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Open Access February 06, 2026

Predictive Modeling of Public Sentiment Using Social Media Data and Natural Language Processing Techniques

Abstract Social media platforms like X (formerly Twitter) generate vast volumes of user-generated content that provide real-time insights into public sentiment. Despite the widespread use of traditional machine learning methods, their limitations in capturing contextual nuances in noisy social media text remain a challenge. This study leverages the Sentiment140 dataset, comprising 1.6 million labeled [...] Read more.
Social media platforms like X (formerly Twitter) generate vast volumes of user-generated content that provide real-time insights into public sentiment. Despite the widespread use of traditional machine learning methods, their limitations in capturing contextual nuances in noisy social media text remain a challenge. This study leverages the Sentiment140 dataset, comprising 1.6 million labeled tweets, and develops predictive models for binary sentiment classification using Naive Bayes, Logistic Regression, and the transformer-based BERT model. Experiments were conducted on a balanced subset of 12,000 tweets after comprehensive NLP preprocessing. Evaluation using accuracy, F1-score, and confusion matrices revealed that BERT significantly outperforms traditional models, achieving an accuracy of 89.5% and an F1-score of 0.89 by effectively modeling contextual and semantic nuances. In contrast, Naive Bayes and Logistic Regression demonstrated reasonable but consistently lower performance. To support practical deployment, we introduce SentiFeel, an interactive tool enabling real-time sentiment analysis. While resource constraints limited the dataset size and training epochs, future work will explore full corpus utilization and the inclusion of neutral sentiment classes. These findings underscore the potential of transformer models for enhanced public opinion monitoring, marketing analytics, and policy forecasting.
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Open Access March 06, 2025

Impact of Food Security on Dietary Diversity and Nutritional Intake Among Pregnant Women in Low-Resource Settings

Abstract Background: Food security and dietary diversity are essential determinants of maternal health, particularly among pregnant women in refugee populations who face heightened vulnerabilities due to displacement and inadequate living conditions. This study examines the impact of food security on dietary diversity and nutritional intake among pregnant Rohingya women residing in the makeshift [...] Read more.
Background: Food security and dietary diversity are essential determinants of maternal health, particularly among pregnant women in refugee populations who face heightened vulnerabilities due to displacement and inadequate living conditions. This study examines the impact of food security on dietary diversity and nutritional intake among pregnant Rohingya women residing in the makeshift camps of Ukhiya, Cox’s Bazar. Methods: A descriptive cross-sectional study was conducted among 96 pregnant Rohingya women from June to September 2022. Data were collected using structured questionnaires assessing socio-demographic characteristics, food security, and dietary diversity. Food security was evaluated using the Household Food Insecurity Access Scale (HFIAS), while dietary diversity was assessed through a 24-hour dietary recall and a 7-day food frequency questionnaire. Data were analyzed using SPSS (Version 26) and Stata (Version 13), employing descriptive statistics and chi-square tests to examine associations. Results: Most participants (57.3%) were food secure, and 85.4% demonstrated high dietary diversity, consuming seven or more food groups. However, 21.9% of households experienced severe food insecurity, highlighting ongoing challenges in food access. The highest consumption was observed for starch, flesh foods, dark green leafy vegetables, and vitamin A-rich fruits and vegetables (99.0%), while dairy products (69.8%) and organ meat (34.4%) were consumed less frequently. Despite high dietary diversity, severe food insecurity persists, indicating gaps in food assistance programs. Conclusions: While food support programs appear to contribute to high dietary diversity among pregnant Rohingya women, severe food insecurity remains a significant concern. Strengthening food security interventions, improving access to diverse nutrient-rich foods, and integrating sustainable food assistance models are essential to addressing these challenges. Future research should explore long-term strategies to enhance food security and assess the impact of targeted nutritional interventions on maternal health outcomes in refugee settings.
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Open Access February 15, 2025

Knowledge related to umbilical cord care among mothers of neonates attending outpatient departments in Sherpur district, Bangladesh

Abstract Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among [...] Read more.
Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among mothers of neonates in Sherpur District, Bangladesh, and identify factors associated with knowledge levels. Methods: A descriptive cross-sectional study was conducted from July to October 2020 at Sherpur Sadar Hospital. A total of 193 mothers of neonates were recruited using a non-randomized purposive sampling method. Data was collected through a pre-tested, semi-structured, interviewer-administered questionnaire. Knowledge levels were categorized as "Good" (>6) or "Poor" (≤6) based on responses to 10 structured questions. Statistical analyses, including chi-square tests and crude odds ratios (COR), were performed to identify socio-demographic factors associated with knowledge levels. Results: Of the 193 participants, 48.7% demonstrated "Good" knowledge, while 51.3% had "Poor" knowledge. Education level (p = 0.01), occupation (p = 0.02), family type (p < 0.001), and family size (p = 0.04) were significantly associated with knowledge levels. Mothers with higher education and those from joint families exhibited better knowledge. However, 28.5% of respondents were unaware of the typical umbilical cord-shedding timeframe, and 44% could not identify signs of infection. Unsafe practices, such as using medications (14.5%) or hot compression (7.2%) for drying the cord, were reported. Conclusion: The study reveals significant gaps in maternal knowledge regarding umbilical cord care in Sherpur District, driven by socio-demographic disparities and cultural practices. Targeted health education programs, emphasizing evidence-based cord care practices and leveraging local social structures, are urgently needed to improve neonatal health outcomes in similar resource-limited settings. Future research should evaluate the effectiveness of these interventions to inform policy and practice.
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Open Access January 15, 2025

Prevalence and determinants of mental health stress among nursing students in Bangladesh: A cross-sectional study

Abstract Background: Nursing students are exposed to significant stress due to academic and clinical demands, which can adversely affect their mental health, academic performance, and future clinical competence. Despite the global acknowledgment of this issue, limited research has been conducted to explore the prevalence and determinants of stress among nursing students in Bangladesh. [...] Read more.
Background: Nursing students are exposed to significant stress due to academic and clinical demands, which can adversely affect their mental health, academic performance, and future clinical competence. Despite the global acknowledgment of this issue, limited research has been conducted to explore the prevalence and determinants of stress among nursing students in Bangladesh. Methods: This cross-sectional study was conducted from December 2023 to February 2024 among 372 nursing students enrolled in selected nursing colleges in Bangladesh. A purposive sampling technique was used, and data was collected using a semi-structured questionnaire. The questionnaire assessed socio-demographic characteristics, academic challenges, and psychological symptoms, with mental health stress measured using a Likert scale. Descriptive statistics and Chi-square tests were used to analyze the data, with a 95% confidence interval applied to all analyses. Results: The findings revealed that 31.7% of nursing students experienced severe stress, 23.9% reported moderate stress, and 16.7% had mild stress. Age, academic semester, and course load difficulties were significantly associated with stress levels (p < 0.05). Psychological symptoms such as anxiety, difficulty concentrating, and loss of interest in activities were also significantly linked to higher stress levels. Notably, students in their first semester and those reporting harder course loads were more likely to experience stress. However, gender was not significantly associated with stress levels. Conclusions: This study underscores the high prevalence of stress among nursing students in Bangladesh, driven by academic and clinical challenges and psychological symptoms. The findings highlight the need for targeted interventions, such as stress management training, enhanced mental health support, and policies to alleviate academic pressures. Future research should explore longitudinal trends in stress and evaluate the effectiveness of interventions to support a resilient nursing workforce.
Article
Open Access January 10, 2025

Artificial Immune Systems: A Bio-Inspired Paradigm for Computational Intelligence

Abstract Artificial Immune Systems (AIS) are bio-inspired computational frameworks that emulate the adaptive mechanisms of the human immune system, such as self/non-self discrimination, clonal selection, and immune memory. These systems have demonstrated significant potential in addressing complex challenges across optimization, anomaly detection, and adaptive system control. This paper provides a [...] Read more.
Artificial Immune Systems (AIS) are bio-inspired computational frameworks that emulate the adaptive mechanisms of the human immune system, such as self/non-self discrimination, clonal selection, and immune memory. These systems have demonstrated significant potential in addressing complex challenges across optimization, anomaly detection, and adaptive system control. This paper provides a comprehensive exploration of AIS applications in domains such as cybersecurity, resource allocation, and autonomous systems, highlighting the growing importance of hybrid AIS models. Recent advancements, including integrations with machine learning, quantum computing, and bioinformatics, are discussed as solutions to scalability, high-dimensional data processing, and efficiency challenges. Core algorithms, such as the Negative Selection Algorithm (NSA) and Clonal Selection Algorithm (CSA), are examined, along with limitations in interpretability and compatibility with emerging AI paradigms. The paper concludes by proposing future research directions, emphasizing scalable hybrid frameworks, quantum-inspired approaches, and real-time adaptive systems, underscoring AIS's transformative potential across diverse computational fields.
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Open Access December 10, 2024

Psychological Corollaries, Self-Care and Coping Behaviors of Healthcare Workers During COVID-19 Pandemic: An Integrative Review

Abstract Background: The COVID-19 pandemic posed significant psychological challenges to frontline healthcare workers (HCWs), including anxiety, stress, and emotional strain. Aim: This study investigates the psychological impact on HCWs during the pandemic and explores coping strategies employed to manage distress. Methods: An integrative review was conducted using 24 studies published [...] Read more.
Background: The COVID-19 pandemic posed significant psychological challenges to frontline healthcare workers (HCWs), including anxiety, stress, and emotional strain. Aim: This study investigates the psychological impact on HCWs during the pandemic and explores coping strategies employed to manage distress. Methods: An integrative review was conducted using 24 studies published between January and December 2020. These studies were analyzed to identify common psychological outcomes and coping mechanisms among HCWs. Results: Healthcare workers experienced significant psychological distress during the COVID-19 pandemic, including anxiety, stress, insomnia, and depression. Anxiety was the most commonly reported issue, particularly among women, younger healthcare workers, and frontline staff. Stress levels were heightened by high workloads, exposure to COVID-19 patients, and inadequate protective measures. Coping strategies and self-care behaviors, such as seeking social support and utilizing institutional resources, varied in effectiveness across populations. Conclusion: The findings highlight the urgent need for targeted mental health support and resilience programs for HCWs, ensuring they are better equipped to face future health crises.
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Integrative Review
Open Access December 03, 2024

Diabetes Nursing Education Its Implication Towards an Improved Quality of Life of Persons with Diabetes: A Systematic Review

Abstract Background: Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. Methods: This study [...] Read more.
Background: Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. Methods: This study uses PRISMA guidelines and a systematic approach to identify and evaluate relevant literature. Results and Discussion: Among the 14 studies reviewed, eight emphasized self-management education, while four incorporated multidisciplinary approaches. Findings consistently demonstrated that structured nursing education programs significantly improved self-management behaviors, glycemic control, and patient knowledge. For instance, nurse-led self-management programs resulted in substantial enhancements in self-care skills and diabetes-related knowledge. Moreover, interventions that combined health education with psychological support were particularly effective, leading to better blood glucose control and increased adherence to treatment. Studies that examined quality of life reported reductions in anxiety, improved lifestyle habits, and better overall self-management. These findings highlight the multifaceted benefits of nursing education, suggesting that structured, supportive programs positively impact both clinical and psychological aspects of diabetes care. Conclusion: The review emphasizes the value of comprehensive nursing education that integrates both clinical guidance and psychological support for holistic diabetes management. Implications: Ongoing professional development and culturally sensitive education programs are recommended to address the diverse needs of diabetic patients. Future research should investigate the long-term effects of nursing education and explore innovative strategies to enhance diabetes management outcomes.
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Systematic Review
Open Access November 15, 2024

Education Does Not Equally Increase Financial Well-being for All

Abstract Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, [...] Read more.
Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, and nativity groups. The theory of Minorities’ Diminished Returns (MDRs) suggests that the positive effects of education on outcomes such as income and financial security are weaker for marginalized groups, including Black individuals, Latinos, and immigrants. Objective: This study examines the diminished returns of education on financial well-being among Black, Latino, and immigrant populations in the United States. We aim to investigate how structural inequalities contribute to weaker financial returns on education for these groups compared to their White and native-born counterparts. Methods: We utilized data from the Understanding America Study (UAS 2014) to conduct a cross-sectional analysis of adult respondents. The study assessed financial well-being outcomes (e.g., income, savings, and financial security) and their association with educational attainment across racial, ethnic, and nativity groups. Regression models were employed to test for interaction effects between education and race/ethnicity/nativity, adjusting for sociodemographic factors such as age, gender, employment, and family structure. Results: Our analysis included 8,121 individuals. The mean age of the respondents was 48 years (SD = 16). High education was associated with higher financial well-being (B = 1.284, 95% CI: 1.157, 1.410). The interaction terms between education and immigrant status (B = -0.507, 95% CI: -0.930, -0.084), race (Black) (B = -0.770, 95% CI: -1.208, -0.331), and ethnicity (Hispanic) (B = -0.589, 95% CI: -0.969, -0.210) were all significant, suggesting that immigrant, Black, and Hispanic individuals experience diminished returns on education in terms of financial well-being, relative to US-born non-Hispanic White individuals. The significant negative interactions between education and minority statuses (Black, Hispanic, and immigrant) indicate that while education generally improves financial well-being, the magnitude of this improvement is substantially smaller for these marginalized groups. Conclusion: Understanding how education translates to financial well-being across different racial, ethnic, and nativity groups is critical for addressing persistent financial disparities.
Article
Open Access April 25, 2024

Green spaces more adapted and resilient to the current and future climatic conditions in the south of Portugal (Algarve): Xerophytic gardens using xeromorphic succulents

Abstract Considering the current climate conjuncture, it is a consensus that green spaces in large contemporary urban areas should be increasingly more numerous and simultaneously more sustainable, being adapted to the edaphoclimatic conditions of the site, and with reduced maintenance costs. In the case of Algarve, where this research is focused, the current and future water availability, assumes a [...] Read more.
Considering the current climate conjuncture, it is a consensus that green spaces in large contemporary urban areas should be increasingly more numerous and simultaneously more sustainable, being adapted to the edaphoclimatic conditions of the site, and with reduced maintenance costs. In the case of Algarve, where this research is focused, the current and future water availability, assumes a preponderant role in the design of green spaces, where the demands mentioned above can only be achieved if we deviate from conventional landscape practices and develop holistic strategies of management and design of green spaces that integrate different areas of knowledge and not merely aesthetic issues. In this context, this work aims to develop more adapted and resilient landscaping practices to the current and future climatic conditions of the Algarve, thus reinventing the concept of landscaping in the south of Portugal. Thus, it will be of paramount importance to develop more sustainable, resilient and tolerant projects to worsening ecological conditions, particularly limitations associated with water availability. The xeromorphic succulents are a group of plants with mechanisms of tolerance to water stress and with very specific characteristics, being succulence one of the most relevant. Studies on these mechanisms are increasingly frequent, which may prove to be very advantageous in our adaptation to future climatic challenges. In addition, their ornamental potential is enormous, since their bold forms and colours are a veritable sensory explosion, which, combined with their morphological and physiological characteristics, make them the species of choice in the reconversion or creation of xerophytic gardens.
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Open Access March 08, 2024

Analysis of Toxic Contaminants in Agriculture: Educational Strategies to Avoid Their Influence on Food

Abstract A diagnosis of the current state of the crops is made regarding the control of weeds, use of pesticides, fungicides; with an assessment of the state of the plant covers in the crop, and its control by different types of herbicides, and we detected a high loss of biological diversity; and some of these compounds are mentioned due to their high toxicity. Similarly, the use of pesticides and [...] Read more.
A diagnosis of the current state of the crops is made regarding the control of weeds, use of pesticides, fungicides; with an assessment of the state of the plant covers in the crop, and its control by different types of herbicides, and we detected a high loss of biological diversity; and some of these compounds are mentioned due to their high toxicity. Similarly, the use of pesticides and fungicides is discussed due to their repercussions on health. In order to avoid the unhealthiness caused by the applications of these products, phytosanitary and educational control strategies are proposed; promoting the inspection of fruit and vegetable markets, and modifying the contents in higher professional and university education. To this end, we propose an active teaching methodology, through which the student acquires skills and responsibility for the use of chemical agents in agriculture, which serves to prevent the entry of these contaminants into the food chain. Of the different polluting chemical agents, in the case of herbicides we highlight Oxyfluorfen and Glyphosate with high toxicity and whose consumption is very high. In the case of pesticides and fungicides, among others are Organochlorine compounds, which have been detected in blood, and Carbon Tetrachloride and Chloroform, considered potent hepatotoxic and neurotoxic. The basic objective of this study is the awareness and acquisition of knowledge by future teachers about polluting agents, which will subsequently have an impact on society.
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Open Access March 05, 2024

Risk Factors of Vitamin D Insufficiency/Deficiency among a sample of Egyptian Females in Child Bearing Period

Abstract Background: Vitamin D plays an important role in the development of bone health and possibly non-communicable diseases. Arab countries had made their own national studies to assess serum vitamin D level among women, yet in Egypt there is no national survey done. The aim of the current study was to identify risk factors affecting vitamin D level among Egyptian females during the [...] Read more.
Background: Vitamin D plays an important role in the development of bone health and possibly non-communicable diseases. Arab countries had made their own national studies to assess serum vitamin D level among women, yet in Egypt there is no national survey done. The aim of the current study was to identify risk factors affecting vitamin D level among Egyptian females during the child-bearing period. Subjects and methods: A total of 100 healthy adult females in their childbearing period who were attending a Family Medicine Center were included in our study. The age of the included women ranged from 19 to 49 years old with a mean age of 34 (SD 8.47) years. The majority of participants had deficiency (43%) and insufficiency (13%) of vitamin D level. Results: Unemployed women were more likely to have vitamin D deficiency than employed women (P<0.05). Participants who were exposed to sun ˃30 minutes/day were more likely to have sufficient vitamin D level (P<0.05). All participants who consume fish ≥3 times/week had sufficient vitamin D level. Therefore, there was a statistically significance association between a number of consuming fish/week and vitamin D3 level groups. Also, there was statistically significant association between number of consumed milk cups/day and vitamin D3 level groups. All participants who drink 2 cups of milk have sufficient vitamin D level. No statistically significance association was found between using multivitamins and vitamin D3 level groups. Conclusion: Unemployment, low fish consumption and infrequent sun exposure were significant risk factors for vitamin D deficiency. Future research on the role of multivitamins supplements in improving vitamin D nutrition is warranted.
Article
Open Access April 11, 2023

Healthcare Management Challenges and Opportunities during COVID Pandemic

Abstract This review aimed to analyze some problems and challenges that emerged from the COVID-19 pandemic since it has affected all global business sectors. During the pandemic, remote work was increased in response to social distance requirements to decrease the transmission of disease. In addition, increased delegation, teamwork, supply chains, sales activities, and business operations have all been [...] Read more.
This review aimed to analyze some problems and challenges that emerged from the COVID-19 pandemic since it has affected all global business sectors. During the pandemic, remote work was increased in response to social distance requirements to decrease the transmission of disease. In addition, increased delegation, teamwork, supply chains, sales activities, and business operations have all been disrupted. Many challenges have emerged in the management of organizations due to the pandemic including the lack of direct contact as the lockdown made many people work from home and placed restrictions on movement and travel and uncertainty about the future. The healthcare system was also affected by the COVID-19 pandemic and faced several difficulties including increased demand for medical supplies and personal protective equipment, a greater need for nurses and other skilled healthcare professionals, and increased pressure on healthcare facilities, emergency services, and critical care departments. These challenges have created some opportunities in the management systems of healthcare organizations and other sectors. It is recommended for leaders prepare and continuously work proactively to be ready for unexpected future crises. Risk management and planning for any unexpected situation are among the very important aspects of organizational management.
Brief Review
Open Access March 16, 2023

The Black-Scholes Exotic Barrier Option Pricing Formula

Abstract The paper considers a specific type of such financial instrument as an option, namely an exotic barrier call option of the European type. Exotic options are gaining popularity among ordinary investors due to the development of information and telecommunication technologies, thanks to which such specific financial instruments as options have become readily available. We investigate the hedging [...] Read more.
The paper considers a specific type of such financial instrument as an option, namely an exotic barrier call option of the European type. Exotic options are gaining popularity among ordinary investors due to the development of information and telecommunication technologies, thanks to which such specific financial instruments as options have become readily available. We investigate the hedging problem for such options with some restrictions on the payment function and the availability of dividend payment on a risky asset in the classical Black-Scholes model. An analogue of the Black-Scholes formula for the mentioned variant of the exotic barrier is proved. In the future, it is planned to generalize the obtained results for put options and for more general payment functions.
Article
Open Access February 21, 2023

Clinicians’ Perception of Spirituality in Oncology Care: A Qualitative Synthesis

Abstract Background: By rediscovering the medical field spiritual foundation, clinicians sought to balance their care and realize that spirituality is frequently associated with healthcare, thus one’s spiritual beliefs influence patients' decisions between aggressive care and complementary therapies in oncology care. Aim: This study investigates clinicians’ experiences and perceptions of [...] Read more.
Background: By rediscovering the medical field spiritual foundation, clinicians sought to balance their care and realize that spirituality is frequently associated with healthcare, thus one’s spiritual beliefs influence patients' decisions between aggressive care and complementary therapies in oncology care. Aim: This study investigates clinicians’ experiences and perceptions of spirituality in oncology care that clinicians can utilize to improve cancer and spiritual care provision. Methods: A thematic, qualitative synthesis. Results: Four main themes emerged from the synthesis of the 11 included studies that can steer future framework and policies to make clinicians more inept in providing care to address spiritual well-being of the patients and their family from a clinician's point of view of spirituality: “Maintaining Hope and Spiritual Wellness, Clinician’s Sensitivity to Cancer Patients, Provision of Culturally Respectful Spiritual Care, and Education in Providing Spiritual Care”. Conclusion: Cancer patients, cancer survivors, and clinicians’ quality of life is correlated with measures of spirituality and spiritual well-being. Spirituality also fulfill these oncologic patients has been linked to improved emotional and spiritual adjustment. Implications: Clinicians with different proficiencies, novice or expert, develop a strong spiritual belief can also be a strength when it comes to caring for those terminally ill patients, to be able to aid them in their sufferings. Amidst the challenges of spiritual care, these clinicians provide a patient strategy approach that is holistic to the care.
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Review Article
Open Access February 07, 2023

Building a Holistic Approach: Uniting Marxist and Smithian Economics for a More Resilient Economic Theory

Abstract In this article, we discuss a new proposed concept of economic engineering that seeks to innovate a new model by combining the theories of Karl Marx and Adam Smith, taking into consideration main economic factors to create a sustainable and inclusive economic system that addresses existing challenges and provides a roadmap for future economic growth. Through a brief analysis of the existing gaps [...] Read more.
In this article, we discuss a new proposed concept of economic engineering that seeks to innovate a new model by combining the theories of Karl Marx and Adam Smith, taking into consideration main economic factors to create a sustainable and inclusive economic system that addresses existing challenges and provides a roadmap for future economic growth. Through a brief analysis of the existing gaps between Marxist and Smithian economics, we developed a new economic matrix that leverages the strengths of both theories while also incorporating the latest insights from modern economic research. Our novel approach to economic engineering represents a fresh perspective on the economy and offers practical tool for addressing the most pressing challenges facing society today.
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Review Article
Open Access February 04, 2023

A framework for evaluation of improvement opportunities for environmental impacts on construction works using life cycle assessment and value stream mapping concepts: offsite and onsite building construction

Abstract There have been various concerns about the environmental impact of construction works. This generates a need to take a more proactive approach in evaluating the environmental impacts of construction operations and further explore ways to reduce the environmental impacts. Enormous opportunities exist within the building industry to achieve a reduction in greenhouse gas emissions. The aim of the [...] Read more.
There have been various concerns about the environmental impact of construction works. This generates a need to take a more proactive approach in evaluating the environmental impacts of construction operations and further explore ways to reduce the environmental impacts. Enormous opportunities exist within the building industry to achieve a reduction in greenhouse gas emissions. The aim of the study is to develop a framework for the evaluation of improvement opportunities for environmental impact for onsite and offsite building construction works using life cycle assessment (LCA) and value-stream-mapping concepts. Various tools for LCA exist; however, there is a need for the development of an LCA framework and improvement opportunities that can be localized to various communities to evaluate improvement opportunities for building construction. This study conducts a review of methods to evaluate the LCA of buildings on local construction sites. A procedure for establishing improvement opportunities is also developed. Based on the author’s knowledge and experience, including site visits, using value stream mapping (VSM) techniques, a conceptual framework of the present state map and future state map of residential construction works was developed. The study presents a procedure for the evaluation of improvement opportunities for the environmental impacts of construction operations.
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Open Access November 30, 2022

A Review of Application of LiDAR and Geospatial Modeling for Detection of Buildings Using Artificial Intelligence Approaches

Abstract Today, the presentation of a three-dimensional model of real-world features is very important and widely used and has attracted the attention of researchers in various fields, including surveying and spatial information systems, and those interested in the three-dimensional reconstruction of buildings. The building is the key part of the information in a three-dimensional city model, so extracting [...] Read more.
Today, the presentation of a three-dimensional model of real-world features is very important and widely used and has attracted the attention of researchers in various fields, including surveying and spatial information systems, and those interested in the three-dimensional reconstruction of buildings. The building is the key part of the information in a three-dimensional city model, so extracting and modeling buildings from remote sensing data is an important step in building a digital model of a city. LiDAR technology due to its ability to map in all three modes of one-dimensional, two-dimensional, and three-dimensional is a suitable solution to provide hyperspectral and comprehensive images of the building in an urban environment. In this review article, a comprehensive review of the methods used in identifying buildings from the past to the present and appropriate solutions for the future is discussed.
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Review Article
Open Access May 04, 2022

First contribution to the ethnobotanical knowledge in the Peloritani Mounts (NE Sicily)

Abstract This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta [...] Read more.
This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta. These practices are presently performed only by a few elderly people, who rely on plants solely for a few activities. Furthermore, ethnobotanical studies are fundamental to clear up the knowledge on the traditional plant uses that are still current in this part of Sicily, to preserve this cultural heritage for future generations.
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Open Access December 15, 2021

Dissemination and Exploitation of Regional Meteo-Hydrological Datasets through Web-based Interactive Applications: The SOL System Case Study

Abstract The effects of climate change are already being felt in several parts of the World. Variability of changing rainfall intensity, drought and weather patterns contribute to determining the vulnerability of many human activities such as agriculture. In the next future, climate change considerations will depend on having appropriate strategies such as strengthen implementation agencies working in a [...] Read more.
The effects of climate change are already being felt in several parts of the World. Variability of changing rainfall intensity, drought and weather patterns contribute to determining the vulnerability of many human activities such as agriculture. In the next future, climate change considerations will depend on having appropriate strategies such as strengthen implementation agencies working in a coordinated manner and with a data-driven approach in order to ensure monitoring, reporting and data verification. In this context, national and regional meteorological Services are facing with high demand for timely and quality information, services and products. A web-based interactive application with the aim of disseminating meteo-hydrological information at regional scale is described in this paper. The web application is built on a relational database and client-side programming has been used for implementing the user interface and controlling the web page behavior. The combination of PHP (Hypertext Preprocessor, a general-purpose scripting language, especially suited to server-side web development) and JavaScript (high-level object-oriented scripting language, nowadays the dominant client-side scripting language of the Web) has been chosen for this reason, since such software is free to use for everyone. The SOL system, developed on behalf of Marche region, Italy, was chosen as a case study, due to its multi-source data framework and because of the processing and public dissemination of several ad-hoc data elaborations.
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Case Study
Open Access August 14, 2021

Syntheses of Novel Coordination Polymers Using Bis-Imidazole Ligand Having Steric Hindrance and Methoxy Group

Abstract Three novel coordination polymers {[Cu2(bitbu-OMe)4(SO4)2]·6MeOH}n (1), {[Co2(bitbu-OMe)4(NCS)4]0.5·2DMF}n (2), {[Co(bitbu-OMe)2(NCS)2]·2MeOH}n (3) (bitbu-OMe = 1,1’-[(5-tert-butyl-2-methoxybenzene-1,3-diyl)dimethanediyl]bis(1H [...] Read more.
Three novel coordination polymers {[Cu2(bitbu-OMe)4(SO4)2]·6MeOH}n (1), {[Co2(bitbu-OMe)4(NCS)4]0.5·2DMF}n (2), {[Co(bitbu-OMe)2(NCS)2]·2MeOH}n (3) (bitbu-OMe = 1,1’-[(5-tert-butyl-2-methoxybenzene-1,3-diyl)dimethanediyl]bis(1H-imidazole)) are synthesized through a slow evaporation method using solvothermal technique of CuSO4·5H2O or Co(SCN)2 with bitbu-OMe. X-ray diffraction analysis results reveal that 1, 2, and 3 have similar two-dimensional layer networks. The study of the effect of the methoxy group in bitbu-OMe towards the stability of ligand conformation in obtained coordination polymers becomes necessary to be conducted in the future to unveil the reason for conformation similarity of ligand in coordination polymers.
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Article
Open Access May 26, 2021

Application of Stochastic Dominance in Hedging Decision during COVID-19 Pneumonia Emergency Events

Abstract With the rise of virtual currencies, Bitcoin has gradually become one of the safe-haven tools in the financial market. During situations of worldwide outbreaks of an infectious disease, investors pay special attention to asset allocation. Therefore, this study discusses the outbreak of COVID-19 in China, which has affected financial markets and has led investors to avoid risks through investing in [...] Read more.
With the rise of virtual currencies, Bitcoin has gradually become one of the safe-haven tools in the financial market. During situations of worldwide outbreaks of an infectious disease, investors pay special attention to asset allocation. Therefore, this study discusses the outbreak of COVID-19 in China, which has affected financial markets and has led investors to avoid risks through investing in traditional financial products or Bitcoin. We found that during the time of the COVID-19 pneumonia, Bitcoin and gold futures were used for hedging transactions in the face of unstable Chinese market conditions and under the pursuit of investors' maximization of return on investment. Furthermore, there was also no difference between hedging through Bitcoin or gold futures; however, investors had a preference to invest in gold futures for hedging under the assumption that an investor was absolutely risk averse.
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Article
Open Access December 22, 2025

Reimagining Mathematical Modeling for a Responsive and Integrated Future in Infectious Disease Epidemiology

Abstract Mathematical modeling plays a central role in infectious disease epidemiology, shaping outbreak response strategies and informing public health policy. The COVID-19 pandemic demonstrated the value of these models but also exposed persistent limitations related to data fragility, lack of transparency, limited stakeholder engagement, and insufficient consideration of social and political contexts. [...] Read more.
Mathematical modeling plays a central role in infectious disease epidemiology, shaping outbreak response strategies and informing public health policy. The COVID-19 pandemic demonstrated the value of these models but also exposed persistent limitations related to data fragility, lack of transparency, limited stakeholder engagement, and insufficient consideration of social and political contexts. Rather than critiquing modeling as a discipline, this perspective argues for a reorientation of infectious disease modeling toward a more responsive, equity-centered, and participatory paradigm. We propose a conceptual framework built on three interrelated principles: adaptability through real-time data integration, transparency via open-source and reproducible practices, and relevance through interdisciplinary and co-produced model design. Drawing on illustrative examples from COVID-19 and dengue control efforts, we highlight how integrating behavioral dynamics, local knowledge, and policy feedback can improve model usefulness and public trust. Reconceptualizing models as dynamic systems of inquiry rather than static forecasting tools can enhance decision-making and promote more equitable and effective responses to future public health emergencies.
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Brief Review
Open Access November 12, 2025

Effect of Sleep Deprivation on Executive Functioning Among Young Adults: Meta-Analysis

Abstract Background: Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on [...] Read more.
Background: Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on executive functioning in healthy young adults. Practical Implications: These findings highlight the need for evidence-based interventions such as university-level sleep education programs, flexible academic scheduling, and workplace policies promoting adequate sleep to optimize cognitive performance and productivity among young adults. Methods: Following PRISMA 2020 guidelines, PubMed, Scopus, PsycINFO, and Web of Science were searched (January 2000–March 2024) for studies assessing acute (<6 hours sleep or ≥24 hours total deprivation) or chronic (<6 hours/night over multiple days) sleep deprivation in young adults. Outcomes included validated executive function tests (e.g., Stroop, N-Back). Random-effects meta-analysis (Hedges’ g) was conducted using R (version 4.3.2) with metafor/meta packages. Heterogeneity (I², Q-test), sensitivity (leave-one-out), and publication bias (funnel plot, Egger’s test) were evaluated. Results: Out of 2,478 screened studies, 39 met inclusion criteria (n=4,578). Sleep deprivation had a moderate-to-large detrimental effect on executive functioning (Hedges’ g = -0.62, 95% CI [-0.78, -0.45], p<0.001). Subdomain analysis revealed greatest impairment in working memory (g = -0.71), followed by inhibitory control (g = -0.59) and cognitive flexibility (g = -0.49) (all p<0.001). Moderate heterogeneity was present (I² = 58%), with results robust to sensitivity analysis. Egger’s test indicated no significant publication bias (p=0.22). Interpretation: Sleep deprivation significantly impairs executive functioning in young adults, especially working memory. Interventions improve sleep may enhance cognitive performance and should be integrated into public health strategies and educational policies. Future research should assess chronic restriction and individual vulnerability factors.
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Meta-Analysis
Open Access October 01, 2025

Place-Based Diminished Returns of Economic Resources in Rural America: A Framework for Understanding Geography-Conditioned Inequality

Abstract Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from [...] Read more.
Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from racially marginalized groups often experience weaker protective effects of SES. There is a lack of evidence on geography—particularly rural residence—as a moderator of SES effects. Objective: This review explores how place, especially rural contexts in the U.S., shapes the extent to which SES translates into improved outcomes. We extend the MDRs framework to include place-based and geography-based marginalization, arguing that even among non-Hispanic White populations, rural residence can lead to diminished returns on education, income, and other forms of capital. Content: Drawing on theoretical models such as Fundamental Cause Theory and Bronfenbrenner’s Ecological Systems Theory, and synthesizing empirical findings from studies of academic achievement, substance use, and educational aspirations, this review highlights how structural disadvantages in rural areas weaken the effectiveness of individual and family-level resources. Conclusion: Rural health and educational disparities are not solely due to a lack of resources but may also reflect systemic conditions that erode the value of existing resources. Policy interventions must be place-aware and address the contextual constraints that limit opportunity. Future research should more explicitly test how geography moderates the effects of SES across a range of outcomes and populations.
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Perspective Article
Open Access September 18, 2025

Does Stress Explain the Effects of Sexual/Gender Minority Status on Children’s Behavioral and Emotional Risk?

Abstract Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and [...] Read more.
Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. Methods: Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. Results: No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. Conclusion: Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences.
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Open Access September 07, 2025

Beyond the Brain: Exploring the Future of Neural Technology with Neuralink

Abstract This paper is a general summary of Neuralink, a revolutionary technology set to elevate human life and neurology. Neuralink itself is a key testimonial to the evolution of neuroscience and even brain-computer interfaces, otherwise known as BCI. The original few BCI experiments were conducted on monkeys in the 1960s and 70s, in which the experiment itself narrowed down and understood brain function [...] Read more.
This paper is a general summary of Neuralink, a revolutionary technology set to elevate human life and neurology. Neuralink itself is a key testimonial to the evolution of neuroscience and even brain-computer interfaces, otherwise known as BCI. The original few BCI experiments were conducted on monkeys in the 1960s and 70s, in which the experiment itself narrowed down and understood brain function as a general concept [3]. More specifically, "Work on these technologies began in the early 1970s, led by computer science professor J.J. Vidal at UCLA" [12]. Science itself progresses day by day, growing rapidly in recent years, especially in neuroscience, something highlighted as a focal point in the previous statement. Moreover, recently we have seen technology go on a rampant rise in terms of popularity, inventions, and changes to the human lifestyle. The interactions humans had with technology initially developed with wearables or wearable technology, such as Apple Watches, AirPods, and Fitbits, and now they have even prompted advancements in brain-computer interfaces. Technology has had the power to advance science, but now it’s capable of changing the human mind. Going back to Neuralink, it’s a startup that began its initiative in 2016 and was approved by the FDA for clinical trials in May of 2023, ready to create a wave of change in the field of neuroscience [6]. The foremost baffling thing is how this chip plans on being placed in the somatosensory system. The somatosensory system is a part of the brain that deals with motor actions, recognition, and perception, and applying Neuralink in this area should supposedly allow for cures and treatment of amyotrophic lateral sclerosis, Parkinson’s disease, spinal cord injuries, epilepsy, autism, depression, schizophrenia, and possibly blindness [9]. Neuralink is deemed to lead to a life-changing future, and with co-founders and investors like Elon Musk, there is a lot to know about this piece of technology.
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Review Article
Open Access September 02, 2025

Listening at the End: A Review of Communication and Compassion in Palliative Settings (2025)

Abstract This review explores the role of listening as a foundational component of communication and compassionate care in palliative settings. Drawing from ten scholarly articles published in 2025, the study examines how listening affects the experiences of patients, families, and healthcare providers. The findings emphasize that listening is not only a professional skill but a human act that reduces [...] Read more.
This review explores the role of listening as a foundational component of communication and compassionate care in palliative settings. Drawing from ten scholarly articles published in 2025, the study examines how listening affects the experiences of patients, families, and healthcare providers. The findings emphasize that listening is not only a professional skill but a human act that reduces suffering, promotes dignity, and strengthens trust, especially where resources or standardized protocols are lacking. The review is organized into four main areas: the importance of listening in clinical decision making; its role in emotional support and team communication; its contribution to preserving patient dignity and comfort; and its impact on family involvement and closure. The study calls for future research to develop standardized tools for measuring listening in palliative care and to explore how cultural, economic, and technological contexts shape listening practices. Ultimately, the review concludes that listening must be at the heart of ethical, patient-centered care during the final stages of life.
Brief Review
Open Access July 30, 2025

Bioinformatic Analysis of GCN1 as a Novel Diagnostic and Prognostic Biomarker in Hepatocellular Carcinoma and Preliminary Exploration of Its Molecular Mechanisms

Abstract Background: Hepatocellular carcinoma (HCC) faces significant challenges in early diagnosis and prognostic assessment, necessitating novel molecular biomarkers. The role of GCN1 in tumorigenesis remains unclear, warranting systematic investigation of its clinical value. Methods: Utilizing multi-omics data from 164 HCC patients in the TCGA database, we comprehensively [...] Read more.
Background: Hepatocellular carcinoma (HCC) faces significant challenges in early diagnosis and prognostic assessment, necessitating novel molecular biomarkers. The role of GCN1 in tumorigenesis remains unclear, warranting systematic investigation of its clinical value. Methods: Utilizing multi-omics data from 164 HCC patients in the TCGA database, we comprehensively evaluated the diagnostic and prognostic value of GCN1 through differential expression analysis, Cox proportional hazards regression, and gene set enrichment analysis (GSEA). Results: GCN1 expression was significantly upregulated in tumor tissues (P<0.001), with ROC analysis demonstrating an AUC of 0.921 (95% CI: 0.893-0.950) for discriminating tumor from normal tissue. Clinical correlation analysis revealed that high GCN1 expression significantly associated with advanced T stage (OR=1.941, P=0.002) and AFP levels >400 ng/ml (OR=3.697, P<0.001). Multivariate survival analysis confirmed its independent prognostic value (HR=1.454, P=0.038). Functional analysis indicated GCN1 promotes tumor progression by regulating cell cycle (NES=2.385) and axon guidance (NES=2.307) pathways. Conclusion: This study first elucidates the dual clinical value of GCN1 in HCC, providing a theoretical foundation for developing novel diagnostic biomarkers and prognostic evaluation systems. Future research should validate its molecular mechanisms and explore potential targeted therapies.
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Open Access July 25, 2025

Significance of Job Satisfaction and Quality Patient Care

Abstract This commentary letter was conducted to evaluate Wang et al.'s (2025) research study on the relationship between perceived staffing and quality of care among hospitals. The current study's findings show that the relationship between professional self-efficacy and job performance is mediated by work engagement. Life contentment influences work engagement, which is associated with enhanced job [...] Read more.
This commentary letter was conducted to evaluate Wang et al.'s (2025) research study on the relationship between perceived staffing and quality of care among hospitals. The current study's findings show that the relationship between professional self-efficacy and job performance is mediated by work engagement. Life contentment influences work engagement, which is associated with enhanced job performance. However, involvement acts as a mediator between job performance and burnout, which could affect the quality of patient care. Staffing satisfaction and quality patient care are closely related, and it is essential for healthcare institutions to prioritize appropriate workforce levels and address the nursing shortage. However, there are still unanswered questions in this sector, such as researching nursing-specific care procedures, addressing data challenges, and understanding the connections between nursing practice and patient care outcomes. Future research should address the "black box" of nursing practice and address variations in the quality of patient care provided by nurses.
Commentary Letter
Open Access June 26, 2025

The Intersection of Climate Change Adaptation and Smallholder Farmer Food Security: A Review of Strategies and Barriers

Abstract Smallholder farmers play a pivotal role in global food security; however, they remain exceptionally vulnerable to the impacts of climate change due to their reliance on natural resources and limited adaptive capacities. This narrative review synthesizes a wide range of global sources to explore the intersection of smallholder agriculture and climate adaptation strategies. The review examines [...] Read more.
Smallholder farmers play a pivotal role in global food security; however, they remain exceptionally vulnerable to the impacts of climate change due to their reliance on natural resources and limited adaptive capacities. This narrative review synthesizes a wide range of global sources to explore the intersection of smallholder agriculture and climate adaptation strategies. The review examines adaptation practices, agroecological methods, and the adoption of climate-resilient crop varieties. It reveals that the implementation of these strategies is frequently hindered by systemic barriers such as financial constraints, limited technological access, and institutional inefficiencies. Recognizing that previous studies have addressed isolated aspects of adaptation or relied on secondary data, this review highlights research gaps and offers a comprehensive synthesis of relevant literature. This review uses a narrative synthesis model suitable for integrating evidence from agronomy, economics, and social science to capture the complex challenges faced by smallholder farmers. The review emphasizes the importance of policy frameworks and participatory approaches that empower smallholder communities. This review synthesizes current evidence to inform potential directions for targeted interventions and future field-based studies, while recognizing the limitations of relying on secondary data. These recommendations aim to facilitate integrated policy reforms and drive research initiatives, ultimately strengthening the resilience and adaptability of smallholder agriculture in the face of ongoing climate change.
Review Article
Open Access June 25, 2025

Deconstructing Soccer Footwear: An Anatomical Review with Implications for Female Athlete-Specific Design

Abstract This review article provides a comprehensive anatomical analysis of soccer footwear, delving into the intricate structure and functional roles of its constituent components, including the upper, heel counter, tongue, toe box, outsole/sole plate, studs, and insole. Manufacturing processes influencing these structural elements are also discussed. Current market offerings and patented innovations in [...] Read more.
This review article provides a comprehensive anatomical analysis of soccer footwear, delving into the intricate structure and functional roles of its constituent components, including the upper, heel counter, tongue, toe box, outsole/sole plate, studs, and insole. Manufacturing processes influencing these structural elements are also discussed. Current market offerings and patented innovations in soccer cleat technology are examined through a biomechanical lens, highlighting their intended functions and limitations. A critical synthesis of existing knowledge underscores the anatomical and biomechanical distinctions between male and female athletes' feet, arguing for the necessity of sex-specific footwear design. This review culminates in emphasizing the imperative for specifically engineered soccer footwear for female athletes to optimize performance, enhance comfort, and mitigate the elevated risk of lower extremity injuries prevalent in the female game, thereby identifying crucial directions for future research in sports biomechanics and footwear engineering.
Commentary
Open Access June 03, 2025

Complexity Leadership Theory Integration into Nursing Leadership and Development in Addressing COVID-19 and Future Pandemics

Abstract Complexity Leadership Theory (CLT) is a new and revolutionary concept in addressing healthcare crises worldwide. Its relevance and applications were tested during the COVID-19 pandemic. However, no definite and encompassing research was done to apply it to nursing leadership. Thus, this study examines CLT integration into nursing leadership to address the challenges posed by the pandemic. Through [...] Read more.
Complexity Leadership Theory (CLT) is a new and revolutionary concept in addressing healthcare crises worldwide. Its relevance and applications were tested during the COVID-19 pandemic. However, no definite and encompassing research was done to apply it to nursing leadership. Thus, this study examines CLT integration into nursing leadership to address the challenges posed by the pandemic. Through a systematic review of literature from PubMed, Scopus, and Web of Science, relevant studies were analyzed to determine how complexity leadership theory was defined, conceptualized, and operationalized within nursing leadership context. The findings reveal that traditional hierarchical leadership models are insufficient in a dynamic crisis environment like the pandemic. Instead, CLT’s framework which encompasses adaptive, administrative, and enabling leadership facilitates innovation, resilience, and effective interprofessional collaboration. Nurse leaders employing these strategies are better positioned to manage resources limitation, foster shared decision-making, and implement technological advancements in rapidly changing healthcare settings. Overall, this study underscores the potential of complexity leadership theory to transform nursing leadership practices by promoting continuous learning and empowerment, thereby enhancing crisis response and preparedness for future pandemics.
Systematic Review
Open Access May 30, 2025

Advancing Women's Soccer: Historical Growth and Challenges Concerning Athlete Health and Diversity

Abstract This exploratory review article synthesizes existing literature on the evolution and increasing significance of women's soccer, particularly in the United States. While acknowledging the sport's progress and the achievements of the U.S. Women's National Team (USWNT), it critically examines two key challenges that impede further advancement: the alarmingly high incidence of knee injuries among [...] Read more.
This exploratory review article synthesizes existing literature on the evolution and increasing significance of women's soccer, particularly in the United States. While acknowledging the sport's progress and the achievements of the U.S. Women's National Team (USWNT), it critically examines two key challenges that impede further advancement: the alarmingly high incidence of knee injuries among female players and the persistent underrepresentation of Black women. The review highlights the biomechanical factors contributing to these issues, emphasizing the need for footwear designed to accommodate the specific anatomical and functional requirements of female athletes. Furthermore, it explores the systemic barriers that contribute to the lack of diversity within the sport, advocating for equitable opportunities and support for Black women. This review concludes by underscoring the necessity for innovative, interdisciplinary approaches to ensure the continued growth and well-being of all participants in women's soccer, and identifies critical areas for future research in kinesiology and related fields.
Review Article
Open Access May 05, 2025

Educated Yet Unhealthy? Diminished Returns of Education for Immigrants in the USA

Abstract Background: Minorities’ Diminished Returns (MDRs) theory posits that the health benefits of socioeconomic resources, such as education, are smaller for marginalized and minoritized populations, including immigrants. While MDRs have been extensively documented for racial and ethnic minorities, less is known about whether these diminished returns extend to immigrant populations. This study [...] Read more.
Background: Minorities’ Diminished Returns (MDRs) theory posits that the health benefits of socioeconomic resources, such as education, are smaller for marginalized and minoritized populations, including immigrants. While MDRs have been extensively documented for racial and ethnic minorities, less is known about whether these diminished returns extend to immigrant populations. This study tested MDRs of education on various health and cognitive outcomes, including self-rated health (SRH), cognitive function, numeracy, number of chronic medical conditions, and limitations in activities of daily living (ADLs) among immigrants compared to non-immigrants in the United States. Objective. To examine whether educational attainment confers weaker protective effects on SRH, cognitive function, numeracy, chronic medical conditions, and ADLs in immigrants compared to non-immigrants, confirming the presence of MDRs across these domains. Methods: We used data from the Understanding America Study (UAS), a nationally representative survey of U.S. adults. We tested the association between educational attainment and five outcomes—SRH, cognitive function, numeracy, number of chronic medical conditions, and limitations in ADLs—across immigrant and non-immigrant groups. Multivariate regression models were employed, adjusting for key sociodemographic covariates. Results: The protective effects of education on a range of health outcomes were significantly weaker for immigrants compared to non-immigrants. Education level showed weaker associations with SRH, cognitive function, numeracy, number of chronic conditions, and ADLs among immigrants. These findings suggest that even at higher levels of educational attainment, immigrants experience poorer health and cognitive functioning than their U.S.-born counterparts. Conclusion: This study offers strong evidence for the MDRs of education on multiple health outcomes among U.S. immigrants. One possible explanation is that, despite achieving higher levels of education, immigrants often face structural barriers—such as discrimination, limited access to resources, and economic inequities—that constrain the health-related benefits typically associated with educational attainment. Additionally, a portion of immigrant education may be acquired outside the United States, where credentials may not be fully recognized or rewarded within the U.S. labor market. These findings highlight the importance of policies aimed at addressing systemic inequities and improving access to healthcare, employment opportunities, and social support for immigrant communities. Future research should further explore the mechanisms underlying these diminished returns and identify policy solutions to reduce their impact. Keywords: Educational Attainment, Immigrants, Nativity, Self-Rated Health, Chronic Disease, Activities of Daily Living (ADL), Cognitive Function
Original Article
Open Access April 10, 2025

Advancements in Pharmaceutical IT: Transforming the Industry with ERP Systems

Abstract The pharmaceutical industry is undergoing a profound transformation driven by advancements in Information Technology (IT), with Enterprise Resource Planning (ERP) systems playing a pivotal role in reshaping operations. These systems offer integrated solutions that streamline key business processes, such as production, inventory management, supply chain optimization, regulatory compliance, and data [...] Read more.
The pharmaceutical industry is undergoing a profound transformation driven by advancements in Information Technology (IT), with Enterprise Resource Planning (ERP) systems playing a pivotal role in reshaping operations. These systems offer integrated solutions that streamline key business processes, such as production, inventory management, supply chain optimization, regulatory compliance, and data integration, contributing significantly to operational efficiency and organizational agility. This paper explores the evolution and impact of ERP systems within the pharmaceutical sector, highlighting their contributions to overcoming the industry’s inherent challenges, including complex regulatory requirements, the need for accurate and real-time data, and the demand for supply chain resilience. The integration of cloud-based ERP solutions, the incorporation of emerging technologies like Artificial Intelligence (AI), Machine Learning (ML), and the Internet of Things (IoT), and enhanced data analytics capabilities have revolutionized pharmaceutical IT. These advancements not only reduce operational costs, improve forecasting accuracy, and enhance collaboration but also ensure compliance with stringent global regulations, such as Good Manufacturing Practices (GMP) and FDA guidelines. Moreover, ERP systems have been instrumental in managing the pharmaceutical supply chain, ensuring product traceability, and improving inventory control and order fulfillment processes. This manuscript examines how ERP systems enable pharmaceutical companies to maintain high standards of product quality, improve decision-making, and ensure the safety and efficacy of drugs through robust tracking and auditing mechanisms. A case study of a pharmaceutical company that implemented an ERP system demonstrates the tangible benefits, including increased operational efficiency, improved compliance rates, and enhanced customer satisfaction. However, despite the clear advantages, challenges such as customization complexities, data integration issues, and resistance to change remain. As the pharmaceutical industry continues to evolve, ERP systems will remain a cornerstone of digital transformation, facilitating smarter decision-making, better resource management, and enhanced collaboration across global operations. This paper also identifies future trends, including the potential of AI and blockchain technologies in further strengthening ERP systems and transforming the pharmaceutical landscape.
Review Article
Open Access April 09, 2025

Color of Poverty Matters: Socioeconomic Resources and Health of Mothers Giving Birth to Children into Poverty

Abstract Background: Childhood poverty is a critical determinant of developmental, health, and behavioral outcomes. However, racial and ethnic differences in how families experience and navigate poverty suggest that a one-size-fits-all approach may not be an effective approach for alleviating disparities. Understanding baseline demographic, socioeconomic, health, and behavioral characteristics among [...] Read more.
Background: Childhood poverty is a critical determinant of developmental, health, and behavioral outcomes. However, racial and ethnic differences in how families experience and navigate poverty suggest that a one-size-fits-all approach may not be an effective approach for alleviating disparities. Understanding baseline demographic, socioeconomic, health, and behavioral characteristics among families in poverty is crucial to designing equitable interventions. Objective: To examine racial and ethnic differences in baseline demographic, socioeconomic, health, and behavioral characteristics among families living in poverty, using data from the Baby's First Years (BFY:2018-2019) Study. Methods: This analysis used baseline data from the BFY study, a randomized controlled trial (RCT) designed to evaluate the effects of monthly cash assistance on children’s developmental outcomes. The sample included 1,050 children and their families, consisting of mothers and, when available, fathers. Descriptive analyses were conducted to compare demographic, socioeconomic, health, and behavioral outcomes across racial and ethnic groups, focusing on Black, Hispanic, and other mothers. Results: Significant racial and ethnic differences were observed. Regarding demographic factors, Hispanic mothers were older than White mothers. In terms of socioeconomic factors, Hispanic mothers had fewer years of education compared to White mothers, while Black mothers were more likely to receive food stamps than mothers from other groups. Regarding health and behaviors, Black mothers reported worse self-rated health but were less likely to plan for breastfeeding compared to White mothers. In contrast, Hispanic mothers reported lower levels of depression and were more likely to plan for breastfeeding. Conclusion: These findings highlight the heterogeneity of experiences among families living in poverty, with significant differences across racial and ethnic groups. Such disparities underscore the importance of tailoring anti-poverty policies to the unique needs of diverse populations. Future research should explore how the effects of interventions, such as cash assistance or guaranteed income, may differ across racial and ethnic groups to inform equitable and effective policy development.
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Article
Open Access March 29, 2025

How Stigma Affects Patients Seeking Help for Drug Addiction

Abstract Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research [...] Read more.
Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research indicates that negative perceptions among healthcare providers contribute to delayed treatment-seeking behaviors, reduced adherence to medication-assisted treatment (MAT), and increased relapse rates. Additionally, patients internalizing these societal judgments experience heightened psychological distress, social isolation, and decreased self-efficacy, further hindering their recovery process. To address these challenges, evidence-based strategies such as addiction medicine education, trauma-informed care, harm reduction approaches, and peer support models have been shown to effectively reduce stigma and improve treatment outcomes. Hospital administrators and nursing leaders play a critical role in fostering a culture of empathy, advocating for the reframing of addiction as a neuro-psycho-biological disease rather than a moral failing. Future research should explore digital mental health interventions, motivational interviewing techniques, and interdisciplinary collaboration to further dismantle stigma and enhance the effectiveness of addiction treatment programs. This study highlights the urgent need for systemic policy changes, targeted educational programs, and a shift in clinical attitudes to create a more inclusive and stigma-free healthcare environment. Through implementing these approaches, healthcare providers can ensure equitable access to treatment and improve long-term health outcomes for individuals with opioid use disorder (OUD) and other substance-related conditions.
Essay
Open Access March 25, 2025

Resting-State Sensory-Motor Connectivity between Hand and Mouth as a Neural Marker of Socioeconomic Disadvantage, Psychosocial Stress, Cognitive Difficulties, Impulsivity, Depression, and Substance Use in Children

Abstract Background: The sensory-motor network is essential for integrating sensory input with motor function and higher-order cognition. Resting-state functional connectivity (rsFC) within this network undergoes significant developmental changes, and disruptions in these connections have been linked to behavioral and psychiatric outcomes. However, the relationship between sensory-motor [...] Read more.
Background: The sensory-motor network is essential for integrating sensory input with motor function and higher-order cognition. Resting-state functional connectivity (rsFC) within this network undergoes significant developmental changes, and disruptions in these connections have been linked to behavioral and psychiatric outcomes. However, the relationship between sensory-motor connectivity, early-life adversity, and later health behaviors remains understudied. Objective: This study examines the associations between rsFC within the sensory-motor network (mouth and hand regions) and key social, psychological, and behavioral factors, including baseline and past socioeconomic status (SES), trauma exposure, family conflict, impulsivity, major depressive disorder (MDD), and future substance use. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, a national sample of U.S. children. Resting-state fMRI data were used to assess functional connectivity within the sensory-motor network. Bivariate analyses examined associations between rsFC in the sensory-motor mouth and hand regions and baseline SES, past SES, childhood trauma exposure, family conflict, impulsivity, and MDD. Longitudinal analyses assessed whether baseline rsFC predicted future substance use. Results: Greater rsFC between the sensory-motor mouth and hand regions was significantly associated with lower SES, higher trauma exposure, and greater family conflict. Increased connectivity was also correlated with older age and more advanced puberty status. Higher rsFC between the sensory-motor mouth and hand regions was linked to greater impulsivity, lower cognitive function, an increased likelihood of MDD, and future marijuana use. Conclusion: These findings suggest that sensory-motor connectivity is sensitive to socioeconomic and psychosocial stressors, with potential long-term implications for mental health and substance use risk. The results highlight the importance of early-life environmental factors in shaping neurodevelopmental trajectories and emphasize the need for targeted interventions to mitigate the effects of adversity on brain function and behavior. Future research should further explore the role of sensory-motor network alterations in behavioral health outcomes as a function of environmental stressors.
Original Article
Open Access March 20, 2025

Weaker Effects of Parental Education on Oral Nicotine Use of High School Students in Rural Areas: Marginalization-Related Diminished Returns

Abstract Background: Nicotine pouches, gummies, and candies have emerged as popular alternatives to traditional tobacco products among U.S. adolescents. While parental educational attainment is generally associated with youth substance use, marginalization-related diminished returns (MDRs) suggest that this effect may be weaker in marginalized populations, including non-Latino White communities. In [...] Read more.
Background: Nicotine pouches, gummies, and candies have emerged as popular alternatives to traditional tobacco products among U.S. adolescents. While parental educational attainment is generally associated with youth substance use, marginalization-related diminished returns (MDRs) suggest that this effect may be weaker in marginalized populations, including non-Latino White communities. In particular, place-based marginalization—such as neighborhood economic disadvantage and school-level poverty—may attenuate the benefits of parental education. This study examines MDRs in the relationship between parental educational attainment and nicotine pouch/gummy/candy use among non-Latino White 12th graders in the 2024 Monitoring the Future (MTF) study. Methods: This study analyzed nationally representative data from the 2024 MTF study, focusing on non-Latino White 12th graders who reported parental education levels and adolescents’ use of nicotine pouch/gummy/candy. Structural equation modeling (SEM) was used to estimate the effects of parental education on adolescents’ use of nicotine pouches, gummies, and candies, while adjusting for demographic covariates. Place-based marginalization was operationalized using rural vs urban /suburban residence. Interaction terms tested whether the effect of parental education varied based on place of residence. Results: Higher parental educational attainment was associated with lower use of nicotine pouches, gummies, and candies. However, this effect was significantly weaker in rural areas. Conclusion: Public health interventions should account for place-based disparities rather than assuming a uniform effect of SES factors. This study highlights the need for policy responses that address structural inequities beyond individual family SES.
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Open Access March 12, 2025

Academic Aspirations of 12th Grade Students in the United States: Place-Based Diminished Returns of Parental Education in Rural Areas

Abstract Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This [...] Read more.
Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This study examines the association between parental education and aspirations for graduate or professional education among non-Latino White adolescents, with a specific focus on urban-suburban versus rural differences. Methods: Using data from the 12th-grade cohort of the Monitoring the Future (MTF) 2024 survey, we conducted multivariate analyses to assess the relationship between parental education and aspirations for graduate or professional education. We further examined whether this association was moderated by geographic location (urban-suburban vs. rural) to identify place-based MDRs. Results: Higher parental education was associated with greater aspirations for advanced education; however, this effect was weaker in rural areas compared to urban and suburban settings. These findings highlight that even among non-Latino White adolescents, rural residence diminishes the benefits of socioeconomic resources, providing evidence of place-based MDRs. Conclusion: Rural residents face a dual disadvantage—both lower socioeconomic status and weaker returns on those resources—necessitating targeted interventions beyond resource allocation. To address disparities in educational aspirations in rural areas, policymakers should focus on improving equitable access to educational opportunities and ensuring that these resources translate into comparable outcomes across different social and geographic contexts.
Article
Open Access March 09, 2025

Gender Differences in Quit Rates in a Tobacco Cessation Program: In Search of Demographic, Socioeconomic, Health, or Behavioral Explanatory Mechanisms

Abstract Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical [...] Read more.
Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. Aims: This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. Methods: Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. Results: Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. Conclusions: Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.
Article
Open Access March 09, 2025

Place-Based Diminished Returns of Parental Education on Adolescents’ Inhalant Use in Rural Areas

Abstract Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer [...] Read more.
Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer employment opportunities and limited recreational activities, may contribute to marginalization-related diminished returns (MDRs) of parental education on adolescent substance use, including inhalant use. Objectives This study applies the MDRs framework to examine whether the protective effect of higher parental education on current inhalant use (past 30 days) among 12th-grade American adolescents varies by geographic location. Specifically, we assess whether youth from highly educated families in rural areas are at a disproportionate risk of inhalant use compared to their urban and suburban peers. Methods Using data from the 2024 Monitoring the Future (MTF) study, a nationally representative survey of 12th-grade adolescents in the U.S., we tested main effects and statistical interactions between parental education and residence (rural vs. urban/suburban) in predicting the odds of inhalant use over the past 30 days. Logistic regression models, both with and without interaction terms, were applied to evaluate whether the protective effects of parental education varied by residence location, controlling for relevant demographic and socioeconomic factors. Results Findings indicate a significant interaction between parental education and rural residence. While higher parental education was associated with lower odds of inhalant use in urban and suburban areas, this protective effect was substantially weaker in rural settings. Adolescents from highly educated families in rural areas exhibited a higher-than-expected risk of inhalant use, suggesting that geographic marginalization attenuates the benefits of parental socioeconomic resources. Conclusions These results highlight the role of place-based marginalization in shaping adolescent substance use disparities, demonstrating that MDRs extend beyond race and ethnicity to location-based disadvantages. Rural youths from highly educated families may face unique structural and social challenges that counteract the protective effects of parental education. Public health efforts should consider place-based interventions that address the economic, recreational, and social limitations of rural environments to reduce substance use risk among high-SES adolescents residing in rural areas.
Article
Open Access March 09, 2025

Hippocampus Functional Connectivity, Impulsivity, and Subsequent Substance Use

Abstract Background: The hippocampus plays a critical role in memory and decision-making processes, with its resting-state functional connectivity (rsFC) linked to various behavioral outcomes. This study investigates whether baseline brain-wide rsFC of the hippocampus mediates the relationship between impulsivity and subsequent substance use, specifically tobacco and marijuana use, in adolescents. [...] Read more.
Background: The hippocampus plays a critical role in memory and decision-making processes, with its resting-state functional connectivity (rsFC) linked to various behavioral outcomes. This study investigates whether baseline brain-wide rsFC of the hippocampus mediates the relationship between impulsivity and subsequent substance use, specifically tobacco and marijuana use, in adolescents. Methods: Data were drawn from the baseline wave of the Adolescent Brain Cognitive Development (ABCD) study. Resting-state fMRI data were used to evaluate the functional connectivity of the hippocampus with key brain networks, including the cingulo-parietal network, visual network, sensory-motor network, and default mode network (DMN). Impulsivity was assessed using validated self-report measures, and substance use (tobacco and marijuana) was evaluated at follow-up. Mediation models were conducted to examine the extent to which hippocampal rsFC explains the association between impulsivity and substance use. Results: Baseline hippocampal rsFC with the cingulo-parietal network, visual network, sensory-motor network, and DMN showed marginal associations with future tobacco and marijuana use. Additionally, hippocampal rsFC was significantly associated with impulsivity, which, in turn, predicted higher substance use at follow-up. These findings suggest that hippocampal rsFC partially mediates the relationship between impulsivity and substance use behaviors. Conclusions: Hippocampal functional connectivity with brain networks may influence the pathway from impulsivity to future substance use in adolescence. These findings emphasize the importance of hippocampal connectivity in understanding the neural mechanisms underlying risk behaviors and may inform the development of targeted interventions to reduce substance use in this vulnerable population.
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Open Access February 26, 2025

Innovations and Challenges in Pharmaceutical Supply Chain, Serialization and Regulatory Landscape

Abstract The pharmaceutical supply chain has become increasingly complex and vulnerable to various risks, including counterfeit drugs, diversion, and fraud. As these challenges threaten patient safety and the integrity of global healthcare systems, serialization has emerged as a pivotal innovation in pharmaceutical logistics and regulatory compliance. Serialization involves assigning unique identifiers to [...] Read more.
The pharmaceutical supply chain has become increasingly complex and vulnerable to various risks, including counterfeit drugs, diversion, and fraud. As these challenges threaten patient safety and the integrity of global healthcare systems, serialization has emerged as a pivotal innovation in pharmaceutical logistics and regulatory compliance. Serialization involves assigning unique identifiers to individual drug packages, enabling precise tracking and authentication at every stage of the supply chain. This process provides unprecedented transparency, enhances product security, and facilitates real-time monitoring of pharmaceutical products as they move from manufacturers to end consumers. Despite its potential to revolutionize pharmaceutical traceability, the integration of serialization technologies faces numerous obstacles. These include high implementation costs, regulatory inconsistencies across regions, and the technological challenges of managing vast amounts of data. Moreover, the complex, multi-tiered nature of the global supply chain introduces additional risks related to data integrity, cybersecurity, and interoperability between systems. As pharmaceutical companies seek to navigate these challenges, innovations in serialization technology—such as blockchain, artificial intelligence (AI), the Internet of Things (IoT), and radio frequency identification (RFID)—are providing promising solutions to enhance efficiency, reduce fraud, and increase visibility. This manuscript explores both the innovative advancements and the key challenges associated with the integration of serialization in the pharmaceutical supply chain. It delves into the evolving regulatory landscape, highlighting the need for global harmonization of serialization standards, and examines the impact of serialization on securing pharmaceutical distribution networks. Additionally, the paper emphasizes the importance of collaboration among manufacturers, technology providers, and regulatory bodies in overcoming implementation barriers and realizing the full potential of serialization. As the pharmaceutical industry moves towards a more interconnected and data-driven future, serialization promises to play a central role in shaping the next generation of drug safety and supply chain management. By addressing the hurdles to adoption and leveraging emerging technologies, the pharmaceutical sector can create a more secure, transparent, and efficient supply chain that better serves public health and fosters greater trust among consumers and healthcare professionals alike.
Review Article
Open Access February 25, 2025

Nucleus Accumbens Resting State Functional Connectivity is Linked to Family Income, Reward Salience, and Substance Use

Abstract Background: As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural [...] Read more.
Background: As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural mechanisms underlying reward processing and the propensity for self-reported reward salience and substance use, research exploring the association between NAcc rsFC and brain networks beyond the default mode network (DMN) and prefrontal cortex (PFC) is limited. Objective: To investigate the role of the resting-state functional connectivity of the NAcc with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network in the association between socioeconomic status, self-reported reward salience, and future substance use. Methods: Data were obtained from the Adolescent Brain Cognitive Development (ABCD) study. NAcc rsFC with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network was assessed at baseline. Socioeconomic status was measured using family income. Self-reported reward salience was assessed using validated psychometric scales. Substance use outcomes were tracked longitudinally over the study period. Structural Equation Modeling was employed to examine the covariances between family income, NAcc rsFC, reward salience, and subsequent substance use. Results: Higher baseline family income was positively associated with baseline NAcc rsFC (B = 0.092, p < 0.001) and negatively associated with baseline reward salience (B = -0.040, p = 0.036) and future substance use (B = -0.081, p < 0.001). Baseline NAcc rsFC was strongly and positively associated with reward salience (B = 0.734, p < 0.001) and future substance use up to age 13 (B = 0.124, p < 0.001). Additionally, baseline reward salience was positively associated with future substance use (Covariance = 0.176, p < 0.001). Conclusion: The findings suggest that NAcc rsFC with brain networks beyond the DMN or PFC may contribute to the links between low parental socioeconomic status, reward salience, and substance use risk. Expanding the understanding of NAcc rsFC provides new insights into the neural mechanisms underlying these associations. These results have important implications for developing targeted interventions aimed at preventing substance use, particularly among low-income youth with heightened reward salience. Further research is needed to explore causal pathways and moderating factors influencing these relationships.
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Article
Open Access February 24, 2025

Socioeconomic Status, Trauma, Cognitive Function, Impulsivity, Reward Salience, and Future Substance Use: Role of Left Caudate Connectivity with the Cingulo-Opercular Network

Abstract Background: While understanding how corticostriatal connectivity is associated with socioeconomic status (SES), trauma exposure, cognitive function, reward salience, impulsivity, and future substance use is essential to identifying neurobiological pathways that contribute to health disparities and behavioral outcomes, very few studies have tested the role of left caudate resting-state [...] Read more.
Background: While understanding how corticostriatal connectivity is associated with socioeconomic status (SES), trauma exposure, cognitive function, reward salience, impulsivity, and future substance use is essential to identifying neurobiological pathways that contribute to health disparities and behavioral outcomes, very few studies have tested the role of left caudate resting-state functional connectivity (rsFC) with the cingulo-opercular network as a proxy of corticostriatal connectivity in social, cognitive, and behavioral processes. Objective: This study investigates the associations between left caudate-cingulo-opercular connectivity and multiple biopsychosocial domains, including low SES, high trauma exposure (financial and life events), cognitive function, reward salience, impulsivity, depression, and future substance use (tobacco and marijuana use). Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) data were analyzed to assess connectivity between the left caudate and the cingulo-opercular network. Data on socioeconomic status, trauma exposure, cognitive performance, and mental health were collected from participants. Future substance use behaviors were evaluated through longitudinal follow-ups. Correlation and regression analyses were conducted to examine relationships between corticostriatal connectivity and the targeted domains. Results: Corticostriatal hypoconnectivity was associated with lower SES, higher trauma exposure, poorer cognitive function, heightened reward salience, higher impulsivity, and history of depression. Additionally, corticostriatal hypoconnectivity at baseline predicted future tobacco and marijuana use during follow-up years. Conclusion: Corticostriatal hypoconnectivity, particularly the rsFC between the left caudate and the cingulo-opercular network, may represent a potential mechanism linking a wide range of social, emotional, and behavioral problems in youth. These findings suggest that corticostriatal hypoconnectivity could serve as a neurobiological marker for identifying individuals at risk for depression, low cognitive function, high reward salience, impulsivity, and substance use, emphasizing the interplay between socioeconomic and neurocognitive factors in shaping behavioral health trajectories.
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Open Access February 19, 2025

The CEASE Tobacco Cessation Controlled Trial for Low-Income Racial and Ethnic Minority Participants: Key Predictors of Success

Abstract Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p [...] Read more.
Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p < 0.05). No other factors, including demographic variables (e.g., age), socioeconomic status (e.g., education, marital status), substance use profiles (e.g., cigarette packs per week, NRT use), or nicotine dependence, were significant predictors of cessation success. Conclusion: Baseline self-reported anxiety/depression and depressive symptoms play a critical role in reducing the likelihood of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program. These findings underscore the importance of addressing mental health challenges as part of tobacco cessation interventions to enhance their efficacy. Future research should explore targeted strategies for integrating mental health support into cessation programs to improve outcomes for underserved populations.
Article
Open Access February 16, 2025

Uneven Impact of Maternal Education at Birth on High School Grades of Black and White Students

Abstract Background: The Minorities' Diminished Returns (MDRs) theory posits that social determinants of health, such as parental education, exert weaker protective effects on health and educational outcomes in racialized and minoritized populations compared to White populations. Aim: This study examines whether higher maternal education is associated with better high school GPA in Black [...] Read more.
Background: The Minorities' Diminished Returns (MDRs) theory posits that social determinants of health, such as parental education, exert weaker protective effects on health and educational outcomes in racialized and minoritized populations compared to White populations. Aim: This study examines whether higher maternal education is associated with better high school GPA in Black youth and whether this association aligns with the MDRs framework. Methods: Data were drawn from the Future of Families and Child Wellbeing Study also known as Fragile Families and Child Wellbeing Study (FFCWS) baseline and 22nd year follow-up (1990-2022). This study included 1873 Black or White participants who were followed from birth to age 22. Linear regression models were used to assess the association between maternal education and high school GPA, adjusting for sociodemographic covariates. Analyses focused on the differential effects of maternal education across racial groups, particularly among Black youth. Results: While maternal education was positively associated with high school GPA, this effect was weaker for Black students compared to their White counterparts. Specifically, each additional year of maternal education corresponded to a lower GPA increase in Black students, consistent with the MDRs hypothesis. Conclusion: Findings support the MDRs theory, indicating that maternal education has a reduced protective effect on high school GPA among Black youth. These results underscore the need for policies that address structural factors beyond education to promote equitable academic achievement.
Article
Open Access February 12, 2025

Unequal Benefits: How Parental Education Falls Short for Black and Latino Youth

Abstract Background: Parental education is a key determinant of academic performance, yet its protective effects may differ by race and ethnicity. The concept of Minorities’ Diminished Returns (MDRs) highlights the weaker association between socioeconomic resources and outcomes for marginalized populations, including Black and Latino youth. Objective: To investigate whether the [...] Read more.
Background: Parental education is a key determinant of academic performance, yet its protective effects may differ by race and ethnicity. The concept of Minorities’ Diminished Returns (MDRs) highlights the weaker association between socioeconomic resources and outcomes for marginalized populations, including Black and Latino youth. Objective: To investigate whether the positive association between parental education and school performance (letter grades) is weaker for Black and Latino youth compared to non-Latino White youth. Methods: Data were drawn from the Monitoring the Future (MTF) 2023 study. The sample included Black, Latino, and non-Latino White youth. The outcome was a nine-level continuous measure of academic performance based on self-reported letter grades, with higher scores indicating better performance. Multivariate regression models tested interactions between parental education and race/ethnicity in predicting grades, adjusting for confounders such as family income, gender, and school characteristics. Results: A total number of 7584 12th graders entered the study. Parental education was positively associated with school performance across all groups, but the magnitude of this association was significantly smaller for Black and Latino youth compared to non-Latino White youth. Even after controlling for socioeconomic and contextual factors, the racial and ethnic differences in the strength of this association persisted. Conclusions: Our findings provide evidence of Minorities’ Diminished Returns (MDRs) in the academic domain, with Black and Latino youth experiencing weaker benefits of parental education on school performance. These disparities suggest that structural barriers and systemic inequities undermine the translation of parental educational attainment into academic success for marginalized groups. Policy interventions must address these structural barriers to promote equity in educational outcomes.
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