Introduction Smartphone accessibility has enabled the widespread use of mobile health applications for managing health conditions. While mobile technology is increasingly adopted globally, integrated digital solutions specifically supporting home-based pressure ulcer care remain limited. This study aimed to design and develop a mobile health (mHealth) application named IPI (Interprofessional Pressure Injury) application that integrates artificial intelligence-based pressure ulcer staging, caregiver-focused education, personalized nutritional support, and visual wound monitoring to assist caregivers and healthcare professionals in delivering timely and effective care. Methods A comprehensive deep learning framework was developed using a clinically validated dataset of pressure ulcer images spanning six categories, including healthy tissue and Stage 1–4 ulcers. To address class imbalance and subtle inter-class variability, a class-adaptive augmentation pipeline and an enhanced Vision Transformer architecture with hierarchical feature representation and specialized self-attention were implemented. Training employed a stratified 5-fold cross-validation, class-balanced focal loss, regularization techniques, and a two-tiered ensemble strategy. Results The proposed k-fold ensemble model achieved an accuracy of 0.9705 and macro F1 score of 0.9695, with perfect classification of Stage 4 ulcers and substantial improvements for underrepresented classes. Discussion These results demonstrate the model's effectiveness for pressure ulcer classification, offering a robust foundation for real-time clinical decision support. The application supports remote monitoring, healing status detection, and educational access, especially in resource-limited settings. This holistic solution not only enhances caregiver confidence and independence but also aids clinicians in wound assessment and intervention planning. A future experimental study will validate the app's clinical utility, impact on patient outcomes, and potential to improve the quality of home-based pressure ulcer management.

The Community Service Program (PKM) conducted by STAI Al-Hidayah Bogor in Citapen Village, Ciawi District, Bogor Regency, aimed to optimize community empowerment through the dimensions of piety, economy, education, and health. The program was carried out for 40 days from January to February 2025, involving lecturers and students as part of the implementation of the Tri Dharma of Higher Education. The activities included diniyah services, teaching at local religious gatherings, distribution of Qur’ans and Iqro books, free medical treatment, mass ruqyah, stunting prevention, free honey distribution, youth seminars on bullying and LGBT issues, the establishment of a literacy corner, social services, children’s competitions, environmental clean-ups, and affordable bazaars. The results indicated high community participation, positive responses to the programs, and tangible impacts on spiritual awareness, health improvement, educational access, and local economic support. Despite minor limitations, the PKM successfully strengthened collaboration between higher education institutions and the community while providing participants with valuable experiences in leadership, social empathy, and creative problem-solving.

Background: Insomnia is the most prevalent sleep disorder, associated with impaired daytime functioning, increased risk of mental and physical illness, as well as social and economic burden. Aim: This review summarizes the current state of knowledge on insomnia disorder and assesses the clinical value of scientifically proven treatment strategies, including both pharmacological and non-pharmacological methods. Methods: A narrative literature review was conducted using PubMed/MEDLINE (January 2015- November 2025). Peer-reviewed human studies, clinical guidelines, systematic reviews, meta-analyses, and high-quality narrative reviews addressing definition and classification, epidemiology, mechanisms, consequences, diagnostic tools, or treatment outcomes were included. Results: Insomnia affects approximately 10% of the adult population and is more common in women, elderly people, individuals with chronic stress, and those with comorbid medical or psychiatric conditions. Evidence supports a multidimensional hyperarousal model as the core mechanism of insomnia pathophysiology. Insomnia is linked to a higher risk of anxiety, depression, cardiometabolic disease, cognitive impairment, accidents, and reduced quality of life. Diagnosis relies on clinical assessment supported by sleep diaries and validated questionnaires. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment, with chronotherapy, mindfulness-based interventions, exercise, and complementary approaches as useful adjuncts. Pharmacological options, including benzodiazepines, "Z-drugs", and other medications, may be considered, but with careful monitoring of safety and potential dependence. Conclusions: Insomnia requires personalized care that prioritizes non-pharmacological strategies. Medications should be used with caution, for selected patients, and for short durations only. Early recognition, patient education, and wider access to CBT-I are essential to reduce the burden of insomnia.

Textbook costs remain a significant barrier to student success in higher education. Open Educational Resources (OER) offer a promising solution by reducing costs and allowing content adaptation. This study examines the perceptions and use of OER by 70 faculty members at a small liberal arts college (Franklin College) through a campus-wide survey assessing faculty knowledge, motivations, challenges, and experiences with OER. Results show growing awareness and use of OER, especially for improving student affordability and access. However, many faculty still need more support to adopt and adapt OER in their courses fully. The study identified a group of experienced faculty who are not only using OER but also actively adapting and remixing materials to fit their teaching needs. Most discovered OER through online repositories, general internet searches, and recommendations from colleagues. Overall, faculty rated the quality of OER positively, though gaps in subject-specific content and in alternative formats such as datasets and assessments remain. Based on these findings, the study offers recommendations, including institution-based training programmes, peer-led workshops led by experienced faculty, and incentives for OER adoption and creation. Overall, faculty are motivated by equity and effectiveness, and with proper support, can play a key role in expanding OER use. These insights offer a roadmap for institutions seeking to scale OER use while fostering a collaborative, inclusive, and innovative teaching culture.

Globalization has brought significant changes to Indonesia's labor dynamics, including increasing labor mobility abroad and the problem of low labor quality due to educational and employment access disparities. This research aims to explain Indonesia's policies for the protection of labor, as well as the forms of international cooperation carried out to protect Indonesian migrant workers. Using the concept of Labor Protection and the framework of International Labor Law (ILO), this study analyzes national regulations, migrant worker protection practices, and Indonesia's collaboration with international organizations (OIs). The results of the study show that the number of Indonesian migrant workers, which reaches around eight million, contributes greatly to the national economy but is still dominated by unskilled workers who are vulnerable to exploitation. The government has made protection efforts through Law No. 18 of 2017 and the policy of exemption of placement fees in certain sectors, although its implementation faces challenges in regional capacity and compliance with placement institutions. At the global level, cooperation through the Decent Work Country Programme (DWCP) between Indonesia and the ILO strengthens the protection of migrant workers through the development of fair industrial relations, expansion of social security, and improvement of the quality of decent work.

Urban Flooding is one of the most prevalent natural hazards worldwide, leading to substantial human and economic losses. Therefore, the assessment and mapping of flood hazard levels are essential for reducing the impact of future flood disasters. This study develops and integrates a methodology to evaluate urban flood susceptibility in Nangarhar Province, Afghanistan, a semi-arid region with limited prior research. Landsat imagery from 2004 to 2024 was used to analyze land use land cover change (LULCC), indicating that built-up areas increased from 124 to 180 km2 in 2004 to 2024, respectively, while agricultural land decreased from 1978 km2 to 1883 km2 during the same period. Climate data exhibit increases in temperatures and intensifying rainfall, exacerbating flood hazards. Geospatial analysis of elevation, slope, drainage density, and proximity to water bodies highlights the high susceptibility of low-lying areas. The Analytical Hierarchy Process (AHP) was employed to integrate diverse flood risk factors and produce accurate flood hazard maps. The findings show that very-high flood susceptibility zones expanded from 1537 to 1699 km2 in 2004 to 2024, whereas low-susceptibility zones declined from 131 km2 to 110 km2. Socioeconomic indicators such as population density, built-up density, and education accessibility were also incorporated into the assessment. This study underscores the need for adaptive land use planning, resilient drainage systems, and community-based flood risk reduction strategies. The findings provide actionable insights for sustainable flood management and demonstrate the value of combining GIS, remote sensing, and multi-criteria analysis in data-scarce, conflict-affected regions.

Blinded comparative evaluation of GPT-generated, online search-derived, and guideline-based answers for HPV-associated oropharyngeal cancer.

This study aims to analyze the determinants of food safety behavior among food handlers by integrating sociodemographic factors and the Knowledge–Attitude–Practice (KAP) framework in the context of hospital nutrition facilities. This research used a qualitative case study design, data were collected through in-depth interviews, direct observation, and documentation review of food handlers, heads of nutrition facilities, nutritionists, and internal quality control officers. The results showed that the level of education and involvement in training greatly influenced food handlers' understanding of food safety principles, as well as shaping their attitudes and practices in implementing safe work procedures. Knowledge plays an important role in increasing awareness of contamination risks, while attitudes determine the level of motivation and commitment to complying with operational standards. Food safety practices are reflected in the consistency of food handlers in implementing hygienic procedures, although variations in behavior were found to be influenced by differences in educational background and access to training. These findings emphasize the need for ongoing training programs, strengthened supervision, and systematic managerial support to ensure compliance with food safety standards

Abstract Globally, education systems have undergone a significant shift—from the institutionalisation of people with disabilities to inclusion within mainstream schooling. This research explores the impacts of historical education practices for people with blindness or low vision (BLV), particularly those educated in specialised residential institutions during the 1930s–1940s in Melbourne, Australia. This study employs qualitative secondary analysis (QSA) to examine existing interview data collected by other researchers. The data includes perspectives from older Australians with BLV who were students, educators, nurses, or carers at a residential school for the blind during the early 20th century. The narratives reveal benefits and limitations of institutional education. While not advocating for a return to segregation, the study highlights how community and shared identity among students with BLV may have supported social and educational development within education. These findings offer a rare lens through which to understand the long‐term effects of specialised education for people with BLV. They also provide a foundation for future comparative research with younger cohorts educated in inclusive mainstream environments. By contributing to this evolving dialogue, the study offers insights for policymakers and educators seeking to improve educational access, community belonging, and equitable outcomes for students with BLV, particularly braille users.

South Africa faces persistent socio-economic challenges, including high unemployment, skills mismatches, and structural inequalities that limit inclusive development. Despite a relatively high youth literacy rate, graduate unemployment has emerged as a critical concern, reflecting the disjuncture between higher education outputs and labour market needs. This article systematically reviews literature published between 2005 and 2025 to explore the complex interplay between graduate unemployment, skills mismatch, and labour mobility in South Africa. A total of 43 peer-reviewed articles from Scopus and Web of Science were analysed using a systematic literature review approach. The findings reveal five interrelated themes: (i) enduring inequities in education access and quality, rooted in colonial and apartheid legacies; (ii) limited transformation of higher education, characterised by poor throughput and uneven responsiveness; (iii) persistent mismatches between academic qualifications and industry requirements; (iv) the ideological framing of policy reforms shaped by global discourses such as Human Capital Theory; and (v) the disruptive effects of technological change, particularly the Fourth Industrial Revolution. Collectively, these themes highlight the need for reforms that strengthen the alignment between education and labour market demands, expand equitable access to work-integrated learning, and promote adaptive lifelong learning strategies. Policy implications underscore the importance of industry–university partnerships, curriculum reform, and context-sensitive labour market planning. While this review is limited to published literature, it provides valuable insights for addressing graduate unemployment and advancing inclusive, skills-driven growth. Future research should focus on longitudinal studies, regional comparisons, and the role of technology in reshaping employability.

Oral health literacy (OHL) is increasingly recognized as a determinant of oral health outcomes; however, its relationship with children’s oral health related quality of life (OHRQoL) in rural Latin-American settings remains unclear. The objective was to examine the correlation between caregiver’s OHL and children’s OHRQoL in rural schools in Arauco, Chile. A cross-sectional study was conducted with 152 caregivers. Data was collected using the validated Cupé-Araujo OHL scale and the Early Childhood Oral Health Impact Scale (ECOHIS). OHRQoL was assessed through caregiver’s proxy reporting. Normality was tested with the Kolmogorov–Smirnov test, and Spearman’s rho (ρ) was used to evaluate associations. The average OHL score was 2.98 ± 0.9, and the mean ECOHIS score was 5.79 ± 6.17. A weak but statistically significant negative correlation was observed between OHL and OHRQoL (ρ = –0.173, P = 0.033). Higher OHL was observed among caregivers with greater education and better access to oral-health information (P < 0.05). Although no significant correlation was identified between caregivers’ OHL and children’s OHRQoL, socio-educational and informational factors appear to influence oral-health outcomes. These findings highlight the need for culturally tailored interventions to strengthen oral-health literacy in rural communities.

Background: Substance abuse is a critical public health concern with significant consequences for individuals, families, and society. While the Youths in the rural communities are particularly vulnerable due to poor socio-economic status, limited job opportunities as well as cultural practices, the youths in the urban are due to peer influence, lack of parental supervision and media influence. Despite governmental efforts, substance abuse persists in Nigeria, especially among the youth population. This study aimed to compare the prevalence, knowledge, attitude, and determinants of substance abuse among youths in rural and urban communities of Rivers State, Nigeria. Methods: A comparative cross-sectional mixed-method design was employed. A total of 602 youths from rural and urban communities in Rivers State aged 15–35 was selected using multistage and snowball sampling techniques. Data were collected via semi-structured questionnaires and focus group discussions. Quantitative data were analyzed using Advanced Excel 2016 vs Winpepi with Chi-square and odds ratio at p<0.05. Ethical clearance and participant consent were obtained. Results: The majority of users were males aged 15–18 years (rural) and 19–28 years (urban). Knowledge of substance risks was significantly higher among urban youths 96% vs 92% (p=0.000), while rural youths demonstrated good attitudes towards substance use (88% vs 56%) (OR=5.5, p=0.000). Substance abuse prevalence was higher in rural areas 45% vs.29% urban, current use; p=0.000). Determinants included age, education, peer influence, and substance accessibility. Urban youths had more diverse and frequent use patterns, while rural youths exhibited higher prevalence. Good knowledge surprisingly correlated with higher use (AOR = 23.87). Conclusion: Although urban youths were better informed, rural youths had better attitudes, yet higher prevalence of substance use. These findings suggest that awareness alone may not deter abuse. Context-sensitive interventions addressing noted determinants are needed for both settings.

Healthcare workers' perceptions of burn care in New South Wales (NSW): guiding a burn model of care.

Cancer centers and health systems are tasked with deciding where to deploy community interventions to reduce the burden of cancer within their catchment areas. Few methods exist to prioritize communities in a systematic manner, considering features of individuals, populations, systems, and policies. We developed a geographically informed index to prioritize census tracts based on community need, with an initial focus on identifying communities in need of breast cancer screening (BCS) interventions. This study used publicly available data to select variables known to be associated with disparities in BCS rates. Variables were identified from five categories: economic stability, education access and quality, neighborhood and built environment, social and community context, and health status and health care access and quality. Data were analyzed at the census tract level across the Sidney Kimmel Comprehensive Cancer Center catchment (N = 1,216). Principal component analysis was applied to 23 variables, and five principal components were selected to construct a composite measure using a weighted sum. The resulting index values were used to stratify the data set for further analysis and mapped for visualization. The analysis produced the Community Need Priority Index (CNPI)-BCS, with values ranging from 0 to 1 (mean, 0.259; standard deviation [SD], 0.161). The top quintile (Q5, n = 243) represented the highest-need communities. Q5 tracts were primarily concentrated in Philadelphia, Camden, and Delaware counties. Philadelphia County had the highest average (mean, 0.364; SD, 1.78) and the most tracts in the top quintile (45%, n = 175). Montgomery county had the lowest average (mean, 0.169; SD, 0.092). This novel methodological approach considered the complex nature of multiple, intersectional barriers to good health to identify priority areas of need within cancer center catchment areas.

Standardized sulforhodamine b colorimetric cell proliferation assay for anticancer activity screening in educational and research laboratories.

Strengthening socio-educational services represents an essential condition for achieving high-quality, adapted, and efficient inclusive education for children with special educational needs (SEN). These services play a cardinal role in supporting the educational process, facilitating the school's ability to respond to the diverse needs of students and ensure equal access to learning and personal development. The theoretical and praxiological construction of the research problem is reflected in the development and harmonization of inclusive education through ensuring the strengthening of educational and social services. Improving access and participation in quality education for all requires a coordinated effort among educational institutions, families, and communities to remove obstacles and create equal opportunities for all students. In practical terms, strengthening socio-educational services involves investments in qualified human resources, implementing monitoring and evaluation systems to track the progress of children with SEN with personalized adjustments in intervention plans, promoting partnerships including between educational institutions and recent research in the field to improve evidence-based practice by identifying interventions that work best for different educational needs, contexts, and educational phases. The way inclusive education practitioners for children with SEN identify and integrate research evidence to support their intervention approaches tends to be one where they design their own interventions or use flexible, fragmented approaches, rather than programs developed from research evidence and then manualized. These findings highlight current practices and suggest areas for improving support for children with SEN. To this end, educational policies must continuously prioritize and allocate adequate resources to strengthen this sector as a foundation for the success of inclusion in our general education institutions.

Water scarcity and inefficient water management practices pose significant threats to agricultural productivity and rural livelihoods in Nigeria, particularly among smallholder farmers who rely heavily on rain-fed agriculture. Despite increasing awareness of water conservation technologies (WCTs) as viable strategies for sustainable agricultural water use, their adoption among farmers remains relatively low and uneven across regions, highlighting the need to understand factors influencing smallholder farmers’ adoption of water conservation technologies in Osun State, Nigeria. The study focused on identifying the WCTs embraced by farmers, understanding their motivations for adoption, and analyzing the factors influencing their adoption decisions. Data was collected via a pre-tested questionnaire administered to 120 smallholder farmers selected through a multistage sampling process. Descriptive statistics and a multivariate probit (MVP) model were employed for data analysis. Findings indicated that the majority (55.8%) of farmers were male, aged 41-50, with primary education (41.7%), and household and farm sizes averaging 6 persons and 4 hectares, respectively. The most adopted WCTs included irrigation/dam (68.3%), grass strips (62.5%), stone bund (50%), soil bund (41.7%), and contour ploughing (32.5%). Reasons for adoption ranged from yield increase to flood control and soil fertility improvement. The MVP model revealed several factors influencing adoption, including farmers' demographics, education, farming experience, land acquisition methods, and access to credit and extension services. The study suggests enhancing educational opportunities, credit access, farmer associations, and extension services as essential policy measures to foster technology adoption in the study area.

Colorectal cancer (CRC) remains a leading cause of cancer mortality in the United States. While screening significantly reduces CRC incidence and mortality, disparities persist, particularly between rural and urban populations. This study assessed the extent and determinants of rural-urban disparities in CRC screening using nationally representative data from the Behavioral Risk Factor Surveillance System (BRFSS) between 2019 and 2023. The study analyzed responses from 535,568 adults using complex survey-weighted logistic regression and Blinder-Oaxaca decomposition analysis. CRC screening status was defined as a binary outcome. Independent variables included geographic classification (rural and urban), age, sex, race/ethnicity, education, income, insurance status, and access to a personal healthcare provider. Overall, 73.0% of eligible adults reported undergoing CRC screening, with a higher prevalence among urban residents (77.7%) than rural residents (74.4%). Decomposition analysis revealed that 27.5% of the rural-urban disparity was attributable to differences in measurable characteristics such as education, income, age distribution, insurance, and provider access. Educational attainment and income contributed most to the explained gap. However, 72.5% of the disparity remained unexplained, indicating potential influences from structural, cultural, and healthcare system-level factors. Substantial rural-urban disparities in CRC screening persist, largely driven by unmeasured contextual factors. Addressing this gap requires multifaceted, equity-focused interventions. Future research should adopt the socio-ecological model to comprehensively examine multilevel determinants influencing screening behaviors, especially within underserved rural communities.

With less than two years remaining from 2027—the year which the government has targeted to achieve zero Indigenous cases, we map the malaria indicators across the 700 + districts for five years between 2019 and 2023 using spatiotemporal maps and also assess the potential drivers of malaria transmission in different regions. We used the annual district-wise malaria data from the National Center for Vector Borne Disease Control Programme (NCVBDC) and the cross-sectional socio-economic data from the National Family Health Survey. We also collated the meteorological and land-use land-cover data from the MERRA-2 and Sentinel-LPA satellites, respectively. We then developed region-specific ensembles of spatiotemporal models that allowed us to identify the associated covariates while the regions were identified using the Getis-Ord Gi* statistics. With 0.33 million malaria cases in 2019, the COVID-19 pandemic led to a significant reduction in reported cases. The P. falciparum affected regions are widespread in North-eastern and Central India. However, after the pandemic, an emerging geographical expansion into the north-eastern parts is observed for the P. vivax, which is evident from the clusters and the spatiotemporal ensemble models. Population belonging to scheduled castes and scheduled tribes and those economically marginalised are among the most vulnerable, but lifestyle habits such as drinking water practices, maternal education, and healthcare accessibility are associated with malaria transmission. We also developed a digital dashboard that allows the general public and the stakeholders to track the malaria indicators for each district and the corresponding year.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-25671-4.

This study utilized a descriptive correlational design in order to describe and examine needs of teachers in Science and Technology and Engineering (STEM) Curriculum among public secondary schools in the Congressional District 1 within the Schools Division of Nueva Ecija. It was participated by 70 STEM teachers who were purposively drawn by the researcher. Developed-survey-questionnaire was utilized. Results reveal that there is reliance on computers and smartphones which emphasize the importance of accessibility in education which provides essential access to information, online resources and communication platforms that enhance learning. In addition, it found out that there are critical aspects of STEM education which put emphasis on the need for comprehensive content, innovative instructional strategies, and well-prepared educators. Further, educational strategies should focus on developing these skills through active, inquiry-based learning approaches, thereby preparing students to tackle complex scientific challenges and fostering a deeper understanding of the subject matter. Also, there was a significant correlation between instructional designs and science process skills highlights the need for innovative teaching strategies that actively engage students in inquiry-based learning.