addresses the question of whether accessibility standards for elementary schools and public green spaces can affect the future directions of residential development and urban spatial policy. The conclusions indicate that, although MSAS are not perfect solutions for a variety of reasons, they represent a step toward sustainable development. Full article

Rising cancer incidence and survival rates have led to an unprecedented demand for psychosocial care. Yet, limited financial and practical resources present a barrier to the provision of evidence-based care. Clinical practice guidelines (CPGs) are well-positioned to enhance the quality and efficiency of psychosocial oncology care; however, little is known about their use and perceptions in the field. The present study explored the use and perceptions of CPGs among 172 Canadian psychosocial oncology clinicians via a cross-sectional, online survey. Findings revealed substantial variation in awareness, with over 20% of participants reporting no familiarity with CPGs, and low to moderate use of CPGs (M = 2.97, SD = 2.96) among users. Key barriers included a lack of formal training, limited applicability to local contexts, and systemic constraints such as high workloads. Conversely, participants highly endorsed facilitators, including accessible training programs, relevant tools/interventions, and greater institutional and community engagement. Clinician perspectives are paramount to the dissemination and implementation of psychosocial oncology CPGs. Our findings suggest that successful implementation requires broader accessibility, widespread adaptation, and greater community engagement. By addressing these systemic constraints, CPGs may be better positioned to bridge the gap between evidence and real-world service provision. Full article

(1) Background: The global prevalence of myopia has increased substantially in recent decades. Myopia development is influenced by both environmental factors and a complex genetic architecture involving more than 400 susceptibility loci. The interaction between genetic predisposition and environmental exposures plays a critical role in myopia onset and progression. Unequal access to preventive strategies and eye care services continue to limit effective global myopia control. (2) Methods: This structured narrative review synthesizes evidence identified through systematic database searches, manual reference screening, prospective cohort studies, randomized controlled trials, mechanistic investigations, and genetic analyses identified through the literature search. (3) Results: Environmental factors such as limited outdoor activity, intensive near-work, and academic pressure contribute to myopia progression. Key biometric indicators, such as AL, AL/CR ratio, and choroidal thinning, are strong predictors. Molecular and cellular mechanisms also contribute significantly to myopia progression. Genetics also plays a significant role, with both syndromic and polygenic pathways involved. (4) Conclusions: As precision medicine evolves, individualized therapeutic strategies are becoming important in myopia management. In the treatment of myopia, biomarkers, genetic profiling, and artificial intelligence may support personalized risk assessment and treatment decisions. Full article

Background/Objectives: Alcohol-related frequent attenders (ARFAs) constitute a small but resource-intensive emergency department (ED) population. Methods: Following PRISMA-ScR guidelines, we searched MEDLINE, PsycINFO, CINAHL Complete, and EMBASE from inception to May 2025 for empirical studies examining ED frequent attendance with alcohol involvement. Definitions had high heterogeneity; therefore, narrative synthesis was conducted. Results: A total of 73 studies were included, most retrospective (57.5%), encompassing sample sizes from 14 to over 4.1 million participants: 59 frequent attender (FA) studies with alcohol subgroup analyses and 14 pure ARFA studies. Research was concentrated in North America and Europe (56/73, 76.7%), with limited Asia-Pacific representation (21.9%). Seven distinct definition threshold categories were identified (≥2 to ≥20 visits annually); 31.5% utilised different definitions. Qualitative studies (n = 6) identified push factors (dependence, mental health crises, housing instability, fragmented services) and pull factors (24/7 access, crisis care model, immediate service) driving frequent attendance. Eight studies evaluated interventions; all employed non-randomised designs examining case management, integrated pathways, and community-based treatments. Conclusions: Critical gaps include the absence of standardised definitions for comparison across studies, a concentration of research in Western settings limiting global applicability, and insufficient rigorous intervention evidence. Priorities include developing empirically validated definitions, expanding non-Western research, and conducting randomised controlled trials with adequate follow-up. Full article

Background: Gestational diabetes mellitus (GDM) affects between 1% and 14% of pregnancies worldwide. Major risk factors include advanced maternal age, excess adiposity, family history of type 2 diabetes, and unhealthy dietary habits. In Mexico, evidence on the association between dietary patterns and GDM remains scarce, particularly in socioeconomically vulnerable populations with limited access to specialized nutrition services. This study aimed to evaluate the association between dietary patterns and the presence of GDM in pregnant women attending the outpatient obstetrics clinic of a teaching public hospital in Guadalajara, México. Methods: We conducted a case–control study including 169 pregnant women: 71 with GDM confirmed by the ADA one-step 75 g oral glucose tolerance test OGTT criteria and 98 without GDM based on a negative OGTT, recruited consecutively from the same clinic during the same period. Dietary intake was assessed using a culturally adapted and validated Food Frequency Questionnaire. Dietary patterns were identified through Principal Component Analysis, and associations were examined using logistic regression adjusted for maternal age, pregestational BMI, and family history of type 2 diabetes. Results: Women with GDM had higher maternal age, greater pregestational BMI, and more frequent family history of type 2 diabetes compared with controls. Three dietary patterns were identified: Western, Healthy, and Dairy/Refined. High adherence to the Western pattern was inversely associated with GDM (aOR = 0.36; 95% CI: 0.16–0.78; p = 0.010); however, this finding most likely reflects post-diagnosis dietary modifications rather than a protective effect, while maternal age remained the strongest risk factor (OR = 1.09; 95% CI: 1.03–1.16; p = 0.002). The Healthy pattern (aOR = 1.25; 95% CI: 0.55–2.82; p = 0.593) and the Dairy/Refined pattern (aOR = 0.80; 95% CI: 0.39–1.66; p = 0.554) were not significantly associated with GDM in the adjusted model. Conclusions: GDM was associated with older maternal age, higher pregestational BMI, and family history of T2DM. The inverse association with the Western pattern may reflect post-diagnosis dietary changes rather than a protective effect. Due to the retrospective design, causal inference is not possible, highlighting the need for longitudinal studies. Full article

This study examines the structural determinants of behavioral intention to use a City Airport Terminal (CAT) in Ulsan using a structural equation modeling (SEM) framework. Whereas prior literature has predominantly explained CAT adoption in terms of accessibility, this study investigates whether usage intention can be sufficiently explained by accessibility alone or whether it reflects a broader multi-factor structure involving service quality and safety, economic efficiency, infrastructure convenience, and perceived public value. To this end, five latent constructs were specified, and a survey of 500 Ulsan residents was conducted. The confirmatory factor analysis indicated an acceptable measurement structure for the five latent constructs. The structural model results show that perceived public value and regional development was the only construct with a statistically significant direct path to CAT usage intention, whereas the baseline accessibility-only model provided a statistically insufficient explanation. A nested model comparison further indicated that non-accessibility constructs collectively contributed additional explanatory value beyond what accessibility alone could provide. These findings suggest that CAT usage intention is not adequately explained by accessibility alone but is better understood through a multi-factor conceptualization of CAT adoption. This study contributes to the literature by providing structural evidence that public value—encompassing regional development expectations and community-level benefits—should be explicitly considered in sustainable airport infrastructure planning. The results highlight the importance of a multi-dimensional approach to CAT implementation policy, integrating service quality and safety, economic efficiency, infrastructure convenience, and community-level value perceptions alongside physical accessibility. From a sustainable mobility perspective, the findings offer useful implications for sustainable airport access planning and air transport management. Full article

The Internet of Vehicles (IoV) is reshaping intelligent transportation through pervasive connectivity, real-time data exchange, cooperative perception, and vehicle–edge–cloud services, while also expanding cybersecurity and privacy risks across heterogeneous cyber–physical environments. This paper presents a PRISMA 2020-informed systematic review of IoV security and privacy protection research. A cross-layer and lifecycle-oriented analytical framework is developed by integrating a four-layer IoV architecture—sensing layer, network access layer, coordinative computing layer, and application layer—with a five-stage data lifecycle covering data collection, transmission, storage, usage, and disposal. Based on this framework, the paper examines representative threat surfaces, vehicle-to-everything (V2X) communication security, public key infrastructure (PKI) based authentication, trust management, privacy-preserving data sharing, intrusion detection, active defense, and AI-assisted security analytics. Privacy-preserving mechanisms, including differential privacy, federated learning, blockchain, homomorphic encryption, and secure multi-party computation, are further compared in terms of deployment layer, lifecycle stage, real-time suitability, and representative performance evidence. In addition, the review discusses the engineering relevance of UNECE WP.29 R155/R156, ISO/SAE 21434, and related national standards, with emphasis on compliance evidence, over-the-air (OTA) governance, supply-chain coordination, and lifecycle cybersecurity management. The review shows that no single protection mechanism can simultaneously satisfy the requirements of real-time performance, scalability, privacy preservation, trustworthiness, and regulatory compliance in dynamic IoV environments. Future research should emphasize lightweight and adaptive protection, cross-layer trust coordination, privacy–utility co-optimization, trustworthy AI-assisted security operations, and evidence-based lifecycle governance. This review provides a structured reference for researchers and a practical basis for secure and privacy-aware IoV system design. Full article

Mobility hubs promise to reduce car dependence and make multimodal travel work in practice, yet behavioural evidence remains limited when hub improvements coexist with easier car access. This article examines the tension at Rome Trastevere, an urban rail node that gradually acquires mobility-hub functions while facing improved parking access near Piazza della Radio. The empirical analysis combines a pilot survey of 83 users with an on-site stated preference survey of 204 valid respondents. The stated preference instrument uses a route-based feasible-choice design with nine choice sets per experiment: respondents evaluate alternatives among bikes, walking, e-scooters, e-mopeds, public transport, private cars, and shared cars under variations in travel time, travel cost, and search time. The paper estimates a multinomial logit model in Apollo and uses sample enumeration, supported by Monte Carlo simulation, to assess four parking and shared-mobility scenarios and produce confidence intervals around predicted probabilities. Results show that users respond to time, monetary cost, and search friction in coherent and policy-relevant ways. Setting the car parking search time to zero increases predicted car probability only marginally, by about 0.9% relative to the baseline. By contrast, a EUR 1/h increase in parking cost reduces predicted car probability by about 14.7%, while a EUR 1.5/h increase reduces it by about 22.4%. A coordinated scenario combining higher parking cost and lower shared-mode search time produces the lowest predicted car probability and strengthens e-scooter and e-moped alternatives, while public transport remains the dominant option. Findings indicate that parking pricing steers behaviour more clearly than parking convenience destabilizes it in the tested range. The paper shows that mobility-hub performance depends on coordinated access management, including parking regulation, shared-service reliability, and legible multimodal transfer. Full article

Hungary is experiencing more frequent and severe droughts due to climate change, with 60% of its arable land in the vulnerable Great Hungarian Plain. Drought events in 2012 and 2022 reduced maize yields by more than 50% in some regions. This review synthesizes studies (2000–2025) on remote sensing capabilities, climate change impacts, and farmer adaptation in Hungarian agriculture. Remote sensing technologies (Sentinel, Landsat, MODIS) and indices (NDVI, VCI, LST, TCI) achieve high accuracy (often >80%) in drought detection under validated conditions, yet technical and financial barriers limit uptake among smallholder farmers. Climate projections indicate that a 2 °C temperature rise by 2050 will expand drought-affected areas. Farmer adaptation varies sharply by farm size: large farms (>100 ha) adopt precision agriculture (65% uptake), while smallholders (<10 ha) rely on crop rotation and drought-resistant varieties. Although substantial support is provided through the EU Common Agricultural Policy, institutional fragmentation and weak extension services—which reach only 32% of farmers—undermine its effectiveness. Bridging this gap requires integrating accessible remote sensing tools with targeted smallholder support and reformed extension services. Full article

Background: Sustainable head and neck cancer (HNC) surgery is challenged by environmental impact, workforce shortages, inequitable access to advanced techniques, and policy constraints. Addressing these areas is critical for equitable, high-quality care. Methods: This structured narrative review synthesizes evidence on environmental sustainability, workforce development, technological innovation, health policy, and socioeconomic determinants in HNC surgery, without aiming to provide a systematic or exhaustive evidence synthesis. Sources included peer-reviewed literature, global workforce surveys, and international policy reports, with a focus on disparities between high-income countries (HICs) and low- and middle-income countries (LMICs). Results: Operating rooms produce up to 70% of hospital solid waste and consume 3–6 times more energy than other units; reusable instruments and improved waste segregation can reduce carbon footprints by over 50%. Workforce shortages are severe in LMICs, where subspecialty training is scarce; global partnerships, bidirectional education, and simulation-based learning can expand local capacity. Telemedicine, artificial intelligence, and three-dimensional printing enhance surgical planning, training, and access but may widen disparities without equitable deployment. Policy tools—including diagnosis-related groups, bundled payments, and universal coverage—affect access and innovation uptake. Pandemic preparedness underscores the value of resilient systems with flexible staffing and telehealth integration. Conclusions: HNC surgery requires coordinated action across environmental, workforce, technological, socioeconomic, and policy domains; however, future systematic reviews are needed to comprehensively map the evidence base and assess its methodological quality. Embedding sustainability in clinical practice, ensuring equitable innovation access, and aligning reimbursement with high-value care can strengthen system resilience, improve outcomes, and support long-term surgical service viability. Full article

To address the demand for high-precision, high-efficiency, and standardized hydrographic information in intelligent shipping, this study systematically investigates key technologies for high-resolution hydrographic data parsing and intelligent information services. Focusing on the East China Sea, a space–air–ground integrated monitoring data access system is established. A hybrid data assimilation method combining four-dimensional variational (4D-Var) and ensemble Kalman filter is adopted to realize quality control, deep fusion, and optimal state estimation of multi-source heterogeneous hydrographic observations. A hybrid tidal harmonic response model is further developed to improve the refined forecasting accuracy of tide levels and ocean currents. A hierarchically decoupled system architecture is designed, and modules for data production, sharing, exchange, and visualization are developed in compliance with the international S-100 standard. By integrating hybrid spatiotemporal indexing, multi-level caching, and intelligent query optimization, the system achieves low-latency and high-concurrency service capabilities. Experimental results show that, compared with conventional models, the proposed framework reduces tidal forecast RMSE by approximately 15.8% under extreme weather, raises the continuity index of current vectors to 0.93, and cuts the S-100 product generation latency to less than 30 s. This research establishes a full-chain technical system from data parsing and product generation to intelligent services, providing a reliable technical support platform for ship intelligent navigation, dynamic route planning, and maritime safety assurance. Full article

Understanding the impact of neighborhood-level factors on stroke prevalence is crucial for addressing existing disparities. However, there is a distinct lack of ecological studies at the census tract level that investigate the social determinants of health (SDOH) influencing stroke prevalence within the U.S. Health and Human Services Region 3 (HHS Region 3: Delaware, Maryland, Pennsylvania, Virginia, West Virginia, and the District of Columbia). This study adopted a multivariate modeling approach to investigate the association between the 13 indicators of the Health Opportunity Index (HOI) and stroke prevalence at the census tract level in HHS Region 3 using four HOI indicator profiles and to highlight the specific SDOHs that are most associated with stroke prevalence. The four HOI indicator profiles include: (a) neighborhood and built environment profile, (b) social and community context profile, (c) resource profile, and (d) economic profile. The methodological approach was quantitative, using secondary data. The sample size was 8021 census tracts. The HOI was estimated for each census tract in the study area. Ordinary least squares regression (OLS) analysis and spatial lag model (SLM) were run to examine whether the 13 indicators of the HOI (categorized into four profiles) reliably predict stroke prevalence and to determine the most appropriate model that best identifies the strongest predictors of stroke prevalence. The results show that affordability, education, spatial segregation, and income inequality indicators were the strongest predictors of stroke prevalence in HHS Region 3. This granular research identifies the neighborhood-level SDOH most strongly linked to stroke prevalence, which can be leveraged to guide the development of targeted public health programs, quality improvement initiatives, resource allocation, and policy creation to combat stroke-related morbidity and mortality across census tracts in HHS Region 3. For example, the built environment, encompassing factors like employment access, affordable housing, and walkability, profoundly influences stroke prevalence and provides urban planners with practical insights for developing healthier, more equitable communities, such as creating neighborhood parks to encourage physical activity, a key factor in stroke prevention. This study also provides neighborhood organizations with the evidence needed to pursue grant funding and raise awareness about the socio-structural influences on stroke outcomes in their respective neighborhoods. Lastly, the insights generated from our study can facilitate collaborative decision-making processes with communities in HHS Region 3 regarding the prioritization of neighborhood-level SDOH for targeted public health interventions. This prioritization should focus on addressing predictors of stroke prevalence that are congruent with the community’s established priorities, thereby maximizing cost savings. Full article

Against the backdrop of China’s urban modernization pathway, the core value of urban innovation systems is increasingly shifting toward an inclusive orientation. Grounded in the theoretical connotation of inclusive urban innovation, this study establishes an evaluation index system covering equal participation opportunities, procedural fairness, and outcome sharing, and applies the entropy method, kernel density analysis, and spatial autocorrelation to empirically examine the spatial distribution characteristics and formation mechanisms of inclusive innovation spaces in Changsha. The results show that (1) Changsha’s inclusive innovation level presents a gradient decline from the central urban area to the periphery; (2) high–high clusters mainly in areas with stronger innovation–resource concentration and better public service conditions, such as Yuelu District and other districts associated with major innovation platforms. Low–low agglomeration zones cluster in peripheral urban areas like certain townships in Liuyang City and remote regions of Ningxiang City; (3) the spatial differentiation of inclusive innovation is jointly shaped by multiple factors, among which Cultural Education and Industrial Structure show relatively stronger explanatory power; and (4) improving inclusive innovation requires enhancing not only innovation agglomeration, but also public service accessibility, talent support, employment inclusion, and the local sharing of innovation outcomes. This study provides a systematic framework for evaluating urban inclusive innovation space and offers policy insights for promoting balanced and inclusive innovation development in regional innovation cities. Full article

The adoption of large language models (LLMs) is reshaping how organizations approach automation, decision-making, and user engagement across sectors. This study investigates the trends, theoretical frameworks, and adoption factors influencing the integration of LLMs in five key domains: education, commerce, banking, healthcare, and service. By employing a systematic literature review and meta-analysis, this paper synthesizes research published between 2022 and early 2026, corresponding to the period when LLMs became widely accessible for public and enterprise use, to evaluate both conceptual and empirical dimensions of LLM adoption. The review identifies the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology, including its extensions, as the most frequently applied frameworks. It also highlights the growing incorporation of complementary models such as the diffusion of innovation, the information system success model, and self-determination theory. The meta-analysis examines 59 pairwise relationships drawn from 154 studies with a cumulative sample size of 88,886 participants. Using correlation coefficients, $I^2$ statistics, and Egger’s test, the analysis reveals strong, consistent associations between behavioral intention and both use behavior and actual use, while also identifying high heterogeneity across contexts. Constructs such as trust, hedonic motivation, and personal innovativeness emerged as influential but were underrepresented in the theoretical modeling. The study underscores the importance of facilitating conditions, infrastructure, and organizational readiness for enabling sustained use while also drawing attention to gaps in addressing perceived risks, privacy concerns, and ethical implications. Full article