Search Results (279)

Background and Objectives: Although the association between frailty and constipation in older adults has attracted growing attention, evidence linking the Clinical Frailty Scale (CFS) to colonic transit time (CTT) remains scarce. In this retrospective study, we examined this association using colon capsule endoscopy (CCE). Materials and Methods: We enrolled 124 older adults (64 men, 60 women) aged ≥ 65 years (mean age 74.6 ± 5.6) who underwent CCE for colorectal polyp screening at Aishinkai Nakae Hospital, Japan, between January 2014 and July 2024. CTT was determined at the time of CCE, and frailty was assessed with the Japanese version of the CFS. To avoid the oversimplification inherent in a strict dichotomy, participants were analyzed primarily as three ordered categories—Robust (CFS 1–2; n = 73), Intermediate (CFS 3–4; n = 43), and Frail (CFS 5–7; n = 8)—and, for comparability with previous reports, also as a Robust versus Non-robust (CFS 3–7; n = 51) dichotomy. The independent association between CFS and CTT was examined with three complementary multivariable linear regression models (Model 2: CFS continuous; Model 3: CFS three-category ordinal; Model 3b: CFS three-category dummy with Robust as reference), each adjusted for 10 covariates: age, sex, body mass index, type 2 diabetes mellitus, laxative use, anticholinergic drug use, psychotropic drug use, hypothyroidism, smoking history, and history of abdominal surgery. Results: CTT rose stepwise across the three frailty categories (Robust: 132.0 min [IQR 81.0–229.0], 157.9 ± 99.9; Intermediate: 198.0 min [90.5–267.0], 186.1 ± 99.8; Frail: 241.5 min [199.0–320.5], 295.8 ± 181.3; Kruskal–Wallis p = 0.027; Jonckheere–Terpstra P for trend = 0.017); the dichotomous comparison was concordant (median 214.0 vs. 132.0 min; Mann–Whitney U U = 1441.5; p = 0.033). A graded dose–response-like relationship was further supported by Spearman correlation between the CFS score and CTT (ρ = 0.232; p = 0.009). Women had significantly longer CTT than men (median 189 vs. 121 min; p = 0.013), and the three-group trend was significant within the female subgroup (Kruskal–Wallis p = 0.032) but not within men (p = 0.138). In multivariable analysis, CFS remained independently associated with CTT prolongation both as a continuous score (Model 2: β = 36.6 per 1-point increase; 95% CI 17.3 to 56.0; p < 0.001) and as an ordinal three-category predictor (Model 3: β = 52.7 per one-step advance; 95% CI 19.7 to 85.8; p = 0.002). In the dummy-coded specification (Model 3b), the Frail-versus-Robust contrast was markedly significant (β = 155.4 min; 95% CI 71.5 to 239.3; p < 0.001), whereas the Intermediate-versus-Robust contrast was not (β = 27.0; 95% CI −15.5 to 69.5; p = 0.210). Female sex retained independent significance across models (β ≈ 47–49 min; p = 0.016–0.021). The original dichotomous Non-robust versus Robust specification (Model 1) was no longer significant after full adjustment (p = 0.372). Conclusions: Frailty progression, as assessed by the CFS, is independently and monotonically associated with prolonged CTT in older adults, with the effect becoming statistically manifest predominantly at the more advanced end of the frailty spectrum and particularly in women. Although these findings do not establish causality between frailty and constipation—and frailty itself reflects a multifactorial age-related process that may not be fully reversible—CCE-measured CTT provides an objective, radiation-free physiological biomarker of frailty-related bowel dysfunction that may support risk stratification and inform future interventional trials targeting potentially modifiable components of the gut–muscle axis. Full article

Self-ear cleaning is widespread in Saudi Arabia, yet public knowledge about proper ear hygiene and associated risks remains variable. This study aimed to assess knowledge, attitudes, and practices regarding self-ear cleaning among adults in the Northern Border Region and to situate the findings within the context of previous studies from other Saudi regions. A cross-sectional online survey was conducted among 534 adults (ages 18–60) residing in the Northern Border Region of Saudi Arabia. Data were collected using a validated questionnaire that assessed sociodemographic characteristics, knowledge, attitudes, practices, and self-reported complications related to self-ear cleaning. Knowledge was evaluated using 8 items, with 1 point per correct response (total score 0–8), and good knowledge was defined as ≥5 correct responses. Most participants (89.1%) reported practicing self-ear cleaning, predominantly using cotton buds (73.7%). Although many recognized potential harms (81.4% believed cotton buds could push wax deeper and 78.1% were aware of the risk of eardrum perforation), 64.1% still believed regular self-ear cleaning was necessary, indicating a knowledge–practice gap. Reported complications included otitis externa (50.6%), pain (44.0%), and bleeding (18.9%). In multivariable logistic regression, higher knowledge was independently associated with postgraduate education, healthcare employment, non-smoking status, and a history of hearing problems. Comparative synthesis with previous surveys from other Saudi regions revealed broadly similar prevalence, preferred tools, and complications, suggesting that self-ear cleaning is a common and often risky behavior nationwide. In conclusion, self-ear cleaning is prevalent in the authors’ region despite substantial awareness of its risks, and a persistent knowledge–practice gap was observed. While the cross-sectional, convenience-sample design limits causal inference and generalizability, these region-specific findings may help inform targeted educational messages and future interventional studies aimed at promoting safer ear hygiene and reducing avoidable ear-related morbidity in similar settings. Full article

Due to enclosed space, long evacuation distances, and complex path structures, key nodes in deep underground spaces are prone to forming bottlenecks during fire evacuation. To collect evacuation behavior data at potential bottlenecks, an interactive video-based hypothetical choice (HC) experiment was conducted with 104 valid samples. Exit distance, sub-safe zone setting, congestion, pedestrian flow guidance, and smoke were systematically examined. The results showed that: (a) exit distance, sub-safe zone setting, congestion at the nearest exit, and smoke significantly affected evacuation decisions, with clear avoidance of near-exit congestion and smoke; (b) congestion on paths to non-nearest exits had a relatively weak effect, and pedestrian flow guidance did not produce significant herding; and (c) gender, age, professional background, and evacuation experience influenced path choice differences under certain conditions. Notably, evacuees prioritized smoke avoidance over all other cues, while congestion triggered non-compensatory route switching rather than herding behavior. These findings enrich the empirical database on pedestrian evacuation dynamics in deep underground spaces and provide a quantitative basis for evacuation simulation, spatial optimization, and safety management. Full article

Background: Lung cancer carries a high psychosocial burden. Tobacco use, the stigma attached to the disease, and coping strategies are thought to interact and shape psychological outcomes, yet they have rarely been examined together. This review aimed to synthesise the evidence on the relationship between tobacco use, lung cancer stigma, and coping, and how these factors interact and influence patients’ psychological outcomes. Methods: Following the PRISMA 2020 guideline, PubMed/MEDLINE and Dialnet were searched (window 2014–April 2026) for empirical studies conducted in adults with lung cancer that addressed stigma, coping, or relevant psychological outcomes (e.g., anxiety, depression, distress, or quality of life). Study selection and data extraction were performed independently by two reviewers, with discrepancies resolved by consensus and, where needed, by a third reviewer. Methodological quality was appraised with design-specific tools (JBI for cross-sectional and cohort studies, CASP for qualitative studies, and COSMIN-oriented criteria for the psychometric study). Given the clinical and methodological heterogeneity, a structured narrative synthesis was conducted following the SWiM guideline. The protocol was registered in the Open Science Framework. Results: Twenty-four studies were included. Stigma was prevalent and consistently associated with depression, anxiety, distress, and poorer quality of life, with longitudinal evidence indicating that stigma precedes and predicts distress. Internalised stigma (guilt, shame, self-blame) was the facet most strongly linked to depression and anxiety. Smoking history graded stigma intensity (current > former > never smokers) but did not determine it, since clinically significant stigma also affected never-smokers. Adaptive coping (e.g., fighting spirit, positive reappraisal) and social support were consistently associated with better psychological adjustment and quality of life, while maladaptive coping (e.g., helplessness, avoidance, anxious preoccupation) was associated with worse outcomes; cross-sectional evidence further indicated that coping modes mediated the relationship between stigma and quality of life and that social support and self-compassion attenuated the impact of stigma on distress. Conclusions: Internalised stigma is a central, modifiable psychosocial stressor in lung cancer that affects smokers and never-smokers alike. Systematic screening for stigma, coping, and social support, together with non-stigmatising care, is warranted. Full article

Background/Objectives: This cross-sectional observational study investigated factors associated with emergency room (ER) utilization for dental pain in a rural inland region of Portugal. The main objective was to examine the relationship between access to dental care, sociodemographic characteristics, oral health behaviors, and clinical outcomes with the use of emergency room services for dental problems. Methods: The study sample comprised 423 participants from the districts of Bragança and Vinhais, in Trás-os-Montes, aged 4 to 90 years, who attended their first dental medicine consultation. Participants completed a structured questionnaire addressing sociodemographic characteristics, general health, oral health behaviors, and dental prosthetic use, and underwent oral examination for assessment of the Decayed, Missing, and Filled Teeth (DMFT) index. Associations with reported ER utilization due to toothache were analyzed using Fisher’s exact test and the Mann–Whitney U test. Results: Overall, 28.4% of participants reported having visited the ER due to dental pain, and most cases were managed with medication followed by discharge. ER utilization was significantly associated with behavioral risk factors such as smoking, as well as poorer oral hygiene practices, including less frequent tooth brushing. In addition, participants who sought ER care presented higher DMFT scores, indicating a greater burden of untreated dental decay and tooth loss. Conclusions: These findings suggest that limited preventive dental care and unfavorable oral health behaviors are associated with to avoidable ER visits for dental pain in rural settings. This study reinforces the need to strengthen access to preventive oral health services and to advance the integration of dental care into Portugal’s National Health Service (SNS), particularly in underserved inland regions. Full article

Background/Objectives: A multivariable prediction model was developed and externally validated to estimate an individual’s current need to visit a dentist among young to middle-aged adults. The objective was to provide an accessible, non-invasive screening tool for independent home self-assessment or integration within routine healthcare workflows. Methods: A cross-sectional study utilised data from two National Health and Nutrition Examination Survey (NHANES) cycles (2011–2014). Logistic regression was applied to develop the prediction model among 1870 dentate adults aged 30–50, a critical onset period for oral diseases. The primary outcome was derived from objective oral examinations conducted by licensed dentists. The resulting questionnaire-based tool provides two recommendations: a visit to a dentist or continuation of routine oral care. Results: External validation using the independent NHANES 2013–2014 cohort (n = 2024) demonstrated robust and clinically relevant predictive capacity, with an AUC of 0.822 (95% CI 0.803–0.842). The model exhibited acceptable calibration (slope 0.85; intercept 0.04) and stable operation. Decision-curve analysis showed net benefit across thresholds; at Pt = 0.33, 14/100 unnecessary screenings were avoided compared with treat-all. Internal validation using a 10% hold-out partition (n = 184) supported these findings, indicating similarly strong discrimination (AUC 0.817, 95% CI 0.751–0.884). Conclusions: Early midlife is a consistent and informative period for oral health intervention. A scalable 14-predictor architecture using accessible indicators established high clinical utility, supporting integration into digital health and primary care. This approach enables efficient population-level prevention. Large-scale, nationally representative NHANES data allowed for the investigation of less-studied factors, including intermittent smoking, metabolic dysregulation, and elevated cholesterol levels. Full article

Acute aortic syndrome (AAS) comprises acute aortic dissection, intramural haematoma, penetrating atherosclerotic ulcer, and limited intimal tear, conditions that require rapid recognition because mortality and resource use are strongly influenced by time to diagnosis, anatomical extent, malperfusion, and the need for emergency surgical or endovascular intervention. This revised narrative review synthesizes contemporary evidence on clinical, genetic, environmental, and health-system determinants of prolonged hospitalisation, intensive care unit (ICU) utilisation, bed occupancy, and costs in patients with AAS. Beyond summarising established risk factors, the review adds a resource-oriented framework that links hypertension, advanced age, female sex, smoking-related comorbidity, hereditary aortopathies, haemodynamic instability, malperfusion, delayed diagnosis, operative complexity, and postoperative complications to measurable downstream outcomes such as ICU length of stay, total hospital length of stay, reoperation, readmission, and longitudinal imaging surveillance. We searched PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for relevant studies, registries, guideline documents, and cost analyses published between January 2000 and May 2026, with particular emphasis on studies from the last five years. The review was not designed as a meta-analysis; therefore, effect estimates are interpreted according to study design and generalisability. AAS imposes a disproportionate burden on hospital systems because high-risk patients often require advanced imaging, prolonged haemodynamic monitoring, complex open or endovascular repair, ICU care, and lifelong follow-up. Earlier diagnosis, structured risk stratification, targeted genetic evaluation, aggressive control of modifiable risk factors, and system-level pathways such as dedicated aortic networks may shorten hospital stay and reduce avoidable costs. Full article

Population-based evidence on sleep quality in Kazakhstan remains limited. This study describes sleep quality as a multidimensional construct among adults in Kazakhstan using data collected during the first national survey wave after the adoption of a single national time zone. The survey was designed as a national post-transition baseline assessment and not as an evaluation of the causal impact of the time-zone reform. Associations with socio-demographic, behavioural, clinical, and regional factors were examined. We conducted a nationally representative cross-sectional survey of adults aged 18–69 years in Kazakhstan from May to October 2025 using a multistage stratified cluster design. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as a global PSQI score > 5. Complete PSQI data were available for 5872 participants. Descriptive analyses examined the global PSQI score and the seven component scores. Survey-weighted multivariable logistic regression was used to identify factors independently associated with poor sleep quality. The weighted prevalence of poor sleep quality was 28.1%, and the weighted mean global PSQI score was 4.43. The greatest component burden was attributable to sleep latency (mean 0.87), subjective sleep quality (0.82), and sleep disturbances (0.80), whereas use of sleep medication contributed minimally (0.11). Poor sleep quality was more common among women, older adults, urban residents, and participants with diabetes, current smoking, heavy episodic drinking, and depressive symptoms. In the adjusted model, female sex (aOR 1.37, 95% CI 1.19–1.57), age 55 years or older versus 18–24 years (1.98, 1.53–2.55), diabetes (1.47, 1.22–1.78), current smoking (1.28, 1.10–1.50), heavy episodic drinking (1.43, 1.16–1.76), and depressive symptoms (4.26, 3.52–5.15) were independently associated with higher odds of poor sleep quality. Rural residence was inversely associated with the outcome (0.71, 0.61–0.84). Compared with the North, higher odds were observed in the Central region (2.00, 1.46–2.74), East (1.94, 1.48–2.53), West (1.48, 1.17–1.88), and Almaty city (2.18, 1.72–2.76). Poor sleep quality is common among adults in Kazakhstan and is characterized primarily by difficulties with sleep initiation, perceived sleep quality, and nocturnal disturbances. The findings provide national post-transition baseline evidence and suggest that sleep health surveillance in Kazakhstan should prioritize demographic, mental health, behavioural, and regional inequalities while avoiding causal interpretation of the time-zone reform itself. Full article

Background/Objective: Kinesiophobia is a major fear-avoidance concept in chronic low back pain (CLBP); however, its independent contribution to pain, disability, and health-related quality of life (HRQoL) beyond sociodemographic and clinical variables remains unclear. This study aimed to evaluate the associations between kinesiophobia and patient-reported outcomes in adults with chronic low back pain regarding (i) pain intensity, (ii) functional disability, and (iii) HRQoL. Methods: This cross-sectional study included 298 participants with CLBP (average age 38.7 ± 13.2 years; 58.0% female). Kinesiophobia was evaluated using the Tampa Scale of Kinesiophobia (range, 17–68). Outcomes were pain intensity (Numerical Pain Rating Scale; 0–10), functional disability (Roland–Morris Disability Questionnaire; 0–24), and HRQoL (RAND-36; 0–100). Two multivariable linear regression models were used per outcome. Model 1 was adjusted for sex and age, and Model 2 was additionally adjusted for BMI, marital status, education, employment, smoking status, and chronic disease. Hierarchical regression analysis evaluated the incremental variance explained by kinesiophobia (ΔR²) when entered after all covariates. Effects were reported per 10-point increase in Tampa score, with 95% confidence intervals (CI). Results: In the fully adjusted models, higher kinesiophobia was associated with greater pain intensity (B = +1.17 points per 10 Tampa; 95% CI 0.55–1.79, p < 0.001), greater disability (B = +3.24 points; 95% CI 2.05–4.43; p < 0.001), and lower HRQoL (B = −7.98 points; 95% CI −11.1–−4.81; p < 0.001). Hierarchical regression analyses showed that kinesiophobia explained additional variance in pain (ΔR² = 0.11), disability (0.12), and HRQoL (0.11), all p < 0.001. Conclusions: In adults with CLBP, kinesiophobia was associated with greater pain intensity, functional disability, and lower HRQoL, accounting for 11–12% of variance in each outcome beyond demographic and clinical covariates. These findings support routine assessment of kinesiophobia and justify longitudinal and interventional studies to determine temporal relationships and treatment effects. Full article

Background: Long-term survivors (LTS) after gynecological cancer may be cured but still face physical and psychological challenges. This multicenter study aimed to assess the long-term side effects, the received follow-up care, and the personal perspectives of survivors. Methods: Between 2019 and 2025, LTS from four European countries within the ENGOT (European Network of Gynecological Oncological Trial Groups) and GCIG (Gynecologic Cancer InterGroup) networks were recruited. Long-term survival was defined as surviving at least five years after the first diagnosis. LTS completed a questionnaire with 81 questions (patient’s characteristics, oncological history, current health status, lifestyle factors). Analyses were mainly descriptive. Results: A total of 677 LTS were enrolled, with a median age of 64.0 years (range: 26–92) and a median survival time of 7 years (range: 5–38). A total of 46.6% were diagnosed with cervical cancer, 32.9% with endometrial cancer, 4.4% with ovarian cancer, and 16.1% with other types of gynecological cancer. Moreover, 36.9% still suffer from physical and psychological symptoms, most frequently being lymphedema (36.2%), hot flashes (22.4%), difficulties with concentration (21.1%), fatigue (20.9%), vaginal dryness (20.1%), and urinary incontinence (18.9%). Median overall health status was ranked (scale 1–5; 1 = very good, 5 = very poor) as 2, while 13.5% rated their health as poor/very poor. Current symptoms were associated with poorer health status (p < 0.001) and a history of recurrent disease (p = 0.001). In addition, 13.6% reported not receiving follow-up care. CA-125 was determined in 80.8% of ovarian LTS, as well as in 30.7% of cervical and 28.9% of endometrial LTS. Pap smear follow-up was reported by 50.5% of endometrial LTS. A total of 33.7% did not exercise at all or exercised less than an hour per week, 13.4% smoke tobacco, and 51.2% drink alcohol more often than once a month. Conclusions: Our findings highlight the need for patient-centered follow-up care, addressing both long-term side effects and education on lifestyle and prevention. Follow-up procedures that do not follow guidelines should be avoided. Full article

Late spring frost poses a serious threat to orchard production, especially in mountainous orchards where timely frost monitoring and adaptive protection are difficult to implement. To address this problem, this study developed an intelligent smoke-based anti-frost machine integrating a LoRa-based wireless temperature monitoring system, a smoke actuation unit, and a closed-loop control terminal. To overcome the slow response and large overshoot of conventional PID control under nonlinear field conditions, a fuzzy PID control strategy optimized by the Hippopotamus Optimization Algorithm (HOA) was proposed to regulate smoke release in real time. Comparative simulations were conducted using conventional PID, fuzzy PID, and HOA-fuzzy PID controllers, and field experiments were performed in an apple orchard. The results showed that the HOA-fuzzy PID controller achieved the best dynamic performance. Compared with conventional PID, the overshoot, rise time, and settling time were reduced by 60.12%, 33.21%, and 61.94%, respectively; compared with fuzzy PID, they were reduced by 22.85%, 50.45%, and 60.11%, respectively. Disturbance simulation further indicated improved control robustness. Field experiments showed that the prototype increased the orchard canopy temperature by 0.9–3.0 K, and the PM_2.5 distribution in the operational area indicated improved smoke coverage. The adaptive regulation strategy also avoided continuous fixed-output operation, suggesting its potential to improve energy-use efficiency. Overall, the proposed system provides a feasible field-operable approach for improving canopy thermal conditions and reducing frost-risk exposure in mountainous orchards, although further biological validation is still required. Full article

Background: Gastroesophageal reflux disease (GERD) is a common digestive disorder with a substantial impact on quality of life. Emerging evidence suggests that dietary patterns and lifestyle behaviors are associated with the occurrence and severity of GERD symptoms; however, integrated data from Romania remain limited. Objective: The aim of this study was to evaluate associations between pro- and anti-inflammatory dietary patterns, lifestyle-related behavioral factors, and the presence and severity of gastroesophageal reflux symptoms in an adult Romanian population. Methods: A national cross-sectional observational study was conducted using a self-administered online questionnaire. All participants included in the study reported a prior diagnosis of gastroesophageal reflux disease (GERD), and participant classification was based exclusively on current symptomatology assessed using the GERD-Q score. Therefore, comparisons were not performed between patients and a healthy population, but rather between individuals at different stages of clinical expression of the same condition, characterized by a fluctuating course. The instrument included standardized GERD-Q items for symptom assessment, together with questions regarding dietary intake and lifestyle behaviors. Pro-inflammatory (PRO), anti-inflammatory (ANTI), and combined (PRO–ANTI) dietary scores were established. Statistical analyses included comparative and correlational tests as well as multivariable logistic regression models. Results: Among the 340 participants included in the study, 72.4% reported symptoms consistent with GERD according to the GERD-Q score. A higher pro-inflammatory dietary score was significantly associated with GERD, with participants in the highest PRO category showing more than a fourfold higher likelihood of GERD in multivariable analyses. Consumption of spicy foods and carbonated beverages was associated with an increased risk of GERD in univariate analyses; however, these associations did not remain significant in multivariable models. Late meals (defined as consumption of one’s last meal of the day less than two hours before bedtime) were independently associated with GERD. Combined analyses indicated a higher risk among participants who reported eating late meals, particularly when combined with large evening meals. Most foods considered protective, along with classical lifestyle factors (smoking, alcohol consumption, and sleeping position), were not independently associated with GERD. Conclusions: These findings suggest that overall dietary patterns with pro-inflammatory potential and meal timing in relation to the sleep–wake cycle may be more consistently associated with GERD symptoms in this sample than isolated food items or traditional lifestyle risk factors. Nutritional and behavioral interventions focused on improving overall dietary patterns and avoiding late meals may represent potential strategies for GERD management. Full article

Indoor air quality (IAQ) is a critical determinant of environmental health, yet awareness among young adults in rapidly urbanizing regions remains unclear. This study assessed knowledge, awareness, and practices related to IAQ among university students in Ras Al Khaimah, United Arab Emirates, and compared outcomes between medical and non-medical disciplines, while examining associations between knowledge levels and IAQ-related behaviors. A cross-sectional survey was conducted among 386 undergraduate students from three universities using a pre-validated, self-administered questionnaire. Overall, 52.1% of participants had heard of IAQ. Appropriate knowledge (≥60%) was demonstrated by 26.9% of students, and only 3.4% achieved high knowledge (≥80%). Medical students were significantly more likely than non-medical students to demonstrate appropriate knowledge (38.1% vs. 18.3%; p = 0.001), and female students scored higher than males (32.8% vs. 20.3%; p = 0.006). Awareness of IAQ guidelines was limited (65.3% unaware). Although 85.2% reported engaging in at least one IAQ-improving behavior, practices were mainly limited to ventilation and avoidance of indoor smoking. Higher knowledge levels were significantly associated with protective behaviors (p < 0.001). These findings indicate limited objective knowledge despite moderate recognition of IAQ importance, underscoring the need for structured educational interventions to enhance environmental health literacy. Full article

Accurate identification of fire smoke is a key link in realizing early fire prevention and control. Traditional intelligent video and image processing technologies are significantly restricted by environmental factors, with weak anti-interference capabilities and limitations in distinguishing fire smoke, leading to a high false alarm rate of fires. To address this problem, this paper proposes an unconventional visual field smoke detection method based on image enhancement. The method innovatively improves the Retinex algorithm by integrating improved guided filtering, adaptive brightness correction, and CLAHE-WWGIF joint processing, which realizes targeted optimization for the unique interference factors of under-construction nuclear power plants such as water mist, low illumination, and equipment occlusion. First, an improved Retinex algorithm is used to process the image to improve the image brightness and contrast, retain edge details while avoiding halo artifacts, reduce the impact of noise, and optimize visual features. Then, the sample data set is integrated, and the YOLOv11 target detection algorithm is used to achieve accurate identification and positioning of smoke targets. Experimental data shows that the fire identification method achieves an accuracy rate of 93.6% and 92.3% for fire smoke identification in interference-prone scenarios such as dark nights and water mist, respectively, and the response time to fire smoke is only 1.8 s and 2.1 s. In practical on-site applications at nuclear power plant construction sites, the method is integrated into an “edge computing + distributed deployment” hardware system, which realizes real-time smoke detection in core areas such as nuclear islands and conventional islands with a false alarm rate of less than 5% and a detection delay of ≤300 ms, meeting the ultra-strict safety monitoring requirements of nuclear power projects. Experiments show that this method can be effectively applied to smoke detection scenarios under unconventional visual fields, accurately identify smoke, provide reliable technical support for fire smoke identification under unconventional visual fields, significantly reduce the false alarm rate of fire detection, and provide technical support for the safety of under-construction nuclear power plants. Full article

Lung cancer remains the leading cause of cancer-related mortality globally and is often diagnosed at advanced stages in Saudi Arabia. This cross-sectional study aimed to quantify public awareness and knowledge of lung cancer screening (LCS) using LDCT and identify barriers to its implementation in Riyadh. A validated 24-item questionnaire was administered to 452 participants to assess demographic factors, smoking history, and LCS knowledge. Results revealed that only 30.1% of participants had heard of LCS, and 50.2% demonstrated “poor” knowledge scores (mean score 11.0 ± 4.97). Higher knowledge scores were significantly associated with being female, having a bachelor’s degree or higher, and being a non-smoker. While 78.1% expressed willingness to undergo screening, the most significant barrier was a lack of knowledge about the test (44.1%), followed by concerns regarding radiation exposure (36.1%). Conversely, a healthcare provider’s recommendation was identified as the primary motivator for 53.3% of respondents. These findings highlight a critical “awareness–willingness” gap. While public willingness is high, this should not be misconstrued as systemic preparedness; substantial educational and structural gaps remain that must be bridged before national implementation can be considered feasible. We conclude that while public willingness is high, successful implementation requires a transition toward organized invitation systems and the use of multifactorial risk profiles. Integrating epidemiological evidence with proactive policy design is essential to ensure that the national program avoids systematic under- or over-inclusion and remains effective for all demographics. Full article