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This paper analyses the conference papers published by double first‐class universities from mainland China between 2006 and 2019. The main findings are as follows: first, the number of conference papers from different double first‐class universities varied greatly, with the annual numbers of papers in the China Proceedings of Conferences Full‐text Database (CPCD) and in the Conference Proceedings Citation Index (CPCI) fluctuating during this period. Second, most of the top 10 disciplines of the papers in the CPCD and CPCI were in the natural sciences, with only two in the social sciences. The CPCD papers and CPCI papers had some overlap in their disciplinary distributions. Third, the CPCD and CPCI papers differed little in total number, with the number of CPCI papers being slightly higher than the number of CPCD papers. With the introduction of new regulations from the Ministry of Science and Technology (MST), there will likely be an increase in the number of Chinese‐language conference papers in the future. [ABSTRACT FROM AUTHOR]

The apps for drawing are present in our children's life. Nevertheless, little is known about the impact of mobile technology on the freehand drawing educational activity. There are few works which are contextualised within short periods of time, with teachers who are not theirs and, in some cases, outside the children's classroom. In this paper, we are focussed on the use of technology on freehand drawing activity. Thus, we have compared the graphics produced by 4- and 5-year-old children with paper&crayon in comparison with those with tablet-finger. Children made the drawings during a planned free-drawing activity, in their ordinary classrooms, with their teachers and during five sessions. Assessment of drawings has evidenced tablet feasibility for making graphics. Nevertheless, with the passing of time, quality of graphics (tablet-finger vs paper&crayons), are nearly matched, demonstrating the low impact level technology has on this activity. In addition, if drawings are analysed specifically according to ages, results have shown that both groups have to develop adaptation strategies of visual perceptual skills and fine motor skills for the touch screen in order to obtain the same quality in the drawings made on both support types. [ABSTRACT FROM AUTHOR]

Natural and synthetic esters are increasingly being chosen instead of mineral oil for environmental and fire safety reasons. However, their use in power transformers is limited due to insufficiently well-understood ageing processes affecting their properties and the properties of cellulosic materials impregnated with them. The research results presented in many scientific papers prove that the use of esters slows the ageing process of cellulosic materials. This article presents the results of research aimed at answering the question of whether the effect of slowing the ageing process will also occur in the case of insulation with very low initial moisture. The answer to this question will allow us to better understand the role of water in the ageing process of the transformer's insulation system. The thermal ageing process was carried out at a temperature of 150 °C in closed systems. The degree of cellulose polymerisation was taken as a measure of the degree of paper ageing. Great attention was paid to measuring the water content in both paper and electro-insulating liquids at various stages of their ageing. Furthermore, measurements of the properties of electro-insulating liquids were made, which are considered markers of ageing. The test results obtained indicate that in the case of a dry insulation system, corresponding to the initial moisture of the new units, the type of liquid used to impregnate the cellulosic material does not significantly affect its depolymerisation process. However, in the case of paper impregnated with natural esters, a lower dynamic of moisture increase in insulation was observed. [ABSTRACT FROM AUTHOR]

The properties of handmade paper used for mounting and conservation of paintings and calligraphy on paper is crucial to the quality and lifespan of such objects. Mounting papers from China, Korea, and Japan vary greatly in performance due to different papermaking methods and fibre materials. In this study, eight types of handmade paper widely used in China, Korea, and Japan were selected for comprehensive comparative analysis investigating their pH as well as optical, mechanical, and ageing properties. The study showed that traditional hanji, improved hanji, and thin Mino paper made of pure kozo fibres performed best in terms of mechanical properties. Among the additives mixed with kozo fibres, clam shell powder was identified as a substance that improves pH and stability of optical properties. Xuan paper Mianliao was found to be a suitable material for mounting hand scrolls and hanging scrolls due to its softness and ageing properties. Traditional hanji, improved hanji, and thin Mino paper are less flexible than xuan paper Mianliao and are considered more suitable for uses other than for mounting scrolls. This study will provide a reference for improving the quality of handmade paper and a theoretical basis for the selection of such papers for the conservation of paintings and calligraphy on paper. [ABSTRACT FROM AUTHOR]

Simple Summary: Blood clots are formed when blood vessels are injured. They help stop bleeding and heal wounds, but can also cause serious problems if they block blood flow or break off and travel to other organs. This study investigates how blood clots differ in people with cancer compared to healthy or non-cancerous individuals. This study found that cancer patients have higher levels of histones in their blood, which make their clots stiffer and resistant to lysis. Further, clots formed in cancer patients have higher viscoelastic properties, and hence are harder to break down. These findings suggest that cancer patients have abnormal clotting properties that may increase their risk of developing thrombosis, and evaluating these properties can be helpful in detecting cancer. Background: Blood viscoelasticity and plasma protein levels can play an important role in the diagnosis and prognosis of cancer. However, the role of histones and DNA in modulating blood clot properties remains to be investigated. This study investigates the differences in blood viscoelasticity and plasma protein levels among cancer patients, individuals with other diseases, and healthy individuals. Methods: Blood samples were collected from 101 participants, including 45 cancer patients, 22 healthy individuals, and 34 individuals with other diseases. Rheological properties of clots formed in vitro by reconstituted elements of fibrinogen or plasma were analyzed with an Anton Paar Rheometer, USA. Plasma protein levels of D-dimer, TPA, EPCR, fibrinogen, and histone H3 were measured through ELISA. Blood clots were formed with or without DNA and histones (H3) by adding thrombin and calcium to plasma samples, and were evaluated for viscoelasticity, permeability, and degradation. Results: Cancer patients show higher blood viscoelasticity and plasma D-dimer levels compared to healthy individuals and individuals with other diseases. Our in vitro analysis showed that the addition of histone to the plasma results in a significant decrease in viscoelasticity and mean fiber thickness of the clot formed thereafter. In parallel studies, using plasma from patients, DNA and histones were detected in fibrin clots and were associated with less degradation by t-PA. Moreover, our results show that the presence of DNA and histones not only increases clots' permeability, but also makes them more prone to degradation. Conclusions: Plasma histones and DNA affect the structure of the clot formed and induce defective fibrinolysis. Moreover, the increased viscoelastic properties of plasma from cancer patients can be used as potential biomarkers in cancer prognosis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate associations between digital urine color and paper urine color with other urine indices to assess hydration status. Methods: Twelve male subjects (mean ± standard deviation; age, 26 ± 8 years; body mass, 57.8 ± 5.3 kg; height, 177.5 ± 8.9 cm; VO2max, 57.8 ± 5.8 ml·kg−1·min−1) performed four exercise trials in the heat. Before and following exercise trials, subjects provide urine samples. Urine samples were measured using a digital urine color chart on a portable device screen. Urine samples were also assessed with urine specific gravity (USG), urine osmolality (UOsmo), and a validated paper urine color chart. Results: There were extremely large associations found between digital urine color and paper urine color (r = 0.926, p < 0.001). Correlation coefficients showing associations with USG and UOsmo were similar between digital urine color (USG, r = 0.695, p < 0.001; UOsmo, r = 0.555, p < 0.001) and paper urine color (USG, r = 0.713, p < 0.001; UOsmo, r = 0.570, p < 0.001). Bland–Altman analysis indicated that no proportional bias was observed between digital and paper urine colors (bias, − 0.148; SD of bias, 0.492; 95% LOA, − 1.11, 0.817; p = 0.094). Conclusions: Strong associations were found between digital and paper urine colors with no proportional bias. Furthermore, the degree of associations with USG and UOsmo was similar between digital and paper urine color. These results indicate that digital urine color is a useful tool to assess hydration status and this method could be used as an alternative method to using paper urine color. [ABSTRACT FROM AUTHOR]

Background: The Integrated Palliative Care Outcome Scale (IPOS) validly and reliably measures symptoms and concerns of those receiving palliative care. Aim: To determine the equivalence of the paper version with an electronic version of the IPOS (eIPOS). Design: Multicentre randomised crossover trial (NCT03879668) with a within-subject comparison of the two modes (washout period 30 min). Setting/Participants: Convenience sample of specialist inpatient and palliative home care patients aged over 18 years with cancer and non-cancer conditions was recruited. Scores were compared using intraclass correlation coefficients (ICC), Bland-Altman plots and via a mixed-effects analysis of variance. Results: Fifty patients were randomised to complete paper-electronic (n = 24) and electronic-paper (n = 26) IPOS with median age 69 years (range 24–95), 56% male, 16% non-cancer. The ICCs showed very high concordance for the total score (ICC 0.99, 95% CI 0.98–1.00), lowest ICCs being observed for symptoms 'Appetite loss' and 'Drowsiness' (ICC 0.95, 95% CI 0.92–0.97). Nine of seventeen items had ICCs above 0.98, as did all subscales. No statistically significant mode, order, age, and interaction effects were observed for IPOS total score and subscales, except for 'Communication' (Fmode = 5.9, p = 0.019). Fifty-eight percent preferred the electronic version. In the group 75+ years, 53% preferred the paper version. Only three entries in the free-text main problems differed between the versions. Conclusion: The very high equivalence in scores and free text between the IPOS and the eIPOS demonstrates that eIPOS is feasible and reliable in an older palliative population. [ABSTRACT FROM AUTHOR]

Since the end of the Cold War, the EU aims to advance to a relevant and autonomous actor in international politics—especially concerning security and defense politics. Scholars interested in whether the EU member states actually converge in their security and defense preferences often analyze strategy papers qualitatively, focusing on selected countries at specific points in time. In this article, we propose a dictionary approach for analyzing the development of security and defense preferences within the EU over the last three decades using quantitative text analysis. We make use of 163 strategy papers, published by all EU member states and the EU itself since 1994. The findings show that EU member states react similarly to international events, but do not converge substantially in their preferences. Furthermore, there is no substantial convergence to the position of the EU itself. We finally discuss usefulness and validity of quantitative text analysis in comparative research more broadly. [ABSTRACT FROM AUTHOR]

Objectives: Most researchers who study the effects of hormonal contraception on menstrual bleeding rely on self-reported data via paper diaries, for which completeness and timeliness have been shown to be poor. The purpose of this exploratory study was to compare the completeness and timeliness of bleeding data collected via paper diaries, text messages or smartphone application (a.k.a "app"). Methods: This was a sub-study of a double-blinded, placebo-controlled randomized trial comparing the effects of a non-steroidal anti-inflammatory drug, naproxen, with placebo when using a copper IUD. Participants tracked bleeding and symptoms over 112 days. Participants tracked bleeding daily using a paper diary as well as with either text messages or a smartphone app. Participants who used paper and the app were also able to record non-bleeding symptoms. Results: Twenty-five participants submitted diaries. Of these participants, 10 completed both paper and app diaries, 7 completed both paper and text messages, 4 completed the paper diary only, 4 completed the app only. Text messages had the most complete data (108 days), followed by the app (96 days) and paper diaries (84 days). The lag time between a bleeding event and the date recording that event was 0.10 days for text, 1.0 days for app, and 4.73 days for paper diaries. Participants using the app reported a median of 33 other symptoms over the study period compared to 7 for the paper diaries. Discussion: Our findings suggest texts demonstrated more complete and timely bleeding data than either paper diaries, or the app. Compared to paper diaries, the app delivered more complete, timely data, and also collected a large set of symptoms. [ABSTRACT FROM AUTHOR]

Objective: to analyse the artistic bindings of the eighteenth-century prints stored in the Historical-artistic Binding Database of the Royal Library, in order to locate the endpapers made with decorated papers, and to classify and describe them according to the proposals of the specialist literature. Methodology: The records from the database were retrieved using the "date" field, and the information is extracted from the "endpapers" and "notes" fields. The reproductions of the endpapers were analysed, identified and described following the classification model of decorated papers inspired by the works of Professor Carpallo Bautista, consisting of five techniques and their variants. Finally, a comparative analysis was carried out. Results: Among the 382 eighteenth-century prints with artistic bindings, ten were located and analysed that include endpapers decorated with xylographic plates, 135 with marbled or mottled papers (with designs corresponding to seven variants), four with paste-glued papers, three with dotted papers, 18 with gold and embossed papers, and four of other kinds such as silver or percaline paper. [ABSTRACT FROM AUTHOR]

The Dimensional Anhedonia Rating Scale (DARS) is a novel questionnaire to assess anhedonia of recent validation. In this work, we aim to study the equivalence between the traditional paper-and-pencil and the digital format of DARS. Sixty-nine patients filled the DARS in a paper-based and digital versions. We assessed differences between formats (Wilcoxon test), validity of the scales [Kappa and intraclass correlation coefficients (ICCs)], and reliability (Cronbach's alpha and Guttman's coefficient). We calculated the comparative fit index and the root mean squared error (RMSE) associated with the proposed one-factor structure. Total scores were higher for paper-based format. Significant differences between both formats were found for three items. The weighted Kappa coefficient was approximately 0.40 for most of the items. Internal consistency was greater than 0.94, and the ICC for the digital version was 0.95 and 0.94 for the paper-and-pencil version (F = 16.7, p < 0.001). Comparative Adjustment Index was 0.97 for the digital DARS and 0.97 for the paper-and-pencil DARS, and RMSE was 0.11 for the digital DARS and 0.10 for the paper-and-pencil DARS. We concluded that the digital DARS is consistent in many respects with the paper-and-pencil questionnaire, but equivalence with this format cannot be assumed without caution. [ABSTRACT FROM AUTHOR]

Is it really better to print everything, including software models, or is it better to view them on screen? With the ever increasing complexity of software systems, software modeling is integral to software development. Software models facilitate and automate many activities during development, such as code and test case generation. However, a core goal of software modeling is to communicate and collaborate. Software models are presented to team members on many mediums and two of the most common mediums are paper and computer screens. Reading from paper or screen is ostensibly considered to have the same effect on model comprehension. However, the literature on text reading has indicated that the reading experiences can be very different which in turn effects various metrics related to reader performance. This paper reports on an experiment that was conducted to investigate the effect of reading software models on paper in comparison with reading them on a computer screen with respect to cognitive effectiveness. Cognitive effectiveness here refers to the ease by which a model reader can read a model. The experiment used a total of 74 software engineering students as subjects. The experiment results provide strong evidence that displaying diagrams on a screen allows subjects to read them quicker. There is also evidence that indicates that on screen viewing induces fewer reading errors. [ABSTRACT FROM AUTHOR]

Objective: To assess differences between traditional paper bag ordering and online ordering from primary school canteens in terms of menu, usage and lunch order characteristics.Design: A cross-sectional study.Setting: New South Wales (NSW) primary schools that offered both paper bag and online canteen ordering.Participants: Students (aged 5-12 years) with a lunch order on the day of the observation.Results: Across the six school canteens, 59-90 % of all available items were listed on both the online and paper menus, with no significant differences in the nutritional quality ('Everyday'/'Occasional') or nutritional content (kJ/saturated fat/sugar/sodium) of menu items. In total, 387 student lunch orders were placed, containing 776 menu items. Most orders (68 %) were placed online. There were no significant differences between order modality in the quantity of items ordered or the cost of orders, or the nutritional quality of orders based on the classification system of the NSW Healthy School Canteen Strategy ('Everyday'/'Occasional'). However, nutritional analysis revealed that paper bag orders contained 222 fewer kJ than online orders (P = 0·001), 0·65 g less saturated fat (P = 0·04) and 4·7 g less sugar (P < 0·001).Conclusions: Online canteens are commonly used to order canteen lunches for primary school children. This is the first study to investigate differences between traditional paper bag ordering and online ordering in this setting. Given the rapid increase in the use of online ordering systems in schools and other food settings and their potential to deliver public health nutrition interventions, additional research is warranted to further investigate differences in ordering modalities. [ABSTRACT FROM AUTHOR]

Bamboo has being used as alternative raw material for construction, reinforcing fibers, paper production, among other applications. Although its recognized potentials as raw material, there are doubts about its environmental performance compared to traditional wood-based products, including paper production, which hinders bamboo-based paper plants in large scales. This study aims to assess the environmental performance of producing office paper from bamboo. Emergy synthesis (with 'm') and global warming potential indicators are calculated and compared with the traditional eucalyptus paper-based production. Results highlights the importance in including the renewability fractions of each input resources into emergy calculations for production systems with high human-labor intensity such as the bamboo agricultural production. Office paper produced from bamboo has similar renewability (28%), moderate environmental load (3.23 vs. 2.49), and emergy unsustainability (0.34 vs. 0.60) compared to paper produced from eucalyptus, but bamboo showed lower performance for global efficiency (568 vs. 442 sej/ton paper), emergy yield (1.09 vs. 1.49), and emergy investment (10.79 vs. 2.05). Focusing on global warming potential, office paper produced from bamboo releases 98 kgCO 2 eq. /ton paper compared to 56–267 kgCO 2 eq. /ton paper for eucalyptus. Notwithstanding, bamboo-based office paper demands four times more land area of agricultural production than eucalyptus, but it has a positive social aspect by requiring higher amount of direct human labor. This work shows the advantages of using eucalyptus rather than bamboo in producing office paper from an emergy and land demand perspectives, while global warming can still be considered inconclusive. Future efforts should consider a quantitative and qualitative analysis of human labor availability in both systems, as well an economic analysis to support discussions towards more sustainable office paper production from different raw materials. • Environmental load of bamboo and eucalyptus for office paper production are compared. • Bamboo has lower emergy performance than eucalyptus. • Including the renewability fraction of labor and services better reflects emergy results. • Bamboo paper emits 98kgCO2eq/ton, eucalyptus paper emits 56–267kgCO2eq/ton. • Bamboo paper needs 4x land compared to eucalyptus and requires more human labor. [ABSTRACT FROM AUTHOR]

Scientific papers are essential manifestations of evolving scientific knowledge, and arguments are an important avenue to communicate research results. This study aims to understand how the argumentation process is represented in scientific papers, which is important for knowledge representation, discovery, and retrieval. First, based on fundamental argument theory and scientific discourse ontologies, a coding schema, including 17 categories was constructed. Thereafter, annotation experiments were conducted with 40 scientific articles randomly selected from two different research areas (library and information science and biomedical sciences). Statistical analysis and the sequential pattern mining method were then employed; the ratio of different argumentation units and evidence types were calculated, the argumentation semantics of figures and tables analyzed, and the argumentation structures extracted. A correlation analysis between argumentation and rhetorical structures was also performed to further reveal how argumentation was represented within scientific discourses. The results indicated a difference in the proportion of the argumentation units in the two types of scientific papers, as well as a similar linear construction with differences in the specific argument structures of each knowledge domain and a clear correlation between argumentation and rhetorical structure. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate the usefulness of a novel acoustic uroflowmetry- (UFM-) based mobile application (app) voiding diary (VD) focusing on the (1) compliance and (2) correlation with a conventional paper-based VD. Materials and Methods. A total of 78 patients were included between December 2019 and June 2020, and a subsequent review of all data was performed. The analyzed data were as follows: (1) survey of convenience/satisfaction/preference comparing the two methods, (2) compliance regarding the completeness of both methods, and (3) correlation of each metric (24-hour urine volume, nocturnal urine volume, nocturnal polyuria index, total number of voids, number of daytime voids, number of nocturnal voids, and maximal bladder capacity) between the two methods. Results. The survey results of convenience, satisfaction, and preference were as follows. With regard to convenience and satisfaction area, higher scores are reported in the mobile app VD (mean ± standard deviation (SD); convenience: 7.47 ± 2.19 [app] vs. 4.20 ± 2.49 [paper]; satisfaction: 7.36 ± 2.17 [app] vs. 5.07 ± 2.65 [paper]). The median score of the overall preference for using the mobile app instead of the paper-based VD was 9 out of 10 (mean ± SD 7.82 ± 2.68). We also found a good correlation between the two methods for nocturnal urine volume (r = 0.55 , p = 0.04), nocturnal polyuria index (r = 0.66 , p = 0.23), total number of voids (r = 0.9 , p = 0.02), number of nocturnal voids (r = 0.83 , p = 0.02), and maximal bladder capacity (r = 0.89 , p = 0.04). Conclusion. The acoustic UFM-based mobile app VD demonstrated favorable findings compared to the conventional paper-based VD. [ABSTRACT FROM AUTHOR]

Environmental and economic concerns are driving tissue paper manufacturers to improve understanding of the relationships between fibres, the networks they form, the forming process, and the final tissue paper properties. This work investigated how pulp fractionation, refining, or addition of microfibrillated cellulose (MFC) affect the compromise between absorbency and strength of 33 ± 2 g/m² model papers made of bleached eucalyptus kraft pulp. The results showed that the compromise of properties was better when fibres were refined than when MFC was added. The absorbency capacity of 2%wt MFC-paper was almost 20% lower than the capacity of the refined paper at the same dry strength. The calculated additional storage capacity due to water-induced deformations of the fibre network was 40% lower in the same range of bulk. By forming a high viscosity gel at inter-fibre contacts, MFC could limit the occurrence of major fibre and network deformation mechanisms when water was imbibing the paper. [ABSTRACT FROM AUTHOR]

The gold standard for measuring anhedonia is the Snaith-Hamilton Pleasure Scale (SHAPS). To date, there are no validated electronic versions of this questionnaire. We aim to study the equivalence between the traditional paper-and-pencil format and a digital version of the SHAPS. A group of 67 patients completed both SHAPS formats, and differences between formats were assessed. McNemar's test showed no significant differences between the two systems. The Kappa coefficient was over 40% for most items, and reliability was above 0.8, showing good to excellent levels of internal consistency. Thus, we have demonstrated a close equivalence between paper-and-pencil and electronic SHAPS. [ABSTRACT FROM AUTHOR]

Alkyl ketene dimer (AKD) and rosin sizing are used in papermaking to decrease paper's tendency to absorb liquid water. Earlier information regarding the effects of internal sizing on paper dry strength is not consistent. In the present laboratory study, AKD sizing of handsheets made from Nordic bleached softwood pulp (NBSK), and rosin sizing of handsheets made from Nordic hardwood chemi-thermomechanical pulp (CTMP) were done via an internal sizing method, and by immersing handsheets in aqueous sizing agent dispersion. In the study, AKD sizing had no significant effect on the dry strength of NBSK handsheets. The result corresponds to practical experiences of papermakers. However, both AKD sizing methods resulted in a substantial and long-lasting increase of handsheet wet-strength. Unlike internal AKD sizing of NBSK handsheets, rosin internal sizing of CTMP handsheets resulted in decreased handsheet dry strength. The decrease indicates that, under the conditions present during the experiment, rosin sizing agents interfered with interfiber hydrogen bonding of CTMP fibers. Given that, in practice, no such undesired effects have been commonly linked to rosin sizing, the observed effect may be specific to sheet-making conditions. However, the effect of rosin sizing on strength properties and their variation cannot be ruled out completely. [ABSTRACT FROM AUTHOR]

A new coating method was developed, based on cellulose regenerated from an N-methylmorpholine N-oxide (NMMO) solution applied to paper. In particular, the purpose of this study was to compare the effectiveness of the "deep coating" method using cellulose regenerated from NMMO solution and the classic pulp refining process as methods to improve paper mechanical properties and overall quality. The "deep coating" name comes from the fact that the coating process is combined with subsequent heating of the coating before its final solidification. As a result of this operation, deep penetration of the cellulosic solution into the paper structure occurs. This increases the contact surface of the solution with the cellulosic fibers, which increases the strength properties of the paper structure. It was found that the cellulosic coating increased the apparent density of the paper, the tensile strength, the elongation, the resistance to bursting, and the double fold number. However, the coating also decreased the air permeability and the tear resistance of the paper samples. Despite some technological difficulties, this method could be an attractive solution in the case of a need for additional functionalization of a paper structure. [ABSTRACT FROM AUTHOR]

• The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. • Improvements on severity of symptoms in both groups suggest that the self-care program using a mobile app or a paper book may be beneficial in individuals with fibromyalgia. • The Sleep Strategies was the most used function of the ProFibro app, followed by the Exercise Program, and the diary for the practice of gratitude. The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale – Revised. No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia. [ABSTRACT FROM AUTHOR]

Users' experiences in mental health assessment are multifaceted, including their emotional experiences. Yet, studies of mobile apps for psychiatric assessment have centered on diagnostic accuracy and perceived usability, with little consideration of the impact of user emotional experiences. In this study, we focused on users' perceived usability and emotions and compared the user experience of a paper-and-pencil and an app-based collection of mental health screening questionnaires: EarlyDetect. The System Usability Scale (SUS) and modality-directed emotion questionnaires were administered using paper-and-pencil or iPad. Modality was assigned pseudo-randomly on patients' first visit at a referral-based mental health clinic. We found that patients assigned to the iPad app reported a significantly higher SUS score than patients assigned to paper-and-pencil, qualified by a modality-by-gender interaction where modality effects were significant for men but not for women. Moreover, enjoyment was positively linked to perceived usability, whereas boredom, frustration, and anxiety were negatively linked to usability. Our findings illustrate the added value of studying user experience applied to psychiatric assessments, where both emotions and gender-specific user experience should be taken into consideration. We further discuss the implications for psychiatric assessments via app versus traditional data collection. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effects that reading on screens (using digital devices with different screen sizes) and on paper have on reading time and comprehension. The study group was comprised of126 secondary students from a private school. To ensure balance, the participants were assigned into test groups, formed according to the size of the reading device, based on class levels, gender, and average school grade. In the data collection process, a narrative text was transferred to both print and electronic media. Access to the text was provided on paper and three digital devices. There were no time limitations. After reading, participants were given comprehension tests that consisted of twenty multiple-choice questions. Female participants' on-screen comprehension scores were found to be relatively higher compared to their paper comprehension scores. They also acquired better scores as the screen size increased. Conversely, male participants had higher comprehension scores on tablets and smart phones. Participants who read the text on smart phones and tablets completed the tasks in less time compared to other groups. However, the effects of reading modality on comprehension and reading time were not found to be statistically significant in either the male or female groups. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to investigate the immediate and delayed effects of kinesiotape (KT) on postural control and patient-reported outcome measures under challenging conditions in individuals with anterior cruciate ligament reconstructions. Methods: Thirty-two anterior cruciate ligament-reconstructed patients for whom 6 months had passed since their operation were randomly assigned to either the KT (n = 16, aged 21.8 [5.5] y) or the placebo KT (n = 16, aged 24.0 [5.1] y) groups. Initially, both groups stood barefoot on a force platform while performing postural tasks in 4 randomized conditions (eyes open, eyes closed, cognitive task, and foam). Before the experiment, patients would bring the 4 conditions, which were written on folded papers, one by one, and in this way, the order of conditions for the examiners was determined. The patients' evaluations were conducted immediately and 48 hours after KT application. Postural control measures, with area and displacement of the center of pressure (CoP) in anterior--posterior and medial--lateral directions, and mean total velocity displacement of CoP (MVELO CoP) served as dependent variables. In addition, the International Knee Documentation Committee score was measured pretreatment and 48 hours posttreatment. Results: Significant group-by-time interactions were observed for displacement of COP in medial--lateral direction (P = .002) and MVELO CoP (P = .034). MVELO CoP significantly decreased (mean difference = 0.60, P = .009) immediately after KT application compared with preapplication measures. In the placebo group, a statistically significant decrease in MVELO CoP (mean difference = 0.869, P = .001) was observed at 48 hours post-KT compared with preapplication values. International Knee Documentation Committee scores significantly improved at 48 hours post-KT application in both groups (P < .05). Conclusions: Though observed at different time points, both KT (immediately after the intervention) and placebo KT (48 h after the intervention) were found to improve postural control measures. It appears that the changes in postural control may be more related to proprioceptive enhancement due to KT rather than the specific KT pattern. [ABSTRACT FROM AUTHOR]

Graphs drawn on rastered paper and a monumental steel sculpture display how visual artists Paul Klee and Henrik Neugeboren conceived of Johann Sebastian Bach's polyphonic style in 1920s Germany. Focusing on the representational decisions behind these artistic translations of music, this article explores the ways in which such artifacts manifest a specific analytical lens. It highlights congruencies with and deviations from the theoretical framework of "linear counterpoint," as epitomized in Ernst Kurth's influential treatise from 1917, and thereby positions the artworks within the controversial reception history of Bach's music and atendant theoretical frameworks in the early twentieth century. More generally, the article proposes that graphical and sculptural renderings of music can offer the opportunity to investigate music theory's intangible methods and conceptual metaphors through different sensory experiences. [ABSTRACT FROM AUTHOR]

Introduction: Motor skills and motor abilities in children are often assessed using pen-paper tests such as tracing and dotting. Therapists also require additional information regarding the quality of movement. Digitisation of these tests may contribute to the accuracy and reliability of the data obtained and its evaluation. But are paper and digital tabletbased versions comparable? Methodology: In this comparative study, data was collected by means of a paper and pen version using the Handednessprofile, a standardised assessment of hand preference and skill. The same assessment was digitized by means of a tablet with a tablet pen. The two data sets were compared using 20 clearly left- or right-handed children aged 4 to 10 years. Eight of the children had motor deficiencies. In addition, the test instructors and the children were asked about perceived deficiencies between the two versions. Results: Although the digitized version achieved significantly more, and thus potentially more accurate data, the non-dominant hand unexpectedly performed better in a few younger and/or children with motor problems. This was not the case with the paper version. Conclusion: The results indicate that the physical characteristics of a tablet appear to distort the data in some younger children and those with motor deficiencies. Motor-related compensatory patterns may not work as well for these children on a tablet, compared to paper. The results indicate that the digitization of a tracing test using a tablet may not be suitable for this target group. Further studies are needed to support these results. [ABSTRACT FROM AUTHOR]

Sewage fine sieved fraction (FSF) is a heterogeneous substrate consisting of mainly toilet paper fibers sequestered from municipal raw sewage by a fine screen. In earlier studies, a maximum biodegradation of 62% and 57% of the sewage FSF was found under thermophilic (55 °C) and mesophilic (35 °C) conditions, respectively. In order to research this limited biodegradability of sewage FSF, this study investigates the biodegradation of different types of cellulosic fibers-based hygiene papers including virgin fibers based toilet paper (VTP), recycled fiber based toilet paper (RTP), virgin pulp for paper production (VPPP) as a raw material, as well as microcrystalline cellulose (MCC) as a kind of fiberless reference material. The anaerobic biodegradation or digestibility tests were conducted under thermophilic and mesophilic conditions. Results of the experiments showed different biomethane potential (BMP) values for each tested cellulose fiber-based substrate, which might be associated with the physical characteristics of the fibers, type of pulping, presence of lignin encrusted fibers, and/or the presence of additive chemicals and refractory compounds. Higher hydrolysis rates (K h ), higher specific methane production rates (SMPR) and shorter required incubation times to achieve 90% of the BMP (t 90% CH 4 ), were achieved under thermophilic conditions for all examined substrates compared to the mesophilic ones. Furthermore, the biodegradability of all employed cellulose fiber-based substrates was in the same range, 38–45%, under both conditions and less than the observed FSF biodegradability, i.e. 57–62%. MCC achieved the highest BMP and biodegradability, 86–91%, among all cellulosic substrates. [ABSTRACT FROM AUTHOR]

A combination of experimental techniques was employed to test primary fragmentation and char particle attrition by abrasion during fluidized bed (FB) combustion of raw paper sludge (Raw-PS), hydrothermally treated paper sludge (HTT-PS), and a subbituminous coal (Sub-C), for comparison. The hydrothermal treatment (HTT) was conducted by a pilot-scale reactor at 197 °C (1.9 MPa) for 30 min. The results showed that all three samples extensively underwent primary fragmentation. Char attrition tests under inert conditions showed that Sub-C intensely experienced particle rounding off at the beginning, but after that it became very strong against mechanical abrasive attrition, followed by HTT-PS and Raw-PS, respectively. The oxidative char attrition tests showed that Sub-C exhibited an initial low amount of carbon elutriation rate followed by an attrition enhancement effect at later stages of burn-off, whereas for the Raw-PS and HTT-PS attrition was always lower than under inert conditions due to extensive postcombustion of fines. HTT-PS always produced a lower amount of elutriated carbon than Raw-PS and this indicates better combustion performance as well as lower unburned carbon emission. Finally, the Primary Ash Particle Size Distribution (PAPSD) of the three fuels was determined, showing that the paper sludge would contribute much more than coal to the ash bed inventory in a full-scale FB combustor. [ABSTRACT FROM AUTHOR]

Over the last few decades, researchers have been investigating the uses of student-generated questions (SGQs) in multifarious areas. In understanding the potential benefits of SGQ, this action research is designed to examine a group of students' perceptions after experiencing interventions of web-based student generated questions (e-SGQs) and paper-based student-generated questions (PB-SGQs) in the classroom. For this research, ten students were recruited to construct test items for their own mid-term preparation. The student generated items were split fairly evenly with about half of the items being e-SGQs and the other half being PB-SGQs. The two modes were compared through the analyses of a survey, a group interview, and individual in-depth interviews. The data analyses reveal that the participants perceived their experiences of generating questions to be very helpful for understanding their class content. Although many of them clearly recognized the advantages of e-SGQs as an educational tool, most of the participants chose PB-SGQ over e-SGQ. This result can be explained by the survey and interview data which illustrate that the respondents preferred the test taking strategies that they were used to such as marking, underlining, and skimming through the test items on a paper. [ABSTRACT FROM AUTHOR]

Background: Paper patching, a method that places cigarette paper over the most mobile quadrants of the tympanic membrane, is one of the treatment options for patulous eustachian tube (PET). Aims/Objectives: The objective of this study was to compare the outcomes of two different treatment strategies for PET. Material and methods: Twenty-three patients underwent paper patching of the tympanic membrane and 16 patients were treated with nasal saline irrigation with or without ipratropium bromide nasal spray. Medical records were reviewed for resolution of PET symptoms as categorical variables (complete remission, partial remission, or no improvement) with a minimum follow-up of 3 months. Results: Immediately after undergoing paper patching, 20 of the 23 patients (87.0%) reported complete remission (CR). The percentage of CR after paper patching was 82.6% at 1 month and 65.2% at 3 months. A greater percentage of patients reported CR of aural symptoms in the paper patching group than in the nasal irrigation group at both 1 and 3 months after treatment (p < .05). Conclusions and significance: Repetitive paper patching resolves aural discomfort in most PET patients for at least 3 months and can be considered as a first-line treatment option for PET in the outpatient setting. [ABSTRACT FROM AUTHOR]

Background Non-cellulose dried matrix spotting (DMS) cards are an alternative to filter paper (FP) for bloodspots. We compared the interpatient distributions of bloodspot areas between DMS and FP for a fixed volume of application of whole blood, and examined correlations of areas with hematocrit. Methods EDTA-whole blood adult patient samples ( n = 49; 25 males, 24 females) were utilized after routine measurement of hemoglobin and hematocrit. Replicate (4 ×) bloodspots were produced by bolus drop application of 50 μL whole blood via a fixed-volume pipettor to either FP or DMS. Dried bloodspot areas were determined by image analysis. Results Hematocrits (HCT) were normally distributed (HCT = 30.9 ± 5.3%). For both FP and DMS, bloodspot areas ( a , cm 2 ) across patients were normally distributed: for FP, a = 1.11 ± 0.056 cm 2 (± 5.0%); for DMS, a = 0.378 ± 0.037 cm 2 (± 9.9%). Relative bloodspot area differences across the population range were > 20% for both DMS and FP. Correlation of bloodspot areas to hematocrit was negative for FP ( r = − 0.80) but positive for DMS ( r = + 0.78). Conclusions Interpatient variation in blood volume per area is a preanalytical variable for both DMS and FP bloodspots. Hematocrit is but one interpatient variable, as correlations of fixed-volume bloodspot areas with hematocrit across patients were substantially inexact ( r 2 < 0.65). [ABSTRACT FROM AUTHOR]

The genetics and evolution of complex traits, including quantitative traits and disease, have been hotly debated ever since Darwin. A century ago, a paper from R.A. Fisher reconciled Mendelian and biometrical genetics in a landmark contribution that is now accepted as the main foundation stone of the field of quantitative genetics. Here, we give our perspective on Fisher's 1918 paper in the context of how and why it is relevant in today's genome era. We mostly focus on human trait variation, in part because Fisher did so too, but the conclusions are general and extend to other natural populations, and to populations undergoing artificial selection. [ABSTRACT FROM AUTHOR]

This paper introduces a novel platform that integrates three preconditioning matrices based on conservative variables: the Turkel, Choi–Merkle and Onur matrices. The platform aims to compare these matrices in terms of accuracy and robustness by investigating their performance in solving three distinct and challenging high-gradient laminar flow problems: (i) Bi-Plane NACA0012 airfoil, (ii) lid-driven flow in a square cavity and (iii) flow in a planar T-junction. These problems serve as new and challenging test cases to accurately determine the abilities of the preconditioning matrices. The preconditioning matrices are applied to evaluate the numerical solutions, and their performance in complex flow fields is assessed in terms of accuracy and efficiency. By solving these flow problems, the effectiveness of the preconditioning matrices is thoroughly analyzed. By integrating these preconditioning matrices into a single platform, this paper significantly contributes to the field. The approach enables a direct and meaningful comparison of the performance of the Turkel, Choi–Merkle and Onur matrices in solving these new and challenging laminar flow problems. While all three matrices demonstrate comparable accuracy in predicting flow characteristics like pressure coefficients, Turkel's method shows superior convergence acceleration across the almost test cases due to alpha parameter and modifications of the momentum equations. In the external flow case, Turkel converges 22–53% faster than the other matrices by adjusting momentum terms with an alpha parameter. For the internal lid-driven cavity case, Turkel again accelerates convergence up to 38% over Choi–Merkle as Reynolds and Mach numbers increase. However, Onur's method stalls at high Reynolds/Mach numbers. At low values of Reynolds and Mach numbers, Onur reduces computational cost by 17%. Finally, for the T-junction case, Turkel and Choi–Merkle perform almost identically, decreasing CPU time by 55% vs Onur, which lacks convergence robustness. While the preconditioning matrices have similar accuracy, Turkel offers the best convergence improvement by accounting for momentum effects. Onur works well at low Reynolds/Mach numbers but shows limitations at higher values. The selection of the optimal preconditioning matrix should be based on whether momentum or viscosity dominates in the flow field, as well as the intensity of the viscosity gradient rate. [ABSTRACT FROM AUTHOR]

Recent technological advancements are transforming the architecture, engineering and construction (AEC) industry, focusing on digitalization and automation opportunities as drivers for improvement. In a realm as complex as building permitting, the drive for automation should be anchored in a comprehensive understanding of the process it seeks to transform. Furthermore, analyzing the process from a global perspective is essential for identifying opportunities for improvement. This article addresses the need for a systematic and robust approach to evaluate and compare building permit processes globally. Traditional approaches for process comparisons fail to capture the intricacies of a building permit process. Hence, in this paper, the authors propose and introduce the Process Analysis and Comparative Evaluation methodology, PACE-BP, which was tailored for building permit processes. The proposed method relies on a previously developed framework for process mapping which provides a comparable data set of building permit process maps in different countries. The comparative evaluation is then performed by assessing the maps based on predefined indicators, which are used to compile a representative vector for each process. The computational method for compiling the vectors and calculating the similarity measures between pairs of processes is described in detail. The application of PACE-BP for analyzing and comparing building permit processes in Germany, the US, Israel, and Italy is demonstrated in this paper. Our findings challenge the pursuit of a universal "best practice," emphasizing the need to balance priorities and stakeholder's objectives. The PACE-BP method is a powerful tool for policymakers and stakeholders, providing meaningful insight into existing processes and pinpointing drawbacks and limitations in current practices, while revealing opportunities for improvement. [ABSTRACT FROM AUTHOR]

Autonomous vehicles are rapidly advancing and have the potential to revolutionize transportation in the future. This paper primarily focuses on vehicle motion trajectory planning algorithms, examining the methods for estimating collision risks based on sensed environmental information and approaches for achieving user-aligned trajectory planning results. It investigates the different categories of planning algorithms within the scope of local trajectory planning applications for autonomous driving, discussing and differentiating their properties in detail through a review of the recent studies. The risk estimation methods are classified and introduced based on their descriptions of the sensed collision risks in traffic environments and their integration with trajectory planning algorithms. Additionally, various user experience-oriented methods, which utilize human data to enhance the trajectory planning performance and generate human-like trajectories, are explored. The paper provides comparative analyses of these algorithms and methods from different perspectives, revealing the interconnections between these topics. The current challenges and future prospects of the trajectory planning tasks in autonomous vehicles are also discussed. [ABSTRACT FROM AUTHOR]

Background: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. Aim: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. Methods: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single‐use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. Results: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). Conclusions: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less. Summary statement: What is already known about this topic? Traditional and dry bed baths are personal care procedures that are frequently carried out by nurses with patients in intensive care units.Bed baths may affect the hemodynamic parameters of patients in intensive care units, but few studies have evaluated their effects.Determination of the hemodynamic parameters of patients during bed baths, the duration of bathing and the cost of consumable bathing materials may help nurses to achieve patients' body hygiene in a more reliable way and to decide on and adopt measures to minimize risks. What this paper adds? This paper contributes to the performance of personal hygiene. It is necessary to closely monitor the hemodynamic parameters of intensive care patients when they are being given bed baths.This study has direct effects in awakening nurses to the potential risk of bed baths causing a change in hemodynamic parameters in intensive care patients and in taking measures to reduce these risks to a minimum. Also, giving dry bed baths, which are superior in taking less time and having lower costs, provides advantages to nurses in terms of work load, physical difficulties and finance. The implications of this paper: This study emphasizes the positive impacts of dry bed baths carried out by nurses for patients in intensive care units.The dry bed bath can be accepted as enhancing patient safety by being easy to perform and by shortening the time when the patient is exposed to environmental risks. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe and evaluate how nurses caring for COVID and non‐COVID patients assess changes in their work and in nursing activities during the two waves of the COVID‐19 pandemic. Methods: Two cross‐sectional surveys were conducted for Estonian nurses working during the first and second waves of the COVID‐19 pandemic, using The impact of COVID‐19 emergency on nursing care questionnaire. Based on convenience sampling, the data were collected among the members of professional organizations, unions and associations. Responses from the first (n = 162) and second wave (n = 284) were analysed using descriptive statistics, Fisher's exact test and McNemar's test. Results: The COVID‐19 pandemic changed the working context during both waves for nurses caring for COVID and non‐COVID patients. Changes were considered to a greater extent during the second wave, when Estonia was severely affected, and by nurses caring for COVID patients. During the second wave, the number and complexity of patients increased, and nurses caring for COVID patients performed fundamental care, nursing techniques and symptom control significantly more frequently compared to nurses caring for non‐COVID patients. Conclusion: Taking care of COVID patients is demanding, requiring nurses to perform more direct patient care. However, the pandemic also increased the frequency of activities not related with direct patient care. Summary statement: What is already known about this topic? The COVID‐19 pandemic has influenced the context of care and all dimensions of nurses' work.Despite increasing research on the impact of the COVID‐19 pandemic on nursing care, little attention has been given to differences between caring for COVID and non‐COVID patients during the different waves of the COVID‐19 pandemic. What this paper adds? Nursing care for COVID patients requires from nurses more direct patient care through fundamental care activities, nursing techniques and symptom control compared to non‐COVID patients.The impact of the COVID‐19 pandemic on nurses' work reflects the severity and progress of different waves of the pandemic, which needs to be considered in preparing for future pandemics.Nursing care during a pandemic may also lead to an extensive workload due to tasks not related to direct patient care as nurses contribute to the management of the pandemic on all levels of health care. The implications of this paper: The COVID‐19 pandemic has had a significant impact on nursing, where the mitigation of long‐term effects of the pandemic is still ongoing, and thus, knowledge about the details of the resulting changes is required.Study findings enable us to mitigate the impact of the pandemic on nurses and to highlight aspects that need to be taken into account when preparing for future pandemics. [ABSTRACT FROM AUTHOR]

Aims: This study intended to explore the workplace bullying, self‐efficacy and emotional distress of the nursing staff and determine the predictors of nursing staff's emotional distress. Methods: Cross‐sectional and correlation designs were used, collecting data including socio‐demographic data, workplace bullying, self‐efficacy and emotional distress scales. Results: Results showed that the frequency of poor sleep quality in the recent 2 weeks, working in the intensive care centre or emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress in nursing staff. Conclusion: Nursing supervisors are advised to design suitable shift schemes to allow adequate time for nurses to maintain proper rest and develop a safety notification system to give bullied victims the assurance of safety. The design and implementation of the programs are encouraged to improve self‐efficacy among nurses by strengthening the training of social skills, improving employees' communication skills and their relationships with other employees. Summary statement: What is already known about this topic? Nursing workplace bullying can lead to health problems and patient safety problems.What this paper adds? This study provides information about workplace bullying, self‐efficacy and emotional distress in nurses.Poor sleep quality in the recent 2 weeks, working in the intensive care centre or the emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress among nurses.The implications of this paper for policy/practice/research/education Hospital managers should arrange education programs to improve nurses' self‐efficacy to avoid emotional distress.Suitable shift schemes should be designed for the nurses to maintain proper rest, and a safety notification system should be provided to the bullied victims for the assurance of safety. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this systematic review was to determine the levels and influencing factors of mental workload in intensive care unit nurses. Background: Intensive care unit nurses have a high mental workload level. To our knowledge, no meta‐analytic research investigating the levels of mental workload in intensive care unit nurses and related factors has yet been performed. Design: This article is a systematic review and meta‐analysis. Methods: Eleven electronic databases were searched from the database setup dates until 31 December 2022. The research team independently conducted study selection, quality assessments, data extractions and analysis of all included studies. The PRISMA guideline was used to guide reportage of the systematic review and meta‐analysis. Results: Seventeen studies were included. In these studies, the pooled mean score of mental workload was 68.07 (95%CI:64.39–71.75). Furthermore, subgroup analyses indicated that intensive care unit nurses' mental workload differed significantly by countries, sample size and publication year. The mental workload influential factors considered were demographic, work‐related and psychological factors. Conclusion: Hospital administrators should develop interventions to reduce mental workload to enhance the mental health of intensive care unit nurses and nursing care quality. Hospital managers should pay attention to the mental health of nurses and guide them to correctly relieve occupational stress and reduce mental workload. Summary statement: What is already known about this topic? The prevalence of mental workload among ICU nurses is higher than in other departments in hospital.There are no published systematic review and meta‐analysis studies that synthesize the current evidence. What this paper adds? This review estimated overall mental workload scores, which indicated that ICU nurses have a high level of mental workload.The levels of mental workload among ICU nurses may be influenced by multiple factors, classified for this review in terms of demographic, work‐related and psychological factors. The implications of this paper: Demographic, work‐related and psychological variables should be taken into account in developing comprehensive interventions to reduce nurses' mental workload.Similar meta‐analyses in the future can evaluate other healthcare workers and those in other regions to determine in what departments the level of mental workload is high. [ABSTRACT FROM AUTHOR]

Background: In example‐based learning, examples are often combined with generative activities, such as comparative self‐explanations of example cases. Comparisons induce heavy demands on working memory, especially in complex domains. Hence, only stronger learners may benefit from comparative self‐explanations. While static text‐based examples can be compared easily, this is challenging for transient video‐based modelling examples used in complex domains because simultaneous processing of two videos is not feasible. Objectives: To allow for such comparisons, we combined video‐based modelling examples with static representations (i.e., summarizing tables) of the observed optimal and a suboptimal solution of the problem‐solving process. A comparative self‐explanation prompt asked learners to compare the different solution approaches. Our study investigated the impact of video‐based modelling examples versus independent problem‐solving on cognitive load and problem‐solving skill development. Moreover, we investigated the effects of comparative versus sequential self‐explanation prompts, depending on learners' prior knowledge. Methods: In an experiment, 118 automotive apprentices learned a car malfunction diagnosis strategy. Apprentices were divided into three groups: (1) modelling examples with comparative self‐explanation prompts, (2) modelling examples with sequential prompts, and (3) no examples or prompts. Diagnostic knowledge and skills were assessed before and after the intervention. Cognitive load was measured retrospectively. Results and conclusions: Despite no observed effects on cognitive load, modelling examples enhanced diagnostic knowledge and diagnostic skills with scaffolds, though not independent diagnostic skills without scaffolds. The need for more practice opportunities to foster independent diagnostic skills is assumed. Additionally, comparative prompts seem promising for learners with higher prior knowledge. Takeaways: Video‐based modelling examples were more beneficial for learning than practising to apply the diagnostic strategy. Static representations allow for comparisons of video examples and comparative prompts are promising for learners with higher prior knowledge (cf. expertise‐reversal effect). Further research, especially on the effects on cognitive load, is necessary. Lay Description: What is already known about the topic?: Text and video examples that model how to solve a problem are widely used in education.Text examples often include self‐explanation prompts that ask learners to compare several examples.For video examples, such comparison prompts have seldom been investigated, because comparisons are difficult to implement for transient videos. What does this paper add?: This paper shows that video examples combined with static summaries of processes that have been shown in the video example are effective and allow for comparisons of video examples.Such comparisons seem to be more promising for learners with higher prior knowledge. Implications for practice: Practitioners could combine video examples with static summaries of the processes shown in the video examples to allow for comparisons. [ABSTRACT FROM AUTHOR]

Background: Instructional videos constitute a pivotal component in flipped learning. Despite their significance, there is a dearth of research specifically dedicated to instructional videos within the context of flipped classrooms. This paucity has led to an empirical void in verifying the efficacy of instructional videos in flipped learning environments. Objectives: The present study endeavours to contribute to the extant literature on flipped pedagogical practices by providing empirical evidence regarding the effectiveness of instructional videos in flipped learning environments. Methods: This study employs a convergent mixed‐methods design. Forty‐five instructional videos in three subtypes were administered in two classes over a 15‐week semester. Data, both quantitative (log data from the learning management system) and qualitative (from focus group discussions at two time points), were concurrently collected from a flipped class (n = 25) and a blended class (n = 28) with the aim of gauging student engagement and learning outcomes in the flipped class and understanding video‐viewing features typical of the flipped class. Results: Both datasets corroborated that participants in the flipped class outperformed their counterparts in the blended class in terms of video‐watching, peer interaction, knowledge retention, and transfer skills. Conclusions: The instructional videos within the flipped classroom setting serve to enhance student engagement in the learning process and improve learning outcomes. The efficacy of these instructional videos in flipped learning can be further augmented through strategic approaches in both their design and implementation. Lay Description: What is currently known about this topic: The flipping pedagogy is conducive to learning.Videos play a crucial role in flipped learning.Videos prepared students for classroom activities.However, engaging students with pre‐class videos presents a challenge. What this paper adds: This paper furnishes direct empirical evidence supporting the effectiveness of instructional videos in flipped learning.It uncovers factors affecting student engagement with videos in flipped learning.It offers insights into the design and implementation of videos in flipped learning. Implications for practice: Considering facilitating conditions and affective factors when creating videos.Acknowledging learner characteristics when designing videos.Utilizing instructional strategies when implementing videos. [ABSTRACT FROM AUTHOR]

Background: Social annotation has emerged as a promising educational technology that fosters collaborative reading and discussion of digital resources among learners. While the positive impact of social annotation on students' learning process and performance is widely acknowledged, students' behavioural patterns in social annotation are underexplored. Objectives: This study investigated patterns in students' use of annotation and response behaviours in social annotation activities. We also explored how students' performance in the behavioural, cognitive, emotional, and social dimensions varied based on their behavioural patterns. Methods: We recruited 93 undergraduates who were enrolled in an elective course at a large North American University. Students were tasked with collaboratively annotating the class readings uploaded to Perusall, a social annotation platform, over 7 weeks. We used metaclustering to determine the optimal number of clusters pertaining to student behaviours. We compared the differences among clusters across multiple performance dimensions. Results and Conclusions: Two distinct clusters were identified and defined as initiators and responders. We found that responders had significantly longer active reading time and exhibited greater social annotation effort compared to initiators. However, initiators received more peer acknowledgement, as evidenced by higher upvotes. No significant difference was found in cognitive insight between initiators and responders, but responders demonstrated significantly higher cognitive discrepancy. Additionally, there were no significant differences in positive and negative tones between initiators and responders; however, responders displayed higher levels of prosocial behaviours than initiators. This study has significant practical implications regarding promoting students' collaborative learning experience in social annotation. Lay Description: What is already known about this topic: Annotation and response behaviours are two primary actions in social annotation.Understanding how students navigate through annotations and respond to their peers' contributions is essential for optimizing their learning experience.Social annotation outcomes can be assessed in the behavioural, cognitive, emotional, and social dimensions. What this paper adds: This paper revealed students' behavioural patterns in social annotation activities.This study offered a comprehensive understanding of the various dimensions of performance among students with different behavioural tendencies. Implications for practice and/or policy: The two student clusters, initiators and responders, revealed distinct engagement patterns in social annotation and informed the design of targeted scaffoldings.Responders were not passive learners since they demonstrated significantly longer active reading time, greater social annotation effort, and higher level of prosocial behaviours.Educators might not need to place significant emphasis on monitoring participants' emotional expressions in social annotation.Social annotation platforms should incorporate features that encourage and reward both initiation and response behaviours. [ABSTRACT FROM AUTHOR]

This paper introduces a novel three‐phase grid‐tied multilevel inverter (MLI) topology that employs a basic unit per phase, yielding a symmetrical configuration capable of generating five‐level output voltage and an asymmetrical configuration producing seven‐level and nine‐level output voltages. The generalization of the proposed MLI is presented in terms of the number of modules (M) and output levels (L). A comprehensive comparative analysis of the proposed MLI topology against existing configurations is presented for both symmetric and asymmetric cases. The switching devices in the MLI are controlled using the in‐phase disposition level shift PWM (IPD‐LSPWM) technique. The synchronization of the grid‐tied MLI is addressed by considering the uncertainties in grid and load parameters at the point of common coupling (PCC). To achieve synchronization, a PLL‐less grid voltage‐ modulated direct power control (GVM‐DPC) technique is implemented. To mitigate the delay associated with PLL, a GVM‐DPC based on the stationary reference frame (SRF) is applied. This paper also includes mathematical modelling of GVM‐DPC without PLL and the design of an LCL filter. A simulation model of a 15‐kVA, three‐phase, nine‐level grid‐tied MLI is developed in MATLAB/Simulink and tested under both steady‐state and dynamic conditions. The proposed controller's performance is evaluated under the load variations and sudden changes in available power from the distributed generator (DG). Robustness is tested under adverse conditions such as voltage sag/swell at the PCC. Furthermore, the system is implemented in the OPAL‐RT OP4510 real‐time simulator, and the results are validated to confirm the effectiveness and robustness of the proposed grid‐tied MLI. [ABSTRACT FROM AUTHOR]

This paper overviews the importance of justice and health-care partnerships in a MOUD feasibility trial in a rural Appalachian community. Research partners included a local jail, a local community supervision office, and a local community federally qualified health center. This paper describes the pilot feasibility study participants and methodology, as well as lessons learned including the challenges encountered and needed changes to address feasibility as the environment changes over time. Implications for social work research, practice, and policy advocacy focused on delivery of extended-release naltrexone and other MOUDs are discussed. [ABSTRACT FROM AUTHOR]

Despite advances in HIV-treatment, adolescents and young adults (AYA) with HIV (AYAHIV) face myriad challenges. They are less likely than children and older adults to be virally suppressed and are at higher risk for mental health conditions compared to their peers who do not have HIV. AYA are also developing in the context of numerous biomedical, neurocognitive, and psychosocial developmental changes. Normative challenges during this time can be exacerbated by HIV and can result in significant physical and mental health problems. Yet, many AYAHIV have shown resilience with positive assets and resources and few health or mental health problems. Historically research has had a risk-focused approach to understanding AYAHIV needs. This paper discusses the rationale for a shift from a risk-focused only approach to one that examines AYAHIV needs from both a risk and resilience perspective. This paper presents: (1) epidemiological data on AYAHIV; (2) conceptual models for understanding both risk (e.g., poverty, stress, trauma, limited resources) and resilience/protective factors (e.g., family and peer support, future orientation, problem-solving skills); (3) global data examining risk and protective factors for physical and mental health challenges; and (4) promising interventions that incorporate elements of resilience to improve overall outcomes among AYAHIV. [ABSTRACT FROM AUTHOR]

Background: People with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease may experience language and communication difficulties. However, the role of speech and language interventions for people with these non‐language led dementias has received little attention. Aims: This study aimed to explore the experiences and perspectives of people living with these conditions, and their families, regarding their language and communication difficulties and how speech and language therapy could address these needs. Methods: This study employed a qualitative design to explore the experiences of people living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy or young onset Alzheimer's disease, and to understand their opinions about speech and language therapy. Participants were recruited from a support service connected to a dementia clinic to attend one of five focus group meetings. Videorecorded focus groups and interviews were transcribed, and reflexive thematic analysis was used to analyse data from people affected by each type of dementia. Results: A total of 25 participants were recruited to the study, with representation across the different forms of non‐language led dementias. The four main themes identified were: (1) communication difficulties as a key difficulty, (2) loss and loneliness, (3) speech and language therapy, and (4) the role of the caregiver. Sixteen subthemes were also identified which highlighted individual issues across disease types. Discussion: Although all the forms of dementia studied here are not considered to be language‐led, people with these conditions and/or their care partners identified speech, language and communication as common challenges. These communication difficulties were reported to have a negative impact on their social participation and mental health and participants felt speech and language interventions could help. There is a need for research exploring speech and language interventions developed for and with people with non‐language led dementias and their care partners, to ensure they meet the needs of the people they are designed for. WHAT THIS PAPER ADDS: What is already known on the subject: People with primary progressive aphasia present with speech, language and communication difficulties, and several speech and language interventions have been developed to meet the needs of this population. However, people with non‐language led dementias may also experience speech, language and communication difficulties, and little is known about interventions that may address these difficulties. What this paper adds to existing knowledge: People living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease report experiencing speech, language and communication difficulties that impact on the person with dementia's social participation and mood. Participants in this study also shared their opinions about how speech and language interventions could help, from the earliest stages of the disease. What are the potential or actual clinical implications of this work?: Speech and language therapists need to address the individual speech, language and communication needs of people with dementias, even those that are not thought to be language‐led. Current speech and language therapy service provision does not meet the needs of people with non‐language led dementias and further research is required to develop interventions and services to meet these needs. [ABSTRACT FROM AUTHOR]

Background: Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent‐based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent‐based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20‐week period. Participants received one of two interventions: (1) Standard Care – indirect group PBI – (PBI) (2) Enhanced Care: indirect group enhanced PBI – (EPBI). Both standardised and non‐standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure – Speech & Language Therapy (PAM‐SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well‐being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. Outcomes and Results: One hundred fifty‐five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur‐Bates Communicative Development Inventories Sentence Length, from pre‐intervention to post‐intervention and 6 months post‐intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval –0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents. WHAT THIS PAPER ADDS: What is already known on the subject: Speech, language and communication needs (SLCN) have a knock‐on effect on emotional well‐being, school readiness, literacy and school attainment, putting children at increased risk of long‐term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge: Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work?: This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes. [ABSTRACT FROM AUTHOR]