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Funding Health Promotion Activities to Reduce Avoidable Hospital Admissions in Frail Older Adults (HomeHealth): Further Challenges to the "Cost-Effective but Unaffordable" Paradox.

Health promotion initiatives are often promoted as being worth the investment given future cash-savings. This paper uses the findings of HomeHealth, a health promotion service for older adults with mild frailty, to examine how economic evaluation relates to local decision making in England. The HomeHealth trial randomised 388 participants aged 65+ years with mild frailty to receive HomeHealth (195 participants) or treatment as usual (193 participants). Health and social care resource use and carer time were self-completed at baseline, 6 months and 12 months. Primary and secondary healthcare resource use and medications were collected from patient files at 12 months post recruitment, covering the past 18 months. Stakeholders including commissioners were consulted on the results of the trial and budget impact. Participants allocated to HomeHealth had a significant reduction in emergency hospital admissions at 12 months (incident rate ratio (IRR) 0.65; 95% confidence interval (CI) 0.45-0.92) and unpaid carer hours at 6 months (- 16 h (95% CI - 18 to - 14 h) or - £360 (95% CI - 369 to - 351) per patient). Although the intervention is cost saving overall due to fewer emergency admissions, at a cost of £457 per patient commissioners do not have the budget to fund it. This case study illustrates the problem with using standard economic evaluation methods to argue for implementation of health promotion initiatives in publicly financed healthcare systems. Although HomeHealth resulted in reduced emergency admissions and may be cost saving to the system as a whole, it is not locally cash releasing. Health promotion initiatives are unlikely to be funded from local budgets without significant system-wide changes.

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  • Journal IconApplied health economics and health policy
  • Publication Date IconJul 9, 2025
  • Author Icon Rachael Maree Hunter + 13
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Applying global NASA data to local planning for extreme heat in Prince George’s County, Maryland

As demand grows for high-quality public information around the increasing societal impacts of extreme weather, making scientific data products more actionable for practitioners has become a top priority for NASA. In early 2024, several of us from NASA Goddard Space Flight Center began collaborating with Prince George’s County, Maryland staff to apply space-based observations to help inform local decisions around building resilience to environmental stressors. Prince George’s County is home to Goddard Space Flight Center hosting a comprehensive array of Earth observing satellite and modeling products and expertise to advance understanding of Earth as a system, providing critical long-term data records over space and time. Scientific and academic communities have primarily used these global data products to advance fundamental understanding of Earth processes and their changes, rather than informing practical decisions. Here we describe a demonstration to bridge that gap, initially around reducing exposure of humans to extreme heat. Working with agency staff from the Prince George’s County Department of Environment and the Prince George’s County Health Department, NASA shared satellite-derived land surface temperatures from Aqua-MODIS and Landsat as well as land cover classifications to analyze seasonal temperature trends with land use changes over the past few decades. Prior to partnering with NASA, the county was using sparse in situ temperature records, extremely valuable and essential for ground-truthing satellite data, but limited spatially and temporally. The addition of space-based data augments these few ground-based measurements with a broad view of spatial and temporal temperature trends that can be layered with additional county data to help identify areas of increased heat with land use change patterns. We also compared the temperature trends to records of annual heat-related emergency room visits. By combining environmental data with local health impacts, the County plans to pinpoint heat-related vulnerability patterns over time. This unique combination of global and local data serves to pilot science-based criteria to inform and prioritize projects and programs to reduce heat exposure of Prince George’s County’s workers and residents.

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  • Journal IconFrontiers in Environmental Science
  • Publication Date IconJul 9, 2025
  • Author Icon Stephanie Schollaert Uz + 5
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Introduction: Colonial Anxieties, Corruption Scandals, and Xenophobia in Nineteenth-Century Infrastructure Development in Romania

This thematic cluster examines the historical relevance of the rail and fluvial-maritime transportation infrastructure for nation-building and modernization of the Romanian Principalities (later Romania) from the 1840s to 1914. Since such transportation infrastructures were seen as both “progressive” and “disruptive,” their construction brought immense pressure on local decision-makers. The articles in this cluster share three common goals. First, they examine anxieties over the possibility that the Principalities/Romania would fall prey to economic and demographic colonization, fears generated by their asymmetrical political and economic interactions with Europe’s Great Powers and neighboring empires. We call these “colonial anxieties.” Second, contributions examine the corruption scandals befalling infrastructure construction, which generated and constantly reshaped colonial anxiety in the process of nation-state-building given the Great Powers’ imperial/colonial political and economic influence. Third, the articles historicize the semantic and political usage of “colonization” and “corruption” in nation-building and infrastructure construction, arguing that, on both accounts, reflexively situating their meanings can disentangle them from the ex-post analytical vocabulary scholars currently employ normatively.

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  • Journal IconEast European Politics and Societies
  • Publication Date IconJul 8, 2025
  • Author Icon Silvia Marton + 1
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Enterprise Security Mesh Architecture: Distributed Security Decision Making in Complex Organizations

Enterprise Security Mesh Architecture (ESMA) introduces a revolutionary framework for cybersecurity governance within expansive, multifaceted organizations through security control decentralization and localized decision authority distribution. Conventional boundary-centric security frameworks prove insufficient when confronting the intricacies of composite environments, cloud infrastructures, and distributed identity systems. ESMA positions security functionalities in proximity to resources, personnel, and devices, implementing situation-responsive directives via microservice components and interface protocols. This configuration enables instantaneous threat identification, flexible trust frameworks, and robust permission structures, bolstering both extensibility and functional responsiveness. Incorporating Zero Trust doctrines, ESMA facilitates protected interdepartmental cooperation while sustaining unified administrative oversight and regulatory adherence. The dispersed configuration of security elements permits isolated incident management alongside comprehensive enterprise-wide monitoring capabilities. Protective measures strategically positioned throughout the infrastructure establish layered defense mechanisms that continuously reconfigure according to emergent security challenges. ESMA yields considerable benefits within intricate corporate structures where centralized protective measures create operational constraints. This architectural blueprint strengthens comprehensive organizational security standing without sacrificing computational efficiency or structural adaptability.

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  • Journal IconJournal of Computer Science and Technology Studies
  • Publication Date IconJul 8, 2025
  • Author Icon Natarajan Ravikumar
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AI as Sub-Symbolic Systems: Understanding the Role of AI in Higher Education Governance

This paper develops the argument that, in the application of AI to improve the system of governance for higher education, machine learning will be more effective in some areas than others. To make that assertion more systematic, a classificatory taxonomy of types of decisions is necessary. This paper draws upon the classification of decision processes as either symbolic or sub-symbolic. Symbolic approaches focus on whole system design and emphasise logical coherence across sub-systems, while sub-symbolic approaches emphasise localised decision making with distributed engagement, at the expense of overall coherence. AI, especially generative AI, is argued to be best suited to working at the sub-symbolic level, although there are exceptions when discriminative AI systems are designed symbolically. The paper then uses Beer’s Viable System Model to identify whether the decisions necessary for viability are best approached symbolically or sub-symbolically. The need for leadership to recognise when a sub-symbolic system is failing and requires symbolic intervention is a specific case where human intervention may be necessary to override the conclusions of an AI system. The paper presents an initial analysis of which types of AI would support which functions of governance best, and explains why ultimate control must always rest with human leaders.

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  • Journal IconEducation Sciences
  • Publication Date IconJul 6, 2025
  • Author Icon Xiaomin Li + 2
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Urban Sprawl Between Spatial Dynamics and Sustainability Issues Case of the City of Béjaïa, Northern Algeria

This paper analyzes the evolution of urban sprawl in the city of Béjaïa, located in northern Algeria, by examining land consumption from the country's independence in 1962 to the present day. Using a diachronic approach supported by Geographic Information Systems, the study highlights the increasing artificialization of land and its impacts on the environmental, social, and economic dimensions of sustainable development. The results reveal a diffuse and uncontrolled urban expansion, characterized by fragmented urban fabric, the loss of agricultural and forested land, and growing spatial disparities. A critical analysis of urban planning tools reveals their limited capacity to manage this phenomenon and provide appropriate solutions. This paper aims to encourage local decision-makers to adopt a more forward-looking urban governance strategy, based on the strategic use of geographic information systems and a prospective approach, to promote a more sustainable and balanced urban development.

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  • Journal IconProceedings of the international conference of contemporary affairs in architecture and urbanism-ICCAUA
  • Publication Date IconJul 5, 2025
  • Author Icon Bounouni Sofiane + 1
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Values From the Frontlines: Planners and Other Local Public Officials on Loss of Life and Equity in Flood Risk Mitigation

Problem, research strategy, and findings Flooding generates the highest level of economic impacts and the second most deaths among U.S. disasters. Multiple actors mitigate flood risks, with local planners and emergency managers (EMs) essential public actors in urban settings. Previous studies have not examined whether these players’ professional values shape their preferences for flood risk outcomes. Our work here asked whether values regarding the costs of protection and the effects of protection on the loss of life and the distribution of flood damages differ between county-level urban planners and EMs. We surveyed more than 600 urban planners and EMs from 47 states, presenting hypothetical scenarios of flood mitigation with different mitigation outcomes among which respondents chose. Employing a mixed logit model, we found that both planners and EMs chose scenarios with lower mitigation costs, less loss of life, and fewer damages. However, compared with planners, EMs chose scenarios with fewer fatalities and overall damages. In contrast, planners chose scenarios that limit damages in lower-income areas. We use these findings to argue that planning researchers and practitioners and others in the hazards community should more explicitly, deliberately, and transparently address different values in local decision making. Takeaway for practice We urge planners and other local officials involved in hazard mitigation planning to articulate and discuss their values about the benefits and cost of flood risk mitigation. Making these explicit can support a common understanding of these values with other practitioners engaged in mitigation and elected officials. Their open discussion in public decision-making forums also can help make those values more visible and better understood by the public.

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  • Journal IconJournal of the American Planning Association
  • Publication Date IconJul 3, 2025
  • Author Icon Kris Wernstedt + 2
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How do Cyber-Risks Vary Across Smart City Technologies?

ABSTRACT Smart city technologies present opportunities for local governments, while also exposing them to new risks. While privacy threats and algorithmic biases have received significant attention within urban studies, cybersecurity has received far less. Our study examines systematic variation across smart city technologies in cyber-risks. We administered a survey to cybersecurity experts in which they ranked the vulnerabilities, threats, and consequences of potential cyberattacks for nine different smart city technologies. Analysis using a Markov-based approach indicates that cyber-risks vary greatly across technologies. Notably, technologies that are more vulnerable in technological terms are also viewed as most likely to be impactful if an attack were to occur, and most likely to be targeted by nation-states. Case studies of emergency or security alerts and smart water meters—ranked as most risky and less risky respectively—underscore and help explain this variation, while also highlighting that local governments vary in their ability to vet vendors, and that cyber-protections are typically subordinated to other concerns in procurement decisions. Our study illustrates the utility of disaggregating the concept of the “smart city,” and the analytic utility of comparisons across technologies rather than geographic units and provides a useful framework for local government decision-making.

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  • Journal IconJournal of Urban Technology
  • Publication Date IconJul 2, 2025
  • Author Icon Giselle Mendonça Abreu + 4
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Portable Incubator for Premature Infants

Premature infants require specialized neonatal care, often through incubators that maintain ideal environmental conditions. However, conventional hospital incubators are costly and not readily available in remote regions. This project presents a low-cost, IoT-based portable incubator for premature infants using edge computing with the Raspberry Pi Zero 2W. The system monitors physiological parameters such as body temperature, blood oxygen, and heart rate, along with cabin temperature and humidity. Actuators like a heater and fan are controlled to maintain optimal conditions. A multi-output neural network trained with sensor data enables prediction of medical needs and environmental adjustments. The system supports local decision-making, real-time control, and remote access via a Telegram chatbot, enhancing neonatal care in low-resource settings.

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  • Journal IconJournal on Materials and its Characterization
  • Publication Date IconJul 2, 2025
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Manoeuvring rural mobility policy for active and sustainable travel.

Manoeuvring rural mobility policy for active and sustainable travel.

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  • Journal IconSocial science & medicine (1982)
  • Publication Date IconJul 1, 2025
  • Author Icon Chloe Asker + 6
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Afghanistan, Wargaming, and Human Behavior

This article seeks to show how our successes and overall strategic failing in Afghanistan – in particular, the swift takeover by Taliban forces despite two decades of nation-building and partnering – can be a teachable moment. Specifically, how a more realistic, grounded understanding of human nature and decision making, informed by concepts of human incentives, uncertainty, and risk, can assist us in certain warzones. This understanding may be critical in current and future conflicts where the (1) the formal governing system is ineffective, (2) said government tends to be unresponsive to the needs of lower-level leaders and the population, and (3) the culture lends itself to a stronger framework for localized self-governance and decision making. The author draws on existing military literature, local ABP/VSO outcomes, and insights into human nature and behavior. Broadly, the article fuses the following themes together in a way that is both academically sound and operationally feasible: Afghan culture and human behavior, bottom-up vs top-down governance, tribal engagement and village stability, US Military operational planning and risk assessment methodology (wargaming), and reconciling our approach with realities on the ground for future wars and conflicts.

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  • Journal IconJournal of Strategic Security
  • Publication Date IconJul 1, 2025
  • Author Icon John A Kirbow
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Advancing the Representation of Human Actions in Large‐Scale Hydrological Models: Challenges and Future Research Directions

Abstract Characterizing the impact of human actions on terrestrial water fluxes and storages at multi‐basin, continental, and global scales has long been on the agenda of scientists engaged in climate science, hydrology, and water resources systems analysis. This need has resulted in a variety of modeling efforts focused on the representation of water infrastructure operations. Yet, the representation of human‐water interactions in large‐scale hydrological models is still relatively crude, fragmented across models, and often achieved at coarse resolutions (10–100 km) that cannot capture local water management decisions. In this commentary, we argue that the concomitance of four drivers and innovations is poised to change the status quo: “hyper‐resolution” hydrological models (0.1–1 km), multi‐sector modeling, satellite missions able to monitor the outcome of human actions, and machine learning are creating a fertile environment for human‐water research to flourish. We then outline four challenges that chart future research in hydrological modeling: (a) creating hyper‐resolution global data sets of water management practices, (b) improving the characterization of anthropogenic interventions on water quantity, stream temperature, and sediment transport, (c) improving model calibration and diagnostic evaluation, and (d) reducing the computational requirements associated with the successful exploration of these challenges. Overcoming them will require addressing modeling, computational, and data development needs that cut across the hydrology community, thereby requiring a major communal effort.

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  • Journal IconWater Resources Research
  • Publication Date IconJul 1, 2025
  • Author Icon Stefano Galelli + 7
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Women Engagement and Empowerment in the National Greening Program: Insights to Sustainable Implementation

Citizen empowerment, particularly women’s engagement, is key to the success and sustainability of greening programs. Women’s involvement in the National Greening Program, from seedling production to forest protection, boosts efficiency and fosters local ownership and sustainable decision-making. This study determined the empowerment of women as predicted by their level of engagement in the National Greening Program (NGP). A quantitative research design utilizing a descriptive-correlational approach was employed. Data were gathered using a researcher-made survey questionnaire based on the variables of social, economic, and environmental sustainability, applied to both the levels of engagement and empowerment of women beneficiaries. A total of 256 respondents from Capiz participated in the survey. The collected data were processed and analyzed using the Statistical Package for the Social Sciences (SPSS). The study revealed that women in Capiz demonstrated very high levels of engagement and empowerment in the NGP across social, economic, and environmental dimensions. However, limited legal and formal participation was found to restrict further empowerment. The results indicated a significant positive relationship between engagement and empowerment, suggesting that higher engagement correlates with greater empowerment among women involved in the NGP.

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  • Journal IconAmerican Journal of Pure and Applied Biosciences
  • Publication Date IconJun 29, 2025
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Exploring OTOPreneurs Organizational Resilience through Ownership Structures Workforce Size and Years in Operation

The One Town, One Product (OTOP) is a government program initiated to promote the Philippine economic growth by supporting the Micro, Small and Medium Enterprises (MSME). The study explores OTOPreneurs’ organizational resilience in the province of Isabela by examining changes in ownership structures and workforce size during the pandemic. A prevailing confidence in sole proprietorships and medium-sized enterprises groups features the adaptability and vulnerability capacity of these local businesses. Retaining a descriptive quantitative approach, the study investigates how OTOPreneurs adapted to difficulties in the operations of local and national businesses, employability, and even access to the marketplace. Although workforce reductions and temporary business closures occurred, many OTOPreneurs demonstrated resilience through strategic adaptations such as the use of family labor, flexible workforce arrangements, and digital platform adoption. The stability in ownership structures, combined with responsive labor strategies, underscores the significance of localized decision-making and operational flexibility in times of crisis. The contributions to a visible understanding of entrepreneurial sustainability inform policymakers to support resilient local businesses.

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  • Journal IconInternational Journal of Research and Innovation in Social Science
  • Publication Date IconJun 28, 2025
  • Author Icon Medilyn M Ines
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Citizen Participation after the Fall of Communism in Romania: Evolving Perceptions and Practices in Local Decision-Making and Governance

The paper examines the perceptions of Romanian local public institutions’ representatives regarding citizen participation in the decision-making process in Romania. We examined the decade-long changes regarding citizen participation in the decision-making process in Romania. To this end, we conducted a survey in late winter 2009 and early spring 2010 on a representative sample of City Halls and County Councils in Romania, collecting 381 valid surveys. We replicated the same survey from March 2024 until July 2024 and collected responses from 621 institutions. The research revealed moderate development in local government toward a more participatory culture, involving citizens more actively in the decision-making process in Romania. However, this progress is not evenly distributed across the local public administration, and the degree of citizen participation appears to be influenced by the size of the local communities. The larger the size of local communities, the higher the degree of citizens’ involvement in the decision-making process is.

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  • Journal IconTransylvanian Review of Administrative Sciences
  • Publication Date IconJun 27, 2025
  • Author Icon Bianca Veronica Radu + 1
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Formation of legitimacy in sport in local decision-making: explaining local politicians’ and administrators’ perceived justification of sport in Finnish municipalities

ABSTRACT Research on sport governance has extensively explored the political and administrative obstacles to legitimacy-building in sport that influence the execution of public sport policy. Local decision-makers perceived justification of sport is addressed utilising a framework grounded in Max Weber’s rational-legal legitimacy. Drawing on large survey data from 1523 politicians and sport officials during two consecutive election periods (2013–16 and 2017–20) in Finnish municipalities, the results from a logistic mixed-effects model indicate that decision-makers’ perceptions were shaped by the local political and administrative hierarchies. Moreover, asymmetry in perceptions between the politicians and officials was explained by the value attributed to sport as a decision-making area and having sufficient sport-related knowledge. Features of rational-legal legitimacy accounted for a notable part of local decision-makers’ perceptions of justifications for sport as formal hierarchies and rational decision-making emerged as crucial factors in shaping legitimacy in sport. The results highlight the need for systematic research to focus on uncovering specific contexts while investigating the various layers of governance.

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  • Journal IconInternational Journal of Sport Policy and Politics
  • Publication Date IconJun 26, 2025
  • Author Icon Anna Lee + 3
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Influence of water balance (Thornthwaite and Mather) on soybean development in Porto Nacional, TO

This study analyzed the climatological water balance (CWB) in Porto Nacional, Tocantins, from 2009 to 2024, to understand its influence on soybean cultivation, a cornerstone of Brazilian agriculture in the Cerrado despite seasonal water variability. Utilizing historical INMET temperature and precipitation data, the Thornthwaite and Mather (1955) method was applied via electronic spreadsheet (Rolim; Sentelhas, 1998) with a 100 mm soil water holding capacity. Average annual precipitation was 1,582.7 mm, with 94.9% concentrated from October to April. Annual potential evapotranspiration was 1,958.31 mm, resulting in a total annual water deficit of 779 mm. The climate classification C₁WA’a’ characterized a dry subhumid climate with accentuated winter deficit and high annual thermal demand. Critical water scarcity periods coincided with sensitive soybean stages like flowering and grain filling. The significant increase in planted area (from ~6,000 ha in 2009 to >27,000 ha in 2022) underscores the need for agricultural planning aligned with water availability. Findings provide technical support for efficient water management and optimal sowing periods, mitigating water stress and promoting sustainable production. This research contributes a detailed CWB analysis for Porto Nacional, offering crucial subsidies for local agricultural decision-making amidst climatic variability and soybean intensification.

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  • Journal IconCONTRIBUCIONES A LAS CIENCIAS SOCIALES
  • Publication Date IconJun 26, 2025
  • Author Icon Eduardo Barros Aires + 6
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It’s Not Just About the Money: What Actually Promotes New Firm Formation? Evidence from Polish Municipalities

This paper examined whether regional differences in Poland affect the use of various tools for supporting local entrepreneurship. It also verified whether there is a universal set of tools that accounts for the level at which local entrepreneurship support tools are used by municipalities. This study was based on a survey conducted among 882 Polish municipalities. Analyses were carried out using classical measures of descriptive statistics, supplemented by the Mann–Whitney U test and Kruskal–Wallis rank. The results reveal that the likelihood of municipalities with a local spatial development plan (LSDP) use more support instruments is statistically significant. For municipalities, having an LSDP also correlates with higher levels of local entrepreneurship. Moreover, the presence of an LSDP contributes not only to increased local entrepreneurship, but also aligns with long-term, sustainable, spatial and economic development goals. It was concluded that municipalities should be encouraged to create comprehensive development plans and, above all, to develop and implement local spatial development plans. Local decision-makers should must be made aware of the role of the plan and its importance for the level of entrepreneurship in the area. More attention should also be focused on the use of tools aimed at direct cooperation with entrepreneurs.

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  • Journal IconSustainability
  • Publication Date IconJun 23, 2025
  • Author Icon Elżbieta Ociepa-Kicińska + 3
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Edge AI in Real-Time Path Planning for Autonomous Delivery Drones

This study evaluates the integration of Edge AI in real-time path planning for autonomous delivery drones to enhance responsiveness, safety, and computational efficiency in urban logistics. Traditional cloud-based systems suffer from latency and connectivity constraints, limiting decision-making speed in dynamic environments. This research proposes a hybrid framework leveraging Edge AI for local decision-making while maintaining synchronization with cloud systems for global updates. A reinforcement learning-based algorithm was deployed on NVIDIA Jetson Nano and tested in real-time navigation scenarios using simulated urban obstacle courses. The results demonstrate a significant reduction in path replanning time, improved obstacle avoidance accuracy, and enhanced delivery reliability. Regression analysis confirmed the inverse correlation between processing latency and task completion efficiency. Predictive models revealed optimal energy allocation patterns under Edge AI scenarios. This paper concludes that Edge AI is a viable enabler for scalable, responsive, and secure autonomous drone delivery systems. Keywords: Edge AI, autonomous drones, real-time path planning, reinforcement learning, delivery systems, obstacle avoidance

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  • Journal IconInternational Journal of Academic and Industrial Research Innovations(IJAIRI)
  • Publication Date IconJun 23, 2025
  • Author Icon Murali Krishna Pasupuleti
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Smart Trigger Execution Framework in IoT Gateway Applications for Home Automation

This paper presents a trigger-based execution framework designed to enhance the responsiveness, flexibility, and reliability of Zigbee-based home automation systems. The framework enables users to define automation triggers—including conditions and corresponding actions-via a mobile application, which are then centrally managed by a local gateway. The gateway processes incoming data from Zigbee sensors in real time, evaluates trigger conditions, and executes actions by interfacing with Zigbee[1] devices. A relational database schema supports structured storage of triggers, conditions, actions, and device metadata. Additionally, the integration of the Paho MQTT [2] client within the Zigbee[1] System-on-Chip (SoC) application allows for direct MQTT[2] communication, improving system autonomy and reducing latency. This architecture minimizes cloud dependency, enhances data privacy, and facilitates dynamic device control, making it a robust and future- ready solution for smart home automation. The proposed system is particularly suited for user-centric environments where intelligent, local decision-making is critical.

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  • Journal IconInternational Journal For Multidisciplinary Research
  • Publication Date IconJun 22, 2025
  • Author Icon Omkar Wagle + 2
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