Search Results (80)

Chronic kidney disease (CKD) is associated with heart failure and neurological disorders. Therefore, point-of-care (POC) detection of CKD is essential, allowing disease monitoring from home and alleviating healthcare professionals’ workload. Lateral flow immunoassays (LFIAs) facilitate POC testing for a renal function biomarker, serum Cystatin C (CysC). LF devices were fabricated and optimised by varying the diluted sample volume, the nitrocellulose (NC) membrane, bed volume, AuNPs’ OD value and volume, and assay formats of partial or full LF systems. Notably, 310 samples were analysed to satisfy the minimum sample size for statistical calculations. This allowed for a comparison between the LFIAs’ results and the general Roche standard assay results from the Southern Health and Social Care Trust. Bland–Altman plots indicated the LFIAs measured 0.51 mg/L lower than the Roche assays. With the 95% confidence interval, the Roche method might be 0.24 mg/L below the LFIAs’ results or 1.27 mg/L above the LFIAs’ results. In summary, the developed non-fluorescent LFIAs could detect clinical CysC values in agreement with Roche assays. Even though the developed LFIA had an increased bias in low CysC concentration (below 2 mg/L) detection, the developed LFIA can still alert patients at the early stages of renal function impairment. Full article

Social media platforms have been recognized as significant contributors to the dissemination of polarizing content, the spread of disinformation, and the proliferation of far-right populist discourse. While certain political actors deliberately seek to disseminate disinformation, a more nuanced understanding is necessary to elucidate why users consume and accept this biased content. Using data from over 120,000 participants across five European and Spanish surveys, we empirically examined the relationships between social media use, disinformation, false news, users’ digital agency, far-right ideology, and far-right voting. We postulated that a lack of users’ digital agency is a significant contributor to this phenomenon and found a significant association between users’ low digital agency and the adoption of far-right ideologies (odds ratio [OR] = 1.16, 95% confidence interval [CI] 1.08–1.23). This association remained after controlling for trust in social media news, psychological and social factors, sociodemographic variables, and response bias. Full article

Effective municipal solid waste (MSW) management is crucial for urban sustainability, especially in fast-growing cities, like Hangzhou, China. This study examines residents’ willingness to pay (WTP) for the following five key MSW measures: differentiated waste charging, smart recycling points, on-site organic waste recovery, volunteer-based waste sorting supervision, and a community self-governance fund. Based on a survey of 521 residents across 13 districts, we use logistic and interval regression models to identify factors influencing WTP and payment amounts. Key findings include the following: Higher-income and more educated residents prefer cost-efficient, technology-driven solutions, like smart recycling and differentiated charging. Newcomers (≤5 years of residence) show higher WTP and greater sensitivity to environmental information, highlighting the need for targeted outreach. Providing explicit environmental benefits (e.g., waste reduction, increased recycling) significantly boosts WTP rates and payment levels. Community characteristics matter—residents in high-density areas favor waste charging, while those in older neighborhoods support volunteer programs and self-governance funds. Policy implications center on targeted outreach, transparent fee structures, and incentive programs to foster public trust and enhance participation. Although MSW management in Hangzhou remains predominantly government-led, select collaboration with private enterprises (e.g., in specialized recycling services) may offer additional efficiency gains. By aligning these measures with localized preferences and demographic patterns, Hangzhou—and other quickly urbanizing regions—can develop robust and inclusive MSW systems that contribute to broader sustainable development objectives. Full article

Although many peers socialize online, there is evidence that adolescents who spend too much time online are lonely, depressed, and anxious. This study incorporates habitual smartphone use as a new way of measuring smartphone engagement, based on the shortcomings of simply measuring ‘hours spent online’. Drawing on a large 2-year longitudinal study, the current research aims to investigate the association between habitual smartphone use and peer attachment among Canadian adolescents. A whole-school approach combined with a convenience sampling method was used to select our sample. A total of 1303 Canadian high school students (Grades 8–12; mage = 14.51 years, SD = 1.17 years; 50.3% females) who completed both waves of data collection were included in this study. A random intercept latent transition analysis (RI-LTA) was utilized to assess the association between habitual smartphone use (absent-minded subscale of the Smartphone Usage Questionnaire) and transition probabilities among profiles of peer attachment (Inventory of Parent and Peer Attachment), after adjusting for age, gender, ethnicity, stress, family attachment, school connectedness, and social goals. Three profiles of peer attachment were identified: (Profile 1: weak communication and some alienation; Profile 2: strong communication, strong trust, and weak alienation; Profile 3: okay communication and high alienation). Results of multivariable RI-LTA indicated that increased habitual smartphone use was significantly associated with a heightened probability of transitioning from Profile 2 at Wave 1 to Profile 1 at Wave 2 (odds ratio (OR) = 1.21, 95% confidence interval (CI) 1.003–1.46). Findings indicate that adolescents who are more habituated to their phones may become less attached to their peers over time. This offers insights for caregivers to focus on management and discussing smartphone engagement with adolescents to strengthen their attachment with peers. Full article

Convex optimization has gained increasing popularity in trajectory planning methods for wide-speed range unmanned aerial systems (UASs) with multiple no-fly zones (NFZs) in the entry phase. To address the issues of slow or even infeasible solutions, a modified fast trajectory planning method using the approaches of variable trust regions and adaptive generated initial values is proposed in this paper. A dimensionless energy-based dynamics model detailing the constraints of the entry phase is utilized to formulate the original entry trajectory planning problem. This problem is then transformed into a finite-dimensional convex programming problem, using techniques such as successive linearization and interval trapezoidal discretization. Finally, a variable trust region strategy and an adaptive initial value generation strategy are adopted to accelerate the solving process in complex flight environments. The experimental results imply that the strategy proposed in this paper can significantly reduce the solution time of trajectory planning for wide-speed range UASs in complex environments. Full article

Introduction: The Delta variant of SARS-CoV-2 dominated Montenegro from July 2020 until early 2022, when Omicron took over. COVID-19 vaccination began on 20 February 2021, two months later than in the EU. The study aimed to investigate the impact of vaccination on mortality rates in Montenegro during Delta’s predominance. Methods: A descriptive study was conducted using data from the Montenegrin Institute of Public Health COVID-19 database, the Population Electronic Immunization Register, which provides data for all administrated COVID-19 vaccines in Montenegro, and EUROSTAT mortality data. Results: COVID-19 accounted for 17.8% of total deaths in Montenegro during the period of study. Crude mortality rate among unvaccinated was almost four times higher compared to those who received at least one vaccine dose. Inactivated vaccines were predominantly administered to those aged 60 and over, while RNA vaccines were mainly given to those under 60. The median interval between the last vaccine dose and death was significantly higher for vector vaccines compared to inactivated vaccines. Discussion: The delayed start of vaccination and limited vaccine choices in Montenegro likely contributed to prolonged high mortality due to COVID-19. Our findings reveal disparities in vaccine distribution and effectiveness, highlighting the need for timely and equitable access to effective vaccines, especially for vulnerable populations. Conclusions: The study underscores the importance of prompt vaccine distribution and the option to choose vaccine types in building public trust and reducing mortality rates. It emphasizes the need for strengthening global mechanisms COVAX and continuing educational activities to address vaccine hesitancy and ensure equitable access to effective vaccines. Full article

In this work, we revise the retrieval of extinction coefficient profiles from Raman Lidar. This is an ill-posed problem, and we show that methods like Levenberg–Marquardt or Tikhonov–Phillips can be applied. We test these methods for a synthetic Lidar profile (known solution) with different noise realizations. Further, we apply these methods to three different cases of data from the Arctic: under daylight (Arctic Haze), under daylight with a high and vertically extended aerosol layer, and at nighttime with high extinction. We show that our methods work and allow a trustful derivation of extinction up to clearly higher altitudes (at about half a signal-to-noise ratio) compared with the traditional, non-regularized Ansmann solution. However, these new methods are not trivial and require a choice of parameters, which depend on the noise of the data. As the Lidar signal quality quickly decreases with range, a separation of the profile into several sub-intervals seems beneficial. Full article

The World Health Organization (WHO) defines vaccine hesitancy as reluctance or refusal to vaccinate despite availability. Contributing factors in visible minority populations include vaccine safety, effectiveness, mistrust, socioeconomic characteristics, vaccine development, information circulation, knowledge, perceived risk of COVID-19, and perceived benefit. Objectives: This study aimed to examine vaccine hesitancy in visible minority populations across Canadian regions. Methods: A survey was conducted among visible minority populations in Canadian regions, using 21 questions from the available literature via the Delphi method. The Canadian Hub for Applied and Social Research (CHASR) administered the survey to individuals 18 years or older who resided in Canada at the time of the survey and identified as visible minorities such as Asian, Black, and Latin American. After recruiting 511 participants, data analysis used Chi-square tests of association and 95% confidence intervals (CIs) to identify regional differences in vaccine choices, side effects, information sources, and reasons for vaccination. A weighted analysis extended the results to represent the visible minorities across provinces. Results: Higher rates of Pfizer were administered to participants in Ontario (73%), the Prairies (72%), British Columbia (71%), and Quebec (70%). British Columbia had the highest Moderna rate (59%). The most common side effect was pain at the injection site in Quebec (62%), Ontario (62%), BC (62%), and in the Atlantic (61%). Healthcare professionals and government sources were the most trusted information sources, with healthcare professionals trusted particularly in the Prairies (70%) and government sources similarly trusted in Quebec (65%) and Ontario (65%). In the Atlantic, 86% of refusals were due to side effects and 69% were due to prior negative vaccine experiences. Conclusions: Leveraging healthcare professionals’ trust, community engagement, and flexible policies can help policymakers improve pandemic preparedness and boost vaccine acceptance. Full article

Background/Objectives: Patients undergoing neoadjuvant therapy have ample time to engage in exercise prehabilitation. This study aimed to describe the current status, facilitators, and barriers of exercise prehabilitation among this population. Methods: This sequential explanatory mixed-methods evaluation was conducted at a general tertiary hospital in Beijing. It included a quantitative survey of patients who received neoadjuvant therapy before cancer surgery and qualitative semi-structured interviews with both patients and physicians. Thematic analysis was conducted using the Capability, Opportunity, and Motivation Behavior model. Results: A total of 269 patients participated in the survey, with a completion rate of 99.6%. Only 52.6% and 1.1% of patients met the standards for aerobic and muscle-strengthening activities, respectively. Fewer than 40% of patients reported learning about exercise prehabilitation from physicians. Patients’ knowledge was associated with meeting aerobic activity standards after adjusting for confounders (Level 1: odds ratio [OR] of 2.06, 95% confidence interval [CI] of 1.02–4.22; Level 2: OR of 2.56, 95% CI of 1.25–5.36). In total, 28 participants were interviewed. Facilitators of patient education on exercise prehabilitation included the surgeon’s ability to gain trust and patients’ prior commitment to exercise. Barriers included physicians’ lack of awareness of exercise benefits, insufficient knowledge or time for patient education, concerns about patients’ exercise ability, lack of referrals to rehabilitation clinics, challenges in follow-up, conflicts with cultural beliefs, and inadequate insurance coverage. Conclusions: This study revealed a lack of physician-led patient education on exercise prehabilitation. Efforts are needed to enhance physician education, implement collaborative clinics, and provide remote supervision. Full article

Pediatricians are among the most trusted sources of vaccine information for parents. We aimed, in this study, to describe the attitudes and practices of Tunisian pediatricians regarding non-National Immunization Schedule (NIS) vaccines, specifically the COVID-19 vaccination for children, and to identify factors associated with their willingness to recommend it. We conducted a national cross-sectional study among Tunisian pediatricians between July and October 2023 using a standardized questionnaire administered face-to-face. We calculated prevalence with 95% confidence intervals (95%CIs) and adjusted odds ratios (aOR) using multivariable logistic regression. Of 330 contacted pediatricians, 192 (58.2%) responded (mean age: 50.9 ± 12.9 years). The majority (89.1%, 95% CI: [84.6–93.5]) said that they recommend other vaccines that are not part of the NIS and 40.6% [33.7–47.6] declared their willingness to recommend the COVID-19 vaccination for children. The odds of pediatricians willing to recommend the COVID-19 vaccination for children were higher among those who believed that this vaccine would reduce school absenteeism (aOR = 2.3 [1.1–5.1]) and among those who have great confidence in the Ministry of Health’s recommendations regarding COVID-19 vaccination (aOR = 6.1 [2.2–16.9]). More than half of the pediatricians in Tunisia recommend other vaccines that are not part of the NIS but show hesitancy toward the COVID-19 vaccine. Thus, involving pediatricians in the decision-making process for childhood vaccination strategies is crucial. Full article

Background: Immunization coverage varies across Papua New Guinea. In East New Britain (ENB) Province in 2022, only 65.5% and 50.2% of children under one year received their first dose of pentavalent (DTP1) and measles–rubella (MR1) vaccine, respectively. This study aimed to examine barriers and enablers to routine immunization in areas of un(der)-vaccination in ENB. Methods: A face-to-face survey was conducted with caregivers of children aged 12–23 months in ENB. We used Poisson regression to calculate incidence rate ratios (IRR) and 95% confidence intervals (95% CI) for factors associated with timely receipt of DTP1 or MR1 vaccines, defined as a child who was vaccinated between –2 and +30 days of the vaccine schedule. Delayed receipt is defined as a child who was vaccinated >30 days from the recommended due date. Results: Among 237 caregivers surveyed, 59.9% of children were vaccinated within the “timely” window for DTP1 and 34.1% for MR1. Timely DTP1 receipt was associated with a facility-based birth (IRR:1.93; 95% CI: 1.10–3.38) and trusting healthcare workers “very much”, compared to “a little or moderately” (IRR:1.53; 95% CI: 1.17–1.99). For MR1, the caregiver having completed tertiary/vocational education (IRR:1.79; 95% CI: 1.15–2.78), reporting taking a child to be vaccinated is affordable (IRR:1.52; 95% CI: 1.04–2.22), and healthcare workers explaining immunization services and answering associated questions (IRR:1.68; 95% CI: 1.18–2.41) were associated with timely vaccination. Conclusions: Activities to improve timely vaccination in ENB could include strengthening healthcare worker interpersonal communication skills to optimize trust and incentivizing women to give birth in a health facility. Full article

Given the increasing integration of trusted leaders in public health science, including vaccination programs, context-specific understandings of community perceptions and levels of trust are critical to intervention. This study aimed to understand the perspectives and attitudes of the southeastern Louisiana community and inform the development of a community-engaged action plan. A cross-sectional survey of 555 southeastern Louisianans—including faith-based organization (FBO) members, community pharmacy (CommRx) customers, community-based organization (CBO) contacts, and Louisiana community-dwelling residents—was conducted from November 2020 to March 2021. Multivariable logistic regression was used to explore factors associated with COVID-19 vaccination likelihood. Of the participants, 89.9% were Black and 56.9% were women (mean age = 53.3 years). Doctors/healthcare providers (HCPs) were the most trusted COVID-19 information sources. Vaccination likelihood was associated with increasing age (odds ratio (OR) = 1.47; 95% confidence interval (CI): 1.27–1.72), trust in doctors/HCPs (OR = 2.83; 95% CI: 1.64–4.88), trust in government (OR = 4.26; 95% CI: 2.44–7.43), and motivations to keep one’s community safe (OR = 1.52; 95% CI: 1.36–1.70). CommRx customers (OR = 1.93; 95% CI: 1.02–3.65) and CBO contacts (OR = 2.57; 95% CI: 1.37–4.83) were more likely to receive a COVID-19 vaccine than FBO members. Engaging underserved communities and trusted stakeholders through collaborative Community–Academic—Public health—Practice (CAPP) partnerships such as the Louisiana Community Engagement Alliance can promote health and wellness and optimize health interventions. Full article

In opportunistic IoT (OppIoT) networks, non-cooperative nodes present a significant challenge to the data forwarding process, leading to increased packet loss and communication delays. This paper proposes a novel Context-Aware Trust and Reputation Routing (CATR) protocol for opportunistic IoT networks, which leverages the probability density function of the beta distribution and some contextual factors, to dynamically compute the trust and reputation values of nodes, leading to efficient data dissemination, where malicious nodes are effectively identified and bypassed during that process. Simulation experiments using the ONE simulator show that CATR is superior to the Epidemic protocol, the so-called beta-based trust and reputation evaluation system (denoted BTRES), and the secure and privacy-preserving structure in opportunistic networks (denoted PPHB+), achieving an improvement of 22%, 15%, and 9% in terms of average latency, number of messages dropped, and average hop count, respectively, under varying number of nodes, buffer size, time to live, and message generation interval. Full article

Tunnel fires are generally detected using various sensors, including measuring temperature, CO concentration, and smoke concentration. To address the ambiguity and inconsistency in multi-sensor data, this paper proposes a tunnel fire detection method based on an improved Dempster-Shafer (DS) evidence theory for multi-sensor data fusion. To solve the problem of evidence conflict in the DS theory, a two-level multi-sensor data fusion framework is adopted. The first level of fusion involves feature fusion of the same type of sensor data, removing ambiguous data to obtain characteristic data, and calculating the basic probability assignment (BPA) function through the feature interval. The second-level fusion derives basic probability numbers from the BPA, calculates the degree of evidence conflict, normalizes the BPA to obtain the relative conflict degree, and optimizes the BPA using the trust coefficient. The classical DS evidence theory is then used to integrate and obtain the probability of tunnel fire occurrence. Different heat release rates, tunnel wind speeds, and fire locations are set, forming six fire scenarios. Sensor monitoring data under each simulation condition are extracted and fused using the improved DS evidence theory. The results show that there is a 67.5%, 83.5%, 76.8%, 83%, 79.6%, and 84.1% probability of detecting fire when it occurs, respectively, and identifies fire occurrence in approximately 2.4 s, an improvement from 64.7% to 70% over traditional methods. This demonstrates the feasibility and superiority of the proposed method, highlighting its significant importance in ensuring personnel safety. Full article

Background: Privacy in healthcare is a fundamental right essential to maintain patient confidentiality and trust. Community pharmacies in Saudi Arabia (SA) play a critical role in the healthcare system by providing accessible services and serving as initial points of contact for medical advice. However, the open nature of these settings poses significant challenges in maintaining patient privacy. Methods: This cross-sectional study used electronic surveys distributed across various online platforms. The target sample included Saudi adults, with a sample size of 385 participants to achieve 80% statistical power at a 95% confidence interval. The survey comprised demographic questions and sections evaluating perceptions of privacy, the importance of privacy, and personal experiences regarding privacy in community pharmacies. Descriptive statistics and logistic regression models were used for the analysis. Results: A total of 511 responses were obtained. The mean age was 33.5 years, with an almost equal distribution of males (49.71%) and females (50.29%). Most participants held a bachelor’s degree or higher (78.67%). Privacy perceptions varied, with only 9.0% strongly agreeing that there was a private space for consultations, while 64.0% felt that the design of community pharmacies did not adequately consider patient privacy, and 86.9% reported that conversations could be overheard. Privacy concerns were notable, with almost one-half of the participants (47.6%) having concerns about privacy and 56.6% doubting the confidentiality of their health information. Moreover, 17.6% reported being asked for unnecessary personal information when buying medication, and 56.2% admitted to avoiding discussing a health problem with the pharmacist due to privacy concerns. Experiences of privacy breaches were reported by 15.7% of respondents. Logistic regression analysis revealed that the availability of private space in the pharmacy and patients feeling that the pharmacy respects their privacy were associated with a lower likelihood of avoiding discussions with pharmacists due to privacy concerns (OR = 0.758, CI = 0.599–0.0957 and OR = 0.715, CI = 0.542–0.945 respectively) Conversely, greater privacy concerns and previous privacy breaches significantly increased the likelihood of avoiding discussions with pharmacists in the community pharmacy (OR = 1.657, CI = 1.317–2.102 and OR = 4.127, CI = 1.886–9.821 respectively). Conclusions: This study highlights the significant concerns regarding privacy practices in community pharmacies in SA. Thus, there is a need for standards to improve privacy in community pharmacies, such as mandating the need for private consultation areas and enhanced staff training on handling privacy-related issues. Addressing the issue of privacy is crucial for maintaining patient trust, improving healthcare service quality, and ensuring effective patient–pharmacist interactions. Full article