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Effect of Lung Cancer Screening, Smoking Cessation, and Cessation Smartphone App to Health-Related Quality of Life Among Heavy Smokers: Randomized Controlled Trial
No full textAbstract
Background:
Lung cancer screening with low-dose computed tomography (LDCT) among heavy smokers can decrease lung cancer mortality. Smoking cessation intervention is recommended within the screening program; however, the methods for smoking cessation in the LDCT screening context are not well established. We have previously shown that a novel smartphone app can increase the chance for smoking cessation along with lung cancer screening. The effects of lung cancer screening, smoking cessation, and the use of smartphone apps on health-related quality of life (HRQoL) are widely unknown.
Objective:
This study aims to investigate the effect of lung cancer screening, smoking cessation, and the use of smoking cessation app on HRQoL, an exploratory end point of the low-dose computed tomography screening for lung cancer combined to different smoking cessation methods in Finland (LDCT-SC-FI) study.
Methods:
This study was conducted as a part of the LDCT-SC-FI (NCT05630950), which was a randomized controlled trial investigating different smoking cessation methods in participants undergoing lung cancer screening with LDCT. The main inclusion criteria included an age of 50‐74 years, a marked smoking history (smoked ≥15 cigarettes per day for ≥25 years or smoked ≥10 cigarettes per day for ≥30 years), an active smoking status, and access to a smartphone. The recruitment was carried out by newspaper and internet advertisements and informing relevant health care units at hospital districts. The study participants (n=200), all at Oulu University Hospital, were randomized in 1:1 fashion to a yearly LDCT with standard smoking cessation (written material) or a stand-alone smartphone app–based cessation. HRQoL, an exploratory study end point, was assessed at baseline and at 1 year with Quality of Life Questionnaire Core 30 (QLQ-C30) and EQ-5D.
Results:
In total, 199 and 186 individuals had both questionnaires completed at baseline and at 1 year, respectively. We did not detect a change in HRQoL between the time points using QLQ-C30 global health status score or EQ-5D index score. Smoking cessation at 1-year time did not affect QLQ-C30 global health status or EQ-5D. We observed improved quality of life scores by EQ-5D at 1 year (control: mean 0.720, SD 0.197 vs app: mean 0.799, SD 0.197; improved in 17/93, 18% of controls vs 29/93, 31% in app arm), while there was no difference in means at baseline. Smartphone app arm reported reduced pain (EQ-5D effect size [ES] 0.049, 95% CI 0.006‐0.12; P=.01; adjusted ES 0.026; P=.007; QLQ-C30 ES 0.076, 95% CI 0.02‐0.16; P<.001; adjusted ES 0.05; P=.02) and increased mobility (EQ-5D ES 0.031, 95% CI 0.01‐0.09; P=.02; adjusted ES 0.037; P=.008) at 1 year. The number of completed questionnaires in the app was associated with improved HRQoL by EQ-5D (ES 0.073, 95% CI 0.00‐0.180; P=.04; adjusted ES 0.071; P=.04).
Conclusions:
This is the first study to test a smoking cessation smartphone app in the context of lung cancer screening. The use of the developed app correlated with improved HRQoL, mainly by decreased pain and fatigue. To conclude, the studied app provides a feasible and effective cessation intervention that is readily implementable in population-based lung cancer screening programs, with enhanced health benefits beyond smoking cessation.
Trial Registration:
ClinicalTrial.gov NCT05630950; https://clinicaltrials.gov/study/NCT05630950Abstract
Background:
Lung cancer screening with low-dose computed tomography (LDCT) among heavy smokers can decrease lung cancer mortality. Smoking cessation intervention is recommended within the screening program; however, the methods for smoking cessation in the LDCT screening context are not well established. We have previously shown that a novel smartphone app can increase the chance for smoking cessation along with lung cancer screening. The effects of lung cancer screening, smoking cessation, and the use of smartphone apps on health-related quality of life (HRQoL) are widely unknown.
Objective:
This study aims to investigate the effect of lung cancer screening, smoking cessation, and the use of smoking cessation app on HRQoL, an exploratory end point of the low-dose computed tomography screening for lung cancer combined to different smoking cessation methods in Finland (LDCT-SC-FI) study.
Methods:
This study was conducted as a part of the LDCT-SC-FI (NCT05630950), which was a randomized controlled trial investigating different smoking cessation methods in participants undergoing lung cancer screening with LDCT. The main inclusion criteria included an age of 50‐74 years, a marked smoking history (smoked ≥15 cigarettes per day for ≥25 years or smoked ≥10 cigarettes per day for ≥30 years), an active smoking status, and access to a smartphone. The recruitment was carried out by newspaper and internet advertisements and informing relevant health care units at hospital districts. The study participants (n=200), all at Oulu University Hospital, were randomized in 1:1 fashion to a yearly LDCT with standard smoking cessation (written material) or a stand-alone smartphone app–based cessation. HRQoL, an exploratory study end point, was assessed at baseline and at 1 year with Quality of Life Questionnaire Core 30 (QLQ-C30) and EQ-5D.
Results:
In total, 199 and 186 individuals had both questionnaires completed at baseline and at 1 year, respectively. We did not detect a change in HRQoL between the time points using QLQ-C30 global health status score or EQ-5D index score. Smoking cessation at 1-year time did not affect QLQ-C30 global health status or EQ-5D. We observed improved quality of life scores by EQ-5D at 1 year (control: mean 0.720, SD 0.197 vs app: mean 0.799, SD 0.197; improved in 17/93, 18% of controls vs 29/93, 31% in app arm), while there was no difference in means at baseline. Smartphone app arm reported reduced pain (EQ-5D effect size [ES] 0.049, 95% CI 0.006‐0.12; P=.01; adjusted ES 0.026; P=.007; QLQ-C30 ES 0.076, 95% CI 0.02‐0.16; P<.001; adjusted ES 0.05; P=.02) and increased mobility (EQ-5D ES 0.031, 95% CI 0.01‐0.09; P=.02; adjusted ES 0.037; P=.008) at 1 year. The number of completed questionnaires in the app was associated with improved HRQoL by EQ-5D (ES 0.073, 95% CI 0.00‐0.180; P=.04; adjusted ES 0.071; P=.04).
Conclusions:
This is the first study to test a smoking cessation smartphone app in the context of lung cancer screening. The use of the developed app correlated with improved HRQoL, mainly by decreased pain and fatigue. To conclude, the studied app provides a feasible and effective cessation intervention that is readily implementable in population-based lung cancer screening programs, with enhanced health benefits beyond smoking cessation.
Trial Registration:
ClinicalTrial.gov NCT05630950; https://clinicaltrials.gov/study/NCT0563095
Prosessidraaman tarkastelu kiusaamisen vastaisena interventiona ja yhteisöllisyyttä rakentavana käytäntönä kouluissa
No full textProcess drama has been widely used in classrooms for varying topics, but in bullying intervention, process drama is a small yet growing research topic. This thesis aims to explore process drama in bullying intervention and attempt to also peek into other factors that affect its successes or shortcomings regarding bullying prevention. Descriptive, narrative literature review was used to interrelate and compare in total of 11 studies and 5 process drama bullying interventions alongside supporting literature.
The main question for this thesis was: “In what ways does process drama influence students’ perceptions of bullying and contribute to the development of a positive school environment?”. Process drama can provide in-depth learning and understanding of bullying through its ability to create places where students can relate to the characters and the story. Bullying prevention in drama is intertwined with social-emotional learning (SEL). Process drama can facilitate development of empathy, social skills and positive interactions, as well as breaking of conventional power balances in classrooms. While it is difficult to ascertain the certain effects of process drama on community development, experiential, serious play can facilitate community building where individuals are not the same but exist together in a shared space. Process drama thus has high potential in involving students in deeper learning and emotional experiences about bullying, simulating empathy and high-stakes scenarios in a safe, fictional environment
Logic-Driven Semantic Communication for Resilient Multi-Agent Systems
No full textAbstract
The advent of 6G networks is accelerating autonomy, intelligence, and interconnectedness in large-scale, decentralized multi-agent systems (MAS). While this evolution enables highly adaptive behavior, it also heightens vulnerability to stressors such as environmental changes, faults, misinformation, and adversarial behavior. Existing literature on resilience in decentralized and multi-agent systems largely focuses on isolated aspects, such as fault tolerance or robustness, without offering a principled, unified definition of multi-agent resilience. This gap limits the ability to design systems that can continuously sense, adapt, and recover under dynamic conditions. This article proposes a formal definition of MAS resilience grounded in two complementary dimensions: epistemic resilience, wherein agents recover and sustain accurate knowledge of the environment, and action resilience, wherein agents leverage that knowledge to coordinate and sustain goals under disruptions. We formalize resilience via temporal epistemic logic and quantify it using recoverability time (how quickly desired properties are re-established after a disturbance) and durability time (how long accurate beliefs and goal-directed behavior are sustained after recovery). We design an agent architecture and develop decentralized algorithms to achieve both epistemic and action resilience. We further provide formal verification guarantees, showing that our specifications are sound with respect to the metric bounds and admit finite-horizon verification, enabling design-time certification and lightweight runtime monitoring. Through a case study on distributed multi-agent decision-making under abrupt network stressors, we show that our approach consistently outperforms baseline methods. Collectively, our formal verification analysis and simulation results highlight that the proposed framework enables resilient, knowledge-driven decision-making and sustained operation, laying the groundwork for resilient decentralized multi-agent systems in next-generation communication infrastructures.Abstract
The advent of 6G networks is accelerating autonomy, intelligence, and interconnectedness in large-scale, decentralized multi-agent systems (MAS). While this evolution enables highly adaptive behavior, it also heightens vulnerability to stressors such as environmental changes, faults, misinformation, and adversarial behavior. Existing literature on resilience in decentralized and multi-agent systems largely focuses on isolated aspects, such as fault tolerance or robustness, without offering a principled, unified definition of multi-agent resilience. This gap limits the ability to design systems that can continuously sense, adapt, and recover under dynamic conditions. This article proposes a formal definition of MAS resilience grounded in two complementary dimensions: epistemic resilience, wherein agents recover and sustain accurate knowledge of the environment, and action resilience, wherein agents leverage that knowledge to coordinate and sustain goals under disruptions. We formalize resilience via temporal epistemic logic and quantify it using recoverability time (how quickly desired properties are re-established after a disturbance) and durability time (how long accurate beliefs and goal-directed behavior are sustained after recovery). We design an agent architecture and develop decentralized algorithms to achieve both epistemic and action resilience. We further provide formal verification guarantees, showing that our specifications are sound with respect to the metric bounds and admit finite-horizon verification, enabling design-time certification and lightweight runtime monitoring. Through a case study on distributed multi-agent decision-making under abrupt network stressors, we show that our approach consistently outperforms baseline methods. Collectively, our formal verification analysis and simulation results highlight that the proposed framework enables resilient, knowledge-driven decision-making and sustained operation, laying the groundwork for resilient decentralized multi-agent systems in next-generation communication infrastructures
Vanadium- and manganese-based metal-organic frameworks for potential environmental and catalysis applications
No full textAbstract
Industrialization has significantly compromised air quality, environmental health, and human well-being. Therefore, it is highly necessary to develop efficient and cost-effective strategies to resolve the issue of environmental pollution while promoting sustainable energy production. Catalysts play a crucial role in the synthesis and conversion of valuable chemicals by providing more active sites that accelerate catalytic reactions, leading to proper activity and selectivity. However, challenges such as catalyst stability, cost-effectiveness, high surface area, reusability, and low loading amount need to be addressed. In this regard, metal organic frameworks (MOFs) could be an intelligent choice due to their tunable structure through altering metal centers and organic ligands along with their structural flexibility, high specific surface area, and diversity. These porous materials have found extensive application in heterogeneous catalysis and environmental remediation thanks to their low cost, abundance in nature and feasible preparation routes. Among first-row transition metal-based MOFs like vanadium (V)- and manganese (Mn)-containing structures have gained popularity in environmental remediation and catalysis due to their different redox states, stability, cost-effectiveness. As limited number of review articles have addressed V and Mn-containing MOFs compared to other first-row transition metals like Ni, Co, Cu and Fe, this review aims at exploring recent advancements in the V- and Mn-based MOFs, their composites, and derivatives within heterogeneous catalysis, highlighting applications in oxidative fuel desulfurization, CO2 reduction, epoxidation, hydroxylation, oxidation of organic compounds, and environmental remediation, including the adsorption and elimination of organic dyes and CO2 capture and conversion. Also, the review emphasizes the structure-performance relationship, offering new insights for overcoming existing challenges and advancing the field.Abstract
Industrialization has significantly compromised air quality, environmental health, and human well-being. Therefore, it is highly necessary to develop efficient and cost-effective strategies to resolve the issue of environmental pollution while promoting sustainable energy production. Catalysts play a crucial role in the synthesis and conversion of valuable chemicals by providing more active sites that accelerate catalytic reactions, leading to proper activity and selectivity. However, challenges such as catalyst stability, cost-effectiveness, high surface area, reusability, and low loading amount need to be addressed. In this regard, metal organic frameworks (MOFs) could be an intelligent choice due to their tunable structure through altering metal centers and organic ligands along with their structural flexibility, high specific surface area, and diversity. These porous materials have found extensive application in heterogeneous catalysis and environmental remediation thanks to their low cost, abundance in nature and feasible preparation routes. Among first-row transition metal-based MOFs like vanadium (V)- and manganese (Mn)-containing structures have gained popularity in environmental remediation and catalysis due to their different redox states, stability, cost-effectiveness. As limited number of review articles have addressed V and Mn-containing MOFs compared to other first-row transition metals like Ni, Co, Cu and Fe, this review aims at exploring recent advancements in the V- and Mn-based MOFs, their composites, and derivatives within heterogeneous catalysis, highlighting applications in oxidative fuel desulfurization, CO2 reduction, epoxidation, hydroxylation, oxidation of organic compounds, and environmental remediation, including the adsorption and elimination of organic dyes and CO2 capture and conversion. Also, the review emphasizes the structure-performance relationship, offering new insights for overcoming existing challenges and advancing the field
The Sustainability Question in Heritage Tourism Development in Africa
No full textAbstract
Sustainability as a construct is complex and, when applied to heritage tourism, integrates social, economic, environmental, and managerial elements. The implementation of policies to promote these aspects of sustainability can often be problematic in contexts where decision-making occurs in a hierarchical governance mode with multiple stakeholders. This is a common concern in heritage tourism management globally and is visible across the African continent, albeit in different forms dependent on local systems. The challenge of sustainability is complicated in the overlapping, yet often incompatible demands of heritage management practices and tourism development at heritage sites. Therefore, in order to provide an in-depth look at sustainability from a variety of heritage and geographic contexts, this chapter will provide brief analyses of sustainability issues of heritage tourism in three different contexts across the continent: Morocco, Ghana, and Tanzania. Drawing on key issues from these three case studies, this chapter will explore the sustainability challenges in the management and use of cultural heritage in tourism development in Africa.Abstract
Sustainability as a construct is complex and, when applied to heritage tourism, integrates social, economic, environmental, and managerial elements. The implementation of policies to promote these aspects of sustainability can often be problematic in contexts where decision-making occurs in a hierarchical governance mode with multiple stakeholders. This is a common concern in heritage tourism management globally and is visible across the African continent, albeit in different forms dependent on local systems. The challenge of sustainability is complicated in the overlapping, yet often incompatible demands of heritage management practices and tourism development at heritage sites. Therefore, in order to provide an in-depth look at sustainability from a variety of heritage and geographic contexts, this chapter will provide brief analyses of sustainability issues of heritage tourism in three different contexts across the continent: Morocco, Ghana, and Tanzania. Drawing on key issues from these three case studies, this chapter will explore the sustainability challenges in the management and use of cultural heritage in tourism development in Africa
Navigating between Grand Challenges and Unusual Work Setbacks: How Do Public Managers Use Strategic Human Resources Management?
No full textAbstract
The current study seeks to identify how public bank managers use strategic human resources management to overcome unusual work setbacks. Study findings revealed three categories of outcomes of the usage of SHRM by public bank managers. The analysis revealed that SHRM usage by public bank managers is visible in form of workplace (securing new work arrangements, caring about mental health, acting as a liaison between bankers and the senior management), task-specific (adjusting job design to suit grand challenges, securing more discretionary power) and contextual (seeking greater stakeholder engagement, using experience and abilities to anticipate economic changes) manifestations.Abstract
The current study seeks to identify how public bank managers use strategic human resources management to overcome unusual work setbacks. Study findings revealed three categories of outcomes of the usage of SHRM by public bank managers. The analysis revealed that SHRM usage by public bank managers is visible in form of workplace (securing new work arrangements, caring about mental health, acting as a liaison between bankers and the senior management), task-specific (adjusting job design to suit grand challenges, securing more discretionary power) and contextual (seeking greater stakeholder engagement, using experience and abilities to anticipate economic changes) manifestations
Comparative evaluation of learning technologies using a randomized controlled trial: Virtual reality, augmented reality, online video platforms, and traditional classroom learning
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The COVID-19 pandemic has propelled the use of technology in education through platforms such as YouTube and immersive technologies (e.g., virtual reality (VR) and augmented reality (AR)). Despite their potential to improve equity, access, engagement, and cognitive achievement, studies comparing their impacts on learning outcomes are scarce. This study investigated the effects of educational technologies such as YouTube, AR, and VR on student learning outcomes compared to conventional classroom learning. It specifically focused on the lower cognitive levels in Bloom’s taxonomy, namely knowledge, understanding, and application. A sample of 139 higher education institution students was randomly assigned to one of four groups: classroom (control), YouTube, AR, and VR. Results from a two-way ANOVA and post-hoc pairwise comparison revealed that contrary to the existing literature, VR did not significantly outperform other learning environments. In addition, no significant differences were observed between YouTube and VR. Among the three cognitive levels of learning, learning in AR had the highest impact on the cognitive level of understanding compared to other learning environments. These findings imply that AR can serve as a mobile-friendly supplement to traditional methods, whereas VR might require further pedagogical enhancement to realize its full potential in learning. Future research should examine how familiarity with these technologies’ influences both immediate and long-term learning outcomes.Abstract
The COVID-19 pandemic has propelled the use of technology in education through platforms such as YouTube and immersive technologies (e.g., virtual reality (VR) and augmented reality (AR)). Despite their potential to improve equity, access, engagement, and cognitive achievement, studies comparing their impacts on learning outcomes are scarce. This study investigated the effects of educational technologies such as YouTube, AR, and VR on student learning outcomes compared to conventional classroom learning. It specifically focused on the lower cognitive levels in Bloom’s taxonomy, namely knowledge, understanding, and application. A sample of 139 higher education institution students was randomly assigned to one of four groups: classroom (control), YouTube, AR, and VR. Results from a two-way ANOVA and post-hoc pairwise comparison revealed that contrary to the existing literature, VR did not significantly outperform other learning environments. In addition, no significant differences were observed between YouTube and VR. Among the three cognitive levels of learning, learning in AR had the highest impact on the cognitive level of understanding compared to other learning environments. These findings imply that AR can serve as a mobile-friendly supplement to traditional methods, whereas VR might require further pedagogical enhancement to realize its full potential in learning. Future research should examine how familiarity with these technologies’ influences both immediate and long-term learning outcomes