Search Results (9,465)

Background/Objectives: Despite growing interest in oral frailty as a public health issue, no nationwide study has assessed regional differences in oral frailty awareness, and the factors associated with such differences remain unclear. This study investigated regional differences in oral frailty awareness among older adults in Japan and identified the associated individual- and municipal-level factors, focusing on local policy measures and community-based oral health programs. Methods: A cross-sectional analysis was conducted using data from the 2022 wave of the Japan Gerontological Evaluation Study. The analytical sample comprised 20,330 community-dwelling adults aged ≥65 years from 66 municipalities. Awareness of oral frailty was assessed via self-administered questionnaires. Individual- and municipal-level variables were analyzed using multilevel Poisson regression models to calculate prevalence ratios (PRs). Results: Awareness of oral frailty varied widely across municipalities, ranging from 15.3% to 47.1%. Multilevel analysis showed that being male (PR: 1.10), having ≤9 years (PR: 1.10) or 10 to 12 years of education (PR: 1.04), having oral frailty (PR: 1.04), and lacking civic participation (PR: 1.06) were significantly associated with lack of awareness. No significant associations were found with municipal-level variables such as dental health ordinances, volunteer training programs, or population density. Conclusions: The study found substantial regional variation in oral frailty awareness. However, this variation was explained primarily by individual-level characteristics. Public health strategies should focus on enhancing awareness among socially vulnerable groups—especially men, individuals with low educational attainment, and those not engaged in civic activities—through targeted interventions and community-based initiatives. Full article

Sexual health constitutes a fundamental aspect of overall well-being, with direct implications for individual development and the broader social and economic progress of communities. Promoting environments that ensure sexual experiences free from coercion, discrimination, and violence is a key public health priority. Sexuality, in this regard, should be understood as an inherent dimension of human experience, shaped by biological, cultural, cognitive, and ideological factors. Accordingly, sexual health education requires a holistic and multidimensional approach that integrates sociocultural, biographical, and professional perspectives. This study aims to examine the level of knowledge and training in sexual health among nursing students and healthcare professionals, as well as to assess the extent to which sexual health content is incorporated into nursing curricula at Spanish universities. A scoping review was conducted using the Dialectical Structural Model of Care (DSMC) as the theoretical framework. The findings indicate a significant lack of knowledge regarding sexual health among both nursing students and healthcare professionals, largely due to educational and structural limitations. Furthermore, sexual health education remains underrepresented in nursing curricula and is frequently addressed from a narrow, fragmented biomedical perspective. These results highlight the urgent need for the comprehensive integration of sexual health content into nursing education. Strengthening curricular inclusion is essential to ensure the preparation of competent professionals capable of delivering holistic, inclusive, and empowering care in this critical area of health. Full article

Introduction: The increasing cultural diversity of patients poses new challenges for nurses. Cultural competence, especially knowledge of the cultural determinants of health and illness, is an important element of professionalism in nursing care. The aim of this study was to analyse nurses’ self-assessment of cultural knowledge, with a focus on the six dimensions of the Giger and Davidhizar model, prior to formal training in this area. Methods: A triangulation method combining qualitative and quantitative analysis was used. The analysis included 353 statements from 36 master’s student nurses. Data were coded according to six cultural phenomena: biological factors, communication, space, time, social structure, and environmental control. Content analysis, ANOVA, Spearman’s rank correlation, and cluster analysis (k-means) were conducted. Results: The most frequently identified that categories were environmental control (34%), communication (20%), and social structure (16%). Significant knowledge gaps were identified in the areas of non-verbal communication, biological differences, and understanding space in a cultural context. Three cultural knowledge profiles of the female participants were distinguished: pragmatic, socio-reflective, and critical–experiential. Conclusions: The cultural knowledge of the participants was fragmented and simplified. The results indicate the need to personalise cultural learning and to take into account nurses’ level of readiness and experience profile. The study highlights the importance of the systematic development of reflective and contextual cultural knowledge as a foundation for competent care. Full article

E-Learning is an emerging dominant phenomenon in education, making the development of robust models that can accurately represent the dynamic behavior of learners in MOOCs even more critical. In this article, we propose the Temporal Sparse Attention-Gated Recurrent Unit (TSA-GRU), a novel deep learning framework that combines TSA with a sequential encoder based on the GRU. This hybrid model effectively reconstructs student response times and learning trajectories with high fidelity by leveraging tthe emporal embeddings of instructional and feedback activities. By dynamically filtering noise from student interactions, TSA-GRU generates context-aware representations that seamlessly integrate both short-term fluctuations and long-term learning patterns. Empirical evaluation on the 2009–2010 ASSISTments dataset demonstrates that TSA-GRU achieved a test accuracy of 95.60% and a test loss of 0.0209, outperforming Modular Sparse Attention-Gated Recurrent Unit (MSA-GRU), Bayesian Knowledge Tracing (BKT), Performance Factors Analysis (PFA), and TSA in the same experimental design. TSA-GRU converged in five training epochs; thus, while TSA-GRU is demonstrated to have strong predictive performance for knowledge tracing tasks, these findings are specific to the conducted dataset and should not be implicitly regarded as conclusive for all data. More statistical validation through five-fold cross-validation, confidence intervals, and paired t-tests have confirmed the robustness, consistency, and statistically significant superiority of TSA-GRU over the baseline model MSA-GRU. TSA-GRU’s scalability and capacity to incorporate a temporal dimension of knowledge can make it acceptably well-positioned to analyze complex learner behaviors and plan interventions for adaptive learning in computerized learning systems. Full article

Governments worldwide are mandating e-invoicing and real-time VAT reporting, yet many cash-intensive service SMEs continue to under-report VAT, eroding fiscal revenues. This study investigates whether financial technology (FinTech) adoption can reduce this under-reporting among tourism SMEs in Greece—an economy with high seasonal spending and a persistent shadow economy. This is the first micro-level empirical study to examine how FinTech tools affect VAT compliance in this sector, offering novel insights into how technology interacts with behavioral factors to influence fiscal behavior. Drawing on the Technology Acceptance Model, deterrence theory, and behavioral tax compliance frameworks, we surveyed 214 hotels, guesthouses, and tour operators across Greece’s main tourism regions. A structured questionnaire measured five constructs: FinTech adoption, VAT compliance behavior, tax morale, perceived audit probability, and financial performance. Using Partial Least Squares Structural Equation Modeling and bootstrapped moderation–mediation analysis, we find that FinTech adoption significantly improves declared VAT, with compliance fully mediating its impact on financial outcomes. The effect is especially strong among businesses led by owners with high tax morale or strong perceptions of audit risk. These findings suggest that FinTech tools function both as efficiency enablers and behavioral nudges. The results support targeted policy actions such as subsidies for e-invoicing, tax compliance training, and transparent audit communication. By integrating technological and psychological dimensions, the study contributes new evidence to the digital fiscal governance literature and offers a practical framework for narrowing the VAT gap in tourism-driven economies. Full article

According to the Transportation Safety Board of Canada, between 2013 and 2023, 62% of aviation accidents occurred during the approach, landing, and post-impact phases of flight. Hence, this study targets factors contributing to increased accident rates during the final stages of flight. It will review how pilot experience influences decision-making and identifies mitigation strategies, focusing on go-arounds to prevent accidents during these critical phases. Surveys and roundtable discussions were conducted to identify factors influencing pilot performance during approach, landing, and go-around manoeuvres. By using a mixed-methods approach that combined thematic and statistical analyses, key safety factors were identified, including situational awareness, decision-making, and operational complexity. The study also examined the relationship between experience and decision-making, highlighting areas for targeted interventions to improve safety. The research emphasises the importance of integrating decision-making considerations into training programmes and connecting these to human factors. Through identifying areas for improvement, this study offers a safety-driven framework to address decision-making challenges during approach, landing, and go-around phases, with the objective of reducing accident and incident rates in general aviation. Full article

Background: Menopause increases the risk of cardiovascular diseases (CVD) accompanied by a decline in muscle function. Myokines, released by skeletal muscle, could play a significant role in cardiovascular health. Objectives and Methods: This study aimed to investigate the changes induced by a 16-week resistance training (RT) program and/or the docosahexaenoic acid (DHA)-rich n-3 PUFA supplementation on myokine and cytokine circulating levels and to study their associations with parameters of body composition, muscle function, and glucose and lipid serum markers in postmenopausal women with overweight/obesity. Results: At baseline, interleukin-6 (IL-6) levels were positively correlated with body fat and with tumor necrosis factor-alpha (TNF-α) levels and negatively associated with meterorin-like (METRNL) levels. Moreover, METRNL was inversely associated with insulin levels and with HOMA-IR. After the intervention, muscle quality improved with either treatment but more notably in response to RT. N-3 supplementation caused significant improvements in cardiometabolic health markers. TNF-α decreased in all experimental groups. Myostatin levels decreased in the RT and in the n-3 groups, and IL-6 increased in the n-3+RT group. Lastly, no interactions between treatments were observed. Conclusions: In postmenopausal women with overweight or obesity, RT could help improve skeletal muscle function, while DHA-rich n-3 supplementation might decrease CVD risk and might potentially improve muscle function. The modulation of myokine levels could be underlying some of the effects of DHA or RT; however, further research is necessary. Full article

This paper proposes an intelligent power adaptation framework for Free-Space Optics (FSO) communication systems operating under different weather conditions exploiting a deep learning (DL) analysis of received eye diagram images. The system incorporates two Convolutional Neural Network (CNN) architectures, LeNet and Wide Residual Network (Wide ResNet) algorithms to perform regression tasks that predict received signal quality metrics such as the Quality Factor (Q-factor) and Bit Error Rate (BER) from the received eye diagram. These models are evaluated using Mean Squared Error (MSE) and the coefficient of determination (${\mathrm{R}}^2$ score) to assess prediction accuracy. Additionally, a custom CNN-based classifier is trained to determine whether the BER reading from the eye diagram exceeds a critical threshold of ${10}^{-4}$; this classifier achieves an overall accuracy of 99%, correctly detecting 194/195 “acceptable” and 4/5 “unacceptable” instances. Based on the predicted signal quality, the framework activates a dual-amplifier configuration comprising a pre-channel amplifier with a maximum gain of 25 dB and a post-channel amplifier with a maximum gain of 10 dB. The total gain of the amplifiers is adjusted to support the operation of the FSO system under all-weather conditions. The FSO system uses a 15 dBm laser source at 1550 nm. The DL models are tested on both internal and external datasets to validate their generalization capability. The results show that the regression models achieve strong predictive performance, and the classifier reliably detects degraded signal conditions, enabling the real-time gain control of the amplifiers to achieve the quality of transmission. The proposed solution supports robust FSO communication under challenging atmospheric conditions including dry snow, making it suitable for deployment in regions like Northern Europe, Canada, and Northern Japan. Full article

UAV-based inspections are an effective way to ensure railway safety and have gained significant attention. However, images captured during complex weather conditions, such as rain, snow, or fog, often suffer from severe degradation, affecting image recognition accuracy. Existing algorithms for removing rain, snow, and fog have two main limitations: they do not adaptively learn features under varying weather complexities and struggle with managing complex noise patterns in drone inspections, leading to incomplete noise removal. To address these challenges, this study proposes a novel framework for removing rain, snow, and fog from drone images, called WeatherClean. This framework introduces a Weather Complexity Adjustment Factor (WCAF) in a parameterized adjustable network architecture to process weather degradation of varying degrees adaptively. It also employs a hierarchical multi-scale cropping strategy to enhance the recovery of fine noise and edge structures. Additionally, it incorporates a degradation synthesis method based on atmospheric scattering physical models to generate training samples that align with real-world weather patterns, thereby mitigating data scarcity issues. Experimental results show that WeatherClean outperforms existing methods by effectively removing noise particles while preserving image details. This advancement provides more reliable high-definition visual references for drone-based railway inspections, significantly enhancing inspection capabilities under complex weather conditions and ensuring the safety of railway operations. Full article

Automated quality control plays a critical role in modern industries, particularly in environments that handle large volumes of packaged products requiring fast, accurate, and consistent inspections. This work presents an anomaly detection system for candle jars commonly used in industrial and commercial applications, where obtaining labeled defective samples is challenging. Two anomaly detection strategies are explored: (1) a baseline model using convolutional neural networks (CNNs) as an end-to-end classifier and (2) a hybrid approach where features extracted by CNNs are fed into One-Class classification (OCC) algorithms, including One-Class SVM (OCSVM), One-Class Isolation Forest (OCIF), One-Class Local Outlier Factor (OCLOF), One-Class Elliptic Envelope (OCEE), One-Class Autoencoder (OCAutoencoder), and Support Vector Data Description (SVDD). Both strategies are trained primarily on non-defective samples, with only a limited number of anomalous examples used for evaluation. Experimental results show that both the pure CNN model and the hybrid methods achieve excellent classification performance. The end-to-end CNN reached 100% accuracy, precision, recall, F1-score, and AUC. The best-performing hybrid model CNN-based feature extraction followed by OCIF also achieved 100% across all evaluation metrics, confirming the effectiveness and robustness of the proposed approach. Other OCC algorithms consistently delivered strong results, with all metrics above 95%, indicating solid generalization from predominantly normal data. This approach demonstrates strong potential for quality inspection tasks in scenarios with scarce defective data. Its ability to generalize effectively from mostly normal samples makes it a practical and valuable solution for real-world industrial inspection systems. Future work will focus on optimizing real-time inference and exploring advanced feature extraction techniques to further enhance detection performance. Full article

The present study examines the barriers that prevent cooling system flexibility from being optimized. In the context of an increasing reliance on renewable energy sources, the necessity for flexible energy utilization is becoming increasingly apparent. A survey and discussion groups were conducted with various stakeholders within the cooling value chain to obtain their experiences and insights regarding barriers to flexibilization. The findings point out that economic, technological, and regulatory barriers are the primary factors impeding the implementation of flexible solutions. In particular, high investment costs, complex technical implementation, a lack of information, and a complicated legal framework were identified as significant impediments. To enhance the flexibility of cooling systems, coordinated efforts are necessary to address these barriers. Practical examples, training, and the standardization and digitalization of processes could facilitate the widespread implementation of flexible cooling systems. Full article

Efficient planning of train crew rosters is a key factor in ensuring operational reliability and promoting long-term sustainability in railway transport, both economically and socially. This article presents a systematic approach to developing a crew rostering model in passenger rail transport, with a focus on the operational setting of the train crew depot in Česká Třebová, a city in the Czech Republic. The seven-step methodology includes identifying available train shifts, defining scheduling constraints, creating roster variants, and calculating personnel and time requirements for each option. The proposed roster reduced staffing needs by two employees, increased the average shift duration to 9 h and 42 min, and decreased non-productive time by 384 h annually. These improvements enhance sustainability by optimizing human resource use, lowering unnecessary energy consumption, and improving employees’ work–life balance. The model also provides a quantitative assessment of operational feasibility and economic efficiency. Compared to existing rosters, the proposed model offers clear advantages and remains applicable even in settings with limited technological support. The findings show that a well-designed rostering system can contribute not only to cost savings and personnel stabilization, but also to broader objectives in sustainable public transport, supporting resilient and resource-efficient rail operations. Full article

With the rapid development of video streaming services, adaptive bitrate (ABR) algorithms have become a core technology for ensuring optimal viewing experiences. Traditional ABR strategies, predominantly rule-based or reinforcement learning-driven, typically employ uniform quality assessment metrics that overlook users’ subjective preference differences regarding factors such as video quality and stalling. To address this limitation, this paper proposes an adaptive video bitrate selection system that integrates preference modeling with reinforcement learning. By incorporating a preference learning module, the system models and scores user viewing trajectories, using these scores to replace conventional rewards and guide the training of the Proximal Policy Optimization (PPO) algorithm, thereby achieving policy optimization that better aligns with users’ perceived experiences. Simulation results on DASH network bandwidth traces demonstrate that the proposed optimization method improves overall Quality of Experience (QoE) by over 9% compared to other mainstream algorithms. Full article

Mental stress is a psychological or emotional strain that typically occurs because of threatening, challenging, and overwhelming conditions and affects human behavior. Various factors, such as professional, environmental, and personal pressures, often trigger it. In recent years, various deep learning (DL)-based schemes using electroencephalograms (EEGs) have been proposed. However, the effectiveness of DL-based schemes is challenging because of the intricate DL structure, class imbalance problems, poor feature representation, low-frequency resolution problems, and complexity of multi-channel signal processing. This paper presents a novel hybrid DL framework, BDDNet, which combines a deep convolutional neural network (DCNN), bidirectional long short-term memory (BiLSTM), and deep belief network (DBN). BDDNet provides superior spectral–temporal feature depiction and better long-term dependency on the local and global features of EEGs. BDDNet accepts multiple EEG features (MEFs) that provide the spectral and time-domain features of EEGs. A novel improved crow search algorithm (ICSA) was presented for channel selection to minimize the computational complexity of multichannel stress detection. Further, the novel employee optimization algorithm (EOA) is utilized for the hyper-parameter optimization of hybrid BDDNet to enhance the training performance. The outcomes of the novel BDDNet were assessed using a public DEAP dataset. The BDDNet-ICSA offers improved recall of 97.6%, precision of 97.6%, F1-score of 97.6%, selectivity of 96.9%, negative predictive value NPV of 96.9%, and accuracy of 97.3% to traditional techniques. Full article

Ulcerative colitis (UC) is a chronic inflammatory bowel disease associated with disrupted lipid metabolism. This study aimed to uncover novel molecular subtypes and biomarkers by integrating sphingolipid metabolism-related genes (SMGs) with machine learning approaches. Using data from the GEO and GeneCards databases, 29 UC-related SMGs were identified. Consensus clustering was employed to define distinct molecular subtypes of UC, and a diagnostic model was developed through various machine learning algorithms. Further analyses—including functional enrichment, transcription factor prediction, single-cell localization, potential drug screening, molecular docking, and molecular dynamics simulations—were conducted to investigate the underlying mechanisms and therapeutic prospects of the identified genes in UC. The analysis revealed two molecular subtypes of UC: C1 (metabolically dysregulated) and C2 (immune-enriched). A diagnostic model based on three key genes demonstrated high accuracy in both the training and validation cohorts. Moreover, the transcription factor FOXA2 was predicted to regulate the expression of all three genes simultaneously. Notably, mebendazole and NVP-TAE226 emerged as promising therapeutic agents for UC. In conclusion, SMGs are integral to UC molecular subtyping and immune microenvironment modulation, presenting a novel framework for precision diagnosis and targeted treatment of UC. Full article